Cognitive Test Performance Research Articles

Necroptosis involved in sevoflurane-induced cognitive dysfunction in aged mice by activating NMDA receptors increasing intracellular calcium

Perioperative neurocognitive disorders are a common surgical and postanesthesia complication. Necroptosis contributes to the emergence of various neurological disorders. We conjecture that cognitive impairment is associated with necroptosis of hippocampal neurons, which is mediated by NMDA receptors leading to cytoplasmic calcium imbalance. C57BL/6 J male mice ( 18 months) were randomly divided into the C ( control group), S ( sevoflurane group), S+M ( sevoflurane plus the NMDA receptor antagonist memantine group) and S+N ( sevoflurane plus necrostatin-1) group. We exposed the mice to 3% sevoflurane for 2 h a day for three consecutive days in the S, S+M and S+N groups. Memantine ( 20 mg/kg) or Nec-1 ( 10 mg/kg) was injected intraperitoneally 1 h before sevoflurane anesthesia in the S+M or S+N group. We used the animal behavior tests to evaluate the cognitive function. Pathological damage, the rate of necroptosis, [Ca2+]i, and the expression of necroptosis-related proteins were evaluated. The cognitive function tests, pathological damage, the rate of necroptosis, the expression of necroptosis-related proteins, NMDAR2A and NMDAR2B were significantly different in the S group ( P < 0.05). Alleviated pathological damage, decreased the rate of necroptosis and down-regulated the expression of necroptosis-related proteins occurred in the S+M and S+N group ( P < 0.05). The lower elevated [Ca2+]i, expression of NMDAR2A and NMDAR2B were found in the S+M group. Our findings highlighted sevoflurane-induced cognitive dysfunction is associated with an imbalance in cytoplasmic calcium homeostasis by activating NMDA receptors, which causes hippocampus neurons to undergo necroptosis and ultimately affects cognitive performance in aged mice.

Online psychoeducation and digital assessments as a first step of treatment for borderline personality disorder: A protocol for a pilot randomized controlled trial

Background Treatment trials for borderline personality disorder (BPD) have consistently demonstrated that approaches that are diagnostically tailored are superior to those which are not. Currently, gold standard treatments for BPD are highly intensive, lengthy, and specialized, leading to a critical gap between the supply and demand of effective, evidence-based treatment for patients who receive a diagnosis of BPD. Psychoeducation, which is a common component of most treatments known to be effective, is a low-cost, low-burden intervention proven to relieve symptoms. The present study builds on psychoeducation research, assessing online video prescriptions as a means of disseminating information patients need to know about their diagnosis and care. Methods This article presents the study protocol for a safety, feasibility, and preliminary efficacy trial of psychoeducational video prescriptions and online assessment with feedback for newly diagnosed individuals with BPD. We aim to recruit 100 adults recently diagnosed with BPD to be randomly assigned to receive videos about BPD or videos about non-BPD mental health topics that are matched in length in the first step of the study. All participants will complete daily surveys about their emotions, interpersonal interactions, and behaviors, as well as self-report assessments and cognitive tests at 4 different time points. Half of the participants in the intervention group will receive feedback on their symptom ratings and cognitive test performance to assess whether there is incremental value in tailoring this online set of interventions with individualized feedback unique to each participant. This study aims to assess the effects of BPD-focused psychoeducational videos with and without personalized feedback, on BPD and depressive symptom severity as well as core mechanisms of the disorder such as loneliness, rejection sensitivity, cognitive control difficulties, and self-clarity. Results will inform efforts to progress to a larger, more definitive trial. Trial registration Clinical trials registration: The protocol is registered with ClinicalTrials.gov NCT05358925.

Higher intake of certain nutrients among older adults is associated with better cognitive function: an analysis of NHANES 2011–2014

BackgroundAn increasing number of adults are over the age of 65, and there is concern about the increasing prevalence of age-associated cognitive decline and poor mental health status in older adults in the United States. Several nutrients are known to have important biological roles in brain health and neurological function, but many individuals fall short of recommended intake levels. The objective of this study was to examine the association between nutrient intake and cognitive function. We also explored whether nutrient intake was associated with depression.MethodsThis cross-sectional study was based on data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 and included participants ≥ 60 years of age who had reliable day 1 dietary recall data and either valid cognitive function data (n = 2713) or valid depression score data (n = 2943). The sample was stratified by gender, and cognitive functioning test (CFT) composite z-scores were analyzed by quartiles. Depression status was assessed using the Patient Health Questionnaire (PHQ-9).ResultsHigher intake and adequacy of a number of different nutrients from food were associated with higher cognitive function in both males and females. Nutrients that showed the most consistent associations with cognitive function across intake and adequacy analyses for food in both males and females were vitamin A, vitamin E, thiamin, riboflavin, vitamin B6, folate, magnesium, potassium, zinc, vitamin K, and lutein and zeaxanthin (p < 0.05 for all). These associations were positive with increasing intake and adequacy being associated with higher CFT composite z-scores. Analysis of nutrient intake and depression yielded results that differed by gender. In females, the nutrients that showed consistent inverse associations with depression scores across both intake and adequacy analyses for food were vitamin A, vitamin C, magnesium, vitamin K, potassium, and dietary fiber (p < 0.05 for all). In males, no significant associations between nutrient intake from food and depression scores were observed.ConclusionsOur findings suggest that older adults with sufficient intakes of certain essential nutrients have higher cognitive function. Future studies are needed to confirm whether a well-balanced diet and/or dietary supplements which emphasize these nutrients are effective for prevention of age-related declines in cognitive function and mood.

