Association Between Anxiety and Cognitive Decline Over 12 Years in a Population-Based Cohort

2021 ◽  
pp. 1-10
Author(s):  
Scherazad Kootar ◽  
Md Hamidul Huque ◽  
Richard Arthur ◽  
Moyra Mortby ◽  
Kaarin J. Anstey
Keyword(s):  
Cognitive Decline ◽  
Processing Speed ◽  
Population Based ◽  
Anxiety Symptoms ◽  
Community Dwelling ◽  
Confounding Factors ◽  
Psychomotor Speed ◽  
Confounding Variables ◽  
Community Dwelling Older Adults

Background: Findings on the associations between anxiety and cognitive decline are mixed and often confounded. Objective: We studied whether anxiety symptoms were associated with the risk of cognitive decline after adequate adjustment of confounding factors. Methods: Our study consists of 2,551 community-dwelling older adults recruited between the ages of 60–64 years and followed up for 12 years in the PATH Through Life cohort study. Anxiety symptoms were measured using the Goldberg Anxiety Scale (GAS; range 0–9). General cognitive function, episodic memory, working memory, verbal intelligence, processing speed, and psychomotor speed were measured. Multilevel analyses were carried out to investigate the association between anxiety symptoms and cognitive decline over 12 years, taking into account confounding variables. Results: We did not find a significant association between baseline anxiety symptoms and cognitive decline over 12 years. Although some associations between anxiety symptoms with psychomotor speed (β= –0.04, 99%CI: –0.08, 0.00) and processing speed (β= –0.27, 99%CI: –0.48, –0.07) were found, these were attenuated after adjusting for depression. We also did not find an association between cumulative anxiety and decline in cognitive performance. Conclusion: In this sample of cognitively healthy men and women aged 60 years and above, anxiety symptoms were not associated with the risk of cognitive decline. Long follow-up study time, appropriate selection of confounding factors, and estimating the effect of cumulative anxiety are important to establish the association between anxiety and cognitive symptoms.

scholarly journals Personality-Related Determinants of Subtle Cognitive Decline in Old Age: A Population-Based Study

2016 ◽  
Vol 6 (1) ◽  
pp. 120-132 ◽  
Author(s):  
Cristelle Rodriguez ◽  
Emiliano Albanese ◽  
Alan Pegna ◽  
Simona Toma ◽  
Marine Ackermann ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Protective Factor ◽  
Brain Aging ◽  
Population Based ◽  
Community Dwelling ◽  
Personality Factors ◽  
Healthy Controls ◽  
Logistic Regression Models ◽  
Healthy Elderly

Background/Aims: Recent studies of cases with mild cognitive impairment (MCI) suggested that besides Alzheimer disease (AD)-related biomarkers, some personality dimensions are associated with progression to AD. To date, there are no studies addressing the psychological determinants of subtle cognitive decline in healthy elderly controls. Methods: 488 community-dwelling healthy controls were assessed with a detailed neuropsychological battery at baseline and an 18-month follow-up. Personality factors and facets were investigated at baseline using the NEO-Personality Inventory-Revised (NEO-PI-R). Upon follow-up, there were 264 stable controls (sCON) and 224 deteriorating controls (dCON). Their personality data were compared to those of the 102 MCI cases using one-way analysis of variance and logistic regression models. Results: Significantly higher scores of Openness factor (as well as Aesthetics, Ideas and Values facets) were found in sCON than in both dCON and MCI cases. The three groups did not differ in the other NEO-PI-R factor and facet scores. Openess factor (and the same facets) was associated with cognitive preservation in healthy controls (OR: 0.72, 95% CI: 0.59, 0.87). Lower scores in the same factor and facets conferred higher risk to have MCI (OR: 0.61, 95% CI: 0.46, 0.79). Conclusion: Higher openness to new experiences and thoughts may be a protective factor against early cognitive decline in brain aging.

scholarly journals Association Between Urate-Lowering Therapies and Cognitive Decline in Community-Dwelling Older Adults: A Post-Hoc Analysis of the MAPT Study.

