Level Of Cognitive Functioning Research Articles

The characteristics and treatment outcomes of people with very late onset of problem drinking.

The characteristics and outcomes of people who begin to experience problems with alcohol later in life are not well understood. This study examines whether people with a very late-onset of problem drinking, defined as occurring after the age of 60, differ in their use of alcohol, mental health functioning, and alcohol treatment outcomes from people with an earlier onset of problem drinking. Seven hundred eighty participants aged 50+ were categorized as either early onset (<25 years, n= 119, 15%), mid-onset (25-39 years, n= 200, 26%), late-onset (40-59 years, n= 376, 48%) or very late-onset problem drinkers (≥60 years, n= 85, 11%). Participants completed measures on alcohol use, mental health, and cognitive functioning. Eleven percent of participants had very late onset of problem drinking. After controlling for age as a covariate, age of onset of problem drinking was not associated with level of alcohol intake or cognitive functioning, but individuals with very late onset of problem drinking had significantly lower levels of depression and significantly better mental health well-being. Age of onset was not associated with treatment outcomes (i.e., change in alcohol use following treatment or treatment completion). People who first experience problems with alcohol after the age of 60 may have better mental health functioning than people with an earlier age of problem drinking. The results suggest that the age of onset of problem drinking may be a poor predictor of alcohol use severity and treatment outcomes and older adults can benefit from alcohol treatment irrespective of the age problem drinking began.

Розумова працездатність та когнітивні функції як концепт здорового способу життя у похилому віці

mental working capacity and cognitive functions in advanced age are the leading indicators of the active functioning of the state of the psyche, which reflects its main properties: attention, perception, thinking, memory. With the help of physical activity, mental activity and cognitive functions prolong vitality in the period of late ontogenesis. the objective of our research was to substantiate the mental working capacity and the level of cognitive functions in the context of a healthy lifestyle of the elderly. to achieve the objectives set in the research, a complex of interconnected and complementary methods was used, which were applied at the theoretical and empirical levels: theoretical (analysis and synthesis, generalization), pedagogical, sociological, psychodiagnostic and mathematical statistics. 187 men aged 60-65 participated in the study. the average passport age was 63.2 years. Research findings. the paper defines the concept of a healthy lifestyle in advanced age, determines the level of mental working capacity and cognitive functions of elderly men as important health components of the people of the third age. Conclusions. During the study of mental working capacity and cognitive functions of the elderly as a concept of a healthy lifestyle, it was determined that the need for activity is quite high. the indicators of cognitive functions were found to be within the norm of most of the respondents. 11.2 % of the participants were diagnosed with cognitive impairment and 2.6 % were diagnosed with mild dementia. It was pointed out that among persons aged 60-65, among indicators of mental working capacity, 10.7 % of men corresponded to a high level. We believe, therefore, that in modern conditions, the issue of organizing spare time of the elderly requires special attention. the complexity of solving this problem lies in the lack of norms and rules for the regulation of the leisure sphere, the lack of specialists in the leisure sphere who would possess new technologies of its organization.

Postmenopausal women’s cognitive function and performance of virtual reality tasks

Objective This study aimed to assess whether prior knowledge of computer use determines performance of virtual reality tasks by postmenopausal women and whether menopausal symptoms, sociodemographic factors, lifestyle and cognition modify or interfere with their performance. Method This cross-sectional study included 152 postmenopausal women divided into two groups: computer users and non-users. Age, ethnicity, time of menopause, menopausal symptoms, female health status, level of physical activity and cognitive function were considered. The participants played a virtual reality game and were assessed for hits, errors, omissions and game time. The Mann–Whitney, chi-square and Fisher exact tests and multivariate linear regression analysis were used. Results Postmenopausal computer users play virtual reality games (p = 0.005) better than postmenopausal non-users of computers. Vasomotor symptoms were high in women who used computers compared to those who did not (p = 0.006). Multivariate linear regression analysis found that the best-fitting predictors for the number of hits – that is, age (p = 0.039), Mini-Mental State Examination score (p = 0.006) and the headache symptom (p = 0.021) – influence the performance of virtual reality tasks. Conclusion Computer users performed virtual reality tasks better than non-users. Headache and age but not vasomotor symptoms negatively affected the postmenopausal women’s performance.

