Digit Symbol Substitution Test Research Articles

Nutrition intake modifies the association between pulmonary function and cognitive performance among elderly Americans from NHANES 2011-2012.

Nutrition intake is one of the modifiable risk factors for cognitive decline. Whether energy and protein intakes alter the association between pulmonary function (PF) and cognition has not been studied. We made use of information from the U.S. National Health and Nutrition Examination Survey (NHANES) 2011-2012. PF measures, including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF), were calculated, whereas cognitive function was assessed through four tests: the Immediate Recall test (IRT), the Delayed Recall test (DRT), the Animal Fluency test (AFT) and the Digit Symbol Substitution test (DSST). Energy and protein intakes were measured using the 24-h dietary recall method. Weighted generalized linear regression was performed upon adjustment for covariates. Further interaction analyses were conducted to investigate the effect of energy and protein intakes on the association between PF and cognition. We finally included 803 participants aged ≥ 60years (54.4% female, weighted value). After adjusting for covariates, multiple measures (including FEV1, FVC, PEF, and composite PF) were all positively associated with better global cognition and the DSST score (P < 0.05). A stronger positive association between the DSST score and FEV1 (P for interaction = 0.001), FVC (P for interaction = 0.004), PEF (P for interaction = 0.003), and composite PF (P for interaction = 0.001) in lower energy intake. Similar results were observed in lower protein intake (all P for interaction < 0.05). Higher PF was independently associated with improved specific components of cognitive function (i.e., the DSST score). The positive association between PF and the DSST score was stronger in individuals with lower energy and protein intakes.

The association between trouble sleeping and obesity among the U.S. elderly from NHANES 2011–2014: A moderated mediation model of depressive symptoms and cognitive function

BackgroundStudies have shown a close association between trouble sleeping and obesity in older adults. However, no studies have explored the underlying mechanism of this relationship. The present study was designed to evaluate the roles of depressive symptoms and cognitive function in the association between trouble sleeping and obesity in older American adults. MethodsA cross-sectional study with 2575 participants (≥60 years old) in the National Health and Nutrition Examination Survey (NHANES) 2011–2014 was used for analysis. Obesity, depressive symptoms, and cognitive function (including Established Consortium for Word Learning in Alzheimer's Disease (CERAD-WL) (immediate learning and recall and delayed recall), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST)) were objectively measured, and trouble sleeping was assessed using a self-reported questionnaire. The moderated mediation analysis was conducted by Hayes' PROCESS macro. ResultsTrouble sleeping was positively associated with obesity among older adults. Depressive symptoms partially and indirectly mediated this association, and DSST moderated the association between trouble sleeping and depressive symptoms. Trouble sleeping had a lower impact on depressive symptoms in older adults with higher cognitive function. LimitationsThe cross-sectional design prevents making causal inferences, and part of self-reported information was not objective enough. ConclusionCognitive function moderated the mediation of depressive symptoms on the indirect, positive association between trouble sleeping and obesity; hence, incorporating methods to strengthen cognitive function and alleviate depressive symptoms may help weak the link between trouble sleeping and obesity among older adults.

The magnitude and direction of the relationship between risk factor and cognition depends on age: a pooled analysis of 5 community-based studies

The mixed evidence of the association between high levels of cardiovascular risk factors (CVRF) and the risk for cognitive impairment may be due to confounding of age across studies. We pooled and harmonized individual-level data (30,967 persons, age range 42–96 years) from five prospective cohorts to investigate by 1 year age increments to investigate whether or not there is change in slope describing the association of CVRF to a cognitive outcome (Digit Symbol Substitution Test; DSST). The CVRF included: systolic and diastolic blood pressure, total cholesterol, fasting glucose and body mass index. Linear and quadratic piecewise regression models were fit to the trajectory patterns of these slopes (betas). The pattern of yearly slope changes showed higher CVRF were associated with lower DSST, but associations attenuated toward zero as age increased for all but DBP where 1 year slopes for DBP changed direction from negative to positive from mid- to late-age. Age is not only a driver of cognitive decline—age also modifies the direction and strength of the association of cognitive function to CVRF and cohort age may be one reason why the evidence for CVRF-CD association is mixed.

