Cognitive Function In Older Adults Research Articles

Analysis of an Everyday Cognitive Training Program on the cognitive functioning of older adults: a randomised controlled trial

Analysis of an Everyday Cognitive Training Program on the cognitive functioning of older adults: a randomised controlled trial

Diabetes, hemoglobin A1c, and cognitive performance in older adults: is there any impact of frailty? Evidence from the ELSI-Brazil study.

The aim of this study was to evaluate the association between diabetes and cognitive performance in a nationally representative study in Brazil. We also aimed to investigate the interaction between frailty and diabetes on cognitive performance. A cross-sectional analysis of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline data that included adults aged 50 years and older was conducted. Linear regression models were used to study the association between diabetes and cognitive performance. A total of 8,149 participants were included, and a subgroup analysis was performed in 1,768 with hemoglobin A1c data. Diabetes and hemoglobin A1c levels were not associated with cognitive performance. Interaction of hemoglobin A1c levels with frailty status was found on global cognitive z-score (P-value for interaction=0.038). These results suggested an association between higher hemoglobin A1c levels and lower cognitive performance only in non-frail participants. Additionally, undiagnosed diabetes with higher hemoglobin A1c levels was associated with both poor global cognitive (β=-0.36; 95%CI: -0.62; -0.10, P=0.008) and semantic verbal fluency performance (β=-0.47; 95%CI: -0.73; -0.21, P=0.001). In conclusion, higher hemoglobin A1c levels were associated with lower cognitive performance among non-frail participants. Higher hemoglobin A1c levels without a previous diagnosis of diabetes were also related to poor cognitive performance. Future longitudinal analyses of the ELSI-Brazil study will provide further information on the role of frailty in the association of diabetes and glycemic control with cognitive decline.

Brief webcam test of hand movements predicts episodic memory, executive function, and working memory in a community sample of cognitively asymptomatic older adults.

Low-cost simple tests for preclinical Alzheimer's disease are a research priority. We evaluated whether remote unsupervisedwebcam recordings of finger-tapping were associated with cognitive performance in older adults. A total of 404 cognitively-asymptomatic participants (64.6 [6.77] years; 70.8% female) completed 10-second finger-tapping tests (Tasmanian [TAS] Test) and cognitive tests (Cambridge Neuropsychological Test Automated Battery [CANTAB]) online at home. Regression models including hand movement features were compared with null models (comprising age, sex, and education level); change in Akaike Information Criterion greater than 2 (ΔAIC > 2) denoted statistical difference. Hand movement features improved prediction of episodic memory, executive function, and working memory scores (ΔAIC > 2). Dominant hand features outperformed nondominant hand features for episodic memory (ΔAIC = 2.5), executive function (ΔAIC = 4.8), and working memory (ΔAIC = 2.2). This brief webcam test improved prediction of cognitive performance compared to age, sex, and education. Finger-tapping holds potential as a remote language-agnostic screening tool to stratify community cohorts at risk for cognitive decline.

The Longitudinal Impact of Self-rated Health, Depression, and Social Participation on the Cognitive Function of Older Adults

The Longitudinal Impact of Self-rated Health, Depression, and Social Participation on the Cognitive Function of Older Adults

Cognitive Benefits of Physical Activity in the Elderly: A Narrative Review

Abstract A huge focus of research has been on the pharmacological trials to find drugs that work to stall the onset of age related cognitive decline and subsequent neurodegenerative disorders like dementia, but pharmacological interventions have not been able to help with cure and hence there has been a shift of focus to other nonpharmacological and behavioral interventions like physical activity (PA) along with the use of medications. There is moderate evidence supporting different forms of exercise for lowering the risk of cognitive decline and dementia. PA has positive effects on the global cognition of the elderly and helps maintain hippocampal volume. Aerobic exercise was found to be the most beneficial among different other forms of PA. Regular involvement in PA not only helps in the prevention and control of various diseases but also is increasingly recommended as a strategy to promote health and encourage the maintenance of functional capacity in the elderly. The main objective of this review is to discuss the effects of PA on brain health and cognitive functions of older adults from a psychophysiological perspective. Important underlying molecular mechanisms have also been discussed which would provide an idea of the biological basis of the same.

