Cognitive Impairment In Older Adults Research Articles

Classification of cognitive impairment in older adults based on brain functional state measurement data via hierarchical clustering analysis.

Cognitive impairment (CI) is a common degenerative condition in the older population. However, the current methods for assessing CI are not based on brain functional state, which leads to delayed diagnosis, limiting the initiatives towards achieving early interventions. A total of one hundred and forty-nine community-dwelling older adults were recruited. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Exam (MMSE) were used to screen for CI, while brain functional was assessed by brain functional state measurement (BFSM) based on electroencephalogram. Bain functional state indicators associated with CI were selected by lasso and logistic regression models (LRM). We then classified the CI participants based on the selected variables using hierarchical clustering analysis. Eighty-one participants with CI detected by MoCA were divided into five groups. Cluster 1 had relatively lower brain functional states. Cluster 2 had highest mental task-switching index (MTSi, 13.7 ± 3.4), Cluster 3 had the highest sensory threshold index (STi, 29.9 ± 7.7), Cluster 4 had high mental fatigue index (MFi) and cluster 5 had the highest mental refractory period index (MRPi), and external apprehension index (EAi) (21.6 ± 4.4, 35.4 ± 17.7, respectively). Thirty-three participants with CI detected by MMSE were divided into 3 categories. Cluster 1 had the highest introspective intensity index (IIi, 63.4 ± 20.0), anxiety tendency index (ATi, 67.2 ± 13.6), emotional resistance index (ERi, 50.2 ± 11.9), and hypoxia index (Hi, 41.8 ± 8.3). Cluster 2 had the highest implicit cognitive threshold index (ICTi, 87.2 ± 12.7), and cognitive efficiency index (CEi, 213.8 ± 72.0). Cluster 3 had higher STi. The classifications both showed well intra-group consistency and inter-group variability. In our study, BFSM-based classification can be used to identify clinically and brain-functionally relevant CI subtypes, by which clinicians can perform personalized early rehabilitation.

Association between vitamin B12 levels and cognitive impairment in older adults

Association between vitamin B12 levels and cognitive impairment in older adults

Longitudinal Sleep Patterns and Cognitive Impairment in Older Adults

Sleep disturbances and clinical sleep disorders are associated with all-cause dementia and neurodegenerative conditions, but it remains unclear how longitudinal changes in sleep impact the incidence of cognitive impairment. To evaluate the association of longitudinal sleep patterns with age-related changes in cognitive function in healthy older adults. This cross-sectional study is a retrospective longitudinal analyses of the Seattle Longitudinal Study (SLS), which evaluated self-reported sleep duration (1993-2012) and cognitive performance (1997-2020) in older adults. Participants within the SLS were enrolled as part of a community-based cohort from the Group Health Cooperative of Puget Sound and Health Maintenance Organization of Washington between 1956 and 2020. Data analysis was performed from September 2020 to May 2023. The main outcome for this study was cognitive impairment, as defined by subthreshold performance on both the Mini-Mental State Examination and the Mattis Dementia Rating Scale. Sleep duration was defined by self-report of median nightly sleep duration over the last week and was assessed longitudinally over multiple time points. Median sleep duration, sleep phenotype (short sleep, median ≤7 hours; medium sleep, median = 7 hour; long sleep, median ≥7 hours), change in sleep duration (slope), and variability in sleep duration (SD of median sleep duration, or sleep variability) were evaluated. Of the participants enrolled in SLS, only 1104 participants who were administered both the Health Behavior Questionnaire and the neuropsychologic battery were included for analysis in this study. A total of 826 individuals (mean [SD] age, 76.3 [11.8] years; 468 women [56.7%]; 217 apolipoprotein E ε4 allele carriers [26.3%]) had complete demographic information and were included in the study. Analysis using a Cox proportional hazard regression model (concordance, 0.76) showed that status as a short sleeper (hazard ratio, 3.67; 95% CI, 1.59-8.50) and higher sleep variability (hazard ratio, 3.06; 95% CI, 1.14-5.49) were significantly associated with the incidence of cognitive impairment. In this community-based longitudinal study of the association between sleep patterns and cognitive performance, the short sleep phenotype was significantly associated with impaired cognitive performance. Furthermore, high sleep variability in longitudinal sleep duration was significantly associated with the incidence of cognitive impairment, highlighting the possibility that instability in sleep duration over long periods of time may impact cognitive decline in older adults.

