Cognitive Function In Older Adults Research Articles

Exploring the association between hemoglobin glycation index and cognitive function in older adults with hypertension: a cross-sectional study

BackgroundThe Hemoglobin Glycation Index (HGI) quantifies the difference between the actual and expected values of glycosylated hemoglobin (HbA1c), a marker that has been closely linked to various adverse health outcomes. Nonetheless, a significant gap exists in the current literature concerning the association between HGI and cognitive function. This study aims at testing such association in older adults with hypertension, a topic that has not yet been extensively investigated.MethodsA linear regression model between glycated hemoglobin A1c (HbA1c) levels and fasting plasma glucose (FPG) was constructed for the calculation of the HGI. The cross-sectional study focused on evaluating the cognitive function of hypertensive individuals (≥ 60 years old), based on the data from the 2011–2014 National Health and Nutrition Examination Survey (NHANES), by using a series of standardized tests, including the Word List Learning (CERAD-WL) and Delayed Recall (CERAD-DR) tests from the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). Weighted logistic and linear regression models served for evaluating the effect of HGI on hypertensive patients’ cognitive function. Restricted cubic spline (RCS) curves assisted in detecting the underlying nonlinear associations between HGI and cognitive outcomes. Furthermore, subgroup analyses and interaction tests were performed to gain deeper insights into these associations.ResultsThe study included 1023 participants ≥ 60 years old from 2011 to 2014 NHANES. Higher HGI was accompanied by lower DSST score (P = 0.009). In the fully adjusted model, participants in the highest quartile (Q4) of HGI possessed a lower DSST score (β = -4.50, 95% CI -8.10– -0.88) versus the lowest quartile (Q1), and were more likely to exhibit low cognitive function as evaluated by the DSST (OR = 2.21, 95% CI 0.98–5.03). According to the results from RCS analysis, HGI presented a linear relevance to cognitive function scores in older adults with hypertension. There is no interaction between HGI and the stratifying variables (sex, age, BMI, alcohol consumption, and smoking status).ConclusionHigh HGI was an important risk factor leading to reduced cognitive performance in hypertensive patients, ensuring HGI to be used for effectively predicting patients’ cognitive decline.

Nonpharmacological Multimodal Interventions for Cognitive Functions in Older Adults With Mild Cognitive Impairment: Scoping Review.

As the global population ages, the prevalence of dementia is expected to rise significantly. To alleviate the burden on health care systems and the economy, it is essential to develop effective strategies to enhance cognitive function in older adults. Previous studies have shown that combined nonpharmacological interventions can improve cognition across various domains in older individuals. However, there is no established gold standard for the exact combination and duration of these interventions, which makes it challenging to assess their overall effectiveness. Given the diversity of nonpharmacological multimodal interventions aimed at preventing cognitive decline in older adults with mild cognitive impairment (MCI), this scoping review sought to identify and summarize the characteristics and outcomes of these interventions. We adhered to the Arksey and O'Malley methodological framework and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) and searched 4 electronic databases (MEDLINE, PsycINFO, CINAHL, and Web of Science) systematically on July 6, 2023, and updated the search on April 17, 2024, using specific terms and keywords. This review included 45 studies from 18 countries with 4705 participants from 2014 to 2024 encompassing different combinations of physical training (PT), cognitive training (CT), nutrition intervention, psychosocial intervention, social activities, and electrical stimulation. There is a growing numbers of studies combining PT and CT for MCI treatment, with additional modalities often added to address various aspects of the condition. Compared to single-modal interventions and usual care, multimodal approaches demonstrated significantly better improvements in cognition domains such as attention, global cognition, executive function, memory, processing speed, and verbal fluency. Technology has been instrumental in delivering these interventions and enhancing the effects of PT and CT. Multimodal interventions also show promise in terms of acceptability and user experience, which can improve treatment adherence. Research is limited regarding the cost-effectiveness and optimal dosage of these interventions, making it difficult to assess the additional benefits of incorporating more modalities. Future research should examine the long-term effects of incorporating multiple modalities, using standardized MCI criteria and outcome measures.

Sex Hormones and Risk of Incident Dementia in Men and Postmenopausal Women.

