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An estimated 65% of ischemic stroke survivors experience
cognitive impairment and decline.
However, little is known about
the varying roles of cognitive risk
and protective factors before, during, and after stroke. To address
this gap in knowledge, scientists
examined changes in cognitive
function surrounding ischemic
stroke in older women over an
8-year period. The retrospective
study, published in Aging, Neuropsychology, and Cognition, analyzed data from 159 participants
ages 65 to 79.
Cognitive function was examined
in three phases: (a) 3 years prior
to ischemic stroke, (b) at the time
of ischemic stroke, and (c) up to 3
years after ischemic stroke. At each
of these phases, the researchers examined how women’s characteristics
were related to cognitive functions,
such as memory, attention, and
verbal fluency.
The team found that a higher
body mass index, presence of hypertension, lower optimism, and higher
physical function were all associated
with significantly greater decreases
in cognitive function at the time
of stroke. However, after ischemic
stroke, there was significantly less
cognitive decline in women with the
same characteristics.
Based on these findings,
interventions could be designed to
target modifiable risk and protec-
Low Memory Test Scores May Predict Alzheimer’s
Disease Earlier
A new study in
Neurology suggests that
errors on memory and
thinking tests may signal
Alzheimer’s disease up
to 18 years before it can
be diagnosed. For the
study, 2,125 European
American and African
American individuals
from Chicago with an
average age of 73 and
without Alzheimer’s
disease were given tests
of memory and thinking skills every 3 years for 18 years.
Twenty-three percent of African Americans and 17% of European
Americans developed Alzheimer’s disease during the study. Individuals
who scored lower overall on the memory and thinking tests had an
increased risk of developing the disease. During the first year of the
study, individuals with lower test scores were approximately 10 times
more likely to be diagnosed with Alzheimer’s disease than those with
higher scores, with the odds increasing by 10 for every standard deviation that the score was lower than the average.
Based on tests completed 13 to 18 years before the final assessments,
one unit lower in performance of the standardized cognitive test score
was associated with an 85% greater risk of future dementia.
© 2015 Shutterstock.com
Physical and
Psychological Factors
Affect Cognitive
Function After Ischemic
Strokes
Source. “Low Scores on Memory and Thinking Tests May Signal Alzheimer’s Earlier than
Thought.” (2015, June 25). Retrieved August 3, 2015, from http://bit.ly/1P4InY8.
tive factors, and to identify individuals likely to receive the greatest
benefit. Further research is needed
on the role of psychological factors (e.g., optimism, depression) in
cognitive decline after stroke, especially in older women, to develop
better psychosocial interventions.
Source. “Physical, Psychological Factors
Have Varied Effects on Cognitive Function
in Elderly Female Stroke Patients.” (2015,
July 6). Retrieved July 9, 2015, from http://
bit.ly/1Rmsm4A.
JOURNAL OF GERONTOLOGICAL NURSING • VOL. 41, NO. 9, 2015
New Study Shows
Inflammation Plays a
Role in the Onset of
Delirium
Delirium is an acute state of
confusion that often affects older
adults following surgery or serious
illness. Now a study published in
the Journals of Gerontology, Series
A: Biological Sciences and Medical
5
Sciences confirms that inflammation (i.e., an immune response that
develops when the body attempts
to protect itself from harmful
stimuli) plays a role in the onset of
delirium.
Researchers examined data
from a patient cohort that followed 566 noncardiac surgical
patients older than 70 for the past
5 years with the goal of finding new
approaches to prevent delirium and
its long-term consequences in older
adults.
The researchers used a threestage approach to examine the
association between inflammatory cytokines and delirium. They
first created what they called a
discovery cohort from a dataset of
the first 272 participants, in which
the matching procedure identified
39 matched pairs of delirium cases
and no-delirium controls. Second, they considered the remaining study sample to identify 36
matched pairs of cases and controls,
© 2015 Shutterstock.com
© 2015 Shutterstock.com
Older Adults Prescribed Mental Health Drugs at
More Than Twice the Rate of Younger Adults
called the replication cohort. Third,
they combined these two cohorts
to create the pooled cohort, which
contained 75 matched pairs.