Analysis of Breakfast Nutrients and Student Study Concentration

One of the main targets of the Sustainable Development Goals (SDGs) program in 2030 is related to the development of Indonesian children, where Indonesian children are human resources whose welfare and intelligence must be improved. To support intelligence, concentration is needed in every learning process. The aim is to analyze the relationship between the habit of consuming nutrients in the breakfast menu with learning concentration. The method in this study is Cross-Sectional, with the population being students of the class of 2020 at a private university located in the city of Banyuwangi. Using the purposive sampling technique, the number of respondents was 115 students. Data retrieval of students' food consumption to see the level of nutritional adequacy of breakfast was obtained through data records of breakfast on the day of the test. Learning concentration was measured using the Digit Symbol Substitution Test (DSST) instrument. In addition, data on breakfast habits was obtained by filling out a questionnaire. The statistical test used in this study was the Pearson Chi-Square which was analyzed by the formula, using ρ 0,05. The study showed that most of the subjects had a regular breakfast habit (70%) and before 09.00 am (74.7%). The learning concentration of most of the subjects (64.5%) was classified as good. From the results of the Pearson Chi-Square statistical analysis, it was obtained. There is a significant relationship between the level of energy adequacy (r count = 6,594, r table = 5,991), and protein (r count = 7,874, r table = 5,991), with learning concentration. There is no significant relationship between the level of nutritional adequacy of fat and carbohydrates in the breakfast menu with learning concentration (r count &lt; 5.991). Keywords: Breakfast Nutrients, Learning concentration, Student

Relationships of Physical Activity and Type 2 Diabetes With Cognition in Mexican Americans and Non-Hispanic Whites.

Problem, Research Strategy, and Findings: Low physical activity (PA) and Type 2 diabetes are associated with cognitive aging and Alzheimer's disease, but the evidence is inconsistent and particularly limited by ethnicity. The purpose of this study was to examine the relationships of PA and Type 2 diabetes with cognition in Mexican Americans and non-Hispanic Whites. The study was a cross-sectional analysis of the Health and Aging Brain Study-Health Disparities (n = 1,982-2,000 after removing outliers). Predictors included Rapid Assessment of Physical Activity and hemoglobin A1c (HbA1c). Episodic memory was assessed by Weschler Memory Scale-Third Edition Logical Memory and Spanish-English Verbal Learning Test, executive function by Weschler Memory Scale-Third Edition Digit Span and Digit Symbol Substitution Test, verbal fluency by FAS and animal naming,and global cognition by the Mini-Mental State Examination. Results show that aerobic PA and HbA1c were not associated with domain-specific, or global cognition, but strength/flexibility PA was associated with FAS (b = 0.404, 95% CI [0.023, 0.761]). Higher aerobic PA was associated with greater verbal fluency for Mexican Americans (b = 0.294, 95% CI [0.96, 0.497]) only. HbA1c was negatively associated with Mini-Mental State Examination (b = 0.838, 95% CI [0.008, 1.656]). For low HbA1c, the association between aerobic PA and Digit Symbol Substitution Test was significant for non-Hispanic Whites (b = 0.838, 95% CI [0.008, 1.656]) in comparison to Mexican Americans. Takeaway for Practice: The relationships between PA, Type 2 diabetes, and cognition vary by cognitive domains and ethnicity. Increasing aerobic activities may be particularly important for Mexican Americans who have elevated HbA1c to potentially improve fluency or executive function.

Association between Body Iron Status and Cognitive Task Performance in a Nationally Representative Sample of Older Adults.

