Aging / Alzheimer's Disease
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/31250
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Browsing Aging / Alzheimer's Disease by Subject "Mild Cognitive Impairment"
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Item A DEPRESSIVE SUBGROUP OF MILD COGNITIVE IMPAIRMENT(2013-04-12) Cushing, BlairPurpose: Late life depression is a risk factor for Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD). MCI represents a transitional period between normal aging and AD and, therefore, represents a potential entry point for preventing AD. Depression is a risk factor for MCI and AD; however, identifying which MCI patients suffer depression-related cognitive impairment remains difficult. The current study sought to identify a clinically-defined depressed sub group among patients with MCI Methods: Data was analyzed from 519 participants (112 MCI) from Project FRONTIER, an ongoing epidemiological study of factors impacting rural aging and health. Depression was assessed with GDS30 and cognition was assessed using the EXIT 25 and RBANS. The sample was randomly split into the training and test sample. Five GDS items were identified in the training sample that were significantly associated with MCI status and were used to create the depressive endophenotype (DepE) of MCI. In the test sample, linear regression was used to examine the impact of depression on neuropsychological tests performance, and logistic regression was conducted to examine the risk of being diagnosed with MCI. Results: In the test sample, DepE was negatively related to RBANS scores of Immediate Memory (B=-2.22, p<0.001), Visuospatial (B=-1.11, p<0.001), Language (B=-1.03, p<0.001), Attention (B=-2.56, p<0.001), and Delayed Memory (B=-1.54, p<0.001), and higher DepE scores were related to poorer executive functioning (EXIT25; B=0.65, p=0.001). DepE scores significantly increased risk for MCI ([OR]= 2.04; 95% CI=l.54-2.69). Conclusions: These findings suggest that a depressed subgroup of MCI exists. Higher DepE scores increased risk for MCI and increased risk for poorer neuropsychological functioning across a range of domains. The DepE may identify those MCI patients who experience depression-related cognitive dysfunction, thereby detecting a selective group that may benefit from depression treatment for prevention of AD.Item THE LINK BETWEEN POTASSIUM AND MILD COGNITIVE IMPAIRMENT IN MEXICAN AMERICANS(2013-04-12) Rohlfing, GeoffreyPurpose: Assessing electrolytes is a cornerstone of the geriatric primary care visit. Research suggests that potassium may be linked to Alzheimer's Disease (AD) and cognitive functioning; however, this link has not been investigated in Mild Cognitive Impairment (MCI) a prodromal category to AD. The purpose of this study was to examine the link between serum electrolytes and diagnosis of MCI. Methods: Data on a total of 473 participants (278 non-Hispanic white and 195 Mexican American) from Project FRONTIER were analyzed. Each participant underwent an interview (i.e. medical history, medications, health behaviors), neuropsychological testing, blood draw, and medical examination, and informant interviews. Weekly consensus reviews were conducted reviewing the data and diagnoses of MCI assigned according to published criteria by clinical experts. Participants classified as cognitively normal control (NC) performed within normal limits on all psychometric assessment. Serum electrolytes included in this study were sodium, chloride, carbon dioxide, and potassium. Age and Education were entered into the models as co-variates. Logistic regression was used to assess the risk of MCI diagnosis. Analysis was split by ethnicity. Results: For Mexican Americans, the results of this study indicated that serum potassium levels significantly increased the risk of diagnosis of MCI (odds ratio [OR]= 3.2, 95% CI=1.2 to 8.2). No other electrolytes were found to significantly increase risk for MCI. For non-Hispanic whites, age and education alone increased risk for MCI diagnosis. No electrolytes were found to increase risk for MCI diagnosis for this ethnic group. Conclusions: Our findings suggested a link between serum potassium levels and a diagnosis of MCI for Mexican Americans. The results of this study support previous research which has suggested that the risk factors for MCI may vary by ethnicity. Additional work is needed to cross-validate these findings and examine their utility in designing treatment protocols.