Cognitive Function In Older Men Research Articles

Muscle strength and physical function are positively correlated with cognitive function in older men

Muscle strength and physical function are positively correlated with cognitive function in older men

Whey protein supplementation but not resistance exercise improves cognitive function in older men

Whey protein supplementation but not resistance exercise improves cognitive function in older men

Egg Consumption and 4-Year Change in Cognitive Function in Older Men and Women: The Rancho Bernardo Study.

The effect of dietary cholesterol on cognitive function is debatable. While eggs contain high levels of dietary cholesterol, they provide nutrients beneficial for cognitive function. This study examined the effects of egg consumption on change in cognitive function among 890 ambulatory adults (N = 357 men; N = 533 women) aged ≥55 years from the Rancho Bernardo Study who attended clinic visits in 1988-1991 and 1992-1996. Egg intake was obtained in 1988-1991 with a food frequency questionnaire. The Mini-Mental Status Exam (MMSE), Trails B, and category fluency were administered at both visits to assess cognitive performance. Sex-specific multiple regression analyses tested associations of egg intake with changes in cognitive function after adjustment for confounders. The mean time between visits was 4.1 ± 0.5 years; average ages were 70.1 ± 8.4 in men and 71.5 ± 8.8 in women (p = 0.0163). More men consumed eggs at higher levels than women; while 14% of men and 16.5% of women reported never eating eggs, 7.0% of men and 3.8% of women reported intakes ≥5/week (p = 0.0013). In women, after adjustment for covariates, egg consumption was associated with less decline in category fluency (beta = -0.10, p = 0.0241). Other associations were nonsignificant in women, and no associations were found in men. Results suggest that egg consumption has a small beneficial effect on semantic memory in women. The lack of decline observed in both sexes suggests that egg consumption does not have detrimental effects and may even have a role in the maintenance of cognitive function.

Effects of resistance exercise and whey protein supplementation on cognitive function in older men: secondary analysis of a randomised, double-blind, placebo-controlled trial

PurposeAgeing is associated with cognitive decline. This study investigated the individual and combined effects of resistance exercise (RE) and whey protein supplementation (PRO) on cognitive function in older men. MethodsIn a pooled-groups analysis, 36 older men (age: 67 ± 4 years) were randomised to either RE (2 x/week; n = 18) or no exercise (NE; n = 18), and either PRO (2 × 25 g/d whey protein isolate; n = 18) or control (CON, 2 × 23.75 g maltodextrin/d; n = 18). A sub-analysis was also conducted between RE + CON (n = 9) and RE + PRO (n = 9). At baseline and 12 weeks, participants completed a battery of neuropsychological tests (CANTAB; Cambridge Cognition, UK) and neurobiological, inflammatory, salivary cortisol and insulin sensitivity biomarkers were quantified. ResultsPRO improved executive function z-score (+0.31 ± 0.08) greater than CON (+0.06 ± 0.08, P = 0.03) and there was a trend towards improved global cognitive function (P = 0.053). RE and RE + PRO did not improve any cognitive function domains (p ≥ 0.07). RE decreased tumor necrosis factor-alpha (P = 0.02) and interleukin-6 (P = 0.048) concentrations compared to NE, but changes in biomarkers did not correlate with changes in cognitive domains. Muscle strength (r = 0.34, P = 0.045) and physical function (ρ = 0.35–0.51, P < 0.05) outcomes positively correlated with cognitive function domains at baseline, but only Δskeletal muscle index correlated with Δepisodic memory (r = 0.34, P = 0.046) following the intervention. ConclusionIn older men, PRO improved cognitive function, most notably executive functioning. RE did not improve any cognitive function domains but did decrease biomarkers of systemic inflammation. No synergistic effects were observed.

Sex steroid and cognitive function among community-dwelling older men with or without vascular risk factors: a cross-sectional study

