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PubMed2002

MRI morphometric study and correlation with cognitive functions in young adults shunted for congenital hydrocephalus related to spina bifida.

We studied the morphometric MRI findings and their correlation with cognitive functions in a population of 10 young adults shunted for congenital hydrocephalus related to spina bifida. Morphometric MRI analysis included measurement of the ventricular dilatation index, frontal and occipital parenchymal thickness and the size of the corpus callosum. The neuropsychological status was evaluated, notably to look for a discrepancy between verbal and performance skills, a finding which has previously been described in hydrocephalic children. We also investigated whether there was a correlation between cognitive function and cerebral morphometric indexes. In each case, MRI demonstrated the structural changes associated with the Chiari II malformation. The size of the lateral ventricles varied, ranging from important dilatation to small ventricles. Six patients had only partial development of the corpus callosum. All patients had a normal global IQ. In our population of young adults, we did not observe any discrepancy between verbal and visuospatial performances as has been described in children with hydrocephalus. We found no relationship between cognitive function and ventricle dilatation or parenchymal thickness or between the size of the corpus callosum and callosal transfer.

Adolescent↗

PubMed2004

Evaluation of the effect of radiotherapy for pituitary tumours on cognitive function and quality of life.

AIMS: Pituitary tumours are often treated with radiotherapy, which can cause cognitive impairment when given in high doses. It is assumed that current regimens do not cause damage, but this has not been established. The aim was to determine whether radiotherapy given to people with pituitary tumours was associated with cognitive impairment and reduced quality of life. MATERIAL AND METHODS: We retrospectively compared two outcome groups (patients with pituitary tumours who had undergone radiotherapy and surgery and patients with pituitary tumours who had surgery alone), and carried out standardised tests of cognitive function and quality of life. RESULTS: The data suggested that patients with pituitary tumours treated with surgery, with or without radiotherapy, had cognitive impairment compared with the normal population. Patients receiving radiotherapy performed significantly worse than those receiving only surgery on the Stroop test, a measure of executive function. They also scored significantly lower on the Physical Health composite of the SF36, although this difference was no longer significant when account was taken of baseline differences between the groups. There were no significant differences in other cognitive functions, mood, general well-being or the Mental Health Composite of the SF36. CONCLUSIONS: Patients treated for pituitary disease may have cognitive impairment. A decrease in cognitive function was found regardless of treatment type. The decrease seemed to be greater in the radiotherapy group and was mainly on executive function. This impairment of executive function could affect daily life. Further prospective studies are required to assess the effect of pituitary disease on cognitive function and the safety of radiotherapy.

Adult↗

PubMed2002

Serum lipoprotein levels, statin use, and cognitive function in older women.

BACKGROUND: Few strategies are available for the prevention of cognitive impairment in elderly persons. Serum lipoprotein levels may be important predictors of cognitive function, and drugs that lower cholesterol may be effective for the prevention of cognitive impairment. OBJECTIVE: To determine whether serum lipoprotein levels, the 4-year change in serum lipoprotein levels, and the use of statin drugs are associated with cognition in older women without dementia. DESIGN, SETTING, AND PARTICIPANTS: An observational study of 1037 postmenopausal women with coronary heart disease enrolled in the Heart and Estrogen/progestin Replacement Study (participants at 10 of 20 centers). MAIN OUTCOME MEASURE: The Modified Mini-Mental State Examination was administered at the end of the study after 4 years of follow-up. Women whose score was less than 84 points (>1.5 SDs below the mean) were classified as having cognitive impairment. Lipoprotein levels (total, high-density lipoprotein, and low-density lipoprotein [LDL] cholesterol and triglycerides) were measured at baseline and at the end of the study; statin use was documented at each visit. RESULTS: Compared with women in the lower quartiles, women in the highest LDL cholesterol quartile at cognitive testing had worse mean plus minus SD Modified Mini-Mental State Examination scores (93.7 plus minus 6.0 vs 91.9 plus minus 7.6; P =.002) and an increased likelihood of cognitive impairment (adjusted odds ratio, 1.76; 95% confidence interval, 1.04-2.97). A reduction in the LDL cholesterol level during the 4 years tended to be associated with a lower odds of impairment (adjusted odds ratio, 0.61; 95% confidence interval, 0.36-1.03) compared with women whose levels increased. Higher total and LDL cholesterol levels, corrected for lipoprotein(a) levels, were also associated with a worse Modified Mini-Mental State Examination score and a higher likelihood of impairment, whereas high-density lipoprotein cholesterol and triglyceride levels were not associated with cognition. Compared with nonusers, statin users had higher mean plus minus SD Modified Mini-Mental State Examination scores (92.7 plus minus 7.1 vs 93.7 plus minus 6.1; P =.02) and a trend for a lower likelihood of cognitive impairment (odds ratio, 0.67; 95% confidence interval, 0.42-1.05), findings that seemed to be independent of lipid levels. CONCLUSIONS: High LDL and total cholesterol levels are associated with cognitive impairment, and lowering these lipoprotein levels may be a strategy for preventing impairment. The association between statin use and better cognitive function in women without dementia requires further study.

