scholarly journals UDSNB 3.0 Neuropsychological Test Norms in Older Adults from a Diverse Community: Results from the Einstein Aging Study (EAS)

2021 ◽  
Vol 83 (4) ◽  
pp. 1665-1678
Author(s):  
Cuiling Wang ◽  
Mindy J. Katz ◽  
Katherine H. Chang ◽  
Jiyue Qin ◽  
Richard B. Lipton ◽  
...  
Keyword(s):  
Cognitive Performance ◽  
Sex Education ◽  
Regression Models ◽  
Normative Data ◽  
First Language ◽  
Linear Regression Models ◽  
Community Based ◽  
Aging Study ◽  
Diverse Community ◽  
Race Ethnicity

Background: The Uniform Data Set, Version 3 Neuropsychological Battery (UDSNB3.0), from the database of the University of Washington’s National Alzheimer’s Coordinating Center (NACC), is widely used to characterize cognitive performance in clinical and research settings; however, norms for underrepresented community-based samples are scarce. Objective: We compared UDSNB 3.0 test scores between the Einstein Aging Study (EAS), composed of racially/ethnically diverse, community-dwelling older adults aged≥70 and the NACC, and report normative data from the EAS. Methods: Analyses included 225 cognitively normal EAS participants and comparable data from 5,031 NACC database participants. Linear regression models compared performance between the samples, adjusting for demographics (sex, age, education, race/ethnicity), depressive symptoms, and whether English was the first language. Linear regression models to examine demographic factors including age, sex, education and race/ethnicity as predictors for the neuropsychological tests were applied in EAS and NACC separately and were used to create a demographically adjusted z-score calculator. Results: Cognitive performance across all domains was worse in the EAS than in the NACC, adjusting for age, sex, education, race/ethnicity, and depression, and the differences remained in visuo-construction, visuospatial memory, confrontation naming, visual attention/processing speed, and executive functioning after further adjusting for whether English was the first language. In both samples, non-Hispanic Whites outperformed non-Hispanic Blacks and more education was associated with better cognitive performance. Conclusion: Differences observed in demographic, clinical, and cognitive characteristics between the community-based EAS sample and the nationwide NACC sample suggest that separate normative data that more accurately reflect non-clinic, community-based populations should be established.

Sleep symptomatology is associated with greater subjective cognitive concerns: Findings from the community-based Healthy Brain Project

SLEEP ◽  
2021 ◽  
Author(s):  
Jessica Nicolazzo ◽  
Katharine Xu ◽  
Alexandra Lavale ◽  
Rachel Buckley ◽  
Nawaf Yassi ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Sleep Quality ◽  
Cognitive Performance ◽  
Sex Education ◽  
Severity Index ◽  
Analysis Of Covariance ◽  
Psychomotor Function ◽  
Community Based ◽  
The Relationship ◽  
Insomnia Severity

Abstract Study objectives To examine if sleep symptomatology was associated with subjective cognitive concerns or objective cognitive performance in a dementia-free community-based sample. Methods A total of 1421 middle-aged participants (mean±standard deviation = 57±7; 77% female) from the Healthy Brain Project completed the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS) to measure sleep quality, insomnia symptom severity, and daytime sleepiness, respectively. Participants were classified as having no sleep symptomatology (normal scores on each sleep measure), moderate sleep symptomatology (abnormal scores on one sleep measure), or high sleep symptomatology (abnormal scores on at least two sleep measures), using established cut-off values. Analysis of covariance was used to compare objective cognitive function (Cogstate Brief Battery) and subjective cognitive concerns (Modified Cognitive Function Instrument) across groups. Results Following adjustments for age, sex, education, mood, and vascular risk factors, persons classified as having high sleep symptomatology, versus none, displayed more subjective cognitive concerns (d=0.24) but no differences in objective cognitive performance (d=0.00-0.18). Subjective cognitive concerns modified the association between sleep symptomatology and psychomotor function. The strength of the relationship between high sleep symptomatology (versus none) and psychomotor function was significantly greater in persons with high as compared with low cognitive concerns (β±SE =-0.37±0.16; p=0.02). Conclusions More severe sleep symptomatology was associated with greater subjective cognitive concerns. Persons reporting high levels of sleep symptomatology may be more likely to display poorer objective cognitive function in the presence of subjective cognitive concerns.

