Word List Recognition Research Articles

Inflammatory Cytokines and Cognition in Alzheimer's Disease and Its Prodrome.

The aim of this study was to investigate the association between blood levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and cognitive impairments among elderly individuals. Peripheral concentration of TNF-α and IL-6 were measured in all subjects. To assess individual cognitive function, the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery (CERAD-NP) was used, and standardized scores (z-scores) were calculated for each test. Cytokine levels were compared between the diagnostic groups, and correlations between blood inflammatory factor levels and z-scores were analyzed. The 37 participants included 8 patients with Alzheimer's disease (AD), 15 subjects with mild cognitive impairment (MCI), and 14 cognitively healthy controls. TNF-α and IL-6 levels were higher in patients with AD than in healthy controls. TNF-α levels were higher in the AD group than in the MCI group. However, after adjusting for age, the associations between diagnosis and TNF-α and IL-6 were not significant. The higher the plasma IL-6 level, the lower the z-scores on the Boston Naming Test, Word List Learning, Word List Recognition, and Constructional Recall. The higher the serum TNF-α level, the lower the z-scores on the Word List Learning and Constructional Recall. Negative correlation between serum TNF-α level and the z-score on Word List Learning remained significant when age was adjusted. The difference in the blood levels of TNF-α and IL-6 between the diagnostic groups may be associated with aging. However, elevated TNF-α levels were associated with worse immediate memory performance, even after adjusting for age.

Choroid plexus enlargement in patients with end-stage renal disease: implications for glymphatic system dysfunction.

The choroid plexus plays a role in eliminating detrimental metabolites from the brain as an integral component of the glymphatic system. This study aimed to investigate alterations in choroid plexus volume in patients with end-stage renal disease (ESRD) compared with healthy controls. We enrolled 40 patients with ESRD and 42 healthy controls. They underwent brain magnetic resonance imaging (MRI), specifically using three dimensional T1-weighted imaging. We analyzed choroid plexus volumes and compared them between patients with ESRD and healthy controls. The diffusion tensor image analysis along the perivascular space (DTI-ALPS) index was calculated. We compared the DTI-ALPS index between the ESRD patients and healthy controls. Additionally, we evaluated the association between choroid plexus volume and neuropsychological tests results in patients with ESRD. There were significant differences in choroid plexus volumes between patients with ESRD and healthy controls. The choroid plexus volumes in patients with ESRD were higher than those in healthy controls (1.392 vs. 1.138%, p < 0.001). The DTI-ALPS index in patients with ESRD was lower than that in healthy controls (1.470 ± 0.239 vs. 1.641 ± 0.266, p = 0.005). There were no differences in choroid plexus volumes between patients with ESRD, regardless of the presence of cognitive impairment. However, among the neuropsychological tests, the scores for word-list recognition in verbal memory were negatively correlated with the choroid plexus volume (r = -0.428, p = 0.006). We demonstrated a significant enlargement of the choroid plexus volume in patients with ESRD compared to healthy controls. This finding suggests that patients with ESRD have glymphatic system dysfunction, which may be related to cognitive impairment.

B - 81 Teleneuropsychological Normative Data for the Spanish CERAD Wordlist for Puerto Rican Adults

Abstract Objective The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Wordlist is one of the most commonly used and sensitive tests to detect early cognitive decline (Seo et al., 2010). However, few studies have utilized it with the Puerto Rican population, and none have established normative data on its teleneuropsychological (TeleNP) use. Therefore, this study aims to establish normative data for the TeleNP version of the CERAD Wordlist among Puerto Ricans. Method 124 cognitively healthy (MMSE: M = 28.9, SD = 1.4) Spanish-speaking Puerto Ricans (Female: 71.8%; Age M = 64.6, SD = 7.3; Education M = 15.9, SD = 3.5) completed an online version of the CERAD Wordlist via Zoom. The impact of age and education was investigated using analyses of variance (ANOVA) and Pearson correlations. Descriptive statistics were conducted to generate normative data stratified by statistically significant demographics. Concurrent validity was established between the delayed recall trials of the CERAD Wordlist and MMSE. Results Age and education significantly impacted CERAD Wordlist scores (p &amp;lt; 0.01) across all Learning Trials and Delayed Recall. All effect sizes were large, except for moderate sizes in Trial 1 and Wordlist Recognition. Age was inversely correlated to scores, while education was positively correlated. Concurrent validity with TeleNP MMSE was 0.43 (p &amp;lt; 0.001). Conclusions This study establishes normative data for Puerto Ricans using the TeleNP version of the CERAD Wordlist, which can improve diagnostic accuracy. Future research on the CERAD Wordlist via TeleNP should explore clinical validity and encompass a broader range of educational backgrounds.

