Marnina B. Stimmel, PhD, from Albert Einstein College of Medicine in New York City, and colleagues examined the utility and discriminative validity of the Spanish and English MoCA versions to identify cognitive impairment among diverse community-dwelling older adults. The analysis included 231 older adults (aged 65 years and older; 43% Hispanic and 39% Black/African American) with cognitive concerns attending outpatient primary care.

The researchers found that neuropsychological assessment identified 90 participants as cognitively normal with subjective cognitive concerns (average MoCA, 19.9), 133 with MCI (average MoCA, 16.6), and eight with dementia (average MoCA, 10.6). The mean English MoCA average was 18.6 versus 16.7 for Spanish. There was a high false-positive rate using the published cutpoint ≤23 for MCI (79%). Using the English MoCA, ≤18.5 was identified as the score to identify MCI or dementia (65% sensitivity; 77% specificity) and ≤16.5 for the Spanish MoCA (64% sensitivity; 73 percent specificity).

“Lower Spanish and English MoCA cutpoints may improve diagnostic accuracy for identifying cognitive impairment in this group, highlighting the need for the creation and validation of accurate cognitive screeners for ethnoculturally and linguistically diverse older adults,” the authors write.

One author disclosed ties to MedRhythms.

Abstract/Full Text (subscription or payment may be required)

Evan L. Reynolds, PhD, from the University of Michigan in Ann Arbor, and colleagues examined the effect of surgical weight loss on cognition in individuals with class II/III obesity. The analysis included 113 participants who completed baseline assessments and 87 who completed two-year follow-up assessments.

The researchers found that the primary outcome, the NIH Toolbox Cognitive Battery (NIHTB-CB) composite score, was stable following bariatric surgery (−0.4). For secondary outcomes following surgery, the NIHTB-CB dimensional card sorting test (executive function assessment), improved (+6.5), while the Rey Auditory Verbal Learning Test (AVLT) delayed recall test (memory assessment) declined (−0.24). There was no association between improvements in metabolic risk factors and diabetes complications with improvements in the NIHTB-CB composite score. At follow-up, the other four NIHTB-CB subtests and Rey AVLT assessments of auditory learning and recognition were unchanged.

“Since individuals with obesity experience more rapid cognitive decline than those without, stable cognition two years after bariatric surgery may be considered a success against historical trends, yet future controlled trials are needed to test this,” Reynolds said in a statement.

Abstract/Full Text (subscription or payment may be required)

Lifelong learning has seamlessly integrated into both my personal and professional life, serving as the driving force behind my belief that senior living communities should offer and ensure access to a wealth of opportunities for expanding the minds of their residents.

The quest for knowledge is a never-ending journey — that’s a belief that lies at the core of my mission. Since joining The Kensington at Walnut Creek, my primary goal has been to ensure that age never becomes a barrier to enriching one’s mind.

Lifelong learning is about so much more than keeping your mind intellectually sharp; it plays a vital role in maintaining a high quality of life. It’s the key to nurturing both a healthy mind and a healthy body, and it can significantly contribute to warding off cognitive conditions, such as dementia, while promoting social connection.

In senior living communities, recognizing the significance of offering a diverse array of social activities tailored to residents’ varying needs is paramount. Providing a multitude of opportunities that span across emotional, occupational, physical, social, intellectual, creative, nutritional and spiritual dimensions of wellness can foster an environment where growth and self-improvement remain continuous pursuits.

Encouraging residents to participate in activities aimed at cognitive enrichment is essential. Those activities may include hosting discussion groups, trivia nights, history lessons or an outing to the latest art exhibit. Empowering residents to influence their learning experiences by enabling them to suggest topics they are passionate about also can prove beneficial. Doing so offers them a meaningful way to keep their minds engaged and curious.

In the modern digital age, maintaining connectivity also is so important. Providing residents with access to technologic resources and the support to use them can help them enrich their online presence, facilitating increased engagement and connection in an increasingly digital world.

