Longitudinal associations between activity and cognition vary by age, activity type, and cognitive domain

The demonstration of correlated change is critical to understanding the relationship between activity engagement and cognitive functioning in older adulthood. Changes in activity have been shown to be related to changes in cognition, but little attention has been devoted to how this relationship may vary between specific activity types, cognitive domains, and age groups. Participants initially aged 65−98 years (M = 77.46 years) from the Australian Longitudinal Study of Ageing (n = 1,321) completed measurements of activity (i.e., cognitive, group social, one-on-one social, and physical) and cognition (i.e., perceptual speed, and immediate and delayed episodic memory) at baseline, 2, 8, 11, and 15 years later. Bivariate latent growth curve models covarying for education, sex, and baseline age and medical conditions revealed multiple positive-level relations between activity and cognitive performance, but activity level was not related to later cognitive change. Change in perceptual speed over 15 years was positively associated with change in cognitive activity, and change in immediate episodic memory was positively associated with change in one-on-one social activity. Old-old adults showed a stronger change−change covariance for mentally stimulating activity in relation to perceptual speed than did young-old adults. The differentiation by activity type, cognitive domain, and age contributes to the growing evidence that there is variation in the way cognitive ability at different ages is related to activity.NHMRC Fellowship No. 1002560 and the ARC Centre of Excellence in Population Ageing Research (project # CE110001029)

Cohort Profile: The Australian Longitudinal Study of Ageing (ALSA)

In response to the expressed need for more sophisticated and multidisciplinary data concerning ageing of the Australian population, the Australian Longitudinal Study of Ageing (ALSA) was established some two decades ago in Adelaide, South Australia. At Baseline in 1992, 2087 participants living in the community or in residential care (ranging in age from 65 to 103 years) were interviewed in their place of residence (1031 or 49% women), including 565 couples. By 2013, 12 Waves had been completed; both face-to-face and telephone personal interviews were conducted. Data collected included self-reports of demographic details, health, depression, morbid conditions, hospitalization, gross mobility, physical performance, activities of daily living, lifestyle activities, social resources, exercise, education and income. Objective performance data for physical and cognitive function were also collected. The ALSA data are held at the Flinders Centre for Ageing Studies, Flinders University. Procedures for data access, information on collaborations, publications and other details can be found at [http://flinders.edu.au/sabs/fcas/].Australian Research Council ARC (DP0879152 and 130100428; LP669272 and 100200413

No clear associations between subjective memory concerns and subsequent change in cognitive function : the PATH through life study

The literature on subjective memory concerns (SMC) as a predictor for future cognitive decline is varied. Furthermore, recent research has pointed to additional complexity arising from variability in the experience of SMC themselves (i.e. whether they are remitting or sustained over time). We investigated the associations between SMC and objectively measured cognition in an Australian population-based cohort. Four waves (4-year intervals between waves) of data from 1236 participants (aged 62.4 ± 1.5 years, 53% male) were used. We categorized participants as experiencing SMC, when they indicated that their memory problems might interfere with their day-to-day life and/or they had seen a doctor about their memory. SMC was categorized as “no” reported SMC, “remitting”, “new-onset” or “sustained” SMC. Cognitive assessment of immediate and delayed recall, working memory, psychomotor speed, attention and processing speed were assessed using a neuropsychological battery. Eighteen percent of participants were characterised as having SMC: 6% (77) “remitting”, 6% (77) “new-onset” and 6% (69) “sustained” SMC. There was no consistent evidence for an association between SMC and subsequent decline in cognition. However, SMC was associated with poorer performance on contemporaneous tasks of attention and processing speed compared to “no” SMC. Asking about SMC may indicate a current decline in cognitive function but, in this sample at least, did not indicate an increased risk of future decline

Evidence-based occupational therapy for people with dementia and their families: What clinical practice guidelines tell us and implications for practice

This author accepted manuscript (post print) is made available following a 12 month embargo from date of publication (3 October 2016) in accordance with the publisher copyright policy.Background: The first evidence based Clinical Practice Guidelines and Principles of Care for People with Dementia in Australia have been released. The Guidelines detail a number of important evidence based recommendations for occupational therapists. Aim: The aim of this paper is (1) to provide an overview of Guideline development, and (2) to describe the evidence supporting a recommendation for occupational therapy. Common characteristics of effective occupational therapy programs for people with dementia are described. Methods: Guideline development involved adaptation of existing high quality guidelines developed overseas and 17 systematic reviews to ensure that the most recent high quality evidence was included. One of the systematic reviews involved examining the evidence for interventions to promote independence in people with dementia. Specifically, we looked at the evidence for occupational therapy and its effect on activities of daily living, quality of life and carer impact. Results: A total of 109 recommendations are included in the Guidelines. Occupational therapy was found to significantly increase independence in activities of daily living and improve quality of life. Effective occupational therapy programs involve: environmental assessment, problem solving strategies, carer education and interactive carer skills training. Conclusion: Occupational therapists working with people with dementia in community settings should ensure that their time is spent on those aspects of intervention that are shown to be effective

Determinants of Self-Rated Health Items With Different Points of Reference Implications for Health Management of Older Adults

Objective: This study assessed whether three commonly used self-rated health (SRH) items (global, age-comparative, and self-comparative) are equivalent measures of health perception for older adults. Method: Regression analyses were used to simultaneously contrast the associations between physical, psychological, and social factors relating to health for three SRH items, in a large ( N = 2,034) population-based sample of older adults (65 years and older) from the Australian Longitudinal Study of Aging. Results: Health perceptions were more positive for the age-comparative SRH measure, compared to the pessimistic ratings of the self-comparative measure, particularly for the oldest-old adults. Different patterns of associations between the health factors and SRH measures were found. Discussion: These results show the three SRH items are not equivalent measures of health and cannot be used interchangeably. The reference point of the SRH item has a considerable influence on health perceptions of older adults as it encapsulates unique health information

A latent growth curve analysis of late-life sensory and cognitive function over 8 years: evidence for specific and common factors underlying change

Washington D

Data from: Blood pressure and dementia: what the SPRINT-MIND trial adds, and what we still need to know

High blood pressure (BP) has been associated with an increased risk of cerebrovascular disease, stroke, and Alzheimer disease pathology. Epidemiologic studies are consistent in showing that high BP, particularly in midlife, is a risk factor for the development of dementia in late life. However, supporting randomized evidence of the inference that BP-lowering therapy can prevent dementia has been slow in coming over the last 30 years. The most recent randomized trial, the Systolic Blood Pressure Intervention Trial—Memory and Cognition in Decreased Hypertension (SPRINT-MIND), therefore, makes a pivotal contribution to the field, reemphasizing broader public health benefits of BP lowering and directing future research