Prevalence Of Mild Cognitive Impairment Research Articles

Comparative prevalence of mild cognitive impairment of Alzheimer’s Disease sub‐type in Adult Ugandans living with HIV and demographically matched HIV‐negative controls

AbstractBackgroundPrevalence rate of mild cognitive impairment (MCI) and Alzheimer’s dementia (AD) in cART treated people living with HIV (PWH) is unknown.Method277 PWH and 189 HIV‐negative Ugandan adults matched by age, sex, and residence were neuropsychologically evaluated i. Impairment in seven domains ‐ including immediate recall, memory and learning (delayed recall, recognition) and others, were defined. Cognitive status – i.e., not impaired, asymptomatic impairment (ANI), minor neurocognitive disorder (MND) or HIV‐associated dementia (i.e., HAD, if HIV+), was defined according to Frascatti criteria. Cognitive dysfunction of the AD subtype was defined per Bondi et al. (2014); MCI included moderate (i.e. ≥1 SD worse in ≥2 tests) or pronounced (i.e. >2.0 SD worse in ≥1 tests) cognitive impairments without functional limitation. AD ‐ i.e., ≥1 pronounced impairment in recognition/delayed recall accompanied with functional limitation. Differences in MCI and AD by HIV status and odds ratios with 95% confidence intervals (CI) were calculated stratified by age (<60 vs. ≥60 years).ResultAmong adults cognitively unimpaired (26.1%) or with ANI (27.8%), amnestic MCI rate was 28.9% (60/204) among PWH and 14.7% (21/133) among HIV‐ controls (OR = 2.18, 95%CI:1.25, 3.84). Similarly, among adults with MND/HAD, prevalent AD was 38.7% (29/75) among PWH and 23% (14/61) among HIV‐ controls (OR = 2.11, 95%CI:0.99, 4.50). Among cognitively unimpaired/ANI affected individuals <60 years old, amnestic MCI prevalence was 16.2% for community controls and 30.3% for PWH (OR = 1.9, 95%CI:1.02, 3.60). Among individuals classified as MND or HAD, prevalent AD was 16.3% for HIV‐ controls vs. 38.6% for PWH (OR = 3.23, 95% CI: 1.23, 8.52) . Among adults 60+ years old with ANI/no impairment, prevalent amnestic MCI was 14.7% for community controls and 41.9% for PWH (OR = 4.04, 95%CI:1.23, 13.40) but the prevalence of AD was identical at 38.9% each for HIV+ and for HIV‐ controls 60+ years old with MND/HAD.ConclusionUgandan PWH are at increased risk for being diagnosed with MCI/AD, and they may be diagnosed at a younger age than HIV‐negative Ugandans. These data highlight the importance of MCI/AD screening in PWH and the need to avail PWH with interventions to mitigate MCI/AD risk.

Posttraumatic Stress Disorder and Risk For Dementia

AbstractBackgroundAccumulating evidence demonstrates that PTSD is associated with higher risk for neurodegenerative disorders. However, the mechanism which drives this relationship and the question of whether the increased risk pertains to the full spectrum of all neurodegenerative disorders is not known. Given that neurodegeneration, as with most illnesses, is caused by complex gene by environment factors, PTSD may be an important disorder to study given that trauma exposure is a large impact environmental exposure.MethodThis presentation will start with a brief review of prospective epidemiologic studies that examine the potential bidirectional relationship between PTSD and dementia disorders. Next, data from the Department of Defense Alzheimer’s Disease Neuroimaging Initiative (DoD ADNI) on amyloid and tau PET imaging in older Vietnam veterans will be presented.ResultData from multiple prospective studies show that having a diagnosis of PTSD is associated with higher risk of subsequent dementia. Further, evidence suggests that PTSD is associated with elevated risk for all types of neurodegenerative disorders including Parkinson’s Disease, though there may be a stronger link to Frontotemporal and Vascular Dementias. Results from a sample 289 non‐demented veterans with PTSD and/or TBI and controls in the DoD ADNI cohort did not show evidence of higher cortical amyloid or tau burden. PTSD was associated with higher prevalence of mild cognitive impairment but in the absence of elevated biomarkers of Alzheimer’s Disease.ConclusionThere are many important questions that need to be resolved to understand what mechanistic pathways for neurodegeneration are facilitated by PTSD. If results from the DoD ADNI study generalize, then future work should focus on whether PTSD increases risk for non‐AD tauopathies or synucleinopathies. Further, the strong association of PTSD with chronic sleep disturbance and elevated pro‐inflammatory cytokines also suggest that need to focus on these candidate mechanisms for accounting for the link between traumatic stress exposure and the development of neurodegenerative disorders.

