Journal articles: 'Cognitive decline'

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Tomaszewski Farias, Sarah, Tania Giovannetti, Brennan R. Payne, Michael Marsiske, George W. Rebok, K. Warner Schaie, Kelsey R. Thomas, et al. "Self-perceived Difficulties in Everyday Function Precede Cognitive Decline among Older Adults in the ACTIVE Study." Journal of the International Neuropsychological Society 24, no. 1 (August 11, 2017): 104–12. http://dx.doi.org/10.1017/s1355617717000546.

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AbstractObjectives: Careful characterization of how functional decline co-evolves with cognitive decline in older adults has yet to be well described. Most models of neurodegenerative disease postulate that cognitive decline predates and potentially leads to declines in everyday functional abilities; however, there is mounting evidence that subtle decline in instrumental activities of daily living (IADLs) may be detectable in older individuals who are still cognitively normal. Methods: The present study examines how the relationship between change in cognition and change in IADLs are best characterized among older adults who participated in the ACTIVE trial. Neuropsychological and IADL data were analyzed for 2802 older adults who were cognitively normal at study baseline and followed for up to 10 years. Results: Findings demonstrate that subtle, self-perceived difficulties in performing IADLs preceded and predicted subsequent declines on cognitive tests of memory, reasoning, and speed of processing. Conclusions: Findings are consistent with a growing body of literature suggesting that subjective changes in everyday abilities can be associated with more precipitous decline on objective cognitive measures and the development of mild cognitive impairment and dementia. (JINS, 2018, 24, 104–112)

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Fonseca, Jose Andres Saez, Rhiannon Ducksbury, Joanne Rodda, Timothy Whitfield, Chitra Nagaraj, Kallur Suresh, Tim Stevens, and Zuzana Walker. "Factors that predict cognitive decline in patients with subjective cognitive impairment." International Psychogeriatrics 27, no. 10 (March 27, 2015): 1671–77. http://dx.doi.org/10.1017/s1041610215000356.

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ABSTRACTBackground:Current evidence supports the concept of a preclinical phase of Alzheimer's disease (AD) where pathological and imaging changes are present in asymptomatic individuals. Subjective cognitive impairment (SCI) may represent the earliest point on the continuum of AD. A better understanding of the baseline characteristics of this group of patients that later decline in cognition will enhance our knowledge of the very early disease processes, facilitate preventive strategies, early diagnosis, timely follow-up and treatment.Methods:An observational exploratory study which followed up 62 consecutive patients with SCI presenting to a memory clinic and compared baseline characteristics of SCI patients who declined cognitively with those who did not. Cognitive decline was defined as a progression to a diagnosis of amnestic mild cognitive impairment (aMCI) or dementia at follow-up.Results:Patients were followed up for a mean of 44 months (range 12–112 months). At the time of follow up, 24% of patients had declined. Patients that declined were significantly older at onset of symptoms and first presentation to memory clinic, and took significantly more medications for physical illnesses. Patients that declined also performed significantly worse on Trail Making Test (TMT) B and Cambridge Cognitive Examination – Revised (CAMCOG-R) at baseline. Survival analysis identified key variables that predicted decline (later age of onset and later age at first assessment).Conclusions:Patients who present with subjective memory complaints and are over the age of 61 years are at high risk of cognitive decline and warrant an in-depth assessment and follow-up.

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Kaufmann, Christopher N., Mark W. Bondi, James D. Murphy, Xin Tu, and Alison A. Moore. "COGNITIVE TRAJECTORIES BEFORE AND AFTER SLEEP TREATMENT INITIATION IN U.S. OLDER ADULTS WITH SLEEP DISTURBANCE." Innovation in Aging 3, Supplement_1 (November 2019): S403—S404. http://dx.doi.org/10.1093/geroni/igz038.1499.

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Abstract Sleep disturbances are associated with cognitive decline but it is not clear if initiation of sleep treatments mitigates decline. We used the 2006-2014 Health and Retirement Study. At each wave, participants were administered cognitive assessments and scores were summed (values=0-35; higher=better cognition). All participants also reported if, in the past two weeks, they had taken medications or used other treatments to improve sleep. Our sample (N=4,650) included individuals who at baseline were cognitively normal and untreated for sleep, and at any wave reported some sleep disturbance. We characterized cognitive performance over study period with comparisons before and after sleep treatment initiation. Between 2006-2014, participants exhibited declines in cognitive performance (B=-2.40; 95% CI=-2.73, -2.06; p<0.001) after controlling for confounders. Following sleep treatment, cognitive decline became less pronounced (interaction B=0.94; 95% CI=0.21, 1.67; p=0.013). Results suggest that in older adults with sleep disturbance, initiation of sleep treatment may slow cognitive decline.

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Fernandez, Shane, Samantha C. Burnham, Lidija Milicic, Greg Savage, Paul Maruff, Madeline Peretti, Hamid R. Sohrabi, et al. "SPON1 Is Associated with Amyloid-β and APOE ε4-Related Cognitive Decline in Cognitively Normal Adults." Journal of Alzheimer's Disease Reports 5, no. 1 (February 24, 2021): 111–20. http://dx.doi.org/10.3233/adr-200246.

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Abstract. Background: Genetic variation in Spondin-1, specifically rs11023139, has been associated with reduced rates of cognitive decline in individuals with Alzheimer’s disease. Objective: The aim of this study was to assess whether the association was present in cognitively normal older adults. Methods: Longitudinal cognitive decline was investigated using linear mixed modelling in a cohort of 590 cognitively normal older adults enrolled in the Australian Imaging, Biomarkers and Lifestyle Study. Results: No independent effect of Spondin-1 rs11023139 on cognitive decline was observed. However, significant associations were observed for the interaction between Apolipoprotein E (APOE) ɛ4 and rs11023139 in individuals with high amyloid-β burden. APOE ɛ4/rs11023139-A carriers declined significantly faster than APOE ɛ4/rs11023139-G_G carriers in measures of global cognition (p = 0.011) and verbal episodic memory (p = 0.020). Conclusion: These results suggest that carriage of the Spondin-1 rs11023139-A allele significantly contributes to a worsening of cognitive performance in APOE ɛ4 cognitively normal older adults with a high neocortical amyloid-β burden.

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Stieger, Mirjam, and Margie Lachman. "Cognitive Activity as a Moderator of Educational Attainment and Work Status in Cognitive Aging." Innovation in Aging 4, Supplement_1 (December 1, 2020): 290–91. http://dx.doi.org/10.1093/geroni/igaa057.931.

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Abstract Cross-sectional findings showed that education differences in memory performance were moderated by frequent cognitive activity (Lachman et al., 2010). The present study examined whether frequent cognitive activity could compensate for lower education when focusing on change in cognitive performance across nine years. The study also explored whether cognitive activity can slow down declines in retired adults as previous research suggested that retiring is associated with an increased risk of cognitive decline (e.g., Wickrama et al., 2013). Longitudinal data from the MIDUS study included N = 3,325 middle-aged and older adults. Outcome variables were two factors of cognitive performance: Episodic Memory (EM) and Executive Functioning (EF). Independent variables were years of education, work status (working vs. retired), and frequency of cognitive activity. The results suggest that cognitive activity moderated the effect of educational attainment on change in EM. Individuals with both higher education and cognitive activity showed the smallest declines in EM. Individuals with lower educational attainment but high cognitive activity had less decline in EM compared to their low education counterparts. Those who increased their cognitive activity over time showed less decline in EF. In terms of work status, working adults had less decline in EM and EF compared to retired adults and retired adults who did not maintain their cognitive activity declined more in EF. The results emphasize the importance of frequent engagement in cognitive activity across the lifespan, which can attenuate cognitive declines especially among those who have lower education or have retired.

