Nondemented Adults Research Articles

The dynamic effects of becoming disabled on work, wages and wellbeing in the UK from 1991 to 2018

Abstract Over recent decades it has consistently been shown that disabled adults in the UK fare worse in the labour market and have lower levels of wellbeing than non-disabled adults. However, this is in part due to the selection into dis-ability of those with existing socio-economic disadvantages. In this article, we use panel data from the combined British Household Panel Survey and Understanding Society, covering the 27 years from 1991 to 2018, to distinguish between the effect of selection, the effect of dis-ability onset and the effect of dis-ability duration on a range of labour market and wellbeing outcomes. We show that there is important selection both into dis-ability and into longer experience of dis-ability on the basis of observable characteristics. We also show the importance of controlling for time-invariant unobservable individual characteristics that similarly affect selection into dis-ability and duration of dis-ability. Even after controlling for both forms of selection, we find significant negative effects of dis-ability onset and duration, and offer policy solutions to address them.

Cognitive status and demographics modify the association between subjective cognition and amyloid.

This study examined the effect of cognitive status, education, and sex on the association between subjective cognitive decline (SCD) and Alzheimer's disease (AD) biomarkers in non-demented older adults. Vanderbilt Memory and Aging Project participants (n = 129), dementia or stroke free, completed fasting lumbar puncture, SCD assessment, and cognitive assessment. Cerebrospinal fluid (CSF) biomarkers for AD were analyzed. Linear regression models related SCD to CSF AD biomarkers and follow-up models assessed interactions of SCD × cognitive status, sex, reading level, and education on AD biomarkers. In main effect models, higher SCD was associated with more amyloidosis (p-values <0.004). SCD was not associated with tau, p-tau, or neurofilament light (NFL) levels (p-values >0.38). SCD score interacted with cognitive status (p < 0.02), sex (p = 0.03), and education (p-values <0.005) on amyloidosis. In stratified models, higher SCD was associated with more amyloid in cognitively unimpaired (p-values <0.003), men (p = 0.0003), and higher education. No SCD score × reading-level interaction was found (p-values >0.51) though SCD related to amyloid markers in the higher reading-level group (p-values <0.004). Higher SCD was associated with greater cerebral amyloid accumulation, one of the earliest pathological AD changes. SCD appears most useful in detecting early AD-related brain changes prior to objective cognitive impairment, in men, and those with higher quantity and quality of education and highlight the importance of considering these factors.

A - 83 Concordance between Informant Measures, Executive Functioning, and Functional Ability in an Older Adult Population

Abstract Objective Informant-report measures often do not correlate with neuropsychological tests measuring the same cognitive construct, yet they may offer insight into everyday difficulties not captured by objective tests. Performance-based measures of functional ability, developed to capture real-world skills, may better align with informant-report measures. Clarifying the relationship between subjective and objective assessment tools in older adults could enhance precision in selecting the most appropriate measures. Method As part of a comprehensive neuropsychological battery, community-dwelling older adults who were cognitively unimpaired or who presented with subjective cognitive decline or mild cognitive impairment completed tests of executive functioning (EF), (D-KEFS Trail Making Test 4, Letter Fluency, WCST, WAIS-Comprehension) and financial capacity, Financial Capacity Instrument (FCI-SF). Informants responded to measures of functional ability, Amsterdam Instrumental Activities of Daily Living Questionnaire Short Version (A-IADL-Q-SV) and Assessment of Functional Capacity Interview (AFCI) and items capturing EF on the Brief Informant Form of Neurobehavioral Symptomatology (BINS). Results Participants’ (N = 97, Mage = 74.64 ± 7.42 years; Meducation = 15.76 ± 2.42 years; 74.2% female) FCI-SF performance significantly correlated with higher A-IADL-Q-SV (r = 0.403, p &amp;lt; 0.01) and AFCI (r = −0.294, p &amp;lt; 0.01) scores, whereas there was no significant correlation between a composite Z-score for traditional neuropsychological tests and select EF items from the BINS, (r = −0.119, p = 0.252). Conclusion We found greater alignment between objective and subjective measures of functional ability than EF, possibly due to the observable nature of functional tasks. Objective and informant measures of EF do not align, potentially targeting different aspects of cognition in non-demented older adults. This should be considered when selecting instruments measuring specific constructs of interest.

