Cognitive Decline In Later Life Research Articles

Association of Delirium With Cognitive Decline in Late Life

Delirium is associated with accelerated cognitive decline. The pathologic substrates of this association are not yet known, that is, whether they are the same as those associated with dementia, are independent, or are interrelated. To examine whether the accelerated cognitive decline observed after delirium is independent of the pathologic processes of classic dementia. Harmonized data from 987 individual brain donors from 3 observational cohort studies with population-based sampling (Vantaa 85+, Cambridge City Over-75s Cohort, Cognitive Function and Ageing Study) performed from January 1, 1985, through December 31, 2011, with a median follow-up of 5.2 years until death, were used in this study. Neuropathologic assessments were performed with investigators masked to clinical data. Data analysis was performed from January 1, 2012, through December 31, 2013. Clinical characteristics of brain donors were not different from the rest of the cohort. Outcome ascertainment was complete given that the participants were brain donors. Delirium (never vs ever) and pathologic burden of neurofibrillary tangles, amyloid plaques, vascular lesions, and Lewy bodies. Effects modeled using random-effects linear regression and interactions between delirium and pathologic burden were assessed. Change in Mini-Mental State Examination (MMSE) scores during the 6 years before death. There were 987 participants (290 from Vantaa 85+, 241 from the Cambridge City Over-75s Cohort, and 456 from the Cognitive Function and Ageing Study) with neuropathologic data; mean (SD) age at death was 90 (6.4) years, including 682 women (69%). The mean MMSE score 6 years before death was 24.7 points. The 279 individuals with delirium (75% women) had worse initial scores (-2.8 points; 95% CI, -4.5 to -1.0; P < .001). Cognitive decline attributable to delirium was -0.37 MMSE points per year (95% CI, -0.60 to -0.13; P < .001). Decline attributable to the pathologic processes of dementia was -0.39 MMSE points per year (95% CI, -0.57 to -0.22; P < .001). However, the combination of delirium and the pathologic processes of dementia resulted in the greatest decline, in which the interaction contributed an additional -0.16 MMSE points per year (95% CI, -0.29 to -0.03; P = .01). The multiplicative nature of these variables resulted in individuals with delirium and the pathologic processes of dementia declining 0.72 MMSE points per year faster than age-, sex-, and educational level-matched controls. Delirium in the presence of the pathologic processes of dementia is associated with accelerated cognitive decline beyond that expected for delirium or the pathologic process itself. These findings suggest that additional unmeasured pathologic processes specifically relate to delirium. Age-related cognitive decline has many contributors, and these findings at the population level support a role for delirium acting independently and multiplicatively to the pathologic processes of classic dementia.

Updating the Evidence on the Association between Serum Cholesterol and Risk ofLate-Life Dementia: Review andMeta-Analysis.

Background: Cohort studies have reported that midlife high total serum cholesterol (TC) is associated with increased risk of Alzheimer’s disease (AD) in late-life but findings have been based on few studies and previous reviews have been limited by a lack of compatible data.Objective: We synthesized all high quality data from cohort studies reporting on the association between total serum cholesterol measured and late-life cognitive outcomes including Alzheimer’s disease (AD), vascular dementia (VaD), any dementia, mild cognitive impairment (MCI), and cognitive decline.Methods: The literature was searched up to October 2016 using a registered protocol. Thirty-four articles meeting study criteria were identified. Seventeen studies published from 1996 to 2014, including 23,338 participants were included in meta-analyses.Results: Relative risk of developing AD for adults with high TC in midlife was 2.14 (95% CI 1.33–3.44) compared with normal cholesterol. Individual studies that could not be pooled also reported high TC in midlife increased the risk of MCI and cognitive decline in late-life. High TC in late-life was not associated with MCI, AD, VaD, any dementia, or cognitive decline. Late-life measured HDL cholesterol and triglycerides were not associated with increased risk of VaD, and HDL was not associated with risk of MCI, AD, or any dementia. There were insufficient data to examine other cholesterol sub-fractions, sex differences, or APOE interactions.Conclusions: Significant gaps in the literature regarding TC and late-life dementia remain. Evidence suggests that high midlife TC increases risk of late-life AD, and may correlate with the onset of AD pathology.

