Cognitive Health In Older Adults Research Articles

HealtheBrain: an innovative smartphone application to improve cognitive function in older adults.

Exercise-based interventions have shown promise in slowing cognitive decline, however there is limited evidence for scalability. Our previous research has linked a novel visuospatial memory exercise intervention, incorporating patterned walking or square-stepping exercise (SSE) with significant improvements in executive function and memory among older adults with normal cognition as well as those with subjective cognitive complaints (SCC) and mild cognitive impairment (MCI). The aim of the current study was to determine the feasibility and utility of the HealtheBrain smartphone app to deliver SSE outside the laboratory among older adults with and without cognitive impairment. Previous healthy research subjects with and without SCC or MCI, who had previous exposure to SSE, and who owned or had access to an iPhone of iPad, were recruited to download the HealtheBrain app and use it up to 3 weeks. There were no restrictions on the number of times subjects could use the app. A 15-question survey was developed to assess feasibility and utility of the HealtheBrain app and completed online following the brief exposure period. Of 135 people who were identified, 95 were contacted between September 2014 to August 2015, 27 downloaded the HealtheBrain app on their iPhone or iPad from the App Store and 19 completed the questionnaire. Subjects (n=19) were an average age of 68.3±5.4; 74% female and had 15.5±2.8 years of education (84% post-secondary education), a mean Mini Mental State examination score of 29.1 (SD 1.2) out of 30 and Montreal Cognitive Assessment score of 26.3 (SD 1.9) out of 30. Subjects used the HealtheBrain app 1-7 days per week, mostly at home. Of possible stages of progression, subjects mainly used the stage 1 and 2 beginner patterns. Subjects reported perceived and technical challenges registering horizontal step patterns associated with stage 2 and greater progression. Sixty percent found the app was easy to use or similar to what they experienced with SSE in the laboratory setting. Most said they would continue to use the HealtheBrain app and would recommend it to friends and family. The HealtheBrain app was feasible in providing SSE to older adults with the appropriate smartphone device outside the laboratory setting. Challenges were identified with perceived capture of higher levels of SSE stages that used horizontal step patterns. This as well as technical issues with horizontal step patterns will be addressed by newer GPS technology in current smartphone devices. Most subjects stated they would continue to use the HealtheBrain app and refer to their friends and family. We believe that our findings in a representative cohort support the HealtheBrain app as a scalable intervention to promote cognitive health in older adults.

Predictive factors for dementia and cognitive impairment among residents living in the veterans' retirement communities in Taiwan: Implications for cognitive health promotion activities.

To identify potentially modifiable risk factors for cognitive decline among veterans' home residents in Taiwan METHODS: The present retrospective cohort study was part of the Veteran Affairs-Comprehensive Geriatric Assessment study that retrieved data of the comprehensive geriatric assessment for 946 residents living at four veterans' homes in Taiwan. The study participants were interviewed every 3-6months from January 2012 and December 2014. Demographic characteristics,multimorbidity by Charlson's Comorbidities Index, physical function by the Barthel Index, cognition by the Mini-Mental State Examination (MMSE), depression by the five-item Geriatric Depression Scale and nutritional status by the Mini-Nutrition Assessment-Short Form were collected for analysis. A generalized estimating equation model was used after it was adjusted for age, educational level, five-item Geriatric Depression Scale, and problem of communication difficulty to identify potential modifiable risk factors for cognitive decline. The mean age of the participants was 85.7±5.2years, with a mean follow-up period of 41±21.6weeks. The prevalence of cognitive impairment (defined by MMSE <24) was 65.6%, whereas 34% of the study participants were positive for depressive symptoms. Approximately one-fifth of the study participants were using psychotropic agents, which was higher among participants with cognitive impairment (23.6% vs 15.6%, P<0.05) than those without. In the generalized estimating equation model, physical function, nutritional status, depressive symptoms, ex-drinker, multimorbidity and stool incontinence were positively correlated with MMSE score; whereas advanced age, low educational level (<6years), presence of communication difficulty and use of psychotropic agents were inversely associated with the MMSE score. Physical function and nutritional status were positively associated with the MMSE score, and use of psychotropic agents was negatively correlated with cognitive function. Further intervention study is required to improve the cognitive health of older adults living in the veterans' retirement communities. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 7-13.

