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Journal articles on the topic 'Awareness of cognitive decline'
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Vogel, Asmus, Frans Boch Waldorff, and Gunhild Waldemar. "Longitudinal changes in awareness over 36 months in patients with mild Alzheimer's disease." International Psychogeriatrics 27, no. 1 (July 30, 2014): 95–102. http://dx.doi.org/10.1017/s1041610214001562.
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ABSTRACTBackground:Longitudinal changes in awareness in dementia have been studied with short follow-up time and mostly in small patient groups (including patients with moderate dementia). We investigated awareness in patients with mild Alzheimer's disease (AD) over 36 months and studied if a decline in awareness was associated with decline in cognition and increase in neuropsychiatric symptoms.Methods:Awareness was measured on a categorical scale in 95 AD patients (age ≥50 years, Mini-Mental State Examination (MMSE) score ≥20). Awareness was rated at three time points (follow-up at 12 and 36 months) where MMSE, Neuropsychiatric Inventory (NPI-Q), and Cornell scale for Depression in Dementia also were applied.Results:At 12 months, 26% had lower awareness rating as compared to baseline and at 36 months lower awareness ratings were found in 39%. At both visits, 16% had higher awareness rating as compared to baseline. Patients with lower awareness at 36 months as compared to baseline had a more rapid increase in NPI-Q score (p = 0.002) over 36 months as compared to patients with stable or improved awareness over 36 months. A more rapid decline in MMSE score was observed for patients with lower awareness at 36 months (as compared to baseline) but only when compared to patients in whom awareness improved over time.Conclusions:The results show essentially no clear relationship between cognitive decline over three years and awareness. In some cases, awareness remained stable or even improved despite significant cognitive decline. In the subgroup where awareness declined over time, overall ratings of neuropsychiatric symptoms declined more rapidly than in the remaining patients.
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Tahmasebi, R., S. Zehetmayer, E. Stögmann, and Johann Lehrner. "Awareness of Olfactory Dysfunction in Subjective Cognitive Decline, Mild Cognitive Decline, and Alzheimer’s Disease." Chemosensory Perception 13, no. 1 (June 24, 2019): 59–70. http://dx.doi.org/10.1007/s12078-019-09267-7.
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Ameriks, John, Andrew Caplin, Minjoon Lee, Matthew D. Shapiro, and Christopher Tonetti. "Cognitive Decline, Limited Awareness, Imperfect Agency, and Financial Well-Being." American Economic Review: Insights 5, no. 1 (March 1, 2023): 125–40. http://dx.doi.org/10.1257/aeri.20210711.
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Cognitive decline may lead older Americans to make poor financial decisions. Preventing poor decisions may require timely transfer of financial control to a reliable agent. Cognitive decline, however, can develop unnoticed, creating the possibility of suboptimal timing of the transfer of control. This paper presents survey-based evidence that older Americans with significant wealth regard suboptimal timing of the transfer of control, in particular delay due to unnoticed cognitive decline, as a substantial risk to financial well-being. This paper provides a theoretical framework to model such a lack of awareness and the resulting welfare loss. (JEL G51, G53, H55, J14, J26, J32)
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Therriault, Joseph, Kok Pin Ng, Tharick A. Pascoal, Sulantha Mathotaarachchi, Min Su Kang, Hanne Struyfs, Monica Shin, et al. "Anosognosia predicts default mode network hypometabolism and clinical progression to dementia." Neurology 90, no. 11 (February 14, 2018): e932-e939. http://dx.doi.org/10.1212/wnl.0000000000005120.
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ObjectiveTo identify the pathophysiologic mechanisms and clinical significance of anosognosia for cognitive decline in mild cognitive impairment.MethodsWe stratified 468 patients with amnestic mild cognitive impairment into intact and impaired awareness groups, determined by the discrepancy between the patient and the informant score on the Everyday Cognition questionnaire. Voxel-based linear regression models evaluated the associations between self-awareness status and baseline β-amyloid load, measured by [18F]florbetapir, and the relationships between awareness status and regional brain glucose metabolism measured by [18F]fluorodeoxyglucose at baseline and at 24-month follow-up. Multivariate logistic regression tested the association of awareness status with conversion from amnestic mild cognitive impairment to dementia.ResultsWe found that participants with impaired awareness had lower [18F]fluorodeoxyglucose uptake and increased [18F]florbetapir uptake in the posterior cingulate cortex at baseline. In addition, impaired awareness in mild cognitive impairment predicted [18F]fluorodeoxyglucose hypometabolism in the posterior cingulate cortex, left basal forebrain, bilateral medial temporal lobes, and right lateral temporal lobe over 24 months. Furthermore, participants with impaired awareness had a nearly 3-fold increase in likelihood of conversion to dementia within a 2-year time frame.ConclusionsOur results suggest that anosognosia is linked to Alzheimer disease pathophysiology in vulnerable structures, and predicts subsequent hypometabolism in the default mode network, accompanied by an increased risk of progression to dementia. This highlights the importance of assessing awareness of cognitive decline in the clinical evaluation and management of individuals with amnestic mild cognitive impairment.
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Lehrner, Johann, Sandra Kogler, Claus Lamm, Doris Moser, Stefanie Klug, Gisela Pusswald, Peter Dal-Bianco, Walter Pirker, and Eduard Auff. "Awareness of memory deficits in subjective cognitive decline, mild cognitive impairment, Alzheimer's disease and Parkinson's disease." International Psychogeriatrics 27, no. 3 (November 10, 2014): 357–66. http://dx.doi.org/10.1017/s1041610214002245.
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ABSTRACTBackground:Impaired awareness of memory deficits has been recognized as a common phenomenon in Alzheimer's disease (AD) and research is now increasingly focusing on awareness in groups at risk for future dementia. This study aimed to determine whether levels of awareness differ among healthy elderly people and patients with subjective cognitive decline (SCD), amnestic and non-amnestic subtypes of mild cognitive impairment (aMCI, naMCI), Alzheimer's disease (AD) and Parkinson's disease (PD), to explore correlates of awareness and to establish frequencies of memory over- and underestimation within each diagnostic group.Methods:756 consecutive outpatients of a memory clinic and 211 healthy controls underwent thorough neuropsychological testing. Impairment of awareness was measured as the difference between subjective memory appraisals (16-item questionnaire on current memory-related problems in everyday life) and objective memory performance (15-item delayed recall task). Subgroups of over- and underestimators were classified using percentile ranks of controls.Results:At group level, awareness significantly decreased along the naMCI→aMCI→AD continuum, with naMCI patients showing a tendency towards overestimation of memory dysfunction. PD patients showed accurate self-appraisals as long as memory function was largely unaffected. However, there was a considerable between-group overlap in awareness scores. Furthermore, different correlates of awareness were observed depending on the diagnostic group. In general, unawareness seems to be associated with decreased cognitive performance in various domains (especially memory), higher age and lower levels of depression and self-reported functional impairment.Conclusion:Impaired awareness is an important symptom in aMCI. Yet, given the considerable variability in awareness scores, longitudinal studies are required to evaluate their predictive power.
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Dourado, M., M. F. B. Sousa, R. L. Santos, P. Simões, T. Belfort, M. Nogueira, R. Dias, B. Torres, M. A. T. Baptista, and I. B. Lacerda. "The Independence Between Awareness and Cognitive Decline in Alzheimer's Disease." European Psychiatry 30 (March 2015): 452. http://dx.doi.org/10.1016/s0924-9338(15)30357-6.
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Costa, Amy, Christina McCrae, Jennifer O'Brien, and Ashley Curtis. "0083 You Don’t Snooze, You Lose (Awareness): Sleep’s Role on Awareness of Cognition in Mild Cognitive Impairment." SLEEP 47, Supplement_1 (April 20, 2024): A36—A37. http://dx.doi.org/10.1093/sleep/zsae067.0083.
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Abstract Introduction In adults with Mild Cognitive Impairment (prodromal phase of Alzheimer’s disease; MCI), the level of awareness of cognitive functioning varies significantly. A lack of awareness of cognitive functioning may interfere with monitoring of disease progression and opportunities for intervention. Therefore, understanding mechanisms associated with this relationship is critical. Given age-related changes in sleep and known relationships between sleep health and cognition, this pilot tested whether sleep moderates associations between subjective and objective cognition in older adults with MCI. Methods Older adults with MCI (N=46, Mage=68.2 years, SD=6.1 years, 33 women) completed one week of sleep diaries [averages of sleep onset latency (SOL), total sleep time (TST), sleep efficiency (SE)], Cognitive Failures Questionnaire (sub-scores CFQ-memory, CFQ-distractibility, CFQ-blunders), and cognitive tasks [Cambridge Brain Sciences; Polygons (processing speed), Feature Match (attention), Double Trouble (attention/inhibition), Digit Span (working memory)]. Multiple regressions tested if sleep parameters moderated associations between subjective and objective cognition, covarying for depressive symptoms and number of medical conditions. Results SE moderated associations between Polygons and CFQ-blunders (R2-change=.08, p=.03). Specifically, at highest SE, slower processing speed was associated with more blunder complaints (B=-.10, p=.04). Additionally, SE moderated associations between Digit Span and CFQ-distractibility (R2-change=.06, p=.03) and CFQ-blunders (R2-change=.12, p=.004). Specifically, at lowest SE, worse working memory was associated with less distractibility (B=3.01, p=.002) and blunders (B=2.45, p<.001) complaints, while at highest SE worse working memory was associated with more blunder complaints (B=-2.48, p=.04). Conclusion Preliminary findings suggest in older adults with MCI, lower sleep efficiency may exacerbate discrepancies between objective and subjective cognition, while higher sleep efficiency may converge this relationship. Sleep efficiency should be considered to fully understand the level of awareness of cognitive functioning in older adults with MCI. Critically, these findings may help identify those at risk of further cognitive decline. While future prospective studies are warranted, present findings suggest a potential next step is to examine whether behavioral treatments for insomnia (e.g., Cognitive Behavioral Therapy for Insomnia, cognitive training) may also change the relationship between objective/subjective cognition. Support (if any) This research was supported in part by the University of Missouri School of Medicine TRIUMPH award (PI: Curtis).