Prospective cohort of elderly patients after hospitalization due to COVID‐19: preliminary results

AbstractBackgroundPost Covid‐19 syndrome is recognized as the maintenance of disease symptoms for weeks to months after the disease has healed. It is suspected that the involvement of the ACE enzyme and IL‐6 may trigger an increased risk of dementia.MethodThis is a cohort study that is evaluating over 12 months the functional status and cognition of elderly people after hospital discharge. One group is composed of elderly people admitted to the hospital for Covid‐19 and the other group is composed of elderly people hospitalized for other clinical reasons. The groups are evaluated with The Mattis (DRS), AD8, IQCODE, ADCS‐ADL, PCL‐C, GDS‐15, FIM, COPM, CFS, FSS, mMRC and SARC‐calf. We will describe the preliminary results of the first 15 patients included in the COVID‐19 group on functional status, cognition, mood and quality of life.ResultsFifteen patients with COVID‐19 were evaluated three months after hospital discharge. One was excluded due to previous mental disorder and another due to a request to be excluded from the study. We found a mean age of 67.7 ± 7.15 years, schooling 8.7 ± 4.7 years, 61.5% female, Charlson Comorbidity Index 1.9 ± 1.4, 69.2% with smoking history had incomplete vaccine protection for COVID‐19. Considering cognition, 15.4% of the sample had no impairment, 53.9% had mild cognitive impairment (MCI) (30.8% amnestic MCI and 23.1% non‐amnesic MCI) and 30.8% had dementia. 23.1% declared their health status and quality of life as fair or poor. Median CFS was 5 (3‐5), mean GDS‐15 was 4.7 ± 2.9, FSS 32.9 ± 18.9, PCL‐c 32.6 ± 12.5, SARC‐calf 3.2 ± 4.2. All had mMRC dyspnea classified between 2 and 4.ConclusionThere was a high prevalence of mild cognitive impairment and dementia among patients after three months of discharge, with a predominance of mild frailty due to CFS and the presence of fatigue. It is noteworthy that a quarter of the sample reported low quality of life.

Cardiovascular health and resilience to cognitive decline and impairment among diverse Hispanics/Latinos: Results from the Study of Latinos‐ Investigation of Neurocognitive Aging (SOL‐INCA)

AbstractBackgroundCardiovascular disease contributes to cognitive impairment and dementia, particularly among populations facing health disparities. However, the long‐term effects of cardiovascular health on later cognitive health have not been examined among Hispanics/Latinos. Therefore, we examined relationships between cardiovascular health with change in cognition and mild cognitive impairment (MCI) among diverse Hispanics/Latinos.MethodHispanics/Latinos (n = 6,223, ages 50‐86 years) were enrolled in the Study of Latinos ‐ Investigation of Neurocognitive Aging (SOL‐INCA), an ancillary study of the Hispanic Community Health Study/SOL (HCHS/SOL). Cardiovascular health was the primary exposure, measured using the American Heart Association’s Life’s Simple 7s (LS7). Outcomes of interest included 7‐year performance in cognition, change in cognition, and MCI prevalence. Cognitive outcomes included measures of learning and memory, verbal fluency, executive functioning and processing speed, and a global composite (average of the z‐scores on each test). Survey linear regressions were used to separately model the associations between LS7 with outcomes of interest, controlling for age, age2, education, language preference, Hispanic/Latino background, and income.ResultsBetter cardiovascular health (higher LS7 Score) was associated with higher global cognitive performance (βGlobal = 0.028 [SE = 0.005], p<0.001). These associations were evident in learning (βB‐SEVLT‐Sum = 0.024 [SE = 0.007], p<0.01), memory (β = 0.024B‐SEVLT‐Recall [SE = 0.008], p<0.01), verbal fluency (β = 0.039WF [SE = 0.008], p<0.001), executive functioning and processing speed (βDSS = 0.027 [SE = 0.007], p<0.001 and βTrails A = ‐0.022 [SE = 0.007], p<0.01). We also observed significant associations between better cardiovascular health and improved global cognitive change (β = 0.023 [SE = 0.008], p<0.01), evident also for learning (βB‐SEVLT‐Sum = 0.017 [SE = 0.008], p<0.05), executive functioning and processing speed (βDSS = 0.034 [SE = 0.008], p<0.001). Lastly, better cardiovascular health decreased the odds ratios for prevalent MCI (ORMCI = 0.90 [0.842, 0.959], p<0.01).ConclusionCardiovascular health was protective of 7‐year cognitive aging and associated with reduced MCI prevalence. Our findings suggest that cardiovascular health may improve resilience to cognitive decline and impairment amongst diverse Hispanics/Latinos, which could prove instrumental in public health efforts for reducing dementia disparities facing Hispanics/Latinos.

