Cognitive Impairment In Older People Research Articles

Cognitive dysfunction characteristics of multiple sclerosis with aging

BackgroundWe aimed to investigate the characteristics of cognitive impairment in older people with multiple sclerosis (MS). MethodsCross-sectional study that included participants that were examined with a common and comprehensive neuropsychological protocol. The subjects were matched by sociodemographic variables and the following groups were generated for comparisons: young MS versus healthy controls (HC) (n = 246), old MS versus HC (n = 198), young MS vs old MS (n = 226), MS vs Alzheimer's disease (AD)(n = 70), and MS vs Parkinson's disease (PD) (n = 62). The ICCoDiMS criteria were used to define cognitive impairment in MS. ResultsCognitive impairment was more frequent in young than old patients (70.8 % vs 52.2 %). Attention and speed processing is the most frequent cognitive domain impaired in MS (54.9 % of young MS vs 32.7 % of old MS). The frequency of impairment in attention/processing speed (54.9 % vs 32.7 %) and episodic memory (27.9 % vs 14.3) was higher in the young group than in the old group. There were no statistically significant differences in the distribution of impairment in executive function (46.0 % vs 35.3 %), visuospatial (17.9 % vs 9.5 %), and language (12.4 % vs 17.7 %). In those patients meeting the criteria for cognitive impairment, young MS patients showed lower performance in attention/processing speed tests. Conversely, old MS patients showed lower performance in episodic memory, verbal fluency, and planning. There were no differences in the correlations between SDMT and other neuropsychological tests in young and old patients, which suggests similar cognitive processes underlying SDMT performance in both groups. There were differences between old MS and prodromal AD, especially in episodic memory, while the cognitive profile of old MS was largely shared with PD. ConclusionsOur study found that the cognitive profile of MS is defined by a characteristic impairment in attention and processing speed, which is present during the lifespan. The impairment in processing speed is less prominent in old age, whereas the impairment of other cognitive functions becomes more relevant. These findings suggest potential differences in the pathophysiological processes associated with cognitive impairment between young and old ages that warrant further investigation.

Digital exclusion and cognitive impairment in older people: findings from five longitudinal studies

ObjectivesOlder people are more likely to have digital exclusion, which is associated with poor health. This study investigated the relationship between digital exclusion and cognitive impairment in older adults from 23 countries across five longitudinal surveys.Design and measurementsDigital exclusion is defined as self-reported non-use of the Internet. We assessed cognitive impairment on three dimensions: orientation, memory, and executive function. We used generalized estimation equations fitting binary logistic regression with exchangeable correlations to study the relationship between digital exclusion and cognitive impairment, and apply the minimum sufficiently adjusted set of causally directed acyclic graphs as the adjusted variable.Setting and participantsWe pooled a nationally representative sample of older adults from five longitudinal studies, including the China Health and Retirement Longitudinal study (CHARLS), the English Longitudinal Study of Ageing (ELSA), the Health and Retirement Study (HRS), the Mexican Health and Ageing Study (MHAS) and the Survey of Health, Ageing and Retirement in European (SHARE).ResultsWe included 62,413 participants from five longitudinal studies. Digital exclusion varied by country, ranging from 21.69% (SHARE) in Denmark to 97.15% (CHARLS) in China. In the original model, digital exclusion was significantly associated with cognitive impairment in all five studies. In the adjusted model, these associations remained statistically significant: CHARLS (Odds ratio [OR] = 2.81, 95% confidence interval [CI] 1.84–4.28, ELSA (1.92 [1.70–2.18]), HRS(2.48[2.28–2.71), MHAS (1.92 [1.74–2.12]), and SHARE (2.60 [2.34–2.88]).ConclusionOur research shows that a significant proportion of older people suffer from digital exclusion, especially in China. Digital exclusion was positively correlated with cognitive impairment. These findings suggest that digital inclusion could be an important strategy to improve cognitive function and reduce the risk of cognitive impairment in older adults.

