Background: Modifiable vascular risk factors have been associated with late-life cognitive impairment. The Life Simple 7 (LS7) score comprises seven cardiovascular health metrics: smoking, diet, physical activity, body mass index, plasma glucose, total serum cholesterol, and blood pressure. Objective: To investigate the association between individual and composite LS7 metrics and rate of cognitive decline, and potential differences in these associations between young-old and old-old individuals. Methods: This cohort study included 1,950 participants aged≥60 years (M = 70.7 years) from the Swedish National Study on Aging and Care-Kungsholmen (SNAC-K), who underwent repeated neuropsychological testing (episodic and semantic memory, verbal fluency, processing speed, global cognition) across 12 years. The LS7 score was assessed at baseline and categorized as poor, intermediate, or optimal. Level and change in cognitive performance as a function LS7 categories were estimated using linear mixed-effects models. Results: Having an optimal LS7 total score was associated with better performance (expressed in standard deviation units) at baseline for perceptual speed (β= 0.21, 95%CI 0.12–0.29), verbal fluency (β= 0.08, 0.00–0.16), and global cognition (β= 0.06, 0.00–0.12) compared to the poor group. Age-stratified analyses revealed associations for cognitive level and change only in the young-old (<  78 years) group. For the specific metrics, diverging patterns were observed for young-old and old-old individuals. Conclusion: Meeting the LS7 criteria for ideal cardiovascular health in younger old age is associated with slower rate of cognitive decline. However, the LS7 criteria may have a different meaning for cognitive function in very old adults.

BackgroundWe investigated whether vascular risk factors (VRFs), assessed with the Life’s Simple 7 (LS7) score, are associated with rate of cognitive decline in the preclinical dementia phase. We sought to test whether (1) poor LS7 further accelerates rate of cognitive decline in preclinical dementia or (2) the dementia process itself overshadows potential effects of LS7.MethodThis population‐based study included 1,449 participants aged ≥ 60 years (M = 69.99, SD = 9.25) from the Swedish National Study on Aging and Care‐Kungsholmen (SNAC‐K). Participants aged < 78 years at baseline (M = 65.03) were categorised into a young‐old group and those ≥ 78 years (M = 82.61) into an old‐old group. An extensive cognitive test battery (episodic memory, semantic memory, verbal fluency, and perceptual speed) was administered across 12 years. VRFs were assessed with the Life’s Simple 7 (LS7) score at baseline and included four behavioral (smoking, diet, physical activity, and body mass index) and three biological (plasma glucose, total serum cholesterol, and blood pressure) metrics. Participants were categorised into having poor or intermediate/optimal cardiovascular health. Preclinical dementia was defined as being dementia‐free at baseline and diagnosed with dementia (DSM‐IV criteria) at one of the follow‐up assessments. Level and change in cognitive performance as a function of LS7 categories and future dementia status were determined using linear mixed‐effects models.ResultParticipants in a preclinical dementia phase were more likely to have a poorer LS7 score initially compared to those who remained dementia‐free (p = 0.023). For young‐old individuals, poor diet was associated with an accelerated perceptual speed decline (β = ‐0.05, 95% CI ‐0.08 to ‐0.02) and a poor plasma glucose score was associated with faster rates of verbal fluency (β = ‐0.019, ‐0.09 to ‐0.01) and global cognitive (β = ‐0.028, ‐0.06 to 0.00) decline in preclinical dementia.ConclusionThe association between VRFs and cognitive decline was most pronounced in young‐old individuals in a preclinical phase of dementia and driven mostly by diet and plasma glucose. Poor cardiovascular health may be associated with further acceleration of cognitive decline in preclinical dementia.

