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Association of diabetes and prediabetes with cognitive impairment and depression among Chinese elderly people: The Confucius Hometown Aging Project
Poster Presentations: P2 PS1 wt expressing cell lines. However, this mutation does not have influence on the production of NICD level. Conclusions: The results suggest that the mutant form of PS1 alter g-secretase activity toward APP but not Notch, producing more Ab 42, which are thought to be prone to aggregate and has higher neuro toxicity. Nevertheless, the precise mechanism needs further investigation. P2-155
ASSOCIATION OF DIABETES AND PREDIABETES WITH COGNITIVE IMPAIRMENT AND DEPRESSION AMONG CHINESE ELDERLY PEOPLE: THE CONFUCIUS HOMETOWN AGING PROJECT
Zhongrui Yan1, Chuanzhu Cai2, Haiqing Song3, Hui Jiang2, Binglun Sun2, Bo Bai3, Chengxuan Qiu4, 1Jining First People’s Hospital, Jining, China; 2 Xing Long Zhuang Coal Mine Hospital, Jining, China; 3Jining Medical University, Jining, China; 4Karolinska Institutet, Stockholm, Sweden. Background: Diabetes is frequently linked to cognitive impairment and depression in older adults, but few studies have been conducted among Chinese elderly people. We seek to investigate the association of diabetes and prediabetes with cognitive impairment and depression among Chinese elderly people. Methods: This cross-sectional study included 1528 participants (age 60 years, mean age 68.6; 59.2% women) of Chinese elderly people who were living in the community nearby the hometown of Confucius (Q€ ufu), Shandong, China. We assessed global cognitive function with Mini-Mental State Examination (MMSE) and depressive symptoms with the 15-item Geriatric Depression Scale (GDS). Diabetes and prediabetes were defined according to self-reported history of diabetes, blood glucose-lowering treatment, insulin injection, and fasting blood glucose test. Data were analyzed with logistic regression models controlling for demographic features and major cardiovascular risk factors. Results: Of the 1528 participants, cognitive impairment (MMSE score <24) was found in 377 (24.7%) and depression (GDS score 5) in 310 (20.3%) subjects. The multiple adjusted OR of cognitive impairment was 1.61 (95% CI 0.92-2.81) for prediabetes, 1.38 (0.97-1.96) for diabetes, and 1.43 (1.041.97) for having either prediabetes or diabetes; such associations did not vary by sex. Overall, there was no significant association of diabetes or prediabetes with depression. However, a statistical interaction of sex with diabetic status (P for interaction term 0.05) on depression was detected, such that men with prediabetes or diabetes had a marginally increased OR of 1.51 (0.98-2.32; P ¼ 0.06) for depression, whereas there was no association between diabetic status and depression among women. Conclusions: Having diabetes or prediabetes is associated with cognitive impairment and depression among Chinese elderly people living in the community. P2-156
ASSOCIATION OF INSTRUMENTAL ACTIVITIES OF DAILY LIVING WITH MCI DIAGNOSIS IN A LARGE, OLDER, COMMUNITY-BASED POPULATION
Emily Trittschuh1, Brenna Cholerton2, Eric Larson3, Paul Crane4, Susan McCurry4, Wayne McCormick5, James Bowen6, Matthew Arbuckle2, Laura Baker7, Suzanne Craft8, 1VA Puget Sound Health Care System/ University of Washington, Seattle, Washington, United States; 2VAPSHCS, Seattle, Washington, United States; 3GHRI, Seattle, Washington, United States; 4University of Washington, Seattle, Washington, United States; 5 UW/Harborview Medical Center, Seattle, Washington, United States; 6 Swedish Neuroscience Institute, Seattle, Washington, United States; 7 University of Washington School of Medicine, Seattle, Washington, United States; 8VA Puget Sound/University of Washington, Seattle, Washington, United States. Background: Loss of independence in activities of daily living (ADLs) is a criterion for dementia diagnosis. With objective evidence of cognitive deficits, the presence or absence of functional decline is often the fulcrum for diagnosis of dementia versus Mild Cognitive Impairment (MCI). At the same time, MCI diagnosis is a consistent risk factor for incident dementia. The Adult Changes in Thought (ACT) cohort provides a unique opportunity to examine whether subtle changes in ADLs might enhance early and accu-
