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  • 1
    In: International Psychogeriatrics, Cambridge University Press (CUP), Vol. 29, No. 11 ( 2017-11), p. 1757-1760
    Abstract: Dementia is a neurodegenerative disorder with global impact, with the largest proportion of cases occurring in low- and middle-income countries. It is estimated that there are 46.8 million cases globally with approximately 10 million new cases each year or a new case occurring every 3 sec (Prince et al. , 2015). For comparison there are 36.7 million HIV cases with an estimated 2 million new cases each year (WHO, 2017). The rise in dementia prevalence is largely due to population ageing, with the oldest being at highest risk. To date there are no diseases modifying medications for Alzheimer's disease or the other causes of dementia. Academics and research groups are increasingly focused on prevention or delay of dementia (Brayne and Miller, 2017) and a number of organizations now prioritize dementia, indicating a strong and coherent international effort to address this problem. Examples include the World Health Organisation (WHO), which has established a Global Dementia Observatory; the World Dementia Council; the Organisation for Economic Co-operation and Development (OECD); the U.S. National Alzheimer's Project Act (NAPA); and the Global Council on Brain Health.
    Type of Medium: Online Resource
    ISSN: 1041-6102 , 1741-203X
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2017
    detail.hit.zdb_id: 2147136-8
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  • 2
    In: International Psychogeriatrics, Cambridge University Press (CUP), Vol. 30, No. 9 ( 2018-09), p. 1345-1354
    Abstract: Emerging genetic, ex-vivo, and clinical trial evidence indicates that calcium channel blockers (CCB) can improve mood and cognitive function. The objective of this study was to examine the effect of selective serotonin reuptake inhibitor (SSRI) therapy augmented with CCB on depression and cognitive decline in an elderly population with hypertension. Methods: Prospective study of 296 persons treated with SSRI and antihypertensive drugs. Baseline and two year clinic assessments were used to categorize participants as users of SSRI + CCB ( n = 53) or users of SSRI + other antihypertensives ( n = 243). Clinic visits were performed up to four times in a ten-year period to assess depression and cognitive function. Results: The sample mean age was 75.2 ± 5.47 years and 78% of participants were female. At two year follow-up there was a significant group by time interaction showing lower Center for Epidemiological Studies-Depression (CESD) scores in the SSRI + CCB group, F (1,291) = 4.13, p = 0.043, η 2 p = 0.014. Over ten-years follow-up, SSRI + CCB use was associated with improved general cognitive function (Mini-Mental State Examination: β = 0.97; 95% CI 0.14 to 1.81, p = 0.023) and immediate visual memory (Boston Visual Retention Test: β = 0.69; 95% CI 0.06 to 1.32, p = 0.033). Conclusion: The findings provide general population evidence that SSRI augmentation with CCB may improve depression and cognitive function.
    Type of Medium: Online Resource
    ISSN: 1041-6102 , 1741-203X
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2018
    detail.hit.zdb_id: 2147136-8
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  • 3
    In: International Psychogeriatrics, Cambridge University Press (CUP), Vol. 33, No. 7 ( 2021-07), p. 727-741
    Abstract: Evidence linking subjective concerns about cognition with poorer objective cognitive performance is limited by reliance on unidimensional measures of self-perceptions of aging (SPA). We used the awareness of age-related change (AARC) construct to assess self-perception of both positive and negative age-related changes (AARC gains and losses). We tested whether AARC has greater utility in linking self-perceptions to objective cognition compared to well-established measures of self-perceptions of cognition and aging. We examined the associations of AARC with objective cognition, several psychological variables, and engagement in cognitive training. Design: Cross-sectional observational study. Participants: The sample comprised 6056 cognitively healthy participants (mean [SD] age = 66.0 [7.0] years); divided into subgroups representing middle, early old, and advanced old age. Measurements: We used an online cognitive battery and measures of global AARC, AARC specific to the cognitive domain, subjective cognitive change, attitudes toward own aging (ATOA), subjective age (SA), depression, anxiety, self-rated health (SRH). Results: Scores on the AARC measures showed stronger associations with objective cognition compared to other measures of self-perceptions of cognition and aging. Higher AARC gains were associated with poorer cognition in middle and early old age. Higher AARC losses and poorer cognition were associated across all subgroups. Higher AARC losses were associated with greater depression and anxiety, more negative SPA, poorer SRH, but not with engagement in cognitive training. Conclusions: Assessing both positive and negative self-perceptions of cognition and aging is important when linking self-perceptions to cognitive functioning. Objective cognition is one of the many variables – alongside psychological variables – related to perceived cognitive losses.
