AbstractBackgroundAlzheimer’s dementia has evolved into a biological construct based on fluid and imaging biomarkers to aid in early diagnosis. Biomarkers are expensive and not widely available. It is therefore important to define signatures of cognitive resiliency to better identify this group in the prodromal stages of dementia. Our AIM was to determine neuropsychological and biochemical characteristics of cognitively intact patients older than age 80.MethodSingle center, cross‐sectional study involving forty patients older than 80, admitted to a community hospital. Participants with diagnoses of dementia, delirium, history of falls, dependency on cognitively focused IADL, and those residing in residential care were excluded. Recruited patients were subjected to neurocognitive evaluation, with emphasis on episodic/working memory, semantic cognition, and visuoperceptual/executive spheres, using the Rey‐Osterrieth figure copy/recall (ROSC) test. Regression analysis was used to establish correlation.ResultThe mean age was 85 years (SD 4.06). The mean level of education was 12.12 years (SD 2.93). Only 28% of participants lived alone. Semantic evaluation was the most difficult task, with only 48% of patients able to pass. Patients who answered 3 memory tasks right, had a mean score of 21 (SD 4.6) on the ROSC recall. Those who pass 2 memory tasks, had a mean score of 18.75 (SD 5.20) on the ROSC recall, and those who pass only one, or failed all of them, had a mean score of 9. We identified the ROSC recall as the most powerful predictor of cognitive resiliency. Age correlated well with ROSC recall (p 0.0017, CI 45‐126), but no years of education (p 0.21, CI 2.32‐21). Hemoglobin had a significant effect on ROSC copy (p 0.0019, CI 5‐26), but no ROSC recall (p 0.84, CI ‐14‐12). No correlation was found between ROSC recall and MCV, RDW, or albumin level.ConclusionWe corroborate that age is the single most important factor for cognitive decay, whereas a normal hemoglobin level appears to be protective. Level of education seems to lose its protective effect in the old‐old and oldest‐old population. Patients able to perform well on the three types of memory, showed great proficiency on the ROSC recall.
Read full abstract