A Longitudinal Study of the Mini‐Mental State Examination in Late Nonagenarians and Its Relationship with Dementia, Mortality, and Education

Skoog, Johan; Bäckman, Kristoffer; Ribbe, Mats; Falk, Hanna; Gudmundsson, Pia; Thorvaldsson, Valgeir; Börjesson‐Hanson, Anne; Östling, Svante; Johansson, Boo; Skoog, Ingmar

doi:10.1111/jgs.14871

Cited by 24 publications

(25 citation statements)

References 27 publications

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“…[10]. In line with reports that cognitive performance is highly correlated with survival in the oldest old [37], we find that the centenarians who score highest on cognitive tests in the ongoing prospective study are underrepresented among the first centenarians in the 100-plus Study who came to autopsy (data no shown). We therefore speculate that individuals with a low burden of pathology might survive until extreme ages, and will come to autopsy at a later time after inclusion.…”

Section: Accumulation Of Neuropathologies Is Common In Centenarianssupporting

confidence: 90%

Neuropathology and cognitive performance in centenarians

Beker

Hulsman

et al. 2018

Preprint

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With aging, the incidence of neuropathological hallmarks of neurodegenerative diseases increases in the brains of cognitively healthy individuals. It is currently unclear to what extent these hallmarks associate with symptoms of disease at extreme ages. Forty centenarians from the 100-plus Study cohort agreed to post-mortem brain donation. Centenarians self-reported to be cognitive healthy at baseline, which was confirmed by a proxy. Objective ante-mortem measurements of cognitive performance were associated with the prevalence, distribution and quantity of age-and AD-related neuropathological hallmarks. Despite self-reported cognitive health, objective neuropsychological testing suggested varying levels of ante-mortem cognitive functioning. Post-mortem, we found that most neuropathological hallmarks related to age and neurodegenerative diseases such as Aβ and Tau pathology, as well as atherosclerosis, were abundantly present in most or all centenarians, whereas Lewy body and pTDP-43 pathology were scarce. We observed that increased pathology loads correlated across pathology subtypes, and an overall trend of higher pathology loads to associate with a lower cognitive test performance. This trend was carried especially by the presence of neurofibrillary tangles (NFTs) and granulovacuolar degeneration (GVD) and to a lesser extent by Aβ-associated pathologies. Cerebral Amyloid Angiopathy (CAA) specifically associated with lower executive functioning in the centenarians. In conclusion, we find that while the centenarians in this cohort escaped or delayed cognitive impairment until extreme ages, their brains reveal varying levels of disease-associated neuropathological hallmarks, some of which associate with cognitive performance.

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Section: Accumulation Of Neuropathologies Is Common In Centenarianssupporting

confidence: 90%

Neuropathology and cognitive performance in centenarians

Beker

Hulsman

et al. 2018

Preprint

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“…In the second year after baseline mortality increased to 28%: specifically, centenarians with high cognitive functioning retained a low mortality of 17%, while centenarians with a decline in cognitive functioning had a mortality rate of 42%. Our results confirm that there is an overlapping etiology of maintained cognitive and overall health, and cognitive functioning might be employed to predict overall decline and mortality [49,50]. The longitudinal set--up of our study will allow us to monitor changes in cognition in combination with other factors of overall health that occur between baseline and death to identify to which extent centenarians escaped or delayed cognitive impairment.…”

Section: Cognitive Performance Is Associated With Mortalitysupporting

confidence: 68%

The 100-plus Study of cognitively healthy centenarians: rationale, design and cohort description

Holstege

Beker

Dijkstra

et al. 2018

Preprint

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“…In addition, people who have higher levels of education have healthier lifestyles, less chronic stress, better socioeconomic status, etc, which may contribute to recover from MCI to NC. Education is related to cognitive reserves, and a study indicated that higher education was associated with higher MMSE scores. Gao et al proposed that those with higher MMSE total scores were more likely to revert to NC.…”

Section: Disscusionmentioning

confidence: 99%

Factors for predicting reversion from mild cognitive impairment to normal cognition: A meta‐analysis

Xue

Hou

et al. 2019

Int J Geriat Psychiatry

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Objective Subjects with mild cognitive impairment (MCI) may revert to normal cognition (NC), but predictive factors are under study. We therefore sought to identify factors which could help in predicting reversion from MCI to NC. Methods Relevant studies were retrieved from PubMed, EMBASE, Cochrane Library, MEDLINE, Web of Science, EBSCO, and OVID. According to the inclusion and exclusion criteria, high‐quality assessments of relevant literatures were conducted, followed by data extraction and meta‐analysis with Stata 12.0 software. Results A total of 17 studies with 6829 participants were included in the meta‐analysis. The overall reversion rate is 27.57%. Positive predictive factors were found in younger age (SMD = −0.345, 95% CI, −0.501 to −0.189), higher education level (SMD = 0.337, 95% CI, 0.117‐0.558), no APOE ε4 allele (OR = 0.728, 95% CI, 0.575‐0.922), no hypertension (OR = 0.826, 95% CI, 0.692‐0.987), no stroke (OR = 0.696, 95% CI, 0.507‐0.953), and higher Mini‐Mental State Examination (MMSE) score (SMD = 0.707, 95% CI, 0.461‐0.953). Conclusion Individuals who are at young age, have higher education level and MMSE score, and have no APOEe4 allele, no hypertension, and no stroke had a high probability to revert from MCI to NC.

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A Longitudinal Study of the Mini‐Mental State Examination in Late Nonagenarians and Its Relationship with Dementia, Mortality, and Education

Abstract: MMSE score is associated with dementia and subsequent mortality even in very old individuals, although the preclinical phase of dementia may be short in older age. Level of education is positively associated with MMSE score but not rate of decline in individuals approaching age 100.

Cited by 24 publications

References 27 publications

Neuropathology and cognitive performance in centenarians

Neuropathology and cognitive performance in centenarians

The 100-plus Study of cognitively healthy centenarians: rationale, design and cohort description

Factors for predicting reversion from mild cognitive impairment to normal cognition: A meta‐analysis

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