Cardiovascular disease and distribution of cognitive function in elderly people: the Rotterdam Study

OBJECTIVE: To investigate the distribution of cognitive function in elderly people and to assess the impact of clinical manifestations of atherosclerotic disease on this distribution. DESIGN: Single centre population based cross sectional door to door study. SETTING: Ommoord, a suburb of Rotterdam, the Netherlands. SUBJECTS: 4971 subjects aged 55 to 94 years. MAIN OUTCOME MEASURE: Cognitive function as measured by the mini mental state examination. RESULTS: The overall participation rate in the study was 80%. Cognitive test data were available for 90% of the participants. Increasing age and lower educational level were associated with poorer cognitive function. Previous vascular events, presence of plaques in the carotid arteries, and presence of peripheral arterial atherosclerotic disease were associated with worse cognitive performance independent of the effects of age and education. On average the differences were moderate; however, they reflected the net result of a shift of the total population distribution of cognitive function towards lower values. Thereby, they resulted in a considerable increase in the proportion of subjects with scores indicative of dementia. CONCLUSIONS: These findings are compatible with the view that atherosclerotic disease accounts for considerable cognitive impairment in the general population.     

Relationships of cerebral MRI findings to ultrasonographic carotid atherosclerosis in older adults : the Cardiovascular Health Study. CHS Collaborative Research Group

Cerebral magnetic resonance imaging (MRI) has demonstrated a high prevalence of infarct-like lesions, white matter hyperintensities, and evidence of cerebral atrophy in older adults. While these findings are generally believed to be related to ischemia and atherosclerosis, their relationship to atherosclerosis in the carotid arteries remains to be explored. Study subjects were part of the multicenter Cardiovascular Health Study, a cross-sectional study of 3502 women and men >/=65 years of age undergoing cranial MRI and carotid ultrasonography. MRI infarcts were detected in 1068 participants (29.3%) and measurable carotid plaque in 2745 (75.3%). MRI infarcts, ventricular and sulcal widening, and white matter score were strongly associated with carotid intimal-medial thickness (IMT) and stenosis degree after adjustment for age and sex (all P<0. 01). Associations with plaque characteristics were less strong and less consistent; MRI infarcts were weakly associated only with surface irregularity, and ventricular size was weakly associated only with lesion density (both P<0.04). In contrast, sulcal widening was strongly related to plaque characteristics, with scores being higher in those with heterogeneous and irregular plaque (both P<0. 009). Adjustment for other risk factors, and for carotid IMT/stenosis, removed associations of MRI findings with plaque characteristics except for weak relationships remaining between MRI infarcts and surface irregularity and between sulcal score and heterogeneous plaque (both P<0.03). MRI abnormalities show strong and consistent relationships with increasing carotid IMT and stenosis degree but less strong associations with plaque characteristics, especially after adjusting for IMT and stenosis.     

Correlates of performance-based measures of muscle function in the elderly: the Cardiovascular Health Study

BACKGROUND: It is unknown how much age-related changes in muscle performance represent normal aging versus the effects of chronic disease and life style. We examined the correlates of four performance measures-gait speed, timed chair stands (TCS), grip strength, and maximal inspiratory pressure (MIP)-using baseline data from the Cardiovascular Health Study (CHS), a population-based study of risk factors for heart disease and stroke in persons > or = age 65. METHODS: We analyzed data from the 5,201 CHS participants. Variables were arranged into nine categories: Personal Characteristics, Anthropometry, Physical Condition, Reported Functional Status, Subjective Health, Psychological Factors, Symptoms, Cognitive Status, Habits and Lifestyle, and Prevalent Disease. Independent correlates were identified using stepwise linear regression. RESULTS: The regression models explained 17.7-25.4% of the observed variability. Although age significantly correlated with each measure, it explained little of the variability (< or = 5.7%). Anthropometric features plus physical condition explained 14.0-17.4% of the variability for grip strength and MIP, but 2.8-12.9% of the variability for gait speed and the log of TCS. Subjective health and psychological factors explained 1.8-9.4% of the variability in gait speed and the log of TCS, but < or = 1.2% of the variability in grip strength and MIP. Variables for prevalent disease explained < or = 1.3% of the variability in each measure. CONCLUSIONS: After age 64, age explained little of the variability in muscle performance in a large sample of mostly functionally intact, community-dwelling older persons. Complex measures such as gait speed were more associated with subjective factors than were direct measures of strength. Prevalent disease contributed surprisingly little to muscle performance.     

