Biomedical subjects

Martin P J van Boxtel

Publications and source records attributed to Martin P J van Boxtel.

At least 19 recordsLinked to original sources

PubMed2006

Effect of a structured course involving goal management training in older adults: A randomised controlled trial.

OBJECTIVE: The objective of this study was to investigate the effects of a structured 6-week neuropsychological course on the executive functioning of older adults with cognitive complaints. METHODS: A randomised controlled design was used involving 69 community dwelling individuals aged 55 years and older. Both objective and subjective measures were included to assess executive functioning. General linear model with repeated measures analysis of variance was used to examine the intervention effects. RESULTS: After the intervention, the participants in the intervention group were significantly less annoyed by their cognitive failures, were better able to manage their executive failures and reported less anxiety symptoms than those in the waiting list control group. CONCLUSION: These findings indicate that a combination of psycho-education and training has the potential to change the attitude of older individuals towards their cognitive functioning. PRACTICE IMPLICATIONS: Because this training focussed on cognitive functions that are among the first to decline in older adults and the subjective evaluation of the people after training was quite favourable, the proposed intervention may be considered a valuable contribution to cognitive interventions for older adults.

Activities of Daily Living↗

PubMed2006

Associations between lifestyle and depressed mood: longitudinal results from the Maastricht Aging Study.

OBJECTIVES: We examined whether healthy lifestyles are associated with absence of depressed mood. METHODS: A sample of 1169 adult participants in the Maastricht Aging Study provided baseline and 6-year follow-up data on smoking, alcohol use, physical exercise, body mass index, and mood. We examined associations between lifestyles and depressed mood using longitudinal analyses controlling for baseline depressive symptoms and covariates. RESULTS: Reports of excessive alcohol use at baseline predicted depressed mood at follow-up (relative risk [RR] = 2.48; 95% confidence interval [CI] = 1.08, 5.69), and reports of more than 30 minutes of physical exercise per day at baseline were associated with an absence of depressed mood at follow-up (RR=0.52; 95% CI=0.29, 0.92). Reports of being engaged in physical exercise throughout the 6-year follow-up period were also associated with absence of depressed mood (RR=0.56; 95% CI=0.34, 0.93). CONCLUSIONS: In this relatively healthy population sample, certain lifestyles either predicted or protected against depressed mood. Adopting or maintaining healthy lifestyles might be a starting point in preventing or treating depressed mood over time.

Adult↗

PubMed2006

Do subjective memory complaints predict cognitive dysfunction over time? A six-year follow-up of the Maastricht Aging Study.

BACKGROUND: Middle-aged and older people often worry that their perceived diminishing memory function may indicate incipient dementia. OBJECTIVES: The present study addresses questions regarding subjective memory complaints as a predictor of lower performance on cognitive tasks. Also, in participants with subjective memory complaints it was investigated, whether trying to keep mentally active improved memory function. Characteristics of the participants who were and were not interested in an intervention to decrease worries and to improve memory in daily life were determined. METHODS: Data were obtained from a large longitudinal study: the Maastricht Aging Study, involving 557 participants aged 55 to 85 years. Follow-up measurement was performed after 6 years. Outcome variables were simple, complex and general information processing speed and immediate and delayed recall. RESULTS: At baseline, forgetfulness was associated with a slower general information processing and delayed recall. At the six-year follow-up, being forgetful was not associated with a significant change in cognitive performance. Taking steps to remain cognitively active was not a predictor of better performance on cognitive tasks at baseline or at the six-year follow-up. CONCLUSION: Being forgetful might be an indicator of slower general information processing speed and delayed recall at baseline but does not predict cognitive change over 6 years in older adults. However, the effects are rather small and cannot directly be generalized to applications in clinical settings. Other factors, such as depression and anxiety might also underlie the cause of the forgetfulness.

Aged↗

PubMed2006

The Letter Digit Substitution Test: normative data for 1,858 healthy participants aged 24-81 from the Maastricht Aging Study (MAAS): influence of age, education, and sex.

The Letter Digit Substitution Test (LDST) is based on earlier developed substitution tests (e.g., Digit Symbol Substitution Test) but uses over-learned signs instead of the symbols used in other substitution tests. The written and oral versions of the LDST were administered to a large, cognitively screened sample (N = 1,858) of adults aged 24 to 81 years. Age was the most important predictor of LDST performance, and females outperformed males. A low level of education profoundly influenced LDST performance: the effect of a low versus high level of education on LDST performance was comparable to about 20 years of aging. Regression-based normative data were prepared for both the written and oral versions of the LDST.

