Research indicates that sleep efficiency below 80% substantially increases mortality risk in elderly persons. The aim of this study was to identify factors that would best predict poor sleep ...efficiency in the elderly, and to determine whether associations between these factors and sleep efficiency were similar for men and women and for younger and older elderly persons.
A total of 2468 individuals aged 65-96 years (40.7% men) participated. They were recruited via random generation of telephone numbers according to a geographic sampling strategy. The participants agreed to have health professionals visit their home and to answer structured interview questions. Sleep efficiency was calculated based on interview responses. Descriptive statistics and logistic regressions were conducted.
The factors most strongly associated with sleep efficiency below 80% were pain, nocturia, sleep medication use, and awakening from bad dreams. Some factors varied by sex: women aged 75 years and older or who had an anxiety disorder were more likely to have sleep efficiency below 80%, whereas being single or having painful illness raised the likelihood for men only. Except for sex, all the factors that showed associations with sleep efficiency affected younger and older elderly persons similarly.
Poor sleep efficiency is prevalent among elderly persons. The results shed new light on factors associated with poor sleep efficiency, highlighting the presence of sex differences and that certain factors make no significant contribution, such as typically proscribed sleep hygiene behaviors, mood disorders, and illness in general.
The Consortium for the early identification of Alzheimer's disease–Quebec (CIMA-Q) created a research infrastructure to recruit, characterize, and track disease progression in individuals at risk of ...dementia.
CIMA-Q established standardized clinical, neuropsychological, neuroimaging, blood (plasma, serum, RNA, genomic DNA), cryopreserved peripheral blood mononuclear cells, and cerebrospinal fluid collection protocols. These data and biological materials are available to the research community.
In phase 1, 115 persons with subjective cognitive decline, 88 with mild cognitive impairment, 31 with early probable Alzheimer's disease, and 56 older adults with no worries nor impairments received detailed clinical and cognitive evaluations as well as blood and peripheral blood mononuclear cells collections. Among them, 142 underwent magnetic resonance imaging, 29 a 18fluorodeoxyglucose positron emission tomography, and 60 a lumbar puncture.
CIMA-Q provides procedures and resources to identify early biomarkers and novel therapeutic targets, and holds promise for detecting cognitive decline in Alzheimer's disease.
•Well-ascertained cohort of 290 community-dwelling elderly individuals in Quebec.•Large number of individuals with subjective cognitive decline studied longitudinally.•Clinical, neuropsychology, neuroimaging, and biomaterials available for Alzheimer's disease studies.
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FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Although evidence has indicated that subjective cognitive decline (SCD) may be an early sign of Alzheimer's disease (AD), the objectification of cognitive impairment in SCD is challenging, mainly due ...to the lack of sensitivity in assessment tools. The present study investigated the potential contribution of two verbal fluency tasks with high executive processing loads to the identification of cognitive impairment in SCD.
A total of 60 adults with SCD and 60 healthy controls (HCs) performed one free action (verb) fluency task and two fluency tasks with more executive processing load-an alternating fluency task and an orthographic constraint fluency task-and the results were compared.
In the free action fluency task, the performance of the participants with SCD and the HCs was similar. However, HCs performed significantly better than SCD in the alternating fluency task, which required mental flexibility, and the orthographic constraint fluency task, which required inhibition.
The study findings suggest that verbal fluency tasks with high executive processing load could be useful in detecting cognitive deficits at the preclinical stage of AD. The inclusion of such tests in assessment batteries should be considered in order to improve the detection of subtle cognitive impairment in preclinical major neurocognitive disorder populations.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Given that aging is associated with higher risk of cognitive decline and dementia, improving early detection of cognitive impairment has become a research and clinical priority. The Montreal ...Cognitive Assessment (MoCA) is a screening instrument used to assess different aspects of cognition. Despite its widespread use, norms adjusted to the sociodemographics of Quebec-French people are not yet available. Such norms are however important because performance on neuropsychological tests varies according to sociodemographic variables including age, sex, and education. As such, the present study aimed to establish normative data for the MoCA in middle-aged and elderly Quebec-French population.
For that purpose, 1,019 community-dwelling older adults aged between 41 and 98 were recruited. Participants from 12 recruiting sites completed the MoCA. Regression-based normative data were produced and cross-validated with a validation sample (n = 200).
Regression analyses indicated that older age, lower education level, and male sex were associated with poorer MoCA scores. The best predictive model included age (p < .001), education (p < .001), sex (p < .001), and a quadratic term for education (education X education; p < .001). This model explained a significant amount of variance of the MoCA score (p < .001, R2 = 0.26). A regression equation to calculate Z scores is presented.
