Cognitive Performance In Middle-aged Adults Research Articles

Large Neutral Amino Acids Moderate the Effects of Metabolic Syndrome on Cognitive Performance in Middle-Aged Adults

Introduction: Two large neutral amino acids (LNAA), tryptophan and tyrosine, are precursors to cerebral neurotransmitters and are involved in cognitive function. Higher levels of LNAA in young adults are associated with improved cognition, although these associations appear to reverse over time. Given that exposure to metabolic syndrome (MetS) may induce premature cognitive aging, the current project aims to fill the gap in the literature by examining the effect of LNAA on cognitive performance in midlife adults with metabolic risks. Methods: Eighty-eight adults, ages 40–61 years, participated in this cross-sectional study. LNAA metabolites were quantified, MetS components were measured using high-performance liquid chromatography, and MetS components were assessed in the laboratory. Composite verbal memory and executive functioning scores were computed using principal component analysis. We used linear regression models to test the interaction between LNAA and MetS while covarying for sex, age, and education. Results: The kynurenine/tryptophan ratio moderated the relation between MetS and verbal memory, even after adjusting for relevant covariates. Tyrosine metabolites were not significant moderators of the association between MetS and executive functioning. Conclusion: Our findings suggest that the detected weaker memory performance in adults with a high number of MetS components may be related to relative tryptophan depletion and possible decreases in serotonin production. Further investigation is warranted to examine the potential role of LNAA in associations between cognitive performance and metabolic risks over time.

Abstract P534: Sex Differences in Left Ventricular Diastolic Function and Cognitive Performance in Midlife: Evidence From the Bogalusa Heart Study

Background: Despite the growing interest in the role of isolated left ventricular (LV) diastolic dysfunction in cardiac remodeling, little is known about its association with cognitive performance in midlife, prior to the onset of dementia. Hypothesis: We hypothesized that LV diastolic dysfunction and cardiac remodeling will be associated with cognitive performance in middle-aged adults. These associations might differ by sex and race. Aim: To investigate the impact of left atrial (LA) size, LV mass, volume, systolic and diastolic function on cognition in middle-aged Black and White, men and women from a rural, community-based cohort, the Bogalusa Heart Study (BHS), in Louisiana. Methods: A total of 1,107 participants from the BHS (48.1±5.4 years, 56.7% female, 34.3% black) with echocardiography and cognitive testing were included. Cognitive performance was quantified in a global cognitive score (GCS) comprised of the z standardized sum of 7 neuropsychiatric tests. Multivariate linear regression analysis was used for the association of E/e’, LA volume index (LAVi), LV end-diastolic volume (LVEDV), mass index (LVMi) as well as ejection fraction (LVEF) with GCS adjusted for age, sex, race, systolic and diastolic blood pressure, total and HDL cholesterol, history of smoking, diabetes, and hypertension as well as education. Interactions by sex and race were tested. Results: Even after adjusting for age, sex and race, larger LAVi, LVEDV, LVMi, higher E/e’ and lower e’ were associated with poorer cognitive function (all p <0.05), but not LVEF. These associations remained significant for E/e’, e’, and LVMi after adjusting for systolic and diastolic blood pressure, total and HDL cholesterol, history of smoking, diabetes, hypertension, as well as education. There was no significant race interaction. In contrast, the association of E/e’ with GCS was significantly stronger (standardized β coefficient =-0.20; p <0.01) in middle-aged women, but not in middle-aged men (standardized β coefficient =-0.04; p <0.36; p interaction=0.02). Conclusion: LV diastolic function is more closely associated with mid-life cognition than systolic function, and the association is present among middle aged women but not men.

Physical activity and cognitive function in middle-aged adults: a cross-sectional analysis of the PATH through life study.