Iron is an essential micronutrient that is necessary for proper cognitive function. However, the dose-response relationship between body iron status and cognitive function remains unclear. The objective of this study was to investigate the association between serum ferritin concentrations, an indicator of body iron status, and cognitive function in older adults. Based on the National Health and Nutrition Examination Survey (NHANES) 1999 -2002 in the United States, nationally representative data was collected from 2,567 adults aged 60 years and older who had objectively measured serum ferritin levels and cognitive performance. High ferritin levels were defined as a serum ferritin level >200 ng/mL in women and >300 ng/mL in men. Low ferritin levels were defined as a serum ferritin level <30 ng/mL. The digit symbol substitution test (DSST) was employed to assess cognitive function. Multivariable logistic regression analyses with survey weights were performed after the DSST was dichotomized at the median score. The weighted prevalence of adults with normal, low, and high serum ferritin levels were 73.98%, 9.12%, and 16.91%, respectively. A U-shaped association between serum ferritin concentrations and cognitive task performance was observed. After adjusting for demographic, socioeconomic, lifestyle, and C-reactive protein factors, the odds ratio (95% confidence intervals) for lower cognitive performance was 1.39 (1.11, 1.74) in adults with high ferritin levels and 1.38 (0.86, 2.22) in adults with low ferritin levels, compared with those with normal ferritin levels. The association between serum ferritin levels and lower cognitive performance was stronger in adults aged 60 to 69 years old than those aged 70 years and older. In conclusion, in a nationally representative sample of older adults in the United States, a high serum ferritin level was significantly associated with worse cognitive task performance. Thus, the relationship between low serum ferritin concentrations and cognitive task performance warrants further investigation.

Association between polycyclic aromatic hydrocarbon exposure and cognitive performance in older adults: a cross-sectional study from NHANES 2011-2014.

Background: polycyclic aromatic hydrocarbons (PAHs) are classified as neurotoxins, but the relationship between exposure to PAHs and cognition in adults is unclear, and their non-linear and mixed exposure association hasn't been explored. Objective: to evaluate the non-linear and joint association between co-exposure to PAHs and multiple cognitive tests in U.S. older people. Methods: restricted cubic spline (RCS) and Bayesian kernel machine regression (BKMR) were conducted to evaluate the non-linear and mixed exposure association, based on the cross-sectional data from NHANES 2011-2014: 772 participants over 60 years old, 4 cognitive test scores, including the Immediate Recall Test (IRT), Delayed Recall Test (DRT), Animal Fluency Test (AFT), and Digit Symbol Substitution test (DSST), and 5 urinary PAH metabolites. Results: a V-shaped nonlinear relationship was found between 3-hydroxyfluorene (3-FLUO), 2-hydroxyfluorene (2-FLUO), and DRT. Negative trends between mixed PAH exposure and IRT, DRT, and DSST scores were observed. 2-FLUO contributed the most to the negative association of multiple PAHs with IRT and DRT scores and 2-hydroxynaphthalene (2-NAP) played the most important role in the decreasing relationship between mixed PAH exposure and DSST scores. Conclusion: our study suggested that PAH exposure in the U.S. elderly might be related to their poor performances in IRT, DRT and DSST. Further prospective studies are needed to validate the association.

Spatial memory and learning: investigating the role of dynamic visual acuity.

The vestibular system's contribution to spatial learning and memory abilities may be clarified using the virtual Morris Water Maze Task (vMWMT). This is important because of the connections between the vestibular system and the hippocampus area. However, there is ongoing debate over the role of the vestibular system in developing spatial abilities. This study aimed to evaluate the relationship between Dynamic Visual Acuity (DVA) across three planes and spatial abilities. This cross-sectional study was conducted with 50 healthy adults aged 18 to 55 with normal stress levels and mental health and no neurological, audiological, or vestibular complaints. The Trail-Making Test (TMT) Forms A and B for the assessment of executive functions, the DVA test battery for the evaluation of visual motor functions, and the Virtual Morris Water Maze Test (vMWMT) for the assessment of spatial learning and spatial memory were performed. All participants also underwent the Benton Face Recognition Test (BFRT) and Digit Symbol Substitution Tests (DSST) to assess their relation with spatial memory. DVA values in horizontal (H-DVA), vertical (V-DVA), and sagittal (S-DVA) planes ranged from (-0.26) to 0.36 logMAR, (-0.20) to 0.36 logMAR, and (-0.28) to 0.33 logMAR, respectively. The latency of three planes of DVA was affected by vMWMT (Horizontal, Vertical, and Sagittal; Estimate: 22.733, 18.787, 13.341, respectively p < 0.001). Moreover, a moderately significant correlation was also found, with a value of 0.571 between the Virtual MWM test and BFRT and a value of 0.539 between the DSST (p < 0.001). Spatial abilities in healthy adults were significantly influenced by dynamic visual functions across horizontal, vertical, and sagittal planes. These findings are expected to trigger essential discussions about the mechanisms that connect the vestibular-visual system to the hippocampus. The original vMWMT protocol is likely to serve as a model for future studies utilizing this technology.

