Early Indicator Of Cognitive Decline Research Articles

A sensor technology to continuously monitor changes in cognition

AbstractBackgroundResearchers are increasingly utilizing real‐time sensors with ultra‐wideband radio frequency identification device (UWB RFID) technology to continuously, automatically and unobtrusively track the behavior and movement of older adults across care settings (Bowen, Kearns, Crenshaw, & Stanhope, 2019; Bowen & Rowe, 2019; Bowen & Rowe, 2016). These systems can be integrated into the health care environment and are ecologically valid measures taken concurrently as adults perform everyday activities of daily living (ADL). The purpose of this study is to examine the use of a UWB RFID system for the early recognition of behaviors associated with cognitive decline among skilled nursing residents (N=23) of two health care facilities.MethodResidents were assessed continuously for an average of 10 months (SD=32.16 weeks). Scoring algorithms from the UWB RFID system utilized 1663 data points developed from x, y coordinates to measure the number and distance (meters) of continuous walking activity in a path. A path is defined as at least 60 seconds of walking and ends with a 30‐second stop. Cognitive function was measured by the Montreal Cognitive Assessment (Nasreddine, et al., 2005) and the Physical and Cognitive Performance Test (Bowen, Rowe, Ersek, Ibrahim, & Shea, 2017).ResultOn average, residents walked 1522.8 meters/week (SD=1572.7) with an average of 23.2 paths/week (SD=25.6). In multilevel models, accounting for ADL ability, an increased average number of paths per week was associated with decreased cognitive functioning (β= ‐0.65; p≤0.01).ConclusionContinuous walking in a path may be an early indicator of cognitive decline. Using an UWB RFID system may aid in the early detection and recognition of cognitive changes in this patient population. Importantly, these changes are also associated with other health events (e.g., falls, delirium, urinary tract infection, hospitalization) that may be ameliorable to intervention.

Western Diet Accelerates the Impairment of Odor-Related Learning and Olfactory Memory in the Mouse.

Olfactory dysfunction could be an early indicator of cognitive decline in type 2 diabetes (T2D). However, whether obesity affects olfaction in people with T2D is unclear. This question needs to be addressed, because most people with T2D are obese. Importantly, whether different contributing factors leading to obesity (e.g., different components of diet or gain in weight) affect specific olfactory functions and underlying mechanisms is unknown. We examined whether two T2D-inducing obesogenic diets, one containing a high proportion of fat (HFD) and one with moderate fat and high sugar (Western diet, WD), affect odor detection/discrimination, odor-related learning, and olfactory memory in the mouse. We also investigated whether the diets impair adult neurogenesis, GABAergic interneurons, and neuroblasts in the olfactory system. Here, we further assessed olfactory cortex volume and cFos expression-based neuronal activity. The WD-fed mice showed declined odor-related learning and olfactory memory already after 3 months of diet intake (p = 0.046), although both diets induced similar hyperglycemia and weight gain compared to those of standard diet-fed mice (p = 0.0001 and p < 0.0001, respectively) at this time point. Eight months of HFD and WD diminished odor detection (p = 0.016 and p = 0.045, respectively), odor-related learning (p = 0.015 and p = 0.049, respectively), and olfactory memory. We observed no changes in the investigated cellular mechanisms. We show that the early deterioration of olfactory parameters related to learning and memory is associated with a high content of sugar in the diet rather than with hyperglycemia or weight gain. This finding could be exploited for understanding, and potentially preventing, cognitive decline/dementia in people with T2D. The mechanisms behind this finding remain to be elucidated.

The Nutrition-Focused Physical Examination: Added Value for Patients and Clinicians

The Nutrition-Focused Physical Examination: Added Value for Patients and Clinicians