Association of Type D personality and mild cognitive impairment in patients with hypertension.

The aim of this study was to evaluate the association between Type D personality and mild cognitive impairment (MCI) in patients with hypertension. A total of 324 subjects with hypertension were included in the study. All of them completed questionnaires on demographic characteristics, Type D personality Scale, Montreal Cognitive Assessment (MoCA), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). The Type D personality effect was analyzed as both dichotomous and continuous methods. The incidence of MCI was 56.5% in hypertensive individuals. Type D personality presenting as a dichotomous construct was an independent risk factor of MCI (odds ratio [OR] = 2.814, 95% confidence interval [CI] = 1.577-5.021, p < 0.001), after adjusting for ages, sex and some clinical factors. Meanwhile, main effect of negative affectivity component was independently related to the prevalence of MCI (OR = 1.087, 95%CI = 1.014-1.165, p = 0.019). However, associations between the main effect of social inhibition component (OR = 1.011, 95%CI = 0.924-1.107, p = 0.811) as well as the interaction of negative affectivity and social inhibition (OR = 1.013, 95%CI = 0.996-1.030, p = 0.127) with MCI were not found. The findings suggest that Type D personality is strongly associated with MCI in patients with hypertension. The negative affectivity component of the Type D appears to drive the correlations between Type D and MCI. These findings provide new ideas for studying the mechanisms underlying the relationship between personality and cognitive decline in hypertensive individuals.

Estimating the Prevalence of Dementia and Mild Cognitive Impairment in the US

Nationally representative data are critical for understanding the causes, costs, and outcomes associated with dementia and mild cognitive impairment (MCI) in the US and can inform policies aimed at reducing the impact of these conditions on patients, families, and public programs. The nationally representative Health and Retirement Study (HRS) is an essential resource for such data, but the HRS substudy providing dementia diagnostic information was fielded more than 20 years ago and more recent data are needed. The Harmonized Cognitive Assessment Protocol (HCAP) was developed to update national estimates of the prevalence of MCI and dementia in the US and examine differences by age, race, ethnicity, and sex. HRS is an ongoing longitudinal nationally representative study of people 51 years and older with staggered entry dates from 1992 to 2022 and follow-up ranging from 4 to 30 years. HCAP is a cross-sectional random sample of individuals in HRS who were 65 years or older in 2016. Of 9972 age-eligible HRS participants, 4425 were randomly selected for HCAP, and 3496 completed a comprehensive neuropsychological test battery and informant interview, none of whom were excluded. Dementia and MCI were classified using an algorithm based on standard diagnostic criteria and comparing test performance to a robust normative sample. Groups were stratified by age, sex, education, race, and ethnicity. National prevalence estimates using population weights. The mean (SD) age of the study population sample (N = 3496) was 76.4 (7.6) years, and 2095 participants (60%) were female. There were 551 participants who self-identified as Black and not Hispanic (16%), 382 who self-identified as Hispanic regardless of race (16%), 2483 who self-identified as White and not Hispanic (71%), and 80 who self-identified as another race (2%), including American Indian or Alaska Native, Asian, Native Hawaiian or Pacific Islander, or another self-described race. A total of 393 individuals (10%; 95% CI, 9-11) were classified as having dementia and 804 (22%; 95% CI, 20-24) as having MCI. Every 5-year increase in age was associated with higher risk of dementia (weighted odds ratio [OR], 1.95 per 5-year age difference; 95%, CI, 1.77-2.14) and MCI (OR, 1.17 per 5-year age difference, 95% CI, 1.09-1.26). Each additional year of education was associated with a decrease in risk of dementia (OR, 0.93 per year of school, 95% CI, 0.89-0.97) and MCI (OR, 0.94, 95% CI, 0.91-0.97). Dementia was more common among non-Hispanic Black individuals (OR, 1.81; 95% CI, 1.20-2.75) and MCI in Hispanic individuals (OR, 1.42; 95% CI, 1.03-1.96) compared with non-Hispanic White individuals. Other group comparisons by race and ethnicity were not possible owing to small numbers. No differences in prevalence were found between female individuals and male individuals. Using a comprehensive neuropsychological test battery and large sample, the national prevalence of dementia and MCI in 2016 found in this cross-sectional study was similar to that of other US-based studies, indicating a disproportionate burden of dementia and MCI among older Black and Hispanic adults and those with lower education.