The time course of motor and cognitive decline in older adults and their associations with brain pathologies: a multicohort study

Many studies have reported that impaired gait precedes cognitive impairment in older people. We aimed to characterise the time course of cognitive and motor decline in older individuals and the association of these declines with the pathologies of Alzheimer's disease and related dementias. This multicohort study used data from three community-based cohort studies (Religious Orders Study, Rush Memory and Aging Project, and Minority Aging Research Study, all in the USA). The inclusion criteria for all three cohorts were no clinical dementia at the time of enrolment and consent to annual clinical assessments. Eligible participants consented to post-mortem brain donation and had post-mortem pathological assessments and three or more repeated annual measures of cognition and motor functions. Clinical and post-mortem data were analysed using functional mixed-effects models. Global cognition was based on 19 neuropsychological tests, a hand strength score was based on grip and pinch strength, and a gait score was based on the number of steps and time to walk 8 feet and turn 360°. Brain pathologies of Alzheimer's disease and related dementias were assessed at autopsy. From 1994 to 2022, there were 1570 eligible cohort participants aged 65 years or older, 1303 of whom had cognitive and motor measurements and were included in the analysis. Mean age at death was 90·3 years (SD 6·3), 905 (69%) participants were female, and 398 (31%) were male. Median follow-up time was 9 years (IQR 5-11). On average, cognition was stable from 25 to 15 years before death, when cognition began to decline. By contrast, gait function and hand strength declined during the entire study. The combinations of pathologies of Alzheimer's disease and related dementias associated with cognitive and motor decline and their onsets of associations varied; only tau tangles, Parkinson's disease pathology, and macroinfarcts were associated with decline of all three phenotypes. Tau tangles were significantly associated with cognitive decline, gait function decline, and hand function decline (p<0·0001 for each); however, the association with cognitive decline persisted for more than 11 years before death, but the association with hand strength only began 3·57 years before death and the association with gait began 3·49 years before death. By contrast, the association of macroinfarcts with declining gait function began 9·25 years before death (p<0·0001) compared with 6·65 years before death (p=0·0005) for cognitive decline and 2·66 years before death (p=0·024) for decline in hand strength. Our findings suggest that average motor decline in older adults precedes cognitive decline. Macroinfarcts but not tau tangles are associated with declining gait function that precedes cognitive decline. This suggests the need for further studies to test if gait impairment is a clinical proxy for preclinical vascular cognitive impairment. National Institutes of Health.

Nutritional Interventions for the Prevention of Cognitive Decline in Patients With Mild Cognitive Impairment and Alzheimer Disease: Protocol for a Network Meta-Analysis of Randomized Controlled Trials.

Mild cognitive impairment (MCI) is the stage between cognitive decline due to physiological aging and the severity of decline seen in neurodegenerative disorders like Alzheimer disease (AD), which is among the most prevalent neurodegenerative disorders characterized by cognitive impairment. People with MCI are at increased risk of developing AD. Although MCI and AD are incurable, nutritional interventions can potentially delay or prevent their onset. Consequently, effective interventions used to decelerate or alleviate the progress of cognitive impairment in older people are a significant focus in geriatric care. Given the synergistic effects of nutrition on health, assessing the effectiveness of nutritional supplements or dietary composition in preventing MCI or AD is essential for developing interventional strategies. Our study aims to assess the effectiveness of various nutritional interventions, including special dietary types, dietary patterns, specific foods, nutritional intake, and nutritional supplements, in preventing cognitive decline among patients diagnosed with MCI or AD. To achieve this, we will use a comprehensive approach, including network meta-analysis, pairwise meta-analysis, and systematic review of randomized controlled trials (RCTs). The review will follow the Population, Intervention, Comparison, Outcome (PICO) model and the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. Two investigators will independently search PubMed electronically. Data extraction will follow the inclusion criteria, and data will be assessed for risk of bias using a revised tool. Additionally, evidence quality will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. The outcomes of interest are assessing the cognitive outcomes in patients with MCI or AD. A systematic literature search will be conducted, identifying randomized controlled trials that investigate the impact of these nutritional interventions on cognitive function decline in individuals with MCI and AD. Network meta-analyses (random-effects model) and pairwise meta-analyses will then estimate the relative effectiveness of different nutritional interventions. We included 51 studies, published between 1999 and 2023 (27 studies for AD and 24 studies for MCI) and involving 8420 participants. We completed data extraction for all 51 studies by December 2023. Currently, we are actively engaged in data analysis and manuscript preparation. We plan to finalize the manuscript and publish the comprehensive results by the end of 2024. Our study holds significant clinical relevance given the rising prevalence of AD and the potential influence of nutritional interventions on cognitive function in individuals with MCI and AD. By investigating this relationship, our research aims to inform evidence-based decision-making in the development of prevention strategies for MCI and AD. The outcomes are expected to contribute to the establishment of reliable recommendations for MCI or AD management, providing substantial support in the field. PROSPERO CRD42022331173; http://tinyurl.com/3snjp7a4. PRR1-10.2196/47196.

