Determinants of frailty development and progression using a multidimensional frailty index: Evidence from the English Longitudinal Study of Ageing

This work was supported by grant number 689592 "my-AHA" from the Horizon 2020 research funding framework of the European Commission (https://ec.europa.eu/programmes/horizon2020/en).Open Access articl

Meta-analyses of the effect of hormone treatment on cognitive function in postmenopausal women

As we age, most of us experience a certain degree of cognitive decline. In most cases, this decline is gradual. However, in some cases, cognitive impairment is so severe it can be classified as dementia and this impacts greatly on activities of daily living. Alzheimer’s disease (AD), the most common form of dementia, has been linked to a reduction in estrogen (E) levels that come with aging. More specifically, many researchers have hypothesized that E, and hence E replacement via Hormone Therapy (HT), could protect against cognitive decline in women. However, recent randomised controlled trials (RCTs) did not reflect this. In fact, some reports showed that HT could be detrimental on cognition in older postmenopausal women. The most publicised of these has been the Women’s Health Initiative Memory Study (WHIMS). However, studies have yielded conflicting results and conclusions. The reasons for this may be due to a number of factors, such as the age of participants, the time of HT onset (‘window of opportunity’ theory), type of treatment, type of menopause (surgical or natural) and, possibly, genetic risk factors. We performed quantitative and qualitative meta-analyses and reviewed each of these factors in detail. The future may lie in combining these factors in order to fully understand the potential mechanisms behind E and its effect on cognition

Approaches to cognitive stimulation in the prevention of dementia

The prevalence of dementia and age-related cognitive impairment is rising due to an aging population worldwide. There is currently no effective pharmacological treatment, but cognitive activity programs could contribute to prevention and risk reduction. However, the results of intervention studies are inconclusive, which may be related to methodological issues. For example, the inconsistent use of umbrella categories to describe cognitive intervention strategies, such as cognitive training or cognitive rehabilitation, has led to confusion regarding their respective contents and efficacies. The interventions studied so far draw on a pool of common basic ingredients. Therefore, rather than focusing on a few high-level categories, it might be beneficial to examine the efficacy of more basic cognitive intervention ingredients, which form the building blocks of complex multi-strand cognitive intervention strategies. Here we suggested a novel format of collating basic cognitive intervention ingredients. Using a representative sample of review articles and treatment studies, we attempted to inventory the most commonly encountered ingredients. Finally, we discuss their suitability for individualized and group-based approaches, as well as the possibility for computerization

Cluster analysis of physical and cognitive ageing patterns in older people from Shanghai

This study investigated the relationship between education, cognitive and physical function in older age, and their respective impacts on activities of daily living (ADL). Data on 148 older participants from a community-based sample recruited in Shanghai, China, included the following measures: age, education, ADL, grip strength, balance, gait speed, global cognition and verbal memory. The majority of participants in the present cohort were cognitively and physically healthy and reported no problems with ADL. Twenty-eight percent of participants needed help with ADL, with the majority of this group being over 80 years of age. Significant predictors of reductions in functional independence included age, balance, global cognitive function (MMSE) and the gait measures. Cluster analysis revealed a protective effect of education on cognitive function that did not appear to extend to physical function. Consistency of such phenotypes of ageing clusters in other cohort studies may provide helpful models for dementia and frailty prevention measures

A cross-sectional study of physical activity and health-related quality of life in an elderly Indonesian cohort

© The College of Occupational Therapists Ltd.Introduction: Improving health-related quality of life (QoL) may have far-reaching clinical implications, and previous studies have shown associations between participation in physical activity and higher QoL. However, it is unclear which types of physical activity are particularly beneficial and how much of this relationship is explained by instrumental activities of daily living (IADL) following physical activity. Method: This observational study measured frequency of participation in several different physical activities and IADL scores in a large elderly, community-dwelling sample. Hierarchical regression analyses were used to assess relationships between these variables and self-rated QoL using the Medical Outcome Survey SF-36 questionnaire. Findings: Participation in walking was found to be associated with higher QoL ratings in older men and women. IADL scores were correlated with QoL ratings but only partially mediated the association between walking and QoL. Participation in other types of physical activity was not significantly associated with QoL ratings. Conclusion:Walking may be recommended alongside treatment for illness or disability due to its potential benefits to QoL and treatment outcomes. Further research should investigate the role of physical fitness in this relationship, to determine whether these findings can be replicated in different populations