Adult↗

PubMed2005

Associations of the angiotensin II type 1 receptor A1166C and the endothelial NO synthase G894T gene polymorphisms with silent subcortical white matter lesions in essential hypertension.

BACKGROUND AND PURPOSE: Silent white matter lesions (WMLs) may represent early target organ damage of the brain in patients with hypertension. Because these lesions may have a genetic background, we assessed the associations between polymorphisms of the renin-angiotensin system and the endothelial NO synthase (NOS3) genes and silent WMLs. METHODS: Ninety-three hypertensive individuals were studied. MRI of the brain was performed to obtain estimates of the total volume of subcortical and the extent of periventricular WMLs. Patients were genotyped for the angiotensinogen (M235T), the angiotensin-converting enzyme (insertion/deletion [I/D]), the angiotensin II type 1 receptor (AGTR1 A1166C), and the NOS3 (G894T) genes. A linear regression model was used to assess the relationship of these gene polymorphisms with both subtypes of WMLs. RESULTS: When adjusted for age, diabetes mellitus, and blood pressure, subcortical WML volume was lowest in the presence of 1 or 2 AGTR1 C alleles (unstandardized beta, -38.8 [95% CI, -66.1 to -11.4] and -112.6 [CI, -188.9 to -36.4], respectively), whereas it was highest in the presence of an NOS3 T allele (31.1[corrected] [CI, 3.6 to 58.4]). No interaction between these polymorphisms on WMLs could be demonstrated. No associations were present with the other polymorphisms, either with subcortical or periventricular lesions. CONCLUSIONS: We found the AGTR1 A1166C as well as the NOS3 G894T polymorphisms to be associated with silent WMLs in the subcortical area.

Adult↗

PubMed2005

Folate and the methylenetetrahydrofolate reductase 677C-->T mutation correlate with cognitive performance.

Low folate status has been associated with cognitive decline. We investigated the association of folate status and the 5,10-methylenetetrahydrofolate reductase (MTHFR) 677C-->T polymorphism with performance on a battery of neuropsychological tests. Furthermore, we investigated whether the association of folate with cognitive performance was mediated by plasma homocysteine or risk of vascular disease. We used cross-sectional data from 818 individuals aged 50-70 years old. Low concentrations of erythrocyte folate but not serum folate were associated with poor performance on complex speed and memory tasks, independent of educational level and conventional risk factors of vascular disease. These associations were not mediated by homocysteine concentrations or carotid intima-media thickness. Subjects with the MTHFR 677TT genotype tended to perform better on cognitive tasks than CC/CT subjects, although this was significant for sensorimotor speed only (differences in Z-scores between MTHFR 677TT homozygotes and CC homozygotes -0.15, 95% CI: -0.30 to 0.00). Low concentrations of erythrocyte folate are associated with decreased cognitive performance, possibly through a homocysteine-independent mechanism such as DNA infidelity and mitochondrial decay.

Aged↗

PubMed2005

Influence of cognitive functioning on functional status in an older population: 3- and 6-year follow-up of the Maastricht Aging Study.

BACKGROUND: To date, it remains unclear to what extent cognitive competence is related to a change in general functional status in older adults. OBJECTIVES: To evaluate both the cross-sectional and the longitudinal relation between cognitive functioning and functional status. METHODS: Sensorimotor speed, memory, and executive functioning were assessed in a large population of healthy adults aged 60 years and older (n = 485) who participated in the Maastricht Aging Study. Data from the baseline (1993-1995), three-year follow-up, and six-year follow-up were used. Functional status was measured using the SF-36, which was coded into a physical and a mental component summary measure. RESULTS: After adjustment for age, sex, and educational level, a high level of cognitive functioning appeared to be associated with better functional status in the cross-sectional analysis. Longitudinal analyses demonstrated, that cognitive functioning was not a predictor of functional status three or six years later. CONCLUSIONS: Thus while cognitive functioning is useful clinically for predicting the short-term functional status of an older person, it is not useful for predicting that person's long-term (>3 years) functional status and thus the period of validity of the results of these tests in answering such questions is limited.