The impact of musical reward responses on cognitive function in older adults with type 2 diabetes

Cognitive decline is prevalent in older adults with type 2 diabetes (T2DM). The use of music has emerged to improve cognitive health. Even though reward from music has been shown to improve cognitive function, no studies have focused on specific factors of musical reward. This study investigated which factors of musical reward impact cognitive function in older adults with T2DM. A secondary data analysis was conducted with 185 older adults with T2DM and subjective cognitive decline. Among the musical reward factors, mood regulation significantly influenced subjective cognitive function (β = 0.315; p < 0.001). The findings suggest that music interventions for older adults with T2DM may need to focus on managing their psychological states for the intervention to have beneficial effects on cognitive function. Future rigorous studies with larger sample sizes should be done to obtain robust evidence for optimal music interventions for older adults with T2DM.

Changes in Adiposity and Cognitive Function in Older Adults: The REGARDS Study.

Adiposity may have a role in the risk of dementia. Fewer studies have focused on the relationship between change in adiposity and cognitive decline. Our study aimed to explore the association between the change in adiposity and cognitive function in Black and White older adults. The participants were 12,204 older adults without cognitive impairment (62.8 ± 8.0 years) in the United States. The percent body mass index change (%BMI change) and percent waist circumference change (%WC change) were measured at 2 in-home visits (first: 2003-2007, second: 2013-2016). Cognitive status was assessed by the Six-Item Screener annually. Memory and executive function were measured by word list learning, MOCA recall and orientation, and letter and animal fluency every 2 years. Logistic regression or linear regression models were used to estimate the relationship between percent change in adiposity and cognitive function. After 12.7 ± 1.7 years, a greater decrease in %BMI change or %WC change was significantly associated with a higher risk of cognitive impairment. Compared to older adults with -5% ≤ change ≤ 5% from baseline, a significantly higher risk of cognitive impairment and greater loss in memory and executive function were found among those who experienced more than a 10% decline in %BMI change or %WC change. Older adults who experienced a 5%-10% decrease in %BMI change had a higher risk of cognitive impairment and greater loss of memory compared to those with -5% ≤ change ≤ 5%. A greater decrease in %BMI (>5%) and %WC (>10%) change was associated with greater cognitive loss observed over time.

INCARCERATION AS A RISK FACTOR FOR IMPAIRMENT IN COGNITIVE FUNCTIONING

Abstract Background Incarceration is a social determinant of health with public health implications, especially among minoritized communities of color. The experiences of incarcerated people have deleterious implications for mental and physical health outcomes. Research has demonstrated an association between incarceration and poorer global cognition in older adults. The current study examines the long-term impact of incarceration on cognitive functioning in older adults and examines whether this relationship is moderated by race, ethnicity, and sex. Methods Data were collected on participants (n=7,557) in the Health and Retirement Study (HRS). They completed a background questionnaire, psychosocial assessments, and a series of neuropsychological tests. T-tests and Chi-Squared analyses determined differences in demographic and health variables by incarceration status. Linear regression analysis determined if incarceration status predicts poorer cognitive functioning in older adults while controlling for age, race, sex, ethnicity, education, hypertension, diabetes status, wealth, depression, and stroke. Subgroup analyses determined whether associations were modified by race, ethnicity, or sex. Results Our sample is on average 74 years old, 13% Black, and 60% female. Formerly incarcerated people were younger, disproportionately Black, less wealthy and educated, and more unhealthy. Analyses indicated that incarceration predicted reduced performance in delayed verbal recall (B = -0.19, p = 0.047) and this relationship may be stronger in Non-Hispanics, African-Americans and Women. Conclusion Incarceration may negatively impact long-term memory in older adults and varies by gender, race, and ethnicity. Future studies should investigate variables that influence this relationship, including SES, depression, and chronic illnesses.