BackgroundThe relationship of testosterone and estradiol concentrations with cognitive function among community-dwelling older men was inconclusive. To examine the association of serum testosterone and estradiol concentrations with cognitive function in older men with or without vascular risk factors (VRFs).MethodsThis cross-sectional study consisted of 224 community-dwelling men aged 65–90 years in the Songjiang District of Shanghai, China. Serum testosterone and estradiol were measured by electrochemiluminescence immunoassay. The following five factors were defined as VRFs in this study: obesity, history of hypertension, diabetes, stroke, and coronary heart disease. Multivariable linear regression was used to examine the association of testosterone and estradiol with the Mini-Mental State Examination (MMSE) in participants with or without VRF. Restricted cubic spline (RCS) regression was performed to account for the nonlinearity of these associations.ResultsAn inverted “U” shaped non-linear relationship was found between testosterone concentration and MMSE score in men with one VRF (P overall =.003, non-linear P =.002). Estradiol showed an inverted “U” shaped non-linear relationship with MMSE score independent of VRFs (men without VRF, P overall =.049, non-linear P =.015; men with one VRF, overall P =.007, non-linear P =.003; men with two or more VRFs, overall P =.009, non-linear P =.005).ConclusionIn older men, an optimal level of sex steroid concentration may be beneficial to cognitive function and the VRFs should be considered when interpreting the relationship between sex steroid and cognitive function.

The Longitudinal Association of Egg Consumption with Cognitive Function in Older Men and Women: The Rancho Bernardo Study.

This study examines the prospective association of egg consumption with multiple domains of cognitive function in older, community-dwelling men and women followed for 16.3 years. Participants were 617 men and 898 women from the Rancho Bernardo Cohort aged 60 and older, who were surveyed about egg intake/week in 1972-1974, and attended a 1988-1991 research visit, where cognitive function was assessed with 12 tests. Analyses showed that egg intake ranged from 0-24/week (means: men = 4.2 ± 3.2; women = 3.5 ± 2.7; p < 0.0001). In men, covariate-adjusted regressions showed that egg intake was associated with better performance on Buschke total (p = 0.04), long-term (p = 0.02), and short-term (p = 0.05) recall. No significant associations were observed in women (p's > 0.05). Analyses showed that in those aged <60y in 1972-1974, egg intake was positively associated with scores on Heaton copying (p < 0.04) and the Mini-Mental Status Exam (MMSE; p < 0.02) in men and category fluency (p < 0.05) in women. Egg intake was not significantly associated with odds of poor performance on MMSE, Trails B, or category fluency in either sex. These reassuring findings suggest that there are no long-term detrimental effects of egg consumption on multiple cognitive function domains, and for men, there may be beneficial effects for verbal episodic memory. Egg consumption in middle age may also be related to better cognitive performance later in life.

Objective Sleep and Circadian Rest‐Activity Rhythms and Multiple Domains of Cognitive Function in Older Men and Women

AbstractBackgroundEmerging evidence from experimental and epidemiologic studies suggests that sleep and circadian rest‐activity rhythms (RAR) play a key role in dementia and Alzheimer Disease (AD) pathology. Studies with objective measures of sleep and RAR and multiple domains of cognition in older adults remain limited.MethodWe studied 820 older men and women enrolled in the Study of Muscle, Mobility, and Aging (SOMMA), a unique cohort designed to study the cellular biology of aging and related loss of mobility. In this initial cross‐sectional analysis, participants wore wrist actigraphs for a mean of 8.0 consecutive days; recordings were processed for traditional sleep‐wake measures including total sleep time (TST) and sleep efficiency (SE); as well as parametric (acrophase, pseudo‐F) and non‐parametric (interdaily stability [IS], intradaily variability [IV], and relative amplitude [RA]) 24‐hour RAR variables. Measures of cognitive function included global cognition (the Montreal Cognitive Assessment), executive function (Trails B test), memory (California Verbal Learning Test‐short form; and psychomotor performance (Digit‐Symbol Coding Test). In models adjusted for age, sex, clinic site and education, we examined adjusted mean cognitive test scores by quartiles or categories of sleep and RAR exposures.ResultMean age of the cohort was 76 years, 58% were female, and 15% were non‐white. Mean TST and SE were 6.9 hours and 85%, respectively. Higher RA, reflecting a more robust 24‐hour RAR, was associated with better cognition on all tests (p for trend &lt;0.05). The association of higher pseudo‐F, a parametric measure or robustness of RAR, to cognition was limited to psychomotor performance (p&lt;0.03). Better psychomotor performance was also related to higher IS (consistency of RAR across days); whereas those with delayed timing (acrophase) had worse psychomotor performance (p&lt;.0006). Lower SE was related to worse cognitive function (psychomotor performance, global cognition, memory; p&lt;.05). There were no associations between TST and any cognitive measures.ConclusionSE and RAR were variably associated with both global and specific domains of cognition in older men and women. The RA in particular was strongly related to multiple domains of cognition related to AD, and may be useful in identifying individuals at risk. Additional analyses will explore gender differences and longitudinal associations.

