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  • 1
    In: Alzheimer's & Dementia, Wiley, Vol. 16, No. S10 ( 2020-12)
    Abstract: Fewer than half of all U.S. adults achieve recommended levels of aerobic activity (150 minutes or more at moderate intensity) (CDC, 2013; USDHHS, 2018). Information related to frequency, dose, duration, and intensity of walking needed to positively impact cognitive function in older adults remains unclear in current U.S. Physical Activity Guidelines (Piercey et al., 2018; Paterson et al., 2010). A paucity of studies have been conducted which examine the association between physical activity (PA), much less PA types, and cognitive function, using a longitudinal, population‐based approach with a racially diverse sample, which limits generalizability of existing findings. Self‐report PA measures often evaluate types of walking separately (e.g., walking for exercise, leisure time, occupational, transportation‐related), without considering total effect of all types of walking on cognitive function. A composite walking measure could provide a more comprehensive picture of perceived daily walking. We examine the association between composite walking and cognitive function and perceptual speed among participants in the Chicago Health and Aging Project (CHAP) over time. Method CHAP is a longitudinal, population‐based study, which examined risk factors of Alzheimer’s Disease and chronic conditions among diverse older adults (Bienas et al., 2003). Data collection included self‐report walking frequency and duration, demographics, chronic conditions, cognitive activities, APOE ϵ4, and cognitive function during three‐year cycles. A composite walking measure was developed. Composite walking was divided into three categories determined by sample size: no walking, 〈 105 minutes/ week, and 〉 105 minutes/ week of walking. Mixed effects regression analyses were conducted to test the association between walking and cognitive function and perceptual speed. Result The sample consists of N=4,320 CHAP participants (Black/ African American: 65%; Female: 65%; Mean Education: 13 years; Mean Age: 75 years). Findings show that composite walking had a statistically significant association with global cognitive function (category 2 β=.0084, p=.0389; category 3 β=.0099, p=.0187) and perceptual speed (category 2 β=.0117, p=.0164; category 3 β=.0162, p=.0013), after controlling for covariates. Conclusion Although it is best to follow PA guidelines, walking for lesser than the recommended amount may still be beneficial for cognitive function, which is useful for promotion of PA among sedentary older adults.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2201940-6
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  • 2
    In: Alzheimer's & Dementia, Wiley, Vol. 17, No. 2 ( 2021-02), p. 255-270
    Abstract: Non‐pharmacological treatments (NPTs) have the potential to improve meaningful outcomes for older people at risk of, or living with dementia, but research often lacks methodological rigor and continues to produce mixed results. Methods In the current position paper, experts in NPT research have specified treatment targets, aims, and ingredients using an umbrella framework, the Rehabilitation Treatment Specification System. Results Experts provided a snapshot and an authoritative summary of the evidence for different NPTs based on the best synthesis efforts, identified main gaps in knowledge and relevant barriers, and provided directions for future research. Experts in trial methodology provide best practice principles and recommendations for those working in this area, underscoring the importance of prespecified protocols. Discussion We conclude that the evidence strongly supports various NPTs in relation to their primary targets, and discuss opportunities and challenges associated with a unifying theoretical framework to guide future efforts in this area.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
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  • 3
    In: Alzheimer's & Dementia, Wiley, Vol. 17, No. 7 ( 2021-07), p. 1157-1165