Impact of amyloid and cardiometabolic risk factors on prognostic capacity of plasma neurofilament light chain for neurodegeneration

BackgroundPlasma neurofilament light chain (NfL) is a blood biomarker of neurodegeneration, including Alzheimer’s disease. However, its usefulness may be influenced by common conditions in older adults, including amyloid-β (Aβ) deposition and cardiometabolic risk factors like hypertension, diabetes mellitus (DM), impaired kidney function, and obesity. This longitudinal observational study using the Alzheimer’s Disease Neuroimaging Initiative cohort investigated how these conditions influence the prognostic capacity of plasma NfL.MethodsNon-demented participants (cognitively unimpaired or mild cognitive impairment) underwent repeated assessments including the Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-Cog) scores, hippocampal volumes, and white matter hyperintensity (WMH) volumes at 6- or 12-month intervals. Linear mixed-effect models were employed to examine the interaction between plasma NfL and various variables of interest, such as Aβ (evaluated using Florbetapir positron emission tomography), hypertension, DM, impaired kidney function, or obesity.ResultsOver a mean follow-up period of 62.5 months, participants with a mean age of 72.1 years (n = 720, 48.8% female) at baseline were observed. Higher plasma NfL levels at baseline were associated with steeper increases in ADAS-Cog scores and WMH volumes, and steeper decreases in hippocampal volumes over time (all p-values < 0.001). Notably, Aβ at baseline significantly enhanced the association between plasma NfL and longitudinal changes in ADAS-Cog scores (p-value 0.005) and hippocampal volumes (p-value 0.004). Regarding ADAS-Cog score and WMH volume, the impact of Aβ was more prominent in cognitively unimpaired than in mild cognitive impairment. Hypertension significantly heightened the association between plasma NfL and longitudinal changes in ADAS-Cog scores, hippocampal volumes, and WMH volumes (all p-values < 0.001). DM influenced the association between plasma NfL and changes in ADAS-Cog scores (p-value < 0.001) without affecting hippocampal and WMH volumes. Impaired kidney function did not significantly alter the association between plasma NfL and longitudinal changes in any outcome variables. Obesity heightened the association between plasma NfL and changes in hippocampal volumes only (p-value 0.026).ConclusionThis study suggests that the prognostic capacity of plasma NfL may be amplified in individuals with Aβ or hypertension. This finding emphasizes the importance of considering these factors in the NfL-based prognostic model for neurodegeneration in non-demented older adults.

A - 84 Associations between Social Vulnerability, Adaptive Functioning, and Personal Distress in Non-Demented Older Adults

Abstract Objective Though social vulnerability is associated with cognitive decline in older adults, its correlation with socioemotional and functional changes, both common in neurogenerative diseases, is often overlooked. We sought to elucidate the interplay between these critical domains in older adults with varying degrees of cognitive compromise, including participants who presented with mild cognitive impairment (MCI), subjective cognitive decline (SCD), or were cognitively unimpaired (CU), with implications for enhancing risk detection in vulnerable populations. Method Participants (N = 97; Mage = 74.64 ± 7.42 years; Meducation = 15.76 ± 2.42 years; 74.2% female) were community-dwelling older adults, along with their informants, who underwent comprehensive neuropsychological testing and responded to the Social Vulnerability Scale (SVS15), an informant-reported assessment designed to identify potential victims of exploitation. A Kruskal-Wallis test determined group differences on SVS15 (CU, SCD, MCI). Spearman correlations tested relationships among SVS15 and adaptive functioning (Assessment of Functional Capacity Interview, Financial Capacity Instrument) and personal distress, a measure of the tendency to experience anxiety/distress in response to others’ suffering (Interpersonal Reactivity Index–Personal Distress). Results SVS15 scores significantly differed across diagnostic groups, H(2) = 7.060, p &amp;lt; 0.05, with the MCI group performing significantly worse than the CU group, H(2) = 17.703, p &amp;lt; 0.05. SVS15 was significantly associated with worse functional (r = 0.571, p &amp;lt; 0.001) and financial (r = −0.224, p = 0.027) capacity and heightened personal distress (r = 0.390, p &amp;lt; 0.001). Conclusions Increased social vulnerability is associated with functional impairment and personal distress in older adults with and without cognitive impairment. Older adults with elevated emotional reactivity in distressing situations and lower levels of functional and financial capacity may be more susceptible to exploitation.

