scholarly journals A Critical Review of the Study of Neuroprotective Diets to Reduce Cognitive Decline

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2264
Author(s):  
Sally C. Duplantier ◽  
Christopher D. Gardner
Keyword(s):  
Cognitive Decline ◽  
Randomized Clinical Trials ◽  
Scoring Systems ◽  
Complementary Therapy ◽  
Cognitive Change ◽  
Biological Mechanisms ◽  
Lifestyle Choices ◽  
The Mediterranean ◽  
The Cost

Alzheimer’s disease (AD) and other dementias are now the seventh leading cause of death in the world and are projected to affect 115.4 million people by 2050. Delaying the onset of AD by just five years is estimated to reduce the cost and prevalence of the disease by half. There is no cure for AD nor any drug therapies to halt its progression once the disease begins. Lifestyle choices including diet are being seen as a viable complementary therapy to reduce cognitive decline, the hallmark of AD. Mediterranean, DASH (Dietary Approaches to Stop Hypertension), and MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diets have biological mechanisms supporting their potential neuroprotective benefits, but the findings of study outcomes about these benefits have been inconsistent. This paper analyzed five Randomized Clinical Trials (RCTs) (from 2000 to 2021) and 27 observational studies (from 2010 to 2021) focused on the link between cognitive health and the Mediterranean/DASH/MIND diets to identify gaps and challenges that could lead to inconsistent results. These include a lack of accuracy in assessing food intake, multiple dietary pattern scoring systems, a shifting metric among studies focused on the Mediterranean diet, a lack of standards in the tools used to assess cognitive decline, and studies that were underpowered or had follow-up periods too short to detect cognitive change. Insights from these gaps and challenges are summarized in recommendations for future RCTs, including both pragmatic and explanatory RCTs.

scholarly journals Change in Depression Symptomatology and Cognitive Function in Twins: A 10-Year Follow-Up Study

2016 ◽  
Vol 19 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Inge Petersen ◽  
Matt McGue ◽  
Qihua Tan ◽  
Kaare Christensen ◽  
Lene Christiansen
Keyword(s):  
Cognitive Decline ◽  
Cognitive Abilities ◽  
Depressive Symptomatology ◽  
Twin Studies ◽  
Cognitive Change ◽  
Depression Symptoms ◽  
Cross Sectional ◽  
The Mean ◽  
Depression Symptomatology

A complex interrelation exists between change in depression symptomatology and cognitive decline. Studies indicate either that depression is a direct risk factor for cognitive change over time, or vice versa. Longitudinal twin studies provide the possibility to unravel cause and effect of correlated traits. Here, we have applied twin modeling approaches to shed light on the genetic correlation between both level and change of depression symptomatology and cognitive functioning, and to further explore the bidirectionality of any such correlation using assessments of both phenotypes at two occasions 10 years apart. The study included 2,866 Danish twins with a mean age of 56.8 years at intake (range: 45–68 years). Of these, 1,267 were intact pairs. A total number of 1,582 twins (55%), of whom 557 were intact pairs, participated in the follow-up survey. We found stable cross-sectional heritability estimates of approximately 60% for general cognitive abilities and 30% for affective depressive symptoms. There was a considerable decline in the mean cognitive performance over 10 years, whereas the mean affective depression symptoms score was stable and with no genetic contribution to any individual change. Additionally, we saw a small but significant cross-trait correlation at both occasions (-0.11 and -0.09, respectively), but cross-trait cross-occasion analysis revealed no evidence that either of the two traits predicts the other over a 10-year interval. Thus, our study was not able to detect any causal association between change in depressive symptomatology and cognitive decline in middle-aged and elderly people over a 10-year interval.

scholarly journals Rates of diagnostic transition and cognitive change at 18-month follow-up among 1,112 participants in the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing (AIBL)

2013 ◽  
Vol 26 (4) ◽  
pp. 543-554 ◽  
Author(s):  
Kathryn A. Ellis ◽  
Cassandra Szoeke ◽  
Ashley I. Bush ◽  
David Darby ◽  
Petra L. Graham ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Transition Rate ◽  
Healthy Aging ◽  
Retention Rate ◽  
Severe Disease ◽  
Cognitive Change ◽  
Disease Stage ◽  
Imaging Biomarkers ◽  
Amyloid Pet