    Abstract: It is unclear whether eating Western diet food components offsets the Mediterranean diet's (MedDiet) potential benefits on cognitive decline. Methods The study includes 5001 Chicago Health and Aging Project participants (63% African American, 36% males, 74 ± 6.0 years old), with food frequency questionnaires and ≥ two cognitive assessments over 6.3 ± 2.8 years of follow‐up. Mixed‐effects models were adjusted for age, sex, education, race, cognitive activities, physical activity, and total calories. Results Stratified analysis showed a significant effect of higher MedDiet on cognitive decline only with a low Western diet score (highest vs lowest MedDiet tertile: β = 0.020, P  = .002; p trend = 0.002) and not with a high Western diet score (highest vs lowest MedDiet tertile: β = 0.010, P  = .11; p trend = 0.09). Conclusion This prospective study found that high consumption of Western diet components attenuates benefits of the MedDiet on cognition.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
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  • 4
    In: Alzheimer's & Dementia, Wiley, Vol. 15, No. 7S_Part_8 ( 2019-07)
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    Language: English
    Publisher: Wiley
    Publication Date: 2019
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  • 5
    In: Alzheimer's & Dementia, Wiley, Vol. 15, No. 7S_Part_4 ( 2019-07)
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    Language: English
    Publisher: Wiley
    Publication Date: 2019
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  • 6
    In: Alzheimer's & Dementia, Wiley, Vol. 16, No. S10 ( 2020-12)
    Abstract: Few older adults are able to achieve recommended levels of moderate‐vigorous physical activity despite known cognitive benefits. Alternatively, small movements, such as increasing movement while standing during usual tasks, can easily be integrated into daily routines by older adults. However, standing activity is best assessed with specific devices (i.e., seismic accelerometers). No existing study of older adults has examined the impact of device‐measured standing activity on cognition. Therefore, the purpose of this secondary analysis is to examine the association between standing activity (as measured by a seismic accelerometer) and cognition in cognitively healthy older adults. Method Participants were 98 cognitively healthy adult participants aged 65 years or older with family history of dementia from the ongoing MIND trial (NCT02817074), which tests the effects of a 3‐year diet intervention on cognitive decline. Exclusion criteria included diagnosis or symptoms of mild cognitive impairment or dementia. Linear regression analyses tested cross‐sectional associations between standing intensity and cognition. Standing activities were mean intensity of standing and static activities (sum of standing and shuffling) assessed by the MoveMonitor+ accelerometer/gyroscope. Cognition was composed of 4 cognitive domains constructed from 12 cognitive performance tests. Result Participants were on average 69.7 years old ( SD =3.7), 69.4% women, and 73.5% had a college degree or higher. Both higher mean intensity of standing activity and static activity were significantly associated with higher levels of executive functioning and perceptual speed in models adjusted for age, gender, and education. Each log unit increase in standing activity intensity was associated with 0.77 units higher of executive function ( p =.041), and 0.85 units higher of perceptual speed ( p =.032). For static activities, significant log unit increases were 0.86 ( p =.009) for executive function and 0.96 ( p =.006) for perceptual speed. When we additionally adjusted for time spent in moderate‐vigorous physical activity and cognitive activity, the positive associations between higher intensity of standing and static activity and perceptual speed remained. Conclusion These findings suggest the importance of considering intensity of standing activity in cognition. The relationships should be further explored in longitudinal analyses and interventions that incorporate small changes to daily routines in addition to promoting moderate‐vigorous physical activity.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2201940-6
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  • 7
    In: Alzheimer's & Dementia, Wiley, Vol. 16, No. S10 ( 2020-12)
    Abstract: While prevention trials are recruiting individuals at high risk of dementia, including those who are genetically predisposed, it has become uncertain whether these interventions, in particular, lifestyle factors can lessen the increased genetic risk. We investigated whether the association between lifestyle factors and cognitive decline differed as a function of APOE4 status in an elderly population. Method Using data from the Chicago Health and Aging Project, a population‐based cohort study, we defined a healthy lifestyle score based on non‐smoking, 〉 =150 min/week moderate/vigorous physical activity, light‐to‐moderate alcohol consumption, high‐quality MIND diet, and engagement