The support person\u27s preferences and perspectives of physical activity programs for older adults with cognitive impairment

Objectives: Physical activity (PA) is beneficial for older adults\u27 cognition. There is limited research investigating perspectives of support persons (SPs) of next-of-kins (NOKs) with cognitive impairment. This exploratory study aimed to investigate perspectives of SPs of older adults with Alzheimer\u27s Dementia (AD) or Mild Cognitive Impairment (MCI). Methods: A telephone survey of 213 SPs of NOKs from the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing (AIBL) was undertaken to quantitatively assess SPs\u27 beliefs and knowledge about PA benefits, current PA level of their NOK, and PA program preferences. The contribution of age, gender, diagnosis and mental health symptoms was assessed using multiple logistic regression analyses. Results: Many SPs were aware of PA benefits for memory (64%) and believed it would help their NOK (72%). Older SP age was associated with less awareness of benefits (p = 0.016). SPs caring for male NOKs were more likely to believe that PA would be helpful than those caring for female NOKs (p = 0.049). NOK AD diagnosis (rather than MCI) (p = 0.014), older age (p = 0.005) and female gender (p = 0.043) were associated with lower PA levels. SPs were mixed regarding preference for their NOKs to participate in individual (45%) or group (54%) PA. Many SPs wanted to participate in PA with their NOK (63%). Conclusions: The results highlight that SPs have high levels of awareness of the cognitive benefits of PA, and describe their preferences regarding PA programs. The findings provide new information to inform targeted public health messaging, PA prescribers and providers, and future research directions

The Association Between Loneliness and Inflammation: Findings From an Older Adult Sample

Loneliness has been linked to poor mental and physical health outcomes. Past research suggests that inflammation is a potential pathway linking loneliness and health, but little is known about how loneliness assessed in daily life links with inflammation, or about linkages between loneliness and inflammation among older adults specifically. As part of a larger investigation, we examined the cross-sectional associations between loneliness and a panel of both basal and LPS-stimulated inflammatory markers. Participants were 222 socioeconomically and racially diverse older adults (aged 70&ndash;90 years; 38% Black; 13% Hispanic) systematically recruited from the Bronx, NY. Loneliness was measured in two ways, with a retrospective trait measure (the UCLA Three Item Loneliness Scale) and an aggregated momentary measure assessed via ecological momentary assessment (EMA) across 14 days. Inflammatory markers included both basal levels of C-reactive protein (CRP) and cytokines (IL-1&beta;, IL-4, IL-6, IL-8, IL-10, TNF-&alpha;) and LPS-stimulated levels of the same cytokines. Multiple regression analyses controlled for age, body-mass index, race, and depressive symptoms. Moderation by gender and race were also explored. Both higher trait loneliness and aggregated momentary measures of loneliness were associated with higher levels of CRP (&beta; = 0.16, p = 0.02; &beta; = 0.15, p = 0.03, respectively). There were no significant associations between loneliness and basal or stimulated cytokines and neither gender nor race were significant moderators. Results extend prior research linking loneliness with systemic inflammation in several ways, including by examining this connection among a sample of older adults and using a measure of aggregated momentary loneliness. &nbsp;</p

Rates of age- and amyloid β-associated cortical atrophy in older adults with superior memory performance

Introduction: Superior cognitive performance in older adults may reflect underlying resistance to age-associated neurodegeneration. While elevated amyloid b (Ab) deposition (Ab1) has been associated with increased cortical atrophy, it remains unknown whether “SuperAgers” may be protected from Ab-associated neurodegeneration. Methods: Neuropsychologically defined SuperAgers (n 5 172) and cognitively normal for age (n 5 172) older adults from the Australian Imaging, Biomarkers and Lifestyle study were case matched. Rates of cortical atrophy over 8 years were examined by SuperAger classification and Ab status. Results: Of the case-matched SuperAgers and cognitively normal for age older adults, 40.7% and 40.1%, respectively, were Ab1. Rates of age- and Ab-associated atrophy did not differ between the groups on any measure. Ab2 individuals displayed the slowest rates of atrophy. Discussion: Maintenance of superior memory in late life does not reflect resistance to age- or Abassociated atrophy. However, those individuals who reached old age without cognitive impairment nor elevated Ab deposition (i.e. Ab2) displayed reduced rates of cortical atrophy

Amyloid-beta and depression in healthy older adults: a systematic review

Depression has been shown to be a risk factor for Alzheimer\u27s disease (AD), and in older adults may provide a marker for the beginning of the prodromal phase of AD. The purpose of this systematic review is to examine the relationship between amyloid-&beta; (A&beta;), a key biomarker of AD, and depression in older adults

Using robust normative data to investigate the neuropsychology of cognitive aging

