Higher Risk Of Cognitive Impairment Research Articles

Ultrarare Coding Variants and Cognitive Function in Schizophrenia

Impaired cognitive function in schizophrenia is associated with poor functional outcomes, but the role of rare coding variants is unclear. To determine whether ultrarare constrained variants (URCVs) are associated with cognition in patients with schizophrenia. Linear regression was used to perform a within-case genetic association study of URCVs and current cognition and premorbid cognitive ability. A multivariable linear regression analysis of the outcomes associated with URCVs, schizophrenia polygenic risk score, polygenic risk score for intelligence and schizophrenia associated copy number variants on cognitive ability was performed. Exome sequencing data from 802 participants with schizophrenia were assessed for current cognition using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery and for estimated premorbid IQ using the National Adult Reading Test. Individuals were recruited from clinical and voluntary mental health services in the UK. Those with a diagnosis of intellectual disability or a neurological disorder known to affect cognition were excluded. Data collection occurred between 2007 and 2015. Data were analyzed between April 2020 and March 2022. Association between URCVs, current cognition, and current cognition adjusted for premorbid IQ. Of the 802 participants, 499 (62%) were men and 303 (38%) were women; mean (SD) age at interview was 43.36 (11.87) years. Ultrarare constrained variants (n = 400) were associated with lower current cognition scores (β = -0.18; SE = 0.07; P = .005). In the univariable analysis, premorbid IQ was associated with URCVs (β = -0.12; SE = 0.05; P = .02) and partly attenuated the association with current cognition (β = -0.09; SE = 0.05; P = .08). Multivariable analysis showed that measured genetic factors combined accounted for 6.2% of variance in current cognition, 10.3% of variance in premorbid IQ, and supported outcomes of URCVs associated with current cognition independent of premorbid IQ (β = -0.10; SE = 0.05; P = .03). The findings of this study suggest that URCVs contribute to variance in cognitive function in schizophrenia, with partly independent associations before and after onset of the disorder. Although the estimated effect sizes were small, future studies may show that the effect sizes will be greater with better annotation of pathogenic variants. Genomic data may contribute to identifying those at particularly high risk of cognitive impairment in whom early remedial or preventive measures can be implemented.

A-127 The Association Between Objectively-Measured Physical Activity and Cognitive Functioning in Middle-Aged and Older People Living with HIV

Abstract Objective: Middle-aged and older people living with HIV (PWH) are at higher risk for cognitive impairment and engage in lower levels of physical activity (PA) than seronegative counterparts. Though some studies have examined self-reported PA and cognitive outcomes in PWH, research examining the association between objectively-measured PA and cognitive function in this population is scarce. This cross-sectional study examined the association between accelerometry-measured PA and cognitive functioning in PWH. Method: In this study of 75 PWH (mean age 55.63) we collected accelerometry-measured PA indices and cognitive functioning from a comprehensive cognitive assessment. Cognitive outcomes included continuous demographically-adjusted T scores for global cognition and individual cognition domains, as well as a binary cognitive impairment variable. Results: Significant associations were found between PA variables and cognitive domains, including higher bouted (in bouts of ≥10 minutes) light PA minutes per week with better executive function, working memory/attention, and speed of processing performance, adjusted for age and current CD4 count. No significant associations were found between PA variables and the binary cognitive impairment variable, nor were associations found between cognitive functioning variables and a binary variable indicating whether participants met CDC recommendations for PA (i.e., at least 150 minutes per week of moderate-to-vigorous PA). Conclusions: Findings suggest that although middle-aged and older PWH engage in more light than moderate-to-vigorous PA, light PA may be beneficial to cognition. Longitudinal studies are needed to understand PA dose–response associations with cognitive trajectories, cognitive domain specificity of PA effects, and underlying neural mechanisms of PA.

Facets of Personality and Risk of Cognitive Impairment: Longitudinal Findings in a Rural Community from Sardinia.