Interactions between mild depressive symptoms and amyloid pathology on the trajectory of neurodegeneration, cognitive decline, and risk of Alzheimer's disease

BackgroundAlzheimer's disease (AD) was driven by the interplay between modifiable environmental factors and β-amyloid (Aβ) pathology. We aimed to investigate the interaction effects of mild depressive symptoms (MDS) with Aβ on AD development. MethodsLongitudinal data of 1746 non-demented adults (mean age = 73 years, female = 53 %, maximum = 10 years) were derived from the Alzheimer's Disease Neuroimaging Initiative cohort. MDS was separately defined by the baseline status, longitudinal latent class, and average intensity during follow-up. Amyloid-positive (A+) status was determined based on cerebrospinal fluid levels of β-amyloid. Regression models were employed to analyze the interactive effects of MDS with A+ on cognitive decline, neurodegeneration, and AD incidence. ResultsIndividuals with both A+ status and MDS at baseline experienced the fastest neurodegeneration (p < 0.01), cognitive decline (p < 0.05), and a higher risk of developing AD (HR = 5.23, p < 0.001). Furthermore, A+ participants with the trajectory of increasing depressive symptoms demonstrated more pronounced neurodegeneration (p < 0.001), cognitive decline (p < 0.01), and elevated risk of AD (HR = 10.45, p < 0.001). Finally, A+ status in combination with a higher average intensity of depressive symptoms was associated with faster brain atrophy (p < 0.01) and brain metabolism decline (p < 0.05), cognitive decline (p < 0.05), and higher AD risk (HR = 13.99, p < 0.001). ConclusionThese findings emphasized that the MDS-Aβ interaction relationship should be considered in risk stratification, prediction, and early management of neurodegeneration and cognitive decline in the pre-dementia stage.

Hippocampal volume maximally modulates the relationship between subsyndromal symptomatic depression and cognitive impairment in non-demented older adults

BackgroundSubsyndromal symptomatic depression (SSD) is associated with an elevated risk of cognitive impairment in non-demented older adults. Given that hippocampal and middle temporal gyrus atrophy have been shown to cause SSD, our study aimed to investigate the effect of hippocampal volume on the association between SSD and cognitive impairment. Methods338 non-demented older adults from the ADNI (Alzheimer's Disease Neuroimaging Initiative) cohort who underwent cognitive assessments, questionnaires on depressive symptoms and MRI brain were studied. SSD group is defined as a score of 1–5 based on Geriatric Depression Scale scores. We conducted causal mediation analyses to investigate the effect of hippocampal volume on cognitive performance cross-sectionally. ResultsThe SSD group displayed lower left and right hippocampal volume (p<0.01) than the non-SSD group. SSD was linked to poorer cognition and smaller hippocampal volume. We found that hippocampal volume partially mediated the effect of SSD on cognitive performance including the global cognition and the cognitive section of Alzheimer's Disease Assessment Scale, with mediation percentages ranging from 6.45 % to 30.46 %. In addition, we found that the thickness of the left middle temporal, right entorhinal and right fusiform gyrus, brain regions linked to AD, mediate the relationship between SSD and cognition with mediation percentages ranging from 8.67 % to 21.44 %. LimitationsOur article didn't differentiate between mild cognitive impairment and normal population. ConclusionThe associations of SSD and cognitive impairment are linked to alterations in Alzheimer's Disease related brain regions.

3T sodium-MRI as predictor of neurocognition in nondemented older adults: a cross sectional study.