The Effect of Psychological Resilience on Cognitive Decline in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study.

Chronic stress is associated with an increased risk of cognitive impairment and Alzheimer's disease. This study aimed to assess whether better coping with stress, as assessed using the Brief Resilience Scale (BRS), is associated with slower cognitive decline in community-dwelling older adults. This study used 2018/2019 data and 2-year follow-up data from the Korean Frailty and Aging Cohort Study. Of the 3,014 total participants, we included 1,826 participants (mean age, 77.6±3.7 years, 51.9% female) who completed BRS and Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Battery and the Korean version of the Frontal Assessment Battery (FAB). Higher BRS score at baseline was associated with a lesser decline in the Mini-Mental State Examination score over 2 years after adjusting for age, sex, years of education, smoking status, hypertension, diabetes, and depression (B, 0.175; 95% confidence interval, 0.025-0.325) for 2 years, which represents global cognitive function. Other cognitive function measurements (Word List Memory, Word List Recall, Word List Recognition, Digit Span, Trail Making Test-A, and FAB) did not change significantly with the BRS score at baseline. These findings suggest that better stress-coping ability, meaning faster termination of the stress response, may limit the decline in cognitive function.

Cognitive and Functional Change Over Time in Cognitively Healthy Individuals According to Alzheimer Disease Biomarker-Defined Subgroups.

It is unclear to what extent cognitive outcome measures are sensitive to capture decline in Alzheimer disease (AD) prevention trials. We aimed to analyze the sensitivity to changes over time of a range of neuropsychological tests in several cognitively unimpaired, biomarker-defined patient groups. Cognitively unimpaired individuals from the Amsterdam Dementia Cohort and the SCIENCe project with available AD biomarkers, obtained from CSF, PET scans, and plasma at baseline, were followed over time (4.5 ± 3.1 years, range 0.6-18.9 years). Based on common inclusion criteria for clinical trials, we defined groups (amyloid, phosphorylated tau [p-tau], APOE ε4). Linear mixed models, adjusted for age, sex, and education, were used to estimate change over time in neuropsychological tests, a functional outcome, and 2 cognitive composite measures. Standardized regression coefficients of time in years (βtime) were reported as outcome of interest. We analyzed change over time with full follow-up, as well as with follow-up limited to 1.5 and 3 years. We included 387 individuals (aged 61.7 ± 8.6 years; 44% female) in the following (partly overlapping) biomarker groups: APOE ε4 carriers (n = 212), amyloid-positive individuals (n = 109), amyloid-positive APOE ε4 carriers (n = 66), CSF p-tau-positive individuals (n = 127), plasma p-tau-positive individuals (n = 71), and amyloid and CSF p-tau-positive individuals (n = 50), or in a control group (normal biomarkers; n = 65). An executive functioning task showed most decline in all biomarker groups (βtime range -0.30 to -0.71), followed by delayed word list recognition (βtime range -0.18 to -0.50). Functional decline (βtime range -0.17 to -0.63) was observed in all, except the CSF and plasma tau-positive groups. Both composites showed comparable amounts of change (βtime range -0.12 to -0.62) in all groups, except plasma p-tau-positive individuals. When limiting original follow-up duration, many effects disappeared or even flipped direction. In conclusion, functional, composite, and neuropsychological outcome measures across all cognitive domains detect changes over time in various biomarker-defined groups, with changes being most evident among individuals with more AD pathology. AD prevention trials should use sufficiently long follow-up duration and/or more sensitive outcome measures to optimally capture subtle cognitive changes over time.

Neurocognitive Features of Mild Cognitive Impairment and Distress Symptoms in Older Adults Without Major Depression.

Two distinct symptom dimensions were identified in older adults who did not have major depressive disorder (MDD): a) a dimension associated with mild cognitive dysfunction, and b) a dimension related to distress symptoms of old age (DSOA). It is uncertain whether previous findings regarding the features of amnestic mild cognitive impairment (aMCI) remain valid when patients with MDD are excluded. To examine the neurocognitive features of aMCI (n = 61) versus controls (n=59) and the objective cognitive characteristics of DSOA in participants without MDD. Neurocognition was evaluated utilizing the Cambridge Neurological Test Automated Battery (CANTAB) and memory tests. This research demonstrated that CANTAB tests may differentiate between aMCI and controls. The One Touch Stockings of Cambridge, probability solved on first choice (OTS_PSFC), Rapid Visual Information Processing, A prime (RVP_ A´), and the Motor Screening Task, mean latency, were identified as the significant discriminatory CANTAB tests. 37.6% of the variance in the severity of aMCI was predicted by OTS_PSFC, RVP_ A´, word list recognition scores, and education years. Psychosocial stressors (adverse childhood experiences, negative life events), subjective feelings of cognitive impairment, and RVP, the probability of false alarm, account for 40.0% of the DSOA score. When MDD is ruled out, aMCI is linked to deficits in attention, executive functions, and memory. Psychosocial stressors did not have a statistically significant impact on aMCI or its severity. Enhanced false alarm response bias coupled with heightened psychological stress (including subjective perceptions of cognitive decline) may contribute to an increase in DSOA among older adults.

