The influence of a 16-week exercise program, APOE status, and age on executive function task performance: A randomized trial.

ATEMPTing to navigate between “lower is better” and “less is more”

The impact of adverse childhood experiences on cognitive function among middle-aged and older Chinese adults: Multiple mediators of cognitive reserve and depressive symptoms

The aim of this study was to examine the associations between age, chronic pain, cognitive function, and pain sensitivity by comparing older and younger adults. The study included 30 older adults with chronic pain, 31 older adults without pain, 26 young adults with chronic pain, and 31 young adults without pain. Cognitive functions were assessed using the Mini-Mental State Examination, Stroop Test, and Clock Drawing Test. Pressure pain thresholds (PPT) were measured in the trapezius, deltoid, and tibialis anterior regions using an algometer. Significant differences were observed in most cognitive functions and PPTs between the groups, particularly between older adults with and without chronic pain, and young adults with and without chronic pain. Generally, moderate to strong negative correlations were found between pain sensitivity and cognitive performance in older adults with chronic pain. In contrast, young adults with chronic pain showed weaker and fewer correlations between pain sensitivity and cognitive function. Chronic pain has a more significant negative impact on cognitive function in older adults, who also exhibit stronger associations between pain sensitivity and cognitive decline. In contrast, younger adults with chronic pain demonstrate weaker correlations, potentially due to adaptive coping mechanisms. These findings highlight the need for age-specific interventions targeting both pain and cognitive decline in older populations.

Background: Aging increased the risks of cognitive impairment and depression. Then, these conditions can lead to poor quality of life by reducing one’s ability to perform activities of daily living. Recently, it is established that physical activity can decrease the cognitive decline and the risk of depression in older adults. Moreover, regular physical activity can improve physical and mental functions in populations of all ages. However, level and speed of cognitive decline occurs varies greatly among individual especially the difference between middle-aged and older adults. Objective: This study aimed to focus on the comparison of physical activity, cognitive function and depression between older and middle-aged adults, which has never been done before. Moreover, the associations of physical activity with cognitive impairment and depression were also investigated in older and middle-aged adults. The information in this study will provide an understanding regarding the design of physical activity program for different age groups. Methods: All participants were divided into two groups of 50 middle-aged adults and 50 older adults. The assessments of physical activity, cognitive function, and level of depression were conducted for all participants. Results: The total level of physical activity and cognitive function in older adults was decreased when compared with middle-aged ones. Moreover, each work and transportation domain of physical activity in older adults also was decreased when compared with that in middle-aged ones. However, the leisure domain of physical activity in older adults was increased via a decreasing depression level. In addition, the level of physical activity associated with both cognitive function and depression and depression alone in middle-aged and older adults, respectively. Conclusion: We suggested that total level of physical activity in older adults can increase via stimulating work and transportation activities in physical activity program. Moreover, the level of physical activity associated with both cognitive function and depression and depression alone in middle-aged and older adults, respectively.

BackgroundCognitive decline is prevalent among older adults and may be associated with their daily activity behaviours. However, no studies have examined how cognitive decline affects older adults’ activity behaviours within a 24-h framework. This study investigates the relationship between cognitive function and 24-h activity behaviours in older adults, further exploring whether these associations differ by sex.MethodThis study analyses data from the eighth wave of the Survey of Health, Ageing and Retirement in Europe, conducting a cross-sectional analysis of 814 older adults. Cognitive function was assessed using the SHARE-Cog tool, encompassing 10-word immediate recall, 10-word delayed recall, verbal fluency, and self-reported memory. 24-h activity behaviours (moderate-to-vigorous physical activity [MVPA], light physical activity [LPA], sedentary behaviour [SB], and sleep) were objectively measured with thigh-worn accelerometers. Compositional multivariate linear regression models were constructed using compositional data as the response variable, with cognitive function measures as predictors.ResultsHigher MVPA was linked to better cognitive outcomes (verbal fluency, 10-word immediate recall, and 10-word delayed recall) while SB and longer sleep related to poorer performance, with these associations being stronger in women (model p ≤ 0.001). Among women, cognitive outcomes were significantly associated with all activity behaviours (p range = 0.010–0.045). Women who self-reported poor memory and scored 0 on the verbal fluency spent approximately 45% of their day in SB, whereas those reporting excellent memory and scoring 60 spent 40.06% (37.18%, 42.86%) and 36.41% (31.53%, 41.10%) of their day sedentary, respectively. In contrast, men’s 24-h activity composition did not vary significantly with cognitive function (p range = 0.051–0.845).ConclusionOlder adults with better cognitive function tend to engage in more PA and reduce sedentary and sleep time. This relationship differed by sex, with females’ activity behaviours being more sensitive to cognitive function changes.ImplicationsThese findings suggest that interventions promoting healthy lifestyles in older adults should account for cognitive function, particularly in females.

