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P2‐574: MIDLIFE ADIPOSITY PREDICTS COGNITIVE DECLINE IN THE PROSPECTIVE MULTICENTER AIDS COHORT STUDY
Author(s) -
Gustafson Deborah R.,
Rubin Leah H.,
Hawkins Kellie L.,
Zhang Long,
Jacobson Lisa P.,
Becker James T.,
Munro Cynthia A.,
Lake Jordan E.,
Martin Eileen,
Levine Andrew,
Brown Todd T.,
Saktor Ned,
Erlandson Kristine M.
Publication year - 2019
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2019.06.2983
Subject(s) - multicenter aids cohort study , medicine , serostatus , body mass index , cohort , waist , cognitive decline , cohort study , obesity , neuropsychology , prospective cohort study , gerontology , demography , human immunodeficiency virus (hiv) , cognition , viral load , psychiatry , immunology , dementia , antiretroviral therapy , disease , sociology
Background: Definition of normality is a big challenge with aging. For numbers of biologic “normal range” published for geriatric patient in the 1980s, identification of diseases associated with aging leads to the conclusion that excluding pathologies give very different figures. Description of senile gait was attributed to normal aging and can now be attributed to sub-cortical vascular pathology. Can we make the same interpretation for cognitive aging?Methods: We compare medical and cognitive evaluations made by medical students of elderly living in the community in the context of mandatory experiential learning activity during the first three years of medical curriculum in Sherbrooke in 1992 (n1⁄480), 2006 (n1⁄4161) and 2012 (n1⁄4172), 2018 (n160). Results: For a mean of 75-77 years old, mean schooling increased from less than 10 years to more than 10 years and Folstein from 23 to 26-27. Using the MOCAwe can see a relation with more deficits without dementia in the metabolic group even without stroke. Majority of those with abnormal result in Moca had metabolic syndrome or vascular risks. These specific deficits are mainly dysexecutive. Conclusions: In these groups the aging of cognition seems changing. Dysfunction attributed to aging can be related to sub-cortical pathology. Schooling, Flint effect related to cognitive reserve plays a role. Metabolic syndrome and systolic hypertension increasing with age can contribute to many changes in cognition attributed to aging. This opens the opportunity for prevention, not only for changing the rate of deterioration in dementia, but also for successful cognitive aging, and can be a good argument to motivate compliance to metabolic syndrom control in adults.