seniors

Major heart surgery not much worse for cognition than other heart treatments

  • A large study found that older adults experiencing heart surgery showed more long-term cognitive decline than those having a less invasive treatment, but not a great deal more.

Data from 3,105 older adults (65+) who had either heart surgery or cardiac catheterization has found that those who had heart surgery didn’t experience much greater cognitive decline compared with those who had the much less invasive, catheter-based procedure.

Two years after the surgery, surgery participants showed a greater amount of decline equal to only 4.6 months of cognitive aging compared with those undergoing catheterization.

https://www.eurekalert.org/pub_releases/2018-12/e-bhn121818.php

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Multimorbidity score linked to cognitive decline

  • A very large study found that older adults with multiple health conditions showed much greater cognitive decline than those with fewer chronic conditions, even when the conditions weren't directly related to brain health.

Data from more than 14,265 people older adults (51+) multiple times over a decade or more through the University of Michigan Health and Retirement Study has found that people with higher “multimorbidity scores” showed much faster cognitive decline than those with lower scores, even though most of the chronic conditions included in the index had no direct relationship with brain health. The higher the score, the faster the decline.

The multimorbidity index was calculated using three long-term studies of more than 250,000 health professionals, and takes into account the different ways different conditions affect people and how they interact.

The tool is free and available at the ePrognosis website for clinicians.

https://www.futurity.org/multimorbidity-score-chronic-conditions-death-2089922-2/

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Is there really a level at which alcohol benefits cognition?

  • A very large study of adults aged 40-73 found evidence that alcohol's suggested benefit for cognition applies to a much lower level of alcohol consumption than previously claimed — only one drink a day.
  • Another longitudinal study that also removed the bias that's thought to come from including non-drinkers in the analysis, found no evidence for any cognitive benefits at any level of alcohol consumption.

Large study shows level of beneficial alcohol consumption much lower than thought

A UK study using data from 13,342 middle-aged and older adults (40-73) has found that having up to one standard unit of alcohol a day improved reaction time, but more than that amount harmed cognitive performance. The effect was more pronounced in older adults.

While several studies have suggested a U-shaped relationship between alcohol and cognition, with light to moderate consumption being beneficial to older adults, this has been quite controversial, with little consensus on how much is too much.

This study uses data from the over half a million people who participated in the UK Biobank prospective cohort study. Of these, 20,346 undertook a repeat assessment 5 years after the initial assessment. The study excluded any who disclosed a history of neurological disorder, and then included only those who consumed alcohol at least once a week. Weekly drinkers had lower levels of socioeconomic deprivation, were more likely to hold a university degree, and to be male.

Cognitive performance was assessed very simply, using a 'stop-go' reaction time task. RT decreased as alcohol consumption increased up to 10g/day, and then increased after that point. This harmful effect became stronger as people got older.

This level of 10 g/day is markedly lower than that suggested by other studies, which have variously argued for: up to 40g for women and 80g for men; up to 34g for middle-aged adults; no more than 16g.

The study omitted people who didn't drink at all, because of the 'sick quitter' effect — it's been argued that the apparent connection between moderate alcohol consumption and better health and cognition is due to bias in the control group, with many people abstaining or quitting due to health issues, and this has been supported by some recent studies. For example, a 2016 review and meta-analysis found no significant difference in mortality for low-volume drinkers once abstainer biases were adjusted for.

The main takeaway from this study — which seems quite robust given the scale of the study — is that the level of 'positive' alcohol consumption is much lower than previously claimed.

The study is open access, and can be read in its entirety at https://academic.oup.com/jpubhealth/article/40/2/304/4793394

Study shows no benefits from alcohol consumption once abstainer bias accounted for

Another longitudinal study, using a subset of participants in the Swedish Twin Registry, found no evidence for any cognitive benefits at any level of alcohol consumption.

Participants were those 486 individuals who had been surveyed on their alcohol intake in their midlife (in 1967), and also taken part in cognitive assessments 25 years later. Cognitive tests occurred at 2-year intervals for the next 10 years.

The study found a significant negative dose-response association between alcohol intake in midlife and performance on the MMSE and tests of episodic memory. There was no significant association with semantic memory and spatial ability.

