Cognitive Impairment In Women Research Articles

Effect of ferric citrate on hippocampal iron accumulation and widespread molecular alterations associated with cognitive disorder in an ovariectomized mice model.

Nowadays, the prevalence of cognitive impairment in women has gradually increased, especially in postmenopausal women. There were few studies on the mechanistic effects of iron exposure on neurotoxicity in postmenopausal women. The aim of this study is to investigate the effect of iron accumulation on cognitive ability in ovariectomized mice and its possible mechanism and to provide a scientific basis for the prevention of cognitive dysfunction in postmenopausal women. Female C57BL/6N ovariectomized model mice were induced with ferric citrate (FAC). The mice were randomly divided into 5 groups: control, sham, ovariectomized (Ovx), Ovx + 50 mg/kg FAC (Ovx + l), and Ovx + 100 mg/kg FAC (Ovx + h). The impact of motor and cognitive function was verified by a series of behavioral tests. The levels of serum iron parameters, malondialdehyde, and superoxide dismutase were measured. The ultrastructure of mice hippocampal microglia was imaged by transmission electron microscopy. The differential expression of hippocampal proteins was analyzed by Tandem Mass Tag labeling. Movement and cognitive function in Ovx + l/Ovx + h mice were significantly decreased compared to control and Sham mice. Then, iron exposure caused histopathological changes in the hippocampus of mice. In addition, proteomic analysis revealed that 29/27/41 proteins were differentially expressed in the hippocampus when compared by Ovx vs. Sham, Ovx + l vs. Ovx, as well as Ovx + h vs. Ovx + l groups, respectively. Moreover, transferrin receptor protein (TFR1) and divalent metal transporter 1 (DMT1) protein expression were significantly increased in the iron accumulation mice model with ovariectomy. Iron exposure could cause histopathological damage in the hippocampus of ovariectomised mice and, by altering hippocampal proteomics, particularly the expression of hippocampal iron metabolism-related proteins, could further influence cognitive impairment in ovariectomized mice.

Lifetime History of Low Birth Weight Delivery and Cognitive Function in Middle-Aged Parous Women.

Pregnancy outcomes such as low birth weight (LBW) delivery may reflect vascular or metabolic dysfunction in mothers and presage future cognitive impairment and dementia. However, the evidence is currently limited. Our objective was to examine the extent to which a lifetime history of LBW delivery was associated with cognitive function in parous middle-aged women. We studied participants from the Nurses' Health Study II, an ongoing longitudinal cohort of female nurses enrolled in 1989. In 2009, participants completed a reproductive history questionnaire. Participants who completed at least one of 2 post-traumatic stress disorder questionnaires were invited to participate in a cognition substudy with 2 waves of baseline data collection (2014 or 2018). We restricted the analysis to participants with one valid cognitive assessment who reported ≥1 birth at 18 years and older. We defined LBW delivery history as having delivered offspring with a birth weight <2,500 g (<5.5 lbs) in any pregnancy. The outcome was a single assessment of cognitive function evaluated with the self-administered Cogstate Brief Battery. The battery comprises 4 tasks, which we used to create 2 composite z-scores measuring psychomotor speed/attention and learning/working memory (higher z-scores = better cognitive function). We used multivariable linear regression models. The analysis included 15,323 participants with a mean age of 62 (standard deviation: 4.9 years) at cognitive assessment. Among them, 1,224 (8%) had a history of LBW delivery. After adjusting for age at cognitive assessment, race, and ethnicity, participants' education, wave of baseline cognitive assessment, socioeconomic status, and prepregnancy characteristics, women with a history of LBW delivery had lower z-scores in the psychomotor speed/attention (β, -0.06; 95% CI -0.12 to -0.01) and learning/working memory (β, -0.05; 95% CI -0.09 to -0.01) composites than parous women without a history of LBW delivery. We observed a gradient of lower z-scores with an increasing number of LBW deliveries. History of LBW delivery may be marker of future poorer cognition. If confirmed, our findings support future investigations into the value of early preventive efforts targeting women with a history of LBW delivery to reduce the burden of cognitive impairment in women.

Sex Disparity in the Association of Metabolic Syndrome with Cognitive Impairment.