Varied effects of age-related neuropathologies on the trajectory of late life cognitive decline.

The objective of this study was to examine whether the effects of age-related neuropathologies on cognition change over time. Participants were 1096 deceased persons from two clinical-pathologic studies. All were without dementia at baseline, completed a detailed battery of cognitive tests annually over up to 21 years, died, and underwent detailed neuropathologic examinations to identify Alzheimer's disease pathology, vascular pathologies (i.e. macro- and microscopic infarcts, atherosclerosis, arteriolar sclerosis, and cerebral amyloid angiopathy), Lewy bodies, transactive response DNA-binding protein 43 (TDP-43) pathology, and hippocampal sclerosis. A time-varying effects model was used to flexibly characterize the trajectory of global cognition and assess whether the effects of demographics and each neuropathologic index on cognition changed over time. Results indicated that the mean trajectory of global cognition was characterized by gradual cognitive decline beginning ∼15 years before death and accelerated decline in the last few years. With the exception of microinfarcts and arteriolar sclerosis, all neuropathologies were associated with the cognitive trajectory. However, the nature of their associations varied. Alzheimer's disease pathology, macroscopic infarcts, Lewy bodies, TDP-43 pathology, and hippocampal sclerosis were associated with progressive cognitive decline, with their deleterious effects increasing over time. By contrast, atherosclerosis and cerebral amyloid angiopathy pathology were associated with a lower level of cognition but their effects were relatively stable over time. These results suggest that age-related neuropathologies are differentially related to late life cognitive trajectories. Whereas some contribute to progressive cognitive deterioration, others lower the level of cognition but exert relatively stable effects over time.

Patterns of late-life depressive symptoms and subsequent declines in cognitive domains.

Depression frequently co-occurs with cognitive decline, but the nature of this association is unclear. We examined relations of late-life depressive symptom patterns to subsequent domain-specific cognitive changes. Depressive symptoms were measured at up to 3 timepoints among 11,675 Nurses' Health Study participants prior to cognitive testing. Depressive symptom patterns were categorized as non-depressed, variable or persistent, based on published severity cutpoints. Outcomes were global, verbal, and executive function-attention composite scores. Participants with persistent depressive symptoms had worse executive function-attention decline compared with non-depressed participants (multivariable-adjusted mean difference = -0.03 units/year, 95% CI: -0.05, -0.01; p = 0.003); this difference was comparable with 8 years of aging. However, being in the persistent versus non-depressed group was not significantly related to verbal (p = 0.71) or global score (p = 0.09) decline. By contrast, compared with the non-depressed group, those with variable depressive symptoms had worse verbal memory decline (multivariable-adjusted mean difference = -0.01 units/year, 95% CI: -0.02, -0.002; p = 0.03); this group showed no differences for global or executive function-attention decline. A variable pattern of depressive symptom severity related to subsequent decline in verbal memory, while a persistent pattern related to decline in executive function-attention. Findings could signal differences in underlying neuropathologic processes among persons with differing depression patterns and late-life cognitive decline. Copyright © 2016 John Wiley & Sons, Ltd.

Which type of social activities may reduce cognitive decline in the elderly?: a longitudinal population-based study.