Background and Objective:The Life’s Simple 7 approach was proposed to define cardiovascular health (CVH) metrics. We sought to investigate the associations between behavioral, biological, and genetic markers for CVH and vascular brain aging in older adults.Methods:This population-based cohort study included participants who had repeated brain MRI measures from 2001-2003 to 2007-2010 (i.e., count of perivascular spaces, volumes of white-matter hyperintensity [WMH] and grey matter, and lacunes). At baseline, global, behavioral, and biological CVH metrics were defined and scored following the Life’s Simple 7 approach and categorized into unfavorable, intermediate, and favorable profiles according to tertiles. The metabolic genetic risk score was calculated by counting 15 risk alleles associated with hypertension, diabetes, or dyslipidemia. Data were analyzed using linear mixed-effects and Cox proportional-hazards models, adjusting for age, sex, and education.Results:The study sample consisted of 317 participants (age ≥60 years; 61.8% women). Favorable and intermediate (vs. unfavorable) global CVH profiles were related to slower WMH progression, with β-coefficients (95% CI) being -0.019(-0.035–-0.002) and -0.018(-0.034–-0.001), respectively. Favorable and intermediate (vs. unfavorable) biological CVH profiles were significantly related to slower WMH increase only in people aged 60-72 years. CVH profiles were not related to progression of other brain measures. Furthermore, a higher metabolic genetic risk score (range: 6-21) was associated with faster WMH increase (β-coefficient=0.005; 95% CI: 0.003–0.008). There were statistical interactions of metabolic genetic risk score with global and behavioral CVH profiles on WMH accumulation. A higher metabolic genetic risk score was related to faster WMH accumulation, with β-coefficients being 0.015(0.007–0.023), 0.005(0.001–0.009), and 0.003(-0.001–0.006) among people with unfavorable, intermediate, and favorable global CVH profiles, respectively; the corresponding β-coefficients were 0.013(0.006–0.020), 0.006(0.003–0.009), and 0.002(-0.002–0.006) among people with unfavorable, intermediate, and favorable behavioral CVH profiles.Discussion:Intermediate-to-favorable global CVH profiles in older adults are associated with slower vascular brain aging. The association of metabolic genetic risk load with accelerated vascular brain aging was evident among people with unfavorable-to-intermediate, but not favorable, CVH profiles. These findings highlight the importance of adhering to favorable CVH profiles, especially healthy behaviors, in vascular brain health.

Matura is a Slovene national examination, which all the students take after successfully completing secondary education. The Matura has two major functions; it is a high school final examination and a selection instrument for University. The goal of the study was to investigate the predictive validity of Matura for predicting academic success in study programmes in the area of humanities and social sciences. Predictive validity was studied both from the traditional correlational perspective and from the multilevel regression perspective. Additionally, we checked for possible differences in predictive validity between study programmes. According to the expectations, the Matura score was a relatively strong and robust predictor of later academic achievement, even after controlling for the high school overall grade. The results support the use of Matura scores in selection of candidates for undergraduate studies in humanities and social sciences.

Background The presence of cardiovascular risk factors leads to negative consequences in old age. To promote the intervention of such risk factors, the American Heart Association defined a metric of ideal cardiovascular health, also referred to as Life’s Simple 7 (LS7). The adherence to the LS7 recommendations has previously been linked to a lower risk of dementia and cognitive decline. The objective of this study was to investigate the association between individual and composite cardiovascular health metrics and rate of cognitive decline in an older population‐based sample. Method Participants aged ≥60 years from the Swedish National Study on Aging and Care‐Kungsholmen underwent repeated neuropsychological testing across 12 years. Domain specific scores were calculated for episodic memory, semantic memory, verbal fluency, and processing speed. The LS7 score, assessed at baseline, was composed of four behavioral (smoking, body mass index, diet, and physical activity) and three biological (serum total cholesterol, plasma glucose, and blood pressure) metrics. All metrics were categorized into three levels (poor = 0, intermediate = 1, and optimal = 2), where the LS7 total score was the sum of seven metrics (range 0‐14). On the basis of tertiles, it was categorized into poor (scores 0‐6), intermediate (7‐9) and optimal (10‐14). Data were analyzed with linear mixed‐effects models. Result Among 1828 participants with data on LS7 (mean age 70.4; 60.8% women), nobody achieved optimal levels for all 7 metrics. The average total score was 7.7 (SD = 1.9) and participants were classified as having poor (26.3%), intermediate (55.6%), or optimal (18.2%) cardiovascular health. People belonging to the intermediate or optimal group of cardiovascular health showed higher levels of cognitive performance. Although a more ideal level on specific metrics (e.g. blood pressure) was significantly associated with slower rates of cognitive decline, we observed no significant associations of the composite cardiovascular health metric with rate of cognitive change. Conclusion In this cohort study, a composite score of cardiovascular health (LS7) did not predict rate of cognitive decline. Ideal cardiovascular health in specific metrics, however, was associated with slower decline rates. Further analyses of subgroups and interaction effects are ongoing.