Background/Objectives: Metabolic syndrome (MS) is a constellation of several cardiometabolic risk factors. We investigated sex disparity in the associations between MS and cognitive impairment using cross-sectional data from Taiwan Biobank. Methods: We determined the associations of MS and its five components with cognitive impairment (mini-mental state examination, MMSE < 24) and the five domains of MMSE using logistic regression analyses. Results: A total of 7399 men and 11,546 women were included, and MS was significantly associated with cognitive impairment only in women (adjusted OR 1.48, 95% CI 1.29-1.71, p = 0.001) (p for interaction 0.005). In women, the association with MS was significant in orientation (adjusted OR 1.21, 95% CI 1.07-1.37, p = 0.003), memory (adjusted OR 1.12, 95% CI 1.01-1.25, p = 0.034) and design copying (adjusted OR 1.41, 95% CI 1.23-1.62, p = 0.001) (p value for interaction 0.039, 0.023, and 0.093, respectively). Among the components of MS, a large waist circumference (adjusted OR 1.25, 95% CI 1.08-1.46, p = 0.003), high fasting glucose (adjusted OR 1.16, 95% CI 1.00-1.34, p = 0.046), and low HDL cholesterol (adjusted OR 1.16, 95% CI 1.00-1.34, p = 0.049) were significantly associated with cognitive impairment in women. Conclusions: Our findings suggest that sex has a significant influence on the association between MS and cognitive dysfunction, especially in orientation and memory.

Cognitive impairments and emotional disorders and their correction in perimenopausal women

The presented literature review reveals the topic of the features of risk factors for cognitive impairment in women in the perimenopausal period (PMP), as well as the possibilities of their earliest detection and correction. The paper searches for various symptoms and predictors of the development of cognitive impairment in women in the PMP. The key features include certain difficulties in making a diagnosis at earlier stages. The relationship of metabolic disorders with factors negatively affecting the health of women in the PPP, as well as contributing to the deterioration of cognitive functions, is considered. Women are more at risk of developing cognitive impairment and represent a specific target group that requires special attention in assessing risk factors and methods for correcting cognitive disorders. To date, the relationship between gender and dementia risk still needs to be studied in more depth. Given this, menopause is an important physiological period, as it is accompanied by intense hormonal changes that may be the direct cause of cognitive decline. Many women experience mood disorders, anxiety, increased mental and/or physical fatigue, irritability, mild cognitive disorders, which requires an interdisciplinary approach by doctors to this issue. All these manifestations should be evaluated and corrected in time to avoid their progression and a decrease in the quality of life. An integrated approach to therapy, both medicinal and non-medicinal, can significantly improve the quality of life of patients in the PPP.

СРАВНИТЕЛЬНЫЙ АСПЕКТ ФОРМИРОВАНИЯ АЛКОГОЛЬНОЙ ЗАВИСИМОСТИ, АССОЦИИРОВАННОЙ С КОГНИТИВНЫМИ РАССТРОЙСТВАМИ, У ЖЕНЩИН В РАЗЛИЧНЫХ ЭТНИЧЕСКИХ ПОПУЛЯЦИЯХ

Background. The development of alcohol dependence in women associated with cognitive impairment has different degrees of severity in different ethnic populations in the Siberian region: Tuvan and Russian ethnic groups. The comparative aspect of the study is important in assessing the typology and course of alcohol dependence in women of different ethnic backgrounds. Objective. To study the features of the development of alcohol dependence and cognitive impairment in women of Tuvan and Russian ethnic backgrounds. Materials and methods. The study included two groups of women with alcohol dependence. The first group consisted of 78 women of Tuvan nationality (mean age 41.6±9.9 years), who were treated in the Republican Narcological Dispensary of the Republic of Tyva. The second group consisted of 66 women of Russian nationality (mean age 41.6±9.0 years), who were treated in the Department of Addictive States of the Research Institute of Mental Health of the Tuvan National Research Medical Center. Clinical-psychopathological, psychological, mathematical-statistical methods were used. Results. In women of Tuvan nationality, the development and formation of alcohol dependence (from the appearance of the first signs to the development of withdrawal syndrome) occurs progressively. They are characterized by a high degree of psychotic forms of alcoholism, which develop after 5-6 years of alcohol abuse, compared to Russian women, in whom the first alcoholic psychosis develops only after 14-15 years of alcohol abuse. In 16.7% of Tuvan women, psychosis acquired a tendency to frequent recurrence. Typical stereotypy in pictograms is associated with alcoholic psychosis. Excessive typical stereotypy was found on pictograms in 50% of Tuvan patients and 30.4% of Russian patients without a history of alcoholic psychosis; In the subgroups of female patients who suffered from alcoholic psychoses, this feature was found in 72.41% of Tuvan and 66% of Russian women. Conclusion. The identified clinical and psychopathological symptoms confirm the progressive development of alcohol dependence in women of Tuvan ethnicity. Cognitive impairments are characterized by the monotony of associative connections, a decrease in the level of generalization, and the volume of working memory.

