scholarly journals MIND Diet, Common Brain Pathologies, and Cognition in Community-Dwelling Older Adults

2021 ◽  
pp. 1-10
Author(s):  
Klodian Dhana ◽  
Bryan D. James ◽  
Puja Agarwal ◽  
Neelum T. Aggarwal ◽  
Laurel J. Cherian ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Functioning ◽  
Sex Education ◽  
The Elderly ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Postmortem Diagnosis ◽  
Cognitive Activities ◽  
The Mind ◽  
Mind Diet

Background: MIND diet, a hybrid of the Mediterranean diet and the Dietary Approaches to Stop Hypertension diet, is associated with a slower cognitive decline and lower risk of Alzheimer’s disease (AD) dementia in older adults. Objective: We aim to examine whether the association of the MIND diet with cognition is independent of common brain pathologies. Methods: Utilizing data from the Rush Memory and Aging Project (MAP), a longitudinal clinical-pathologic study, we studied 569 decedents with valid dietary data, cognitive testing proximate to death, and complete autopsy data at the time of these analyses. A series of regression analyses were used to examine associations of the MIND diet, dementia-related brain pathologies, and global cognition proximate to death adjusting for age, sex, education, APOE ɛ4, late-life cognitive activities, and total energy intake. Results: A higher MIND diet score was associated with better global cognitive functioning proximate to death (β= 0.119, SE = 0.040, p = 0.003), and neither the strength nor the significance of association changed substantially when AD pathology and other brain pathologies were included in the model. The β-estimate after controlling for global AD pathology was 0.111 (SE = 0.037, p = 0.003). The MIND diet-cognition relationship remained significant when we restricted our analysis to individuals without mild cognitive impairment at the baseline (β= 0.121, SE = 0.042, p = 0.005) or in people diagnosed with postmortem diagnosis of AD based on NIA-Reagan consensus recommendations (β= 0.114, SE = 0.050, p = 0.023). Conclusion: MIND diet is associated with better cognitive functioning independently of common brain pathology, suggesting that the MIND diet may contribute to cognitive resilience in the elderly.

scholarly journals Dual-task gait speed and mobility are positively associated with declarative memory

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 879-879
Author(s):  
Michelle Gray ◽  
Sally Paulson ◽  
Joshua Gills ◽  
Erica Madero ◽  
Jennifer Myers ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Physical Function ◽  
Sex Education ◽  
Dual Task ◽  
Declarative Memory ◽  
Peak Velocity ◽  
Paired Comparison ◽  
Community Dwelling ◽  
Cognitive Testing

Abstract In the US, it is not recommended to perform routine screening assessments for cognitive function or impairment among older adults, due to the lack of effective pharmacological treatments. These common practices result in delayed identification and treatments for slowing cognitive decline progression. Thus, the purpose of the present investigation was to determine the ability to predict cognition from common measures of physical function. Seventy-five community-dwelling older adults (80.7±5.4 years) completed physical function and cognitive assessments. Physical function was assessed using the Short Physical Performance Battery (SPPB), peak velocity during a power sit-to-stand task, and dual-task walking test. Cognition (declarative memory) was assessed using a validated Visual Paired Comparison test. 38% of the variance in cognition was accounted for by the predictor variables (age, sex, education, SPPB, dual-task, peak velocity). Significant predictors included dual-task walking (p = .03), SPPB (p = .02), and education (p = .02). For each 1 second faster during the dual-task performance, cognition increased by 4 percentile units. Likewise, each 1 unit increase in SPPB resulted in an increase of 4 percentile points in cognition. The results indicate more than a third of the variance in declarative memory can be predicted by commonly assessed measures of physical function. This information is useful when identifying older adults that may have cognitive impairment before overt signs are realized. With the lack of recommended cognitive testing, using physical function declines to identify possible cognitive decline is promising. These results are preliminary in nature and longitudinal determination is warranted.

scholarly journals Dietary Patterns and Self-reported Incident Disability in Older Adults

