Abstract
Background
Exceptional long‐lived individuals (ELLI) are known for their improved health status and independence regardless of life‐style and health behaviors. Yet, little is known about ...their cognitive function correlates. The aim of the present study was to assess the correlation between social, clinical, behavioral and personality factors and cognitive impairment in a sample of Ashkenazi Jews (AJ) ELLIs.
Method
The study sample included 401 AJ participants, aged 95 years or older, of the Longevity Genes Project at Einstein, who were residents of the northeastern United States and lived independently in the community. Socio‐demographic, medical history data and life‐style factors were collected via mailed questionnaires, telephone calls, or in‐person visits. Personality was assessed through the Personality Outlook Profile Scale. In the event that participants had difficulty responding to questions in a reliable manner, their children or legal guardian assisted them. Cognitive status was assessed using the Mini Mental State Exam (MMSE) with a score of 24 or lower considered as cognitive impairment. Cross‐sectional associations of medical, social, life‐style and personality characteristics with odds for cognitive impairment were assessed using logistic regression models while adjusting for potential confounders.
Result
Of the total sample (mean age=97.72.8 years, 84% women), 178 (44%) were cognitively impaired. Following adjustment for age, sex and education, prevalent skin cancer (OR, 95% CI: 0.40, 0.22‐0.74) as well as being conservative religious (OR, 95% CI: 0.18, 0.03‐0.97) and attending temple in Holidays only (OR, 95% CI=0.25, 0.07‐0.88) and weekly (OR, 95% CI: 0.25, 0.06‐0.97) at age ∼70 years were associated with lower odds for cognitive impairment.
Conclusion
Cognitive impairment correlates in ELLI may differ from those in the general population. Future studies are warranted to explore the role of religious involvement in brain aging. Furthermore, the strong link between a history of skin cancer and cognition in the oldest‐old should be examined.
Full text
Available for:
FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Ultra-processed food (UPF) consumption is related to increased morbidity and mortality. However, knowledge on its association with cognitive function is lacking. In this longitudinal study, we ...examined the associations between UPF intake and cognitive decline in older adults with type-2 diabetes (T2D).
The sample included initially nondemented T2D older adults (≥65 years), from the Israel Diabetes and Cognitive Decline study, who had complete information on nutrition at baseline and at least 3 cognitive assessments (mean follow-up 5.3 ± 1.5 years). Nutritional intake was evaluated by a validated Food-Frequency Questionnaire, and foods were categorized as UPF based on NOVA classification. Percent of calories from UPF were calculated from total caloric consumption in total and specific food groups. Mixed effect models were used to examine the link between UPF intake (top vs bottom quartiles) and change in cognitive function overall and in specific domains, adjusting for potential confounders.
Of the total sample (N = 568; mean age 71.3 ± 4.5 years, 60% men), 141 consumed >31% kcal from UPF (top quartile). Greater intake of ultra-processed meat was associated with a faster decline in executive functions and global cognition (β = -0.041 ± 0.013; p = .002 and β = -0.026 ± 0.010; p = .011, respectively). Additionally, consumption of ultra-processed oils/spreads was associated with faster decline in executive functions and global cognition (β = -0.037 ± 0.014; p = .006 and β = -0.028 ± 0.010; p = .009, respectively). Total UPF consumption and UPF-derived from dairy products and bread/pastries/starch were not associated with cognitive change.
This study suggests that a high intake of ultra-processed meat and oils/spreads may be associated with accelerated cognitive decline in older individuals with T2D.