JGMS EDITOR’S CHOICE ARTICLES OF 2022: BIOLOGIC AND SOCIAL INFLUENCES ON COGNITIVE AND PHYSICAL AGING

Abstract This symposium will present four 2022 “Editor’s Choice” articles from the Journal of Gerontology Medical Sciences that focus on the biological and social influences on cognitive and physical aging. Mercedes Sotos-Prieto and her colleagues, in their article “A Mediterranean Lifestyle and Frailty Incidence in Older Adults: The Seniors-ENRICA-1 Cohort” examine the association between a Mediterranean lifestyle, which included diet, customs, and traditions, and frailty incidence in older adults. Mark Espeland and his colleagues, in “Racial/Ethnic Disparities in Alzheimer’s Disease Risk: Role of Exposure to Ambient Fine Particles” used unique data from the Women’s Health Initiative Memory Study to investigate this previously unstudied relationship between racial disparities, ambient fine particle exposure, and risk of Alzheimer’s. “Trans-Ethnic Meta-Analysis of Interactions Between Genetics and Early-Life Socioeconomic Context on Memory Performance and Decline in Older Americans,” written by Jessica Faul and colleagues, examines whether gene regions previously associated with cognitive performance, dementia, and related traits had an interaction with childhood socioeconomic context on memory performance or decline. Lingxiao He and coauthors, in their article, “Prospective Associations of Plasma Growth Differentiation Factor 15 With Physical Performance and Cognitive Functions in Older Adults” examines the relationship between Plasma GDF15, lower-limb physical performance, and global cognitive function in older adults. Our discussant, Peggy Cawthon, will highlight commonalities and lessons learned from these studies.

BLOOD PRESSURE MEASURES ARE NOT CORRELATED WITH NIH TOOLBOX COGNITIVE BATTERY PERFORMANCE IN BLACK OLDER ADULTS

Abstract Elevated blood pressure has been inconsistently associated with cognitive performance in older adults. Black adults experience higher rates of elevated blood pressure and cognitive impairment than White adults. This study investigated whether blood pressure measurements were associated with cognitive performance on the NIH Toolbox Cognition Battery (NIHTB-CB) in older Black adults. 77 older Black adults 65+ years of age (M=72.6, SD=4.9) with subjective cognitive decline were administered the NIHTB-CB, a battery of computer-based cognitive tests. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured before and after cognitive testing and a cognitive task-based EEG/ERP. Average SBP, DBP, and pulse pressure (PP) were calculated. Difference scores from pre- to post-EEG/ERP served as a reactivity index following cognitive task engagement. A ratio of the difference scores to the baseline measures controlled for resting blood pressure. Bayesian correlations examined the relations between blood pressure measurements and NIHTB-CB performance. Data analysis used fully corrected T scores from the NIHTB-CB subtests. Average SBP, SBP difference scores, and baseline SBP were not associated with NIHTB-CB performance on any measurement (all BF10 &amp;lt; 3.0). Similarly, DBP and PP were unrelated to NIHTB-CB performance. Systolic and diastolic blood pressure were not associated with any NIHTB-CB measure. Additionally, blood pressure reactivity was not related to cognitive performance. Future research may investigate the relationship between SBP reactivity and cognitive performance across multiple measurement periods. Antihypertensive medication and duration of hypertension among hypertensive individuals may also be an important consideration in future studies.