This study provides normative data for the MoCA test in the middle-aged and elderly French-Quebec people. These data will facilitate more accurate detection and follow-up of the risk of cognitive impairment in this population, taking into account culture, age, education, and sex.
OBJECTIVES: To examine in men and women the independent associations between anxiety and depression and 1‐year incident cognitive impairment and to examine the association of cognitive impairment, no ...dementia (CIND) and incident cognitive impairment with 1‐year incident anxiety or depression.
DESIGN: Prospective cohort study.
SETTING: General community.
PARTICIPANTS: Population‐based sample of 1,942 individuals aged 65 to 96.
MEASUREMENTS: Two structured interviews 12 months apart evaluated anxiety and mood symptoms and disorders according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. Incident cognitive impairment was defined as no CIND at baseline and a follow‐up Mini‐Mental State Examination score at least 2 points below baseline and below the 15th percentile according to normative data. The associations between cognitive impairment and anxiety or depression were assessed using logistic regression adjusted for potential confounders.
RESULTS: Incident cognitive impairment was, independently of depression, associated with baseline anxiety disorders in men (odds ratio (OR)=6.27, 95% confidence interval (CI)=1.39–28.29) and anxiety symptoms in women (OR=2.14, 95%=1.06–4.34). Moreover, the results indicated that depression disorders in men (OR=8.87, 95%=2.13–36.96) and anxiety symptoms in women (OR=4.31, 95%=1.74–10.67) were particularly linked to incident amnestic cognitive impairment, whereas anxiety disorders in men (OR=12.01, 95%=1.73–83.26) were especially associated with incident nonamnestic cognitive impairment. CIND at baseline and incident cognitive impairment were not associated with incident anxiety or depression.
CONCLUSION: Anxiety and depression appear to have different relationships with incident cognitive impairment according to sex and the nature of cognitive impairment. Clinicians should pay particular attention to anxiety in older adults because it may shortly be followed by incident cognitive treatment.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
This study examined childhood socioeconomic status (SES) as a predictor of later life cognitive decline. Data came from 519 participants in the Lothian Birth Cohort 1936 (LBC1936) study. SES measures ...at 11 years of age included parental educational attainment, father's occupational status, household characteristics and a composite measure of global childhood SES (i.e., a total of low SES childhood indicators). Cognitive abilities were assessed by the Mini-Mental State Exam at ages 69.8, 72.8 and 76.7 years. Most indicators of low childhood SES (i.e., father manual worker, less than secondary school father education, household overcrowding, exterior located toilet, and global childhood SES) did not predict cognitive decline between the ages of 69.8 and 76.7. Participants with less educated mothers showed an increase in cognitive decline (
= -0.132,
= 0.048, and CI = -0.80, -0.00). The relationship between maternal educational attainment and cognitive decline became non-significant when controlling for adult SES (i.e., participant educational attainment and occupation). Adult SES did not mediate the latter relationship. This study provides new evidence that childhood SES alone is not strongly associated with cognitive decline. New knowledge is critical to improving population health by identifying life span stages in which interventions might be effective in preventing cognitive decline.
•Higher reserve scores relate to activation of the right inferior temporal gyri.•Higher reserve scores relate to activation of the left occipital fusiform gyri.•The temporal activation moderates the ...effect of hippocampal volume on memory.•Recruitment of the temporal lobe protects against hippocampal atrophy.•Temporal activation supports cognitive reserve to sustains memory performance.
Cognitive reserve can be defined as a property of the brain that enables an individual to sustain cognitive performance in spite of age-related neural changes. This study uses brain imaging to identify which cognitive reserve mechanisms protect against the detrimental effect of hippocampal atrophy on associative memory.
The study included 108 older adults from the Quebec Consortium for the early identification of Alzheimer’s disease. They received a magnetic resonance imaging examination to measure memory-related activations and hippocampal volume. Participants also completed a reserve-proxy questionnaire, and received a comprehensive clinical assessment.
Higher scores on the reserve questionnaire were associated with more activation in the right inferior temporal and left occipital fusiform gyri. The activation of the right temporal gyrus moderated the relationship between the volume of the hippocampus and face-name memory. A smaller volume was associated with weaker memory in participants with lower activation, but not in those with greater activation.