2021 ◽  
Author(s):  
Luc MOLET-BENHAMOU ◽  
Kelly VIRECOULON GIUDICI ◽  
Philipe BARRETO ◽  
Yves ROLLAND
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Composite Score ◽  
Cognitive Score ◽  
Using Data ◽  
Community Dwelling Older Adults

Abstract Introduction Long-term use of urate-lowering therapies (ULT) may reduce inflammaging and thus prevent cognitive decline during aging. This article examined the association between long-term use of ULT and cognitive decline among community-dwelling older adults with spontaneous memory complaints. Material and methods We performed a secondary observational analysis using data of 1,673 participants ≥ 70 years old from the Multidomain Alzheimer Preventive Trial (MAPT Study), a randomized controlled trial assessing the effect of a multidomain intervention, the administration of polyunsaturated fatty acids (PUFA), both, or placebo on cognitive decline. We compared cognitive decline during the 5-year follow-up between three groups according to ULT use: participants treated with ULT during at least 75% of the study period (PT ≥ 75; n = 51), less than 75% (PT < 75; n = 31), and non-treated participants (PNT; n = 1,591). Cognitive function (measured by a composite score) was assessed at baseline, 6 months and every year for 5 years. Linear mixed models were performed and adjusted for age, sex, body mass index (BMI), diagnosis of arterial hypertension or diabetes, baseline composite cognitive score, and MAPT intervention groups. Results After the 5-year follow-up, only non-treated participants presented a significant decline in the cognitive composite score (mean change − 0.173, 95%CI -0.212 to -0.135; p < 0.0001). However, there were no differences in change of the composite cognitive score between groups (adjusted between-group difference for PNT vs. PT < 75: 0.089, 95%CI -0.160 to 0.338, p = 0.484; PNT vs. PT ≥ 75: 0.174, 95%CI -0.042 to 0.391, p = 0.115). Conclusion Use of ULT was not associated with reduced cognitive decline over a 5-year follow-up among community-dwelling older adults at risk of dementia.

scholarly journals Higher Serum Brain-Derived Neurotrophic Factor Levels Are Associated With a Lower Risk of Cognitive Decline: A 2-Year Follow Up Study in Community-Dwelling Older Adults

2021 ◽  
Vol 15 ◽  
Author(s):  
Yoshinori Fujiwara ◽  
Kazushige Ihara ◽  
Mitsugu Hachisu ◽  
Hiroyuki Suzuki ◽  
Hisashi Kawai ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Neurotrophic Factor ◽  
Lower Risk ◽  
Community Dwelling ◽  
Baseline Serum ◽  
Bottom Quartile ◽  
Community Dwelling Older Adults ◽  
Serum Bdnf

ObjectiveTo assess the relationship of serum brain-derived neurotrophic factor (BDNF) levels with the subsequent short-term decline in cognitive functioning in community-dwelling older adults.DesignTwo-year prospective, observational study.Setting and ParticipantsThe study included 405 adults aged 65–84 years, initially free of a dementia diagnosis who were living in Tokyo, Japan.MethodsParticipants underwent health assessments at baseline (2011) and follow-up (2013). Serum BDNF levels and scores from the Montreal Cognitive Assessment-Japanese version (MoCA-J) were systematically measured. Logistic regression was used to estimate the odds of cognitive decline between baseline and follow-up assessments in the full MoCA-J scale (operationally defined as a decrease of two or more points), as well as in MoCA-J subscales (decline of one or more points in a specific subscale), as a function of serum BDNF level, adjusting for baseline demographics, prevalent chronic diseases, and baseline cognitive scores.ResultsAmong individuals who performed worse on the full MoCA-J at baseline (i.e., scores in the bottom quartile [≤21], which is consistent with a mild cognitive impairment status), but not among those who performed better (top 3 quartiles), those with highest baseline serum BDNF levels (top quartile) had lower odds of subsequent decline in the full MoCA-J scale than those with lowest (bottom quartile); i.e., odds ratio (OR): 0.10 (95% confidence interval [CI]: 0.02–0.62; p = 0.013). Regarding MoCA-J subscales, adjusted odds of decline in the executive function subscale, but not in the other five subscales, were substantially low among those with highest baseline serum BDNF levels (top quartile), as compared to those with the lowest (bottom quartile), i.e., OR: 0.27 (95% CI:0.13–0.60; p &lt; 0.001).Conclusion and ImplicationsHigher serum BDNF levels were associated with a lower risk of decline in cognitive function in a sample of community-dwelling older Japanese adults. Risk varied across cognitive subdomains and according to baseline cognition. This warrants further research to evaluate the added-value of serum BDNF in health promotion initiatives directed toward cognitive decline prevention in community-dwelling older adults.