CSF Extracellular Vesicle Aβ42 and Tau/Aβ42 Ratio Are Associated with Cognitive Impairment in Older People with HIV.

HIV-associated neurocognitive disorders (HAND) remain prevalent despite viral suppression on antiretroviral therapy (ART). Older people with HIV (PWH) are also at risk for amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD). β-amyloid (Aβ) and Tau biomarkers are associated with aMCI/AD, but their relationship to HAND is unclear. Given the role of extracellular vesicles (EVs) in age-related neurological disorders, we investigated soluble and EV-associated Aβ42, total Tau, NFL, GFAP, ICAM-1, VCAM-1, and CRP in relation to cognitive impairment in PWH. Plasma and CSF EVs were isolated from 184 participants (98 PWH on ART and 86 HIV- controls). Biomarkers were measured using Meso Scale Discovery assays. The median age of PWH was 53 years, and 52% were diagnosed with mild forms of HAND. PWH had increased plasma NFL (p = 0.04) and CSF Aβ42 (p = 0.0003) compared with HIV- controls but no significant difference in Tau or EV-associated forms of these markers. CSF EV Aβ42 was decreased (p = 0.0002) and CSF EV Tau/Aβ42 ratio was increased (p = 0.001) in PWH with HAND vs. no HAND, while soluble forms of these markers showed no significant differences. Decreased CSF EV Aβ42 (p < 0.0001) and an increased CSF EV Tau/Aβ42 ratio (p = 0.0003) were associated with lower neurocognitive T scores in age-adjusted models; an optimal model included both CSF EV Aβ42 and plasma NFL. Levels of soluble, but not EV-associated, ICAM-1, VCAM-1, and CRP were increased in PWH with HAND vs. no HAND (p < 0.05). These findings suggest that decreased Aβ42 and an increased Tau/Aβ42 ratio in CSF EVs are associated with cognitive impairment in older PWH, and these EV-associated biomarkers may help to distinguish aMCI/AD from HIV-related cognitive disorders in future studies.

Impact of cataract surgery on cognitive impairment in older people.

To examine the impact of cataract surgery on mild cognitive impairment (MCI) and dementia in older people. This prospective observational study included patients aged 75 years and older who underwent cataract surgery between 2019 and 2021. Mini-mental state examination (MMSE) and MMSE for the visually impaired (MMSE-blind) were measured to evaluate cognitive function before and 3 months after cataract surgery. MMSE score at baseline was used to categorize patients into dementia (MMSE ≤ 23) and MCI groups (23 < MMSE ≤ 27). Logistic regression models were used to estimate associations between improvement in cognitive function and other factors. Of 132 patients screened for inclusion in the study, 88 met the inclusion criteria; 39 patients were assigned to the dementia group (mean age, 85.7 ± 4.2 years) and 49 to the MCI group (mean age, 84.2 ± 3.4 years). The MCI group showed significant improvement from before to after surgery in the MMSE score (25.65 ± 1.03 vs. 27.08 ± 1.99, respectively, p < 0.001) and MMSE-blind score (18.04 ± 1.14 vs. 19.41 ± 2.01, respectively, p < 0.001). Cognitive function improved significantly in the MCI group compared with the dementia group (odds ratio, 2.85; 95% confidence interval, 1.02-7.97; and p = 0.046). Cataract surgery significantly increases cognitive test scores in older patients with MCI. After cataract surgery, the likelihood of improvement in cognitive function may be highly dependent on a patient's preoperative cognitive state.