INTERSECTIONAL AND BIOSOCIAL PATHWAYS TO COGNITIVE FUNCTION AMONG OLDER HISPANICS AND LATINOS

Abstract Hispanics/Latinos are the fastest-growing segment of older adults in the United States (U.S.). They are at high risk for cognitive impairment (CI) and Alzheimer’s disease and related dementias (ADRD). While increased research attention has been given to the socioeconomic and cultural factors that influence the prevention, diagnosis, and care provided to Hispanics/Latinos with CI and ADRD, there are still theoretical and methodological gaps in clarifying the mechanisms and pathways that produce ADRD inequities, including life course and multilevel mechanisms. Given the diverse origins of Hispanics/Latinos in the U.S. – in ethnic origin, birthplace, and current residence – it is crucial to understand how these social conditions get “under the skin” that influence cognitive function in older adulthood. Namely, it is important to unpack how different intersectional positions show different relationships with deprivation that influence cognitive and healthy aging. Thus, this study had two main objectives: (1) to examine the mediating role of physiological (dys)regulation between education and cognition, and (2) to understand for which Hispanic/Latino subgroups the interrelated relationships are stronger/weaker for. Correspondingly, we employed multigroup structural equation modeling to address our study objectives. We used data from the Health and Retirement Study (HRS) to discern and assess the effects between education, physiological factors, and cognitive function at baseline and follow-up by Hispanic/Latino subgroups (e.g., foreign-born Mexicans, U.S.-born Mexicans, island-born Puerto Ricans, foreign-born Cubans, etc.). The results from this study underscore the role of structural interventions and community engagement in reducing and eliminating cognitive health disparities among Hispanics/Latinos.

GREATER PHYSICAL ACTIVITY AND SOCIAL ENGAGEMENT OFFER PROTECTION AGAINST COGNITIVE DECLINE OVER TIME

Abstract Evidence suggests that physical activity and social engagement in later life are associated with a less pronounced and reduced risk of cognitive decline over time; however, findings are mixed and knowledge concerning the effect of these factors on cognitive functioning in older adults with mild cognitive impairment (MCI) is underdeveloped. To enhance understanding, we extracted data from eight waves (2004-2018) of the Health and Retirement Study and used hierarchical linear mixed models to investigate the impact of physical activity and social engagement on cognitive functioning in Americans aged 60 years and older with MCI (n=1462). The average cognitive score (sum of immediate and delayed word recall, serial seven subtraction test, counting backwards, range: 0 to 27) at baseline was 9.6, which decreased by 0.14 points each year. Each unit increase in physical activity (weighted sum of light, moderate, vigorous activity; range: 9 to 45) and social engagement (measure capturing social visits, volunteerism, religious participation; range: 0 to 3) reduced the effect of time on cognitive functioning by 0.01 (β=0.007, p&amp;lt;.0001) and 0.04 (β=0.040, p&amp;lt;.0001) points, respectively, while simultaneously controlling for APOE genotype and other covariates. This means, for example, that the cognitive score of someone with a physical activity score of 40 was, on average, 3.1 points higher than someone with a physical activity score of 10 after 16 years of follow-up. Findings suggest that greater physical activity and social engagement offer protection against cognitive decline and could minimize MCI progression among older adults experiencing MCI.

GENDER DIFFERENCES IN ASSOCIATIONS OF SLEEP INTRAINDIVIDUAL VARIABILITY AND MILD COGNITIVE IMPAIRMENT

Abstract Previous studies suggest that cognitive function in older adults is related to sleep, with females more vulnerable to poor sleep. Little is known about the relationship between cognition and intraindividual variability of sleep (IIV). We examined the cross-sectional relationship between sleep IIV and mild cognitive impairment (MCI) by gender using data from the Einstein Aging Study. We hypothesize that individuals with MCI have a greater IIV in daily sleep characteristics, and these associations will be stronger for females. Eighty-nine men (age = 76.81±4.73, 61% White, 28% Black, 27% MCI) and 197 women (age = 76.60 ± 4.93, 40% White, 46% Black, 29% MCI) were included in the analysis. Individuals completed 2 weeks of actigraphy (mean ± SD = 15.7 ± 1.1 days), and the Montreal Cognitive Assessment, and MCI was based on the Jack/Bondi criteria. Sleep IIV was estimated as within person standard deviation of nighttime sleep duration, 24-hour sleep duration, wake after sleep onset, and nighttime sleep midpoint. Linear regression models evaluated associations between sleep IIV and MCI status separately by gender, controlling for BMI, age, ethnicity/race, nocturnal hypoxemia, Oxygen Desaturation Index ≥15. Among women, having MCI was associated with greater IIV in nighttime sleep midpoint (b=0.19, p=.002), and in 24-hour total sleep duration (b=13.10, p = .047) with a similar trend in nighttime sleep duration (p = .050). No significant associations were found among men. Findings suggest the importance to keep considering gender in work to understand how sleep variability relates to MCI status in older adults.