BackgroundPrevious studies have found that social activities are beneficial for the reduction of cognitive decline (CD) in the elderly. However, knowledge regarding the types of social activities that reduce CD in later life is limited. The aim of this study is to examine which type of social activities reduce CD 4 years later among young-old (Y-O) and old-old (O-O) adults.MethodsWe conducted a secondary analysis using data from cognitively intact adults 65 years of age or older who participated in the Korean Longitudinal Study of Aging (KLoSA). Cognitive function was assessed using the Korean version of the Mini-Mental State Examination (MMSE). We computed CD between 2008 and 2012 by subtracting the Wave 4 MMSE score from the Wave 2 MMSE score. Multivariate linear regression analysis was conducted regarding the effects of social activities on CD after adjusting for age, sex, education, income, marital status, activities of daily living (ADL), instrumental activities of daily living (IADL), chronic diseases, quality of life, depressive symptom, change in depressive symptom, and cognitive functioning at baseline.ResultsSubjects who participated in senior citizen clubs or senior centers at baseline had a lower risk of CD 4 years later than those who did not in Y-O adults. Frequent contact with offspring by phone or letters was associated with reduced CD in O-O adults. Frequent face-to-face contact with offspring was positively associated with CD in O-O adults. Participating in two or more formal social activities was associated with reduced CD compared with nonparticipation in O-O adults.ConclusionEncouraging older adults to participate in senior citizen clubs or to have frequent contacts with adult children by phone or letters may help reduce CD in later life among older adults. Participation in a variety of formal social activities may also have a beneficial effect on preventing CD in older adults.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0343-x) contains supplementary material, which is available to authorized users.

The APOE paradox: do attentional control differences in mid-adulthood reflect risk of late-life cognitive decline

Possession of an Apolipoprotein E (APOE) e4 allele is an established risk factor for Alzheimer's disease, whereas the less commonly studied e2 variant is premised to offer some protection. This research explores the purported deleterious-protective dichotomy of APOE variants on attentional control in mid-adulthood. Sixty-six volunteers, aged 45–55 years, completed 3 tasks that provided complementary measures of attentional control: prospective memory, sustained attention, and inhibition. Performance was compared between e2 carriers, e4 carriers, and e3 homozygotes (the population norm). Carriers of the e4 allele showed subtle disadvantages, compared with the e3 group, in accuracy of Stroop task and prospective memory performance. Contrary to expectations, e2 carriers showed performance disadvantages in sustained attention. The finding of detrimental effects in attentional control for both e4 and e2 complicates the current model that proposes opposing effects of these variants on later-life cognition. Future research is needed to understand how cognitive differences develop with increasing age, and the physiological mechanisms that underpin these changes.

WWII COMBAT EXPOSURE IS NOT ASSOCIATED WITH LATE-LIFE COGNITIVE DECLINE, DEMENTIA, NEUROPATHOLOGIC ALZHEIMER’S DISEASE, OR OTHER NEUROPATHOLOGIC ABNORMALITIES: THE HONOLULOU-ASIA AGING STUDY (HAAS)

WWII COMBAT EXPOSURE IS NOT ASSOCIATED WITH LATE-LIFE COGNITIVE DECLINE, DEMENTIA, NEUROPATHOLOGIC ALZHEIMER’S DISEASE, OR OTHER NEUROPATHOLOGIC ABNORMALITIES: THE HONOLULOU-ASIA AGING STUDY (HAAS)

Changing Behavioral Lifestyle Risk Factors Related to Cognitive Decline in Later Life Using a Self-Motivated eHealth Intervention in Dutch Adults.

