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  • 1
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Alzheimer Disease & Associated Disorders Vol. 33, No. 3 ( 2019-07), p. 240-245
    In: Alzheimer Disease & Associated Disorders, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. 3 ( 2019-07), p. 240-245
    Abstract: We hypothesized that higher quality of life would be associated with better cognitive function and a reduced risk of incident all cause dementia and Alzheimer disease (AD) in older adults. Materials and Methods: Participants included 1183 older adults with an average age of 78.2 (SD=5.3) from Einstein Aging Study. The 36-Item Short-Form Health Survey was used to measure health-related quality of life (HRQoL). We investigated baseline associations between the cognitive domains of memory, executive function, and general fluid ability with 8 subscales of the 36-Item Short-Form Health Survey (physical functioning, role limitations due to physical problems, bodily pain, general health perceptions, social functioning, role limitations due to emotional problems, vitality, and general mental health) and the 2 component summary scores of physical component summary (PCS) and mental component summary (MCS). Next, we used Cox proportional hazard models to assess the predictive validity of HRQoL subscales for the onset of incident dementia and incident AD. Results: At baseline, higher scores (better HRQoL) on MCS and its 4 subscales (social functioning, role limitations due to emotional problems, vitality, and general mental health) were associated with higher performance on both memory and executive function domains. Higher scores in role limitation due to physical problems, role limitation due to emotional problems, and general mental health subscales were associated with reduced risk of incident dementia. Higher MCS, but not PCS, predicted a reduced incident of all-cause dementia and AD. Conclusions: These findings suggest that diminution of HRQoL precedes the onset of diagnosable dementia and may be useful in the prediction of dementia onset.
    Type of Medium: Online Resource
    ISSN: 0893-0341
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2048789-7
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  • 2
    In: Alzheimer's & Dementia, Wiley, Vol. 14, No. 7S_Part_28 ( 2018-07)
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2201940-6
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  • 3
    In: Alzheimer's & Dementia, Wiley, Vol. 14, No. 7S_Part_25 ( 2018-07)
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2201940-6
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  • 4
    In: Current Alzheimer Research, Bentham Science Publishers Ltd., Vol. 16, No. 2 ( 2019-02-04), p. 109-115
    Abstract: Chronic pain is common among older adults and is associated with cognitive dysfunction based on cross-sectional studies. However, the longitudinal association between chronic pain and incident dementia in community-based samples is unknown. Objective: We aimed to evaluate the association of pain intensity and pain interference with incident dementia in a community-based sample of older adults. Methods: Participants were 1,114 individuals 70 years of age or older from Einstein Aging Study (EAS), a longitudinal cohort study of community-dwelling older adults in the Bronx County, NY. The primary outcome measure was incident dementia, diagnosed using DSM-IV criteria. Pain intensity and interference in the month prior to first annual visit were measured using items from the SF-36 questionnaire. Pain intensity and pain interference were assessed as predictors of time to incident dementia using Cox proportionate hazards models while controlling for potential confounders. Results: Among participants, 114 individuals developed dementia over an average 4.4 years (SD=3.1) of follow-up. Models showed that pain intensity had no significant effect on time to developing dementia, whereas higher levels of pain interference were associated with a higher risk of dementia. In the model that included both pain intensity and interference as predictors of incident dementia, pain interference had a significant effect on incident dementia, and pain intensity remained non-significant. Conclusion: As a potential remediable risk factor, the mechanisms linking pain interference to cognitive decline merit further exploration.
    Type of Medium: Online Resource
    ISSN: 1567-2050
    Language: English
    Publisher: Bentham Science Publishers Ltd.
    Publication Date: 2019
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  • 5
    In: Journal of the American Geriatrics Society, Wiley, Vol. 65, No. 8 ( 2017-08), p. 1836-1841
    Abstract: To examine the association between vascular pathology and rate of cognitive decline in older adults independent of Alzheimer's disease ( AD ) pathology. Design Prospective cohort study. Setting Community sample. Participants Individuals from the Einstein Aging Study autopsy series (N = 62). Measurements The Blessed Information‐Memory‐Concentration ( BIMC ) test was used to assess global cognitive status. AD pathology was quantified according to Braak stage ( 〈 3 vs ≥ 3). Vascular pathology was quantified using a previously reported macrovascular lesion ( MVL ) score. The association between vascular pathology and antemortem rates of cognitive decline adjusted for level of AD pathology was assessed using linear mixed‐effects models. Results Mean age was 81.8 at enrollment and 89.0 at death. Participants with more than two MVL s had faster cognitive decline than those with no MVL s (difference in annual rate of change in BIMC 0.74 points/yr, P  = .03). Braak stage was also associated with cognitive decline (difference 0.57 points/yr, P  = .03). The difference in rate of cognitive decline between those with more than two MVL s and those free of vascular lesions persisted after adjustment for AD pathology (difference in rate of change in BIMC 0.68 points/yr, P  = .04). The effect of vascular pathology on cognitive decline was not significantly different according to AD pathology. Conclusion Vascular brain pathology is associated with rate of cognitive decline after adjusting for level of AD pathology.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2040494-3