Dementia is a burgeoning global problem. Novel magnetic resonance imaging (MRI) metrics beyond volumetry may bring new insight and aid clinical trial evaluation of interventions early in the Alzheimer's disease course to complement existing imaging and clinical metrics. To determine whether: (i) normalized regional sodium-MRI values (Na-SI) are better predictors of neurocognitive status than volumetry (ii) cerebral amyloid PET status improves modelling. Nondemented older adult (>60 years) volunteers of known Alzheimer's Disease Assessment Scale (ADAS-Cog11), Mini-Mental State Examination (MMSE) and Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neurocognitive test scores, ApolipoproteinE (APOE) e4 +/- cerebral amyloid PET status were prospectively recruited for 3T sodium-MRI brain scans. Left and right hippocampal, entorhinal and precuneus volumes and Na-SI (using the proportional intensity scaling normalization method with field inhomogeneity and partial volume corrections) were obtained after segmentation and co-registration of 3D-T1-weighted proton images. Descriptive statistics, correlation and best-subset regression analyses were performed. In our 76 nondemented participants (mean(standard deviation) age 75(5) years; woman 47(62%); cognitively unimpaired 54/76(71%), mildly cognitively impaired 22/76(29%)), left hippocampal Na-SI, not volume, was preferentially in the best models for predicting MMSE (Odds Ratio (OR) = 0.19(Confidence Interval (CI) = 0.07,0.53), P-value = 0.001) and ADAS-Cog11 (Beta(B) = 1.2(CI = 0.28,2.1), P-value = 0.01) scores. In the entorhinal analysis, right entorhinal Na-SI, not volume, was preferentially selected in the best model for predicting ADAS-Cog11 (B = 0.94(CI = 0.11,1.8), P-value = 0.03). While right entorhinal Na-SI and volume were both selected for MMSE modelling (Na-SI OR = 0.23(CI = 0.09,0.6), P-value = 0.003; volume OR = 2.6(CI = 1.0,6.6), P-value = 0.04), independently, Na-SI explained more of the variance (Na-SI R 2 = 10.3; volume R 2 = 7.5). No imaging variable was selected in the best CERAD models. Adding cerebral amyloid status improved model fit (Akaike Information Criterion increased 2.0 for all models, P-value < 0.001-0.045). Regional Na-SI were more predictive of MMSE and ADAS-Cog11 scores in our nondemented older adult cohort than volume, hippocampal more robust than entorhinal region of interest. Positive amyloid status slightly further improved model fit.

Objective Sleep Function is Associated with Hippocampal Subfield Volumes in Community-Dwelling Adults.

Sleep patterns often shift as people age, a phenomenon frequently associated with the onset of neurodegenerative conditions. Additionally, distinct alterations occur in brain structure as individuals grow older, particularly within the hippocampus, a region known for its role in cognition and sleep regulation. Yet, how exactly do changes in sleep relate to specific subfields within the hippocampus is still unclear. We conducted a study involving non-demented healthy adults from the Aiginition Longitudinal Biomarker Investigation Of Neurodegeneration (ALBION) cohort. Participants underwent objective sleep measurements using wrist Actiwatch and WatchPAT devices. Further, all participants underwent the same Magnetic Resonance Imaging (MRI) protocol, including a 3D high resolution T1-weighted sequence, on the same 3.0 Tesla MRI scanner using an eight-channel head coil. The study aimed to examine the relationship between objectively measured sleep metrics and the morphology of twenty-two distinct hippocampal subregions. In total, 75 non-demented participants with 63 mean years of age were included in the study. Results indicated that a higher frequency of awakenings during sleep was associated with increased volume in the right presubiculum body (beta = 0.630, p False Discovery Rate (FDR) <0.036). Longer sleep duration showed a tendency to be associated with smaller volumes of the right presubiculum body, hinting at a possible negative impact of prolonged sleep on this brain region. Similar trends were observed regarding sleep apnea and the presubiculum body volume. Further analysis based on age stratification revealed that in younger participants, longer sleep duration was linked to decreased volume of the presubiculum body, while a greater number of awakenings was correlated with increased volume of the same region. Among older participants, higher frequencies of awakenings were associated with larger volumes in various hippocampal subfields. These findings shed light on the complex relationship between sleep characteristics and brain structure, highlighting potential age-related differences. The study provides valuable insights into how sleep disruptions may impact hippocampal morphology and cognitive function of cognitively healthy adults. Further research is warranted to elucidate the underlying mechanisms and implications for neurodegenerative diseases.

Disability Mortality Disparity: Risk Of Mortality For Disabled Adults Nearly Twice That For Nondisabled Adults, 2008-19.