Joint effect of abnormal systemic immune-inflammation index (SII) levels and diabetes on cognitive function and survival rate: A population-based study from the NHANES 2011-2014.

The purpose of this study was to investigate whether the combination of abnormal systemic immune-inflammation index (SII) levels and hyperglycemia increased the risk of cognitive function decline and reduced survival rate in the United States. This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) database from 2011-2014 and enrolled 1,447 participants aged 60 years or older. Restricted cubic splines (RCS), linear regression and kaplan-meier(KM) curve were employed to explore the combined effects of abnormal SII and hyperglycemia on cognitive function and survival rate, and subgroup analysis was also conducted. The RCS analysis revealed an inverted U-shaped relationship between lgSII levels and cognitive function. Linear regression analysis indicated that neither abnormal SII nor diabetes alone significantly contributed to the decline in cognitive function compared to participants with normal SII levels and blood glucose. However, when abnormal SII coexisted with diabetes (but not prediabetes), it resulted to a significant decline in cognitive function. After adjusting for various confounding factors, these results remained significant in Delayed Word Recall (β:-0.76, P<0.05) and Digit Symbol Substitution tests (β:-5.02, P<0.05). Nevertheless, these results showed marginal significance in Total Word Recall test as well as Animal Fluency test. Among all subgroup analyses performed, participants with both abnormal SII levels and diabetes exhibited the greatest decline in cognitive function compared to those with only diabetes. Furthermore, KM curve demonstrated that the combination of abnormal SII levels and diabetes decreased survival rate among participants. The findings suggest that the impact of diabetes on cognitive function/survival rate is correlated with SII levels, indicating that their combination enhances predictive power.

Effect of Anaemia on Cognitive Ability in Female Dental Undergraduate Students: A Cross-sectional Study

Introduction: Anaemia not only impairs physical growth but also affects behavioral and cognitive abilities. Past studies have proved that increased haemoglobin levels result in improved Central Nervous System (CNS) functions. However, there is a significant lacuna between cognition and anaemia among young adults, especially females. Aim: To assess the cognitive ability of female undergraduate dental students with and without anaemia. Materials and Methods: This cross-sectional study included 100 young female dental students, aged between 18 and 23 years, who presented in the Department of Physiology, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India, from February to July 2019. Haemoglobin levels were analysed using the colourimetric cyanmethemoglobin method with Drabkin’s solution, and based on this, the students were divided into anaemic and non anaemic groups. Cognitive status was assessed using the Digit Symbol Substitution Test (DSST), letter cancellation test, and Stroop test. The Student’s t-test and Pearson’s correlation were used to examine the association between haemoglobin levels and cognition. Results: The mean age in the anaemic group and non anaemic group was 19.95±1.80 years and 19.64±1.60 years, and the Body Mass Index (BMI) was 19.54±1.62 kg/m2 and 19.32±1.43 kg/m2 , respectively. Haemoglobin levels were significantly lower in the anaemic subjects at 10.408 gm/dL compared to the non anaemic subjects (p-value&lt;0.001). A statistically significant difference was observed between the two groups on DSST scores (21.10±2.99 versus 32.60±14.69), letter cancellation test (25.80±4.63 versus 35.80±4.56), and Stroop test (132.10±8.15 versus 123.56±10.52). Conclusion: The present study reported a significant association between anaemia and cognitive function. Therefore, early screening and prompt treatment of anaemia are crucial for improving both physical as well as mental health

Altered brain texture features in end-stage renal disease patients: a voxel-based 3D brain texture analysis study.