Highlights • We explored the association between inflammation and future cognition in individuals with a history of cardiovascular disease. • Increased plasma CRP levels were associated with poorer ...cognitive performance overall and in executive function and attention domains. • A greater decline in cognition was observed in participants with high vs. low CRP. • These associations were independent of vascular risk factors and markers of cerebrovascular disease.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Dementia is currently diagnosed based on clinical symptoms and signs, but significant brain damage has already occurred by the time a clinical diagnosis of dementia is made, and it is increasingly ...recognized that this may be too late for any effective intervention. It would therefore be of great public health and preventive value to define a variety of biomarkers that could permit early detection of persons at a higher risk for developing dementia, and specifically dementia due to Alzheimer's disease. Nevertheless, for the purpose of large-scale screening, circulating biomarkers are more appropriate because they are less invasive than lumbar puncture, less costly than brain amyloid imaging and can be easily assessed repeatedly in a primary care clinic setting. In this brief review we will review a number of candidate molecules implicated as possible predictors of dementia risk. These candidates include markers of vascular injury, metabolic and inflammatory states, amyloid and tau pathway markers, measures of neural degeneration and repair efforts, and other molecules that might contribute to anatomical and functional changes characteristic of dementia and Alzheimer's disease.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Background
Physical activity (PA), and particularly moderate to vigorous intensity PA (MVPA), may protect against cognitive decline. However, the underlying mechanisms are not fully understood. ...Cardiac autonomic balance is influenced by PA and implicated in dementia pathogenesis. Therefore, the study aimed to examine whether autonomic balance mediates the association between PA and cognitive function.
Method
The sample included 1,939 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study. MVPA was obtained in 7 consecutive examinations from baseline (1985‐86; 18‐30 years) to the Year 20 exam. Cardiac autonomic balance was assessed at Year 20 via resting heart rate, and via measures of heart rate variability: standard deviation normal to normal (SDNN) and root mean square of successive differences (RMSDD). A comprehensive cognitive assessment was performed at Year 30. Group‐based trajectory modeling was used to identify homogenous MVPA trajectory groups, and formal mediation analysis was used to test whether cardiac autonomic function indices lie on the causal pathway between MVPA trajectories and cognitive function.
Result
Three distinct PA trajectory patterns were identified: (1) Below MVPA guidelines (n = 1,122; 57.9%); (2) Meeting MVPA guidelines (n = 652; 33.6%); and (3) Exceeding MVPA guidelines (n = 165; 8.5%) (Figure). Meeting and exceeding MVPA guidelines were related to lower resting heart rate and higher heart rate variability, which indicate improved autonomic balance. Meeting and exceeding MVPA guidelines were additionally associated with improved semantic fluency performance. The association between higher MVPA level and semantic fluency performance was fully mediated by RMSDD and partially mediated by SDNN. No additional associations were observed between MVPA trajectories and other cognitive outcomes, and no statistically significant mediation by autonomic balance indices was found for these associations (Table).
Conclusion
Higher MVPA levels across the young adult to midlife transition were associated with better cardiac autonomic function, which in turn explained some of the associations between PA trajectories and better semantic fluency performance. Future studies, particularly among older individuals are warranted to clarify the role of autonomic balance in the link between physical activity and brain health. These findings may lead to more targeted PA recommendations across the life‐course to slow cognitive decline and decrease dementia risk.
Full text
Available for:
FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Holocaust victims experienced extreme physical and mental stress that could lead to prolonged deficits in psychological and physiological well-being. We aimed to examine whether exposure to Holocaust ...conditions is associated with cognitive function and decline in a sample of old male adults with coronary heart disease (CHD).
The sample included 346 individuals with CHD who participated in a clinical trial in 1990–1997 (mean age 56.7 ± 6.5 y). During 2004–2008 (mean age 71.8 ± 6.5 y) and 2011–2013 (mean age 77.1 ± 6.4 y) participants underwent computerized cognitive assessments. Exposure to Holocaust conditions was based on self-report at the second assessment. Linear regression and mixed-effect models were conducted to evaluate the associations between Holocaust survivorship and subsequent cognitive performance and rate of cognitive decline.
Forty-Three participants (12%) survived concentration camps/ghettos, 69 (20%) were Holocaust survivors who escaped concentration camps/ghettos, and 234 (68%) were not Holocaust survivors. After adjustment for potential confounders, concentration camp/ghetto survivors had poorer global cognitive performance and poorer attention (β = −3.90; 95%CI: 7.11;-0.68 and β = −4.11; 95%CI: 7.83;-0.38, respectively) compared to individuals who were not exposed to Holocaust conditions. Additionally, participants who reported being at concentration camps/ghettoes had increased cognitive decline in global performance and executive function (β = −0.19; 95%CI: 0.37;-0.008 and β = −0.29; 95%CI: 0.53;-0.06, respectively) compared to participants who were not Holocaust survivors. Lastly, those who were Holocaust survivors but not in concentration camps/ghettos had greater decline in attention (β = −0.11; 95%CI: 0.21;-0.01).