Clinical Manifestations.

Prediction of the course of cognitive function is of central importance in the care of patients with dementia of Alzheimer type (DAT) for individual management, counseling and treatment. Baseline clinical examination and cognitive function testing are decisive in the classification of the dementia type and stage, but their predictive value to foresee the future course of the disease is critical. This project aims to examine the relationship of baseline dementia stage and Alzheimer's disease neuropathological changes (ADNC) at autopsy with cognitive function during the course of the disease. This study is based on longitudinal data from The National Alzheimer's Coordinating Center (NACC)-Uniform and Neuropathology Data Set. Participants were retrospectively included based on the following criteria: Clinical diagnosis of DAT, cognitive function testing by Mini-Mental State Examination (MMSE), and report of ADNC at autopsy (ABC score). Baseline dementia stages were defined by the MMSE score (≥27/20-26/10-19/≤9). Neuropathological diagnosis of Alzheimer's disease was defined by ABC score levels "High" or "Intermediate" (confirmed-ADNC) as opposed to ABC score levels "Low" or "Not" (no-ADNC). Of 44,359 participants, 1,469 met inclusion criteria with 5,649 cognitive data points (i. e., on average 4.6±1.9 MMSE scores/participant). At baseline, 33%/49%/16%/2% of participants were assigned MMSE ranges of ≥27/20-26/10-19/≤9 respectively. The proportion of confirmed-ADNC within the respective groups increased as a function of the baseline MMSE range (76%/90%/95%/96% respectively). Cognitive function changes from baseline to last visit depended on the neuropathological diagnosis (-7 vs. -4 MMSE score points for confirmed-ADNC vs. no-ADNC respectively), but not on MMSE score at baseline (all -7 score points). Participants with a baseline MMSE score ≤9 decreased even less (-3 score points). The present descriptive analysis does not provide evidence for a clear association of cognitive function decline during follow-up and baseline MMSE scores, in contrast to ADNC which predicted faster decline, in patients with DAT. Modelling analyses including covariates will be presented.

Tu-Xian Decoction ameliorates diabetic cognitive impairment by inhibiting DAPK-1

Tu-Xian decoction (TXD), a traditional Chinese medicine (TCM) formula, has been frequently administered to manage diabetic cognitive impairment (DCI). Despite its widespread use, the mechanisms underlying TXD’s protective effects on DCI have yet to be fully elucidated. As a significant regulator in neurodegenerative conditions, death-associated protein kinase-1 (DAPK-1) serves as a focus for understanding the action of TXD. This study was designed to whether TXD mediates its beneficial outcomes by inhibiting DAPK-1. To this end, a diabetic model was established using Sprague-Dawley (SD) rats through a high-fat, high-sugar (HFHS) diet regimen, followed by streptozotocin (STZ) injection. The experimental cohort was stratified into six groups: Control, Diabetic, TC-DAPK6, high-dose TXD, medium-dose TXD, and low-dose TXD groups. Following a 12-week treatment period, various assessments—including blood glucose levels, body weight measurements, Morris water maze (MWM) testing for cognitive function, brain magnetic resonance imaging (MRI), and histological analyses using hematoxylin-eosin (H&E), and Nissl staining—were conducted. Protein expression in the hippocampus was quantified through Western blotting analysis. The results revealed that TXD significantly improved spatial learning and memory abilities, and preserved hippocampal structure in diabetic rats. Importantly, TXD administration led to a down-regulation of proteins indicative of neurological damage and suppressed DAPK-1 activity within the hippocampal region. These results underscore TXD's potential in mitigating DCIvia DAPK-1 inhibition, positioning it as a viable therapeutic candidate for addressing this condition. Further investigation into TXD's molecular mechanisms may elucidate new pathways for the treatment of DCI.

