seniors

Stress in midlife affects cognitive decline later in life

  • A large long-running study found that stressful life experiences (but not traumatic events) during middle-age were associated with greater memory decline in later life — but only for women.
  • A large long-running study found that middle-aged adults with higher levels of the stress hormone cortisol had poorer cognition than those with average cortisol levels, and this was also associated with greater brain atrophy.
  • A study found that older adults (65-95) who responded to stressful events with more negative emotions showed greater fluctuations in cognitive performance.

Stressors in middle age linked to cognitive decline in older women

Data from some 900 older adults has linked stressful life experiences among middle-aged women, but not men, to greater memory decline in later life.

Previous research has found that the effect of age on the stress response is three times greater in women than in men.

Having a greater number of stressful life experiences over the last year in midlife in women was linked to a greater decline in recalling words later and recognizing those words. There was no association, however, to traumatic events — suggesting that ongoing stress has more of a negative effect on cognition.

The data came from 909 Baltimore residents participating in the National Institute of Mental Health Epidemiologic Catchment Area study, begun in 1981. Participants were an average age of 47 during their mid-life check-in in the 90s.

https://www.eurekalert.org/pub_releases/2019-08/jhm-im080219.php

https://www.futurity.org/mid-life-stress-women-memory-alzheimers-2127072-2/

Stress hormone linked to impaired memory, smaller brain in middle age

Data from 2,231 participants (mean age 48.5) in the Framingham Heart Study has found that adults in their 40s and 50s with higher levels of the stress hormone cortisol had poorer cognition than those with average cortisol levels. Higher cortisol was also associated with smaller brain volumes.

There was no association between higher cortisol level and APOE genotype.

Age, sex, smoking and body mass index were taken into account in the analysis.

https://www.eurekalert.org/pub_releases/2018-10/uoth-sci102418.php

Response to daily stressors could affect brain health in older adults

A study following 111 older adults (65-95) for 2½ years, has found that those who responded to stressful events with more negative emotions and reported a more dour mood in general showed greater fluctuations in their performance on cognitive tests.

Cognitive testing occurred every six months, for six days over a two-week period.

Stressful events and emotional reactions were assessed by self-report.

Interestingly, there were age differences. For the oldest participants (late 70s and older), being more reactive to stressors than usual contributed to worse cognitive performance, but those in their late 60s to mid-70s actually did better on the test if they reported more stressors.

https://www.eurekalert.org/pub_releases/2018-11/osu-rtd111918.php

Reference: 

Munro, C. A., Wennberg, A. M., Bienko, N., Eaton, W. W., Lyketsos, C. G., & Spira, A. P. (2019). Stressful life events and cognitive decline: Sex differences in the Baltimore Epidemiologic Catchment Area Follow-Up Study. International Journal of Geriatric Psychiatry, 34(7), 1008–1017. https://doi.org/10.1002/gps.5102

[4483] Echouffo-Tcheugui, J. B., Conner S. C., Himali J. J., Maillard P., DeCarli C. S., Beiser A. S., et al.
(2018).  Circulating cortisol and cognitive and structural brain measures.
Neurology. 91(21), e1961.

[4482] Stawski, R., Cerino E., Witzel D., & MacDonald S\.
(Submitted).  Daily Stress Processes as Contributors to and Targets for Promoting Cognitive Health in Later Life.
Psychosomatic Medicine. 81(1), 81 - 89.

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Visual impairment associated with a decline in cognitive function

  • A large study indicates that visual impairment can play a role in age-related cognitive decline.

A study involving more than 2,500 older adults (65+) found that the rate of worsening vision was associated with the rate of cognitive decline. More importantly, vision has a stronger influence on cognition than the reverse.