Life course rural/urban place of residence, depression and cognitive impairment among older adults: Findings from the Longitudinal Aging Study in India

AbstractBackgroundGiven the unique socioeconomic structures and rural/urban differentials in mental health outcomes in the country, this study aimed to explore the associations of childhood, adulthood and late‐life place of residence with mental health outcomes of depression and cognitive impairment among older adults in India. The study also examined the relationship between older individuals’ life‐course rural/urban place of residence and late‐life mental and cognitive health.MethodUtilizing data from the Longitudinal Aging Study in India (n = 28,041 older adults age 60 years and above), I employed multivariable logistic and linear regression models to examine the association between urban/rural residential status, life‐course residence, depression and cognitive impairment among older adults.ResultChildhood and adulthood place of residence was not associated with depression in older men and women. Current rural place of residence was positively associated with depression in older women [OR: 1.37, CI: 1.05‐ 1.80] but not men. Childhood [OR: 1.88, CI: 1.16‐ 3.04], adulthood [OR: 2.00, CI: 1.26‐ 3.16] and current rural residence [OR: 1.93, CI: 1.27‐ 2.91] was positively associated with cognitive impairment in men. Only current rural residence [OR: 1.71, CI: 1.29‐ 2.27] was associated with cognitive impairment in women. There was no significant association between life‐course place of residence and depression except in case of lifetime rural residence Respondents with urban‐urban‐urban place of residence were less likely to be depressed [Coef.: ‐0.14, CI: ‐0.21‐ ‐0.07] compared to those with rural‐rural‐rural place of residence. There were significant associations between life‐course residence and cognitive impairment except among rural‐urban‐rural and urban‐rural‐rural migrants, showing a urban advantage in cognitive function among older adults.ConclusionThis study showed significant associations between life‐course residence and depression among permanent rural/urban residents. The study also showed significant associations between life‐course residence and cognitive impairment except among rural‐urban‐rural and urban‐rural‐rural migrants. Considering the rural disadvantage, the government should continue to support policies that can promote education among people residing in rural areas. The findings also urge social scientists and gerontologists, in particular, to consider the importance of lifetime historical context while evaluating mental and cognitive health of older persons.

Enfermedad cardiovascular previa y posterior a la infección por COVID-19. Supervivencia a un año

AimTo analyze the risk of COVID-19 in relation to previous morbidity; to analyze the risk of new cardiovascular events (CVE) in COVID-19 patients and one-year survival. MethodologyCase–control study and prospective cohort study. Two hundred and seventy-five randomized patients >18 years old with COVID-19 were included and matched with 825 without COVID-19 by age and sex (ratio 1:3). The main variables were diagnosis of COVID-19 and post-COVID-19 events. Sociodemographic variables, comorbidity, and previous CVD were studied. Two predictive models of factors associated with the development of COVID-19 and post-COVID-19 CVE were performed, as well as a one-year survival analysis. ResultsMen with a previous CVE double the risk of suffering from COVID-19 (OR 2.11; 95% CI: 1.32–3.36). In women, the risk increases with age (OR 1.01; 95% CI: 1.00–1.02), diabetes (DM) (OR 1.90; 95% CI: 1.14–3.17) and cognitive impairment (OR 4.88; 95% CI: 2.50–9.53). Immunosuppression acts as a protective factor in both sexes. Age (OR 1.02; 95% CI: 1.00–1.04), arterial hypertension (OR 2.21; 95% CI: 1.17–4.17), COVID-19 infection (OR 4.81; 95% CI: 2.89–7.98) and previous CVE (OR 4.46; 95% CI: 2.56–7.75) predict the development of a new post-COVID-19 CVE. Positive COVID-19 has lower survival (median 7 days vs. 184 days). ConclusionsPrevious CVE in men and DM along with cognitive impairment in women increase the risk of presenting COVID-19. Age, arterial hypertension, previous CVE, and COVID-19 infection predict the appearance of new CVE.

Life course rural/urban place of residence, depressive symptoms and cognitive impairment among older adults: findings from the Longitudinal Aging Study in India

