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Objectives/background: There is good documentation of the impact of insomnia on daytime cognitive function based on self-reports, but not on neuropsychological test performance. The study investigated the association of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA) complaints with daytime domain-specific neuropsychological performance in older adults., Participants/methods: Participants were 859 older adults (mean 71.9 years) in the Singapore Longitudinal Ageing Studies. They were interviewed and assessed at community-based eldercare activity centres and completed a sleep survey questionnaire and a battery of neuropsychological tests (Digit span, Rey Auditory Verbal Learning Test, Story memory, Brief Visuospatial Memory Test-Revised, Color Trails Test (1 and 2), Block design, and Verbal fluency)., Results: Insomnia complaints were present in 18.0% (n = 155) of participants. Controlling for the presence of other insomnia complaints, psychosocial and medical variables, and depression, EMA was independently and significantly associated with worse executive functioning (p = 0.031). DIS and DMS were not independently associated with poorer performance on any cognitive domain., Conclusion: The association of EMA among older adults with decreased executive functioning and underlying mechanistic factors should be further investigated., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Objective: Chinese is the most commonly spoken language in the world. The availability of Chinese translations of assessment scales is useful for research in multi-ethnic and multinational studies. This study aimed to establish whether each of the Chinese translations (Mandarin, Hokkien, Teochew, and Cantonese) of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) achieved measurement equivalence to the English version., Method: Participants included 1856 ethnic Chinese, older adults. The RBANS was administered in the language/dialect according to the participants' preference by interviewers who were fluent in that language/dialect. Multiple regression analysis was used to adjust for demographic and clinical differences between participants who spoke different languages/dialects. Equivalence (practical equivalence) was declared if the 90% confidence interval for the adjusted mean difference fell entirely within the pre-specified equivalence margin, ±.2 (±.4) standard deviations., Results: The delayed memory index was at least practically equivalent across languages. The Mandarin, Hokkien, and Teochew versions of the immediate memory, language, and total scale score were practically equivalent to the English version; the Cantonese version showed small differences from the English version. Equivalence was not established for the Hokkien and Teochew versions of the visuospatial/constructional index. The attention index was different across languages., Conclusions: Data from the English and Chinese versions for the total scale score, language, delayed, and immediate memory indexes may be pooled for analysis. However, analysis of the attention and visuospatial/constructional indexes from the English and Chinese versions should include a covariate that represents the version in the statistical adjustment.

Asia will experience a surge in dementia prevalence within the next 20-40 years, but there is a dearth of well-normed neuropsychological tests that could assist with dementia diagnosis. Here, we report normative data for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in Elderly ethnic Chinese Singaporeans aged 55-91 years of age. A total of 1,165 male and female community-dwelling, cognitively normal elderly Chinese persons in Singapore, with varying levels of education and range of languages, were tested with the RBANS version A. The effects of age, education, language and gender on RBANS performance were examined. Negative effects of increased age and positive effects of education on the RBANS subtests, Index and Total Scale scores were found suggesting differential associations between age-related cognitive decline and education that vary according to the specific cognitive ability measured. The findings indicate that unique cultural and educational profile of elderly Chinese should be considered when applying the RBANS in this population., (© The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

There is a paucity of normative studies outside of North America and on elderly populations with very low education level. In the present study we examined the performance of poorly educated elderly on the Repeatable Battery Assessment of Neuropsychological Status (RBANS) with 352 cognitively normal elderly Chinese persons living in the community in Singapore who were enrolled in the Singapore Longitudinal Ageing Study (SLAS). Those with no formal education performed significantly less well than those with some years of formal education across four of five RBANS indices as well as the Total Scale score. Age- and education-adjusted normative data for the RBANS were established for the sample. The means and standard deviations of each of 12 subtests raw scores, five Index scores and the Total Scale score were calculated and stratified by age and education. Data from the present study should considerably advance the clinical utility of the RBANS in Chinese geriatric evaluations in Singapore, and can serve as a reference source for poorly educated elderly Chinese from around the region and beyond.