Few studies have examined the associations between personality facets and dementia risk and rarely included individuals from rural settings or with low education. To examine the association between personality and the risk of cognitive impairment. Participants (N = 1,668; age 50 to 94 at baseline; 56.4% women; 86.5% less than high school diploma) were from a rural region of Sardinia (Italy) who completed the Revised NEO Personality Inventory (NEO-PI-R) during the first wave (2001-2004) and the Mini-Mental State Examination (MMSE) at waves two to five (2005-2021). Cox regression was used to test personality and covariates as predictors of cognitive impairment based on MMSE education-adjusted cutoffs. During the up to 18-year follow-up (M = 10.38; SD = 4.76), 187 individuals (11.2%) scored as cognitively impaired. Participants with higher neuroticism (particularly the depression facet [HR = 1.22, 95% CI = 1.06-1.40]), and lower agreeableness (particularly the modesty facet [HR = 0.83, 95% CI = 0.71-0.97]) and lower conscientiousness (particularly the dutifulness facet [HR = 0.78, 95% CI = 0.67-0.92]) were at higher risk of cognitive impairment. Lower warmth ([HR = 0.75, 95% CI = 0.65-0.87], facet of extraversion) and ideas ([HR = 0.76, 95% CI = 0.65-0.89], facet of openness) were also associated with increased risk of impairment. These associations were virtually unchanged in models that accounted for other risk factors, including smoking, depression, obesity, hypertension, diabetes, and apolipoprotein E (APOE) ɛ4 carrier status. Across the five domains, sex and the APOE variant did not moderate the associations. In a sample with demographic characteristics underrepresented in dementia research, this study identifies personality domains and facets most relevant to the risk of cognitive impairment.

Long-covid cognitive impairment: Cognitive assessment and apolipoprotein E (APOE) genotyping correlation in a Brazilian cohort.

IntroductionFew studies have objectively evaluated cognitive deficits after the acute phase of COVID-19 disease. Moreover, the role of apolipoprotein E (APOE) genotypes in cognitive decline in patients with COVID-19 has not been evaluated yet.MethodsThis cross-sectional study was conducted in confirmed cases of COVID-19 patients with neurological symptoms that persisted for more than 3 months from the onset. We determined APOE genotypes.ResultsThe final sample consisted of 141 patients. The most frequent APOE genotype was E3/E3 (N = 95; 67.3%). In total, 93 patients (65.9%) had memory impairment symptoms as the main complaint, objectively confirmed through screening tests in 25 patients (17.7%). Patients with cognitive impairment had a lower frequency of anosmia than the normal and subjective cognitive decline (SCD) groups (p = 0.005). In addition, depression was recurrent in the cognitive impairment group and the SCD group (p = 0.046). Cognitive impairment was significantly more frequent in hospitalized patients and those with a lower education level. Cognitive status was not associated with APOE genotypes.DiscussionHospitalized patients had more severe infection with a greater possibility of systemic complications, greater inflammatory response, and prolonged hospitalization, which could impact cognitive performance. Cognitive impairment in patients with COVID-19 does not necessarily involve specific APOE polymorphisms. However, psychiatric disorders may also be responsible for cognitive complaints. Cognitive complaints are frequent in patients with COVID-19, even after the acute phase of the disease and in mild cases. Hospitalized participants and depressed patients may have a higher risk of cognitive impairment. APOE genotypes or haplotypes may not significantly play a role in COVID-19 cognitive impairment.