The association of English‐Spanish and Indigenous‐Spanish bilingualism with cognition among older adults in the Mexican Health and Aging Study (MHAS)

AbstractBackgroundWhile several studies have reported a “bilingual advantage” in cognition among older adults, others have not. Most studies of bilingualism and cognitive aging are in urban settings among high income countries, limiting the generalizability among bilinguals residing in lower‐and middle‐income countries, such as Mexico. Additionally, the association of bilingualism and cognition among indigenous populations is unknown. In Mexico, there are almost 7 million speakers of indigenous languages, residing primarily in rural areas, and over 15 million people that report speaking English, predominantly in urban settings. To account for sociocultural factors confounding the type of bilingualism (i.e., English‐Spanish, Indigenous‐Spanish), we evaluated whether bilingualism was associated with better cognitive functioning among adults across urban and rural regions in Mexico.MethodAnalyses included participants from the Mexican Health and Aging Study (MHAS) aged 55 and older in urban (N = 1053, 12% Spanish‐English bilinguals) and rural (N = 814, 20% Spanish‐Indigenous bilinguals) areas. Participants reported speaking English and/or an indigenous language in addition to Spanish. Participants completed comprehensive cognitive testing assessing memory, language, executive function, and visuospatial domains. General linear models stratified by region evaluated bilingualism on cognitive domain performance covarying for sociodemographic factors.ResultSociodemographic characteristics differed by region and language group. English‐Spanish bilinguals in urban areas were younger, predominantly men, with higher education, less likely illiterate, and with greater U.S. migration history compared to monolinguals. In rural areas, Indigenous‐Spanish bilinguals were younger, with less education, higher prevalence of illiteracy, and less likely to have U.S. migration history compared to monolinguals. In urban settings, English‐Spanish bilingualism was not associated with performance on any cognitive domain (p&gt;0.05). In rural settings, Indigenous‐Spanish bilingualism was associated with worse performance across all cognitive domains (p&lt;0.01).ConclusionThere was no evidence of a bilingual cognitive advantage among older adults residing in urban and rural regions in Mexico. While indigenous bilinguals demonstrated the lowest cognitive test performance, further work is required to understand the socioeconomic and environmental factors associated with bilingualism among indigenous populations in Mexico. Greater characterization of their bilingualism (i.e., age and context of acquisition, proficiency, frequency of use) across all languages can help elucidate the association between bilingualism and cognitive test performance.

Neuromodulation for Mild Cognitive Impairment: Improvements in Spatial Navigation and Associative Memory with Acute Transcutaneous Vagus Nerve Stimulation: VINCI‐AD

AbstractBackgroundNew therapeutic strategies to treat Mild Cognitive Impairment (MCI) are urgently needed. Transcutaneous Vagus Nerve Stimulation (tVNS) is a neuromodulation technique which uses a handheld device to peripherally stimulate the afferent vagus nerve. tVNS has shown promise in augmenting memory in cognitively healthy populations but data in cognitively impaired populations is sparse.MethodVINCI‐AD is an investigator‐led, single‐blind, sham‐controlled crossover pilot study assessing the effects of tVNS in amnestic MCI. All participants have MCI (CDR global 0.5) with amnestic neuropsychological profile (RBANS delayed memory index &lt;85). Participants are randomised over 3 study visits to baseline (no stimulation) active stimulation (at the CC of left ear) or sham stimulation (earlobe). Cognitive tests include Face‐Name Association Task (FNAT), Sustained Attention Response Test (SART) and Sea Hero Quest Navigation Test (SHQ) among others.ResultInterim data analysis of 28 participants is presented (mean age 71.5 (range 55‐85), 17 male, RBANS DMI 73.3 ±11.1). CSF AD biomarkers were positive for 75% (21/28) (AB‐42 460.4pg/ml (± 83.3pg/ml) and p‐tau181 82.5pg/ml [± 53.2pg/ml]) and 78% (22/28) of participants had a Charleston Comorbidity Index of ≥3. Mean tVNS stimulation time pre‐cognitive assessments was 21.2 minutes, with mean amplitude setting during active stimulation of 2.5mA (1.8‐4.5) and sham of 2.0mA (0.9‐3.1). During FNAT, active tVNS had no effect on facial recognition or reaction times, however recall accuracy was significantly improved (69.2% ±3.13) compared to baseline (44.7% ±3.51 p = 0.016) and sham (50.1% ±3.28 p = 0.021) and during active tVNS spatial navigation (38.94sec [±1.68]) was quicker than baseline (51.49sec (±3.2) p = 0.0164) and sham (51.9sec (±3.15) p = 0 .0038). We noted no significant improvements in SART or other cognitive tests performance during tVNS.ConclusiontVNS may be a useful complementary tool to augment spatial and associative memory in MCI. Further larger studies are needed to delineate precise settings in this population.