Associations of body mass index and sarcopenia with screen-detected mild cognitive impairment in older adults in Colombia.

More research is required to understand associations of body mass index (BMI) and sarcopenia with cognition, especially in Latin America. The objective of this study was to investigate associations of BMI and sarcopenia with mild cognitive impairment in Colombia. Data were from the National Survey of Health, Wellbeing and Aging in Colombia (SABE Colombia, in Spanish). Community-dwelling adults aged 60 years or older were invited to participate. Trained interviewers administered a shorter version of the mini-mental state examination and mild cognitive impairment was defined as a score of 12 or less out of 19. Body mass index was defined using standard cut-offs. Sarcopenia was defined as low grip strength or slow chair stands. Logistic regression models were adjusted for age, sex, height, education, income, civil status, smoking, and alcohol drinking. The prevalence of mild cognitive impairment was 20% in 23,694 participants in SABE Colombia and 17% in 5,760 participants in the sub-sample in which sarcopenia was assessed. Overweight and obesity were associated with decreased risk of mild cognitive impairment and sarcopenia was associated with increased risk. Sarcopenia was a risk factor for mild cognitive impairment in those with normal BMI (adjusted model included 4,911 men and women). Compared with those with normal BMI and without sarcopenia, the odds ratio for mild cognitive impairment was 1.84 in those with normal BMI and sarcopenia (95% confidence interval: 1.25, 2.71). Sarcopenia was also a risk factor in those with obesity but did not present a greater risk than sarcopenia alone. Compared with those with normal BMI and without sarcopenia, the odds ratio was 1.62 in those with obesity and sarcopenia (95% confidence interval: 1.07, 2.48). Sarcopenia was not a risk factor for mild cognitive impairment in those with overweight. Similar results were observed when reference values from Colombia were used to set cut-offs for grip strength. Similar results were also observed in cross-validation models, which suggests the results are robust. This is the first study of the combined associations of sarcopenia and obesity with cognition in Colombia. The results suggest that sarcopenia is the major predictor of screen-detected mild cognitive impairment in older adults, not overweight or obesity.

Association between fasting plasma glucose and mild cognitive impairment in Chinese 55 and older population from four provinces

Objective: To analyze the association of fasting plasma glucose (FPG) with mild cognitive impairment (MCI) in the Chinese middle-aged and elderly population from four provinces. Methods: Data were drawn from the baseline data of the Community-based Cohort Study on Nervous System Disease 2018-2019. We selected 3 272 subjects aged 55 and above with completed information on demographics, lifestyle, disease history, cognitive test, psychological assessment, and bio-chemistries measurement, and who were capable of performing basic activities of daily living but without Alzheimer's disease during recruitment. A multivariate logistic regression model was employed to analyze the association between FPG and MCI. Results: Median level of FPG in the study population was 5.5 mmol/L. The prevalence of MCI was 24.8%, and those in groups of the FPG quintile were 19.4%, 22.2%, 29.2%, 26.6%, and 26.1%, respectively, which significantly increased the trend (P=0.002). After adjustment of confounders, multivariate logistic regression analysis found that the MCI risk of subjects in the Q3,Q4 and Q5 groups was 1.641 (95%CI: 1.226-2.131), 1.373 (95%CI: 1.036-1.825), 1.402 (95%CI: 1.054-1.871) times as high as that in the Q1 group, respectively. Conclusion: High FPG level might serve as a risk factor for MCI in the middle-aged and elderly population, suggesting the importance of monitoring and controlling plasma glucose even without diabetes.

Anxiety and depression and their correlation between mild cognitive impairment and Mini-Mental impairment in older adults

In people older than 65 years, depression affects quality of life; depressed older adults generally have more anxiety. Objective: To determine mood states and their relationship with mild cognitive impairment in older adults. In the present investigation, depression was evaluated by means of the Beck Test, anxiety by means of the Hamiliton Test and cognitive deterioration by means of Mini Mental to 10 participants of the "Geronto Geriatrics" center of the State of Durango. Methodology: This is a quantitative, exploratory, non-experimental, observational and cross-sectional study with descriptive and correlational statistical analysis. Contribution: Chronbach's alpha of the analyzed data refers that the higher the anxiety and depression, the higher the prevalence of mild cognitive impairment with a moderate positive significance. The correlation between anxiety and neurocognitive functions was significant r = .50 with p = .55 with 95% reliability. And the correlation between depression and neurocognitive functions with an r = .40, with p = .15 with 95% reliability. The high frequency of the incidence of anxiety in the sample studied plus the significant correlation suggest the need to implement programs to address anxiety and depression in adulthood.

