Poor Physical Performance and Dementia in the Oldest Old

Bullain, Szófia S.; Corrada, María M.; Shah, Barbara Agee; Mozaffar, Farah; Panzenboeck, Martina; Kawas, Claudia H.

doi:10.1001/jamaneurol.2013.583

Cited by 32 publications

(32 citation statements)

References 31 publications

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“…25,26 Absence of a protective effect of education on aMCI risk in the present study is consistent with the rapid cognitive decline observed in highly educated late-stage aMCI patients from a memory clinic. 27 The association of increasing gait speed with decreased risk of naMCI is in keeping with the documented increase in the odds ratio of dementia with decreasing gait speed in persons in the 901 study 28 and with MCI in the MCSA cohort. 29 In the MCSA, depressive symptoms were associated with an increased risk of aMCI.…”

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confidence: 69%

Risk and protective factors for cognitive impairment in persons aged 85 years and older

et al. 2015

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Objective: To determine risk and protective factors for mild cognitive impairment (MCI) among persons 85 years and older.Methods: Participants in the population-based prospective Mayo Clinic Study of Aging were comprehensively evaluated at baseline and at 15 monthly intervals to determine incident MCI. At baseline, lifestyle factors in midlife and late life were assessed by self-reported questionnaire; vascular and comorbid conditions were abstracted from participants' medical records.Results: Of 256 participants who were cognitively normal at enrollment (median age 87.3 years, Individuals aged 85 years and older are the most rapidly growing group in the United States and worldwide.1 Studies of the oldest old are difficult to conduct and to interpret. Persons aged 90 years and older typically have sensory losses, difficulty providing valid and reliable information, high comorbidity, and a high prevalence of dementia 2 ; most are typically women. Often, factors associated with risk of cognitive impairment at younger ages are no longer predictive, raising the possibility that multiple coexisting diseases might be more predictive than solitary diseases. Because many individuals aged 90 years and older already have early stages of mild cognitive impairment (MCI), studies are often cross-sectional and can only assess risk of dementia or Alzheimer disease (AD). Furthermore, potential interventions at these ages may have limited long-term benefit. The goal of this study was to identify risk and protective factors for incident MCI among cognitively normal persons aged 85-89 years at enrollment to the Mayo Clinic Study of Aging (MCSA).METHODS Study cohort at baseline. Participants were randomly selected from among Olmsted County, Minnesota, residents for participation in the MCSA. Details of the study design and methodology have been published. 3,4 Briefly, residents aged 70-89 years were identified using the medical records linkage system of the Rochester Epidemiology Project (REP).5 Eligible participants wereFrom the Divisions

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confidence: 69%

Risk and protective factors for cognitive impairment in persons aged 85 years and older

et al. 2015

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“…Physical performance tests, based on measures from the Adult Changes in Thought Study, using items from the Short Physical Performance Battery (SPPB; 4‐m timed walk, five chair stands time, 10‐second standing balance, grip strength), were evaluated at baseline. To maintain consistency with prior publications on physical performance, cutoff values of sex‐specific performance quartiles previously established in this cohort were used . In accordance with an earlier study, all four physical performance measures were scored from 0 to 4 (0 = unable to perform, 1 = below first quartile of performance cutoff, 2 = between first and second quartile of performance cutoffs, 3 = between second and third quartile of performance cutoffs, 4 = best performance, above the cutoff of the third performance quartile).…”

Section: Methodsmentioning

confidence: 99%

“…In The 90+ Study, a strong, dose‐dependent, cross‐sectional association between poor physical performance on 4‐m walk, balance, five chair stands, and grip strength and dementia was previously shown, with poorer physical performance associated with greater odds of prevalent dementia in the oldest‐old …”

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confidence: 93%

Sound Body Sound Mind? Physical Performance and the Risk of Dementia in the Oldest‐Old: The 90+ Study

Bullain

Corrada

Perry

et al. 2016

J American Geriatrics Society

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OBJECTIVES:To examine the longitudinal association between physical performance and risk of dementia in individuals aged 90 and older without dementia. DESIGN: Population-based longitudinal study. SETTINGS: The 90+ Study, Laguna Woods, California. PARTICIPANTS: Men n = 176 and women n = 402 without dementia from The 90+ Study (n = 578, mean age 93.3). At baseline, 54% of participants were cognitively normal, and 46% had cognitive impairment, no dementia. MEASUREMENTS: Physical performance measures (4-m walk, 5 chair stands, handgrip, standing balance) were scored from 0 (unable to perform) to 4 (best performance). The outcome was dementia, diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. Hazard ratios (HRs) for dementia in relation to baseline physical performance were estimated using Cox regression after adjustment for potential confounders. HRs and P-values for the overall Wald chi-square are reported to show the magnitude of each physical performance measure and the strength of the association between each measure and incident dementia. RESULTS: Poor physical performance in most measures was associated with greater risk of incident dementia over a mean follow-up of 2.6 years (range 0.6-9.0 years). After controlling for potential confounders, standing balance had the strongest association with incident dementia (HRs = 1.9-2.5, overall P = .02), followed by 4-m walk (HRs = 1.1-1.8, overall P = .04) and handgrip (HRs = 1.0-2.0, overall P = .03). The association with five chair stands was not significant. In a subanalysis limited to cognitively normal participants, HRs were attenuated, but most remained in the same direction. CONCLUSION:Poor physical performance is associated with risk of developing dementia over an average 2.6-year follow-up in the oldest-old, indicating that poor physical performance may be an early sign of late-age dementia. J Am Geriatr Soc 64:1408-1415, 2016.Key words: dementia; gait; longitudinal survey; oldestold; postural balance I n the United States, the number of people living to age 90 and older the oldest-old, is projected to quadruple by 2050, resulting in 8.7 million of the oldest-old individuals by midcentury. 1,2 Living longer does not necessarily mean living well, as the oldest-old has the highest incidence of dementia. 3 The combination of rapid growth of the oldest population and high rates of dementia is one of the greatest public health challenges facing the United States unless effective treatment or preventive options are identified.In The 90+ Study, a strong, dose-dependent, crosssectional association between poor physical performance on 4-m walk, balance, five chair stands, and grip strength and dementia was previously shown, with poorer physical performance associated with greater odds of prevalent dementia in the oldest-old. 4 Although studies in younger adults (mean age <85) have shown that poor physical performance is associated with greater odds of poor cognition cross-sectionally 5,6 and longitudinally, 7,8...

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“…The time to complete the path was measured in seconds. Participants were scored based on performance, with 0 representing unable to perform and 1, 2, 3, and 4 representing respective sex‐specific quartiles of performance . Participants with a score of 0 or 1 for walk time met the frailty criteria for slowness.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of Frailty and Factors Associated with Frailty in Individuals Aged 90 and Older: The 90+ Study

Lee

Kawas

Gibbs

et al. 2016

J American Geriatrics Society

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Poor Physical Performance and Dementia in the Oldest Old

Abstract: To examine the cross-sectional relationship between physical performance and dementia in the oldest old (those Ն90 years of age).

Cited by 32 publications

References 31 publications

Risk and protective factors for cognitive impairment in persons aged 85 years and older

Risk and protective factors for cognitive impairment in persons aged 85 years and older

Sound Body Sound Mind? Physical Performance and the Risk of Dementia in the Oldest‐Old: The 90+ Study

Prevalence of Frailty and Factors Associated with Frailty in Individuals Aged 90 and Older: The 90+ Study

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