- Email: [email protected]
P4-130: Telomere length and cognitive function in community-dwelling elders: Findings from the Health Aging and Body Composition (Health ABC) Study
T708
Poster Presentations P4:
Lewy bodies may reflect comorbidity not only among these recognized pathogenic processes, but with those underlying ARPBA as well. P4-129
THE IMPACT OF MAINTAINING COGNITIVE FUNCTION ON DISABILITY AND DEATH
Kristine Yaffe1, Karla Lindquist1, Eric Vittinghoff1, Deborah Barnes1, Eleanor Simonsick2, Anne Newman3, Suzanne Satterfield4, Caterina Rosano3, Susan Rubin1, Hilsa Ayonayon1, Tamara Harris5, 1 UCSF, San Francisco, CA, USA; 2National Institute on Aging, Baltimore, MD, USA; 3University of Pittsburgh, Pittsburgh, PA, USA; 4 University of Tennessee Health Science Center, Memphis, TN, USA; 5 National Institute on Aging, Bethesda, MD, USA. Contact e-mail: [email protected] Background: Little is known about elders who experience long-term maintenance of cognitive function. Furthermore, whether maintenance of cognitive function is associated with health advantages such as lower mortality or incident disability is unclear. Methods: We studied 2733 elders (mean age 74 years at baseline; 80 years at follow-up) participating in a longitudinal study of aging. Cognition was measured with the Modified Mini-Mental State Examination (3MS), a test of global cognition, and we included participants who had testing at least 2 times. We defined three cognitive groups based on 4-year participant-specific slopes (“maintainers” with a positive or 0 slope, “typical decliners” with slope ⬍0 but ⬍1sd below the mean and “major decliners” with slope ⱖ1sd below the mean). We then determined if cognitive group was associated with death and incident physical disability (difficulty with activities of daily living or mobility) during the subsequent 3 years. Results: 984 (36%) were maintainers, 1314 (48%) typical decliners, and 435 (16%) major decliners. Compared to those with typical decline, elders who maintained cognition had lower mortality (7% vs 14%, hazard ratio (HR) ⫽0.48; 95%CI 0.360.63) and incident disability (22% vs 29%, HR⫽0.74; 95% CI⫽0.62-0.89). After adjustment for age, race, gender, education, APOE e4, depression, body mass index, stroke, hypertension and diabetes, these differences remained. As expected, those with major cognitive decline had greater mortality (20%) and incident disability (40%) compared to those with typical decline. Conclusions: A substantial proportion of elders maintain cognitive function in their eighth and ninth decades of life. These elders demonstrate lower risk of death and functional decline than those with minor cognitive decline supporting the concept of “successful” cognitive aging. P4-130
TELOMERE LENGTH AND COGNITIVE FUNCTION IN COMMUNITY-DWELLING ELDERS: FINDINGS FROM THE HEALTH AGING AND BODY COMPOSITION (HEALTH ABC) STUDY
Kristine Yaffe1,2, Karla Lindquist1, Molly Kluse1, Richard Cawthon3, Tamara Harris4,5, Wen-Chi Hsueh1, Eleanor Simonsick4, Lewis Kuller6, Rongling Li7, Hilsa Ayonayon1, Susan Rubin1, Steven R. Cummings8, 1 UCSF, San Francisco, CA, USA; 2San Francisco VA Medical Center, San Francisco, CA, USA; 3University of Utah, Saly Lake City, UT, USA; 4 National Institute on Aging, Bethesda, MD, USA; 5National Institute of Aging, Baltimore, MD, USA; 6University of Pittsburgh, Pittsburgh, PA, USA; 7University of Tennessee Health Science Center, Memphis, TN, USA; 8California Pacific Medical Center, San Francisco, CA, USA. Contact e-mail: [email protected] Background: Telomere shortening is a marker of cellular aging and has been associated with increased risk of Alzheimer’s disease. No study has determined if telomere length is associated with cognitive decline in non-demented elders. Methods: We prospectively studied 2,734 nondemented elders participating in an ongoing longitudinal study of aging. Cognitive status was measured with the Modified Mini-Mental State Exam (3MS) at baseline and repeated at Years 3, 5, and 8. Telomere length was measured in blood leukocytes at baseline and classified by tertile as “short”