scholarly journals Race/Ethnic Disparities in Mild Cognitive Impairment and Dementia: The Northern Manhattan Study

2020 ◽  
Author(s):  
Clinton B. Wright ◽  
Janet T. DeRosa ◽  
Michelle P. Moon ◽  
Kevin Strobino ◽  
Charles DeCarli ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
White Matter ◽  
White Matter Hyperintensity ◽  
Prevalence Rates ◽  
Vascular Risk ◽  
Community Based ◽  
Diverse Community ◽  
Race Ethnicity

ABSTRACTOBJECTIVEEstimate the prevalence of mild cognitive impairment (MCI) and probable dementia in the racially and ethnically diverse community-based Northern Manhattan Study cohort and examine sociodemographic, vascular risk factor, and brain imaging correlates.METHODSCases of MCI and probable dementia were adjudicated by a team of neuropsychologists and neurologists and prevalence was estimated across race/ethnic groups. Ordinal proportional odds models were used to estimate race/ethnic differences in prevalence rates for MCI or probable dementia adjusting for sociodemographic variables (model 1), model 1 plus potentially modifiable vascular risk factors (model 2), and model 1 plus structural imaging markers of brain integrity (model 3).RESULTSThere were 989 participants with cognitive outcome determinations (mean age 69 ± 9 years; 68% Hispanic, 16% Black, 14% White; 62% women; mean (±SD) follow-up five (±0.6) years). Prevalence rates for MCI (20%) and probable dementia (5%) were significantly different by race/ethnicity even after accounting for age and education difference across race-ethnic groups; Hispanic and Black participants had greater prevalence rates than Whites. Adjusting for sociodemographic and brain imaging factors explained the most variance in the race/ethnicity associations. White matter hyperintensity burden explained much of the disparity between Black and White, but not between Hispanic and White, participants.CONCLUSIONSIn this diverse community-based cohort, white matter hyperintensity burden partially explained disparities in MCI and dementia prevalence in Black but not Hispanic participants compared to Whites. Longer follow-up and incidence data are needed to further clarify these relationships.

CSF Aβ 42 levels correlate with amyloid-neuropathology in a population-based autopsy study

Neurology ◽  
2003 ◽  
Vol 60 (4) ◽  
pp. 652-656 ◽  
Author(s):  
D. Strozyk ◽  
K. Blennow ◽  
L. R. White ◽  
L. J. Launer
Keyword(s):  
Regression Models ◽  
Population Based ◽  
Japanese American ◽  
Amyloid Angiopathy ◽  
Linear Regression Models ◽  
Autopsy Study ◽  
Aging Study ◽  
Relationship Of ◽  
The Relationship ◽  
Diffuse Plaques

Objective: To investigate the relationship of amyloid neuropathology to postmortem CSF Aβ 42 levels in an autopsy sample of Japanese American men from the population-based Honolulu–Asia Aging Study.Methods: In 1991, participants were assessed and diagnosed with dementia (including subtype) based on published criteria. At death CSF was obtained from the ventricles. Neuritic plaques (NP) and diffuse plaques in areas of the neocortex and hippocampus were examined using Bielschowsky silver stains. Cerebral amyloid angiopathy (CAA) was measured by immunostaining for β4 amyloid in cerebral vessels in the neocortex. Neuropathologically confirmed AD was diagnosed using Consortium to Establish a Registry for Alzheimer’s Disease criteria. In 155 autopsy samples, log transformed linear regression models were used to examine the association of NP and CAA to Aβ 42 levels, controlling for clinical dementia severity, time between diagnosis and death, age at death, brain weight, hours between death and collection of CSF, education, and APOE genotype.Results: Higher numbers of NP in the neocortex (p trend = 0.001) and in the hippocampus (p trend = 0.03) were strongly associated with lower levels of Aβ 42. Individuals with CAA had lower Aβ 42 levels (β coefficient = −0.48; 95% CI −0.9, −0.1). Compared to participants with a diagnosis of clinical dementia, those with pathologically confirmed AD had lower Aβ 42 levels (β coefficient = −0.74; 95% CI −1.4, −0.1).Conclusion: The current study suggests that lower Aβ 42 levels reflect neuropathologic processes implicated in amyloid-related pathologies, such as NP and CAA.