BackgroundGiven the unique socioeconomic structures, and the rural/urban differentials in the prevalence of mental illnesses in the country, this study aimed to explore the associations of childhood, adulthood and late-life rural/urban place of residence with mental health outcomes, namely depressive symptoms and cognitive impairment, among older adults in India. The study also examined the relationship between older individuals’ life-course rural/urban place of residence and late-life mental and cognitive health.MethodsUtilizing data from the Longitudinal Aging Study in India (n = 28,027 older adults age 60 years and above), the study employed multivariable logistic and linear regression models to examine the association between urban/rural residential status, life-course residence, depressive symptoms and cognitive impairment among older adults.ResultsChildhood and adulthood place of residence was not associated with depressive symptoms in older men and women. Current rural place of residence was positively associated with depressive symptoms in older women [adjusted odds ratio (aOR): 1.37, confidence interval (CI): 1.05–1.80] but not men. Childhood [aOR: 1.88, CI: 1.16–3.04], adulthood [aOR: 2.00, CI: 1.26–3.16] and current rural residence [aOR: 1.93, CI: 1.27–2.91] was positively associated with cognitive impairment in men. Only current rural residence [aOR: 1.71, CI: 1.29–2.27] was associated with cognitive impairment in women. There was no significant association between life-course place of residence and depressive symptoms except in case of lifetime rural residence Respondents with urban-urban-urban (childhood-adulthood-current) place of residence were less likely to have depressive symptoms [adjusted coefficient (aCoef.): -0.14, CI: -0.21- -0.07] compared to those with rural-rural-rural place of residence. There were significant associations between life-course residence and cognitive impairment except among rural-urban-rural and urban-rural-rural migrants, showing an urban advantage in cognitive function among older adults.ConclusionsThis study showed significant associations between life-course residence and depressive symptoms among permanent rural/urban residents. The study also showed significant associations between life-course residence and cognitive impairment except among rural-urban-rural and urban-rural-rural migrants. Considering the rural disadvantage in mental and cognitive health among older adults, the government should continue to support policies that can improve access to education and healthcare among people residing in rural areas and women, in particular. The findings also urge social scientists and gerontologists in particular, to consider the importance of lifetime historical context while evaluating mental and cognitive health of older persons.

Sex differences in plasma phosphorylated‐tau181 vary between older adults with and without mild cognitive impairment

AbstractBackgroundWomen exhibit higher tau pathology than men on central nervous system biomarkers of tau (e.g., PET imaging, CSF), particularly among APOE4 carriers and those with symptomatic Alzheimer’s disease (AD). The purpose of this study was to determine if these sex differences were detectible using a novel plasma biomarker of tau pathology in non‐demented adults.MethodPlasma phosphorylated‐tau181 (P‐tau181)was assayed (Quanterix Simoa) in 132 cognitively unimpaired individuals (CU; 61 men, 71 women) and 43 individuals with mild cognitive impairment (MCI; 28 men, 15 women)who underwent florbetapir PET imaging. Controlling for age, linear regression examined plasma P‐tau181 as a function of sex, diagnosis, and their interaction. To determine whether sex‐differences in plasma P‐tau181 were influenced by amyloid pathology, results were compared before and after accounting for APOE4 genotype and Aβ‐PET positivity.ResultThe sex by diagnosis interaction on plasma P‐tau181 was statistically significant (β = 0.19; p = .044), and this effect strengthened after covarying for APOE4 and Aβ‐PET (β = 0.23; p = .006). In MCI, women exhibited higher mean plasma P‐tau181 concentrations than men (3.59 pg/ml vs. 3.06 pg/ml; Cohen’s d = 0.70; p = 0.032). In CU, women trended towards lower mean pTau concentrations than men (1.90 pg/ml vs. 2.28 pg/ml; Cohen’s d = ‐0.33; p = 0.064).ConclusionResults demonstrate greater tau burden, as measured with plasma P‐tau181, in women than men with MCI, consistent with prior studies using CSF P‐tau181 and tau‐PET imaging. In contrast, women without cognitive symptoms had the lowest levels of plasma P‐tau181, suggesting elevated plasma P‐tau181 may be particularly sensitive to cognitive impairment in women. Statistical adjustment for APOE4 and Aβ‐PET did not account for, but instead magnified, the sex by diagnosis interaction on plasma P‐tau181, suggesting factors beyond amyloid (e.g., sex hormones) may mediate diagnostic‐dependent patterns of sex‐differences in plasma P‐tau181 and could help clarify mechanisms that predispose women to tau pathology.

Association of serum uric acid and fasting plasma glucose with cognitive function: a cross-sectional study

BackgroundThe combined effect of serum uric acid (SUA) and blood glucose on cognition has not been explored. This study aimed to examine the separate and combined association of SUA and fasting plasma glucose (FPG) or diabetes mellitus (DM) with cognition in a sample of Chinese middle-aged and elderly population.MethodsA total of 6,509 participants aged 45 years or older who participated in the China Health and Retirement Longitudinal Study (CHARLS, 2011) were included. The three cognitive domains assessed were episodic memory, mental status, and global cognition (the sum of the first two terms). Higher scores indicated better cognition. SUA and FPG were measured. The participants were grouped based on SUA and FPG quartiles to evaluate their combined associations of cognition with SUA Q1–Q3 only (Low SUA), with FPG Q4 only (High FPG), without low SUA and high FPG levels (Non), and with low SUA and high FPG levels (Both), multivariate linear regression models were used to analyze their association.ResultsLower SUA quartiles were associated with poorer performance in global cognition and episodic memory compared with the highest quartile. Although no association was found between FPG or DM and cognition, high FPG or DM combined with low SUA levels in women (βFPG = -0.983, 95% CI: -1.563–-0.402; βDM = -0.800, 95% CI: -1.369–-0.232) had poorer cognition than those with low SUA level only (βFPG = -0.469, 95% CI: -0.926–-0.013; βDM = -0.667, 95% CI: -1.060–-0.275).ConclusionMaintaining an appropriate level of SUA may be important to prevent cognitive impairment in women with high FPG.