Dementia poses a major global public health challenge, with its risk varying by sex. Women were nearly twice as likely to have Alzheimer's and other forms of dementia compared to men. Although testosterone levels are believed to influence cognitive function in older adults, existing studies have reported inconsistent findings, leaving the relationship between sex hormones and dementia unclear. We used data from UK Biobank. Serum total testosterone and sex hormone binding globulin (SHBG) were measured by immunoassay. Serum free testosterone was calculated using vermeulen method. The incident dementia and Alzheimer's disease (AD) was recorded from hospital inpatient data. Cox proportional hazards regression was conducted to assess the association between sex hormones and dementia, adjusted for age and other variables. Restricted cubic spline models were employed to quantify dose-response relationships. A total of 186,296 men (mean age: 56.68 years, SD: 8.18) and 126,109 postmenopausal women (mean age: 59.73 years, SD: 5.78) were included. After 12.0 (IQR: 11.0-13.0)-year follow-up, 3874 (2.08%) male participants and 2523 (2.00%) female participants developed dementia. Men in the highest quintile of free testosterone levels had a reduced risk of all-cause dementia (HR: 0.63, 95%CI: 0.56-0.71) and AD (0.49, 0.60-0.72) compared to those in the lowest quintile. Conversely, men in the highest quintile of SHBG levels had an increased risk of all-cause dementia (1.47, 1.32-1.64) and AD (1.32, 1.11-1.58) compared to those in the lowest quintile. Among postmenopausal women, those in the fourth quintile of free testosterone levels exhibited a lower risk of all-cause dementia (0.84, 0.78-0.95) and AD (0.76, 0.63-0.91). Higher SHBG was linked to an increased incidence of all-cause dementia (1.35, 1.28-1.55) and AD (1.52, 1.25-1.85) in menopausal women. Our findings revealed that higher SHBG and lower free testosterone concentrations seem to be associated with higher incidence of all-cause dementia and AD and further studies must be done to determine causality.

Water intake, hydration status and cognitive functions in older adults – a pilot study

PurposeThis study aimed to assess the relationship between the hydration status and cognitive functioning of older adults. The novelty of the study was the simultaneous use of several indicators of hydration status, including plasma and urine osmolality, specific gravity and urine color, as well as the assessment of total body water content from body composition measurements, together with comprehensive cognitive assessment.MethodsA cross-sectional pilot study included 35 participants aged ≥ 60 years. Water intake was assessed using the 3-day food record method. Hydration status was assessed by plasma osmolality (Posm), urine osmolality (Uosm), specific gravity (USG) and color (UC), extracellular water (ECW) and percentage of total body water (%TBW). Cognitive functions were assessed using a set of standardized neuropsychological tests including: two verbal tests (Digit Span, DS and Vocabulary, VT) from the Wechsler Adult Intelligence Scale, California Verbal Learning Test (CVLT), Verbal Fluency Test (VFT), Grooved Pegboard Test (GPT) and Global Cognitive Function (GCF).ResultsThe %TBW was the most strongly related to cognitive processes of all the measures of hydration status. %TBW was significantly related to the performance on memory/learning based on CVLT (r = -0.55, p = 0.002), after a short delay (r = -0.59, p = 0.001) and long delay (r = -0.57, p = 0.001) and GCF (r = -0.43, p = 0.019). Marked correlations were also present between %TBW and psychomotor speed using the GPT (r = 0.41, p = 0.028). Moreover, significant relationships were obtained in cluster analyses. Cluster 2 (lower hydration status) was characterized by lower water intake and AI% (% of Adequate Intake), higher Uosm, USG, UC, ECW and %TBC than cluster 1. At the same time, it had significantly higher scores for language ability: VT (p = 0.041) and VFT (p = 0.041).ConclusionSignificant relationships between some indicators of hydration status and selected cognitive domains were observed. This pilot study complements previous research on the relationship between hydration status and cognitive function in older adults, emphasizing that even small changes in hydration status assessment parameters can affect cognitive outcomes. In healthy, free-living older adults without dehydration assessed by plasma osmolality, other parameters of hydration status, such as water intake and urine parameters, influence language functions, suggesting the need to assess multiple markers simultaneously. The long-term effect of low water intake should be evaluated in a larger study group.