Longitudinal Associations Between Sleep and Cognitive Function in a Cohort of Older Puerto Rican Adults: Sex and Age Interactions.

Evidence on sleep duration or quality and cognitive function in diverse older adults is limited. We examined prospective associations between subjective sleep measures and cognitive function, with modifying effects of sex and age (<65 vs ≥65 years). Data are from the longitudinal Boston Puerto Rican Health Study, Waves 2 (n = 943) and 4 (n = 444), with mean follow-up of 10.5 years (range 7.2-12.8). Subjective measures of sleep duration (short <7, ref. 7, or long ≥8 hours) and insomnia symptoms (sum of difficulty falling asleep, waking up at night, and early morning awakening), were assessed at Wave 2. Linear regression models were used to assess changes in global cognition, executive function, memory, and Mini-Mental State Examination, and tested for modifying roles of sex and age. Significant 3-way interaction (sex × age × cognition) in fully adjusted models showed greater decline in global cognitive function in older men with short (β [95% confidence interval]: -0.67 [-1.24, -0.10]) or long sleep duration (-0.92 [-1.55, -0.30]), compared to women, younger men, and older men with 7 hours of sleep. Insomnia symptoms were associated with a greater decline in memory (-0.54, [-0.85, -0.22]) among older men, compared to women and younger men. Sleep duration showed a U-shaped association with cognitive decline, and insomnia symptoms were associated with memory decline in fully adjusted models. Older men, versus women and younger men, were at relatively greater risk for cognitive decline associated with sleep factors. These findings are important for personalizing sleep interventions to support cognitive health.

Exercise Associated with Cognitive Function in Older Men with Prostate Cancer Undergoing Androgen Deprivation Therapy.

To examine associations between exercise and cognitive function in older men undergoing hormone therapy for prostate cancer. Men ≥ 65years old with prostate cancer, currently undergoing androgen deprivation therapy for ≥ 6months (n = 50), completed the Godin-Shephard Leisure-Time Physical Activity Questionnaire, and standard neuropsychological tests. Pearson's correlations and linear regressions were used to examine associations between exercise and cognitive performance. Exercise was significantly positively correlated with performance on tests of memory, attention, and executive function. Linear regressions showed that when controlling for age and education, exercise remained a significant predictor of attention and executive function performance (p < 0.05), and showed moderate, but statistically non-significant effects on memory performance (p < 0.10). Greater exercise is associated with better functioning in multiple cognitive domains in men with prostate cancer undergoing hormone therapy, providing proof-of-concept evidence that exercise may be a feasible intervention to limit cognitive dysfunction in prostate cancer patients.

Age Acceleration is Associated with Reduced Cognitive Function in Older Men: Results from the Normative Aging Study

BACKGROUND AND AIM: DNA methylation (DNAm) has been used to quantify the biological effects of external factors on aging processes. This study examined the association between age acceleration and cognitive function in older men using DNAm-based clocks. METHODS: We evaluated the associations of age acceleration on cognitive function among participants in the Normative Aging Study (NAS). We tested GrimAgeAccel (a biomarker linked with mortality), PhenoAgeAccel (capturing risks for diverse outcomes), Intrinsic (IEAA), and Extrinsic (EEAA) Age Acceleration, and the DNAm-related mortality risk score (DNAmRS). DNAm was determined using Illumina 450K arrays. We modeled six cognitive tests (Mini-Mental State Examination [global function], Word List Memory Task [recent memory], Digit Span Backwards [executive function], Verbal Fluency Test [language], Sum of Drawings [visuospatial ability], and Pattern Comparison Task [visuospatial function]) in linear mixed models adjusted for chronological age, alcohol, smoking status, fish consumption, physical activity, hypertension, diabetes mellitus, English as the first language, computer experience, education, body mass index, and methylation technical covariates. RESULTS: We evaluated 549 men (mean age: 74.3 years, standard deviation: 6.5 years), mostly white (91.23%). GrimAgeAccel showed significant negative associations with global cognition (β = -0.029, 95% Confidence Interval [95%CI] -0.043, -0.015, p-value &amp;#x3c; 0.001) and visospatial ability (β = -0.018, 95% CI -0.033, -0.003, p-value = 0.019). PhenoAgeAccel was negatively associated with executive function (β = -0.009, 95% CI -0.017, -0.001, p-value = 0.041) and visuospatial ability (β = -0.019, 95% CI -0.029, -0.008, p-value &amp;#x3c; 0.001). DNAmRS was negatively associated with recent memory and executive function. IEAA and EEAA did not show consistent results. CONCLUSIONS: Selected age acceleration biomarkers were associated with accelerated cognitive decline in older men. DNAm-based biological clocks may help identify individuals at higher risk for age-related cognitive decline. KEYWORDS: Aging, age acceleration, cognitive function, age-related, DNA methylation.

