Ten-year effects of the advanced cognitive training for independent and vital elderly cognitive training trial on cognition and everyday functioning in older adults. Timing of onset of cognitive decline: results from Whitehall II prospective cohort study Effects of a comprehensive educational group intervention in older women with cognitive complaints: A randomized controlled trial The effect of age on the association between blood pressure and cognitive function later in life. Effects of age, gender, and education on cognitive tests in a rural elderly community sample: norms from the Monongahela Valley Independent Elders Survey. The ACTIVE cognitive training trial and health-related quality of life: protection that lasts for 5 years. Twelve-week physical and leisure activity programme improved cognitive function in community-dwelling elderly subjects: a randomized controlled trial. Life long changes in cognitive ability are associated with prescribed medications in old age. Rehabilitation outcome of elderly patients after a first stroke: effect of cognitive status at admission on the functional outcome. The effect of small class sizes on mortality through age 29 years: evidence from a multicenter randomized controlled trial. Blood pressure and late-life cognitive function change The PACE study: a randomized clinical trial of cognitive activity strategy training for older people with mild cognitive impairment. Does cognitive training improve internal locus of control among older adults? Nonresponse pattern and bias in a community-based cross-sectional study of cognitive functioning among the elderly. Prevalence of Cognitive Impairment: Effects of Level of Education, Age, Sex and Associated Factors Designing clinical trials for assessing the effects of cognitive training and physical activity interventions on cognitive outcomes: The Seniors Health and Activity Research Program Pilot (SHARP-P) Study, a randomized controlled trial Factors Associated with the Functional Status of Community‐dwelling Elderly
OBJECTIVES To determine the effects of cognitive training on cognitive abilities and everyday function over 10 years . DESIGN Ten-year follow-up of a r and omized , controlled single-blind trial ( Advanced Cognitive Training for Independent and Vital Elderly ( ACTIVE ) ) with three intervention groups and a no-contact control group . SETTING Six U.S. cities . PARTICIPANTS A volunteer sample of 2,832 persons ( mean baseline age 73.6 ; 26 % African American ) living independently . INTERVENTION Ten training sessions for memory , reasoning , or speed of processing ; four sessions of booster training 11 and 35 months after initial training . MEASUREMENTS Objective ly measured cognitive abilities and self-reported and performance-based measures of everyday function . RESULTS Participants in each intervention group reported less difficulty with instrumental activities of daily living ( IADLs ) ( memory : effect size = 0.48 , 99 % confidence interval ( CI ) = 0.12 - 0.84 ; reasoning : effect size = 0.38 , 99 % CI = 0.02 - 0.74 ; speed of processing : effect size = 0.36 , 99 % CI = 0.01 - 0.72 ) . At a mean age of 82 , approximately 60 % of trained participants , versus 50 % of controls ( P < .05 ) , were at or above their baseline level of self-reported IADL function at 10 years . The reasoning and speed-of-processing interventions maintained their effects on their targeted cognitive abilities at 10 years ( reasoning : effect size = 0.23 , 99 % CI = 0.09 - 0.38 ; speed of processing : effect size = 0.66 , 99 % CI = 0.43 - 0.88 ) . Memory training effects were no longer maintained for memory performance . Booster training produced additional and durable improvement for the reasoning intervention for reasoning performance ( effect size = 0.21 , 99 % CI = 0.01 - 0.41 ) and the speed-of-processing intervention for speed-of-processing performance ( effect size = 0.62 , 99 % CI = 0.31 - 0.93 ) . CONCLUSION Each Advanced Cognitive Training for Independent and Vital Elderly cognitive intervention result ed in less decline in self-reported IADL compared with the control group . Reasoning and speed , but not memory , training result ed in improved targeted cognitive abilities for 10 years Objectives To estimate 10 year decline in cognitive function from longitudinal data in a middle aged cohort and to examine whether age cohorts can be compared with cross sectional data to infer the effect of age on cognitive decline . Design Prospect i ve cohort study . At study inception in 1985 - 8 , there were 10 308 participants , representing a recruitment rate of 73 % . Setting Civil service departments in London , United Kingdom . Participants 5198 men and 2192 women , aged 45 - 70 at the beginning of cognitive testing in 1997 - 9 . Main outcome measure Tests of memory , reasoning , vocabulary , and phonemic and semantic fluency , assessed three times over 10 years . Results All cognitive scores , except vocabulary , declined in all five age categories ( age 45 - 49 , 50 - 54 , 55 - 59 , 60 - 64 , and 65 - 70 at baseline ) , with evidence of faster decline in older people . In men , the 10 year decline , shown as change/range of test × 100 , in reasoning was −3.6 % ( 95 % confidence interval −4.1 % to −3.0 % ) in those aged 45 - 49 at baseline and −9.6 % ( −10.6 % to −8.6 % ) in those aged 65 - 70 . In women , the corresponding decline was −3.6 % ( −4.6 % to −2.7 % ) and −7.4 % ( −9.1 % to −5.7 % ) . Comparisons of longitudinal and cross sectional effects of age suggest that the latter overestimate decline in women because of cohort differences in education . For example , in women aged 45 - 49 the longitudinal analysis showed reasoning to have declined by −3.6 % ( −4.5 % to −2.8 % ) but the cross sectional effects suggested a decline of −11.4 % ( −14.0 % to −8.9 % ) . Conclusions Cognitive decline is already evident in middle age ( age 45 - 49 ) Objective : This study presents a new comprehensive educational group intervention that offers psycho-education about cognitive aging and context ual factors ( i.e. , negative age stereotypes , beliefs , health , and lifestyle ) , focuses on skills and compensatory behavior , and incorporates group discussion . Its effects were investigated in community-dwelling older women who report normal age-related cognitive complaints . Methods : A r and omized controlled trial with an experimental and waiting-list control condition was carried out in a sample of 50 women aged 60–75 years . As the main problem of these individuals were perceived cognitive deficits without actual cognitive decrements , metacognition served as the primary outcome measure . Objective cognitive functioning and psychological well-being were secondary outcome measures . A double baseline and a follow-up assessment were carried out . Results : Participants in the experimental condition reported significantly fewer negative emotional reactions toward cognitive functioning ( U = 164.500 , p = 0.004 ) . The reported effect size ( δ = −0.473 ) could be interpreted as large . Conclusions : This new comprehensive educational group intervention  reduces negative emotional reactions toward cognitive functioning , which seems a prerequisite for improved subjective cognitive functioning and well-being . It can potentially contribute the well-being of an important and large group of older adults OBJECTIVES To determine the prospect i ve relationship between blood pressure ( BP ) and cognitive function across a wide age range . DESIGN Prospect i ve population -based cohort study . SETTING The Rotterdam Study and the Leiden 85-plus Study . PARTICIPANTS Three thous and seventy-eight men and women , initial age 55 to 84 from the Rotterdam Study and 276 men and women , initial age 85 , from the Leiden 85-plus Study . MEASUREMENTS  Systolic BP ( SBP ) and diastolic BP ( DBP ) were measured at baseline , cognitive function was assessed at the end of follow-up using a dedicated neuropsychological test battery . The association between baseline BP levels and cognitive function later in life was assessed in 10-year age groups in the Rotterdam Study and in 85-year-olds of the Leiden 85-plus Study . RESULTS In the youngest participants ( < 65 ) , SBP and DBP were not associated with cognitive function 11 years later . For persons aged 65 to 74 , higher baseline SBP and DBP were related to worse cognitive function 11 years later . In contrast , in older age ( > or = 75 ) , higher SBP and DBP seemed to be related to better cognitive function at the end of follow-up . This effect appeared strongest in the highest age group ( aged 85 ) . CONCLUSION High BP was associated with greater risk of cognitive impairment in persons younger than 75 but with better cognitive function  in older persons . Age-specific guidelines for BP management are needed , because the current directive that " lower is better " may not apply to BP levels in the very old A r and om sample of 1,350 persons aged 65 years and older in a rural community underwent cognitive screening as part of a survey to establish a population -based registry of dementing disorders . The screening battery included the neuropsychological tests of the assessment protocol used in the National Institute on Aging multicenter Consortium to Establish a Registry for Alzheimer 's Disease ( CERAD ) . This paper reports a large body of normative neuropsychological data from this sample with members of relatively low socioeconomic status . Age , sex , and educational level were found to have statistically significant effects on test scores . The implication s of these findings for the establishment of screening cutoff scores are discussed OBJECTIVE We evaluated the ability of the three cognitive training interventions ( memory , reasoning , or speed of processing ) fielded in the Advanced Cognitive Training for Independent and Vital Elderly ( ACTIVE ) multisite r and omized controlled trial to protect against two thresholds of extensive decline in health-related quality of life ( HRQoL ) at 2 and 5 years post-training . METHOD Adults aged 65 years or older ( 2802 ) were enrolled and r and omized to three cognitive interventions or a no-contact control group .  