Relationship between physical performance and mild cognitive impairment in elderly hemodialysis patients is modified by the presence of diabetes: A multicenter cross-sectional study.

ObjectiveThe purpose of this study was to observe the relationship between physical performance and mild cognitive impairment (MCI) in the presence or absence of type 2 diabetes in elderly hemodialysis patients.MethodsIn this multicenter cross-sectional study, 396 clinically stable and aged ≥60 years hemodialysis patients (255 men; mean age: 68.3 ± 5.9 years) were included from seven dialysis units in Shanghai, China. The Chinese version of the Modified Mini-Mental State Examination (MMSE) and the Instrumental Activities of Daily Living (IADL) scale were utilized to assess MCI. The performance-based assessments consisted of three physical tests, grip strength (GS), Timed Up and Go Test (TUGT), and 4-m walking test, which respectively represent muscle strength, mobility, and walking speed (WS). Logistic regression and multivariate linear regression were used for analysis.ResultsHemodialysis patients with diabetes had a high prevalence of MCI (20.6%). The odds ratio (OR) of MCI for the interacted items [(TUGT) * (diabetes) and (WS) * (diabetes)] was significant (p < 0.05). In diabetes patients, TUGT was positively associated with MCI, and WS was negatively associated with MCI after adjusting covariates [OR = 0.129; 95% confidence interval (CI) = 0.028–0.704, p = 0.021]. However, no significant association was found between physical performance and MCI in the non-diabetes hemodialysis patients (p > 0.05). Further analysis showed that TUGT was negatively associated with attention and calculation and language. WS was positively associated with recall and language in diabetic hemodialysis patients.ConclusionsPhysical performance was associated with MCI in diabetic hemodialysis patients rather than the non-diabetes group. Whether increasing mobility or WS can positively influence MCI in individuals with type 2 diabetes requires further study.

Gender-specific prevalence and risk factors of mild cognitive impairment among older adults in Chongming, Shanghai, China.

ObjectiveThis study explores the gender differences in the prevalence of mild cognitive impairment (MCI) and the correlation between multiple influencing factors.Materials and methodsThe sample was comprised of 1325 relatively healthy participants aged ≥ 60 years in a Shanghai community-dwelling (557 males and 768 females). Cognitive function was assessed by Mini-Mental State Examination (MMSE). The Instrumental Activities of Daily Living (IADL) scale was used to assess the activities of daily living.ResultsThe overall prevalence of MCI was 15.2%, with 10.2% in men and 18.9% in women. In older male subjects, those with higher the Geriatric Depression Scale (GDS) scores [odds ratio (OR) = 1.07, 95% confidence interval (CI) = 1.01–1.14] and hypertension (OR = 2.33, 95% CI = 1.15–4.73) had a higher risk of MCI. female subjects who were illiterate (OR = 2.95, 95% CI = 1.82–4.78), had a farming background (OR = 1.69, 95% CI = 1.05–2.72), and a history of stroke (OR = 1.96, 95% CI = 1.07–3.59) had a higher risk of MCI, but this was not true for males. However, Male subjects who never smoked were less likely to have MCI (OR = 0.22, 95% CI = 0.09–0.54). Additionally, the prevalence of MCI was lower in older women with high grip strength (OR = 0.96, 95% CI = 0.92–0.99) and hyperlipidemia (OR = 0.45, 95% CI = 0.22–0.96).ConclusionThe prevalence of MCI was higher in the population of elderly women compared to men. Moreover, it was found that members with MCI tended to having higher GDS scores, smoking, and hypertension; whereas a history of farming, illiteracy, stroke, grip strength, and hyperlipidemia were correlated with MCI in women.