    Type of Medium: Online Resource
    ISSN: 1041-6102 , 1741-203X
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2021
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  • 4
    Online Resource
    Online Resource
    Cambridge University Press (CUP) ; 2018
    In:  International Psychogeriatrics Vol. 30, No. 2 ( 2018-02), p. 221-232
    In: International Psychogeriatrics, Cambridge University Press (CUP), Vol. 30, No. 2 ( 2018-02), p. 221-232
    Abstract: A dearth of population-based epidemiological research examines neuropsychiatric symptom (NPS) in sub-clinical populations across the spectrum from normal aging to mild cognitive impairment (MCI). The construct of mild behavioral impairment (MBI) describes the emergence of sustained and impactful NPS in advance of or in combination with MCI. This is the first epidemiological study to operationalize the recently published diagnostic criteria for MBI and determine prevalence estimates across the spectrum from cognitively normal to MCI. Methods: MBI was assessed in 1,377 older (age range 72–79 years; 52% male; MCI ;= 133; cognitively normal, but-at-risk = 397; cognitively healthy = 847). MBI was assessed in accordance with the ISTAART-AA diagnostic criteria for MBI using the neuropsychiatric inventory. Results: 34.1% of participants met the criteria for MBI. High prevalence of MBI across the cognitive spectrum was reported (48.9% vs. 43.1% vs. 27.6%). Irrespective of level of cognitive impairment, impulse dyscontrol (33.8% vs. 28.7% vs. 17.2%) and decreased motivation (32.3% vs. 26.2% vs. 16.3%) were the most frequently met MBI domains. MBI was more prevalent in men (χ 2 = 4.98, p = 0.026), especially the domains of decreased motivation and impulse dyscontrol. Conclusions: This study presents the first population-based prevalence estimates for MBI using the recently published ISTAART-AA diagnostic criteria. Findings indicate relatively high prevalence of MBI in pre-dementia clinical states and amongst cognitively healthy older adults. Findings were gender-specific, with MBI affecting more men than women. Knowing the estimates of these symptoms in the population is essential for understanding and differentiating the very early development of clinical disorders.
    Type of Medium: Online Resource
    ISSN: 1041-6102 , 1741-203X
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2018
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  • 5
    Online Resource
    Online Resource
    Cambridge University Press (CUP) ; 2016
    In:  International Psychogeriatrics Vol. 28, No. 3 ( 2016-03), p. 349-356
    In: International Psychogeriatrics, Cambridge University Press (CUP), Vol. 28, No. 3 ( 2016-03), p. 349-356
    Abstract: With the number of older drivers projected to increase by up to 70% over the next 20 years, preventing injury resulting from crashes involving older drivers is a significant concern for both policy-makers and clinicians. While the total number of fatal crashes per annum has steadily decreased since 2005 in Australia, the rate of fatalities has demonstrated an upward trend since 2010 in drivers aged 65 years and above (8.5 per 100,000), such that it is now on par with the fatality rate in drivers aged 17–25 years (8.0 per 100,000) (Austroads, 2015). Similar statistics are reported for the United States (NHTSA, 2012), implying there is a need for better identification of those older drivers who are unsafe and implementation of strategies that can enhance mobility while maximizing road safety.
