Prevalence of Cognitive Frailty, Do Psychosocial-Related Factors Matter?

Cognitive frailty (CF) is a topic of growing interest with implications for the study of preventive interventions in aging. Nevertheless, little research has been done to assess the influence of psychosocial variables on the risk of CF. Our objectives were to estimate the prevalence of CF in a Spanish sample and to explore the influence of psychosocial variables in this prevalence. Physical frailty and cognitive, functional, psychosocial, and socio-demographic aspects were assessed in a sample of 285 participants over 60 years. Univariate and multivariate logistic regression models were carried out. Aprevalence of 21.8% (95% CI 17.4-26.9) was established when both frail and pre-frail conditions were included, and a prevalence of 3.2% (95% CI 1.7-5.9) if only frail individuals were considered. Age, educational level, profession and psychological well-being variables significantly predicted CF. Frailty and pre-frailty are high-prevalence health conditions in older adults influenced by socio-demographic, socio-educative and affective factors

Using an overlapping time interval strategy to study diagnostic instability in mild cognitive impairment subtypes.

(1) Background: Mild cognitive impairment (MCI) is a diagnostic label in which stability is typically low. The aim of this study was to examine temporal changes in the diagnosis of MCI subtypes by using an overlapping-time strategy; (2) Methods: The study included 435 participants aged over 50 years with subjective cognitive complaints and who completed at least one follow-up evaluation. The probability of transition was estimated using Bayesian odds ratios; (3) Results: Within the different time intervals, the controls with subjective cognitive complaints represented the largest proportion of participants, followed by sda-MCI at baseline and in the first five intervals of the follow-up, but not in the last eight intervals. The odds ratios indicated higher odds of conversion to dementia in sda-MCI and mda-MCI groups relative to na-MCI (e.g., interval 9-15 months-sda-MCI OR = 9 and mda-MCI OR = 3.36; interval 27-33-sda-MCI OR = 16 and mda-MCI = 5.06; interval 42-48-sda-MCI OR = 8.16 and mda-MCI = 3.45; interval 45-51-sda-MCI OR = 3.31 and mda-MCI = 1); (4) Conclusions: Notable patterns of instability consistent with the current literature were observed. The limitations of a prospective approach in the study of MCI transitions are discussed

Longitudinal patterns of the Tip-Of-the-Tongue phenomenon in people with subjective cognitive complaints and mild cognitive impairment

Background: The Tip-of-the-Tongue (ToTs) state is considered a universal phenomenon and is a frequent cognitive complaint in old age. Previous cross-sectional studies have found that ToT measures successfully discriminate between cognitively unimpaired adults and adults with Mild Cognitive Impairment (MCI). The aim of this study was to identify longitudinal patterns of ToTs in individuals with subjective complaints and with MCI regarding progress of their cognitive status. Method: The study included 193 participants with subjective cognitive complaints (SCC) and 56 participants with MCI who completed a baseline and two follow-up assessments, with an interval of about 18 months between each assessment. Participants were classified into three groups by considering cognitive stability or deterioration from the baseline diagnosis: SCC-stable, MCI-stable and MCI-worsened. Participants performed a ToT task involving recognition and naming of famous people depicted in 50 photographs. Generalized Linear Mixed Models (GLMM) were used to model longitudinal changes in familiarity, feeling of knowing, semantic access, phonological access and verbal fluency. Results: Phonological access differentiated MCI patients, stable and worsened, from adults with SCCs at all evaluation times. Phonological access declined over time in the three groups, without significant interactions between groups and time. Discussion: This study provides the first longitudinal evidence of differences in ToT measures for adults with MCI. The findings indicate that phonological access measures successfully differentiated between the diagnostic groups. However, slopes remain irrespective of the diagnostic group and progression toward more advance stages of cognitive impairment

Predicting progression of cognitive decline to dementia using dyadic patterns of subjective reporting: evidence from the CompAS longitudinal study

ObjectiveTo analyze the validity of self and informant reports, depressive symptomatology, and some sociodemographic variables to predict the risk of cognitive decline at different follow-up times.MethodsA total of 337 participants over 50 years of age included in the CompAS and classified as Cognitively Unimpaired (CU), Subjective Cognitive Decline (SCD) and Mild Cognitive Impairment (MCI) groups were assessed at baseline and three follow-ups. A short version of the QAM was administered to assess the severity of subjective cognitive complaints (SCCs), and the GDS-15 was used to evaluate the depressive symptoms. At each follow-up assessment, participants were reclassified according to the stability, regression or progression of their conditions. Logistic regression analysis was used to predict which CU, SCD and MCI participants would remain stable, regress or progress at a 3rd follow-up by using self- and informant-reported complaints, depressive symptomatology, age and education at baseline and 2nd follow-ups as the predictive variables.ResultsOverall, self-reported complaints predicted progression between the asymptomatic and presymptomatic stages. As the objective deterioration increased, i.e., when SCD progressed to MCI or dementia, the SCCs reported by informants proved the best predictors of progression. Depressive symptomatology was also a predictor of progression from CU to SCD and from SCD to MCI.ConclusionA late increase in self-reported complaints make valid estimates to predict subjective decline at asymptomatic stages. However, an early increase in complaints reported by informants was more accurate in predicting objective decline from asymptomatic stages. Both, early and late decrease in self-reported complaints successfully predict dementia from prodromic stage. Only late decrease in self-reported complaints predict reversion from prodromic and pre-symptomatic stages

The influence of diversity on the measurement of functional impairment : An international validation of the Amsterdam IADL questionnaire in 8 countries

Peer reviewe

The role of dyadic cognitive report and subjective cognitive decline in early ADRD clinical research and trials: Current knowledge, gaps, and recommendations.