Investigate the independent associations of objectively measured or self-reported physical activity at different intensities with cognitive performance in middle-aged adults. Cross-sectional. 156 middle-aged adults (age: 40.6 ± 1.5, 58.3% female) participated in the physical activity sub-study of the Personality and Total Health through life (PATH) project. Physical activity was measured objectively with the SenseWear™ armband (SWA), worn for seven consecutive days, and measured via self-report with a Physical Activity Recall survey (PAR). Cognitive performance was assessed with the Symbol Digit Modalities Test, the Digit Span Backwards, and an Immediate and Delayed Recall task. Associations between physical activity intensity and cognitive function were investigated in general linear models, controlling for age, sex, and education. Neither objectively measured nor self-reported physical activity were associated with cognitive function at light-, moderate-, vigorous-, or combined moderate-to-vigorous intensity in this cohort of well educated, healthy middle-aged adults. Sensitivity analyses with additional moderators (e.g., body mass index, hypertension, alcohol intake) and the use of composite cognitive measures did not alter the results. In this cohort of middle-aged adults, objectively measured and self-reported physical activity do not appear to be associated with cognitive function. Longitudinal follow-ups utilising objective physical activity measures may be important in determining the impact of mid-life behaviours on the trajectory of cognitive changes into older age.

Relationship of prefrontal brain lateralization to optimal cognitive function differs with age

There is considerable debate about whether additional fMRI-measured activity in the right prefrontal cortex readily observed in older adults represents compensatory activation that enhances cognition or whether maintenance of youthful brain activity best supports cognitive function in late adulthood. To investigate this issue, we tested a large lifespan sample of 461 adults (aged 20–89) and treated degree of left-lateralization in ventrolateral and dorsolateral prefrontal cortex during a semantic judgment fMRI task as an individual differences variable to predict cognition. We found that younger adults were highly left-lateralized, but lateralization did not predict better cognition, whereas higher left-lateralization of prefrontal cortex predicted better cognitive performance in middle-aged adults, providing evidence that left-lateralized, youth-like patterns are optimal in middle age. This relationship was reversed in older adults, with lower laterality scores associated with better cognition. The findings suggest that bilaterality in older adults facilitates cognition, but early manifestation of this pattern during middle age is characteristic of low performers. Implications of these findings for current theories of neurocognitive aging are discussed.

Associations Between Cerebral Vasoreactivity and Cognitive Function in the Middle-Aged Non-Demented Population.

Increasing evidence shows early vascular dysregulation in the pathophysiology of Alzheimer's disease (AD) in elderly population. We wondered about the relationship between vascular health and cognitive performance in middle-aged adults. The present study aims to evaluate whether and which brain vascular hemodynamic parameters are associated with cognitive functions in a middle-aged, non-demented population. We recruited 490 middle-aged community-based participants (30-60 years). Transcranial color-coded sonography was used to measure cerebral vascular hemodynamics, including mean flow velocity, pulsatility index, and breath-holding index (BHI) in the middle cerebral arteries (MCAs). Cognitive functions were assessed using the Montreal Cognitive Assessment (MoCA). A multivariate linear regression model was used to determine the association between the MoCA scores and each intracranial hemodynamic parameter. In 369 participants (median age 52 years [IQR 47-56], 48.8% men) with robust acoustic windows, the factors related to poorer MoCA scores were older age, less education extent, and the habitats of cigarette smoking or alcohol consumption. Multivariate analyses did not show a significant association between any intracranial hemodynamic parameters in both MCAs and MoCA scores in the total study population. Left MCA BHI was found to be significantly and independently correlated with the MoCA scores only in people aged 55-60 years (n = 111, B = 0.70, 95% confidence interval, 0.13-1.26, p = 0.017), however, not in people younger than 55 years. Our results emphasize the role of neurovascular abnormalities in the early pathophysiology of cognitive impairment and suggest cerebral vasoreactivity as the earliest detectable cognition-associated hemodynamic parameter.

Higher literacy is associated with better white matter integrity and cognition in middle age.