Relationship between cognitive and social dysfunction in schizophrenia

Cytogenetic monitoring was carried out on a group of 38 nurses who reconstitute antineoplastic drugs in order to determine the extent of chromosomal damage. Genotoxic activities of antineoplastic drugs are studied by chromosome aberration assay, micronucleus assay, sister chromatid exchange (SCE) frequency high frequency cells (HFC) analysis, and mitotic activity of peripheral lymphocytes. Results confirmed that occupational exposure to a mixture of antineoplastic drugs may cause genome damages. The results of this study show that biomonitoring after exposure to a mixture of antineoplastic drugs which express clastogenic and aneugenic activity should involve a battery of cytogenetic methods.     

Relationship between repression-sensitization and interpersonal cognitive complexity.

Administered Byrne's Repression-Sensitization (R-S) scale to 82 undergraduates. Ss then completed the Role Construct Repertory Test (G. Kelly), a measure of interpersonal cognitive complexity. An analysis of variance indicated a significant difference between R-S levels in terms of their interpersonal cognitive complexities. Multiple comparisons revealed that both sensitizers and neutrals were more cognitively complex than repressors. The negative category of role figures indicated more complexity across R-S levels than did the positive category. No interaction, however, was found between R-S levels and categories of role figures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between loneliness, social support, and decline in cognitive function in the hospitalized elderly

To determine the effects of preexisting levels of loneliness and social support on cognitive decline during hospitalization, 145 elderly subjects 65 to 92 years old without impaired cognition were tested for levels of loneliness, social support, and cognitive status on admission to an acute care hospital. Five days later, cognitive status was again measured in the remaining 86 patients. Loneliness was found to be inversely related to cognitive status on admission. In those with high loneliness scores on admission, cognitive status had improved significantly 5 days later. High social support was correlated with high cognitive status on admission and significant cognitive decline during hospitalization.     

Relationship between supervisory cognitive style and social orientation.

159 supervisors from 3 different organizations completed a version of the Embedded Figures Test and ranked 10 inner/outer-directed adjectives according to their importance for success on their jobs. The hypothesis that field independent supervisors rank inner-directed attributes as most important for success was supported for the attribute of "independence" in all 3 organizations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between cognitive tempo and selective attention in learning disabled children

The relationship between cognitive tempo and selective attention in 29 learning disabled children was investigated. The performance of the 9 reflective and the 9 impulsive children on selective-attention tasks was compared. An examination of t tests and correlations between variables for each task showed a relationship between cognitive tempo and selective attention. This relationship was stronger for central than for incidental recall.     

Relationship between supervisors' and trainees' cognitive styles and the supervision process.

33 beginning counseling practicum students and their supervisors rated their supervisory relationship and satisfaction with supervision; supervisors also evaluated their trainees. Ss' cognitive styles were determined through the Myers-Briggs Type Indicator (MBTI). The Barrett-Lennard Relationship Inventory, Counselor Evaluation and Rating Scale, and individual Likert scales were used as measures of the independent variables. Trainees' scores on certain indices (most notably the Sensing–Intuition index) were related to supervisors' perceptions of the interpersonal nature of their relationship, supervisors' satisfaction with trainees' performances, and supervisors' evaluations of trainees. On the other hand, supervisors' cognitive styles were not related to the independent variables. Cognitive style similarity between supervisor and trainees on specific MBTI scales was related to mutual perceptions of their interpersonal relationships. (44 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between cognitive style and cognitive development: A 2-year longitudinal study.