An exploration of the relationship between financial hardship and cognitive functioning in later life

AbstractBackgroundThere is a connection between stress and negative health outcomes including cognitive impairment. Few studies have examined the relationship between perceived financial hardship as a secondary stressor and cognitive function. This study aimed to test four indicators of perceived financial hardship and the impact on cognitive function among older adults.MethodsUsing data from four waves of the Health and Retirement Study of persons 65 years and older, we analyzed (N = 6612) across waves 1 and 2 using generalized linear regressions. There were four financial hardship variables (difficulty paying bills, food insecurity, taking less medication due to cost and ongoing financial strain). Cognitive status was conceptualized as a composite variable of episodic memory and mental status.ResultsResults suggests that all four financial hardships were associated with lower mental status scores with food insecurity having the strongest association of the four indicators.ConclusionThese findings highlight the negative effects of stress in later life. Even secondary stressors such as financial hardships do in fact tax the mental status of older persons. There are higher risks for cognitive impairments in older adults with financial hardships than those without financial hardships This study underlines the importance of interventions to reduce stress while also creating greater access to food and medications specifically.

Cognitive sequealae of COVID‐19 is not predicted by SARS‐CoV‐2 variants

AbstractBackgroundThe long term sequelae of COVID‐19 in older adults are only beginning to be clarified, and its predictors and underlying molecular mechanisms may shed light on the relationship between viral infections and Alzheimer’s disease and related dementia.MethodA prospective cohort of 874 older adult Amerindians from Argentina with COVID‐19 illness confirmed by PCR of nasal swabs as well as controls, was established during the first year of the COVID‐19 pandemic. We obtained data on the severity of the acute illness, as well as extensive neuropsychiatric and cognitive assessments, neurological exams (including quantitative hyposmia/anosmia), plasma for biomarkers and preliminary brain MRI images using the ADNI‐3 protoco (n = 300)l,and whole genome sequencing (n = 300). Isolates from SARS‐CoV‐2 were obtained by the provincial Direction of Epidemiology and sequenced by the national Ministry of Health. Variants of interest/concern were allocated to each case on the basis of the prevalent community isolate at the time of confirmed positive PCR. A deep learning strategy was used to identify predictive factors of cognitive and clinical outcomes.ResultFour distinctive cognitive profiles were identified. Greater cognitive impairment was associated with older age (p = E−9), worse acute COVID‐19 illness (p = 0.008), unvaccinated status (p = E−7), and severity of anosmia (p = E−5). SARS‐CoV‐2 variant was associated with severity of acute illness ((p = E−6) but notably not with cognitive impairment. Preliminary analysis of genomic and brain imaging data will be presented.ConclusionOur data strongly suggest that all SARS‐CoV‐2 variants of interest up to the omicron wave seem equally likely to result in cognitive impairment in older adults, modulated by the severity of the acute illness.