in late‐life cognitive activities, yielding an overall composite score that ranged from 0 to 5. Global cognitive function was assessed using brief tests of episodic memory, executive function, and the MMSE in approximately 3‐year cycles for over 18‐years. We examined the association of adherence to lifestyle factors with cognitive decline separately in those with and without APOE4 using a linear mixed effect model adjusted for age, sex, education, race, cardiovascular disease, time, and their interactions with time. Result Of 3,886 older adults included in the study, 1,269 (33%) were APOE4 carriers. Compared to non‐carriers, APOE4 carriers were younger (71y vs. 72y; p 〈 0.001), mostly African American (68% vs. 57%; p 〈 0.001), and had a lower global cognitive score at baseline (0.37 vs. 0.43; p=0.01). In the multivariable‐adjusted model, a higher healthy lifestyle (4‐5 healthy lifestyle factors versus 0‐1 factor) was associated with a slower rate of cognitive decline in both carriers (beta=0.029; p 〈 0.001) and non‐carriers (beta=0.011; p=0.013). However, when we created a propensity score‐matching sample where groups with and without APOE4 were not different concerning age, gender, race, education, baseline global cognitive score, and sample size, these associations differed by APOE4 status. In the matched sample, adherence to a healthy lifestyle was not associated with a cognitive decline in non‐APOE4 carriers (beta=0.002; p=0.763) but remained significant in APOE4 carriers (beta=0.046; p 〈 0.001). Conclusion A healthy lifestyle should be promoted to everyone, especially to individuals with a genetic predisposition for Alzheimer’s dementia.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2201940-6
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  • 8
    In: Alzheimer's & Dementia, Wiley, Vol. 16, No. S2 ( 2020-12)
    Abstract: Copper (Cu) is an essential metal for brain health. Limited studies reported no association of plasma Cu and inverse association of Cu in human hair with cognitive abilities in older adults. However, no study investigated the association of Cu levels in the human brain with the long‐term change in cognitive functioning before death. Thus, we aim to examine the association of brain Cu with cognitive decline in a community‐based cohort study. Method Using data from 625 deceased participants from the Rush Memory and Aging Project. Brain copper levels were measured using ICP‐MS in gray matter from inferior temporal, mid frontal, anterior cingulate, and cerebellum. Composite global cognition and specific domains were derived from z‐scores of a 19‐panel cognitive tests that were performed annually for up to 14 years proximate to death. We used linear mixed‐effects models to examine associations of Cu (grouped in tertiles) in the brain with cognitive decline. All the models were controlled for age at death, sex, education, late‐life cognitive activity, physical activity, smoking, and APOE‐ɛ4 status. Result The mean age at first cognitive assessment was 82.7 (±5.8) years, 71% were women, and 25% carried an APOE‐ɛ4 allele. Participants in the highest and the middle tertile of Brain Cu in the inferior temporal region had a slower annual rate of cognitive decline (T3 vs. T1:β= 0.027; T2 vs. T1: β= 0.032; p for trend= 0.007). Similar associations were found for specific domains, including episodic memory (T3 vs. T1: β= 0.027; T2 vs. T1: β= 0.033; p for trend= 0.03), semantic memory ((T3 vs. T1:β= 0.040; T2 vs. T1: β= 0.050; p for trend= 0.001) and perceptual speed (T3 vs. T1:β= 0.024; T2 vs. T1: β= 0.035; p for trend= 0.03). Concentrations of Cu in the other brain regions were not associated with cognitive decline. Conclusion The association of higher brain copper levels in the vulnerable region of Alzheimer’s disease, such as the inferior temporal region with slower cognitive decline, supports the role of copper dyshomeostasis in the disease process.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2201940-6
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  • 9
    In: Alzheimer's & Dementia, Wiley, Vol. 16, No. S2 ( 2020-12)