    Type of Medium: Online Resource
    ISSN: 1041-6102 , 1741-203X
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2016
    detail.hit.zdb_id: 2147136-8
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  • 6
    Online Resource
    Online Resource
    Cambridge University Press (CUP) ; 2023
    In:  Journal of the International Neuropsychological Society Vol. 29, No. 6 ( 2023-07), p. 594-604
    In: Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 29, No. 6 ( 2023-07), p. 594-604
    Abstract: Previous research has indicated that cognition and executive function are associated with decision-making, however the impact of mild cognitive impairment (MCI) on decision-making under explicit risk conditions is unclear. This cross-sectional study examined the impact of MCI, and MCI subtypes, on decision-making on the Game of Dice Task (GDT), among a cohort of older adults. Method: Data from 245 older adult participants (aged 72–78 years) from the fourth assessment of the Personality and Total Health Through Life study were analyzed. A diagnostic algorithm identified 103 participants with MCI, with subtypes of single-domain amnestic MCI (aMCI-single; n = 38), multi-domain amnestic MCI (aMCI-multi; n = 31), and non-amnestic MCI ( n = 33), who were compared with an age-, sex-, education-, and income-matched sample of 142 cognitively unimpaired older adults. Decision-making scores on the GDT (net score, single number choices, and strategy changes) were compared between groups using nonparametric tests. Results: Participants with MCI showed impaired performance on the GDT, with higher frequencies of single number choices and strategy changes. Analyses comparing MCI subtypes indicated that the aMCI-multi subtype showed increased frequency of single number choices compared to cognitively unimpaired participants. Across the sample of participants, decision-making scores were associated with measures of executive function (cognitive flexibility and set shifting). Conclusion: MCI is associated with impaired decision-making performance under explicit risk conditions. Participants with impairments in multiple domains of cognition showed the clearest impairments. The GDT may have utility in discriminating between MCI subtypes.
    Type of Medium: Online Resource
    ISSN: 1355-6177 , 1469-7661
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2000018-2
    SSG: 5,2
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  • 7
    Online Resource
    Online Resource
    Cambridge University Press (CUP) ; 2013
    In:  Journal of the International Neuropsychological Society Vol. 19, No. 9 ( 2013-10), p. 971-976
    In: Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 19, No. 9 ( 2013-10), p. 971-976
    Abstract: Intraindividual variability (IIV) refers to reaction time (RT) variation across the trials of a given cognitive task. Little research has contrasted different measures of IIV or assessed how many RT trials are required to provide a robust measure of the construct. We, therefore, investigated three measures of IIV (raw SD , coefficient of variation, and intraindividual SD statistically removing time-on-task effects) in relation to frontal white matter hyperintensities (obtained through structural MRI) in 415 cognitively normal community-dwelling adults aged 44 to 48 years. Results indicated the three IIV measures did not differ greatly in predictions of white matter hyperintensities, although it is possible that time-on-task effects were influential. As few as 20 trials taking approximately 52 s to administer provided a reliable prediction of frontal white matter hyperintensities. We conclude that future work should evaluate the comparative utility of different IIV measures in relation to persons exhibiting clear neuropathology. ( JINS , 2013, 19 , 1–6)
    Type of Medium: Online Resource
    ISSN: 1355-6177 , 1469-7661
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2013
    detail.hit.zdb_id: 2000018-2
    SSG: 5,2
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  • 8
    In: British Journal of Nutrition, Cambridge University Press (CUP), Vol. 127, No. 8 ( 2022-04-28), p. 1259-1268
    Abstract: The Maintain Your Brain (MYB) trial is one of the largest internet-delivered multidomain randomised controlled trial designed to target modifiable risk factors for dementia. It comprises four intervention modules: physical activity, nutrition, mental health and cognitive training. This paper explains the MYB Nutrition Module, which is a fully online intervention promoting the adoption of the ‘traditional’ Mediterranean Diet (MedDiet) pattern for those participants reporting dietary intake that does not indicate adherence to a Mediterranean-type cuisine or those who have chronic diseases/risk factors for dementia known to benefit from this type of diet. Participants who were eligible for the Nutrition Module were assigned to one of the three diet streams: Main, Malnutrition and Alcohol group, according to their medical history and adherence to the MedDiet at baseline. A short dietary questionnaire was administered weekly during the first 10 weeks and then monthly during the 3-year follow-up to monitor whether participants adopted or maintained the MedDiet pattern during the intervention. As the Nutrition Module is a fully online intervention, resources that promoted self-efficacy, self-management and process of change were important elements to be included in the module development. The Nutrition Module is unique in that it is able to individualise the dietary advice according to both the medical and dietary history of each participant; the results from this unique intervention will contribute substantively to the evidence that links the Mediterranean-type diet with cognitive function and the prevention of dementia and will increase our understanding of the benefits of a MedDiet in a Western country.