Research suggests that older adults who remain socially active and cognitively engaged have better cognitive function than those who are isolated and disengaged. This study examined the efficacy of learning and using an online social networking website, Facebook.com, as an intervention to maintain or enhance cognitive function in older adults. Forty-one older adults were assigned to learn and use Facebook (n = 14) or an online diary website (active control, n = 13) for 8 weeks or placed on a waitlist (n = 14). Outcome measures included neuropsychological tests of executive functions, memory, and processing speed and self-report questionnaires about social engagement. The Facebook group showed a significant increase in a composite measure of updating, an executive function factor associated with complex working memory tasks, compared to no significant change in the control groups. Other measures of cognitive function and social support showed no differential improvement in the Facebook group. Learning and using an online social networking site may provide specific benefits for complex working memory in a group of healthy older adults. This may reflect the particular cognitive demands associated with online social networking and/or the benefits of social engagement more generally.

BackgroundMany studies have proposed important risk and protective factors for dementia, although most are from Western samples in high‐income settings, including those summarized in the 2024 Lancet Commission on dementia. Our goal was to characterize modifiable risk factors of cognitive decline in a nationally representative study of older adults in India.MethodWe used a detailed neuropsychological battery administered to N = 6,166 community‐living adults aged 60+ years across two waves of the nationally‐representative Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI‐DAD). We established the factor structure of the cognitive battery, derived co‐calibrated measures of cognitive functioning across waves, and evaluated associations of modifiable and non‐modifiable risk factors for late‐life cognitive decline with up to 6.4 years of follow‐up. Risk factors included demographic characteristics, self‐reported and objective health characteristics (i.e., markers of cardiovascular disease), health behaviors, and sensory function.ResultConfirmatory factor analyses to co‐calibrate measures of general cognitive functioning, memory, executive functioning/attention, language/fluency, visuospatial ability, and orientation domains across LASI‐DAD waves 1 and 2 fit well to the data. Most risk factors, particularly demographics and cardiovascular characteristics, were associated with steeper cognitive decline.ConclusionMost risk factors we evaluated were associated with decline in expected directions, highlighting the potential generalizability of previously identified risk factors for dementia in India. Summary measures of cognitive domains derived in this study can be used in future longitudinal research on cognitive aging in India.

Feasibility and effects of high-intensity interval training in older adults with mild to moderate depressive symptoms: A pilot cluster-randomized controlled trial.