The association of white matter free water with cognition in older adults

BackgroundExtracellular free water within cerebral white matter tissue has been shown to increase with age and pathology, yet the cognitive consequences of free water in typical aging prior to the development of neurodegenerative disease remains unclear. Understanding the contribution of free water to cognitive function in older adults may provide important insight into the neural mechanisms of the cognitive aging process. MethodsA diffusion-weighted MRI measure of extracellular free water as well as a commonly used diffusion MRI metric (fractional anisotropy) along nine bilateral white matter pathways were examined for their relationship with cognitive function assessed by the NIH Toolbox Cognitive Battery in 47 older adults (mean age ​= ​74.4 years, SD ​= ​5.4 years, range ​= ​65–85 years). Probabilistic tractography at the 99th percentile level of probability (Tracts Constrained by Underlying Anatomy; TRACULA) was utilized to produce the pathways on which microstructural characteristics were overlaid and examined for their contribution to cognitive function independent of age, education, and gender. ResultsWhen examining the 99th percentile probability core white matter pathway derived from TRACULA, poorer fluid cognitive ability was related to higher mean free water values across the angular and cingulum bundles of the cingulate gyrus, as well as the corticospinal tract and the superior longitudinal fasciculus. There was no relationship between cognition and mean FA or free water-adjusted FA across the 99th percentile core white matter pathway. Crystallized cognitive ability was not associated with any of the diffusion measures. When examining cognitive domains comprising the NIH Toolbox Fluid Cognition index relationships with these white matter pathways, mean free water demonstrated strong hemispheric and functional specificity for cognitive performance, whereas mean FA was not related to age or cognition across the 99th percentile pathway. ConclusionsExtracellular free water within white matter appears to increase with normal aging, and higher values are associated with significantly lower fluid but not crystallized cognitive functions. When using TRACULA to estimate the core of a white matter pathway, a higher degree of free water appears to be highly specific to the pathways associated with memory, working memory, and speeded decision-making performance, whereas no such relationship existed with FA. These data suggest that free water may play an important role in the cognitive aging process, and may serve as a stronger and more specific indicator of early cognitive decline than traditional diffusion MRI measures, such as FA.

SUBJECTIVE MEMORY COMPLAINTS AND COGNITIVE PERFORMANCE: THE MODERATING ROLE OF DEPRESSIVE SYMPTOMS

Cognitive health is a rising public health concern in the U.S. Currently, approximately 5.7 million older adults suffer from Alzheimer’s disease (AD), and by the year 2050 this number is expected to increase to 14 million. Subjective memory complaints (SMC) are shown to be an early indicator of cognitive decline, and accordingly included as a clinical criterion for diagnoses of MCI, an indicator of pre-dementia states, and a research criterion for AD diagnoses. Among older adults, depressive symptoms hinder the accuracy of memory self-ratings. However, there has yet to be consensus regarding the nature of how depressive symptoms may condition the relationship between SMC and cognitive performance. The aims of the present study are to both investigate whether SMC is related to episodic memory and to determine whether depressive symptoms act as a moderator for the relationship between SMC and episodic memory among older adults. This research used nationally representative sample of 8,123 older adults aged 65 and older who completed the Leave Behind Questionnaire in the 2012 and 2014 waves of the Health and Retirement Study. Linear regression was performed and results showed that there was a significant main effect of SMC on episodic memory performance, in that older adults with increased SMC have worse episodic memory. There was also a significant moderating effect of depressive symptoms, in that depressive symptoms cause older adults to underestimate their memory abilities. In order to use SMC as a tool for early detection efforts it is critical to understand these complex relationships.

Olfaction and smell identification tests: A novel test that may correlate with cochlear implant outcomes

A cochlear implant (CI) is a prosthetic implantable device that is available for people who do not benefit from traditional, non-invasive means of amplification. Although many people receive significant improvement in their ability to understand speech with CI, there can be variability in patients’ ability to understand open-set speech and some people may not get the expected degree of benefit after CI surgery. Currently, the patient-related factors that appear to correlate with CI outcomes are limited to age and duration of deafness. Recent work has suggested cognition, specifically, cognitive decline, may be an additional patient-related factor that contributes to poor CI outcomes. This work is based on the concept that processing of sound requires intact central processing and neurocognitive function. While the relationship between cognition and hearing is evolving, it is well-established that olfactory dysfunction is an early indicator of cognitive decline. Given this relationship, it stands to reason that olfaction may provide information regarding one’s ability to process auditory information, which relies heavily on central functioning and cognition. We hypothesize that olfaction and smell identification scores on the University of Pennsylvania Smell Identification Test (UPSIT) may correlate with CI outcomes. More specifically, we hypothesize that olfactory dysfunction may serve as a potential predictor of poor CI outcomes. Evaluating this relationship has the potential to change the standard evaluation for CI candidates and may offer simple and efficient prognostic information for patients who are considering CI.