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Taler, Vanessa, Cassandra Morrison, and Christine Sheppard. "Cognitive Performance in Older Adults With Subjective Cognitive Decline." Innovation in Aging 4, Supplement_1 (December 1, 2020): 291. http://dx.doi.org/10.1093/geroni/igaa057.932.
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Abstract Subjective cognitive decline (SCD) refers to a perceived decline in cognitive function in the absence of neuropsychological deficits. Older adults with SCD are at increased of subsequent development of mild cognitive impairment or dementia. We had 224 adults aged 65+ complete questionnaires assessing their subjective appraisal of their cognitive function, including questions about word-finding difficulty, memory, and attention/concentration. Participants also completed the Montreal Cognitive Assessment (MoCA). All participants exhibited cognitive performance that was within normal limits for age and education. In total, 29.5% of participants reported word-finding difficulties, 16.5% reported difficulties with remembering things, and 8.5% reported difficulties with attention/concentration. We found that (1) self-reported word-finding difficulties were associated with lower performance on delayed word recall, and (2) self-reported difficulties in concentration/attention or memory were associated with lower performance on the abstraction subtask in the MoCA. No other MoCA subtasks were associated with self-reported cognitive function. A subset of the participants (n=69) also completed a battery of tasks assessing semantic function, including picture naming, associative matching tasks, identification of semantic features, and semantic questions. Again, self-reported word-finding difficulty predicted lower performance on semantic tasks. These results suggest that older adults may be aware of changes in their cognitive performance prior to objective neuropsychological impairment. Moreover, their awareness appears to be domain-specific: self-reported language difficulty is associated with lower performance on language-based tasks, while self-reported difficulty in memory, attention, or concentration is associated with lower performance on an abstraction task.
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Lautenschlager, Nicola T. "Awareness of memory deficits in subjective cognitive decline, mild cognitive impairment, Alzheimer's disease and Parkinson's disease." International Psychogeriatrics 27, no. 3 (February 2, 2015): 355–56. http://dx.doi.org/10.1017/s1041610214002786.
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Anosognosia or reduced awareness of cognitive and functional problems is a known clinical phenomenon in patients experiencing cognitive decline. It is common even in mild dementia syndromes and is often reported to increase with clinical disease progression (Aalten et al., 2006). More recently it also has been described in older adults with cognitive-impairment-no-dementia (CIND) and mild cognitive impairment (MCI) (Greenop et al., 2011; Maki et al., 2012). The clinical significance of awareness is a topic of controversy in the literature and determining its biological correlates in brain function and structure is an ongoing challenge (Zamboni et al., 2013; Ford et al., 2014).
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Gigi, Ariela, and Merav Papirovitz. "Association of Anxiety Awareness with Risk Factors of Cognitive Decline in MCI." Brain Sciences 11, no. 2 (January 21, 2021): 135. http://dx.doi.org/10.3390/brainsci11020135.
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Studies demonstrate that anxiety is a risk factor for cognitive decline. However, there are also study findings regarding anxiety incidence among people with mild cognitive impairment (MCI), which mostly examined general anxiety evaluated by subjective questionnaires. This study aimed to compare subjective and objective anxiety (using autonomic measures) and anxiety as a general tendency and anxiety as a reaction to memory examination. Participants were 50 adults aged 59–82 years who were divided into two groups: MCI group and control group, according to their objective cognitive performance in the Rey Auditory Verbal Learning Test. Objective changes in the anxiety response were measured by skin conductivity in all tests and questionnaires. To evaluate subjective anxiety as a reaction to memory loss, a questionnaire on “state-anxiety” was used immediately after completing memory tests. Our main finding was that although both healthy and memory-impaired participants exhibited elevations in physiological arousal during the memory test, only healthy participants reported an enhanced state anxiety (p = 0.025). Our results suggest that people with MCI have impaired awareness of their emotional state.
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Reed, Marilyn, Morris Freedman, Amy E. Mark Fraser, Matthew Bromwich, Anna Theresa Santiago, Christina Elizabeth Gallucci, and Andrew Frank. "Enhancing Clinical Visibility of Hearing Loss in Cognitive Decline." Journal of Alzheimer's Disease 86, no. 1 (March 8, 2022): 413–24. http://dx.doi.org/10.3233/jad-215377.
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Background: Hearing loss is the largest potentially modifiable risk factor for dementia and is highly prevalent among older adults, yet it goes largely unreported, unidentified, and untreated, at great cost to health and quality of life. Hearing screening is a proven cost-effective solution to overcome delays in its identification and management yet is not typically recommended by physicians for older adults. Objective: To demonstrate the feasibility and value of hearing screening for older adults at risk for dementia in order to enhance physicians’ awareness of hearing loss and improve access to timely hearing care. Methods: Patients referred to two academic medical clinics for memory disorders were offered hearing screening as part of clinic protocol. Patients with hearing loss were recruited to the study if they consented to a post-appointment telephone interview and chart review. Memory Clinic physicians were surveyed about the usefulness of the screening information and referral of patients with hearing loss to audiology. Results: Hearing loss was reliably detected in Memory Clinic patients with both in-office and online screening tools. Physicians reported that screening enhanced their awareness of hearing loss and increased the referral rate to audiology. Conclusion: Hearing screening in Memory Clinic patients is a useful component of clinic protocol that facilitates timely access to management and addresses an important risk factor for dementia.
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Ball, Harriet A., Elizabeth Coulthard, Mark Fish, Antony Bayer, John Gallacher, and Yoav Ben-Shlomo. "Predictors and prognosis of population-based subjective cognitive decline: longitudinal evidence from the Caerphilly Prospective Study (CaPS)." BMJ Open 13, no. 10 (October 2023): e073205. http://dx.doi.org/10.1136/bmjopen-2023-073205.
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ObjectivesTo understand associations between the subjective experience of cognitive decline and objective cognition. This subjective experience is often conceptualised as an early step towards neurodegeneration, but this has not been scrutinised at the population level. An alternative explanation is poor meta-cognition, the extreme of which is seen in functional cognitive disorder (FCD).DesignProspective cohort (Caerphilly Prospective Study).SettingPopulation-based, South Wales, UK.ParticipantsThis men-only study began in 1979; 1225 men participated at an average age of 73 in 2002–2004, including assessments of simple subjective cognitive decline (sSCD, defined as a subjective report of worsening memory or concentration). Dementia outcomes were followed up to 2012–2014. Data on non-completers was additionally obtained from death certificates and local health records.Primary and secondary outcome measuresThe primary outcome measure was incident dementia over 10 years. Secondary outcome measures included prospective change in objective cognition and cross-sectional cognitive internal inconsistency (the existence of a cognitive ability at some times, and its absence at other times, with no intervening explanatory factors except for focus of attention).ResultssSCD was common (30%) and only weakly associated with prior objective cognitive decline (sensitivity 36% (95% CI 30 to 42) and specificity 72% (95% CI 68 to 75)). Independent predictors of sSCD were older age, poor sleep quality and higher trait anxiety. Those with sSCD did not have excess cognitive internal inconsistency, but results suggested a mild attentional deficit. sSCD did not predict objective cognitive change (linear regression coefficient −0.01 (95% CI −0.13 to 0.15)) nor dementia (odds ratio 1.35 (0.61 to 2.99)) 10 years later.ConclusionssSCD is weakly associated with prior objective cognitive decline and does not predict future cognition. Prior sleep difficulties and anxiety were the most robust predictors of sSCD. sSCD in the absence of objective decline appears to be a highly prevalent example of poor meta-cognition (ie, poor self-awareness of cognitive performance), which could be a driver for later FCD.
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Teylan, Merilee, Kathryn Gauthreaux, Nicole M. Thomas, Yen-Chi Chen, Kwun Chuen Gary Chan, Charles Mock, and Walter A. Kukull. "P4-415: LONGITUDINAL COGNITIVE PERFORMANCE IN PARTICIPANTS WITH MILD COGNITIVE IMPAIRMENT AND IMPAIRED AWARENESS OF DECLINE." Alzheimer's & Dementia 15 (July 2019): P1462. http://dx.doi.org/10.1016/j.jalz.2019.06.4087.