Cognitive impairment in patients with end-stage renal disease (ESRD) is associated with brain structural damage. However, no prior studies have investigated the relationship between brain texture features and the cognitive function in ESRD patients. This study aimed to investigate changes in brain texture features in ESRD patients and their relationships with cognitive function using voxel-based 3D brain texture analysis (TA), and further predict individual cognitive-related brain damage in ESRD patients. Forty-seven ESRD patients and 45 control subjects underwent whole-brain high-resolution 3D T1-weighted imaging scans and neuropsychological assessments. The voxel-based 3D brain TA was performed to examine inter-group differences in brain texture features. Additionally, within the ESRD group, the relationships of altered texture features with neuropsychological function and clinical indicators were analyzed. Finally, receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive ability of brain texture features for cognitive-related brain damage in ESRD patients. Compared to the control group, the ESRD group exhibited altered texture features in several brain regions, including the insula, temporal lobe, striatum, cerebellum, and fusiform gyrus (p < 0.05, Gaussian random-field correction). Some of these altered texture features were associated with scores from the Digit Symbol Substitution Test and the Trail Making Test Parts A (p < 0.05), and showed significant correlations with serum creatinine and calcium levels within the ESRD group (p < 0.05). Notably, ROC curve analysis revealed that the texture features in the right insula and left middle temporal gyrus could accurately predict cognitive-related brain damage in ESRD patients, with the area under the curve values exceeding 0.90. Aberrant brain texture features may be involved in the neuropathological mechanism of cognitive decline, and have high accuracy in predicting cognitive-related brain damage in ESRD patients. TA offers a novel neuroimaging marker to explore the neuropathological mechanisms of cognitive impairment in ESRD patients, and may be a valuable tool to predict cognitive decline.

The Association of Neighborhood Socioeconomic Status with Executive Function and Processing Speed in Cognitively Normal Mexican American Elders from the Health and Aging Brains Study: Health Disparities Cohort

Introduction: Neighborhood socioeconomic status (NSES) has been linked with overall health, and this study will evaluate whether NSES is cross-sectionally associated with cognition in non-Hispanic whites (NHWs) and Mexican Americans (MAs) from the Health and Aging Brain: Health Disparities Study (HABS-HD). Methods: The HABS-HD is a longitudinal study conducted at the University of North Texas Health Science Center. The final sample analyzed (n = 1,312) were 50 years or older, with unimpaired cognition, and underwent an interview, neuropsychological examination, imaging, and blood draw. NSES was measured using the national area deprivation index (ADI) percentile ranking, which considered socioeconomic variables. Executive function and processing speed were assessed by the trail making tests (A and B) and the digit-symbol substitution test, respectively. Linear regression was used to assess the association of ADI and cognitive measures. Results: MAs were younger, more likely to be female, less educated, had higher ADI scores, performed worse on trails B (all p < 0.05), and had lower prevalence of APOE4 + when compared to NHWs (p < 0.0001). A higher percentage of MAs lived in the most deprived neighborhoods than NHWs. For NHWs, ADI did not predict trails B or DSS scores, after adjusting for demographic variables and APOE4. For MAs, ADI predicted trails A, trails B, and DSS after adjusting for demographic covariates and APOE4 status. Conclusion: Our study revealed that living in an area of higher deprivation was associated with lower cognitive function in MAs but not in NHWs, which is important to consider in future interventions to slow cognitive decline.

Longitudinal trajectories of cognitive decline and cerebral blood flow abnormalities in octogenarian men with normal global cognition

AimsCognitive and perfusion changes have been previously observed in older men with Mini Mental State Examination scores>24 points. We aimed to investigate time change in cognitive domains in a cohort of non-demented men between age 68 and 82, and how they are expressed in regional defects estimated by Cerebral Blood Flow (rCBF). Methods103 men at age 81 with MMSE scores >24 (mean 28.4 ± 1.7), no dementia or stroke, were examined with the same cognitive test battery at age 68 and age 81: Synonyms (SRB-1), Block design (SRB-3), Paired Associates, Digit Symbol Substitution and Benton Visual Retention test. rCBF was estimated using 99mTc-HMPAO SPECT at age 82. ResultsBetween ages 68 and 82 we observed a relative decline (Δ%) of cognitive test scores: SRB-3 and Benton tests, -33.7 % (SD 16,8) and -25.8 % (SD 23.9) respectively, followed by Digit Symbol test: -22,6 % (SD 15,6). The cluster of men (46 %) could be detected, grouped on the largest test score decline and highest overall test predictors’ importance in decreasing order: Δ% SRB-3, Δ% Paired Associates, Δ% Digit Symbol, Δ% Benton VR and Δ% SRB-1. Compared to the cluster with stable cognitive functions, it expressed lower rCBF in frontal and parietal lobes, and in subcortical areas. ConclusionNearly half of the studied, community-dwelling cohort of non-demented, octogenarian men with MMSE > 24, had a combination of decreasing visuospatial ability and episodic memory during preceding years, expressed by widespread rCBF changes in fronto-subcortical areas.