Development and validation of a risk model for cognitive impairment in the older Chinese inpatients: An analysis based on a 5-year database

Early diagnosis of cognitive impairment is important but difficult. Prediction models may work as an efficient way to identify high risk individuals for this disease. This study aimed to develop a simple and convenient model to identify high-risk individuals of cognitive impairment in the older Chinese inpatients. We enrolled 1300 inpatients aged 60 years or above from the department of geriatrics of the First Affiliated Hospital of Chongqing Medical University during 2013 to 2017. The model for cognitive impairment was established in the developing cohort of 1100 participants and tested in another validating cohort of 200 participants. Logistic regression analyses were used to identify the candidate variables of cognitive impairment. Receiver operating curve was adopted to validate the model. Logistic regression analyses showed that increasing age, diabetes, depression and low educational level were independently associated with cognitive impairment. The model was generated in the following way: Pmodel = ey/(1 + ey), where y = −6.874 + 0.088 * age + 0.317 * diabetes + 0.647 * depression + 0.345 * education level. The value of Pmodel indicates the probability of cognitive impairment for each patient. The present model proved to be a reliable marker for identifying people at high risk of cognitive impairment (area under curve = 0.790, 95% CI = 0.728–0.852, p < 0.001). It had a high sensitivity (86.2%) but a relatively low specificity (59.4%). It may be helpful to “recognize” those at high risk of cognitive impairment rather than “rule out” those at low risk of this disease.

Plant-based dietary patterns and cognitive function: A prospective cohort analysis of elderly individuals in China (2008-2018).

IntroductionPlant‐based diets confer health benefits, especially on the prevention of noncommunicable diseases. The relationship between plant‐based dietary patterns on cognitive function as a neurological outcome needs more evidence. We aimed to assess the associations between plant‐based dietary patterns and cognitive function among Chinese older adults.MethodsWe used four waves (2008–2018) of the Chinese Longitudinal Healthy Longevity Survey. We included 6136 participants aged 65 years and older with normal cognition at baseline. We constructed an overall plant‐based diet index (PDI), healthful plant‐based diet index (hPDI), and unhealthful plant‐based diet index (uPDI) from questionnaires. We used the Mini‐Mental State Examination (MMSE) to assess cognitive function. We used the multivariable‐adjusted generalized estimating equation to explore the corresponding associations.ResultsThe multivariable‐adjusted models showed inverse associations between plant‐based dietary patterns and cognitive function. The highest quartiles of PDI and hPDI were associated with a 55% (odds ratio [OR] = 0.45, 95% CI: 0.39, 0.52) decrease and a 39% (OR = 0.61, 95% CI: 0.54, 0.70) decrease in the odds of cognitive impairment (MMSE < 24), compared with the lowest quartile. In contrast, the highest quartile of uPDI was associated with an increased risk (OR = 2.03, 95% CI: 1.79, 2.31) of cognitive impairment. We did not observe pronounced differences by selected socioeconomic status, physical activity, residential greenness, and APOE ε4 status.ConclusionsOur findings suggested that adherence to healthy plant‐based dietary patterns was associated with lower risks of cognitive impairment among older adults, and unhealthy plant‐based dietary patterns were related to higher risks of cognitive impairment.

Olfactory, Auditory, and Vestibular Performance: Multisensory Impairment Is Significantly Associated With Incident Cognitive Impairment

BackgroundDysfunction in the olfactory, auditory, and vestibular systems are commonly seen in aging and are associated with dementia. The impact of sensory loss(es) on cognition is not well understood. Our aim was to assess the relationships between performance on objective multisensory testing and quantify the impact of dysfunction on cognition.MethodsPatients presenting with subjective hearing loss presenting to a tertiary care otologic/audiologic clinic were identified and underwent multisensory testing using the Affordable, Rapid Olfactory Measurement Array (AROMA), pure tone audiometric evaluations, and the Timed “Up and Go” test. Cognitive impairment (CI) was assessed via the Montreal Cognitive Assessment (MoCA) was also administered.Key Results180 patients were enrolled. Thirty one percentage (n = 57) screened positive for cognitive impairment. When evaluating single sensory impairments, we found that olfactory dysfunction, gait impairment, and sensorineural hearing loss were all statistically significantly (p < 0.05) associated with a higher risk of cognitive impairment (ORs 3.89, 3.49, and 2.78, respectively) for CI. Multisensory impairment was significantly associated with cognitive impairment. Subjects with dysfunction in all domains were at the highest risk for cognitive impairment (OR 15.7, p < 0.001) vs. those with impairment in 2 domains (OR 5.32, p < 0.001).ConclusionDysfunction of the olfactory, auditory, and vestibular systems is associated with a significantly increased risk of CI. The dramatically increased risk of CI with multisensory dysfunction in all three systems indicated that MSD may synergistically contribute to CI.