A dedication to lifelong learning is in harmony with a broader philosophy that prioritizes the well-being of residents. This philosophy offers a personalized approach to wellness, tailored to meet the unique needs and priorities of each resident. It includes offering programs that encompass various aspects of well-being, including daily fitness classes, cardio programs, nutritional consultations and opportunities for residents to give back to the community through philanthropic activities. Those carefully crafted programs should go beyond being mere offerings; they should be designed to be evolving experiences that adapt to the changing needs and desires of residents, ensuring that their well-being remains a central focus.

Lifelong learning begins with those who genuinely care about providing people of all ages with ongoing opportunities for growth. By fostering a lifelong pursuit of self-enrichment, we empower individuals to embark on journeys of self-discovery and intellectual expansion, regardless of their age. This commitment serves as a transformative force that shapes lives and nurtures an ever-curious and engaged community.

Joseph Villanueva is executive director at The Kensington at Walnut Creek, a Kisco Senior living community in Walnut Creek, CA.

The opinions expressed in each McKnight’s Senior Living guest column are those of the author and are not necessarily those of McKnight’s Senior Living.

Have a column idea? See our submission guidelines here.

Yue Leng, PhD, from the University of California in San Francisco, and colleagues examined the association between sleep duration and quality among adults in their mid-30s to late 40s and midlife cognition assessed 11 years later. Sleep duration and quality were assessed objectively and subjectively in 2003 to 2005; midlife cognition was evaluated during 2015 to 2016.

Data were included for 526 participants (58% women; 44% Black), with a mean age of 40.1 ± 3.6 years at baseline. Overall, 45.6% of the participants reported poor sleep, defined as a Pittsburgh Sleep Quality Index global score >5. The researchers found that those in the highest versus the lowest tertile of the sleep fragmentation index had significantly increased odds of poor cognitive performance on the Digit Symbol Substitution Test, fluency and Montreal Cognitive Assessment test (odds ratios, 2.97, 2.42 and 2.29, respectively) after adjustment for demographics, education, smoking, body mass index, depression, physical activity, hypertension and diabetes.

No difference was seen in the association between sleep fragmentation and cognitive performance by race or sex. No association was seen for objective sleep duration or subjective sleep quality with cognition in midlife.

“Our findings indicate that the quality rather than the quantity of sleep matters most for cognitive health in midlife and that the measures of sleep should go beyond self-report,” the authors write.

Abstract/Full Text (subscription or payment may be required)

Costanza Peinkhofer, MD, from Copenhagen University Hospital in Denmark, and colleagues examined whether long-term cognitive, psychiatric or neurologic complications differ for patients hospitalized for COVID-19 versus those hospitalized for other medical conditions of similar severity as well as healthy controls in a prospective cohort study. One hundred twenty patients with COVID-19 were included and matched with 125 patients hospitalized for pneumonia, myocardial infarction or non-COVID-19 intensive care-requiring illness between March 1, 2020, and June 30, 2021, and 100 healthy age- and sex-matched individuals.

The researchers found that compared with healthy controls, patients with COVID-19 had worse cognitive status (estimated Screen for Cognitive Impairment in Psychiatry [SCIP] score, 59.0 versus 68.8; estimated mean Montreal Cognitive Assessment [MoCA] score, 26.5 versus 28.2); scores were similar when compared with hospitalized controls (mean SCIP score, 61.6; mean MoCA score, 27.2). During all other psychiatric and neurologic assessments, patients with COVID-19 performed worse than healthy controls. The brain health of patients with COVID-19 was not more impaired than among hospitalized control patients, with the exception of executive dysfunction.

“Although studies with broader cognitive test batteries are needed to confirm these findings, brain health after COVID-19 seems overall comparable to that after other diseases of similar severity,” the authors write.

Several authors disclosed ties to the Novo Nordisk Foundation and Lundbeck Foundation, both of which partially funded the study.

Abstract/Full Text

Roy Adams, PhD, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted a cohort study to examine whether thyrotoxicosis is associated with an increased risk for cognitive disorders. Patients aged 65 years and older with at least two visits to their primary care physicians 30 days apart were eligible; the analysis included 65,931 patients. The exposure variable was low TSH level, characterized based on the clinical context as due to endogenous thyrotoxicosis, exogenous thyrotoxicosis, or unknown cause.