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Kiselica, A., J. Benge, A. Kaser, B. Small, and T. Webber. "A-01 Objective and Subjective Cognitive Declines as Complementary Symptoms of Early Alzheimer’s Disease." Archives of Clinical Neuropsychology 35, no. 6 (August 28, 2020): 774. http://dx.doi.org/10.1093/arclin/acaa067.01.

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Abstract Objective Subjective and objective cognitive declines are given equal weight as symptoms of pre-mild cognitive impairment in Alzheimer’s disease by recent research criteria. However, the overlap of these constructs is unclear. We used standardized regression-based (SRB) change to define subtle objective cognitive decline across serial neuropsychological assessments. We then examined the associations between objective change and subjective cognitive complaints. Finally, we investigated the impact of different symptom combinations on rates of classification for the early stages of the Alzheimer’s Continuum. Method Data from 1,341 cognitively intact older adults with serial Uniform Data Set 3.0 Neuropsychological Battery assessments (6–24-month follow-ups) were used to compute SRB declines at the following z-scores cut-points: −1.282, −1.645, and − 1.96. We used Chi-square tests and Cohen’s kappa statistics to evaluate the relationship between SRB change and presence/absence of subjective cognitive decline at follow-up. We also examined the prevalence rates of different symptom combinations in an amyloid positive sample (n = 29). Results The base rate of having at least one significant SRB decline ranged from 26.00% to 59.40%. Subjective cognitive decline was positively associated with SRB-defined decline in the normative sample, though agreement was limited (= − .01–.10). SRB decline with no subjective decline occurred in 0.0–37.90% of amyloid positive participants, while 3.40–37.90% had subjective but not objective decline. 37.90–79.30% of amyloid positive participants exhibited either SRB or subjective decline. Conclusions Subjective and objective cognitive declines appear to represent unique symptom classes and should be separately considered when staging patients on the Alzheimer’s Continuum.

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Dasgupta, Indranil, Mitesh Patel, Nuredin Mohammed, Jyoti Baharani, Thejasvi Subramanian, G. Neil Thomas, and George Tadros. "Cognitive Function Declines Significantly during Haemodialysis in a Majority of Patients: A Call for Further Research." Blood Purification 45, no. 4 (2018): 347–55. http://dx.doi.org/10.1159/000485961.

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Introduction: Cognitive impairment (CI) is very common condition that occurs in haemodialysis patients and it is associated with reduced functional capacity and mortality. We assessed the change in cognitive function during haemodialysis and associated risk factors. Methods: All patients ≥50 years, on haemodialysis for ≥3 months, no dementia from 2 dialysis centres were selected. Cognition was assessed before and after a haemodialysis session using parallel versions of the Montreal Cognitive Assessment (MOCA) tool. Multiple regression was used to examine potential confounders. Results: Eight-two patients completed both tests – median age 73 (52–91) years, 59% male, dialysis vintage 41 (3–88) months. Sixty-two (76%) had CI at baseline. Cognition declined over dialysis (MOCA 21 ± 4.8 to 19.1 ± 4.1, p < 0.001) and domains affected were attention, language, abstraction and delayed recall. Age and dialysis vintage were independently associated with decline. Conclusion: Cognitive function declines over a haemodialysis session and this has significant clinical implications over health literacy, self-management and tasks like driving. More research is needed to find the cause for this decline in cognition.

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Atkinson, Taylor, Dylan Jester, and William Haley. "Spousal Caregiving and Cognitive Trajectories: Does Care Recipient Dementia Status Matter?" Innovation in Aging 4, Supplement_1 (December 1, 2020): 359–60. http://dx.doi.org/10.1093/geroni/igaa057.1157.

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Abstract Caregiving is often considered stressful, even more so if the care recipient has been diagnosed with dementia. The current study examines the rate of cognitive decline of spousal caregivers of persons with dementia (CG-D) when compared to spousal caregivers of persons without dementia (CG) before and after the death of the care recipient. Health and Retirement Study (HRS) data from 1998-2016 were used to examine cognitive trajectories of CG-D (n=364) and CG (n=1,649) before and after the care recipient death. Cognition was measured through the HRS’s shortened Telephone Interview of Cognitive Status and separated into measures of total cognition and memory. Covariates included age, education, sex, race, ethnicity, care hours, frailty, socioeconomic status, nursing home placement of the recipient, and whether the death was expected. Piecewise mixed models were constructed to examine two two-year periods of decline leading up to the death of the care recipient, and two two-year periods of decline after the death of the care recipient. CG-D and CG declined at equivalent rates on measures of total cognition and memory (ps > .05). In all caregivers, total cognition and memory declined at a stable rate before the death of the care recipient. However, an accelerated decline was evident after the death of the care recipient (ps < .001). Our results suggest that cognitive decline is not differentially affected by care recipient dementia diagnosis. We find evidence that the death of a spousal care recipient is accompanied by hastened cognitive decline in our population-based sample.

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Tales, Andrea, Frank Jessen, Christopher Butler, Gordon Wilcock, Judith Phillips, and Tony Bayer. "Subjective Cognitive Decline." Journal of Alzheimer's Disease 48, s1 (September 24, 2015): S1—S3. http://dx.doi.org/10.3233/jad-150719.

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Sander, Ruth. "Detecting cognitive decline." Nursing Older People 24, no. 2 (February 24, 2012): 13. http://dx.doi.org/10.7748/nop.24.2.13.s11.

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Gordon, Phillip. "Postoperative Cognitive Decline." American Journal of Biomedical Science & Research 4, no. 4 (August 6, 2019): 237–38. http://dx.doi.org/10.34297/ajbsr.2019.04.000806.

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Scheltens, Philip. "Subjective cognitive decline." Journal of the Neurological Sciences 429 (October 2021): 118004. http://dx.doi.org/10.1016/j.jns.2021.118004.

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Weinstein, Barbara E. "Preventing Cognitive Decline." Hearing Journal 68, no. 9 (September 2015): 22. http://dx.doi.org/10.1097/01.hj.0000471627.83736.cc.

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Hunt, Summer. "Preventing Cognitive Decline." Nursing for Women's Health 22, no. 2 (April 2018): 109. http://dx.doi.org/10.1016/s1751-4851(18)30079-5.

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Sauër, Anne-Mette, Cornelis Kalkman, and Diederik van Dijk. "Postoperative cognitive decline." Journal of Anesthesia 23, no. 2 (May 2009): 256–59. http://dx.doi.org/10.1007/s00540-009-0744-5.

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Nolan, Karen A., and John P. Blass. "Preventing Cognitive Decline." Clinics in Geriatric Medicine 8, no. 1 (February 1992): 19–34. http://dx.doi.org/10.1016/s0749-0690(18)30495-6.

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Eckenhoff, Roderic G., and Emmanuel Planel. "Postoperative Cognitive Decline." Anesthesiology 116, no. 4 (April 1, 2012): 751–52. http://dx.doi.org/10.1097/aln.0b013e31824be8e1.

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Roy, Shumita, Allison Drake, Tom Fuchs, Michael G. Dwyer, Robert Zivadinov, Benjamin P. Chapman, Bianca Weinstock-Guttman, and Ralph HB Benedict. "Longitudinal personality change associated with cognitive decline in multiple sclerosis." Multiple Sclerosis Journal 24, no. 14 (January 24, 2018): 1909–12. http://dx.doi.org/10.1177/1352458517753720.

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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.

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Smid, Jerusa, Adalberto Studart-Neto, Karolina Gouveia César-Freitas, Marcia Cristina Nascimento Dourado, Renata Kochhann, Breno José Alencar Pires Barbosa, Lucas Porcello Schilling, et al. "Subjective cognitive decline, mild cognitive impairment, and dementia - syndromic approach: recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology." Dementia & Neuropsychologia 16, no. 3 suppl 1 (September 2022): 1–24. http://dx.doi.org/10.1590/1980-5764-dn-2022-s101en.