Lifetime physical activity and the cognitive condition of adults. Research of three independent groups of Polish adults

One of the typical symptoms of aging is the deterioration of the functioning level in specific cognitive areas. A significant number of research reports suggest that physical activity over the life course may be conducive to maintaining cognitive efficiency in late adulthood and old age. Aim: Research was undertaken to investigate whether the level of the reported physical activity over the life span can determine cognitive performance in the selected areas in adults. Material and methods: The material was collected from 2019. Individuals aged 40+ were invited to participate in the study. Three independent assessments were carried out in separate groups of subjects (Group 1: N = 120; Group 2: N = 90; Group 3: N = 60). A total of 270 individuals participated in the study. A questionnaire designed by the authors was used to assess the intensity of physical activity. The MoCA test, WAIS-R PL subtests, verbal fluency tests, BDI-II and DEX-S were applied to assess cognitive and emotional functions. In Group 3 the Trail Making Test was also used. Results: Linear regression analyses showed significant similarities across groups. Higher age was associated with lower cognitive performance, whereas higher level of physical activity reported by the subjects corresponded to better efficiency in the specific cognitive competencies. Physical activity was the main determinant of cognitive performance in the youngest study group (aged between 45 and 60 years). Conclusions: Older age promotes cognitive decline. Higher level of the reported lifetime physical activity positively affects cognitive functioning at later stages of life. Physical activity may play a compensatory role and support cognitive competencies in older adults, especially in operations involving executive functions. However, the relation between physical activity and cognitive performance varies depending on the age of the subjects. The older a person gets, the more important the age factor becomes for the level of cognitive functioning, and the observed impact of physical activity decreases.

Early Intervention of Elateriospermum tapos Yoghurt in Obese Dams Mitigates Intergenerational Cognitive Deficits and Thigmotactic Behaviour in Male Offspring via the Modulation of Metabolic Profile

Maternal obesity is an intergenerational vicious cycle and one of the primary causes of cognitive deficits and high anxiety levels in offspring, which often manifest independently of sex. It is proven that curbing the intergenerational inheritance of obesity through early intervention during the gestation period has a positive outcome on the body composition, cognitive function, and anxiety level of the offspring. A recent discovery shows that the consumption of Elateriospermum tapos (E. tapos) seed extract modulates body mass and ameliorates stress hormones in obese dams, while a probiotic bacterial strain can cross the placenta and boost a child's memory. Thus, we speculate that probiotics are the best medium to integrate plant extract (E. tapos extract) to access the effect on the child's cognition. Thus, this study aimed to investigate the early intervention of E. tapos yoghurt in obese dams in the cognition and anxiety levels of male offspring. In this study, 40 female rats were fed with a high-fat diet (HFD) to induce obesity before pregnancy, while another 8 rats were fed with standard rat pellets for 16 weeks. Upon successful copulation, treatment was initiated for the obese dams up to the postnatal day (PND) 21. The groups included normal chow and saline (NS), HFD and saline (HS), HFD and yoghurt (HY), HFD and 5 mg/kg E. tapos yoghurt (HYT5), HFD and 50 mg/kg E. tapos yoghurt (HYT50), and HFD and 500 mg/kg E. tapos yoghurt (HYT500). All rats were euthanised on PND 21, and the body mass index (BMI), Lee index, and waist circumference were measured for the male offspring. Hippocampal-dependent memory tests and open field tests were conducted to access for cognition and anxiety status. Fasting blood glucose (FBG), total fat (%), insulin, leptin, lipid profile, and antioxidant parameter on serum and hypothalamus (FRAP and GSH) were accessed on PND 21. The result shows male offspring of 50 mg/kg-supplemented obese dams have comparable total fat (%), lipid profile, insulin level, FBG level, plasma insulin level, recognition index, low anxiety level, and improved hypothalamic FRAP and GSH levels to the normal group. In conclusion, this study highlights that the effect of early intervention of our novel formulation of E. tapos yoghurt in obese dams alleviates cognitive deficits and anxiety in male offspring by modulating metabolic profiles at the dose of 50 mg/kg.