(average length 3,510 base pairs), “mid” (average length 4,740 base pairs), or “long” (average length 6,280 base pairs). Baseline and decline in 3MS score across telomere length tertile was analyzed by random effects models. Results: Participants had a mean age of 74 years at baseline and 81 years at follow-up; those with longer telomeres were more likely to be younger, female and Black (p⬍.001 for all). At baseline there was no difference in 3MS score by telomere length (elders with long telomere length had a mean of 90.3 points vs. 90.1 and 90.0 for those with mid and short length, p ⫽ 0.46). However, cognitive decline over 7 years was less among elders with long telomere length compared to those with mid or short telomere length (-2.4 points vs. -3.5 and -3.3 respectively, p ⫽ 0.03). Multivariate adjustment for age, gender, race, education, assay variability, and baseline score did not appreciatively change the results. There was no interaction between telomere length and APOE e4, p⫽0.19. Conclusions: Telomere length may serve as a biomarker for cognitive aging, with longer telomere length associated with a decreased risk of cognitive decline in old age. P4-131
COGNITIVE AND SOCIODEMOGRAPHIC FACTORS ASSOCIATED TO DEPRESSIVE SYNDROME IN ELDERLY BRAZILIAN SUBJECTS
Ricardo Barcelos-Ferreira, Jony Arrais Pinto Ju´nior, Eduardo Yoshio Nakano, Ju´lio Litvoc, Ca´ssio Machado de Campos Bottino, University of Sao Paulo Medical School, Sao Paulo, Brazil. Contact e-mail: [email protected] Background: Investigators conducting longitudinal studies have found that older persons with depressive symptoms have increased risk of cognitive decline and dementia. 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. Therefore, to identify cognitive decline in depressive not demented older people may contribute to clarify this relationship. The present study aims to determine the cognitive and sociodemographic factors associated to depressive syndrome (DS) in a sample of not demented elderly subjects, from Sao Paulo city, State of Sao Paulo, Brazil. Methods: Cross-sectional study of a randomized community sample of 1,313 elderly subjects aged 60 years or older without cognitive and functional impairment, including dementia. The following instruments were used: a 10-item scale for screening depression in elderly people, Fuld Object Memory Evaluation (FOME), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), the Bayer Activities of Daily Living Scale (B-ADL) and a socioeconomic questionnaire. Results: The univariated analysis indicated independent factors associated to DS. After adjusting for all the variables, the multivariate analysis showed an association with low social class (OR⫽3.2; p⫽ 0.07), cognitive decline measured by the IQCODE’s score (OR⫽3.0; p⫽0.01), and female gender (OR⫽ 2.0; p⫽0.003). The frequency of subjects with DS was 10.4%, and there was no association with schooling, occupation, skin color, and scores on the FOME test. Conclusions: There was a significant association with IQCODE’s score and gender. In our sample, depressive syndrome in elderly not demented subjects was associated with sociodemographic factors and cognitive decline. P4-132
HOSPITAL ADMISSION OF DEMENTED PATIENTS: CLINICAL, FUNCTIONAL CHARACTERISTICS AND OUTCOMES
Angelo Bianchetti1,2, Piera Ranieri1,2, Ilaria Badini1,2, Roberta Scudellari1,2, Marta Grigolo1,2, Marco Trabucchi2, 1Istituto Clinico S. Anna, Brescia, Italy; 2Geriatric Research Group, Brescia, Italy. Contact e-mail: [email protected] Background: Demented patients were frequently admitted to medical ward for acute diseases. Little is known about the clinical characteristics of these subjects compared with not demented. To analyse social, clinical factors and outcomes associate to hospitalization we study a group of demented patents in an Acute Medical Ward. Methods: 1508 elderly