The study finding suggests maintaining good vision through the prevention and treatment of vision disorders in old persons may be a strategy to lessen age-related cognitive changes.

https://www.eurekalert.org/pub_releases/2018-06/jn-via062718.php

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Hearing loss linked to increased cognitive decline & dementia risk

  • A very large Taiwanese study found that adults with hearing loss had a higher dementia risk, and this was particularly so for those aged 45-64.
  • A very large Japanese study found that a dramatically greater proportion of older adults (65+) with hearing loss reported memory loss, compared to much fewer of those without hearing loss.
  • A very large study found that older adults (50+) who used hearing aids for hearing loss showed better performance on tests of working memory and attention compared with those who didn't use hearing aids for their hearing loss.
  • A large long-running study found that, while hearing impairment was associated with accelerated cognitive decline in older adults (mean age 73.5), the impact might be lessened by higher education.
  • A very large 8-year study found that hearing loss was associated with higher risk of subjective cognitive decline in older men (62+).
  • A very small study suggests that cognitive problems in some older adults may derive directly from hearing impairments, and may be fixed by addressing this.
  • A large, long-running study found that eating a healthy diet was associated with a lower risk of acquired hearing loss in women.

Hearing loss linked to increased dementia risk

A Taiwanese study involving 16,270 adults, of whom half had newly diagnosed hearing loss, found that those with hearing loss had a higher risk of dementia, particularly among those aged 45-64. Six comorbidities (cerebrovascular disease, diabetes, anxiety, depression, alcohol-related illnesses, and head injury) were also significantly associated with a higher dementia risk.

Among the study participants, 1,868 developed dementia during the 13-year study period.

https://www.eurekalert.org/pub_releases/2019-07/jn-hld072919.php

Hearing loss linked to limitations, distress, and memory loss in older people

Data from the 2016 Comprehensive Survey of Living Conditions of Japan has found that, of those 137,723 respondents who were aged 65 or older, about 9% reported hearing loss. There were substantial differences between those with hearing loss and those without:

  • 28.9% of those with hearing loss reported limitations in outdoor activities such as shopping or travel, vs. 9.5% of those without hearing loss
  • 39.7% of those with hearing loss reported psychological distress, vs 19.3%
  • 37.7% of those with hearing loss reported memory loss, vs only 5.2% of those without hearing loss.

https://www.eurekalert.org/pub_releases/2019-07/uot-hlt071919.php

Wearing hearing aid may help protect brain in later life

Data from the PROTECT online study of 25,000 older adults (50+) has found that those who wear a hearing aid for age-related hearing problems maintain better brain function over time than those who do not.

Participants undertook annual cognitive tests over two years. After that time, the group who wore hearing aids performed better in measures assessing working memory and aspects of attention than those who did not.

The findings were presented at the 2019 annual Alzheimer's Association International Conference, Los Angeles.

https://www.eurekalert.org/pub_releases/2019-07/uoe-wha071219.php

Hearing loss linked to greater cognitive decline but education mitigates effect

A large, long-running study, involving 1,164 older adults (mean age 73.5), found that, while hearing impairment was associated with accelerated cognitive decline, the impact might be lessened by higher education.

The study found that almost half of the participants (49.8%) had mild hearing impairment, with 16.8% suffering moderate-to-severe hearing loss. Those with more serious hearing impairment showed worse performance on the MMSE and the Trail-Making Test, Part B. Hearing impairment was also associated with greater decline in performance over time, for both the mildly and more severely impaired.

However, the association of mild hearing impairment with rate of cognitive decline was found only among those without a college education, while moderate-to-severe hearing impairment was associated with steeper MMSE decline regardless of education level.

Somewhat surprisingly, degree of social engagement did not affect the association of hearing impairment with cognitive decline.

https://www.eurekalert.org/pub_releases/2019-02/uoc--wac021219.php

Male hearing loss linked to cognitive decline

An eight-year longitudinal study among 10,107 older men (62+) found that hearing loss was associated with higher risk of subjective cognitive decline.