Internet use, physical activity, and cognitive function in Chinese older adults: a cross-lagged panel analysis

BackgroundWith the arrival of an aging society, cognitive health in older adults has become a global focal point. Cross-sectional studies have shown that internet use and physical activity may significantly affect cognitive function in older adults, but their longitudinal relationships and underlying mechanisms have not been fully explored.ObjectiveThis study aims to explore the relationship between internet use, physical activity, and cognitive function, and examine the mediating role of physical activity.MethodsThis study uses two rounds of longitudinal data from the China Health and Retirement Longitudinal Study (2018 and 2020), including a total of 2,383 individuals aged 60 and above. Cross-lagged regression analysis is used to test the bidirectional relationship between internet use and cognitive function, while a semi-longitudinal mediation model is used to examine the mediating role of physical activity.ResultsThe results indicate that there is a bidirectional relationship between internet use, physical activity levels, and cognitive function. Higher levels of internet use are associated with better cognitive function, and physical activity levels mediate the longitudinal relationship between internet use and cognitive function in older adults.ConclusionThis study reveals the complex relationship between cognitive function, internet use, and physical activity in older adults, and provides new perspectives for interventions aimed at improving cognitive health in older adults. Future research should further explore the dynamic changes between these variables to develop more effective intervention strategies and improve cognitive health and well-being in older adults.

Association between wooden toy engagement and cognitive function among Chinese older adults: a cross-sectional study

BackgroundThe rising prevalence of cognitive impairment among older adults poses a significant public health challenge. While wooden toys are traditionally regarded as tools for cognitive stimulation, research on their potential relationship with cognitive function in older adults remains limited. This study aims to explore the association between engagement with wooden toys and cognitive function in older adults.MethodsA cross-sectional study was conducted in May 2023, involving 387 older adults aged 60–94 years from Yunhe County, Zhejiang Province, China. Both bivariate analysis and multivariable linear regression analysis were performed to assess the association between wooden toy engagement and cognitive function.ResultsAmong the participants, 22.2% reported having experience with wooden toys. Older adults who played with wooden toys regularly or occasionally demonstrated significantly better cognitive performance compared to those who had never played. Importantly, the association between toy engagement frequency and cognitive function varied across age groups. Specifically, adults aged 60–64 who engaged with wooden toys regularly scored higher on the cognitive function than those who did not. Similarly, participants aged 65–69 who played regularly or occasionally also exhibited superior cognitive scores. Multivariable linear regression analysis confirmed that participation in wooden toy activities was positively associated with cognitive function (B = 0.86, 95% CI: 0.14–1.57 in the MMSE model; B = 0.99, 95% CI: 0.16–1.83 in the MoCA model).ConclusionThis study highlights a positive association between engagement with wooden toys and cognitive function in older adults. The frequency of engagement emerged as a critical factor in this relationship, with higher levels of participation linked to better cognitive outcomes. These findings offer valuable insights for developing strategies and policies to prevent or slow cognitive decline in aging populations. Promoting simple, accessible activities such as playing with wooden toys may serve as an effective intervention to enhance cognitive health among older adults.

Factors influencing the cognitive performance in cognitively unimpaired older adults and people living with Alzheimer’s disease: Insights from a middle-income Latin American country

Low- and middle-income countries, such as Brazil, often face higher dementia risk due to factors like lower education levels, with up to 90% of dementia cases remaining undiagnosed. Understanding factors that contribute to the cognitive performance of older adults may support healthcare professionals from these countries in their decision-making process when screening for cognitive decline in their communities. This study investigates factors associated with cognitive performance in older adults from a Latin American country. This cross-sectional and analytical study involved 137 participants (84 cognitively unimpaired older adults and 53 people with Alzheimer’s Disease) from Brazil. The assessment included a sociodemographic questionnaire, the Addenbrooke’s Cognitive Examination-Revised (ACE-R), the Mini-Mental State Examination (MMSE), the Memory Complaint Scale (MCS), Clinical Dementia Rating (CDR), Geriatric Depression Scale (GDS-15), Geriatric Anxiety Inventory (GAI-5), Katz scale, Lawton and Brody scale, and Pfeffer Functional Activity Questionnaire (PFAQ). Data were analyzed using descriptive statistics, linear regression, and mediation analysis, with a significance level set at p<0.05. AD participants were older, had fewer years of formal education, showed poorer cognitive performance, and had lower functionality. Age, education, and functionality were significantly associated with cognitive performance. Mediation analysis showed that years of education mediated the relationship between functionality and cognitive performance. This study underscores the significance of age, education, and functionality as key factors in cognitive performance among older adults in Brazil, providing valuable knowledge for improving cognitive assessment practices in Latin American countries.

