Balance and cognitive decline in older adults in the cardiovascular health study

2021 ◽  
Author(s):  
Claire C Meunier ◽  
Ellen Smit ◽  
Annette L Fitzpatrick ◽  
Michelle C Odden
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
P Value ◽  
Digit Symbol Substitution Test ◽  
Cross Sectional ◽  
Symbol Substitution ◽  
Rate Of Decline

Abstract Background Previous studies have demonstrated an association between gait speed and cognitive function. However, the relationship between balance and cognition remains less well explored. This study examined the cross-sectional and longitudinal relationship of balance and cognitive decline in older adults. Methods A cohort of 4,811 adults, aged ≥65 years, participating in the Cardiovascular Health Study was followed for 6 years. Modified Mini-Mental State Examination (3MSE) and Digit Symbol Substitution Test (DSST) were used to measure cognition. Tandem balance measures were used to evaluate balance. Regression models were adjusted for demographics, behavioural and disease factors. Results Worse balance was independently associated with worse cognition in cross-sectional analysis. Longitudinally, participants aged ≥76 years with poorer balance had a faster rate of decline after adjustment for co-variates: −0.97 points faster decline in 3MSE per year (95% confidence interval (CI): −1.32, −0.63) compared to the participants with good balance. There was no association of balance and change in 3MSE among adults aged <76 years (P value for balance and age interaction < 0.0001). DSST scores reflected −0.21 (95% CI: −0.37, −0.05) points greater decline when adjusted for co-variates. In Cox proportional hazard models, participants with worse balance had a higher risk of being cognitively impaired over the 6 years of follow-up visits (adjusted HR:1.72, 95% CI: 1.30, 2.29). Conclusions Future studies should evaluate standing balance as a potential screening technique to identify individuals at risk of cognitive decline. Furthermore, a better understanding of the pathophysiological link between balance and cognition may inform strategies to prevent cognitive decline.

Abstract 04: Incident Heart Failure and Longitudinal Cognitive Trajectories in the Cardiovascular Health Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Christa Schank ◽  
Natalie J Blades ◽  
Sarwat I Chaudhry ◽  
John A Dodson ◽  
W T Longstreth ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Cognitive Decline ◽  
Cardiovascular Health ◽  
Self Report ◽  
Cognitive Test ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Incident Heart Failure ◽  
Rate Of Decline

OBJECTIVE: To determine whether older adults who develop incident heart failure (HF) experience faster cognitive decline than those without HF. METHODS: We analyzed longitudinal cognitive test data from the Cardiovascular Health Study, a community-based study of adults aged 65 years and older. Participants in this analysis did not have HF or history of stroke at baseline and were censored when they experienced incident clinical stroke. Incident HF was identified by self-report of physician-diagnosed HF and confirmed by adjudicated review of inpatient and outpatient medical records and medication use. Outcomes were mean score and rate of decline in mean score on the 100-point Modified Mini-Mental State Examination (3MSE), administered annually up to nine times from 1990 to 1998. A linear mixed effects model was used to model the relationship of cognitive decline with HF and age, adjusted for demographics, health behaviors, and comorbid conditions including hypertension and diabetes. RESULTS: Analyses included 5,211 participants with mean age 74 years at baseline, of whom 545 (10.5%) developed incident HF over a median follow-up of 7.8 years. Mean 3MSE score was lower at the time of HF diagnosis compared with no HF, and declined faster after incident HF compared with no HF. For example, at age 80, covariate-adjusted predicted mean 3MSE score was 88.6 points (95% CI: 88.3, 89.0) in participants without HF, but 87.6 points (95% CI: 87.3, 87.9) in those with newly diagnosed HF. Predicted five-year decline in mean 3MSE score from age 80 to age 85 was 5.9 points (95% CI: 5.7, 6.0) in participants without HF, but 10.0 points (95% CI: 8.6, 11.3) in those diagnosed with incident HF at age 80. Faster decline in 3MSE score after HF diagnosis was seen at all ages studied. The figure shows predicted mean 3MSE score trajectories without HF (solid line) and after HF diagnosed at ages 70, 75, 80, and 85 (dashed lines), with 95% CI shaded. CONCLUSIONS: Older adults diagnosed with incident HF experience faster average cognitive decline than those without HF.

scholarly journals Association of Balance Scores With Cognitive Function in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 155-155
Author(s):  
Claire Meunier ◽  
Ellen Smit ◽  
Annette Fitzpatrick ◽  
Michelle Odden
Keyword(s):  
Cognitive Function ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
P Value ◽  
Digit Symbol Substitution Test ◽  
Longitudinal Models ◽  
Balance Test ◽  
Cross Sectional ◽  
Longitudinal Association

