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Cognitive decline
About: Cognitive decline is a research topic. Over the lifetime, 29308 publications have been published within this topic receiving 1174689 citations.
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TL;DR: Executive function and visuomotor skills were differentially affected by the combined presence of midlife hypertension and Q4 WHR while measures of verbal memory function were not related to these risk factors in the authors' sample, a pattern consistent with vascular cognitive impairment.
Abstract: Background: Obesity has been related to the incidence of dementia but its impact on cognitive performance in persons without dementia is less clear. We hypothesized that mid-life obesity may modulate the impact of conventional cardiovascular risk factors (CVRF) on cognitive impairment. We tested this hypothesis in the community-based Framingham Offspring Study sample. Methods: At Examination cycle 4 (1988-90) of the Offspring Cohort, indices of obesity (BMI and Waist-Hip Ratio [WHR]) and baseline CVRF levels were ascertained in 1,814 men and women, aged 40-69 years. Obesity and hypertension were related to the score on each of 8 neurocognitive tests measured at Examination 8, 12 years later (1999-2002). Results: Midlife measures of central obesity (WHR in the uppermost quartile- Q4) and of hypertension (BP≥140/≥90 or use of anti-hypertensive medication) were each significantly related to poorer performance on executive function & visuomotor skills (Trails B, Visual Reproductions-Immediate and Delayed Recall). Further, the relation of hypertension to neurocognitive performance was significantly modified by WHR; hypertension was not associated with neurocognitive performance in WHR Q1-Q3, but was associated with a marked adverse performance in Q4 WHR. Neither HTN nor obesity was individually or synergistically related to verbal memory (immediate or delayed recall). Conclusions: Executive function and visuomotor skills were differentially affected by the combined presence of midlife hypertension and Q4 WHR while measures of verbal memory function were not related to these risk factors in our sample, a pattern consistent with vascular cognitive impairment. Control of mid-life elevated blood pressure and central obesity may be strategies to reduce cognitive decline with age.
242 citations
TL;DR: This data indicates that serum level of testosterone and estradiol is associated with cognition in older community‐dwelling men and this work aims to clarify the mechanisms behind this association.
Abstract: OBJECTIVES: Recent studies have suggested that estrogen may improve cognitive function or prevent cognitive decline in older women. Little research has been conducted on exogenous or endogenous sex hormones and cognition in older men, yet it has been hypothesized that testosterone, either directly or by conversion to estrogens, may improve cognitive function. We investigated whether serum level of testosterone and estradiol is associated with cognition in older community-dwelling men.
DESIGN: A cross-sectional study.
SETTING: Population-based listings in the Monongahela Valley near Pittsburgh, Pennsylvania.
PARTICIPANTS: Three hundred ten men (mean age ± standard deviation = 73.0 ± 7.1) who were part of a cohort study.
MEASUREMENTS: We measured cognitive function using the Mini-Mental State Examination (MMSE), Trails B, and Digit Symbol. Sex hormone levels were determined by radioimmunoassay from serum obtained at the time of cognitive testing and analyzed by tertile.
RESULTS: No consistent association between total testosterone level and cognitive test scores was observed. However, men with high bioavailable (loosely protein-bound) testosterone had better cognitive test scores on all three tests (P≤ .001). Total estradiol levels were associated with worse cognitive scores on Digit Symbol (P .10).
CONCLUSIONS: Our findings support the hypothesis that higher levels of bioavailable testosterone, but not of bioavailable estradiol, are associated with better cognitive function in older men. In addition, bioavailable measures of testosterone may better reflect hormone levels available to the brain and thus be more closely associated with central nervous system outcomes such as cognition. Future studies, especially randomized trials, should be undertaken to determine whether testosterone may protect against cognitive decline in older men.
242 citations
TL;DR: The data suggest that vascular abnormalities, independently of blood pressure levels, may play a role in the setting of subjective memory complaints as well as of WMH in elderly hypertensive patients.
Abstract: Background and Purpose— Arterial stiffening and thickening and endothelial dysfunction may be associated with cognitive decline or white matter hyperintensities (WMH) independently of blood pressure level. We aimed to investigate, using an integrative approach, the relative contributions of structural and functional vascular factors to the degree of cognitive impairment (primary outcome) and the severity of WMH (secondary outcome) in elderly hypertensive patients with subjective memory complaints, a group prone to dementia. Methods— A prospective, dedicated, cross-sectional population of 198 elderly hypertensive patients (mean age 69.3±6.2 years) with subjective memory complaints underwent a full set of cognitive function assessments, brain MRI with semiquantification of WMH, carotid ultrasonography, carotid–femoral pulse wave velocity, brachial endothelial function, and plasma von Willebrand Factor measurements. Results— After adjustment for the usual cardiovascular risk factors, increased arterial stiff...
242 citations
TL;DR: Results indicate that once psychiatric symptoms are present in patients with Alzheimer's disease, they frequently recur, and these symptoms vary with age, sex, and rate of illness progression.
Abstract: Objective: The goal of this study was to define the recurrence or continuation of neuropsychiatric symptoms iii patients u’ith Alzheimer’s disease who were observed serially for a 1-year period. Method: One hundred eighty-one patients tvith probable Alzheimer ‘s disease were assessed five times at 3-monti, intervals with a standardized neuropsychiatric rating instrumemit. Results: Recurrence rates of neuropsychiatric symptoms during the 1-year period u’ere 85% for depression, 93% for agitation, and 95% for psychosis. Symptom frequency at any point in time underestimated the cumulative 1 -year frequency. Recurrence rates were sigmzificant!) greater among patients tt’ho had multiple symptoms. Women exhibited more symptoms thami mcmi. Patients in the oldest age group (76-87 years) had more psychosis, less depression and agitation, and slower cognitive declimie. Psychosis was associated with muzore rapid cognitive decline, amid agitation was associated with more rapid functional deterioration. Conclusions: These results indicate that omucepsychiatric symptoms are present in patiemits with Alzheimner’s disease, they frequently recur. These symptoms vary with age, sex, amid rate of ill,zess progression. (AmJ Psychiatry 1996; 153:1438-1443)
242 citations
TL;DR: The role of nutrition science is highlighted in promoting healthy aging and in improving the prognosis in cases of age-related diseases, including applicability of metrics used in body-composition and diet adequacy for older adults and mechanisms to reduce nutritional frailty and to promote diet resilience.
242 citations