Differences in clinical manifestations of late-onset, compared to earlier-onset essential tremor: A scoping review

Across the world, Essential Tremor (ET) is the most common tremor diagnosis but up to half of these diagnoses are inaccurate. The misdiagnosis rate is particularly high in late-onset ET, when tremor begins after the age of 60 years. Currently, ET is reported to affect 5.5% of those over 65 years old and 21.7% aged over 95 but there is emerging evidence that late-onset ET has associations with dementia, mortality and more rapid progression. With ageing populations, and a range of new surgical treatments for ET, there is urgent need to clarify whether the clinical manifestations of late-onset ET are the same as for earlier-onset ET. This scoping review used MEDLINE, EMBASE and CINAHL as the information sources of published peer-reviewed research articles between 2011 and 2021. Analysis was done by narrative synthesis. 14 relevant papers were retrieved from studies conducted in Denmark, India, Italy, Germany, Spain and the US and, together, they comprised 7684 participants in total. Compared to older adults with earlier-onset ET, there is evidence that late-onset ET is associated with higher risk of cognitive impairment and dementia, higher mortality rate, faster rate of progression, lack of family history, altered cortical electrical activity, prolonged pupillary responses, and less propensity to demonstrate characteristic alcohol sensitivity. There is evidence that late-onset ET has different clinical manifestations to earlier-onset ET; in particular there is higher risk of dementia and mortality. The prognosis is important for clinicians to consider when selecting candidates for deep brain stimulation surgery and also for advanced care planning.

Association of Proximal Tubular Secretory Clearance with Long-Term Decline in Cognitive Function.

People with chronic kidney disease (CKD) are at high risk for cognitive impairment and progressive cognitive decline. Retention of protein-bound organic solutes that are normally removed by tubular secretion is hypothesized to contribute to cognitive impairment in CKD. We followed 2362 participants who were initially free of cognitive impairment and stroke in the prospective Chronic Renal Insufficiency Cohort (CRIC) Study. We estimated tubular secretory clearance by the 24-hour kidney clearances of eight endogenous solutes that are primarily eliminated by tubular secretion. CRIC study investigators assessed participants' cognitive function annually using the Modified Mini-Mental State (3MS) Examination. Cognitive decline was defined as a sustained decrease of more than five points in the 3MS score from baseline. Using Cox regression models adjusted for potential confounders, we analyzed associations between secretory solute clearances, serum solute concentrations, and cognitive decline. The median number of follow-up 3MS examinations was six per participant. There were 247 incident cognitive decline events over a median of 9.1 years of follow-up. Lower kidney clearances of five of the eight secretory solutes (cinnamoylglycine, isovalerylglycine, kynurenic acid, pyridoxic acid, and tiglylglycine) were associated with cognitive decline after adjustment for baseline eGFR, proteinuria, and other confounding variables. Effect sizes ranged from a 17% to a 34% higher risk of cognitive decline per 50% lower clearance. In contrast, serum concentrations of the solutes were not associated with cognitive decline. Lower kidney clearances of secreted solutes are associated with incident global cognitive decline in a prospective study of CKD, independent of eGFR. Further work is needed to determine the domains of cognition most affected by decreased secretory clearance and the mechanisms of these associations.

