- Email: [email protected]
Effects of physical activity and high density lipoprotein cholesterol (HDL) on cognitive performance: The Third National Health and Nutrition Examination Survey (NHANES III)
P294
Poster Presentations P2
developed and tested on 490 persons from the Rotterdam Scan Study, a population-based cohort study on diseases among the elderly. For each subject 3 different MR sequences, a WML segmentation obtained with an automated method, and a semi-quantitative lesion classification by two trained observers were available. For the automated WML classification, the lesions were classified based on their three-dimensional distance to the ventricles, which were segmented using an automated method. Maximizing the Pearson correlation coefficient between the automatically classified WML volumes and the rating assigned by the observers on a random subset of 100 subjects, suggested a distance of 7mm as the optimal cut-off distance to distinguish periventricular from subcortical WMLs. This was validated in the remaining 390 persons by computing correlations between the automated and observer-based lesion scores. Subsequently, we assessed whether the automated classification replicated previous findings of a different effect of periventricular and subcortical lesion loads on the risk of dementia. Results: Correlation coefficients between automated and visual ratings were 0.71 (p-value<0.001) for periventricular WMLs and 0.60 (p-value<0.001) for subcortical WMLs. The hazard ratios of dementia per standard deviation increase, adjusted for sex and age, were 1.87 (95%-CI: 1.39-2.52) for periventricular lesions and 1.45 (95%-CI: 1.13-1.86) for subcortical lesions. Adjusted for each other, the hazard ratio slightly increased for periventricular WMLs (1.98 (95%-CI: 1.26-3.13)), but attenuated for subcortical WMLs (0.93 (95%-CI: 0.60-1.44)). Conclusions: The automated WML classification is comparable to that of trained observers. The results support the notion that periventricular and subcortical WMLs bear different risks on the development of dementia. P2-109
DESCRIPTIVE ANALYSIS OF ELDERLY FROM DIFFERENT INSTITUTIONS OF THE BRAZILIAN MIDDLE-WEST: EVALUATION OF COGNITIVE DECREASE AND FUNCTIONAL CAPACITY
Fernando Jose´ Souza1, Thiago Potrich Rodrigues1, Felizardo Paixa˜o1, Bianca Borsatto Galera2, Siulmara Cristina Galera3, Elza Maria Moreira Gil4, Elisabeth Carmen Duarte5, Anielle Jacomini1, Cristiane Singulane1, 1 UNIC - University of Cuiaba, Cuiaba, Brazil; 2General University Hospital - Department of Molecular Biology and Human Genetic, Cuiaba, Brazil; 3 UniFOR - University of Fortaleza, Fortaleza, Brazil; 4General University Hospital, Cuiaba, Brazil; 5UNB - University of Brasilia, Brasilia, Brazil. Contact e-mail: [email protected] Background: The change in demographic and epidemiological profile of the world’s population is reflected in the increase of individual longevity. The normal aging may be accompanied by decrease of cognition and functional capacity that in some cases can be misidentify as a dementia. To attend the health needs of the elderly population it is important to knowledge the peculiarities of these people and what injuries occur more frequently in this group. Methods: This study was conducted with a random sample of elderly from three differents health care institutions - School Hospital, Center for Living and Unit-Family Health, totaling 573 individuals. The sample was recruited in the period between February 2007 and October 2008, and all participants were subjected to standardized to collect the variables of interest, Mini Mental State Examination (MMSE), Clock Test, Verbal Fluency (animal category), Katz, Pfeefer and Geriatric Depression Scale (GDS). Results: Of the total sample of 573 individuals, 438 were females and 135 males, the mean age were 66.30 years. The totals of 54.45% of the interviewed are ethnic skin and black. Only 12.39% have complete or incomplete higher education, 59.16% have income of 3 minimum wages, 56.72% do not practice any kind of artistic and cultural activity, 65.97% have no habit of reading, 77.66% have some type of health problem and 80.63% use some type of medicine. As for testing for activity of daily living (Katz) 85.48% obtained zero scores, in tests of functional activity (Pfeffer) 45.55% had scores zero. In 73.82% of the sample was observed normal GDS scores, however, 4.01% presented symptoms that indicate severe depression. In test clock 22.51% had nine points and the average score of the MEEM was 23.72 points. Conclusions: Considering these data, there is a rising concern regarding diseases and disorders resulting from aging, especially those of neurodegenerative origin. No such study regarding test of daily and functional capacity in addition to the evaluation of cognitive scale had been conducted