Association Between Executive Dysfunction-Related Activities of Daily Living Disability and Clinical Dementia Rating Domain Patterns in Patients With Vascular Dementia and Age-Matched Patients With Alzheimer's Dementia.

Although the Clinical Dementia Rating (CDR) scale was originally developed to stage Alzheimer's dementia (AD), it is now used globally for various types of dementia. The aim of this study was to investigate the characteristic pattern of CDR domains and its association with neuropsychological findings and activities of daily living (ADL) in patients with vascular dementia (VaD) and patients with AD. We recruited very mild to mild VaD and AD patients who were age-matched among the first visitors to a dementia clinic. All subjects underwent a standardized clinical interview, physical and neurological examinations, and laboratory tests, including brain magnetic resonance imaging, according to the protocol of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment battery. A total of 105 pairs of VaD and AD patients participated in this study. Although the adjusted scores on Korean version of the Mini-Mental State Examination were similar between the two groups, the VaD patients performed better on the Boston Naming Test, Word List Memory, Word List Recall, Word List Recognition, and Constructional Recall Test. However, the scores on global CDR, CDR sum of boxes, and ADL-related CDR domains were higher in VaD patients than in AD patients (p<0.001). The VaD patients also showed poor performances on the Disability Assessment for Dementia Scale, Frontal Assessment Battery, Executive Clock Drawing Task, and Stroop tests. Despite similar general cognitive function and better memory function, patients with VaD tend to be staged as severer dementia on the CDR scale than patients with AD because of more impaired ADL associated with executive dysfunction.

RACIAL/ETHNIC DIFFERENCES IN NEUROCOGNITIVE PROFILES OF OLDER ADULTS WITH 6-YEAR INCIDENT DEMENTIA

Abstract Hispanic and non-Hispanic Black (NHB) older adults have higher dementia rates than non-Hispanic Whites (NHWs). Estimates of dementia prevalence and incidence in community-based cohorts are mostly based on threshold value performance on cognitive assessment batteries. We used longitudinal data from the HRS Harmonized Cognitive Assessment Protocol (HCAP) to (1) generate and compare, across race/ethnicity, neurocognitive profiles for older adults (&amp;gt;65 years) not meeting research criteria for dementia in 2010 and developing dementia by 2016 (using Langa-Weir’s dementia classification), (2) assess racial/ethnic differences in these profiles, and (3) test socio-demographic effects on dementia-specific differences in neurocognitive performance. Performance on all HCAP measures was highly sensitive to 6-year incident dementia classification. However, we found notable domain-specific differences in test sensitivity, whereby performance on general screeners (e.g., MMSE) and memory-based tests (e.g., CERAD word list recognition) were significantly lower (≤2 SDs from normed population means). Hispanics and NHBs generally performed lower than NHWs, with more pronounced group differences in general screeners and executive function tests. Sociodemographic characteristics significantly attenuated Hispanic differences, but less so for NHBs, relative to NHWs. Despite these group differences, NHWs with incident dementia had worse neurocognitive profiles than their NHB and Hispanic counterparts. Dementia classification algorithms (e.g., Langa-Weir) sensitively detect cognitive impairment. However, these algorithms more accurately identify higher severity cognitive impairment in NHWs compared to NHBs and Hispanics. Such methods can yield dementia estimates biased by sociocultural factors. Further research is needed to identify culturally appropriate neurocognitive tests that enhance precise dementia diagnosis, using population-level epidemiological data.

The relationship between executive dysfunction‐associated activities of daily living (ADL) and the pattern of Clinical Dementia Rating (CDR) in patients with vascular dementia and age‐matched patients with Alzheimer’s disease