Data on 1804 participants were available at both the 2- and 5-year follow-ups . HRQoL was measured by the eight MOS 36-Item Short-Form Health Survey ( SF-36 ) scales . Clinical ly relevant decline on each scale was defined as a drop of > or = 0.5 st and ard deviations from baseline . Extensive HRQoL decline was defined as clinical ly relevant drops on ( i ) > or = 4 SF-36 scales , and ( ii ) > or = 3 SF-36 scales , and was assessed using multiple logistic regressions , weighted to adjust for potential attrition bias . Results . At 2 years post-training , 23.7 % and 36.6 % had clinical ly relevant drops on > or = 4 and > or = 3 SF-36 scales , respectively . At 5 years post-training , 32.9 % and 47.3 % had clinical ly relevant drops on > or = 4 and > or = 3 SF-36 scales , respectively . Participants in the speed of processing intervention arm were significantly less likely to have extensive HRQoL decline compared to participants in the control group regardless of the threshold or time period , whereas participants in the memory and reasoning intervention arms were significantly less like to have extensive HRQoL decline only at 5 years post-training and only at the lower threshold . Conclusion . The effect of the speed of processing intervention was stronger and evident earlier than those for the memory and reasoning interventions . This result stems from the speed of processing intervention being the most procedural intervention , operating through sensory-motor elaboration and repetition , bringing about a broader pattern of regional brain activation . At 5 years post-training , however , all three interventions were successful in protecting against a lower threshold of age-related extensive declines in BACKGROUND Japan is one of the most rapidly ageing societies in the world . A number of municipalities have started services for the prevention of cognitive decline for community-dwelling elderly individuals , but the effectiveness of these services is currently insufficient . Our study explored the efficacy of a comprehensive intervention programme consisting of physical and leisure activities to prevent cognitive decline in community-dwelling elderly subjects . METHOD We administered a 12-week intervention programme consisting of physical and leisure activities aim ed at enhancing participants ' motivation to participate and support one another by providing a pleasant atmosphere , empathetic communication , praise , and errorless support . This programme for the prevention of cognitive decline was conducted as a service by the city of Maebashi . All participants underwent the Five-Cog test , which evaluated the cognitive domains of attention , memory , visuospatial function , language , and reasoning . Executive function was evaluated by the Wechsler Digit Symbol Substitution Test and Yamaguchi Kanji-Symbol Substitution Test . Subjective health status , level of social support , functional capacity , subjective quality of life , and depressive symptoms were assessed with a question naire . Grip strength test , timed up- and -go test , 5-m maximum walking times test , and functional reach test were performed to evaluate physical function . Fifty-two participants were r and omly allocated to  intervention ( n = 26 ) and control ( n = 26 ) groups . Twenty-six participants , aged between 65 - 87 years , received intervention once a week at a community centre . The programme was conducted by health-care professionals , with the help of senior citizen volunteers . RESULTS The intervention group ( n = 19 ) showed significant improvement on the analogy task of the Five-Cog test ( F(1,38 ) = 4.242 , P = 0.046 ) and improved quality of life ( F(1,38 ) = 4.773 , P = 0.035 ) as compared to the control group ( n = 24 ) . CONCLUSION A community-based 12-week intervention programme that aim ed to enhance motivation to participate in activities result ed in improvements in some aspects of cognitive function and quality of life .  Senior citizens who volunteered in the present intervention enabled the smooth implementation of the programme and alleviated the burden on professional staff OBJECTIVES To determine the association between prescribed medication and life long changes in cognitive ability . DESIGN Retrospective cohort study . SETTING Community residents of a largely urban region of South East Scotl and . PARTICIPANTS Four hundred and seventy-eight survivors of the 1932 Scottish Mental Health Survey ( n=87,498 ) without dementia . MEASUREMENTS The Moray House Test ( MHT ) of intelligence administered at age 11 and age 80 years . Hospital Anxiety and Depression Scale ( HADS ) score , history of disease and current prescribed medications age 80 years . RESULTS After adjusting for sex , neuroactive drugs had a detrimental effect on life long cognitive change age ( F=12.2 , p=0.001 , partial eta-squared=0.026 ) , statins a beneficial effect ( F=5.78 , p=0.017 , partial eta-squared=0.013 ) and polypharmacy a detrimental effect ( F=6.46 , p=0.011 , partial eta-squared=0.014 ) . In the optimal model estimated marginal means revealed : a relative improvement for statin users , IQ age 11=93.2 ( 95 % CI 87.9 - 98.4 ) and age 80=100.6 ( 95 % CI 95.3 - 105.9 ) ; compared with non-users , IQ age 