Optimal exercise temporal parameters of Traditional Chinese Exercises for cognitive function of older adults with mild cognitive impairment: a systematic review and dose–response meta-analysis of randomized controlled trials

BackgroundMild cognitive impairment (MCI) is characterized by a progressive decline in memory and other cognitive functions, falling between normal cognition and dementia. Traditional Chinese Exercises (TCEs) have been proven effective for managing MCI. A dose–response meta-analysis was conducted to evaluate the correlation between exercise temporal parameters and their effectiveness in older adults with MCI.MethodsRandomized controlled trials (RCTs) on TCEs for MCI were searched across eight databases from their inception to September 2024. Literature was screened based on inclusion and exclusion criteria. Data from the selected studies were extracted, and the risk of bias was assessed using the RoB2 tool. The quality of the included studies was evaluated using the PEDro scale. The visualizations were conducted using the “robvis” package in R 4.3.3 software, while Stata 15.0 software was used to analyze the dose–response relations.ResultOut of 2,216 records,17 RCTs were included in the meta-analysis. Although significant heterogeneity was present among the studies, sensitivity analysis demonstrated good robustness. The results revealed significant improvements in cognitive function among older adults with MCI in the TCEs group: Montreal Cognitive Assessment (MoCA) (SMD = 1.04, 95% CI: 0.71–1.38) and Mini-Mental State Examination (MMSE) (SMD = 0.82, 95% CI: 0.41–1.42). The relations between exercise cycle, frequency, and overall cognitive function (MoCA and MMSE) followed a “Λ”-shaped curve. For MoCA, the relations with exercise duration also exhibited a “Λ”-shaped curve, while the relations between duration and MMSE was nonlinear. The peak improvements in MoCA and MMSE were observed at 12 weeks (25.59, 95% CI: 25.07–26.10) and 13 weeks (26.24, 95% CI: 25.38–27.09). Improvement was positively correlated with the number of cycles up to a peak, after which it declined, following a “Λ”-shaped pattern.ConclusionThis study demonstrates a nonlinear dose–response relations between exercise temporal parameters and therapeutic effects on cognitive function in older adults with MCI. Regarding exercise cycle, MoCA and MMES yield the optimal outcomes at 12 and 13 weeks. For exercise frequency, MoCA and MMES optimize results at three times per week. Concerning exercise duration, MoCA achieves optimal results at 45 min; MMES shows gradual improvement after 30 min.Systematic review registrationThe study protocol was registered with PROSPER on May 29, 2024, under the registration number CRD42024510378, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024510378

Disparities in neighborhood food environment and cognitive decline among US older adults: a cohort study

BackgroundDisparities in neighborhood food environments in the United States, attributed to numerous complex economic, social, and political factors, likely to contribute to disparities in access to healthy food and cognitive function in older adults. However, the role of food environment in cognitive function is not well understood. Accordingly, this study examined the association of residing a low food access and low-income neighborhood with changes in cognitive function among older adults in urban areas.MethodsThis is a cohort study leveraging existing datasets. The 2010 Food Access Research Atlas data was linked to the 2011–2021 National Health and Aging Trends Study (NHATS). A total of 4768 urban-dwelling older adults aged 65 years and older were included in this analysis. Total cognitive function (range: 0–33) was assessed through tests of orientation, executive function, immediate memory, and delayed memory. An unhealthy food environment was defined as residing in census tracts with both low access to healthy food stores and low income. Survey-weighted mixed-effects models were fitted, adjusting for individual- and area-level covariates.ResultsThe mean age of participants was 77.1 years (SD = 7.6), and 2779 were women (weighted % = 56.7). A total of 1238 participants (weighted % = 9.9%) were racialized as Black, 365 (weighted % = 9.1%) racialized as Latinx, and 3165 (weighted % = 81.1%) racialized as White. In adjusted models, older urban- and community-dwelling adults living in neighborhoods with low access and low income had faster annual cognitive decline than their peers (β = − 0.19; 95% CI = − 0.32, − 0.05).ConclusionsLiving in neighborhoods with both low food access and low income may be a risk factor for accelerated cognitive decline among urban-dwelling older adults and contribute to widening disparities in healthy food access and cognitive decline.

Dietary vitamin D intake and 2-year changes in cognitive function in older adults with overweight or obesity and metabolic syndrome.