AbstractBackgroundClinical dementia rating (CDR) scale was originally developed to stage the severity of Alzheimer’s dementia (AD) but is now used globally regardless of types of dementia. This study aims to investigate the relationship between the characteristic pattern of CDR domains, neuropsychological findings, and activities of daily living (ADL) in patients with vascular dementia (VaD), compared with age‐matched patients with AD.MethodVery mild to mild VaD and AD patients matched for age were recruited among the first visitors to a dementia clinic. All subjects were administered a standardized clinical interview, physical and neurological examinations, and laboratory tests including the brain MRI according to the protocol of the Korean version of the CERAD assessment battery.ResultOne hundred and five pairs of VaD and AD patients participated in this study. Although the adjusted scores on MMSE were similar between two groups and the performances on Boston naming, word list memory, word list recall, word list recognition, constructional recall test were better in VaD patients, the scores on global CDR, CDR sum of box (SOB), and ADL‐related CDR domains were higher in VaD patients than in AD patients (p&lt;0.001). The poor performances on disability assessment for dementia scale, frontal assessment battery, executive clock drawing task, and Stroop tests were observed in VaD patients.ConclusionDespite similar general cognitive function and better memory function, patients with VaD tend to be staged as severer dementia on the CDR scale than patients with AD because of more impaired ADL associated with executive dysfunction.

Effect of multivitamin‐mineral supplementation on change in cognitive function in the COSMOS Clinical subcohort and meta‐analysis of COSMOS cognition studies

AbstractBackgroundFew randomized clinical trials (RCTs) have investigated the effect of multivitamin‐mineral supplementation (MVM) on cognitive change among community‐dwelling older adults and effects remain untested using detailed in‐person, gold‐standard neuropsychological assessments; thus, we tested the effect of daily MVM vs. placebo on cognitive function among older adults enrolled in the in‐clinic component of COSMOS (COcoa Supplement and Multivitamin Outcomes Study). Furthermore, we conducted a meta‐analysis of the findings from the three COSMOS cognition studies: COSMOS‐Clinic (n = 603 for the detailed in‐person cognitive assessments), COSMOS‐Mind (n = 2262 for telephonic‐based cognitive assessments); and COSMOS‐Web (n = 3562 for computer‐based cognitive assessments) to provide a robust evaluation of the effects of MVM on cognition.MethodsCOSMOS is a 2×2 factorial RCT of cocoa extract supplements (Mars Edge; containing 500 mg/day flavanols) and/or MVM (Haleon, as Centrum Silver) for cardiovascular and cancer prevention. In COSMOS‐Clinic, n = 573 of n = 603 COSMOS‐Clinic participants completed all cognitive tests at baseline; n = 492 completed all cognitive tests at both baseline and 2‐year follow‐up. The primary outcome was global cognitive score [averaging z‐scores of 11 tests: general cognition (the Modified Mini‐Mental State), episodic memory (Consortium to Establish a Registry for Alzheimer’s Disease [CERAD] word list learning and delayed recall tests; East Boston Memory Test immediate and delayed recall trials), CERAD word list recognition, and executive function/attention (two fluency tests; Trail Making Tests A and B; digit span backwards)]. Episodic memory and executive function/attention were examined separately. Finally, we used random‐effects models to meta‐analyze the findings of three COSMOS cognition studies.ResultsIn COSMOS‐Clinic, we observed a signal for effect of MVM vs. placebo on improvement in global cognition over two years (mean difference = 0.06, 95% confidence interval [CI]: ‐0.003, 0.12). MVM vs. placebo led to significant improvement in episodic memory (mean difference = 0.11, 95% CI: 0.001, 0.23) but not in executive function/attention (mean difference = 0.04, 95% CI: ‐0.04, 0.11). The meta‐analysis of three COSMOS studies showed significant benefits of MVM on global cognition and episodic memory (will be presented in detail).ConclusionDaily MVM compared to placebo showed improvement in global cognition and episodic memory over 2 years among community‐dwelling older adults.

SEX DIFFERENCES IN THE ASSOCIATION BETWEEN BODY COMPOSITION AND 2-YEAR CHANGE IN COGNITIVE FUNCTION

Abstract In the process of aging, the loss of lean mass and increase in fat mass are associated with cognitive decline. This study investigated sex differences in the association between body composition and changes in cognitive function in community-dwelling older adults in Korea. A total of 1,420 participants (aged 70–84 years, 54.2% men) of the Korean Frailty and Aging Cohort Study with data from baseline and 2-year follow-up surveys were included. Body composition was measured using dual-energy X-ray absorptiometry and cognitive function was assessed using the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet. The total fat mass was lower in men than in women (p&amp;lt; 0.001), whereas total lean mass was higher in men than in women (p&amp;lt; 0.001). Total body fat mass was positively associated with the time taken to finish the Trail Making Test-A only in women (standardized beta coefficient [ß]= -1.371, p=0.018), and a negative association was observed between trunk fat mass and digit span total only in men (ß= -0.092, p=0.039). Appendicular lean mass was significantly positively associated with word list recognition only in women (ß=0.087, p=0.010) and was significantly positively associated with digit span total (ß=0.108, p=0.027) and digit span forward (ß=0.081, p=0.025) only in men. The results of this study indicated that higher fat mass was associated with the protection of decline in cognitive function only in women, while lean mass was positively associated with a change in cognitive function in both sexes.