11=100.9 ( 95 % CI 99.4 - 102.3 ) and age 80=100.0 ( 95 % CI 98.6 - 101.5 ) . CONCLUSIONS Clinical ly , the degree to which drugs impair cognition in relatively fit , older people may not be apparent . However , in population terms , medication use , particularly polypharmacy , is important . Statins , used as currently indicated for cardiovascular disease , appear promising in ameliorating cognitive decline in older people . However , firm recommendation of their use should await the outcome of ongoing r and omised clinical trials OBJECTIVE To assess whether , and to what extent , cognitive outcome relates to overall functional outcome among elderly stroke patients . DESIGN Nonconcurrent prospect i ve study . SETTING Geriatric rehabilitation division at a large , urban , academic , freest and ing hospital in Israel . PARTICIPANTS Three hundred thirty-six patients aged 60 years and older admitted consecutively for rehabilitation after first acute stroke . Inclusion criteria were met by 315 patients , who were included in the final analysis . Average age was 75.3 years . The stroke was right sided in 44.1 % . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES The motor subscale of the FIM instrument assessed functional status . Absolute functional gain was determined by the FIM motor gain . Relative functional gain was calculated according to the Montebello Rehabilitation Factor Score . Cognitive status was assessed with the  Mini-Mental State Examination ( MMSE ) and the FIM cognitive subscale . RESULTS FIM scores increased significantly during rehabilitation , mainly due to improvement in motor functioning . A strong association was found between the cognitive scales ( r=.853 , P<.001 ) . Better rehabilitation outcomes were observed in patients with higher admission cognitive status , adjusting for the effect of age , sex , onset to admission interval , length of stay , and severity of stroke ( odds ratio = 2.0 ; 95 % confidence interval , 1.5 - 2.5 ) . CONCLUSIONS Impaired cognitive status at admission negatively affects the rehabilitation outcome of elderly stroke patients . The utility of routinely using a cognitive test for all patients before admission to rehabilitation , preferably the MMSE , is emphasized . The time , cost , and effort involved in performing such a test are negligible , and the potential benefits are considerable Limiting the number of students per classroom in the early years has been shown to improve educational outcomes . Improved education is , in turn , hypothesized to improve health . The authors examined whether smaller class sizes affect  mortality through age 29 years and whether cognitive factors play a role . They used data from the Project Student Teacher Achievement Ratio , a 4-year multicenter r and omized controlled trial of reduced class sizes in Tennessee involving 11,601 students between 1985 and 1989 . Children r and omized to small classes ( 13 - 17 students ) experienced improved measures of cognition and academic performance relative to those assigned to regular classes ( 22 - 25 students ) . As expected , these cognitive measures were significantly inversely associated with mortality rates ( P < 0.05 ) . However , through age 29 years , students r and omized to small class size nevertheless experienced higher mortality rates than those r and omized to regular size classes ( hazard ratio ( HR ) = 1.58 , 95 % confidence interval ( CI ) : 1.07 , 2.32 ) . The groups at risk included males ( HR = 1.73 , 95 % CI : 1.05 , 2.85 ) , whites/Asians ( HR = 1.68 , 95 % CI : 1.04 , 2.72 ) , and higher income students ( HR = 2.20 , 95 % CI : 1.06 , 4.57 ) . The authors speculate that small classes might produce behavior changes that increase mortality through young adulthood that are stronger than the protective effects of enhanced cognition Objective : To examine the relation of blood pressure ( BP ) to subsequent decline in cognitive function among persons age 65 or over . Methods : All persons age 65 or over in a geographically defined community were invited to participate in a longitudinal study of problems of the elderly .  Interviews were conducted in the participants ’ homes and included two BP measures and four tests of cognitive function . Follow-up interviews 3 and 6 years after baseline repeated the cognitive function tests . These analyses included 4,284 individuals who had baseline and at least one follow-up measure of cognitive function .  