Examined developmental changes in the relationship between reflection–impulsivity, spatial perspective taking, and conservation behavior in 40 4–8 yr olds. Ss were administered the Matching Familiar Figures Test. Results indicate no relationship between these variables for 4-yr-olds. At 6 and 8 yrs of age, however, moderately strong negative correlations were found between impulsivity and the expression of operative knowledge. Structural regression analyses suggested that the expression of a reflective cognitive style at 6 yrs of age was causally linked to the emergence of operativity at 8 yrs of age. Longitudinal data confirmed a developmental shift from what is seen in perspective-taking tasks to how it is seen. Discussion focuses on the role of cognitive styles in the development and use of cognitive structures and on the nature of perspective-taking development. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between blood pressure and renal function

RENAL DAMAGE CAUSED BY HYPERTENSION: Renal vasoconstriction seems to be a key factor in the origin of arterial hypertension and accounts for the decrease in renal blood flow commonly observed in patients with hypertension. An inverse correlation has been found between renal blood flow and clinic blood pressure levels in established hypertension. Other features of renal damage attributable to high blood pressure have also been correlated with clinic blood pressure levels. Microalbuminuria is a good example of an alteration in renal function that depends in part on blood pressure levels. EFFECTS OF ANTIHYPERTENSIVE AGENTS: Antihypertensive agents can prevent or ameliorate renal vascular damage secondary to arterial hypertension, including renal failure. Ambulatory blood pressure monitoring is an excellent method of studying blood pressure levels in relation to end-organ damage and the blood pressure response to antihypertensive agents. Preliminary studies using this technique indicate that changes in renal function are closely correlated with the average daily blood pressure in arterial hypertension. CONCLUSIONS: Further studies are needed on the mechanisms of renal deterioration and on how to preserve renal function in arterial hypertension.     

Reflections on conceptual tempo: Relationship between cognitive style and performance as a function of task characteristics.

Reflectives have been shown to outperform impulsives on tasks that require a cautious, systematic approach. A study was conducted to determine whether reflectives, particularly high-anxious reflectives, would show superior performance on speeded tasks; i.e., whether they would exhibit flexibility vs continued caution at the expense of performance. 46 male and 54 female 4th graders, selected by their scores on the Test Anxiety Scale for Children and the Lie Scale for Children as being reflective and impulsive, high and low anxious, were presented with speeded tasks of increasing difficulty. Results reveal that contrary to prediction, high-anxious reflectives performed as well as low-anxious reflectives and both were generally faster and more accurate than impulsives. Only for girls on the most difficult task was there evidence that reflection in combination with high anxiety resulted in overly cautious behavior and impaired performance. Results suggest a definition of cognitive style that stresses the strategy used rather than the disposition for long or short decision times. In addition, a model is proposed to predict the relative speed and accuracy of reflectives and impulsives as a function of the strategy required and the degree of intertrial transfer on the task. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

健身气功与心性之关系研究

从健身气功的历史渊源与心性的思想来源探究它们存在着难以割舍的关系,对健身气功这种善行的直觉修养、道德追求、养心寡欲、身心一体进行逻辑分析,认为它的本质是体现道血气,以求长年、长心、长德.此为身也的心性修养.     

Genetic and vascular modifiers of age-sensitive cognitive skills: Effects of COMT, BDNF, ApoE, and hypertension.

Several single nucleotide polymorphisms have been linked to neural and cognitive variation in healthy adults. We examined contribution of three polymorphisms frequently associated with individual differences in cognition (Catechol-O-Methyl-Transferase Val158Met, Brain-Derived-Neurotrophic-Factor Val66Met, and Apolipoprotein E ?4) and a vascular risk factor (hypertension) in a sample of 189 volunteers (age 18-82). Genotypes were determined from buccal culture samples, and cognitive performance was assessed in 4 age-sensitive domains?fluid intelligence, executive function (inhibition), associative memory, and processing speed. We found that younger age and COMT Met/Met genotype, associated with low COMT activity and higher prefrontal dopamine content, were independently linked to better performance in most of the tested domains. Homozygotes for Val allele of BDNF polymorphism exhibited better associative memory and faster speed of processing than the Met allele carriers, with greater effect for women and persons with hypertension. Carriers of ApoE ε4 allele evidenced steeper age-related increase in costs of Stroop color interference, but showed no negative effects on memory. The findings indicate that age-related cognitive performance is differentially affected by distinct genetic factors and their interactions with vascular health status. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between cognitive status and behavioral symptoms in Alzheimer's disease and mixed dementia