Background: Few studies have comprehensively evaluated the relationship between vascular disease and cognition of older adults without cardiac disease.Objective: We explored the associations of structural atherosclerosis, vascular stiffness, and reactivity with global, memory, attention, language, visuospatial ability, and executive function in community-dwelling, non-demented older Asians without cardiac diseases.Methods: Cognition was assessed by Mini-Mental State Examination (MMSE) (n = 308) and detailed neuropsychological tests (n = 155). Vascular measures included carotid intima-media thickness; aortic stiffness [carotid-femoral pulse wave velocity (CFPWV), aortic augmentation index (AI), and aortic pulse pressure (PP)]; carotid stiffness [elasticity modulus (Ep), beta index (β), arterial compliance (AC), carotid AI]; and endothelial function [reactive hyperemia index (RHI)]. Multivariable analyses controlled for potential confounding by demographics, apolipoprotein E genotype and cardiovascular risk factors.Results: The participants' mean age was 63.0 ± 6.1 years. Inverse associations with MMSE were found for AC (β= 0.128, p = 0.019), Ep (β= -0.151, p = 0.008), β index (β= -0.122, p = 0.029), carotid stiffness z-score (β= -0.154, p = 0.007); with executive function for CFPWV (β= -0.209, p = 0.026), AC (β= 0.214, p = 0.005), Ep (β= -0.160, p = 0.050), β index (β= -0.165, p = 0.041), and both aortic (β= -0.229, p = 0.010) and carotid (β= -0.208, p = 0.010) stiffness z-scores; with verbal memory for AI (β= -0.229, p = 0.004) and aortic (β= -0.263, p = 0.004) stiffness z-score; with language for AI (β= -0.155, p = 0.025), aortic stiffness z-score (β= -0.196, p = 0.011). RHI positively correlated with visuospatial ability (β= 0.195, p = 0.013) and executive function (β= 0.151, p = 0.045).Conclusion: The results support a link between systemic vascular health and neurocognitive function in older Asian adults. Subclinical noninvasive measures of arterial stiffness and reactivity may identify individuals vulnerable to cognitive impairment. [ABSTRACT FROM AUTHOR]

Introduction: Various cognitive deficits associated with reduced pulmonary function are reported in different studies, but the pattern of cognitive deficits across multiple domains and its associated everyday functional disability remain unclear. Methods: We analyzed neuropsychological functioning, cognitive impairment and accompanying disability in instrumental activities of daily living (IADL) associated with reduced pulmonary function in community-living middle-aged and older adults in Singapore. Performance on a comprehensive battery of neuropsychological tests, spirometry and cognitively demanding IADLs were assessed in the population-based Singapore Longitudinal Ageing Studies. Results: Consecutive 10% increase in forced expiratory volume in 1 s (FEV1) as percent of predicted was positively associated with 0.18 points increase in Mini-mental state examination (MMSE) and 0.04 points increase in executive function, independent of age, education and other variables. Subjects with moderate-to-severe airway obstruction showed significantly poorer MMSE score (p for linear trend = 0.001), and information processing speed (p for linear trend < 0.001). FEV1 (per 10% of predicted) was significantly associated with lower risk of cognitive impairment (OR = 0.92, 95% CI: 0.87-0.98, P = 0.005) and cognitive IADL disability (OR = 0.86,95% CI:0.79-0.93, P < 0.001). Pulmonary restriction was associated with greater risk of cognitive impairment (OR = 1.98, 95% CI: 1.26-3.11, P = 0.003) and cognitive IADL disability (OR = 2.43, 95% CI: 1.31-4.53, P = 0.005). Moderate-to-severe airway obstruction (OR = 2.04, 95% CI: 1.11-3.74, P = 0.022) was positively associated with cognitive IADL disability. Conclusion: The findings suggest a measurable but modest cognitive effect of low pulmonary function that was accompanied by corresponding disability in living activities. The effect on executive functioning should be further investigated in longitudinal studies. [ABSTRACT FROM AUTHOR]