After years of advocacy by the disability community and allied organizations, on September 26, 2023, the National Institute on Minority Health and Health Disparities (NIMHD) designated disabled people as a health disparities population in the US. During its deliberations, the NIMHD emphasized that there was not sufficient empirical evidence on health disparities between disabled and nondisabled adults. My study addressed this gap by examining 2008-19 data from the National Health Interview Survey Linked Mortality Files on people ages eighteen and older to identify, categorize, and quantify disparities in mortality risk among disabled and nondisabled adults. The risk of mortality during the study period was 1.9 times higher overall for disabled compared with nondisabled adults. The risk increased with the number of reported disabilities and varied by disability category. These findings underscore the need to improve access to high-quality, evidence-based health care among disabled people. To gain a full understanding of the scope of disparity and the interventions needed to mitigate it, it is critical to develop more equitable and inclusive measures of disability and ableism for use in population health surveys.

Brain activations elicited during task-switching generalize beyond the task: A partial least squares correlation approach to combine fMRI signals and cognition.

An underlying hypothesis for broad transfer from cognitive training is that the regional brain signals engaged during the training task are related to the transfer tasks. However, it is unclear whether the brain activations elicited from a specific cognitive task can generalize to performance of other tasks, esp. in normal aging where cognitive training holds much promise. In this large dual-site functional magnetic resonance imaging (fMRI) study, we aimed to characterize the neurobehavioral correlates of task-switching in normal aging and examine whether the task-switching-related fMRI-blood-oxygen-level-dependent (BOLD) signals, engaged during varieties of cognitive control, generalize to other tasks of executive control and general cognition. We therefore used a hybrid blocked and event-related fMRI task-switching paradigm to investigate brain regions associated with multiple types of cognitive control on 129 non-demented older adults (65-85 years). This large dataset provided a unique opportunity for a data-driven partial least squares-correlation approach to investigate the generalizability of multiple fMRI-BOLD signals associated with task-switching costs to other tasks of executive control, general cognition, and demographic characteristics. While some fMRI signals generalized beyond the scanned task, others did not. Results indicate right middle frontal brain activation as detrimental to task-switching performance, whereas inferior frontal and caudate activations were related to faster processing speed during the fMRI task-switching, but activations of these regions did not predict performance on other tasks of executive control or general cognition. However, BOLD signals from the right lateral occipital cortex engaged during the fMRI task positively predicted performance on a working memory updating task, and BOLD signals from the left post-central gyrus that were disengaged during the fMRI task were related to slower processing speed in the task as well as to lower general cognition. Together, these results suggest generalizability of these BOLD signals beyond the scanned task. The findings also provided evidence for the general slowing hypothesis of aging as most variance in the data were explained by low processing speed and global low BOLD signal in older age. As processing speed shared variance with task-switching and other executive control tasks, it might be a possible basis of generalizability between these tasks. Additional results support the dedifferentiation hypothesis of brain aging, as right middle frontal activations predicted poorer task-switching performance. Overall, we observed that the BOLD signals related to the fMRI task not only generalize to the performance of other executive control tasks, but unique brain predictors of out-of-scanner performance can be identified.

Occupational balance of children and families in early childhood interventions

ABSTRACT We examined occupational balance, individuals’ level of satisfaction with their ability to meet various occupational needs through their activity patterns and quality of life (QOL), in families of children receiving early intervention and preschool special education services, using a web-based, cross-sectional, non-experimental survey design. The survey consisted of the Life Balance Inventory, the Kemp Quality of Life Scale, the Mastery/Control section of the Kansas Inventory of Parental Perceptions due to the relationship of control to QOL, and open-ended questions. While most participants classified themselves as moderately balanced or very balanced overall, the majority (60.9%) were unbalanced or very unbalanced in health. Fewer participants reported high quality of life compared to other non-disabled adults. Participants identified both barriers and facilitators of occupational balance related to service delivery. Occupational therapists should utilize intervention strategies that enhance occupational balance.

The Moderating Effect of Serum Vitamin D on the Relationship between Beta-amyloid Deposition and Neurodegeneration.

