Cognitive Status In Older Adults Research Articles

The Cognitive Status of Older Adults: Do Reduced Time Constraints Enhance Sequence Learning?

Research has indicated that older adults perform movement sequences more slowly than young adults. The purpose of the present experiment was to compare movement sequence learning in young and older adults when the time to perform the sequence was extended, and how the elderly’s cognitive status (Montreal Cognitive Assessment [MoCA]) interacted with sequence learning. The task was to minimize the difference between a target sequence pattern and the sequence produced by elbow extension-flexion movements. On Day 1, participants (28 young adults; 28 older adults) practiced the sequence under two time windows: 1300 ms or 2000 ms. On Day 2, retention performance and the cognitive status were assessed. The results demonstrated that young adults performed superior compared to older adults. Additional time to perform the sequence did not improve retention performance for the older adults. The correlation between the error score and the MoCA score of r = –.38 (p < .05) in older adults indicated that a better cognitive status was associated with performance advantages in sequence learning.

The Effect of Ceramic Painting on the Life Satisfaction and Cognitive Status of Older Adults Residing in a Nursing Home

Objectives: The aim of this experimental study was to assess the cognitive activity and satisfaction with life of older adults in nursing home before and after ceramic painting. Methods: The sample of the survey consisted of 15 older adults each in the intervention and control groups. Data for the study were collected using a questionnaire form developed to determine the sociodemographic characteristics of the older adults, the Mini-Mental State Examination, and the Life Satisfaction Scale. Results: There was a statistically significant increase in the mean Mini-Mental State Examination score of the intervention group compared with the control group at the end of ceramic painting (P &lt; .05). The intervention group had increased average Life Satisfaction Scale scores in the posttest compared with the control group, although the difference was not statistically significant. Conclusions: The results showed that art therapy with ceramic painting was a positive effect on the cognitive levels and quality of life of older adults.

The association between cognition and dual-tasking among older adults: the effect of motor function type and cognition task difficulty.

BackgroundDual-task actions challenge cognitive processing. The usefulness of objective methods based on dual-task actions to identify the cognitive status of older adults has been previously demonstrated. However, the properties of select motor and cognitive tasks are still debatable. We investigated the effect of cognitive task difficulty and motor task type (walking versus an upper-extremity function [UEF]) in identifying cognitive impairment in older adults.MethodsOlder adults (≥65 years) were recruited, and cognitive ability was measured using the Montreal Cognitive Assessment (MoCA). Participants performed repetitive elbow flexion under three conditions: 1) at maximum pace alone (Single-task); and 2) while counting backward by ones (Dual-task 1); and 3) threes (Dual-task 2). Similar single- and dual-task gait were performed at normal speed. Three-dimensional kinematics were measured for both motor functions using wearable sensors.ResultsOne-hundred older adults participated in this study. Based on MoCA score <20, 21 (21%) of the participants were considered cognitively impaired (mean age =86±10 and 85±5 for cognitively impaired and intact participants, respectively). Within ANOVA models adjusted with demographic information, UEF dual-task parameters, including speed and range-of-motion variability were significantly higher by 52% on average, among cognitively impaired participant (p<0.01). Logistic models with these UEF parameters plus age predicted cognitive status with sensitivity, specificity, and area under curve (AUC) of 71%, 81% and 0.77 for Dual-task 1. The corresponding values for UEF Dual-task 2 were 91%, 73% and 0.81, respectively. ANOVA results were non-significant for gait parameters within both dual-task conditions (p>0.26).ConclusionThis study demonstrated that counting backward by threes within a UEF dual-task experiment was a pertinent and challenging enough task to detect cognitive impairment in older adults. Additionally, UEF was superior to gait as the motor task component of the dual-task. The UEF dual-task could be applied as a quick memory screen in a clinical setting.

Community-Based Activity and Sedentary Patterns Are Associated With Cognitive Performance in Mobility-Limited Older Adults.