The Association Between Street Network Accessibility and Cognitive Impairment

AbstractBackgroundAccess to different amenities has been hypothesised to reduce the risk of cognitive impairment in older adults. Literature in urban planning shows that a well‐connected street network enables access to amenities, however, the role of street network accessibility has not been studied extensively in relation to cognitive function. The aim of this study is to investigate the cross‐sectional relationship between street network accessibility and cognitive impairment in older people in England, UK.MethodThe baseline data from the Cognitive Function and Ageing Study (CFAS) II (2008‐2011), a cohort study of people aged 65+ across three areas in England, was used (N = 7485) excluding 144 housebound participants. Cognitive impairment was defined by the Mini Mental State Exam (MMSE) score: mild‐severe (MMSE<26) and moderate‐severe (MMSE<21). Using Geographical Information System (GIS) data, proximity to a main road was represented by betweenness centrality (shortest routes corresponding to high potential of through movement) of the street network, using normalised angular choice (NACH ‐ range of 0‐1.5, with 0.9+ meaning a main road). Mean NACH was calculated within 300m walk of participants’ postcode centroid and categorised into tertiles (low = NACH<0.8, medium = NACH 0.8‐0.9, high = NACH>0.9). Logistic regression was used to investigate the relationship between proximity to a main road, the risk of mild‐severe and moderate‐severe cognitive impairment adjusting for age, sex, education, and area deprivation.ResultThe prevalence was 24% for mild‐severe cognitive impairment and 7.3% for moderate‐severe cognitive impairment. Compared to those living at low proximity from a main road, those who lived at medium (OR 0.817 95% CI [0.716, 0.932]) and high proximity (OR 0.756 95% CI [0.662, 0.863]) had lower risk of mild‐severe cognitive impairment. The adjusted associations remained similar (OR 0.771 95% CI [0.671, 0.886] for medium proximity, OR 0.755 95% CI [0.656, 0.869] for high proximity). Proximity to a main road was not associated with moderate‐severe cognitive impairment.ConclusionThe results suggest evidence for the role of proximity to a main road in reducing the risk of mild‐severe cognitive impairment in non‐housebound individuals, but not moderate‐severe cognitive impairment. More research is needed on other aspects of street network accessibility.

Omega‐3 fatty acid derivatives associated with reduced risk of cognitive impairment in older adults

AbstractBackgroundCognitive decline etiology is not fully understood, and many pathways undoubtedly play a role. Oxidative stress, inflammation, and other factors likely modify one’s risk. To understand metabolic underpinnings of cognitive impairment, untargeted metabolomics were performed, and the data analyzed.MethodUntargeted metabolomics were conducted, using UPLC‐mass spectrometry, in 167 fasted plasma samples obtained from the Wake Forest Alzheimer’s Disease Research Center. Subjects without diagnosis of mild cognitive impairment or any form of dementia per the National Alzheimer’s Coordinating Center’s criteria were deemed cognitively normal (n = 102), and comparisons were made between these subjects and subjects diagnosed with cognitive impairment (n = 65). For each of the 1,627 biochemicals assessed, Mann‐Whitney U tests were performed to determine if differences existed between cognition groups. Further investigation was performed via multinomial regression stratified by APOE genotype and by BMI category (<18.5, 18.5‐24.9, 25‐29.9, 30+ kg/m2), adjusted for sex, age, race, and educational attainment.ResultMann‐Whitney U testing identified 101 metabolites significantly different among those with cognitive impairment versus those without. Adjusted, stratified regression abrogated most associations, though several metabolites continued to show notable differences between groups. Elevation of eicosenedioate was associated with increased odds of cognitive impairment for both normal weight (OR 1.62, 95% CI [0.93,2.82], p = 0.08) and overweight/obesity groups (OR 1.79, CI [0.88,10.51], p = 0.07), nearing statistical significance. In those with overweight or obesity, elevation of three omega‐3‐derived fatty acids were significantly associated with decreased odds of being cognitively impaired (OR 0.08‐0.13, CI[0.006,0.99), p = 0.009‐0.049). Five omega‐3 derived fatty acids were also significantly associated with decreased risk of cognitive impairment among those APOE genotype E3/E3 (OR 0.09‐0.21, CI [0.01,0.82], p = 0.01‐0.02). Several additional metabolites of interest, including alpha‐tocopherol (OR 0.06, CI [0.06,1.45]), ergothioneine (OR 0.27, CI [0.06,1.18]), and carotene diols (OR 0.08, CI [0.006,1.24]) approached significance in association with reduced cognitive impairment risk.ConclusionIn untargeted metabolomics, metabolites across a range of pathways were found to be associated with cognitive impairment. Upon adjustment for key, many omega‐3 fatty acid‐ derived metabolites continued to be associated with reduced risk of cognitive impairment.