Ubiquitin Is Not a Blood Biomarker of an Early Cognitive Decline in the Polish Elderly.

Together with development of new pharmaceutical interventions, as well as the introduction of the concept of initial dementia phase, the demand for early diagnosis has been growing. Research on potential blood biomarkers, amazingly attractive, mainly due to the facility of deriving the material, has provided ambiguous results throughout. The existence of an association between ubiquitin and Alzheimer's disease pathology suggests that it could be a potential neurodegeneration biomarker. The present study aims to identify and assess the relationship between ubiquitin with regard to the adequacy as a biomarker of an initial dementia and cognitive decline in the elderly. Method: The study sample was composed of 230 participants: 109 women and 121 men aged 65 and older. The relationships of plasma ubiquitin levels with cognitive performance, gender, and age were analyzed. The assessments were performed in three groups of cognitive functioning level: cognitively normal, mild cognitive impairment, and mild dementia, of which the subjects were divided with the Mini-Mental State Examination (MMSE). Results: No significant disparities in plasma ubiquitin levels for various levels of cognitive functioning were identified. Significantly higher plasma ubiquitin levels in women were found in comparison to men. No significant differences were found in ubiquitin concentrations based on age. Results suggest that ubiquitin does not meet the requirements for qualification as a blood biomarker of an early cognitive decline. In order to thoroughly evaluate the potential of research on ubiquitin in connection to an early neurodegenerative process, further studies are needed.

Genome-wide DNA methylation analysis of aggressive behaviour: a longitudinal population-based study.

Human aggression is influenced by an interplay between genetic predisposition and experience across the life span. This interaction is thought to occur through epigenetic mechanisms, inducing differential gene expression, thereby moderating neuronal cell and circuit function, and thus shaping aggressive behaviour. Genome-wide DNA methylation (DNAm) levels were measured in peripheral blood obtained from 95 individuals participating in the Estonian Children Personality Behaviours and Health Study (ECPBHS) at 15 and 25 years of age. We examined the association between aggressive behaviour, as measured by Life History of Aggression (LHA) total score and DNAm levels both assessed at age 25. We further examined the pleiotropic effect of genetic variants regulating LHA-associated differentially methylated positions (DMPs) and multiple traits related to aggressive behaviours. Lastly, we tested whether the DNA methylomic loci identified in association with LHA at age 25 were also present at age 15. We found one differentially methylated position (DMP) (cg17815886; p= 1.12 × 10-8 ) and five differentially methylated regions (DMRs) associated with LHA after multiple testing adjustments. The DMP annotated to the PDLIM5 gene, and DMRs resided in the vicinity of four protein-encoding genes (TRIM10, GTF2H4, SLC45A4, B3GALT4) and a long intergenic non-coding RNA (LINC02068). We observed evidence for the colocalization of genetic variants associated with top DMPs and general cognitive function, educational attainment and cholesterol levels. Notably, a subset of the DMPs associated with LHA at age 25 also displayed altered DNAm patterns at age 15 with high accuracy in predicting aggression. Our findings highlight the potential role of DNAm in the development of aggressive behaviours. We observed pleiotropic genetic variants associated with identified DMPs, and various traits previously established to be relevant in shaping aggression in humans. The concordance of DNAm signatures in adolescents and young adults may have predictive value for inappropriate and maladaptive aggression later in life.

Effects of depression on cognitive function in patients with diabetes in different age groups

ABSTRACT Aims To investigate the effects of depression on cognitive function in patients of different ages with diabetes mellitus (DM). Methods 6,549 patients with DM who were assessed using the Mini-Mental State Examination (MMSE) and Self-Rating Depression Scale (SDS) in 2016 were selected from the 2016 Kailuan Group staff physical examinations. Generalized linear regression models were used to analyze the effects of SDS index score on MMSE score in DM patients in different age groups. We also analyzed the effects of SDS index score on MMSE score in DM patients with different risk factors. Results Generalized linear regression analysis showed that higher SDS index score was associated with lower MMSE score (β = −0.06; P < 0.01). In addition, there was an interaction effect between SDS index score and age groups on cognitive function. Meanwhile, SDS index score also has an interaction effect with level of education. Conclusions The negative association between the degree of depression and cognitive function level increases with age in DM patients.