Fuzzy modelling approach and soft computing mechanism for predicting cognitive impairment in old people

Growing older is a phenomenon that is associated with increasingly complex health situations as a result of the coexistence of several chronic diseases. As a result, there is a downward tendency in both older people and their caretakers’ quality of life, which frequently results in frailty. There are numerous solutions available to treat the issue, which primarily affects older people. The basic and most popular imaging method for predicting cognitive impairment is magnetic resonance imaging. Furthermore, few of the earlier models had a definite level of accuracy when diagnosing the condition. Further, there is a critical need to put in place a stronger, more reliable approach to precise prediction. When compared to other procedures, using magnetic resonance images to predict cognitive decline is the safest and most straightforward. The advanced concept for a better optimized strategy to predict cognitive impairment at an early stage is presented in this research. The hybrid krill herd and grey wolf optimization method is offered as a solution to address the challenges in locating the impacted area. In a short amount of time, a significant number of MRI images are analyzed, and the results show a more precise or higher rate of recognition.

Virtual‐ and Augmented Reality‐Assisted Screening for Early Detection of Cognitive Impairments

AbstractBackgroundA key element in providing future dementia patients with sufficient care is the early detection of cognitive impairment. Using augmented reality (AR) and virtual reality (VR), the project “Smart Cognition &amp; Behaviour Screening powered by Augmented Reality” (SCOBES‐AR) seeks to create a multimodal screening tool (MST) for the early and easy detection of cognitive impairment. The MST focusses on non‐pharmacological prevention by assessing behavioral and lifestyle‐associated risk factors and identifying personal resources.MethodsFirst, a validation study was carried out utilizing the established Cognitive Functions Dementia (CFD) test battery to evaluate a set of selected test procedures. The validated test procedures were implemented in an MST prototype based on AR/VR techniques. Using observational summative evaluation and the co‐discovery method, the usability and applicability of the validated test methods for therapists and subjects were further assessed in a subsequent cross‐over study with 98 healthy individuals (age 60‐75 years).Results310 people were involved in the validation study (age 60‐75 years). Among other things, the assessment of olfactory performance (r = 0.09, p = 0.003), reaction time (r = ‐0.47, p&lt;0.001), and activities of daily living (r = 0.29, p&lt;0.001) revealed a particularly high agreement with the CFD. Further, the MST prototype, that includes a tablet PC, AR head‐mounted display with smartphone, VR head‐mounted display, and Flic Buttons as input devices, was developed (see fig. 1). It allows the therapist to have control and direction over the screening process (see fig. 2).ConclusionThe focus of the MST is on non‐clinical cognitive and physical functionalities, as it integrates tests from multiple health professions and is low‐threshold viable. The development of the MST prototype enables the determination of ideal procedures for multimodal AR/VR‐based testing to measure cognitive impairment in older people. To bolster the findings and advance research, clinical trials involving people with cognitive decline and those who already have dementia would be required.

Instant diagnosis of dementia in older patients who were admitted with forgetfulness to a single geriatric memory clinic

AbstractBackgroundAging is a process associated with progressive and predictable changes that can cause many diseases. As in other systems, structural changes occur in the brain, behavior, and cognitive functions with age. Older people often complain about the decrease in cognitive skills, especially in the memory area and forgetfulness is one of the most common cognitive complaints. In this study, we evaluated the diagnosis of major and minor cognitive impairment in older people who were admitted with forgetfulness to our clinicMethodThis cross‐sectional study, retrospectively desgned, was conducted between January 2018 and January 2022 on a total of 1440 participants who applied to the Geriatrics department with the complaint of forgetfulness, without any acute health problems and with a complete geriatric assessment, including activities of daily living, evaluation of cognitive functions and mood, and blood tests. Dementia diagnosis was made according to the DSM‐V and related specific diagnostic criteria. All demented patients had brain imaging, and cerebrospinal fluid biomarkers, if possible.ResultThe mean age and female frequency were higher in patients with major and minor cognitive impairment while estimated glomerular filtration, folate, and TSH levels were lower. The prevalence of major and minor cognitive impairment was 7.70% and 21.30% respectively. Most of the 3 major neurocognitive impairment diagnoses were Alzheimer’s Disease (7.40%), dementia with Lewy body (3.50%), and Parkinson’s Disease Dementia (1.70%).ConclusionConsidering the risk of dementia in older adults, evaluating the memory complaints has of great importance. This study shows that the majority of the older adults who applied with the complaint of forgetfulness do not have dementia. It is remarkable that the rate of major and minor cognitive impairment was too high to be ruled out in our study population.

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&lt;26) and moderate‐severe (MMSE&lt;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&lt;0.8, medium = NACH 0.8‐0.9, high = NACH&gt;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.

