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Background Few studies have compared gait speed and its correlates among different ethnogeographic regions. The goals of this study were to describe usual and rapid gait speed, and identify their correlates across Australian, Asian, and African countries. Methods We used data from 6 population-based cohorts of adults aged 65+ from 6 countries and 3 continents (N  = 6 472), with samples ranging from 231 to 1 913. All cohorts are members of the Cohort Studies of Memory in an International Consortium collaboration. We investigated whether clinical (body mass index [BMI], hypertension, stroke, apolipoprotein status), psychological (cognition, mood, general health), and behavioral factors (smoking, drinking, physical activity) correlated with usual (N  = 4 cohorts) and rapid gait speed (N  = 3 cohorts) similarly across cohorts. Regression models were controlled for age, sex, and education, and were sex-stratified. Results Age- and sex-standardized usual gait speed means ranged from 0.61 to 1.06 m/s and rapid gait speed means ranged from 1.16 to 1.64 m/s. Lower BMI and better cognitive function consistently correlated with faster gait speed in all cohorts. Less consistently, not having hypertension and greater physical activity engagement were associated with faster gait speed. Associations with mood, smoking, and drinking were largely nonsignificant. These patterns were not attenuated by demographics. There was limited evidence that the associations differed by sex, except physical activity, where the greater intensity was associated with usual gait among men but not women. Conclusions This study is among the first to describe the usual and rapid gait speeds across older adults in Africa, Asia, and Australia. [ABSTRACT FROM AUTHOR]

The 10-item Kessler Psychological Distress Scale (K−10) is a widely applied distress measure; however, its psychometric properties were not established with older populations using advanced methodology. The aim of this study was to examine psychometric properties of the K-10 through application of Rasch methodology and if possible, develop an ordinal-to-interval conversion to improve its reliability in older populations. The Partial Credit Rasch Model was applied to analyse K-10 scores of the sample including 490 participants (56.3 % females) aged 70 to 90 years and without dementia from the Sydney Memory and Ageing Study (MAS). The initial analysis of the K-10 showed poor reliability and significant deviation from the expectations of the Rasch model. The best model fit was evident after correcting disordered thresholds and creating two testlet models to address local dependency between items (χ2(35) = 29.87, p = 0.71). The modified K-10 demonstrated strict unidimensionality, enhanced reliability and scale invariance across personal factors, such as sex, age, and education and permitted development of ordinal-to-interval transformation algorithms. Ordinal-to-interval conversion can only be applied for older adults with complete data. The K-10 satisfied principles of fundamental measurement defined by Rasch model after minor modifications. Clinicians and researchers can transform K-10 raw scores into interval-level data using converging algorithms published here without altering the original scale response format, which increases reliability of the K-10. • Accurate measurement of distress in older people is important for diagnosis and assessment of dementia risks • Rasch analysis is a powerful methodology to examine and improve measurement • Rasch analysis was applied to the Kessler Psychological Distress Scale (K-10) • This study examined and improved accuracy of K-10 assessment scores • Ordinal-to-interval conversion tables were developed to enhance precision of K-10 [ABSTRACT FROM AUTHOR]