The protective role of dietary vitamin D intake on cognitive function is of interest, but evidence remains inconsistent. We aimed to evaluate the association between dietary vitamin D intake and 2-year cognitive changes in older adults at risk of cognitive decline. This longitudinal study comprised 5454 individuals (aged 55-75years in men and 60-75years in women) who exhibited overweight/obesity and metabolic syndrome. Data on dietary vitamin D intake was assessed using a validated 143-item food frequency questionnaire. Cognitive function was assessed through five composite scores derived from a comprehensive battery of eight neuropsychological tests, encompassing global cognitive function, general cognitive function, attention, executive function, and language domains. Multivariable-adjusted linear regression models were fitted to examine the association between energy-adjusted cumulative average dietary vitamin D intake over time and 2-year changes in cognitive function. After adjusting for multiple covariates, energy-adjusted cumulative average dietary vitamin D intake as a continuous variable was associated with greater 2-year improvements in global cognitive function (β 1.18 × 10-2; 95% CI 0.19 × 10-2 to 2.17 × 10-2), executive function (β 1.12 × 10-2; 95% CI 0.03 × 10-2 to 2.21 × 10-2), and language (β 1.61 × 10-2; 95% CI 0.43 × 10-2 to 2.78 × 10-2). Additionally, the higher cumulative average dietary vitamin D intake quartile was associated with an increase in global cognitive function (β 7.10 × 10-2; 95% CI 0.59 × 10-2 to 13.6 × 10-2), language (β 7.07 × 10-2; 95% CI - 0.52 × 10-2 to 14.7 × 10-2), and a lower decline in attention (β 9.58 × 10-2; 95% CI 1.60 × 10-2 to 17.5 × 10-2). A higher dietary vitamin D intake was associated with modest favorable changes in cognitive function and a reduced cognitive decline over a 2-year period. These findings highlight the need for further research to explore the potential benefits of boosting dietary vitamin D intake for cognitive health in older adults.

Elevated urine albumin-to-creatinine ratio as a risk factor for cognitive impairment in older adults: A cross-sectional analysis of NHANES data.

Cognitive impairment is an escalating challenge in aging populations, with risk factors extending beyond traditional domains. The urine albumin-to-creatinine ratio (UACR), a marker of kidney and vascular health, has been associated with systemic dysfunction, yet its association with cognitive impairment remains underexplored. This study aims to delve into the association between UACR and cognitive function in older adults. This study conducted a cross-sectional analysis using data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES), including 2,385 adults aged ≥60 years. Cognitive function was assessed using composite 'Cognitive Scores' derived from standardized tests. Participants were categorized into quartiles based on UACR levels. Multivariate linear regression models were used to evaluate the association between UACR and cognitive scores. Additionally, multivariate logistic regression models were used to assess the relationship between UACR and cognitive impairment, adjusting for demographic and clinical covariates. Smooth curve fitting and interaction analyses were also performed to further investigate the relationship between UACR and cognitive impairment. For every 10-unit increase in UACR, cognitive scores declined by 0.019 (β = -0.019, 95% CI: -0.036 to -0.002; P < 0.05), and the odds of cognitive impairment increased by 2.6% (OR = 1.026, 95% CI: 1.004 to 1.048; P < 0.05). This trend was also observed in participants with UACR levels below 30, where for every 10-unit increase in UACR, cognitive scores decreased by 0.013 (β = -0.013, 95% CI: -0.027 to -0.001; P < 0.05), and the odds of cognitive impairment increased by 1.4% (OR = 1.014, 95% CI: 1.003 to 1.038; P < 0.05). The study also identified a nonlinear relationship, where the risk of cognitive impairment increased with rising UACR levels, but this risk plateaued at a UACR value of 12.86. Hypertension was found to be a significant factor influencing the relationship between UACR and cognitive impairment (P for interaction < 0.05). This study highlights the significant association between elevated UACR and cognitive impairment in older adults. Notably, even at lower UACR levels, increases in UACR are associated with a higher risk of cognitive impairment. These findings underscore the importance of incorporating kidney health management into strategies aimed at preventing cognitive decline. Further longitudinal studies are needed to clarify the causal relationship and explore interventions targeting UACR to preserve cognitive function.