BackgroundOur labor force is aging, but aged workers are not yet coached on how to stay cognitively fit for the job.ObjectiveIn this study, we tested whether a self-motivated, complex eHealth intervention could improve multiple health-related behaviors that are associated with cognitive aging among working Dutch adults.MethodsThis quasi-experimental prospective study with a pre-post design was conducted with employees of Dutch medium to large companies. All employees with Internet access, a good understanding of the Dutch language, and who provided digital informed consent were eligible to participate. In total, 2972 participants (2110/2972, 71.11% females) with a mean (standard deviation, SD) age of 51.8 (SD 12.9) years were recruited; 2305 became active users of the intervention, and 173 completed the 1-year follow-up. This self-motivated eHealth lifestyle intervention stimulates participants to set personally relevant, monthly health behavior change goals using Goal Attainment Scaling and to realize these goals by implementing behavior change techniques grounded in behavior change theory. The primary outcomes were the goal-setting success rate and the change in overall lifestyle score from baseline to the 1-year follow-up; the score was based on physical activity, diet, smoking, alcohol, sleep, and stress scores. The secondary outcomes were the changes in body weight, body mass index, specific lifestyle characteristics, and website usage.ResultsA total of 1212 participants set 2620 behavior change goals; 392 participants assessed 1089 (1089/2288, 47.59%) goals and successfully achieved 422 (422/1089, 38.75%) of these goals. Among the goal-setting participants in follow-up, this led to a +0.81-point improvement (95% CI 0.49-1.13, P<.001) in overall lifestyle (d=0.32) and weight loss of 0.62 kg (95% CI −1.16 to −0.07, P=.03). These participants also showed significant improvement in 8 out of 11 specific lifestyle components.ConclusionsAmong an adult Dutch population, this eHealth intervention resulted in lifestyle changes in behavioral risk factors associated with cognitive decline, and these improvements lasted over the period of 1 year. Given the general aging of our workforce, this eHealth intervention opens new avenues for the widespread use of cost-effective self-motivated prevention programs aimed at prevention of early-stage cognitive decline and more self-management of their risk factors.Trial RegistrationNederlands Trial Register: NTR4144; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4144 (Archived by WebCite at http://www.webcitation.org/6cZzwZSg3).

Depressive symptoms in spouse caregivers of dementia patients: A longitudinal study in South Korea.

To investigate the association between spouse cognitive status and depressive symptoms in cohabiting spouses, and to further analyze how participation in social network-enhancing activities interplays in the objected relationship. Data from the Korean Longitudinal Study of Aging, 2006-2012, were used. A total of 2782 male and 2515 female married participants currently cohabiting with their partners were included in the baseline. The association between spouse cognitive status and depressive symptoms, measured using the Center for Epidemiological Studies Depression scale, was investigated through the generalized estimating equation model. When setting the participants living with spouses of normal cognitive function as reference, participants living with spouses having mild dementia (male β 0.7349, P ≤ 0.0001; female β 0.8042, P ≤ 0.0001), and moderate and severe dementia (male β 1.1504, P ≤ 0.0001; female β 1.2462, P ≤ 0.0006) showed higher depression scores in a dose-response relationship. Additionally, male and female subjects participating in social network facilitating activities had lower increases in depression scores than their non-participating counterparts. Spouse cognitive impairment is associated with increasing depression scores in cohabiting caregivers. Individuals not participating in social network-facilitating activities are more vulnerable to the negative mental health effects of spouse cognitive impairment. Hence, considering the increasing importance of late life depression and cognitive decline in aging societies, it is important to note the protective effects of social network and support in addressing the mental health of spouse caregivers. Geriatr Gerontol Int 2017; 17: 973-983.

Postmortem MRI: a novel window into the neurobiology of late life cognitive decline

This study tested the hypothesis that indices of brain tissue integrity derived from postmortem magnetic resonance imaging (MRI) are associated with late life decline in cognitive function and dementia, over and above contributions from common age-related neuropathologies. Cerebral hemispheres were obtained from 425 deceased older adults who had undergone 2 or more annual cognitive assessments, which included clinical diagnosis of dementia. Specimens underwent MRI to produce maps of transverse relaxation rate, R2. Voxelwise regression revealed brain regions where R2 was associated with cognitive decline. We then used random effects models to quantify the extent to which R2 accounted for variation in decline, after adjustment for demographics and neuropathologic indices of the 3 most common causes of dementia: Alzheimer's disease, cerebrovascular disease, and Lewy body disease. We additionally tested whether R2 was tied to greater likelihood of clinical diagnosis of Alzheimer's dementia using logistic regression models. During an average of 8.1 years, the mean rate of decline in global cognitive function was 0.13 unit per year (p < 0.0001). The tissue alteration most commonly related to decline was R2 slowing in white matter. Each unit decrease in R2 was associated with an additional 0.053-unit per year steepening of the rate of global cognitive decline (p < 0.001). Furthermore, R2 accounted for 8.4% of the variance in rate of global cognitive decline, above and beyond the 26.5% accounted for by demographics and neuropathologic indices, and 7.1%–11.2% of the variance of the decline rates in episodic, semantic, and working memory and perceptual speed. Alterations in R2 were also related to an increased odds of clinical diagnosis of Alzheimer's dementia (odds ratio = 2.000, 95% confidence interval 1.600, 2.604). Therefore, postmortem MRI indices of brain tissue integrity, particularly in white matter, are useful for elucidating the basis of late life cognitive impairment in older adults and complement traditional indices of neuropathology derived using histopathologic methods.