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  • 6
    In: Alzheimer's & Dementia, Wiley, Vol. 11, No. 7S_Part_14 ( 2015-07)
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2201940-6
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  • 7
    Online Resource
    Online Resource
    SAGE Publications ; 2019
    In:  Journal of Geriatric Psychiatry and Neurology Vol. 32, No. 2 ( 2019-03), p. 97-103
    In: Journal of Geriatric Psychiatry and Neurology, SAGE Publications, Vol. 32, No. 2 ( 2019-03), p. 97-103
    Abstract: There is increasing evidence that depressive symptoms are associated with increased risk of cognitive impairment and dementia in older adults. In current study, we aimed to investigate the effect of depressive symptoms on incident Alzheimer disease and all-cause dementia in a community sample of older adults. Methods: Participants were 1219 older adults from the Einstein Aging Study, a longitudinal cohort study of community-dwelling older adults in Bronx County, New York. The Geriatric Depression Scale (GDS, 15-item) was used as a measure of depressive symptoms. The primary outcome was incident dementia diagnosed using the Diagnostic and Statistical Manual, Fourth Edition, criteria. Cox proportional hazard models were used to estimate the risk of incident dementia as a function of GDS score for the whole population and also for 2 different time intervals, 〈 3 years and ≥3 years after baseline assessment. Results: Among participants, 132 individuals developed dementia over an average 4.5 years (standard deviation [SD] = 3.5) of follow-up. Participants had an average age of 78.3 (SD = 5.4) at baseline, and 62% were women. Among all participants, after controlling for demographic variables and medical comorbidities, a 1-point increase in GDS was associated with higher incidence of dementia (hazard ratio [HR] = 1.11, P = .007). After up to 3 years of follow-up, depressive symptoms were not significantly associated with dementia incidence (HR = 1.09; P = .070). However, after more than 3 years, GDS score was a significant predictor of incident dementia (HR = 1.13, P = .028). Conclusions: Our results suggest that depressive symptoms are associated with an increased risk of incident dementia in older adults.
    Type of Medium: Online Resource
    ISSN: 0891-9887 , 1552-5708
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2094096-8
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  • 8
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Alzheimer Disease & Associated Disorders Vol. 30, No. 2 ( 2016-04), p. 93-98
    In: Alzheimer Disease & Associated Disorders, Ovid Technologies (Wolters Kluwer Health), Vol. 30, No. 2 ( 2016-04), p. 93-98
    Abstract: Stress is a potentially remediable risk factor for amnestic mild cognitive impairment (aMCI). Our objective is to determine whether perceived stress predicts incident aMCI and to determine if the influence of stress on aMCI is independent of known aMCI risk factors, particularly demographic variables, depression, and apolipoprotein genotype. The Einstein Aging Study is a longitudinal community-based study of older adults. The Perceived Stress Scale (PSS) was administered annually in the Einstein Aging Study to participants (N=507; 71 developed incident aMCI; mean follow-up time=3.6 y, SD=2.0) who were aged 70 years and older, free of aMCI and dementia at baseline PSS administration, and had at least 1 subsequent annual follow-up. Cox hazard models were used to examine time to aMCI onset adjusting for covariates. High levels of perceived stress are associated with a 30% greater risk of incident aMCI (per 5-point increase in PSS: hazard ratio=1.30; 95% confidence interval, 1.08-1.58) independent of covariates. The consistency of results after covariate adjustment and the lack of evidence for reverse causation in longitudinal analyses suggest that these findings are robust. Understanding of the effect of perceived stress on cognition may lead to intervention strategies that prevent the onset of aMCI and Alzheimer dementia.
    Type of Medium: Online Resource
    ISSN: 0893-0341
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2048789-7
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  • 9
    Online Resource
    Online Resource
    Wiley ; 2017
    In:  Journal of the American Geriatrics Society Vol. 65, No. 12 ( 2017-12), p. 2659-2664
    In: Journal of the American Geriatrics Society, Wiley, Vol. 65, No. 12 ( 2017-12), p. 2659-2664
    Abstract: To determine whether transcranial Doppler ultrasound ( TCD ) measures of mean blood flow velocity ( MBFV ) in the major cerebral arteries are associated with measures of lower extremity function in community‐dwelling older adults. Design Cross‐sectional study. Setting Community sample. Participants Individuals aged 70 and older (mean 79.5, 54% female) without dementia participating in the Einstein Aging Study (N = 200). Measurements All participants underwent TCD assessments and tests of lower extremity function at an annual clinic visit. Average MBFV for anterior (left and right anterior and middle cerebral arteries ( MCA s)) and posterior (vertebral ( VA ) and basilar ( BA ) artery) circulation was measured using a standardized TCD protocol. Lower extremity function was characterized according to gait speed (cm/s) measured using an instrumented walkway, balance according to unipedal stance time ( UPST , seconds), and lower extremity strength according to timed repeated chair rise (seconds). Results Multiple regression models adjusted for age, sex, race, education, and medical comorbidities showed that lower MBFV in the MCA was associated with slower gait speed and chair rise time but not with UPST . Ordinal regression models showed that lower MBFV in the VA and BA is associated with shorter UPST . Conclusion Low MBFV in the anterior and posterior cerebral circulation was associated with worse lower extremity function and balance in older adults. This might be indicative of the importance of age‐related changes in cerebral hemodynamics in the function of brain regions involved in specific aspects of physical performance.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2040494-3
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