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ABSTRACT This consensus, performed by the Brazilian Academy of Neurology (BAN) will approach practically how to evaluate patients with cognitive complaints and how to clinically and etiologically diagnose the three clinical syndromes associated with the different stages of cognitive decline: subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia. This BAN consensus discusses SCD diagnosis for the first time, updates MCI and dementia diagnoses, recommends the adequate cognitive tests and the relevant etiological work-up and care of patients with cognitive decline at different levels of care within the Brazilian Unified Health System. We also review the main assessment instruments used in Brazil and Latin America.

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Smits, L. L., A. C. van Harten, Y. A. L. Pijnenburg, E. L. G. E. Koedam, F. H. Bouwman, N. Sistermans, I. E. W. Reuling, et al. "Trajectories of cognitive decline in different types of dementia." Psychological Medicine 45, no. 5 (September 17, 2014): 1051–59. http://dx.doi.org/10.1017/s0033291714002153.

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Background.To investigate trajectories of cognitive decline in patients with different types of dementia compared to controls in a longitudinal study.Method.In 199 patients with Alzheimer's disease (AD), 10 with vascular dementia (VaD), 26 with dementia with Lewy bodies (DLB), 20 with behavioural variant frontotemporal dementia (bvFTD), 15 with language variant frontotemporal dementia (lvFTD) and 112 controls we assessed five cognitive domains: memory, language, attention, executive and visuospatial functioning, and global cognition (Mini-Mental State Examination, MMSE). All subjects had at least two neuropsychological assessments (median 2, range 2–7). Neuropsychological data were standardized into z scores using baseline performance of controls as reference. Linear mixed models (LMMs) were used to estimate baseline cognitive functioning and cognitive decline over time for each group, adjusted for age, gender and education.Results.At baseline, patients with dementia performed worse than controls in all cognitive domains (p < 0.05) except visuospatial functioning, which was only impaired in patients with AD and DLB (p < 0.001). During follow-up, patients with AD declined in all cognitive domains (p < 0.001). DLB showed decline in every cognitive domain except language and global cognition. bvFTD showed rapid decline in memory, language, attention and executive functioning (all p < 0.01) whereas visuospatial functioning remained fairly stable. lvFTD declined mostly in attention and executive functioning (p < 0.01). VaD showed decline in attention and executive functioning.Conclusions.We show cognitive trajectories of different types of dementia. These estimations of natural disease course have important value for the design of clinical trials as neuropsychological measures are increasingly being used as outcome measures.

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Zammit, Andrea R., Jingyun Yang, Aron S. Buchman, Sue E. Leurgans, Graciela Muniz-Terrera, Richard B. Lipton, Charles B. Hall, Patricia Boyle, and David A. Bennett. "Latent Cognitive Class at Enrollment Predicts Future Cognitive Trajectories of Decline in a Community Sample of Older Adults." Journal of Alzheimer's Disease 83, no. 2 (September 14, 2021): 641–52. http://dx.doi.org/10.3233/jad-210484.

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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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Kikkert, Lisette H. J., Nicolas Vuillerme, Jos P. van Campen, Bregje A. Appels, Tibor Hortobágyi, and Claudine J. C. Lamoth. "The relationship between gait dynamics and future cognitive decline: a prospective pilot study in geriatric patients." International Psychogeriatrics 30, no. 9 (December 10, 2017): 1301–9. http://dx.doi.org/10.1017/s1041610217002770.

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ABSTRACTBackground:Walking ability recently emerged as a sub-clinical marker of cognitive decline. Hence, the relationship between baseline gait and future cognitive decline was examined in geriatric patients. Because a “loss of complexity” (LOC) is a key phenomenon of the aging process that exhibits in multiple systems, we propose the idea that age- and cognition-related LOC may also become manifested in gait function. The LOC theory suggests that even healthy aging is associated with a (neuro)physiological breakdown of system elements that causes a decline in variability and an overall LOC. We used coordination dynamics as a conceptual framework and hypothesized that a LOC is reflected in dynamic gait outcomes (e.g. gait regularity, complexity, stability) and that such outcomes could increase the specificity of the gait-cognition link.Methods:19 geriatric patients (age 80.0±5.8) were followed for 14.4±6.6 months. An iPod collected three-dimensional (3D) trunk accelerations while patients walked for 3 minutes. Cognition was evaluated with the Mini-Mental State Examination (MMSE) and the Seven-Minute screen (7MS) test. The Reliable Change Index (RCI) quantified the magnitude of cognitive change. Spearman's Rho coefficients (ρ) indexed correlations between baseline gait and future cognitive change.Results:Seven patients showed reliable cognitive decline (“Cognitive Decline” group), and 12 patients remained cognitively stable (“Cognitive Stable” group) over time. Future cognitive decline was correlated with a more regular (ρ = 0.579*) and predictable (ρ = 0.486*) gait pattern, but not with gait speed.Conclusions:The increase in gait regularity and predictability possibly reflects a LOC due to age- and cognition-related (neuro)physiological decline. Because dynamic versus traditional gait outcomes (i.e. gait speed and (variability of) stride time) were more strongly correlated with future cognitive decline, the use of wearable sensors in predicting and monitoring cognitive and physical health in vulnerable geriatric patients can be considered promising. However, our results are preliminary and do require replication in larger cohorts.

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Clark, Lindsay R., Dawn M. Schiehser, Gali H. Weissberger, David P. Salmon, Dean C. Delis, and Mark W. Bondi. "Specific Measures of Executive Function Predict Cognitive Decline in Older Adults." Journal of the International Neuropsychological Society 18, no. 1 (November 24, 2011): 118–27. http://dx.doi.org/10.1017/s1355617711001524.

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AbstractDecline in executive function has been noted in the prodromal stage of Alzheimer's disease (AD) and may presage more global cognitive declines. In this prospective longitudinal study, five measures of executive function were used to predict subsequent global cognitive decline in initially nondemented older adults. Of 71 participants, 15 demonstrated significant decline over a 1-year period on the Dementia Rating Scale (Mattis, 1988) and the remaining participants remained stable. In the year before decline, the decline group performed significantly worse than the no-decline group on two measures of executive function: the Color-Word Interference Test (CWIT; inhibition/switching condition) and Verbal Fluency (VF; switching condition). In contrast, decliners and non-decliners performed similarly on measures of spatial fluency (Design Fluency switching condition), spatial planning (Tower Test), and number-letter switching (Trail Making Test switching condition). Furthermore, the CWIT inhibition-switching measure significantly improved the prediction of decline and no-decline group classification beyond that of learning and memory measures. These findings suggest that some executive function measures requiring inhibition and switching provide predictive utility of subsequent global cognitive decline independent of episodic memory and may further facilitate early detection of dementia. (JINS, 2012, 18, 118–127)

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Sliwinski, Martin J., Robert S. Stawski, Charles B. Hall, Mindy Katz, Joe Verghese, and Richard Lipton. "Distinguishing Preterminal and Terminal Cognitive Decline." European Psychologist 11, no. 3 (January 2006): 172–81. http://dx.doi.org/10.1027/1016-9040.11.3.172.

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This paper reviews different methodological approaches taken to examine terminal decline in cognitive function, and presents new findings from the Bronx Aging Study (BAS). Numerous approaches have been taken to assess mortality effects on cognition: comparing survivors and decedents level and rate of change in cognition, and identifying individual differences in cognition associated with time-to-death. However, few studies have actually modeled within-person change in cognition as a function of time-to-death. Using linear mixed models with a change point, intraindividual change in episodic memory was modeled as a function of both age and time-to-death. A dramatic increase in the rate of decline was identified at 8.4 years prior to death, providing clear evidence of a terminal-decline phase that is much longer than previously estimated. These results emphasize the importance of modeling the time course and effects of terminal cognitive decline for understanding cognitive change in aging adults.