Over the last few decades, considerable evidence shows that greater levels of aerobic exercise and cardiovascular fitness benefit cognitive performance. However, the degree to which free-living activity in community settings is related to cognitive performance remains unclear, particularly in older adults vulnerable to disability. Also, it is unknown whether the manner in which daily physical activity (PA) and sedentary time are accumulated throughout the day is associated with cognition. Cross-sectional associations between accelerometer-characterized PA and sedentary patterns and cognitive performance were examined in 1,274 mobility-limited older adults. Percent time spent in various bout lengths of PA (≥1, ≥2, and ≥5 min) and sedentary (≥1, ≥30, and ≥60 min) was defined as the number of minutes registered divided by total wear time × 100. Percent time was then tertiled for each bout length. Multiple linear regression models were used to estimate the associations between accelerometer bout variables and separate cognitive domains that included processing speed (Digit Symbol Coding; DSC), immediate and delayed recall (Hopkins Verbal Learning Test; HVLT), information processing and selective attention (Flanker), working memory (n-back), reaction time (switch and non-switch reaction time), and a composite score that averaged results from all cognitive tests. After adjusting for demographics, behavioral factors, and morbid conditions, more time spent in PA was associated with higher DSC for all bout lengths (p < 0.03 for all). Higher PA was associated with higher HVLT and global cognition scores but only for longer bout lengths (p < 0.05 for all). The association was largely driven by participants who spent the lowest amount of time performing activity while awake (p < 0.04). An inverse linear relationship was observed between total sedentary time and DSC (p = 0.02), but not for other measures of cognition. These results suggest that, while higher PA was associated with higher cognitive performance, PA’s association with memory was sensitive to bout duration. The time, but not the manner, spent in sedentary behaviors showed a minor association with executive function. Further research is warranted to characterize longitudinal changes in daily activity and sedentary patterns as potential biophysical markers of cognitive status in older adults.

The Relationship Between Dietary Fat and Cognitive Status in Older Adults

The Relationship Between Dietary Fat and Cognitive Status in Older Adults

Predicting Cognitive Status of Older Adults by Using Directional Accuracy in Explicit Timing Tasks

The early effects of age-related cognitive decline on explicit timing have been widely reported. However, it is not clear to what extent measures from the internal clock and working memory are predictive of cognitive function in older adults. During this study, we examined three target intervals (i.e., 2, 6, 10 s) using Production and Reproduction tasks to assess the performance measures representative of the functioning of an internal clock and working memory, respectively. Participants were 36 older adults (19 females) with mean age of 68.4 ± 5.1 year and mean Montreal Cognitive Assessment (MoCA) scores of 27.9 ± 2.0. During the Reproduction task, the participants were asked to reproduce the duration of a previously seen stimulus generated by a virtual reality program, whereas in the Production task the participants had to produce a target interval explicitly requested by the program. Each task consisted of nine trials with three repetitions of each target interval in a pseudo-random sequence. The average relative signed error for each target interval was calculated based on the participants’ estimations. The six calculated signed errors, as well as the participant’s age and gender were used as predictors for a linear regression model to determine the best predictors for the participants’ MoCA scores using a backward method. The final regression model was found to be significant (F(2, 33) = 5.06, p < .01, R2 = 0.24) using only the two predictors of 6- and 10-s reproduction intervals. Our results show that measures of working memory provide a more reliable account of the variation of older adults’ cognitive scores compared to age and the measures of the internal clock.

Movement velocity in the chair squat is associated with measures of functional capacity and cognition in elderly people at low risk of fall.