A comparison of two obesity-related hypoventilation disorders: Impact on sleep, quality of life and neurocognitive outcomes and the effects of positive airway pressuretherapy.

Symptom impact and neurocognitive function have not been previously compared between patients with obesity-associated hypoventilation disorders (obesity hypoventilation syndrome [OHS]) and hypoventilation in the setting of obesity and obstructive airways disease (OHAD). The aim of this study is to compare baseline sleep-related symptoms, health-related quality of life, and neurocognitive function between OHS and OHAD and the impact of PAP therapy on these outcomes. Epworth Sleepiness Scale (ESS), Pittsburgh Sleepiness Quality Index (PSQI), SF36, and various neurocognitive tests, in addition to anthropometric, polysomnography, lung function, and blood gas data from participants with OHS and participants with OHAD, were included in the analysis. These data were originally collected in their respective randomized clinical trials, comparing the efficacy of different PAP modes (bilevel PAP vs. CPAP) in resolving hypercapnia. Between groups (OHS vs OHAD), pre- and post-treatment (with 3 months of positive airway pressure) comparisons were made using linear mixed modeling. 45 OHS participants (mean age 51 years old, 33% female, BMI 52kg/m2, FER 0.81, PaCO2 54 mmHg, AHI 87/h) and 32 OHAD participants (mean age 61years old, 31% female, BMI 43kg/m2, FER 0.60, PaCO2 54 mmHg, AHI 59/h) were included in the analysis. Both OHS and OHAD had similar baseline ESS (14(5.6) vs. 12(5.4)), Global PSQI (10(3.2) vs. 11(4.8)), SF36 and neurocognitive test performances (other than OHAD had lower digit symbol substitution test performance). Treatment with PAP therapy resulted in similar ESS, Global PSQI, and SF36 improvements in both groups. Neurocognitive performance did not significantly improve after PAP therapy in either group. The symptom impact between two separate hypoventilation disorders (OHS and OHAD), in terms of sleepiness, sleep quality, quality of life, and cognitive function, were similar. OHS and OHAD had similar treatment responses in these parameters after 3 months of PAP therapy.Nocturnal ventilatory support in OHS.

Association between 2,4-dichlorophenoxyacetic acid and cognitive impairment in older adults: a cross-sectional study from NHANES 2001-2002 and 2011-2014.

2,4-Dichlorophenoxyacetic acid (2,4-D) is reported to be the most widely used herbicide in home and garden environments, rendering it commonly encountered in daily life. Despite being ubiquitous, there is a scarcity of studies that have comprehensively assessed the relationship between 2,4-D exposure and cognition using multiple models. To explore the association between 2,4-D exposure and cognition among older American people. This was a cross-sectional study that included 3 cycles of data from the National Health and Nutrition Examination Survey. Generalized linear models (GLMs), restricted cubic spline (RCS) regression, and generalized additive models (GAMs) were used to assess the relationship between exposure to 2,4-D and cognitive performance by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) word learning sub-test, Digit Symbol Substitution Test (DSST), and Animal Fluency Test (AFT). A total of 1364 older U.S. adults (60+ years) were included in the study. The GLMs revealed a negative association between median high levels(0.315-0.566μg/L) of 2,4-D and cognitive impairment on the DSST and AFT, with multivariate-adjusted ORs of 0.403 (95% CI: 0.208-0.781, P = 0.009) and 0.396 (95% CI: 0.159-0.986, P = 0.047); the RCS regression and GAMs revealed a "U" shaped curve, the left part of which is consistent with the result of the GLMs. There is a U-shaped relationship between human urinary 2,4-D concentrations andcognitive impairmentin older U.S. adults, especially in males, so controlling 2,4-D exposurewithin an appropriate range is particularly important for cognitive function.

