Dataset Information

Lower retinal capillary density in minimal cognitive impairment among older Latinx adults.

ABSTRACT: Introduction:We investigated the hypothesis that retinal capillary perfusion is a biomarker of early cognitive decline and cerebrovascular perfusion associated with small vessel disease in a pilot data set of Latinx adults at high risk for vascular cognitive impairment and dementia. Methods:High-resolution optical coherence tomography angiography (OCTA) images were acquired from dilated eyes of Latinx subjects using a 3 × 3 mm2 scan pattern from a commercially available device. A previously validated method was used to quantify the density of perfused retinal capillaries as the retinal vessel skeleton density (VSD). The association of VSD with Clinical Dementia Rating Sum of Boxes, total Montreal Cognitive Assessment (MoCA) score, and individual MoCA test elements were analyzed using multivariate statistics that adjusted for confounders. VSD was also compared with magnetic resonance imaging (MRI) measures of cerebrovascular reactivity (CVR) and perfusion in the middle cerebral artery perforator (MCA-Perf) territory. Results:The mean (± SD) age of the subjects was 68 (± 6) years. For every 0.01-unit lower VSD, the risk of having a CDR-SOB >0 was 20% higher (95%CI = 5%-90%; P = .031). Similarly, a lower VSD was associated with lower total MoCA score (r = 0.3; P = .038). The Visuospatial/Executive domain of the MoCA assessment showed the strongest association with VSD ( ? = 0.02; P = .022). Lower retinal VSD was associated with worse MRI measure of CVR (r = 0.7, P = .04) and less perfusion in the MCA-Perf territory (r = 0.45, P = .02). Discussion:Impaired retinal capillary perfusion is associated with cognitive impairment and abnormalities in cerebrovascular perfusion and function. OCTA-based retinal capillary assessment holds promise for identifying and quantifying retinal correlates of neurovascular abnormalities associated with vascular cognitive impairment.

SUBMITTER: Ashimatey BS

PROVIDER: S-EPMC7447879 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Lower retinal capillary density in minimal cognitive impairment among older Latinx adults.

Ashimatey Bright S BS D'Orazio Lina M LM Ma Samantha J SJ Jann Kay K Jiang Xuejuan X Lu Hanzhang H Wang Danny J J DJJ Ringman John M JM Kashani Amir H AH

Alzheimer's & dementia (Amsterdam, Netherlands) 20200825 1

<h4>Introduction</h4>We investigated the hypothesis that retinal capillary perfusion is a biomarker of early cognitive decline and cerebrovascular perfusion associated with small vessel disease in a pilot data set of Latinx adults at high risk for vascular cognitive impairment and dementia.<h4>Methods</h4>High-resolution optical coherence tomography angiography (OCTA) images were acquired from dilated eyes of Latinx subjects using a 3 × 3 mm<sup>2</sup> scan pattern from a commercially available ...[more]

PMID: 32875053

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Project description:ImportanceSleep disturbances and clinical sleep disorders are associated with all-cause dementia and neurodegenerative conditions, but it remains unclear how longitudinal changes in sleep impact the incidence of cognitive impairment.ObjectiveTo evaluate the association of longitudinal sleep patterns with age-related changes in cognitive function in healthy older adults.Design, setting, and participantsThis cross-sectional study is a retrospective longitudinal analyses of the Seattle Longitudinal Study (SLS), which evaluated self-reported sleep duration (1993-2012) and cognitive performance (1997-2020) in older adults. Participants within the SLS were enrolled as part of a community-based cohort from the Group Health Cooperative of Puget Sound and Health Maintenance Organization of Washington between 1956 and 2020. Data analysis was performed from September 2020 to May 2023.Main outcomes and measuresThe main outcome for this study was cognitive impairment, as defined by subthreshold performance on both the Mini-Mental State Examination and the Mattis Dementia Rating Scale. Sleep duration was defined by self-report of median nightly sleep duration over the last week and was assessed longitudinally over multiple time points. Median sleep duration, sleep phenotype (short sleep, median ≤7 hours; medium sleep, median = 7 hour; long sleep, median ≥7 hours), change in sleep duration (slope), and variability in sleep duration (SD of median sleep duration, or sleep variability) were evaluated.ResultsOf the participants enrolled in SLS, only 1104 participants who were administered both the Health Behavior Questionnaire and the neuropsychologic battery were included for analysis in this study. A total of 826 individuals (mean [SD] age, 76.3 [11.8] years; 468 women [56.7%]; 217 apolipoprotein E ε4 allele carriers [26.3%]) had complete demographic information and were included in the study. Analysis using a Cox proportional hazard regression model (concordance, 0.76) showed that status as a short sleeper (hazard ratio, 3.67; 95% CI, 1.59-8.50) and higher sleep variability (hazard ratio, 3.06; 95% CI, 1.14-5.49) were significantly associated with the incidence of cognitive impairment.Conclusions and relevanceIn this community-based longitudinal study of the association between sleep patterns and cognitive performance, the short sleep phenotype was significantly associated with impaired cognitive performance. Furthermore, high sleep variability in longitudinal sleep duration was significantly associated with the incidence of cognitive impairment, highlighting the possibility that instability in sleep duration over long periods of time may impact cognitive decline in older adults.