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Gharehbagh, Sanaz Shoja, Birthe Krogh Rasmussen, Emil Smilkov, and Rigmor Højland Jensen. "Spontaneous intracranial hypotension presenting with progressive cognitive decline." BMJ Case Reports 14, no. 7 (July 2021): e241285. http://dx.doi.org/10.1136/bcr-2020-241285.
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A 63-year-old woman presented with headache, progressive somnolence, neurocognitive decline and urinary incontinence through a year. Medical history was unremarkable except for hypertension and hypercholesterolaemia. Neurological examination was normal. Brain MRI showed findings typical for spontaneous intracranial hypotension (subdural fluid collection, pachymeningeal enhancement, brain sagging) and pituitary tumour. The patient’s complaints improved dramatically but temporarily after treatment with each of repeated targeted as well as non-targeted blood patches and a trial with continuous intrathecal saline infusion. Extensive work up including repeated MRI-scans, radioisotope cisternographies, CT and T2-weighted MR myelography could not localise the leakage, but showed minor root-cysts at three levels. Finally, lateral decubitus digital subtraction dynamic myelography with subsequent CT myelography identified a tiny dural venous fistula at the fourth thoracic level. After surgical venous ligation, the patient fully recovered. Awareness of spontaneous dural leaks and their heterogeneous clinical picture are important and demands an extensive workup.
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Lin, Zhuoer, Mark Schlesinger, and Xi Chen. "COGNITIVE MISPERCEPTION, DISABILITY, AND MORTALITY AMONG OLDER ADULTS IN 25 COUNTRIES." Innovation in Aging 7, Supplement_1 (December 1, 2023): 210. http://dx.doi.org/10.1093/geroni/igad104.0694.
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Abstract Despite a large body of literature on cognitive ability and health, less is known about the health consequences of biased cognitive perception. Using harmonized and nationally representative longitudinal surveys from 25 countries spanning Asia, Europe and the Americas, we document the growing gap between actual and perceived cognitive ability that appears to increase with age, and construct a standardized measure of cognitive misperception. Linking this novel measure with mortality and disability, we model the cognitive misperception – health gradient. Results show that being in the upper quartile of cognitive misperception (i.e., showing heightened overconfidence in cognition) leads to higher mortality rates within 1 year, 3 years, and 5 years. Conditional on survival, being overconfident in cognition also greatly increases the risks of incident disability and frailty, especially for older adults receiving less family support. We identify two possible pathways inducing poorer outcomes: the first stemming from increased risk taking and financial vulnerability; the second associated with suboptimal use of preventive services and declines in health-promoting behaviors. Given the large and profound impacts of cognitive misperception on older adults’ health and well-being, more family and social supports, public investment in education and health literacy, and better healthcare access and affordability are needed to increase the timely awareness of cognitive decline.
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Fidder, Hester, Ruth B. Veenhuizen, Ineke J. Gerridzen, Wessel N. van Wieringen, Martin Smalbrugge, Cees M. P. M. Hertogh, and Anouk M. van Loon. "Impaired Awareness in People with Severe Alcohol-Related Cognitive Deficits Including Korskoff’s Syndrome: A Network Analysis." Journal of Clinical Medicine 12, no. 9 (April 26, 2023): 3139. http://dx.doi.org/10.3390/jcm12093139.
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Background: Impaired awareness of one’s own functioning is highly common in people with Korsakoff’s syndrome (KS). However, it is currently unclear how awareness relates to impairments in daily functioning and quality of life (QoL). Methods: We assessed how impaired awareness relates to cognitive, behavioral, physical, and social functioning and QoL by applying a network analysis. We used cross-sectional data from 215 patients with KS or other severe alcohol-related cognitive deficits living in Dutch long-term care facilities (LTCFs). Results: Apathy has the most central position in the network. Higher apathy scores relate positively to reduced cognition and to a greater decline in activities of daily living and negatively to social participation and the use of antipsychotic drugs. Impaired awareness is also a central node. It is positively related to a higher perceived QoL, reduced cognition and apathy, and negatively to social participation and length of stay in the LTCF. Mediated through apathy and social participation, impaired awareness is indirectly related to other neuropsychiatric symptoms. Conclusions: Impaired awareness is closely related to other domains of daily functioning and QoL of people with KS or other severe alcohol-related cognitive deficits living in LTCFs. Apathy plays a central role. Network analysis offers interesting insights to evaluate the interconnection of different symptoms and impairments in brain disorders such as KS.
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McBride, M. R., L. Eskenazi, M. C. Alcedo, M. Tzuang, D. Tan, E. Yau, M. Adelman, and D. Gallagher-Thompson. "AGING AND DIVERSE LGBT COMMUNITIES: BUILDING AWARENESS FOR COGNITIVE DECLINE AND CAREGIVING NEEDS." Innovation in Aging 1, suppl_1 (June 30, 2017): 172. http://dx.doi.org/10.1093/geroni/igx004.666.
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Sánchez-Benavides, Gonzalo, Oriol Grau, Marc Suárez-Calvet, Raffaele Cacciaglia, Carolina Minguillon, Juan Domingo Gispert, and José Luis Molinuevo. "O3-12-02: SUBJECTS WITHOUT SELF-AWARENESS OF COGNITIVE DECLINE PRESENT DIFFERENT COGNITIVE AND BRAIN MORPHOLOGICAL FEATURES." Alzheimer's & Dementia 14, no. 7S_Part_19 (July 1, 2006): P1050—P1051. http://dx.doi.org/10.1016/j.jalz.2018.06.2838.
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Therriault, Joseph, Kok Pin Ng, Tharick A. Pascoal, Sulantha S. Mathotaarachchi, Min Su Kang, Monica Shin, Serge Gauthier, Vasavan Nair, and Pedro Rosa-Neto. "[IC-P-148]: LACK OF SELF-AWARENESS OF COGNITIVE DEFICITS PREDICTS METABOLIC DECLINE IN MILD COGNITIVE IMPAIRMENT." Alzheimer's & Dementia 13, no. 7S_Part_2 (July 2017): P112. http://dx.doi.org/10.1016/j.jalz.2017.06.2422.
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Rogalski, Yvonne, and Muriel Quintana. "Activity Engagement in Cognitive Aging: A Review of the Evidence." Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders 23, no. 1 (May 2013): 1–12. http://dx.doi.org/10.1044/nnsld23.1.35.
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The population of older adults is rapidly increasing, as is the number and type of products and interventions proposed to prevent or reduce the risk of age-related cognitive decline. Advocacy and prevention are part of the American Speech-Language-Hearing Association’s (ASHA’s) scope of practice documents, and speech-language pathologists must have basic awareness of the evidence contributing to healthy cognitive aging. In this article, we provide a brief overview outlining the evidence on activity engagement and its effects on cognition in older adults. We explore the current evidence around the activities of eating and drinking with a discussion on the potential benefits of omega-3 fatty acids, polyphenols, alcohol, and coffee. We investigate the evidence on the hypothesized neuroprotective effects of social activity, the evidence on computerized cognitive training, and the emerging behavioral and neuroimaging evidence on physical activity. We conclude that actively aging using a combination of several strategies may be our best line of defense against cognitive decline.
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Mehegan, Laura, and Chuck Rainville. "ADULTS’ UNDERSTANDING OF COGNITIVE DECLINE, DEMENTIA, AND ALZHEIMER’S DISEASE." Innovation in Aging 7, Supplement_1 (December 1, 2023): 130. http://dx.doi.org/10.1093/geroni/igad104.0425.
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Abstract A 2021 nationally representative survey fielded by AARP of adults aged 40 and older (N=3,022) showed that nearly six in ten (58%) believe that cognitive decline is inevitable, and two-thirds (66%) believe they will experience cognitive decline as they age. Nearly half (48%) think it is likely they will get dementia. As a follow up to this research, in 2022, AARP sponsored focus groups (N=31) and in-depth interviews (N=24) to further explore the perceptions of dementia and cognitive decline among individuals aged 40 and older. The main purpose of this research was to evaluate how Americans understand and communicate about dementia and cognitive decline. The results of this research showed personal experience played a greater role than age when it came to participants’ concern and understanding about cognitive decline. Worry about cognitive decline increased for those caring for a friend or family members with dementia or Alzheimer’s disease. Participants expressed feelings of inevitability of cognitive decline, but not dementia or Alzheimer’s disease. Forgetfulness was mentioned by many participants as part of the aging process, but they were clear that dementia and Alzheimer’s disease were not inevitable and were not the same as age-related memory lapses. Normal, age-related changes in memory and cognitive function were not well-understood and neither was the distinction between dementia and Alzheimer’s disease. The results from these studies suggest the general population needs information on cognitive decline, dementia, and Alzheimer’s disease to better understand each and to raise awareness on the proactive steps needed for brain health
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Bahar-Fuchs, Alex, Simon Moss, Christopher Rowe, and Greg Savage. "Awareness of olfactory deficits in healthy aging, amnestic mild cognitive impairment and Alzheimer's disease." International Psychogeriatrics 23, no. 7 (January 21, 2011): 1097–106. http://dx.doi.org/10.1017/s1041610210002371.