BackgroundThe purpose of this study was to analyze the relationships between muscular performance consisting of a single repetition on the chair squat exercise (CSQ) and different measures of functional capacity, balance, quality of life and cognitive status in older adults.MethodsA total of 40 participants (22 women, 18 men; age = 72.2 ± 4.9 years) joined the investigation. Muscular performance was assessed by measuring movement velocity in the CSQ with no external load using a validated smartphone application (PowerLift for iOS). Functional capacity, balance, quality of life and cognitive status were evaluated using the hand-grip strength (HGS) test, the Berg-scale, the EuroQol 5D (EQ-5D) and the Mini mental state examination questionnaire (MMSE). Finally, participants were divided into two subgroups (N = 20) according to their velocity in the CSQ exercise.ResultsPositive correlations were obtained between movement velocity in the CSQ and HGS (r = 0.76, p < 0.001), the Berg-scale (r = 0.65, p < 0.001), the EQ-5D (r = 0.34, p = 0.03) and the MMSE (r = 0.36, p = 0.02). Participants in the fastest subgroup showed very likely higher scores in the Berg-scale (ES = 1.15) and the HGS (ES = 1.79), as well as likely higher scores in the MMSE scale (ES = 0.69).DiscussionThese results could have potential clinical relevance as they support the use of a time-efficient, non-fatiguing test of muscular performance (i.e., the CSQ) to evaluate functional capacity and mental cognition in older adults.

Hearing Loss and Ethnicity in Age-related Cognitive Decline

Hearing Loss and Ethnicity in Age-related Cognitive Decline

A lower ratio of omega-6 to omega-3 fatty acids predicts better hippocampus-dependent spatial memory and cognitive status in older adults.

Evidence from several cross-sectional studies indicates that an increase in omega-6 to omega-3 fatty acids (FAs) may negatively affect cognition in old age. The hippocampus is among the first neural structures affected by age and atrophy in this brain region is associated with cognitive decline. Therefore, we hypothesized that a lower omega-6:3 FA ratio would predict better hippocampus-dependent spatial memory, and a higher general cognitive status. Fifty-two healthy older adults completed a Food Frequency Questionnaire, the Montreal Cognitive Assessment test (MoCA; a test of global cognition) and virtual navigation tasks that assess navigational strategies and spatial memory. In this cross-sectional study, a lower ratio of omega-6 to omega-3 FA intake strongly predicted more accurate hippocampus-dependent spatial memory and faster learning on our virtual navigation tasks, as well as higher cognitive status overall. These results may help elucidate why certain dietary patterns with a lower omega-6:3 FA ratio, like the Mediterranean diet, are associated with reduced risk of cognitive decline. (PsycINFO Database Record

Cognitive Status of Older Adults on Admission to a Skilled Nursing Facility According to a Hospital Discharge Diagnosis of Dementia

ObjectiveDescribe the cognitive status on admission to a skilled nursing facility (SNF) according to a hospital discharge diagnosis of dementia in a national sample of Medicare beneficiaries. DesignRetrospective cohort design. SettingSNFs in the United States. ParticipantsMedicare-fee-for-service beneficiaries newly admitted to an SNF within 3 days of discharge from an acute hospital during 2013–2014 (n = 1,885,015). MeasurementsBeneficiaries with a discharge diagnosis of dementia were identified using ICD-9 CM codes from the Medicare Provider Analysis and Review (MedPAR) Part A file. Cognitive status at SNF admission was classified as cognitively intact, mildly impaired, moderately impaired, or severely impaired according to the Cognitive Function Scale using items in the Minimum Data Set 3.0. ResultsFor beneficiaries with a discharge diagnosis of dementia (n = 252,970), 17.9% were classified as cognitively intact, 25.8% were mildly impaired, and 56.3% were moderately or severely impaired on SNF admission. Approximately 65% of beneficiaries without a hospital diagnosis of dementia were cognitively intact on admission to an SNF, whereas 13.1% were classified as moderately or severely impaired. ConclusionMedicare beneficiaries with a hospital diagnosis of dementia are often classified as cognitively intact or mildly impaired on admission to an SNF. These findings provide evidence that a hospital diagnosis of dementia might not always reflect cognitive status on admission to an SNF.

