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Objectives The oldest‐old (aged ≥80 years) are the fastest growing population segment and age is related to cognitive impairment. We aimed to estimate the association between cognitive impairment and all‐cause mortality, in addition to the relationship with different cognitive subdomains among the oldest‐old in China. Methods We analyzed 25,285 participants recruited from 22 out of 30 provinces in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 1998 to 2008, with mortality follow‐up until 2014. Cognitive function was measured by the Chinese‐version 30‐item Mini‐Mental State Examination (MMSE), classified as no (MMSE score: 25–30), mild (18–24), moderate (10–17), and severe (0–9) impairment. We used time‐dependent Cox model to evaluate the relationship between time‐varying cognition and mortality. Results The relationship between cognition and mortality showed a dose–response pattern among the overall population. Compared to those with no impairment, participants with moderate (HR = 1.41, 95% CI 1.28–1.56) and severe (HR = 1.77, 95% CI 1.59–1.96) cognitive impairment showed increased mortality risk. Impairment in the subdomain of orientation was independently associated with increased mortality risk (HR = 1.20, 95% CI 1.05–1.36) among participants without overall cognitive impairment. Urban and rural residents had similar mortality risk. Conclusions A consistent dose–response pattern existed between cognitive impairment and all‐cause mortality. Orientation was associated with mortality in the population without cognitive impairment. Similar mortality regardless of residence areas indicated scarce health care and treatment for cognitive impairment in China from 1998 to 2014., Based on 25,285 Chinese participants 80 years or older, we found a clear negative dose–response relationship between the severity of time‐varying cognitive impairment and the probability of survival for both female and male and the total population. The relationship between cognition and mortality was similar for urban and rural residents, and the dose–response pattern disappeared in the highest educated group. The orientation subscale was associated with mortality risk independent of the overall MMSE score.

Objectives To investigate the association between hearing loss, hearing aid use, and cognitive decline. Design Prospective population-based study. Setting Data gathered from the Personnes Agees QUID study, a cohort study begun in 1989–90. Participants Individuals aged 65 and older (N = 3,670). Measurements At baseline, hearing loss was determined using a questionnaire assessing self-perceived hearing loss; 137 subjects reported major hearing loss, 1,139 reported moderate problems (difficulty following the conversation when several persons talk at the same time or in a noisy background), and 2,394 reported no hearing trouble. Cognitive decline was measured using the Mini-Mental State Examination (MMSE), administered at follow-up visits over 25 years. Results Self-reported hearing loss was significantly associated with lower baseline MMSE score (β = −0.69, P < .001) and greater decline during the 25-year follow-up period (β = −0.04, P = .01) independent of age, sex, and education. A difference in the rate of change in MMSE score over the 25-year follow-up was observed between participants with hearing loss not using hearing aids and controls (β = −0.06, P < .001). In contrast, subjects with hearing loss using a hearing aid had no difference in cognitive decline (β = 0.07, P = .08) from controls. Conclusion Self-reported hearing loss is associated with accelerated cognitive decline in older adults; hearing aid use attenuates such decline.

Aim The present cross-sectional study aimed at assessing muscle strength of hands, the dominant arm and legs in Spanish institutionalized elderly people according to sex, age and cognitive status. Methods A total of 153 elderly subjects (102 females, 51 males, mean age 83.6 ± 6.8 years) living in the region of Madrid were measured for handgrip strength (kg) with a Takei TKK 5101 digital dynamometer (range 5–100 kg, precision 0.1 kg), and arm and leg endurance strength (repetitions) according to the Rikli and Jones tests. Cognitive status was determined with the Mini-Mental State Examination (MMSE). Results The values for men and women were, respectively: 23.5 ± 7.3 kg and 11.6 ± 4.6 kg (right handgrip), 22.0 ± 7.8 kg and 10.7 ± 4.8 kg (left handgrip), 13 ± 5 and 10 ± 5 repetitions (arm strength), 8 ± 5 and 5 ± 4 repetitions (legs strength), and 21 ± 6 and 17 ± 7 (MMSE score). All parameters were significantly higher for men (P ≤ 0.01), but strength decline with age was less pronounced in women. In all MMSE groups, lower strength was associated with lower cognitive status. Conclusions Strength values were lower in older subjects in both sexes; this difference was higher in men than in women. Higher strength values were associated with better cognitive status, which was the most influencing variable, even more than sex and age. Geriatr Gerontol Int 2013; 13: 1026–1034.