Poster Presentations P4:
Lewy bodies may reflect comorbidity not only among these recognized pathogenic processes, but with those underlying ARPBA as well. P4-129
THE IMPACT OF MAINTAINING COGNITIVE FUNCTION ON DISABILITY AND DEATH
Kristine Yaffe1, Karla Lindquist1, Eric Vittinghoff1, Deborah Barnes1, Eleanor Simonsick2, Anne Newman3, Suzanne Satterfield4, Caterina Rosano3, Susan Rubin1, Hilsa Ayonayon1, Tamara Harris5, 1 UCSF, San Francisco, CA, USA; 2National Institute on Aging, Baltimore, MD, USA; 3University of Pittsburgh, Pittsburgh, PA, USA; 4 University of Tennessee Health Science Center, Memphis, TN, USA; 5 National Institute on Aging, Bethesda, MD, USA. Contact e-mail: [email protected] Background: Little is known about elders who experience long-term maintenance of cognitive function. Furthermore, whether maintenance of cognitive function is associated with health advantages such as lower mortality or incident disability is unclear. Methods: We studied 2733 elders (mean age 74 years at baseline; 80 years at follow-up) participating in a longitudinal study of aging. Cognition was measured with the Modified Mini-Mental State Examination (3MS), a test of global cognition, and we included participants who had testing at least 2 times. We defined three cognitive groups based on 4-year participant-specific slopes (“maintainers” with a positive or 0 slope, “typical decliners” with slope ⬍0 but ⬍1sd below the mean and “major decliners” with slope ⱖ1sd below the mean). We then determined if cognitive group was associated with death and incident physical disability (difficulty with activities of daily living or mobility) during the subsequent 3 years. Results: 984 (36%) were maintainers, 1314 (48%) typical decliners, and 435 (16%) major decliners. Compared to those with typical decline, elders who maintained cognition had lower mortality (7% vs 14%, hazard ratio (HR) ⫽0.48; 95%CI 0.360.63) and incident disability (22% vs 29%, HR⫽0.74; 95% CI⫽0.62-0.89). After adjustment for age, race, gender, education, APOE e4, depression, body mass index, stroke, hypertension and diabetes, these differences remained. As expected, those with major cognitive decline had greater mortality (20%) and incident disability (40%) compared to those with typical decline. Conclusions: A substantial proportion of elders maintain cognitive function in their eighth and ninth decades of life. These elders demonstrate lower risk of death and functional decline than those with minor cognitive decline supporting the concept of “successful” cognitive aging. P4-130
TELOMERE LENGTH AND COGNITIVE FUNCTION IN COMMUNITY-DWELLING ELDERS: FINDINGS FROM THE HEALTH AGING AND BODY COMPOSITION (HEALTH ABC) STUDY
Kristine Yaffe1,2, Karla Lindquist1, Molly Kluse1, Richard Cawthon3, Tamara Harris4,5, Wen-Chi Hsueh1, Eleanor Simonsick4, Lewis Kuller6, Rongling Li7, Hilsa Ayonayon1, Susan Rubin1, Steven R. Cummings8, 1 UCSF, San Francisco, CA, USA; 2San Francisco VA Medical Center, San Francisco, CA, USA; 3University of Utah, Saly Lake City, UT, USA; 4 National Institute on Aging, Bethesda, MD, USA; 5National Institute of Aging, Baltimore, MD, USA; 6University of Pittsburgh, Pittsburgh, PA, USA; 7University of Tennessee Health Science Center, Memphis, TN, USA; 8California Pacific Medical Center, San Francisco, CA, USA. Contact e-mail: [email protected] Background: Telomere shortening is a marker of cellular aging and has been associated with increased risk of Alzheimer’s disease. No study has determined if telomere length is associated with cognitive decline in non-demented elders. Methods: We prospectively studied 2,734 nondemented elders participating in an ongoing longitudinal study of aging. Cognitive status was measured with the Modified Mini-Mental State Exam (3MS) at baseline and repeated at Years 3, 5, and 8. Telomere length was measured in blood leukocytes at baseline and classified by tertile as “short”
