Neuroinflammation and Cognitive Aging

Cognitive aging describes the changes in mental abilities that occur with increasing age. Although experts disagree on the core underlying processes involved, one factor that links many factors associated with cognitive aging is neuroinflammation. Markers of inflammation are associated directly with deficits in cognitive function and with diseases that are risk factors for cognitive decline. Neuroinflammation is also associated with depression and may account for the complex interaction of depression and cognition in older adults. Interventions that reduce inflammation may improve cognition. Understanding how neuroinflammation affects cognition may provide directions for useful interventions to prevent or treat cognitive decline in older adults.     

慢性失眠症的团体认知行为疗法

慢性失眠症主要治疗手段包括药物治疗与认知行为治疗。传统的失眠症个体认知行为治疗需要连续4~8周的会谈,疗程长,花费高,专业治疗师数量少,难以有效、完整地实施。失眠的团体认知行为治疗由临床医生、心理治疗师等带领,采取治疗小组或大型工作坊形式进行集中的团体治疗,提供了一种成本-效益更高的选择。文中就团体认知行为治疗的机制与技术、疗效对比、优缺点、改良方案与发展趋势进行综述。     

心理生理性失眠伴发情绪障碍与抑郁性失眠多导睡眠图分析

目的：探讨心理生理性失眠与抑郁性失眠多导睡眠图（PSG）特点。方法：选择收治的75例慢性失眠症患者（其中心理生理性失眠39例和抑郁性失眠症36例），停用镇静药物后，在适宜条件的实验室中给予整夜多导睡眠图监测。结果：抑郁性失眠组与心理生理性失眠组相比，其快速动眼期（REM）潜伏期和非快速动眼期（NREM）百分比降低，快动眼百分比增加。结论：心理生理性失眠患者PSG无特殊表现，抑郁性失眠患者PSG呈现快动眼睡眠活跃的特征。     

Analyzing Connections Between User Attributes,Images, and Text

Cognitive Computation - This work explores the relationship between a person’s demographic/psychological traits (e.g., gender and personality) and self-identity images and captions. We use a...     

Aging and Positive Mood: Longitudinal Neurobiological and Cognitive Correlates

ObjectiveDespite the losses commonly associated with aging, older adults seem to possess particularly preserved emotional regulation. To further understand this phenomenon, the authors examined longitudinal trajectories between age, depressive symptoms, brain structure, and cognition.MethodsSeven hundred and sixteen functionally intact older adults (age M = 67.9, 56.8% female), followed longitudinally (visit range: 1–13, M = 2.5), completed cognitive testing and the Geriatric Depression Scale (GDS). A subset (N = 327) underwent 3T brain MRI. Mixed-effects linear regression models were conducted controlling for sex, education, and total intracranial volume.ResultsThere was a significant interaction between age and time on GDS, such that GDS improved with increasing age over time, but attenuated around age 71 (age*time b = 0.10, p <0.001). Fractional anisotropy (FA) and mean diffusivity interacted with age to predict longitudinal changes in GDS (FA: b = -0.02, p = 0.01; MD: b = 0.03, p = 0.007), such that age-related benefits on GDS were attenuated in those with declining FA. Executive function (EF) and processing speed also interacted with age to predict longitudinal changes in GDS (EF: b = -0.04, p = 0.03; speed: b = 0.04, p = 0.04). Again, the positive effect of age on GDS attenuated in those with worsening EF and speed. There were no associations with memory, semantic fluency, or gray matter (p values >0.05).ConclusionEF, processing speed, and white matter integrity moderated the longitudinal relationship between age and mood. Previous studies demonstrate the link between positivity and better cognitive control, leading to improved mood in older adults. Our results are not only consistent, but establish a potential neurobiological correlate. Future research further exploring biological mechanisms driving psychological processes may have important therapeutic implications.     

Practice Effects and Longitudinal Cognitive Change in Normal Aging vs. Incident Mild Cognitive Impairment and Dementia in The Mayo Clinic Study of Aging

The objective of this study was to examine practice effects and longitudinal cognitive change in a population-based cohort classified as clinically normal at their initial evaluation. We examined 1390 individuals with a median age of 78.1 years and re-evaluated them up to four times at approximate 15-month intervals, with an average follow-up time of 5 years. Of the 1390 participants, 947 (69%) individuals remained cognitively normal, 397 (29%) progressed to mild cognitive impairment (MCI), and 46 (3%) to dementia. The stable normal group showed an initial practice effect in all domains which was sustained in memory and visuospatial reasoning. There was only a slight decline in attention and language after visit 3. We combined individuals with incident MCI and dementia to form one group representing those who declined. The incident MCI/dementia group showed an unexpected practice effect in memory from baseline to visit 2, with a significant decline thereafter. This group did not demonstrate practice effects in any other domain and showed a downward trajectory in all domains at each evaluation. Modeling cognitive change in an epidemiologic sample may serve as a useful benchmark for evaluating cognitive change in future intervention studies.     