in elderly in Brazil’s Middle West. Therefore, this study may leads to a course of action with the intention of improving the care of this population with cognitive decline in this Brazilian region. P2-110
EFFECTS OF PHYSICAL ACTIVITY AND HIGH DENSITY LIPOPROTEIN CHOLESTEROL (HDL) ON COGNITIVE PERFORMANCE: THE THIRD NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (NHANES III)
Jamie L. Hamilton, Rajesh Chintala, Janell Hill, Richard F. Gillum, Thomas O. Obisesan, Howard University, Washington, DC, USA. Contact e-mail: [email protected] Background: High levels of physical activity (PA) are associated with increasing levels of high density lipoprotein cholesterol (HDL). While high levels of HDL has been associated with reduced toxicity of amyloid b protein, however, studies on the combined effects of PA with HDL on cognitive function in a nationally representative sample are lacking. We test the hypothesis that high levels of PA and related HDL levels, collectively, are associated with enhanced cognitive performance. Methods: We analyzed data from the national health survey of civilian, non-institutionalized population in the US. The sample consisted of 5,724 American men and women aged 60 years and over, examined in 1988-1994, who had complete data on short portable mini-mental state examination (Sp-MMSE) and HDL levels. The SpMMSE was administered to participants, and fasting HDL levels were measured and dichotomized into < 40 mg/dl (low) and 40 mg/dl (normal). After the initial ttest, ANOVA was used to test the combined effects of PA and HDL on cognitive function in the final analysis. Results: In age, gender, ethnicity, education, income, and stroke adjusted model using ANOVA, performance on the Sp-MMSE significantly associated with PA in the presence of normal HDL in age 60-69 (P¼0.04); tended towards significance in age 7079 (P¼0.07; P¼0.09) respectively; and significantly associated with PA at age >79 in both low and normal HDL groups (low HDL: P¼<0.02; and normal HDL: P<0.0001), respectively. Remarkably, the favorable effects of HDL on cognitive performance were also most remarkable in the > 79 age-group: sedentary-HDL (normal) group performed better than sedentary-HDL (low) group. Conclusions: We conclude that low HDL levels are associated with poorer cognitive performance, especially in sedentary older persons. P2-111
CLINICALLY SIGNIFICANT DEPRESSIVE SYMPTOMS AND ASSOCIATED FACTORS IN A COMMUNITY SAMPLE OF ELDERLY SUBJECTS
Ricardo Barcelos Ferreira1, David C. Steffens2, Ca´ssio Machado de Campos Bottino1, 1Old Age Research Group (Proter)/University of Sao Paulo Medical School, Sao Paulo, Brazil; 2Department of Psychiatry and Behavioral Sciences, Duke University Medical Center (DCS), Durham, NC, USA. Contact e-mail: [email protected] Background: A recent meta-analysis showed that persons with a history of depression were more likely to be diagnosed as having Alzheimer’s disease later in life, mainly those one that have cognitive and functional impairment associated to clinically significant depressive symptoms (CSDS). This study aims to determine the frequency of CSDS in a community sample of Brazilian elderly subjects and to assess the relationship with sociodemographic factors, cognitive and functional impairment (CFI), clinical diseases and Alzheimer’s Disease (DA). Methods: Cross-sectional study of a randomized community sample of 1,563 elderly subjects aged 60 years or older. The following instruments were used: a 10-item scale for screening depression in elderly people (D-10), the Mini Mental State Examination (MMSE), the Fuld Object Memory Evaluation (FOME), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), the Bayer Activities of Daily Living Scale (BADL), a sociodemographic and clinical questionnaire. Results: The frequency of CSDS was 13.0%. Univariate analysis identified independent factors associated with these symptoms in our sample. Logistic regression analysis indicated that being female, brown-skinned, previously depressed, having CFI, using psychotropics, and not practicing physical exercise were