ABSTRACTBackground:The Australian Imaging, Biomarkers and Lifestyle (AIBL) Flagship Study of Ageing is a prospective study of 1,112 individuals (211 with Alzheimer's disease (AD), 133 with mild cognitive impairment (MCI), and 768 healthy controls (HCs)). Here we report diagnostic and cognitive findings at the first (18-month) follow-up of the cohort. The first aim was to compute rates of transition from HC to MCI, and MCI to AD. The second aim was to characterize the cognitive profiles of individuals who transitioned to a more severe disease stage compared with those who did not.Methods:Eighteen months after baseline, participants underwent comprehensive cognitive testing and diagnostic review, provided an 80 ml blood sample, and completed health and lifestyle questionnaires. A subgroup also underwent amyloid PET and MRI neuroimaging.Results:The diagnostic status of 89.9% of the cohorts was determined (972 were reassessed, 28 had died, and 112 did not return for reassessment). The 18-month cohort comprised 692 HCs, 82 MCI cases, 197 AD patients, and one Parkinson's disease dementia case. The transition rate from HC to MCI was 2.5%, and cognitive decline in HCs who transitioned to MCI was greatest in memory and naming domains compared to HCs who remained stable. The transition rate from MCI to AD was 30.5%.Conclusion:There was a high retention rate after 18 months. Rates of transition from healthy aging to MCI, and MCI to AD, were consistent with established estimates. Follow-up of this cohort over longer periods will elucidate robust predictors of future cognitive decline.

Comparison of the Sensitivity of Three Instruments for the Detection of Cognitive Decline in Elderly Living at Home

1987 ◽  
Vol 150 (6) ◽  
pp. 808-814 ◽  
Author(s):  
A. Little ◽  
D. Hemsley ◽  
K. Bergmann ◽  
J. Volans ◽  
R. Levy
Keyword(s):  
Cognitive Decline ◽  
Rating Scale ◽  
Cognitive Change ◽  
Screening Tools ◽  
Associate Learning ◽  
Mental Test Score ◽  
Learning Test ◽  
Elderly Living ◽  
At Home

We followed up 181 elderly living at home over 2 years. The changes shown on a brief dementia rating scale (the Abbreviated Mental Test Score (AMTS)) were monitored. At follow-up, subjects were classified as organic or non-organic by three potential screening tools-a screening questionnaire (the Psychogeriatric Assessment Schedule), a psychometric test (the Inglis' Paired Associate Learning Test) and a dementia scale (the AMTS). The value of these as screening tools for community samples was considered as a function of their sensitivity to cognitive decline. The classifications made by each were significantly related to previous cognitive change, but all were conservative, missing many subjects who had declined. Of the three, the AMTS appeared the most useful as a predictor of previous change on the AMTS. It remains to be seen whether it is equally useful with different samples and with different measures of outcome.

Longitudinal personality change associated with cognitive decline in multiple sclerosis

2018 ◽  
Vol 24 (14) ◽  
pp. 1909-1912 ◽  
Author(s):  
Shumita Roy ◽  
Allison Drake ◽  
Tom Fuchs ◽  
Michael G Dwyer ◽  
Robert Zivadinov ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Decline ◽  
Cognitive Assessment ◽  
Cognitive Change ◽  
Personality Change ◽  
Cognitive Deterioration ◽  
Time Interaction ◽  
Personality Dysfunction ◽  
Neo Five Factor Inventory

We previously reported that personality and cognition were stable over 3 years in patients with multiple sclerosis (MS). This study examined whether a longer duration would reveal evidence of emerging personality dysfunction. The NEO Five-Factor Inventory and Brief International Cognitive Assessment for MS was used to assess personality and cognition, respectively. Patients were classified as “Cog Stable” or “Cog Decline” based on cognitive deterioration over 5 years. Extraversion and Conscientiousness declined across pooled groups. Follow-up of a group by time interaction found that decline in these traits was more evident in the Cog Decline group, demonstrating a link between personality and cognitive change.

scholarly journals Randomized placebo-controlled trial of the effects of aspirin on dementia and cognitive decline

Neurology ◽  
2020 ◽  
Vol 95 (3) ◽  
pp. e320-e331 ◽  
Author(s):  
Joanne Ryan ◽  
Elsdon Storey ◽  
Anne M. Murray ◽  
Robyn L. Woods ◽  
Rory Wolfe ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Low Dose ◽  
Controlled Trial ◽  
Verbal Learning ◽  
Cognitive Change ◽  
Community Dwelling ◽  
Older Individuals ◽  
Dose Aspirin ◽  
Low Dose Aspirin