Cognitively Stimulating Leisure Activity and Subsequent Cognitive Function: A SHARE-based Analysis.

The aim of the inquiry was to examine whether cognitively stimulating leisure activity (CSLA) can delay or reduce cognitive decline in late life and whether its effect is moderated by education, age, or activity pattern. Employing secondary analysis of data on respondents aged 65 and older from the 4th and 5th waves of the Survey of Health, Ageing and Retirement in Europe (N = 16,572), the inquiry regressed cognitive function (memory, numeracy, and fluency) at Time 2 on frequency of engagement in CSLA at baseline, controlling for cognitive function scores at baseline and a range of confounders. The study also considered education by CSLA and age by CSLA interactions, as well as the effect of CSLA patterns. CSLA frequency was found to be positively related to subsequent cognitive functioning on all measures, 2 years later. The effect of CSLA on memory and fluency was stronger among those with lower education, whereas the age by CSLA interaction was not significant. Respondents who started CSLA after baseline showed better cognitive functioning at Time 2 than those who did not engage in CSLA at all and those who had engaged in such activity at baseline but stopped. The study documents that CSLAs constitute a potential source for the delay or reduction of cognitive decline, regardless of one's age. As such, practitioners should recognize the value of this medium and encourage its greater use in appropriate settings.

Executive control in older Welsh monolinguals and bilinguals

ABSTRACTEvidence for a bilingual advantage in executive control has led to the suggestion that being bilingual might protect against late-life cognitive decline. We assessed the performance of socially homogeneous groups of older (≥60 years) bilingual Welsh/English (n = 50) and monolingual English (n = 49) speakers on a range of executive control tasks yielding 17 indices for comparison. Effect sizes (>.2) favoured monolinguals on 10 indices, with negligible differences observed on the remaining 7 indices. Univariate analyses indicated that monolinguals performed significantly better on 2 of 17 indices. Multivariate analysis indicated no significant overall differences between the two groups in performance on executive tasks. Older Welsh bilinguals do not show a bilingual advantage in executive control, and where differences are observed, these tend to favour monolinguals. A possible explanation may lie in the nature of the socio-linguistic context and its influence on cognitive processing in the bilingual group.

Occupational cognitive requirements and late-life cognitive aging.

To examine whether occupational cognitive requirements, as a marker of adulthood cognitive activity, are associated with late-life cognition and cognitive decline. Main lifetime occupation information for 7,637 participants aged >65 years of the Chicago Health and Aging Project (CHAP) was linked with standardized data on worker attributes and job characteristics from the Occupational Information Network (O*NET). Ratings of cognitive processes required in 10 work-related tasks were used to create a summary measure of occupational cognitive requirements (possible range 0-7). Multivariable-adjusted linear mixed models were used to estimate the association of occupational cognitive requirements score (OCRS) with cognitive function and rate of cognitive decline. Higher OCRS corresponded to significantly better late-life cognitive performance at baseline in 1993 (p < 0.001) and to slower decline in global cognitive function over time (p = 0.004). Within a genotyped subsample (n = 4,104), the associations of OCRS with rate of cognitive decline did not differ significantly by APOE ε4 carriership (p = 0.11). Findings suggest that occupational cognitive requirements are associated with better cognition and a slower rate of cognitive decline in older age. Adulthood cognitive activity may contribute to cognitive reserve in late life.