Aged↗

PubMed2005

The effect of two types of memory training on subjective and objective memory performance in healthy individuals aged 55 years and older: a randomized controlled trial.

The objective of the study was to examine the effectiveness of two types of memory training (collective and individual), compared to control (waiting list), on memory performance. Participants were 139 community-dwelling older individuals recruited through media advertisements asking for people with subjective memory complaints to participate in a study. Data were collected at baseline, and at 1 week and 4 months after the intervention. Training efficacy was assessed using measures of subjective and objective memory performance. After the intervention, participants in the collective training group reported more stability in memory functioning and had fewer feelings of anxiety and stress about memory functioning. In addition, positive effects were found on objective memory functioning. Compared with the other two groups, the collective training group participants had an improved recall of a previously learned word list. Compared to controls, participants in the individual training group reported fewer feelings of anxiety and stress in relation to memory functioning.

Affect↗

PubMed2005

Rey's verbal learning test: normative data for 1855 healthy participants aged 24-81 years and the influence of age, sex, education, and mode of presentation.

The Verbal Learning Test (VLT; Rey, 1958) evaluates the declarative memory. Despite its extensive use, it has been difficult to establish normative data because test administration has not been uniform. The purpose of the present study was to gather normative data for the VLT for a large number (N = 1855) of healthy participants aged 24-81 years, using a procedure in which the words to be learned were presented either verbally or visually. The results showed that VLT performance decreased in an age-dependent manner from an early age. The learning capacity of younger versus older adults differed quantitatively rather than qualitatively. Females and higher educated participants outperformed males and lower educated participants over the entire age range tested. Presentation mode affected VLT performance differently: auditory presentation resulted in a better recall on Trial 1 (a short-term or working memory measure), whereas visual presentation yielded a better performance on Trial 3, Trial 4, and Delta (a learning measure).

Adolescent↗

PubMed2005

Relation between health status and cognitive functioning: a 6-year follow-up of the Maastricht Aging Study.

The aim of this study was to determine whether physical and psychological functioning can predict 6-year cognitive decline in older adults. A group of 669 participants aged 60 to 81 years was recruited from a longitudinal study (the Maastricht Aging Study). Physical functioning was measured in terms of perceived health and instrumental activities of daily living. Psychological functioning or mood was evaluated by the Depression and Anxiety subscales of the Symptom Check List-90. Although physical functioning and psychological functioning were related to several measures of cognitive functioning at baseline, psychological functioning was specifically related to memory functioning 6 years later. Poor psychological functioning (i.e., depressive and anxiety symptomatology), rather than poor physical health, may have the strongest implications for long-term cognitive functioning in older men and women.

Activities of Daily Living↗

PubMed2005

Change in sensory functioning predicts change in cognitive functioning: results from a 6-year follow-up in the maastricht aging study.

OBJECTIVES: To examine the longitudinal relationship between sensory functioning and a broad range of cognitive functions after 6 years follow-up and whether cataract surgery or first-time hearing aid use affected cognition. DESIGN: Hierarchical regression procedures were employed to determine whether sensory functioning was predictive of cognitive performance. SETTING: Maastricht University and the University Hospital Maastricht, the Netherlands. PARTICIPANTS: Older Dutch adults (>/=55) enrolled in the Maastricht Aging Study (N=418). MEASUREMENTS: Visual and auditory acuity, the Visual Verbal Learning Test (VVLT), the Stroop Color Word Test (SCWT), the Concept Shifting Task (CST), the Verbal Fluency Test, and the Letter-Digit Substitution Test (LDST). RESULTS: A change in visual acuity was associated with change in most cognitive measures, including the total and recall scores of the VVLT, the mean score of the first two SCWT cards, the mean score of the first two CST cards and the LDST. In addition, a change in auditory acuity predicted change in memory performance (VVLT total and recall scores), and auditory acuity measured at baseline predicted change in the mean score of the first two SCWT cards and the LDST. CONCLUSION: The findings support the notion of a strong connection between sensory acuity in auditory and visual domains and cognitive performance measures, both from a cross-sectional and a longitudinal perspective. They also suggest that it is essential to screen older individuals in a clinical context for sensory functioning so that changes in visual or auditory acuity are not interpreted as changes in cognitive performance.

Adult↗

PubMed2005

Sensory impairment and cognitive functioning in oldest-old subjects: the Leiden 85+ Study.