Exercise is Medicine for the Aging Brain

Cognitive decline is a common feature of aging. Physical activity is a modifiable lifestyle factor that has been identified as positively impacting cognitive health of older adults. Here, we review the current evidence from epidemiological (i.e., longitudinal cohort) and intervention studies on the role of physical activity and exercise in promoting cognitive health in older adults both with and without cognitive impairment. We highlight some of the potential underlying mechanisms and discuss some of the potential modifying factors, including exercise type and target population, by reviewing recent converging behavioral, neuroimaging, and biomarker evidence linking physical activity with cognitive health. We conclude with limitations and future directions for this rapidly expanding line of research.

Effects of Video Game Training on Behavioral and Electrophysiological Measures of Attention and Memory: Protocol for a Randomized Controlled Trial.

BackgroundNeuroplasticity-based approaches seem to offer promising ways of maintaining cognitive health in older adults and postponing the onset of cognitive decline symptoms. Although previous research suggests that training can produce transfer effects, this study was designed to overcome some limitations of previous studies by incorporating an active control group and the assessment of training expectations.ObjectiveThe main objectives of this study are (1) to evaluate the effects of a randomized computer-based intervention consisting of training older adults with nonaction video games on brain and cognitive functions that decline with age, including attention and spatial working memory, using behavioral measures and electrophysiological recordings (event-related potentials [ERPs]) just after training and after a 6-month no-contact period; (2) to explore whether motivation, engagement, or expectations might account for possible training-related improvements; and (3) to examine whether inflammatory mechanisms assessed with noninvasive measurement of C-reactive protein in saliva impair cognitive training-induced effects. A better understanding of these mechanisms could elucidate pathways that could be targeted in the future by either behavioral or neuropsychological interventions.MethodsA single-blinded randomized controlled trial with an experimental group and an active control group, pretest, posttest, and 6-month follow-up repeated measures design is used in this study. A total of 75 cognitively healthy older adults were randomly distributed into experimental and active control groups. Participants in the experimental group received 16 1-hour training sessions with cognitive nonaction video games selected from Lumosity, a commercial brain training package. The active control group received the same number of training sessions with The Sims and SimCity, a simulation strategy game.ResultsWe have recruited participants, have conducted the training protocol and pretest assessments, and are currently conducting posttest evaluations. The study will conclude in the first semester of 2017. Data analysis will take place during 2017. The primary outcome is transfer of benefit from training to attention and working memory functions and the neural mechanisms underlying possible cognitive improvements.ConclusionsWe expect that mental stimulation with video games will improve attention and memory both at the behavioral level and in ERP components promoting brain and mental health and extending independence among elderly people by avoiding the negative personal and economic consequences of long-term care.Trial RegistrationClinicaltrials.gov NCT02796508; https://clinicaltrials.gov/ct2/show/NCT02796508 (archived by WebCite at http://www.webcitation.org/6nFeKeFNB)

Plasma Lutein and Zeaxanthin Are Associated With Better Cognitive Function Across Multiple Domains in a Large Population-Based Sample of Older Adults: Findings from The Irish Longitudinal Study on Aging

Low blood serum or plasma concentrations of the xanthophyll carotenoids lutein and zeaxanthin have been implicated in poorer cognitive health in older adults. However, equivocal results from smaller studies and clinical trials highlight the need for large population-based studies with comprehensive measures of cognitive function and adjustment for multiple confounders to examine such associations in more depth. In the current study, we investigated the association between plasma lutein and zeaxanthin and domain-specific cognitive performance in 4,076 community-dwelling adults aged 50 years or older from The Irish Longitudinal Study on Ageing. Mixed-effects models were fitted with adjustment for demographic and socioeconomic factors, health conditions, and health behaviors. Higher plasma lutein and zeaxanthin were independently associated with better composite scores across the domains of global cognition, memory, and executive function. We also found evidence that higher plasma zeaxanthin, but not lutein, was associated with better processing speed. These associations were consistent across domains. Further investigation of the prognostic value of carotenoid concentrations, and their changes, on cognition in similar population-based samples longitudinally is warranted.

Aging and effort expenditure: The impact of subjective perceptions of task demands.