Abstract GS1-04: Patient-reported cognitive impairment in women participating in the RxPONDER trial (SWOG S1007) by menopausal status

Abstract Introduction: Breast cancer treatment is associated with cancer-related cognitive impairment (CRCI). However, the differential effect of endocrine therapy (ET) vs chemotherapy followed by endocrine therapy (CET), including the impact of menopausal status, on CRCI is not well understood. Methods: Participants (pts) with hormone receptor positive, HER2 negative breast cancer with 1-3 positive lymph nodes and an Oncotype DX recurrence score of 0-25 enrolled in the RxPONDER trial were randomly assigned to ET alone versus CET. Until the health-related quality of life (HRQoL) accrual goal was reached, English speaking pts in the US were invited to complete HRQoL questionnaires including the 8-item PROMIS Perceived Cognitive Function Concerns (PCF) Short Form questionnaire shortly after randomization (baseline), as well as 6, 12, and 36 months after baseline. Analysis of measures of anxiety and fatigue is presented separately. Standardized T scores (mean 50; SD 10) for PCF were computed with higher scores indicating less cognitive impairment. The primary endpoint of this exploratory analysis was to compare mean PCF T scores by treatment arm and menopausal status. Separately by menopausal status, a generalized estimating equations (GEE) model was fit to the three timepoints adjusting for baseline to estimate the difference between treatment arms and whether there was a time trend over the three follow-up measures. Results: The HRQoL accrual exceeded the goal of 500 patients, with 74% of pts participating voluntarily until the QOL invitation was removed from the protocol (Dec 1, 2012). A total of 139 pre and 429 postmenopausal pts completed the questionnaires at baseline. T scores were similar between ET and CET arms at baseline [Table 1]. In the ET arm, T scores decreased from baseline to 6 and 12 months but recovered to baseline at 36 months. In the CET arm, T scores decreased from baseline to 6 months and 12 months but did not return to baseline at 36 months. The mean score difference between CET and ET over time was -3.02 (p=0.01) and -2.36 (p=0.003) for pre and postmenopausal pts, respectively. Adjusting for baseline, there was no significant time trend over the three follow-up periods for either premenopausal (p=0.12) or postmenopausal (p=0.49) pts. Dropoff occurred over time with 79%, 76%, 60% of pts at baseline participating at 6, 12, and 36 months. Complete endocrine treatment adherence data are not yet available at each timepoint. Conclusion: Chemoendocrine therapy has a greater negative effect on patient-reported CRCI compared to ET alone in both pre- and post-menopausal pts and it is sustained over 36 months. Interventions to prevent or treat CRCI are needed to improve the long-term quality of life of patients treated with CET. Table 1. Comparisons of mean Cognitive Function score by treatment arm and menopausal status. Citation Format: Irene Kang, Jamie K. Forschmiedt, Michelle M. Loch, William E. Barlow, Danika L. Lew, Julie R. Gralow, Funda Meric-Bernstam, Kathy S. Albain, Daniel F. Hayes, Nancy U. Lin, Edith A. Perez, Lori J. Goldstein, Priya Rastogi, Anne F. Schott, Steven Shak, Priyanka Sharma, Jieling Miao, Debu Tripathy, Lajos Pusztai, Gabriel N. Hortobagyi, Kevin Kalinsky, N. Lynn Henry. Patient-reported cognitive impairment in women participating in the RxPONDER trial (SWOG S1007) by menopausal status [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr GS1-04.

Effects of follicle-stimulating hormone on fat metabolism and cognitive impairment in women during menopause.

Lipid metabolism disorder is a common pathological manifestation of menopausal women, and is also an important risk factor for many diseases at this stage of life. Epidemiological studies have shown that high levels of follicle-stimulating hormone (FSH) in menopausal women are closely associated with changes in body composition, central obesity, and cognitive decline. Exogenous FSH causes growth and proliferation of adipose, whereas blockage of the FSH signaling pathway leads to decline in adipose. Mechanistically, FSH, FSH receptor (FSHR), G protein coupling, gene mutation and other pathways are involved in adipogenesis and cognitive impairment. Here, we review the critical role and potential interactions of FSH in adipogenesis and cognitive impairment in menopausal women. Further understanding of the exact mechanisms of FSH aggravating obesity and cognitive impairment may provide a new perspective for promoting healthy aging in menopausal women.

Cognitive impairment in women newly diagnosed with thyroid cancer before treatment.

