Objective The objective of this study was to compare whether different sources of cognitive complaint (i.e., subjective and informant) predict diagnostic conversion in nondemented older adults. Methods Participants from the National Alzheimer’s Coordinating Center had a baseline diagnosis of normal cognition (NC; n=4414, 73±8 years, 69% female) or mild cognitive impairment (MCI; n=1843, 74±8 years, 52% female). Multinomial logistic regression related baseline cognitive complaint (no-complaint, self only, informant only, or both self-and informant) to diagnostic outcome (reversion, stable or conversion). Results At follow-up, 14% of NC participants converted to MCI/dementia (3.5±1.8 years), and 41% of MCI participants converted to dementia (3.0±1.6 years). Among NC participants, self-complaint only (OR=2.1; 99%CI=1.5–2.9, p<0.001), informant-complaint only (OR=2.2; 99%CI=1.2–3.9, p<0.001), and both self-and informant-complaint (OR=4.2; 99%CI=2.9–6.0, p<0.001) were associated with diagnostic conversion, compared to no-complaint. Among participants with MCI—compared with no-complaint, informant-complaint only (OR, 2.2; 99% CI, 1.2–4.3, P = .002), and both self- and informant-complaint (OR, 2.9; 99% CI, 1.8–4.8; P < .001)—were associated with conversion. Conclusions Cognitive complaints are related to conversion among non-demented older adults. Complaint from both (i.e. mutual complaint) sources was most predictive of diagnostic outcome, followed by informant complaint, highlighting the need for obtaining informant corroboration to enhance prognosis and distinguish underlying pathological processes from normal cognitive aging. Self-complaint was inconsistently related to diagnostic outcome.

Background Human rhinoviruses (HRVs) cause common colds, and the recently discovered HRV-C is increasingly associated with lower respiratory illness among populations such as children and asthmatic patients. Objective To determine how HRV-C is associated with respiratory illness and to evaluate changes in prevalence and species over 2 decades. Methods A prospective study of children younger than 5 years was performed at the Vanderbilt Vaccine Clinic over a 21-year period. Nasal-wash specimens from children presenting with upper or lower respiratory illness at acute care visits were tested for HRV and HRV-positives genotyped. Demographic and clinical features were compared between children with or without HRV, and with different HRV species. Results HRV was detected in 190 of 527 (36%) specimens from a population of 2009 children from 1982 through 2003. Of these, 36% were HRV-C. Age (P = .039) and month of illness (P <.001) were associated with HRV infection and HRV species. HRV-C was significantly associated with lower respiratory illness, compared with HRV-A (P = .014). HRV-A and HRV-C prevalence fluctuated throughout the 21-year period; HRV-C was more prevalent during winter (P = .058). Conclusions HRV-C is not a new virus but has been significantly associated with childhood lower respiratory illness in this population for several decades. Temporal changes in virus prevalence occur, and season may predict virus species. Our findings have implications for diagnostic, preventive, and treatment strategies due to the variation in disease season and severity based on species of HRV infection.

Hypertension has adverse effects on cognition, can alter cerebral vasculature integrity, and is associated with the pathogenesis of dementia. Using meta-analysis, we correlated blood pressure to multiple cognitive domains among older adults free of clinical stroke and dementia. We identified 230 studies indexed in PubMed and PsycINFO relating blood pressure and cognition. After applying exclusion criteria, we selected n = 12 articles with n = 4,076 participants (age range 43-91 years). Meta-analysis yielded an association between blood pressure and episodic memory (r = -.18, p < .001) and between blood pressure and global cognition (r = -.07, p < .001). When limiting analyses to studies adjusting for vascular covariates (n = 8, n = 2,141), blood pressure was modestly related to global cognition (r = -.11, p < .001), attention (r = .14, p = .002), and episodic memory (r = -.20, p < .001) with a trend for language (r = -.22, p = .07). Findings underscore the need to manage blood pressure as a key prevention method in minimizing abnormal cognitive aging prior to the onset of clinical dementia.

This study lacked sufficient evidence to claim an association between a positive RVP and LOS in pediatric patients, adjusting for their underlying diagnosis. However, we found that a positive RVP was associated with a shorter duration of intravenous antibiotic administration in certain groups of patients and those with some common respiratory diagnoses. These findings help clarify the utility of rapid viral testing in the management of hospitalized pediatric patients.

Background The relation between the source of cognitive complaint and objective cognitive performance is not well understood. Objective Examine self and informant cognitive complaint as predictors of objective cognitive and functional trajectory in non-demented elders. Methods Participants from the National Alzheimer’s Coordinating Center had a baseline diagnosis of normal cognition (NC; n=6133, 72±8 years, 68% female) or mild cognitive impairment (MCI; n=3010, 74±8 years, 55% female). Four independent groups defined cognitive complaint: no complaint, self-only complaint, informant-only complaint, or mutual complaint (both self and informant complaint). Linear mixed model regression analyses related complaint status (referent was no complaint) to cognitive and functional trajectories, adjusting for age, sex, race, education, and follow-up period. Results Among NC participants, mutual complaint related to faster decline in global cognition (p<0.0001), language (all p-values<0.0001), processing speed (p=0.0002), and executive functioning (p=0.0006). Informant-only complaint related to faster decline in global cognition (p=0.0001) and processing speed (p=0.0001). Self-only complaint related to greater decline in immediate (p<0.0001) and delayed (p=0.0005) episodic memory. In MCI, mutual complaint related to faster decline in global cognition (p<0.0001), verbal episodic memory (all p-values<0.0001), language (all p-values<0.0001), and processing speed (all p-values<0.0006). Informant-only or self-only complaint associations with cognitive trajectory did not survive correction factor for multiple comparisons. Conclusion Cognitive complaint appears to have clinical significance, as it is related to declines in objective cognitive performance over time. Mutual complaint was associated with the worst cognitive trajectory in both NC and MCI elders, highlighting the importance of incorporating an informant into evaluation of elders whenever feasible.