As with the other study, in order to remove abstainer bias, non-drinkers were excluded from the analysis. There were 181 non-drinkers, and this group were more likely to be women, to have less education, lower socioeconomic status, higher BMI, and were more likely to have diabetes and hypertension. They did indeed perform worse on all cognitive tests, but as you can see, most of the characteristics of this group do lend themselves to such a result.

Midlife alcohol consumption was used because it was assumed that this would give a better reflection of lifetime habits than that reported in old age. As it happened, there were no heavy drinkers in the cohort — the highest consumption was 15 units/week. In this study, 1 unit corresponded to 12g.

The study is open access, and can be read in its entirety at https://www.frontiersin.org/articles/10.3389/fnagi.2018.00081/full

Reference: 

Giovanni Piumatti, Simon C Moore, Damon M Berridge, Chinmoy Sarkar, John Gallacher, The relationship between alcohol use and long-term cognitive decline in middle and late life: a longitudinal analysis using UK Biobank, Journal of Public Health, Volume 40, Issue 2, June 2018, Pages 304–311, https://doi.org/10.1093/pubmed/fdx186

Hassing, L. B. (2018). Light Alcohol Consumption Does Not Protect Cognitive Function: A Longitudinal Prospective Study. Frontiers in Aging Neuroscience, 10. https://doi.org/10.3389/fnagi.2018.00081

 

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Belly fat in older adults linked with cognitive impairment

  • A large Irish study found that belly fat was linked to poorer cognition in older adults, while BMI was not, probably because it doesn't distinguish between muscle and fat.

Data from over 5,000 individuals found that a measure of belly fat (waist:hip ratio) was associated with reduced cognitive function in older Irish adults (60+). Body mass index (BMI), however, was found to protect cognitive function.

BMI is a crude measure of body fat and cannot differentiate between fat and muscle — the muscle component is likely to be the protective factor.

Research indicates that as we age, our fat becomes less efficient at producing a hormone that helps support the growth and survival of neurons and helps regulate their activity.

That hormone is adiponectin, which is made by fat cells, circulates in our blood and enters our brain. Inside fat cells, its production is regulated by PPAR-γ (peroxisome proliferator-activated receptor gamma).

Adiponectin is anti-inflammatory and can help regulate neuronal activity, including turning activity of some neurons up and others down. However, adiponectin is reduced in Alzheimer’s patients. Delivering adiponectin to the brain has been shown to improve cognition in mice.

Chronic stress can also decrease fat's production of PPAR-γ and adiponectin.

Fat cells become less efficient at making adiponectin in obesity, and with age. One theory is that fat cells start making inflammation-promoting signals called cytokines and this inflammation then inhibits adiponectin production.

The shift from beneficial subcutaneous fat to unhealthy fat that piles up on our bellies and around the organs inside our abdominal cavity is one that naturally occurs with age, but it is of course worse if you have a lot of excess weight around your abdomen.

Genetic variations in PPAR-γ and adiponectin as well as low blood levels of adiponectin are associated with an increased Alzheimer's risk.

https://www.eurekalert.org/pub_releases/2018-08/tcd-mob080118.php

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Nutrients linked to better brain connectivity, cognition in older adults

  • A study found that higher levels of several key nutrients were associated with more efficient brain connectivity and better cognitive performance in older adults.

A study involving 116 healthy older adults (65-75) has found that higher levels of several key nutrients in the blood were associated with more efficient brain connectivity and better cognitive performance. In fact, the findings suggest that the level of nutrients governs the strength of the association between functional brain network efficiency and cognitive performance.

The study looked at 32 key nutrients in the Mediterranean diet. The effective nutrients, which appeared to work synergistically, included omega-3 and omega-6 fatty acids, carotenoids, lycopene, riboflavin, folate, vitamin B12 and vitamin D.

A pattern of omega-3s, omega-6s and carotene was linked to better functional brain network efficiency.