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ABSTRACTBackground: Olfactory dysfunction is present in early Alzheimer's disease (AD), and has now been reported in people with amnestic mild cognitive impairment (aMCI). Recent evidence suggests that unawareness of an olfactory deficit may predict which MCI patients will subsequently meet AD criteria. However, important methodological limitations challenge this suggestion. While addressing some of the limitations of previous research, this preliminary study explores unawareness of olfactory deficits as a predictive factor of future AD among people with aMCI.Methods: Twenty-five participants with aMCI, 25 AD patients, and 22 healthy elderly participants underwent testing of olfactory identification. Subjective reports regarding perceived decline in olfactory detection and olfactory identification were also obtained. A subset of participants was reassessed 12 months later.Results: Control participants performed better than both aMCI and AD patients on olfactory identification. Almost uniformly, participants did not report decline in either olfactory detection or identification. Prediction of olfactory identification scores from subjective reports of olfactory function was poor, and awareness of olfactory decline bore no relationship to the likelihood of aMCI patients progressing to AD by the 12-month review.Conclusions: Treating awareness of olfactory function as a unitary construct can be misleading, and there is a poor relationship between subjective and objective measures of olfactory ability. Our preliminary data suggest that unawareness of olfactory decline does not improve the identification of patients with MCI who are more likely to be in the prodromal phase of AD. Replication in a larger cohort is needed to support these findings.
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Eriksson, Johan, Anne Larsson, and Lars Nyberg. "Item-specific Training Reduces Prefrontal Cortical Involvement in Perceptual Awareness." Journal of Cognitive Neuroscience 20, no. 10 (October 2008): 1777–87. http://dx.doi.org/10.1162/jocn.2008.20064.
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Previous studies on the neural correlates of perceptual awareness implicate sensory-specific regions and higher cortical regions such as the prefrontal cortex (PFC) in this process. The specific role of PFC regions is, however, unknown. PFC activity could be bottom-up driven, integrating signals from sensory regions. Alternatively, PFC regions could serve more active top-down processes that help to define the content of consciousness. To compare these alternative views of PFC function, we used functional magnetic resonance imaging and measured brain activity specifically related to conscious perception of items that varied in ease of identification (by being presented 0, 12, or 60 times previously). A bottom-up account predicts that PFC activity would be largely insensitive to stimulus difficulty, whereas a top-down account predicts reduced PFC activity as identification becomes easier. The results supported the latter prediction by showing reduced activity for previously presented compared to novel items in the PFC and several other regions. This was further confirmed by a functional connectivity analysis showing that the interaction between frontal and visual sensory regions declined as a function of ease of identification. Given the attribution of top-down processing to PFC regions in combination with the marked decline in PFC activity for easy items, these findings challenge the prevailing notion that the PFC is necessary for consciousness.
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Ryu, Seon Young, Ahro Kim, SangYun Kim, Kyung Won Park, Kee Hyung Park, Young Chul Youn, Dong Woo Lee, et al. "Self‐ and informant‐reported cognitive functioning and awareness in subjective cognitive decline, mild cognitive impairment, and very mild Alzheimer disease." International Journal of Geriatric Psychiatry 35, no. 1 (October 30, 2019): 91–98. http://dx.doi.org/10.1002/gps.5224.
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Jaroudi, Wafa, Julia Garami, Sandra Garrido, Michael Hornberger, Szabolcs Keri, and Ahmed A. Moustafa. "Factors underlying cognitive decline in old age and Alzheimer’s disease: the role of the hippocampus." Reviews in the Neurosciences 28, no. 7 (October 26, 2017): 705–14. http://dx.doi.org/10.1515/revneuro-2016-0086.
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AbstractThere are many factors that strongly influence the aetiology, development, and progression of cognitive decline in old age, mild cognitive impairment (MCI), and Alzheimer’s disease (AD). These factors include not only different personality traits and moods but also lifestyle patterns (e.g. exercise and diet) and awareness levels that lead to cognitive decline in old age. In this review, we discuss how personality traits, mood states, and lifestyle impact brain and behaviour in older adults. Specifically, our review shows that these lifestyle and personality factors affect several brain regions, including the hippocampus, a region key for memory that is affected by cognitive decline in old age as well as AD. Accordingly, appropriate recommendations are presented in this review to assist individuals in decreasing chances of MCI, dementia, AD, and associated symptoms.
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Sabatini, Serena, Obioha Ukoumunne, Clive Ballard, Kaarin Anstey, Manfred Diehl, Allyson Brothers, Hans-Werner Wahl, and Linda Clare. "Higher Awareness of Positive and Negative Age-Related Changes Relate to Lower Objective Cognitive Scores." Innovation in Aging 4, Supplement_1 (December 1, 2020): 597–98. http://dx.doi.org/10.1093/geroni/igaa057.2010.
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Abstract Existing evidence suggests that individuals’ subjective experience of cognitive decline may be a risk state for dementia. However, whether self-awareness of positive changes confer cognitive protection is unknown. We examined the extent to which awareness of positive (AARC gains) and negative (AARC losses) age-related changes explains variability in objective cognitive performance in a sample of 6,231 UK residents (Mean age= 66.1 years, 75.9% women) without cognitive impairment. We tested a structural equation model with AARC gains and losses as predictors of cognitive performance and depressive symptoms as a mediator of the association of AARC losses with cognitive performance. The model fit the data well. The correlation between AARC gains and losses was negligible, yet higher levels of both AARC gains and losses predicted poorer cognitive scores. Hence, higher AARC gains did not confer cognitive protection. This unexpected pattern of results underscores the complexity of mapping individuals’ awareness onto objective outcomes.
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Nakhla, M., B. Pulido, C. Salcedo-Borrego, J. Lewis, L. Cohen, D. Yassai-Gonzalez, M. J. Marquine, D. Schiehser, D. Salmon, and Z. Zlatar. "Subjective Cognitive Decline Predicts Concurrent Cognition in Hispanics, but not in Non-Hispanic Whites: A Pilot Study." Archives of Clinical Neuropsychology 34, no. 7 (August 30, 2019): 1267. http://dx.doi.org/10.1093/arclin/acz029.34.
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Abstract Objective Subjective cognitive decline (SCD) is prevalent among older adults and may be indicative of future cognitive decline. However, the expression of SCD may vary across ethnic groups due to factors such as educational level, awareness of decline, and depression. This study explored whether SCD scores predicted concurrent cognition in Hispanic and Non-Hispanic White older adults, after adjusting for variables known to affect this relationship. Participants and Method Twenty-two Hispanic (mostly Mexican-American) and 27 Non-Hispanic White older adults were recruited from ongoing studies at the University of California, San Diego. The “My Cognition” version of the Subjective Cognitive Decline Questionnaire (SCD-Q) developed in Spain measured SCD (modified to “Mexican” Spanish and administered in language of preference - 55% in Spanish). The Mattis Dementia Rating Scale (DRS) measured global cognition and the Geriatric Depression Scale (GDS) measured mood. Results A hierarchical regression examined if ethnic group moderated the association between SCD-Q total score and DRS total score after adjusting for age, gender, education, and GDS score. Ethnicity moderated the relationship between SCD and DRS (β = -1.071, p = .024). Higher SCD-Q scores significantly predicted lower DRS scores in Hispanics (β = -.97, p < .01), but not in Non-Hispanic Whites (β = -.23, p = .33), after adjusting for co-variates. Education level was the only significant predictor of DRS scores in the Non-Hispanic group. Conclusions Preliminary findings indicate that the SCD-Q may be a sensitive predictor of concurrent cognitive function in Hispanics, compared to Non-Hispanic Whites, suggesting that the SCD-Q may be culturally sensitive. Future studies should replicate these findings and investigate ethnic differences in the correlates of SCD (i.e., education, acculturation, depression reporting), which may account for the current findings. Importantly, future research should investigate if SCD can predict future cognitive changes in Hispanics.
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Reed, Nia, Christopher A. Taylor, Benjamin Olivari, Karen Wooten, and Lisa C. McGuire. "RACE AND ETHNICITY DISPARITIES IN SUBJECTIVE COGNITIVE DECLINE." Innovation in Aging 3, Supplement_1 (November 2019): S839. http://dx.doi.org/10.1093/geroni/igz038.3091.
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Abstract Alzheimer’s disease (AD) is the most common form of dementia. Subjective cognitive decline (SCD) is the self-reported experience of worsening or more frequent confusion or memory loss and it is one of the earliest noticeable symptoms of AD. Data from respondents aged 45 years and older to the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System Cognitive Decline module were examined to identify race and ethnicity disparities in SCD. This module was administered by 49 participating states, District of Columbia, and Puerto Rico from 2015-2018. Data were analyzed using SAS statistical software and methods that accounted for survey design and weighted data. Prevalence of SCD by race/ethnicity with 95% confidence intervals (CI) was calculated. Among adults aged 45 years and older, one in nine (10.8%; CI=10.5-11.2) non-Hispanic white adults experienced SCD. In comparison, among adults aged 45 years and older, one in nine (11.2%; CI=9.8-12.7) Hispanic, one in eight (13.2%; CI=12.0-14.3) African American/black, and one in five (19.6%; CI=16.0-23.2) American Indian/Alaska Native (AI/AN) adults experienced SCD. These numbers are expected to increase significantly over time, especially for some minority groups. More specifically, Hispanics and African Americans are expected to constitute a large proportion of older adults in the coming decades. There are implications in how communities are reached with respect to awareness of cognitive decline (this includes AI/AN adults, as well). Race and ethnicity disparities in SCD may be influenced by differences in chronic diseases and other risk factors that are also disparate between communities.