Aged↗

PubMed2001

Effect of duration of pilocarpine-induced status epilepticus on subsequent cognitive function in rats.

The aim of this study was to determine the effect of the duration of pilocarpine-induced status epilepticus (SE) on subsequent cognitive function in rats. SE was induced by pilocarpine (320 mg/kg i.p.) and was terminated by injection of 1 mg/kg diazepam at 30, 60 and 90 min in 3 groups of 10 rats each. Cognitive function was tested by a passive avoidance task and was assessed at the baseline and on days 1, 7, 14 and 21 (post SE). It was found that cognitive function was disrupted on days 7, 14 and 21 post SE in rats who had SE for 60 and 90 min, whereas it was not affected in rats that had 30 min of SE. Hence, the duration of SE may affect future cognitive performance and mandates emergency treatment.

Animals↗

PubMed1995

Cognitive functioning and the incidence of limitations in activities of daily living in an elderly community sample.

Although it is well-known that cognitive impairment in the elderly is usually accompanied by limitations in activities of daily living (ADL), it is not known whether cognitive impairment predicts the onset of new ADL limitations. The purpose of this analysis was to determine whether poor scores on a brief measure of cognitive functioning at baseline (1982) would predict the onset of persistent limitations in ADL during the subsequent 3 years, in a probability sample of community-dwelling elderly persons living in New Haven, Connecticut, who were initially free of ADL limitations (n = 1,856). Cognitive functioning was assessed with Pfeiffer's Short Portable Mental Status Questionnaire. Persistent incident ADL limitations were defined as the onset of one or more ADL limitations after 1982, with no subsequent reports of zero ADL limitations. Compared with persons who scored zero to one errors on the Short Portable Mental Status Questionnaire at baseline, persistent, incident ADL limitations occurred more frequently in persons who scored four or more errors (odds ratio for males = 2.72, 95% confidence interval 1.36-5.43; odds ratio for females = 2.60, 95% confidence interval 1.52-4.44) after adjustment for the confounding effects of housing type, age, race, history of chronic health conditions, and incident health conditions. These results suggest that knowledge of scores on brief cognitive function tests can be used to forecast service needs and to develop intervention programs to prepare for the possible onset of ADL limitations.

Activities of Daily Living↗

PubMed2004

Effect of soy protein containing isoflavones on cognitive function, bone mineral density, and plasma lipids in postmenopausal women: a randomized controlled trial.

CONTEXT: Postmenopausal estrogen therapy has been posited to have some beneficial effects on aging processes, but its use has risks. Isoflavones, estrogenlike compounds naturally occurring in plant foods, might confer positive effects with fewer adverse effects. OBJECTIVE: To investigate whether soy protein with isoflavones improves cognitive function, bone mineral density, and plasma lipids in postmenopausal women. DESIGN, SETTING, AND PARTICIPANTS: Double-blind, randomized, placebo-controlled trial of 202 healthy postmenopausal women aged 60 to 75 years, recruited from a population-based sample in the Netherlands, conducted between April 2000 and September 2001. INTERVENTION: Participants were randomly assigned to receive 25.6 g of soy protein containing 99 mg of isoflavones (52 mg genistein, 41 mg daidzein, and 6 mg glycetein or total milk protein as a powder on a daily basis for 12 months. MAIN OUTCOME MEASURES: Cognitive function was assessed using the following instruments: dementia, Mini-Mental State Examination; memory, Rey Auditory Verbal Learning Test, immediate recall, delayed recall, and recognition, the Digit Span forward and reversed, and the Doors test; complex attention tasks, Digit Symbol Substitution and Trailmaking, A1, A2, and B; and verbal skills, Verbal Fluency A and N, animals and occupations, and the Boston Naming Task. Bone mineral density of the hip and lumbar spine was assessed using dual-energy x-ray absorptiometry scanning. Lipid assessment included lipoprotein(a), total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides. RESULTS: A total of 175 women completed the baseline and at least 1 postintervention analysis and were included in the modified intent-to-treat analysis. Adherence was good (median plasma genistein levels, 17.2 and 615.1 nmol/L for placebo and soy group, respectively). Cognitive function, bone mineral density, or plasma lipids did not differ significantly between the groups after a year. CONCLUSION: This double-blind randomized trial does not support the hypothesis that the use of soy protein supplement containing isoflavones improves cognitive function, bone mineral density, or plasma lipids in healthy postmenopausal women when started at the age of 60 years or later.