FOOD DESERT RESIDENCE AND COGNITIVE TRAJECTORIES IN US OLDER POPULATION AGED 65 AND OLDER

Abstract A food desert is defined as a census tract with limited access to affordable and nutritious foods. Inequitable access to healthy food may contribute to disparities in cognitive health, but little is known about the role of food deserts in cognitive health. We examined association between living in food deserts and cognitive function in older adults 65 years and older. These analyses employed cohort design by linking the US Department of Agriculture 2010 Food Access Research Atlas data to 2011-2021 National Health and Aging Trends Study. Orientation, executive function, and memory were assessed annually. Food desert residence at baseline was determined if more than 500 or 33% residents within a census tract had low income and low access to healthy and affordable foods. Weighted mixed-effects models were fitted among 5270 community-dwelling older adults without dementia at baseline. Mean baseline age was 76.7 (±7.4) years and 10.7% participants (n = 659) lived in food deserts. Black and Hispanic people and individuals with lower educational attainment were more likely to live in food deserts. At the age of 80 years, individuals living in food deserts showed orientation and executive function scores that were -0.26 points (95% CI: -0.48, -0.03) and -0.13 points (95% CI: -024, -0.01) lower than their peers, respectively. Living in food deserts was also associated with 0.05 points faster annual decline (95% CI: -0.09, -0.01) in orientation. Residence in food deserts is associated with worse cognition in older age and could be a driver of disparities in cognitive health.

ASSOCIATIONS OF PLASMA GDF15 WITH PHYSICAL PERFORMANCE AND COGNITIVE FUNCTIONS IN OLDER ADULTS

Abstract Background Growth differentiation factor 15 (GDF15) has been associated with several age-related disorders, but its associations with functional abilities in community-dwelling older adults are not well studied. Methods The study was a secondary analysis on 1096 community-dwelling older adults (aged 69 to 94 years) recruited from the Multidomain Alzheimer’s Preventive Trial. Plasma GDF15 was measured one year after participants’ enrolment. Annual data of physical performance (grip strength and short physical performance battery [SPPB]) and global cognitive functions (mini-mental state examination [MMSE] and a composite cognitive score) were measured for four years. Adjusted mixed-effects linear models were performed for cross-sectional and longitudinal association analyses. Results A higher GDF15 was cross-sectionally associated with a weaker grip strength (β = -1.1E-03, 95%CI [-2.0E-03, -1.5E-04]), a lower SPPB score (β = -3.1E-04, 95%CI [-5.4E-04, -9.0E-05]) and worse cognitive functions (β = -2.4E-04, 95%CI [-3.3E-04, -1.6E-04] for composite cognitive score; β = -4.0E-04, 95%CI [-6.4E-04, -1.6E-04] for MMSE). Participants with higher baseline GDF15 demonstrated greater longitudinal declines in SPPB (β = -1.0E-04, 95%CI [-1.7E-04, -2.0E-05]) and composite cognitive score (β = -2.0E-05, 95%CI [-4.0E-05, -3.6E-06]). The optimal initial GDF15 cutoff values for identifying participants with minimal clinically significant decline after one year were 2189 pg/mL for SPPB (AUC: 0.580) and 2330 pg/mL for composite cognitive score (AUC: 0.587). Conclusions Plasma GDF15 is cross-sectionally and longitudinally associated with lower-limb physical performance and global cognitive function in older adults. Circulating GDF15 alone has limited capacity of discriminating older adults who will develop clinically significant functional declines.