(average length 3,510 base pairs), “mid” (average length 4,740 base pairs), or “long” (average length 6,280 base pairs). Baseline and decline in 3MS score across telomere length tertile was analyzed by random effects models. Results: Participants had a mean age of 74 years at baseline and 81 years at follow-up; those with longer telomeres were more likely to be younger, female and Black (p⬍.001 for all). At baseline there was no difference in 3MS score by telomere length (elders with long telomere length had a mean of 90.3 points vs. 90.1 and 90.0 for those with mid and short length, p ⫽ 0.46). However, cognitive decline over 7 years was less among elders with long telomere length compared to those with mid or short telomere length (-2.4 points vs. -3.5 and -3.3 respectively, p ⫽ 0.03). Multivariate adjustment for age, gender, race, education, assay variability, and baseline score did not appreciatively change the results. There was no interaction between telomere length and APOE e4, p⫽0.19. Conclusions: Telomere length may serve as a biomarker for cognitive aging, with longer telomere length associated with a decreased risk of cognitive decline in old age. P4-131
COGNITIVE AND SOCIODEMOGRAPHIC FACTORS ASSOCIATED TO DEPRESSIVE SYNDROME IN ELDERLY BRAZILIAN SUBJECTS
Ricardo Barcelos-Ferreira, Jony Arrais Pinto Ju´nior, Eduardo Yoshio Nakano, Ju´lio Litvoc, Ca´ssio Machado de Campos Bottino, University of Sao Paulo Medical School, Sao Paulo, Brazil. Contact e-mail: [email protected] Background: Investigators conducting longitudinal studies have found that older persons with depressive symptoms have increased risk of cognitive decline and dementia. 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. Therefore, to identify cognitive decline in depressive not demented older people may contribute to clarify this relationship. The present study aims to determine the cognitive and sociodemographic factors associated to depressive syndrome (DS) in a sample of not demented elderly subjects, from Sao Paulo city, State of Sao Paulo, Brazil. Methods: Cross-sectional study of a randomized community sample of 1,313 elderly subjects aged 60 years or older without cognitive and functional impairment, including dementia. The following instruments were used: a 10-item scale for screening depression in elderly people, Fuld Object Memory Evaluation (FOME), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), the Bayer Activities of Daily Living Scale (B-ADL) and a socioeconomic questionnaire. Results: The univariated analysis indicated independent factors associated to DS. After adjusting for all the variables, the multivariate analysis showed an association with low social class (OR⫽3.2; p⫽ 0.07), cognitive decline measured by the IQCODE’s score (OR⫽3.0; p⫽0.01), and female gender (OR⫽ 2.0; p⫽0.003). The frequency of subjects with DS was 10.4%, and there was no association with schooling, occupation, skin color, and scores on the FOME test. Conclusions: There was a significant association with IQCODE’s score and gender. In our sample, depressive syndrome in elderly not demented subjects was associated with sociodemographic factors and cognitive decline. P4-132
HOSPITAL ADMISSION OF DEMENTED PATIENTS: CLINICAL, FUNCTIONAL CHARACTERISTICS AND OUTCOMES
Angelo Bianchetti1,2, Piera Ranieri1,2, Ilaria Badini1,2, Roberta Scudellari1,2, Marta Grigolo1,2, Marco Trabucchi2, 1Istituto Clinico S. Anna, Brescia, Italy; 2Geriatric Research Group, Brescia, Italy. Contact e-mail: [email protected] Background: Demented patients were frequently admitted to medical ward for acute diseases. Little is known about the clinical characteristics of these subjects compared with not demented. To analyse social, clinical factors and outcomes associate to hospitalization we study a group of demented patents in an Acute Medical Ward. Methods: 1508 elderly