ASSOCIATION BETWEEN RISK FACTORS AND COGNITIVE IMPAIRMENT AMONG TYPE 2 DIABETES MELLITUS PATIENTS

Background: Diabetes mellitus type 2 is considered as one of the leading causes of illness and mortality through over the globe. Diabetic retinopathy, neuropathy, and nephropathy are all effectively screened on a regular basis. Recent research have shown that cognitive deterioration can occur in patients with diabetes and that it can go unnoticed for a long time, implying that routine screening is necessary. &#x0D; Methodology: An observational cross sectional study was conducted among 158 patients with complaint of T2DM aged between 60-79 years of age were found with cognitive impairment on the basis of MMSE score in a tertiary care centre. Detailed history along with laboratory and biochemical data were taken from patients after taking written informed consent and approval of Institutional Ethical committee through the pre-structured questionnaire. &#x0D; Results: Mild cognitive impairment was noted in 88 (55.69%) type 2 diabetes mellitus patients and Normal cognitive function in 70 (44.30%). Those with MCI had higher HbA1c (6.57 ± 1.27 vs. 6.13 ± 1.22), higher FBS (148.34 ± 18.61 vs. 145.25 ± 16.31), PPBS (173.91 ± 42.64 vs. 167.47 ± 38.15) and TNF-α (79.32 ± 8.74 vs. 72.98 ± 6.76), which were statistically significant. The cognitive domains of executive function, naming, attention, language, and memory showed a statistically significant difference between those with Mild cognitive impairment and Normal cognitive function. There were no differences in the mean age, duration of disease, and education level between the groups. &#x0D; Conclusion: The significant prevalence of Mild cognitive impairment in type 2 diabetes patients emphasizes the value of routine screening of cognitive functions. Further research into the link between cognitive impairment and poor blood glucose control is needed to see if improving blood glucose control can assist in enhancing cognitive functions.

Exercise Training for Mild Cognitive Impairment Adults Older Than 60: A Systematic Review and Meta-Analysis.

Background:The prevalence of mild cognitive impairment (MCI) continues to increase due to population aging. Exercise has been a supporting health strategy that may elicit beneficial effects on cognitive function and prevent dementia.Objective:This study aimed to examine the effects of aerobic, resistance, and multimodal exercise training on cognition in adults aged > 60 years with MCI.Methods:We searched the Cochrane Library, PubMed, and Embase databases and ClinicalTrials.gov (https://clinicaltrials.gov) up to November 2021, with no language restrictions. We included all published randomized controlled trials (RCTs) comparing the effect of exercise programs on cognitive function with any other active intervention or no intervention in participants with MCI aged > 60 years.Results:Twelve RCTs were included in this review. Meta-analysis results revealed significant improvements in resistance training on measures of executive function (p < 0.05) and attention (p < 0.05); no significant differences were observed between aerobic exercise and controls on any of the cognitive comparisons.Conclusion:Exercise training had a small beneficial effect on executive function and attention in older adults with MCI. Larger studies are required to examine the effects of exercise and the possible moderators.

Worldwide prevalence of mild cognitive impairment among community dwellers aged 50years and older: a meta-analysis and systematic review of epidemiology studies.

Mild cognitive impairment (MCI) is the preclinical and transitional stage between healthy ageing and dementia that may be a potential 'target' for interventions designed to delay progression to dementia. In this systematic review and meta-analysis, we assessed the prevalence of MCI worldwide in community-dwelling adults aged 50years and older. PubMed, Web of Science, Embase and PsycINFO database searches were conducted from their respective inception dates to 1 September 2021. Data on the overall prevalence of MCI were synthesised using random effects models. A total of 66 articles covering 242,804 participants fulfilled study criteria for inclusion. The overall prevalence of MCI was 15.56% (95%CI: 13.24-18.03%). Prevalence rates of amnestic MCI and non-amnestic MCI were 10.03% (95%CI: 7.98-12.27%) and 8.72% (95%CI: 6.78-10.89%), respectively. The prevalence of MCI increased with age and decreased with education level. Subgroup and meta-regression analyses revealed that region of study site and male gender proportion per sample were significant correlates of MCI prevalence. The global prevalence of MCI among community dwellers is over 15% and is affected by age, gender, education level and region of study sites. Assessment and interventions targeting MCI within at-risk population subgroups should be considered toward the prevention of dementia.

Hyperparameter Tuning with High Performance Computing Machine Learning for Imbalanced Alzheimer's Disease Data.