2018 ◽  
Vol 74 (8) ◽  
pp. 1331-1337 ◽  
Author(s):  
Puja Agarwal ◽  
Yamin Wang ◽  
Aron S Buchman ◽  
David A Bennett ◽  
Martha C Morris
Keyword(s):  
Older Adults ◽  
Sex Education ◽  
Functional Disability ◽  
Cox Proportional Hazards ◽  
Hazard Ratio ◽  
Mobility Disability ◽  
The Mediterranean ◽  
Adl Disability ◽  
The Mind ◽  
Mind Diet

Abstract Background or Objectives Disability in older adults is associated with low quality of life and higher mortality. Diet may be a potentially important public health strategy for disability prevention in aging. We examined the relations of the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean–DASH Intervention for Neurodegenerative Delay (MIND) diets to functional disability in the Rush Memory and Aging Project. Methods A total of 809 participants (mean age = 80.7 ± 7.2 years, 74% female) without functional disability at baseline were followed for an average of 5.3 years. Standardized measures for self-reported disability including, activities of daily living ADL), instrumental ADL, and mobility disability were assessed annually. The diet scores were computed based on a validated food frequency questionnaire administered at baseline. Results In Cox proportional hazards models adjusted for age, sex, education, smoking, physical activity, and total calories, the second (hazard ratio = 0.75, 95% CI: 0.60–0.95) and third tertiles (hazard ratio = 0.67, 95% CI: 0.53–0.86) of MIND diet scores had lower rates of ADL disability compared to the lowest tertile (p for trend = .001), whereas only the third tertiles of the Mediterranean (hazard ratio = 0.73, 95% CI: 0.57–0.94) and DASH (hazard ratio = 0.75, 95% CI: 0.59–0.95) diets were significantly associated with ADL disability. Instrumental ADL disability was inversely and linearly associated with the MIND diet score only (p for trend = .04). Mobility disability was associated with the MIND (p for trend = .02), Mediterranean (p for trend = .05) and DASH (p for trend = .02) diet scores. Conclusion These findings are encouraging that diet may be an effective strategy for the prevention of functional disability in older adults.

scholarly journals A Modified CAIDE Risk Score as a Screening Tool for Cognitive Impairment in Older Adults

2021 ◽  
pp. 1-14
Author(s):  
Magdalena I. Tolea ◽  
Jaeyeong Heo ◽  
Stephanie Chrisphonte ◽  
James E. Galvin
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Risk Score ◽  
Clinical Sample ◽  
Community Sample ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Risk Scores ◽  
Predictive Values

Background: Although an efficacious dementia-risk score system, Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) was derived using midlife risk factors in a population with low educational attainment that does not reflect today’s US population, and requires laboratory biomarkers, which are not always available. Objective: Develop and validate a modified CAIDE (mCAIDE) system and test its ability to predict presence, severity, and etiology of cognitive impairment in older adults. Methods: Population consisted of 449 participants in dementia research (N = 230; community sample; 67.9±10.0 years old, 29.6%male, 13.7±4.1 years education) or receiving dementia clinical services (N = 219; clinical sample; 74.3±9.8 years old, 50.2%male, 15.5±2.6 years education). The mCAIDE, which includes self-reported and performance-based rather than blood-derived measures, was developed in the community sample and tested in the independent clinical sample. Validity against Framingham, Hachinski, and CAIDE risk scores was assessed. Results: Higher mCAIDE quartiles were associated with lower performance on global and domain-specific cognitive tests. Each one-point increase in mCAIDE increased the odds of mild cognitive impairment (MCI) by up to 65%, those of AD by 69%, and those for non-AD dementia by >  85%, with highest scores in cases with vascular etiologies. Being in the highest mCAIDE risk group improved ability to discriminate dementia from MCI and controls and MCI from controls, with a cut-off of ≥7 points offering the highest sensitivity, specificity, and positive and negative predictive values. Conclusion: mCAIDE is a robust indicator of cognitive impairment in community-dwelling seniors, which can discriminate well between dementia severity including MCI versus controls. The mCAIDE may be a valuable tool for case ascertainment in research studies, helping flag primary care patients for cognitive testing, and identify those in need of lifestyle interventions for symptomatic control.

