Cognitive status in the oldest old and centenarians: a condition crucial for quality of life methodologically difficult to assess

Arosio, Beatrice; Ostan, Rita; Mari, Daniela; Damanti, Sarah; Ronchetti, Francesco; Arcudi, Sara; Scurti, Maria; Franceschi, Claudio; Monti, Daniela

doi:10.1016/j.mad.2017.02.010

Cited by 34 publications

(24 citation statements)

References 90 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The nutritional status was mainly described by BMI, whereas MNA-SF may be more accurate [55]. It could have been interesting to verify if sensitivity and specificity were identical when they were used for people aged 90 and over [56][57][58]. This gives rise to the need for a standardization in the assessments performed.…”

Section: Commentary On Resultsmentioning

confidence: 99%

Cognitive, functional, physical, and nutritional status of the oldest old encountered in primary care: a systematic review

et al. 2020

View full text Add to dashboard Cite

Background: The oldest old (individuals over 90 years) are a fast-growing population. Characterizing their specificity would be helpful to adapt health care. This study aimed to characterize the cognitive, functional, nutritional, and physical status of individuals over 90. Methods: We conducted a systematic review of cross-sectional or cohort studies of individuals aged 90 years old or more, living at home or in a nursing home, in April 2018. Two reviewers selected eligible articles, extracted data, and evaluated the risk of bias (assessed by the Newcastle-Ottawa Scale). Results: The search strategy identified 3086 references; 35 articles were included referring to 8 cross-sectional and 27 longitudinal studies. Dementia was diagnosed in 30-42.9% of study participants, cognitive impairment in 12-50%, and 31-65% had no cognitive impairment. In terms of activities of daily living, 14-72.6% of individuals had no difficulty, 35.6-38% had difficulty, and 14.4-55.5% were dependent. For instrumental activities of daily living, 20-67.9% needed help. Regarding nutritional status, the Mini Nutritional Assessment Short Form mean score ranged from 10.3 (SD: 1.8) to 11.1 (SD: 2.4). Eight to 32% of individuals could not stand up from a chair, 19-47% could stand without the use of their arms; and 12.9-15% were not able to walk 4 m. Conclusions: These results suggest a heterogeneous population with a certain proportion of oldest old with a low level of disability. These findings suggest that a specific approach in the care of the oldest old could help prevent disability.

show abstract

Section: Commentary On Resultsmentioning

confidence: 99%

Cognitive, functional, physical, and nutritional status of the oldest old encountered in primary care: a systematic review

et al. 2020

View full text Add to dashboard Cite

show abstract

“…3 Results from cross-sectional studies indicated that approximately 50% of centenarians show clear symptoms of dementia and that 25% of centenarians exhibit at least some symptoms of cognitive impairment, whereas approximately 25% are considered to be cognitively healthy. [4][5][6][7] However, these numbers vary across studies, because it is difficult to define cognitive health in centenarians, in part because of their physical frailty, which hampers accurate cognitive assessment. 4,7 Despite the high risk of developing dementia at extreme ages, some centenarians escape developing symptoms of cognitive decline until well beyond age 100 years.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Maintenance of Cognitive Health in Centenarians in the 100-plus Study

et al. 2020

View full text Add to dashboard Cite

IMPORTANCE Some individuals who reach ages beyond 100 years in good cognitive health may be resilient against risk factors associated with cognitive decline. Exploring the processes underlying resilience may contribute to the development of therapeutic strategies that help to maintain cognitive health while aging. OBJECTIVE To identify individuals who escape cognitive decline until extreme ages and to investigate the prevalence of associated risk factors. DESIGN, SETTING, AND PARTICIPANTS The 100-plus Study is a prospective observational cohort study of community-based Dutch centenarians enrolled between 2013 and 2019 who were visited annually until death or until participation was no longer possible. The centenarians self-reported their cognitive health, as confirmed by a proxy. Of the 1023 centenarians approached for study inclusion, 340 fulfilled the study criteria and were included in analyses. Data analysis was performed from April 2019 to December 2019. MAIN OUTCOMES AND MEASURES Cognition was assessed using the Mini-Mental State Examination (MMSE). To identify centenarians who escape cognitive decline, this study investigated the association of baseline cognition with survivorship and cognitive trajectories for at least 2 years of follow-up using linear mixed models, adjusted for sex, age, and education. This study investigated the prevalence of apolipoprotein E (APOE) genotypes and cardiovascular disease as risk factors associated with cognitive decline. RESULTS At baseline, the median age of 340 centenarians was 100.5 years (range, 100.0-108.2 years); 245 participants (72.1%) were female. The maximum survival estimate plateaued at 82% per year (95% CI, 77% to 87%) across centenarians who scored 26 to 30 points on the baseline MMSE (hazard ratio, 0.56; 95% CI, 0.42 to 0.75; P < .001), suggesting that an MMSE score of 26 or higher is representative of both cognitive and physical health. Among the 79 centenarians who were followed up for 2 years or longer, those with baseline MMSE score less than 26 experienced a decline in MMSE score of 1.68 points per year (95% CI, −2.45 to −0.92 points per year; P = .02), whereas centenarians with MMSE scores of 26 or higher at baseline experienced a decline of 0.71 point per year (95% CI, −1.08 to −0.35 points per year). For 73% of the centenarians with baseline MMSE scores of 26 or higher, no cognitive changes were observed, which often extended to ensuing years or until death. It is estimated that this group is representative of less than 10% of Dutch centenarians. In this group, 18.6% carried at least 1 APOE-ε4 allele, compared with 5.6% of the centenarians with lower and/or declining cognitive performance. CONCLUSIONS AND RELEVANCE Most centenarians who scored 26 or higher on the MMSE at baseline maintained high levels of cognitive performance for at least 2 years, in some cases despite (continued) Key Points Question Is it possible to identify centenarians who escape cognitive decline? Findings In this cohort study of 340 centenarians, most individuals who scored 2...