Bone Density↗

PubMed2005

Mood and cognitive function in elderly diabetic patients living in care facilities.

Community studies found deficits of cognitive function in elderly persons with diabetes. The aim of the present study was to compare diabetes and other age-related diseases among residents of senior citizens' care facilities. Participants were 130 residents with and 130 without a diagnosis of diabetes aged between 65 and 98 years. Measures were neuropsychological tests designed for this age group, questionnaires of mood, quality of life and daily activities and level of glycosylated hemoglobin (HbA(1c)) as an index of metabolic control. Only verbal memory was significantly more impaired in residents with than without diabetes. Otherwise, both groups showed overall impairment of cognitive function and mood. Unexpectedly, a slightly elevated HbA(1c) level (6-8%) was associated with an increased level of cognitive and everyday functioning. In old age, diabetic patients might benefit from a slightly higher level of blood glucose than has hitherto been assumed.

Activities of Daily Living↗

PubMed2001

Effects of home environment, socioeconomic status, and health status on cognitive functioning in children with HIV-1 infection.

OBJECTIVE: To investigate the effects of the home environment, socioeconomic status (SES), and health status on cognitive functioning in a sample of children with HIV-1 infection in a cross-sectional study. METHODS: Forty-three caregivers and their children (2.5 to 12 years) participated. Caregivers completed two self-report measures of the home environment that included questions regarding the organization of the environment, play materials, parental involvement, variety of stimulation, and parental attitudes toward the provision of a cognitively stimulating environment. Cognitive functioning was assessed using a standardized intelligence (IQ) test. Children's medical charts were reviewed for HIV-1 classification status (CDC, 1994), CD4 cell counts, and current medication. RESULTS: This study revealed two primary findings. First, measures of the home environment mediated the association between SES and child IQ. Second, measures of the home environment had a stronger association with child IQ during the advanced stages of disease than earlier stages of disease. CONCLUSIONS: The home environment is associated with cognitive functioning among children with HIV-1 infection. Moreover, interventions aimed at enhancing the quality of the home environment may have a positive impact on these children's cognitive development.

Child↗

PubMed2001

Hypoglycaemia and cognitive function in diabetes.

The human brain is almost totally dependent on a continuous supply of glucose, deprivation of which rapidly causes malfunction. In the brain there are regional differences in the susceptibility to neuroglycopenia with the cerebral cortex being most sensitive while deeper structures are more resistant. A fall in blood glucose provokes a hierarchy of responses including secretion of counter-regulatory hormones and development of warning symptoms which alert the individual to treat the hypoglycaemia. Symptoms are generated when blood glucose falls to specific threshold concentrations, although these are dynamic and can be modified by various factors. Symptoms can be classified as autonomic and neuroglycopenic, with the latter being related to altered cognitive functioning. Acute hypoglycaemia produces electroencephalographic (EEG) changes as well as neurophysiological abnormalities including increased latency and/or reduced amplitude of sensory evoked potentials. At blood glucose below 3 mmol/l cognitive functioning becomes impaired but the degree of dysfunction differs in various domains and a battery of psychometric tests are required to assess impairment of cognitive function during hypoglycaemia. Complex, attention-demanding and speed-dependent responses are most impaired with accuracy often preserved at the expense of speed. Cognitive function does not recover fully until 40-90 min after blood glucose is restored to normal. Hypoglycaemia also provokes changes in mood, increases anxiety and may induce depression and fear of further hypoglycaemia, which can modify behaviour and influence quality of glycaemic control. Recurrent severe hypoglycaemia may have long-term sequelae in the form of cumulative cognitive impairment and impaired awareness of hypoglycaemia.