P313
rate identification of MCI. Methods: Participants in a community-based, random sample of non-demented older adults are seen biennially and receive cognitive examinations which have included tests known to be sensitive to the early effects of cognitive decline. Diagnosis of MCI was determined based on published definitions and a cut-off of 1.5 sd below normative means. Instrumental ADLs were assessed during a phone conversation subsequent to biennial visits. Experienced raters completed the Activities of Daily Living Questionnaire (ADLQ), a 15-question, 45-point scale based on participant self-report. We used logistic regression to determine whether ADLQ scores were associated with MCI diagnosis. We adjusted models for age and education. Additional analyses considered MCI subtype and ADLQ items. Results: The ADLQ was completed for n ¼ 1144 participants (mean age ¼ 81.3, standard deviation ¼ 0.2). ADLQ scores were associated with MCI diagnosis in crude and adjusted models; each point of ADLQ was associated with a 16% reduced odds of MCI (OR ¼ 0.84; 95% confidence interval 12-20%, P <0.01, for the adjusted model). The association between ADLQ score and MCI diagnosis was stronger for amnestic than non-amnestic MCI. Preliminary analyses suggest that not all ADLQ items are equally useful. Conclusions: These findings suggest assessment of ADLs has a role beyond “ruling out” dementia. Questionnaires such as the ADLQ are easily administered, inexpensive, and well tolerated, and may add to the armamentarium designed to identify people who are more likely to go on to develop dementia. Perhaps more intriguing, is the possibility that these scores might assist in predicting those individuals likely to stay stable. P2-157
EFFECTS OF MULTICOMPONENT EXERCISE ON CEREBRAL HEMOGLOBIN OXYGENATION IN OLDER ADULTS WITH AMNESTIC MILD COGNITIVE IMPAIRMENT: FUNCTIONAL MONITORING USING NIR SPECTROSCOPY
Hyuntae Park1, Hiroyuki Shimada2, Hyuma Makizako3, Takehiko Doi3, Daisuke Yoshida3, Kota Tsutsumimoto4, Yuya Anan4, Kazuki Uemura4, Takao Suzuki4, 1National Center for Geriatrics and Gerontology, Obu, Aichi, Japan; 2National Center for Geriatrics and Gerontology, Aichi, Japan; 3National Center for Geriatrics and Gerontology, Obu, Japan; 4 National Center for Geriatrics and Gerontology, Obu, Aichi, Japan. Background: It has been suggested that moderate exercise and habitual physical activity may have a neuroprotective effects in those at risk for Alzheimer’s disease. A recent randomized controlled trials examining the effect of exercise has been proposed to be associated with varied cognitive benefits in older adults diagnosied with mild cognitive impairement. Moreover, a recent meta-analysis reported that physical activity or exercise may have neurogenic and angiogenic effects in human hippocampi. Near-infrared spectroscopy (NIRS) is a noninvasive neuroimaging tool for studying evoked cerebral hemodynamic changes, and has been used as a practical indicator of cerebral oxygenation and hemodynamic change. However, no quantitative analysis has been performed on the cumulative evidence from studies that used NIRS to measure brain hemodynamic responses before and after exercise intervention in MCI patients. Methods: Twenty subjects (9 men) with aMCI ranging in age from 65 to 86 years (mean age, 73 years) were divided arbitrarily into two groups. Subjects in the multicomponent exercise group (n ¼ 10) performed moderate exercise under the supervision of physiotherapists for 90 min/d, 2 d/wk, 80 times for 6 months. The exercise was included aerobic exercise, muscle strength training, and postural balance retraining which was conducted under multitask conditions to stimulate cognitive functions. The control group (n ¼ 10) attended three times education class during the same period of time. We used NIRS to measure cerebral oxygenation oxygenation changes during a verbal-fluency task before and after the intervention. Results: Compared to a baseline condition, we found a significant increase of delta HbO during the execution of the VFT over both hemispheres in intervention group. In the delta group activation maps from VFT using HRF models using NIRS-SPM (Ye et al. 2008), the t-statistic value and the activated regions from HbO signal during VFT significantly increased after 6 month exercise training in the left hemisphere areas and inferior frontal gyrus (all Ps < .05). Conclusions: The results of this study suggest that the 6-month multicomponent exercise intervention