The average of z scores of the individual cognitive function tests was used as a global measure of cognitive function . Results : In r and om effects analyses controlling for age , sex , education , and race , there was no significant linear association of either systolic or diastolic BP with 6-year change in global cognitive function score . There was no significant curvilinear association with systolic BP . In tests for a curvilinear association with diastolic BP , there was a suggestion of increased decline among those with low or high diastolic BP ( p = 0.03 for the quadratic diastolic term ) . At baseline , 50 % of participants took some type of medication affecting BP . Conclusion : In this community population where BP treatment was common , there was no association of either high systolic or high diastolic BP at the beginning of the observation interval with 6-year cognitive decline OBJECTIVE The role of cognition-focused interventions in reducing cognitive decline in older people remains uncertain . This study aim ed to clarify whether a group cognitive activity ( CA ) strategy -training program would decrease the 2-year rate of cognitive decline of people with mild cognitive impairment ( MCI ) . DESIGN R and omized controlled trial . SETTING One study site . PARTICIPANTS 160 older adults with MCI ≥65 years of age ( mean : 75 , SD : 5.8 ) . INTERVENTION Five-week CA strategy training or a control nonspecific educational program . The primary outcome measure was change from baseline in the total score on the Cambridge Cognitive Examination-Revised ( CAMCOG-R ) . Secondary outcomes of interest included changes in memory , attention , executive functions , mood , and quality of life . Endpoints were collected 10 , 52 , and 104 weeks post baseline . RESULTS Intention to treat analysis identified no significant difference in CAMCOG-R scores over time between the two groups ( mean difference : -0.36 , 95 % CI : -1.02,0.29 ) or across secondary outcome measures . The exceptions were better performance of the CA group on immediate attention ( Digit Span Forwards , adjusted mean difference : 0.15 , 95 % CI : 0.01,0.30 ) and better quality of life ( adjusted mean difference : 0.57 , 95 % CI : 0.10,1.04 ) compared with controls . CONCLUSION The devised program of CA did not improve general cognitive performance of older adults with MCI over a period of 2 years . Although favorable , the beneficial effects of the intervention on attention and quality of life were small , and of uncertain significance OBJECTIVES We evaluated the effect of cognitive training among 1,534 participants in the Advanced Cognitive Training for Independent and Vital Elderly ( ACTIVE ) r and omized controlled trial ( RCT ) on 5-year improvements in 3 cognitive-specific measures of locus of control-internal , chance , and powerful others . METHODS ACTIVE was a multisite RCT ( age > or = 65 ) , with 4 groups ( memory , reasoning , speed of processing , and no-contact control ) . Complete 5-year follow-up data were available for 1,534 ( 55 % ) of the 2,802 participants . A propensity score model was used to adjust for potential attrition bias . Clinical ly important improvements ( and decrements ) in the cognitive-specific locus of control scale scores were defined as greater than or equal to 0.5 SD ( medium ) and greater than or equal to 1.0 SD ( large ) . Multinomial logistic regression was used to simultaneously contrast those who improved and those who declined with those whose locus of control scale score was unchanged . RESULTS Statistically significant effects reflecting medium-sized ( > or = 0.5 SD ) improvements in internal locus of control between baseline and the 5-year follow-up were found for the reasoning and speed of processing intervention groups who were 76 % ( p < .01 ) and 68 % ( p < .05 ) more likely , respectively , to improve than the no-contact control group . No improvement effects were found on the chance or powerful others locus of control measures or for the memory intervention group . CONCLUSION Cognitive training that targets reasoning and speed of processing can improve the cognitive-specific sense of personal control over one 's life in older adults The demographic , health , and mental functioning characteristics of nonresponders to a community-based cross-sectional study  of cognitive functioning among the elderly in Amsterdam , the Netherl and s ( Amsterdam Study of the Elderly ( AMSTEL ) , October 1990 to May 1991 ) , were examined and compared with responders . The r and omly selected age-stratified ( 65 - 74 , 75 - 84 years ) sample was drawn from nonresponders listed with a sub sample ( n = 8) of general practitioners whose lists served as the sampling frame for the main study . The general practitioners approached and interviewed the responding nonresponders using the same st and ardized questions that were used in the main study . Nonresponders ( n = 115 ) and responders ( n = 999 ) from the same medical practice s were compared by means of chi-square and odds ratios . Compared with responders , these nonresponders more often reported a history of psychiatric illness , heart attack , stroke , and diabetes , and were more likely to be unmarried , to have a lower education , and to do poorly on the cognitive test ( odds ratio = 1.6 , 95 % confidence interval 1.0 - 2.6 ) . Most significant physical and mental health differences by response status were seen among the persons aged < 75 years and not among those aged > or = 75 years . The odds for poor cognitive test performance associated with age and stroke were relatively more biased than those associated with other risk factors . These results suggest that the characteristics of young-old and old-old elderly nonresponders to cross-sectional studies of cognitive function may differ , and that there may be selective nonresponse that could bias , to a different degree , estimates of risk for poor cognitive functioning . Studies should investigate the possibilities for nonresponse in their own setting Aims : To examine the prevalence of cognitive impairment  in a Spanish elderly population and to analyse its association with some social and medical factors . Methods : We r and omly selected a representative sample ( n = 600 ) of people over 65 from Narón Council ( A Coruña ) . Socio-demographic and biomedical data were collected and  cognitive  status was assessed using the  Mini-Mental State Examination ( MMSE ) .  