An analysis of psychosocial predictors of cognitive impairment in older people living in social housing ‐ data from longitudinal study: “Porto. Importa‐se”

AbstractBackgroundCognitive Impairment (CI) is a growing public health problem among the older population, with well‐established risk factors. However, the role of psychosocial predictors still needs to be clarified. This study aimed to analyze whether psychosocial factors may be predictors of CI in older persons.MethodIn the framework of “Porto. Importa‐se” longitudinal project, this study included older persons (≥70y.o. living alone and couples ≥75y.o.), living in social housing in Porto city, Portugal. The research protocol included: Six‐item Cognitive Impairment Test (CI), Barthel and Lawton Index (Basic/Instrumental Activities of Daily Living‐BADLs/IADLs), Geriatric Depression Scale‐15 (depressive symptoms) and Lubben Social Network Scale‐6 (social isolation). Loneliness was assessed with a categorical question: Do you feel lonely?. A logistic regression analysis was conducted to identify predictors of CI. Odds Ratio (OR) and its 95% Confidence Interval (95%CI) were calculated. A p&lt;0.05 was considered statistically significant.ResultOf the 1213 older persons (mean age 81±5.7) included, most were female (74%) and 36% had low education level (&lt;4years). About 11% were severely dependent on IADLs and 27% presented CI. Around 35% of participants were at risk of social isolation, 54% reported loneliness and 48% showed depressive symptoms.The logistic regression model was statistically significant [X2(5,N = 1213) = 148.596,p&lt;.001], explaining 19.7%(Nagelkerke R2) of variance in CI (correctly classified 77% of cases). The adjusted model had a moderate sensitivity (63%) and specificity (78%). The oldest persons (≥80 years old) were 1.77 as likely to have CI than younger (OR = 1.77, 95%CI[1.3, 2.4]). Those with less education (&lt;4years) were 0.26 times as likely to present CI than reference group (≥4years) (OR = 0.26, 95%CI[0.2, 0.4]) and females 1.5 times more than males (OR = 1.50, 95%CI[1.0, 2.2]). Older persons at risk of social isolation were 1.85 as likely to have CI (OR = 1.85, 95%CI[1.4, 2.5] and those with depressive symptoms were 1.39 likely to present CI (OR = 1.39, 95%CI[1.0, 1.9]).ConclusionOlder age, female gender, low education, depressive symptoms and social isolation were predictors of CI. The existence of potentially modifiable factors (e.g., social isolation, depression), means that CI prevention is possible through the implementation of effective individual and community‐level interventions, aiming to protect older persons from CI.

Evaluating Prevalence of Cognitive Impairment in Older People Living with HIV Served by a Community‐Based Organization in Colorado, USA

AbstractBackgroundOlder people living with HIV (PLWH) experience unique pathophysiology contributing to accelerated and accentuated aging when compared to older adults living without HIV. Indeed, cognitive dysfunction is a significant age‐related risk exacerbated by HIV. This study investigated prevalence of Mild Cognitive Impairment (MCI) in older PLWH by employing the Montreal Cognitive Assessment (MoCA), which has a high sensitivity for assessing cognitive performance, and its relationship with HIV health, socioeconomic status, and functional aptitude.MethodA cross‐sectional study was conducted in older PLWH ≥50 years receiving HIV‐related care and services at a Community‐Based Organization (CBO) between June and October 2022. The MoCA English Version (8.1) was used to screen cognitive performance. MCI was defined as MoCA scores 18‐26; 10‐17 for moderate cognitive impairment (MoCI); and ≤9 for dementia. Functional aptitude was measured by participants’ Ryan White Part A Wellness acuity scores (0‐41), where higher scores are indicative of lower functional aptitude.ResultDuring the study period, 31 participants were screened; 64.5% were male and 88.9% had virologic suppression. The median age was 60.7 (standard deviation [SD] 6.3) and the median years living with HIV was 23 years (SD 8.9). The median MoCA score was 23 (SD 3.5): 21 (67.7%) with MCI; 3 (9.7%) with MoCI. The median acuity score was 18 (SD 11.9): 21 (SD 11.8) for MCI; 28 (SD 8.5) for MoCI. Multivariable linear regression analysis revealed that a lower MoCA score was associated with lower educational attainment (≤12 years) (r = 0.671, p = 0.0276) and low annual income (r = 0.789, p = 0.0043). A higher acuity score was not significantly associated with MoCA scores.ConclusionA majority of older PLWH screened were within range for M/MoCI. Thus, it is both necessary and ethically responsible for CBO’s serving older PLWH to integrate routine cognitive screening to identify early and pre‐symptomatic stages of impairment, providing prompt services to reduce symptoms and improve health outcomes.