Objectives: Computerised neuropsychological assessments (CNAs) are proposed as an alternative method of assessing cognition to traditional pencil-and-paper assessment (PnPA), which are considered the "gold standard" for diagnosing dementia. However, limited research has been conducted with culturally and linguistically diverse (CALD) individuals. This study investigated the suitability of PnPAs and CNAs for measuring cognitive performance in a heterogenous sample of older, Australian CALD English-speakers compared to a native English-speaking background (ESB) sample. Methods: Participants were 1037 community-dwelling individuals aged 70–90 years without a dementia diagnosis from the Sydney Memory and Ageing Study (873 ESB, 164 CALD). Differences in the level and pattern of cognitive performance in the CALD group were compared to the ESB group on a newly developed CNA and a comprehensive PnPA in English, controlling for covariates. Multiple hierarchical regression was used to identify the extent to which linguistic and acculturation variables explained performance variance. Results: CALD participants' performance was consistently poorer than ESB participants on both PnPA and CNA, and more so on PnPA than CNA, controlling for socio-demographic and health factors. Linguistic and acculturation variables together explained approximately 20% and 25% of CALD performance on PnPA and CNA respectively, above demographics and self-reported computer use. Conclusions: Performances of CALD and ESB groups differed more on PnPAs than CNAs, but caution is needed in concluding that CNAs are more culturally-appropriate for assessing cognitive decline in older CALD individuals. Our findings extend current literature by confirming the influence of linguistic and acculturation variables on cognitive assessment outcomes for older CALD Australians. [ABSTRACT FROM AUTHOR]

Background: A major issue in evaluating the cognitive status of ageing populations is a clear distinction between enduring and dynamic aspects of global cognition necessary for evaluating risks of dementia and effectiveness of preventive interventions. Materials and methods: Generalizability Theory was applied to investigate dynamic and enduring aspects of global cognition using longitudinal data over 10 years of follow‐up. Measures included the Mini‐Mental Status Examination (MMSE) and the Telephone Interview for Cognitive Status‐modified (TICS‐M). The sample (N = 238) included 154 females, mean age = 76.54 years, SD = 3.94 from the Sydney Memory and Ageing Study. Results: The MMSE measured dynamic and enduring aspects of cognition to a comparable degree with 56% of variance explained by enduring aspects and 44% by dynamic aspects and showed low sensitivity/high specificity in detecting dementia. A shortened version of the MMSE (MMSE‐D8) better captured dynamic aspects of cognition after removing three items less sensitive to change. The TICS‐M predominantly measured enduring aspects of cognition (72%) with the remaining 28% due to dynamic aspects and displayed high sensitivity/high specificity for dementia screening. Conclusions: The MMSE measures both dynamic and enduring cognitive aspects and is suitable for general clinical assessments, while the MMSE‐D8 can be used to monitor transitory changes of global cognition over time. The TICS‐M is more useful for measuring enduring features of cognition and screening for dementia. Our findings highlight the value of generalizability theory to distinguish dynamic and enduring features of cognition, which may contribute to preventive interventions and monitoring cognitive ability over time. [ABSTRACT FROM AUTHOR]

Background: Subjective cognitive complaints (SCCs) are a risk factor for dementia; however, little is known about their trajectories. Method: Participants were 873 older adults (mage = 78.65 years; 55% females) from the Sydney Memory and Ageing Study that were followed‐up biennially. SCCs were measured using the six‐item Memory Complaint Questionnaire. Associations between initial level of SCC reporting, linear change in SCC reporting, and change in global cognition over 6 years was examined using latent growth curve analysis. Risk of dementia was examined over 10 years using Cox regression. Results: After controlling for demographics, mood and personality, results revealed a negative longitudinal association between the slope of SCCs and the slope of global cognition scores (b = −0.01, p = 0.005, β = −0.44), such that participants who reported increasing SCCs showed a steeper rate of decline in global cognition over 6 years. Cox regression also revealed participants who reported increasing SCCs had a nearly fourfold increased risk of developing dementia over 10 years (hazard ratio 3.70, 1.24–11.01). Conclusion: This study explored whether initial levels of, and change in, SCCs over time are associated with both cognitive decline and risk of dementia. These findings are clinically relevant as GPs should note patients reporting increasing SCCs as they may be at greater risk of cognitive decline and incident dementia. Highlights: Existing longitudinal data on the association between subjective cognitive complaints (SCCs) and cognitive outcomes over time has focused on associations with decline in memory or other cognitive domains, or on associations with risk of incident dementia, but not both.To our knowledge, no study has examined whether changes in SCCs reporting predict both cognitive decline and incident dementia in the same cohort.Controlling for mood and personality, participants who reported increasing SCCs showed a steeper rate of cognitive decline over 6 years and had a nearly fourfold increased risk of dementia over 10 years.Examining longitudinal features of SCCs provides novel and important insight into their association with underlying cognitive changes. GPs and Clinicians should note patients reporting increasing SCCs over time as this is associated with future cognitive decline and risk of dementia. [ABSTRACT FROM AUTHOR]