Compared with men with no hearing loss, the relative risk of cognitive decline was 30% higher among men with mild hearing loss, 42% higher among men with moderate hearing loss, and 54% higher among men with severe hearing loss but who did not use hearing aids. While those who did use hearing aids showed a reduced risk of cognitive decline (37%), this wasn’t statistically significant (not enough men in these groups, I assume).

The men were all health professionals. Subjective cognitive function was assessed using a six-item questionnaire, which was administered three times, at four-yearly intervals.

https://www.eurekalert.org/pub_releases/2019-01/bawh-etc012819.php

Signs of memory problems could be symptoms of hearing loss instead

A very small study found that 11 out of 20 participants being evaluated for cognitive concerns had some form of mild to severe hearing loss, but only 4 of them used hearing aids. A quarter of the participants didn’t show any signs of memory loss due to a brain disorder. It’s suggested that, for some, cognitive problems may derive directly from hearing impairments, and can be fixed by addressing this issue.

Hearing loss is the third most common chronic health condition in older adults, which is experienced by 50% of individuals over the age of 65 and 90% of people over the age of 80. It takes an average of 10 years before people seek treatment and fewer than 25% of those who need hearing aids will buy them.

https://www.eurekalert.org/pub_releases/2019-01/bcfg-som011819.php

Healthy diet may lower risk of hearing loss in women

A large, long-running study (the Nurses' Health Study II ) has found that eating a healthy diet was associated with a lower risk of acquired hearing loss in women. Women whose diets most closely resembled the AMED or DASH dietary patterns had an approximately 30% lower risk of moderate or worse hearing loss, compared with women whose diets resembled these dietary patterns the least.

The Alternate Mediterranean diet (AMED) diet includes extra virgin olive oil, grains, legumes, vegetables, fruits, nuts, fish and moderate intake of alcohol. The Dietary Approaches to Stop Hypertension (DASH) diet is high in fruits and vegetables and low-fat dairy, and low in sodium.

https://www.eurekalert.org/pub_releases/2018-05/bawh-hdm051118.php

Reference: 

[4479] Liu, C-M., & Lee C. Tzu- Chi
(2019).  Association of Hearing Loss With Dementia.
JAMA Network Open. 2(7), e198112 - e198112.

Iwagami, M., Kobayashi, Y., Tsukazaki, E., Watanabe, T., Sugiyama, T., Wada, T., … Tamiya, N. (2019). Associations between self-reported hearing loss and outdoor activity limitations, psychological distress and self-reported memory loss among older people: Analysis of the 2016 Comprehensive Survey of Living Conditions in Japan. Geriatrics & Gerontology International, 19(8), 747–754. https://doi.org/10.1111/ggi.13708

Alattar, A. A., Bergstrom, J., Laughlin, G. A., Kritz-Silverstein, D., Richard, E. L., Reas, E. T., … McEvoy, L. K. (n.d.). Hearing impairment and cognitive decline in older, community-dwelling adults. The Journals of Gerontology: Series A. https://doi.org/10.1093/gerona/glz035

Curhan, S et al. Longitudinal study of hearing loss and subjective cognitive function decline in men. Alzheimer's & Dementia DOI: 10.1016/j.jalz.2018.11.004

Dupuis, K., Yusupov, I., Vandermorris, S., Murphy, K., Rewilak, D., Stokes, K., & Reed, M. (2019). Considering Age-Related Hearing Loss in Neuropsychological Practice: Findings from a Feasibility Study. Canadian Journal on Aging / La Revue Canadienne Du Vieillissement, 38(2), 245-252. doi:10.1017/S0714980818000557

[4480] Curhan, S. G., Wang M., Eavey R. D., Stampfer M. J., & Curhan G. C.
(2018).  Adherence to Healthful Dietary Patterns Is Associated with Lower Risk of Hearing Loss in Women.
The Journal of Nutrition. 148(6), 944 - 951.

