Aims: The present study set out to investigate the relation of the high-density lipoprotein cholesterol (HDL-C) level to cognitive performance and its interplay with key markers of cognitive reserve in a large sample of older adults. Methods: We assessed tests of working memory, immediate and delayed cued recall in 701 older adults from Amazonas, Brazil. The HDL-C level was derived from fasting blood samples. In addition, we interviewed individuals on their education, past occupation, and cognitive leisure activity. Results: A critically low HDL-C level (<40 mg/dL) was significantly related to lower performance in working memory, immediate and delayed cued recall. Moderation analyses suggested that the relations of the HDL-C level to working memory and delayed cued recall were negligible in individuals with longer education, a higher cognitive level of the job, and greater engagement in cognitive leisure activity. Conclusion: Cognitive reserve accumulated during the life course may reduce the detrimental influences of a critically low HDL-C level on cognitive functioning in old age.
We investigated whether the relations of the cognitive reserve markers education and cognitive level of work to the physical and the mental component of health-related quality of life (HRQoL) were mediated via cognitive functioning in a large sample of 701 older adults (mean age = 70.36 years, SD = 6.87). HRQoL was measured with the 12-item Short-Form Health Survey. To measure cognitive functioning, we used the COGTEL, which is a cognitive test battery assessing prospective memory, verbal short-term memory, verbal long-term memory, working memory, verbal fluency, and inductive reasoning, combined into a composite score. Individuals reported information on their education and their main profession during their working life. Mediation analyses showed that better cognitive functioning mediated the association of higher values in the cognitive reserve markers (longer education and a high cognitive level of work) with higher HRQoL. In conclusion, the present study suggests that the sustainability of cognitive functioning in old age with the help of cognitive reserve is fundamental for the sustainability of quality of life, presumably particularly for the mental HRQoL component.
Objectives: To study the reliability/stability of the Cognitive Telephone Screening Instrument (COGTEL) for the assessment of cognitive functions, and to investigate the concurrent validity (that is, the relationship between the COGTEL scores and external variables, such as level of education and MMSE results) in a pilot study of elderly persons residing in the community in the municipal regions of Apuí, Fonte Boa and Manaus (Amazonas, Brazil). Method: This pilot study included 90 elderly persons (29 men and 61 women) aged 60-85 years of age [68.2 (± 6.7)]. The COGTEL, the MMSE and socio-economic survey were applied in the form of two interviews, a week apart and under the same conditions. Results: The test-retest intraclass correlation coefficient of the COGTEL total score (and respective six subtests), MMSE and educational level ranged from acceptable to high (0.708 < R <0.946). There was a strong positive correlation between the total score of the COGTEL with the MMSE (r =0.682; p <0.001), as well as with educational level (r =0.604; p <0.001). Conclusion: This study presents preliminary evidence of the reliability/stability and concurrent validity of the COGTEL in the evaluation of cognitive functions in elderly persons residing in the community. The results of this study support the use of COGTEL as a short, reliable and valid instrument for analyzing differences in cognitive functioning in inter-individual studies with elderly persons.
Physical activity and exercise contribute to the accumulation of cognitive reserve, which is instrumental for preserving cognitive health in old age. In a large sample of 701 older adults (mean age = 70.36 years), we investigated whether the relationship between having experienced a fall in the past and lower performance in cognitive functioning was mediated via less physical activity engagement as a cognitive reserve contributor. General cognition was assessed using the mini-mental state examination (MMSE), long-term memory using a word-pair delayed recall test and working memory using a backward digit-span test. In face-to-face interviews, individuals reported information on falls during the past 12 months and their habitual physical activity engagement. Our analyses demonstrated that the relationship between having experienced a fall in the past and lower performance in the cognitive functioning measures was partly mediated (by 16.3% for general cognition, 30.6% for long-term memory, and 33.1% for working memory, respectively) via less physical activity engagement. In conclusion, we suggest as a core bio-psychological mechanism that experiencing a fall at an older age is a critical life event that hinders sufficient physical activity engagement and thereby impedes cognitive reserve build-up, resulting in lower cognitive functioning outcomes.
