cognitive decline

Chronic inflammation in middle age may lead to thinking and memory problems later

February 13, 2019

Science Daily/American Academy of Neurology

People who have chronic inflammation in middle-age may develop problems with thinking and memory in the decades leading up to old age.

 

There are two kinds of inflammation. Acute inflammation happens when the body's immune response jumps into action to fight off infection or an injury. It is localized, short-term and part of a healthy immune system. Chronic inflammation is not considered healthy. It is a low-grade inflammation that lingers for months or even years throughout the body. It can be caused by autoimmune disorders like rheumatoid arthritis or multiple sclerosis, physical stress or other causes. Symptoms of chronic inflammation include joint pain or stiffness, digestive problems and fatigue.

 

Ways to reduce chronic inflammation include getting regular exercise, following an anti-inflammatory heart healthy diet, and getting enough sleep.

 

"Chronic inflammation is tough on the body, and can damage joints, internal organs, tissue and cells," said study author Keenan A. Walker, PhD, of Johns Hopkins University in Baltimore, Md. "It can also lead to heart disease, stroke and cancer. While other studies have looked at chronic inflammation and its effects on the brain in older people, our large study investigated chronic inflammation beginning in middle age and showed that it may contribute to cognitive decline in the decades leading up to old age."

 

As part of the Atherosclerosis Risk in Communities (ARIC) Study, researchers followed 12,336 people with an average age of 57 for approximately 20 years. Researchers took blood samples from participants at the start of the study, measuring four biomarkers of inflammation: fibrinogen, white blood cell count, von Willebrand factor, and factor VIII. They created a composite inflammation score for the four biomarkers. Three years later, researchers measured C-reactive protein, another blood biomarker of inflammation. Participants were divided into four groups based on their composite inflammation scores and C-reactive protein levels.

 

Participants' thinking and memory skills were tested at the beginning of the study, six to nine years later, and at the end of the study.

 

Researchers found the group with the highest levels of inflammation biomarkers had an 8-percent steeper decline in thinking and memory skills over the course of the study than the group with the lowest levels of inflammation biomarkers. The group with the highest C-reactive protein levels had a 12-percent steeper decline in thinking and memory skills than the group with the lowest levels. These results were derived after researchers adjusted for other factors that could affect thinking and memory skills, such as education, heart disease and high blood pressure. Further analyses revealed that inflammation-associated declines in thinking were most prominent in areas of memory, compared to other aspects of thinking such as language and executive functioning.

 

"Overall, the additional change in thinking and memory skills associated with chronic inflammation was modest, but it was greater than what has been seen previously associated with high blood pressure in middle age," Walker said.

 

"Many of the processes that can lead to a decline in thinking and memory skills are believed to begin in middle age, and it is in middle age that they may also be most responsive to intervention," said Walker. "Our results show that chronic inflammation may be an important target for intervention. However, it's also possible that chronic inflammation is not a cause and instead a marker of, or even a response to, neurodegenerative brain diseases that can lead to cognitive decline."

 

A limitation of the study was that participants with higher levels of chronic inflammation at the start of the study were more likely to drop out or die before the final follow-up visit, so surviving participants may not be representative of the general population.

 

Future studies could include more frequent assessments of thinking and memory skills. They could also examine a larger variety of inflammation markers in the blood.

https://www.sciencedaily.com/releases/2019/02/190213160535.htm

With age comes hearing loss and a greater risk of cognitive decline

But study suggests higher education might counter effects of milder hearing impairment

February 12, 2019

Science Daily/University of California - San Diego

In a new study, researchers report that hearing impairment is associated with accelerated cognitive decline with age, though the impact of mild hearing loss may be lessened by higher education

 

Hearing impairment is a common consequence of advancing age. Almost three-quarters of U.S. adults age 70 and older suffer from some degree of hearing loss. One unanswered question has been to what degree hearing impairment intersects with and influences age-related cognitive decline.

 

In a new study, researchers at University of California San Diego School of Medicine report that hearing impairment is associated with accelerated cognitive decline with age, though the impact of mild hearing loss may be lessened by higher education.

 

The findings are published in the February 12, 2019 issue of the Journal of Gerontology: Series A Medical Sciences.

 

A team of scientists, led by senior author Linda K. McEvoy, PhD, professor in the departments of Radiology and Family Medicine and Public Health, tracked 1,164 participants (mean age 73.5 years, 64 percent women) in the longitudinal Rancho Bernardo Study of Healthy Aging for up to 24 years. All had undergone assessments for hearing acuity and cognitive function between the years 1992 to 1996 and had up to five subsequent cognitive assessments at approximately four-year intervals. None used a hearing aid.

