Memory Complaints in Older Adults: Prognostic Value and Stability in Reporting over Time.

OBJECTIVE: The purpose of this longitudinal study was to examine the prognostic value of subjective memory complaints in 156 cognitively intact community-dwelling older adults with a mean age of 83 years. METHODS: Participants were assessed for subjective memory complaints, cognitive performance, functional status, and mood at annual evaluations with a mean follow-up of 4.5 years. RESULTS: Subjective memory complaint at entry (n=24) was not associated with impaired memory performance and did not predict memory decline or progression to incipient dementia. Memory complaints were inconsistent across examinations for 62% of participants who reported memory problems. CONCLUSIONS: Memory complaints by older adults are inconsistent over time. Memory complaint's value as a research criterion for selecting people at risk for dementia is weak among community dwelling older adults. Age, length of follow-up, and other population characteristics may affect the implication of self-reported memory problems.

Intelligent Systems For Assessing Aging Changes: home-based, unobtrusive, and continuous assessment of aging.

OBJECTIVES: To describe a longitudinal community cohort study, Intelligent Systems for Assessing Aging Changes, that has deployed an unobtrusive home-based assessment platform in many seniors homes in the existing community. METHODS: Several types of sensors have been installed in the homes of 265 elderly persons for an average of 33 months. Metrics assessed by the sensors include total daily activity, time out of home, and walking speed. Participants were given a computer as well as training, and computer usage was monitored. Participants are assessed annually with health and function questionnaires, physical examinations, and neuropsychological testing. RESULTS: Mean age was 83.3 years, mean years of education was 15.5, and 73% of cohort were women. During a 4-week snapshot, participants left their home twice a day on average for a total of 208 min per day. Mean in-home walking speed was 61.0 cm/s. Participants spent 43% of days on the computer averaging 76 min per day. DISCUSSION: These results demonstrate for the first time the feasibility of engaging seniors in a large-scale deployment of in-home activity assessment technology and the successful collection of these activity metrics. We plan to use this platform to determine if continuous unobtrusive monitoring may detect incident cognitive decline.

Serial position effects in mild cognitive impairment.

Mild cognitive impairment (MCI) is often associated with the preclinical phase of Alzheimer's disease (AD). Special scoring of word-list recall data for serial position has been suggested to improve discrimination of normal aging from dementia. We examined serial position effects in word-list recall for MCI participants compared to Alzheimer patients and controls. Individuals with MCI, like Alzheimer patients, had a diminished primacy effect in recalling words from a list. No alternative scoring system was better than standard scoring of word-list recall in distinguishing MCI patients from controls. Retention weighted scoring improved the discrimination of MCI and AD groups.

Unobtrusive assessment of activity patterns associated with mild cognitive impairment.

BACKGROUND: Timely detection of early cognitive impairment is difficult. Measures taken in the clinic reflect a single snapshot of performance that might be confounded by the increased variability typical in aging and disease. We evaluated the use of continuous, long-term, and unobtrusive in-home monitoring to assess neurologic function in healthy and cognitively impaired elders. METHODS: Fourteen older adults 65 years and older living independently in the community were monitored in their homes by using an unobtrusive sensor system. Measures of walking speed and amount of activity in the home were obtained. Wavelet analysis was used to examine variance in activity at multiple time scales. RESULTS: More than 108,000 person-hours of continuous activity data were collected during periods as long as 418 days (mean, 315 +/- 82 days). The coefficient of variation in the median walking speed was twice as high in the mild cognitive impairment (MCI) group (0.147 +/- 0.074) as compared with the healthy group (0.079 +/- 0.027; t(11) = 2.266, P < .03). Furthermore, the 24-hour wavelet variance was greater in the MCI group (MCI, 4.07 +/- 0.14; healthy elderly, 3.79 +/- 0.23; F = 7.58, P

Patterns of dietary supplement usage in demographically diverse older people.

OBJECTIVE: To analyze dietary supplement usage data from 494 older adults, aged 65 to 101 years. SETTING: Community dwellers living independently of institutionalized care. DESIGN: All dietary supplements, including botanicals, were recorded to aid in assessing the health status of older adults. PARTICIPANTS: 1) 224 individuals enrolled in a study that follows the health of persons 85 years and older (oldest-old) in Klamath County, a non-metropolitan area in southern Oregon; 2) 134 participants of oldest-old age living in the metropolitan Portland area, enrolled in a randomized clinical trial of GBE biloba extract (GBE) for dementia prevention; and 3) 136 participants, ages 65-85 years (young-old), also of the Portland area, enrolled in a study of the effects of yoga and exercise on cognition. MEASUREMENTS: Data verified from labels, not from self-report. RESULTS: Of the participants, 70.6% used dietary supplements. Women took supplements more often than men, and usage decreased with age. A greater percentage, 67.4%, of the non-metropolitan oldest-old took supplements, compared to 56.7% of the metropolitan oldest-old. The greatest usage, 89.7%, was in the metropolitan young-olds. All of these percentages exceed those for comparable age groups in national representative surveys. CONCLUSIONS: Dietary supplement usage by older adults in these studies in Oregon exceeded that in other reports and may reflect high interest in complementary and alternative medicine. This report confirms the results of other studies showing that elderly adults, particularly women, use dietary supplements more than other segments of the US population. Researchers and clinicians should be aware of this pattern and potential conflicts with research design or treatment regimen intended for older people.

MRS in relation to hippocampal volume in the oldest old.

The MRS brain metabolite ratio N-acetylaspartate (NAA)/myo-inositol (mI) is reported to be decreased in AD. MRS was used to study medial temporal and parietal regions in 60 cognitively healthy subjects older than 85 years. Subjects with small hippocampal volumes, a putative risk factor for dementia, had significantly lower NAA/mI in parietal and temporal lobes compared with other subjects. Neuropsychological tests and APOE genotype did not correlate with MRS ratios. MRS measures are candidate biomarkers for dementia risk.