Association of retinal fibre layer thickness with cognition in a population‐based study

AbstractBackground: The retina is part of the central nervous system. Layers of the retina can be investigated non‐invasively by optical coherence tomography (OCT). Previously, associations of retinal nerve fibre layer thickness (RNFLT) with cognitive function were established in population‐based studies. Clinical relevance constitutes the improvement of early detection of dementia precursors.Objectives: Investigate the relationship of RNFLT to cognitive function based on different neurocognitive testing procedures in a large population‐based sample.Methods: Within the population‐based LIFE‐Adult study (Leipzig Research Center for Civilization Diseases; Germany), circumpapillary RNFLT was measured by spectral domain OCT (Heidelberg Engineering, Heidelberg). RNFLT was evaluated for subjects with reliable measurements (≥50 B‐scan repetitions, quality ≥20 dB, ≤5% missing A‐scans) and without clinical ocular pathology. The relationship between cognitive function and RNFLT was investigated for six sectors: temporal (T), temporal superior (TS), temporal inferior (TI), nasal (N), nasal superior (NS), nasal inferior (NS) and global mean (G). Neuropsychological questionnaires included single tests from the German version of the CERAD Neuropsychological Test Battery (Consortium to Establish a Registry for Alzheimer's Disease), Trail Making Test, Stroop‐Test, Reading the Mind in the Eyes‐Test and Multiple Choice Vocabulary Intelligence Test‐B. Cognitive function was additionally examined using the CERAD Boston Naming Test and CERAD Phonematic Fluid in people over 60 years of age.Results: 5646 eyes of 5646 subjects were evaluated. After correction for multiple comparisons, statistically significant correlation with RNFLT was found for the CERAD test battery, Verbal Fluid Animals (T,TS), Word List Retrieval (G,T,TS,TI), and Word List Learning (G,T,TS,TI,NS). Furthermore, there was a correlation of RNFLT with the trail making test TMT‐A and TMT‐B (G,T,TS,TI). The Stroop‐neutral and Stroop‐incongruent condition (G,T,TS,TI,NS) and the vocabulary test (T,N,NS,NI) also showed a statistically significant association with RNFLT. The Reading the Mind in the Eyes test and some CERAD categories (Mini Mental Status Test (MMSE), Boston Naming Test, Figure Drawing, Figure Recall, Phonematic Fluid, Word List Recognition) did not correlate. Regression, after adjustment for age and refraction, presented with the following associations: TMT‐A (G,TS,TI), TMT‐B (G), Stroop incongruent condition (NS), vocabulary test (T).Discussion: For LIFE‐Adult, cognitive function was correlated with RNFLT using CERAD word list learning, trail making test, Stroop test and vocabulary test. In comparison, subjects of the Rotterdam study with a thinner RNFLT showed an increased risk of developing dementia within a few years; furthermore, a correlation between RNFLT to MMSE and Stroop test was established. The Erasmus Rucphen Family study found an association of thicker RNFL with better cognitive function especially in subjects under 40 years of age; RNFLT correlated with TMT‐B. In the Three‐City‐Alienor study, it was shown that thicker RNFLT was associated with better cognitive function in the Free and Cued Selective Reminding Test; this was particularly true for temporal, superotemporal and inferotemporal segments.Conclusions: Individual neurocognitive tests correlate with thickness differences in RNFLT. We found a thicker RNFLT associated with better cognitive function, while deficits in cognitive function were associated with a significantly thinner RNFLT.

Cognitive Performance at Time of AD Diagnosis: A Clinically Augmented Register-Based Study.

We aimed to evaluate the feasibility of using real-world register data for identifying persons with mild Alzheimer’s disease (AD) and to describe their cognitive performance at the time of diagnosis. Patients diagnosed with AD during 2010–2013 (aged 60–81 years) were identified from the Finnish national health registers and enlarged with a smaller private sector sample (total n = 1,268). Patients with other disorders impacting cognition were excluded. Detailed clinical and cognitive screening data (the Consortium to Establish a Registry for Alzheimer’s Disease neuropsychological battery [CERAD-nb]) were obtained from local health records. Adequate cognitive data were available for 389 patients with mild AD (31%) of the entire AD group. The main reasons for not including patients in analyses of cognitive performance were AD diagnosis at a moderate/severe stage (n = 266, 21%), AD diagnosis given before full register coverage (n = 152, 12%), and missing CERAD-nb data (n = 139, 11%). The cognitive performance of persons with late-onset AD (n = 284), mixed cerebrovascular disease and AD (n = 51), and other AD subtypes (n = 54) was compared with that of a non-demented sample (n = 1980) from the general population. Compared with the other AD groups, patients with late-onset AD performed the worst in word list recognition, while patients with mixed cerebrovascular disease and AD performed the worst in constructional praxis and clock drawing tests. A combination of national registers and local health records can be used to collect data relevant for cognitive screening; today, the process is laborious, but it could be improved in the future with refined search algorithms and electronic data.