Empirically Defining Trajectories of Late-Life Cognitive and Functional Decline.

Background:Alzheimer’s disease (AD) is associated with variable cognitive and functional decline, and it is difficult to predict who will develop the disease and how they will progress.Objective:This exploratory study aimed to define latent classes from participants in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database who had similar growth patterns of both cognitive and functional change using Growth Mixture Modeling (GMM), identify characteristics associated with those trajectories, and develop a decision tree using clinical predictors to determine which trajectory, as determined by GMM, individuals will most likely follow.Methods:We used ADNI early mild cognitive impairment (EMCI), late MCI (LMCI), AD dementia, and healthy control (HC) participants with known amyloid-β status and follow-up assessments on the Alzheimer’s Disease Assessment Scale - Cognitive Subscale or the Functional Activities Questionnaire (FAQ) up to 24 months postbaseline. GMM defined trajectories. Classification and Regression Tree (CART) used certain baseline variables to predict likely trajectory path.Results:GMM identified three trajectory classes (C): C1 (n = 162, 13.6%) highest baseline impairment and steepest pattern of cognitive/functional decline; C3 (n = 819, 68.7%) lowest baseline impairment and minimal change on both; C2 (n = 211, 17.7%) intermediate pattern, worsening on both, but less steep than C1. C3 had fewer amyloid- or apolipoprotein-E ɛ4 (APOE4) positive and more healthy controls (HC) or EMCI cases. CART analysis identified two decision nodes using the FAQ to predict likely class with 82.3% estimated accuracy.Conclusions:Cognitive/functional change followed three trajectories with greater baseline impairment and amyloid and APOE4 positivity associated with greater progression. FAQ may predict trajectory class.

Prevention of cognitive decline: Lifestyle and other issues

Ageing often leads to decline in cognitive abilities. Significant cognitive impairment leads to functional impairment and need for care. Prevention of cognitive decline and delaying its progression would help to reduce the need for long-term care. Both genetic and environmental factors are important determinants of cognitive health in late life. A better cognitive reserve helps to prevent cognitive decline. Cognitive reserve is now considered as a functional reserve rather than a structural reserve. Cognitive reserve can be enhanced through experience. People with higher level of education tend to have higher cognitive reserve. Better cognitive reserve can act as a buffer. Engagement in cognitively stimulating activities may prevent cognitive decline in late life. Physical exercise also improves cognitive health. Aerobic exercises, which improve cardiorespiratory fitness, improve cognitive functions like motor functions, cognitive speed, and auditory and visual attention. Beneficial effects on executive functions are also reported. Healthy diet, especially adherence to Mediterranean diet (MeDi), is considered to be useful in preserving cognitive health. Engagement in social activities might also reduce cognitive decline. Encouraging adherence to a healthy lifestyle and continuing to be physically, socially, and cognitively active seems to be a promising strategy to prevent cognitive decline.

Aerobic and Cognitive Exercise (ACE) Pilot Study for Older Adults: Executive Function Improves with Cognitive Challenge While Exergaming.

Dementia cases are increasing worldwide; thus, investigators seek to identify interventions that might prevent or ameliorate cognitive decline in later life. Extensive research confirms the benefits of physical exercise for brain health, yet only a fraction of older adults exercise regularly. Interactive mental and physical exercise, as in aerobic exergaming, not only motivates, but has also been found to yield cognitive benefit above and beyond traditional exercise. This pilot study sought to investigate whether greater cognitive challenge while exergaming would yield differential outcomes in executive function and generalize to everyday functioning. Sixty-four community based older adults (mean age=82) were randomly assigned to pedal a stationary bike, while interactively engaging on-screen with: (1) a low cognitive demand task (bike tour), or (2) a high cognitive demand task (video game). Executive function (indices from Trails, Stroop and Digit Span) was assessed before and after a single-bout and 3-month exercise intervention. Significant group × time interactions were found after a single-bout (Color Trails) and after 3 months of exergaming (Stroop; among 20 adherents). Those in the high cognitive demand group performed better than those in the low cognitive dose condition. Everyday function improved across both exercise conditions. Pilot data indicate that for older adults, cognitive benefit while exergaming increased concomitantly with higher doses of interactive mental challenge.

