Taeko Makino

Relationship between small cerebral white matter lesions and cognitive function in patients with Alzheimer's disease and amnestic mild cognitive impairment

The main purpose of the present study was to investigate the influence of small cerebral white matter lesions on cognitive functions, and its difference by clinical stage.

Relationship between cardiac autonomic function and cognitive function in Alzheimer's disease

Alzheimers disease (AD) affects many central nervous structures and neurotransmitter systems. These changes affect not only cognitive function, but also cardiac autonomic function. However, the functional relationship between cardiac autonomic function and cognition in AD has not yet been investigated. The objective of the present study was to evaluate the association between cardiac autonomic function measured by heart rate variability and cognitive function in AD.

The Associations among Insulin Resistance, Hyperglycemia, Physical Performance, Diabetes Mellitus, and Cognitive Function in Relatively Healthy Older Adults with Subtle Cognitive Dysfunction

Insulin resistance (IR), diabetes mellitus (DM), sarcopenia, and cognitive dysfunction are thought to be mutually associated. We conducted a comprehensive assessment of the relationships among IR, gait speed, hyperglycemia, and DM by cross-sectionally analyzing the baseline data of an interventional study for cognitive preservation with physical exercise (the TOyota Preventional Intervention for Cognitive decline and Sarcopenia [TOPICS]). The participants (n = 444) were relatively healthy older individuals who had mild cognitive impairment without dementia, and 61 of the participants had DM. Slow gait speed and hyperglycemia were associated with cognitive dysfunction, mainly in the executive function domain, whereas IR was associated with memory impairment. The participants with DM had lower general cognition and executive function. Executive dysfunction in the DM participants seemed to be partly explained by hyperglycemia and/or slow gait speed. Our findings confirmed that IR, DM, sarcopenia, and cognitive dysfunction are mutually associated in complex ways. Understanding the mechanisms underlying these associations will lead to effective strategies to prevent and treat cognitive dysfunction in older individuals.

Objectively measured physical activity and cognitive function in urban-dwelling older adults: Physical activity and cognition

Physical activity (PA) and cognition have reportedly been associated with each other. However, it remains to be elucidated what intensities of PA are most strongly associated with cognition. In the current study, we aimed to determine the association between the intensities of objectively measured PA and cognitive function.

Neuroanatomical Correlates of Error Types on the Clock Drawing Test in Alzheimer’s Disease Patients

We sought to identify the relationship between regional cerebral blood flow (rCBF) and error types on the Clock Drawing Test (CDT) in patients with Alzheimers disease (AD).

Cognitive Dysfunction in Urban-Community Dwelling Prefrail Older Subjects

ObjectivesA number of studies have reported that frailty is cross-sectionally associated with cognitive decline and is also a risk for future cognitive decline or dementia; however, there have been only a few studies that focus on the association between prefrailty and cognitive dysfunction. In the current study, we investigated the association between prefrailty and cognitionDesignA cross-sectional study of the data obtained at registration in a randomized control trial.SettingToyota, Japan.ParticipantsCommunity-dwelling older subjects (male 54.6%) who had cognitive complaints.MeasurementsA battery of neuropsychological and physical assessments were performed. Prefrailty was defined as exhibiting one or two of the five Fried criteria (weight loss, exhaustion, weakness, slow gait speed and low physical activity). We performed a multiple regression analysis to investigate the associations of cognitive performance with prefrailty, adjusting for the factors that were significantly different between the robust and prefrailty groups. To assess the cognitive attributes that were significantly associated with prefrailty, logistic analysis was performed to see if one specific criterion of the five frailty criteria was associated with cognitive performance.ResultsThe study subjects included 183 prefrail and 264 robust individuals. The prefrail subjects with cognitive complaints were older, less educated, more depressive, and more likely to have diabetes mellitus than the robust subjects. The prefrail subjects had lower performance in a wide-range of cognitive domains, and after adjustments for age, education, depressive mood, and diabetes mellitus, prefrailty was associated with a decline in delayed memory and processing speed. Among the components of the Fried criteria, slow gait speed and loss of activity were significantly associated with slow processing speed as assessed by the digit symbol substitution test.ConclusionThe current results demonstrated that prefrailty was associated with worse memory and processing speed performance, but not with other cognitive domains.