OBJECTIVE: Because studies on the association of sensory impairment (both hearing and visual impairment) and cognitive functioning in elderly persons yielded conflicting results, the authors explored this association within the Leiden 85+ Study. METHODS: Within this population-based study of 459 participants aged 85+ years, hearing impairment was measured by audiometry and visual impairment by a visual acuity chart, both under standardized conditions. The Mini-Mental State Exam (MMSE) assessed global cognitive functioning. In participants with MMSE scores >18, the authors further assessed memory (Word-Learning Test, Immediate and Delayed Recall) and cognitive speed (by Stroop Test, Letter-Digit Coding test). RESULTS: Both hearing impairment (prevalence: 85%) and visual impairment (prevalence: 59%) were associated with lower scores on the MMSE. Increasing visual impairment was associated with poorer scores on memory and cognitive speed, as measured with visually presented cognitive tests. In contrast, there was no association between hearing impairment and memory and cognitive speed. CONCLUSIONS: In elderly people, cognitive functioning as assessed by visual cognitive tests relates to visual impairment but not to hearing impairment. The authors therefore assume that the association between sensory impairment and cognitive functioning is, at least partly, based on practical disadvantages of elderly persons with sensory impairment during cognitive assessments.

Aged, 80 and over↗

PubMed2005

Homocysteine in relation to cognitive performance in pathological and non-pathological conditions.

Elevated serum homocysteine has been associated with increased risk of Alzheimer's disease. Furthermore, elevated homocysteine levels are related to cognitive dysfunction in the elderly. The aim of the present study was to explore the disease specificity of the relation between serum total homocysteine levels and cognitive function. For this, we summarize data from several studies on homocysteine levels in both normal and pathological conditions performed in our laboratories and evaluate possible mechanisms of effects of elevated homocysteine levels in the central nervous system. Total homocysteine levels were measured in serum of: 1) healthy aging individuals; 2) patients with Alzheimer's and Parkinson's disease and patients with other cognitive disorders; and 3) patients with multiple sclerosis. Increased serum homocysteine concentration was related to worse cognitive performance over a 6-year period in the normal aging population (r=-0.36 to -0.14, p<0.01 for the Word learning tests; r=0.76, p<0.05 for the Stroop Colored Word test). Homocysteine was only increased in patients with Parkinson's disease on L-Dopa therapy (18.9 vs. 16.5 micromol/L in healthy controls), and not in dementia patients. Homocysteine was elevated in patients with progressive multiple sclerosis (15.0 micromol/L, n=39, compared to 12.0 micromol/L in 45 controls) and correlated to both cognitive and motor function (r=-0.33 and -0.33, p<0.05, respectively). The relationship between homocysteine and cognitive function in non-pathological and pathological situations indicates that changes in its levels may play a role in cognitive functioning in a broad spectrum of conditions.

Animals↗

PubMed2004

A voxel-based morphometric study to determine individual differences in gray matter density associated with age and cognitive change over time.

Voxel-based morphometry (VBM) was used to examine the relation between age and gray matter density cross-sectionally and to study the association between gray matter density and longitudinal decline in performance on cognitive tests in healthy, non-demented elderly individuals. Participants were neuropsychologically tested at baseline and again after 3 years. Thirty-seven subjects (mean age 72.5 years) who showed a decline in cognitive test performance at follow-up were compared with 38 individually matched control subjects (mean age 71.8 years) whose performance did not change over time. Magnetic resonance imaging scans were acquired at follow-up and individual differences in regional gray matter density were examined with VBM. The largest age effects were found in various regions in the prefrontal cortex, the (medial) temporal lobes and the striate cortex. Longitudinal cognitive decline was associated with decreased gray matter density in prefrontal areas, the (medial) temporal lobes and the posterior parietal cortex. These findings suggest that prefrontal and temporal cortical regions are of particular relevance both in aging and age-related cognitive decline in healthy elderly individuals.

Adult↗

PubMed2004

[Education about dementia. Effectiveness of a public lecture].

Memory and dementia are often topics of educational activities, however there is only limited information about the effectiveness of this education. In this study the effectiveness of a lecture, as part of a series of lectures about dementia, has been evaluated. The results showed an improvement in knowledge after the lecture and the participants were satisfied afterwards. Finally, it showed that there is a need for this kind of education; for professionals and for people who were worried about their memory or their partners' memory.