Associations of Bioavailable Serum Testosterone With Cognitive Function in Older Men: Results From the National Health and Nutrition Examination Survey.

Age-associated cognitive decline may be influenced by testosterone status. However, studies evaluating the impact of bioavailable testosterone, the active, free testosterone, on cognitive function are scarce. Our study determined the relationship between calculated bioavailable testosterone and cognitive performance in older men. We used data from the U.S. National Health and Nutrition Examination Survey (NHANES) between 2013 and 2014. This study consisted of 208 men aged ≥60 years. Bioavailable serum testosterone was calculated based on the total serum testosterone, sex hormone-binding globulin, and albumin levels, whereas cognitive performance was assessed through the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word List Learning Test (WLLT), Word List Recall Test (WLRT), and Intrusion Word Count Test (WLLT-IC and WLRT-IC), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). Multiple linear regression analyses were performed upon adjustment for age, ethnicity, socioeconomic status, education level, medical history, body mass index, energy, alcohol intake, physical activity levels, and sleep duration. A significant positive association between bioavailable testosterone and DSST (β: 0.049, p = .002) score was detected, with no signs of a plateau effect. No significant associations with CERAD WLLT (p = .132), WLRT (p = .643), WLLT-IC (p = .979), and WLRT-IC (p = .387), and AFT (p = .057) were observed. Calculated bioavailable testosterone presented a significant positive association with processing speed, sustained attention, and working memory in older men above 60 years of age. Further research is warranted to elucidate the impact of the inevitable age-related decline in testosterone on cognitive function in older men.

Association of Chemotherapy, Enzalutamide, Abiraterone, and Radium 223 With Cognitive Function in Older Men With Metastatic Castration-Resistant Prostate Cancer

Older adults are at greater risk of cognitive decline with various oncologic therapies. Some commonly used therapies for advanced prostate cancer, such as enzalutamide, have been linked to cognitive impairment, but published data are scarce, come from single-group studies, or focus on self-reported cognition. To longitudinally examine the association between cognitive function and docetaxel (chemotherapy), abiraterone, enzalutamide, and radium Ra 223 dichloride (radium 223) in older men with metastatic castration-resistant prostate cancer. A multicenter, prospective, observational cohort study was conducted across 4 academic cancer centers in Ontario, Canada. A consecutive sample of 155 men age 65 years or older with metastatic castration-resistant prostate cancer starting any treatment with docetaxel, abiraterone acetate, enzalutamide, or radium Ra 223 dichloride (radium 223) were enrolled between July 1, 2015, and December 31, 2019. First-line chemotherapy (docetaxel), abiraterone, enzalutamide, or radium 223. Cognitive function was measured at baseline and end of treatment using the Montreal Cognitive Assessment, the Trail Making Test part A, and the Trail Making Test part B to assess global cognition, attention, and executive function, respectively. Absolute changes in scores over time were analyzed using univariate and multivariable linear regression, and the percentages of individuals with a decline of 1.5 SDs in each domain were calculated. A total of 155 men starting treatment with docetaxel (n = 51) (mean [SD] age, 73.5 [6.2] years; 34 [66.7%] with some postsecondary education), abiraterone (n = 29) (mean [SD] age, 76.2 [7.2] years; 18 [62.1%] with some postsecondary education), enzalutamide (n = 54) (mean [SD] age, 75.7 [7.4] years; 33 [61.1%] with some postsecondary education), and radium 223 (n = 21) (mean [SD] age, 76.4 [7.2] years; 17 [81.0%] with some postsecondary education) were included. Most patients had stable cognition or slight improvements during treatment. A cognitive decline of 1.5 SDs or more was observed in 0% to 6.5% of patients on each measure of cognitive function (eg, 3 of 46 patients [6.5%; 95% CI, 2.2%-17.5%] in the group receiving chemotherapy [docetaxel] had a decline of 1.5 SDs for Trails A and Trails B). Although patients taking enzalutamide had numerically larger declines than those taking abiraterone, differences were small and clinically unimportant. These findings suggest that most older men do not experience significant cognitive decline in attention, executive function, and global cognition while undergoing treatment for advanced prostate cancer regardless of the treatment used.

