Cognitive Tests And Derivation Of Cognitive Scores
A comprehensive battery of neuropsychological tests was used to measure: verbal fluency, using the Controlled Oral Word Association Test executive function interference, using the Victoria Stroop Test working memory, using the digit span subtest of the Wechsler Adult Intelligence ScaleThird Edition attention-processing speed, using the Victoria Stroop dot tests, symbol search and digit symbol-coding subtests of the Wechsler Adult Intelligence ScaleThird Edition visuospatial ability, using the ReyOsterrieth Complex Figure Test, copy task verbal memory, using the Hopkins Verbal Learning TestRevised generating scores for total immediate recall, delayed recall and recognition memory visual memory, with a delayed reproduction after 20 min of the ReyOsterrieth Complex Figure Test . For individual tests, scores were standardised at each visit by creating z scores using the mean and SD from the baseline visit. These domain scores were averaged to create a global cognitive score and also average scores for each of the seven listed cognitive domains. Domain scores with more than one cognitive test were restandardised to an SD of 1. These scores were used in the regression analysis to allow comparison of associations across cognitive domains, as has been done previously .
What This Article Tells Us That Is New
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Elderly subjects after surgery experienced an increased rate of brain atrophy during the initial evaluation interval, a time associated with risk for postoperative cognitive dysfunction
THERE have been numerous reports of impairment of cognitive performance following surgery.,,However, it is not yet known which patients are at risk for post operative cognitive dysfunction .
POCD occurs in approximately 10% of elderly patients after noncardiac surgery.The presence of POCD is determined by the comparison of preoperative and postoperative cognitive performance using a battery of neuropsychometric tests that assess memory and executive function.A goal of the present study was to examine short-term longitudinal changes in brain volume and in cognition in elderly patients pre- and postsurgery in order to improve our understanding of the risk of POCD.
Clinical And Biochemical Characteristics At Baseline And After 3 Years Of Follow
Diabetic patients were well controlled during the 3 years with an average HbA1c of 6.95 ± 0.62% . The average blood pressure during follow-up was 136.3 ± 10.6/72.9 ± 6.5 mm Hg. After 3 years, HDL-cholesterol, diastolic blood pressure, and eGFR values were decreased, and TNF-, uric acid, and sICAM-1 levels were increased significantly, as compared with baseline values. Also, the rates of patients with a low eGFR and albuminuria had significantly increased after 3 years . As for cognitive function, scores for the MMSE, immediate word recall, and DSS test had declined after 3 years .
Table 1
Clinical and biochemical characteristics at baseline and after 3 years of follow-up in elderly diabetic patients
During the 3-year follow-up, SBI progression was noted in 5 patients , and progression of PWMLs and SWMLs was observed in 6 and 3 patients , respectively. As for brain atrophy, the HAI increased from 1.50 ± 0.76 to 1.75 ± 0.94 , and the WBAI increased from 8.65 ± 2.62 to 9.78 ± 2.93% .
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Clinical And Neuropsychological Assessments
Participants received standardized clinical and neuropsychological assessments by trained psychiatrists. This assessment followed the KBASE clinical assessment protocol, which included the CERAD-K assessment packet . The KBASE neuropsychological assessments which incorporated the CERAD-K neuropsychological battery were also administered to participants by trained psychometrists.
Structural Imaging And Analyses
Image acquisition
The data sets included standard T1-weighted magnetic resonance images acquired sagittally using volumetric 3D magnetization prepared rapid gradient echo with 1.25×1.25mm in-plane spatial resolution and 1.2mm thick sagittal slices performed on 1.5T scanners.
Image analysis
CERND MRI analysis was based on an image processing protocol developed at the Section of Biomedical Image Analysis of the Department of Radiology at the University of Pennsylvania and previously described in detail . Global volumes were obtained via an automated segmentation technique that labels the brain into white matter, grey matter, CSF and ventricles, after a sequence of preprocessing steps that remove extracranial material and aligns each scan with the anteriorposterior commissure plane. Quantification of regional brain volumes is performed through an elastic atlas warping algorithm that coregisters a template of brain anatomy with each individual scan . The template has 97 regions of interest based on the Montreal Neurological Institute template, which are transferred to individual scans, so that regional volumetric and functional measurements can be obtained. These regions of interest were then collapsed into 14 larger regions of interest. To limit the number of variables presented, we calculated the average of the right and left volumes for each region of interest and present grey matter volumes only .