ASSOCIATION OF DIABETES AND PREDIABETES WITH COGNITIVE IMPAIRMENT AND DEPRESSION AMONG CHINESE ELDERLY PEOPLE: THE CONFUCIUS HOMETOWN AGING PROJECT
Zhongrui Yan1, Chuanzhu Cai2, Haiqing Song3, Hui Jiang2, Binglun Sun2, Bo Bai3, Chengxuan Qiu4, 1Jining First People’s Hospital, Jining, China; 2 Xing Long Zhuang Coal Mine Hospital, Jining, China; 3Jining Medical University, Jining, China; 4Karolinska Institutet, Stockholm, Sweden. Background: Diabetes is frequently linked to cognitive impairment and depression in older adults, but few studies have been conducted among Chinese elderly people. We seek to investigate the association of diabetes and prediabetes with cognitive impairment and depression among Chinese elderly people. Methods: This cross-sectional study included 1528 participants (age 60 years, mean age 68.6; 59.2% women) of Chinese elderly people who were living in the community nearby the hometown of Confucius (Q€ ufu), Shandong, China. We assessed global cognitive function with Mini-Mental State Examination (MMSE) and depressive symptoms with the 15-item Geriatric Depression Scale (GDS). Diabetes and prediabetes were defined according to self-reported history of diabetes, blood glucose-lowering treatment, insulin injection, and fasting blood glucose test. Data were analyzed with logistic regression models controlling for demographic features and major cardiovascular risk factors. Results: Of the 1528 participants, cognitive impairment (MMSE score <24) was found in 377 (24.7%) and depression (GDS score 5) in 310 (20.3%) subjects. The multiple adjusted OR of cognitive impairment was 1.61 (95% CI 0.92-2.81) for prediabetes, 1.38 (0.97-1.96) for diabetes, and 1.43 (1.041.97) for having either prediabetes or diabetes; such associations did not vary by sex. Overall, there was no significant association of diabetes or prediabetes with depression. However, a statistical interaction of sex with diabetic status (P for interaction term 0.05) on depression was detected, such that men with prediabetes or diabetes had a marginally increased OR of 1.51 (0.98-2.32; P ¼ 0.06) for depression, whereas there was no association between diabetic status and depression among women. Conclusions: Having diabetes or prediabetes is associated with cognitive impairment and depression among Chinese elderly people living in the community. P2-156
ASSOCIATION OF INSTRUMENTAL ACTIVITIES OF DAILY LIVING WITH MCI DIAGNOSIS IN A LARGE, OLDER, COMMUNITY-BASED POPULATION
Emily Trittschuh1, Brenna Cholerton2, Eric Larson3, Paul Crane4, Susan McCurry4, Wayne McCormick5, James Bowen6, Matthew Arbuckle2, Laura Baker7, Suzanne Craft8, 1VA Puget Sound Health Care System/ University of Washington, Seattle, Washington, United States; 2VAPSHCS, Seattle, Washington, United States; 3GHRI, Seattle, Washington, United States; 4University of Washington, Seattle, Washington, United States; 5 UW/Harborview Medical Center, Seattle, Washington, United States; 6 Swedish Neuroscience Institute, Seattle, Washington, United States; 7 University of Washington School of Medicine, Seattle, Washington, United States; 8VA Puget Sound/University of Washington, Seattle, Washington, United States. Background: Loss of independence in activities of daily living (ADLs) is a criterion for dementia diagnosis. With objective evidence of cognitive deficits, the presence or absence of functional decline is often the fulcrum for diagnosis of dementia versus Mild Cognitive Impairment (MCI). At the same time, MCI diagnosis is a consistent risk factor for incident dementia. The Adult Changes in Thought (ACT) cohort provides a unique opportunity to examine whether subtle changes in ADLs might enhance early and accu-
P313