Literacy can be a better measure of quality of education. Its association with brain health in midlife has not been thoroughly investigated. We studied, cross-sectionally, 616 middle-aged adults (mean age of 55.1±3.6 years, 53% female and 38% Black) from the Coronary Artery Risk Development in Young Adults (CARDIA) study. We correlated literacy with cognitive tests, gray matter volumes, and fractional anisotropy (FA) values (indirect measures of white matter integrity) using linear regression. The higher-literacy group (n=499) performed better than the low-literacy group (n=117) on all cognitive tests. There was no association between literacy and gray matter volumes. The higher-literacy group had greater total-brain FA and higher temporal, parietal, and occipital FA values after multivariable adjustments. Higher literacy is associated with higher white matter integrity as well as with better cognitive performance in middle-aged adults. These results highlight the importance of focusing on midlife interventions to improve literacy skills.

CAROTID VASCULAR RESISTANCE ASSOCIATED WITH COGNITIVE FUNCTION AMONG MIDDLE-AGE ADULTS

Objective: Carotid flow velocity and peripheral blood pressure were independently associated with cognitive function among the elderly population, but unknown among middle-aged adults. We aimed to investigate the association between carotid hemodynamics and cognitive performance among the middle-age population. Design and method: A total of 490 middle-age adults (between 30 and 60 years) participated in the ongoing survey (2017–2020) of the Cardiovascular Disease Risk Factors two-Township study and received the Montreal Cognitive Assessment (MOCA) to evaluate the global cognitive function. Carotid-formal pulse wave velocity (cf-PWV) was measured using carotid and femoral arterial tonometry. Carotid vascular resistance was calculated by mean carotid pressure divided into mean carotid volume flow. Results: MOCA levels were similar between men and women (27.1 vs. 27.2, p = 0.6036). Age(r = -0.22, P < 0.001), and education(r = 0.39, p < 0.001) were associated with MOCA. Controlled for age, gender and education, peak systolic velocity (r = 0.077 @left; r = 0.012@Right, all p > 0.05), end diastolic velocity (r = 0.029, r = -0.062, all p > 0.05), mean flow (r = 0.060; r = -0.038, all p > 0.05), carotid resistive index (r = 0.020, r = 0.05, all p > 0.05), carotid pulsatility(r = 0.015; r = 0.058; p > 0.05), diameter(r = 0.060; r = -0.008, all p > 0.05) at both sides were not associated with MOCA. Only carotid vascular resistance (CVR) at left side was associated with MOCA (r = -0.158, p = 0.0010), but not at right carotid artery (r = -0.030, p = 0.5369). CVR@Left (standard beta = -0.144; p = 0.0022) remains associated with MOCA in the multivariable with further controlling glucose, low density lipoprotein and carotid-formal pulse wave velocity. Those with top, 2nd and 3th quartile of CVR@left had 2.4-fold [Odds Ratio = 2.40; 95% confidence intervals = 1.14–5.04], 1.95-fold(1.95;0.93–4.07) and 0.99-fold (0.99;0.45–2.17) risk for poor cognitive performance (MOCA < 26), compared to those with lowest quartile of CVR@left in the multivariable model. Conclusions: Carotid vascular resistance is a marker of cerebrovascular resistance and associated with cognitive performance in middle-aged adults.

Peripheral Inflammation and Cognitive Performance in Middle-Aged Adults With and Without Type 2 Diabetes: Results From the ENBIND Study.

Midlife Type 2 Diabetes Mellitus (T2DM) is associated with a greater risk of dementia in later life. Peripheral inflammation and its impact on cognition is proposed as one of the pathological mechanisms mediating this link. However, studies have primarily focused on older individuals with established cognitive impairment and a long duration of T2DM. Importantly, knowledge of which individuals with midlife T2DM who are at greatest risk of later cognitive decline is lacking. We examined the cross-sectional relationship between serum levels of 8 pro-inflammatory markers (IL-1β, IL-6, TNF-α, IL-8, MCP-1, CXCL10, IL-12p70, CRP) and performance on a detailed neuropsychological assessment battery in middle-aged adults with uncomplicated T2DM (N = 89; 52 ± 8.1 years, 47% female) and matched healthy controls (N = 50; 52 ± 8.3 years, 59% female). Linear regression was used to analyze associations between serum markers and cognitive performance in the overall cohort, followed by a T2DM∗protein concentration interaction analysis to identify any T2DM-specific effects. We observed a significant T2DM-specific association between serum TNF-α levels and scores on the Paired Associates Learning (PAL) task (β: −3.16, SE: 1.32, p = 0.01, Std. Beta: −0.94), a task with significant working memory demands previously implicated in T2DM-related cognitive dysfunction. However, this did not persist on controlling for multiple testing. We provide exploratory evidence for a significant T2DM-specific relationship between serum TNF-α and memory performance. These findings require further replication and longitudinal analysis with the aim of selecting-out individuals with midlife T2DM at risk of future cognitive decline for potential preventative interventions.