Efficient identification of cognitive decline and Alzheimer's disease (AD) risk in early stages of the AD disease continuum is a critical unmet need. Subjective cognitive decline is increasingly recognized as an early symptomatic stage of AD. Dyadic cognitive report, including subjective cognitive complaints (SCC) from a participant and an informant/study partner who knows the participant well, represents an accurate, reliable, and efficient source of data for assessing risk. However, the separate and combined contributions of self- and study partner report, and the dynamic relationship between the two, remains unclear. The Subjective Cognitive Decline Professional Interest Area within the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment convened a working group focused on dyadic patterns of subjective report. Group members identified aspects of dyadic-report information important to the AD research field, gaps in knowledge, and recommendations. By reviewing existing data on this topic, we found evidence that dyadic measures are associated with objective measures of cognition and provide unique information in preclinical and prodromal AD about disease stage and progression and AD biomarker status. External factors including dyad (participant-study partner pair) relationship and sociocultural factors contribute to these associations. We recommend greater dyad report use in research settings to identify AD risk. Priority areas for future research include (1) elucidation of the contributions of demographic and sociocultural factors, dyad type, and dyad relationship to dyad report; (2) exploration of agreement and discordance between self- and study partner report across the AD syndromic and disease continuum; (3) identification of domains (e.g., memory, executive function, neuropsychiatric) that predict AD risk outcomes and differentiate cognitive impairment due to AD from other impairment; (4) development of best practices for study partner engagement; (5) exploration of study partner report as AD clinical trial endpoints; (6) continued development, validation, and optimization, of study partner report instruments tailored to the goals of the research and population

Diferencias de edad en la ejecución de una tarea de atención dividida

Setenta y seis participantes (entre 40-91 años) ejecutaron aislada y concurrentemente la tarea de Atención Dividida del TAP (Zimmermann y Fimm, 1993). Un análisis no-paramétrico sobre los aciertos y sendos análisis ANOVAs one-way sobre los T.R. de las condiciones aislada y dual fueron realizados para sondear las diferencias de edad por condición. Asimismo, se realizaron dos análisis de MLG (MANOVA y MANCOVA) para analizar las diferencias de edad en la ejecución dual tomando como referencia la ejecución aislada controlando o no, respectivamente, el efecto que la complejidad inherente a la ejecución dual puede ejercer en relación con la edad. Se obtuvieron diferencias de edad en los ANOVAs realizados separadamente sobre las condiciones, pero no en los MLGs que analizan la ejecución dual tomando como referencia la aislada. Los resultados se discuten apelando a la necesidad de considerar las características de las tareas duales en este tipo de estudios atencionales

Diferencias de edad en la ejecución de una tarea de atención dividida

Setenta y seis participantes (entre 40-91 años) ejecutaron aislada y concurrentemente la tarea de Atención Dividida del TAP (Zimmermann y Fimm, 1993). Un análisis no-paramétrico sobre los aciertos y sendos análisis ANOVAs one-way sobre los T.R. de las condiciones aislada y dual fueron realizados para sondear las diferencias de edad por condición. Asimismo, se realizaron dos análisis de MLG (MANOVA y MANCOVA) para analizar las diferencias de edad en la ejecución dual tomando como referencia la ejecución aislada controlando o no, respectivamente, el efecto que la complejidad inherente a la ejecución dual puede ejercer en relación con la edad. Se obtuvieron diferencias de edad en los ANOVAs realizados separadamente sobre las condiciones, pero no en los MLGs que analizan la ejecución dual tomando como referencia la aislada. Los resultados se discuten apelando a la necesidad de considerar las características de las tareas duales en este tipo de estudios atencionales

Relación entre cambios cognitivos y lenguaje narrativo en la vejez

Se estudian las relaciones entre cambios cognitivos y capacidad narrativa en 80 sujetos sanos de entre 40 y 91 años, considerando su nivel académico, hábitos lectoescritores y de cálculo, y habilidad verbal. Los resultados muestran cambios significativos con la edad en cantidad, cohesión y cantidad y calidad del contenido de las narraciones. Las variables que mejor predicen esos cambios son las de velocidad de procesamiento, las de habilidad verbal y las de memoria operativ

Cognitiva

Resúmen tomado del autor. Resúmen en castellano y en inglésMemoria operativa, atención selectiva y velocidad de procesamiento son los tres aspectos del funcionamiento cognitivo a los que con mayor frecuencia se apela para construir modelos explicativos que den cuenta del descenso del rendimiento cognitivo en la vejez. Se estudian las relaciones entre ellos, y se explora la hipótesis de que la velocidad con la que se ejecutan los procesos cognitivos más básicos ejerza un efecto mediador entre la edad y la atención selectiva/ procesos inhibitorios y la memoria operativa, afectando a la eficacia con la que se ejecutan gran cantidad de operaciones mentales. Se aplican seis tareas a un total de 79 sujetos, con bajo nivel educativo y edades comprendidas entre los 40 y los 91 años, con la finalidad de evaluar el funcionamiento de los tres aspectos cognitivos mencionados. Los resultados obetenidos a partir de un análisis LISREL permiten considerar un modelo estructural que confirma la existencia de un elevado grado de relación entre los tres aspectos cognitivos considerados y apoya la hipotesis de que la velocidad de procesamiento funciona como un eficaz mediador entre, por una parte, la edad, y por otra, la atención selectiva/procesos inhibitorios y la memoria operativa, afectando a la eficacia con la que se ejecutan gran cantidad de operaciones mentales.MadridBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]