Cognitive Assessment of Monolingual and Bilingual US Older Latino Populations

AbstractCommonly used neuropsychological tests may not be sensitive to cognitive changes in Native Spanish‐speaking Latinos living in the United States. Cognitive abilities are culturally bound, and therefore cultural and educational factors can influence an individual’s cognitive test performance. Cognitive tests have been most often developed for middle‐class English speakers, and therefore, they may present bias when the same tests are used within the Spanish‐speaking Latino community. Thus, cultural and linguistic factors, as well as other sociodemographic factors, need to be considered to assure validity and fairness in neuropsychological assessments. Culturally appropriate cognitive assessment is a critical issue when working with socio‐economically diverse Latino populations in the US.Many Latino adults in the US are bilingual, with 59% of those speaking English also speaking Spanish. As language experience powerfully shapes the brain and cognitive function, bilingualism may play an important role in decreasing the risk of developing dementia later in life. Studies examining the role of sociocultural factors, including acculturation and quality of education, are needed, as well as research that helps develop more appropriate cognitive tests and normative data for different Latino heritages. In this session, the US Consortium of Aging, Dementia &amp; Latino Studies (CADLAS) Cognition and Assessment Special Interest Group (SIG) will discuss recent developments, current challenges, and opportunities, as well as future research directions in this area. The SIG aims to promote collaborations among investigators from different States in the US to harmonize cognitive measures and assessment across cohorts and advance clinical research with US Latino populations.

Describing the effects of iron dyshomeostasis on cognitive function and dementia in UK Biobank

AbstractBackgroundIron dyshomeostasis is a feature of neurodegenerative disease. In circulating blood, changes in iron are associated with dementia disease phenotypes, while in brain tissue increased iron is associated with dementia progression. In UK Biobank, whole body imaging includes variables derived from the brain swMRI data which are indicative of iron in brain tissue. Complete blood counts per participant include hemoglobin concentration indicative of iron in oxygen transportation. Using the cognitive assessment and participants with all‐cause dementia we aimed to understand how measured changes in iron would affect dementia in a large UK‐based cohort.MethodUsing cross–sectional analysis at shared time points in UK Biobank data collection we compared both the iron phenotypes with cognitive measures. Firstly, the baseline values at the primary assessment centre visit where 478,082 participants were tested for cognitive function and red blood cell measures. Secondly, at Visit 2 (n = 5861), where brain imaging derived T2* measures and complete blood count (hemoglobin concentration) were captured alongside the repeated cognitive measures. Each linear regression model includes cognitive function (outcome) and iron measures (exposure) with correction for age and sex. Adjusted models include correction for education years, assessment centre and ethnicity.ResultWe found association between low hemoglobin and all‐cause dementia (beta = ‐0.125, p &lt;0.001). This association was replicated with poorer cognitive function and low haemoglobin analysing cognitive function tests (including verbal and numerical reasoning and reaction time) and mean corpuscular hemoglobin, (p&lt;0.05). Using quantile sets of hemoglobin concentration we found a non‐linear effect, whereby both high and low iron had a negative association on cognitive outcome (verbal reasoning ‐0.029,‐0.019, p’s = 0.002,0.049). Using MRI T2* we found associations between newer cognitive function tests, matrix pattern puzzles and symbol digit substitution (p &lt;0.0001) as well as verbal reasoning (p = 0.015). These cognitive function measures were strongly associated with the T2* hippocampus region.ConclusionWe have shown an association between dementia and low hemoglobin concentration. We have demonstrated the complexities of this iron homeostasis relationship, showing how lower cognitive function is associated with both increased and reduced iron concentration in blood and how iron changes in brain effect different cognitive traits.