Engagement in cognitively demanding activities has a positive impact on cognitive health in older adults. Previous work, however, has suggested that the costs associated with engagement increase in later life and influence motivation. We examined how subjective perceptions of these costs varied with age and influenced task engagement. The following questions were of specific interest: (a) Are there age differences in subjective perceptions of cognitive costs? (b) What is the impact of these perceptions on engagement? We tested 39 older (ages 65-84) and 37 younger (20-42) adults on a working memory task. Systolic blood pressure responsivity (SBP-R; reflective of effort) and subjective perceptions of task difficulty were assessed. We found that age was associated with an increase in the perceptions of cognitive costs, and that these subjective perceptions had a stronger impact on older adults' engagement than on that of younger adults. More important, this impact was specific to subjective perceptions of cognitive costs. The results provide further support for the hypothesis that increased costs associated with cognitive engagement influence older adults' willingness to engage cognitive resources, and that these costs in part reflect subjective perceptions that are independent of objective task demands. (PsycINFO Database Record

Mindfulness Training for Emotional and Cognitive Health in Late Life

Purpose of Review There is a growing interest in psychosocial interventions that can enhance emotional and cognitive health in older adults, both to treat psychopathology and/or cognitive decline and to prolong optimum functioning in healthy individuals. Mindfulness-based interventions (MBIs) have been proposed as an accessible and effective means of promoting emotional and cognitive health. This article reviews recent clinical trials of MBIs in older adults.

Longitudinal Association Between Low- And High-light Intensity Physical Activity And Cognitive Function In Older Adults

PURPOSE: Regular moderate-to-vigorous intensity physical activity (MVPA) provides benefits for cognitive health among older adults. Recently, there has been a shift from focusing on MVPA to considering the potential benefits of light intensity PA (LPA), because older adults accumulate 3-4 hr/day of LPA. This study investigated the longitudinal association of objectively measured low-light intensity PA (LLPA) and high-light intensity PA (HLPA) with cognitive function in older adults. METHODS: Participants were recruited from the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. ActicalTM accelerometers provided estimates of LLPA (50-556 counts/min), HLPA (557-1,064 counts/min), MVPA (>1,065 counts/min), for 4-7 consecutive days. Incidence of cognitive impairment was defined by the Six-Item Screener. Letter fluency, animal fluency, word list learning and Montreal Cognitive Assessment (orientation and recall) were conducted to develop z-scores for domains of executive function and memory. Associations between LPA and cognitive impairment were examined using multivariate logistic regression models. General Linear regression models were used to assess the association between LPA and z-scores of executive function and memory. RESULTS: During 3.3 ± 0.5 years of follow-up, 4,941 participants (70.1 ± 8.6 yr, 54.2% women, 31.7% African American) were included, with 283 incident cases of cognitive impairment. Average time spent in LLPA and HLPA were 167.4±61.1, and 24.0±19.2 min/day, respectively. After adjustments for age, sex, race, education and other health related factors, participants in the highest HLPA quartile (40.9 min/day) had 35% lower risk of cognitive impairment than the lowest quartile (HR: 0.65, 95% C.I.: 0.45-0.94). Quartiles of HLPA were inversely associated with change over time in executive function and memory z-scores (P<0.01). CONCLUSION: Higher levels of objectively measured HLPA were independently associated with lower incidence of cognitive impairment, and better maintenance of memory and executive function in older adults. Future PA guidelines may need to be modified to include HLPA in addition to MVPA to sustain cognitive health in older adults.

Loneliness and Cognitive Function in Older Adults: Findings From the Chinese Longitudinal Healthy Longevity Survey.

To examine the relationship between loneliness and cognitive function and to explore the mediating role of physical health on the loneliness-cognition relationship in Chinese older adults (OAs). Data came from a nationally representative sample of 14,199 Chinese OAs (aged 65+) from 2002, 2005, 2008, and 2011 waves of the Chinese Longitudinal Healthy Longevity Survey. A latent variable cross-lagged panel model combined with mediation analysis was used to determine the relationship between loneliness and cognitive function and the mediating effect of increase in the number of chronic conditions (ΔNCCs) on the ascertained loneliness-cognition relationship. Severe loneliness at prior assessment points was significantly associated with poorer cognitive function at subsequent assessments, and vice versa. The ΔNCCs partially mediated this prospective reciprocal relationships, accounting for 2.58% of the total effect of loneliness on cognition and 4.44% of the total effect of cognition on loneliness, respectively. Loneliness may predict subsequent cognitive decline, and vice versa. This loneliness-cognition relationship is partially explained by their impact on physical health. Multidisciplinary interventions aimed at reducing loneliness and cognitive decline per se and their associated risk factors as well as improving chronic illness management would be beneficial for emotional well-being and cognitive health in OAs.