rate identification of MCI. Methods: Participants in a community-based, random sample of non-demented older adults are seen biennially and receive cognitive examinations which have included tests known to be sensitive to the early effects of cognitive decline. Diagnosis of MCI was determined based on published definitions and a cut-off of 1.5 sd below normative means. Instrumental ADLs were assessed during a phone conversation subsequent to biennial visits. Experienced raters completed the Activities of Daily Living Questionnaire (ADLQ), a 15-question, 45-point scale based on participant self-report. We used logistic regression to determine whether ADLQ scores were associated with MCI diagnosis. We adjusted models for age and education. Additional analyses considered MCI subtype and ADLQ items. Results: The ADLQ was completed for n ¼ 1144 participants (mean age ¼ 81.3, standard deviation ¼ 0.2). ADLQ scores were associated with MCI diagnosis in crude and adjusted models; each point of ADLQ was associated with a 16% reduced odds of MCI (OR ¼ 0.84; 95% confidence interval 12-20%, P <0.01, for the adjusted model). The association between ADLQ score and MCI diagnosis was stronger for amnestic than non-amnestic MCI. Preliminary analyses suggest that not all ADLQ items are equally useful. Conclusions: These findings suggest assessment of ADLs has a role beyond “ruling out” dementia. Questionnaires such as the ADLQ are easily administered, inexpensive, and well tolerated, and may add to the armamentarium designed to identify people who are more likely to go on to develop dementia. Perhaps more intriguing, is the possibility that these scores might assist in predicting those individuals likely to stay stable. P2-157
EFFECTS OF MULTICOMPONENT EXERCISE ON CEREBRAL HEMOGLOBIN OXYGENATION IN OLDER ADULTS WITH AMNESTIC MILD COGNITIVE IMPAIRMENT: FUNCTIONAL MONITORING USING NIR SPECTROSCOPY
Hyuntae Park1, Hiroyuki Shimada2, Hyuma Makizako3, Takehiko Doi3, Daisuke Yoshida3, Kota Tsutsumimoto4, Yuya Anan4, Kazuki Uemura4, Takao Suzuki4, 1National Center for Geriatrics and Gerontology, Obu, Aichi, Japan; 2National Center for Geriatrics and Gerontology, Aichi, Japan; 3National Center for Geriatrics and Gerontology, Obu, Japan; 4 National Center for Geriatrics and Gerontology, Obu, Aichi, Japan. Background: It has been suggested that moderate exercise and habitual physical activity may have a neuroprotective effects in those at risk for Alzheimer’s disease. A recent randomized controlled trials examining the effect of exercise has been proposed to be associated with varied cognitive benefits in older adults diagnosied with mild cognitive impairement. Moreover, a recent meta-analysis reported that physical activity or exercise may have neurogenic and angiogenic effects in human hippocampi. Near-infrared spectroscopy (NIRS) is a noninvasive neuroimaging tool for studying evoked cerebral hemodynamic changes, and has been used as a practical indicator of cerebral oxygenation and hemodynamic change. However, no quantitative analysis has been performed on the cumulative evidence from studies that used NIRS to measure brain hemodynamic responses before and after exercise intervention in MCI patients. Methods: Twenty subjects (9 men) with aMCI ranging in age from 65 to 86 years (mean age, 73 years) were divided arbitrarily into two groups. Subjects in the multicomponent exercise group (n ¼ 10) performed moderate exercise under the supervision of physiotherapists for 90 min/d, 2 d/wk, 80 times for 6 months. The exercise was included aerobic exercise, muscle strength training, and postural balance retraining which was conducted under multitask conditions to stimulate cognitive functions. The control group (n ¼ 10) attended three times education class during the same period of time. We used NIRS to measure cerebral oxygenation oxygenation changes during a verbal-fluency task before and after the intervention. Results: Compared to a baseline condition, we found a significant increase of delta HbO during the execution of the VFT over both hemispheres in intervention group. In the delta group activation maps from VFT using HRF models using NIRS-SPM (Ye et al. 2008), the t-statistic value and the activated regions from HbO signal during VFT significantly increased after 6 month exercise training in the left hemisphere areas and inferior frontal gyrus (all Ps < .05). Conclusions: The results of this study suggest that the 6-month multicomponent exercise intervention