Using deep learning model on drawing tasks as a screening tool for mild cognitive impairment in older adults with sensory impairments

AbstractBackgroundMild cognitive impairment (MCI) and sensory impairments commonly co‐exist in an aging population (e.g., Rong et al. 2020). A previous study has shown that patients with hearing impairment tend to do worse on verbal tests (Utoomprurkporn 2020). The reason is that the patients fail to hear the task instructions and have to put in more effort which is cognitively taxing. Therefore, a non‐verbal cognitive task for MCI screening is needed.MethodWe developed a deep learning model for MCI screening which requires only drawing tasks (trail‐making task, cube‐copying task, clock drawing task) on a digital tablet as its inputs. We cross‐validated the model on 981 subjects (age 55‐89, 77% female, 29% MCI) from our healthy aging clinic. The model used VGG16 as a backbone with self‐attention layers which expect to both improve the model performance and provide visual explanations.ResultThe model can discriminate between MCI and healthy controls with an AUC of 0.84. Our model provided better visual explanations that are compatible with how experienced clinical psychologists interpret the drawings. To increase the generalizability, we further developed a second model that aims to automate the clock drawing scoring. The models were tested in patients with and without sensory impairments.ConclusionWe investigated the feasibility of our deep learning models on drawings as a potential tool for MCI screening in an aging population with sensory impairments. The tool requires little or no human clinical experience and potentially can be used as a part of the population‐based MCI screening program.

Association of sarcopenia with cognitive impairment in older adults in the open population

AbstractBackgroundSarcopenia is a progressive and generalised skeletal muscle condition where there is a loss of muscle mass and function, while cognitive impairment is a clinical syndrome characterised by impairment in different cognitive and neuropsychological domains. Cognitive impairment has been studied as a risk factor for sarcopenia, however, it has not been established whether sarcopenia is a risk factor for cognitive impairment.MethodThis is a secondary analysis of 2,158 adults aged 65 and over assessed within the Dementia Research Group 10/66 protocols. In which grip strength, calf circumference and physical performance were measured to establish a diagnosis of sarcopenia. In addition, they were divided into groups depending on cognitive status.ResultOf all the older adults assessed, those with cognitive impairment or dementia had worse indicators in anthropometric measurements and in sarcopenia‐related measurements.ConclusionIn older Mexican adults, the presence of sarcopenia was not found to be associated with mild cognitive impairment, but was associated with the presence of dementia, even after controlling for other risk factors widely documented in the literature.

Lower Physical Activity Is Associated With Objective But Not Subjective Cognitive Impairment In Older Adults Without Dementia

AbstractBackgroundPhysical activity has been associated with better performance on cognitive assessments for older adults in both observational and interventional studies. Older adults who exercise the 150 minutes a week recommended by the Physical Activity Guidelines for Americans were also less likely to report subjective cognitive decline on the Behavioral Risk Factor Surveillance System than those with lower levels of physical activity. Potential explanations for a cognitive benefit from exercise include reduction of vascular risk factors, preservation of brain mass and neuronal structural integrity, and promotion of psychological health and self‐efficacy.MethodCross‐sectional data on exercise habits, self‐reported memory problems, and cognition were collected for 137 older adults without dementia as part of a larger observational study. Participants were categorized as meeting (3 or more hours a week of physical activity) or not meeting (< 3 hours) physical activity recommendations. We used multivariable logistic regression to evaluate the association between exercise and self‐reported memory problem, and linear regression for association between exercise and total score on the Montreal Cognitive Assessment (MoCA) after adjusting for potential confounders including age, sex, level of education, cognitive status (CDR global score of 0 vs 0.5), and Geriatric Depression Scale score.ResultData on baseline exercise was available for 103 cognitively normal older adults and 34 with mild cognitive impairment (MCI). Mean participant age was 66.6 years and 58.4% were female. 48 participants (35%) reported exercising at least 3 hours per week. Participants with at least 3 hours a week of physical activity had significantly higher scores on the MoCA compared with those with less than 3 hours a week (B = 1.22, p = 0.040) after adjusting for age, sex, level of education, cognitive status, and depressive symptoms. There was no association between physical activity and participant‐reported memory symptoms using the same covariates (B = ‐0.50, p = 0.223).ConclusionWeekly physical activity levels consistent with current guidelines were associated with better performance on a cognitive assessment in older adults without dementia. Physical activity was not associated with presence or absence of a self‐reported memory problem in this sample.