Objective The extent to which increasing age is associated with impairment in cognitive function, termed cognitive aging, may have been overestimated in prior studies. The inclusion of individuals with severe or uncontrolled systemic medical illness or prodromal neurodegenerative disease in normal aging samples is likely to bias estimates toward lower cognitive performance and inflate estimates of variability. Method Unbiased estimates of cognitive aging in 658 adults aged 60–84, who underwent rigorous screening to ensure their general and cognitive health, were computed. The first study screened the psychometric properties of a battery of neuropsychological tests in order to identify those with optimal properties to evaluate cognitive aging. The second study used the selected tests to compare baseline performance within 5-year age bands from 60 to 84. Results The first study identified a battery of 12 tests that provided reliable measures of memory, psychomotor speed, attention, and executive function and were appropriate for investigating age-related cognitive changes. The second study observed moderate to large age-related impairment for performance on tests of complex psychomotor function, category fluency, verbal learning, and verbal and visual memory. No, or only small, age effects were observed for working memory, phonemic fluency, learning of visual information, and reaction time. Conclusions These data suggested that while increasing age is associated with impairment in cognitive function, this impairment is less severe and is evident only on more complex neuropsychological tests than estimated previously in samples selected using less rigorous criteria to ensure cognitive health

Using Robust Normative Data to Investigate the Neuropsychology of Cognitive Aging

Objective The extent to which increasing age is associated with impairment in cognitive function, termed cognitive aging, may have been overestimated in prior studies. The inclusion of individuals with severe or uncontrolled systemic medical illness or prodromal neurodegenerative disease in normal aging samples is likely to bias estimates toward lower cognitive performance and inflate estimates of variability. Method Unbiased estimates of cognitive aging in 658 adults aged 60–84, who underwent rigorous screening to ensure their general and cognitive health, were computed. The first study screened the psychometric properties of a battery of neuropsychological tests in order to identify those with optimal properties to evaluate cognitive aging. The second study used the selected tests to compare baseline performance within 5-year age bands from 60 to 84. Results The first study identified a battery of 12 tests that provided reliable measures of memory, psychomotor speed, attention, and executive function and were appropriate for investigating age-related cognitive changes. The second study observed moderate to large age-related impairment for performance on tests of complex psychomotor function, category fluency, verbal learning, and verbal and visual memory. No, or only small, age effects were observed for working memory, phonemic fluency, learning of visual information, and reaction time. Conclusions These data suggested that while increasing age is associated with impairment in cognitive function, this impairment is less severe and is evident only on more complex neuropsychological tests than estimated previously in samples selected using less rigorous criteria to ensure cognitive health

Amyloid-β, Anxiety, And Cognitive Decline In Preclinical Alzheimer Disease A Multicenter, Prospective Cohort Study

IMPORTANCE: Alzheimer disease (AD) is now known to have a long preclinical phase in which pathophysiologic processes develop many years, even decades, before the onset of clinical symptoms. Although the presence of abnormal levels of amyloid-β (Aβ) is associated with higher rates of progression to clinically classified mild cognitive impairment or dementia, little research has evaluated potentially modifiable moderators of Aβ-related cognitive decline, such as anxiety and depressive symptoms. OBJECTIVE: To evaluate the association between Aβ status and cognitive changes, and the role of anxiety and depressive symptoms in moderating Aβ-related cognitive changes in the preclinical phase of AD. DESIGN, SETTING, AND PARTICIPANTS: In this multicenter, prospective cohort study with baseline and 18-, 36-, and 54-month follow-up assessments, we studied 333 healthy, older adults at hospital-based research clinics. MAIN OUTCOMES AND MEASURES: Carbon 11-labeled Pittsburgh Compound B (PiB)-, florbetapir F 18-, or flutemetamol F 18-derived measures of Aβ, Hospital Anxiety and Depression Scale scores, and comprehensive neuropsychological evaluation that yielded measures of global cognition, verbal memory, visual memory, attention, language, executive function, and visuospatial ability. RESULTS: A positive Aβ (Aβ+) status at baseline was associated with a significant decline in global cognition, verbal memory, language, and executive function, and elevated anxiety symptoms moderated these associations. Compared with the Aβ+, low-anxiety group, slopes of cognitive decline were significantly more pronounced in the Aβ+, high-anxiety group, with Cohen d values of 0.78 (95%CI, 0.33-1.23) for global cognition, 0.54 (95%CI, 0.10-0.98) for verbal memory, 0.51 (95%CI, 0.07-0.96) for language, and 0.39 (95%CI, 0.05-0.83) for executive function. These effects were independent of age, educational level, IQ, APOE genotype, subjective memory complaints, vascular risk factors, and depressive symptoms; furthermore, depressive symptoms and subjective memory complaints did not moderate the association between Aβ and cognitive decline. CONCLUSIONS AND RELEVANCE: These results provide additional support for the deleterious effect of elevated Aβ levels on cognitive function in preclinical AD. They further suggest that elevated anxiety symptoms moderate the effect of Aβ on cognitive decline in preclinical AD, resulting in more rapid decline in several cognitive domains. Given that there is currently no standard antiamyloid therapy and that anxiety symptoms are amenable to treatment, these findings may help inform risk stratification and management of the preclinical phase of AD