Abstract Previous research has reported an association between balance and cognitive function; however, there is a paucity of data on this relationship over time. This study examined the cross-sectional and longitudinal association between balance and cognitive function in 4,811 participants aged 65 years and older in the Cardiovascular Health Study (CHS). Cognitive function measures included the Modified Mini-Mental State Examination (3MSE) and Digit Symbol Substitution Test (DSST); measures were collected annually for six years, starting in 1992-1993. A tandem stance balance test was administered at baseline; this test was held for 5 seconds. Cross-sectional and longitudinal models were adjusted for demographics, behavioral and disease covariates. We found that participants with worse balance scores had lower cognitive function scores, and this effect was limited to participant who were above the median age (76 years) (p-value for interaction = 0.03 in a demographic-adjusted model). Participants 76 years and older who failed the balance test had an average adjusted decline of -0.97 (95% CI: 1.20, 2.29) 3MSE scores per year more than participants who completed the balance test. DSST showed similar results; participants with poor balance decreased -0.21 (95% CI: -0.37, -0.05) points per year more than participants who completed the balance test. The adjusted Cox proportional hazard model found participants with poorer balance had a higher risk of cognitive impairment over the six years (HR= 1.72 95% CI: 1.30, 2.29). A better understanding of the pathophysiological link between balance and cognition may inform strategies to prevent cognitive decline.

scholarly journals Association Between Activity Diversity and Frailty in Community-Dwelling Older Japanese: A Cross-Sectional Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 185-185
Author(s):  
Junta Takahashi ◽  
Shuichi Obuchi ◽  
Hisashi Kawai ◽  
Kaori Ishii ◽  
Koichiro Oka ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Cardiovascular Health ◽  
Economic Status ◽  
Japanese Version ◽  
Community Dwelling ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Cross Sectional ◽  
Indirect Contact

Abstract In addition to intensity and quality, diversity of activity will be an important factor to explain health outcomes among older adults. Few studies, though, examined an association between activity diversity and health outcomes. This study aimed to examine the association between activity diversity and frailty among community-dwelling older Japanese. Participants were community-dwelling older adults who participated in a cohort study, the “Otassya-Kenshin” in 2018 . The participants were asked frequency of 20 daily activities, inside/outside chores, leisure activities with/without physically, direct/indirect contact with friends and so on, in a week and activity diversity score were calculated using the formula of Shannon’s entropy. Frailty was defined by the Japanese version of the Cardiovascular Health Study criteria. The difference in diversity score between frail and non frail were examined by t-test. Logistic regression analysis with covariates, age, sex, economic status, living alone, BMI, Mini-Mental State Examination, and IADL was adopted to find association between activity diversity score and presence of frailty. Of 652 participants (age: 72.8±6.3, women: 60.6%) analyzed, 27 (4.1%) were defined as frail. Frailty group revealed significantly lower activity diversity score than non-frailty group (0.66±0.11 vs 0.75±0.08, P<0.01). 0.2 point of decrease in diversity score increase 5 times chance of frailty after controlling covariates. We found significant relationship between activity diversity and health outcome among older subjects. The activity diversity may provide additional information to number or intensity of activity.

scholarly journals Hemostatic factor levels and cognitive decline in older adults: the Cardiovascular Health Study

2021 ◽  
Author(s):  
Laura B. Harrington ◽  
Alexa N. Ehlert ◽  
Evan L. Thacker ◽  
Nancy S. Jenny ◽  
Oscar Lopez ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Hemostatic Factor

scholarly journals Coagulation factor VIII, white matter hyperintensities and cognitive function: Results from the Cardiovascular Health Study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242062
Author(s):  
Jessica L. Rohmann ◽  
W. T. Longstreth ◽  
Mary Cushman ◽  
Annette L. Fitzpatrick ◽  
Susan R. Heckbert ◽  
...  
Keyword(s):  
Cognitive Function ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Cardiovascular Health ◽  
Coagulation Factor ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Digit Symbol Substitution Test ◽  
Cross Sectional ◽  
Over Time