OUT-OF-HOME MOBILITY, DAILY WORKING MEMORY, AND NEIGHBORHOOD WALKABILITY IN HEALTHY OLDER ADULTS

Abstract Out-of-home mobility could enhance cognitive performance, but environmental contexts — such as neighborhood walkability — may influence the associations. This study examined daily out-of-home mobility in relation to daily cognitive performance in healthy older adults and the moderator effects of neighborhood walkability therein. Participants wore a custom-built mobile GPS sensor („uTrail“) and completed smartphone-based working memory assessments for 15 days, and responded to the baseline Neighborhood Environment Walkability Scale. Analyses included 947 days’ data from 109 Swiss older adults aged 65 to 89 years. Out-of-home mobility (i.e., out-of-home time, maximum distance from home) were extracted from the GPS data. Multilevel models showed that daily out-of-home time and daily maximum distance from home were not associated with daily working memory performance across the study sample, but the associations were moderated by neighborhood walkability. Out-of-home time and maximum distance from home were positively (vs. negatively) associated with working memory performance in participants who lived in neighborhood with higher (vs. lower) street connectivity and more (vs. less) access to places for walking and cycling. Additionally, maximum distance from home were positively (vs. negatively) associated with working memory performance in participants in neighborhood with lower (vs. higher) mixture of land use. To conclude, spending more time out of home and travelling longer distance away from home could be beneficial for daily cognitive performance of older adults who lived in well-connected and higher-walkable and -bikeable neighborhood. Travelling longer distance could also benefit those who lived in a neighborhood with a lower mixture of land use.

NEIGHBORHOOD DISORDER MODERATES THE EFFECT OF SLEEP DIFFICULTIES ON COGNITIVE DECLINE AMONG OLDER AMERICANS

Abstract Research suggests that the neighborhood where people live can be a risk or protective factor for various health outcomes, including cognitive decline. Similar to the impact of neighborhood on health outcomes, sleep quality has been linked to cognitive functions in older adults. However, limited studies have examined how neighborhood disorders moderate the effect of sleep on cognitive decline. Data were obtained from 2,494 respondents (1,065 men and 1,429 women) from wave 11 of National Health and Aging Trends (NHATS) data. Approximately 55% of the respondents were age 80+, and 74% identified as non-Hispanic White Americans. Sleep quality was operationalized as the absence of difficulties in falling and staying asleep. Neighborhood disorder (e.g., vandalism, graffiti) was based on observations by interviewers. Cognitive decline was operationalized as subjective reports of increasing or worse memory loss in the past 12 months. Moderated regression analysis using PROCESS macro (model 1) was performed to determine the associations between sleep, neighborhood, and cognitive decline. Results showed a significant main effect between neighborhood and cognitive decline (higher levels of neighborhood disorder result in an increase in cognitive decline, B= 0.369, p =.014), but no significant main effect between sleep and cognitive decline. There was a significant interaction between sleep and neighborhood on cognitive decline. Participants who reported higher-than-average sleep difficulties experienced a greater effect of neighborhood disorder on cognitive decline. Our findings could add to inform future health interventions and policy recommendations that can address modifiable sources of cognitive decline.

GDF15 AND REDUCED PHYSICAL FUNCTION FOLLOWING TOTAL KNEE REPLACEMENT: A STUDY OF PHYSICAL RESILIENCE AND AGING

Abstract The metabolic and inflammatory cytokine growth-differentiation factor 15 (GDF15) increases with age and negatively associates with physical and cognitive function in older adults. We hypothesized GDF15 also negatively associates with resilient outcomes after surgery. This hypothesis was tested in the SPRING study of physical resiliency after total knee replacement by assessing relationships between pre-operative plasma GDF15 levels and postoperative resilience measures including short physical performance battery (SPPB) scores, fatigability, and grip strength. GDF15 analyses and physical resilience were assessed in 127 SPRING participants (age 70±6 yrs, n=83 women). Baseline GDF15 levels correlated with age (r=0.263, P&amp;lt; 0.05); age-adjusted analyses were applied. In total, pre-operative GDF15 levels did not significantly correlate with functional measures at any timepoint. However, in men (n=44), GDF15 levels correlated with age (r=0.408, P&amp;lt; 0.05) and significant age-adjusted correlations were observed in fatigue (r=0.368, P&amp;lt; 0.05), gait speed (r=-0.428, P&amp;lt; 0.05), and SPPB score (r=-0.329, P&amp;lt; 0.05). Additionally, GDF15 levels correlated with chair stands at six months (r=-0.398, P&amp;lt; 0.05), SPPB score at six months (r=-0.384, P&amp;lt; 0.05), and gait speed after one year (r=-0.487, P&amp;lt; 0.05). GDF15 did not significantly correlate with changes in SPPB score (P&amp;gt;0.05). There were no significant correlations between GDF15 and any of these functional measures in women (r-value range: -0.259 to 0.107; p-value range: 0.112 to 0.969). Elevated pre-operative GDF15 appears to correlate with worsening physical function following knee replacement in men, but not women. Further investigation is necessary to understand the relationship between GDF15 and the biology of physical resiliency.

