5 results
Social connections and risk of incident mild cognitive impairment, dementia, and mortality in 13 longitudinal cohort studies of ageing
- Gowsaly Mahalingam, Suraj Samtani, Ben Chun Pan Lam, Darren M Lipnicki, Maria Fernanda Lima-Costa, Sergio Luis Blay, Erico Castro-Costa, Xiao Shifu, Maëlenn Guerchet, Pierre-Marie Preux, Antoine Gbessemehlan, Ingmar Skoog, Jenna Najar, Therese Rydberg Sterner, Nikolaos Scarmeas, Mary Yannakoulia, Themis Dardiotis, Ki-Woong Kim, Steffi Riedel-Heller, Susanne Röhr, Alexander Pabst, Suzana Shahar, Katya Numbers, Mary Ganguli, Tiffany F. Hughes, Ching-Chou H. Chang, Michael Crowe, Tze Pin Ng, Xinyi Gwee, Denise Qian Ling Chua, representatives from SHARED work packages, Joanna Rymaszewska, Karin Wolf-Ostermann, Anna-Karin Welmer, Jean Stafford, Myrra Vernooij-Dassen, Yun-Hee Jeon, Perminder S Sachdev, Henry Brodaty
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 16-17
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Background:
Good social connections are proposed to positively influence the course of cognitive decline by stimulating cognitive reserve and buffering harmful stress-related health effects. Prior meta-analytic research has uncovered links between social connections and the risk of poor health outcomes such as mild cognitive impairment, dementia, and mortality. These studies have primarily used aggregate data from North America and Europe with limited markers of social connections. Further research is required to explore these associations longitudinally across a wider range of social connection markers in a global setting.
Research Objective:We examined the associations between social connection structure, function, and quality and the risk of our primary outcomes (mild cognitive impairment, dementia, and mortality).
Method:Individual participant-level data were obtained from 13 longitudinal studies of ageing from across the globe. We conducted survival analysis using Cox regression models and combined estimates from each study using two-stage meta-analysis. We examined three social constructs: connection structure (living situation, relationship status, interactions with friends/family, community group engagement), function (social support, having a confidante) and quality (relationship satisfaction, loneliness) in relation to the risks of three primary outcomes (mild cognitive impairment, dementia, and mortality). In our partially adjusted models, we included age, sex, and education and in fully adjusted models used these variables as well as diabetes, hypertension, smoking, cardiovascular risk, and depression.
Preliminary results of the ongoing study:In our fully adjusted models we observed: a lower risk of mild cognitive impairment was associated with being married/in a relationship (vs. being single), weekly community group engagement (vs. no engagement), weekly family/friend interactions (vs. not interacting), and never feeling lonely (vs. often feeling lonely); a lower risk of dementia was associated with monthly/weekly family/friend interactions and having a confidante (vs. no confidante); a lower risk of mortality was associated with living with others (vs. living alone), yearly/monthly/weekly community group engagement, and having a confidante.
Conclusion:Good social connection structure, function, and quality are associated with reduced risk of incident MCI, dementia, and mortality. Our results provide actionable evidence that social connections are required for healthy ageing.
The combination of olfactory dysfunction and depression increases the risk of incident dementia in older adults
- Shafi Kalam, Katya Numbers, Darren M. Lipnicki, Ben C. P. Lam, Henry Brodaty, Simone Reppermund
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- Journal:
- International Psychogeriatrics / Volume 36 / Issue 2 / February 2024
- Published online by Cambridge University Press:
- 02 June 2023, pp. 130-141
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Objectives:
Olfactory dysfunction and depression are common in later life, and both have been presented as risk factors for dementia. Our purpose was to investigate the associations between these two risk factors and determine if they had an additive effect on dementia risk.
Design:Olfactory function was assessed using the Brief Smell Identification Test (BSIT), and depression was classified using a combination of the 15-item Geriatric Depression Scale (GDS) score and current antidepressant use. Cross-sectional associations between depression and olfactory function were examined using correlations. Cox regression analyses were conducted to examine the longitudinal relationship between olfaction and depression and incident dementia across 12-years of follow-up.
Participants:Participants were 780 older adults (aged 70–90 years; 56.5% female) from the Sydney Memory and Ageing Study (MAS) without a diagnosis of dementia at baseline.
Results:Partial correlation revealed a nonsignificant association between baseline depression and olfactory function after accounting for covariates (r = −.051, p = .173). Cox regression showed that depression at baseline (hazard ratio = 1.706, 95% CI 1.185–2.456, p = .004) and lower BSIT scores (HR = .845, 95%CI .789–.905, p < .001) were independently associated with a higher risk of incident dementia across 12 years. Entering both predictors together improved the overall predictive power of the model.
Conclusions:Lower olfactory identification scores and depressive symptoms predict incident dementia over 12 years. The use of BSIT scores and depression in conjunction provides a greater ability to predict dementia than either used alone. Assessment of olfactory function and depression screening may provide clinical utility in the early detection of dementia.