Contribution of Components of Metabolic Syndrome to Cognitive Performance in Middle-Aged Adults.

IntroductionMetabolic syndrome (MetS) has been associated with impaired cognition in different cognitive domains. This study investigated the association between MetS and cognitive functioning in middle-aged Bulgarians across different definitions of MetS severity.Material and MethodsOur cross-sectional sample included 112 participants (67 free of MetS and 45 with MetS) with a mean age of 50.04 ± 3.31 years. The following MetS variables were considered—presence of MetS, continuously measured MetS components, dichotomized MetS components, number of MetS components present, and Metabolic Syndrome Severity Score (MSSS). Participants’ cognitive performance was assessed using the Consortium to Establish a Registry for Alzheimer’s Disease Neuropsychological Battery (CERAD-NB). We employed multivariate regression models to investigate the associations between different measures of MetS severity and CERAD-NB total and subtest scores.ResultsBivariate analyses showed that the CERAD-NB total score was significantly higher in women, participants with a university degree, those with normal blood pressure, normal waist circumference, and low triglyceride levels, compared with their counterparts. MetS participants had lower CERAD-NB total score (78.87 ± 6.89 vs. 84.97 ± 7.84) and specifically performed poorer on the subtest Word List Recall (7.16 ± 1.52 vs. 7.99 ± 1.52). These findings persisted after controlling for age, gender, and education. Next, generalized linear regression indicated that the CERAD-NB total score was lower in participants with MetS (β = −4.86; 95% confidence interval [CI]: −7.60, −2.11), those with more MetS components (β = −8.31; 95% CI: −14.13, −2.50 for fours vs. 0 components) and with an increase in MSSS (β = −3.19; 95% CI: −4.67, −1.71). Hypertension independently contributed to lower CERAD-NB total score (β = −4.00; 95% CI: −6.81, −1.19).ConclusionsAcross several definitions, MetS was associated with lower cognitive functioning, and MetS severity appeared to be a better predictor than most MetS components. Recognizing and reducing severity of MetS components might be helpful in supporting cognitive functioning. Further longitudinal research is needed to shed more light on the relationship between MetS and cognitive functioning across the life span.

Improved metabolic function and cognitive performance in middle-aged adults following a single dose of wild blueberry

PurposeResearch has demonstrated cognitive benefits following acute polyphenol-rich berry consumption in children and young adults. Berry intake also has been associated with metabolic benefits. No study has yet examined cognitive performance in middle-aged adults. We investigated the relationships among cognitive and metabolic outcomes in middle-aged adults following wild blueberry (WBB) consumption.MethodsThirty-five individuals aged 40–65 years participated in a randomized, double blind, cross-over study. Participants consumed a breakfast meal and 1-cup equivalent WBB drink or matched placebo beverage on two occasions. Participants completed cognitive tasks and had blood drawn before and at regular intervals for 8 h after each meal/treatment. Changes in episodic memory and executive function (EF) were assessed alongside plasma levels of glucose, insulin, and triglyceride.ResultsAnalysis of the memory-related Auditory Verbal Learning Task (AVLT) word recognition measure revealed a decrease in performance over the test day after placebo intake, whereas performance after WBB was maintained. For the AVLT word rejection measure, participants identified more foils following WBB in comparison to placebo. Benefits were also observed for EF on the Go/No-Go task with fewer errors following WBB intake on cognitively demanding invalid No-Go trials in comparison to placebo. Furthermore, in comparison to placebo, response times were faster for the Go/No-Go task, specifically at 4 h and 8 h following WBB treatment. We also observed reduced post-meal glucose and insulin, but not triglyceride, concentrations in comparison to placebo over the first 2 h following ingestion. Though the addition of Age, BMI, glucose and insulin as covariates to the analysis reduced the significant effect of beverage for AVLT word rejection, metabolic outcomes did not interact with treatment to predict cognitive performance with the exception of one isolated trend.ConclusionsThis study indicated acute cognitive benefits of WBB intake in cognitively healthy middle-aged individuals, particularly in the context of demanding tasks and cognitive fatigue. WBB improved glucose and insulin responses to a meal. Further research is required to elucidate the underlying mechanism by which WBB improves cognitive function.

