Public perceptions about risk and protective factors for cognitive health and impairment: a review of the literature.

Neurodegenerative Dementias: Improving Brain Health to Decrease Risk.

The present review assesses the public's perceptions about cognitive health and Alzheimer's disease among adults in the United States. We searched the published literature and Internet, and contacted experts in the field to locate surveys assessing the public's perceptions about cognition. We found 10 eligible surveys and abstracted data concerning the public's knowledge, beliefs, concerns, and sources of information. Most of the surveys were conducted in the 2000s and focused on Alzheimer's disease rather then cognitive health. Based on the findings from the surveys, most adults were found to be aware of Alzheimer's disease but lacked specific information about the disease and its treatments. Most respondents did not perceive themselves as being very knowledgeable about Alzheimer's disease. Although we could classify the findings into several overarching domains, such as knowledge, we found considerable variability among surveys in the questions asked. Additional work is needed to understand the public's perceptions about cognitive health. Moreover, we also lack studies that help us understand perceptions about cognition across diverse demographic and cultural groups. Only by addressing these gaps can we develop targeted and effective strategies to enhance knowledge and beliefs about cognitive impairment and health.

Influence of Studies Published by the Journal of the American Geriatrics Society: Top 20 Articles from 2000-2015.

Mild cognitive impairment (MCI) has a high prevalence and is a risk factor for dementia. Furthering understanding of MCI has been identified as a public health priority. This research aimed to explore views about the causes of cognitive impairment and identify associations between cognitive impairment, dementia, and normative ageing. Semi-structured qualitative interviews were conducted with 22 participants with different stakeholder perspectives on the area of MCI in England, and analysed thematically. Our analysis focuses on two main themes: 1) causes of cognitive impairment, and 2) ageing, dementia, and dying. Most participants viewed cognitive impairment as a transitional state between normative ageing and dementia. Participants expressed their fear of cognitive impairment and dementia, and made clear links between cognitive impairment and dying. Participants also showed an awareness of the links between lifestyle factors and cognitive health. However, linkage between lifestyle and cognition was discussed only when explicitly asked, suggesting that this was not especially salient for participants when considering the causes and risk factors for cognitive impairment. The results of this study highlight key areas for future public health initiatives, such as a focus on the multitude of benefits offered by adopting a healthy diet and physical exercise in reducing risk of cognitive impairment.

The Cognition–Kidney Disease Connection: Lessons From Population-Based Studies in the United States

Safeguarding cognitive health in an ageing population

This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Cognitive impairments, including MCI and dementia, significantly heighten fall risk due to motor dysfunction and balance deficits. Although physical activity is essential for dementia prevention, older adults often struggle with balance issues, fear of falling, and reduced mobility. This study investigated the impact of balance training, alone or combined with cognitive exercises, on functional balance and cognitive performance in individuals with cognitive impairments. A comprehensive literature search was conducted across three electronic databases to identify peer-reviewed studies written in English that examined the effects of balance-oriented physical therapy, either alone or in combination with cognitive training, on individuals with cognitive or concurrent cognitive and balance impairments. The outcomes of interest included balance and cognitive function. The risk of bias was evaluated independently by two reviewers using the ROB-1 tool. The effectiveness of the intervention was analyzed using RevMan software. This systematic review found that stand-alone physical exercise significantly improved postural stability in 15 out of 24 studies and enhanced cognitive function in 5 out of 25 studies. Furthermore, the integration of cognitive training alongside physical exercise demonstrated additional benefits in improving balance and cognition in 7 out of 11 studies. These findings suggest that such interventions may be beneficial for older adults with cognitive impairments, warranting further research to establish definitive conclusions. This systematic review emphasizes the potential benefits of physical balance exercises, often combined with cognitive training, in improving balance, cognitive function, and certain aspects of quality of life among individuals with cognitive impairment.

Growing evidence supports a strong and likely causal association between cardiovascular disease (CVD), and its risk factors, with incidence of cognitive decline and Alzheimer's disease. Individuals with subclinical CVD are at higher risk for dementia and Alzheimer's. Several cardiovascular risk factors are also risk factors for dementia, including hypertension, high LDL cholesterol, low HDL cholesterol and especially diabetes. Moderate alcohol appears to be protective for both CVD and dementia. In contrast, inflammatory markers predict cardiovascular risk, but not dementia, despite biological plausibility for such a link. The substantial overlap in risk factors points to new avenues for research and prevention.