Predictors of Physical Activity Levels in Community-Dwelling Older Adults: A Multivariate Approach Based on a Socio-Ecological Framework

2018 ◽  
Vol 26 (1) ◽  
pp. 114-120 ◽  
Author(s):  
Koren L. Fisher ◽  
Elizabeth L. Harrison ◽  
Brenda G. Bruner ◽  
Joshua A. Lawson ◽  
Bruce A. Reeder ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Environmental Factors ◽  
The Elderly ◽  
Home Care Services ◽  
Community Dwelling ◽  
Nursing Home Care ◽  
Activity Levels ◽  
Inverse Association ◽  
Cross Sectional

The purpose of this study was to explore cross-sectional relationships between self-reported physical activity (PA) and personal, social, and environmental factors in community-dwelling adults aged 50 years and older. Accounting for clustering by neighborhood, generalized estimating equations were used to examine associations between selected correlates and the Physical Activity Scale for the Elderly (PASE) score while adjusting for confounders. Data for 601 participants were analyzed: 79% female, 37% married, mean age 76.8 (± 8.7) years, mean PASE score 112.6 (± 64.8). Age, living in seniors’ housing, using nursing/home care services, receiving encouragement to be active, and having benches available in the neighborhood were inversely associated with PASE. Self-efficacy, SF-12 score, PA barriers, social support, and the presence of trails showed positive associations. Several personal, social, and environmental factors associated with PA were identified. The inverse association between PA and living in seniors’ housing units should be considered when developing PA programs for older adults.

Abstract 22: Visit-to-Visit Variability in Blood Pressure is Related to Late-Life Cognitive Decline

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Bo Qin ◽  
Anthony J Viera ◽  
Linda S Adair ◽  
Brenda L Plassman ◽  
Lloyd J Edwards ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Verbal Memory ◽  
Repeated Measures ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Nutrition Survey

Introduction: Recent studies suggest higher visit-to-visit variability of blood pressure (BP) is associated with worse cognitive function, but evidence based on longitudinal cognitive testing has not been reported. Hypothesis: We assessed the hypothesis that higher visit-to-visit variability in BP, but not mean BP, would be associated with faster decline in cognitive function among community-dwelling older adults. Methods: This prospective cohort study comprised 1213 adults who had two or more waves of BP measurements as part of the China Health and Nutrition Survey from 1991, up to their first cognitive tests, and completed a cognitive screening test at two or more waves in 1997, 2000 or 2004. Mean (SD) age at first cognitive test was 64 (6) y. Outcomes were repeated measures of global cognitive scores (baseline mean ± SD: 19 ± 6 points), standardized composite cognitive and verbal memory scores (standardized units [SU]). Visit-to visit BP variability was expressed as the standard deviation [SD] or as the variation independent of mean (SD/mean^x, with x derived from curve fitting) in BP measures obtained at a mean interval of 3.6 years. Multivariable-adjusted linear mixed-effects models were used to determine the association of changes in cognitive scores with visit-to visit BP variability. Results: Higher visit-to-visit variability in systolic BP, but not mean systolic BP, was associated with a faster decline of cognitive function (adjusted mean difference [95% CI] for high vs. low tertile of SD in variability (Figure): global score -0.23 points/y [-0.41 to -0.04], composite scores -0.029 SU/y [-0.056 to -0.002] and verbal memory -0.044 SU/y [-0.075 to -0.012]). Higher visit-to-visit variability in diastolic BP was associated with a faster decline of global cognitive function only among adults 55-64 years, independent of mean diastolic BP. Conclusion: Higher long-term BP visit-to-visit variability predicted a faster rate of cognitive decline among older adults.

scholarly journals Childhood infectious diseases and old age cognitive functioning: a nationally representative sample of community-dwelling older adults

2020 ◽  
pp. 1-8
Author(s):  
A. Rotstein ◽  
S. Z. Levine
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Infectious Diseases ◽  
Cognitive Functioning ◽  
Old Age ◽  
Early Life ◽  
Representative Sample ◽  
Community Dwelling ◽  
Sensitivity Analyses ◽  
Nationally Representative