Poster Presentations P2
developed and tested on 490 persons from the Rotterdam Scan Study, a population-based cohort study on diseases among the elderly. For each subject 3 different MR sequences, a WML segmentation obtained with an automated method, and a semi-quantitative lesion classification by two trained observers were available. For the automated WML classification, the lesions were classified based on their three-dimensional distance to the ventricles, which were segmented using an automated method. Maximizing the Pearson correlation coefficient between the automatically classified WML volumes and the rating assigned by the observers on a random subset of 100 subjects, suggested a distance of 7mm as the optimal cut-off distance to distinguish periventricular from subcortical WMLs. This was validated in the remaining 390 persons by computing correlations between the automated and observer-based lesion scores. Subsequently, we assessed whether the automated classification replicated previous findings of a different effect of periventricular and subcortical lesion loads on the risk of dementia. Results: Correlation coefficients between automated and visual ratings were 0.71 (p-value<0.001) for periventricular WMLs and 0.60 (p-value<0.001) for subcortical WMLs. The hazard ratios of dementia per standard deviation increase, adjusted for sex and age, were 1.87 (95%-CI: 1.39-2.52) for periventricular lesions and 1.45 (95%-CI: 1.13-1.86) for subcortical lesions. Adjusted for each other, the hazard ratio slightly increased for periventricular WMLs (1.98 (95%-CI: 1.26-3.13)), but attenuated for subcortical WMLs (0.93 (95%-CI: 0.60-1.44)). Conclusions: The automated WML classification is comparable to that of trained observers. The results support the notion that periventricular and subcortical WMLs bear different risks on the development of dementia. P2-109
DESCRIPTIVE ANALYSIS OF ELDERLY FROM DIFFERENT INSTITUTIONS OF THE BRAZILIAN MIDDLE-WEST: EVALUATION OF COGNITIVE DECREASE AND FUNCTIONAL CAPACITY
Fernando Jose´ Souza1, Thiago Potrich Rodrigues1, Felizardo Paixa˜o1, Bianca Borsatto Galera2, Siulmara Cristina Galera3, Elza Maria Moreira Gil4, Elisabeth Carmen Duarte5, Anielle Jacomini1, Cristiane Singulane1, 1 UNIC - University of Cuiaba, Cuiaba, Brazil; 2General University Hospital - Department of Molecular Biology and Human Genetic, Cuiaba, Brazil; 3 UniFOR - University of Fortaleza, Fortaleza, Brazil; 4General University Hospital, Cuiaba, Brazil; 5UNB - University of Brasilia, Brasilia, Brazil. Contact e-mail: [email protected] Background: The change in demographic and epidemiological profile of the world’s population is reflected in the increase of individual longevity. The normal aging may be accompanied by decrease of cognition and functional capacity that in some cases can be misidentify as a dementia. To attend the health needs of the elderly population it is important to knowledge the peculiarities of these people and what injuries occur more frequently in this group. Methods: This study was conducted with a random sample of elderly from three differents health care institutions - School Hospital, Center for Living and Unit-Family Health, totaling 573 individuals. The sample was recruited in the period between February 2007 and October 2008, and all participants were subjected to standardized to collect the variables of interest, Mini Mental State Examination (MMSE), Clock Test, Verbal Fluency (animal category), Katz, Pfeefer and Geriatric Depression Scale (GDS). Results: Of the total sample of 573 individuals, 438 were females and 135 males, the mean age were 66.30 years. The totals of 54.45% of the interviewed are ethnic skin and black. Only 12.39% have complete or incomplete higher education, 59.16% have income of 3 minimum wages, 56.72% do not practice any kind of artistic and cultural activity, 65.97% have no habit of reading, 77.66% have some type of health problem and 80.63% use some type of medicine. As for testing for activity of daily living (Katz) 85.48% obtained zero scores, in tests of functional activity (Pfeffer) 45.55% had scores zero. In 73.82% of the sample was observed normal GDS scores, however, 4.01% presented symptoms that indicate severe depression. In test clock 22.51% had nine points and the average score of the MEEM was 23.72 points. Conclusions: Considering these data, there is a rising concern regarding diseases and disorders resulting from aging, especially those of neurodegenerative origin. No such study regarding test of daily and functional capacity in addition to the evaluation of cognitive scale had been conducted