We aimed to determine the gender-specific predictors of depressive symptoms among an Iranian elderly community population. A cross-sectional study. This study was performed on elderly subjects (aged ≥60 yr) who participated in the Amirkola Health and Aging Project, Amirkola, Babol, northern Iran in 2011-12. Depression was assessed by the Geriatric Depression Scale. Fourteen variables, including marital status, age, education, occupation, living alone, social support, dependency in daily activities, physical activity, smoking, body mass index, chronic pain, medicine use, comorbidities, and cognitive impairment, were analyzed as predictors of depression. In males, age group of 80-84 yr (odds ratio (OR)=0.22, 95% confidence interval (CI): 0.09, 0.55), occupation (OR=0.62, 95% CI: 0.42, 0.90) and social support (OR=0.82, 95% CI: 0.77, 0.88) had protective effects against depression, and smoking (OR=1.67, 95% CI: 1.15, 2.44), cognitive impairment (OR=2.18, 95% CI: 1.34, 3.45) and comorbidities(OR=1.42, 95% CI: 1.27, 1.60) were found as risk factors. In females, social support (OR=0.97, 95% CI: 0.65, 1.44) and higher education (OR=0.10, 95% CI: 0.01, 0.84) were two protective factors against depression, and being unmarried (OR=1.88, 95% CI: 1.13, 2.35), cognitive impairment (OR=1.50, 95% CI: 1.01, 2.21), comorbidities(OR=1.30, 95% CI: 1.18, 1.44) and chronic pain (OR=1.57, 95% CI: 1.01, 2.44) were four positive predictors of depression. There were both similarities and differences in predictors of depression between old males and females. These findings suggest physicians and healthcare executives consider gender-specific risk/protective factors to improve preventive mental health programs in older males and females.

BackgroundMany studies showed that addressing modifiable risk factors has an impact on dementia prevalence and incidence. Most studies have focussed on universal prevention, irrespective of individual risk stage, with risk factors for dementia mainly identified in the general population. Less is known about the most important target risk factors in persons with subjective cognitive decline (SCD) or mild cognitive impairment (MCI), and hence, whether they have a similar potential for risk reduction as the general population. Therefore, this study aims to identify modifiable risk and protective factors for cognitive deterioration and dementia in persons with SCD or MCI.MethodWe use a mixed‐methods approach combining findings from a systematic literature review and an online Delphi study. Four electronic databases (PubMed, EMBASE, PsycINFO, Web of Science) were searched to review relevant literature. A broad search term was developed in consultation with an experienced librarian and consisted of terms linked to SCD, MCI, dementia, modifiable risk factors and disease progression. Observational studies with at least 50 participants and 1 year of follow‐up were considered for inclusion. Twenty international dementia prevention experts were invited to participate in the online Delphi study. In two rounds, experts were asked to spontaneously name, rank and weigh modifiable risk and protective factors in order of importance for the target population.ResultOur search yielded 19,128 abstracts in total. After removal of duplicates, 9,862 abstracts were considered for inclusion and 203 full‐texts were read, of which 69 were included in our review. Several risk and protective factors were encountered including somatic, lifestyle and neuropsychiatric factors, and they are further scrutinized. Eighteen experts named 31 risk and protective factors in the first Delphi study round, of which physical activity, social isolation and hypertension were ranked highest. Results of round two are being collected.ConclusionFindings from the current study will result in an inventory of relevant modifiable risk and protective factors linked with clinical progression in persons with SCD or MCI. Results will serve as the basis for the development and testing of an online dementia risk reduction tool for use in clinical populations with SCD and MCI.

BackgroundMany potentially modifiable risk factors for MS are investigated. It is not known, however, if these factors also apply to MS-related cognitive impairment (CI), a frequent consequence of MS.ObjectiveThe aim of our study was to assess risk factors for CI in MS patients, focusing on environmental exposures, lifestyle and comorbidities.MethodsWe included MS patients referring to MS Centers in Florence and Barletta between 2014 and 2017. Neuropsychological performance was assessed through the Rao’s battery and Stroop test, cognitive reserve (premorbid intelligence quotient–IQ) was evaluated using the National Adult Reading Test (NART). Potential risk factors were investigated through a semi-structured questionnaire.Results150 patients were included. CI was detected in 45 (30%) subjects and was associated with older age (p<0.005), older age at MS onset (p = 0.016), higher EDSS score (p<0.005), progressive disease course (p = 0.048) and lower premorbid IQ score (p<0.005). As for risk factors, CI was related with lower physical activity in childhood-adolescence (p<0.005). In women, hormonal therapy resulted to be protective against CI (p = 0.041). However, in the multivariable analysis, the only significant predictors of CI were older age (p<0.05; OR 1.06, 95% CI 1.02–1.10) and lower premorbid IQ (p<0.05; OR 0.93, 95% CI: 0.88–0.98). Removing IQ from the model, CI was associated with higher EDSS (p = 0.030; OR 1.25, 95% CI 1.02–1.53) and, marginally, previous physical activity (p = 0.066; OR 0.49, 95% CI: 0.23–1.05)ConclusionsOur findings suggest that physical activity in childhood-adolescence could be a contributor to cognitive reserve building, thus representing a potential protective factors for MS-related CI susceptible to preventive strategies.

[This corrects the article DOI: 10.1371/journal.pone.0222929.].

World War II Vets Study Still Providing MH Data

Chapter 24 - Hippocampal atrophy associated with dementia risk factors and dementia