Enhancing precision of the 16-item Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16) using Rasch methodology

2021 ◽  
pp. 1-11
Author(s):  
Quoc Cuong Truong ◽  
Carol Choo ◽  
Katya Numbers ◽  
Alexander G. Merkin ◽  
Perminder S. Sachdev ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Rasch Model ◽  
Interval Data ◽  
The Elderly ◽  
Community Dwelling ◽  
Model Fit ◽  
Level Scale ◽  
Clinical Conditions ◽  
Community Dwelling Older Adults

Abstract Objective: This study aimed to investigate psychometric properties and enhance precision of the 16-item Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16) up to interval-level scale using Rasch methodology. Design: Partial Credit Rasch model was applied to the IQCODE-16 scores using longitudinal data spanning 10 years of biennial follow-up. Setting: Community-dwelling older adults aged 70–90 years and their informants, living in Sydney, Australia, participated in the longitudinal Sydney Memory and Ageing Study (MAS). Participants: The sample included 400 participants of the MAS aged 70 years and older, 109 out of those were diagnosed with dementia 10 years after the baseline assessment. Measurements: The IQCODE-16. Results: Initial analysis indicated excellent reliability of the IQCODE-16, Person Separation Index (PSI) = 0.92, but there were four misfitting items and local dependency issues. Combining locally dependent items into four super-items resulted in the best Rasch model fit with no misfitting or locally dependent items, strict unidimensionality, strong reliability, and invariance across person factors such as participants’ diagnosis and relationship to their informants, as well as informants’ age and sex. This permitted the generation of conversion algorithms to transform ordinal scores into interval data to enhance precision of measurement. Conclusions: The IQCODE-16 demonstrated strong reliability and satisfied expectations of the unidimensional Rasch model after minor modifications. Ordinal-to-interval transformation tables published here can be used to increase accuracy of the IQCODE-16 without altering its current format. These findings could contribute to enhancement of precision in assessing clinical conditions such as cognitive decline in older people.

scholarly journals Apathy and cognitive and functional decline in community-dwelling older adults: results from the Baltimore ECA longitudinal study

2010 ◽  
Vol 22 (5) ◽  
pp. 819-829 ◽  
Author(s):  
Diana E. Clarke ◽  
Jean Y. Ko ◽  
Constantine Lyketsos ◽  
George W. Rebok ◽  
William W. Eaton
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
General Health Questionnaire ◽  
Functional Decline ◽  
Population Based ◽  
Community Dwelling ◽  
Public Health Importance ◽  
Cross Sectional ◽  
Prevalence Estimates

ABSTRACTBackground: Apathy, a complex neuropsychiatric syndrome, commonly affects patients with Alzheimer's disease. Prevalence estimates for apathy range widely and are based on cross-sectional data and/or clinic samples. This study examines the relationships between apathy and cognitive and functional declines in non-depressed community-based older adults.Methods: Data on 1,136 community-dwelling adults aged 50 years and older from the Baltimore Epidemiologic Catchment Area (ECA) study, with 1 and 13 years of follow-up, were used. Apathy was assessed with a subscale of items from the General Health Questionnaire. Logistic regression, t-tests, χ2 and Generalized Estimating Equations were used to accomplish the study's objectives.Results: The prevalence of apathy at Wave 1 was 23.7%. Compared to those without, individuals with apathy were on average older, more likely to be female, and have lower Mini-mental State Examination (MMSE) scores and impairments in basic and instrumental functioning at baseline. Apathy was significantly associated with cognitive decline (OR = 1.65, 95% CI = 1.06, 2.60) and declines in instrumental (OR = 4.42; 95% CI = 2.65, 7.38) and basic (OR = 2.74; 95%CI = 1.35, 5.57) function at 1-year follow-up, even after adjustment for baseline age, level of education, race, and depression at follow-up. At 13 years of follow-up, apathetic individuals were not at greater risk for cognitive decline but were twice as likely to have functional decline. Incidence of apathy at 1-year follow up and 13-year follow-up was 22.6% and 29.4%, respectively.Conclusions: These results underline the public health importance of apathy and the need for further population-based studies in this area.

Pre-Dementia Stages and Incident Dementia in the NuAge Study

2021 ◽  
Vol 80 (4) ◽  
pp. 1465-1470
Author(s):  
Olivier Beauchet ◽  
Harmehr Sekhon ◽  
Cyrille P. Launay ◽  
Pierrette Gaudreau ◽  
José A. Morais ◽  
...  
Keyword(s):  
Older Adults ◽  
Successful Aging ◽  
Population Based ◽  
Community Dwelling ◽  
Cognitive Risk ◽  
Incident Dementia ◽  
Annual Visit ◽  
Observational Cohort ◽  
Community Dwelling Older Adults