Apathy as a behavioural marker of cognitive impairment in Parkinson\u2019s disease: a longitudinal analysis

BackgroundUnderstanding the longitudinal course of non-motor symptoms, and finding markers to predict cognitive decline in Parkinson’s disease (PD), are priorities. Previous work has demonstrated that apathy is one of the only behavioural symptoms that differentiates people with PD and intact cognition from those with mild cognitive impairment (MCI-PD). Other psychiatric symptoms emerge as dementia in PD develops.ObjectiveWe explored statistical models of longitudinal change to detect apathy as a behavioural predictor of cognitive decline in PD.MethodsWe followed 104 people with PD intermittently over 2 years, undertaking a variety of motor, behavioural and cognitive measures. We applied a linear mixed effects model to explore behavioural factors associated with cognitive change over time. Our approach goes beyond conventional modelling based on a random-intercept and slope approach, and can be used to examine the variability in measures within individuals over time.ResultsGlobal cognitive scores worsened during the two-year follow-up, whereas the longitudinal evolution of self-rated apathy scores and other behavioural measures was negligible. Level of apathy was negatively (− 0.598) correlated with level of cognitive impairment and participants with higher than average apathy scores at baseline also had poorer cognition. The model indicated that departure from the mean apathy score at any point in time was mirrored by a corresponding departure from average global cognitive score.ConclusionHigh levels of apathy are predictive of negative cognitive and behavioural outcomes over time, suggesting that apathy may be a behavioural indicator of early cognitive decline. This has clinical and prognostic implications.

A shift to glycolysis accompanies the inflammatory changes in PBMCs from individuals with an IQ-discrepant memory

Identification of a blood-based biomarker that can detect early cognitive decline presents a significant healthcare challenge. We prepared peripheral blood mononuclear cells (PBMCs) from individuals who had a poorer than predicted performance in their delayed recall performance on the Logical Memory II Subtest of the Wechsler Memory Scale (WMS) relative to their IQ estimated by the National Adult Reading Test (NART); we described these individuals as IQ-discrepant, compared with IQ-consistent, individuals. Stimulation with Aβ + LPS increased production of TNFα to a greater extent in cells from IQ-discrepant, compared with IQ-consistent, individuals. This was associated with a shift towards glycolysis and the evidence indicates that 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase (PFKFB)3 plays a role in driving glycolysis. A similar shift towards glycolysis was observed in MDMs prepared from IQ-discrepant, compared with IQ-consistent, individuals. The important finding here is that we have established an increased sensitivity to Aβ + LPS stimulation in PBMCs from individuals that under-perform on a memory task, relative to their estimated premorbid IQ, which may be an indicator of early cognitive decline. This may be a useful tool in determining the presence of early cognitive dysfunction.

Prospective memory and subjective memory decline: A neuropsychological indicator of memory difficulties in community-dwelling older people

ABSTRACTIntroduction: Prospective memory difficulties are known to occur in Alzheimer’s disease, and may provide an early indicator of cognitive decline. Older people reporting high levels of subjective memory decline (SMD) but without evidence of cognitive decline on standard neuropsychological tests are increasingly considered at increased risk for Alzheimer’s disease. Therefore, the objective of this study was to investigate whether prospective memory performance is differentially impaired in older people reporting high levels of SMD as compared to a control group. Method: A total of 195 community-dwelling older adults (Mage = 73.48 years) were assessed for self-reported complaints of memory decline and allocated to either a group reporting high levels of SMD (SMD, n = 96) or a healthy control group (HC, n = 99). Groups were assessed on neuropsychological tests, an experimental prospective memory task (focal vs. nonfocal cue conditions), and a naturalistic prospective memory task. Results: The groups did not differ in performance on standard neuropsychological tests of working memory, executive attention, and episodic retrospective memory. Furthermore, on an experimental task of prospective memory (the Supermarket Shopping Trip task), although performance of both groups was better when cues for prospective memory were focal to the ongoing activity (η2 = .35), the SMD group were not impaired relative to the control group. On a naturalistic prospective memory task, however, there was a small but significant effect, with the SMD group performing more poorly than the HC group (η2 = .02). Conclusions: In older adults with high levels of SMD, naturalistic measures of prospective memory provide an approach to assessing memory performance that can offer a means of investigating the memory complaints of people with SMD. Identifying prospective memory difficulties in SMD also offers a focus for intervention.