Project description:There has been a growing interest in using computerized cognitive assessment to detect age-related cognitive disorders. We have developed a tablet-based cancellation test (e-CT), previously shown as a reliable measure of executive functions and free of effect of familiarity with computer-based devices in healthy older adults. This study aimed to investigate the influence of demographics and current daily use of computer-based devices in older adults with Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD). We further studied the ability of the e-CT to discriminate MCI and AD patients from older adults with normal cognition (NC).The e-CT was administered to 325 older adults (NC = 112, MCI = 129, AD = 84). Subjects also performed the K-T test, a paper-and-pencil cancellation test from which the e-CT was developed. Multiple linear regression analyses were conducted to assess the contribution of demographics and current daily use of computer-based devices on the e-CT in patient groups. The Receiver Operating Characteristic (ROC) curves and the Area Under the Curve (AUC) were established to compare the efficacy of the e-CT and the K-T test to classify subjects into diagnostic groups.In the MCI group, age (B = -0.37, p<0.001) and current daily use of computer-based devices (B = 5.85, p<0.001) were associated with the number of correct cancellations of the e-CT. In the AD group, only current daily use of a computer-based device was a significant contributor (B = 6.28, p<0.001). The e-CT (AUC = 0.811; 95% confidence interval [CI]: 0.756-0.867) and the K-T (AUC = 0.837; CI: 0.787-0.887) showed good and comparable diagnostic accuracy to discriminate between MCI and NC subjects. To discriminate between NC and AD, both tests showed high diagnostic accuracy, with the AUC values of 0.923 (CI: 0.876-0.971) and 0.929 (95%CI: 0.886-0.972) for the e-CT and the K-T, respectively.The e-CT presents satisfying discriminative validity and is a promising tool for detection of early cognitive impairment in older adults.

Project description:BackgroundThe ability to detect one's own memory capacity and develop strategies based on daily contexts is important for daily activities. The Contextual Memory Test (CMT) assesses self-awareness, self-efficacy, self-perception/evaluation of performance, recall, and strategy use that are associated with daily contexts, and could be a potentially suitable measurement for assessing memory and meta-memory in older adults with and without cognitive impairment. Nevertheless, the test-retest reliability and minimal detectable change (MDC) remain unknown in these individuals.ObjectiveThe purpose of this study was to examine test-retest reliability and calculate MDC of the CMT in healthy older adults and those with mild cognitive impairment (MCI).MethodsEighty-three participants completed the CMT twice with a one-month interval. Test-retest reliability was examined using intraclass correlation coefficient (ICC) in all seven domains of the CMT and the recognition subtest. The standard error of measurement (SEM) and MDC were calculated. The Bland-Altman analysis was performed to evaluate the degree of agreement between measurements.ResultsThe ICC of five domains (self-awareness, self-perception/evaluation of performance, immediate/delayed/total recall) and the recognition subtest were good to excellent (ICC = 0.63-0.94) in healthy and MCI participants and the MDC% were less than 30% The ICC of the other two domains (self-efficacy and total strategy use, TSS) were low (ICC = 0.07-0.59) and the MDC% exceeded 30%. The Bland-Altman analysis showed generally better performance in the 2nd than the 1st measurement in most CMT domains.ConclusionsOur results revealed sufficient test-retest reliability and acceptable MDC in most CMT domains in healthy and MCI participants. Only the self-efficacy and TSS domains demonstrated low ICC and large MDC. Possible practice effects were found between repeated measurements. Clinicians should be cautious when evaluating self-efficacy and strategy use using the CMT in older adults. Further improvements are needed for these two domains.

Project description:Higher levels of optimism have been linked with positive health behaviors, biological processes, and health conditions that are potentially protective against cognitive impairment in older adults. However, the association between optimism and cognitive impairment has not been directly investigated. We examined whether optimism is associated with incident cognitive impairment in older adults.Data are from the Health and Retirement Study. Optimism was measured by using the Life Orientation Test-R and cognitive impairment with a modified version of the Telephone Interview for Cognitive Status derived from the Mini-Mental State Examination. Using multiple logistic regression models, we prospectively assessed whether optimism was associated with incident cognitive impairment in 4624 adults 65 years and older during a 4-year period.Among participants, 312 women and 190 men developed cognitive impairment during the 4-year follow-up. Higher optimism was associated with decreased risk of incident cognitive impairment. When adjusted for sociodemographic factors, each standard deviation increase in optimism was associated with reduced odds (odds ratio [OR] = 0.70, 95% confidence interval [CI] = 0.61-0.81) of becoming cognitively impaired. A dose-response relationship was observed. Compared with those with the lowest levels of optimism, people with moderate levels had somewhat reduced odds of cognitive impairment (OR = 0.78, 95% CI = 0.59-1.03), whereas people with the highest levels had the lowest odds of cognitive impairment (OR = 0.52, 95% CI = 0.36-0.74). These associations remained after adjusting for health behaviors, biological factors, and psychological covariates that could either confound the association of interest or serve on the pathway.Optimism was prospectively associated with a reduced likelihood of becoming cognitively impaired. If these results are replicated, the data suggest that potentially modifiable aspects of positive psychological functioning such as optimism play an important role in maintaining cognitive functioning.

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Lower retinal capillary density in minimal cognitive impairment among older Latinx adults.

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Lower retinal capillary density in minimal cognitive impairment among older Latinx adults.

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