Introduction Frailty and impaired cognitive functioning often co-occur in older adults and are associated with adverse health outcomes. However, their relationship is unclear. This study sought to examine the association of frailty status with cognitive functioning in older adults. Method The study population consisted of 2,296 older adults aged ≥60 from the National Health and Nutrition Examination Survey 2011–2014. Frailty status was measured based on the Fried Phenotype and the participants were categorized into three groups- robust, pre-frailty, and frailty. Cognitive functioning was measured using the Consortium to Establish a Registry for Alzheimer’s Disease Word Learning subtest (CERAD-WL) immediate and delayed recall tests, the Animal Fluency test (AFT), and the Digit Symbol Substitution Test (DSST). Test-specific and global cognition z-scores were calculated. Multinomial linear regression models were constructed to examine the association between frailty status (reference: robust) and test-specific and global cognition z-scores. Multiple linear regression models were used to examine the relationship between the number of frailty dimensions and test-specific and global cognition z-scores. All models controlled for age, race/ethnicity, education, total cholesterol level, and systolic blood pressure. Results About half of the participants (median age 68 years) were female (49.9%) and non-Hispanic White (48.7%). A quarter (23.3%) of the participants completed some college and above. Multinominal linear regression showed that compared with participants who were robust, those with frailty had worse DSST [β = –0.234, 95% confidence interval (CI): –0.391, –0.078, P = 0.003] and global cognition z scores (β = –0.129, 95% CI –0.233, –0.025, P = 0.02). Multiple linear regression model showed that the number of frailty dimensions was significantly associated with decreased the DSST (β = –0.065, 95% CI –0.103, –0.026, P = 0.001) and global cognition z-scores (β= –0.034, 95% CI –0.06, –0.009, P = 0.009). Conclusion Frailty is associated with worse processing speed, sustained attention, working memory, and global cognition in older adults. Prevention and treatment of frailty in older adults may help protect their cognitive functioning. Further, clinicians should consider assessing cognitive functioning, especially processing speed, sustained attention, and working memory, among frail older patients, which may allow early identification and interventions of cognitive impairment.

/pdf/frailty-is-associated-with-worse-cognitive-functioning-in-1evfx4qv.pdf

Frailty is associated with worse cognitive functioning in older adults

Abstract Objectives Klotho, consisting of membrane klotho and soluble alpha-klotho, is found to be associated with better cognitive outcomes in small samples of the aged population. We aimed to examine the association of serum soluble alpha-klotho with cognitive functioning among older adults using a nationally representative sample of U.S. older adults. Method A total of 2,173 U.S. older adults aged 60–79 years in the National Health and Nutrition Examination Survey from 2011 to 2014 were included in this cross-sectional analysis. Serum soluble alpha-klotho was measured in the laboratory and analyzed with an ELISA kit. Cognitive function was measured using the Consortium to Establish a Registry for Alzheimer’s Disease Word Learning subtest (CERAD-WL) immediate and delayed memory, the Animal fluency test (AFT), and the Digit Symbol Substitution Test (DSST). Test-specific and global cognition z-scores were calculated based on sample means and standard deviations. Multivariable linear regression models were applied to examine the association of quartiles and continuous value of serum soluble alpha-klotho with test-specific and global cognition z-scores. Subgroup analysis was conducted by sex. The following covariates were included in the analysis- age, sex, race/ethnicity, education, depressive symptoms, smoking status, body mass index (BMI), physical activity, stroke, prevalent coronary heart disease, total cholesterol, and systolic blood pressure. All the information was self-reported or obtained from health exams. Results Serum soluble alpha-klotho level in the lowest quartile was associated with lower z-scores for DSST (beta [β] =-0.13, 95% confidence interval [CI]: -0.25, -0.01). For subgroup analysis, serum soluble alpha-klotho level in the lowest quartile was associated with lower z-scores for DSST (β=-0.16, 95% CI: -0.32, -0.003) and global cognition (β=-0.14, 95% CI: -0.28, -0.01) among female participants. No association was found between continuous serum soluble alpha-klotho and cognitive functioning among the participants. Conclusions Lower serum soluble alpha-klotho quartile was associated with poorer cognitive functioning among older women. Future studies are expected to examine the longitudinal association between klotho levels and cognitive outcomes. 