Acute Effect of Exercise on Cognitive Performance in Middle-Aged Adults: Aerobic Versus Balance.

Recent evidence has suggested that chronic physical activities including balance exercises have positive effects on cognition, but their acute effects are still unknown. In the present study, the authors tested the hypothesis that an acute bout of balance exercise would enhance cognitive performance compared with aerobic activity. A total of 20 healthy middle-aged adults completed 2 acute 30-minute balance and moderate-intensity aerobic exercise sessions on 2 counterbalanced separate occasions. To assess cognitive functions, performance tasks in executive control, perceptual speed, and simple reaction time were tested before and immediately after each exercise session. Although there were no significant interactions (time × exercise condition, P > .05), the main effects of time were significant in executive control (P < .05), perceptual speed (P < .05), and simple reaction time (P < .001), showing improvements after both exercises. These findings highlight that both types of exercise (aerobic, more metabolic and less cognitively demanding; balance, more cognitively and less metabolically demanding) were able to positively affect simple reaction time performance, perceptual speed, and executive control independently of physiological adjustments occurring during aerobic or balance exercise.

Association between depressive symptoms, metabolic risk factors, and cognitive function: cross-sectional results from a community study in Quebec, Canada

Objective To investigate the cross-sectional association between depressive symptoms and metabolic risk factors with cognitive function in a middle-aged population. Methods A stratified subsample of the CARTaGENE (CaG) cohort (n = 1991) was used to compare cognitive function outcomes between groups. The stratification was based on the presence of depressive symptoms and metabolic dysregulation (MetD): the presence of a) neither condition (reference group); b) MetD only; c) depressive symptoms only; and d) both depressive symptoms and MetD. Individuals with type 2 diabetes were excluded. Three cognitive domains were assessed: processing speed, episodic memory, and executive function. An overall cognitive function score, standardized for age and education, was computed. Poor cognitive function was defined as the lower quartile of the overall cognitive function distribution. Linear and logistic regression analyses were conducted. Results The poorest cognitive performance was observed in the group with both depressive symptoms and MetD, followed by the group with depressive symptoms only, then the group with MetD only and the reference group. Mean (SD) overall cognition scores for the four groups were −0.25 (1.13), −0.13 (1.05), 0.11 (0.90), and 0.15 (0.93), respectively. Linear regression analyses suggested a linear increase in cognitive function across groups. In the logistic regression analyses, the highest risk of poor cognitive function was observed in the comorbid (depressive symptoms and MetD) group (adjusted OR = 1.99, 95% CI 1.46, 2.71). Conclusion Comorbidity of depressive symptoms and MetD was associated with reduced cognitive performance in middle-aged adults without diabetes. KEY POINTS Poor cognitive function is a major public health concern and can be potentially prevented by targeting its modifiable risk factors. Metabolic dysregulation and depression have both been independently associated with poor cognitive function. Comorbidity of metabolic dysregulation and depressive symptoms is associated with an increased risk of poor cognitive function in middle-aged individuals. Future health interventions might benefit by screening for comorbidity in patients with poor cognitive function and by targeting depression and metabolic dysregulation together.