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Natural Supplements That Protect Brain Volume
Even though the array of factors that can cause brain shrinkage can be daunting, there is good news. Since brain shrinkage results from the same basic processes that cause other symptoms of aging, its likely that brain shrinkage is preventableespecially when caught early enough.
Thats why we want to provide you with information on key nutrients that have been shown to powerfully protect the brain. Here are four of the most potent brain-protecting nutrients.
How To Keep Your Brain From Shrinking
Brain atrophy increases with age and is a major factor in cognitive, depressive, and movement disorders. Shrinkage of our brain also markedly increases risk of premature death. The good news is that loss of brain mass can be prevented by following a program already practiced by many Life Extension® members.
Scientifically reviewed by: Dr. Shanti Albani, ND, Physician, in May 2022. Written by: Barry Volk.
Even if you seem perfectly healthy, you may be losing as much as 0.4% of your brain mass every year.1,2 The rate of brain shrinkage increases with age and is a major factor in early cognitive decline and premature death.2-7
Studies show that older adults with significant brain shrinkage are much more likely to have cognitive and movement disorders than similarly aged people with normal brain size. They are also at an increased risk of vascular death and ischemic stroke.4,8-10
In addition, atrophy of specific brain regions has been associated with a variety of cognitive, behavioral, and mental health problems. Shrinkage of the temporal lobes, for example, is associated with a 181% increase in the risk of major depression.7
Perhaps most alarmingly, brain shrinkage sharply increases risk of early death:
Brains also shrink from the inside out, resulting in enlargement of the fluid-filled ventricles, or hollow spaces on the interior of the brain such shrinkage has its own modest effect on early death.2
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Learn More About Cerebral Atrophy From Baptist Health
Brain health is body health. If you or a family member is experiencing symptoms of cognitive impairment, contact the Baptist Health Neuroscience and Stroke team to schedule an appointment. Persons with stroke symptoms should treat them as a medical emergency. Dial 911 or go to the nearest medical-emergency facility.
Surgery And Brain Atrophy In Cognitively Normal Elderly Subjects And Subjects Diagnosed With Mild Cognitive Impairment
Richard P. Kline, Elizabeth Pirraglia, Hao Cheng, Susan De Santi, Yi Li, Michael Haile, Mony J. de Leon, Alex Bekker, for the Alzheimer’s Disease Neuroimaging Initiative Surgery and Brain Atrophy in Cognitively Normal Elderly Subjects and Subjects Diagnosed with Mild Cognitive Impairment. Anesthesiology 2012 116:603612 doi:
Structural magnetic resonance imaging is used to longitudinally monitor the progression of Alzheimer disease from its presymptomatic to symptomatic phases. Using magnetic resonance imaging data from the Alzheimer’s Disease Neuroimaging Initiative, we tested the hypothesis that surgery would impact brain parameters associated with progression of dementia.
Brain images from the neuroimaging initiative database were used to study normal volunteer subjects and patients with mild cognitive impairment for the age group 55 to 90 inclusive. We compared changes in regional brain anatomy for three visits that defined two intervisit intervals for a surgical cohort and a propensity matched nonsurgical control cohort . The first interval for the surgical cohort contained the surgical date. Regional brain volumes were determined with Freesurfer and quantitatively described with J-image software . Statistical analysis used Repeated Measures ANCOVA .
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Do I Need Emergency Help For A Seizure
Typically, seizures dont require emergency medical care. But if one or more of these symptoms happens, youll need to go to the hospital:
- The seizure lasts more than five minutes.
- The seizure occurs in water.
- This is your first seizure.
- Youre injured during the seizure.
- Youre struggling to breathe or wake up.
- You have a second seizure following the first one.
- You have a health condition, such as diabetes or heart disease.