Association between Grip Strength and Future Cognitive Function in male

AbstractBackgroundFrailty is an aging‐related syndrome of physiological decline, and has been associated with cognitive function.Grip strength, could be used as a marker for frailty and older adult health status. Frailty has been associated with cognitive function. However, its mechanism has not been fully investigated.We aimed to investigate the association between grip strength with cognitive function.MethodWe prospectively recruited 184 participants who underwent a grip strength test, cognitive function test. Data was collected from the Korean Aging Study for the Early Diagnosis and Prediction of Alzheimer’s Disease (KBASE), an ongoing prospective cohort study which started in 2014. Frailty was represented by grip strength (kg). Cognitive function was assessed using Mini‐Mental State Examination(MMSE) and The Consortium to Establish a Registry for Alzheimer’s Disease‐K(CERAD‐K).Multiple linear regression models were used to analyze the associations between grip strength and cognitive function. We adjusted age, gender, years of education, and BMI.ResultAmong 184 participants, 119 (64.7%) were cognitively normal. 32 (17.4%) were diagnosed with mild cognitive impairment and 33 (17.9) were a probable AD. Mean age of the participants was 69.4 (8.2) years. 43.5% of the participants were female. Grip strength was positively associated with MMSE at 1 year later in male (ß = 0.182 p = 0.004). In terms of cognitive domain, verbal and visual memory, language, visuospatial, and frontal‐executive functions were related to grip strength (vebal memory: ß = 0.037 p = 0.022, visual memory: ß = 0.046 p = 0.002, language: ß = 0.055 p&lt;0.001, visuospatial: ß = 0.068 p = 0.0213, frontal‐executive: ß = 0.050 p&lt;0.001).ConclusionWeakness of grip strength is associated with decreased future cognitive function. This support concept that grip strength could be a marker for cognitive decline.

P198: Correlation between depressive symptom severity and functional status in patients with mild cognitive impairment.

Objectives:Although depression is a common co-morbid disorder in patients with mild cognitive impairment (MCI), not all patients with MCI exhibit depressive symptoms. This study aimed to investigate the effect of depression on cognitive and functional decline in MCI.Methods:281 patients with MCI (MCI) defined by 0.5 score on Clinical Dementia Rating were included in the study. Patients were divided into three groups based on their Geriatric Depression Scale (GDS) scores: MCI without depression (GDS&lt;10, n=50), MCI with mild depression (GDS10~19, n=120), and MCI with severe depression (GDS&gt;20, n=111). Cognitive function tests (cognitive domains in CERAD-K including letter fluency, trail making test-A and B, and verbal learning test) and Blessed Dementia Scale-Activities of Daily Living (BDS-ADL) were measured. Group differences were analyzed using an analysis of variance (ANOVA). Correlation between GDS scores and BDS-ADL were analyzed.Results:An ANOVA test showed that activities of daily living differed significantly across groups (F(2, 276) = 13.53, p&lt;0.001). Post-hoc analysis showed MCI with severe depression had a significantly higher mean BDS-ADL score compared with both MCI without depression and MCI with mild depression (both, p&lt;0.001). Correlation analysis showed significant positive correlation between GDS and BDS-ADL (r=0.366, p&lt;0.001). However, mean scores of cognitive function tests were not different among three groups.Conclusions:The present study suggests that co-morbid depressive symptoms may have negative impact on functional status in patients with MCI. This may further suggest the importance of evaluation and treatment of depressive symptoms in patients with MCI.

A Study on the effects of seasonal variations in cognitive function on driving behaviour.

AbstractBackgroundThe population in Japan is ageing, and approximately 30% of the elderly are said to have Alzheimer’s disease. On the other hand, however, there are areas with insufficient transport services due to the declining birth rate, and the elderly have to drive cars. In order to reduce accidents caused by drivers with dementia, it is necessary to know the relationship between cognitive function and driving, but cognitive function is said to fluctuate daily. The aim of this study is to obtain knowledge that contributes to the prediction of accidents by observing the seasonal variation in cognitive function and driving using the same subjects.MethodA cognitive function test, a driving skill test at a driving school and an observation 1‐month survey of driving behaviour on public open roads were conducted on 40 drivers aged 70 years or older who drive their cars daily. The survey was conducted twice on the same subjects, once between April and June and once between October and December. From the data obtained, seasonal differences were verified.ResultIt is said that elderly drivers often drive short distances in their neighbourhood, but in reality they also make long trips. Comparing spring/summer and autumn/winter, autumn/winter drivers are more likely to be in a state of cognitive decline and drive more unevenly.ConclusionCognitive function and driving behaviour of older drivers differ depending on the season. As the passage of time and more short‐term fluctuations may have an impact, it is important to systematise the fluctuating changes in various cycles and link them to safe driving support.

Predicting cognitive stage transition using plasma p‐tau181, the Centiloid scale, and other measures