Omega-3 fatty acids are abundant in fish, walnuts and Brussels sprouts; omega-6 fatty acids are found in flaxseed, pumpkin seeds, pine nuts and pistachios; lycopene is the vivid red pigment in tomatoes, watermelon and a few other fruits and vegetables; alpha- and beta-carotenoids give sweet potatoes and carrots their characteristic orange color.

https://www.eurekalert.org/pub_releases/2018-12/uoia-sln121918.php

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Diet quality in midlife not associated with dementia risk

  • A large, long-running study found that self-reported diet during midlife was not linked to later dementia risk.

A long-running study involving 8225 adults found that self-reported diet during midlife (mean age 50) was not significantly associated with subsequent risk for dementia.

Dietary intake was assessed in 1991-1993, 1997-1999, and 2002-2004, with follow-up for incident dementia until March 31, 2017. Diet quality was assessed using the Alternate Healthy Eating Index (AHEI), an 11-component diet quality score (score range, 0-110), with higher scores indicating a healthier diet.

There were 344 cases of incident dementia developed in the study period. 69.1% of participants were male.

https://www.eurekalert.org/pub_releases/2019-03/jn-wdq030719.php

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Older people less apt to recognize they've made a mistake

  • A small study has found that older adults (average age 68) are less able to recognize when they made errors.

A small study comparing 38 younger adults (average age 22) and 39 older adults (average age 68) found that the older adults were less able to recognize when they made errors.

The simple test involved looking away from a circle that appeared in a box on one side of a computer screen. It’s hard not to look at something that’s just appeared, and each time the participant glanced at the circle before shifting their gaze, they were asked whether they had made an error. They were then asked to rate how sure they were of their answer.

The younger participants were correct in acknowledging when they had erred 75% of the time, while the older test-takers were correct only 63% of the time. Moreover, when they judged themselves correct in error, the younger participants were far less certain of their judgment than the older ones.

This was confirmed by their eye dilation. Our pupils dilate when something unexpected occurs, and when we think we’ve made a mistake. Younger adults' pupils dilated when they thought they erred, and dilated to a smaller extent when they didn’t recognize their error. Older adults, on the other hand, showed no dilation at all when they committed an error they didn’t recognize.

Research has recently discovered the existence of "error neurons" — specific neurons in the human medial frontal cortex that signal the detection of errors. Perhaps future research will find that these neurons are, in some way, vulnerable to loss during the aging process. But this is pure speculation, and there are other possible causes for older adults' decreasing ability to recognize errors.

The important thing, on a practical level, is to be aware of this danger. I suspect, for most people, this will go a long way to improving the situation.

https://www.eurekalert.org/pub_releases/2018-08/uoi-sop080318.php

https://www.eurekalert.org/pub_releases/2018-12/cmc-np120418.php

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Does mental stimulation help fight age-related cognitive decline?

  • A large study found that mentally stimulating activities in mid-life and later were linked to a lower risk or delay of MCI.
  • A very large study found that the more regularly older adults played puzzles such as crosswords and Sudoku, the better they performed on tasks assessing attention, reasoning and memory.
  • A review of 32 studies has concluded that mind-body exercises such as tai chi do help improve cognition in older adults.

Can computer use, crafts and games slow or prevent age-related memory loss?

A study involving 2,000 healthy older adults (average age 78) found that mentally stimulating activities were linked to a lower risk or delay of MCI, and that the timing and number of these activities may also play a role.

During the study, 532 participants developed MCI.

Using a computer in middle-age (50-65) was associated with a 48% lower risk of MCI, while using a computer in later life was associated with a 30% lower risk, and using a computer in both middle-age and later life was associated with a 37% lower risk.

Engaging in social activities, like going to movies or going out with friends, or playing games, like doing crosswords or playing cards, in both middle-age and later life were associated with a 20% lower risk of developing MCI.

Craft activities were associated with a 42% lower risk, but only in later life.

Those who engaged in two activities were 28% less likely to develop MCI than those who took part in no activities, while those who took part in three activities were 45% less likely, those with four activities 56% percent less likely and those with five activities were 43% less likely.

It should be noted that activities in middle-age were assessed by participants’ memory many years later.

https://www.eurekalert.org/pub_releases/2019-07/aaon-ccu071019.php

Regular crosswords & sudoku linked to sharper brain in later life

Data from the PROTECT online platform, involving 19,000 healthy older adults (50-96), found that the more regularly older adults played puzzles such as crosswords and Sudoku, the better they performed on tasks assessing attention, reasoning and memory.