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S, Evans, Paitel E, Gregg T, Ballard Z, Otteman C, and Nielson K. "A-163 APOE ε4 Alters Self-Awareness of Executive Function in Cognitively Intact Middle Aged and Older Adults." Archives of Clinical Neuropsychology 35, no. 6 (August 28, 2020): 957. http://dx.doi.org/10.1093/arclin/acaa068.163.
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Abstract Objective Subjective cognitive complaints (SCC) may be an early indicator of future cognitive decline. Although early executive function (EF) decline in Alzheimer’s disease (AD) may be a sensitive predictor, the predicative utility of SCCs specific to EF is unknown. Thus, this study examined whether EF performance predicts SCCs of EF in healthy, well-educated middle aged and older adults, and whether carrying of APOE ε4 alters that prediction. Method Fifty-five cognitively intact middle aged to older adults (Mage = 64.1, range = 48–84, 19 e4+) completed the Frontal Systems Behavior Scale (FrSBe) Executive Dysfunction Scale (EXECDYS) to measure SCCs and an EF battery (Trail-making A&B, Symbol-digit Modalities Test, verbal fluency (letter, category), which principal components analysis (varimax rotation) reduced to a single EF factor. We examined whether SCCs (EXECDYS) were predicted by EF performance (age, depression covaried), and whether ε4 moderated that prediction (PROCESS 3.0). Results The model was significant (R2 = 0.31; p = 0.002), with a significant EXECDYS X ε4 interaction (ß = 4.24, t(55) = 2.37; p = .02), indicating that EF performance predicted EXECDYS, but in ε4-carriers only, those with poorer EF were less aware of that dysfunction. Conclusions Amongst APOE ε4-carriers, a group with high risk for AD, those with poorer EF had less accurate self-awareness of their EF, suggesting earlier formal assessment is needed in ε4-carriers to detect decline. Furthermore, as our study examined healthy, well-educated, cognitively intact adults from middle age, these findings suggest ε4-carriers are at particularly high risk for AD if their self-awareness and performance of EF are both low. Combining EF assessment with self-appraisal of EF may aid AD diagnostics.
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Ramírez-Barrantes, Ricardo, Marcelo Arancibia, Jana Stojanova, Mauricio Aspé-Sánchez, Claudio Córdova, and Rodrigo A. Henríquez-Ch. "Default Mode Network, Meditation, and Age-Associated Brain Changes: What Can We Learn from the Impact of Mental Training on Well-Being as a Psychotherapeutic Approach?" Neural Plasticity 2019 (April 2, 2019): 1–15. http://dx.doi.org/10.1155/2019/7067592.
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Aging is a physiological process accompanied by cognitive decline, principally in memory and executive functions. Alterations in the connectivity of the default mode network (DMN) have been found to participate in cognitive decline, as well as in several neurocognitive disorders. The DMN has antisynchronic activity with attentional networks (task-positive networks (TPN)), which are critical to executive function and memory. Findings pointing to the regulation of the DMN via activation of TPN suggest that it can be used as a strategy for neuroprotection. Meditation is a noninvasive and nonpharmacological technique proven to increase meta-awareness, a cognitive ability which involves the control of both networks. In this review, we discuss the possibility of facilitating healthy aging through the regulation of networks through meditation. We propose that by practicing specific types of meditation, cognitive decline could be slowed, promoting a healthy lifestyle, which may enhance the quality of life for the elderly.
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Garcia-Cifuentes, Elkin, Isabela Marquez, and Carlos Cano. "Motoric Cognitive Risk Syndrome: Prevalence and Cognitive Performance." Innovation in Aging 5, Supplement_1 (December 1, 2021): 592. http://dx.doi.org/10.1093/geroni/igab046.2277.
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Abstract Cognitive decline and dementia have a significant impact older adult. Motor Cognitive Risk Syndrome (MCRS) is a pre-dementia stage where slow gait speed and subjective memory complaints are present. MCRS increases the risk of frailty, dementia, disability, falls and overall mortality. We used data from the SABE Colombia study (Health, Well-Being, and Aging) conducted in 2015 in adults aged 60 years and older. After adjusting for confounding variables MCRS was associated with MMSE (OR 0.90, CI 0.82-0.99), pre-frail (OR 9.1, CI 3.26-25.47) and frail (OR 21.38, CI 6.30-72.57). This study found a prevalence of 5.45% of MCRS in Colombian older adults. We found an associations between cognitive performance (MMSE), frailty and MCRS. Our results increase the awareness of a pre-dementia stages different to Mild Cognitive Impairment (MCI), as these individuals are at greater risk than those with MCI to develop dementia.
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Peters, Ruth, Ying Xu, Ranmalee Eramudugolla, Perminder S. Sachdev, Nicolas Cherbuin, Phillip J. Tully, Moyra E. Mortby, and Kaarin J. Anstey. "Diastolic Blood Pressure Variability in Later Life May Be a Key Risk Marker for Cognitive Decline." Hypertension 79, no. 5 (May 2022): 1037–44. http://dx.doi.org/10.1161/hypertensionaha.121.18799.
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Background: There is an increasing awareness of the need to understand the interaction between long-term blood pressure patterns and their impact on the brain and cognition. Methods: Our aim was to investigate the relationship between repeated blood pressure measures and change in cognitive performance over 12 years and imaging data at 12 years using a longitudinal population study. The data consisted of 2 cohorts, one midlife and one later life. Using linear regression, we examined the relationship between blood pressure (systolic, diastolic, change in blood pressure between visits, and visit-to-visit variability), change in cognitive performance and imaging at 12 years. Results: Data on cognitive change were available in 1054 at midlife, baseline age 42.7 (SD 1.5) and 1233 in later life, 62.5 (1.5) years. Imaging data were available in 168 and 233, respectively. After adjustment for multiple comparisons greater diastolic blood pressure variability in later life was associated with a −1.95 point decline (95% CI, −2.89 to −1.01) on an attention-based task and a −0.42 point (95% CI, −0.68 to −0.15) decline in performance on a psychomotor task. A higher SD in diastolic pressure across follow-up was associated with greater white matter hyperintensity volume (%increase per 10 mm Hg increase in the SD [1.50 (95% CI, 1.16–1.94]). Conclusions: In a largely normotensive/mildly hypertensive population, our analyses reported no relationships between blood pressure and cognition in midlife but a potential role for diastolic blood pressure variability in later life as a risk marker for cognitive decline. This may indicate an at-risk period or a means to identify an at-risk population at the age where diastolic pressure is starting to decline.
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Liu, Huijun, Yaolin Pei, and Bei Wu. "Association between cognitive functioning and active life engagement: A time-use study of older adults in rural China." International Journal of Population Studies 8, no. 1 (June 27, 2022): 52. http://dx.doi.org/10.18063/ijps.v8i1.1301.
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This study aimed to examine the pattern of active life engagement and the association between cognitive functioning and active life engagement among older adults in rural China. Two waves of panel data with the previous day’s activities in a time-use survey were collected among older adults age 60 and older in rural China. Logistic and OLS regressions were used to examine the impacts of cognitive functioning on participation and intensity in six types of activities. The overall active life engagement level of older adults in rural China was relatively low. Cognitive functioning and its decline significantly associated with the active life engagement. Older adults with higher cognitive functioning were more likely to engage in household work, recreational activity, and socially connected activity, and the decline in cognitive functioning was also significantly associated with the lower likelihood of engaging in household work, recreational activity, physical activity, and lower intensity of socially connected activity. Participation in diverse life activities is an important component of successful aging. The findings of this study suggest the need for increasing awareness of the influence of cognition on daily activities. Future interventions need to consider cognitive health to maximize active life engagement in Chinese rural older adults.
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Chan, Kayla Y., Samuel Lee, Catherine H. Ju, Destiny J. Weaver, John Ferguson, and Adriana Hughes. "34 Association Between Subjective Cognitive Decline and Mental Wellbeing in Normal Cognition and MCI Older Adults." Journal of the International Neuropsychological Society 29, s1 (November 2023): 344–45. http://dx.doi.org/10.1017/s1355617723004708.