Adult↗

PubMed2003

Is there a side predilection for cerebrovascular disease?

In studies on carotid artery intima-media thickness and stroke, researchers implicitly assume that cerebrovascular abnormalities show a symmetrical distribution. To evaluate whether there is a difference in intima-media thickness between the 2 carotids, we compared left and right common carotid artery intima-media thickness as measured by B-mode ultrasonography in a group of 102 untreated hypertensive patients. This yielded a significant difference between both sides (left, 0.75+/-0.11 mm; right, 0.71+/-0.11 mm; P<0.001). This was associated with a higher cross-sectional area of the intima-media complex and a higher flow velocity at the left side. Arterial diameters, however, were not different. We also assessed whether there is a side preference with respect to cerebrovascular accidents. To this end, we explored our population-based Stroke Registry of 1843 subjects and indeed found a significantly higher incidence of nonlacunar cerebrovascular stroke at the left side, whereas lacunar infarcts were symmetrically distributed. Our findings suggest a predilection for cerebrovascular disease at the left side, which may be related to greater hemodynamic stress and intimal damage in the left carotid artery.

Adult↗

PubMed2002

Cigarette smoking and alcohol consumption in relation to cognitive performance in middle age.

In the elderly, cigarette smoking has been related to reduced cognitive performance and moderate alcohol consumption to increased cognitive performance. It is not clear whether these associations also exist in middle age. The authors examined these relations in a population-based cohort study of 1,927 randomly selected, predominantly middle-aged subjects aged 45-70 years at the time of cognitive testing and living in the Netherlands. From 1995 until 2000, an extensive cognitive battery was administered, and compound scores were calculated. Risk factors had been assessed approximately 5 years previously. Multiple linear regression analyses (in which one unit of the cognitive score = one standard deviation) showed that, after the authors adjusted for age, sex, education, alcohol consumption, and cardiovascular risk factors, current smokers had reduced psychomotor speed (beta = -0.159, 95% confidence interval: -0.071, -0.244; p = 0.0003) and reduced cognitive flexibility (beta = -0.133, 95% confidence interval: -0.035, -0.230; p = 0.008) compared with never smokers. This effect was similar to that of being approximately 4 years older. Alcohol consumption was related to increased speed and better flexibility, especially among women who drank 1-4 alcoholic beverages a day. In conclusion, among middle-aged subjects, current smoking was inversely and alcohol consumption positively related to psychomotor speed and cognitive flexibility. This finding suggests that actions to prevent cognitive decline can be taken in middle age.

Age Distribution↗

PubMed2002

Differential residual effects of zaleplon and zopiclone on actual driving: a comparison with a low dose of alcohol.

STUDY OBJECTIVES: To compare residual effects of zaleplon 10 mg, zopiclone 7.5 mg, and placebo, and a social dose of alcohol on car driving, memory, and psychomotor performance. DESIGN: Two-part placebo controlled, crossover study. Part 1 was single blind, Part 2 double blind. SETTING: University research institute. PARTICIPANTS: Thirty healthy volunteers (15 men and 15 women, mean age 32 +/- 7 years) INTERVENTIONS: In Part 1 alcohol and alcohol-placebo drinks were administered around noon. In Part 2 single oral doses of zaleplon 10 mg, zopiclone 7.5 mg and placebo were administered at bedtime. MEASUREMENT AND RESULTS: A highway driving test, laboratory tests of word learning, critical tracking and divided attention, and subjective assessments of sleep, mood, and effects of treatments on driving. Driving started 40 minutes after a second alcohol dose in Part 1, and 10 hours after drug intake in Part 2. The results demonstrated that alcohol, at average plasma concentrations of approximately 0.030 g/dl, significantly impaired performance in all tests. Zaleplon's residual effects did not differ significantly from those of placebo in any test. In contrast, zopiclone had significant residual effects on driving, divided attention, and memory. The magnitude of impairment in the driving test observed the morning after zopiclone 7.5 mg was twice that observed with alcohol. CONCLUSION: Zaleplon 10 mg has no residual effects on driving when taken at bedtime, 10 hours before driving. In contrast, zopiclone 7.5 mg can cause marked residual impairment. Patients should be advised to avoid driving the morning after zopiclone administration.

Acetamides↗