Associations of fat and muscle tissue with cognitive status in older adults: the AGES-Reykjavik Study.

studies on the association of dementia with specific body composition (BC) components are scarce. Our aim was to investigate associations of BC measures with different levels of cognitive function in late-life. we studied 5,169 participants (mean age 76 years, 42.9% men) in the AGES-Reykjavik Study of whom 485 (9.4%) were diagnosed with mild cognitive impairment (MCI) and 307 (5.9%) with dementia. Visceral fat, abdominal and thigh subcutaneous fat, and thigh muscle were assessed by computed tomography. MCI and dementia were based on clinical assessment and a consensus meeting; those without MCI or dementia were categorised as normal. Multinomial regression models assessed the associations stratified by sex and in additional analyses by midlife body mass index (BMI). among women, there was a decreased likelihood of dementia per SD increase in abdominal subcutaneous fat (OR 0.72; 95% CI: 0.59-0.88), thigh subcutaneous fat (0.81; 0.67-0.98) and thigh muscle (0.63; 0.52-0.76), but not visceral fat, adjusting for demographics, vascular risk factors, stroke and depression. Inverse associations of fat with dementia were attenuated by weight change from midlife and were strongest in women with midlife BMI <25. In men, one SD increase in thigh muscle was associated with a decreased likelihood of dementia (0.75; 0.61-0.92). BC was not associated with MCI in men or women. a higher amount of abdominal and thigh subcutaneous fat were associated with a lower likelihood of dementia in women only, while more thigh muscle was associated with a lower likelihood of dementia in men and women.

The Cognitive Daisy - A novel method for recognising the cognitive status of older adults in residential care: Innovative Practice.

The Cognitive Daisy is an innovative assessment system created to provide healthcare staff with an instant snapshot of the cognitive status of older adults in residential care. The Cognitive Daisy comprises a flower head consisting of 15 colour coded petals depicting information about: visual-spatial perception, comprehension, communication, memory and attention. This study confirmed the practicality of the Cognitive Daisy protocol for assessing cognition in a sample of 33 older adults living in residential care and endorsed the use of the Cognitive Daisy as a tool for recognising the cognitive status of care home residents.

Perceived loneliness and general cognitive status in community-dwelling older adults: the moderating influence of depression

ABSTRACTThe relationship between depression, loneliness, and cognitive functioning among the elderly is not well understood in the literature. In the present study, we tested the moderating influence of depressive symptoms on loneliness and cognitive functioning. We recruited 100 community-dwelling older adults in Hong Kong. Demographic information, perceived loneliness, depressed mood, and general cognitive status were assessed. Results indicated that married participants reported lower levels of perceived loneliness (t (96) = 2.26, p = .03). We found a significant moderating effect of depressive symptoms on the relationship between perceived loneliness and general cognitive status (B = −.05, p = .002). Perceived loneliness correlated negatively with general cognitive status only in participants with higher levels of depressed mood (B = −.16, p = .01). Together, these findings suggest that perceived loneliness combined with depressed mood is related to poorer general cognitive status in older adults. The implications of these findings are discussed.

CEREBROVASCULAR RESERVE AS A MARKER OF VASCULAR PATHOLOGY AND COGNITIVE STATUS IN OLDER ADULTS

CEREBROVASCULAR RESERVE AS A MARKER OF VASCULAR PATHOLOGY AND COGNITIVE STATUS IN OLDER ADULTS

Structural neuroimaging correlates of cognitive status in older adults: A person-oriented approach