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Objective:Subjective cognitive decline (SCD, i.e., perceived cognitive decline without neuropsychological deficits) is associated with Alzheimer’s disease pathology and increased risk for cognitive impairment but is heterogenous in etiology and has been linked to other factors including personality and depression. Mental wellbeing (i.e., the perception and functioning of social, emotional, and health-related aspects of one’s life) has been associated with subjective memory complaints, but its relationship with other subjective cognitive domains is poorly understood. Further characterizing the relationship between mental wellbeing and SCD could refine understanding of SCD and inform development of interventions that prevent progression to objective cognitive decline. This study aimed to describe the relationship between mental wellbeing and subjective decline in multiple cognitive domains and examine whether this relationship differs between older adults with normal cognition and those with mild cognitive impairment (MCI).Participants and Methods:Community-dwelling older adults (normal: n = 58, Mage = 73.7±5.6; MCI: n = 43, Mage = 75.9±6.1) completed the Everyday Cognition scale, a validated self-report measure of SCD, and the RAND-36 Health Survey, a validated self-report measure of health-related quality of life which includes a mental wellbeing subscale. Spearman’s rank correlations were conducted between self-reported mental wellbeing and each self-reported cognitive domain (i.e., memory, language, visuospatial, and executive function) for the Normal Cognition and MCI groups.Results:Worse mental wellbeing was associated with worse subjective language and executive function in the normal group, rs(56) = -.42, p =.001; rs(56) = -.37, p =.005, but not for the MCI group, rs(41) = -.23, p =.15; rs(41) = -.12, p =.46. Worse mental wellbeing was associated with worse subjective visuospatial function in the MCI group, rs(41) = -.39, p =.009, but not in the normal group, rs(56) = -.11, p =.39. For both groups, worse mental wellbeing was associated with worse subjective memory, rs(56) = -.45, p < .001; rs(41) = -.37, p =.02. While this correlation was greater in the normal group, the difference was not significant (z = 0.38, p =.71).Conclusions:These results suggest that perceptions of mental wellbeing are related to perceptions of cognitive decline in multiple domains, and that the specific domains involved differ between normal and MCI groups. The differential associations may mean perception of specific cognitive domains more strongly affect mental wellbeing, or mental wellbeing more acutely influences perception of those domains. The overall observed relationship between SCD and mental wellbeing may have several explanations: the impact of broader health perceptions may extend to cognitive perception, behavioral changes associated with poor wellbeing may reduce subjective cognitive function, or worse subjective cognitive function may lead to negative experiences of wellbeing. Future longitudinal investigation could inform causal inferences. The more limited associations between mental wellbeing and SCD among MCI individuals may point to the role of decreased self-awareness (due to cognitive impairment) precluding detection of subtle changes in cognition or wellbeing. This study highlights the importance of better understanding mental wellbeing in experiences of SCD in both normal and MCI older adults to improve cognitive and mental health outcomes.
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Therriault, Joseph, Kok Pin Ng, Tharick A. Pascoal, Min Su Kang, Sulantha S. Mathotaarachchi, Hanne Struyfs, Monica Shin, Serge Gauthier, Vasavan Nair, and Pedro Rosa-Neto. "[P1-368]: LACK OF SELF-AWARENESS OF COGNITIVE DEFICITS PREDICTS DEFAULT MODE NETWORK METABOLIC DECLINE IN MILD COGNITIVE IMPAIRMENT." Alzheimer's & Dementia 13, no. 7S_Part_8 (July 2017): P401. http://dx.doi.org/10.1016/j.jalz.2017.06.384.
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Fiore, Alixandria A., Wilson B. Pfeiffer, Syed A. A. Rizvi, Anais Cortes, Conrad Ziembinski, Ronald Pham, Stephanie Graves, and Urvesh Patel. "Hashimoto Encephalopathy as a Complication of Autoimmune Thyroiditis." Medical Principles and Practice 28, no. 1 (October 24, 2018): 91–95. http://dx.doi.org/10.1159/000494800.
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Objective: To present a case of Hashimoto encephalopathy as a complication of autoimmune thyroiditis. Clinical Presentation and Intervention: A previously healthy 56-year-old female presented with rapidly progressive cognitive decline and visual hallucinations. Being a diagnosis of exclusion, Hashimoto encephalopathy required an extensive laboratory and diagnostic workup, which was done over the course of a 15-day hospitalization. The patient recovered after initial treatment with intravenous methylprednisolone and was then switched to prednisone p.o. Conclusion: This case report illustrates the importance of awareness for Hashimoto encephalopathy, as it remains one of the few easily treatable and reversible causes of rapid cognitive decline.
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Chan, Randolph, Jennifer Y. M. Tang, Tianyin Liu, and Gloria H. Y. Wong. "DIRECTIONALITY BETWEEN COGNITION AND DEPRESSIVE SYMPTOMS: A LONGITUDINAL CROSS-LAGGED PANEL ANALYSIS." Innovation in Aging 3, Supplement_1 (November 2019): S166. http://dx.doi.org/10.1093/geroni/igz038.592.
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Abstract Background and Objectives: The relationship between objective and subjective cognitive function and depressive symptoms is complex and potentially multidirectional. This longitudinal prospective study examined the directionality of their relationship among a community sample of older people with no known diagnosis or treatment for dementia or depression. Research Design and Methods: We examined the temporal relationship between objective cognitive functioning, subjective cognitive complaints, and depressive symptoms in 1,814 community-dwelling older people at baseline and one-year follow-up using regression and two-wave cross-lagged panel analyses, after controlling for demographic and health confounders. Results: Cross-lagged analysis showed that depressive symptoms at follow-up were directly predicted by baseline subjective cognitive complaints, but not baseline objective cognitive functioning. The effect differed across objective cognitive functioning levels. In people with clinically significant cognitive impairment at baseline, objective cognitive decline but not baseline subjective cognitive complaints predicted depressive symptoms. In people with mild objective cognitive impairment at baseline, baseline subjective complaints but not objective cognitive decline predicted depressive symptoms. Discussion and Implications: The effects of objective and subjective cognitive decline on depressive symptoms varied across older people with different levels of cognitive impairment. Awareness and insight of one’s cognitive status may contribute to the development/progression in depressive symptom in people with mild cognitive impairment. Mechanisms unrelated to appraisal may be involved in increased depressive symptoms among older persons with significant objective cognitive impairment.
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D'Souza, Caitlin E., Melanie R. F. Greenway, Jonathan Graff-Radford, and James F. Meschia. "Cognitive Impairment in Patients with Stroke." Seminars in Neurology 41, no. 01 (January 8, 2021): 075–84. http://dx.doi.org/10.1055/s-0040-1722217.
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AbstractDespite substantial advances in stroke care, vascular cognitive impairment remains a prominent source of disability. Unlike sensorimotor impairments, cognition often continues to decline after stroke. An aging population will increase the prevalence of vascular cognitive impairment, with stroke playing an important role. Ten percent of patients presenting with stroke have pre-stroke dementia; an additional 10% will develop incident dementia with a first stroke, and 30% with a recurrent stroke. While stroke increases the risk of cognitive impairment, the presence of cognitive impairment also impacts acute stroke treatment and increases risk of poor outcome by nearly twofold. There is substantial overlap in the clinical and pathological aspects of vascular and degenerative dementias in many patients. How they relate to one another is controversial. The treatment of vascular cognitive impairment remains supportive, focusing on treating vascular risk factors. Cognitive rehabilitation after stroke is an area of active research, and existing pharmacologic treatments have limited benefit. Heightened awareness of cognitive impairment in the setting of stroke is imperative for prognostication and management, impetus for research and, ultimately, the discovery of efficacious treatments.
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Evans, Sarah A., Elizabeth R. Paitel, Riya Bhasin, and Kristy A. Nielson. "Genetic Risk for Alzheimer’s Disease Alters Perceived Executive Dysfunction in Cognitively Healthy Middle-Aged and Older Adults." Journal of Alzheimer's Disease Reports 8, no. 1 (February 16, 2024): 267–79. http://dx.doi.org/10.3233/adr-230166.
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Background: Subjective cognitive complaints (SCC) may be an early indicator of future cognitive decline. However, findings comparing SCC and objective cognitive performance have varied, particularly in the memory domain. Even less well established is the relationship between subjective and objective complaints in non-amnestic domains, such as in executive functioning, despite evidence indicating very early changes in these domains. Moreover, particularly early changes in both amnestic and non-amnestic domains are apparent in those carrying the Apolipoprotein-E ɛ4 allele, a primary genetic risk for Alzheimer’s disease (AD). Objective: This study investigated the role of the ɛ4 allele in the consistency between subjective and objective executive functioning in 54 healthy, cognitively intact, middle-aged and older adults. Methods: Participants (Mage = 64.07, SD = 9.27, range = 48–84; ɛ4+ = 18) completed the Frontal Systems Behavior Scale (FrSBe) Executive Dysfunction Scale (EXECDYS) to measure subjective executive functioning (SEF) and multiple executive functioning tasks, which were condensed into a single factor. Results: After accounting for age, depression, and anxiety, objective executive functioning performance significantly predicted SEF. Importantly, ɛ4 moderated this effect. Specifically, those carrying the ɛ4 allele had significantly less accurate self-awareness of their executive functioning compared to ɛ4 non-carriers. Conclusions: Utilizing an approach that integrates self-evaluation of executive functioning with objective neurocognitive assessment may help identify the earliest signs of impending cognitive decline, particularly in those with genetic risk for AD. Such an approach could sensitively determine those most prone to future cognitive decline prior to symptom onset, when interventions could be most effective.