A note from Cleveland Clinic
Brain atrophy happens when an area of your brain, or your entire brain, loses neurons. Many conditions cause brain atrophy, so the severity of damage can vary. Some people have mild memory loss, while others have trouble talking and reading. Seeing your healthcare provider can help you get the correct diagnosis and create a treatment plan that reduces symptoms and improves your day-to-day life.
Last reviewed by a Cleveland Clinic medical professional on 03/10/2022.
References
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy
Progressive Atrophy Versus Acute Atrophy
To put these atrophy results in a more quantitative context, we compared mean baseline volumes for three severity groups on the same bar plot as the mean atrophy for surgical and control subjects during the first evaluation interval . This allowed us to compare, from the same data set, atrophy associated with surgery to volume changes during transition between severity groups , where we know that there is a difference in cognition.For example , a mean 8.1% reduction in hippocampal volume for MCI subjects can be compared to a 2.9% atrophy for surgical patients. Similar results were found for the other regions of interest . For GM, the mean change from NL to MCI is 3.5% vs. a 1.39% atrophy in the surgical group. For the LV volume, an enlargement of MCI versus NL of 15.9% can be compared to a 5.3% enlargement for the surgical patients.
For comparison of atrophy values with those quoted in aging/dementia studies,we also calculated the mean difference of the annual percent change . Comparing the two atrophy rates for hippocampal volume, surgical versus nonsurgical control groups, the mean difference in the annual pecent change was 3.7% comparing annualized atrophy rates for GM volume gives a difference in annual percent change of 2.2% and, comparing annualized enlargement rates for LV, there was a 4.4% greater rate for the surgery subjects.
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Evaluating The Association Between Brain Atrophy Hypometabolism And Cognitive Decline In Alzheimers Disease: A Pet/mri Study
Yifan Chen1,*,, Junkai Wang2,3,4,*,, Chunlei Cui1,, Yusheng Su1,, Donglai Jing5,, LiYong Wu5,, Peipeng Liang3,4,, Zhigang Liang1,,
- 1 Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- 2 Department of Psychology, Tsinghua University, Beijing, China
- 3 School of Psychology, Capital Normal University, Beijing, China
- 4 Beijing Key Laboratory of Learning and Cognition, Beijing, China
- 5 Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
Parity And Brain Changes
We found no significant association between parity group and global A deposition, regardless of the statistical models used . Similarly, we observed no association between parity group and A positivity . In contrast, the grand multiparity group exhibited significantly smaller HVa, SPARE-AD volume and SPARE-BA volume than the 04 parity group in both Model 1 and 2 . The association between parity group and WMH volume was not significant , regardless of the model used.
Table 2. Relationship of grand multiparity with global A retention, adjusted hippocampal volume, SPARE-AD volume, SPARE-BA volume, and WMH.
Figure 1. The relationships between parity and global A retention, between parity and adjusted hippocampal volume, between parity and SPARE-AD volume, and between parity and SPARE-BA volume with standard errors. Adjusted for age, education, APOE4 positivity, cognitive status, VRS, income level at early adulthood, level of lifetime occupation, age at menarche age and age at menopause. A, -amyloid SPARE-AD, spatial patterns of abnormality for recognition of early AD SPARE-BA, spatial pattern of atrophy for recognition of brain aging APOE4, apolipoprotein E 4 VRS, vascular risk factors score.
Table 3. Results of the multiple logistic regression analyses of grand multiparity with A positivity.
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Copyright: © 2021 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Obesity And Your Brain
Like diabetes, obesity is a known cause of brain atrophy.39 Even in people with normal cognition, higher body mass index is associated with lower brain volume in obese and overweight people.40
Obesity and diabetes share many similar mechanisms, including insulin resistance and oxidative stress, both of which are known to contribute to brain atrophy.38,41 In addition, fat deposits produce huge amounts of inflammatory signaling molecules that may contribute to brain cell death and brain volume loss.39
Additional links between obesity and brain shrinkage may be even more fundamental. About46% of Western Europeans and their descendants carry a gene variant called FTO, which is associated with fat mass and obesity. People who carry this gene weigh on average about 2.64 pounds more and have an extra half-inch of waist circumference compared to those who lack the gene variant.42 Recent findings show that carriers of the FTO gene variant have approximately 8% smaller frontal lobe volumes, and 12% smaller occipital volumes than people who dont carry this gene variant. These changes werenot associated with differences in cholesterol levels or blood pressure, suggesting an independent relationship.42
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Factors Associated With Brain Atrophy Hai And Wbai
HAI was significantly correlated with GDS score, age, a low eGFR, and the number of SBI at baseline, and multivariate analysis showed that GDS score and a low eGFR had a tendency to be associated with HAI . In contrast, WBAI was significantly correlated with age, sex, GDS score, the number of SBIs, PWML grade, SWML grade, eGFR, and levels of serum albumin, sICAM-1, log TNF-, and LDL-cholesterol, and multivariate analysis showed that age , GDS score , and SWML grade were associated with WBAI .