AbstractBackgroundA combination of plasma phospho‐tau (p‐tau), amyloid beta (Aβ)‐PET, brain magnetic resonance imaging, cognitive function tests, and other biomarkers might predict future cognitive decline. This study aimed to investigate the efficacy of combining these biomarkers in predicting future cognitive stage transitions within 3 years.MethodAll participants were from the validation cohort of the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer’s Disease (KBASE‐V) study. Among the participants in the KBASE‐V study, 49 mild cognitive impairment (MCI) and 113 cognitively unimpaired (CU) participants with Aβ‐PET and brain imaging data were analyzed. Main outcome was cognitive stage transitions within 3 years. The best combination model that predicts cognitive stage transition was considered by significant change of area under the curve (AUC) and Akaike information criterion value.ResultWithin 3 years, 19.1% of the participants showed a cognitive stage transition. Older age, increased plasma p‐tau, Aβ‐PET positivity, and decreased semantic fluency were independently associated with cognitive stage transitions. Plasma p‐tau181 (AUC = 0.673) and the Centiloid scale (AUC = 0.769) alone predicted cognitive stage transition well and correlated with each other significantly. Combining age, p‐tau181, the Centiloid scale, semantic fluency, and hippocampal volume produced better accuracy (AUC = 0.879). In MCI participants, the model combining age, p‐tau181, and the Centiloid scale demonstrated the highest predictive value (AUC = 0.963).ConclusionPlasma p‐tau181 and Centiloid scale, in combination with other biomarkers, might have high predictive value in predicting future cognitive stage transition in non‐dementia patients.

Association between Anemia and Dementia in Korea older adults: A national cohort study

AbstractBackgroundAs the global elderly population increases, the prevalence of dementia is also increasing. Korea is one of the rapidly aging countries in the world, and 10.33% of elderly people aged 65 and older are receiving treatment for dementia as reported in 2021. Since disease modifying drugs have not yet been developed for dementia, the importance of modifiable risk factors that can lower the risk of dementia is being emphasized, and one of them is anemia in the elderly. We analyze national cohort data of approximately 20 years to disclose the relationship between anemia and dementia in Korean elderly, and suggest that anemia is a modifiable risk factor for dementia needed active intervention.MethodWe analyzed a large population‐based cohort study of aged ³65 years who participated in the national health screening program including blood tests and cognitive function tests from 2007 to 2008 in Korean National Health Insurance Service database 2006‐2020. The risk of AD according to the presence and severity of anemia was evaluated using a multivariable Cox regression model, after adjustments for sex, BMI, HTN, DM, LDL, TG, SCr, GFR and past medical history (depression, HTN, DM, cardiovascular disease, cerebrovascular disease).ResultAs a result of the analysis, dementia occurred in 27.9% of the total subjects (316,881 persons) during the follow‐up period until 2020. Also, dementia occurred in 27.5% of the normal group, but 30.1% of the anemia group. As a result of survival analysis, even after adjusting for sex, there was a statistically significant difference between the presence of anemia and the prevalence of dementia (HR 1.07, 95% CI 1.05‐1.09). In addition, even after adjusting for sex, BMI, HTN, DM, LDL, SCr, GFR, and past medical history, there was a statistically significant association between anemia and dementia (HR 1.05, 95% CI 1.03‐1.07).ConclusionWe reported that the presence of anemia statue and the severity of anemia in the elderly were related to the occurrence of dementia through a national date of Korea. We suggest that anemia is a modifiable risk factor for dementia and requires intensive intervention in the elderly.

Correlation between depressive symptom severity and functional status in patients with mild cognitive impairment

AbstractBackgroundAlthough depression is a common co‐morbid disorder in patients with mild cognitive impairment (MCI), not all patients with MCI exhibit depressive symptoms. This study aimed to investigate the effect of depression on cognitive and functional decline in MCI.Method281 patients with MCI (MCI) defined by 0.5 score on Clinical Dementia Rating were included in the study. Patients were divided into three groups based on their Geriatric Depression Scale (GDS) scores: MCI without depression (GDS&lt;10, n = 50), MCI with mild depression (GDS10∼19, n = 120), and MCI with severe depression (GDS&gt;20, n = 111). Cognitive function tests (cognitive domains in CERAD‐K including letter fluency, trail making test‐A and B, and verbal learning test) and Blessed Dementia Scale‐Activities of Daily Living (BDS‐ADL) were measured. Group differences were analyzed using an analysis of variance (ANOVA). Correlation between GDS scores and BDS‐ADL were analyzed.ResultAn ANOVA test showed that activities of daily living differed significantly across groups (F(2, 276) = 13.53, p&lt;0.001). Post‐hoc analysis showed MCI with severe depression had a significantly higher mean BDS‐ADL score compared with both MCI without depression and MCI with mild depression (both, p&lt;0.001). Correlation analysis showed significant positive correlation between GDS and BDS‐ADL (r = 0.366, p&lt;0.001). However, mean scores of cognitive function tests were not different among three groups.ConclusionThe present study suggests that co‐morbid depressive symptoms may have negative impact on functional status in patients with MCI. This may further suggest the importance of evaluation and treatment of depressive symptoms in patients with MCI.