ABSTRACT Background: Cumulative evidence suggests that health-related risk factors during midlife and old-age are associated with cognitive impairment. However, studies are needed to clarify the association between early-life risk factors and impaired cognitive functioning to increment existing knowledge. Objective: To examine the association between childhood infectious diseases and late-life cognitive functioning in a nationally representative sample of older adults. Participants: Eligible respondents were 2994 community-dwelling individuals aged 65–85. Measurements: Cognitive functioning was assessed using the Mini-Mental State Examination (MMSE). Childhood infectious diseases (i.e. chicken pox, measles, and mumps) were self-reported. The study covariates were age, sex, highest educational level achieved, smoking status, body mass index, and depression. The primary statistical analysis examined the association between the number of childhood infectious diseases and total MMSE scores, accounting for all study covariates. Regression models of progressive complexity were examined for parsimony. The robustness of the primary results was tested in 17 sensitivity analyses. Results: The most parsimonious model was a linear adjusted model (Bayesian Information Criterion = 12646.09). Late-life cognitive functioning significantly improved as the number of childhood infectious diseases increased (β = 0.18; 95% CI = 0.11, 0.26; p < 0.001). This effect was not significantly attenuated in all sensitivity analyses. Conclusion: The current study results are consistent with prior ecological findings indicating that some childhood infectious diseases are associated with better cognitive functioning in old-age. This points to an early-life modifiable risk factor associated with older-life cognitive functioning. Our results may reflect selective mortality and/or beneficial effects via hormetic processes.

scholarly journals The Effectiveness of a Dyadic Pain Management Program for Community-Dwelling Older Adults with Chronic Pain: A Pilot Randomized Controlled Trial

2020 ◽  
Vol 17 (14) ◽  
pp. 4966
Author(s):  
Ziyan Li ◽  
Mimi Tse ◽  
Angel Tang
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Controlled Trial ◽  
The Elderly ◽  
Management Program ◽  
Community Dwelling ◽  
Control Group ◽  
Pain Management Program ◽  
Community Dwelling Older Adults ◽  
Experimental Group

Background: Chronic pain is a major health problem among older adults and their informal caregivers, which has negative effects on their physical and psychological status. The dyadic pain management program (DPMP) is provided to community-dwelling older adults and informal caregivers to help the dyads reduce pain symptoms, improve the quality of life, develop good exercise habits, as well as cope and break the vicious circle of pain. Methods: A pilot randomized controlled trial was designed and all the dyads were randomly divided into two groups: the DPMP group and control group. Dyads in the DPMP group participated in an 8-week DPMP (4-week face-to-face program and 4-week home-based program), whereas dyads in the control group received one page of simple pain-related information. Results: In total, 64 dyads participated in this study. For baseline comparisons, no significant differences were found between the two groups. After the interventions, the pain score was significantly reduced from 4.25 to 2.57 in the experimental group, respectively. In the repeated measures ANOVA, the differences in pain score (F = 107.787, p < 0.001, d = 0.777) was statistically significant for the group-by-time interaction. After the interventions, the experimental group participants demonstrated significantly higher pain self-efficacy compared with the control group (F = 80.535, p < 0.001, d = 0.722). Furthermore, the elderly increased exercise time significantly (F = 111.212, p < 0.001, d = 0.782) and reported developing good exercise habits. Conclusions: These results provide preliminary support for the effectiveness of a DPMP for relieving the symptoms of chronic pain among the elderly.

scholarly journals Is the prevalence of dehydration among community-dwelling older adults really low? Informing current debate over the fluid recommendation for adults aged 70+years

2005 ◽  
Vol 8 (8) ◽  
pp. 1275-1285 ◽  
Author(s):  
Jodi Dunmeyer Stookey ◽  
Carl F Pieper ◽  
Harvey Jay Cohen
Keyword(s):  
Older Adults ◽  
Functional Status ◽  
The Elderly ◽  
Community Dwelling ◽  
Plasma Sodium ◽  
Current Debate ◽  
Creatinine Ratio ◽  
Cross Sectional ◽  
Low Prevalence ◽  
Community Dwelling Older Adults