Person-oriented approaches to clinical research aim to uncover subgroups of patients with different patterns of clinically relevant variables. Such approaches, however, are not yet widely employed in clinical neuroimaging research. This paper demonstrates an accessible approach to person-oriented research using model-based clustering in high-dimensional structural neuroimaging data. Cortical thickness measurements for 369 older adults (182 women, 187 men) were obtained from the Alzheimer’s Disease Neuroimaging Initiative. Model-based cluster analysis was performed on these imaging variables and then validated using variables that were not used in the clustering process. Variable selection identified two specific regions that contributed to cluster formation: the left and right entorhinal cortices. Two subgroups were uncovered: a “typical” cluster with higher entorhinal thickness (M=3.59mm, 95% confidence interval=3.57, 3.62), and an “atypical” cluster with relatively lower thickness (M=2.84mm, 95% confidence interval=2.75, 2.92). Members of the atypical cluster also had lower hippocampal volumes, memory scores, and executive function scores, and were also more likely to be clinically classified as cognitively impaired. These findings demonstrate the utility of model-based clustering of structural neuroimaging data in studies of ageing. The role of the entorhinal cortices in cluster formation is consistent with the known pathological substrate of Alzheimer’s disease. The entorhinal cortices are implicated in the early genesis of the disease and atrophy of these regions is strongly associated with the cognitive phenotype. Overall, this approach can be readily applied to future neuroimaging investigations.

Psychoacoustic Evaluation of the Effects of Aging

Many older adults experience difficulties in complex listening environments that exceed expectations based on their audiometric thresholds. Review of past study of the auditory abilities of older adults indicates that age-related deficits are found primarily for aspects of temporal processing, with task complexity and uncertainty often increasing the effect of aging on performance. In many studies, but not all, significant association has been found between psychoacoustic measures of temporal processing and both speech-in-noise abilities and cognitive status. Intended for clinical use, a brief procedure for evaluating psychoacoustic discrimination of static and dynamic spectral patterns is discussed. Along with showing a deleterious effect of aging on task performance, results indicate significant association between discrimination ability and the cognitive status of older adults. In preliminary evaluation of longitudinal data, the rate of decline in global cognitive status was significantly associated with baseline discrimination of dynamic spectral patterns. These results are consistent with the prominence of age-related deficits for temporal processing with stimulus uncertainty increasing the psychoacoustic effect.

Alzheimer's Biomarkers are Correlated with Brain Connectivity in Older Adults Differentially during Resting and Task States.

β-amyloid (Aβ) plaques and tau-related neurodegeneration are pathologic hallmarks of Alzheimer’s disease (AD). The utility of AD biomarkers, including those measured in cerebrospinal fluid (CSF), in predicting future AD risk and cognitive decline is still being refined. Here, we explored potential relationships between functional connectivity (FC) patterns within the default-mode network (DMN), age, CSF biomarkers (Aβ42 and pTau181), and cognitive status in older adults. Multiple measures of FC were explored, including a novel time series-based measure [total interdependence (TI)]. In our sample of 27 cognitively normal older adults, no significant associations were found between levels of Aβ42 or pTau181 and cognitive scores or regional brain volumes. However, we observed several novel relationships between these biomarkers and measures of FC in DMN during both resting-state and a short-term memory task. First, increased connectivity between bilateral anterior middle temporal gyri was associated with higher levels of CSF Aβ42 and Aβ42/pTau181 ratio (reflecting lower AD risk) during both rest and task. Second, increased bilateral parietal connectivity during the short-term memory task, but not during rest, was associated with higher levels of CSF pTau181 (reflecting higher AD risk). Third, increased connectivity between left middle temporal and left parietal cortices during the active task was associated with decreased global cognitive status but not CSF biomarkers. Lastly, we found that our new TI method was more sensitive to the CSF Aβ42-connectivity relationship whereas the traditional cross-correlation method was more sensitive to levels of CSF pTau181 and cognitive status. With further refinement, resting-state connectivity and task-driven connectivity measures hold promise as non-invasive neuroimaging markers of Aβ and pTau burden in cognitively normal older adults.

