老年人认知功能减退知情者问卷检测老年人认知功能损害

目的评价老年人认知功能减退知情者问卷在中国老年人群中应用的信效度,以及在认知功能损害筛查中的有效性。方法认知功能损害患者93例,应用简短版本的老年人认知功能减退知情者问卷(IQCODE)对其知情者进行问卷调查。对128名60岁以上来自于社区的健康老年人的知情者进行调查,作问卷的信效度检验。结果 IQCODE 内部一致性系数达0.83。重测信度Pearson 相关系数为0.86。与简短精神状态量表(MMSE)、日常生活活动能力量表(ADL)的效度系数分别为-0.78和0.71。IQCODE 得分在轻度认知障碍和轻、中、重度痴呆患者中分别为(3.5±0.4)分和、(4.2±0.4)分、(4.7±0.2)分和(4.9±0.2)分,差异有统计学意义,但在阿尔茨海默病(AD)和血管性痴呆(VaD)等不同痴呆病因组间差异无统计学意义。结论 IQCODE 信效度良好。得分与病情严重程度密切相关,此问卷能将痴呆和轻度认知功能损害患者与健康人群很好地区分开来,可用于认知功能损害的检测。但对 AD、VaD 等痴呆类型的鉴别作用有限。     

Modified Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a screening test for dementia for Thai elderly

A potential test for early detection of dementia in the elderly is the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), which is based on information from the informant for the elderly about the changes of the elderly in everyday cognitive functioning associated with dementia. The present study aimed to modify and assess the reliability and validity of the modified IQCODE consisting of 32 items. The study consisted of two methods of assessing dementia: DSMIV diagnosis carried out by clinicians, and informants responding to the IQCODE. The subjects were 200 pairs of elderly subjects and their informants who visited the Geriatric Clinic, Ramathibodi Hospital. The optimal cutoff score on the modified IQCODE was 3.42, with 90% sensitivity and 95% specificity. The positive predictive values, negative predictive values, and accuracy were 0.94, 0.90, and 0.92, respectively. The IQCODE items had high internal consistency. The IQCODE associated with the elderly person's age, but not with their gender and educational level; nor were they associated with the demographic characteristics of the informant. Therefore, the IQCODE could be used as an alternative screening test for dementia in Thailand with acceptable sensitivity and specificity. This tool may be useful for dementia screening in the community and the geriatric clinic for early detection of disease.     

Self‐ and Informant Report of Financial Abilities in Patients with Alzheimer's Disease: Reliable and Valid?

OBJECTIVES: To evaluate the consistency, stability, and accuracy of reports by patients with Alzheimer's disease (AD) and their caregivers regarding the patients' premorbid and current financial abilities. DESIGN: Consistency of reports was assessed within patient/caregiver dyads and within control/control informant dyads. Stability of reports over a 1-month interval was assessed for each group: patients with AD, caregivers, controls, and control informants. Accuracy of each group's reports was evaluated in reference to patients' and controls' performance on a direct psychometric measure of financial capacity. SETTING: University medical center. PARTICIPANTS: Twenty patients with AD and 20 family caregivers; 23 controls and 23 family informants. MEASUREMENTS: The Prior Financial Capacity Form (PFCF) and the Current Financial Capacity Form (CFCF) were used. Parallel versions assessed self-report (patients, controls) and informant report (caregivers, control informants) at two visits 1 month apart. Patients with AD and controls were also administered the Financial Capacity Instrument (FCI), a direct assessment of the same abilities reported on the PFCF and CFCF. RESULTS: Patients with AD reported that they had more-intact current abilities than their caregivers reported. Patients with AD and their caregivers showed lower levels of stability over time on the PFCF and CFCF than did controls and their informants. Half of the patients with AD overestimated their current abilities relative to their FCI performance, whereas caregivers demonstrated both underestimation and overestimation errors. Controls and informants evidenced high levels of consistency, stability, and accuracy in PFCF and CFCF ratings. CONCLUSION: Patients with AD overestimate their financial abilities in comparison with the reports of their family caregivers. Both patients and caregivers' reports of patients' financial abilities showed limited stability and validity. The reliability and accuracy of self- and informant reports of financial abilities may be compromised in the context of dementia and caregiving, underscoring the need for direct assessment methods to augment self- and informant report in assessing functional decline in dementia.     