Work-related stress and cognitive performance among middle-aged adults: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Assessing risk factors exposure, such as stress in the workplace during adulthood, may contribute to detecting early signs of cognitive impairment in order to implement effective actions to improve brain health and consequently to decrease cognitive disorders later in life. In this cross-sectional study, we aimed to investigate whether work-related stress is associated with low cognitive performance in middle-aged adults from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) and whether social support mediates this relationship. Work-related stress was evaluated in 9,969 workers using the Demand-Control-Support Questionnaire. Cognitive function was assessed using the verbal fluency, trail-making version B, and delayed recall word tests. Work-related stress was associated with lower performance on the delayed recall, verbal fluency, and executive function tests in middle-aged adults. Social support may mediate the association between work demands and cognitive performance. These findings support that work-related stress is associated with cognitive performance during adulthood.

Anticholinergic drug use and cognitive performances in middle age: findings from the CONSTANCES cohort

BackgroundPrevious studies have shown associations between the use of anticholinergics (AC) and cognitive performance in the elderly, considering AC as a homogeneous set of drugs. The present study aims to...

Interleukin-6 and Depressive Mood Symptoms: Mediators of the Association Between Childhood Abuse and Cognitive Performance in Middle-Aged Adults.

Childhood abuse is a risk factor for the development of cognitive deficits in adulthood, a relation that is likely mediated by stress-sensitive psychological and physiological indicators. To evaluate whether the link between exposure to childhood abuse and cognitive function in middle adulthood is mediated by interleukin-6 (IL-6), metabolic risk, and depressive mood symptoms. Participants were 770 adults aged 40-65 recruited from the community, who completed the following: (i) a questionnaire assessing exposure to abuse prior to age 18, (ii) a phone interview assessing current depressive mood symptoms, and (iii) a home visit that included blood sampling for evaluation of IL-6 and assessment of metabolic risk indices. A follow-up telephone assessment evaluating cognitive function was completed by 555 of the participants. Structural equation modeling was used to test study hypotheses. Childhood abuse predicted higher levels of IL-6, depressive mood symptoms, and metabolic risk scores (p < .05). The relation between childhood abuse and poorer cognitive performance was mediated by IL-6 (p = .046) and depressive mood symptoms (p = .023), but not metabolic risk. IL-6 and depressive mood symptoms significantly mediated the relation between childhood abuse and adult cognitive function. Exposure to early abuse conveys enduring physiological and psychological effects, which may contribute to cognitive deficits that are evident by middle adulthood. Increased vulnerability for cognitive decline among adults with a history of early trauma and the mediating roles of IL-6 and depressive mood symptoms point to the potential value of interventions that address inflammation or depression, singly or together, to prevent cognitive decline in this at-risk population.

Martial Art Training and Cognitive Performance in Middle-Aged Adults.

Cognitive performance includes the processes of attention, memory, processing speed, and executive functioning, which typically declines with aging. Previous research has demonstrated that aerobic and resistance exercise improves cognitive performance immediately following exercise. However, there is limited research examining the effect that a cognitively complex exercise such as martial art training has on these cognitive processes. Our study compared the acute effects of 2 types of martial art training to aerobic exercise on cognitive performance in middle-aged adults. We utilized a repeated measures design with the order of the 3 exercise conditions randomly assigned and counterbalanced. Ten recreational middle-aged martial artists (mean age = 53.5 ± 8.6 years) participated in 3 treatment conditions: a typical martial art class, an atypical martial art class, and a one-hour walk at a self-selected speed. Cognitive performance was assessed by the Stroop Color and Word test. While all 3 exercise conditions improved attention and processing speed, only the 2 martial art conditions improved the highest order of cognitive performance, executive function. The effect of the 2 martial art conditions on executive function was not different. The improvement in executive function may be due to the increased cortical demand required by the more complex, coordinated motor tasks of martial art exercise compared to the more repetitive actions of walking.