ASSOCIATIONS OF PERCEIVED PHYSICAL AND MENTAL FATIGABILITY WITH COGNITIVE PERFORMANCE

Abstract Greater perceived fatigability has been associated with neurological diseases, but we do not know whether there are associations with cognition among at-risk older adults. At baseline, SOMMA participants completed the Pittsburgh Fatigability Scale (PFS) Physical and Mental subscales (each range 0–50; higher scores = greater fatigability; clinically meaningful increment=4-point physical, 3-point mental) and four cognitive function assessments [Digit Symbol Substitution Test (DSST), Montreal Cognitive Assessment (MoCA), Trail Making Test Part B (TMT-B), and California Verbal Learning Test-Second Edition, Short Form (CVLT-II SF)]. Linear regression quantified associations between PFS subscales and cognitive assessment scores adjusting for site, age, sex, race, education, marital status, and history of stroke, cancer, heart failure, and lung disease. In the 873 participants (59.2% women; age 76.3+/-5.0 years; 85% White), 54% had greater physical fatigability (PFS Physical≥15) and 23% had greater mental fatigability (PFS Mental≥13). Prevalence of cognitive impairment was 2% moderate (MoCA 10-17) and 0% severe ( &amp;lt;10). After adjustments, for each 4-point higher PFS Physical score participants had 0.8 fewer correct DSST items [Beta coefficient and 95% confidence interval: -0.8 (-1.2, -0.4); n=866] and 2.0 seconds slower TMT-B time [2.0 (0.1, 3.8); n=835]. Associations were similar for each 3-point higher PFS Mental score [DSST: -0.7 (-1.1, -0.4) and TMT-B time: 2.5 (1.0, 4.1)]. Neither PFS subscale was associated with MoCA or CVLT. Our results suggest that higher perceived physical and mental fatigability scores may both be indicative of cognitive impairment, particularly in processing speed.

THE RELATIONSHIP BETWEEN SEDENTARY BEHAVIOR AND COGNITIVE DOMAINS AMONG PEOPLE LIVING WITH DEMENTIA

Abstract Greater sedentary behavior negatively impacts cognition among older adults without dementia; however, the relationship between sedentary behavior and cognitive domains among people living with dementia (PWD) is unclear. Our aim was to explore the association between sedentary behavior and cognitive domains in PWD in residential care facilities. The testing took place at one nursing home (n=15/23), one memory care unit (n=4/23), and one assisted living facility (n=4/23). Participants completed a battery of cognitive tests (global cognition: Montreal Cognitive Assessment; executive function: Trail Making test, Digit Span Backwards Test; perception and orientation: Benton Judgment of Line Orientation Test; language: Boston Naming Test; learning and memory: Rey Auditory Verbal Learning Test; complex attention: Digit Symbol Substitution Test). We used the Morse Fall Scale to measure fall risk. Participants wore an actigraphy monitor on their wrist over seven days to measure sedentary behavior. Most participants were male (74%), white (87%), and had unspecified dementia (48%). Participants were sedentary for 8.0±2.7 hours/day. The regression model for sedentary behavior was significant (R2=0.82, F(10, 12)=5.39, RMSE=92.47, p&amp;lt; 0.05). Greater sedentary behavior was associated with poorer language function (β=-0.82, p=0.02), poorer learning and memory (β=-0.82, p=0.002), and greater fall risk (β=-0.43, p=0.03). Sedentary behavior was not associated with the other cognitive domains. Greater sedentary behavior may indicate a decline in language function, learning and memory, and increase fall risk in PWD. Sedentary behavior should be considered in routine assessments, as it may play an important role in monitoring cognitive decline in PWD in residential care facilities.