A critical literature review of the effectiveness of various instruments in the diagnosis of dementia in adults with intellectual disabilities

AbstractIntroductionCurrently, there is no consensus on dementia diagnostics in adults with intellectual disabilities (ID). There are three types of assessments available: direct cognitive tests, test batteries, and informant reports.MethodsA systematic literature search was conducted in four databases yielding 9840 records. Relevant studies were identified and selected using predefined inclusion and exclusion criteria and then coded and classified according to assessment type. This was completed by two independent researchers, with a third consulted when discrepancies arose. The review collates diagnostic instruments and presents strengths and weaknesses.ResultsOverall 47 studies met the search criteria, and 43 instruments were extracted from the selected studies. Of which, 10 instruments were classified as test batteries, 23 were classified as direct cognitive tests, and the remaining 10 were informant reports.DiscussionThis review can recommend that cognitive test batteries can offer the most practical and efficient method for dementia diagnosis in individuals with ID

Volatile organic compound markers of psychological stress in skin: a pilot study

The forehead was studied as a possible sampling site for capturing changes in volatile organic compound (VOC) profiles associated with psychological-stress. Skin-VOCs were sampled with a polydimethylsilicone (PDMS)-coupon and the resulting VOCs were recovered and analysed with two-stage thermal desorption gas chromatography-mass spectrometry. Fifteen young adult volunteers (19 years–26 years) participated in two interventions run in a randomised crossover design. One intervention, termed ‘Neutral’, required the participants to listen to peaceful music, the other, termed a ‘paced audio serial addition task’, required the participants to undertake a series of rapid mental arithmetic calculations in a challenging environment that induced a stress response. Skin-VOC samples were taken during each intervention. The resultant data were processed with dynamic background compensation, deconvolved, and registered to a common retention index scale. The importance of freezing skin patch samplers to −80 °C was determined during the method development phase of this study. The cumulative distribution function of the GC-MS data indicates the possibility that PDMS-coupons are selective towards the lower volatility VOC components in skin. The frequency distribution of the GC-MS data was observed to be approximately log-normal, and on the basis of this study, a further two-orders of magnitude reduction in sensitivity may be required before the complete skin-VOC profile may be characterised. Multi-variate analysis involving Pareto-scaling prior to partial least squares discriminant analysis identified four VOCs with the highest probability of contributing to the variance between the two states, and the responses to these VOCs were modelled with principle components analysis (PCA). Two VOCs, benzoic acid and n-decanoic acid were upregulated (14 and 8 fold respectively) and appear to be PASAT sensitive, with areas under (AUC) their receiver operator characteristic (ROC) curves of 0.813 and 0.852 respectively. A xylene isomer and 3-carene were down regulated 75% and 97% respectively, and found to be predictive of the neutral intervention (ROC AUC values of 0.898 and 0.929 respectively). VOC profiles in skin appear to change with stress either due to increased elimination, elevated bacterial activity, or perhaps increased oxidative pathways

The effect of a paced auditory serial addition test (PASAT) intervention on the profile of volatile organic compounds in human breath: a pilot study