 

The researchers found that almost half of the participants had mild hearing impairment, with 16.8 percent suffering moderate-to-severe hearing loss. Those with more serious hearing impairment showed worse performance at the initial visit on a pair of commonly used cognitive assessment tests: the Mini-Mental State Exam (MMSE) and the Trail-Making Test, Part B. Hearing impairment was associated with greater decline in performance on these tests over time, both for those with mild hearing impairment and those with more severe hearing impairment.

 

However, the association of mild hearing impairment with rate of cognitive decline was modified by education. Mild hearing impairment was associated with steeper decline among study participants without a college education, but not among those with higher education. Moderate-to-severe hearing impairment was associated with steeper MMSE decline regardless of education level.

 

"We surmise that higher education may provide sufficient cognitive reserve to counter the effects of mild hearing loss, but not enough to overcome effects of more severe hearing impairment," said McEvoy.

 

Degree of social engagement did not affect the association of hearing impairment with cognitive decline. "This was a somewhat unexpected finding" said first author Ali Alattar. "Others have postulated that cognitive deficits related to hearing impairment may arise from social isolation, but in our study, participants who had hearing impairment were as socially engaged as those without hearing loss."

 

The findings, said the authors, emphasize the need for physicians to be aware that older patients with hearing impairments are at greater risk for cognitive decline. They also emphasized the importance of preventing hearing loss at all ages, since hearing impairment is rarely reversible. One important way to protect hearing, they said, is to minimize loud noise exposure since this is the largest modifiable risk factor for hearing impairment.

https://www.sciencedaily.com/releases/2019/02/190212134802.htm

 

Memory complaints and cognitive decline: Data from the GuidAge study

A memory complaint, also called Subjective Cognitive Decline (SCD), is a subjective disorder that appears to be relatively common, especially in elderly persons

November 13, 2017

Science Daily/IOS Press

A memory complaint, also called Subjective Cognitive Decline (SCD), is a subjective disorder that appears to be relatively common, especially in elderly persons. The reports of its prevalence in various populations range from approximately 10% to as high as 88%, although it is generally thought that the prevalence of everyday memory problems lie within the range of 25% to 50%.

 

The McNair and Kahn Scale or Cognitive Difficulties Scale was employed to define and characterize cognitive complaints in the GuidAge study, involving a population of more than 2800 individuals aged 70 years or older having voluntarily complained of memory problems to their general practitioner (GPs). It contains items that are related to difficulties in attention, concentration, orientation, memory, praxis, domestic activities and errands, facial recognition, task efficiency, and name finding.

 

The results of the GuidAge study suggest that the assessment of cognitive complaint voluntarily reported to primary-care physicians, by the McNair and Kahn scale can predict a decline in cognitive performance, as 5 items out of 20 were statistically significant.

 

These 5 items are:

·      item 1, "I hardly remember usual phone numbers",

·      item 5, "I forget appointment, dates, where I store things",

·      item 6, "I forget to call people back when they called me",

·      item 10, "I forget the day of the week",

·      item 13, "I need to have people repeat instructions several times."

 

Thanks to this short scale GPs, in clinical practice, can identify which patients with memory complaints should be referred to a memory center to assess cognitive functions.

https://www.sciencedaily.com/releases/2017/11/171113095443.htm

Older adults with too much salt in diet and too little exercise at greater risk of cognitive decline

August 23, 2011

Science Daily/Baycrest Centre for Geriatric Care

Older adults who lead sedentary lifestyles and consume a lot of sodium in their diet may be putting themselves at risk for more than just heart disease. A new study has found evidence that high-salt diets coupled with low physical activity can be detrimental to cognitive health in older adults.

 

"The results of our study showed that a diet high in sodium, combined with little exercise, was especially detrimental to the cognitive performance of older adults," said Dr. Fiocco. "But the good news is that sedentary older adults showed no cognitive decline over the three years that we followed them if they had low sodium intake."

 

"These data are especially relevant as we know that munching on high-salt processed snacks when engaged in sedentary activities, such as watching TV or playing in front of the computer, is a frequent pastime for many adults," said Dr. Carol Greenwood, a senior author on the study and internationally-renowned scientist in the field of nutrition and cognitive function in late life.

http://www.sciencedaily.com/releases/2011/08/110822111737.htm

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