show abstract

“…Previous studies indicated that, an estimated 25% of the centenarians have retained their cognitive health, while 25% have symptoms of cognitive impairment and 50% may be regarded as having dementia . To evaluate cognitive impairment in this heterogeneous group, it is important to implement suitable instruments that consider the specific characteristics of centenarians …”

mentioning

confidence: 99%

“…3,4 To evaluate cognitive impairment in this heterogeneous group, it is important to implement suitable instruments that consider the specific characteristics of centenarians. 5 Cognitive test performance of centenarians is often evaluated relative to normative data generated in younger adults. However, norms derived in younger samples may not account for cognitive decline as part of the normal aging process.…”

mentioning

confidence: 99%

Neuropsychological Test Performance of Cognitively Healthy Centenarians: Normative Data From the Dutch 100‐Plus Study

Beker

Sikkes

Hulsman

et al. 2018

J American Geriatrics Society

View full text Add to dashboard Cite

Objectives The fraction of the population that reaches the age of 100 years is growing. At this age, dementia incidence is high and cognitive functioning is highly variable across individuals. Normative data for neuropsychological tests are lacking in centenarians, which hampers the ability to evaluate their cognitive functioning for both research and clinical practice. Here, we generated norms for neuropsychological tests in a sample of cognitively healthy centenarians while taking sensory impairments into account. Design Cross‐sectional cohort study. Setting Centenarians who participate in the prospective 100‐plus Study. Participants A total of 235 centenarians (71.5% female), who self‐reported to be cognitively healthy, which was confirmed by an informant and a trained researcher. Measurements We generated normative data for 15 cognitive tests, measuring global cognition (Mini‐Mental State Examination [MMSE]), premorbid intelligence, attention, language, memory, executive function, and visuospatial function by multiple linear regressions and/or by reporting percentiles. Results Normative data for global cognition resulted in a mean MMSE score of 25.6 ± 3.1 (range = 17‐30; interquartile range = 24‐28). Vision problems and fatigue often complicated the ability to complete tests, and these problems explained 41% and 22% of the missing test scores, respectively. In contrast, hearing problems (4%) and task incomprehension (6%) rarely complicated test performance. While educational level was associated with performance on the majority of the tests, sex and age were only weakly associated with test performance. Conclusions We generated normative data for 15 common neuropsychological tests in a large sample of cognitively healthy centenarians, while taking age‐related sensory impairments into consideration. These normative data allow the detection of deficits across a wide range of cognitive domains. Our results suggest that, next to education level, vision ability and the level of fatigue should be taken into account when evaluating cognitive functioning in centenarians. J Am Geriatr Soc 67:759–767, 2019.

show abstract

Cognitive status in the oldest old and centenarians: a condition crucial for quality of life methodologically difficult to assess

Cited by 34 publications

References 90 publications

Cognitive, functional, physical, and nutritional status of the oldest old encountered in primary care: a systematic review

Cognitive, functional, physical, and nutritional status of the oldest old encountered in primary care: a systematic review

Longitudinal Maintenance of Cognitive Health in Centenarians in the 100-plus Study

Neuropsychological Test Performance of Cognitively Healthy Centenarians: Normative Data From the Dutch 100‐Plus Study

Contact Info

Product

Resources

About