Accurate detection is still a challenge in machine learning (ML) for Alzheimer's disease (AD). Class imbalance in imbalanced AD data is another big challenge for machine-learning algorithms working under the assumption that the data are evenly distributed within classes. Here, we present a hyperparameter tuning workflow with high-performance computing (HPC) for imbalanced data related to prevalent mild cognitive impairment (MCI) and AD in the Health and Aging Brain Study-Health Disparities (HABS-HD) project. We applied a single-node multicore parallel mode to hyperparameter tuning of gamma, cost, and class weight using a support vector machine (SVM) model with 10 times repeated fivefold cross-validation. We executed the hyperparameter tuning workflow with R's bigmemory, foreach, and doParallel packages on Texas Advanced Computing Center (TACC)'s Lonestar6 system. The computational time was dramatically reduced by up to 98.2% for the high-performance SVM hyperparameter tuning model, and the performance of cross-validation was also improved (the positive predictive value and the negative predictive value at base rate 12% were, respectively, 16.42% and 92.72%). Our results show that a single-node multicore parallel structure and high-performance SVM hyperparameter tuning model can deliver efficient and fast computation and achieve outstanding agility, simplicity, and productivity for imbalanced data in AD applications.

The relationship between cardiopulmonary function and cognitive function in the elderly in Beijing

Objective: This study was conducted on 27 senior adults in a community in Beijing with the purpose of examining the possible correlation between cardiorespiratory function and cognitive function. Methods: A questionnaire was designed for the basic demographic characteristics. The electronic blood pressure meter and electronic lung capacity meter were used to test cardiorespiratory function. The items of the cardiorespiratory function were scored in standard percentage. The MoCA Scale was used for cognitive function measurement. Results: The average heart rate (beats per minute) was 78.9 with a standard deviation of 13.5, and the average vital capacity (ml) was 1386.3 with a standard deviation of 37.0. In 15 people, the measured blood pressure was above the hypertension standard. The average cognitive function score was 22.5 with a standard deviation of 4.3. Eighteen people (66.7%) had mild cognitive impairments. Multiple linear regression analysis showed that there was no statistically significant correlation between cardiorespiratory function and cognitive function in the elderly (P &gt; 0.05). Conclusion: No correlation was found between cardiopulmonary function and cognitive function in the elderly participating in this study and further large-scale population research is needed in the future. In this study, the prevalence of mild cognitive impairment was higher than in other studies. Attention should be paid to this issue, and early intervention should be done to avoid inactivity in senior adults.

Traumatic brain injury and post-traumatic stress disorder are not associated with Alzheimer's disease pathology measured with biomarkers.

Epidemiological studies report an association between traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) and clinically diagnosed Alzheimer's disease (AD). We examined the association between TBI/PTSD and biomarker-defined AD. We identified 289 non-demented veterans with TBI and/or PTSD and controls who underwent clinical evaluation, cerebrospinal fluid (CSF) collection, magnetic resonance imaging (MRI), amyloid beta (Aβ) and tau positron emission tomography, and apolipoprotein E testing. Participants were followed for up to 5.2 years. Exposure groups (TBI, PTSD, and TBI + PTSD) had higher prevalence of mild cognitive impairment (MCI: P<.0001) and worse Mini-Mental State Examination scores (PTSD: P=.008; TBI & PTSD: P=.009) than controls. There were no significant differences in other cognitive scores, MRI volumes, Aβ or tau accumulation, or in most longitudinal measures. TBI and/or PTSD were not associated with elevated AD biomarkers. The poorer cognitive status of exposed veterans may be due to other comorbid pathologies.

The prevalence of mild cognitive impairment by aspects of social isolation.

ObjectivesThis study describes the prevalence of mild cognitive impairment (MCI) across different aspects of social isolation among adults 65 years or older.MethodsIn this cross-sectional study, we utilized the Wave 3 data from the National Social Life, Health, and Aging Project (NSHAP). MCI was defined as a Montreal Cognitive Assessment (MoCA) score less than 23. Prevalence of MCI was calculated for above and below average social disconnectedness (SD), perceived isolation (PI), and demographic variables age, gender, race/ethnicity, education, and household income.ResultsThe overall prevalence [and 95% confidence interval] of MCI was 27.5% [25.5–29.6]. The high prevalence of MCI was found in those who had above average SD (32.0% [29.1–34.9]), above average PI (33.3% [29.7–36.8]), were older in age (43.1% [38.9–47.3]), male (28.7% [25.9–31.5]), Black (61.1% [52.5–69.6]), had less than a high school education (66.3% [58.9–73.8]), or were in the lowest income group (46.2% [39.7–52.7]). Those with above average SD or PI had a higher prevalence of MCI in almost all demographics, compared to those with below average SD or PI. Those who were Black or African American or had less than a high school education did not have a greater prevalence of MCI when SD was above average.DiscussionThis current study adds to the body of literature that links SD and PI to MCI and sheds light on the possible existing socio-demographic disparities. Groups with greater than average SD or PI tend to have a higher prevalence of MCI. Further studies are needed to establish a causal association of SD and PI with MCI.