Acute Disease↗

PubMedDate not supplied

Outcomes of day care: a pilot study on changes in cognitive function and agitated behaviors of demented elderly in Korea.

This study examined outcomes of Korean day care for demented elderly Koreans. Changes in the cognitive function and agitation of demented elderly individuals were assessed over time. A one-group repeated measures design was used. The data were collected on a sample of 13 individuals from March to August 1999. The cognitive function of the subjects remained stable during the 10-week study period, while their level of agitation increased over time, indicating a need for the examination of factors that affect problematic behaviors of the demented elderly. This pilot study showed that day-care programs in Korea may be an effective way to maintain the stability of cognitive function in elderly Koreans with mild- to moderate-stage dementia. Further investigation of effective behavioral modifications within day-care settings could justify additional government support of Korean day-care programs for those suffering from dementia.

Aged↗

PubMed1995

Effects of night work on the cognitive function in young and elderly subjects with specific reference to the auditory P300.

To estimate the effects of night work on the human cognitive function, P300 event related potentials (ERPs) evoked with an auditory "oddball" paradigm were recorded for 17 nurses (mean age 27.4 +/- 6.1 years; range 21-41 years) for 3 epochs; after a night of work, after a day of work and on a holiday, and for 12 elderly security guards (mean age 62.8 +/- 2.2 years; range 60-67 years) for 2 epochs; after a night of work and on a holiday. The Stress Arousal Check List (SACL) was used for all the subjects just prior to the P300 ERP recording to determine the extent of stress and the arousal grades. Fourteen of the nurses were in their twenties (mean age 24.9 +/- 2.6 years; range 21-29 years), and 3 (39.0 +/- 2.6) were older (36, 40 and 41 years). The 14 nurses were classed as the young group. All the security guards were classed as the elderly group. In the young group, the stress grade scores increased significantly (P < 0.05) and the arousal grades decreased significantly (P < 0.01) after night work as compared to the holiday values. Although statistically not significant, the amplitude of the P300 component tended to decrease after night work, whereas the latency was very stable for these 2 epochs. The P300 latencies of the 3 older nurses were as stable as those of the young group, but their amplitudes were significantly reduced after night work as compared with the holiday amplitudes (P < 0.05). In contrast, the 12 elderly security guards showed no statistically significant changes in the scores for the stress and arousal grades between the 2 epochs, after night work and holiday. Latency prolongation however, was statistically significant (P < 0.01) after night work. The P300 amplitudes for many of the elderly security guards also tended to decrease after night work, but were not statistically significant. The P300 amplitude is considered to reflect the amount of attentional resources and the latency to reflect the time needed for the cognitive process, indicating that the elderly security guards experiences slowing of the cognitive process in night work. Our results suggest that the effect of night work on the cognitive function is greater for elderly than for young workers. We conclude that P300 can be used to evaluate changes in the human cognitive function produced by night or rotating shift work and that the results provide useful information with which to plan shift schedules on the basis of worker age.

Adult↗

PubMed1990

[Diffuse bilateral periventricular hyperintensity of unknown origin on MRI spin-echo sequence. Cognitive function and regional cerebral blood flow].

Cognitive function and regional cerebral blood flow (rCBF) were studied in 26 patients (mean age 77.9) who showed bilaterally an ill-defined diffuse periventricular hyperintensity (PVH) on the magnetic resonance imaging (MRI) spin-echo sequence. Diffuse PVH was classified into two groups according to severity, group A (more severe) and group B (less severe); their cognitive impairment was classified into three stages, stage 1 (mildly impaired) through stage 3 (severely impaired). rCBF was assessed by single photon emission computed tomography (SPECT). The result showed that 6 of 7 MRI-group A patients were stage 3, but the stages of 19 group B patients varied. Five of 7 MRI-group A patients showed severe hypoperfusion, but rCBF of group B patients also varied. Nineteen patients had a hypertensive history, but only 10 patients complained of cerebrovascular incidents before admission. All 3 younger patients (one in his fifties and two in their sixties), however, showed hypertension, stepwise neurological deterioration as in Binswanger's disease. These results suggest that there might be various pathogenesis of diffuse bilateral PVH in the elderly and they are different from that of the classical "Binswanger's disease".

Aged↗

PubMed1993

Hereditary influences on cognitive functioning in older men. A study of 4000 twin pairs.