ObjectiveTo determine the effect of low-dose aspirin vs placebo on incident all-cause dementia, incident Alzheimer disease (AD), mild cognitive impairment (MCI), and cognitive decline in older individuals.MethodsAspirin in Reducing Events in the Elderly (ASPREE) was a double-blind, placebo-controlled trial of low-dose aspirin. In the United States and Australia, community-dwelling individuals aged ≥70 years (US minorities ≥65 years) and free of cardiovascular disease, physical disability, and diagnosed dementia were enrolled. Participants were randomized 1:1–100 mg daily aspirin or placebo. The Modified Mini-Mental State Examination, Hopkins Verbal Learning Test–Revised, Symbol Digit Modalities Test, and Controlled Oral Word Association Test assessed cognition at baseline and over follow-up. Additional cognitive testing was performed in participants with suspected dementia (“trigger”) based on within-study assessments or clinical history. Dementia was adjudicated according to DSM-IV criteria. National Institute on Aging–Alzheimer’s Association criteria were used for AD and MCI subclassification.ResultsA total of 19,114 participants were followed over a median 4.7 years and 964 triggered further dementia assessments. There were 575 adjudicated dementia cases, and 41% were classified as clinically probable AD. There was no substantial difference in the risk of all dementia triggers (hazard ratio [HR], 1.03; 95% confidence interval [CI], 0.91–1.17), probable AD (HR, 0.96; 95% CI, 0.74–1.24), or MCI (HR, 1.12; 95% CI, 0.92–1.37) between aspirin and placebo. Cognitive change over time was similar in the aspirin and placebo groups.ConclusionsThere was no evidence that aspirin was effective in reducing risk of dementia, MCI, or cognitive decline. Follow-up of these outcomes after initial exposure is ongoing.Classification of evidenceThis study provides Class II evidence that for healthy older individuals, low-dose aspirin does not significantly reduce the incidence of dementia, probable AD, MCI, or cognitive decline.Clinicaltrials.gov identifierNCT01038583.

scholarly journals The Heterogeneity of Longitudinal Cognitive Decline in Euthymic Bipolar I Disorder With Clinical Characteristics and Functional Outcomes

2021 ◽  
Vol 12 ◽  
Author(s):  
Wen-Yin Chen ◽  
Ming-Chyi Huang ◽  
Ya-Chin Lee ◽  
Chiao-Erh Chang ◽  
Shih-Ku Lin ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Functional Outcomes ◽  
Mood Stabilizer ◽  
Cognitive Change ◽  
World Health ◽  
Type I ◽  
Correlation Pattern ◽  
Cognitive Domains ◽  
Biological Studies

We characterized the heterogeneity and risk factors of cognitive decline in euthymic bipolar disorder (BD), and their magnitude of associations with subjective daily functions. In this retrospective cohort, BD type I patients (N = 128) were followed for an average of 6.5 years. Intelligence quotient (IQ) at index date was recorded, and premorbid IQ was estimated. We used Brief Assessment of Cognition in Affective Disorders (BAC-A) to assess cognition at follow-up. We evaluated current functions with World Health Organization Disability Assessment Schedule 2.0. Clinical and sociodemographic factors were examined for their independent effects on longitudinal cognitive decline. In addition, we employed multivariate adaptive regression spline to detect inflection points for the nature of slope changes in cognitive decline among BD patients. During follow-up years, 21 BD patients (16.4%) showed longitudinal cognitive decline. In cognitive decline group, all cognitive domains of BAC-A were significantly worsened. We found that density of episodes with psychotic features was an independent risk factor for cognitive decline after adjusted for age, gender and dose of mood stabilizer. After the age of 42 years, a steeper cognitive change was observed in the cognitive decline group. The correlation pattern between cognitive domains and functional outcomes differed between patients with and without cognitive decline. The present study characterized cognitive heterogeneity longitudinally in BD patients. As density of episodes play roles for cognitive decline, our results emphasize the importance of relapse prevention. Our findings provide hints for future personalized interventions and facilitating genetic and biological studies for dissecting the heterogeneity of bipolar illness.