Pesticides and cognitive impairment in older adults: evidence from southern Colombia

AbstractBackgroundEnvironmental exposure to specific chemical groups of pesticides (Carbamates, Organophosphates, Pyrethroids, and Organochlorines), as well as the non or inadequate use of personal protective equipment during pest management, have been associated to cognitive decline and increased risk of dementia (Hayden et al., 2010). This study investigated cognitive functioning in older adults exposed to pesticides in southern Colombia.MethodsA sample of 353 older adults was recruited. Of these, 279 had not been exposed to pesticides (n‐Exp) and 74 had (Exp). They were matched according to age [n‐Ex: 63.80 (3.25), Ex: 63.30 (6.96), t = 0.618, p = 0.538] and years of education [n‐Ex: 9.29 (6.28), Ex: 8.95(6.35), t = 0.418, p = 0.676]. They were assessed with a battery of cognitive tests including CERAD (Aguirre‐Acevedo et al., 2016), The Addenbrooke’s Cognitive Examination (ACE‐R), the Free and Cued Selective Reminding Test (FCSRT) and questionnaires.ResultsFDR corrected comparisons revealed overall lower cognitive abilities in the Exp group (ACE‐R, q = 0.027). They also displayed Memory (FCSRT, q = 0.020; World List Learning q = 0.014) and Constructional Praxis (q = 0.007) impairments. Of those exposed, 73% reported no use of personal protective equipment, and neither the participants nor their family members reported concerns about cognitive decline [Self‐reported: n‐Exp: 14.27 (7.44), Exp: 14.92 (7.98), t = ‐0.654, p = 0.513; Family‐reported: n‐Exp: 10.43 (7.12), Exp: 10.26 (7.45), t = ‐0.182, p = 0.856].ConclusionOlder adults from southern Colombia who have been exposed to pesticides show significant cognitive impairments, which have gone unnoticed by both the affected individuals and their family. Cognitive abilities found to be affected have been associated with risk of dementia caused by Alzheimer’s Disease or Parkinson’s Disease (FCSRT and Constructional Praxis). These types of dementia have been previously associated with this environmental risk factor (Chin‐Chan et al., 2015). More awareness about environmental factors and actions to mitigate their risk are urgently needed, and should be considered by future recommendations (e.g., Livingston et al., 2020).Aguirre‐Acevedo et al. (2016). Int. Psychogeriatr, 28(3), 503‐510. https://doi.org/S1041610215001660.Chin‐Chan et al. (2015). Frontiers in Cellular Neuroscience, 9. https://www.frontiersin.org/articles/10.3389/fncel.2015.00124Hayden et al. (2010). Neurology, 74(19), 1524‐1530. https://doi.org/10.1212/WNL.0b013e3181dd4423Livingston et al. (2020). Lancet, 396(10248), 413‐446. https://doi.org/10.1016/S0140‐6736(20)30367‐6

The associations between handgrip strength asymmetry and future cognitive impairment in older adults

AbstractBackgroundThe incidence and prevalence of dementia continue to increase exponentially as people age. Finding a pre‐clinical marker to detect dementia early is paramount in clinical practice. There are few prospective studies evaluating handgrip strength, handgrip strength asymmetry, and their combination on cognitive impairment. This study aimed to investigate the association of handgrip strength and handgrip strength asymmetry with future global and specific cognitive domain impairment.MethodThis is a seven‐year prospective cohort study (Fig 1). We used data from the ongoing Taiwan Initiative of Geriatric Epidemiological Research (TIGER), wave 3 (2015‐2017) to wave 5 (2019‐2022), with wave 3 as the baseline (n = 446). Low handgrip strength was defined as the lowest tertile of sex‐specific handgrip strength. Handgrip strength asymmetry was defined as a handgrip strength ratio <0.85 or >1.15 (i.e., a 15% difference). The cognitive assessment included global and specific cognitive domains. Generalized linear mixed models were used to assess the association of handgrip strength asymmetry and cognitive performance adjusted for age, years of education, cigarette smoking, alcohol drinking, hypertension, diabetes, hyperlipidemia, and physical activity.ResultThe mean age of participants was 75.7 years, and 55% were female. Participants with handgrip strength asymmetry were mostly female, never smokers, and more likely to have lower handgrip strength. Handgrip strength asymmetry was associated with poor global cognition [ = ‐2.14, 95% confidence interval (CI): ‐3.60, ‐0.68] and digit span‐forward ( = ‐0.69, 95% CI: ‐1.25 to ‐0.14) over time in men. Low handgrip strength was associated with cognitive impairment (global cognition: = ‐1.13, 95% CI: ‐2.07 to ‐0.19; immediate free recall: = ‐0.48, 95%CI: ‐0.87 to ‐0.09; delayed free recall: = ‐0.45, 95% CI: ‐0.85 to ‐0.08); Trail Making Test‐ A: = ‐0.43, 95% CI: ‐0.75 to ‐0.12), and digit span‐forward ( = ‐0.67 to 95% CI: ‐1.02 to ‐0.31) over time in men. Concomitant weakness and handgrip strength asymmetry had greater impairment in cognitive function in men.ConclusionIn this community‐dwelling older population, those with low handgrip strength and handgrip strength asymmetry had an increased risk of cognitive impairment. This relationship seems more prominent in men than women.