OBJECTIVE: To investigate the relationship between cognitive and behavioral impairments in Alzheimer's disease (AD) and to examine whether the addition of cerebrovascular disease modifies that relationship. DESIGN: Correlational analysis. SETTING: An outpatient dementia clinic. PATIENTS: An autopsy-confirmed series of 28 patients with AD and 16 patients with mixed Alzheimer and vascular dementia (MIX). MEASUREMENTS: Neuropsychological and behavioral tests during life: Mini-Mental State (MMS), Blessed Dementia Scale (BDS), Haycox Dementia Behavior Scale (HDBS), and two non-cognitive functional scales derived from the BDS and HDBS. RESULTS: In the AD group, MMS scores correlated significantly with scores on the BDS, HDBS, and two non-cognitive functional scales. In the MIX group, however, no significant relationship was observed between MMS scores and scores on any of the behavioral measures. CONCLUSIONS: These observations suggest that in AD, cognitive and behavioral impairments progress simultaneously. However, with the addition of a vascular component to the dementing process, cognitive and behavioral impairments may progress more independently.     

The interaction between mood and cognitive function studied with PET

BACKGROUND: Experimentally induced depressed mood is a suggested model for retarded depression. We describe the neural response associated with induced mood and the locus of the interaction between systems mediating mood and cognitive function. METHODS: Normal subjects performed a verbal fluency task during induced elated and depressed mood states. Regional cerebral blood flow (rCBF) was measured as an index of neural activity using Positron Emission Tomography (PET). RESULTS: In both elated and depressed mood state rCBF was increased in lateral orbitofrontal cortex, rCBF was also increased in the midbrain in elated mood. In the depressed condition rCBF was decreased in rostral medial prefrontal cortex. Verbal fluency produced an expected increase of rCBF in left dorsolateral prefrontal, inferior frontal and premotor cortex, anterior cingulate and insula cortex bilaterally, the left supramarginal gyrus posteriorly and the thalamus. Activation in the verbal fluency task was attenuated throughout the left prefrontal, premotor and cingulate cortex and thalamus in both elated and depressed mood conditions. An attenuation of anterior cingulate activation was specific to depressed mood. CONCLUSIONS: Alteration of mood is associated with activation of orbitofrontal cortex which may be critical to the experience of emotion. The mood induced modulation of verbal fluency induced activations is consistent with resting state findings of decreased function in these regions in depressed patients. The present data suggest that resting state rCBF profile may represent the modulation of spontaneous activity in this network by a core system that is dysfunctional in depression.     

Relationship between external resistances, lung function changes and maximal exercise capacity

In upper airway obstruction (UAO) the relationship between the degree of obstruction, exercise limitation and lung function indices is not well established. Therefore, we investigated in nine healthy subjects (age 36+/-9 yrs) the effects of two added resistances at the mouth (R1 = added resistance with 7.8 mm diameter; R2 = 5.7 mm) on forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), airway resistance (Raw) and maximal breathing capacity (measured during 15 s = measured maximum breathing capacity (MBCm); calculated as FEV1x37.5 = calculated maximum breathing capacity (MBCc)) on the one hand, and maximum exercise capacity (W'max), minute ventilation (V'E) and CO2 elimination (V'CO2) on the other. We found that R1 had almost no influence on FEV1 but decreased PEF by approximately 35% and increased Raw by almost 300%; it decreased W'max by merely approximately 10% while maximal exercise ventilation (V'Emax) was only 65% of control and only reached approximately 40% MBCc and approximately 70% MBCm; yet V'E and V'CO2 were significantly reduced at high exercise levels indicating hypoventilation. With R2, FEV1 was reduced by 25% and PEF by 55%, and Raw was increased by 600%; W'max was approximately 60% of control, V'Emax was only 35% of control and reached approximately 30% MBCc and approximately 60% MBCm, V'E was already reduced at moderate exercise levels. We conclude that: 1) an upper airway obstruction of 6 mm diameter (but not of 8 mm) had a marked influence on maximum exercise capacity due to hypoventilation; 2) calculated maximum breathing capacity markedly overestimated measured maximum breathing capacity because the forced expiratory volume in one second is an insensitive index of upper airway obstruction and because it does not take inspiratory flow limitation into account; and 3) a 10% decrease in maximum exercise capacity was linearly related with a 7% decrease in the forced expiratory volume in one second and a 150% increase in airway resistance. A 10% decrease in maximal exercise ventilation was related to a 8.5% decrease in peak expiratory flow and 9% decrease in measured maximum breathing capacity.