Mild cognitive impairment--beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment

The First Key Symposium was held in Stockholm, Sweden, 2-5 September 2003. The aim of the symposium was to integrate clinical and epidemiological perspectives on the topic of Mild Cognitive Impairment (MCI). A multidisciplinary, international group of experts discussed the current status and future directions of MCI, with regard to clinical presentation, cognitive and functional assessment, and the role of neuroimaging, biomarkers and genetics. Agreement on new perspectives, as well as recommendations for management and future research were discussed by the international working group. The specific recommendations for the general MCI criteria include the following: (i) the person is neither normal nor demented; (ii) there is evidence of cognitive deterioration shown by either objectively measured decline over time and/or subjective report of decline by self and/or informant in conjunction with objective cognitive deficits; and (iii) activities of daily living are preserved and complex instrumental functions are either intact or minimally impaired.     

Pulse pressure and pulse wave velocity are related to cognitive decline in the Baltimore Longitudinal Study of Aging

Pulse pressure and pulse wave velocity, markers of arterial stiffness, have been associated with stroke, dementia, and lowered levels of cognitive function. Here we examine longitudinal relations of pulse pressure and pulse wave velocity to multiple domains of cognitive function among nondemented, stroke-free persons. Up to 1749 participants from the Baltimore Longitudinal Study of Aging completed tests of verbal and nonverbal memory, attention, perceptuo-motor speed, confrontation naming, executive functions, and cognitive screening measures, as well as concurrent sphygmomanometric assessment of blood pressure (for derivation of pulse pressure) on 1 to 8 occasions over 14 years. A subset of 相似文献   

A randomized trial of vitamin E supplementation and cognitive function in women

BACKGROUND: Oxidative stress may play a key role in the development of cognitive impairment. Long-term supplementation with vitamin E, a strong antioxidant, may provide cognitive benefits. METHODS: The Women's Health Study is a randomized, double-blind, placebo-controlled trial of vitamin E supplementation (600 IU [alpha-tocopherol acetate], on alternate days) begun between 1992 and 1995 among 39 876 healthy US women. From 1998, 6377 women 65 years or older participated in a cognitive substudy. Three cognitive assessments of general cognition, verbal memory, and category fluency were administered by telephone at 2-year intervals. The primary outcome was a global composite score averaging performance on all tests. Repeated measures analyses were conducted to examine mean performance and mean differences in cognitive change, and logistic regression was used to estimate relative risks of substantial decline. RESULTS: There were no differences in global score between the vitamin E and placebo groups at the first assessment (5.6 years after randomization: mean difference, -0.01; 95% confidence interval [CI], -0.04 to 0.03) or at the last assessment (9.6 years of treatment: mean difference, 0.00; 95% CI, -0.04 to 0.04). Mean cognitive change over time was also similar in the vitamin E group compared with the placebo group for the global score (mean difference in change, 0.02; 95% CI, -0.01 to 0.05; P = .16). The relative risk of substantial decline in the global score in the vitamin E group compared with the placebo group was 0.92 (95% CI, 0.77 to 1.10). CONCLUSION: Long-term use of vitamin E supplements did not provide cognitive benefits among generally healthy older women.     

The validity of informant report for grading the severity of Alzheimer's dementia

The validity of informant-based techniques has been established for the detection of dementia cases by non-pathological individuals, but is still controversial for the assessment of the severity of dementia. This study aimed at ascertaining whether informant-based evaluation (the so-called informant report) of the cognitive and behavioral impairment of a patient is valid for grading the severity of dementia, and consistent with objective assessment of the patient's cognitive and behavioral functioning. We enrolled 96 community-dwelling outpatients and 56 controls assessed at the Geriatric Evaluation Unit of the University of Modena, Italy. All patients scored lower than 27 on the MMSE, and met DSM-IV inclusion criteria for Alzheimer's dementia. Patients and controls were administered the CAMDEX interview, containing a section which collects participant (patient or control) and informant evaluations on dementia-related cognitive and behavioral deficits. The informant report resulted effective at MANOVA for grading the severity of dementia in 4 of its 5 measures (namely, memory, everyday activities, general mental functioning and depressed mood), and was correlated with the scores of several scales of the CAMDEX cognitive section (i.e., CAMCOG). Instead, the participant's (patient or control) report showed a lower capacity for grading dementia, and was poorly correlated with the psychometric outcomes of cognitive functioning. On the whole, the results corroborated the validity of the informant report in the diagnostic work-up for grading dementia, given its sensitivity to the severity of dementia, and its consistency with cognitive psychometric outcomes.     