Aim: Although several researchers have examined the effect of age on disease progression in patients with Alzheimer's disease (AD), the results are controversial. We investigated the effect of age on the rate of progression of cognitive impairment and on regional cerebral blood flow (rCBF) deficits using longitudinal single photon emission computed tomography (SPECT) studies. Methods: We divided 75 patients with AD who were followed up for 24–90 months into the younger AD group (n = 32, age at initial examination ≤75 years) and the older AD group (n = 43, age at initial examination >75 years). We assessed changes in Mini-Mental State Examination (MMSE) scores and rCBF between initial and final examinations. Results: The change in the annual MMSE score was greater in the younger AD group than in the older AD group. The mean annual MMSE score changes correlated significantly with age at the initial examination. The initial and follow-up SPECT studies showed more severe and extensive rCBF deficits in the younger AD group than in the older AD group. Conclusion: Our longitudinal SPECT study showed that the rate of progression of cognitive impairment and the rCBF deficits were higher in younger patients with AD than in older patients with AD. Therefore, age is an important factor to consider, not only in the diagnosis, but also in the treatment and prognosis of patients with AD. Geriatr Gerontol Int 2013; 13: 555–562.

Park MH, Kwon DY, Jung JM, Han C, Jo I, Jo SA. Mini-Mental StatusExamination as predictors of mortality in the elderly.Objective: Because the number of elderly is increasing worldwide,cognitive dysfunction becomes important health care issue. This studyinvestigated the association between cognitive dysfunction andmortality in the elderly.Method: Data were analyzed from a longitudinal mortality follow-upstudy of 2712 Korean elderly aged 60 and over, examined in 2002 withcomplete data followed an average 6.03 years. Measurements includedsocio-demographic and clinical factors and Mini-Mental StateExamination (MMSE). MMSE was categorized into groups with no,mild, or moderate cognitive dysfunction, and the subscores of MMSEdomains were categorized into no dysfunction or dysfunction. The Coxproportional hazards models were conducted to examine theassociation between MMSE score and mortality, after adjusting forage, gender, education and other socio-demographic factors.Results: Death during follow-up occurred in 318 subjects. Themortality risk was significantly associated with the elderly with mildcognitive dysfunction [hazard ratio (HR) = 1.93] and with moderatecognitive dysfunction (HR = 2.66). Orientation-to-time(HR = 1.39) and Attention (HR = 1.48) domains of MMSE wereindependently associated with mortality.Conclusion: This study showed that cognitive dysfunctionindependently predicted mortality inthe elderly. Cognitive dysfunctionshould be considered part of identifying the elderly at high risk formortality.

Background: The present study investigated when children acquire the cognitive abilities and daily living skills that are lost in Alzheimer's disease. Methods: Among a total of 1046 students in kindergarten and elementary schools affiliated with Gunma University, Japan, five female and five male students in each grade were selected at random and examined by the mini-mental state examination (MMSE) and physical self-maintenance scale (PSMS). For comparison, a total of 135 outpatients with Alzheimer's disease were examined. The results of MMSE and PSMS from the first visit to Gunma University Hospital after the onset of Alzheimer's disease were used. Results: The MMSE score gradually increased from 10 points in the 1st year of kindergarten (age 3 in Japan) to 29 points in the 6th grade of elementary school (age 11 in Japan). The PSMS score increased similarly from 3 points in the 1st year of kindergarten to 6 points in the 6th grade of elementary school. The mean scores of MMSE and PSMS were 17.3 and 3.7 in the Alzheimer patients’ group. These findings suggested that cognitive and daily performance abilities examined by MMSE and PSMS are acquired in childhood during kindergarten and the early grades of elementary school. Conclusion: These cognitive and daily performance abilities of Alzheimer's disease outpatients regress to a level of a child between 4 and 5 years old. This simple understanding of Alzheimer's disease patients may contribute to further appropriate care by non-specialists and caregivers.