Previous studies have reported that vitamin D deficiency increased the risk of Alzheimer's disease (AD) dementia in older adults. However, little is known about how vitamin D is involved in the pathophysiology of AD. Thus, this study aimed to examine the association and interaction of serum vitamin D levels with in vivo AD pathologies including cerebral beta-amyloid (Aβ) deposition and neurodegeneration in nondemented older adults. 428 Nondemented older adults were recruited from the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's Disease, a prospective cohort that began in 2014. All participants underwent comprehensive clinical assessments, measurement of serum 25-hydroxyvitamin D (25[OH]D), and multimodal brain imaging including Pittsburgh compound B (PiB) positron emission tomography and magnetic resonance imaging. Global PiB deposition was measured for the Aβ biomarker. Intracranial volume-adjusted hippocampal volume (HVa) was used as a neurodegeneration biomarker. Overall, serum 25(OH)D level was not associated with either Aβ deposition or HVa after controlling for age, sex, apolipoprotein E ε4 positivity, and vascular risk factors. However, serum 25(OH)D level had a significant moderating effect on the association between Aβ and neurodegeneration, with lower serum 25(OH)D level significantly exacerbating cerebral Aβ-associated hippocampal volume loss (B = 34.612, p = 0.008). Our findings indicate that lower serum vitamin D levels may contribute to AD by exacerbating Aβ-associated neurodegeneration in nondemented older adults. Further studies to explore the potential therapeutic effect of vitamin D supplementation on the progression of AD pathology will be necessary.

Association of modified dementia risk score with cerebrospinal fluid biomarkers and cognition in adults without dementia.

This study aimed to investigate the cognitive profile and prospective cognitive changes in non-demented adults with elevated Modified Dementia Risk Scores (MDRS), while also exploring the potential relationship between these associations and cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease (AD) pathology and neuroinflammation. Within the Chinese Alzheimer's Biomarker and LifestylE (CABLE) database, 994 participants without dementia were assessed on MDRS, CSF biomarkers and cognition. We examined the associations of the MDRS with CSF biomarkers and cognitive scores using linear regressions. Causal mediation analyses were conducted to analyze the associations among MDRS, brain pathologies, and cognition. The Alzheimer's Disease Neuroimaging Initiative (ADNI) study was used to validate the mediation effects and to investigate the longitudinal association between MDRS and cognitive decline. The results revealed that higher MDRS were linked to poorer cognitive performance (Model 1: PFDR < 0.001; Model 2: PFDR < 0.001) and increases in CSF levels of phosphorylated tau (P-tau, Model 1: PFDR < 0.001; Model 2: PFDR < 0.001), total tau (T-tau, Model 1: PFDR < 0.001; Model 2: PFDR < 0.001), P-tau/Aβ42 ratio (Model 1: PFDR = 0.023; Model 2: PFDR = 0.028), T-tau/Aβ42 ratio (Model 1: PFDR < 0.001; Model 2: PFDR < 0.001) and soluble triggering receptor expressed on myeloid cells 2 (sTrem2, Model 1: PFDR < 0.001; Model 2: PFDR < 0.001) in the CABLE study. The impact of MDRS on cognition was partially mediated by neuroinflammation and tau pathology. These mediation effects were replicated in the ADNI study. Baseline MDRS were significantly associated with future cognitive decline, as indicated by lower scores on the Mini-Mental State Examination (MMSE, Model 1: PFDR = 0.045; Model 2: PFDR < 0.001), ADNI composite memory score (ADNI-MEM, Model 1: PFDR = 0.005; Model 2: PFDR < 0.001), ADNI composite executive function score (ADNI-EF, Model 1: PFDR = 0.045; Model 2: PFDR < 0.001), and higher score on the Alzheimer's Disease Assessment Scale (ADAS13, Model 1: PFDR = 0.045; Model 2: PFDR < 0.001). The findings of this study revealed significant associations between MDRS and cognitive decline, suggesting a potential role of tau pathology and neuroinflammation in the link between MDRS and poorer cognitive performance in individuals without dementia. Consequently, the MDRS holds promise as a tool for targeted preventive interventions in individuals at high risk of cognitive impairment.