The Effects of an Exercise and Lifestyle Intervention Program on Cardiovascular, Metabolic Factors and Cognitive Performance in Middle-Aged Adults with Type II Diabetes: A Pilot Study

Canada is experiencing a rise in type II diabetes mellitus (T2DM), a known risk factor for accelerated cognitive decline and dementia. Within the context of an aging population, this will impose significant individual and societal burden, making the development of prevention programs imperative. This pilot study examines the effects of the Diabetes Exercise and Healthy Lifestyle Service, a 24-week intervention program, on cardiovascular, metabolic regulation and cognitive function in adults with T2DM. Seventeen middle-aged participants provided blood samples for biological markers, underwent cognitive testing and a physical stress test pre- and post-intervention. Cognitive performance was evaluated using the California Verbal Learning Test (CVLT), Digit Symbol Substitution Tasl (DSST) and fluency test. Adjusted models reveal participants displayed increased cardiovascular fitness (VO2 peak: Mchange=4.09 mL∙kg∙min(-1) SE=1.4), peak heart rate (Mchange= 9.28 beats⋅min(-1) SE=2.68) and change in heart rate (Mchange=10.71 SE=1.76) in response to the stress test (ps<0.05) following the 24-week intervention. A decrease in body mass index (BMI) (Mchange=-1.03 SE=0.40) and depressive symptomatology (CES-D: Mchange=-3.62 SE=1.44) was also found (ps<0.05). No change was found for lipid and glucose levels. Surprisingly, analyses showed that cognitive performance on the CVLT immediate recall (M=-4.37 SE=2.21), CVTL short-delay recall (M=-1.06 SE=0.55), DSST (Mchange=-3 SE=0.53) and category fluency (Mchange=-1.69 SE=0.78) declined following the intervention (ps<0.05); however, decline on the CVLT was limited to adults with co-morbid T2DM and hypertension. Additional research is needed to evaluate the benefit of an exercise and lifestyle program that targets cognitive health in those with T2DM.

Cognitive activities and cognitive performance in middle-aged adults at risk for Alzheimer’s disease.

Cognitive activity is thought to provide some protection against dementia, but the mechanism and timing of these effects are unknown. Data for this study were drawn from the Wisconsin Registry for Alzheimer's Prevention (WRAP), an at-risk middle-aged sample (mean age = 54 years) enriched for parental family history of Alzheimer's disease (AD). We had two main aims: (a) to determine the relative contribution of three facets of cognitive activity-education, occupational complexity with data, and cognitive leisure activities-to WRAP participants' cognitive performance; and (b) to assess for interactions between genetic risk factors and cognitive activity in explaining cognitive performance. Results from mixed effects models indicate that some of the variance usually attributed to education may be more closely accounted for by cognitive activities later in life. Overall, our analyses suggest cautious optimism for cognitive activities, especially game playing, as a strategy for preserving cognitive strengths in midlife.

History of coronary heart disease and cognitive performance in midlife: the Whitehall II study

Some studies show coronary heart disease (CHD) to be a risk factor for cognitive function while others report no association between the two. We examined the effect of CHD history and duration on cognition in a middle-aged population. Data come from the Whitehall II study of 10,308 participants (33% women), aged 35-55 years at baseline (Phase 1; 1985-88). CHD events were assessed up to Phase 7 (2002-04) when 5837 participants (28.4% women) undertook six cognitive tests: reasoning, vocabulary, phonemic and semantic fluency, memory and the mini-mental-state-examination (MMSE); standardized to T-scores (mean = 50, standard deviation = 10). Analysis of covariance was used first to model the association between CHD history and cognition and then to examine the effect of time since first CHD event (in the last 5 years, 5-10 years ago, >10 years ago). Among men, in analyses adjusted for age, education, marital status and medication for cardiovascular disease, CHD history was associated with lower T-scores on reasoning [-1.16; 95% confidence interval (CI) = -2.07, -0.25], vocabulary (-2.11; 95% CI = -3.01, -1.21), and the MMSE (-1.45; 95% CI = -2.42, -0.49). In women, these effects were also evident for phonemic and semantic fluency. Among men, the trend within CHD cases suggested progressively lower scores on reasoning, vocabulary and semantic fluency among those with longer duration of CHD. Our findings go some way towards suggesting an association between CHD history and cognitive performance in middle-aged adults.

P4-012: Increased duration of statin use is associated with better cognitive performance in middle-aged adults: The Wisconsin Registry for Alzheimer's Prevention (WRAP)

P4-012: Increased duration of statin use is associated with better cognitive performance in middle-aged adults: The Wisconsin Registry for Alzheimer's Prevention (WRAP)