Impact of type, intensity, frequency, duration and volume of physical activity on dementia and mild cognitive impairment in older adults: protocol for a systematic review and meta-analysis

IntroductionWorldwide, the prevalence of degenerative diseases such as dementia and mild cognitive impairment (MCI) is increasing with population ageing and increasing life expectancy. Both conditions share modifiable risk factors. Physical...

Influence of Nutritional Status and Physical Fitness on Cognitive Domains among Older Adults: A Cross-Sectional Study.

The health issues presented by the aging population can result in reduced muscle mass, poorer physical function, and cognitive impairment. The goal of this study was to determine how nutritional status and physical fitness relate to cognitive impairment in older adults. A cross-sectional descriptive and analytical study involving 100 participants was carried out to analyze the impact of nutritional status and physical fitness on cognitive impairment. Nutritional status was assessed with the Eating Assessment Tool (EAT-10) and The Mini Nutritional Assessment-Short Form (MNA-SF); physical fitness via the implementation of manual grip evaluation, the 4-m walking test (4-MWT), and the Timed Up and Go (TUG) test; and cognitive impairment evaluation was conducted using the Mini-Mental State Examination (MMSE), the Boston Naming Test (BNT) and the Controlled Oral Word Association Test (COWAT). Data analysis revealed that higher malnutrition status was associated with fewer correct responses in the COWAT (R2 = 0.421), while a correlation between higher MMSE and BNT scores, faster completion times for the 4-m walking and TUG tests, and an increase in handgrip strength load was also observed. The analysis of the data revealed that those individuals with superior nutritional status and greater levels of physical fitness outperformed others on the cognitive evaluation.

The associations of osteoporosis and possible sarcopenia with disability, nutrition, and cognition in community-dwelling older adults

BackgroundOsteoporosis and sarcopenia, respectively, have detrimental impact on health, and combination of both conditions, termed osteosarcopenia, is becoming an increasingly important disorder in older adults as populations age. This study aimed to explore the relationship between osteoporosis and possible sarcopenia and their joint effect on physical performance, nutritional status, and cognition in community-dwelling older adults.MethodsThis study was conducted at a medical center in Taiwan, which included the adjacent community care station. The participants were recruited through regular activities at the community care station between January 01, 2015 and February 28, 2022. During the study period, dual-energy X-ray absorptiometry and comprehensive geriatric assessment consisting of comorbidity burden, functional status, cognition, mood, and nutritional status were performed during the study period. Possible sarcopenia was identified utilizing the criteria set by the Asian Working Group on Sarcopenia in 2019 using the criteria of low muscle strength alone, and osteoporosis was defined by the World Health Organization criteria. Accordingly, the study subjects were divided into four groups: normal, only osteoporosis, only possible sarcopenia, and possible osteosarcopenia.ResultsThere were 337 participants (68.6% female) with a median age of 78.0 years (interquartile range: 71.0–85.0 y/o). According to the clinical definition of osteosarcopenia, 78 participants were normal, 69 participants showed possible sarcopenia, 61 participants had osteoporosis, and 129 had osteoporosis with possible sarcopenia. Among the four groups, the prevalence rates of chronic illness, functional capacity, physical performance, cognitive impairment, and malnutrition revealed statistically significant differences. Using logistic regression analysis after adjusting for the other covariates, osteoporosis with possible sarcopenia was associated with an increased odds ratio of cognitive impairment.ConclusionsThe findings suggest that compared to osteoporosis or possible sarcopenia alone, osteoporosis with possible sarcopenia was more likely to be associated with cognitive impairment. Early identification and targeted interventions for cognitive impairment in older adults with osteosarcopenia may be valuable in maintaining cognitive well-being and overall quality of life.