Type 2 Deiodinase Thr92Ala Polymorphism Is Not Associated with Cognitive Impairment in Older Adults: A Cross-Sectional Study.

Background: Type 2 Deiodinase (DIO2) converts thyroxine (T4) into the active hormone triiodothyronine (T3). Thr92Ala DIO2 polymorphism has been associated with reduced conversion of T4 into T3 and central nervous system hypothyroidism. However, how Thr92Ala DIO2 polymorphism affects cognitive function is still unclear. Objective: To assess the association between Thr92Ala DIO2 polymorphism and cognitive performance in older adults. Design: Cross-sectional study. Setting: University-based tertiary hospital in Brazil. Patients: > 65-year-old with no limiting clinical disease. Interventions: All participants answered a standard questionnaire before undergoing thyroid function laboratory evaluation and genotyping of the Thr92Ala DIO2 polymorphism. Main Outcomes: Cognitive impairment measured by the Word List Memory task from the Consortium to Establish a Registry for Alzheimer’s Disease Neuropsychological Battery (CERAD-NB) and the Brief Cognitive Screening Battery (BCSB). Results: A hundred individuals were included. Clinical and laboratory characteristics were similar among DIO2 genotypes (all p > 0.05). No differences were found in the Word List Memory, recall, or recognition tests of the CERAD-NB assuming a recessive model for the Ala/Ala vs. Thr/Ala-Thr/Thr genotypes. Results of Clock Drawing Test, Animal Fluency Test, Mini-Mental State Exam, and Figure Memory Test of the BCSB were similar between groups. Conclusions: These findings suggest that Thr92Ala DIO2 polymorphism is not associated with relevant cognitive impairment in older adults.

Adherence to the MIND diet and cognitive performance in the ELSA‐Brasil study

AbstractBackgroundAdherence to healthy dietary patterns such as the MIND diet has been associated with better cognition, but little is known about this relationship in studies from low‐ to middle‐income countries. This study aims to investigate the association between adherence to the MIND diet and cognitive performance in the ELSA‐Brasil study baseline.MethodAdherence to the MIND diet score was assessed using a food frequency questionnaire and cognitive performance was evaluated using three cognitive domains: memory domain (immediate word list recall, late word list recall, word list recognition), fluency domain (semantic and phonemic verbal fluency) and executive domain (Trail Making test version B). We used z scores for the three domains and created a standardized global composite score. We used linear regression to investigate the association between MIND diet adherence and cognitive performance adjusted for sociodemographics and clinical variables. We also investigated interactions between adherence to the MIND diet and age, race, and education.ResultMIND diet adherence was associated with better cognitive performance in all three domains and with global cognition in unadjusted analysis. However, adherence to the MIND diet was related to a worse performance in the executive domain in a full adjusted model (Table 1). Adherence showed significant interaction with age, race and education, suggesting better cognitive performance with higher adherence in older people (Figure 1), white participants (Figure 2) and those in higher levels of education (Figure 3), but a lower cognitive performance with higher adherence in those in lower levels of education (Figure 3).ConclusionMIND diet adherence was associated with worse performance in an executive function test. Older, white and high‐educated participants had better performance with higher adherence scores.

Brain amyloid accumulation possibly exacerbates concurrent mild cognitive impairment with subthreshold depression in older adults: A 1-year follow-up study

BackgroundThis study aimed to investigate the 1-year changes in neuropsychological test results in older adults with concomitant late-life depression (LLD) and mild cognitive impairment (MCI) according to the presence or absence of brain amyloidopathy. MethodsAll subjects underwent 18F‐florbetaben‐positron emission tomography and a standardized neuropsychological battery. The subjects were divided based on brain amyloidopathy and severity of depressive symptoms into the following groups: LLD-MCI-A(+), subthreshold depression (STD)-MCI-A(+), major depressive disorder (MDD)-MCI-A(+), LLD-MCI-A(-), STD-MCI-A(-), and MDD-MCI-A(-). After one year, follow-up neurocognitive tests were conducted. Fifty-nine participants completed both the baseline and 1-year follow-up neurocognitive tests. ResultsIn the LLD-MCI-A(+) group, the word list recall and word list recognition scores decreased during the follow-up period. The STD-MCI-A(+) group also showed a significant decrease in word list recall score and the score/Z-score of word list recognition. On the other hand, the word list recall Z-score improved at the 1-year follow-up in the LLD-MCI-A(-) group. In particular, the MDD-MCI-A(-) group showed significant increases in word list memory score/Z-score and word list recall Z-score during the follow-up period. LimitationsConsidering that AD progresses slowly, a longer follow-up period may be required. ConclusionsOur findings showed differences in the extent of change of neuropsychological test results depending on the severity of depressive symptoms and presence or absence of brain amyloidopathy. Our results suggest that clinicians might explore the underlying neuropathology when assessing older adults with concomitant depression and cognitive impairment, even if the symptoms of depression are not severe.