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Riedel, Wim J., and Jellemer Jolles. "Cognition Enhancers in Age-Related Cognitive Decline." Drugs & Aging 8, no. 4 (April 1996): 245–74. http://dx.doi.org/10.2165/00002512-199608040-00003.

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Kang, Minjeong, Inhwan Lee, Haeryun Hong, Jeonghyeon Kim, and Hyunsik Kang. "Predictors of Changes in Cognitive Function in Older Korean Adults: The 2006–2018 Korean Longitudinal Study of Aging." International Journal of Environmental Research and Public Health 18, no. 12 (June 11, 2021): 6345. http://dx.doi.org/10.3390/ijerph18126345.

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Cognitive decline with normal aging varies widely among individuals. This study aimed to investigate predictors of longitudinal changes in cognitive function in community-dwelling Korean adults aged 65 years and older. Data from 727 older adults who participated in the Korean Longitudinal Study of Aging (KLoSA) survey from 2006 (baseline) until 2018 (seventh wave) were used. Cognitive performance was assessed with the Korean Mini-Mental State Examination. The participants were retrospectively classified into normal cognition, mild cognitive impairment, and moderate/severe cognitive impairment. Education, income, religion, living area, alcohol intake, smoking, physical activity, handgrip strength, functional dependency, depression, comorbidity, medications, fall experience, and unintentional weight loss were included as covariates. A linear mixed regression analysis showed that a steeper decline in cognitive function over time was significantly associated with parameters of poor socio-economic status, health conditions, and unhealthy behaviors. Individuals with mild cognitive impairment or moderate/severe cognitive impairment were likely to have steeper cognitive declines compared with individuals with normal cognition. The current findings of the study showed that age-related cognitive decline was multifactorial in older Korean adults.

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Sharma, Dr Ankita. "Activities, Social Engagement and Cognitive Decline among Elderly Male." International Journal of Scientific Research 3, no. 8 (June 1, 2012): 393–98. http://dx.doi.org/10.15373/22778179/august2014/121.

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Motyl, Jiri, Lucie Friedova, Manuela Vaneckova, Jan Krasensky, Balazs Lorincz, Jana Blahova Dusankova, Michaela Andelova, et al. "Isolated Cognitive Decline in Neurologically Stable Patients with Multiple Sclerosis." Diagnostics 11, no. 3 (March 7, 2021): 464. http://dx.doi.org/10.3390/diagnostics11030464.

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(1) Background: Cognitive deterioration is an important marker of disease activity in multiple sclerosis (MS). It is vital to detect cognitive decline as soon as possible. Cognitive deterioration can take the form of isolated cognitive decline (ICD) with no other clinical signs of disease progression present. (2) Methods: We investigated 1091 MS patients from the longitudinal GQ (Grant Quantitative) study, assessing their radiological, neurological, and neuropsychological data. Additionally, the confirmatory analysis was conducted. Clinical disease activity was defined as the presence of new relapse or disability worsening. MRI activity was defined as the presence of new or enlarged T2 lesions on brain MRI. (3) Results: Overall, 6.4% of patients experienced cognitive decline and 4.0% experienced ICD without corresponding clinical activity. The vast majority of cognitively worsening patients showed concomitant progression in other neurological and radiologic measures. There were no differences in disease severity between completely stable patients and cognitively worsening patients but with normal cognition at baseline. (4) Conclusions: Only a small proportion of MS patients experience ICD over short-term follow-up. Patients with severe MS are more prone to cognitive decline; however, patients with normal cognitive performance and mild MS might benefit from the early detection of cognitive decline the most.

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Butler, Mary, Ellen McCreedy, Victoria A. Nelson, Priyanka Desai, Edward Ratner, Howard A. Fink, Laura S. Hemmy, et al. "Does Cognitive Training Prevent Cognitive Decline?" Annals of Internal Medicine 168, no. 1 (December 19, 2017): 63. http://dx.doi.org/10.7326/m17-1531.

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Singh-Manoux, Archana, Michael G. Marmot, Maria Glymour, Séverine Sabia, Mika Kivimäki, and Aline Dugravot. "Does cognitive reserve shape cognitive decline?" Annals of Neurology 70, no. 2 (May 11, 2011): 296–304. http://dx.doi.org/10.1002/ana.22391.

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Wion, Rachel, Nikki Hill, Tyler Bell, Jacqueline Mogle, Jennifer Yates, and Iris Bhang. "Does Cognitive Self-Report Measure Type Differentially Predict Cognitive Decline? A Systematic Review." Innovation in Aging 4, Supplement_1 (December 1, 2020): 292. http://dx.doi.org/10.1093/geroni/igaa057.936.

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Abstract Up to 47% of older adults without measurable cognitive impairment report difficulties with memory and thinking which potentially increases their risk for developing cognitive decline. Many measures are used for assessing self-reported cognition; however, certain types of these measures may be more predictive of cognitive decline. The purpose of this systematic review was to compare the role of cognitive self-report measure types in predicting risk for cognitive decline. PubMed, CINAHL, and PsycINFO databases were searched using the following inclusion criteria: longitudinal studies, outcome of cognitive decline, and two or more cognitive self-report measures. A total of 4,319 articles were identified during the initial search and narrowed to 19 final articles. The Quality in Prognosis Studies tool was used to determine study quality. Six comparison themes emerged during synthesis: self-reported cognition or memory with or without worry; self-reported global cognition or self-reported memory; self-reported memory decline and self-reported executive function decline; self-reported cognition and self-reported memory by others; self-reported memory and self-reported memory problems in comparison with peers; and self-reported memory and self-reported memory affecting daily function. Self-reported memory decline with worry and self-reported memory problems by others were most predictive of future impairment. It was difficult to definitively determine whether certain cognitive self-report measure types where more predictive of risk for cognitive decline because there were very few articles in some of the comparison groups. Future investigations of self-reported cognition should focus on using measures that have been shown to be the most efficacious at predicting risk for cognitive decline.

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Insel, Philip S., Michael Weiner, R. Scott Mackin, Elizabeth Mormino, Yen Ying Lim, Erik Stomrud, Sebastian Palmqvist, et al. "Determining clinically meaningful decline in preclinical Alzheimer disease." Neurology 93, no. 4 (July 9, 2019): e322-e333. http://dx.doi.org/10.1212/wnl.0000000000007831.

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ObjectiveTo determine the time required for a preclinical Alzheimer disease population to decline in a meaningful way, use estimates of decline to update previous clinical trial design assumptions, and identify factors that modify β-amyloid (Aβ)–related decline.MethodsIn 1,120 cognitively unimpaired individuals from 3 international cohorts, we estimated the relationship between Aβ status and longitudinal changes across multiple cognitive domains and assessed interactions between Aβ and baseline factors. Power analyses were performed to explore sample size as a function of treatment effect.ResultsCognitively unimpaired Aβ+ participants approach mild cognitive impairment (MCI) levels of performance 6 years after baseline, on average. Achieving 80% power in a simulated 4-year treatment trial, assuming a 25% treatment effect, required 2,000 participants/group. Multiple factors interacted with Aβ to predict cognitive decline; however, these findings were all cohort-specific. Despite design differences across the cohorts, with large sample sizes and sufficient follow-up time, the Aβ+ groups declined consistently on cognitive composite measures.ConclusionsA preclinical AD population declines to the cognitive performance of an early MCI population in 6 years. Slowing this rate of decline by 40%–50% delays clinically relevant impairment by 3 years—a potentially meaningful treatment effect. However, assuming a 40%–50% drug effect highlights the difficulties in preclinical AD trial design, as a more commonly assumed treatment effect of 25% results in a required sample size of 2,000/group. Designers of preclinical AD treatment trials need to prepare for larger and longer trials than are currently being considered. Interactions with Aβ status were inconsistent and not readily generalizable.