scholarly journals Diet-related practices and BMI are associated with diet quality in older adults

2013 ◽  
Vol 17 (7) ◽  
pp. 1565-1569 ◽  
Author(s):  
Dara W Ford ◽  
Terryl J Hartman ◽  
Christopher Still ◽  
Craig Wood ◽  
Diane Mitchell ◽  
...  
Keyword(s):  
Older Adults ◽  
Diet Quality ◽  
Regression Models ◽  
Screening Tool ◽  
Dietary Quality ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Rural Aging ◽  
Food Sufficiency ◽  
Aging Study

AbstractObjectiveTo assess the association of diet-related practices and BMI with diet quality in rural adults aged ≥74 years.DesignCross-sectional. Dietary quality was assessed by the twenty-five-item Dietary Screening Tool (DST). Diet-related practices were self-reported. Multivariate linear regression models were used to analyse associations of DST scores with BMI and diet-related practices after controlling for gender, age, education, smoking and self- v. proxy reporting.SettingGeisinger Rural Aging Study (GRAS) in Pennsylvania, USA.SubjectsA total of 4009 (1722 males, 2287 females; mean age 81·5 years) participants aged ≥74 years.ResultsIndividuals with BMI < 18·5 kg/m2 had a significantly lower DST score (mean 55·8, 95 % CI 52·9, 58·7) than those individuals with BMI = 18·5–24·9 kg/m2 (mean 60·7, 95 % CI 60·1, 61·5; P = 0·001). Older adults with higher, more favourable DST scores were significantly more likely to be food sufficient, report eating breakfast, have no chewing difficulties and report no decline in intake in the previous 6 months.ConclusionsThe DST may identify potential targets for improving diet quality in older adults including promotion of healthy BMI, breakfast consumption, improving dentition and identifying strategies to decrease concern about food sufficiency.

scholarly journals Actigraphic Measures of Sleep Quality Associated With Ambulatory Cognitive Performance in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 578-578
Author(s):  
Orfeu Buxton ◽  
Ruixue Zhaoyang ◽  
June Jiao ◽  
Rachel Zimmerman ◽  
Martin Sliwinski ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Response Time ◽  
Cognitive Performance ◽  
Sleep Onset ◽  
Study Cohort ◽  
Learning Effects ◽  
Community Based ◽  
Shape Accuracy ◽  
Error Proportion ◽  
Aging Study

Abstract Few longitudinal studies link objectively assessed sleep and cognitive performance in ecologically-valid environments. Participants enrolled in the community-based Einstein Aging Study cohort (n=224, M[age]=77.17). Wake after sleep onset (WASO) was associated with worse cognitive performance with and without MCI (2-week smartphone-based EMA, six assessments/day). Models include age, gender, ethnicity, education, learning effects, sleep duration, WASO*MCI interaction (p=0.015 for Symbol Match; p=0.002 for Color Shape). Associations were stronger among those with MCI, thirty minutes more nightly WASO predicted a 500ms longer Symbol Match response time (p&lt;0.0001), 5.05% higher Color Dot error proportion (p=0.002), 0.184 points lower Color Shape accuracy (p&lt;0.0001). In those without MCI, WASO was associated with worse cognition: thirty minutes more nightly WASO predicted +166.7ms Symbol Match response time (p=0.03) and -0.06 points Color Shape accuracy (p=0.013). Actigraphic sleep quality associated with ambulatory cognitive performance (and worse with MCI status) suggests targets for prevention/mitigation of cognitive decline. Part of a symposium sponsored by the Sleep, Circadian Rhythms and Aging Interest Group.