Accelerated Epigenetic Age in Normal Cognitive Aging of Korean Community-Dwelling Older Adults.

Epigenetic age acceleration has been studied as a promising biomarker of age-related conditions, including cognitive aging. This pilot study aims to explore potential cognitive aging-related biomarkers by investigating the relationship of epigenetic age acceleration and cognitive function and by examining the epigenetic age acceleration differences between successful cognitive aging (SCA) and normal cognitive aging (NCA) among Korean community-dwelling older adults (CDOAs). We used data and blood samples of Korean CDOAs from the Korean Frailty and Aging Cohort Study. The participants were classified into two groups, SCA (above the 50th percentile in all domains of cognitive function) and NCA. The genome-wide DNA methylation profiling array using Illumina Infinium MethylationEPIC BeadChip was used to calculate the following: the DNA methylation age, universal epigenetic age acceleration, intrinsic epigenetic age acceleration (IEAA), and extrinsic epigenetic age acceleration (EEAA). We also used Pearson correlation analysis and independent t-tests to analyze the data. Universal age acceleration correlated with the Frontal Assessment Battery test results (r = -0.42, p = 0.025); the EEAA correlated with the Word List Recognition test results (r = -0.41, p = 0.027). There was a significant difference between SCA and NCA groups in IEAA (p = 0.041, Cohen's d = 0.82) and EEAA (p = 0.042, Cohen's d = 0.78). Epigenetic age acceleration can be used as a biomarker for early detection of cognitive decline in Korean community-dwelling older adults. Large longitudinal studies are warranted.

Cognitive test norms and comparison to normal cognition and mild cognitive impairment: A population‐based study among community‐dwelling Filipinos

AbstractBackgroundClinicians use neuropsychological assessment to screen individuals for cognitive impairment since it more convenient and can detect impaired parts of cognition to provide early treatment. This study is aimed to differentiate the cognitive performance on the Alzheimer’s Disease Assessment Scale – Cognition (ADAS‐Cog) among the older adults with normal cognition and with MCI.MethodThe sample composed of 302 participants aged ≥60 years old who met the score of 25 in the Mini‐mental status examination (MMSE). Psychologists would then administer cognitive measures (ADAS‐Cog, logical memory recognition and delayed recall, verbal fluency on animals and vegetables, digit span forward and backward, digit symbol, and trailmaking A and B) upon meeting. ADAS‐Cog total and subtest scores were compared across the two groups. Receiver operating characteristics (ROC) analysis were performed and, sensitivity and specificity were calculated.ResultMost of the participants are female (81.8%) compared to males (17.9%). 64.2% has normal cognition while 35.8% of them have MCI. The mean age was 69.16 (±5.77) years and mean years of education of 9.11 (±3.57). The MCI group they have a cut‐off ADAS‐Cog score of 13.57(±5.49) (sensitivity= 0.63; specificity= 0.69) while the normal group have a score of 9.96 (±4.79). It also showed significant difference (t=5.971; p≤0.01) among the groups; domains showed a significant relationship i.e.: word list recall, naming, commands, ideational praxis, orientation, word list recognition (p≤0.01) and constructional praxis (p=0.015). Other cognitive measures besides digit symbol (t=1.578; p=0.116) are significant i.e. logical memory recognition and recall, verbal fluency on animals and vegetables, digit span forward and backward, and trailmaking A and B (p≤0.01).ConclusionThe ADAS‐Cog is inapplicable as a screening tool for MCI but specific for MCI diagnosis. There is significant difference found between functional impairment among MCI and normal cognition in the overall and subtests scores.