Abstract 13062: Association Between Blood Pressure Levels and Cognitive Decline in Community-Dwelling Older Adults: A Prospective Analysis of the China Health and Retirement Longitudinal Study

Background: The association between blood pressure (BP) and the risk of cognitive impairment in older adults is limited. It is unclear at which thresholds BP increases the risk of cognitive decline. We aimed to investigate the association between BP and hypertension treatment status with cognitive decline in older adults. Methods: This study used data from the China Health and Retirement Longitudinal Study (CHARLS). Participants were categorized into five groups according to their visit measures of BP: 1) BP <120/80 mm Hg; 2) systolic BP (SBP) 120-129 mm Hg and diastolic BP (DBP) <80 mmHg; 3) BP ≥130/80 and <140/90 mmHg; 4) BP ≥ 140/90 mmHg; 5) and participants with anti-hypertensive medication treatment regardless of their BP levels. The global cognitive Z score was calculated as the average score of episodic memory and mental intactness. Linear mixed models were used to assess the longitudinal association between the BP group, SBP, pulse pressure (PP), and cognitive decline. Results: A total of 11,671 participants from CHARLS were included (47.3% men and mean age 58.6 ± 9.0 years). After adjusting for potential confounders, participants with BP ≥ 140/90 mm Hg but no anti-hypertensive medication were independently associated with accelerated cognitive decline ( β = -0.020, 95% CI -0.028 to -0.012; P <0.001). This trend was not significant for participants on anti-hypertensive treatment regardless of their BP levels. Elevated SBP and PP were found to be independently associated with accelerated cognitive decline ( P < 0.001 for both). However, participants on anti-hypertensive treatment for pre-existing hypertension, but with controlled SBP < 140 mm Hg and PP < 70 mm Hg did not have a significantly increased risk of cognitive decline. Conclusions: Uncontrolled hypertension was associated with subsequent cognitive decline. Effectively controlling BP with anti-hypertensive treatment can preserve cognitive health in older adults.

Association between sensation, perception, negative socio-psychological factors and cognitive impairment

BackgroundEvidence has suggested that sensation and socio-psychological factors may be associated with cognitive impairment separately in older adults. However, the association between those risk factors and cognitive impairment is still unknown. ObjectiveTo investigate the association between sensation, perception, negative socio-psychological factors, and cognitive impairment in institutionalized older adults. MethodsFrom two public aged care facilities, 215 participants were investigated. The Mini-mental State Examination was applied to assess cognitive function. The sensory function was bifurcated into auditory and somatosensory realms which were evaluated using pure tone audiometry and Nottingham Sensory Assessment, respectively. Albert's test, left and right resolution, and visuospatial distribution were used to evaluate perception. Depression and social isolation were selected as negative socio-psychological factors and were evaluated by the Geriatric Depression Scale and the Lubben Social Network Scale. The multivariate analysis was performed utilizing binary logistic regression. ResultsParticipants with moderately severe or severe hearing loss exhibited significant cognitive impairment compared to those with mild hearing loss. It was observed that perceptual dysfunction and depression were independently related to cognitive impairment. However, there was no significant association between somatosensory function, social isolation, and cognitive impairment in the institutionalized older adults. ConclusionMore profound hearing loss, abnormal perception, and depression are associated with cognitive impairment in older adults. Subsequent research endeavors should delve into the causal mechanisms underpinning these associations and explore whether combined interventions have the potential to postpone the onset of cognitive impairment.

Cognitive impairment in long-living adults: a genome-wide association study, polygenic risk score model and molecular modeling of the APOE protein.