Reproductive History and Cognitive Aging: The Bogalusa Heart Study

BackgroundAlthough it has become increasingly clear that pregnancy-related health predicts later-life cardiometabolic health, the relationship between reproductive history and cognitive health is less frequently studied. Although some research has identified associations between parity or hypertensive disorders of pregnancy and cognitive changes, the evidence is mixed.ObjectiveTo examine the association between reproductive history and midlife cognition in a community-based population.Study designSeven hundred and thirty midlife women in the Bogalusa Heart Study completed a brief cognitive battery (memory, attention, executive function, and processing speed) and were interviewed about their reproductive history. Reproductive history (parity, age at first pregnancy, and breastfeeding) and pregnancy complications (low birthweight, preterm birth, hypertensive disorders, and miscarriage) were examined as predictors of cognitive function, with adjustment for potential confounders.ResultsNulliparous women had an overall lower cognitive score (adjusted beta −1.50, standard error [SE]: 0.41). Adolescent birth was associated with a somewhat better performance on the Trail Making Test (beta −0.31, SE: 0.15 for birth <16 years), while high parity was not strongly associated with any of the cognitive measures. History of pregnancy complications was not strongly associated with cognitive function, whereas history of miscarriage was associated with better cognitive function, as was a history of breastfeeding (beta overall score 0.90, SE: 0.29), particularly noticeable for semantic memory and in those with more total breastfeeding time (beta for overall score among those with >24 weeks lifetime breastfeeding, beta 1.21, SE: 0.44).ConclusionNulliparity and breastfeeding are associated with midlife cognition in women. Future studies should examine possible mechanisms by which these associations are created.     

Insomnia in patients with chronic tinnitus: Cognitive and emotional distress as moderator variables

IntroductionTinnitus is often associated with disturbed sleep, but there are also patients without sleep problems. The mechanisms for developing insomnia or not in tinnitus patients are still unknown. The aim of the present study was to extract possible tinnitus specific factors that increase the risk of developing insomnia based on the analysis of a large patient cohort suffering from chronic tinnitus.Method173 patients presenting at the multidisciplinary tinnitus center of a University Hospital completed a questionnaire measuring specific psychological symptoms of insomnia (RIS) and a tinnitus questionnaire (TQ). The scores of all ten RIS items were compared between tinnitus patients and 94 healthy individuals by separate ANOVAs in order to specify the extent of insomnia specific symptoms in the tinnitus group. In a second step a multiple linear regression analysis was performed in the tinnitus sample with subscales of the TQ (excluding the TQ sleep scale), age and duration of tinnitus as independent variables and the RIS score as the dependent variables.ResultsTinnitus patients differed from healthy controls not only in impaired sleep quality but also in insomnia specific concerns and anxiety. Tinnitus related emotional and cognitive distress and somatic complaints correlated with severity of insomnia, whereas no association of age or duration of tinnitus with severity of insomnia was found.ConclusionOur results suggest that chronic tinnitus patients have more sleeping difficulties and associated worries about sleep or negative emotions in contrast to healthy controls. Tinnitus-related distress is related to insomnia     