scholarly journals Comparison of UDSNB 3.0 normative data with those developed in a diverse community cohort of older adults: Results from the Einstein Aging Study

2021 ◽  
Vol 17 (S6) ◽  
Author(s):  
Cuiling Wang ◽  
Mindy J. Katz ◽  
Katherine H Chang ◽  
Carol A. Derby ◽  
Richard B. Lipton ◽  
...  
Keyword(s):  
Older Adults ◽  
Normative Data ◽  
Aging Study ◽  
Diverse Community

scholarly journals Dietary Patterns and Cognition in US Older Adults

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 29-29
Author(s):  
Yian Gu ◽  
Jing Guo ◽  
Alanna Moshfegh
Keyword(s):  
Older Adults ◽  
Sex Education ◽  
Dietary Patterns ◽  
Healthy Eating Index ◽  
Digit Symbol Substitution Test ◽  
Z Score ◽  
Linear Regression Models ◽  
Annual Household Income ◽  
Race Ethnicity ◽  
Nationally Representative

Abstract Objectives Community-based population cohort studies found that following healthy dietary patterns is protective against cognitive decline in older adults. The current study aims to confirm the associations in nationally representative samples. Methods The current cross-sectional study included 2864 participants (≥60 years) of National Health and Nutrition Examination Survey (NHANES) 2011–2014 who completed both dietary and cognitive assessments. Self-reported dietary intake was collected by trained interviewers using the USDA's Automated Multiple-Pass Method in two nonconsecutive 24-hour dietary recalls. Mediterranean-type Diet (MeDi) and Healthy Eating Index 2015 (HEI15) scores were estimated from the mean intakes of the two diet recalls. Cognitive function was measured by the Consortium to Establish a Registry for Alzheimer's disease Word Learning sub-test (WL), Animal Fluency test (AF), and Digit Symbol Substitution test (DSST). Age, sex, race/ethnicity adjusted z-scores were calculated for three cognitive scores, which were then averaged to get a composite cognitive score. Linear regression models were applied to examine the associations of diet and cognition, adjusted for age, sex, education, race/ethnicity, caloric intake, survey cycles, and annual household income. Results MeDi and HEI2015 were associated with 0.028 (95% CI = 0.004–0.05; P = 0.023) and 0.004 (0.0002–0.007; P = 0.038) higher mean cognitive z-score, respectively. Compared to the lowest tertile of MeDi, the highest tertile of MeDi was associated with 0.141 (95% CI = 0.029–0.253, P = 0.015; p-trend = 0.016) higher mean cognitive z-score. Compared to the lowest tertile, the highest MeDi tertile was associated with 1.001 (0.161–1.840, 0.021; 0.021), 1.05 (0.227–1.875, 0.014; 0.015) and 3.02 (1.004–5.027, 0.005; 0.004) higher WL, AF, and DSST, respectively, and the highest HEI15 tertile was associated with 0.827 (0.154–1.499, 0.018; 0.018) higher AF. The effect size of the highest compared to the lowest tertile of dietary score was approximately equivalent to 3–4 less years of aging. Conclusions Following a healthy diet is associated with better cognitive performance in a nationally representative sample of older adults. Funding Sources The current study was supported by grants from National Institution on Aging.

Perceived Discrimination, Nativity, and Cognitive Performance in a Multi-ethnic Study of Older Adults: Findings from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study

