Rudolf W. H. M. Ponds

Cognitive functioning in healthy older adults aged 64-81: a cohort study into the effects of age, sex, and education.

ABSTRACT The objective of this study was to determine a possible differential effect of age, education, and sex on cognitive speed, verbal memory, executive functioning, and verbal fluency in healthy older adults. A group of 578 healthy participants in the age range of 64–81 was recruited from a large population study of healthy adults (Maastricht Aging Study). Even in healthy individuals in this restricted age range, there is a clear, age-related decrease in performance on executive functioning, verbal fluency, verbal memory, and cognitive speed tasks. The capacity to inhibit information is affected most. Education had a substantial effect on cognitive functioning: participants with a middle or high level of education performed better on cognitive tests than did participants with a low level of education. Women performed better than men on verbal memory tasks. Therefore, education and sex must be taken into account when examining an older individuals cognitive performance.

Cognitive Functioning after Stroke: A One-Year Follow-Up Study

Cognitive disorders after stroke are one of the main causes of disability in daily activities. The main aim of this study was to investigate the frequency of post-stroke dementia, post-stroke mild cognitive impairment (MCI) and post-stroke amnestic MCI at different times after first-ever stroke; 196 patients were included in the study. In addition, cognitive disorders and their clinical course were studied. Frequency of post-stroke dementia was about 10% at all evaluation times; most patients had post-stroke MCI. Of the cognitive functions investigated, mental speed and calculation were most frequently affected. Performance on almost all cognitive tests was improved 6 and 12 months after stroke. Thus, while the frequency of post-stroke dementia is low, the frequency of post-stroke MCI is high, but improvement of cognitive function is possible.

Mental work demands protect against cognitive impairment: MAAS prospective cohort study.

Little is known about whether persons with mentally demanding jobs are protected against cognitive impairment and whether this association is independent of intellectual abilities and other confounders. Longitudinal data from the Maastricht Aging Study (MAAS) were used to examine this association. After the 1993-1995 baseline examination, there was a first 3-year follow-up examination (1996-1998) among 630 men and women, aged 50 to 80, who exhibited no cognitive impairment at baseline. Persons with mentally demanding jobs had lower risks of developing cognitive impairment during follow-up (36 cases), compared with persons without such jobs (odds ratio = 0.79; 95% confidence interval: 0.65-0.96). About 1.5% of the persons with high mental work demands developed impairment compared to 4% of the persons with few work demands. The protective effect was independent of intellectual abilities and other confounders. Our findings provide evidence that continued and potentially modifiable mental stimulation during adult life may protect men and women against cognitive impairment.

Prevalence and Covariates of Subjective Forgetfulness in a Normal Population in the Netherlands

In this study we examined the prevalence and covariates of forgetfulness in a large sample of almost 2,000 subjects in the age range twenty-four to eighty-six years. Nearly 40 percent of the participants considered themselves to be forgetful. There was a systematic increase in the prevalence of forgetfulness with age, from 29 percent in the young age group to 52 percent in the oldest age group. Forgetfulness was not considered to be a serious problem in terms of perceived hindrance and worry by most subjects, independent of their age. Age, depression, and subjective health (especially complaints about vitality) acted as covariates of forgetfulness. Gender and education had no effect on the prevalence of forgetfulness. The younger adults ascribed their forgetfulness more to potentially reversible and manageable memory-extrinsic causes such as tension and emotional problems, whereas the older adults mentioned less manageable and more or less irreversible memory-intrinsic causes such as aging more often.

Distinction Between Preclinical Alzheimer's Disease and Depression

OBJECTIVE: To assess the prevalence of depression in subjects with preclinical Alzheimers disease (AD) and to investigate the possibility of differentiating subjects with preclinical AD and depression from subjects with depression‐related cognitive impairment.

Driving competence in older persons

Older drivers form a growing segment of the driving population which in comparison to most other modes of transportation, is relatively user-friendly for older people. There are two important problems. The first is the increase of physical vulnerability with age which means that the same accident often leads to much more severe injury in an older than a younger adult driver. The second problem is the decline of sensory, perceptual-motor and cognitive abilities (impairments) because of ageing-related degenerative processes and diseases. As a result, processing of and responding to traffic information is slowed and activities cannot well be performed simultaneously. Much of this may be compensated by behavioural changes. However, studies of accident characteristics and driving skill in relation to ageing suggest that compensation breaks down in complex and ambiguous traffic situations and in individuals with strongly impaired perceptual and cognitive function. Possible changes to reduce ageing-related accidents, and which make driving more user-friendly for older drivers, are discussed.

Effect of test duration on age-related differences in Stroop interference

The effect of test duration on age-related differences in Stroop interference was assessed in a large cross-sectional study involving 429 healthy subjects in four age groups (25-35 years, 40-50 years, 55-65 years, 70-80 years). The results show a clear effect of test duration on Stroop interference. The Stroop Color Word Test was run in two parts. The young group performed the first part relatively rapidly but became slower in the second part, whereas the old group showed the reverse effect. The two middle-aged groups did not show differences between the first and second parts of the test. The results are interpreted in terms of a deficit in response inhibition by a controlled processing strategy. A psychological interpretation of the study findings in terms of increased cautiousness appears less probable. The first part of the test, that is, an abridged version of the test, may prove superior to the regular version for both clinical and research purposes.