Are demographic factors, masticatory performance and structural brain signatures associated with cognitive impairment in older people? A pilot study of cross-sectional neuroimaging data.

The occurrence of cognitive impairment (CI) is expected to increase within an ageing population. CI is associated with tooth loss, which influences masticatory performance. A decrease in masticatory performance may cause functional and morphological changes in the brain. However, whether CI is associated with masticatory performance, demographics, and structural brain signatures has not been studied yet. To assess the associations between CI on the one hand, and masticatory performance, demographic factors, and structural brain signatures (i.e. cortical volume and thickness) on the other hand. In total, 18 older adults with CI (mean ± SD age = 72.2 ± 9.5 years) and 68 older adults without CI (65.7 ± 7.5 years) were included in this study. Masticatory performance was quantified using a colour-changeable chewing gum. A Magnetic Resonance Imaging (MRI) scan was used to map structural brain signatures. To study our aim, a multivariate binary logistic regression analysis with backward selection was performed. The cortical volume of the right entorhinal cortex was negatively associated with CI (p < .01). However, demographic factors, masticatory performance, and the other structural brain signatures under investigation were not associated with CI. A decrease in the volume of the right entorhinal cortex is associated with CI in older people.

Dementia and mild cognitive impairment in older people in Trøndelag.

The number of people with dementia is expected to triple by 2050. We present figures showing the prevalence of dementia and mild cognitive impairment in Trondheim, and show how weighting for non-response and nursing home residency affects these figures when comparing Trondheim with Nord-Trøndelag. In the fourth data collection in the Trøndelag Health Study (HUNT4) in the Norwegian county of Trøndelag, people aged 70 and over in Trondheim were invited to participate in HUNT4 Trondheim 70+. The participants were interviewed and underwent cognitive testing. A diagnostic team diagnosed dementia and mild cognitive impairment. Weights adjusting for non-response bias were used in the comparison of Trondheim and Nord-Trøndelag. The prevalence of dementia in Trondheim was estimated at 16.2% for the age group 70 years and over, after weighting for non-response bias with regard to age, sex, education and proportion of nursing home residents. Unadjusted dementia prevalence was 21.0% in Trondheim and 15.7% in Nord-Trøndelag. After weighting, the prevalence was almost identical in the two samples. Weighting for non-response is crucial for obtaining representative figures in prevalence studies of dementia.

Vertigoheel promotes rodent cognitive performance in multiple memory tests.

Cognitive impairment associated with old age or various brain disorders may be very disabling for affected individuals, placing their carers and public health services under considerable stress. The standard-of-care drugs produce only transient improvement of cognitive impairment in older people, so the search for novel, safe and effective therapeutics that would help to reverse or delay cognitive impairment is warranted. Repurposing pharmacological therapies with well-established safety record for additional indications is a promising recent trend in drug development. Vertigoheel (VH-04), a multicomponent drug made of Ambra grisea, Anamirta cocculus L., Conium maculatum, and Petroleum rectificatum, has been successfully used for several decades in the treatment of vertigo. Here, we investigated effects of VH-04 on cognitive performance in standard behavioral tests assessing different types of memory and explored cellular and molecular underpinnings of VH-04's biological activity. In the majority of behavioral experiments, namely in the spontaneous and rewarded alternation tests, passive avoidance test, contextual/cued fear conditioning, and social transmission of food preference, we examined the ability of single and repeated intraperitoneal administrations of VH-04 to improve cognitive parameters of mice and rats disrupted by the application of the muscarinic antagonist scopolamine. In addition, we also assessed how VH-04 affected novel object recognition and influenced performance of aged animals in Morris water maze. Furthermore, we also studied the effects of VH-04 on primary hippocampal neurons in vitro and mRNA expression of synaptophysin in the hippocampus. Administration of VH-04 positively influenced visual recognition memory in the novel object recognition test and alleviated the impairments in spatial working memory and olfactory memory caused by the muscarinic antagonist scopolamine in the spontaneous alternation and social transmission of food preference tests. In addition, VH-04 improved retention of the spatial orientation memory of old rats in the Morris water maze. In contrast, VH-04 did not have significant effects on scopolamine-induced impairments in tests of fear-aggravated memory or rewarded alternation. Experiments in vitro showed that VH-04 stimulated neurite growth and possibly reversed the age-dependent decrease in hippocampal synaptophysin mRNA expression, which implies that VH-04 may preserve synaptic integrity in the aging brain. Our findings allow a cautious conclusion that in addition to its ability to alleviate manifestations of vertigo, VH-04 may be also used as a cognitive enhancer.