Serum soluble alpha-klotho klotho and cognitive functioning in older adults aged 60 and 79: an analysis of cross-sectional data of the National Health and Nutrition Examination Survey 2011 to 2014

INTRODUCTION Tobacco contains carcinogens called tobacco-specific nitrosamines. Among the tobacco-specific nitrosamines, is nicotine-derived nitrosamine ketone (NNK) which produces the metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL). We aimed to examine the association between urinary tobacco-specific NNAL and cognitive functioning among older adults. METHODS A total of 1673 older adults aged ≥60 years from the National Health and Nutrition Examination Survey 2013–2014 were included. Urinary tobacco-specific NNAL was analyzed in the laboratory. Cognitive functioning was measured using the Consortium to Establish a Registry for Alzheimer’s Disease Word Learning subtest (CERAD-WL) immediate and delayed memory tests, the Animal Fluency test (AFT), and the Digit Symbol Substitution Test (DSST). Test-specific and global cognition z-scores were calculated based on means and standard deviations of the cognitive test scores. Multivariable linear regression models were constructed to examine the independent association between quartiles of urinary tobacco-specific NNAL and cognitive test-specific and global cognition z-scores controlling for age, sex, race/ethnicity, education level, depressive symptoms, body mass index, systolic blood pressure, urinary creatinine, hypertension, diabetes, alcohol use, and smoking status. RESULTS About half of the participants (mean age 69.8 years) were female (52.1%), non-Hispanic White (48.3%), and completed some college and above (49.7%). Multivariable linear regression results showed that participants in the 4th quartile (highest quartile) of urinary NNAL, compared with those in the 1st quartile (lowest quartile), had lower DSST z-scores (β= -0.19; 95% CI: -0.34 – -0.04). CONCLUSIONS Tobacco-specific NNAL was negatively associated with processing speed, sustained attention, and working memory in older adults.

https://www.tobaccoinduceddiseases.org/pdf-162368-89705?filename=Urinary tobacco_specific.pdf

Urinary tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and cognitive functioning in older adults: The National Health and Nutrition Examination Survey 2013–2014

Rana, Vipin, Meenu Dangi, Sandepan Bandopadhayay, Vijay K. Sharma, Satyabrat Srikumar, Jitesh Goyal, and B.V. Rao. Hyperhomocysteinemia, High Altitude, and Varied Retinal Manifestations: Unravelling the Enigma. High Alt Med Biol. 00:000-000, 2023.-We present five cases of young defense personnel, who were posted at high altitude (HA) for >6 months and presented with reduction of vision between June 2022 and February 2023. The diagnosis made were ocular ischemic syndrome, central retinal artery occlusion, central retinal vein occlusion, branch retinal vein occlusion, and branch retinal artery occlusion. There were no associated comorbidities. Hematological workup revealed increased serum homocysteine and hemoglobin in all patients. Computed tomography angiography was done in cases of ocular ischemic syndrome, and central retinal artery occlusion, which revealed occlusion of carotid artery. All patients were given tab folic acid in view of hyperhomocysteinemia (HHcy). This case series highlights that prolonged exposure to HA may lead to HHcy, which can directly or indirectly lead to various sight-threatening retinal diseases. Thus, effective preventive strategies, such as dietary or pharmacological interventions aimed at lowering serum homocysteine levels, are crucial for individuals posted at HA for longer duration.

Hyperhomocysteinemia, High Altitude, and Varied Retinal Manifestations: Unravelling the Enigma.