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Sherman, Janet Cohen, Charles R. Henderson, Suzanne Flynn, James W. Gair, and Barbara Lust. "Language Decline Characterizes Amnestic Mild Cognitive Impairment Independent of Cognitive Decline." Journal of Speech, Language, and Hearing Research 64, no. 11 (November 8, 2021): 4287–307. http://dx.doi.org/10.1044/2021_jslhr-20-00503.

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Purpose This research investigated the nature of cognitive decline in prodromal Alzheimer's disease (AD), particularly in mild cognitive impairment, amnestic type (aMCI). We assessed language in aMCI as compared with healthy aging (HA) and healthy young (HY) with new psycholinguistic assessment of complex sentences, and we tested the degree to which deficits on this language measure relate to performance in other general cognitive domains such as memory. Method Sixty-one individuals with aMCI were compared with 24 HA and 10 HY adults on a psycholinguistic measure of complex sentence production (relative clauses). In addition, HA, HY, and a subset of the aMCI participants ( n = 22) were also tested on a multidomain cognitive screen, the Addenbrooke's Cognitive Examination–Revised (ACE-R), and on a verbal working memory Brown–Peterson (BP) test. General and generalized linear mixed models were used to test psycholinguistic results and to test whether ACE-R and BP performance predicted performance on the psycholinguistic test similarly in the aMCI and HA groups. Results On the psycholinguistic measure, sentence imitation was significantly deficited in aMCI in comparison with that in HA and HY. Experimental factorial designs revealed that individuals with aMCI had particular difficulty repeating sentences that especially challenged syntax–semantics integration. As expected, the aMCI group also performed significantly below the HY and HA groups on the ACE-R. Neither the ACE-R Memory subtest nor the BP total scores predicted performance on the psycholinguistic task for either the aMCI or the HA group. However, the ACE-R total score significantly predicted psycholinguistic task performance, with increased ACE-R performance predicting increased psycholinguistic task performance only for the HA group, not for the aMCI group. Conclusions Results suggest a selective deterioration in language in aMCI, specifically a weakening of syntax–semantics integration in complex sentence processing, and a general independence of this language deficit and memory decline. Results cohere with previous assessments of the nature of difficulty in complex sentence formation in aMCI. We argue that clinical screening for prodromal AD can be strengthened by supplementary testing of language, as well as memory, and extended evaluation of strength of their relation.

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Karcher, Helene, Marina Savelieva, Luyuan Qi, Noemi Hummel, Angelika Caputo, Valery Risson, Gorana Capkun, and Alzheimer’s Disease Neuroimaging Initiative. "Modelling Decline in Cognition to Decline in Function in Alzheimer’s Disease." Current Alzheimer Research 17, no. 7 (November 16, 2020): 635–57. http://dx.doi.org/10.2174/1567205017666201008105429.

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Objective: : The study aimed to evaluate and quantify the temporal link between cognitive and functional decline, and assess the impact of the apolipoprotein E4 (APOE-e4) genotype on Alzheimer’s disease (AD) progression. Methods: A nonlinear mixed-effects Emax model was developed using longitudinal data from 659 patients with dementia due to AD sourced from the Alzheimer's disease neuroimaging initiative (ADNI) database. A cognitive decline model was first built using a cognitive subscale of the AD assessment scale (delayed word recall) as the endpoint, followed by a functional decline model, using the functional assessment questionnaire (FAQ) as the endpoint. Individual and population cognitive decline from the first model drove a functional decline in the second model. The impact of the APOE-e4 genotype status on the dynamics of AD progression was evaluated using the model. Results: Mixed-effects Emax models adequately quantified population average and individual disease trajectories. The model captured a higher initial cognitive impairment and final functional impairment in APOE-e4 carriers than non-carriers. The age at cognitive decline and diagnosis of dementia due to AD was significantly lower in APOE-e4 carriers than that of non-carriers. The average [standard deviation] time shift between cognitive and functional decline, i.e. the time span between half of the maximum cognitive decline and half of the maximum functional decline, was estimated as 1.5 [1.6] years. Conclusion: The present analysis quantifies the temporal link between a cognitive and functional decline in AD progression at the population and individual level, and provides information about the potential benefits of pre-clinical AD treatments on both cognition and function.

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van Harten, Argonde C., Michelle M. Mielke, Dana M. Swenson-Dravis, Clinton E. Hagen, Kelly K. Edwards, Rosebud O. Roberts, Yonas E. Geda, David S. Knopman, and Ronald C. Petersen. "Subjective cognitive decline and risk of MCI." Neurology 91, no. 4 (June 29, 2018): e300-e312. http://dx.doi.org/10.1212/wnl.0000000000005863.

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ObjectiveWe investigated different dimensions of subjective cognitive decline (SCD) to determine which was the best prognostic risk factor for incident mild cognitive impairment (MCI) among cognitively unimpaired participants.MethodsWe included 1,167 cognitively unimpaired participants, aged 70 to 95 years, from the Mayo Clinic Study of Aging based on 2 concurrent SCD scales (part of the Blessed memory test and the 39-item Everyday Cognition [ECog] scale, which included a validated 12-item derivative) and a single question assessing worry about cognitive decline. We evaluated multiple ways to dichotomize scores. In continuous models, we compared average scores on 4 ECog domains and multidomain (39- and 12-item) ECog scores. Cox proportional hazards models were used to assess the association between each measure and risk of MCI in models adjusted for objective memory performance, depression, anxiety, sex, APOE ε4 carriership, and medical comorbidities.ResultsIt was possible to select a substantial group of participants (14%) at increased risk of incident MCI based on combined baseline endorsement of any consistent SCD on the ECog (any item scored ≥3; 12-item ECog hazard ratio [HR] 2.17 [95% confidence interval 1.51–3.13]) and worry (HR 1.79 [1.24–2.58]) in an adjusted model combining these dimensions. In continuous models, all ECog domains and the multidomain scores were associated with risk of MCI with a small advantage for multidomain SCD (12-item ECog HR 2.13 [1.36–3.35] per point increase in average score). Information provided by the informant performed comparable to self-perceived SCD.ConclusionPrognostic value of SCD for incident MCI improves when both consistency of SCD and associated worry are evaluated.

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Alibhai, Shabbir M. H., Henriette Breunis, Narhari Timilshina, Aaron Richard Hansen, Anthony M. Joshua, Padraig Richard Warde, Richard William Gregg, et al. "The effect of docetaxel, enzalutamide, abiraterone, and radium-223 on cognitive function in older men with metastatic castrate-resistant prostate cancer (mCRPC)." Journal of Clinical Oncology 38, no. 6_suppl (February 20, 2020): 73. http://dx.doi.org/10.1200/jco.2020.38.6_suppl.73.