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Sleep problems linked to age-related cognitive problems

  • A very large Canadian study found that older adults with chronic insomnia performed significantly worse on cognitive tests.
  • A small study links older adults' increasing difficulties with consolidating memories to poorer synchronization of brainwaves during sleep.
  • A fruitful study shows that oxidative stress drives sleep, and that this is regulated by a specific molecule that monitors the degree of oxidative stress.

Chronic insomnia linked to memory problems

Data from 28,485 older Canadians (45+) found that those with chronic insomnia performed significantly worse on cognitive tests than those who had symptoms of insomnia without any noticable impact on their daytime functioning and those with normal sleep quality. The main type of memory affected was declarative memory (memory of concepts, events and facts).

Chronic insomnia is characterized by trouble falling asleep or staying asleep at least three nights a week for over three months with an impact on daytime functioning (mood, attention, and daytime concentration).

https://www.eurekalert.org/pub_releases/2019-05/cu-cia051519.php

Poor brainwave syncing behind older adults failure to consolidate memories

We know that memories are consolidated during sleep, and that for some reason this consolidation becomes more difficult with age. Now a new study shows why.

To consolidate memories (move them into long-term storage), low and speedy brain waves have to sync up at exactly the right moment during sleep. These brain rhythms synchronize perfectly in young adults, but in old age, it seems, slow waves during non-rapid eye movement (NREM) sleep are not so good at making timely contact with the speedy electrical bursts known as “spindles.”

These difficulties are thought to be due to atrophy of the gray matter in the medial frontal cortex.

The study compared the overnight memory of 20 healthy young adults to that of 32 healthy older adults (mostly in their 70s). Before going to sleep, participants learned and were then tested on 120 word sets. They were tested again in the morning. EEG results from their sleeping brains showed that in older people, the spindles consistently peaked early in the memory-consolidation cycle and missed syncing up with the slow waves.

http://www.futurity.org/memories-sleep-older-adults-1633432/

https://www.eurekalert.org/pub_releases/2017-12/uoc--obd121417.php

Oxidative stress governs sleep

A fruitfly study has shown how oxidative stress leads to sleep. Fruitflies (and, it is believed, humans) have sleep-control neurons that act like an on-off switch: if the neurons are electrically active, the fly is asleep; when they are silent, the fly is awake. The switch is triggered, it appears, by an electrical current that flows through two ion channels, and this, it now appears, is regulated by a small molecule called NADPH.

The state of NADPH reflects the degree of oxidative stress. Sleeplessness causes oxidative stress, driving the behavior of NADPH.

I'm wildly speculating here, but is it possible that increased sleep problems often found with age are linked to a growing inability of this molecule to sensitively monitor the degree of oxidative stress, perhaps due to high levels of oxidative stress??

https://www.eurekalert.org/pub_releases/2019-03/uoo-saa032119.php

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Inflammation linked to brain health

  • Study indicates APOE4 carriers are only at greater Alzheimer's risk if they have chronic inflammation.
  • Large study finds increasing inflammation linked to more white matter damage.
  • Common causes of chronic inflammation include cardiovascular disease, heart failure, diabetes, high blood pressure and infections.

Link found between chronic inflammation and Alzheimer's gene risk

Data from the Framingham Heart Study has found carriers of the ApoE4 gene were much more likely to develop Alzheimer’s if they also had chronic low-grade inflammation. Indeed, the researchers suggest that, in the absence of inflammation, there might be no difference of Alzheimer's risk between ApoE4 and non-ApoE4 carriers.

https://www.eurekalert.org/pub_releases/2018-10/buso-lfb101818.php

Mid- to late-life increases in chronic inflammation age brain

Data from 1,532 participants in a long-running study, in which participants were tested five times every 3 years (on average), found that those who showed increasing inflammation had greater abnormalities in the brain's white matter structure.

90 people transitioned from low to persistently elevated C-reactive protein during midlife, indicating increasing inflammation. Their brains appear similar to that of a person 16 years older, researchers estimate.