Objective To investigate the relationship between high FVIII clotting activity (FVIII:C), MRI-defined white matter hyperintensities (WMH) and cognitive function over time. Methods Data from the population-based Cardiovascular Health Study (n = 5,888, aged ≥65) were used. FVIII:C was measured in blood samples taken at baseline. WMH burden was assessed on two cranial MRI scans taken roughly 5 years apart. Cognitive function was assessed annually using the Modified Mini-Mental State Examination (3MSE) and Digit Symbol Substitution Test (DSST). We used ordinal logistic regression models adjusted for demographic and cardiovascular factors in cross-sectional and longitudinal WMH analyses, and adjusted linear regression and linear mixed models in the analyses of cognitive function. Results After adjustment for confounding, higher levels of FVIII:C were not strongly associated with the burden of WMH on the initial MRI scan (OR>p75 = 1.20, 95% CI 0.99–1.45; N = 2,735) nor with WMH burden worsening over time (OR>p75 = 1.18, 95% CI 0.87–1.59; N = 1,527). High FVIII:C showed no strong association with cognitive scores cross-sectionally (3MSE>p75 β = -0.06, 95%CI -0.45 to 0.32, N = 4,005; DSST>p75 β = -0.69, 95%CI -1.52 to 0.13, N = 3,954) or over time (3MSE>p75 β = -0.07,95% CI -0.58 to 0.44, N = 2,764; DSST>p75 β = -0.22, 95% CI -0.97 to 0.53, N = 2,306) after confounding adjustment. Interpretation The results from this cohort study of older adult participants indicate no strong relationships between higher FVIII:C levels and WMH burden or cognitive function in cross-sectional and longitudinal analyses.

Abstract 029: Cardiovascular Health and Cognitive Decline in Older Adults: The Cardiovascular Health Study

Circulation ◽  
2019 ◽  
Vol 139 (Suppl_1) ◽  
Author(s):  
Kristine MaWhinney ◽  
Mamadou D Tounkara ◽  
Kirsten Evans ◽  
Emily Startup ◽  
Alexa Ehlert ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study

Abstract P348: Long-term Cognitive Decline in Older Adults After Incident Coronary Heart Disease or After First Receipt of Coronary Artery Bypass Grafting Surgery or Percutaneous Coronary Intervention

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Jacqueline E Kunzelman ◽  
Rachel M Gabor ◽  
Monica Scrobotovici ◽  
Natalie J Blades ◽  
W T Longstreth ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Cardiovascular Health ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Percutaneous Coronary

Objective: We investigated two hypotheses: First, incident CHD, defined as myocardial infarction or definite angina, leads to faster long-term cognitive decline. Second, among those with CHD, treatment with CABG surgery or PCI leads to slower long-term cognitive decline. Methods: The Cardiovascular Health Study is a cohort of US adults aged 65+. Global cognitive ability was assessed annually up to 9 times from 1990 to 1998 with the 100-point Modified Mini-Mental State Examination (3MS). We estimated trajectories of 3MS scores in the absence of stroke, adjusting for demographics, health behaviors, and comorbidities. For hypothesis 1, we compared 3MS trajectory after incident CHD with 3MS trajectory in the absence of CHD, censoring at first receipt of CABG/PCI. For hypothesis 2, among participants with CHD, we compared 3MS trajectory after first receipt of CABG/PCI with 3MS trajectory without CABG/PCI. Results: For hypothesis 1, of 4,122 participants, 398 had incident CHD during a mean of 5.9 years of follow-up. Figure Panel A shows model-predicted mean 3MS trajectories without CHD (blue) and after incident CHD (red) diagnosed at ages 70, 75, 80, or 85. Model-predicted 3MS score declined faster after incident CHD, especially for CHD diagnosed at age 80 or later. For example, after incident CHD at age 85, predicted 5-year decline in mean 3MS score through age 90 was 13.9 points (95% CI: 11.0, 16.7) versus 8.9 points (95% CI: 8.1, 9.7) among those without CHD. For hypothesis 2, of 1,183 participants who had prevalent or incident CHD, 118 had their first CABG/PCI during a mean of 4.1 years of follow-up. Model-predicted 3MS score declined faster after first receipt of CABG/PCI ( Figure Panel B ). Conclusions: Older adults diagnosed with incident CHD had faster average cognitive decline than those without CHD. However, treatment with CABG/PCI did not slow cognitive decline among those with CHD. This finding may be due to adverse effects of CABG/PCI on brain health or CABG/PCI recipients having more severe CHD or more cerebral atherosclerosis.

Cognitive decline in older adults with epilepsy: The Cardiovascular Health Study

Epilepsia ◽  
2020 ◽  
Author(s):  
Hyunmi Choi ◽  
Evan L. Thacker ◽  
William T. Longstreth ◽  
Mitchell S. V. Elkind ◽  
Amelia K. Boehme
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study
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