Background: The Reading the Mind in the Eyes test (RMET) is a 36-item assessment for theory of mind (ToM) performance. While this measure has been shown to be sensitive to age-related ToM difficulties, there are no established cutoffs or guidelines currently available that are specific to older adults. This article seeks to validate a short-form version of the RMET appropriate for use in such populations.Methods: Cross-sectional data from 295 participants (mean age 86 years) from the Sydney Memory and Ageing Study, a longitudinal community observational cohort. Participants underwent an assessment battery that included the RMET. Individuals who scored >1SD below the RMET scores of cognitively normal participants were deemed to have below average RMET scores. Various model-building methods were used to generate short-form solutions of the RMET, which were compared with previously validated versions in their predictive power for below average full RMET performance.Results: Individuals with below average RMET performance tended to be older and have poorer global cognition. Of the eight short-form solutions, the 21-item version generated using genetic algorithm exhibited the best classification performance with an area under the receiver operating curve (AUROC) of 0.98 and had 93.2% accuracy in classifying individuals with below average ToM. A shorter 10-item solution derived by ant colony optimization also had acceptable performance.Conclusion: We recommend the 21-item version of the RMET for use in older adult populations for identifying individuals with impaired ToM. Where an even shorter version is needed with a trade-off of slightly reduced performance, the 10-item version is acceptable. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has posed unique risks to people with Alzheimer disease and dementia. Research from 2020 has shown that these people have a relatively high risk of contracting severe COVID-19, and are also at risk of neuropsychiatric disturbances as a result of lockdown measures and social isolation. Key advances: People with dementia are at high risk of SARS-CoV-2 infection because cognitive symptoms cause difficulty with following safeguarding procedures and living arrangements in care homes facilitate viral spread1. Once infected, older adults with dementia are more likely to experience severe virus-related outcomes, including death, than are people without dementia4. A homozygous APOE ε4 genotype is associated with an increased risk of hospitalization for COVID-19 (ref.8), possibly owing to exacerbated inflammation and cytokine production that leads to a cytokine storm. Older adults with dementia, especially those in care homes, are at high risk of worsening psychiatric symptoms and severe behavioural disturbances as a result of social isolation during the pandemic3. [ABSTRACT FROM AUTHOR]

Evidence suggests that lifestyle activities impact cognitive and mental health in older populations. However, how lifestyle factors are associated with one another, and which factors are most important for cognitive function and mental health has received comparatively little attention. Bayesian-Gaussian network analysis was used to investigate unique associations between mental activities (MA; i.e., activities involving cognitive engagement), global cognition, and depression at three time-points in a large sample of older adults (baseline, 2 years, and 4 years follow-up). This study used longitudinal data from participants living in Australia and participating in the Sydney Memory and Ageing Study. The sample included 998 participants (55% female) aged between 70 and 90, without a diagnosis of dementia at baseline. Neuropsychological assessment of global cognition, self-reported depressive symptoms, and self-reported information about daily MA. Cognitive functioning was positively associated with playing tabletop games and using the internet in both sexes at all time-points. MA were differentially linked in men and women. Depression was not consistently associated with MA in men across the three time-points; women who visited artistic events consistently had lower depression scores. Engaging with tabletop games and using the internet was associated with better cognition in both sexes, however sex acted as a modifier for other associations. These findings are useful for future investigations that consider interactive associations between MA, cognition, and mental health in older adults, and their possible roles in promoting healthy aging. [ABSTRACT FROM AUTHOR]