PSICE Project Protocol: Evaluation of the Unified Protocol for Transdiagnostic Treatment for Adolescents with Emotional Symptoms in School Settings

Background: The aim of the PSICE (Evidence-based Psychology in Educational Contexts) Project is to examine the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Adolescents (UP-A) with symptoms of anxiety and depression in school settings. The goal is to prevent emotional problems and to improve adolescents’ socioemotional adjustment, learning processes, and academic performance. Method: A randomized controlled trial with two groups will be performed: active control (progressive relaxation training) and experimental (UP-A). After screening, participants with subclinical emotional symptomatology will be selected for pre- and post-test evaluation and follow-up at 6, 12, and 18 months. Results: The impact of different indicators at behavioral, cognitive, affective, social and academic functioning levels will be analyzed, as well as their effects in the short, medium and long term. Conclusions: Examining the effectiveness of the UP-A in the Spanish educational context will, among other things, provide data for informed decision-making in the field of educational psychology. In addition, it will ensure that such interventions, using standardized protocols, are accessible to a large population at such an important stage of human development as adolescence. The PSICE project will provide leadership and guidance on the importance of psychology in schools.

Study on the effect of community legal consciousness health management on cognitive function of senile patients

BackgroundSenile asthenia is an old-age syndrome. Patients have increased vulnerability due to degenerative changes in the body and a variety of chronic diseases. Senile asthenia involves multiple bodily system functions of patients and is a pre-disease state. Its incidence shows an upward trend with the increase in the age. This study takes community health service as the breakthrough point to explore the role of community legal awareness health management in improving the cognitive function of elderly frail patients, hoping to provide references for improving the health level of elderly frail patients.Subjects and Methods660 elderly patients who were hospitalized at our hospital from June to December 2021 were selected as the study objects and were randomly divided into the management intervention group and the general group, with 30 cases each. Both groups of patients were given basic disease treatment and in-hospital rehabilitation guidance, while the management intervention group increased community legal awareness of health management services at community health service stations. The cognitive function of patients was evaluated by Mini Mental State Examination (MMSE). The senile weakness, cognitive function score, and quality of life of the two groups of patients were compared and analyzed.ResultsIt can be seen from the comparison of the cognitive function scores of the two groups of patients that the cognitive function level of the management intervention group is significantly higher than that of the conventional group. The cognitive function score of the management intervention group after treatment is 26.46±2.39 points, and that of the conventional group after treatment is 23.58±2.41 points. The difference between the two groups is statistically significant (P &lt; 0.05). As shown in Table 1.Table 1.MMSE scores of two groups of patients before and after treatmentModeManagement intervention groupGeneral grouptPBefore treatment22.54±2.3722.56±2.291.305&gt;0.05After treatment26.46±2.3923.58±2.416.398&lt;0.05t6.4542.743--P&lt;0.05&gt;0.05--ConclusionsCarrying out community legal awareness health management services can effectively improve the cognitive function level of the elderly and weak patients, and promote the improvement of the quality of life of the elderly and weak patients. Publicizing legal awareness to the elderly and weak patients and carrying out community health and health management services can help the elderly and weak patients solve their life problems in time. Legal awareness management education with disease prevention and health education can promote cognitive function training and improvement of the elderly and weak patients.

Parallel distributed processing

After briefly reviewing the appealing psychological properties of PDP systems, an introduction to their historical roots and basic computational mechanisms are provided. A variety of network architectures are described including one-layered perceptrons, backpropagation networks, Boltzmann machines and recurrent systems. Three PDP simulations are analysed: First, a model that purports to learn the past tense of English verbs; Second, a constraint satisfaction network which is able to interpret the alternative configurations of a Necker cube; Finally, a recurrent network which is able to decipher membership of grammatical classes from word-order information. The notion that PDP approaches provide a sub-symbolic account of cognitive processes, in contrast to theclassical symbolic view, is examined. The article concludes with brief speculation concerning the explanatory power of PDP systems at the cognitive level of functioning.