Lap Time Variation Predicts Task Error During Dual-Task Walking In Cognitively Healthy Women

Variation in lap time (LTV) during a fast pace 400m walk test is a new metric thought to be an early indicator of cognitive decline in older adults. While LTV has been found to associate with executive function, no study has examined the potential for LTV to predict capacity of the brain to divide attention and meet the demand of walking and performing other tasks simultaneously. PURPOSE: The purpose of this study was to test the hypothesis that greater LTV would associate with larger dual-task cost during walking. METHODS: Fifty-two cognitively healthy (MoCA>25) women across a broad age range (30-80y) performed fast pace walking while balancing a tray (Dual1) or balancing a tray while vocalizing serial subtractions by 7’s (Dual2). Task error was quantified by degrees of tray tilt and subtraction error. On a separate day, women completed a fast pace 400m walk test (40m x 10 laps) with time to complete each lap recorded. LTV was defined as standard deviation of residuals estimated from the random effects linear model where each lap time was regressed on a person-specific random intercept and random slope associated with lap. Women were categorized into tertiles based on LTV. Comparisons were made between tertiles using ANCOVA after adjusting for age, years of education, and mean lap time. RESULTS: Gait speed (p=0.57) or the percent change in gait speed (p=0.34) were not significantly different between tertiles for the Dual1 condition, but tilt angle was larger in women with greater LTV (tertiles 1 vs. 3: 1.37±0.12 vs. 1.94±0.11 degrees; p=0.006). During the Dual2 condition, women with greater LTV had faster gait speed (p=0.02), lower percent change in gait speed (tertiles 1 vs. 3: 20.5±2.8 vs. 9.3±2.6%, p=0.02), similar subtraction error (p=0.58), but larger tilt angle (tertiles 1 vs. 3: 1.24±0.19 vs. 2.09±0.17 degrees, p=0.007). CONCLUSION: Lap time variation identified women that exhibited greater difficulty balancing an object while walking suggesting that LTV may be sensitive to deficits in the ability to share neural substrate for sensorimotor function. Supported by a Women’s Health Research Scholar Grant award from the Laura W. Bush Institute of Women’s Health and University Medical Center in Lubbock, TX.

Cognitive capacity and smartphone dual-task gait measurement

Walking and cognitive function are interrelated, and thus normal control of gait is perturbed by cognitive impairment. Changes in gait, as measured by quantitative analysis, can be a useful mechanism for detecting early indicators of cognitive decline. Observing changes in gait in the dual-task paradigm, i.e. when the subject walks while performing an attention-demanding task, can be a more sensitive measure. In the study reported in this paper, we developed a mobile application to perform quantitative gait assessment in the single and dual-task condition, using a smartphone’s built in sensor system. We show that the gait parameters, as measured by a mobile device, are significantly related to the corresponding parameters reported by a gold-standard motion capture system. We also demonstrate that this approach may be comparable to previously validated assessments of cognition and executive functioning. Mobile technologies offer a platform for sensitive assessment of changes in cognitive function through gait analysis in dual-task conditions. This methodology opens the way for more frequent assessments of cognition, as part of physiotherapy and rehabilitation practice.

Impaired sense of smell linked to dementia risk.

Decreased ability to identify smells could be an early indicator of cognitive decline and dementia, say researchers from Columbia University Medical Center in the US.

A Potential VEP Biomarker for Mild Cognitive Impairment: Evidence from Selective Visual Deficit of Higher-Level Dorsal Pathway.