AbstractObjectiveThe fluid recommendation for adults aged 70+ years has been criticised on the basis of a low prevalence of dehydration in community-dwelling older adults. This study explores whether the low prevalence might reflect limitations of individual dehydration indices.DesignCross-sectional data on plasma sodium, blood urea nitrogen (BUN), creatinine, glucose and potassium were used to classify 1737 participants of the 1992 Established Populations for Epidemiologic Studies of the Elderly (EPESE) (70+ years) according to multiple dehydration indices. Associations between dehydration indices, health and functional status were evaluated.ResultsDepending on the indicator used, the prevalence of dehydration ranged from 0.5% for hypotonic hypovolaemia only (plasma tonicity <285 mOsm l−1 with orthostatic hypotension) to 60% with dehydration defined as either plasma sodium ≥145 mEq l−1, BUN/creatinine ratio ≥20, tonicity ≥295 mOsm l−1, or hypotonic hypovolaemia. Elevated tonicity and BUN/creatinine ratio were respectively associated with chronic disease and functional impairment.ConclusionsThe true prevalence of dehydration among community-dwelling adults may be low or high, depending on the indicator(s) used to define dehydration. Before we can pinpoint a generalisable prevalence of dehydration for community-dwelling seniors and draw conclusions about fluid recommendations, validation studies of dehydration indices and longitudinal studies of dehydration, health and functional status are needed.

scholarly journals ASSOCIATION BETWEEN THE NIH TOOLBOX COGNITION BATTERY AND GAIT IN OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S931-S931
Author(s):  
Kate Hamel ◽  
Sarah Barber ◽  
Carl Ketcham ◽  
Kristy Lui
Keyword(s):  
Older Adults ◽  
Sex Education ◽  
Stride Length ◽  
Dimensional Change ◽  
Community Dwelling ◽  
Trail Making Test ◽  
Card Sort ◽  
Cognitive Predictors ◽  
Trail Making ◽  
Temporal Measures

Abstract The relationship between older adults’ gait and cognition has been well-studied, however there is little consensus regarding a best set of measures to assess cognition. One option that has not been previously examined is the NIH Toolbox Cognition Battery (NIHT-CB), which was developed to be used across the lifespan and across research disciplines. This study examined the relationships between the seven subtests of the NIHT-CB, Trail-Making Tests A and B, and temporospatial measures of gait. One hundred sixty-seven healthy, community-dwelling older adults (115 females, 73.4 ± 4.5 years) completed these cognitive measures and also walked at their self-selected pace back-and-forth five times along a temporospatial-measuring walkway. The mean and coefficient of variation were calculated for each gait variable (stride length, width, time and velocity; stance/swing time and % of stride). After controlling for potential confounders (height, weight, age, sex, education, self-efficacy, health, exercise and falls history), executive function measures were typically the most significant cognitive predictors. More specifically, the Dimensional Change Card Sort task was the best predictor of temporal measures and stride velocity (all ps &lt; 0.001) and the Trail-Making Test Part B was the best predictor for variability measures (five of eight p-values &lt; 0.001). Interestingly, stride length and also stance and swing % of stride were strongly related to a measure of language - Picture Vocabulary (all ps &lt; 0.006). The NIHT-CB appears to be a useful tool for studies of gait in older adults, particularly when used in conjunction with Trail-Making Test B.

scholarly journals A Qualitative Exploration of Choral Singing in Community-dwelling Older Adults

2019 ◽  
Vol 42 (5) ◽  
pp. 340-347 ◽  
Author(s):  
Darina V. Petrovsky ◽  
Justine S. Sefcik ◽  
Pamela Z. Cacchione
Keyword(s):  
Older Adults ◽  
Low Socioeconomic Status ◽  
The Elderly ◽  
Community Dwelling ◽  
Main Theme ◽  
Choral Singing ◽  
Care For The Elderly ◽  
Qualitative Descriptive ◽  
Qualitative Exploration ◽  
Participatory Arts

Recent research has recognized the value of participatory arts, including choirs, as a strategy to engage older adults in the community. Less is known about the participation of minority older adults of low socioeconomic status (SES) in choirs. The purpose of this qualitative descriptive study was to explore the perceived benefits of choral singing among older adults from Program of All-Inclusive Care for the Elderly (PACE) day centers. We elicited perceptions from 19 choir participants from three focus groups, the majority of whom were Black or African American (N =17/19), each held at a different PACE center. One main theme emerged, “Something for us to do that we love,” with two subthemes, “Joyful time together” and “Uplifting experience performing for others.” These study findings have implications for promoting choir singing in older adults to serve as a place for engagement in social interactions in a lifelong activity they love.

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