Predominant Objective Cognitive Function Groups and their Association with Risk Factors in Older Adults: Cross-Sectional Study

Background: The epidemiological characterization of the predominant population groups by cognitive function allows supporting health policies to prevent dementia in Older Adults (OA). Objective: To analyze if there are association among predominant cognitive function groups and lifestyle factors, comorbidity and motor function in OA. Materials and Methods: Cross-sectional study with a probabilistic sample of insured OA, &gt;60 years old of either sex. Sociodemographic, habits, comorbidities and motor function data were the risk factors. Data for hierarchical cluster analysis were subjective and objective cognitive function, sex and academic level. Cognitive function from population groups defined according to DSM-5, and their association with risk factors. Results: A sample of 350 OA, 65 ± 7.4 years old. Cluster analysis grouped four groups: i) without Neurocognitive Disorder (NCD), ii) with major NCD, iii and iv) with minor NCD in OA ≥70 years and &lt;70 years. The factors associated with major NCD were unqualified work, Living Alone (LA), Diabetes Mellitus (DM), Hypertension (HT), reduced March Speed (MS), frailty and alteration of Activities of Daily Life (ADL). The minor NCD &gt;70 years: unqualified work, LA, DM, frailty and alterations in ADL; and finally, minor NCD &lt;70 were unqualified work, LA, DM, HT, dyslipidemia, obesity, cardiac diseases and hypothyroidism. Physical activity was a protector for the three groups. The likelihood value for major NCD had lower values than the model soft heminor NCD groups. Conclusions: There are association among lifestyle factors, comorbidity, and motor function for protection and risk for the predominant cognitive function groups.

Beta-Hydroxybutyrate (BHB), Glucose, Insulin, Octanoate (C8), and Decanoate (C10) Responses to a Medium-Chain Triglyceride (MCT) Oil with and without Glucose: A Single-Center Study in Healthy Adults

MCTs are increasingly being used to promote ketogenesis by patients on ketogenic diet therapy, but also by people with other conditions and by the general public for the perceived potential benefits. However, consumption of carbohydrates with MCTs and untoward gastrointestinal side effects, especially at higher doses, could decrease the sustainability of the ketogenic response. This single-center study investigated the impact of consuming carbohydrate as glucose with MCT oil compared to MCT alone on the BHB response. The effects of MCT oil versus MCT oil plus glucose on blood glucose, insulin response, levels of C8, C10, BHB, and cognitive function were determined, and side effects were monitored. A significant plasma BHB increase with a peak at 60 min was observed in 19 healthy participants (24.4 ± 3.9 years) after consuming MCT oil alone, and a more delayed but slightly higher peak was observed after consuming MCT oil plus glucose. A significant increase in blood glucose and insulin levels occurred only after MCT oil plus glucose intake. The overall mean plasma levels of C8 and C10 were higher with the intake of MCT oil alone. MCT oil plus glucose consumption showed improved scores for the arithmetic and vocabulary subtests.

Serum levels of IL-6 are associated with cognitive impairment in the salus in apulia population-based study

Growing evidence suggests that inflammation contributes to brain aging and neurodegeneration. This study investigates the relationship between global cognitive as well executive function and the inflammatory markers IL-6, CRP, and TNF-α in a population-based study of older adults. A population-based sample, of older people in Southern Italy, was enrolled. We measured serum levels of IL-6, CRP, and TNF-α. We also administered two neuropsychological tests: Mini-Mental State Examination and Frontal Assessment Battery. Rank-based regression models were performed to investigate the relationship between inflammatory markers and cognitive functions, including major demographic and clinical confounders for adjustment. The sample consisted of 1929 subjects aged between 65 and 95 years. Multivariate linear regression analysis revealed that higher serum levels of IL-6 were associated with lower MMSE and FAB scores even after adjustment for demographic data and cardiovascular risk factors. No significant associations were found between cognitive functioning and serum levels of CRP and TNF-α. Our results suggest that higher levels of IL-6 were associated with cognitive impairment in an older adult population of Southern Italy.