Visual dysfunctions are common in Alzheimer's disease (AD). Our aim was to establish a neurophysiological biomarker for amnestic mild cognitive impairment (aMCI). Visual evoked potentials (VEPs) were recorded in aMCI patients who later developed AD (n = 15) and in healthy older (n = 15) and younger controls (n = 15). Visual stimuli were optimized to separately activate lower and higher levels of the ventral and dorsal streams. We compared VEP parameters across the three groups of participants and conducted a linear correlation analysis between VEPs and data from neuropsychological tests. We then used a receiver operating characteristic (ROC) analysis to discriminate those with aMCI from those who were healthy older adults. The latency and phase of VEPs to lower-level stimuli (chromatic and achromatic gratings) were significantly affected by age but not by cognitive decline. Conversely, VEP latencies for higher-ventral (faces and kanji-words) and dorsal (kana-words and optic flow motion) stimuli were not affected by age, but they were significantly prolonged in aMCI patients. Interestingly, VEPs for higher-dorsal stimuli were related to outcomes of neuropsychological tests. Furthermore, the ROC analysis showed that the highest areas under the curve were obtained for VEP latencies in response to higher-dorsal stimuli. These results suggest aMCI-related functional impairment specific to higher-level visual processing. Further, dysfunction in the higher-level of the dorsal stream could be an early indicator of cognitive decline. Therefore, we conclude that VEPs associated with higher-level dorsal stream activity can be a sensitive biomarker for early detection of aMCI.

Intraindividual variability in performance on associative memory tasks is elevated in amnestic mild cognitive impairment

Elevations in intraindividual variability (IIV) are an indicator of neurocognitive compromise and are seen on reaction time tasks in individuals with mild cognitive impairment (MCI). We examined IIV on memory tasks known to be sensitive to early cognitive change in a group of 24 individuals with amnestic MCI and 21 matched controls. Traditional measures of accuracy and speed, as well as indices of IIV statistically purified for systematic between-group and trial effects, were derived from performance on two computer-based associative recognition tests of word–word and face-name pairs. Accuracy and speed were reduced and IIV was elevated in the MCI group compared to controls on both tasks. Logistic regression analyses demonstrated that IIV, but not speed, was a unique predictor of group membership, over and above performance accuracy. Observed elevations in IIV in MCI are congruent with the notion that IIV may reflect disturbance in distributed neural networks, including medial temporal regions, in addition to frontal systems dysfunction. Present findings have diagnostic implications for accurate identification of individuals with MCI and add to the growing literature on IIV as an early indicator of cognitive decline in older adults.

Sleep quality and cognitive decline in a community of older adults in Daqing City, China

ObjectivesTo examine the association between self-reported sleep quality and cognitive decline one year later. Patients/MethodsA longitudinal study of 1010 cognitively intact adults, aged 65–80 years at baseline, from two urban communities in China was performed. Sleep quality at baseline was measured using the Pittsburgh Sleep Quality Index (PSQI). Cognitive function was determined by using the Chinese version of Mini-Mental State Examination (CMMSE) at the baseline and one year later. Substantial CMMSE decline was defined as the CMMSE score decreases by three or more points during the follow-up. Potential confounders, such as age, sex, education, baseline CMMSE score, depression, physical activity level, drinking status, smoking status, body mass index, snoring frequency, history of hypertension, diabetes, and coronary heart disease were measured via questionnaires or physical examination. ResultsAfter adjusting for potential confounders, individuals with poor sleep quality (PSQI > 7), relative to whose with good sleep quality, had 0.32 (95% CI: −0.62, −0.02; p = 0.04) CMMSE-points more decline and tended to have a higher likelihood of developing substantial CMMSE decline (OR = 1.46; 95% CI: 0.97, 2.18; p = 0.06). Among seven subscales of the PSQI, poor sleep efficiency was associated with greater CMMSE decline (beta = −0.16, 95% CI: −0.29, −0.03; p = 0.01) and higher risk of substantial CMMSE decline (OR = 1.24, 95% CI: 1.05, 1.46; p = 0.01). Short sleep duration (sleeping ≤5 h/night) was also significantly associated with more CMMSE decline and a higher likelihood of developing substantial CMMSE decline (p < 0.05 for both). ConclusionsSelf-reported poor sleep quality may be an indicator of early cognitive decline for elderly people and should be paid particular attention by clinicians.