Instruments for the assessment of pain in older persons with cognitive impairment

Pain in older persons with cognitive impairment is often unrecognized and inadequately treated. A major problem associated with this undertreatment is the challenging nature of pain assessment and in particular the selection of accurate and useful assessment instruments. The purpose of this study was to review pain measurement instruments for acute and chronic pain suggested for use with cognitively impaired older persons and to summarize available evidence on their reliability and validity. A systematic search for pain instruments was conducted using several bibliographic databases, supplemented by a manual search of the bibliographies of retrieved articles and review chapters and by articles received from experts and clinicians in the field. Instruments were retained for review when the pain instrument was used or recommended for use with older persons with cognitive impairment. Thirty-nine instruments were reviewed; nine were excluded for various reasons. Of the remaining 30, 18 were self-report and 12 were staff administered. There were no instruments for which all major tests of reliability or validity were reported. Reliability and validity data were basic or unavailable for many instruments. One instrument had excellent validity but no reliability data. The remaining instruments had weak or adequate reliability and validity. The authors conclude that there is a need for further rigorous development and testing of pain instruments for use with cognitively impaired older persons. An adequate instrument would be one component of an effective program for assessment and management of pain in this population.     

Screening for preexisting cognitive impairment in older intensive care unit patients: use of proxy assessment

OBJECTIVES: To determine the prevalence of preexisting cognitive impairment (CI) in patients admitted to the medical intensive care unit (ICU) and compare two different proxy measures of preexisting CI in ICU patients. DESIGN: Cross-sectional comparative study. SETTING: Urban university teaching hospital. PARTICIPANTS: One hundred thirty patients aged 65 and older admitted to the medical ICU. MEASUREMENTS: Two previously validated proxy measures of CI: the Modified Blessed Dementia Rating Scale (MBDRS) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). RESULTS: The prevalence of preexisting CI in the ICU, determined using a combination of the measures, was 42%. Agreement between the two CI measures was 86%, with a kappa of 0.69, with discrepancies being related to the different domains measured by each instrument. CONCLUSION: There is a high prevalence of preexisting CI in patients admitted to the medical ICU. Both the MBDRS and IQCODE can be used to screen for preexisting CI in situations where direct patient assessment is not feasible. Future studies are needed to address physician recognition of CI and its effect on patient care decisions and outcomes.     

Computer-based tools for assessing micro-longitudinal patterns of cognitive function in older adults

Patterns of cognitive change over micro-longitudinal timescales (i.e., ranging from hours to days) are associated with a wide range of age-related health and functional outcomes. However, practical issues of conducting high-frequency assessments make investigations of micro-longitudinal cognition costly and burdensome to run. One way of addressing this is to develop cognitive assessments that can be performed by older adults, in their own homes, without a researcher being present. Here, we address the question of whether reliable and valid cognitive data can be collected over micro-longitudinal timescales using unsupervised cognitive tests.In study 1, 48 older adults completed two touchscreen cognitive tests, on three occasions, in controlled conditions, alongside a battery of standard tests of cognitive functions. In study 2, 40 older adults completed the same two computerized tasks on multiple occasions, over three separate week-long periods, in their own homes, without a researcher present. Here, the tasks were incorporated into a wider touchscreen system (Novel Assessment of Nutrition and Ageing (NANA)) developed to assess multiple domains of health and behavior. Standard tests of cognitive function were also administered prior to participants using the NANA system.Performance on the two “NANA” cognitive tasks showed convergent validity with, and similar levels of reliability to, the standard cognitive battery in both studies. Completion and accuracy rates were also very high. These results show that reliable and valid cognitive data can be collected from older adults using unsupervised computerized tests, thus affording new opportunities for the investigation of cognitive.     

Dementia and its associations in type 2 diabetes mellitus: the Fremantle Diabetes Study

BACKGROUND: recent studies indicate that diabetes is an important risk factor for dementia in older patients, but the cause remains unknown. OBJECTIVES: to determine whether vascular or diabetes-related risk factors predict the development of dementia in older subjects with diabetes. PATIENTS: 63 patients with type 2 diabetes of mean age 75.3 years. METHODS: Subjects were screened for cognitive impairment using the Mini-Mental State Examination (MMSE) and informants who knew the subjects answered the Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE). Probable dementia was diagnosed using highly specific criteria based on the combination of both tests. Potential risk factors for dementia obtained at the time of the cognitive test and annually from a median of 3.2 years previously were examined using univariate methods and simple general linear modelling. RESULTS: since there was a significant association between MMSE and English speaking ability, ten non-Anglo-Celt patients were excluded from the analysis. Probable dementia was diagnosed in six of the remaining 53 subjects (11%). Dementia was significantly and independently associated with higher diastolic and mean arterial blood pressure measurements over the 3 years before assessment. Blood pressure declined over this time in the patients with probable dementia and was similar to that in non-demented subjects at the time of cognitive assessment. CONCLUSIONS: these preliminary data suggest that the high rate of dementia found in older people with diabetes may be explained by the high rate of hypertension in this population.     