Exposure to Holocaust conditions in early-life may be linked with poorer cognitive function and greater cognitive decline decades later in old-adults with CHD.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Objective and subjective health are two powerful constructs which predict morbidity and mortality across a range of conditions including Type 2 Diabetes (T2D). Studies, however, suggest that these ...two constructs do not necessarily correlate, as some people with poor objective health perceive their health as good, while other people with good objective health perceive their health as poor. We seek to examine the role of personality as a moderator of the associations between objective and subjective health among older adults with T2D, who are likely to experience poor objective and subjective health due to their chronic medical condition.
Cross-sectional study of 368 individuals with T2D (72 ± 4 years, 42% women), participating in the Israel Diabetes and Cognitive Decline Study. Personality was conceptualized using the five-factor model (agreeableness, conscientiousness, extraversion, neuroticism, openness). Objective health was operationalized by T2D-related clinical status, cognitive function, and motor ability. Subjective health was assessed using a single self-report question. Hayes' process macro was used for the moderation analyses.
The objective-subjective health associations were stronger among individuals with increased neuroticism (proportion of days covered: p = 0.02; cognitive function: p = 0.003; hand grip: p = 0.02; 3-m walk: p = 0.04) as well as decreased openness (cognitive status: p = 0.04) and agreeableness (3-m walk: p = 0.02).
Personality traits, and specifically neuroticism, can modify the associations between objective and subjective health in older adults with T2D. Findings contribute to the understanding of health as a multidimensional construct that encompasses medical and psychological aspects, especially among older adults with a chronic illness.
•The link between objective and subjective health is complex.•Personality traits can moderate (modify) this link.•Neuroticism is the main personality trait that moderates this link.•The construct of health encompasses medical and psychological aspects.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
IMPORTANCE In animal studies, brain-derived neurotrophic factor (BDNF) has been shown to impact neuronal survival and function and improve synaptic plasticity and long-term memory. Circulating BDNF ...levels increase with physical activity and caloric restriction, thus BDNF may mediate some of the observed associations between lifestyle and the risk for dementia. Some prior studies showed lower circulating BDNF in persons with Alzheimer disease (AD) compared with control participants; however, it remains uncertain whether reduced levels precede dementia onset. OBJECTIVE To examine whether higher serum BDNF levels in cognitively healthy adults protect against the future risk for dementia and AD and to identify potential modifiers of this association. DESIGN, SETTING, AND PARTICIPANTS Framingham Study original and offspring participants were followed up from 1992 and 1998, respectively, for up to 10 years. We used Cox models to relate BDNF levels to the risk for dementia and AD and adjusted for potential confounders. We also ran sensitivity analyses stratified by sex, age, and education, as well as related BDNF genetic variants to AD risk. This community-based, prospective cohort study involved 2131 dementia-free participants aged 60 years and older (mean SD age, 72 7 years; 56% women). MAIN OUTCOMES AND MEASURES Ten-year incidence of dementia and AD. RESULTS During follow-up, 140 participants developed dementia, 117 of whom had AD. Controlling for age and sex, each standard-deviation increment in BDNF was associated with a 33% lower risk for dementia and AD (P = .006 and P = .01, respectively) and these associations persisted after additional adjustments. Compared with the bottom quintile, BDNF levels in the top quintile were associated with less than half the risk for dementia and AD (hazard ratio, 0.49; 95% CI, 0.28-0.85; P = .01; and hazard ratio, 0.46; 95% CI, 0.24-0.86; P = .02, respectively). These associations were apparent only among women, persons aged 80 years and older, and those with college degrees (hazard ratios for AD: 0.65, 95% CI, 0.50-0.85, P = .001; 0.63 95% CI, 0.47-0.85, P = .002; and 0.27 95% CI, 0.11-0.65, P = .003, respectively). Brain-derived neurotrophic factor genetic variants were not associated with AD risk. CONCLUSIONS AND RELEVANCE Higher serum BDNF levels may protect against future occurrence of dementia and AD. Our findings suggest a role for BDNF in the biology and possibly in the prevention of dementia and AD, especially in select subgroups of women and older and more highly educated persons.