Cardiovascular Risk Factors May Serve as Early Indicator of Cognitive Decline

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessCardiovascular Risk Factors May Serve as Early Indicator of Cognitive DeclineVabren WattsVabren WattsSearch for more papers by this authorPublished Online:3 Sep 2015https://doi.org/10.1176/appi.pn.2015.8b10AbstractLower total brain, hippocampal, precuneus, and posterior cingulate volumes are associated with cardiovascular risk factors and with impaired cognitive function before the onset of clinical dementia.A study recently published in the journal Radiology suggests that subtle differences in regional brain volumes that appear to be related to cardiovascular risk factors may potentially serve as an early indicator of cognitive decline before the onset of dementia.simone mescolini/ShutterstockResearchers from the Keck School of Medicine at the University of Southern California and the University of Texas Southwestern Medical Center led a retrospective study to investigate modifiable cardiovascular risk factors (alcohol consumption, smoking, diabetes, and obesity) associated with regional brain volume changes and their association with preclinical deficits in cognitive performance. The specific brain regions studied included the hippocampus, prenuceus, and posterior cingulate cortex—all brain regions involved with cognition.“We already know that vascular risk factors damage the brain and can result in cognitive impairment,” Kevin King, M.D., an assistant professor of radiology at the University of Southern California, said in a press statement. “But our findings give us a more concrete idea about the relationship between specific vascular risk factors and brain health.”For the study, the researchers analyzed data from 1,629 participants who were aged 25 to 73 and enrolled in the Dallas Heart Study from 2000 to 2002. Participants’ cardiovascular risk factors were evaluated in an initial baseline visit; brain volumes and cognitive function were assessed seven years later by, respectively, magnetic resonance imaging and the Montreal Cognitive Assessment (MoCA).The results showed that alcohol consumption and diabetes were associated with smaller total brain volume, and smoking and obesity were associated with reduced volumes in the posterior cingulate cortex. Lower hippocampal volume was associated with previous alcohol consumption and smoking, and lower precuneus volume correlated with alcohol consumption, obesity, and high fasting blood glucose numbers.Low total scores for MoCA were associated with reduced posterior cingulate volume in participants under 50 and with reduced hippocampal and precuneus volumes in those 50 and over.“Our findings reveal that lower total brain, hippocampal, precuneus, and posterior cingulate volumes are associated with cardiovascular risk factors and with impaired cognitive performance before the onset of clinical dementia. … even in participants younger than 50 years,” the researchers noted. The researchers concluded that subtle differences in regional brain volumes in midlife may serve as a biomarker for brain insult before the onset of dementia.“In the future, we may be able to provide patients with useful and actionable information about the impact different risk factors may be having on their brain health during routine clinical imaging,” King stated. The study was funded by the National Institutes of Health. ■“Cardiovascular Risk Factors Associated With Smaller Brain Volumes in Regions Identified as Early Predictors of Cognitive Decline” can be accessed here. ISSUES NewArchived

Cerebral amyloidosis associated with cognitive decline in autosomal dominant Alzheimer disease.

To investigate the associations of cerebral amyloidosis with concurrent cognitive performance and with longitudinal cognitive decline in asymptomatic and symptomatic stages of autosomal dominant Alzheimer disease (ADAD). Two hundred sixty-three participants enrolled in the Dominantly Inherited Alzheimer Network observational study underwent neuropsychological evaluation as well as PET scans with Pittsburgh compound B. One hundred twenty-one participants completed at least 1 follow-up neuropsychological evaluation. Four composite cognitive measures representing global cognition, episodic memory, language, and working memory were generated using z scores from a battery of 13 standard neuropsychological tests. General linear mixed-effects models were used to investigate the relationship between baseline cerebral amyloidosis and baseline cognitive performance and whether baseline cerebral amyloidosis predicts cognitive change over time (mean follow-up 2.32 years ± 0.92, range 0.89-4.19) after controlling for estimated years from expected symptom onset, APOE ε4 allelic status, and education. In asymptomatic mutation carriers, amyloid burden was not associated with baseline cognitive functioning but was significantly predictive of longitudinal decline in episodic memory. In symptomatic mutation carriers, cerebral amyloidosis was correlated with worse baseline performance in multiple cognitive composites and predicted greater decline over time in global cognition, working memory, and Mini-Mental State Examination. Cerebral amyloidosis predicts longitudinal episodic memory decline in presymptomatic ADAD and multidomain cognitive decline in symptomatic ADAD. These findings imply that amyloidosis in the brain is an indicator of early cognitive decline and provides a useful outcome measure for early assessment and prevention treatment trials.