Associations Between Muscle Quality and Cognitive Function in Older Men: Cross-Sectional Data From the Geelong Osteoporosis Study

Sarcopenia-related declines appear to be adversely associated with cognition in the elderly. Poor muscle quality is a marker for sarcopenia, yet little research has examined the concurrence of poor muscle quality and poor cognition. The aim of this study was to investigate the association between muscle quality and cognitive function, overall and in specific domains, in older men. This study involved 342 men from the Geelong Osteoporosis Study (ages 60–96 years). Handgrip strength (HGS, kg) was measured by dynamometry (Vernier, LoggerPro3), and lean mass of arms (kg) and appendicular lean mass (ALM, kg) by dual-energy X-ray absorptiometry (Lunar). Muscle quality was expressed as HGS/(arm lean mass) (kg/kg) as well as HGS/ALM (kg/kg). Cognitive function was assessed in 4 domains: visual attention, psychomotor function, working memory and visual learning. Overall cognitive function scores were calculated. Higher scores represent poorer cognitive performance in attention, psychomotor function and working memory, but better performance for visual memory/learning and overall cognitive function. Additionally, cognitive impairment was determined by the mini-mental state exam (score ≤ 24). Linear regression analyses and logistic regression were performed. There were age-related declines observed for all measures relating to muscle and cognition. Muscle quality (HGS/arm lean mass) was associated with all cognition assessments before and after adjusting for age, except for age-adjusted working memory. Muscle quality (HGS/arm lean mass) was associated with psychomotor function (B -0.01, 95% CI -0.02, -0.005) and overall cognitive function (b + 0.07, 95% CI 0.03, 0.11) after adjusting for age and education. Greater muscle quality was also associated with the likelihood of cognitive impairment OR 0.64 (95%CI 0.46–0.88) after adjusting for age; associations with attention and visual memory/learning were attenuated after further adjustment for confounders. Similar patterns were observed when muscle quality was determined as HGS/ALM. Our data support an association between muscle quality and cognitive function. Further research is needed to examine temporal changes between the Two.

Obstructive sleep apnea in older adults: Differential cognitive impairment moderated by sex?

AbstractBackgroundObstructive sleep apnea (OSA) is a risk factor for cognitive decline, but the effect of sex on this association is unknown. This study aims at characterizing the relationship between risk of OSA and cognitive function in older men and women.MethodWe included 152 women (73 ± 6 years) and 89 men (75 ± 6 years) matched for education, age and presence of APOE4 allele. They were part of the Quebec Consortium for Early Identification of Alzheimer’s Disease (CIMA‐Q) and were either cognitively healthy or had subjective cognitive decline or mild cognitive impairment. All participants were tested with a neuropsychological battery measuring cognitive domains typically affected by Alzheimer’s disease. Risk of OSA was determined using a validated questionnaire that considers signs and symptoms associated with OSA such as snoring (S), tiredness (T), observation of apneas (O), high blood pressure (P), high body mass index (B) and larger neck circumference (N), which provides a risk score (STOP‐BN). Multiple linear regressions were performed between STOP‐BN and cognitive scores in men and women separately.ResultHigher risk of OSA, identified by a higher score on the STOP‐BN, is correlated with slower information processing speed (Stroop, condition 2) in women (β= 0,896, p = 0,006) and men (β= 0,954, p = 0,043). In men, higher risk of OSA correlated with worse performance in short (Digit symbol, incidental learning score: β = 0,982, p = 0,034) and long‐term memory (Face‐name associations, delayed recall: β = 0,318, p = 0,047).ConclusionOur results suggest that sex has a moderating effect on the association between OSA and cognitive function. An altered information processing speed has already been reported in apneic patients and does not necessarily reflect a risk of dementia. However, altered memory in men at higher risk of OSA needs to be investigated longitudinally to determine whether OSA could represent an early marker of cognitive decline.