The researchers found that the incidence of cognitive disorder was 11.0 and 6.4% by age 75 years for patients exposed and not exposed, respectively, to thyrotoxicosis. Across age groups, all-cause thyrotoxicosis was associated with the risk for cognitive disorder diagnosis after adjustment (adjusted hazard ratio, 1.39). Exogenous thyrotoxicosis remained a significant risk factor when stratified by cause and severity (adjusted hazard ratio, 1.34), with point estimates indicating a dose response.

“An increased risk of cognitive disorders is among the potential negative consequences of thyroid hormone excess, a common consequence of thyroid hormone treatment,” the authors write.

One author disclosed ties to the biopharmaceutical industry.

Abstract/Full Text (subscription or payment may be required)

Editorial (subscription or payment may be required)

Yanzhi Li, PhD, from Sun Yat-sen University in Guangzhou, China, and colleagues explored the association of pet ownership with cognitive decline among 7,945 participants (mean age, 66.3 years) in the English Longitudinal Study of Ageing.

The researchers found that pet ownership was associated with slower rates of decline in composite verbal cognition (β = 0.008 standard deviation [SD]/year), verbal memory (β = 0.006 SD/year) and verbal fluency (β = 0.007 SD/year). All three associations were modified by living alone. Among individuals living alone, pet ownership was associated with slower rates of decline for composite verbal cognition (β = 0.023 SD/year), verbal memory (β = 0.021 SD/year) and verbal fluency (β = 0.018 SD/year). But associations did not persist among those living with others. 

“These findings suggest that pet ownership may be associated with slower cognitive decline among older adults living alone,” the authors write. “Randomized clinical trials are needed to assess whether pet ownership slows the rate of cognitive decline in older adults living alone.”

Abstract/Full Text

Liulu Pan, from the Zhejiang University School of Medicine in Hangzhou, China, and colleagues used data from the Health and Retirement Study conducted among US adults older than 50 years to examine whether negative wealth shock is associated with cognitive decline and incident dementia. The final sample included 8,082 participants.

The researchers found that 1,441 participants developed incident dementia during a median follow-up of 14 years. Participants with negative wealth shock had accelerated cognitive decline (β coefficient, −0.014) and an increased risk for dementia (hazard ratio, 1.27) compared with those who had positive wealth without shock. Participants with asset poverty at baseline also had higher dementia risks (hazard ratio, 1.61). Associations were significant for white participants and those younger than 65 years (hazard ratios, 1.34 and 1.38, respectively), but not for those of other races and ethnicities or those aged 65 years or older.

“The negative wealth shock-associated dementia risks were more apparent among white participants and those who were younger,” the authors write. “Further prospective and interventional studies are warranted to confirm our findings.”

Abstract/Full Text

There’s no playing games, in one manner, when it comes to brain health, especially for older adults who are facing cognitive difficulties. 

That’s why one brain-game system developer includes sensor tools to provide objective measurements of users’ brain activity and what regions are being activated in real-time. 

MBK Senior Living’s Bellevue, WA, location, the Bellettini, will be offering Thinkie Inc.’s game suite to residents under a new partnership, the two companies announced earlier this month. 

That effort will expand on an initial pilot program that began earlier this year between Seattle-area senior living communities and Thinkie, the company explained. 

“We are thrilled Thinkie will be part of MBK’s Mind + Body Wellness program and available for all Bellettini residents to use and enjoy,” Kota Ageiwa, CEO of Thinkie Inc, said in a statement. “We believe The Bellettini is the perfect environment to benefit individuals who want to prioritize improvement in their cognitive wellness over time.”  

The sensor used to track the users’ brain activity “hides” in a headband worn during gameplay, the company explained. 

Both users and their caregivers can use Thinkie’s app to see how they are performing over time on a variety of metrics, including mental speed, memory and concentration, Thinkie’s website shows.

Although no game developer would deny that its products, even when aimed at the senior market, are largely for entertainment, many senior game companies have tried to bolster their offerings, both with new technology and studies that their games provide some additional, possibly clinical, benefit. 

One intriguing ongoing study will use video gameplay by older adults living with Parkinson’s to track how well treatment is affecting their mobility. Like the Thinkie games, study participants will have their brain activity tracked in real time, with the ultimate goal of creating a three-dimensional brain map that could inform future treatments, McKnight’s Senior Living previously reported.