Motor alterations associated with cognitive impairment in a third‐level hospital

AbstractBackgroundCognition and motor function declines have been shown to precede cognitive impairments, and motor changes have been proposed as potential clinical biomarkers to help predict dementia syndromes; there are reports that gait speed declined a decade before the diagnosis of MCI and preceded declines in cognitive function tests. The slow gait speed associated with cognitive complaint, motor cognitive risk syndrome is a clinical biomarker for high risk of neurologic degeneration.MethodThis report is a secondary analysis from a transversal study, the inclusion criteria include adults from 60 or older, who complete evaluations at the baseline in a from a dementia clinic at a tertiary care center in Mexico. Gait performance were evaluated in all the participants which had to walk 10 meter distance and timed, slow gait were considered as those more than 1 meter/second. Variables such as sex, age, education, marital status, occupation, depression, anxiety, frailty, cognitive impairments and geriatric syndromes were considered for the analysis. The outcome was the description of the characteristics of gait disturbance in the follow‐up evaluation and their relationships with the variables discussed.ResultFinally, 222 patients were studied, highlighting a prevalence of 73% (n = 158) being female and 28% (n = 64) being male. A total of 72% (n = 160) of patients presented a speed &lt;1m/s and 28% (n = 62) with a speed &gt;1m/s. Polypharmacy, intestinal habit disorder, sensory deprivation, and housewife occupation were associated with a decrease in gait speed. The group with mild cognitive impairment, 32% (n = 72), predominantly had a gait speed of less than 1 m/s. Regarding functionality, we found that the moderate dependence group, 31% (n = 71), and pre‐frail patients, 32% (n = 72), had a greater association with a decrease in gait speed. A significant association was found between MMSE and gait speed (p = 0.003).ConclusionIt was found that female patients have a prevalence of slow walking speed &lt;1m/sec. In addition, patients with mild cognitive impairment have a higher prevalence, which suggests that walking speed may be a prodromal sign for mild cognitive impairment. Only was significative sex, polypharmacy, and fraility.

Psychophysiology, Cognitive Function, and Musculoskeletal Status Holistically Explain Tactical Performance Readiness and Resilience.

Thompson, AG, Ramadan, JH, Alexander, JS, and Galster, SM. Psychophysiology, cognitive function, and musculoskeletal status holistically explain tactical performance readiness and resilience. J Strength Cond Res 37(12): 2443-2456, 2023-This study aimed to advance the techniques used in quantifying holistic readiness and resilience within military personnel. Tactical performers, instructors, and applied human performance scientists designed a weeklong competition to reflect realistic operational demands, test specific underlying performance constructs, and elucidate how modernized assessments could drive programmatic action. By placing first in their installation's local preliminary competition, 34 active-duty Marines earned the opportunity to compete in a series of 7 intense events for the title of champion. All inferential statistics were set to a p ≤ 0.05 level of significance. Morning heart rate variability identified top from bottom quartile finishers before a single competition event. By day 3, morning countermovement jump force production (normalized reactive strength index-modified) and cognitive psychomotor vigilance were significant indicators of performance resilience and final competition group rank. Heart rate variability also tracked performer readiness across time, identifying within-group and between-group differences among top, bottom, and field. Collectively, these holistic assessments proved significant markers of acute and chronic tactical performance capabilities. In summary, the incorporation of psychophysiological monitoring, cognitive performance testing, and musculoskeletal force plate evaluations could help inform selection and support needs, drive workload or recovery modulation, and provide critical metrics for evaluating training efficacy and operational readiness. Defense organizations should consider routinely incorporating and actioning similar holistic status monitoring strategies in training and operational settings. Moreover, leveraging other tactical competitions may provide key opportunities for advancing the standard of practice through additional scientific investigation.

Associations between depressive symptoms, glial fibrillary acid protein, and cognitive decline in a population‐based study

AbstractBackgroundDepressive symptoms are a known risk factor for dementia, and higher concentrations of glial fibrillary acid protein (GFAP) is associated with a faster rate of cognitive decline. However, it is unknown whether the two risk factors increase the risk of cognitive decline additively.MethodThis investigation is based on 1,169 participants from the Chicago Health and Aging Project (CHAP), a population‐based cohort study, who completed at least two cognitive performance assessments with baseline serum GFAP measurement. Depressive symptoms were determined utilizing a modified version of the Center for Epidemiologic Studies‐Depression Scale. A composite global cognitive function score was calculated using cognitive performance testing. Linear mixed effects regression models were conducted to examine the association of depressive symptoms and GFAP concentrations on baseline global cognitive function and the annual rate of cognitive decline. Regression models also adjusted for age, race, sex, education, chronic medical conditions, and their interactions with time.ResultOur study sample consisted of 60% African American participants and 63% female participants and had an average age of 77 (SD = 6.0) years. In our sample, 21% had few depressive symptoms (0‐2), and the remaining 79% had more depressive symptoms (3‐10). We found a statistically significant interaction between depressive symptoms and GFAP (β = ‐111 (SE = .039), p = .005) on global cognitive function. Stratified analysis showed that the associations between the log of GFAP and global cognitive function were statistically significant for participants with few (0‐2) depressive symptoms (β = ‐.223 (SE = .087), p = .010) and more (3‐10) depressive symptoms (β = ‐.781 (SE = .198), p = .000). Statistically significant associations were also observed between the log of GFAP and global cognitive decline for participants with few (β = ‐.069 (SE = .017), p = .000) and more (β = ‐.100 (SE = .040), p = .012) depressive symptoms.ConclusionOur findings show additive effects of depressive symptoms in the association between the log of GFAP with baseline global cognitive function and rate of cognitive decline. Prevention and treatment of depression in old age can significantly impact the risk of progressive cognitive decline, especially among individuals with higher concentrations of GFAP.