Muscle strength and gait speed rather than lean mass are better indicators for poor cognitive function in older men

We aimed to examine muscle strength, function and mass in relation to cognition in older men. This cross-sectional data-set included 292 men aged ≥60 yr. Handgrip strength (kg) was measured by dynamometry, gait speed by 4-metre walk (m/s) and appendicular lean mass (kg) by dual-energy x-ray absorptiometry. Cognition was assessed across four domains: psychomotor function, attention, visual learning and working memory. Composite scores for overall cognition were calculated. Bivariate analyses indicated that handgrip strength and gait speed were positively associated with cognitive function. After accounting for confounders, positive associations between individual muscle (or physical) measures and cognitive performance were sustained for handgrip strength and psychomotor function, gait speed and psychomotor function, gait speed and attention, handgrip strength and overall cognition, and gait speed and overall cognition. In multivariable models, handgrip strength and gait speed independently predicted psychomotor function and overall cognition. No associations were detected between lean mass and cognition after adjusting for confounders. Thus, low muscle strength and slower gait speed, rather than low lean mass, were associated with poor cognition in older men.

Relation between cadmium body burden and cognitive function in older men: A cross-sectional study in China

Cadmium (Cd) is a known neurotoxicant and its relation with cognition has been well studied in children. However, evidence linking Cd and cognitive function among older individuals is limited. To evaluate the association between Cd exposure and cognitive function in older age, we conducted a cross-sectional study involving 375 older men aged 60–74 years (mean age: 66.0 years) in Guangxi, China. Urinary Cd concentrations were measured. Cognitive function was assessed by the Chinese version of Mini-Mental State Examination (MMSE) and cognitive impairment was identified using education-specific cutoff points of MMSE scores. General linear regression and logistic regression models were applied to evaluate the associations of urinary Cd concentrations with MMSE scores and the risk of cognitive impairment, respectively. The median urinary Cd concentration of all participants was 1.58 μg/g creatinine. Urinary Cd levels were inversely associated with MMSE scores [β = −0.76; 95% confidence interval (CI): -1.28 to −0.23 for a 2-fold increase in urinary Cd]. A 2-fold increase in urinary Cd was associated with increased risk of cognitive impairment [adjusted odds ratio (OR) = 1.46; 95% CI: 1.14 to 1.86]. When urinary Cd levels were analyzed as quartiles, higher urinary Cd levels were also significantly associated with increased risk of cognitive impairment in a dose-response manner (adjusted OR = 2.68; 95% CI: 1.33 to 5.38 for the highest vs. lowest quartile; p for trend = 0.002). Our findings suggest that long-term exposure to Cd may have adverse consequences for older men’s cognitive function, but these results need further confirmation.

The effect of docetaxel, enzalutamide, abiraterone, and radium-223 on cognitive function in older men with metastatic castrate-resistant prostate cancer (mCRPC).

73 Background: Older adults are at greater risk of cognitive decline with various oncologic therapies. Emerging data suggest cognitive effects of various therapies for mCRPC but study populations are highly selected and published data are limited and focus mostly on self-reported cognitive function. We evaluated the effects of treatment with docetaxel chemotherapy (CHEMO), abiraterone (ABI), enzalutamide (ENZA), and radium 223 (Ra223) on cognitive function in older men with mCRPC. Methods: Men age 65+ with mCRPC starting any of the 4 treatments for mCRPC were enrolled in this multicenter prospective cohort study. Three short yet reliable and sensitive measures in older adults were administered at baseline and final visit (6 months with CHEMO and Ra223, mean 14-16 months with ENZA and ABI) using the Montreal Cognitive Assessment (MoCA), Trails A, and Trails B to assess global cognition, attention, and executive function, respectively. Absolute changes in cognitive scores over time were analyzed using multivariable linear regression, and the percentage of individuals with a decline of 1.5 SD in each domain were calculated. Higher scores on MoCA are better but worse for Trails A/B. Results: A total of 51, 26, 49, and 21 men starting CHEMO, ABI, ENZA, and Ra223 with complete data were included. Mean age, education, and baseline cognition were similar between groups (Table). Most patients demonstrated stable cognition or slight reductions. Executive function was the most sensitive of the 3 cognitive domains, and declined by at least 1.5 SD in about one-fifth of each cohort. Although ABI had numerically smaller declines than ENZA, differences were generally small and clinically unimportant. Conclusions: Most older men do not experience significant cognitive decline while on treatment for mCRPC regardless of treatment used.[Table: see text]

The mediating role of low-grade inflammation on the prospective association between sleep and cognitive function in older men and women: 8-year follow-up from the English Longitudinal Study of Ageing