Objective:Mind-wandering—the spontaneous shift in attention away from the external task to internal thoughts (including daydreaming, fantasizing, rumination, and worrying)—is negatively associated with performance across a variety of tasks including the sustained attention to response task, the Stroop task, tasks of working memory, choice reaction time, visual search, as well as more ecologically related tasks like reading comprehension and mathematics. There has also been promising evidence suggesting a potential link between mind-wandering, functional connectivity of the canonical networks of the brain, and Alzheimer’s disease (AD). However, no study has directly examined the relationship between neural correlates of mind-wandering and AD pathogenesis. In prior work, our lab has identified a whole-brain, functional connectivity-based marker of mind-wandering—the mwCPM—which predicted response time variability in older adults. In this study, we sought to evaluate the ability of this mind wandering CPM, derived from response time variability, to predict CSF p-tau/Aß42 ratio in 289 older adults from the Alzheimer’s Disease Neuroimaging Initiative. We hypothesized that the combined mind-wandering model including functional connections that predict high mind-wandering and functional edges that predict stability in attention, would predict AD pathology.Participants and Methods:Resting-state functional MRI data from 289 older adults (147 healthy older adults, 111 individuals with mild cognitive impairment, and 31 older adults with AD) from the Alzheimer’s Disease NeuroImaging Initiative was analyzed for the current study. Participants were only included in the analyses if they had resting-state fMRI data, CSF measures of amyloid beta and tau pathology, and performance on cognitive composites of global cognition, episodic memory, and executive functioning. Using the well-established methodology of connectome-based predictive modeling, the mind-wandering model was applied to the resting-state fMRI data to predict CSF-based biomarker levels of p-tau and Aß42. Moreover, we also examined if this mind-wandering model predicted individual differences in composite measures of global cognition, episodic memory, and executive functioningResults:The high mwCPM model successfully predicted measured CSF p-tau/Aß ratios (high model: p = .137, p = .0196), controlling for mean framewise displacement. However, the combined network and the low MW network were not significant (combined model: p = .0731, p = .216; low model: p = -.0027, p = .960). We next examined the association between connectivity strengths of the high mwCPM and cognitive functioning in the domains of general cognition, episodic memory, and executive functioning. Connectivity strength in the high mwCPM—functional edges that were associated with high behavioral variability—were negatively associated with all three cognitive composites (global cognition: r = -.239, p < .0001; episodic memory: r = -.208, p = < .0001; executive functioning: r = -.178, p < .0001).Conclusions:This study provides the first empirical support for a link between a neuromarker of mind-wandering and AD pathophysiology. Moreover, mind-wandering also has downstream consequential effects for key domains of cognitive functioning in older adults. Interventions targeted at reducing mind-wandering, particularly before the onset of AD pathogenesis, may make a significant contribution to the prevention of AD-related cognitive decline.

BackgroundSensory and cognitive function can impact physical performance, but the relationship of multiple sensory impairments (SIs) with mobility in older adults is not well understood. We hypothesized that severity and number of SIs would be associated with worse timed physical mobility performance, and that cognitive processing speed would mediate the association.MethodsParticipants (N = 832) were older adults (mean age 76.3 ± 5.0 years; 59.4% women; 84.2% non-Hispanic White) who completed tests of physical performance, cognitive function, and multiple sensory domains. Separate linear regression models examined the association of SI with 400-m walk, expanded Short Physical Performance Battery (eSPPB), 4-square step test (FSST), and stair climb test. Cognitive measures of executive function/processing speed (Digit Symbol Coding [DSC] and Trail Making Test [Trails] B) were tested as potential mediators of the relationship between SI and physical performance.ResultsEach 1-point decrement in SI scale was associated with slower 400-m walking speed (β = −0.01 m/s, p = .03), lower eSPPB score (β = −0.05 points, p < .001), and longer FSST time (β = 0.20 seconds, p = .01), but there was no association with stair climb time. Using a causal mediation approach with DSC and Trails B as potential mediators, 47.9% of the association of SI with 400-m walk, 43.8% of the association of SI with eSPPB, and 56.7% of the association of multiple SI with FSST were mediated.ConclusionsGreater SIs were associated with worse physical performance in older adults, and the association was partially mediated by measures of cognitive processing speed and executive function. Future studies should investigate the temporal relationship between SIs, cognitive function, and physical function.