The study aims to assess cognitive function in women newly diagnosed with non-metastatic thyroid cancer before any treatment and to identify factors associated with cognitive problems. Korean women newly diagnosed with thyroid cancer awaiting initial surgical treatment (n = 130) completed neuropsychological tests and self-report questionnaires on symptom distress and psychological distress. Additionally, information on thyroid function was obtained through a medical chart audit. Descriptive statistics and multivariable regression analyses were performed to describe the incidence of cognitive problems and to identify possible predictors of neuropsychological performance. Approximately 95% of women newly diagnosed with thyroid cancer had impaired neuropsychological test scores on one or more tests of attention and cognitive control. Further analyses found that 78% of women met both the Global Deficit Score and the International Cancer and Cognition Task Force criteria for impairment. Finally, regression analyses found that older age, fewer years of education, greater depressed mood, and having a hypothyroid state but not having a comorbid condition, fatigue, sleep problems, symptom burden, or symptom interference were associated with worse neuropsychological test performance in this sample. Additional explorative regression analysis using mean T-scores corrected for age, education, and gender continued to find that hypothyroid state was associated with worse neuropsychological test performance. Findings suggest that individuals newly diagnosed with non-metastatic thyroid cancer are vulnerable to cognitive deficits at diagnosis before any treatment. As such, healthcare workers should assess individuals newly diagnosed with thyroid cancer diagnosis awaiting treatment for the disease for cognitive deficits and intervene to reduce symptom distress and optimize function.

Long-term changes of cognitive impairment among older breast cancer survivors.

Cancer-related cognitive impairment is common during cancer treatment; however, it is unclear whether the impairment persists over time. Our study aimed to examine long-term cognitive impairment among older breast cancer survivors. Participants included 2420 community-dwelling women aged 65years or older at enrollment (1986-1988) (404 breast cancer cases and 1:5 matched cancer-free controls) from the Study of Osteoporotic Fractures. Participants were followed for 20years with measured cognitive function repeated up to 6 times. Cognitive impairment was defined by the Modified Mini-Mental State Examination and Trail Making Test B. Generalized linear models were used to model risk of cognitive impairment in relation to breast cancer status and time from breast cancer diagnosis. Compared with controls, cognitive impairment in women with breast cancer significantly accelerated after cancer diagnosis. We also observed a more pronounced cognitive impairment after cancer diagnosis for women diagnosed with breast cancer at age ≥ 80years or at advanced stage for both measures. Our study with more than 20years of follow-up data found that breast cancer survivors had accelerated cognitive impairment after cancer diagnosis, especially among women diagnosed at older age or at advanced stage, relative to women without cancer. Breast cancer survivors may be encouraged to engage in both physical activity and cognitive training.

Mechanisms in Chronic Kidney Disease and Associated Cardiovascular Remodeling Contributes to the Progression of Cognitive Impairment in Women

IntroductionIn end‐stage chronic kidney disease (CKD) (stages 4‐5) the prevalence of cognitive impairment (CI) has been estimated at 30‐60%, twice the values observed in age‐ and sex‐matched controls. CKD is greater in females vs. males due to a higher risk of renal infections, especially during the pregnancy, which may result in the renal complications later in life, when the level of protective estrogen declines. Cardiovascular diseases (CVD) including hypertension and increased central arterial stiffness (CAS) accompany CKD development across all stages of this disease. CAS drives pulse pressure (PP) and pulsatile component index (PCI) increases and cerebral microvascular damage resulting in a reduction of blood supply to the brain hereby contributing to CI. Elevated PP and PCI are associated with higher mortality in CVD and CKD independently of BP. Moreover, PP is a cardiovascular risk factor independent on PCI in women &gt;55 years.HypothesisThe aim of the study was to determine whether CKD potentiates development of CI due to cardiovascular remodeling and whether CI in CKD is more pronounced in women. Furthermore, this study also aimed to determine whether reduced estrogen levels in older women with CKD contribute to the progression of CI.MethodsAll research was performed in accordance with the guidelines and regulations set forth by the Declaration of Helsinki regarding the use and enrollment of human subjects in research. A total of 26 female CKD patients (age 45‐50 years and older, CKD stage 4, GFR 15‐29, and Creatinine &gt; 1mg/dL) and 30 age and sex‐ matched healthy control patients were enrolled with exclusion criteria (history of HIV, hepatitis, malignancies, admission and/or surgery for trauma, head injury and pregnancy at time of enrollment). Blood pressure (systolic and diastolic blood pressure (SBP, DBP) was measured, clinical blood work, echocardiography (ECHO) and mini‐mental state examination (MMSE) was performed as well as levels of amyloid beta‐40 (Aβ‐40) measured. PCI was calculated as difference between peak systolic and end diastolic flow velocity, divided by the flow velocity. Estrogen levels were measured in the plasma samples. The data were analyzed by unpaired two‐tailed t‐test and Pearson correlation with P values adjusted for false discovery rate.ResultsCKD patients had higher SBP, PP, PCI, LV systolic and diastolic volume (estimated by ECHO), lower LV ejection fraction, higher plasma NT‐proBNP and AST (CVD markers), glucose, triglycerides, plasma Aβ‐40 (Alzheimer’s disease marker), BUN and creatinine (CKD markers) and lower score in MMSE vs. healthy control (p&lt;0.05). Plasma estrogen levels were significantly lower in CKD patients which correlated with the cognitive test scores and the renal function. Cognitive test results positively correlated with LV stroke volume, negatively correlated with PCI, a measurement of pulsatility of blood pressure, and negatively correlated with plasma ASP, a marker of CVD.ConclusionHigher PP, PCI, plasma Aβ‐40 and lower levels of estrogen and lower score in MMSE in female CKD patients supports our hypothesis that cardiovascular remodeling in women with CKD contributes to the development and progression of CI.