Cognitive impairment is an irreversible, aging-associated condition that robs people of their independence. The purpose of this study was to investigate possible causes of this condition and propose preventive options. We assessed cognitive status in long-living adults aged 90+ (n = 2,559) and performed a genome wide association study using two sets of variables: Mini-Mental State Examination scores as a continuous variable (linear regression) and cognitive status as a binary variable (> 24, no cognitive impairment; <10, impairment) (logistic regression). Both variations yielded the same polymorphisms, including a well-known marker of dementia, rs429358in the APOE gene. Molecular dynamics simulations showed that this polymorphism leads to changes in the structure of alpha helices and the mobility of the lipid-binding domain in the APOE protein. These changes, along with higher LDL and total cholesterol levels, could be the mechanism underlying the development of cognitive impairment in older adults. However, this polymorphism is not the only determining factor in cognitive impairment. The polygenic risk score model included 45 polymorphisms (ROC AUC 69%), further confirming the multifactorial nature of this condition. Our findings, particularly the results of PRS modeling, could contribute to the development of early detection strategies for predisposition to cognitive impairment in older adults.

Relationship between reaction time variability on go/no go tasks and neuropsychological functioning in younger and older adults

ABSTRACT Introduction Early detection of cognitive impairment in older adults is important for the prevention of dementia. Intra-individual variability in reaction time (IIV-RT) during go/no-go tasks can be used for the early detection of cognitive impairment in older adults living in the community. This study aimed to determine the relationship between IIV-RT and cognitive function during go/no-go tasks and the cutoff values for determining the risk of cognitive impairment in community-dwelling older adults. Methods This study included 31 older adults without cognitive impairment, 15 community-dwelling older adults with cognitive impairment, and 34 healthy young adults. All participants performed a go/no-go task to assess the IIV-RT. Additionally, older adults underwent neuropsychological testing. Based on the results of the Japanese version of the Montreal Test of Cognitive Abilities (MoCA-J), older adults were divided into those with normal cognition and those with cognitive impairment. Results There were significant differences in the IIV-RT among groups, including a higher IIV in the cognitively impaired group than in young adults and cognitively normal older adults. Moreover, the IIV-RT was correlated with the MoCA-J (r = −0.531, p < 0.001), Trail Making Test Part A (r = 0.571, p < 0.001), and Verbal Fluency Test scores (r = −0.442, p = 0.002). Receiver operating curve analysis showed that the area under the curve for IIV-RT was 0.935, and the cutoff value at which the IIV-RT identified cognitive impairment was 25.37%. Conclusions These findings indicate that the IIV-RT during go/no-go tasks is a useful early indicator of cognitive impairment in community-dwelling older adults.

Effect of Virtual Reality Training on Cognitive Function and Motor Performance in Older Adults With Cognitive Impairment Receiving Health Care: A Randomized Controlled Trial

Given the prevalence of cognitive impairment in older adults and its frequent misdiagnosis or delayed diagnosis, non-pharmacological interventions have been proposed as solutions, which include cognitive training, prevention or risk reduction of dementia using virtual reality (VR) technology. This study aimed to investigate the effects of a virtual reality cognitive-motor training intervention (VRCMTI) on improving cognitive and physical function in older adults with cognitive impairment. We co-designed the VRCMTI system with multiple stakeholders by organizing symposiums and conducting pilot evaluations. The VRCMTI consisted of three virtual cognitive tasks and three upper limb movement tasks focused on improving working memory, spatial cognition, attention shifting, executive control, joint flexibility, and coordination. One hour of brain cognition and upper limb motor training was performed each week during the 12-week intervention. Sixty older adults were included in the study and randomly assigned to either the VR group or the control group. Participants in the control group received usual care and would not undergo any intervention training. Task independence, accuracy and time were measured during each session. The results showed that the VR group significantly improved global cognitive ability scores compared to the control group, especially in attention and verbal cognition. In addition, older adults in the VR group also showed significant improvements in upper limb motor skills, driven primarily by movement quality and processing speed. The findings suggest that VRCMTI could improve cognitive function and enhance motor performance. When implemented with routine health care for older adults, this practical and effective intervention may be an appropriate complementary strategy for maintaining cognitive health and preventing motor deterioration.