scholarly journals Cognitive Trajectories Following Acute Infection in Older Patients With and Without Cognitive Impairment: An 1-Year Follow-Up Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Ana Rita Silva ◽  
Patrícia Regueira ◽  
Ana Luísa Cardoso ◽  
Inês Baldeiras ◽  
Isabel Santana ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Older Patients ◽  
Acute Infection ◽  
Systemic Infection ◽  
Change Score ◽  
Cognitive Change ◽  
Dementia Patients ◽  
Delirium Superimposed On Dementia

Introduction: Dementia is a known risk factor for both delirium and acute systemic infections which may also play a significant role in promoting or accelerating neurodegenerative disease. Infections are both the main causes of hospitalization of dementia patients and can be a major precipitant of delirium but currently it is not possible to predict the risk of cognitive decline in older patients exposed to acute infection.Objectives: We aimed to determine the level of cognitive change at 1-year follow up in individuals with different patterns of cognitive function (dementia, delirium, delirium superimposed on dementia) at the time of their hospitalization due to a systemic infection and to correlate these cognitive patterns with clinical status variables.Methods: We recruited 53 hospitalized geriatric patients with a systemic infection, and we collected 12-months follow up data for 34 patients. These patients were classified in four groups: no cognitive impairment (controls—C), delirium only (D), dementia only (Dem), and delirium superimposed to dementia (DD). Cognitive performance was measured by change in score on the Montreal Cognitive Assessment (MoCA) and delirium was identified using Confusion Assessment Measure (CAM). We examined performance on the MoCA in the first year after hospitalization, controlling for demographic characteristics, coexisting medical conditions, and type of infection.Results: For the 34 patients to whom follow-up data was available, delirium presence in individuals with prior dementia (DD group) was associated with a negative mean change score of 3-point (p < 0.02) at 1 year follow up, whereas dementia patients without delirium had a mean change score of 1.5-point lower at 12-months (p = 0.04), when comparing follow-up and baseline MoCA scores. Cognitively healthy patients did not significantly decrease their MoCA score at follow-up (p = 0.15). MoCA and NPI scores during hospitalization were significantly correlated with the level of cognitive decline in the four groups (r = 0.658, p < 0.01 and r = 0.439, p = 0.02, respectively).Conclusions: Premorbid dementia and delirium superimposed on dementia during hospitalization in older patients with acute infections predict cognitive decline at 1 year following admission. Taken together, our findings suggest a pathophysiological interaction between neurodegenerative changes, acute infection, and delirium.

scholarly journals A-09 Concussion History May Accelerate Cognitive Decline in Older Adults

2020 ◽  
Vol 35 (6) ◽  
pp. 799-799
Author(s):  
Bell S ◽  
Maietta J ◽  
Caldwell J ◽  
Hawley N ◽  
Ritter A ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Effect Size ◽  
Repeated Measures ◽  
Cognitive Change ◽  
Cognitive Outcomes ◽  
History Of ◽  
Concussion History ◽  
One Year

Abstract Objective Concussion is a common occurrence among older adults, stemming largely from falls. Evidence suggests that history of moderate–severe traumatic brain injury (TBI) increases risk for cognitive decline and dementia; however, long-term outcomes associated with concussion remain unclear. This study aims to investigate longitudinal cognitive change among older adults with self-reported concussion history (CH). Method Older adults (n = 39) enrolled in an observational, longitudinal study by the Center for Neurodegeneration and Translational Neuroscience diagnosed with mild cognitive impairment or Alzheimer’s disease were studied, including 14 with CH. Participants completed baseline and one-year follow-up testing, including the Montreal Cognitive Assessment (MoCA). Repeated measures ANCOVA with age and education covariates assessed change in MoCA Total Scores from baseline to follow-up based on CH. Results Main effects for age, education, time, and CH were not significant; however, significant interaction for CH by time was revealed, F(1,34) = 4.46, p < .05 such that those with CH demonstrated significantly greater decline from baseline to follow-up than those without CH (p < .05). In the CH group, change over time was associated with an effect size of 1.20 (Cohen’s d) compared to an effect size of 0.22 in the non-CH group. Conclusions History of concussion may lead to accelerated rate of cognitive decline in those diagnosed with MCI and AD over a 1-year period, which is consistent with prior research in moderate–severe TBI. These results preliminarily support the notion that concussion may be associated with significantly worse cognitive outcomes among older adults. Confirmation of our findings in larger samples and prospective validation of the observation are warranted.