Objective:Physical, sensory, and cognitive function are all related to successful aging, quality of life, and independence in older age. Decline in cognitive function, in particular, can create difficulty in many Instrumental Activities of Daily Living such as driving and other aspects of everyday function. Loss of driving competence can subsequently lead to depression, isolation, loss of independence and reduced quality of life. Results from a large randomized controlled trial investigating the long-term impact of Speed of Processing Training will be presented demonstrating the impact of such training on cognitive and everyday function. Speed of Processing Training is an adaptive cognitive intervention administered on a computer that improves visual attention, and has been shown to enhance the connections needed for visual attention using task-driven and resting state fMRI.Participants and Methods:The ACTIVE clinical trial recruited a volunteer sample of 2,832 community dwelling older adults between the ages of 65 and 94 years at six different field sites in six different states. This study evaluated the impact of three cognitive interventions targeted at improving cognitive and everyday function which served as contract control conditions for each other. Participants were randomly assigned to speed of processing training, reasoning training, memory training, or a no-contact control group. Follow-up testing was collected in person for ten years, and at twenty years final archival data was collected from the Departments of Motor Vehicles at each of the six field sites, as well as the Medicare/Medicaid data across the twenty years since enrollment. Outcomes included measures of cognitive function, measures of IADL (including crash involvement and driving cessation), and secondary outcomes of mobility (falls, driving habits, life space), quality of life, mortality and health conditions (from Medicare Records).Results:Results will be presented with respect to everyday function including several longitudinal measures of mobility: number of miles driven per year and driving difficulty, rates of driving cessation, and crash involvement. Random effects modelling, cox proportional hazards, and rate ratios will be presented illustrating the positive impact of cognitive training on these outcome measures. In particular, Speed of Processing Training was found to sustain driving competence with respect to continued driving relative to other types of training, and to reduce the risk of crash involvement over ten years. Furthermore, decline in Speed of Processing was the only cognitive measure predictive of crash involvement longitudinally in the no-contact control group. Positive benefits were also observed for Health Related Quality of Life (HRQoL), and depression.Conclusions:The ACTIVE clinical trial, among other studies, has demonstrated that cognitive training can have long-term positive benefit on the everyday abilities, quality of life, and continued independence of older adults.

Cognitive activity in early and late life has been associated with increased cognitive function among older adults. There is less evidence on the effects of midlife cognitive activity. We examined the association of midlife cognitive activity with cognitive function after age 65. We studied 78 men 68years old or older. We asked participants to assess their current and midlife cognitive activity using adaptations of a measure created by Wilson et al., which includes reading, writing letters, visiting museums and other leisure activities. Our outcomes were validated measures of cognitive and overall function. We compared midlife cognitive activity to our outcome measures in simple bivariable analyses, then adjusted for demographic characteristics using linear regression. Our study population of older (mean age 74.8years) men was primarily white (87%) and well-educated; 65% had at least some post high school education. Although 67% were retired, household income was high (24% < $30k and 44% > $50k). More midlife cognitive activity was related to more current cognitive activity (p = < .0001, r2 = 0.55339). However, midlife activity was not associated with measures of cognitive or overall function, adjusted analyses gave similar results. We did not find an association between midlife cognitive activity and later life function. However, the Wilson measure of cognitive activity that we used excludes instrumental cognitive activities such as dealing with finances or healthcare, likely underestimating cognitive activity for many participants. Midlife cognitive activity was associated with late-life cognitive activity, suggesting efforts to increase late-life cognitive activity may need to start earlier in life. However, more robust measures of everyday cognitive activity might detect such an association.

BackgroundGenome‐wide association studies (GWAS) conducted primarily in populations of European ancestry have revealed the polygenic nature of cognitive abilities [1, 2] but genetic discoveries in other populations, including Hispanics/Latinos, are lagging. Genetically, US Hispanics/Latinos have uniquely admixed genomes, encompassing African, Amerindian, and European ancestries.[3] Admixture patterns in genomic regions (local ancestry) can be leveraged in gene mapping when frequencies of trait‐associated genetic variants located within these regions differ between ancestries.MethodWe conducted genome‐wide admixture mapping analyses followed by fine mapping to identify genetic variants associated with cognitive function in 7,140 Hispanic and Latino adults (mean age 55 years; 60.5% women) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Five measures of cognitive function were investigated: Six‐Item Screener (SIS), Brief Spanish English Verbal Learning Test (SEVLT), Word Fluency Test (WFT), Digit Symbol Substitution Test (DSST), and a measure of general cognitive function (PC1). We tested the identified variants for replication in independent samples with similar neurocognitive measures.ResultWe identified 9 significant local ancestry‐associated regions for the 5 cognitive tests. Counts of African ancestry on at 13q12.11, 4q14, 10p12.2 and 9p22.1 were associated with DSST, PC1, SIS, and WFT, respectively. Counts of Amerindian ancestry at 1q25.2 were associated with DSST; and at 12q14.2 and 12q15 with SIS. Counts of European ancestry at 8p22 were associated with SEVLT; and at 13q12.13 with, both, DSST and PC1. Fine mapping via SNP association testing in each region identified genetic variants that partially or totally explained the admixture signal. While statistical evidence of independent replication of the prioritized variants was generally weak, with only two replicated associations at chr8p22 and chr13q12.13, there was strong biological support for the observed associations to cognitive function. For example, the prioritized variant at 8q22 is an eQTL for CNOT7, which regulates synaptic plasticity and is essential for hippocampal‐dependent learning and memory [4].ConclusionOur admixture mapping analyses identified multiple novel loci associated with measures of cognitive function. This demonstrates the effectiveness of admixture mapping in complementing GWAS [5] and provides an opportunity to identify genetic loci that may be particularly relevant in underrepresented populations.