Visual memory tests enhance the identification of amnestic MCI cases at greater risk of Alzheimer’s disease
- Javier Oltra-Cucarella, Miriam Sánchez-SanSegundo, Darren M. Lipnicki, John D. Crawford, Richard B. Lipton, Mindy J. Katz, Andrea R. Zammit, Nikolaos Scarmeas, Efthimios Dardiotis, Mary H. Kosmidis, Antonio Guaita, Roberta Vaccaro, Ki Woong Kim, Ji Won Han, Nicole A. Kochan, Henry Brodaty, José A. Pérez-Vicente, Luis Cabello-Rodríguez, Perminder S. Sachdev, Rosario Ferrer-Cascales, Cohort Studies of Memory in an International Consortium (COSMIC)
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- Journal:
- International Psychogeriatrics / Volume 31 / Issue 7 / July 2019
- Published online by Cambridge University Press:
- 25 October 2018, pp. 997-1006
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Objectives:
To investigate whether amnestic mild cognitive impairment (aMCI) identified with visual memory tests conveys an increased risk of Alzheimer’s disease (risk-AD) and if the risk-AD differs from that associated with aMCI based on verbal memory tests.
Participants:4,771 participants aged 70.76 (SD = 6.74, 45.4% females) from five community-based studies, each a member of the international COSMIC consortium and from a different country, were classified as having normal cognition (NC) or one of visual, verbal, or combined (visual and verbal) aMCI using international criteria and followed for an average of 2.48 years. Hazard ratios (HR) and individual patient data (IPD) meta-analysis analyzed the risk-AD with age, sex, education, single/multiple domain aMCI, and Mini-Mental State Examination (MMSE) scores as covariates.
Results:All aMCI groups (n = 760) had a greater risk-AD than NC (n = 4,011; HR range = 3.66 – 9.25). The risk-AD was not different between visual (n = 208, 17 converters) and verbal aMCI (n = 449, 29 converters, HR = 1.70, 95%CI: 0.88, 3.27, p = 0.111). Combined aMCI (n = 103, 12 converters, HR = 2.34, 95%CI: 1.13, 4.84, p = 0.023) had a higher risk-AD than verbal aMCI. Age and MMSE scores were related to the risk-AD. The IPD meta-analyses replicated these results, though with slightly lower HR estimates (HR range = 3.68, 7.43) for aMCI vs. NC.
Conclusions:Although verbal aMCI was most common, a significant proportion of participants had visual-only or combined visual and verbal aMCI. Compared with verbal aMCI, the risk-AD was the same for visual aMCI and higher for combined aMCI. Our results highlight the importance of including both verbal and visual memory tests in neuropsychological assessments to more reliably identify aMCI.
Hippocampal and amygdala volumes in an older bipolar disorder sample
- Chanaka Wijeratne, Sonal Sachdev, Wei Wen, Olivier Piguet, Darren M. Lipnicki, Gin S. Malhi, Phillip B. Mitchell, Perminder S. Sachdev
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- Journal:
- International Psychogeriatrics / Volume 25 / Issue 1 / January 2013
- Published online by Cambridge University Press:
- 29 August 2012, pp. 54-60
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Background: Brain volumetric magnetic resonance imaging (MRI) studies of adult bipolar disorder samples, compared with healthy controls, have reported conflicting results in hippocampal and amygdala volumes. Among these, few have studied older bipolar samples, which would allow for examination of the effects of greater duration in mood episodes on brain volumes. The aim of this study was to compare hippocampal and amygdala volumes in older bipolar patients with controls.
Methods: High-resolution MRI scans were used to determine hippocampal and amygdala volumes that were manually traced using established protocols in 18 euthymic patients with DSM-IV bipolar I disorder (mean age 57 years) and 21 healthy controls (mean age 61 years). Analysis of covariance (ANCOVA) was used to explore group differences while controlling for intracranial volume (ICV), age, sex, and years of education.
Results: While gray matter, white matter, and cerebrospinal fluid volumes did not differ between the groups, bipolar disorder patients had smaller ICV (t = 2.54, p = 0.015). After correcting for ICV, the bipolar group had smaller hippocampal (left hippocampus F = 13.944, p = 0.001; right hippocampus F = 10.976, p = 0.002; total hippocampus F = 13.566; p = 0.001) and right amygdala (F = 13.317, p = 0.001) volumes. Total hippocampal volume was negatively associated with the duration of depressive (r = −0.636; p = 0.035) and manic (r = −0.659; p = 0.027) episodes, but not lithium use. Amygdala volumes were not associated with the duration of mood episodes.
Conclusions: Older bipolar disorder patients had smaller hippocampal and amygdala volumes. That smaller hippocampal volume was associated with the duration of mood episodes may suggest a neuroprogressive course related to the severity of the disorder.
Screening for dementia: a review of self- and informant-assessment instruments
- Nicolas Cherbuin, Kaarin J. Anstey, Darren M. Lipnicki
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- Journal:
- International Psychogeriatrics / Volume 20 / Issue 3 / June 2008
- Published online by Cambridge University Press:
- 21 February 2008, pp. 431-458
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Background: The objective of this study was to review available dementia screening instruments that could be recommended for self-administration, particularly in electronic format. Owing to the gradual loss of insight associated with the progression of dementia, a broad definition of self-administration including self-administration by concerned informants (family, friends, carers) was used.
Method: A systematic search of PubMed, PsychINFO, and the Cochrane Library Database was conducted. Only available full-text articles about dementia screening instruments written in English were included. Articles reporting on instruments used in a non-English context were excluded unless a validated English version of the instrument was available. Included instruments were assessed against the precise criteria and characteristics of the Mini-mental State Examination (MMSE), the most widely used screening instrument.
Results: The Concord Informant Dementia Scale (CIDS) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) were the only instruments meeting all selection criteria. The Memory Impairment Screen (MIS) also met the criteria, although it lacks validation for self-administration. No instrument has been validated for self-administration in electronic format.
Conclusions: It is recommended that the MIS, the CIDS and the IQCODE be validated for self-administration in electronic format.