scholarly journals Accelerated epigenetic age and cognitive decline among urban-dwelling adults

Neurology ◽  
2019 ◽  
Vol 94 (6) ◽  
pp. e613-e625 ◽  
Author(s):  
May A. Beydoun ◽  
Danielle Shaked ◽  
Salman M. Tajuddin ◽  
Jordan Weiss ◽  
Michele K. Evans ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Cognitive Performance ◽  
Visual Memory ◽  
Multiple Testing ◽  
Healthy Aging ◽  
Cognitive Change ◽  
Longitudinal Change ◽  
Cell Aging ◽  
Epigenetic Age

ObjectivesEpigenetic modifications are closely linked with aging, but their relationship with cognition remains equivocal. Given known sex differences in epigenetic aging, we explored sex-specific associations of 3 DNA methylation (DNAm)–based measures of epigenetic age acceleration (EAA) with baseline and longitudinal change in cognitive performance among middle-aged urban adults.MethodsWe used exploratory data from a subgroup of participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span study with complete DNA samples and whose baseline ages were >50.0 years (2004–2009) to estimate 3 DNAm EAA measures: (1) universal EAA (AgeAccel); (2) intrinsic EAA (IEAA); and (3) extrinsic EAA (EEAA). Cognitive performance was measured at baseline visit (2004–2009) and first follow-up (2009–2013) with 11 test scores covering global mental status and specific domains such as learning/memory, attention, visuospatial, psychomotor speed, language/verbal, and executive function. A series of mixed-effects regression models were conducted adjusting for covariates and multiple testing (n = 147–156, ∼51% men, k = 1.7–1.9 observations/participant, mean follow-up time ∼4.7 years).ResultsEEAA, a measure of both biological age and immunosenescence, was consistently associated with greater cognitive decline among men on tests of visual memory/visuoconstructive ability (Benton Visual Retention Test: γ11 = 0.0512 ± 0.0176, p = 0.004) and attention/processing speed (Trail-Making Test, part A: γ11 = 0.219 ± 0.080, p = 0.007). AgeAccel and IEAA were not associated with cognitive change in this sample.ConclusionsEEAA capturing immune system cell aging was associated with faster decline among men in domains of attention and visual memory. Larger longitudinal studies are needed to replicate our findings.

Latent Cognitive Class at Enrollment Predicts Future Cognitive Trajectories of Decline in a Community Sample of Older Adults

2021 ◽  
pp. 1-12
Author(s):  
Andrea R. Zammit ◽  
Jingyun Yang ◽  
Aron S. Buchman ◽  
Sue E. Leurgans ◽  
Graciela Muniz-Terrera ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Latent Variable ◽  
Community Sample ◽  
Cognitive Change ◽  
Cognitive Profiles ◽  
Longitudinal Trajectories ◽  
Variable Approach ◽  
Latent Variable Methods

Background: Methods that can identify subgroups with different trajectories of cognitive decline are crucial for isolating the biologic mechanisms which underlie these groupings. Objective: This study grouped older adults based on their baseline cognitive profiles using a latent variable approach and tested the hypothesis that these groups would differ in their subsequent trajectories of cognitive change. Methods: In this study we applied time-varying effects models (TVEMs) to examine the longitudinal trajectories of cognitive decline across different subgroups of older adults in the Rush Memory and Aging Project. Results: A total of 1,662 individuals (mean age = 79.6 years, SD = 7.4, 75.4%female) participated in the study; these were categorized into five previously identified classes of older adults differing in their baseline cognitive profiles: Superior Cognition (n = 328, 19.7%), Average Cognition (n = 767, 46.1%), Mixed-Domains Impairment (n = 71, 4.3%), Memory-Specific Impairment (n = 274, 16.5%), and Frontal Impairment (n = 222, 13.4%). Differences in the trajectories of cognition for these five classes persisted during 8 years of follow-up. Compared with the Average Cognition class, The Mixed-Domains and Memory-Specific Impairment classes showed steeper rates of decline, while other classes showed moderate declines. Conclusion: Baseline cognitive classes of older adults derived through the use of latent variable methods were associated with distinct longitudinal trajectories of cognitive decline that did not converge during an average of 8 years of follow-up.

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