Factors associated with changes in HAI and WBAI during the 3-year follow-up are shown in table 2. Changes in HAI were significantly correlated with changes in eGFR, age, diastolic blood pressure at baseline, changes in HDL-cholesterol, ApoE 4 carrier, and albuminuria during follow-up in univariate analysis, and multivariate analysis showed that changes in eGFR, ApoE 4 carrier, and albuminuria during follow-up were independent factors for changes in HAI. In contrast, although changes in WBAI were significantly correlated with the factors listed in table 2, only change in the number of SBIs was an independent factor in multivariate analysis.
Table 2
Factors associated with changes in HAI and WBAI during the 3-year follow-up
Fig. 2
Can I Prevent Cerebral Atrophy
There is no clear-cut evidence that cerebral atrophy is preventable, but taking certain steps reduces the possibility of its early or severe onset. These include exercising regularly, regulating blood pressure, and eating a healthy diet. Foods rich in antioxidants and omega-3 fatty acids are good for your gray matter.
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Exercise For Brain Atrophy
A 2011 review suggests that regular exercise could slow or even reverse brain atrophy related to aging or dementia.
However, one found that high intensity exercise and strength training did not slow cognitive impairment in people with mild-to-moderate dementia. Additional research is therefore necessary to determine what effect, if any, exercise has on preventing or reversing brain atrophy due to dementia.
Assessment Of Potential Confounders
Grand multiparity was previously reported to be associated with several socioeconomic conditions as well as health outcomes , including low income, low or no formal education, and lack of employment . As mentioned above, grand multiparity has also been linked to various vascular disorders . Therefore, all study participants were systematically evaluated for these potential confounders. Vascular risk factors , consisting of hypertension, diabetes mellitus, dyslipidemia, coronary heart disease, transient ischemic attack, and stroke, were assessed through systematic interviews. The VRF score was calculated as the percentage of the number of VRF present . Income level at early adulthood and lifetime occupation were also assessed through systematic interviews. Income level was classified into 3 groups according to the household income. The three groups were low if below the minimum cost of living , middle if below the twice the MCL, and high if above the twice of MCL.1 The MCL was defined following the administrative rules announced in November 2012 by the Ministry of Health and Welfare, Republic of Korea. The minimum cost of living was 572,168 Korean Won for single-person households with addition of 286,840 Korean Won for each additional person. Lifetime occupation level was classified into 4 levels following the National Statistics Socio-Economic Classification .
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Is Brain Shrinkage Normal As You Age
It’s completely normal to experience changes in your brain as you age.
Your cerebral cortex, the wrinkled outer layer of the brain, gets thinner as you age. It’s especially noticeable in the frontal lobe, which processes memory, emotions, impulse control, problem-solving, social interaction, and motor function. Thinning can also be noticeable in parts of the temporal lobe, which is located behind the ears and helps people understand words, speak, read, write, and connect words with their meanings.
The parts of the brain that are the last to mature during adolescence are the first to start to age and shrink. Some refer to this as a “last in, first out” theory. In short, the last parts of the brain to develop as you’re growing up are the first to decline in old age.
The parts of the brain that shrink contain important nerve fibers . When your brain shrinks, there are fewer connections between neurons, and the neurotransmitter systems that communicate information from the brain to different parts of the body change, resulting in numerous complications.
All of these factors play a role in the aging process and age-related cognitive decline.