In some areas the improvement was quite dramatic, for example, on measures of problem-solving, people who regularly do these puzzles performed equivalent to an average of eight years younger compared to those who don't.

https://www.eurekalert.org/pub_releases/2019-05/uoe-rca051419.php

Mind-body exercises improve cognitive function in older adults

A meta-analysis of 32 randomized controlled trials with 3,624 older adults with or without cognitive impairment has concluded that mind-body exercises, especially tai chi and dance mind-body exercise, help improve global cognition, cognitive flexibility, working memory, verbal fluency, and learning in older adults.

https://www.eurekalert.org/pub_releases/2018-12/w-mem121718.php

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Krell-Roesch, J., Syrjanen, J. A., Vassilaki, M., Machulda, M. M., Mielke, M. M., Knopman, D. S., … Geda, Y. E. (2019). Quantity and quality of mental activities and the risk of incident mild cognitive impairment. Neurology, 93(6), e548. https://doi.org/10.1212/WNL.0000000000007897

Brooker, H., Wesnes, K. A., Ballard, C., Hampshire, A., Aarsland, D., Khan, Z., … Corbett, A. (2019). The relationship between the frequency of number-puzzle use and baseline cognitive function in a large online sample of adults aged 50 and over. International Journal of Geriatric Psychiatry, 34(7), 932–940. https://doi.org/10.1002/gps.5085

Brooker, H., Wesnes, K. A., Ballard, C., Hampshire, A., Aarsland, D., Khan, Z., … Corbett, A. (2019). An online investigation of the relationship between the frequency of word puzzle use and cognitive function in a large sample of older adults. International Journal of Geriatric Psychiatry, 34(7), 921–931. https://doi.org/10.1002/gps.5033

Wu, C., Yi, Q., Zheng, X., Cui, S., Chen, B., Lu, L., & Tang, C. (2019). Effects of Mind-Body Exercises on Cognitive Function in Older Adults: A Meta-Analysis. Journal of the American Geriatrics Society, 67(4), 749–758. https://doi.org/10.1111/jgs.15714

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Education & IQ linked to later cognitive decline & dementia

  • A large, long-running study found those with a college education maintained good cognition substantially longer than those who didn't complete high school.
  • A very large online study found that higher levels of education were strong predictors of better cognitive performance across all ages (15-60 years), but this was more true for types of cognition such as reasoning and less true for processing speed.
  • A large study of older men found that their cognitive ability at age 20 was a stronger predictor of cognitive function later in life than other factors, such as higher education, occupational complexity or engaging in late-life intellectual activities.

Americans with a college education live longer without dementia and Alzheimer's

Data from the large, long-running U.S. Health and Retirement Study found that healthy cognition characterized most of the people with at least a college education into their late 80s, while those who didn’t complete high school had good cognition up until their 70s.

The study found that those who had at least a college education lived a much shorter time with dementia than those with less than a high school education: an average of 10 months for men and 19 months for women, compared to 2.57 years (men) and 4.12 years (women).

The data suggests that those who graduated high school can expect to live (on average) at least 70% of their remaining life after 65 with good cogntion, compared to more than 80% for those with a college education, and less than 50% for those who didn't finish high school.

The analysis was based on a sample of 10,374 older adults (65+; average age 74) in 2000 and 9,995 in 2010.

https://www.eurekalert.org/pub_releases/2018-04/uosc-awa041618.php

https://academic.oup.com/psychsocgerontology/article/73/suppl_1/S20/4971564 (open access)

More education linked to better cognitive functioning later in life

Data from around 196,000 subscribers to Lumosity online brain-training games found that higher levels of education were strong predictors of better cognitive performance across the 15- to 60-year-old age range of their study participants, and appear to boost performance more in areas such as reasoning than in terms of processing speed.

Differences in performance were small for test subjects with a bachelor's degree compared to those with a high school diploma, and moderate for those with doctorates compared to those with only some high school education.

