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- The Relation of Having Experienced a Fall in the Past to Lower Cognitive Functioning in Old Age Is Mediated via Less Physical Activity Engagement as Cognitive Reserve ContributorPublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Marques, Adilson; Marconcin, Priscila; Nascimento, Marcelo de Maio; Haas, Maximilian; Jurema, Jefferson; Tinôco, Maria A.; Kliegel, MatthiasSimple Summary: Experiencing a fall in old age represents a critical life event affecting physical and cognitive health and the ability to engage in physical activities and exercise. This is crucial since physical activity engagement contributes to the accumulation of the so-called cognitive reserve relevant for maintaining cognitive health at old age. The goal of our study was to investigate whether the relationship between having experienced a fall and lower cognitive functioning can be explained by hampered physical activity engagement. Confirming this idea, our findings demonstrated that experiencing a fall at an older age hinders sufficient physical activity engagement and thereby impedes cognitive reserve accumulation, resulting in lower cognitive functioning outcomes. Consequently, our study suggests that at old age, the prevention of falls and related accidents is not only crucial to avoid injuries and preserve physical health, but it is also essential for maintaining one’s ability to engage in physical activities and exercises and, consequently, for preserving cognitive health in later life. Abstract: Physical activity and exercise contribute to the accumulation of cognitive reserve, which is instrumental for preserving cognitive health in old age. In a large sample of 701 older adults (mean age = 70.36 years), we investigated whether the relationship between having experienced a fall in the past and lower performance in cognitive functioning was mediated via less physical activity engagement as a cognitive reserve contributor. General cognition was assessed using the mini-mental state examination (MMSE), long-term memory using a word-pair delayed recall test and working memory using a backward digit-span test. In face-to-face interviews, individuals reported information on falls during the past 12 months and their habitual physical activity engagement. Our analyses demonstrated that the relationship between having experienced a fall in the past and lower performance in the cognitive functioning measures was partly mediated (by 16.3% for general cognition, 30.6% for ong-term memory, and 33.1% for working memory, respectively) via less physical activity engagement. In conclusion, we suggest as a core bio-psychological mechanism that experiencing a fall at an older age is a critical life event that hinders sufficient physical activity engagement and thereby impedes cognitive reserve build-up, resulting in lower cognitive functioning outcomes.
- The relation of education, occupation, and cognitive activity to cognitive status in old age: the role of physical frailtyPublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Freitas, Duarte; Jurema, Jefferson; Odim, Angeany P.; Kliegel, MatthiasBackground: It remains unclear so far whether the role of cognitive reserve may differ between physically frail compared to less frail individuals. Therefore, the present study set out to investigate the relation of key markers of cognitive reserve to cognitive status in old age and its interplay with physical frailty in a large sample of older adults. Methods: We assessed Mini-Mental State Examination (MMSE) in 701 older adults. We measured grip strength as indicator of physical frailty and interviewed individuals on their education, past occupation, and cognitive leisure activity. Results: Greatergripstrength,longereducation,highercognitivelevelofjob,andgreaterengagingincognitive leisure activity were significantly related to higher MMSE scores. Moderation analyses showed that the relations of education, cognitive level of job, and cognitive leisure activity to MMSE scores were significantly larger in individuals with lower, compared to those with greater grip strength. Conclusions: Cognitive status in old age may more strongly depend on cognitive reserve accumulated during the life course in physically frail (compared to less frail) older adults. These findings may be explained by cross-domain compensation effects in vulnerable individuals.
- High-density lipoprotein cholesterol level relates to working memory, immediate and delayed cued recall in brazilian older adults: the role of cognitive reservePublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Freitas, Duarte L.; Jurema, Jefferson; Tinôco, Maria A.; Kliegel, MatthiasAims: The present study set out to investigate the relation of the high-density lipoprotein cholesterol (HDL-C) level to cognitive performance and its interplay with key markers of cognitive reserve in a large sample of older adults. Methods: We assessed tests of working memory, immediate and delayed cued recall in 701 older adults from Amazonas, Brazil. The HDL-C level was derived from fasting blood samples. In addition, we interviewed individuals on their education, past occupation, and cognitive leisure activity. Results: A critically low HDL-C level (<40 mg/dL) was significantly related to lower performance in working memory, immediate and delayed cued recall. Moderation analyses suggested that the relations of the HDL-C level to working memory and delayed cued recall were negligible in individuals with longer education, a higher cognitive level of the job, and greater engagement in cognitive leisure activity. Conclusion: Cognitive reserve accumulated during the life course may reduce the detrimental influences of a critically low HDL-C level on cognitive functioning in old age.
- Cognitive reserve attenuates 6-year decline in executive functioning after strokePublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Cheval, Boris; Sieber, Stefan; Cullati, Stéphane; Kliegel, MatthiasAims: We investigated whether the longitudinal relationship between history of stroke and subsequent decline in executive functioning over 6 years differed by cognitive reserve. Methods: We analyzed longitudinal data from 897 older adults (mean age, 74.33 years) tested on the Trail Making Test (TMT) in two waves 6 years apart. Participants reported information on key frequently used proxies of lifelong cognitive reserve accumulation (i.e., education, occupation, and leisure activity engagement), and history of stroke. Results: There was a significant interaction of stroke with leisure activity engagement on latent change in executive functioning. Specifically, only for individuals with low (but not those with high) leisure activity engagement, history of stroke significantly predicted a steeper subsequent decline in executive functioning across 6 years (i.e., increases in TMT completion time). Conclusion: The detrimental aftereffects of stroke on subsequent decline in executive functioning may be attenuated in individuals who have accumulated greater cognitive reserve through leisure activity engagement across their life.