Forced expiratory volume in 1 second and cognitive aging in men

OBJECTIVES: To evaluate forced expiratory volume in 1 second (FEV₁, a measure of overall lung function), long‐term average FEV₁, and rate of decline in FEV₁ in relation to cognition and cognitive decline in older men. DESIGN: Prospective observational study. SETTING: Community‐based population. PARTICIPANTS: Eight hundred sixty‐four older men from the Normative Aging Study. MEASUREMENTS: Starting in 1984, participants underwent triennial clinical evaluations. Lung function assessments provided estimates of FEV₁. Cognitive assessments entailing tests of several cognitive abilities began in 1993. FEV₁ measured approximately 12 years before baseline cognitive testing, average FEV₁ over the 12‐year period, and rate of change in FEV₁ were all evaluated in relation to baseline and change in performance on the cognitive tests. RESULTS: In multivariable‐adjusted analyses, associations between FEV₁ and baseline cognitive scores were mixed, although average FEV₁ predicted significantly better performance on tests of visuospatial ability (P=.04) and general cognition (P=.03). Higher FEV₁ was more consistently associated with slower cognitive decline, but only the association between historical FEV₁ and attention was significant (difference per standard deviation in FEV₁=0.056, P=.05). Rate of FEV₁ decline was not consistently associated with cognitive function or decline. Findings were generally similar or stronger in men who had never smoked. To account for potential bias due to selective attrition, inverse probability of censoring weights were applied to the cognitive decline analyses, yielding slightly larger estimates; the inadequate prognostic power of the censoring models limited this approach. CONCLUSION: Overall, the data provide limited evidence of an inverse association between FEV₁ and cognitive aging.     

Monitoring progression in Alzheimer's disease.

OBJECTIVE: To compare several clinical methods of following change in Alzheimer's disease (AD) over time. DATA SOURCES: MEDLINE search (restricted to English language); bibliographies of pertinent articles or books. STUDY SELECTION: Studies included only if aim was to follow a cohort of AD patients; diagnosis of AD used DSM-III-R or NINCDS-ADRDA guidelines; techniques or scales used for serial assessment were well-established in terms of validity and reliability. DATA EXTRACTION: All 3 authors reviewed all studies cited and reached consensus about interpretation. RESULTS: Global instruments detect long term deterioration in AD and describe distinct through possibly artificial stages. Cognitive screening tests decline at a consistent rate for groups of AD patients but show considerable variability. Scales measuring activities of daily living (ADLs) need further study to determine annual rate of change. Instrumental ADLs decline early in AD and reach a floor before cognitive screening tests. Electrophysiologic or radiographic techniques do not necessarily change over time and are not superior to clinical methods for following AD. Variability in rate of cognitive change and prognosis in AD has not been adequately explained. CONCLUSIONS: Cognitive screening tests provide useful measures of rate of change in AD for clinical and therapeutic studies. Further studies should take advantage of longer follow-up and more sophisticated statistical techniques to optimize use of these measures.     

Non-valvular atrial fibrillation and cognitive decline: a longitudinal cohort study

OBJECTIVES: non-valvular atrial fibrillation (NVAF) is an established risk factor for thromboembolism and stroke. Small cross-sectional studies suggest associations between NVAF, silent cerebral infarction and decreased cognitive function. We compared change in cognitive function between patients with recent onset NVAF and controls 12 and 36 months after baseline assessment, and examined the impact of anti-thrombotic therapy. DESIGN: prospective longitudinal cohort study with follow-up at 12 and 36 months. SETTING: Sunderland and South Tyneside, North East of England. Participants: community-dwelling men and women aged over 60 with recently identified NVAF or in sinus rhythm, matched for age, sex and general practice (N = 362, 174 NVAF, 188 sinus rhythm). Participants were stratified for use of anti-thrombotic therapy. MEASUREMENTS: assessment included stroke risk factors and a comprehensive battery of neuropsychological tests. RESULTS: at 3 years, 74 cases and 86 controls remained, giving an attrition rate for cases (59%) versus controls (52%); p = 0.15. Analysis of change in cognitive function between baseline and follow-up at 12 and 36 months revealed no clinically important differences between cases and controls, nor between subgroups on aspirin, warfarin or neither. Age and other confounders did not influence the results. CONCLUSIONS: there was no association between overall cognitive decline and NVAF after 3 years' follow-up, nor any apparent effect of anti-thrombotic therapy. This is consistent with our baseline results, but conflicts with previous studies. Cognitive decline is probably multifactorial and any influence of NVAF was not identified in this study.     