Suboptimal sleep patterns predict poorer cognitive function in older adults and induce inflammatory responses. Inflammation could also adversely affect cognitive function. This study explored whether systemic inflammation may be one biological mechanism through which sleep influences cognitive performance. Participants were 4877 men and women from the English Longitudinal Study of Ageing who were followed-up for 8 years starting at wave 4 (2008-09), through wave 6 (2012-13), and until wave 8 (2016–17). Sleep quality and duration were measured with self-reported questionnaires. Cognitive function was assessed objectively with tests of verbal fluency, memory (immediate and delayed recall) and time orientation. Analyses were stratified by sex and adjusted for socio-economic circumstances, health behaviours, limiting long-standing illness, medication, depressive symptoms, and baseline inflammation and cognition. In men, in comparison with optimal sleep duration, short sleep (≤6 h: β = -0.343, C.I. -0.611 to -0.076; >6-7 h: β = -0.263, C.I. -0.506 to -0.020) and long sleep (β = -0.536, C.I. -1.019 to -0.053) measured at baseline predicted lower scores in delayed memory recall at follow-up. In women, sleep duration was unrelated to cognitive performance at follow-up, and in both sexes, there was no relationship between sleep quality and follow-up cognitive performance. There was no evidence of mediating effects of inflammatory markers in the relationship between sleep measures and cognitive performance in both sexes. In conclusion, baseline short and long sleep duration is associated with follow-up cognitive performance in older men, but we found no evidence of any mediating effects of inflammation.

Does lifestyle matter? Individual lifestyle factors and their additive effects associated with cognitive function in older men and women

Objectives: This study investigated the association between healthy lifestyle comprised of multiple domains, gender, and cognitive function in older Chinese people in Hong Kong.Methods: We conducted a cross-sectional analysis with data from 1,831 community-dwellers aged 65 years and above. Participants’ basic demographics, comorbidity, and six lifestyle factors: diet; smoking; alcohol drinking; and physical, mental, and social activities were surveyed. Cognitive function was assessed using the Cantonese Chinese Montreal Cognitive Assessment (CC-MoCA). Linear regressions were performed to examine the associations between lifestyle, gender, and cognitive performance.Results: There were gender differences in lifestyle: men smoked (χ2(1) = 159.4) and drank more (χ2(1) = 85.9) and were more active in mentally stimulating activities (χ2(1) = 14.3, all p<.001); while women were more socially active (χ2(1) = 28.0). Age, gender and education explained the greatest variance in cognition (R2=.32). Being active/healthy in more domains further contributed to better cognitive function, although the effect was small (ΔR2=0.03 in women; ΔR2=0.01 in men, both p<.05). Among the lifestyle domains, physical activity showed the strongest effects on cognitive function (ΔR2=0.004 in men and ΔR2=0.02 in women, both p<.05).Conclusions: Naturalistically, a physically active lifestyle and being active/healthy in more domains is associated with better cognitive function in older people after controlling for non-modifiable and early-life factors. The effects are however small. There are gender differences in lifestyle and the impact of lifestyle on cognitive function. Preventive strategies targeting lifestyle domains for cognitive health in older people may consider these naturalistic associations.

Temporal associations between sexual function and cognitive function in community-dwelling older men: the Concord Health and Ageing in Men Project.

previous cross-sectional studies have reported bidirectional associations between sexual activity and cognitive function among older people. However, the temporal associations have not been studied. community-dwelling men aged 70+ from the Concord Health and Ageing in Men Project were assessed. This study was based on 986 men at baseline, 829 men at 2 year and 595 men at 5-year follow-up. Sexual function using a standardised questionnaire (erectile function, sexual activity, sexual satisfaction, sexual desire) was analysed by generalised estimating equations to examine associations between changes in sexual function and changes in mini-mental state examination (MMSE) across three time points over 5 years. Age, BMI, comorbidity, self-rated health, smoking, number of medications, country of birth, education, marital status, depression and reproductive hormones were also measured at all time points. in unadjusted models, declines in erectile function (β = -0.317) and sexual activity (β = -0.575) over time were statistically significantly associated with a decline in MMSE over time. The associations observed in the unadjusted models remained after adjusting for a range of covariables. Declines in sexual satisfaction and sexual desire over time were not associated with changes in MMSE. our findings provide evidence of a longitudinal temporal relationship between sexual activity and cognitive function. Further studies are warranted to examine whether maintaining a healthy sexual life has a positive effect on cognitive function in older men.