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73 Background: Older adults are at greater risk of cognitive decline with various oncologic therapies. Emerging data suggest cognitive effects of various therapies for mCRPC but study populations are highly selected and published data are limited and focus mostly on self-reported cognitive function. We evaluated the effects of treatment with docetaxel chemotherapy (CHEMO), abiraterone (ABI), enzalutamide (ENZA), and radium 223 (Ra223) on cognitive function in older men with mCRPC. Methods: Men age 65+ with mCRPC starting any of the 4 treatments for mCRPC were enrolled in this multicenter prospective cohort study. Three short yet reliable and sensitive measures in older adults were administered at baseline and final visit (6 months with CHEMO and Ra223, mean 14-16 months with ENZA and ABI) using the Montreal Cognitive Assessment (MoCA), Trails A, and Trails B to assess global cognition, attention, and executive function, respectively. Absolute changes in cognitive scores over time were analyzed using multivariable linear regression, and the percentage of individuals with a decline of 1.5 SD in each domain were calculated. Higher scores on MoCA are better but worse for Trails A/B. Results: A total of 51, 26, 49, and 21 men starting CHEMO, ABI, ENZA, and Ra223 with complete data were included. Mean age, education, and baseline cognition were similar between groups (Table). Most patients demonstrated stable cognition or slight reductions. Executive function was the most sensitive of the 3 cognitive domains, and declined by at least 1.5 SD in about one-fifth of each cohort. Although ABI had numerically smaller declines than ENZA, differences were generally small and clinically unimportant. Conclusions: Most older men do not experience significant cognitive decline while on treatment for mCRPC regardless of treatment used.[Table: see text]

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Ismail, Zahinoor, Alexander McGirr, Sascha Gill, Sophie Hu, Nils D. Forkert, and Eric E. Smith. "Mild Behavioral Impairment and Subjective Cognitive Decline Predict Cognitive and Functional Decline." Journal of Alzheimer's Disease 80, no. 1 (March 9, 2021): 459–69. http://dx.doi.org/10.3233/jad-201184.

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Background: Mild behavioral impairment (MBI) and subjective cognitive decline (SCD) are dementia risk states, and potentially represent neurobehavioral and neurocognitive manifestations, respectively, of early stage neurodegeneration. Both MBI and SCD predict incident cognitive decline and dementia, are associated with known dementia biomarkers, and are both represented in the NIA-AA research framework for AD in Stage 2 (preclinical disease). Objective: To assess the associations of MBI and SCD, alone and in combination, with incident cognitive and functional decline in a population of older adults. We tested the hypothesis that MBI and SCD confer additive risk for decline. Methods: Cognitively normal participants were followed up annually at Alzheimer’s Disease Centers. Logistic regression assessed the relationship between baseline classification (MBI-SCD-, MBI-SCD+, MBI+SCD-, or MBI+SCD+) and 3-year outcome. Results: Of 2,769 participants (mean age=76), 1,536 were MBI-SCD-, 254 MBI-SCD+, 743 MBI+SCD-, and 236 MBI+SCD+. At 3 years, 349 (12.6%) declined to CDR >0, including 23.1% of the MBI+group, 23.5% of the SCD+group, and 30.9% of the intersection group of both MBI+and SCD+participants. Compared to SCD-MBI-, we observed an ordinal progression in risk (ORs [95% CI]): 3.61 [2.42–5.38] for MBI-SCD+ (16.5% progression), 4.76 [3.57–6.34] for MBI+SCD- (20.7%), and 8.15 [5.71–11.64] for MBI+SCD+(30.9%). Conclusion: MBI and SCD together were associated with the greatest risk of decline. These complementary dementia risk syndromes can be used as simple and scalable methods to identify high-risk patients for workup or for clinical trial enrichment.

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Grässler, Bernhard, Anita Hökelmann, and Richard Halti Cabral. "Resting heart rate variability as a possible marker of cognitive decline." Kinesiology 52, no. 1 (2020): 72–84. http://dx.doi.org/10.26582/k.52.1.9.

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Cognition is a major subject to be addressed nowadays due to the increasing number of cognitively affected people in most societies. Because of a lack of pharmaceutical therapies treating cognitive decline, its indicators should be diagnosed before it becomes prevalent. Scientific evidence indicates a relationship between cognition and the nervous system, especially its autonomic part. Heart rate variability (HRV) as an indicator of the autonomic nervous system functioning has been studied as a biological marker for the evaluation of cognitive performance. Therefore, HRV is a possible indicator of cognitive impairment. The aim was to provide a systematic literature review about the association between resting HRV and the cognitive performance. Five cognitive functions were analysed separately: executive functions, memory and learning, language abilities, visuospatial functioning, and processing speed. Furthermore, the global cognitive function evaluated with cognitive test batteries was considered too. An electronic database search was conducted with five databases. Three search fields comprised HRV, cognitive performance, and adult subjects. The final dataset consisted of 27 articles. Significant correlations in each cognitive function were found, except for processing speed, suggesting a positive association between resting HRV and cognitive performance. Mechanisms underlying this association between cardiovascular health and cognition are discussed. For the future, HRV could be used in diagnostics as an indicator of cognitive impairment before symptoms of dementia get apparent. With a timely diagnosis, preventative tools could be initiated at an early stage of dementia.

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Okely, Judith A., and Ian J. Deary. "Associations Between Declining Physical and Cognitive Functions in the Lothian Birth Cohort 1936." Journals of Gerontology: Series A 75, no. 7 (January 20, 2020): 1393–402. http://dx.doi.org/10.1093/gerona/glaa023.

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Abstract Background The ageing process is characterized by declines in physical and cognitive function. However, the relationship between these trajectories remains a topic of investigation. Methods Using four data waves collected triennially between ages 70 and 79, we tested for associations between multiple cognitive ability domains (verbal memory, processing speed, and visuospatial ability) and physical functions (walking speed, grip strength, and lung function). We first tested for associations between linear declines in physical and cognitive functions over the entire 9-year study period, and then, for lead-lag coupling effects between 3-year changes in cognitive and physical functions. Results Steeper linear decline in walking speed was moderately correlated with steeper linear declines in each cognitive domain. Steeper linear decline in grip strength was moderately correlated with steeper linear declines in verbal memory and processing speed. Lead-lag coupling models showed that decline in verbal memory was preceded by declines in walking speed and grip strength. By contrast, decline in grip strength was preceded by declines in processing speed and visuospatial ability, and decline in walking speed was preceded by decline in visuospatial ability. Following additional adjustment for covariates, only coupling effects from earlier decline in processing speed to later decline in grip strength remained significant (β = 0.545, p = .006). Conclusion Our findings provide further evidence of an association between cognitive and physical declines and point to the potential order in which these changes occur. Decline in processing speed in particular may serve as a unique early marker of declining upper body strength.

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Chapman, Silvia, Preeti Sunderaraman, Jillian L. Joyce, Martina Azar, Leigh E. Colvin, Megan S. Barker, Ian McKeague, William C. Kreisl, and Stephanie Cosentino. "Optimizing Subjective Cognitive Decline to Detect Early Cognitive Dysfunction." Journal of Alzheimer's Disease 80, no. 3 (April 6, 2021): 1185–96. http://dx.doi.org/10.3233/jad-201322.

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Background: The utility of subjective cognitive decline (SCD) as an indicator of preclinical AD is overshadowed by its inconsistent association with objective cognition. Objective: This study examines if manipulations of SCD measurement affect its association with early cognitive dysfunction characteristic of preclinical AD. Methods: Cognitively healthy older adults (n = 110) completed SCD questionnaires that elicited complaints in general, compared to 5 years ago (retrospective SCD) and compared to their peers (age-anchored SCD) in binary and Likert scales. Outcome cognitive tasks included an associative memory task (Face-Name Test), a visual short-term memory binding task (STMB test), and a clinical neuropsychological list learning test (Selective Reminder Test). Results: SCD complaints, when compared to age-matched peers (age-anchored SCD) were endorsed less frequently than complaints compared to 5 years ago (retrospective SCD) (p < 0.01). In demographically adjusted regressions, age-anchored ordinal-rated SCD was associated with short term memory binding (β= –0.22, p = 0.040, CI = –0.45, –0.01), associative memory (β= –0.26, p = 0.018, CI = –0.45, –0.06), and list learning (β= –0.31, p = 0.002, CI = –0.51, –0.12). Retrospective and general ordinal-rated SCD was associated with associative memory (β= –0.25, p = 0.012, CI = –0.44, –0.06; β= –0.29, p = 0.003, CI = –0.47, –0.10) and list learning only (β= –0.25, p = 0.014, CI = –0.45, –0.05; β= –0.28, p = 0.004, CI = –0.48, –0.09). Conclusion: Ordinal age-anchored SCD appears better suited than other SCD measurements to detect early cognitive dysfunction characteristic of preclinical AD.