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Mimmack, Kayden J., Geoffroy P. Gagliardi, Gad A. Marshall, Patrizia Vannini, Michael W. Weiner, Arthur W. Toga, Laurel Beckett, Paul Aisen, Ronald Petersen, and Joseph Locascio. "Measurement of Dimensions of Self-awareness of Memory Function and Their Association With Clinical Progression in Cognitively Normal Older Adults." JAMA Network Open 6, no. 4 (April 25, 2023): e239964. http://dx.doi.org/10.1001/jamanetworkopen.2023.9964.
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ImportanceThe ability to separately explore 2 dimensions of self-awareness of memory function—increased and decreased awareness—in cognitively normal older adults provides an important opportunity to understand subtle changes in either direction in relation to risk of Alzheimer disease.ObjectiveTo investigate the association of a novel measure for self-awareness of memory function with future clinical progression in individuals who were cognitively normal at baseline.Design, Setting, and ParticipantsThis cohort study used data from the Alzheimer’s Disease Neuroimaging Initiative, a multicenter study. Participants were older adults who were cognitively normal (ie, Clinical Dementia Rating [CDR] global score of 0) at baseline and had at least 2 years of follow-up. Data were collected from June 2010 to December 2021 and pulled from the University of Southern California Laboratory of Neuro Imaging database on January 18, 2022. Clinical progression was defined as the first instance of 2 consecutive follow-up CDR scale global scores of 0.5 or greater.Main Outcomes and MeasuresA traditional awareness score was measured by calculating the mean discrepancy between the participant and their study partner’s scores on the Everyday Cognition questionnaire. An unawareness or heightened awareness subscore was generated by capping item-level positive or negative differences at zero before averaging. The main outcome—risk of future clinical progression—was analyzed for each baseline awareness measure using Cox regression analysis. Longitudinal trajectories of each measure were additionally compared using linear mixed-effects models.ResultsThe 436-person sample included 232 (53.2%) female participants, with a mean (SD) age of 74.5 (6.7) years; 25 participants (5.7%) were Black, 14 (3.2%) Hispanic, and 398 (91.3%) White; and 91 participants (20.9%) clinically progressed over their period of observation. Survival analyses showed that a 1-point improvement on the unawareness subscore was associated with an 84% reduction in progression hazard (hazard ratio, 0.16 [95% CI, 0.07-0.35]; P &lt; .001), or equivalently, a 1-point decrease was associated with a 540% increase in progression hazard (95% CI, 183% to 1347%), with no significant results for the heightened awareness or traditional scores.Conclusions and RelevanceIn this cohort study of 436 cognitively normal older adults, unawareness, rather than heightened awareness, of memory decline was strongly associated with future clinical progression, providing further support that discordant self- and informant-reported cognitive decline may provide important information to practitioners.
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Finlay, Jessica, Robert Melendez, and Philippa Clarke. "CONTEXTS OF COGNITIVE DECLINE: MAPPING NEIGHBORHOOD OPPORTUNITIES AND BARRIERS FOR HEALTHY AGING IN PLACE." Innovation in Aging 6, Supplement_1 (November 1, 2022): 139. http://dx.doi.org/10.1093/geroni/igac059.553.
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Abstract Stark geographic variation in later-life health outcomes suggests that local built and social environments are critical in shaping disease and disability, physical and cognitive function, and engagement in everyday life among older adults. This paper presents a community-engaged mapping project aiming to depict the uneven distribution of hazards and amenities relevant to cognitive aging across the United States. Living in neighborhoods with opportunities for social interaction (e.g., coffee shops, senior centers), intellectual stimulation (e.g., museums, libraries) and physical activity (e.g., parks, walkable streets) may slow rates of cognitive decline and reduce risk for Alzheimer’s disease. We assembled a community advisory board to translate research findings into a pilot website and interactive map that assesses neighborhoods for cognitive aging resources and amenities. The objective is to increase public awareness and inform public health and policy efforts to ameliorate community barriers and create more equitable opportunities to promote healthy aging in place.
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Coliță, Daniela, Cezar-Ivan Coliță, Dirk M. Hermann, Eugen Coliță, Thorsten R. Doeppner, Ion Udristoiu, and Aurel Popa-Wagner. "Therapeutic Use and Chronic Abuse of CNS Stimulants and Anabolic Drugs." Current Issues in Molecular Biology 44, no. 10 (October 15, 2022): 4902–20. http://dx.doi.org/10.3390/cimb44100333.
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The available evidence suggests that affective disorders, such as depression and anxiety, increase risk for accelerated cognitive decline and late-life dementia in aging individuals. Behavioral neuropsychology studies also showed that cognitive decline is a central feature of aging impacting the quality of life. Motor deficits are common after traumatic brain injuries and stroke, affect subjective well-being, and are linked with reduced quality of life. Currently, restorative therapies that target the brain directly to restore cognitive and motor tasks in aging and disease are available. However, the very same drugs used for therapeutic purposes are employed by athletes as stimulants either to increase performance for fame and financial rewards or as recreational drugs. Unfortunately, most of these drugs have severe side effects and pose a serious threat to the health of athletes. The use of performance-enhancing drugs by children and teenagers has increased tremendously due to the decrease in the age of players in competitive sports and the availability of various stimulants in many forms and shapes. Thus, doping may cause serious health-threatening conditions including, infertility, subdural hematomas, liver and kidney dysfunction, peripheral edema, cardiac hypertrophy, myocardial ischemia, thrombosis, and cardiovascular disease. In this review, we focus on the impact of doping on psychopathological disorders, cognition, and depression. Occasionally, we also refer to chronic use of therapeutic drugs to increase physical performance and highlight the underlying mechanisms. We conclude that raising awareness on the health risks of doping in sport for all shall promote an increased awareness for healthy lifestyles across all generations.
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Wang, Shanshan, Johanna de Almeida Mello, Mary S. Mittelman, and Anja Declercq. "Feasibility, acceptability and potential helpfulness of the PROACTIVE intervention in Flanders, Belgium: A survey study." PLOS ONE 18, no. 8 (August 10, 2023): e0289952. http://dx.doi.org/10.1371/journal.pone.0289952.
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Background/objectives This study aimed to explore the feasibility of a Flemish adaptation of the New York University Caregiver Intervention (i.e., PROACTIVE intervention) modifying the recruitment and intervention content for informal caregivers of people with early cognitive decline, and across different subgroups. A feasibility study is necessary in order to reduce research waste for intervention adaptation and evaluation. Methods Researchers constructed, tested, and sent out a survey consisting of 43 questions on the following topics: awareness of symptoms of early cognitive decline, levels of cognitive performance using the updated Cognitive Performance Scale (CPS2), acceptability, and potential helpfulness of the intervention, and sociodemographic characteristics. Quantitative data were analyzed using descriptive statistics and logistic regression with SAS 9.4©. Qualitative data were analyzed using an inductive content analysis. Results A total of 463 informal caregivers completed the survey (mean age 58.8 ± 11.8, 83.6% female). Among them, 230 respondents who cared for people with cognitive decline indicated they would probably or certainly participate in the study. Identified factors influencing the recruitment were cognition, co-habitation, education, and employment status. Over half of the target caregivers indicated almost all services from the intervention could satisfy their needs. A majority perceived the PROACTIVE intervention would be helpful (69.4%), especially the CPS2 = 3 (76.1%) and CPS2 = 4 (74.1%) subgroups. Conclusion The recruitment of target participants for a subsequent RCT evaluation study is feasible, and identified associated factors should be considered during the recruitment process. The PROACTIVE intervention and core components except ‘peer-group participation’ were perceived as helpful by most caregivers. The CPS2 = 3–4 subgroups were most accepting of the intervention and were most likely to benefit from the intervention.
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López-Granero, Caridad, Leona Polyanskaya, Diego Ruiz-Sobremazas, Angel Barrasa, Michael Aschner, and Matilde Alique. "Particulate Matter in Human Elderly: Higher Susceptibility to Cognitive Decline and Age-Related Diseases." Biomolecules 14, no. 1 (December 26, 2023): 35. http://dx.doi.org/10.3390/biom14010035.
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This review highlights the significant impact of air quality, specifically particulate matter (PM), on cognitive decline and age-related diseases in the elderly. Despite established links to other pathologies, such as respiratory and cardiovascular illnesses, there is a pressing need for increased attention to the association between air pollution and cognitive aging, given the rising prevalence of neurocognitive disorders. PM sources are from diverse origins, including industrial activities and combustion engines, categorized into PM10, PM2.5, and ultrafine PM (UFPM), and emphasized health risks from both outdoor and indoor exposure. Long-term PM exposure, notably PM2.5, has correlated with declines in cognitive function, with a specific vulnerability observed in women. Recently, extracellular vesicles (EVs) have been explored due to the interplay between them, PM exposure, and human aging, highlighting the crucial role of EVs, especially exosomes, in mediating the complex relationship between PM exposure and chronic diseases, particularly neurological disorders. To sum up, we have compiled the pieces of evidence that show the potential contribution of PM exposure to cognitive aging and the role of EVs in mediating PM-induced cognitive impairment, which presents a promising avenue for future research and development of therapeutic strategies. Finally, this review emphasizes the need for policy changes and increased public awareness to mitigate air pollution, especially among vulnerable populations such as the elderly.