A LEAP! FORWARD?: DOES PERSONALIZED EXERCISE HELP MAINTAIN COGNITIVE FUNCTION IN OLDER ADULTS?

Abstract Maintaining cognitive function is important to health in older adulthood. Physical activity can decrease the risk of cognitive decline in older individuals. We tested whether LEAP! Rx, a personalized exercise, and lifestyle education program would improve cognition in older adults. We randomized 220 participants (Mean age (SD) = 72 (4.83)), into the program or a control group. We used the NIH Toolbox Cognitive Battery to assess cognition. We analyzed change in cognitive performance from baseline to week 12 using repeated measures ANCOVA to compare the intervention and control groups, adjusting for age, gender, and education. Referral source (self- vs. physician-referred), treatment group (intervention vs. control), and measurement time (baseline vs. week 12) had a significant three-way interaction F(8, 212) = 4.57, p&amp;lt; 0.05. That is, clinician-referred participants in the intervention group improved more (vs. the clinician-referred control group), whereas self-referred control group participants improved more (vs. the self-referred intervention group). Older age, male gender, and lower education predicted poorer verbal learning F(1,218 = 18.79, p&amp;lt; 0.05; F(1, 218) = 28.67, p&amp;lt; 0.05; F(1, 219) = 4.13. Overall, cognitive scores improved more over 12 weeks in the intervention group compared to the control group. Thus, we conclude that personalized exercise programs may enhance or maintain cognitive function in older adults. The differences we observed in physician-referred versus self-referred participants has implications for implementation and scalability of health behavior change interventions, as well as implications for recruitment methods and representation in clinical trials research broadly.

A bidirectional relationship between cognitive reserve and cognition among older adults in a rural Chinese community: a cross-lagged design.

The concept of cognitive reserve (CR) plays a crucial role in understanding cognitive aging and resilience. Accumulating evidence revealed the influence of CR proxy on cognitive function, but it remains unknown whether a reverse association or reciprocal effect exists. The aim of this study is to observe the bidirectional relationship between cognitive reserve proxies and cognitive function among older adults in rural Chinese communities, providing a better understanding of the underlying mechanisms and potential moderating factors involved. This longitudinal study analyzed 792 older adults (70.23 ± 5.87 years; 59.8%female) aged 60 years and older from the health status of rural older adults (HSRO) study over a 3-year period. Cognition was assessed by the Mini-Mental State Examination (MMSE). Cross-lagged panel modeling was utilized to analyze the interrelationship between cognitive reserve proxies and cognitive performance. Additionally, latent profile analysis was employed to identify different subtypes of neuropathic load within the study population. Our cross-lagged analyses revealed significant associations between CR at T0 and MMSE scores at T1 (β = 0.81), as well as between MMSE scores at T0 and CR at T1 (β = 0.04). However, when conducting stratified analyses, we found no significant lagged relationships among individuals with high neuropathic load or those at an advanced age (p > 0.05). Furthermore, our longitudinal comparisons indicated changes in the contribution of CR proxy factors over time. The findings suggested a bidirectional relationship between cognitive reserve and cognitive performance in older adults. These results emphasized the importance of implementing timely public health measures to enhance cognitive reserve and cognitive performance ultimately promoting healthier aging among older adults.