Relationship between 25-hydroxy vitamin D and cognitive status in older adults: the COGNIDAGE study

The aim of the COGNIDAGE study was to examine the association between 25(OH)D and cognitive status in a group of elderly patients with vitamin D deficiency and high burden of comorbidities attending Geriatric Outpatient Clinics. We studied the relationship between 25(OH)D and cognitive functions taking into account comorbidities and cognitive functions assessed by MMSE (Mini Mental State Examination), CDT (Clock Drawing Test) and CIRS (Cumulative Illness Rating Scale), in 132 consecutive elderly patients with low levels of 25(OH)D (<10 ng/ml) compatible with the condition of vitamin deficiency. The association among 25(OH)D levels, MMSE score, CDT score and CIRS scores were analyzed using Pearson correlation. All the elderly patients received an adequate vitamin D supplementation and were reassessed after 6 months. At baseline, mean MMSE and CIRS scores were: 21.8+5.56 and 2.96 +1.63 respectively. Mean CDT score was 3,66+-2.05. No associations were found between 25(OH)D levels and global cognitive function. A significant relationship was observed between the total CIRS score and 25(OH)D levels (r=0.305; p=0.000) as well as between total CIRS score and MMSE (r=-0.375; p=0.000). After 6 months, 83.9 % had 25(OH)D levels >20 ng/ml. Mean MMSE and CDT scores were 22.20+-5.76 and 3.90+-2.06 respectively. There was no significant correlation among 25(OH)D, MMSE and CDT scores while a significant correlation was found between 25(OH)D and CIRS- severity score (r=0.275; p=0.001) and between MMSE and total CIRS scores (r=-0.247; p=0.005 for CIRS-comorbidities; r=-0.184; p=0.04 for CIRS-severity). A post hoc evaluation on two subgroups of elderly patients (the first with vitamin D deficiency without cognitive impairment, the second with vitamin D deficiency and dementia) showed a statistically significant difference (p=0.00001) regarding the CIRS-comorbidities scores. In our cohort of elderly patients with a high burden of comorbidities, 25(OH)D low levels (<10 ng/ml) are not associated with MMSE and CDT scores. There is no statistically difference among the levels of 25(OH)D and MMSE and CDT scores after 6 months. The strong correlation we found regarding CIRS-comorbidities in the two sub-groups suggests that vitamin D deficiency may play a role in promoting cognitive impairment only with comorbidities.

Automated Video Analysis of Handwashing Behavior as a Potential Marker of Cognitive Health in Older Adults.

The identification of different stages of cognitive impairment can allow older adults to receive timely care and plan for the level of caregiving. People with existing diagnosis of cognitive impairment go through episodic phases of dementia requiring different levels of care at different times. Monitoring the cognitive status of existing patients is, thus, critical to deciding the level of care required by older adults. In this paper, we present a system to assess the cognitive status of older adults by monitoring a common activity of daily living, namely handwashing. Specifically, we extract features from handwashing trials of participants diagnosed with different levels of dementia ranging from cognitively intact to severe cognitive impairment, as assessed by the mini-mental state exam (MMSE). Based on videos of handwashing trials, we extract two classes of features: one characterizing the occupancy of different sink regions by the participant, and the other capturing the path tortuosity of the motion trajectory of participant's hands. We perform correlation analysis to assess univariate capacity of individual features to predict MMSE scores. To assess multivariate performance, we use machine learning methods to train models that predict the cognitive status (aware, mild, moderate, severe), as well as the MMSE scores. We present results demonstrating that features derived from hand washing behavior can be potential surrogate markers of a person's dementia, which can be instrumental in developing automated tools for continuously monitoring the cognitive status of older adults.

Efficacy of a computerized cognitive training application for older adults with and without memory impairments

It has been shown that cognitive training might help to protect against age-related cognitive decline. Our aim was to evaluate the efficacy of a computerized cognitive training application and its near transfer effects on the cognitive status of older adults. Performance on the 7-Minute Screen at baseline and at the end of the program was analyzed by using a pre-post design. Adults aged 55 and older (n = 101; mean age ± standard deviation: 68.97 ± 5.81 years) with and without memory impairments were trained. Significant improvements after the training program were found in memory, visuo-spatial and verbal fluency abilities, regardless of age, gender or education. Moreover, participants without significant memory impairments and those with Age-Associated Memory Impairment gained from the program more than subjects with mild cognitive impairment. Computerized cognitive training programs, such as Telecognitio®, may be used as a practical and valuable tool in clinic to improve cognitive status.