Segmental Bioimpedance Variables in Association With Mild Cognitive Impairment.

ObjectiveTo examine the changes in body composition, water compartment, and bioimpedance in mild cognitive impairment (MCI) individuals.MethodsWe obtained seven whole-body composition variables and seven pairs of segmental body composition, water compartment, and impedance variables for the upper and lower extremities from the segmental multi-frequency bioelectrical impedance analysis (BIA) of 939 elderly participants, including 673 cognitively normal (CN) people and 266 individuals with MCI. Participants’ characteristics, anthropometric information, and the selected BIA variables were described and statistically compared between the CN participants and those with MCI. The correlations between the selected BIA variables and neuropsychological tests such as the Korean version of the Mini-Mental State Examination and Seoul Neuropsychological Screening Battery – Second Edition were also examined before and after controlling for age and sex. Univariate and multivariate logistic regression analyses with estimated odds ratios (ORs) were conducted to investigate the associations between these BIA variables and MCI prevalence for different sexes.ResultsParticipants with MCI were slightly older, more depressive, and had significantly poorer cognitive abilities when compared with the CN individuals. The partial correlations between the selected BIA variables and neuropsychological tests upon controlling for age and sex were not greatly significant. However, after accounting for age, sex, and the significant comorbidities, segmental lean mass, water volume, resistance, and reactance in the lower extremities were positively associated with MCI, with ORs [95% confidence interval (CI)] of 1.33 (1.02–1.71), 1.33 (1.03–1.72), 0.76 (0.62–0.92), and 0.79 (0.67–0.93), respectively; with presumably a shift of water from the intracellular area to extracellular space. After stratifying by sex, resistance and reactance in lower extremities remained significant only in the women group.ConclusionAn increase in segmental water along with segmental lean mass and a decrease in body cell strength due to an abnormal cellular water distribution demonstrated by reductions in resistance and reactance are associated with MCI prevalence, which are more pronounced in the lower extremities and in women. These characteristic changes in BIA variables may be considered as an early sign of cognitive impairment in the elderly population.

CORRELATION OF COGNITIVE STATUS WITH IMPAIRED SKIN MICROVASCULAR REACTIVITY IN NEWLY DIAGNOSED UNTREATED HYPERTENSIVES

Objective: Untreated hypertension (HT) in the early midlife is strongly correlated with mild cognitive impairment (MCI) later on, in the elderly. HT is also associated with significant microvascular alterations in several vascular beds including skin. Skin microcirculation has been correlated with microvascular alterations in other beds and has been proposed as a model of generalized microvascular dysfunction. We sought to estimate the prevalence of MCI in newly diagnosed untreated hypertensive patients (UHTs) and compare it to normotensive healthy individuals (NTs). We also investigated possible associations between MCI and parameters of skin microvascular reactivity by using a novel laser technique, namely Laser Speckle Contrast Imaging (LSCI). Design and method: We consecutively enrolled 51 individuals including 31 UHTs and 20 NTs. All patients were free from diabetes mellitus or any cardiovascular disease. Diagnosis of HT was based on conventional office BP and 24h-Ambulatory Blood Pressure Measurement (24h-ABPM) criteria, according to standard guidelines. The Montreal Cognitive Assessment test (MoCA test) was used to assess cognitive function with a score equal to or lower than 26 being suggestive of MCI for all participants. The LSCI technique combined with post-occlusive reactive hyperemia (PORH) protocol was used to assess skin microvascular reactivity. Skin microvascular results are expressed as percentage increase of cutaneous perfusion from baseline to peak condition (base to peak flux, %). Results: Base to peak flux was significantly lower in UHTs compared to NTs (211.0 ± 53.1 vs 154.0 ± 53.0 %, p &lt; 0.01). Although the prevalence of MCI did not differ between UHTs and NTs, there was also a significant positive correlation between the MoCA test score and base to peak flux in the UHTs group (r = 0.491, p = 0.02). Conclusions: Although UHTs did not present impaired cognitive status compared to NTs, they do present impaired skin microvascular reactivity which is strongly correlated with their cognitive status from the very early stages of hypertension. Early and effective treatment of essential hypertension may contribute to the prevention of MCI and the improvement of skin microvascular function in hypertensive patients.