The Relationship between Handgrip Strength, Timed Up-and-Go, and Mild Cognitive Impairment in Older People during COVID-19 Pandemic Restrictions

The COVID-19 lockdown restrictions affected physical performance and cognitive function in older people as they were confined to their homes. There is an association between physical and cognitive functions. Mild Cognitive Impairment (MCI) is a condition that risks progressing to dementia. This study aimed to identify the relationship between handgrip strength (HGS), Timed Up-and-Go (TUG), and MCI in older people during the COVID-19 pandemic restrictions. The cross-sectional study recruited 464 eligible participants for an interview and anthropometric measurement. The Montreal Cognitive Assessment-Basic (MoCA-B), HGS, and TUG were measured in addition to demographic and health characteristics. A total of 398 participants (85.8%) were found to have MCI when screened with the MoCA-B. Their mean age was 71.09 ± 5.81 years. Forward multiple regression analysis demonstrated that HGS (β = 0.032, p < 0.001), education level (β = 2.801, p < 0.001), TUG (β = -0.022, p = 0.013), Thai Geriatric Depression Score, TGDS (β = -0.248, p = 0.011), and age (β = -1.677, p = 0.019) were associated with MCI. A decrease in HGS and an increased TUG might allow for the early detection of MCI and promote physical training in order to reduce the risk of MCI. Further studies can investigate multidomain indicators for MCI, for example, fine motor skills and pinch strength as components of the motor abilities.

The sleep condition and its association with cognitive function of the elderly in six provinces of China

Objective: To analyze the association between sleep duration and cognitive function of the elderly in six provinces of China. Methods: Based on the cross-sectional survey data of the elderly from the Healthy Ageing Assessment Cohort Study in 2019, 4 644 participants' sociodemographic and economic indicators, lifestyle, prevalence of major chronic diseases, and sleep status, including night-time sleep duration, daytime sleep duration and insomnia, were collected by questionnaires. Cognitive function was evaluated by the Mini-Mental State Examination. Multivariate logistic regression was used to analyze the association between night-time sleep duration, daytime sleep duration and cognitive function. Results: The mean age of 4 644 respondents was (72.3±5.7) years, and 2 111 of them were males (45.5%). The mean total daily sleep time of the elderly was (7.9±1.9) hours, and the proportion of those who slept less than 7.0, 7.0-8.9 and≥9.0 hours was 24.1% (1 119), 42.1% (1 954) and 33.8% (1 571), respectively. The mean sleep time at night was (6.9±1.7) hours. About 23.7% (1 102) of the elderly did not sleep during the day, and the mean duration of the elderly who slept during the day was (78±51) minutes. Among the elderly with insomnia, 47.9% were still satisfied with their sleep quality. The mean value of MMSE score of 4 644 respondents was (24.5±5.3), and the cognitive impairment rate was 28.3% (1 316). The results of multivariate logistic regression model analysis showed that the OR (95%CI) value of the risk of cognitive impairment in older people who did not sleep, slept for 31 to 60 minutes and slept more than one hour was 1.473 (1.139 to 1.904), 1.277 (1.001 to 1.629) and 1.496 (1.160 to 1.928), respectively, compared with those who slept for 1 to 30 minutes during the daytime. Compared with those who slept for 7.0‒8.9 hours at night, the OR (95%CI) value of the risk of cognitive impairment in older people who slept more than 9.0 hours was 1.239 (1.011 to 1.519). Conclusion: The cognitive function is related to sleep duration in the Chinese elderly.

Association between Sarcopenia, Falls, and Cognitive Impairment in Older People: A Systematic Review with Meta-Analysis.