Common causes of chronic inflammation include cardiovascular disease, heart failure, diabetes, high blood pressure and infections such as hepatitis C or HIV.

61% of participants were women, and 28% were African-American. At the final visit, participants were an average age of 76.

https://www.eurekalert.org/pub_releases/2018-07/jhm-mtl070218.php

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Smoking, hypertension, diabetes & obesity each linked to poor brain health

  • A large study has found that smoking, high blood pressure, diabetes, and obesity are each linked to more brain atrophy, and damage to white matter.
  • The more of these you have, the greater the shrinkage and damage.

Brain scans of 9,772 people aged 44 to 79, who were enrolled in the UK Biobank study, have revealed that smoking, high blood pressure, high pulse pressure, diabetes, and high BMI — but not high cholesterol — were all linked to greater brain shrinkage, less grey matter and less healthy white matter.

Smoking, high blood pressure, and diabetes were the most important factors, but there was also a compound effect, with the number of vascular risk factors being associated with greater damage to the brain. On average, those with the highest vascular risk had nearly 3% less volume of grey matter, and one-and-a-half times the damage to their white matter, compared to people who had the lowest risk.

The brain regions affected were mainly those involved in ‘higher-order’ thinking, and those known to be affected early in the development of dementia.

The associations were as strong for middle-aged adults as for older ones, suggesting the importance of tackling these factors early.

While the effect size was small, the findings emphasize how vulnerable the brain is to vascular factors even in relatively healthy adults. This also suggests the potential of lifestyle changes for fighting cognitive decline.

Although this study didn't itself examine cognitive performance in its participants, other studies have shown links between cognitive impairment and vascular risk factors, particularly diabetes, obesity, hypertension, and smoking.

https://www.eurekalert.org/pub_releases/2019-03/esoc-shb030719.php

Cognitive decline in type 2 diabetes linked to white matter hyperintensities

While type 2 diabetes has been associated with cognitive problems, the mechanism has been unclear. Now a study involving 93 people with type 2 diabetes has found that greater white matter hyperintensities (indicative of cerebral small vessel disease) were associated with decreased processing speed (but not with memory or executive function).

https://www.eurekalert.org/pub_releases/2018-09/w-rem091818.php

Reference: 

Cox, Simon R. et al. 2019. Associations between vascular risk factors and brain MRI indices in UK Biobank. European Heart Journal. doi:10.1093/eurheartj/ehz100

[4395] Mankovsky, B., Zherdova N., van den Berg E., Biessels G.-J., & de Bresser J.
(2018).  Cognitive functioning and structural brain abnormalities in people with Type 2 diabetes mellitus.
Diabetic Medicine. 35(12), 1663 - 1670.

 

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Air pollution substantially reduces cognitive ability in older adults

  • A very large study shows that greater exposure to air pollution was linked to poorer cognitive performance in older adults, especially men and the less educated.

A large Chinese study involving 20,000 people has found that the longer people were exposed to air pollution, the worse their cognitive performance in verbal and math tests. The effect of air pollution on verbal tests became more pronounced with age, especially for men and the less educated.

The study followed the participants from 2010 to 2014, meaning that the same individuals could be assessed as air pollution varied from one year to the next.

The findings add to previous research showing the harmful effects of air pollution on cognitive performance in children.

https://www.theguardian.com/environment/2018/aug/27/air-pollution-causes-huge-reduction-in-intelligence-study-reveals

Reference: 

Xin Zhang, Xi Chen, Xiaobo Zhang. 2018. The impact of exposure to air pollution on cognitive performance. Proceedings of the National Academy of Sciences Sep 2018, 115 (37) 9193-9197; DOI: 10.1073/pnas.1809474115

 

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Depression linked to faster cognitive decline in older adults

  • A review of 34 studies confirms depression is linked to faster cognitive decline in older adults.