Psychological Well-being Relates to Healthcare and Financial Decision Making in a Study of Predominantly White Older Adults.

The purpose of this study was to test the hypotheses that psychological well-being is associated with healthcare and financial decision making in older adults and that this association varies by the level of cognitive function. Participants were 1082 older adults (97% non-Latino White; 76% women; mean age = 81.04years; SD = 7.53) without dementia (median MMSE score = 29.00, IQR = 27.86-30.00). In a regression model adjusted for age, gender, and years of education, higher levels of psychological well-being were associated with better decision making (estimate = 0.39, standard error [SE] = 0.11, p < .001), as was better cognitive function (estimate = 2.37, SE = 0.14, p < .0001). In an additional model, an interaction of psychological well-being and cognitive function was significant (estimate = -0.68, SE = 0.20, p < .001), such that higher levels of psychological well-being were most beneficial for decision making among participants with lower levels of cognitive function. Higher levels of psychological well-being may help sustain decision making among older persons, particularly those with lower levels of cognitive function.

Power and distribution of evoked gamma oscillations in brain aging and cognitive performance.

Gamma oscillations (≈25-100 Hz) are believed to play an essential role in cognition, and aberrant gamma oscillations occur in brain aging and neurodegeneration. This study examined age-related changes in visually evoked gamma oscillations at two different time points 5 years apart and tested the hypothesis that the power of gamma oscillations correlated to cognitive skills. The cohort consists of elderly males belonging to the Metropolit 1953 Danish Male Birth Cohort (first visit, N=124; second visit, N=88) over a 5-year period from 63 to 68 years of age. Cognitive functions were assessed using a neuropsychological test battery measuring global cognition, intelligence, memory, and processing speed. The power of steady-state visual evoked potentials (SSVEP) was measured at 8 Hz (alpha) and 36 Hz (gamma) frequencies using EEG scalp electrodes. Over the 5-year period cognitive performance remained relatively stable while the power of visually evoked gamma oscillations shifted from posterior to anterior brain regions with increasing age. A higher-than-average cognitive score was correlated with higher gamma power in parieto-occipital areas and lower in frontocentral areas, i.e., preserved distribution of the evoked activity. Our data reveal that the distribution of visually evoked gamma activity becomes distributed with age. Preserved posterior-occipital gamma power in participants with a high level of cognitive performance is consistent with a close association between the ability to produce gamma oscillations and cognition. The data may contribute to our understanding of the mechanisms that link evoked gamma activity and cognition in the aging brain.

A Systematic Review of Cognitive Functioning and its Relationship to Outcomes Following Amputation Secondary to Vascular Etiology.

Amputation is a major life event, impacting on all aspects of daily living, and has the goal of achieving maximal patient mobility and independence. The level of cognitive function of those patients who are assigned a prosthesis is an important consideration in the rehabilitation process. Therefore we set out to understand the relationship between cognitive functioning and functional and/or health outcomes following amputation secondary to a vascular condition. This systematic review searched five databases: PsycINFO, Cumulative index to nursing and allied health literature (CINAHL), Scopus, MEDLINE, and Web of Science for peer-reviewed English language articles that met the inclusion criteria. Two authors independently assessed suitability for inclusion, determined biases (Cochrane risk of bias assessment) and extracted data. Results are presented as associations determined on the balance of probabilities. A total of 14 studies were included, with a total of 6891 participants across six domains. Evidence of an association between cognitive function and prosthetic use, mobility and activities of daily living (ADLs) were found. Evidence revealed 83.3% association for cognition and mobility, 66.7% for cognition and ADL, and 62.5% for cognition and prosthetic use. The evidence was indeterminate for an association between cognitive function and living/discharge destination. There was insufficient weight of evidence to determine an association between cognitive function and general health or social participation. The associations found between cognitive function and prosthetic use, mobility and ADL highlight the need for cognitive assessment to form part of the postoperative pathway for vascular amputees.