Recruitment of the temporal lobe protects against the detrimental effect of hippocampal atrophy on associative memory and contributes to cognitive reserve.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Background Rapid-eye movement (REM) sleep highly depends on the activity of cholinergic basal forebrain (BF) neurons and is reduced in Alzheimer's disease. Here, we investigated the associations ...between the volume of BF nuclei and REM sleep characteristics, and the impact of cognitive status on these links, in late middle-aged and older participants. Methods Thirty-one cognitively healthy controls (66.8 + or - 7.2 years old, 13 women) and 31 participants with amnestic Mild Cognitive Impairment (aMCI) (68.3 + or - 8.8 years old, 7 women) were included in this cross-sectional study. All participants underwent polysomnography, a comprehensive neuropsychological assessment and Magnetic Resonance Imaging examination. REM sleep characteristics (i.e., percentage, latency and efficiency) were derived from polysomnographic recordings. T1-weighted images were preprocessed using CAT12 and the DARTEL algorithm, and we extracted the gray matter volume of BF regions of interest using a probabilistic atlas implemented in the JuBrain Anatomy Toolbox. Multiple linear regressions were performed between the volume of BF nuclei and REM sleep characteristics controlling for age, sex and total intracranial volume, in the whole cohort and in subgroups stratified by cognitive status. Results In the whole sample, lower REM sleep percentage was significantly associated to lower nucleus basalis of Meynert (Ch4) volume (beta = 0.32, p = 0.009). When stratifying the cohort according to cognitive status, lower REM sleep percentage was significantly associated to both lower Ch4 (beta = 0.48, p = 0.012) and total BF volumes (beta = 0.44, p = 0.014) in aMCI individuals, but not in cognitively unimpaired participants. No significant associations were observed between the volume of the BF and wake after sleep onset or non-REM sleep variables. Discussion These results suggest that REM sleep disturbances may be an early manifestation of the degeneration of the BF cholinergic system before the onset of dementia, especially in participants with mild memory deficits. Keywords: REM Sleep, Cholinergic Basal Forebrain, Nucleus Basalis of Meynert, Mild Cognitive Impairment, Neurodegeneration, Aging
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
This systematic review examined the longitudinal association between amyloid-β (Aβ) accumulation and cognitive decline in cognitively healthy adults. It was conducted using the PubMed, Embase, ...PsycInfo, and Web of Science databases. The methodological quality of the selected articles was assessed. In fine, seventeen longitudinal clinical studies were included in this review. A minority (seven out of 17) of studies reported a statistically significant association or prediction of cognitive decline with Aβ change, measured by positron emission tomography (PET; n = 6) and lumbar puncture (n = 1), with a mean follow-up duration of 3.17 years for cognition and 2.99 years for Aβ. The studies reporting significant results with PET found differences in the frontal, posterior cingular, lateral parietal and global (whole brain) cortices as well as in the precuneus. Significant associations were found with episodic memory (n = 6) and global cognition (n = 1). Five of the seven studies using a composite cognitive score found significant results. A quality assessment revealed widespread methodological biases, such as failure to report or account for loss-to follow up and missing data, and failure to report p-values and effect sizes of non-significant results. Overall, the longitudinal association between Aβ accumulation and cognitive decline in preclinical Alzheimer’s disease remains unclear. The discrepancy in results between studies may be explained in part by the choice of neuroimaging technique used to measure Aβ change, the duration of longitudinal studies, the heterogeneity of the healthy preclinical population, and importantly, the use of a composite score to capture cognitive changes with increased sensitivity. More longitudinal studies with larger sample sizes are needed to elucidate this relationship.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Embodiment has highlighted the importance of sensory-motor components in cognition. Perception and memory are thus very tightly bound together, and episodic and semantic memories should rely on the ...same grounded memory traces. Reduced perception should then directly reduce the ability to encode and retrieve an episodic memory, as in normal aging. Multimodal integration deficits, as in Alzheimer's disease, should lead to more severe episodic memory impairment. The present study introduces a new memory test developed to take into account these assumptions. The SEMEP (SEMantic-Episodic) memory test proposes to assess conjointly semantic and episodic knowledge across multiple tasks: semantic matching, naming, free recall, and recognition. The performance of young adults is compared to healthy elderly adults (HE), patients with Alzheimer's disease (AD), and patients with semantic dementia (SD). The results show specific patterns of performance between the groups. HE commit memory errors only for presented but not to be remembered items. AD patients present the worst episodic memory performance associated with intrusion errors (recall or recognition of items never presented). They were the only group to not benefit from a visual isolation (addition of a yellow background), a method known to increase the distinctiveness of the memory traces. Finally, SD patients suffer from the most severe semantic impairment. To conclude, confusion errors are common across all the elderly groups, whereas AD was the only group to exhibit regular intrusion errors and SD patients to show severe semantic impairment.
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