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Related Experiment Video

Updated: Dec 9, 2025

Assessment of Age-related Changes in Cognitive Functions Using EmoCogMeter, a Novel Tablet-computer Based Approach
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What Determines Cognitive Functioning in the Oldest-Old? The EMIF-AD 90+ Study.

Nienke Legdeur1, Maryam Badissi1, Maqsood Yaqub2

  • 1Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands.

The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences
|September 8, 2020
PubMed
Summary

Cognitive function in the oldest-old is linked to physical health, nutrition, and brain changes like white matter hyperintensities (WMH) and hippocampal atrophy. Physical performance may impact cognition via hippocampal volume.

Keywords:
Alzheimer’s diseaseBrain pathology biomarkersCognitive agingOldest-oldRisk factors

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Area of Science:

  • Neuroscience
  • Gerontology
  • Cognitive Science

Background:

  • Cognitive functioning in the oldest-old (90+ years) is not well understood.
  • Identifying determinants of cognition in this population is crucial for interventions.

Purpose of the Study:

  • To investigate associations between risk factors, brain pathology (white matter hyperintensities, hippocampal atrophy, amyloid aggregation), and cognition in the oldest-old.
  • To determine if brain pathology mediates the relationship between risk factors and cognition.

Main Methods:

  • Cross-sectional analysis of 84 cognitively unimpaired and 38 cognitively impaired individuals (mean age 92.4 years) from the EMIF-AD 90+ Study.
  • Assessed risk factors (cognitive activity, physical parameters, nutrition, inflammation, cardiovascular factors), brain pathology (MRI for WMH and hippocampal volume, PET for amyloid binding), and cognition.
  • Tested independent associations of brain pathology with cognition and mediation effects of risk factors on cognition via brain pathology.

Main Results:

  • Worse cognition was associated with lower handgrip strength, Short Physical Performance Battery (SPPB) scores, nutritional status, HbA1c, and hippocampal volume.
  • Higher white matter hyperintensities (WMH) volume and amyloid binding correlated with poorer cognition.
  • Physical performance (SPPB) partially mediated the association between cognition and hippocampal volume.

Conclusions:

  • Physical parameters, nutritional status, HbA1c, WMH, hippocampal atrophy, and amyloid binding are significant factors associated with cognitive impairment in the oldest-old.
  • Physical performance may influence cognition through its impact on hippocampal atrophy.
  • A multifactorial approach is essential for assessing cognition in the oldest-old population.