    Type of Medium: Online Resource
    ISSN: 0007-1145 , 1475-2662
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2016047-1
    SSG: 12
    SSG: 21
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  • 9
    Online Resource
    Online Resource
    Cambridge University Press (CUP) ; 2022
    In:  Journal of the International Neuropsychological Society Vol. 28, No. 7 ( 2022-08), p. 661-672
    In: Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 28, No. 7 ( 2022-08), p. 661-672
    Abstract: Social cognition is impaired in mild cognitive impairment (MCI) and dementia. However, its relationship to social functioning and perceived social support has yet to be explored. Here, we examine how theory of mind (ToM) relates to social functioning in MCI and dementia. Methods: Older adults (cognitively normal = 1272; MCI = 132; dementia = 23) from the PATH Through Life project, a longitudinal, population-based study, were assessed on the Reading the Mind in the Eyes Test (RMET), measures of social functioning, and social well-being. The associations between RMET performance, social functioning, and cognitive status were analysed using generalised linear models, adjusting for demographic variables. Results: Participants with MCI ( b =−.52, 95% CI [−.70, −.33]) and dementia ( b =−.78, 95% CI [−1.22, −.34]) showed poorer RMET performance than cognitively normal participants. Participants with MCI and dementia reported reduced social network size ( b =−.21, 95% CI [−.40, −.02] and b =−.90, 95% CI [−1.38, −.42], respectively) and participants with dementia reported increased loneliness ( b = .36, 95% CI [.06, .67]). In dementia, poorer RMET performance was associated with increased loneliness ( b =−.07, 95% CI [−.14, −.00]) and a trend for negative interactions with partners ( b =−.37, 95% CI [−.74, .00]), but no significant associations were found in MCI. Conclusions: MCI and dementia were associated with poor self-reported social function. ToM deficits were related to poor social function in dementia but not MCI. Findings highlight the importance of interventions to address social cognitive deficits in persons with dementia and education of support networks to facilitate positive interactions and social well-being.
    Type of Medium: Online Resource
    ISSN: 1355-6177 , 1469-7661
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2000018-2
    SSG: 5,2
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  • 10
    Online Resource
    Online Resource
    Cambridge University Press (CUP) ; 2010
    In:  Journal of the International Neuropsychological Society Vol. 16, No. 5 ( 2010-09), p. 939-944
    In: Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 16, No. 5 ( 2010-09), p. 939-944
    Abstract: Hazard perception in driving is the one of the few driving-specific skills associated with crash involvement. However, this relationship has only been examined in studies where the majority of individuals were younger than 65. We present the first data revealing an association between hazard perception and self-reported crash involvement in drivers aged 65 and over. In a sample of 271 drivers, we found that individuals whose mean response time to traffic hazards was slower than 6.68 s [the receiver operating characteristic (ROC) curve derived pass mark for the test] were 2.32 times [95% confidence interval (CI), 1.46, 3.22) more likely to have been involved in a self-reported crash within the previous 5 years than those with faster response times. This likelihood ratio became 2.37 (95% CI, 1.49, 3.28) when driving exposure was controlled for. As a comparison, individuals who failed a test of useful field of view were 2.70 (95% CI, 1.44, 4.44) times more likely to crash than those who passed. The hazard perception test and the useful field of view measure accounted for separate variance in crash involvement. These findings indicate that hazard perception testing and training could be potentially useful for road safety interventions for this age group. ( JINS , 2010, 16 , 939–944.)
    Type of Medium: Online Resource
    ISSN: 1355-6177 , 1469-7661
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2010
    detail.hit.zdb_id: 2000018-2
    SSG: 5,2
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