Maximum gait speed is associated with a wide range of cognitive functions in Japanese older adults with a Clinical Dementia Rating of 0.5: Maximum gait speed and cognition

Physical and cognitive functions are mutually associated. However, it is unknown which markers of physical functions or body composition are most strongly associated with cognition. Here, we explored the association between body composition/physical performance and comprehensive neuropsychological assessments in an effort to identify reliable markers of cognition among factors in body composition/physical performance, including both usual and maximum gait speeds.

Association between insulin resistance and objective measurement of physical activity in community-dwelling older adults without diabetes mellitus

AIMS The main objective of this study was to determine the association between objectively measured physical activity (PA) and cardiometabolic risk factors, particularly insulin resistance (IR), in Japanese community-dwelling older adults without diabetes mellitus. METHODS Daily PA was measured by accelerometers in 388 community-dwelling older adults. IR was determined using homeostasis model assessment of insulin resistance (HOMA-IR). Regression analyses adjusted by age and sex were performed to determine the association of light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), or total steps per day with cardiometabolic risk factors. Then, multiple regression analysis was performed with HOMA-IR as an independent variable and those factors with p < 10% in the regression analysis as explanatory variables. RESULTS Objectively measured LPA was negatively associated with systolic blood pressure, diastolic blood pressure, waist circumference, body mass index, and triglyceride (TG) and positively associated with high-density lipoprotein cholesterol (HDL-C). LPA was also negatively associated with IR. Total steps per day also had significant association with IR. MVPA was associated with TG, HDL-C, and IR. Multiple regression analysis showed that the association between LPA and IR was independent of other covariates, whereas that between MVPA and IR was lost after adjustment for other covariates. CONCLUSION IR was associated with LPA or total steps, but not with MVPA, in community-dwelling older adults without diabetes mellitus.

EFFECTS OF AEROBIC TRAINING ON FUNCTIONAL CONNECTIVITY IN THE BRAINS OF OLDER ADULTS WITH AMNESTIC MILD COGNITIVE IMPAIRMENT

impairment at low genetic risk for Alzheimer’s (defined as APOE ε4 non-carriers), long-term statin-use was associated with lower tau (p1⁄40.033) and marginally non-significantly associated with lower amyloid (p1⁄40.073), with both analyses significant (p1⁄40.030 and p1⁄40.029) after controlling for mid-life dyslipidemia. Conclusions: In this study, long-term statin use was associated with changes in white matter tract integrity even in the absence of changes in overall WMH. Our findings also suggest that statins may have clinical subpopulation-specific protective effects on amyloid and tau deposition. As an avenue to individualized therapy, additional study is warranted to clarify the likely complex interactions of statins with genetic and acquired comorbid factors.

Authors’ reply to the letter by Esra et al.: Reply to Esra et al.

therapy with donepezil plus cilostazol. Now the clinical trial of cilostazol in dementing disorders is ongoing (https://clinicaltrials.gov/ct2/show/NCT02491268). However, there is no report on such a combinational effectiveness with other acetylcholinesterase inhibitors, nor on a comprehensive three factors, such as cognitive, affective and activities of daily living (ADL) functions for AD patients, nor on both patterns of the combination from acetylcholinesterase or cilostazol monotherapy to the alternative add-on therapy. In the present study, therefore, we analyzed the clinical effects of galantamine or cilostazol monotherapy to the add-on combination therapy on cognitive, affective and ADL functions in patients with AD with asymptomatic lacunar infarction. This is the first report to show the effectiveness of the two-drug combination therapy from both sides of monotherapy for patients with AD plus CVD.