proteins was quantitated using a l abel-free protein quantification method, and these were competed with the concentrations of A b42, pTau181, and tTau. Results: The MMSE score in AD patients was 21.3 6 4.9, and the average CDR scores were 0.86 0.3. All of the CSF samples were sufficient to establish the diagnostic cut-off value of the Ab42/pTau181 and Ab42/ tTau ratios in our laboratory.Fifteen of the 724 protein samples demonstrated a significant correlation with at least one of the AD biomarkers (p < 0.05). Seven of these proteins were previously identified as AD biomarkers, whereas eight were newly found. T he direction of change in the levels of Ab42 was found to be opposite to those of the levels of the Tau proteins in all analytes. Regarding the Ab42 levels, four proteins revealed a significant correlation. Another four proteins demonstrated a significant correlation with both pTau181 and tTau concentrations. We found three proteins to have a significant relationship only with pTau181, whereas two proteins showed a significant correlation only with tTau levels. Interestingly, t here were no analytes that demonstrated a correlation with both Ab42 and Tau proteins simultaneously. The remaining proteins showed a distinct correlation with the combined ratio of Ab42/ pTau181 or Ab42/tTau; however, the relationship with the individual concentrations was statistically negligible. Conclusions: Through our work, we identified new candidate CSF biomarkers of AD. Considering their biological roles, these candidate markers are suggested to be intimately related to AD pathophysiology. Further investigations are needed to identify their values as surrogate biomarkers or therapeutic targets in AD.

Score Name Description T-MSBL-FP Mixed L2/L1 RIDGE ADAS ADAS total score 0.683 6 0.076 0.663 6 0.068 0.681 6 0.063 MMSE MMSE score 0.678 6 0.030 0.671 6 0.037 0.681 6 0.042 RAVLT-Total Total score of the first 5 trials 0.592 6 0.070 0.554 6 0.062 0.561 6 0.057 RAVLT-T30 30 minute delay # of words recalled 0.534 6 0.079 0.480 6 0.073 0.492 6 0.071 RAVLT-Recog 30 minute delay recognition score 0.512 6 0.089 0.451 6 0.054 0.470 6 0.055 TRAILSA Trail making A score 0.471 6 0.070 0.446 6 0.069 0.466 6 0.068 TRAILSB Trail making B score 0.584 6 0.104 0.561 6 0.111 0.566 6 0.108 TRAILS(B-A) TRAILSB TRAILSA 0.511 6 0.126 0.467 6 0.126 0.477 6 0.123 Alzheimer’s Imaging Consortium Poster Presentations: IC-P P63

Reported problems in visual acuity were examined as determinants of loneliness experienced by community dwelling people with either impaired or unimpaired cognition. The Mini-Mental State Examination (MMSE) was used as a screening instrument to form a cognitively-impaired (MMSE 20–23/30) and a cognitively-intact group (MMSE 28–30/30). A total of 147 subjects took part in the study and were examined by an optometrist. Subjects with intact cognition tended to report visual problems more often than subjects with cognitive deficits. One out of two subjects had slight visual impairment, in both cognitive groups. After acuity had been optimally corrected, six to seven out of ten subjects' visual acuity did improve. In a multiple regression analysis, higher MMSE score and visual improvement were significantly related to lower levels of self-reported loneliness among the elderly with their cognition intact, but not among the subjects with impaired cognition.

corrections) index for executive function comprised of Letter-Number Sequencing and Stroop Color-Word trial. Results: Figures 1a and b details regions with significant (p < 0.05 FDR) positive correlation between MWF and MMSE score; and EXEC score, respectively. These results are the first direct investigation of myelin content alteration in AD. Based on the relationship with symptom severity, they suggest a role for WM and myelin disruption in AD. References: [1] Deoni SCL et al. (2008). Magn. Reson. Med. 60, 1372-1387. [2] Deoni SCL et al. (2010). Magn. Reson. Med. (ahead of print).

correlated moderately with change in MMSE score. Conclusions: We conclude that WBA, VE and HV rates of change from our institute are not significantly different than those from the DRC and CIND, respectively. We also observed that the measured WBA, VE and HV rate changes were significantly higher in AD subjects relative to the normal control group, showing that our methods were sensitive enough to detect changes in subjects with AD.