OBJECTIVE: To determine the contribution of genetic factors to cognitive functioning in older men. DESIGN: Cognitive testing by telephone interview in an epidemiologically defined population. PARTICIPANTS: 2077 monozygotic and 2225 dizygotic male twin pairs, all between the ages of 62 and 73 years, recruited from the National Academy of Sciences twin registry. MAIN OUTCOME MEASURES: The Telephone Interview for Cognitive Status--Modified total score and factor scores were analyzed. The Falconer heritability statistic and maximum likelihood estimates of genetic and environmental components were computed. RESULTS: Heritability of the total Telephone Interview for Cognitive Status--Modified score was estimated to be 30%. Shared environmental effects accounted for an additional 18% of the variance; most of this was related to years of education. Of the four cognitive factors derived, the language/attention factor had the highest heritability estimate. CONCLUSIONS: Genetic factors and educational achievement together account for almost half of the variance in the cognitive functioning of older men. Studies of the genetics of dementing illnesses need to consider the degree to which cognitive capacities are themselves under genetic control.

Aged↗

PubMed2000

Childhood cognitive functioning in schizophrenia patients and their unaffected siblings: a prospective cohort study.

While it is known that children of schizophrenia parents perform more poorly on tests of cognitive functioning than children of normal parents, less certain is the degree to which such deficits predict schizophrenia outcome, whether cognitive functioning deteriorates during childhood in preschizophrenia individuals, and whether nongenetic etiologic factors (such as obstetric complications) contribute to these deficits. In the present study, 72 patients with schizophrenia or schizoaffective disorder, 63 of their siblings not diagnosed with schizophrenia, and 7,941 controls with no diagnosis were ascertained from a birth cohort whose members had been evaluated with standardized tests of cognitive functioning at 4 and 7 years of age. Adult psychiatric morbidity was ascertained via a longitudinal treatment data base indexing regional public health service utilization, and diagnoses were made by review of all pertinent medical records according to DSM-IV criteria. Both the patients with schizophrenia and their unaffected siblings performed significantly worse than the nonpsychiatric controls (but did not differ from each other) on verbal and nonverbal cognitive tests at 4 and 7 years of age. Preschizophrenia cases and their siblings were increasingly overrepresented across decreasing quartiles of the performance distributions. There was not significant intra-individual decline, and there were no significant relationships between obstetric complications and test performance among the preschizophrenia subjects. These results suggest that during the period from age 4 to age 7 years, premorbid cognitive dysfunction in schizophrenia represents a relatively stable indicator of vulnerability deriving from primarily genetic (and/or shared environmental) etiologic influences.

Adult↗

PubMed2000

The influence of ergotamine abuse on psychological and cognitive functioning.

Migraine patients abusing ergotamine often have chronic daily headaches associated with tiredness, sleep and memory disturbances, and reduced general well-being. We quantified psychological and cognitive functioning in 12 migraine patients with and 12 without ergotamine abuse (> or = 5 days/week for > or = 6 months) and 12 healthy controls. Psychological functioning assessed by Symptom Checklist-90 (SCL-90) and Profile Of Mood State (POMS), was impaired in ergotamine abusers compared to healthy controls. Cognitive functioning divided into four domains: attention (critical flicker frequency analysis and mental control subscale of the Wechsler Memory Scale (WMS), speed of information processing (reaction time tasks and lexical decision tasks), memory (four subscales of the WMS) and cognitive flexibility (trailmaking test and WMS digits backwards), was impaired in ergotamine abusers in speed of information processing and cognitive flexibility. These differences disappeared after correction for total SCL-90 scores. In conclusion, ergotamine abuse is associated with high psychological distress but not with structural impaired cognitive functioning.

Cognition↗

PubMed2000

Immobilization stress-induced changes in brain acetylcholinesterase activity and cognitive function in mice.