The researchers then measured
cytokines in blood samples taken
prior to surgery to establish a
baseline figure. Additional measurements were then taken at
three separate time points. Older
patients with delirium had significantly elevated levels of the
inflammatory marker interleukin-6
2 days after surgery; elevated levels
6
Older Americans receive prescriptions for mental health medications at more than twice the rate than younger adults, a new study
finds. They are also much less likely to get mental health care from a
psychiatrist. The new findings come from the first study to compare
overall outpatient mental health treatment in adults older than 65
with that of patients ages 18 to 64.
Researchers started with information from more than 100,000 outpatient visits to outpatient physicians between 2007 and 2010
collected by the National Ambulatory Medical Care Survey. They
examined four types of visits: where patients (a) received a mental
health diagnosis, (b) saw a psychiatrist, (c) received psychotherapy,
and/or (d) received a prescription or renewal of a psychotropic
medication. They converted the results to a population-based visit
rate, which helped consider the number of visits of the eligible pool of
potential outpatients in the community.
Visits related to antidepressant agent and anti-anxiety drug use
among older adults (63 and 62 visits per 100 individuals per year,
respectively) occurred at nearly double the rates of such visits by
younger adults (36 and 29 visits per year per 100 individuals, respectively). In contrast, older adults saw psychiatrists at approximately
one half of the rate of younger adults (6.3 vs. 12 visits per year per
100 individuals).
Source. “Seniors Get Mental Health Drugs at Twice the Rate of Younger Adults, but See Psychiatrists Less .” (2015, July 29). Retrieved August 3, 2015, from http://bit.ly/1IXIwxA.
of interleukin-2 were also identified in delirious patients. Together,
these findings may help clinicians
identify patients at greatest risk of
developing delirium and aid in the
treatment of this condition.
Source. “Link Between Inflammation and
Delirium Shown in Older Patients.” (2015,
July 23). Retrieved August 3, 2015, from http://
bit.ly/1M3pchk.
Changes in Biomarkers
May Predict Dementia
By studying brain scans and
cerebrospinal fluid of healthy
adults, scientists have shown that
Copyright © SLACK Incorporated
VOLUME
40, NUMB
© 2015 Shutterstock.com
changes in key biomarkers of
Alzheimer’s disease during midlife
may help identify individuals who
will develop dementia years later,
according to a study published in
JAMA Neurology.
The study focused on data
gathered over 10 years and
involved 169 cognitively normal
research participants ages 45 to 75.
Each participant received a complete clinical, cognitive imaging,
and cerebrospinal fluid biomarker
analysis every 3 years, with a
minimum of two evaluations. At
the initial assessments, researchers
divided participants into three age
groups: early-middle age (45 to
54 years); mid-middle age (55 to
64 years); and late-middle age (65
to 74 years).
The scientists found that drops
in amyloid beta 42 levels in the
cerebrospinal fluid among cognitively normal participants (ages 45
to 54) are linked to the appearance
of plaques in brain scans years
later. Researchers also found that
tau and other biomarkers of braincell injury increase sharply in some
individuals as they reach their
mid-50s to mid-70s, and YKL-40
rises throughout the age groups.
Previous research has shown
that these biomarkers may be
affected by Alzheimer’s disease,
but this is the first large data
set to show that the biomarkers
change over time in middleaged individuals. Scientists have
been following participants
4
䉸
F O R
Source. “Midlife Changes in Alzheimer’s
Biomarkers May Predict Dementia.” (2015,
July 3). Retrieved July 9, 2015, from http://bit.
ly/1IMDXVe.
doi:10.3928/00989134-20150814-44
ER 4
APRIL 201
CNE ARTIC
with and without a family history of the disease, with the
aim of identifying Alzheimer’s
biomarkers most closely associated with the development of fullblown disease years later.
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