Automated Video Analysis of Handwashing Behavior as a Potential Marker of Cognitive Health in Older Adults.

The identification of different stages of cognitive impairment can allow older adults to receive timely care and plan for the level of caregiving. People with existing diagnosis of cognitive impairment go through episodic phases of dementia requiring different levels of care at different times. Monitoring the cognitive status of existing patients is, thus, critical to deciding the level of care required by older adults. In this paper, we present a system to assess the cognitive status of older adults by monitoring a common activity of daily living, namely handwashing. Specifically, we extract features from handwashing trials of participants diagnosed with different levels of dementia ranging from cognitively intact to severe cognitive impairment, as assessed by the mini-mental state exam (MMSE). Based on videos of handwashing trials, we extract two classes of features: one characterizing the occupancy of different sink regions by the participant, and the other capturing the path tortuosity of the motion trajectory of participant's hands. We perform correlation analysis to assess univariate capacity of individual features to predict MMSE scores. To assess multivariate performance, we use machine learning methods to train models that predict the cognitive status (aware, mild, moderate, severe), as well as the MMSE scores. We present results demonstrating that features derived from hand washing behavior can be potential surrogate markers of a person's dementia, which can be instrumental in developing automated tools for continuously monitoring the cognitive status of older adults.

Accounting for differences in cognitive health between older adults in New Zealand and the USA.

National differences in cognitive health of older adults provide an opportunity to shed light on etiological factors. We compared the cognitive health of older adults in New Zealand and the USA, and examined differences in known risk factors. Two nationally representative samples were derived from the 2010 waves of the New Zealand Longitudinal Study of Ageing (n = 953) and the US Health and Retirement Study (HRS) (n = 3,746). Data from comparable measures of cognitive function, gender, age, income, education, prevalence of cancer, diabetes, heart disease, hypertension and stroke, exercise, alcohol consumption, smoker status, depression, and self-reported health were subjected to hierarchical regression analysis to examine how national differences in cognitive function might be explained by differences in these risk factors. The New Zealand sample scored 4.4 points higher on average than the US sample on the 43 point cognitive scale. Regression analyses of the combined samples showed that poorer cognitive health is more likely in those who are male, older, less educated, have suffered a stroke, consume alcohol less frequently, are more depressed, and report worse overall health. Controlling for age and sex reduced the mean difference to 2.6 and controlling for risk factors further reduced it to 2.3. Older New Zealand adults displayed better cognitive function than those in a US sample. This advantage can be partially explained by age and sex differences and, to some extent, by differences in known risk factors. However, the national advantage remained even when all measured risk factors are statistically controlled.

Maintaining Cognitive Health in Older Adults: Australians’ Experience of Targeted Computer-Based Training, using the Brain Fitness Program

ABSTRACTAims: This study explores the experience of older Australians completing the Brain Fitness Program (BFP). The BFP is computer-based training, of 40 hours duration, designed to address cognitive decline in healthy older individuals. Methods: Ten Australians participated in an exploratory concurrent mixed method study. Cognitive outcome measures and participant-reported quality of life were used to examine the effect of the training. Pre-intervention measures were taken immediately prior to training and post-intervention scores were measured within one week of completing the training. The lived experience of completing the BFP was explored via interviews. Results: All participants made statistically significant improvement in measures of attention and concentration. Six reported improvements in thinking or communication skills in everyday life, while four could not identify any changes to their lives. Universally, participants found the BFP easy to use, although eight participants found it arduous to complete, requiring strong motivation and persistence to finish the program. Most found the repetitive nature of the instructions frustrating, and all participants found the American presentation style and American-English culturally inappropriate in the Australian setting. Conclusions: Our results concur with the literature, such that the BFP positively affects the attributes of attention and concentration. However, our findings suggest that not all older Australians will report transfer of trained skills to everyday function and that older Australians may find the BFP arduous and culturally inappropriate. Our findings add to the debate on the usefulness of brain training software, although, to be fully conclusive, further investigation with greater participant numbers is required.