Aim
The current study aims to investigate the association of serum brain‐derived neurotrophic factor (BDNF) levels with symptoms of depression in adults with and without prevalent cardiovascular ...disease (CVD), an often burdensome comorbidity.
Methods
This cross‐sectional study included participants from FHS (Framingham Heart Study) who had available serum BDNF levels. Depressive symptoms were assessed using the Center for Epidemiological Studies–Depression Scale (CES‐D) with a score ≥16 indicating mild to moderate and ≥21 severe depression. Participants taking antidepressant medications were excluded from the study.
Results
Altogether 3716 FHS participants were included in the final analysis (mean age, 64.3 ± 11.5 years; 55% women). After adjusting for potential confounders, greater BDNF levels were associated with reduced severe depression risk (odds ratio OR, 0.78 95% CI, 0.64–0.96; P = 0.016). Among participants with CVD, greater BDNF levels were related to lower risk of depressive symptoms (CES‐D ≥ 16 OR, 0.63 95% CI, 0.45–0.89, P = 0.008; CES‐D ≥ 21 OR, 0.49 95% CI, 0.31–0.76, P = 0.002). The inverse relationship between BDNF and depressive symptom risk was present in women with CVD (CES‐D ≥ 16 OR, 0.63 95% CI, 0.40–0.99, P = 0.047; CES‐D ≥ 21 OR, 0.38 95% CI, 0.21–0.70, P = 0.002) but not in men.
Conclusion
Lower serum BDNF levels are associated with a higher risk of depressive symptoms in CVD, particularly among women. These findings implicate BDNF in the complex biological mechanisms that underlie prior associations observed between CVD and depression. To reduce the burden of depression in the large proportion of midlife and older adults with CVD, a better understanding of how BDNF may modify these pathways is merited.
Full text
Available for:
FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Lipid levels are associated with an increased risk of cardiovascular disease.
We investigated the association between plasma lipids, apolipoproteins levels, apolipoprotein B/low-density lipoprotein ...cholesterol (Apo-B/LDL-C), and Apo-B/Apo-A ratios and rate of cognitive decline two decades later in men with coronary heart disease (CHD).
A subset of 337 men (mean age at baseline 56.6±6.4 years) who previously participated in the Bezafibrate Infarction Prevention (BIP) trial (1990-1997) underwent cognitive evaluations 15±3 years (T1) and 19.9±1 years after baseline (T2) as part of the BIP Neurocognitive study. Lipid and apolipoprotein fractions were measured at baseline. Cognitive function for memory, executive function, visual spatial, attention domains, and composite score were assessed using the NeuroTrax Computerized Battery at T1 and T2 evaluations. Linear mixed models were used to assess change in cognitive function between the two cognitive evaluations.
Controlling for confounders, the decline in composite cognitive score (β= -0.161±0.06; p = 0.013) as well as in memory (β= -0.269±0.10; p = 0.009) and visual spatial function (β= -0.304±0.12; p = 0.010) was greater among patients in the upper (≥105 mg/dL) Apo-B tertile as compared to counterparts with < 105 mg/dL. The decline in the composite cognitive score (β= -0.124±0.06; p = 0.043) was also greater among patients in the estimated LDL-C≥160 mg/dL group compared to counterparts with LDL-C<160 mg/dL. Upper tertile of Apo-B/LDL-C ratio (≥0.75) compared to the lower tertiles was significantly associated with change in memory score (β= -0.210±0.10; p = 0.041).
Our findings suggest that the plasma concentrations of Apo-B, LDL-C, and Apo-B/LDL-C ratio are potential predictors of accelerated late-life cognitive decline among men with CHD.
PDF