Sex-Specific Associations of Diabetes With Brain Structure and Function in a Geriatric Population

IntroductionGlobally, women with dementia have a higher disease burden than men with dementia. In addition, women with diabetes especially are at higher risk for cognitive impairment and dementia compared to men with diabetes. Differences in the influence of diabetes on the cerebral vasculature and brain structure may contribute to these sex-specific differences. We examined sex-specific patterns in the relationship between diabetes and brain structure, as well as diabetes and cognitive function.MethodsIn total, 893 patients [age 79 ± 6.6 years, 446 (50%) women] from the Amsterdam Ageing Cohort with available data on brain structures (assessed by an MRI or CT scan) and cognitive function were included. All patients underwent a thorough standardized clinical and neuropsychological assessment (including tests on memory, executive functioning, processing speed, language). Brain structure abnormalities were quantified using visual scales.ResultsCross-sectional multivariable regression analyses showed that diabetes was associated with increased incidence of cerebral lacunes and brain atrophy in women (OR 2.18 (1.00–4.72) but not in men. Furthermore, diabetes was associated with decreased executive function, processing speed and language in women [B −0.07 (0.00–0.13), −0.06 (0.02–0.10) and −0.07 (0.01–0.12) resp.] but not in men.ConclusionsDiabetes is related to increased risk of having lacunes, brain atrophy and impaired cognitive function in women but not in men. Further research is required to understand the time trajectory leading up to these changes and to understand the mechanisms behind them in order to improve preventive health care for both sexes.

Retirement is not associated with age-related cognitive impairment in Korean adults.

The literature provides conflicting evidence as to whether retirement may harm cognition. This study aimed to determine the relationship between retirement and cognitive impairment in Korean adults. This study was performed using biennial data collected during the Korean Longitudinal Study of Ageing survey between 2006 and 2018. A total of 6363 adults aged 45 years or older with normal cognition were followed for up to 12 years. Linear regression, adjusted for potential covariates, was used to examine the association between retirement and cognitive impairment. Retirees composed 27.6% of participants were older, and had several cohort-related features such as a lower education level and income. They were more likely to be single and to participate in religious activities, and had better healthy habits, but participated in fewer social activities and were more likely to have a depressive mood. Unadjusted models indicated that retirees were at higher risk of cognitive impairment, but this association became nonsignificant in age-adjusted models. Multivariate regression analysis identified several risk factors associated with cognitive impairment, but these did not include retirement. Retirement was not associated with cognitive impairment in Korean adults.

1011 CONTINUUM OF GERIATRIC CARE FOR OLDER ADULTS WITH DUAL SENSORY LOSS DURING THE COVID-19 PANDEMIC IN CANADA: LESSONS LEARNED

IntroductionAround 1.1 million older Canadians live with combined hearing and vision impairment (dual sensory loss/DSL). Evidence highlights that they are at a high risk of cognitive impairment, functional decline, social isolation, falls, depression, and mortality. Compared to their non-DSL peers, older adults with DSL experience various challenges in accessing healthcare, which were exacerbated during the COVID-19 pandemic. This study aimed to explore the continuum of geriatric care for older adults with DSL by integrating their perspectives, those of caregivers who accompany them on healthcare visits, and their healthcare providers in Canada during the pandemic.MethodWe conducted a qualitative study with 32 older Canadians with DSL and their caregivers, and an online survey with 228 healthcare providers across the country. Qualitative interviews were audio-recorded using Zoom and transcribed verbatim, while the survey data were collected using Lime Survey. Thematic analysis was used to analyse qualitative data, whereas descriptive statistics were used for quantitative survey data.ResultsThe findings highlighted the gaps in the continuum of care for this population. The reported gaps were lack of training on DSL among healthcare providers, lack of time and comfort to go beyond one’s specialty, lack or limited support to overcome communication challenges while providing care to older adults with DSL, difficulty in using technologies for virtual/telehealth, presence of comorbidities such as cognitive impairment, and restrictions in caregiver accompaniment during the pandemic.ConclusionOur findings indicate that the continuum of care for this group is negatively affected due to the pandemic, in a disproportionate manner, and structural barriers are experienced by older adults with DSL and their caregivers for access to care. To ensure effective care, healthcare professionals need training on DSL-specific accessibility and communication. A collaborative, cross-disciplinary geriatric care approach with the active involvement of essential care partners is an utmost need.