Depressive symptoms and cognitive decline: A longitudinal analysis of potentially modifiable risk factors in community dwelling older adults

BackgroundDepressive symptoms have been associated with increased risk of cognitive decline in later life. There are no interventions proven to reduce risk of cognitive decline in older adults with depression, and it is unclear how these effects are mediated. We aim to determine what mediates the relationship between depressive symptoms and cognitive decline in later life. MethodsSeven thousand six hundred and sixty six community dwelling older adults (age≥50) from the English Longitudinal study of Ageing (ELSA) underwent clinical assessment. Inflammation was assessed with C Reactive Protein and depressive symptoms were assessed with the 8-item version of the Center for Epidemiologic Studies (CESD) scale. ResultsFive thousand, five hundred and ninety (73.5%) had a follow-up cognitive assessment after a median of 47 months. Depressive symptoms were independently associated with cognitive decline (B=0.09, p<0.001). Low physical activity, inflammation, metabolic syndrome and vascular risk factors were associated with elevated depressive symptoms. Low physical activity (z=2.16, p=0.03) and inflammation (z=2.3, p=0.02) mediated the relationship between depressive symptoms and cognitive decline while hypertension, diabetes and smoking also contributed. LimitationsThis is an observational study with a limited duration of follow up. Not all variables related to cognitive decline were accounted for in this analysis. ConclusionsThe relationship between depressive symptoms and cognitive decline in later life appears to be mediated by low physical activity, increased inflammation and vascular risk factors that may be amenable to modification.

Dietary interventions for maintaining cognitive function in cognitively healthy people in mid life

This is the protocol for a review and there is no abstract. The objectives are as follows: In this review we will set out to evaluate the effects of dietary interventions for maintaining cognitive function in cognitively healthy people in mid-life and preventing cognitive decline in late life.

Dietary interventions for maintaining cognitive function in cognitively healthy people in late life

This is the protocol for a review and there is no abstract. The objectives are as follows: In this review we will set out to evaluate the effects of dietary interventions for maintaining cognitive function in cognitively healthy people in mid-life and preventing cognitive decline in late life.

The Influence of Vascular Risk Factors and Stroke on Cognition in Late Life: Analysis of the NACC Cohort.

Vascular risk factors in mid-life predict late life cognitive decline in previously normal populations. We sought to investigate the contribution of vascular risk factors in late life to cognitive decline in a cohort of normal elderly individuals. Cognitively normal subjects were identified from the longitudinal cohort of participants in the National Alzheimer Coordinating Center (NACC) database (n=2975). The association between a composite score of vascular risk factors (based on the Framingham Stroke Risk Profile) and cognitive function was tested at baseline visit and estimated in longitudinal analyses using linear mixed-effects models. Total vascular risk factor burden was associated with worse cognitive performance at baseline and faster decline longitudinally in univariate analyses but only with worse WAIS digit symbol performance in cross-sectional (estimate=-0.266 units/1 unit of Framingham Stroke Risk Profile Score; 95% confidence interval, -0.380 to -0.153; P<0.001) and longitudinal (estimate=-0.034 units/1 unit of Framingham Stroke Risk Profile Score/year; 95% confidence interval, -0.055 to -0.012; P=0.002) analyses after adjusting for age, education, and APOE genotype. Individuals with history of stroke performed significantly worse on the trails B, category fluency, and Boston naming tests in cross-sectional analyses and in delayed logical memory and digit span backwards in longitudinal analyses. Although the modified Framingham Stroke Risk Profile in late-life predicts rate of decline on selective neurocognitive measures in previously normal elderly individuals, age appears to be the strongest risk factor for cognitive impairment in this population. History of stroke independently influences rate of cognitive decline in these individuals.