Approximately 14.9% of Canadians aged 65 and older are living with cognitive impairment, including dementia, which means that there is likely an equal or even greater number of Canadians involved in their care. Relative to non-caregivers, caregivers of persons with dementia typically show more cognitive difficulties (e.g., executive function, memory), and report increased perceived stress, depression, and poor quality of life. The first aim of this dissertation was to compare caregivers’ cognitive and psychological function with that of non-caregiving older adults. The second aim was to assess whether a standardized mindfulness-based stress reduction (MBSR) intervention could improve cognitive function and well-being in caregivers, compared to a psychoeducational control group. In Study 1, 57 older adult caregivers completed an assessment of cognitive and psychosocial functioning. Their performance was compared with that of 97 healthy, non-caregiving older adults who completed a similar battery of measures. It was hypothesized that caregivers would show decreased performance on measures of cognitive function, as well as significantly poorer psychosocial outcomes relative to the non-caregiver group. In Study 2, caregivers were randomized into an eight week MBSR program (n = 33) or a psychoeducation control group (n = 24). At post-program, all participants completed a re-assessment of cognitive and psychosocial functioning. Results of Study 1 showed that relative to non-caregivers, caregivers made significantly more errors on a measure of cognitive flexibility, generated fewer words on measures of phonemic fluency and semantic fluency, and learned significantly fewer words on a list learning task. Caregivers also reported significantly more stress and depressive symptoms, and reported lower quality of life. Results of Study 2 showed that post-intervention cognitive performance did not significantly differ as a function of group assignment. However, participants in the MBSR group showed a significantly larger reduction in depression and perceived stress relative to controls. Results of this RCT provide preliminary evidence for the selective benefits of MBSR relative to psychoeducation in a group of older caregivers of individuals with dementia.

Approximately 14.9% of Canadians aged 65 and older are living with cognitive impairment, including dementia, which means that there is likely an equal or even greater number of Canadians involved in their care. Relative to non-caregivers, caregivers of persons with dementia typically show more cognitive difficulties (e.g., executive function, memory), and report increased perceived stress, depression, and poor quality of life. The first aim of this dissertation was to compare caregivers’ cognitive and psychological function with that of non-caregiving older adults. The second aim was to assess whether a standardized mindfulness-based stress reduction (MBSR) intervention could improve cognitive function and well-being in caregivers, compared to a psychoeducational control group. In Study 1, 57 older adult caregivers completed an assessment of cognitive and psychosocial functioning. Their performance was compared with that of 97 healthy, non-caregiving older adults who completed a similar battery of measures. It was hypothesized that caregivers would show decreased performance on measures of cognitive function, as well as significantly poorer psychosocial outcomes relative to the non-caregiver group. In Study 2, caregivers were randomized into an eight week MBSR program (n = 33) or a psychoeducation control group (n = 24). At post-program, all participants completed a re-assessment of cognitive and psychosocial functioning. Results of Study 1 showed that relative to non-caregivers, caregivers made significantly more errors on a measure of cognitive flexibility, generated fewer words on measures of phonemic fluency and semantic fluency, and learned significantly fewer words on a list learning task. Caregivers also reported significantly more stress and depressive symptoms, and reported lower quality of life. Results of Study 2 showed that post-intervention cognitive performance did not significantly differ as a function of group assignment. However, participants in the MBSR group showed a significantly larger reduction in depression and perceived stress relative to controls. Results of this RCT provide preliminary evidence for the selective benefits of MBSR relative to psychoeducation in a group of older caregivers of individuals with dementia.