Lower cognitive function attenuates the convergence between self-ratings and observer ratings of depressive symptoms in late-life cognitive impairment.

Assessment of depressive symptoms in older adults is challenging especially in the presence of risks in cognitive impairment. We aimed to examine whether the convergence between two measures of depressive symptoms (self-report and observer ratings) is affected by varying levels of cognitive function in older adults. Self-reported scale of depression, informant-based rating of affective symptoms, and global cognitive function were assessed in 2533 older adults with no impairment, mild cognitive impairment, and Alzheimer's disease. The strength of rank-order correlation between the Geriatric Depression Scale (GDS) and behavioral ratings of the Neuropsychiatric Inventory (NPI) was examined as the metric of convergent validity. The results showed that the strength of convergence between the two measurements gradually decreased as a function of lowered cognitive function. Overall tendency showed that diagnoses of cognitive impairment and lower levels of cognitive function were associated with lower correspondence between the two depression measurements. The loss of convergent validity is especially evident in the behavioral symptom of apathy. Utilizing self-report scales of depression in older adults requires a cautious approach even with minimal or mild levels of cognitive impairment.

Predictors of cognitive functioning trajectories among older Americans: A new investigation covering 20 years of age- and non-age-related cognitive change.

Despite the extensive study of predictors of cognitive decline in older age, a key uncertainty is how much these predictors explain both the intercept and age- and non-age-related change in cognitive functioning (CF). We examined the contribution of a broad range of life course determinants to CF trajectories. Data came from 7,068 participants in the 1996-2016 Health and Retirement Study. CF was measured as a summary score on a 27-point cognitive battery of items. We estimated multilevel growth curve models to examine the CF trajectories in individuals ages 54-85. We found that the variation in CF level at age 54 was three times as much as the variation in age slope. All the observed individual predictors explained 38% of the variation in CF at age 54. Personal education was the most important predictor (25%), followed by race, household wealth and income, parental education, occupation, and depression. The contributions of activity limitations, chronic diseases, health behaviors (obesity, smoking, vigorous activity), childhood conditions (childhood health, nutrition, financial situation), gender, marital status, and religion were rather small (<5%). Even though the age slope varied with many adulthood factors, they only explained 5.6% of the between-person variation in age slope. Moreover, age explained 23% of within-person variation in CF from age 54 to 85. The rest non-age-related within-person variation could not be explained by the observed time-varying factors. These findings suggest that future research is urgently needed to discover the main determinants of the slope of cognitive decline to slow down the progression of cognitive impairment and dementia.

Hypertension, sleep quality, depression, and cognitive function in elderly: A cross-sectional study.

Hypertension, sleep disorders, and depression are highly prevalent in the elderly population and are all associated with cognitive impairment, but the role that sleep quality and depression play in the association between hypertension and cognitive impairment is unclear. The aim of this study was to investigate whether sleep quality and depression have a mediating role in the association between hypertension and cognitive impairment. A cross-sectional study was conducted to collect data from the Tongji Hospital Comprehensive Geriatric Assessment Database. Sleep quality, depression and cognitive function were measured by the Pittsburgh Sleep Quality Index (PSQI), the Geriatric Depression Scale (GDS-15) and the Mini-Mental State Examination (MMSE), respectively. Correlation analysis, regression analysis and Bootstrap analysis were used to examine correlations between key variables and mediating effects of sleep quality and depression. Adjustments for multiple comparisons were performed using Benjamini-Hochberg adjustment for multiple testing. A total of 827 participants were included, hypertension was present in 68.3% of the sample. After correcting for covariates, hypertensive patients aged 65 years or older had worse cognitive function, poorer-sleep quality and higher levels of depression. Sleep quality was significantly negatively associated with depression and cognitive function, while depression was negatively associated with cognitive function. Mediation analysis revealed that hypertension can affect cognitive function in older adults through a single mediating effect of sleep quality and depression and a chain mediating effect of sleep quality and depression. This study found that sleep quality and depression can mediate the relationship between hypertension and cognitive function in elderly. Enhanced supervision of sleep quality and depression in elderly patients with hypertension may be beneficial in maintaining cognitive function.