Associations between IL-1β, IL-6, and TNFα polymorphisms and longitudinal trajectories of cognitive function in non-demented older adults

Inflammation is implicated in Alzheimer's disease (AD), and specific single nucleotide polymorphisms (SNPs) in inflammatory cytokine genes are associated with increased AD risk. Whether the same polymorphisms also predict domain-specific cognitive change in cognitively healthy older adults is unclear. Specific SNPs in three cytokine genes, IL-1β (rs16944), IL-6 (rs1800795), and TNFα (rs1800629) were assessed for association with longitudinal trajectories spanning up to 16 years of global cognitive function, episodic memory, attention and working memory, and executive function in a sample of 324 non-demented older adults. Only rs1800629 (TNFα) was associated with significant change in global cognitive function over time [γ = 5.22; 95% CI: 0.61, 9.83; p = 0.027]. Despite an association with AD risk, rs16944 and rs1800795 may not predict cognitive decline in cognitively healthy older adults. The presence of an A at rs1800629 (TNFα) may have broad, protective effects on cognitive function, over time. More validation studies are needed to determine whether specific cytokine SNPs are associated with respective serum levels to further understanding of AD biomarkers that may also serve as markers of cognitive decline.

Examining the Post-School Decision-Making and Self-Determination of Disabled Young Adults in Ireland

Reflecting the neglect of childhood disability in transitions research, there is a notable dearth of research on the factors shaping self-determination in post-school decision-making for disabled young adults. To address this gap, we explore how early educational experiences, parental expectations, economic vulnerability, school context, and educational supports shape perceived school support in developing self-determination skills among disabled and non-disabled secondary school students in Ireland. Utilising data from the nationally representative Growing Up in Ireland study, descriptive analyses map post-school decision-making and self-determination skills development among disabled and non-disabled young adults at age 20. Multivariate analyses explore the experiences of students with different disabilities, investigating how family, school, and peer influences shape such skill development. Disparities are found between disabled and non-disabled students, as well as among disabled students in school support for this skills development, with gender, socioeconomic background, cultural capital, and early educational experiences also important in perceived support. Positive school engagement and student-teacher relationships, as well as high self-expectations, emerge as protective factors, indicating that fostering supportive environments and self-concept may enhance students’ self-determination skills. The findings underscore the importance of promoting causal agency, providing support for proxy agency, and taking action to create enriching opportunities and choices for all students.

Baseline Frontoparietal Gray Matter Volume Predicts Executive Function Performance in Aging and Mild Cognitive Impairment at 24-Month Follow-Up.

Executive dysfunction in mild cognitive impairment (MCI) has been associated with gray matter atrophy. Prior studies have yielded limited insight into associations between gray matter volume and executive function in early and late amnestic MCI (aMCI). To examine the relative importance of predictors of executive function at 24 months and relationships between baseline regional gray matter volume and executive function performance at 24-month follow-up in non-demented older adults. 147 participants from the Alzheimer's Disease Neuroimaging Initiative (mean age = 70.6 years) completed brain magnetic resonance imaging and neuropsychological testing and were classified as cognitively normal (n = 49), early aMCI (n = 60), or late aMCI (n = 38). Analyses explored the importance of demographic, APOEɛ4, biomarker (p-tau/Aβ42, t-tau/Aβ42), and gray matter regions-of-interest (ROI) variables to 24-month executive function, whether ROIs predicted executive function, and whether relationships varied by baseline diagnostic status. Across all participants, baseline anterior cingulate cortex and superior parietal lobule volumes were the strongest predictors of 24-month executive function performance. In early aMCI, anterior cingulate cortex volume was the strongest predictor and demonstrated a significant interaction such that lower volume related to worse 24-month executive function in early aMCI. Educational attainment and inferior frontal gyrus volume were the strongest predictors of 24-month executive function performance for cognitively normal and late aMCI groups, respectively. Baseline frontoparietal gray matter regions were significant predictors of executive function performance in the context of aMCI and may identify those at risk of Alzheimer's disease. Anterior cingulate cortex volume may predict executive function performance in early aMCI.