Samostojna vožnja avtomobila posamezniku omogoča neodvisnost in dejavno vključenost v družbo. Predstavlja kompleksno dejavnost, ki zahteva uporabo kognitivnih, senzoričnih in motoričnih sposobnosti voznika. Naraščajoči delež starejših v Sloveniji, tako kot v ostalih delih razvitega sveta, pomeni, da se bo v bližnji prihodnosti pomembno povečalo tudi število oseb z nevrodegenerativnimi boleznimi, najpogostejši med njimi sta Alzheimerjeva bolezen in Parkinsonova bolezen. Čeprav starejši povzročijo razmeroma malo prometnih nezgod, se to najverjetneje povezuje s pogostostjo njihove udeležbe v prometu. Upoštevajoč število prevoženih kilometrov so starejši ena od starostnih skupin, ki povzroči največ prometnih nesreč. Pri bolnikih z napredovalo demenco pa so sposobnosti vožnje še dodatno poslabšane, učinkovitost strategij kompenzacije vožnje (npr. izogibanje vožnji ponoči in vožnji po avtocesti) pa vprašljiva. Raziskave o vozniški uspešnosti posameznikov v začetni fazi demence niso povsem enoznačne, zato se o vozniški sposobnosti ne smemo odločati le na osnovi diagnoze. Potrebna je individualna skrbna analiza kliničnega stanja in dodatnih podatkov, dobljenih z nevropsihološkimi testi in preizkusno vožnjo. Ključno je upoštevanje posebnosti nevroloških in drugih okvar pri posameznih boleznih ter možnosti kompenzacije okrnjenih sposobnosti. Glede na široko paleto dejavnikov, ki vplivajo na oceno vozniške zmožnosti, enoznačnega priporočila o vozniški zmožnosti ob postavitvi diagnoze demenca ali parkinsonizem ni moč podati.

Prevalenci sladkorne bolezni in demence v zadnjih letih naraščata, bolezni pa si delita številne dejavnike tveganja, kot so hipertenzija, dislipidemija, čezmerna telesna teža, nezdrava prehrana in telesna neaktivnost. Pomanjkanje glikemičnega nadzora se povezuje z višjim tveganjem za kognitivni upad, mikrožilni in makrožilni zapleti sladkorne bolezni pa z višjim tveganjem za razvoj demence. Bolniki s sladkorno boleznijo imajo oškodovane različne kognitivne domene. Posebej izrazite so težave na področju spomina in izvršilnih funkcij. Tovrstne težave lahko vplivajo na potek sladkorne bolezni, posameznikove možnosti uvida v lastno bolezen in sposobnosti sledenja režimu zdravljenja. Kognitivne motnje pri bolnikih s sladkorno boleznijo se povezujejo s slabšim znanjem in slabšo skrbjo za lastno bolezen, pogostejšimi napakami pri spremljanju krvne glukoze in odmerjanju inzulinskih injekcij, pogosteje zamujenimi zdravstvenimi pregledi in večjim številom epizod hipoglikemije ter srčnožilnih zapletov. Pomembno je, da pri bolnikih s sladkorno boleznijo prepoznamo kognitivne težave in jih upoštevamo pri načrtovanju zdravljenja; opredelitvi tarčnih vrednosti, edukaciji, izbiri farmakoloških in nefarmakoloških načinov zdravljenja ter nudenju podpore bolnikom in njihovim svojcem oziroma skrbnikom. Pomembni so individualni pristop, postopno uvajanje sprememb in čim bolj enostaven protokol zdravljenja (npr. uporaba zdravil s podaljšanim učinkom, uporaba razdelilcev zdravil), ki upoštevajo tudi socialno situacijo posameznika.