Association between sarcopenia and cognitive impairment in the older people: a meta-analysis

The effects of sarcopenia on the older people are profound, increasing the risk of adverse outcomes for older patients. Although the substantial impact of sarcopenia on maintaining functional independence and adverse health outcomes has been described many times in the past, the link between sarcopenia and cognitive impairment in older adults remains lacking in evidence and controversial. Therefore, we conducted a comprehensive search of available national and international databases and carried out a meta-analysis to examine the association between sarcopenia in older people and cognitive impairment. Relevant experiments had been recognized via looking out electronic databases and conference sessions.The present study included case-control, cohort, or cross-sectional studies of the association between sarcopenia and cognitive impairment in the older people. The meta-analysis included 26 articles and 18,788 participants were involved after assessment of eligibility. The results of this meta-analysis showed that the risk of developing cognitive impairment was significantly higher in patients with sarcopenia than in those without sarcopenia [OR = 1.75; 95%CI = 1.57, 1.95; P < 0.00001], MMSE score of sarcopenia group was lower than that of non-sarcopenia group, the difference was statistically significant [OR = -2.23; 95% CI = -2.48, -1.99; P < 0.00001]. Overall, this meta-analysis showed an association between sarcopenia and cognitive impairment in the older people, demonstrating a significant association between sarcopenia and cognitive impairment. This suggested that providing comprehensive sarcopenia screening and active prevention for the older people with cognitive decline has certain clinical value for improving the quality of life of the older people.

The Impact of Alcohol Consumption on Cognitive Impairment in Patients With Diabetes, Hypertension, or Chronic Kidney Disease.

To investigate the impact of alcohol use on the risk of cognitive impairment in older adults with chronic illness, we used the Digit Symbol Substitution Test (DSST) to evaluate cognitive function in older adults (≥ 60 years) in the National Health and Nutrition Examination Survey. Participants were categorized as light drinkers, moderate and heavy drinkers. Logistic regression analyses were used to explore associations between cognitive impairment and alcohol drinking in patients with or without diabetes, hypertension, and chronic kidney disease (CKD). Multivariate analysis showed that alcohol heavy drinkers was significantly associated with a higher risk of cognitive impairment in patients with hypertension (aOR 6.089, 95% CI 1.318–28.13) and CKD (aOR 6.324, 95% CI 1.158–34.52) compared with light drinkers. The dose-response analyses revealed that moderate to heavy alcohol use was associated with a higher risk of cognitive decline in patients with diabetes and CKD, heavy drinking increased the risk of cognitive impairment in patients with hypertension. The impacts of alcohol drinking on cognitive impairment are significantly different in patients with different comorbidities.

Heterogeneous adverse childhood experiences and cognitive function in an elderly Chinese population: a cohort study

ObjectiveTo identify the heterogeneity of adverse childhood experiences (ACEs) as well as their association with cognitive function in an elderly Chinese population.DesignA retrospective cohort study.ParticipantsThe data were from the latest...

Racial Differences in the Association of Fruit and Vegetable Intake With Cognitive Decline