Game-Based Community Cognitive Health Intervention for Minority and Lower Socioeconomic Status Older Adults: A Feasibility Pilot Study.

The purpose of this pilot study was to investigate the feasibility of implementing a noncomputerized, game-based, community cognitive health intervention with minority and/or lower socioeconomic status (SES) older adults in order to improve cognitive performance and quality of life. Through partnerships with community organizations, we implemented an innovative pilot 10-week cognitive training intervention. Noncomputerized games were used to combine social interaction and cognitive training that challenged attentional and memory function for 1 hour each week over the span of 10 weeks. One game used in the intervention program was created by adapting a working memory training task into a fun and competitive card game; the other two games were commercially available. The intervention and pre/post assessments were able to be delivered in a community setting. Overall retention was satisfactory, but it dropped in later weeks of the intervention. Older adult participants reported enjoying the games and being invested in their performance. They also reported playing the games with family and friends at home. Older adult participants complied with game rules but were reluctant to comply with instructions to rotate game partners and game types. They preferred their first partners, and they preferred the card game over the existing commercial games. This intervention has the potential to improve quality of life and reduce disparities in cognitive health in older adults because it is an accessible game-based intervention program that motivates older adult participants to engage cognitively and to continue this engagement beyond the formal training sessions. However, in order to carry this out on a larger scale, particular attention must be paid to recruitment, retention, and training procedures. This article discusses the critical need for cognitive training interventions in minority and lower SES older adults, the intended benefits, and the best approaches to conducting this type of intervention.

Kidney function and cognitive health in older adults: the Cardiovascular Health Study.

Recent evidence has demonstrated the importance of kidney function in healthy aging. We examined the association between kidney function and change in cognitive function in 3,907 participants in the Cardiovascular Health Study who were recruited from 4 US communities and studied from 1992 to 1999. Kidney function was measured by cystatin C-based estimated glomerular filtration rate (eGFRcys). Cognitive function was assessed using the Modified Mini-Mental State Examination and the Digit Symbol Substitution Test, which were administered up to 7 times during annual visits. There was an association between eGFRcys and change in cognitive function after adjustment for confounders; persons with an eGFRcys of less than 60 mL/minute/1.73 m(2) had a 0.64 (95% confidence interval: 0.51, 0.77) points/year faster decline in Modified Mini-Mental State Examination score and a 0.42 (95% confidence interval: 0.28, 0.56) points/year faster decline in Digit Symbol Substitution Test score compared with persons with an eGFRcys of 90 or more mL/minute/1.73 m(2). Additional adjustment for intermediate cardiovascular events modestly affected these associations. Participants with an eGFRcys of less than 60 mL/minute/1.73 m(2) had fewer cognitive impairment-free life-years on average compared with those with eGFRcys of 90 or more mL/minute/1.73 m(2), independent of confounders and mediating cardiovascular events (mean difference = -0.44, 95% confidence interval: -0.62, -0.26). Older adults with lower kidney function are at higher risk of worsening cognitive function.

Nutraceutical Intervention Improves Older Adults' Cognitive Functioning

Interventions to improve the cognitive health of older adults are of critical importance. In the current study, we conducted a double-blind, placebo-controlled clinical trial using a pill-based nutraceutical (NT-020) that contained a proprietary formulation of blueberry, carnosine, green tea, vitamin D3, and Biovin to evaluate the impact on changes in multiple domains of cognitive functioning. One hundred and five cognitively intact adults aged 65-85 years of age (M=73.6 years) were randomized to receive NT-020 (n=52) or a placebo (n=53). Participants were tested with a battery of cognitive performance tests that were classified into six broad domains--episodic memory, processing speed, verbal ability, working memory, executive functioning, and complex speed at baseline and 2 months later. The results indicated that persons taking NT-020 improved significantly on two measures of processing speed across the 2-month test period in contrast to persons on the placebo whose performance did not change. None of the other cognitive ability measures were related to intervention group. The results also indicated that the NT-020 was well tolerated by older adults, and the presence of adverse events or symptoms did not differ between the NT-020 and placebo groups. Overall, the results of the current study were promising and suggest the potential for interventions like these to improve the cognitive health of older adults.