Influence of level of activity on cognitive performance and cognitive plasticity in elderly persons

As a result of the rapid increase in the elderly population over recent decades, the analysis of factors influencing cognitive aging has become a focus of great interest for current research. In this area, numerous papers have indicated a relation between specific psychosocial variables and the level of activity and cognitive performance and plasticity in old age. This study aimed at testing a theoretical model, which establishes relations between level of activity, cognitive performance and cognitive plasticity in old age. In this study 176 elderly persons participated and were evaluated by means of a cognitive screening test, two cognitive plasticity evaluation tests and a questionnaire on the level of activity before and after retirement. A structural equation analysis was carried out on the data, which reveal significant relations between level of activity after retirement and cognitive performance and plasticity. Similarly, a significant relation is established between cognitive functioning and plasticity. The findings lend support to studies affirming that a high level of activity protects against cognitive decline and is related to cognitive plasticity in old age.     

Vision impairment and combined vision and hearing impairment predict cognitive and functional decline in older women

OBJECTIVES: To determine the association between vision and hearing impairment and subsequent cognitive and functional decline in community-residing older women. DESIGN: Prospective cohort study. SETTING: Four metropolitan areas of the United States. PARTICIPANTS: A total of 6,112 women aged 69 and older participating in the Study of Osteoporotic Fractures (SOF) between 1992 and 1994. MEASUREMENTS: Five thousand three hundred forty-five participants had hearing measured, 1,668 had visual acuity measured, and 1,636 had both measured. Visual impairment was defined as corrected vision worse than 20/40. Hearing impairment was defined as the inability to hear a tone of 40 dB or greater at 2,000 hertz. Participants completed the modified Mini-Mental State Examination and/or a functional status assessment at baseline and follow-up. Cognitive and functional decline were defined as the amount of decline from baseline to follow-up that exceeded the observed average change in scores by at least 1 standard deviation. RESULTS: About one-sixth (15.7%) of the sample had cognitive decline; 10.1% had functional decline. In multivariate models adjusted for sociodemographic characteristics and chronic conditions, vision impairment at baseline was associated with cognitive (odds ratio (OR)=1.78, 95% confidence interval (CI)=1.21-2.61) and functional (OR=1.79, 95% CI=1.15-2.79) decline. Hearing impairment was not associated with cognitive or functional decline. Combined impairment was associated with the greatest odds for cognitive (OR=2.19, 95% CI=1.26-3.81) and functional (OR=1.87, 95% CI=1.01-3.47) decline. CONCLUSION: Sensory impairment is associated with cognitive and functional decline in older women. Studies are needed to determine whether treatment of vision and hearing impairment can decrease the risk for cognitive and functional decline.     

The Mexican Cognitive Aging Ancillary Study (Mex-Cog): Study Design and Methods

ObjectiveDescribe the protocol sample and instruments of the Cognitive Aging Ancillary Study in Mexico (Mex-Cog). The study performs an in-depth cognitive assessment in a subsample of older adults of the ongoing Mexican Health and Aging Study (MHAS). The Mex-Cog is part of the Harmonized Cognitive Assessment Protocol (HCAP) design to facilitate cross-national comparisons of the prevalence and trends of dementia in aging populations around the world, funded by the National Institute on Aging (NIA).MethodsThe study protocol consists of a cognitive assessment instrument for the target subject and an informant questionnaire. All cognitive measures were selected and adapted by a team of experts from different ongoing studies following criteria to warrant reliable and comparable cognitive instruments. The informant questionnaire is from the 10/66 Dementia Study in Mexico.ResultsA total of 2,265 subjects aged 55-104 years participated, representing a 70% response rate. Validity analyses showed the adequacy of the content validity, proper quality-control procedures that sustained data integrity, high reliability, and internal structure.ConclusionsThe Mex-Cog study provides in-depth cognitive data that enhances the study of cognitive aging in two ways. First, linking to MHAS longitudinal data on cognition, health, genetics, biomarkers, economic resources, health care, family arrangements, and psychosocial factors expands the scope of information on cognitive impairment and dementia among Mexican adults. Second, harmonization with other similar studies around the globe promotes cross-national studies on cognition with comparable data. Mex-Cog data is publicly available at no cost to researchers.     