With the aging process, elderly people present changes in their bodies that can lead them to suffer several geriatric syndromes. The present study aimed to analyze and synthesize the literature produced concerning the association of sarcopenia with falls in elderly people with cognitive impairment. This is a systematic review study on etiology and risk, conducted according to the JBI methodology using the Medline (Pubmed), Cinahl, Embase, Scopus, and Web of Science databases. The gray literature search was conducted in the CAPES Brazilian Digital Library of Theses and Dissertations, Google Scholar, Networked Digital Library of Theses and Dissertations (NDLTD), EBSCO Open Dissertations, DART-e, and ACS Guide to Scholarly Communication. The identification of the association between the variables was extracted from the articles themselves (Odds Ratio and the 95% Confidence Intervals). Four articles published between 2012 and 2021 were included in this review. A prevalence of falls was identified, ranging from 14.2% to 23.1%, of cognitive impairment ranging from 24.1% to 60.8%, and of sarcopenia ranging from 6.1 to 26.6%. The meta-analysis found that elderly people with cognitive impairment who suffer falls are at a 1.88 times greater risk of presenting sarcopenia (p = 0.01). There is evidence of an association between the variables, but it is necessary to conduct follow-up studies to support this association as well as other factors that may influence the senescence and senility process.

Cognitive impairment as a comorbidity of epilepsy in older adults: Analysis of global and domain-specific cognition.

This study aimed to explore the association between epilepsy and cognitive impairment and to determine the factors associated with cognitive impairment in older people with epilepsy. People with epilepsy and controls aged ≥50 years were recruited and their global and domain-specific cognitive functions were evaluated by a comprehensive neuropsychological battery. Clinical characteristics were obtained from medical records. Analysis of covariance was used to examine the difference of cognition between two groups, after adjusting for age, gender, education years, hypertension, diabetes, and heart disease. A multiple linear regression model was used to explore the potential impact factors of cognitive functions among people with epilepsy. This study recruited 90 people with epilepsy and 110 controls. The proportion of cognitive impairment among older adults with epilepsy was 62.2%, which was significantly higher than controls (25.5%, p < .001). People with epilepsy performed worse on global cognition (p < .001), especially in domains of memory (p < .001), executive function (p < .001), language (p < .001), and attention (p = .031). Among older adults with epilepsy, age was negatively correlated with the scores of memory (β = -.303, p = .029), executive function (β = -.354, p = .008), and attention (β = -.558, p < .001). Females performed better on executive function (β = -.350, p = .002) than males. Education years had a positive correlation with global cognition (β = .314, p = .004). Number of antiseizure medications was also negatively correlated with scores of spatial construction function (β = -.272, p = .019). Our results indicated that cognitive impairment was a major comorbidity of epilepsy. Number of antiseizure medications is suggested as a potential risk factor of impaired cognition in older people with epilepsy.

Testing the cognitive effects of tadalafil. Neuropsychological secondary outcomes from the PASTIS trial

Cerebral small vessel disease (SVD) is a major cause of cognitive impairment in older people. As secondary endpoints in a phase-2 randomised clinical trial, we tested the effects of single administration of a widely-used PDE5 inhibitor, tadalafil, on cognitive performance in older people with SVD. In a double-blinded, placebo-controlled, cross-over trial, participants received tadalafil (20 mg) and placebo on two visits ≥ 7 days apart (randomised to order of treatment). The Montreal Cognitive Assessment (MOCA) was administered at baseline, alongside a measure to estimate optimal intellectual ability (Test of Premorbid Function). Then, before and after treatment, a battery of neuropsychological tests was administered, assessing aspects of attention, information processing speed, working memory and executive function. Sixty-five participants were recruited and 55 completed the protocol (N = 55, age: 66.8 (8.6) years, range 52–87; 15/40 female/male). Median MOCA score was 26 (IQR: 23, 27], range 15–30). No significant treatment effects were seen in any of the neuropsychological tests. There was a trend towards improved performance on Digit Span Forward (treatment effect 0.37, C.I. 0.01, 0.72; P = 0.0521). We did not identify significant treatment effects of single-administration tadalafil on neuropsychological performance in older people with SVD. The trend observed on Digit Span Forward may help to inform future studies. Clinical trial registrationhttp://www.clinicaltrials.gov. Unique identifier: NCT00123456, https://eudract.ema.europa.eu. Unique identifier: 2015–001,235–20NCT00123456.