Subjective memory complaints, vascular risk factors and psychological distress in the middle-aged: a cross-sectional study

BackgroundSubjective memory complaints (SMC) are common but their significance is still unclear. It has been suggested they are a precursor of mild cognitive impairment (MCI) or dementia and an early indicator of cognitive decline. Vascular risk factors have an important role in the development of dementia and possibly MCI. We therefore aimed to test the hypothesis that vascular risk factors were associated with SMC, independent of psychological distress, in a middle-aged community-dwelling population.MethodsA cross-sectional analysis of baseline data from the 45 and Up Study was performed. This is a cohort study of people living in New South Wales (Australia), and we explored the sample of 45, 532 participants aged between 45 and 64 years. SMC were defined as 'fair' or 'poor' on a self-reported five-point Likert scale of memory function. Vascular risk factors of obesity, diabetes, hypertension, hypercholesterolemia and smoking were identified by self-report. Psychological distress was measured by the Kessler Psychological Distress Scale. We tested the model generated from a randomly selected exploratory sample (n = 22, 766) with a confirmatory sample of equal size.Results5, 479/45, 532 (12%) of respondents reported SMC. Using multivariate logistic regression, only two vascular risk factors: smoking (OR 1.18; 95% CI = 1.03 - 1.35) and hypercholesterolaemia (OR 1.19; 95% CI = 1.04 - 1.36) showed a small independent association with SMC. In contrast psychological distress was strongly associated with SMC. Those with the highest levels of psychological distress were 7.00 (95% CI = 5.41 - 9.07) times more likely to have SMC than the non-distressed. The confirmatory sample also demonstrated the strong association of SMC with psychological distress rather than vascular risk factors.ConclusionsIn a large sample of middle-aged people without any history of major affective illness or stroke, psychological distress was strongly, and vascular risk factors only weakly, associated with SMC, although we cannot discount psychological distress acting as a mediator in any association between vascular risk factors and SMC. Given this, clinicians should be vigilant regarding the presence of an affective illness when assessing middle-aged patients presenting with memory problems.

Thirteen-year prospective study between fish consumption, long-chain n-3 fatty acids intakes and cognitive function.

Because of their structural, anti-inflammatory and antithrombic properties, long-chain n-3 fatty acids may be key factors in the aging process. We sought to elucidate the association between intake of long-chain n-3 fatty acids and/or fish and cognitive function evaluated 13 years after dietary assessment. Prospective population-based study. 3,294 adults from the SU.VI.MAX study (Supplementation with Antioxidant Vitamins and Minerals study). MEASUREMENTS/STATISTICAL ANALYSIS: Subjects underwent a standardized clinical examination which included cognitive tests and self-reported cognitive difficulties scale (2007-2009). Poor scores were defined using percentiles as cut-off. Dietary data were assessed through repeated 24-h dietary records. Odd ratio (OR), comparing the fourth (Q4) to the first quartile (Q1), of having a poor score were calculated using adjusted logistic regression. Self-reported cognitive difficulties were less frequent among subjects with higher intakes of total n-3 long chain fatty acids (OR = 0.72, CI 95%=0.56-0.92) and eicosapentaenoic acid (OR Q4 versus Q1 = 0.74, CI 95%=0.58-0.95), even after adjustment for depressive symptoms. A borderline significant association was also found with high fish consumption (OR Q4 versus Q1 = 0.80, CI 95%=0.63-1.01). Cognitive complaints, which may be an early indicator of cognitive decline, are less frequent among the elderly who have a high long-chain n-3 acids intake, as assessed 13 years earlier.

Can fluid and general intelligence be differentiated in an older adult population?

The question of whether fluid intelligence can be differentiated from general intelligence in older adults is addressed. Data indicate that the developmental pattern of performance on fluid tasks differs from the pattern of general intelligence. These results suggest that it is important to identify changes in fluid cognitive functions associated with frontal lobe decline, as they may be early indicators of cognitive decline.