Search

Cognitive function and physical function are associated however less is known about task complexity and how individual tasks relate to one another. This project seeks to describe the relationship between cognition and physical function measures across 22 tasks ranging in task complexity and difficulty. Data are from the baseline visits of a new longitudinal study, Brain Networks and Mobility Function (B-NET) Study, mean age: 76.0±4.2 years; 55% women, and 90% Caucasian. We hypothesize there would be a set of “complex” tasks that would intersect both cognitive and physical function abilities such as the Four Square Step Test or Dual Task. We conducted principal components analysis on data from the first 110 participants to describe what factors could be identified across cognition and physical function measures. Seven factors, explaining 73% of the variability, were identified: 1) a complex physical function (postural sway on foam, expanded Short Physical Performance Battery, 400 meter walk, Four Square Step Test, Dual Task), 2) physical strength (grip strength and leg press), 3) visual recall (Brief Visuospatial Memory Test- immediate and delayed), 4) Craft story recall (immediate and delayed), 5) global cognition & fluency (MoCA, category and word fluency) 6) auditory recall (Auditory Verbal Learning Test- immediate and delayed), and 7) executive function (Trail Making Test A & B). We did not identify factors that intersected both physical and cognitive tasks. These results may help to inform measurement selection in future studies that seek to evaluate components of function among older adults.

Brain pathologies are increasingly understood to confer mobility risk, but the malleability of functional brain networks may be a mechanism for mobility reserve. In particular, white matter hyperintensities (WMH) are strongly associated with mobility and alter functional network connectivity. To assess the potential role of brain networks as a mechanism of mobility reserve, 116 participants with MRI from the Brain Networks and Mobility Function (B-NET) were categorized into 4 groups based on median splits of SPPB scores and WMH burden: Expected Healthy (EH: low WMH, SPPB>10, N=45), Expected Impaired (EI: high WMH, SPPB10, N=24), Unexpected Impaired (EI: low WMH, SPPB

Identifying safe, affordable, and well-tolerated interventions that prevent or delay cognitive decline in older adults is of critical importance. There is growing evidence from basic science and small randomized trials that cocoa flavanols may provide protection against this decline. Funded by the NIA, COSMOS-Mind is an ancillary study of COSMOS and was designed to add cognitive outcomes to the parent study, a 2x2 factorial randomized controlled trial testing the effects of cocoa flavanols (600 mg/d) and a multivitamin with matching placebo on cardiovascular disease and cancer endpoints. A validated telephone-based protocol conducted at baseline and then annually for three years measures attention, memory, language, executive function, and global cognitive functioning in 2,262 women and men, ages 65 and older without insulin-dependent diabetes. Cases of mild cognitive impairment and Alzheimer’s and related dementias will be centrally adjudicated. For participants who score below a pre-specified threshold on a test of global cognition, a study partner is interviewed to obtain additional information regarding cognitive and functional status. With >5,000 interviews completed, this presentation will describe the cognitive battery, operational procedures used to ensure high data fidelity, and strategies employed that have maintained retention at >90%. Our experiences in COSMOS-Mind can inform the design and implementation of other large, multi-site RCTs and epidemiological studies. Telephone-based assessments of cognitive function are a cost-efficient method for assessing cognitive function.

Identifying a safe, affordable, and well-tolerated intervention that prevents or delays cognitive decline in older adults is critically important. There is growing evidence from basic science and small randomized trials that cocoa flavanols may provide protection against cognitive decline. COSMOS-MIND is an ancillary study to the COcoa Supplement and Multivitamin Outcomes Study (COSMOS), a large randomized controlled trial with more than 21000 participants. COSMOS-MIND examines the potential cognition-protecting effects of 3 years of treatment with cocoa flavanol extract (600mg/d), with and without co-administration of a standard multivitamin, concurrently with the evaluation of cardiovascular disease and cancer endpoints in the parent COSMOS trial. COSMOS-MIND uses validated telephone interviews to test whether these supplements improve cognitive function (or slow its decline). Proxy interviews are conducted for participants scoring below cognitive thresholds to inform adjudication of the study’s cognitive impairment outcomes, including mild cognitive impairment, Alzheimer’s and other forms of dementia. COSMOS-MIND enrolled 2,282 randomized participants (60% women), median [range] age 73 [65–94] years. Its composite primary outcome is based on scores from standardized telephone assessments of memory, executive function, and global cognitive function. We used percentile regression to portray its relationships with baseline age. The observed trajectories demonstrate that the battery is sensitive to age-related differences. Data from additional baseline measures of subjective memory problems, depression, and insomnia will be presented. COSMOS-MIND demonstrates that large simple trials with cognitive and dementia outcomes derived from telephone interviews are feasible, and may serve as a model for future clinical trials testing well-tolerated interventions.