in elderly in Brazil’s Middle West. Therefore, this study may leads to a course of action with the intention of improving the care of this population with cognitive decline in this Brazilian region. P2-110
EFFECTS OF PHYSICAL ACTIVITY AND HIGH DENSITY LIPOPROTEIN CHOLESTEROL (HDL) ON COGNITIVE PERFORMANCE: THE THIRD NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (NHANES III)
Jamie L. Hamilton, Rajesh Chintala, Janell Hill, Richard F. Gillum, Thomas O. Obisesan, Howard University, Washington, DC, USA. Contact e-mail: [email protected] Background: High levels of physical activity (PA) are associated with increasing levels of high density lipoprotein cholesterol (HDL). While high levels of HDL has been associated with reduced toxicity of amyloid b protein, however, studies on the combined effects of PA with HDL on cognitive function in a nationally representative sample are lacking. We test the hypothesis that high levels of PA and related HDL levels, collectively, are associated with enhanced cognitive performance. Methods: We analyzed data from the national health survey of civilian, non-institutionalized population in the US. The sample consisted of 5,724 American men and women aged 60 years and over, examined in 1988-1994, who had complete data on short portable mini-mental state examination (Sp-MMSE) and HDL levels. The SpMMSE was administered to participants, and fasting HDL levels were measured and dichotomized into < 40 mg/dl (low) and 40 mg/dl (normal). After the initial ttest, ANOVA was used to test the combined effects of PA and HDL on cognitive function in the final analysis. Results: In age, gender, ethnicity, education, income, and stroke adjusted model using ANOVA, performance on the Sp-MMSE significantly associated with PA in the presence of normal HDL in age 60-69 (P¼0.04); tended towards significance in age 7079 (P¼0.07; P¼0.09) respectively; and significantly associated with PA at age >79 in both low and normal HDL groups (low HDL: P¼<0.02; and normal HDL: P<0.0001), respectively. Remarkably, the favorable effects of HDL on cognitive performance were also most remarkable in the > 79 age-group: sedentary-HDL (normal) group performed better than sedentary-HDL (low) group. Conclusions: We conclude that low HDL levels are associated with poorer cognitive performance, especially in sedentary older persons. P2-111
CLINICALLY SIGNIFICANT DEPRESSIVE SYMPTOMS AND ASSOCIATED FACTORS IN A COMMUNITY SAMPLE OF ELDERLY SUBJECTS
Ricardo Barcelos Ferreira1, David C. Steffens2, Ca´ssio Machado de Campos Bottino1, 1Old Age Research Group (Proter)/University of Sao Paulo Medical School, Sao Paulo, Brazil; 2Department of Psychiatry and Behavioral Sciences, Duke University Medical Center (DCS), Durham, NC, USA. Contact e-mail: [email protected] Background: A recent meta-analysis showed that persons with a history of depression were more likely to be diagnosed as having Alzheimer’s disease later in life, mainly those one that have cognitive and functional impairment associated to clinically significant depressive symptoms (CSDS). This study aims to determine the frequency of CSDS in a community sample of Brazilian elderly subjects and to assess the relationship with sociodemographic factors, cognitive and functional impairment (CFI), clinical diseases and Alzheimer’s Disease (DA). Methods: Cross-sectional study of a randomized community sample of 1,563 elderly subjects aged 60 years or older. The following instruments were used: a 10-item scale for screening depression in elderly people (D-10), the Mini Mental State Examination (MMSE), the Fuld Object Memory Evaluation (FOME), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), the Bayer Activities of Daily Living Scale (BADL), a sociodemographic and clinical questionnaire. Results: The frequency of CSDS was 13.0%. Univariate analysis identified independent factors associated with these symptoms in our sample. Logistic regression analysis indicated that being female, brown-skinned, previously depressed, having CFI, using psychotropics, and not practicing physical exercise were