But people from lower educational backgrounds learned novel tasks nearly as well as those from higher ones.

https://www.eurekalert.org/pub_releases/2017-08/l-mel082117.php

http://www.futurity.org/higher-education-cognitive-peak-1523712/

Youthful cognitive ability strongly predicts mental capacity later in life

Data from more than 1,000 men participating in the Vietnam Era Twin Study of Aging revealed that their cognitive ability at age 20 was a stronger predictor of cognitive function later in life than other factors, such as higher education, occupational complexity or engaging in late-life intellectual activities.

All of the men, now in their mid-50s to mid-60s, took the Armed Forces Qualification Test at an average age of 20. The same test of general cognitive ability (GCA) was given in late midlife, plus assessments in seven cognitive domains.

GCA at age 20 accounted for 40% of the variance in the same measure at age 62, and approximately 10% of the variance in each of the seven cognitive domains. Lifetime education, complexity of job and engagement in intellectual activities each accounted for less than 1% of variance at average age 62.

The findings suggest that the impact of education, occupational complexity and engagement in cognitive activities on later life cognitive function simply reflects earlier cognitive ability.

The researchers speculated that the role of education in increasing GCA takes place primarily during childhood and adolescence when there is still substantial brain development.

https://www.eurekalert.org/pub_releases/2019-01/uoc--yca011819.php

Reference: 

[4484] Crimmins, E. M., Saito Y., Kim J. Ki, Zhang Y. S., Sasson I., & Hayward M. D.
(2018).  Educational Differences in the Prevalence of Dementia and Life Expectancy with Dementia: Changes from 2000 to 2010.
The Journals of Gerontology: Series B. 73(suppl_1), S20 - S28.

Guerra-Carrillo, B., Katovich, K., & Bunge, S. A. (2017). Does higher education hone cognitive functioning and learning efficacy? Findings from a large and diverse sample. PLOS ONE, 12(8), e0182276. https://doi.org/10.1371/journal.pone.0182276

[4485] Kremen, W. S., Beck A., Elman J. A., Gustavson D. E., Reynolds C. A., Tu X. M., et al.
(2019).  Influence of young adult cognitive ability and additional education on later-life cognition.
Proceedings of the National Academy of Sciences. 116(6), 2021.

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Low social engagement linked to cognitive decline & dementia risk

  • A very large, very long-running British study found that higher social contact at age 60 was associated with a significantly lower risk of developing dementia.
  • A 3-year study of older adults found that lower social engagement was only associated with greater cognitive decline in those with higher amyloid-beta levels.

Socially active 60-year-olds face lower dementia risk

Data from the Whitehall II study, tracking 10,228 participants for 30 years, found that increased social contact at age 60 is associated with a significantly lower risk of developing dementia later in life. Someone who saw friends almost daily at age 60 was 12% less likely to develop dementia than someone who only saw one or two friends every few months.

While previous studies have found a link between social contact and dementia risk, the long follow-up in the present study strengthens the evidence that social engagement could protect people from dementia (rather than precursors of dementia bringing about a decline in social engagement).

https://www.eurekalert.org/pub_releases/2019-08/ucl-sa6073119.php

Low social engagement plus high amyloid linked to cognitive decline

A three-year study of 217 healthy older adults (63-89) enrolled in the Harvard Aging Brain Study, has found that higher amyloid-beta levels in combination with lower social engagement was associated with greater cognitive decline over three years. Lower social engagement wasn’t associated with cognitive decline in those with a lower amyloid-beta burden.

https://www.eurekalert.org/pub_releases/2019-06/bawh-scl062819.php

Reference: 

Sommerlad, A., Sabia, S., Singh-Manoux, A., Lewis, G., & Livingston, G. (2019). Association of social contact with dementia and cognition: 28-year follow-up of the Whitehall II cohort study. PLOS Medicine, 16(8), e1002862. https://doi.org/10.1371/journal.pmed.1002862

Biddle, K et al, "Social Engagement and Amyloid-b-Related Cognitive Decline in Cognitively Normal Older Adults." American Journal of Geriatric Psychiatry. DOI: https://doi.org/10.1016/j.jagp.2019.05.005

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