UNLOCKING NEUROLOGICAL MYSTERIES: MACHINE LEARNING APPROACHES to EARLY DETECTION of ALZHEIMER'S DISEASE

Dementia is a clinical illness that becomes more common as people get older. It is defined by a decline in cognitive abilities across several domains and eventually impacts everyday functioning. Consequently, this leads to a decline in autonomy, impairment, dependence on assistance, and ultimately, mortality. Alzheimer's disease (AD) is responsible for 50–80% of all occurrences of dementia, and its occurrence increases by a factor of five every five years beyond the age of 65. Given the availability of health data and the decrease in data processing costs, it is now feasible to detect Alzheimer's disease at an early stage. The objective of this study is to classify individuals as either Alzheimer's sufferers or healthy individuals by employing various machine learning techniques. The OASIS-2 dataset, which consists of longitudinal MRI data from both nondemented and demented older adults, was utilized for this study. Given its potential for early detection of Alzheimer's dementia, the study is anticipated to enhance clinical decision support systems pertaining to modifiable risk factors.

Implications of helplessness in depression: diagnosing mild cognitive impairment and analyzing its effects on cognitive decline in older adults.

This study focuses on how elements of depression correlate with mild cognitive impairment (MCI) in older adults and the diagnostic efficacy of combining these components with the Mini-Mental State Examination (MMSE). The study also investigated the connection between individual depression components and overall cognitive function, as measured by the total score (TS) of the consortium to establish a registry for Alzheimer's disease (AD) assessment battery. The study included 196 nondemented adults aged 65 to 90 years at a university hospital and community. Comprehensive clinical assessments including the 30-item Geriatric Depression Scale (GDS) to measure components of depressive symptoms, TS, and blood nutritional biomarkers. Our stepwise logistic regression analysis highlighted the 'helplessness item' (odds ratio = 4.531, 95% CI = 2.218 to 9.258, p < 0.001) as a significant predictor for MCI diagnosis. Further, models incorporating 'helplessness item + MMSE' demonstrated markedly enhanced accuracy in diagnosing MCI, surpassing the performance of the MMSE used independently. Notably, the group characterized by helplessness showed a significant reduction in TS (B = -5.300, SE = 1.899, β = -0.162, p = 0.006), with this trend being particularly pronounced in individuals exhibiting lower levels of physical activity. Interestingly, this correlation did not manifest in participants with higher physical activity levels. Our findings suggest that helplessness is highly effective in diagnosing MCI and is linked to a decrease in cognitive function. Therefore, when addressing MCI and AD-related cognitive decline, clinicians should consider helplessness.

Association between oral health and cognitive impairment in older adults: Insights from a Six-year prospective cohort study

ObjectiveThis study aims to investigate the relationships between four baseline oral conditions (periodontal status, dental caries, tooth wear, and dentition) and repeated global cognition or domain-specific cognition (memory, executive function, attention, and verbal fluency) in non-demented older adults over time. MethodsThis prospective cohort study (2011–2019) enrolled 516 non-demented community-dwelling older adults (age ≥ 65) to explore the association between oral health and cognitive function. Global and domain-specific cognition were assessed biennially (four repeats) using a battery of neuropsychological tests. The baseline oral health conditions were examined, including periodontal status, dental caries, tooth wear, and dentition. The association of these oral conditions with cognition was evaluated by generalized linear mixed models. Stratified analyses were performed by important covariates. ResultsOver time, dental caries was associated with poor memory in two different logical memory tests (β^= -0.06 and β^= -0.04). Incomplete dentition with less than 28 teeth was associated with poor performance in attention (β^= -0.05) and verbal fluency (β^= -0.03). These associations became more evident in those with an elevated inflammatory marker (IL-6, β^= -0.11 to -0.08). In contrast, tooth wear was associated with better memory in two different logical memory tests (β^= 0.33 and β^= 0.36) and better executive function (β^= 0.06) over time, and this association became more evident in those with the lowest inflammatory marker (IL-6, β^= 0.10). ConclusionsDental caries and incomplete dentition were associated with poor memory, attention, and verbal fluency performance. Conversely, tooth wear was associated with better memory performance and executive function. Clinical SignificanceFor early prevention of dementia, an evaluation of multiple dental and periodontal status in older adults helps predict the risk of dementia in the preclinical phase. Maintaining intact tooth structure without caries progression and eventually tooth loss may help prevent the worsening of memory, attention, and verbal fluency over time.