Mapping inequalities in the health of older adults around the world: Heterogeneities in cognitive and physical functioning

Amid global population ageing and evidence that health disparities in later life often stem from accumulated disadvantage, it is essential to assess health inequalities in older adults in an internationally comparable and comprehensive way. Addressing the shortcomings of analysing average health levels in a population while preserving the comparability of countries and subpopulations, we estimate Gini coefficients to examine inequalities in physical and cognitive functioning of older adults in 41 countries, stratified by gender and five-year age group. Utilising data from 11 nationally representative surveys on the health and ageing of older adults, we find substantial heterogeneities in physical and cognitive functioning inequalities across countries for both women and men. Notably, countries with higher median scores in cognitive functioning tend to exhibit significantly less pronounced inequalities. Furthermore, our results reveal a steep positive age gradient in both dimensions of cognitive functioning. Taken together, our descriptive results provide a valuable foundation for researchers and policymakers aiming to identify targeted interventions and policy measures to address health disparities.

Longitudinal, Bidirectional Association between Gait Speed and Cognitive Function in Community-Dwelling Older Adults without Dementia.

Longitudinal, Bidirectional Association between Gait Speed and Cognitive Function in Community-Dwelling Older Adults without Dementia.

Brain physiological pulsations are linked to sleep architecture and cognitive performance in older adults.

Brain physiological pulsations are linked to sleep architecture and cognitive performance in older adults.

Cochlear implantation and cognitive function in the older adult population: current state of the art and future perspectives.

Cochlear implantation and cognitive function in the older adult population: current state of the art and future perspectives.

Region-specific cognitive effects of HD-tDCS in older adults: M1, DLPFC, and cerebellum.

Region-specific cognitive effects of HD-tDCS in older adults: M1, DLPFC, and cerebellum.

Gender differences in the mediating effects of social participation and number of children on psychological resilience and cognitive function in older adults.

Gender differences in the mediating effects of social participation and number of children on psychological resilience and cognitive function in older adults.

Associations between physical activity, glucose variability, and cognitive function in older adults with type 2 diabetes.

Associations between physical activity, glucose variability, and cognitive function in older adults with type 2 diabetes.

Association of dietary pattern and cognitive function in the elderly: A systematic review and meta-analysis.

Association of dietary pattern and cognitive function in the elderly: A systematic review and meta-analysis.

Blood Angiogenesis Markers and Cognition in Older Adults at Risk for Dementia: Marqueurs sanguins de l'angiogenèse et cognition chez les personnes âgées à risque de démence.

ObjectiveChanges in angiogenesis have been shown to contribute to cognitive decline and dementia. We aimed to identify angiogenesis blood markers associated with cognitive performance in older adults with mild cognitive impairment (MCI), remitted major depressive disorder (rMDD), or both (rMDD + MCI) who are at risk for dementia.MethodWe analyzed data from participants with MCI, rMDD, or rMDD + MCI in the Prevention of Alzheimer's Dementia with Cognitive Remediation plus Transcranial Direct Current Stimulation in Mild Cognitive Impairment and Depression study. Elastic net regression was used to select variables associated with cognitive performance among 19 angiogenesis markers and 6 covariates. Linear regressions were used to determine which of the selected angiogenesis markers were associated with cognitive performance, controlling for the selected covariates. Significant angiogenesis markers were independently analyzed without other angiogenesis markers, controlling for covariates, with subgroup analyses in those with and without rMDD.ResultsAngiogenin was the only selected marker associated with cognitive performance (β = 0.28, Padj = 0.03, f² = .02) when controlling for other selected markers (endothelial cell-specific molecule 1, e-selectin, interleukin-33 [IL-33], oncostatin M, platelet-derived growth factor-AB, IL-33 receptor, and tissue inhibitor of metalloproteinases-1) and selected covariates (age, education, apolipoprotein E ε4 status, diagnosis, and cardiovascular risk factors). When independently analyzed, angiogenin remained positively associated with cognitive performance (β = 0.21, P = 0.01, f² =.02), controlling for the covariates. In subgroup analyses, angiogenin was also associated with cognition in rMDD and rMDD + MCI participants (β =0.50, SE = 0.14, P < 0.001, f² = 0.08) and in MCI-only participants (β= 0.20, SE = 0.09, P = 0.02, f² = 0.02).ConclusionThe association of angiogenin with cognitive performance highlights a potentially novel biological pathway that could influence cognition in older adults at risk for dementia. Angiogenin may protect against cognitive decline, opening new avenues for innovative preventive, or therapeutic interventions.