A review of 34 longitudinal studies, involving 71,244 older adults, has concluded that depression is associated with greater cognitive decline.

The study included people who presented with symptoms of depression as well as those that were diagnosed as clinically depressed, but excluded any who were diagnosed with dementia at the start of study.

Previous research has found that depression is associated with an increased dementia risk.

The researchers recommend that preventative measures such as exercising, practicing mindfulness, and undertaking recommended therapeutic treatments, such as Cognitive Behaviour Therapy, might help protect cognitive health.

While the review included some studies into anxiety, the numbers were insufficient to draw a conclusion.

https://www.eurekalert.org/pub_releases/2018-05/uos-dsu052318.php

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Fruit & veges slow memory decline in long-running study

  • A large, long-running study has found an association between consumption of fruit & vegetables and subjectively assessed memory skills in older men.

A study following nearly 28,000 older men for 20 years has found that regular consumption of leafy greens, dark orange and red vegetables and berry fruits, and orange juice, was associated with a lower risk of memory loss.

The study looked at 27,842 male health professionals, who were an average age of 51 in 1986, when the study began. Participants filled out questionnaires about how many servings of fruits, vegetables and other foods they had each day, at the beginning of the study and then every four years.

Specifically:

  • those who consumed the most vegetables (around six servings a day) were 34% less likely to develop poor thinking skills than the men who consumed the least amount of vegetables (around two servings)
  • 6.6% of men who consumed the most vegetables developed poor cognitive function, compared to 7.9% of men who consumed the least
  • those who drank orange juice every day were 47% less likely to develop poor thinking skills than those who drank less than one serving per month
  • 6.9% of men who drank orange juice every day developed poor cognitive function, compared to 8.4 % of men who drank orange juice less than once a month

Interestingly, those who ate larger amounts of fruits and vegetables 20 years earlier were less likely to develop cognitive problems, whether or not they kept eating larger amounts of fruits and vegetables about six years before the memory test.

Cognition was not, however, assessed objectively, nor was it tested at baseline. In 2008 and 2012, participants were given a short cognitive test to assess their subjective judgments of their memory and cognition. The brief test included such questions as:

  • "Do you have more trouble than usual remembering a short list of items, such as a shopping list?"
  • "Do you have more trouble than usual following a group conversation or a plot in a TV program due to your memory?"

Just over half the participants (55%) had good thinking and memory skills, 38% had moderate skills, and 7% had poor thinking and memory skills.

https://www.eurekalert.org/pub_releases/2018-11/aaon-ojl111918.php

Reference: 

Changzheng Yuan et al. 2019. Long-term intake of vegetables and fruits and subjective cognitive function in US men. Neurology, 92 (1) e63-e75.

 

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Poor sleep drives Alzheimer’s progression

  • Getting a good night’s sleep is given greater importance with the discovery that sleep deprivation appears to rapidly increase the spread of tau tangles.

Poor sleep has been associated with the development of Alzheimer's disease, and this has been thought to be in part because the protein amyloid beta increases with sleep deprivation. A new study explains more.

Experiments with mice show that sleep deprivation also rapidly increases levels of the other key Alzheimer’s disease protein, tau tangles.

The work built on findings that tau is high in older people who sleep poorly, and that, when people are kept awake all night, their tau levels rise by about 50%.

When mice had tau proteins seeded in the hippocampus of their brains, those who were kept awake for long periods each day (mice are nocturnal), showed significantly greater spread of tau tangles than those mice allowed to sleep normally. Moreover, the new tangles appeared in the same areas of the brain affected in people with Alzheimer’s.

Disrupted sleep also increased release of synuclein protein, a hallmark of Parkinson’s disease. People with Parkinson’s—like those with Alzheimer’s—often have sleep problems.

All of this supports the idea that sleep directly protects against the development of Alzheimer's.

https://www.futurity.org/alzheimers-disease-sleep-tau-1966962/

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