Cardiovascular and Sympathetic Neural Responses to Cognitive Tasks in Women with Posttraumatic Stress Disorder

BackgroundPosttraumatic stress disorder (PTSD) is more prevalent in women than men and is associated with an increased risk for dementia. Indeed, we previously showed that cognitive function is impaired in women with PTSD, but the underlying mechanisms remain unknown. In patients with mild cognitive impairment, the cardiovascular response during cognitive tasks have been shown to be blunted. Thus, we hypothesized that cardiovascular and sympathetic neural responses to a cognitive task would be smaller in women with PTSD than healthy women.MethodsWe measured heart rate (HR), mean arterial pressure (MAP), cardiac output (CO, Modelflow), total peripheral resistance (TPR = MAP/CO), and muscle sympathetic nerve activity (MSNA, microneurography) in 16 women with PTSD (42 ± 11 [SD] yrs) and 9 age‐matched healthy women (controls; 41 ± 9 yrs) during 3 min of the Stroop Color and Word Test (SCWT) in the supine position.ResultsIn response to SCWT, HR, MAP, and CO increased (all P &lt; 0.001) but TPR remained unchanged (P = 0.753) in both groups. Increases (Δ) in HR (6 ± 4 vs. 11 ± 6 bpm) and CO (0.6 ± 0.6 vs. 0.9 ± 0.4 L/min) during SCWT were smaller in PTSD than controls (both P &lt; 0.05), while ΔMAP was similar between groups (P = 0.169). MSNA burst frequency and incidence were significantly higher in women with PTSD than controls at baseline and throughout SCWT (P = 0.003), but ΔMSNA during SCWT was similar between groups.ConclusionsCardiovascular, but not sympathetic neural responses to SCWT were blunted in women with PTSD. Our findings suggest that cognitive impairment in women with PTSD may be related to the insufficient cardiac response rather than sympathetic vasoconstriction during cognitive tasks.

Asociación entre el deterioro cognitivo y factores socioeconómicos y sociodemográficos en adultos mayores colombianos

IntroductionWorldwide, because of the demographic transition, the proportion of older adults has increased, which has been reflected in an increase in the prevalence of major neurocognitive disorder (MND). This phenomenon is especially important in low- and middle-income countries such as Colombia, given the high economic and social costs it entails. The objective was to analyse the association between socioeconomic variables with the presence of cognitive impairment in Colombian older adults. MethodsThe records of 23,694 adults over 60 years-of-age surveyed for SABE Colombia 2015, that took a stratified sample by conglomerates and were representative of the adult population over 60 years-of-age. This instrument assessed cognitive impairment using the abbreviated version of the Minimental (AMMSE) and collected information on multiple socioeconomic variables. Results19.7% of the older adults included in the survey were reviewed with cognitive impairment by presenting a score <13 in the AMMSE. There was a higher prevalence of cognitive impairment in women (21.5%) than in men (17.5%). The socioeconomic variables were shown to impact the prevalence of deterioration, especially being currently working (OR=2.74; 95%CI, 2.43-3.09) as a risk factor and having attended primary school as a protective factor (OR=0.30; 95%CI, 0.28-0.32), differentially according to gender. ConclusionsAn association between socioeconomic and sociodemographic factors with cognitive impairment in Colombian older adults was evidenced. Despite the above, a differential impact dependent on sex is suggested.