Results : We determined variations in the prevalence from 35.2 % , when age or level of education distribution was not applied , to 22.2 % when they were applied . Women showed a higher probability of cognitive impairment than men . Negative correlation was observed between the age of the subject and the MMSE score ( Spearman correlation ρ = –0.45 , p < 0.001 ) , with the possibility of developing cognitive impairment increasing each year . For our sample , cognitive impairment was associated with an increase of morbidity and mortality in the elderly population . This association was found with the presence of dementia , heart failure , anaemia , stroke and auditory deficits . Conclusions : Knowledge of the real prevalence rates , together with the establishment of adequate preventive and intervention measures , can be factors that may diminish the socio-sanitary impact of cognitive impairment Background The efficacy of non-pharmacological intervention approaches such as physical activity , strength , and cognitive training for improving brain health has not been established . Before definitive trials are mounted , important design questions on participation/adherence , training and interventions effects must be answered to more fully inform a full-scale trial . Methods SHARP-P was a single-blinded r and omized controlled pilot trial of a 4-month physical activity training intervention ( PA ) and /or cognitive training intervention ( CT ) in a 2 × 2 factorial design with a health education control condition in 73 community-dwelling persons , aged 70 - 85 years , who were at risk for cognitive decline but did not have mild cognitive impairment . Results Intervention attendance rates were higher in the CT and PACT groups : CT : 96 % , PA : 76 % , PACT : 90 % ( p=0.004 ) , the interventions produced marked changes in cognitive and physical performance measures ( p≤0.05 ) , and retention rates exceeded 90 % . There were no statistically significant differences in 4-month changes in composite scores of cognitive , executive , and episodic memory function among arms . Four-month improvements in the composite measure increased with age among participants assigned to physical activity training but decreased with age for other participants ( intervention*age interaction p = 0.01 ) . Depending on the choice of outcome , two-armed full-scale trials may require fewer than 1,000 participants ( continuous outcome ) or 2,000 participants ( categorical outcome ) . Conclusions Good levels of participation , adherence , and retention appear to be achievable for participants through age 85 years . Care should be taken to ensure that an attention control condition does not attenuate intervention effects . Depending on the choice of outcome measures , the necessary sample sizes to conduct four-year trials appear to be feasible . Trial Registration Clinical trials.gov Identifier : Purpose : This research sought to answer the following question : To what extent is the functional status of elderly people explained by gender , age , geographical residence , level of cognitive function , and depression ? Method : Two hundred r and omly selected community‐dwelling elderly people aged 65 to 80 years old completed the Mini‐Mental State Examination ( MMSE ) , Geriatric Depression Scale ( GDS ) , and Physical Performance Test ( PPT ) .  Results : Correlation analysis and simple linear regression models showed that age , MMSE , GDS , and geographical residence were significantly associated with the functional level , whereas gender was not . In the multiple regression model , MMSE and geographical residence together explained 40 % of the variance in functional status ; age and GDS did not add to the explanation . Conclusion : Since cognitive function had the strongest association with functional performance to an extent greater than the other variables , adding a treatment regimen that stimulates cognitive function might further enhance functional level or prevent decline of functional status compared with an exercise intervention alone
The results showed that cognitive decline is strongly associated with frailty , being a probable main clinical outcome .
In this sense , any strategy aim ed at mitigating or reversing the incidence of frailty with ageing should take into account that physical and cognitive frailty seem to have similar temporal trajectories
The purpose of present study was to analyze the magnitude of the effect-size in the assessment of the cognitive status of population s over 60 years of age .