In the present study, the effect of acute and chronic immobilization stress on brain acetylcholinesterase (AChE) enzyme activity and cognitive function in mice was investigated. Mice were immobilized by strapping for 150 min. One group of mice were only immobilized once (acute stress) while in another group mice were immobilized (150 min) daily for 5 consecutive days (chronic stress). Specific AChE enzyme activity (micromol min(-1)mg(-1)) was estimated by a spectrophotometric method in the whole brain of mice subjected to acute and chronic stress. In the acute stress group, AChE activity (0.24922 +/- 0.011) in the detergent-soluble fraction was found to be significantly decreased in comparison to the control group (0.33561 +/- 0.022). Chronic stress did not cause any significant change in AChE activity in the detergent-soluble fraction. In the salt-soluble fraction, AChE activity was significantly decreased only in the chronic stress group (0.08791 +/- 0.011) as compared to the control group (0.12051 +/- 0.011). A passive avoidance test was used to assess cognitive function. The transfer latency time (TLT) from a light to dark chamber was recorded in the control and acute stress groups (30 min after immobilization is over) on day 1 (Trial I) and the following day (Trial II). The acute stress group showed an increase (178%) in TLT from Trial I to Trial II, which was significantly higher than that of the non-stress control group (75%). In the chronic stress group, Trial I was undertaken 30 min after the last immobilization, i.e. on day 5 and 24 hr later, Trial II. However, the chronically stressed mice showed an increase (70%) in TLT similar to the control group. Thus this study shows that acute immobilization stress may enhance cognitive function in mice which may be attributed to a decrease in AChE activity leading to an increase in cholinergic activity in the brain.

Acetylcholinesterase↗

PubMed1993

Correlates of cognitive function scores in elderly outpatients.

OBJECTIVE: To determine medical, ophthalmologic, and demographic predictors of cognitive function scores as measured by the Telephone Interview for Cognitive Status (TICS), an adaptation of the Folstein Mini-Mental Status Exam. A secondary objective was to perform an item-by-item analysis of the TICS scores to determine which items correlated most highly with the overall scores. DESIGN: Cross-sectional cohort study. SETTING: The Glaucoma Consultation Service of the Massachusetts Eye and Ear Infirmary. SUBJECTS: 472 of 565 consecutive patients age 65 and older who were seen at the Glaucoma Consultation Service between November 1, 1987 and October 31, 1988. MEASUREMENTS: Each subject had a standard visual examination and review of medical history at entry, followed by a telephone interview that collected information on demographic characteristics, cognitive status, health status, accidents, falls, symptoms of depression, and alcohol intake. RESULTS: A multivariate linear regression model of correlates of TICS score found the strongest correlates to be education, age, occupation, and the presence of depressive symptoms. The only significant ocular condition that correlated with lower TICS score was the presence of surgical aphakia (model R2 = .46). Forty-six percent (216/472) of patients fell below the established definition of normal on the mental status scale. In a logistic regression analysis, the strongest correlates of an abnormal cognitive function score were age, diabetes, educational status, and occupational status. An item analysis using step-wise linear regression showed that 85 percent of the variance in the TICS score was explained by the ability to perform serial sevens and to repeat 10 items immediately after hearing them. Educational status correlated most highly with both of these items (Kendall Tau R = .43 and Kendall Tau R = .30, respectively). CONCLUSION: Education, occupation, depression, and age were the strongest correlates of the score on this new screening test for assessing cognitive status. These factors were stronger correlates of the TICS score than chronic medical conditions, visual loss, or medications. The Telephone Interview for Cognitive Status is a useful instrument, but it may overestimate the prevalence of dementia in studies with a high prevalence of persons with less than a high school education.

Accidental Falls↗

PubMed1993

Relation of smoking and low-to-moderate alcohol consumption to change in cognitive function: a longitudinal study in a defined community of older persons.

To determine whether smoking habits and alcohol consumption are related to changes in cognitive function, the authors conducted a prospective, community-based study of persons aged 65 years and over in East Boston, Massachusetts. In 1982 and again in 1985, the subjects were given three brief tests of cognitive function: immediate memory, digit span, and a mental status questionnaire, which primarily assessed orientation. The 1,201 individuals who performed well in 1982 were included in linear regression analyses of 3-year change in performance, adjusted for age, sex, education, and income. Relative to nonsmoking, current smoking, past smoking, and pack-years were not significantly related to change in immediate memory. None was significantly related to change in orientation. Only pack-years was significantly related to normal change score in digit span (normal change score change per unit of predictor = 0.001, 95% confidence interval 0.0003-0.002). Low-to-moderate alcohol consumption during the month preceding baseline testing was not significantly related to a subsequent 3-year change in performance in two of the three tests. However, people who consumed a very small amount of alcohol had a normal change score that was 0.088 (95% confidence interval 0.015-0.160) better for digit span than did nondrinkers. This study provides evidence that the reported levels of smoking and alcohol use among older persons are not consistent or substantial predictors of the longitudinal change in cognitive function observed in a community.

Aged↗