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Dos Santos, Brenda Pina, Bruno Costa Poltronieri, and Amer Cavalheiro Hamdan. "Associação entre declínio cognitivo e funcional em idosos hospitalizados: uma revisão Integrativa/Association between cognitive and functional decline in hospitalized elderly: an integrative review." Revista Interinstitucional Brasileira de Terapia Ocupacional - REVISBRATO 2, no. 3 (July 31, 2018): 639–53. http://dx.doi.org/10.47222/2526-3544.rbto12792.

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Introdução: O declínio cognitivo e funcional é importante preditor de fragilidade em idosos. Isso justifica a necessidade de se investigar a existência de associação direta entre cognição e capacidade funcional no contexto da hospitalização. Objetivo: levantar qual a associação entre declínio cognitivo e funcional em idosos hospitalizados. Metodologia: revisão integrativa realizada no SCIELO, LILACS, COCHRANE e PUBMED, no período de 2014 a julho de 2016, a partir das estratégias de busca “elderly AND hospitalization”, “elderly AND hospitalization AND functional decline” ou “elderly AND hospitalization AND cognition” nos idiomas inglês, espanhol e português. Foram encontrados 36 artigos publicados entre 2009 e 2015, porém apenas 13 preencheram os critérios de inclusão. Resultados: todos os artigos citaram mencionaram a existência de associação entre declínio cognitivo e funcional em idosos durante a hospitalização apenas dois estudos apresentaram -- no método -- significância na correlação estatística. Discussão: Dependendo do tipo de estudo, os resultados mostraram-se contraditórios. Estudos transversais, alguns longitudinais, um ensaio clínico e um coorte prospectivo apontaram que as funções cognitivas apresentaram maior declínio no momento da admissão hospitalar, bem como existência de declínio funcional prévio às 48 horas da hospitalização com melhora na alta. Resultados diferentes, em grande parte estudos coortes -- descritivos e prospectivos -- mostraram a existência de declínio cognitivo e funcional ou piora do quadro após 48 horas da admissão sem recuperação pós-alta. Conclusão: os estudos confirmaram a associação entre cognição e capacidade funcional no idoso hospitalizado, apesar de diferenças quanto ao início do comprometimento. AbstractIntroduction: Cognitive and functional decline are important predictors of frailty in the elderly, which justifies the need to investigate the existence of a direct association between cognition and functional capacity in the context of hospitalization. Objective: to raise the association between cognitive and functional decline in hospitalized elderly. Methodology: A integrative review conducted in SCIELO, LILACS, COCHRANE and PUBMED in the period 2014 to July 2016, from the search strategies "elderly AND hospitalization", "elderly AND hospitalization AND functional decline" or "elderly AND hospitalization AND cognition "in English, Spanish and Portuguese. They found 36 articles published between 2009 and 2015, but only 13 met the inclusion criteria. Results: All items cited the existence of an association between cognitive and functional decline in the elderly during hospitalization, but only two studies showed the significance in statistical correlation method. Depending on the type of study, the results were conflicting. Cross-sectional studies, some longitudinal, a clinical trial and a prospective cohort study showed that cognitive function showed further decline at the time of hospital admission, and existence of functional decline prior to 48 hours of hospitalization with improved high. Much of differents results of the cohort, descriptive and prospective studies have shown the existence of cognitive and functional decline or worsening of symptoms after 48 hours of admission without post-discharge recovery. Conclusion: The study confirmed the association between cognition and functional ability in the hospitalized elderly, despite the differences in the beginning of impairment.Keywords: Activities of daily living; Cognition; Hospitalization, Elderly.

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Nooyens, Astrid C. J., H. Bas Bueno-de-Mesquita, Boukje M. van Gelder, Martin P. J. van Boxtel, and W. M. Monique Verschuren. "Consumption of alcoholic beverages and cognitive decline at middle age: the Doetinchem Cohort Study." British Journal of Nutrition 111, no. 4 (August 23, 2013): 715–23. http://dx.doi.org/10.1017/s0007114513002845.

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Accelerated cognitive decline increases the risk of dementia. Slowing down the rate of cognitive decline leads to the preservation of cognitive functioning in the elderly, who can live independently for a longer time. Alcohol consumption may influence the rate of cognitive decline. The aim of the present study was to evaluate the associations between the total consumption of alcoholic beverages and different types of alcoholic beverages and cognitive decline at middle age. In 2613 men and women of the Doetinchem Cohort Study, aged 43–70 years at baseline (1995–2002), cognitive function (global cognitive function and the domains memory, speed and flexibility) was assessed twice, with a 5-year time interval. In linear regression analyses, the consumption of different types of alcoholic beverages was analysed in relation to cognitive decline, adjusting for confounders. We observed that, in women, the total consumption of alcoholic beverages was inversely associated with the decline in global cognitive function over a 5-year period (P for trend = 0·02), while no association was observed in men. Regarding the consumption of different types of alcoholic beverages in men and women together, red wine consumption was inversely associated with the decline in global cognitive function (P for trend < 0·01) as well as memory (P for trend < 0·01) and flexibility (P for trend = 0·03). Smallest declines were observed at a consumption of about 1·5 glasses of red wine per d. No other types of alcoholic beverages were associated with cognitive decline. In conclusion, only (moderate) red wine consumption was consistently associated with less strong cognitive decline. Therefore, it is most likely that non-alcoholic substances in red wine are responsible for any cognition-preserving effects.

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Wei, Melissa Y., Deborah A. Levine, Laura B. Zahodne, Mohammed U. Kabeto, and Kenneth M. Langa. "Multimorbidity and Cognitive Decline Over 14 Years in Older Americans." Journals of Gerontology: Series A 75, no. 6 (June 6, 2019): 1206–13. http://dx.doi.org/10.1093/gerona/glz147.

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Abstract Background Multimorbidity is associated with greater disability and accelerated declines in physical functioning over time in older adults. However, less is known about its effect on cognitive decline. Methods Participants without dementia from the Health and Retirement Study were interviewed about physician-diagnosed conditions, from which their multimorbidity-weighted index (MWI) that weights diseases to physical functioning was computed. We used linear mixed-effects models to examine the predictor MWI with the modified Telephone Interview for Cognitive Status (TICSm, global cognition), 10-word immediate recall and delayed recall, and serial 7s outcomes biennially after adjusting for baseline cognition and covariates. Results Fourteen thousand two hundred sixty-five participants, 60% female, contributed 73,700 observations. Participants had a mean ± SD age 67 ± 9.3 years and MWI 4.4 ± 3.9 at baseline. Each point increase in MWI was associated with declines in global cognition (0.04, 95% CI: 0.03–0.04 TICSm), immediate recall (0.01, 95% CI: 0.01–0.02 words), delayed recall (0.01, 95% CI: 0.01–0.02 words), and working memory (0.01, 95% CI: 0.01–0.02 serial 7s; all p < .001). Multimorbidity was associated with faster declines in global cognition (0.003 points/year faster, 95% CI: 0.002–0.004), immediate recall (0.001 words/year faster, 95% CI: 0.001–0.002), and working memory (0.006 incorrect serial 7s/year faster, 95% CI: 0.004–0.009; all p < .001), but not delayed recall compared with premorbid slopes. Conclusions Multimorbidity using a validated index weighted to physical functioning was associated with acute decline in cognition and accelerated and persistent cognitive decline over 14 years. This study supports an ongoing geriatric syndrome of coexisting physical and cognitive impairment in adults with multimorbidity. Clinicians should monitor and address both domains in older multimorbid adults.

