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- The Cognitive Telephone Screening Instrument (COGTEL): A Brief, Reliable, and Valid Tool for Capturing Interindividual Differences in Cognitive Functioning in Epidemiological and Aging StudiesPublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Kliegel, MatthiasAims: The present study set out to evaluate the psychometric properties of the Cognitive Telephone Screening Instrument (COGTEL) in 2 different samples of older adults. Methods: We assessed COGTEL in 116 older adults, with retest after 7 days to evaluate the test-retest reliability. Moreover, we assessed COGTEL in 868 older adults to evaluate convergent validity to the Mini-Mental State Examination (MMSE). Results: Test-retest reliability of the COGTEL total score was good at 0.85 (p < 0.001). Latent variable analyses revealed that COGTEL and MMSE correlated by 0.93 (p < 0.001), indicating convergent validity of the COGTEL. Conclusion: The present analyses suggest COGTEL as a brief, reliable, and valid instrument for capturing interindividual differences in cognitive functioning in epidemiological and aging studies, with the advantage of covering more cognitive domains than traditional screening tools such as the MMSE, as well as differentiating between individual performance levels, in healthy older adults.
- 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.
- 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.
- Sex differences in relation patterns between health-related quality of life of older adults and its correlates: a population-based cross-sectional study in Madeira, PortugalPublication . Gouveia, Bruna R.; Ihle, Andreas; Kliegel, Matthias; Freitas, Duarte L.; Gouveia, Élvio R.A population-based cross-sectional study aimed to examine sex differences in health-related quality of life (HRQoL) of older adults, and investigate whether the relation patterns between HRQoL and its correlates differed between sexes. A stratified proportional and representative sample included 802 volunteers, aged 60-79. HRQoL (36-item Short Form Health Survey), functional fitness (Senior Fitness Test), physical activity (PA) (Baecke questionnaire), demographic information and health features (questionnaires) were assessed. Men showed significantly higher HRQoL (P<0.001). Body mass index, body strength, aerobic endurance, PA, depressive symptoms, falls, and living alone were significantly related to HRQoL. With sex as moderator, these relations were not significant, except for PA (β=0.12, P=0.004). A significant interaction of sex with PA on HRQoL (β=0.08, P=0.037) was found, indicating that this relation was higher in men. A similar relation pattern was found for HRQoL physical component. HRQoL and its correlates differed between sexes, demanding a sex specific approach to promote HRQoL.
- Cognitive function and its associations in older adults from Amazonas, BrazilPublication . Freitas, Duarte Luís; Gouveia, Bruna Raquel; Ribeiro, Euler Esteves; Muniz, Bárbara Régia; Odim, Angeany Pinto; Machado, Floramara Teles; Jurema, Jefferson; Kliegel, Matthias; Ihle, Andreas; Gouveia, Élvio Rúbio; Tinôco, Maria Antonieta de CamposThe objectives of this study were: (1) to investigate the age-related differences in cognitive function (CF), nutritional status (MNA), physical activity (AF), quality of life (QoL), depression, social satisfaction (SS) and socioeconomic status (SES), and (2) to explore the relationships between CF and the previous variables. This cross sectional study included 268 men and 433 women (aged 71.4 ± 7.0 years). CF was determined with the Cognitive Telephone Screening Instrument (COGTEL) and the Mini-Mental State Examination (MMSE). Correlates were as follows: Mini Nutritional Assessment (MNA), PA (Baecke questionnaire modified for older adults), Quality of life (QoL SF12), Geriatrics Depression Scale (GDS), Satisfaction and Social Support Scale, and Socioeconomic status (SES). All instruments were applied in a face to face interview. An independent t-test identified significantly higher scores in young-old adults (≤ 69 years) for CF (p < 0.001), PA (p = 0.046) and SES (p = 0.007), compared to old-old adults (≥ 70 years). The results of multiple linear regression analysis indicated that the most significant CF correlates were SES (β = 0.45; p < 0.001), age (β = -0.12; p < 0.001), SS (β = 0.12; p = 0.001), GDS (β = -0.11; p = 0.003) and QoL (β = 0.08; p = 0.017). The overall regression model explained 36% of the total variance in the COGTEL. The oldest and the more depressed adults obtained lower scores for FC. The present study suggests that, between the correlates studied, SES was the strongest predictor in the explanation of CF in older adults.