Cognitive measures in the Canadian Longitudinal Study on Aging

Objective: We describe the implementation of cognitive measures within the Canadian Longitudinal Study on Aging (CLSA), a nationwide, epidemiological study of aging, and relate CLSA Tracking cohort data (n over 20,000) to previous studies using these measures.Method: CLSA participants (aged 45–85, n over 50,000) provided demographic, social, physical/clinical, psychological, economic, and health service utilization information relevant to health and aging through telephone interviews (Tracking cohort, n over 20,000) or in-person (i.e. Comprehensive cohort, n over 30,000) in both official languages (i.e. English, French). Cognitive measures included: the Rey Auditory Verbal Learning Test (RAVLT) – Trial 1 and five-minute delayed recall; Animal Fluency (AF), the Mental Alternation Test (MAT) (both cohorts); Controlled Oral Word Association Test, Stroop Test, Prospective Memory Test, and Choice reaction times (Comprehensive Cohort).Results: Performance on the RAVLT Trial 1 and AF were very similar to comparable groups studied previously; CLSA sample sizes were far larger. Within the CLSA Tracking cohort, main effects of age and language were observed for all cognitive measures except RAVLT delayed recall. Interaction effects (language × age) were observed for AF.Conclusion: This preliminary examination of the CLSA Tracking cognitive measures lends support to their use in large studies of aging. The CLSA has the potential to provide the ‘best’ comparison data for adult Canadians generated to date and may also be applicable more broadly. Future studies examining relations among the psychological, biological, health, lifestyle, and social measures within the CLSA will make unique contributions to understanding aging.     

Racial/Ethnic Differences in Correspondence Between Subjective Cognitive Ratings and Cognitive Impairment

ObjectivesResponding to racial/ethnic disparities in dementia diagnosis and care, we examined the role of race/ethnicity in the correspondence between subjective and objective ratings of cognitive impairment. Our examination focused on the two types of discordance: (1) positive ratings in the presence of cognitive impairment and (2) negative ratings in the absence of cognitive impairment.Design and ParticipantsA cross-sectional assessment was conducted using the data from the Harmonized Cognitive Assessment Protocol project, a sub-study of the Health and Retirement Study. Our analytic sample included 3,096 participants: 2,257 non-Hispanic Whites, 498 Blacks, and 341 Hispanics.MeasurementsDiscordant groups were identified based on self-ratings of cognition (positive versus negative) and the Langa–Weir classification of cognitive impairment (normal versus impaired).ResultsBlacks and Hispanics were more prone to falsely positive perceptions of their cognitive function in the presence of cognitive impairment than non-Hispanic Whites. On the other hand, non-Hispanic Whites were more likely to manifest negative ratings even in the absence of cognitive impairment.ConclusionOur findings demonstrate the critical role of race/ethnicity in determining discordance between subjective and objective measures of cognition and highlight the importance of a tailored effort to promote dementia diagnosis and care.     

Mediation Effect of Insomnia Symptoms on Relation Between Stress and Quality of Life

Objective Among various causes of insomnia, stress is the most common and representative cause. Insomnia is also known to negatively affect the quality of life (QoL). The objective of this study was to explore the effect of stress on QoL and the mediating role of insomnia symptoms in the relationship between stress and QoL. Methods In this study, the mediating effect of insomnia symptoms on the relationship between stress and QoL was analyzed by enrolling 3,714 participants from the Ansung and Ansan cohorts of the Korea Association Resource project from 2001 to 2004. These cohort participants were asked about how much they felt stressed during their everyday life. Insomnia symptoms were evaluated by asking participants whether they had trouble sleeping such as difficulty in falling asleep, disrupted sleep, and early morning awakening due to the lack of a validated questionnaire for this cohort. QoL was evaluated using the World Health Organization QoL Scale Brief Version. Results In total, stress was positively associated with insomnia symptoms, which in turn predicted QoL. The same result could be derived from subgroup analysis according to sex, and it was confirmed that insomnia symptoms acted as a mediating factor more significantly in female than in male. Conclusion In this study, insomnia symptoms were confirmed to act as a significant mediating factor between stress and QoL, suggesting that insomnia symptoms should be actively identified and controlled to alleviate the negative effect of stress on QoL in clinical practice.     

血浆同型半胱氨酸与腔隙性脑梗死及认知功能关系

目的:探讨血浆同型半胱氨酸(Hcy)与腔隙性脑梗死的关系以及对认知功能的影响。方法:选取112例腔隙性脑梗死患者及50名健康对照者,检测血浆Hcy水平以及简易智能精神状态检查表(MMSE)评分。结果:①Hcy水平腔隙性脑梗死组明显高于对照组(P<0.05);②Logistic回归证实Hcy水平升高是腔隙性脑梗死的独立危险因素,OR为1.212;③Hcy水平与MMSE分值呈负相关(r=-0.552,P<0.001);④多元线性回归分析得出腔隙性脑梗死患者MMSE分数=45.771-7.314×logHcy-0.171×年龄。结论:血浆Hcy水平升高是腔隙性脑梗死的独立危险因素,对认知功能有独立的影响。