- The relation of hypertension to performance in immediate and delayed cued recall and working memory in old age: the role of cognitive reservePublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Freitas, Duarte L.; Jurema, Jefferson; Machado, Floramara T.; Kliegel, MatthiasWe investigated the relation of hypertension to cognitive performance and its interplay with key markers of cognitive reserve in a large sample of older adults. Method: We assessed tests of immediate and delayed cued recall and working memory in 701 older adults. We measured systolic blood pressure and interviewed individuals on their education, past occupation, and cognitive leisure activity. Results: Hypertension (≥140 mmHg) was related to lower performance in all three cognitive measures. Moderation analyses suggested that these relations were reduced in individuals with greater engaging in cognitive leisure activity. Hierarchical regression analyses showed that hypertension was not related to any of the three investigated cognitive performance measures when education, cognitive level of job, and cognitive leisure activity were simultaneously taken into account. Discussion: The detrimental influences of hypertension on cognitive functioning in old age may be reduced in individuals with greater cognitive reserve accumulated during the life course.
- The relation of education and cognitive activity to mini‑mental state in old age: the role of functional fitness statusPublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Freitas, Duarte L.; Jurema, Jefferson; Ornelas, Rui T.; Antunes, António M.; Muniz, Bárbara R.; Kliegel, MatthiasIt remains unclear so far whether the role of cognitive reserve for cognitive functioning in old age may differ between individuals with low, compared to those with high functional fitness status. Therefore, the present study set out to investigate the relation of education and cognitive leisure activity as key markers of cognitive reserve to mini-mental state in old age (as an indicator of the extent of cognitive impairment) and its interplay with functional fitness status in a large sample of older adults. We assessed MMSE in 701 older adults (M = 70.4 years, SD = 6.9, range: 60–91). We measured functional fitness status using the Senior Fitness Test battery and interviewed individuals on their education and cognitive leisure activity. Results showed that better functional fitness status, longer education, and greater engagement in cognitive leisure activity were significantly related to higher MMSE scores. Moderation analyses showed that the relations of education and cognitive leisure activity to MMSE scores were significantly larger in individuals with low, compared to those with high functional fitness status. In conclusion, cognitive functioning in old age may more strongly depend on cognitive reserve accumulated during the life course in older adults with low, compared to those with high functional fitness status. These findings may be explained by cross-domain compensation effects in vulnerable individuals and may (at least partly) account for the large variability in cognitive reserve–cognition relations debated in the literature.
- Cognitive Functioning Mediates the Association of Cognitive Reserve with Health-Related Quality of LifePublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Marques, Adilson; Marconcin, Priscila; Nascimento, Marcelo de Maio; Jurema, Jefferson; Tinôco, Maria A.; Kliegel, MatthiasWe investigated whether the relations of the cognitive reserve markers education and cogni tive level of work to the physical and the mental component of health-related quality of life (HRQoL) were mediated via cognitive functioning in a large sample of 701 older adults (mean age = 70.36 years, SD = 6.87). HRQoL was measured with the 12-item Short-Form Health Survey. To measure cog nitive functioning, we used the COGTEL, which is a cognitive test battery assessing prospective memory, verbal short-term memory, verbal long-term memory, working memory, verbal fluency, and inductive reasoning, combined into a composite score. Individuals reported information on their education and their main profession during their working life. Mediation analyses showed that better cognitive functioning mediated the association of higher values in the cognitive reserve markers (longer education and a high cognitive level of work) with higher HRQoL. In conclusion, the present study suggests that the sustainability of cognitive functioning in old age with the help of cognitive reserve is fundamental for the sustainability of quality of life, presumably particularly for the mental HRQoL component.
- Cognitive Reserve Mediates the Relation between Neighborhood Socio-Economic Position and Cognitive DeclinePublication . Ihle, Andreas; Gabriel, Rainer; Oris, Michel; Gouveia, Élvio R.; Gouveia, Bruna R.; Marques, Adilson; Marconcin, Priscila; Kliegel, MatthiasWe investigated the mediating role of leisure activity engagement as marker of cognitive reserve in the relation between neighborhood socio-economic position (SEP) and cognitive decline over 6 years. Methods: The study analyzed longitudinal data from 897 older adults who par ticipated in the two waves (2011 and 2017) of the Vivre-Leb en-Vivere (VLV) survey in Switzerland (M = 74.33 years in the first wave). Trail Making Test parts A and B were adminis tered in both waves. Leisure activity engagement was as sessed during interviews. Neighborhood SEP was derived from the Swiss Neighborhood Index of Socio-Economic Position (Swiss-SEP), provided by the Swiss National Cohort (SNC). Results: Latent change score modeling revealed that 42.5% of the relationship between higher neighborhood SEP and smaller cognitive decline was mediated via a higher frequency of leisure activities in the first wave. Conclusion: Neighborhood SEP constitutes an important contextual fac tor potentially influencing the pathways of cognitive reserve accumulation and, therefore, should be taken into account to better understand their effects on cognitive decline in old age.