Abstract Objectives Diet has been shown to be related to slower cognitive decline but there is limited knowledge on whether this relationship varies across race. Given the higher risk of cognitive impairment among African Americans (AA), diet could be a modifiable risk factor in this population. In this study, we examined racial differences (AA vs others) in the association of fruit (total fruits; berries) and vegetable (total vegetables; green leafy) intake with cognitive decline. Methods Analyses included 5423 participants of the Chicago Health and Aging Project (62% African American, 63% women, age = 73.6 (±6.1) years, education = 12.5 (±3.5) years) who completed a food frequency questionnaire and had at least two cognitive assessments (for each, a composite of 4 cognitive tests) for an average follow-up of 7.8 (±4.6) years. We used mixed models adjusted for age, sex, education, race, cognitive activities, physical activity, and total calories. Subsequent models tested interactions of diet (fruits and vegetables) with race, and models were race-stratified if p for interaction ≤0.05. Results Compared to NHW, AA had a lower (p &amp;lt; 0.0001) intake of total fruits, berries, and vegetables but a similar green leafy intake (p = 0.94). At baseline those in the highest quintile of vegetable (β = 0.126, p &amp;lt; 0.0001) and green leafy (β = 0.094, p = 0.0001) intake had better cognitive scores compared to those at the lowest quintile. During follow-up, vegetable intake in the overall population was associated with slower cognitive decline (Q5(4 servings/day) vs. Q1(&amp;lt;1 serving day) = β = 0.011, p = 0.02) and the association for green leafy intake (&amp;gt;1 serving/day vs. once/week) showed a trend (p = 0.08). There were no racial differences in the associations for vegetable and green leafy intake, however, the berry*race interaction was significant (p = 0.05). In stratified models, berry (≥once a week vs. less: β = 0.016, p = 0.01) intake was related to slower cognitive decline, but only in AA. Fruit intake was not associated with cognitive decline in either group. Conclusions Vegetable and green leafy intake may slow cognitive decline in older adults. Increasing berry intake may be an important public health intervention for brain health, particularly among African Americans. Funding Sources Alzheimer's Association and NIA.

Sex-Influenced Risk Factors for Cognitive Impairment Among Community-Dwelling Older Adults.

The current study aimed to explore sex-influenced risk factors for cognitive impairment among community-dwelling older adults in Taiwan. This cross-sectional study was a secondary analysis using a population-based design. We accessed and analyzed data from the Taiwan Longitudinal Study on Aging survey of 2011. Participants were older adults aged ≥55 years living in non-indigenous townships. A total of 3,392 community-dwelling older adults were included. Results showed that the prevalence of cognitive impairment in females and males was 15.3% and 5.7%, respectively. Having a low educational level and being single (i.e., single, widowed, or divorced) were risk factors for cognitive impairment in both sexes. Males who had more than two chronic diseases had a higher risk of cognitive impairment. Self-reported hearing loss and depression increased risk of cognitive impairment in older females. Older age, lower educational level, and single marital status were associated with cognitive impairment among community-dwelling older adults in Taiwan. The effects of self-reported hearing loss, depression, and chronic disease on cognitive impairment were influenced by sex. [Journal of Gerontological Nursing, 48(6), 19-25.].

Relationships of leisure activities with physical and cognitive functions among Chinese older adults: A prospective community-based cohort study

Objectives Based on a prospective design, this study aimed to investigate the relationships of leisure activities with physical and cognitive functions among Chinese older adults. Methods The respondents aged 65 years or more were selected from the 2014-2018 of the Chinese Longitudinal Healthy Longevity Survey. Physical function measurement indicators were reflected by activities of daily living (ADL), instrumental activities of daily living (IADL), and physical performance (PP), while cognitive function was assessed by Mini-Mental State Examination. Fine-Gray competing risk regression models were used to analyze the data. Results Using the figures for 2014 as a baseline for the study, we included 6047, 6216, 5951, and 5916 respondents in the ADL, IADL, PP, and cognitive function analyses, respectively. The prospective results showed that keeping domestic animals or pets was related to a lower risk of ADL disability of respondents after adjustment (SHR: 0.619, 95% CI: 0.486, 0.788). Similarly, taking part in social activities (SHR: 0.781, 95%CI: 0.658, 0.929) and reading books or newspapers (SHR: 0.793, 95% CI: 0.656, 0.958) were associated with a lower risk of IADL disability. Playing cards or mahjong was correlated with a lower risk of cognitive impairment (SHR: 0.669, 95% CI: 0.507, 0.882), while keeping domestic animals or pets was related to a higher risk of cognitive impairment (SHR: 1.279, 95% CI: 1.047, 1.562). Conclusion Participation in leisure activities moderately may decrease the risk of a decline in physical and cognitive functions among Chinese older adults.