THE DIFFERENCE BETWEEN CYSTATIN C- AND CREATININE-BASED EGFR AND ASSOCIATIONS WITH COGNITION IN THE CHS

Abstract The difference (eGFRDiff) between cystatin C-based estimated glomerular filtration rate (eGFRcys) and creatinine based eGFR (eGFRcr) has been shown to be associated with frailty and mortality, but its association with cognition is unclear. Among 4,764 adults aged ≥ 65 from the Cardiovascular Health Study, we analyzed eGFRDiff per 1-SD lower (18.6 mL/min/1.73m2). Cognitive function was evaluated annually using the Modified Mini Mental State Exam (3MS; range 0-100), and the Digit Symbol Substitution Test (DSST; range 0-90); higher scores mean better performance. We used linear regression for cross-sectional analyses, and mixed models for longitudinal analyses adjusted for demographic and clinical variables. The mean age was 72.2 ±, the mean eGFRDiff was 0.64, and mean follow-up was 4.4 ± years. eGFRDiff was not associated with 3MS at baseline. Each SD lower eGFRDiff at baseline was associated with a 0.82 [95% CI: -1.22, -0.42] lower DSST score. In longitudinal analyses each SD lower eGFRDiff was associated with a significant 0.06 [95% CI: -0.11, -0.01] faster decline in 3MS scores and a 0.04 [95% CI: -0.08, -0.01] faster decline in DSST scores over time. In older adults, we found that lower eGFRDiff was associated with lower cognitive scores at baseline, and associated with more rapid decline over time. This suggests that eGFRDiff could be used clinically as a laboratory-based screen to identify older adults in need for cognitive assessment.

EXPLORING THE ASSOCIATION OF SLEEP WITH COGNITIVE DOMAINS AMONG PEOPLE LIVING WITH DEMENTIA

Abstract People living with dementia (PWD) commonly experience sleep disruptions, which impacts mental alertness, increases daytime sleepiness, and results in poorer quality of life. While sleep preserves cognitive function among PWD, the relationship between sleep and different cognitive domains is unclear. Our objective was to explore the association between sleep and cognition domains among PWD. Twenty-three PWD completed a battery of cognitive tests (global cognition: Montreal Cognitive Assessment; executive function: Trail-Making Test (TMT), Digit Span Forward Test; perception and orientation: Benton Judgement of Line Orientation Test (BJLO); language: Boston Naming Test; learning and memory: Rey Auditory Verbal Learning Test; complex attention: Digit Symbol Substitution Test) at two residential care facilities. Participants wore a motion watch on their wrist for 7 days to monitor sleep. Participants were primarily male (74%), white (87%), and 48% had unspecified dementia. The average number of hours of sleep per night was 4.6±1.2 hours. The overall regression model for sleep was significant (R2=0.80, F(10,12)=4.68, RMSE=42.32, p&amp;lt; 0.05). More sleep was associated with better perception and orientation (BJLO:β=0.57, p=0.03), greater sleep efficiency (β=0.93, p=0.01), longer wake after sleep onset (β=1.19, p 0.002), and there was a trend for better executive function (TMT:β=-0.34, p=0.09). PWD have inadequate sleep. Greater amounts of sleep seem to preserve perception and orientation and may play a protective role for executive function, but more evidence is needed. Regularly assessing sleep may be useful in screening and monitoring cognitive changes among PWD in residential care facilities.

SEX DIFFERENCES IN THE ROLE OF SLEEP ON EXECUTIVE FUNCTION IN OLDER ADULTS

Abstract Advancing age is associated with a decline in sleep quality and cognitive performance. Previous work has shown that women report a higher number of sleep complaints, possibly due to hormonal and physiologic developmental changes across the lifespan. However, whether the effects of sleep quality on cognitive performance differ between sexes in older populations remains unclear. To address this gap, we analyzed data from 117 cognitively normal participants (44 men and 73 women) aged 60 and older (M = 74.82, SD = 6.52) to compare the effects of objectively measured sleep on executive function. Total sleep time was recorded with the GT9X Link Actigraph worn for seven consecutive days. The composite score of executive function was derived from a confirmatory factor analysis consisting of four separate tests (Verbal Fluency, Trail Making Test Part B, Digit Symbol Substitution Test, and Stroop Interference). We used hierarchical multiple regression to investigate sex differences in the effects of total sleep time on executive function. A quadratic model of total sleep time was a significant predictor of executive function in women (β = -.251, p = .034), but not in men adjusting for age and education. Longer sleep duration predicted improved executive function, but the performance decreased with oversleeping. These findings imply that interventions aimed at optimizing sleep duration may be beneficial for executive function in older women. Further research is necessary to identify sex-specific sleep requirements, which can inform the development of personalized interventions for older adults.