generalizing to national estimates and adjusting for patient characteristics. Three distinctive functional disability trajectories were identified in the overall sample and applied to national sample weights; 75.6% had no disability, while 14.7% had mild and increasing disability and 9.7% had severe and increasing disability. Persons with probable dementia had the highest odds ratios of functional disability. We found that approximately 25% of the US communitydwelling population ≥ 65 is likely to have functional disability over 5-years. Persons with dementia only had the highest odds of functional disability over a 5-years. Interventions targeting the dementia population are needed to prolong functional independence. To date, no study has systematically investigated the prevalence of sarcopenia in cardiovascular disease (CVD) according to the international consensus definition. The aim of this study was to investigate the prevalence and prognostic value of sarcopenia in older patients with CVD. The study population consisted of 1929 admitted patients aged 60 years and older (72.3 ± 7.3 years, 633 females) with CVD. Sarcopenia was defined according to the recommended diagnostic algorithm of the Asia Working Group for Sarcopenia (AWGS). Handgrip strength was measured with a handheld dynamometer, and gait speed was measured by a 10-m walking test. Using the cut-off points from the AWGS consensus, low hand grip strength was defined as <26 kg for men and <18 kg for women, and slow gait speed was defined as <0.8 m/sec. The muscle mass was estimated according to a previously validated anthropometric equation in Asian population. The endpoint was all-cause mortality. The prevalence of sarcopenia was 26.8% (male:17.6%, female:45.7%) and increased with age (<75 years: 16.5%, 75-84 years: 40.3%, ≥85 years: 62.6%, P for trend <0.001). During follow-up (2.3 ± 2.2years), 203 deaths occurred. Patients with sarcopenia had a higher risk of all-cause death compared with non-sarcopenic patients (age-sex adjusted hazard ratio: 2.00, 95% confidence interval: 1.46 -2.73, P < 0.001). The present study suggests that sarcopenia is highly prevalent among older patients with CVD and it is associated with increased mortality. It remains unclear so far whether the negative relation of critically low high-density lipoprotein cholesterol (HDL-C) level to cognitive functioning in old age may be reduced in individuals with higher cognitive reserve accumulated during the life course. Therefore, the present study set out to investigate the relation of HDL-C level to cognitive performance and its interplay with key markers of cognitive reserve (education, cognitive level of job, and cognitive leisure activity) in a large sample of older adults. We assessed tests of working, short-term, and long-term memory in 701 older adults (mean age = 70.4 years) from Fonte Boa, Apuí, and Manaus, Brazil. HDL-C level was derived from fasting blood samples. In addition, we interviewed individuals on their education, past occupation, and cognitive leisure activity...
The objectives of this study were: (1) to investigate the age-related differences in cognitive function (CF), nutritional status (MNA), physical activity (AF), quality of life (QoL), depression, social satisfaction (SS) and socioeconomic status (SES), and (2) to explore the relationships between CF and the previous variables. This cross sectional study included 268 men and 433 women (aged 71.4 ± 7.0 years). CF was determined with the Cognitive Telephone Screening Instrument (COGTEL) and the Mini-Mental State Examination (MMSE). Correlates were as follows: Mini Nutritional Assessment (MNA), PA (Baecke questionnaire modified for older adults), Quality of life (QoL SF-12), Geriatrics Depression Scale (GDS), Satisfaction and Social Support Scale, and Socioeconomic status (SES). All instruments were applied in a face to face interview. An independent t-test identified significantly higher scores in young-old adults (≤ 69 years) for CF (p < 0.001), PA (p = 0.046) and SES (p = 0.007), compared to old-old adults (≥ 70 years). The results of multiple linear regression analysis indicated that the most significant CF correlates were SES (β = 0.45; p < 0.001), age (β = -0.12; p < 0.001), SS (β = 0.12; p = 0.001), GDS (β = -0.11; p = 0.003) and QoL (β = 0.08; p = 0.017). The overall regression model explained 36% of the total variance in the COGTEL. The oldest and the more depressed adults obtained lower scores for FC. The present study suggests that, between the correlates studied, SES was the strongest predictor in the explanation of CF in older adults. (60)(61)(62)(63)(64)(65)(66)(67)(68)(69)001), AF (p = 0,046) e ESSE (p = 0,007) (β = 0,45; p < 0,001), idade (β = -0,12; p < 0,001), SS (β = 0,12; p = 0,001), 11; p = 0,003) e QV (β = 0,08; p = 0,017 RESUMO Os objetivos deste estudo foram: (1) investigar as diferenças associadas à idade na função cognitiva (FC), status nutricional (MNA), atividade física (AF), qualidade de vida (QV), depressão, satisfação social (SS) e estatuto socioeconômico (ESSE), e (2) explorar as relações entre a FC e as varáveis anteriores. Este estudo, de natureza transversal, incluiu 268 homens e 433 mulheres (71,4 ± 7,0 anos de idade). A FC foi determinada a partir do Cognitive Telephone Screening Instrument (COGTEL) e do Mini-Mental State Examination (MMSE). Os preditores analisados incluíram: o Mini Nutritional Assessment (MNA), a AF (questionário de Baecke modificado para idosos), a QV (SF-12), a Escala de Depressão em Geriatria (GDS), a Escala de Satisfação com o Suporte Social e o ESSE (Estatuto Socioeconômico). Todos os instrumentos foram aplicados sob forma de entrevista. Um t-teste de medidas independentes identificou scores significativamente mais elevados nos adultos-idosos mais jovens , comparativamente aos mais idosos (70 -91 anos de idade). Os resultados da análise de regressão linear múltipla indicaram que os preditores mais significativos da FC foram: ESSE
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