Post‐covid cognitive performance in subjects at risk of developing dementia in Uruguay

AbstractBackgroundthe study of the medium and long‐term consequences of coronavirus infection (SARS‐CoV‐2) is of great relevance from the clinical and public health perspective. Recent evidence has shown that patients may present cognitive complaints after overcoming the acute stage of infection, particularly memory disturbances. Although significant progress has been made in the knowledge of this sequel, the studies are generally limited by small sample sizes, cognitive screening techniques with ceiling effects, and samples with healthy subjects without comorbidities, among others. The objective of this study is to compare the cognitive performance of subjects at risk of developing dementia with and without a history of SARS‐CoV‐2 in Uruguay.Methodparticipants from the LatAm FINGERS Uruguay Project were included. Performance in the different cognitive tests (symbol‐digit, trail making A, trail making B, free and cued selective remingind test) included in the project protocol was compared between the participants with and without a history of covid infection.Results27 subjects with a history of covid infection prior to baseline cognitive assessment and 62 subjects without a history of covid infection were analyzed. None of the participants had serious complications or requiring hospitalization due to SARS‐CoV‐2 infection. The performance of both groups in attentional, executive and memory tests was compared. There were no significant differences between groups.Conclusionsthe impact of covid on cognition is still a controversial topic. In our sample of subjects at risk of dementia, there was no evidence of impaired cognitive performance due to SARS‐CoV‐2 infection. More studies in underrepresented populations with larger samples are needed to address this issue.

Positron emission tomography (PET) imaging of neuroinflammation in healthy and Alzheimer disease participants using TSPO tracers

AbstractBackgroundAlzheimer’s disease (AD) is the most common type of dementia. In addition to the widely recognized accumulation of amyloid and tau protein being the core pathology of AD, neuroinflammation is another cause of brain dysfunction and structural change. Expression of translocator protein (TSPO) on the outer mitochondrial membrane of activated microglia is strongly associated with neuroinflammation. With the development of TSPO positron emission tomography (PET) tracer, we were able to evaluate neuroinflammation non‐invasively in a clinical cohort of AD spectrum.MethodCognitively impaired patients (including AD and mild cognitive impairment (MCI)) and cognitively normal controls (CN) were recruited from single dementia clinic. [18F]FEPPA, the second‐generation PET ligand specifically binds TSPO was synthesized fully automated. Structural brain MRI and functional PET imaging were performed simultaneously with a PET/MR scanner (SIGNA, GE Company, USA). Kinetic analyses were performed using PMOD 4.2 modeling software. Total distribution volume (VT) in each ROI, including frontal, temporal, inferiolateral parietal, occipital, hippocampus and cerebellum, were derived from a two‐tissue compartment model (2‐TCM). In addition, APOE and rs6971 polymorphism genotyping were conducted in all subjects. Mann‐Whitney U Tet, Kruskal‐Wallis Test and linear correlation were performed.ResultA total of 39 participants (23 males and 16 females) participated, including 13 cognitively normal, 9 with MCI and 17 with Alzheimer’s disease. The rs6971 genotype had no significant effect on [18F]FEPPA binding to TSPO. The amount of TSPO expression was independent of age, gender, and APOE ε4 carrier status. The VT of each ROI did not differ significantly between cognitive groups. VT of frontal, temporal, inferiolateral parietal and occipital lobe were all negatively correlated with MMSE, Boston Naming Test and Trial Making A performance. However, such association was not observed between VT of hippocampus and cognitive tests.ConclusionAlthough there was no difference between TSPO expression in each ROI among cognitive groups, we still observed that higher TSPO expression in the cortex was associated with worse performance in certain cognitive tests. This implied that the increase in neuroinflammation was related to the decline of cognitive performance regardless of cognitive diagnosis.