Investigating predictors of incident cognitive impairment in women

AbstractBackgroundMore women than men are affected by Alzheimer’s disease (AD). However, risk factors for cognitive impairment (CI) among older women by race/ethnicity are not completely understood. The well‐characterized Women’s Health Initiative Memory Study (WHIMS) has followed for more than 25 years postmenopausal women to assess cognitive and brain outcomes. WHIMS provides a unique opportunity to determine the extent to which risk factors for CI vary between White and Black women. Due to the high‐dimensional nature of this problem we based our analyses on machine learning methods.MethodTo investigate signatures of predictors of incident CI (either mild cognitive impairment or probable dementia) in women, we included 6778 women (503 Black and 6275 White) with up to 25 years of follow‐up including annual cognitive assessments. Mild cognitive impairment and probable dementia were adjudicated annually across all phases of the trial and subsequent observational study by a central, multidisciplinary adjudication panel of experts. We selected 52 potential predictors collected at baseline representing different domains–demographic, health, social, psycho‐social, biological, and medical. Survival Random Forests (SRF) were used to identify the most reliable predictors of incident CI. Here we use the SRF implementation available in the RandomForestSRC R library. SRF models were fitted independently using White and Black participants based on the default parameters of the software. The permutation index was used to determine predictors’ relevance. The concordance index was used as a measure of model performance.ResultThe most important predictors of incident CI in Black women were lower education, higher systolic blood pressure, lower income and higher high‐density lipoprotein cholesterol. The concordance index was 0.64. A different profile of predictors was observed among White women. Baseline age was the most relevant predictor of ICI followed by self‐reported forgetfulness, self‐reported difficulty concentrating, physical function and higher depression. The concordance index for this model was 0.71.ConclusionPhenotypic signatures predicting incident CI differed between older Black and White women. Education, markers of vascular disease and income were major predictors in Black women and age, self‐reported cognitive difficulties, physical function and mood were major predictors in White women.

Effects of nutrition, depression symptoms and demographic characteristics on dementia in the elderly population

Objective: Due to the increase in the elderly population, there is an increase in chronic diseases, infections, depression , and nutritional problems as well as a decrease in cognitive abilities. This study aimed to investigate the effects of nutritional status, depression symptoms and demographic characteristics on dementia in the elderly population. Materials and Methods: This study is a cross-sectional analytic study which took place between first day of April to first day of June in 2018 in three family health centers selected by simple random sampling from random numbers table in Konya, Turkey. Mini Nutritional Assessment normal (MNA) and short form (MNA-SF), Geriatric Depression Scale-30 (GDS-30) and the Standardized Mini-Mental Test (SMMT) was applied to 298 elderly people. Results: Mild dementia was found in 11.4% (n=34) and, depression symptoms were detected in 5.7% (n=17) of total. MNA-SF showed that 15.8% were under the risk of malnutrition while 2.3% had malnutrition. MNA-SF total score (p=0.004) was significantly higher in males than in females showing that there was more cognitive impairment in women than men. There was a significant relationship between the presence of dementia and gender (p=0.048), age groups (p=0.006), education (p&amp;lt;0.001), MNA-SF (p=0.012) and MNA (p=0.002). Conclusion: The frequency of dementia was higher in women, in low educated, depressive and aged ones and in those with malnutrition. Regarding dementia, depression and malnutrition in the elderly in primary care; it is important to use well designed specific scales to these conditions for early diagnosis.

Association between Sour Taste SNP KCNJ2-rs236514, Diet Quality and Mild Cognitive Impairment in an Elderly Cohort.

Differences in sour-taste thresholds have been identified in cognition-related diseases. Diet is a modulator of cognitive health, and taste perception influences dietary preferences and habits. Heritable genetics and polymorphisms in the KCNJ2 gene involved in the transduction of sour taste have been linked to variations in sour taste and non-gustatory functions. However, relationships between sour taste genetics, mild cognitive impairment, and diet quality are yet to be elucidated. This study investigated the associations between the presence of the KCNJ2-rs236514 variant (A) allele, diet quality indices, and mild cognitive impairment evaluated by the Mini-Mental State Examination (MMSE), in a secondary cross-sectional analysis of data from the Retirement Health & Lifestyle Study. Data from 524 elderly Australians (≥65y) were analyzed, using standard least squares regression and nominal logistic regression modeling, with demographic adjustments applied. Results showed that the presence of the KCNJ2-A allele is associated with increased proportions of participants scoring in the range indicative of mild or more severe cognitive impairment (MMSE score of ≤26) in the total cohort, and males. These associations remained statistically significant after adjusting for age, sex, and diet quality indices. The absence of association between the KCNJ2-A allele and cognitive impairment in women may be related to their higher diet quality scores in all indices. The potential link between sour taste genotype and cognitive impairment scores may be due to both oral and extra-oral functions of sour taste receptors. Further studies are required on the role and relationship of neurotransmitters, sour taste genotypes and sour taste receptors in the brain, and dietary implications, to identify potential risk groups or avenues for therapeutic or prophylactic interventions.