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Zheng, Fanfan, Li Yan, Baoliang Zhong, Zhenchun Yang, and Wuxiang Xie. "Progression of cognitive decline before and after incident stroke." Neurology 93, no. 1 (May 24, 2019): e20-e28. http://dx.doi.org/10.1212/wnl.0000000000007716.

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ObjectiveTo determine the trajectory of cognitive decline before and after incident stroke.MethodsBy using data from the English Longitudinal Study of Ageing, we studied 9,278 participants without dementia with no history of stroke who underwent cognitive assessment at baseline (wave 1) and at least 1 other time point (waves 2–7). We used linear mixed models to analyze repeated measures and longitudinal data.ResultsAmong the 9,278 participants (56.8% women, mean age 63.1 ± 10.3 years), 471 (5.1%) incident stroke events were identified. Compared with stroke-free participants, multivariable-adjusted rates of prestroke cognitive decline in global cognition, memory, semantic fluency, and temporal orientation of participants who later experienced an incident stroke were increased by −0.029 , −0.016, −0.022, and −0.024 SD/y, respectively. Among the 471 stroke survivors, the multivariable-adjusted acute changes in the 4 cognitive domains were −0.257, −0.150, −0.121, and −0.272 SD, respectively. In the years after stroke, global cognition declined over time and was steeper than its prestroke slope, that is, by −0.064 SD/y after multivariable adjustment. The rates of memory, semantic fluency, and temporal orientation decline were −0.046, −0.033, and −0.037 SD/y, respectively.ConclusionsAccelerated prestroke cognitive decline and poststroke cognitive decline were associated with incident stroke over a follow-up period of 12 years. Attention should be paid to the long-term cognitive problems of stroke survivors, and intervention and management of major vascular risk factors should start from early life or midlife to reduce the risk of cerebrovascular disease and the associated cognitive impairment.

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Chase, Jo-Ana, Lizyeka Jordan, Christina Whitehouse, and Kathryn Bowles. "Unmet Caregiving Needs Are Associated With Cognitive Functioning Among Older Sepsis Survivors." Innovation in Aging 4, Supplement_1 (December 1, 2020): 255. http://dx.doi.org/10.1093/geroni/igaa057.820.

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Abstract Sepsis survivorship is associated with cognitive decline and complex post-acute care needs. Family caregivers may be unprepared to manage these needs, resulting in decline or no improvement in patient outcomes. Using a national dataset of Medicare beneficiaries who were discharged from the hospital for sepsis and received post-acute HHC between 2013 and 2014 (n=165,228), we examined the relationship between unmet caregiving needs and improvement or decline in cognitive functioning. Multivariate logistic regression was used to determine associations between unmet caregiving needs at the start of HHC and changes in cognitive functioning. Unmet caregiving needs included seven items from the start of care Outcome and Assessment Information Set (OASIS). Changes in cognitive functioning were measured using the start of care and discharge OASIS assessments. Twenty-four percent of patients either declined or did not improve in cognitive functioning from HHC admission to discharge, with variation seen by unmet need type. Sepsis survivors with unmet caregiving needs for activities of daily living assistance (OR 1.05, 95% CI 1.01, 1.09), medication assistance (OR 1.06, 95% CI 1.02,1.10), and supervision and safety assistance (OR 1.110, 95% CI 1.06,1.16) were more likely to decline or not improve in cognitive functioning, even after accounting for clinical and demographic characteristics. Older sepsis survivors with both cognitive impairment and unmet caregiving needs in the post-acute HHC setting are at high-risk for worsening cognition. Alerting the care team of cognitively impaired sepsis survivors with unmet caregiving needs may trigger evidence-based strategies to enhance caregiver training and reduce unmet caregiving needs.

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Lawrence, Andrew J., Eva A. Zeestraten, Philip Benjamin, Christian P. Lambert, Robin G. Morris, Thomas R. Barrick, and Hugh S. Markus. "Longitudinal decline in structural networks predicts dementia in cerebral small vessel disease." Neurology 90, no. 21 (April 25, 2018): e1898-e1910. http://dx.doi.org/10.1212/wnl.0000000000005551.

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ObjectiveTo determine whether longitudinal change in white matter structural network integrity predicts dementia and future cognitive decline in cerebral small vessel disease (SVD). To investigate whether network disruption has a causal role in cognitive decline and mediates the association between conventional MRI markers of SVD with both cognitive decline and dementia.MethodsIn the prospective longitudinal SCANS (St George's Cognition and Neuroimaging in Stroke) Study, 97 dementia-free individuals with symptomatic lacunar stroke were followed with annual MRI for 3 years and annual cognitive assessment for 5 years. Conversion to dementia was recorded. Structural networks were constructed from diffusion tractography using a longitudinal registration pipeline, and network global efficiency was calculated. Linear mixed-effects regression was used to assess change over time.ResultsSeventeen individuals (17.5%) converted to dementia, and significant decline in global cognition occurred (p = 0.0016). Structural network measures declined over the 3-year MRI follow-up, but the degree of change varied markedly between individuals. The degree of reductions in network global efficiency was associated with conversion to dementia (B = −2.35, odds ratio = 0.095, p = 0.00056). Change in network global efficiency mediated much of the association of conventional MRI markers of SVD with cognitive decline and progression to dementia.ConclusionsNetwork disruption has a central role in the pathogenesis of cognitive decline and dementia in SVD. It may be a useful disease marker to identify that subgroup of patients with SVD who progress to dementia.

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Howrey, Bret T., Soham Al Snih, Joyce A. Middleton, and Kenneth J. Ottenbacher. "Trajectories of Frailty and Cognitive Decline Among Older Mexican Americans." Journals of Gerontology: Series A 75, no. 8 (February 3, 2020): 1551–57. http://dx.doi.org/10.1093/gerona/glz295.

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Abstract Background Progressive physical frailty and cognitive decline in older adults is associated with increased risk of falls, disability, institutionalization, and mortality; however, there is considerable heterogeneity in progression over time. We identified heterogeneous frailty and cognitive decline trajectory groups and examined the specific contribution of health conditions to these trajectories among older Mexican origin adults. Methods We use a sample from the Hispanic Established Population for the Epidemiological Study of the Elderly (HEPESE) with at least two measures of frailty criteria during 18 years follow-up: slow gait, weak handgrip strength, exhaustion, and unexplained weight loss (n = 1362, mean age 72). Cognition was measured using the Mini-Mental State Examination (MMSE). Results Using group-based trajectory models we identified three frailty groups—non-frail (n = 331), moderate progressive (n = 855), and progressive high (n = 149)—and three cognitive decline groups—non-cognitively impaired (476), moderate decline (677) and rapid decline (n = 209). The probability of membership in a high-frailty group given membership in a progressive cognitive decline group was 63%, while the probability of being in a non-frail group given membership in a non-cognitively impaired group was 68%. Predictors of membership into both the progressive high frailty and rapid cognitive decline groups combined were low education and diabetes. Weekly church attendance was associated with a 66% reduction in the odds of being in the combined groups. Conclusions Interventions to reduce frailty rates and cognitive decline might focus on the management of underlying chronic disease and on increasing participation in activities outside the home.

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Markus, Hugh. "Hereditary vascular cognitive decline." Journal of the Neurological Sciences 429 (October 2021): 117951. http://dx.doi.org/10.1016/j.jns.2021.117951.

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Shimada, Hiroyuki. "Prevention of cognitive decline." Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 49, no. 1 (2012): 60–62. http://dx.doi.org/10.3143/geriatrics.49.60.

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Canevelli, Marco, Matteo Cesari, and Gabor Abellan van Kan. "Frailty and cognitive decline." Current Opinion in Clinical Nutrition and Metabolic Care 18, no. 1 (January 2015): 43–50. http://dx.doi.org/10.1097/mco.0000000000000133.

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Journal articles on the topic 'Cognitive decline'

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