Housing Wealth, Psychological Well-being, and Cognitive Functioning of Older Americans

Economic security around retirement age may be an important determinant of psychological and cognitive well-being of older adults. This study examines the impact of the dramatic increase in housing prices from the mid-1990s to the mid-2000s on psychological and cognitive outcomes among Americans born between 1924 and 1960. Our quasi-experimental empirical strategy exploits geographic differences in housing market price trends during the housing boom (from the mid-1990s until 2006). We use individual-level data from the Health and Retirement Study (HRS) and estimates of housing values from DataQuick, a California-based real estate consultancy firm, to estimate the association of housing price increases with psychological and cognitive outcomes at follow-up. Greater housing appreciation over the follow-up period was associated with a significantly lower risk of anxiety (for women) and an improved performance on some but not all cognitive tasks. Effects for depressive symptoms, positive and negative affect, and life satisfaction were all in the beneficial direction but not statistically significant. The effects of price run-ups were concentrated on homeowners, as opposed to renters, suggestive of wealth-driven effects. Housing market volatility may influence the psychological and cognitive health of older adults, highlighting potential health consequences of pro-home ownership policies, which may be especially important in light of recent dramatic housing price declines.

Participation in Social Activities in Later Life: Does Enjoyment Have Important Implications for Cognitive Health?

Studies have demonstrated that regularly participating in activities with others may be important for cognitive health. However, less is known about why social activities are beneficial to cognitive health. This review will highlight several important concepts to consider when studying social activities and the cognitive health of older adults. The potential psychological and physiological mechanisms linking social activities to cognitive health will be discussed, with special attention to enjoyment and the elements important for enjoyment. Little is known about enjoyment in later life and if it is important for cognitive health. A deeper understanding of the mechanisms by which enjoyment in later life may affect cognitive health could help to inform future clinical and public health interventions.

Depresión y función cognitiva de adultos mayores de una comunidad urbano marginal

Introduction: Psychological and cognitive health of older adults can present changes related to aging. Depression often leads to cognitive impairment, conditions to be identified for early detection and prevention of damage. Objective: To identify association between depression and cognitive function of the elderly, to guide the planning of educational intervention strategies. Method: A descriptive, cross-correlation in 252 elderly men and women. Instruments: Test Yesavage (sensitivity 84%, specificity 95%) and Mini-mental State Examination (sensitivity 82%, specificity 84%). Analysis: SPSS v.18, Spearman correlation. Results: The 40.1% without depression, 3.9% mild depression and 25% established depression; 58.3% whole cognitive function and 41.7% cognitive decline. Negative correlation between depression and cognitive function (rs =-0242; p =0.000). Discussion: The correlation found is similar to that reported in other studies. Conclusion: The values obtained with the Spearman correlation test showed no association in the expected direction.

Brain Health and Exercise in Older Adults

Identifying feasible and effective interventions aimed at mitigating the effects of cognitive decline in older adults is currently a high priority for researchers, clinicians, and policy makers. Evidence suggests that exercise and cognitive training benefit cognitive health in older adults; however, a preferred modality has to be endorsed yet by the scientific community. The purpose of this review is to discuss and critically examine the current state of knowledge concerning the effects of aerobic, resistance, cognitive, and novel dual-task exercise training interventions for the preservation or improvement of cognitive health in older adults. A review of the literature suggests that the potential exists for multiple exercise modalities to improve cognitive functioning in older adults. Nonetheless current limitations within the field need to be addressed prior to providing definitive recommendations concerning which exercise modality is most effective at improving or maintaining cognitive health in aging.

Session III: Mechanisms of Age-Related Cognitive Change and Targets for Intervention: Inflammatory, Oxidative, and Metabolic Processes

There is increasing evidence from basic science and human epidemiological studies that inflammation, oxidative stress, and metabolic abnormalities are associated with age-related cognitive decline and impairment. This article summarizes selected research on these topics presented at the Cognitive Aging Summit II. Speakers in this session presented evidence highlighting the roles of these processes and pathways on age-related cognitive decline, pointing to possible targets for intervention in nondemented older adults. Specific areas discussed included age differences in the production of cytokines following injury or infection, mechanisms underlying oxidative stress-induced changes in memory consolidation, insulin effects on brain signaling and memory, and the association between metabolic syndrome and cognitive decline in older adults. These presentations emphasize advances in our understanding of mechanisms and modifiers of age-related cognitive decline and provide insights into potential targets to promote cognitive health in older adults.