Renal dysfunction is associated with decline of cognitive function in community-dwelling older adults: Korean frailty and aging cohort study

BackgroundCognitive decline is common in older adults. Similarly, the prevalence of renal dysfunction is also increased in the elderly population. We conducted this study to clarify the relationship between renal dysfunction and decline of cognitive function in community-dwelling elderly population.MethodsA cross-sectional analysis was performed using data from the Korean Frailty and Aging Cohort Study, a nationwide cohort study. Total 2847 (1333 men, 1514 women) eligible participants were enrolled for this study. The estimated glomerular filtration rate (eGFR, mL/min/1.73m2) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Global cognitive function was assessed with the Mini-mental State Examination-Korean version. Other domains of cognitive function were tested with the Consortium to Establish a Registry for Alzheimer’s disease and the Frontal Assessment Battery.ResultsThe mean age of all participants was 76.0 ± 3.9 years and eGFR (all in mL/min/1.73 m2) was 77.5 ± 14.3. And the mean eGFR was 91.7 ± 3.2 in quartile 1, 84.9 ± 1.8 in quartile 2, 76.1 ± 3.7 in quartile 3, and 57.2 ± 10.8 in quartile 4. In baseline characteristics, participants with lower eGFR tend to have lower cognitive function scores than participant with higher eGFR. In linear regression analysis, eGFR was correlated with the word list memory (β = 0.53, P = 0.005), word list recall (β = 0.86, P < 0.001), and word list recognition (β = 0.43, P = 0.030) after adjustment of confounding variables. Moreover, after multivariate adjustment the association with cognitive impairment in quartile 2 was stronger (adjusted OR: 1.535, 95% CI: 1.111–2.120, P = 0.009), and the ORs of cognitive impairment were 1.501 (95% CI: 1.084–2.079, P = 0.014) in quartile 3 and 1.423 (95% CI: 1.022–1.983, P = 0.037) in quartile 4.ConclusionIn older adults, the immediate, recent memory, and recognition domains were significantly related to renal function. Also, the mild renal dysfunction was independently associated with impairment of global cognitive function. These results suggest that the early stages of renal dysfunction could be an effective target to prevent worsening of cognitive impairment. Therefore, regular monitoring and early detection of mild renal dysfunction in elderly population might be needed.

SUN-353 Physical and Cognitive Functioning Before and Six Months After Initiating Enzyme Replacement Therapy for an Adult with Hypophosphatasia: A Case Study

We present changes on physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) assessments for a patient pre- and 6 months post-initiation of recombinant alkaline phosphatase therapy for hypophosphatasia (HPP).Our patient is a 30-year-old male diagnosed with pediatric onset HPP at the age of 28. Features of his HPP include skull deformities and scoliosis noted as a toddler, early loss of primary dentition with the root intact prior to the age of 4, severe bone and muscle pain described as “severe growing pain”, and fatigue as a teenager. He was noted to have arthritis in his feet requiring surgical fusion, which was complicated by nonunion. By the age of 30, he required the use of assistive devices for ambulation due to fatigue and pain. Biochemistry was notable for ALP 17U/L (40-150), serum PLP 241 mcg/L (5-50), urine phosphethanolamine 47 nmolmgCr (0-27), and genetic testing demonstrated a variant of undetermined significance of ALPL genet (Het. C.1364G>A p.Gly455Asp).PT and OT assessments included a thorough musculoskeletal and neurologic examination, as well as functional testing of mobility, balance, motor control, and activity of daily living tasks. After 6 months of enzyme replacement therapy (ERT), the patient’s scores on measures of body structure and function were grossly unchanged or diminished (muscle strength). However, activity-based measures of functional performance generally improved on ERT. Performance on the Five Times Sit to Stand Test (FTSTS), gait speed, Functional Gait Assessment, Sensory Organization Test, and Six-Minute Walk Test (6MWT) improved. His most significant improvements were on the FTSTS and 6MWT; his FTSTS improved from 15.4 seconds to 9.1 seconds, surpassing the cut-off for falls risk (12s), while his 6MWT improved from 1,228 feet to 1,541 feet, surpassing the minimal detectable change for individuals with osteoarthritis (201 ft).Cognitive testing revealed improvement in delayed memory (e.g., word-list recognition, story-retell) on the Repeatable Battery of the Assessment of Neuropsychological Status from baseline (7%tile) to 6 months post therapy (47%tile). He also demonstrated improvement in Trail Making Part A [TM A, cognitive processing speed] & TM B (executive functioning) from baseline (45s, 49s) to 6 months post therapy (21s, 38s). Mean performance on TM A&B for adults 25-34 yrs is 24.4s±8.71 and 50.7s±12.4, respectively.Overall, the patient demonstrated improvement in delayed memory, cognitive processing speed and executive functioning on ERT. Additionally, while his performance on bedside impairment-based testing generally declined or remained unchanged, his performance on standardized functional assessments improved on ERT. These functional improvements in physical and cognitive domains likely enable the patient to more fully participate in life roles to improve quality of life.