This study sought to identify if detectable changes in human breath profiles may be observed following a psychological intervention designed to induce stress, a paced auditory serial addition test (PASAT). Breath samples were collected from 22 participants (10 male and 12 female) following a double cross-over randomized design with two experimental interventions. One intervention required participants to listen to classical music chosen to be neutral. The other intervention required participants to undertake a PASAT that induced cardiovascular responses consistent with acute stress. Both interventions also involved two sequences of cognitive function tests. Blood-pressure and heart-rate were recorded throughout each intervention and distal breath samples were collected onto Tenax® TA/Carbograph 1 thermal desorption tubes, using an adaptive breath sampler. Samples were collected before and after the PASAT. Breath samples were analysed by thermal desorption gas chromatography-mass spectrometry. Data registration using retention indexing and peak deconvolution followed by partial least-squares discriminant analysis identified six stress sensitive compounds. A principal components analysis model based on these components generated a model that predicted post-PASAT versus post-neutral intervention samples with a sensitivity of 83.3% and a selectivity of 91.6% for females, compared to 100% sensitivity and 90% selectivity for males. Of the six compounds indole, 2-hydroxy-1-phenylethanone, benzaldehyde, and 2-ethylhexan-1-ol were identified on the basis of mass spectral, retention indexing and confirmation against pure standards. 2-methylpentadecane was tentatively identified from mass spectral and retention indexing, whilst one component has yet to be assigned, although the mass spectrum is indicative of a terpene. Indole and 2-methylpentadecane concentrations increased in response to the PASAT intervention, while the other compounds reduced in their abundance in human breath, possibly as a result of ventilation effects

The relationship of moderate-to-vigorous physical activity to cognitive processing in adolescents: findings from the ALSPAC birth cohort

The aim of this study was to assess the relations of daily moderate-to-vigorous physical activity (MVPA) to cognitive functions in 15-year-old adolescents from the Avon Longitudinal Study of Parents and Children while controlling for aerobic fitness. A sub-sample of 667 adolescents (M(age) = 15.4 ± 0.16 years; 55 % females) who provided valid data on variables of interest, were used in the analyses. MVPA was objectively assessed using an Actigraph GT1M accelerometer and aerobic fitness was expressed as physical work capacity at the heart rate of 170 beats per minute from a cycle ergometer test. A computerized stop-signal task was used to measure mean reaction time (RT) and standard deviation of RT, as indicators of cognitive processing speed and variability during an attention and inhibitory control task. MVPA was not significantly related to cognitive processing speed or variability of cognitive performance in hierarchical linear regression models. In simple regression models, aerobic fitness was negatively related to mean RT on the simple go condition. Our results suggest that aerobic fitness, but not MVPA, was associated with cognitive processing speed under less cognitively demanding task conditions. The results thus indicate a potential global effect of aerobic fitness on cognitive functions in adolescents but this may differ depending on the specific task characteristics

Sprint-based exercise and cognitive function in adolescents

Moderate intensity exercise has been shown to enhance cognition in an adolescent population, yet the effect of high-intensity sprint-based exercise remains unknown and was therefore examined in the present study. Following ethical approval and familiarisation, 44 adolescents (12.6 ± 0.6 y) completed an exercise (E) and resting (R) trial in a counter-balanced, randomised crossover design. The exercise trial comprised of 10 × 10 s running sprints, interspersed by 50 s active recovery (walking). A battery of cognitive function tests (Stroop, Digit Symbol Substitution (DSST) and Corsi blocks tests) were completed 30 min pre-exercise, immediately post-exercise and 45 min post-exercise. Data were analysed using mixed effect models with repeated measures. Response times on the simple level of the Stroop test were significantly quicker 45 min following sprint-based exercise (R: 818 ± 33 ms, E: 772 ± 26 ms; p = 0.027) and response times on the complex level of the Stroop test were quicker immediately following the sprint-based exercise (R: 1095 ± 36 ms, E: 1043 ± 37 ms; p = 0.038), while accuracy was maintained. Sprint-based exercise had no immediate or delayed effects on the number of items recalled on the Corsi blocks test (p = 0.289) or substitutions made during the DSST (p = 0.689). The effect of high intensity sprint-based exercise on adolescents' cognitive function was dependant on the component of cognitive function examined. Executive function was enhanced following exercise, demonstrated by improved response times on the Stroop test, whilst visuo-spatial memory and general psycho-motor speed were unaffected. These data support the inclusion of high-intensity sprint-based exercise for adolescents during the school day to enhance cognition