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Hsiao, Chih-Chun, Chun-Chieh Lin, Chun-Gu Cheng, Yin-Han Chang, Hui-Chen Lin, Hsing-Chen Wu, and Chun-An Cheng. "Self-Reported Beneficial Effects of Chinese Calligraphy Handwriting Training for Individuals with Mild Cognitive Impairment: An Exploratory Study." International Journal of Environmental Research and Public Health 20, no. 2 (January 6, 2023): 1031. http://dx.doi.org/10.3390/ijerph20021031.
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Background: Dementia is a common disease in aging populations. The treatment has mainly focused on memory decline prevention and behavior control. Nonpharmacological treatments, such as cognition training, physical exercise, and music therapy have been effective in slowing memory decline. Chinese calligraphy handwriting (CCH) through breath regulation and fine hand control involves high concentration levels, emotion regulation, and self-awareness. CCH is a mind and body activity that is culturally relevant to older Chinese adults. This study evaluated the beneficial effects of CCH on mild cognitive impairment. Methods: In 2018, we conducted 8 weeks of CCH training at the Tri-Service General Hospital. The participants were asked to copy a regular script. At the end of the course, they gave oral presentations and showed their work. Self-report questionnaires on emotion, memory, upper limb coordination, attention, and language were collected before and after training. Results: The five questionnaires showed significantly positive feelings after CCH training. The conditions of emotional stability, concentration, hand movement, memory, and speech improved. Conclusions: CCH training stimulated the brain and improved cognition, psychological symptoms, and hand stability. It is inexpensive and worthwhile for elderly Chinese individuals with mild cognitive impairment to take time daily to practice calligraphy.
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Clements-Cortes, Amy, Lee Bartel, Heidi Ahonen, Morris Freedman, Michael Evans, and David Tang-Wai. "Can Rhythmic Sensory Stimulation Decrease Cognitive Decline in Alzheimer's Disease?: A Clinical Case Study." Music and Medicine 9, no. 3 (July 28, 2017): 174. http://dx.doi.org/10.47513/mmd.v9i3.565.
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Background/Objectives: To present Rhythmic Sensory Stimulation (RSS) as a potential new treatment of Alzheimer’s disease (AD).Design: Longitudinal case study over a three year period.Setting: RSS was provided both in a long-term care/research facility and in-home.Participant: One 92 year old female with AD.Intervention: Treatments consisted of RSS resulting in gamma frequency entrainment, provided by two different treatment devices over three years.Measurements: Quantitative and qualitative measures were used including: MMSE, SLUMS, interviews, observation notes and a participant question sheet.Results: MMSE scores since diagnosis three years earlier, as well as cognition, clarity, and awareness were reported by the case’s husband to have remained unchanged.Conclusion: Although further research is warranted, this case suggests that RSS has potential to help maintain cognition in AD.
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Kita, Masahiro, Kuniaki Obara, Sumio Kondo, Satoshi Umeda, and Yasuhisa Ano. "Effect of Supplementation of a Whey Peptide Rich in Tryptophan-Tyrosine-Related Peptides on Cognitive Performance in Healthy Adults: A Randomized, Double-Blind, Placebo-Controlled Study." Nutrients 10, no. 7 (July 13, 2018): 899. http://dx.doi.org/10.3390/nu10070899.
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Background: Previous epidemiological and clinical studies have shown that dairy products have beneficial effects on cognitive decline and dementia. Enzymatic digestion of whey protein produces a whey peptide rich in tryptophan-tyrosine-related peptides which improve cognitive performance in mice. We evaluated the effects of whey peptides on cognitive functions in healthy adults in a randomized, double-blind, placebo-controlled design. Methods: 101 healthy adults (45 to 64 years), with a self-awareness of cognitive decline received either whey peptide or placebo supplements for 12 weeks. Changes in cognitive function were assessed using neuropsychological tests at 6 and 12 weeks after the start of supplementation. Results: Verbal fluency test (VFT) score changes tended to be higher in the whey peptide group compared with the placebo at 12 weeks. Subgroup analysis classified by the degree of subjective fatigue showed that changes in the VFT as well as the Stroop and subjective memory function tests between baseline and 6 weeks of intervention were significantly better in subjects with high-level fatigue from the whey peptide group as compared to the placebo group. Conclusions: Intake of whey peptide might improve cognitive function in healthy middle- and older-aged adults with high subjective fatigue levels. Further studies will elucidate the relationship among cognitive improvement, whey peptides, and psychological fatigue.
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Ni, Lianghui, Mingyan Zhao, Zhishan Hu, Kun Yang, Xing Zhao, Haijing Niu, and Hua Lin. "Neural Mechanism of Shentai Tea Polyphenols on Cognitive Improvements for Individuals with Subjective Cognitive Decline: A Functional Near-Infrared Spectroscopy Study." Journal of Alzheimer's Disease 82, no. 3 (August 3, 2021): 1137–45. http://dx.doi.org/10.3233/jad-210469.
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Background: A growing awareness about non-pharmacological intervention for cognitively impaired individuals may represent an alternative therapeutic approach that is actively accepted by patients with very early stage of Alzheimer’s disease. Understanding the neural basis of non-pharmacological intervention is a crucial step toward wide use for patients with cognitive disorders. Objective: To investigate the underlying neural mechanism of shentai tea polyphenols in subjects with subjective cognitive decline (SCD) using functional near-infrared spectroscopy (fNIRS). Methods: A total number of 36 patients with SCD participated in the study and received supplementation with shentai tea polyphenols for three months. All participants underwent a series of tests on neuropsychological function and fNIRS assessment during n-back tasks at baseline and follow-up. Results: After intervention with shentai tea polyphenols in SCD, increased cerebral activity was observed in left dorsolateral prefrontal cortex (DLPFC), left premotor cortex (PMC), left primary somatosensory cortex (PSC), right inferior frontal gyrus (IFG), and premotor cortex (PMC). Moreover, shentai tea polyphenols intervention of three months significantly improved SCD subjects’ cognitive functions (memory, language, and subjective cognitive ability) and depression condition. We further found that the improvement of Hamilton Depression Rating Scale and Auditory Verbal Learning Test-recognition scores had positive correlations with increased brain activity in right IFG and left DLPFC, respectively. Conclusion: This study provides new evidence that the frontal cortex was found to be specifically activated after non-pharmacological intervention of shentai tea polyphenols in SCD, which may be associated with cognitive enhancement and mental wellbeing. These findings provide important implications for the selection of shentai tea polyphenols interventions for SCD.
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Ling, Janet, Wai Lan Yeung, Kam Lun Hon, Ivan F. M. Lo, Ho-Ming Luk, Cheuk Wing Fung, and Alexander K. C. Leung. "Successful Treatment of Drug-Resistant Seizures Secondary to Ring 20 Mosaicism with Perampanel as an Add-On Antiepileptic Drug." Case Reports in Pediatrics 2022 (May 26, 2022): 1–6. http://dx.doi.org/10.1155/2022/7414628.
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We report a girl with drug-resistant seizures, progressive behavioral changes, and cognitive decline. Investigations showed abnormal EEG with frequent high-voltage bifrontotemporal sharp and slow waves, especially during sleep. Seizures were difficult to control, despite the usage of various antiepileptic drugs. Perampanel as an add-on antiepileptic drug appeared efficacious. Due to the recognizable pattern of seizures and EEG findings, a karyotype study was performed which revealed 46 chromosomes with a ring 20 chromosome mosaicism. Ring 20 chromosome is associated with drug-resistant refractory seizures, cognitive decline, and behavioral problems. This case highlights the difficulty and challenge faced in managing drug-resistant refractory seizures associated with ring 20 chromosome. While ring 20 chromosome is often underdiagnosed, one should have a high index of awareness and suspicion of such rare epilepsy syndrome, so that an early diagnosis can be made.
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Engmann, Birk. "Mild Cognitive Impairment in the Elderly." GeroPsych 24, no. 2 (June 2011): 71–76. http://dx.doi.org/10.1024/1662-9647/a000036.
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The article reviews the relationship between depressive symptoms and mild cognitive impairment (MCI). Evidence bearing on this relation comes from clinical findings, neuroimaging, and cerebrospinal fluid markers. Depression in elderly people is associated with a higher occurrence of cognitive impairment, whereas the decline of cognitive functions over time seems to be a predictor of the development of dementia. Further symptoms predicting a high risk of progression from MCI to dementia are anxiety, restlessness, and low awareness of cognitive malfunction. There are controversies in the literature, however, about the connections among vascular brain lesions, depression, and MCI. Frontal and temporal brain regions seem to be at the core of functional changes in MCI patients. Several studies of cerebrospinal fluid point out the role of tau protein in predicting the outcome of MCI over time. In conclusion, diagnosis of MCI demands a complex assessment. MCI patients with and without depression need careful follow-up investigations.