2021 ◽  
Author(s):  
Erika Meza ◽  
Rachel Peterson ◽  
Paola Gilsanz ◽  
Kristen M George ◽  
Sunita J Miles ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Performance ◽  
Cognitive Aging ◽  
Healthy Aging ◽  
Life Experiences ◽  
Community Dwelling ◽  
Future Research ◽  
Linear Regression Models ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Background Despite growing research on the association between discrimination and disparities in cognitive aging, an evidence gap remains on how the association varies by racial/ethnic group. This study evaluates the associations of experiences of discrimination with cognitive function and whether these associations varied by race/ethnicity and nativity. Methods Using the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) cohort (N=1,712) with approximately equal groups of Black, White, Latino, and Asian community-dwelling older adults aged 65 years and older, we evaluated the associations between self-reported experiences of everyday and major lifetime discrimination with overall cognitive performance and domain-specific cognition (verbal episodic memory, semantic memory and executive functioning) across race/ethnicity and nativity. Linear regression models examined the cross-sectional association between self-reported experiences of everyday and major lifetime discrimination with z-standardized coefficients for cognition. We tested for effect modification by race and nativity. All models controlled for age, sex and education. Results Among KHANDLE participants (mean age: 76 years; standard deviation: 6.8), everyday discrimination was not associated with cognitive scores. Major lifetime discrimination was associated with better average cognitive scores among Black participants but not among other racial/ethnic groups. Major lifetime discrimination was associated with better average cognitive scores among US-born but not among non-US born individuals. Conclusion Our findings do not imply that discrimination improves cognition, but rather suggest that future research should include more detailed measures on discrimination and unfair treatment that could help disentangle the extent to which relationships are causal or reflect some other underlying factor.

scholarly journals One-Carbon Metabolites, B Vitamin Intake, Apolipoprotein E Genotype, and Their Interactive Effects on Cognitive Performance: Secondary Outcomes of the REACH Cohort

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 16-16
Author(s):  
Nicola Gillies ◽  
Amber Milan ◽  
David Cameron-Smith ◽  
Cathryn Conlon ◽  
Pamela von Hurst ◽  
...  
Keyword(s):  
Apolipoprotein E ◽  
Cognitive Performance ◽  
Regression Models ◽  
Interactive Effects ◽  
Linear Regression Models ◽  
Vitamin Intake ◽  
Ε4 Allele ◽  
B Vitamin ◽  
Apolipoprotein E Genotype ◽  
Apolipoprotein Ε4

Abstract Objectives To investigate associations between one-carbon metabolites and cognitive performance in older adults, and to examine the interactive effects of B vitamin intake, apolipoprotein E genotype, and one-carbon metabolites on cognition. Methods Three hundred and thirteen healthy older men and women (65–74 years, 65% female) were included in this secondary analysis of the REACH cohort. Cognitive performance was assessed by the Computerised Mental Performance Assessment System (COMPASS). Fasting plasma one-carbon metabolites (betaine, choline, cysteine, dimethylglycine, glycine, homocysteine, methionine, S-adenosylmethionine, serine) were quantified by ultra high performance liquid chromatography with tandem mass spectrometry, and four-day food records were analyzed for nutrient intake. Presence of the apolipoprotein E ε4 allele was measured by polymerase chain reaction amplification. Linear regression models were adjusted for age, sex, batch effects, education level, physical activity, energy intake and supplement use. Interaction terms were fit between continuous (metabolites) and categorical (quartiles of B vitamin intake or metabolites not fit as the main independent variable, presence of apolipoprotein ε4 allele) variables. Results Higher glycine concentrations were associated with better global cognitive performance (β = 1.340, P = 0.017), episodic memory (β = 1.396, P = 0.016) and location learning (β = 1.394, P = 0.027) in linear regression models, although this relationship was not apparent in participants with higher choline concentrations or the apolipoprotein ε4 genotype (interaction, P &lt; 0.05). Conversely, the apolipoprotein ε4 genotype and higher vitamin B12 intake both attenuated the inverse association between Hcy and cognition across several domains of cognitive performance (interaction, P &lt; 0.05). Conclusions The relationship between cognitive performance and one-carbon metabolites, notably glycine and homocysteine, is modified by vitamin B12 intake, apolipoprotein E genotype, and status of inter-connected metabolites. These findings point towards the need for a personalized approach to dietary interventions which protect against age-related cognitive decline. Funding Sources This work was supported by the Health Research Council of New Zealand and AgResearch Ltd.

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