    Abstract: Copper (Cu) is an essential element for brain health. There is increasing recognition that altered Cu homeostasis is related to the development of Alzheimer’s disease (AD). Neuropathologic findings of amyloid plaque and neurofibrillary tangles are the hallmarks of Alzheimer's disease process. Whether brain Cu is associated with AD neuropathology in humans is unknown. This study examines the relationship between brain Cu levels and AD neuropathology in autopsies from a community sample of older adults. Method The study was conducted in 679 deceased participants from the Rush Memory and Aging Project, a cohort study. Brain Cu levels were measured using ICP‐MS in gray matter from inferior temporal, mid frontal, anterior cingulate, and cerebellum. Diffuse and neuritic plaques and neurofibrillary tangles were assessed in multiple brain regions and summarized as standard measures of AD pathology, including Braak, CERAD, NIA‐Reagan, global AD pathology. Linear regression analyses were used to evaluate the associations of brain Cu (grouped in tertiles) with the AD pathology in models controlled for age at death, sex, education, and APOE‐ ε 4 status. Result The mean age at death was 90.2 (±6.2) years, 70% were women, and 25% carriers of the APOE4 allele. Higher brain Cu levels were associated with less AD neuropathology. Participants in the middle and highest tertile of overall brain Cu levels had less global AD pathology (T3 vs. T1:β = ‐0.10; T2 vs. T1 = ‐0.11; p trend = 0.007) and Braak stage (T3 vs. T1: β = ‐0.31; T2 vs. T1 = ‐0.22; p trend = 0.005) when compared to those in the lowest tertile. Similar associations were found between inferior temporal brain Cu levels and AD neuropathology: global AD pathology (T3 vs. T1: β = ‐0.17, p =  〈 0.0001); Braak (T3 vs. T1: β = ‐0.42, p = 0.0001); CERAD (T3 vs. T1: β = ‐0.17, p = 0.008); NIA‐Reagan (T3 vs. T1: β = ‐0.21, p = 0.002)). Brain Cu levels in mid‐frontal and cerebellum had a marginal association, whereas anterior cingulate Cu levels had no association with AD neuropathology. Conclusion Higher brain copper levels are associated with fewer AD neuropathology, suggesting that brain Cu levels either may reflect the severity of the disease or may indicate its potential beneficial effect on the disease process.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2201940-6
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  • 10
    In: Alzheimer's & Dementia, Wiley, Vol. 16, No. S4 ( 2020-12)
    Abstract: Cortical thickness has been associated with cognitive functioning and the risk of Alzheimer’s dementia. Macronutrients, such as fatty acids, are modifiable dietary factors known to be important in brain development. Whether fatty acid intake moderates the relationship between cortical thickness and cognitive performance deserves examination. Method The study population included 261 cognitively‐ healthy adults at risk of Alzheimer’s dementia from the ongoing MIND trial (NCT02817074) that studies the role of the MIND diet on cognition. Cortical thickness was measured on 34 regions of each hemisphere of the brain using FreeSurfer. Dietary fatty acids, including good fats, omega‐3, monounsaturated, polyunsaturated, and bad fats such as saturated and trans‐fatty acids, were assessed through a validated, interviewer‐administered 142‐item food‐frequency‐questionnaire. Participants grouped into high (n=130) or low (n=131) intake of fatty acids based on the median of the study population. Global cognition was composed as a summary measure of 4 cognitive domains from 12 cognitive tests. Linear regression models adjusted for age, sex, site, caloric intake, education, and cognitive activities were used to examine associations between cortical thickness and global cognition according to the dietary intake of fatty acids. Result The average age of study participants was 70 years (range, 65‐83), and 57% were women. Cortical thickness was significantly associated with higher global cognition (beta=1.046, p=0.02). Fatty acids modified the association between cortical thickness and global cognition. Among individuals with a higher intake of omega‐3 or polyunsaturated fatty acids, cortical thickness was associated with higher global cognitive functioning [beta (p‐value): 1.49 (0.032) and 1.366 (0.062), respectively]. In contrast, there was no association between cortical thickness and global cognitive function in individuals with a lower intake of these good fatty acids. In individuals with low consumption of saturated or trans‐fatty acids (bad fats), cortical thickness was associated with higher global cognitive functioning [beta (p‐value): 1.737 (0.009) and 1.467 (0.024), respectively] , but not in individuals with high intake of these fatty acids (all p’s 〉 0.3). Conclusion In cognitively healthy individuals at risk of Alzheimer’s dementia, higher cortical thickness was associated with better cognitive performance, but the dietary intake of fatty acids modified the relationship.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2201940-6
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