The joint effect of apolipoprotein E epsilon4 and MRI findings on lower-extremity function and decline in cognitive function

BACKGROUND: Cognitive decline and poor physical function are risk factors for disability in old age and may occur more often in subjects with the apolipoprotein E epsilon4 (ApoE-epsilon4) allele. The objective of this study was to investigate the joint effect of ApoE-epsilon4 and structural changes detected on MRI brain scans on cognitive decline and lower-extremity function. METHODS: Brain MRI (1.5 T), neuropsychological tests, and lower-extremity physical function tests were administered to World War II male veteran twins ages 69 to 80. Quantification of MRI scans used a previously published algorithm to segment brain images into total cerebral brain (TCB), cerebrospinal fluid (CSF), and white-matter hyperintensity (WMH) volumes. A short battery of physical performance tests was used to assess lower-extremity function. Ten-year changes in performance on the Mini-Mental State Exam (MMSE), the Benton Visual Retention Test (BVRT), and the Digit Symbol Substitution (DSS) test were used to assess cognitive decline. RESULTS: For the sample as a whole, the comparison of subjects by median split of total cerebral brain volume found that those with brain volumes below the median performed worse on tests of gait and balance (p < .01) and experienced greater cognitive decline on the MMSE and BVRT cognitive test batteries (both p < .01). In addition, subjects with WMH volumes above the median had poor performance on the standing balance tasks and experienced greater decline on the DSS test (p < .01). Stratified analyses revealed that the joint effect of radiological findings and the ApoE-epsilon4 allele on cognitive decline and lower-extremity function was often greater than that expected from the separate effects combined. CONCLUSIONS: We conclude that radiological findings in conjunction with ApoE-epsilon4 may single out a group at higher risk for dementia. We speculate that the observed interaction effect may be due to increased susceptibility to brain injury or impaired repair mechanisms in subjects with ApoE-epsilon4.     

Anxiety, cognitive performance, and cognitive decline in normal aging

A sample of 704 cognitively intact individuals (M age = 63.7 years) performed a battery of cognitive tests on as many as three occasions, at approximately 3-year intervals. The authors used random effects models to analyze cross-sectional relationships between cognitive performance and state anxiety and longitudinal relationships between cognitive change and neuroticism, after controlling for gender, age, and education. Cross-sectionally, higher state anxiety was associated with poorer performance on Wechsler Adult Intelligence Scale Synonyms, WIT III Analogies, Koh's Block Design, two measures of visual learning (Names and Faces and Thurstone's Picture Memory), and, for men, CVB-Scales Digit Span Test and Card Rotations. In longitudinal models, the main effects for neuroticism were significant for Block Design, Symbol Digit, and Names and Faces, but there were no significant interactions among neuroticism, gender, and time. These results provide some support for Eysenck's processing efficiency theory but none for neuroticism as a risk factor for cognitive decline in normal aging.     

The relationship between cognitive and physical performance: MacArthur Studies of Successful Aging

BACKGROUND: The relationship between change in cognitive and physical performance has yet to be fully understood. Because aging decreases the ability to learn new information while preserving more established knowledge, this article examines whether the association between change in cognitive and physical performance depends on the nature of the physical task. METHODS: Data from the MacArthur Research Network on Successful Aging Community Study--a longitudinal three-site, cohort study of high-functioning, disability-free Americans aged 70 to 79 in 1988 (reinterviewed in 1991 and 1995)--are used for this investigation. We examine the association between change in cognitive performance and two categories of physical performance: novel/attentional demanding physical tasks (e.g., standing on a single leg) or routine physical tasks (e.g., walking at a normal pace). Change in physical performance (over 7 years) is regressed on change in cognitive performance (over the same period) controlling for baseline cognitive ability, demographic factors, health status, and behavioral characteristics. RESULTS: The findings suggest that declines in cognitive performance are associated with declines in both novel/attentional demanding and routine physical tasks. In addition to decline in cognition, gender, prevalent health conditions (e.g., cancer, high blood pressure, and the fracture of a hip), and smoking behavior are associated with decline in performance on some physical tasks. CONCLUSIONS: The findings suggest that the successful execution of physical tasks demands cognitive processes regardless of the nature of the task. Researchers using performance-based measures of physical functioning should pay particular attention to the cognitive capacities of their subjects and how these might influence their assessment.