Highly transparent UV-shielding film via Hantzsch’s reaction to prevent artwork from UV bleaching

Introduction Secondhand smoke (SHS) is common in older adults; however, its cognitive effect is unclear. We aimed to examine the association between serum cotinine level and cognitive functioning among non-smoking older adults. Materials and methods A total of 2,703 older adults aged 60 and above from the National Health and Nutrition Examination (NHANES) Survey 2011–2014 were included. Serum cotinine level was analyzed in the laboratory. A level ≤10 ng/ml and a response of “no” to the question “Do you currently smoke?” were used to select non-smokers. Cognitive functioning was measured using the Consortium to Establish a Registry for Alzheimer’s disease Word Learning subtest (CERAD-WL) immediate and delayed recall tests, the Animal Fluency test (AFT), and the Digit Symbol Substitution test (DSST). Multivariable linear regression models were constructed to examine the association between serum cotinine level quartile and test-specific and global cognition z scores adjusting for age, race/ethnicity, education, depressive symptoms, body mass index, alcohol use, smoking history, prevalent coronary heart disease (CHD), stroke, and systolic blood pressure. Results About half of the participants (mean age 70.5 years) were female (53.6%), non-Hispanic White (48.3%), and completed some college and above (50.2%). Multivariate linear regressions with a reference group being those in the 1st quantile (lowest) showed that participants in the 4th quartile (highest) of serum cotinine level had lower immediate recall [β = −0.16, 95% confidence interval (CI) = −0.29, −0.03], AFT (β = −0.19, 95% CI = −0.33, −0.05), DSST (β = −0.27, 95% CI = −0.39, −0.15), and global cognition (β = −0.26, 95% CI = −0.39, −0.14) z scores. Participants in the 3rd quartile had lower immediate recall (β = −0.16, 95% CI = −0.30, −0.02) and global cognition (β = −0.16, 95% CI = −0.29, −0.02) z scores. Participants in the 2nd quartile had lower delayed recall z scores (β = −0.16, 95% CI = −0.29, −0.02). Conclusion Higher serum cotinine level was associated with worse cognitive functioning in non-smoking older adults. Prevention and reduction of SHS in older adults may help protect their cognitive functioning.

Higher blood cotinine level is associated with worse cognitive functioning in non-smoking older adults

Abstract This study investigated the relationship between residence altitude and serum folate levels in healthy Tibetans living on the Tibetan Plateau. Participants were selected from those who underwent physical examinations at our health center between November 2019 and February 2020. Demographic characteristics and medical histories were collected, and fasting blood was tested for serum folate and other hematological indicators. The relationship between altitude and serum folate levels was analyzed using a multivariable linear regression model. Serum folate levels were associated with altitude ( β = − 0.44; 95% confidence interval [CI] − 0.71; − 0.16), hemoglobin ( β = − 0.01; 95% CI − 0.03; − 0.00), red blood cells ( β = − 0.72; 95% CI − 1.18; − 0.27), hematocrit ( β = − 0.07; 95% CI − 0.12; − 0.02), high-density lipoprotein cholesterol ( β = 2.67; 95% CI 1.35; 3.98), and sex ( β = 0.68; 95% CI 0.12; 1.23). Multivariate linear regression analysis revealed that altitude was negatively associated with serum folate levels. After adjusting for confounding factors, serum folate levels decreased by 0.33 ng/mL per each 500-m increase in altitude ( β = − 0.33; 95% CI − 0.6; − 0.05; P = 0.022). Altitude was negatively associated with serum folate levels in Tibetan adults. The relationship between altitude and folate levels should be further explored in populations of different races and disease states. Further large-scale prospective studies should illustrate the causality of this relationship. 

/pdf/the-association-between-altitude-and-serum-folate-levels-in-unefxxpq.pdf

The association between altitude and serum folate levels in Tibetan adults on the Tibetan plateau

/pdf/correction-an-epigenetic-mechanism-for-over-consolidation-of-3d5m9ym3.pdf

Correction: An epigenetic mechanism for over-consolidation of fear memories

Role of the epigenetic enzyme EZH2 in compulsive alcohol intake

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Higher blood cotinine level is associated with worse cognitive functioning in non-smoking older adults

The association between altitude and serum folate levels in Tibetan adults on the Tibetan plateau

Correction: An epigenetic mechanism for over-consolidation of fear memories

Role of the epigenetic enzyme EZH2 in compulsive alcohol intake