Intensive blood pressure control and cognitive impairment in chronic kidney disease: The jury is still out

Globally, 55 million people suffer from dementia, mainly Alzheimer's disease (60–70% of cases), and over 60% of patients live in low- or middle-income countries. This number is estimated to rise to 78 million in 2030 and 139 million in 2050, and over 70% of new cases will occur in poorer countries, with huge socioeconomic costs for affected individuals, their relatives, and governments [ [1] World Health Organization SGGlobal action plan on the public health response to dementia 2017–25. 2017; (Available at https://www.who.int/publications/i/item/global-action-plan-on-the-public-health-response-to-dementia-2017-2025 Accessed on 08/05/2022) Google Scholar ]. People with chronic kidney disease (CKD), as defined by an estimated glomerular filtration rate [eGFR] lower than 60 mL/min/1.73 m2, or eGFR ≥ 60 plus a marker of kidney damage (albuminuria, abnormal kidney ultrasound scan, etc.) [ [2] Stevens P.E. Levin A. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013; 158: 825-830 Crossref PubMed Scopus (1475) Google Scholar ] have a significantly higher risk for cognitive impairment compared to the general population [ [3] Drew D.A. Weiner D.E. Sarnak M.J. Cognitive impairment in CKD: pathophysiology, management, and prevention. American Journal of Kidney Diseases. 2019; 74: 782-790 Abstract Full Text Full Text PDF PubMed Scopus (60) Google Scholar ]. As the global prevalence of CKD is as high as 13.4% (i.e. over 700 million people) [ [4] Hill N.R. Fatoba S.T. Oke J.L. Hirst J.A. O’Callaghan C.A. Lasserson D.S. et al. Global prevalence of chronic kidney disease - a systematic review and meta-analysis. PLoS ONE. 2016; 11 (e0158765-e) Crossref Scopus (1572) Google Scholar ], it is hardly surprising that there is a great interest in the primary and secondary prevention of dementia worldwide.

The Relationship Between Pre-existing Coronary Heart Disease and Cognitive Impairment Is Partly Explained by Reduced Left Ventricular Ejection Fraction in the Subjects Without Clinical Heart Failure: A Cross-Sectional Study.

BackgroundCoronary heart disease (CHD) is closely associated with cognitive impairment, especially in severe cases of heart failure. However, it is unclear whether cardiac systolic function plays a role in the relationship between pre-existing CHD and cognitive impairment in subjects without clinical heart failure.MethodsIn total, 208 subjects from the First Affiliated Hospital of Xi’an Jiaotong University were recruited from June 2014 to January 2015, and were divided into CHD (n = 118) and non-CHD (n = 90) groups according to the inclusion and exclusion criteria. The global cognitive function of all subjects was assessed by the Mini-Mental State Examination (MMSE) and cognitive impairment was defined as the score lower than the cutoff value. Left ventricular ejection fraction (LVEF) was measured using transthoracic echocardiograms. The relationship among pre-existing CHD, LVEF, and cognitive impairment was analyzed by multivariate logistic regression.ResultsIn total, 34 subjects met the criteria of cognitive impairment. Univariate analysis showed that the cognitive impairment prevalence in the CHD group was significantly higher than that in the non-CHD group (22.0 vs. 8.9%, p = 0.011). Multivariate logistic analysis revealed that CHD was significantly associated with a higher risk of cognitive impairment (odds ratio [OR] = 3.284 [95% CI, 1.032–10.450], p = 0.044) after adjusting for confounds except for LVEF. However, the OR of CHD decreased (OR = 2.127 [95% CI, 0.624–7.254], p = 0.228) when LVEF was further corrected as a continuous variable, and LVEF was negatively associated with the risk of cognitive impairment (OR = 0.928 [95% CI, 0.882–0.976], p = 0.004).ConclusionPre-existing CHD is associated with a higher risk of cognitive impairment, and such an association can be considerably explained by reduced LVEF. An impaired cardiac systolic function may play a key role in the relationship between CHD and cognitive impairment among patients with pre-heart failure conditions.