Memory complaints in elderly people: the role of memory abilities, metamemory, depression, and personality

This study examined the relation between memory complaints, memory performance, and metamemory variables by comparing a group of elderly participants (n = 50) with memory complaints with a group of participants without memory complaints (n = 52). The groups were matched for age, sex, and education; mean age was 63 years. Data were also collected for personality variables (anxiety, neu‐roticism) and affective state. Metamemory was measured with the Metamemory in Adulthood (MIA) questionnaire. The memory tests used were the Auditory Verbal Learning Test, the Rivermead Behavioral Memory test, and two category fluency tasks. Significant group differences were found on all subscales of the MIA (except Locus) and for verbal fluency and depression. Logistic regression analysis with depression, memory performance, and the MIA as independent variables showed that only the memory self‐efficacy factor of the MIA (Capacity, Change, and Anxiety subscales) could discriminate between the groups. Furthermore, those in th...

Engaged lifestyle and cognitive function in middle and old-aged, non-demented persons: a reciprocal association?

Summary. Some studies have shown that cognitive function is positively affected by an engaged and active lifestyle. However, a recent study found evidence for an opposite causal direction, i.e., persons with good cognitive function more often start to engage in leisure-time activities. Here, we longitudinally examine the causal direction of the association between an engaged lifestyle and cognitive function in middle and old-aged Dutch men and women.    The participants in the prospective cohort study “Maastricht Aging Study” (MAAS) were recruited from a register of 15 family practices in the South of the Netherlands. There were 830 non-demented men and women, aged 49 to 81 in 1993–1995 (baseline phase). They were re-examined three years later (follow-up phase). During both phases, all persons reported on their participation in mental, social, and physical activities. Six separate neuropsychological tests, including the Mini-Mental State Examination, were used to define cognitive function at baseline and follow-up.    All three activities measured were negatively related to cognitive decline between both phases. Effects were moderate, but consistent. Persons participating in all three activities were particularly protected against longitudinal decline. Furthermore, persons with the best baseline cognitive performance were more likely to increase their number of activities during follow-up compared with persons with the poorest scores.    In summary, an engaged lifestyle and cognitive function mutually influence each other in middle and old aged, non-demented persons. This reciprocal association is characterized by simultaneous positive effects of leisure-time activities and good cognitive function on cognitive function and leisure-time activities, respectively. This reciprocal association may create a self-reinforcing, beneficial or adverse life-course in middle and old age.Zusammenfassung. Verschiedene Untersuchungen haben ergeben, dass ein engagierter Lebensstil die kognitive Funktion positiv beeinflusst. Jedoch, eine rezente Untersuchung hat eine entgegengesetzte kausale Richtung dargestellt, d.h. dass Personen, die gut kognitiv funktionieren, häufiger und früher Freizeitaktivitäten entwickeln. In dieser Studie haben wir den kausalen Zusammenhang zwischen einem aktiven Lebensstil und der kognitiven Funktion bei älteren und alten niederländischen Männern und Frauen erforscht.   Für diese prospektive Kohorten-Untersuchung „Maastricht Aging Study (MAAS)“ entnahmen wir die Teilnehmernamen einem ärztlichen Register von 15 Praxen im Süden der Niederlande. In den Jahren 1993–1995 untersuchten wir 830 nicht-demente Männer und Frauen im Altersbereich von 49–81 Jahren (erste Phase). Nach drei Jahren wurde die Untersuchung wiederholt (zweite Phase). In beiden Phasen wurden die Personen um ihre mentalen, sozialen und physischen Aktivitäten befragt. Damit das kognitive Funktionieren in der ersten und zweiten Phase festgestellt werden konnte, verwendeten wir sechs unterschiedliche neuropsychologische Tests, einschließlich der Mini Mental State Examination.    Die drei untersuchten Aktivitäten beeinträchtigten, jede für sich die kognitive Leistung zwischen den beiden Phasen. Die Effekte waren zwar bescheiden, aber konsistent. Die Personen, die alle drei Aktivitäten ausübten, waren besonders vor kognitiver Beeinträchtigung geschützt. Die Personen, die ihre Aktivitäten zwischen der ersten und zweiten Phase erweitern, waren auch diejenigen, die in der ersten Phase am besten kognitiv funktionierten.    Kurz gefasst, ein aktiver Lebensstil und die kognitive Funktion beeinflussen sich bei nicht dementen Personen mittleren und höheren Alters gegenseitig und im positiven Sinne. Diese reziproke Assoziation wird durch simultane, positive Effekte von Freizeitaktivitäten auf die kognitive Funktion einerseits, und von der kognitiven Funktion auf die Freizeitaktivitäten andererseits charakterisiert. Diese reziproke Assoziation kann bewirken, dass sich – sich selbst verstärkend – ein positiver oder aber ungünstiger Lebensverlauf in mittlerem und höherem Alter entwickelt.

Memory self-efficacy predicts memory performance: Results from a 6-year follow-up study.

The purpose of this study was to examine the relationship between memory self-efficacy (MSE) and a 6-year follow-up assessment of memory functioning in a sample of Dutch older adults. MSE was assessed by a Dutch abridged version of the Metamemory in Adulthood questionnaire (MIA; R. A. Dixon, D. F. Hultsch, & C. Hertzog, 1988; C. Hertzog, D. F. Hultsch, & R. A. Dixon, 1989; R. W. H. M. Ponds & J. Jolles, 1996). The total MSE score predicted memory performance at 6 years, as measured by the Visual Verbal Learning Task (VVLT; N. Brand & J. Jolles, 1985). A separate analysis of the different MSE subscales indicated that the MIA Change score was the most salient domain-specific MSE predictor of subsequent memory performance after 6 years. An extreme groups analysis of the MIA Change score revealed a pattern of performance for those who perceived that their memory was worsening, performing less well on the 3 trials of the VVLT when these were readministered at the 6-year follow-up.