Background: Motoric cognitive risk syndrome (MCR) and mild cognitive impairment (MCI) are two pre-dementia stages with an overlap, which may influence the risk for dementia. Objective: The study aims to examine the association of MCR, MCI, and their combination with incident dementia in Quebec community-dwelling older adults. Methods: 1,063 older adults (i.e., ≥65) were selected from a population-based observational cohort study known as the “Nutrition as a determinant of successful aging: The Quebec longitudinal study” (NuAge). Participants were separated into four groups at the baseline assessment: those without MCR and MCI (i.e., cognitively healthy individual; CHI), those with MCR alone, those with MCI alone, and those with MCR plus MCI. Incident dementia was recorded at each annual visit during a 3-year follow-up. Results: The prevalence of CHI was 87.2%, MCR 3.0%, MCI 8.8%, and MCR plus MCI 0.9%. The overall incidence of dementia was 2.4% and was significantly associated with MCR alone (Odd Ratio (OR) = 5.00 with 95% Confidence interval (CI) = [1.01;24.59] and p = 0.049), MCI alone (OR = 6.04 with 95% CI = [2.36;15.47] and p≤0.001), and the combination of MCR and MCI (OR = 25.75 with 95% CI = [5.32;124.66] and p≤0.001). Conclusion: Combining MCR and MCI increased the risk for incident dementia. These results also demonstrated that this combination is a better predictor of dementia than MCI or MCR alone.

Life satisfaction and frailty in community-based older adults: cross-sectional and prospective analyses

2013 ◽  
Vol 25 (10) ◽  
pp. 1709-1716 ◽  
Author(s):  
Philip D. St John ◽  
Suzanne L. Tyas ◽  
Patrick R. Montgomery
Keyword(s):  
Older Adults ◽  
Life Satisfaction ◽  
Population Based ◽  
Community Dwelling ◽  
Community Based ◽  
Cross Sectional ◽  
Gender Education ◽  
Community Dwelling Older Adults ◽  
Prospective Analyses

ABSTRACTBackground:Frailty may be associated with reduced life satisfaction (LS). The objectives of this paper are to determine if (1) frailty is associated with LS in community-dwelling older adults in cross-sectional analyses; (2) frailty predicts LS five years later; and (3) specific domains of LS are preferentially associated with frailty.Methods:This paper presents analysis of an existing population-based cohort study of 1,751 persons aged 65+ who were assessed in 1991, with follow-up five years later. LS was measured using the terrible–delightful scale, which measures overall LS and LS in specific domains. Frailty was measured using the Brief Frailty Instrument. Analyses were adjusted for age, gender, education, and marital status.Results:Frailty was associated with overall LS at time 1 and predicted overall LS at time 2. This was seen in unadjusted analyses and after adjusting for confounding factors. Frailty was associated with all domains of LS at time 1, and predicted LS at time 2 in all domains except housing and self-esteem. However, the effect was stronger for LS with health than with other domains for both times 1 and 2.Conclusions:Frailty is associated with LS, and the effect is strongest for LS with health.

Longitudinal Association Between Subjective Fatigue and Future Falls in Community-Dwelling Older Adults: The Locomotive Syndrome and Health Outcomes in the Aizu Cohort Study (LOHAS)

2017 ◽  
Vol 31 (1) ◽  
pp. 67-84 ◽  
Author(s):  
Tsukasa Kamitani ◽  
Yosuke Yamamoto ◽  
Noriaki Kurita ◽  
Shin Yamazaki ◽  
Shingo Fukuma ◽  
...  
Keyword(s):  
Older Adults ◽  
Short Form ◽  
Community Dwelling ◽  
Multivariable Logistic Regression Analysis ◽  
Confounding Factors ◽  
Subjective Fatigue ◽  
Sf 36 ◽  
Longitudinal Association ◽  
Community Dwelling Older Adults

Objective:We examined the longitudinal association between the severity of fatigue and falls in community-dwelling older adults. Method: Subjective fatigue was assessed using the Short Form 36 Health Survey (SF-36) Vitality subscale and classified into four categories by quartile (mildest, mild, moderate, severe). The main outcome was the incidence of any falls during the 2-year follow-up period. Results: Of the 751 participants, 236 (31.4%) experienced falls during the 2-year period. In multivariable logistic regression analysis with adjustment for possible confounding factors, the adjusted odds ratios (and 95% confidence intervals) for mild, moderate, and severe categories (vs. mildest category) of 1.60 (0.94-2.75), 1.87 (1.12-3.11), and 2.15 (1.23-3.76), respectively ( p for trend = .007). Discussion: Our results suggest that the severity of fatigue is associated with the risk of subsequent falls for community-dwelling older adults even after adjustment for possible confounding factors.

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