The 100-plus Study of cognitively healthy centenarians: rationale, design and cohort description.

Although the incidence of dementia increases exponentially with age, some individuals reach more than 100 years with fully retained cognitive abilities. To identify the characteristics associated with the escape or delay of cognitive decline, we initiated the 100-plus Study ( www.100plus.nl ). The 100-plus Study is an on-going prospective cohort study of Dutch centenarians who self-reported to be cognitively healthy, their first-degree family members and their respective partners. We collect demographics, life history, medical history, genealogy, neuropsychological data and blood samples. Centenarians are followed annually until death. PET-MRI scans and feces donation are optional. Almost 30% of the centenarians agreed to post-mortem brain donation. To date (September 2018), 332 centenarians were included in the study. We analyzed demographic statistics of the first 300 centenarians (25% males) included in the cohort. Centenarians came from higher socio-economic classes and had higher levels of education compared to their birth cohort; alcohol consumption of centenarians was similar, and most males smoked during their lifetime. At baseline, the centenarians had a median MMSE score of 25 points (IQR 22.0-27.5); most centenarians lived independently, retained hearing and vision abilities and were independently mobile. Mortality was associated with cognitive functioning: centenarians with a baseline MMSE score ≥ 26 points had a mortality percentage of 17% per annual year  in the second year after baseline, while centenarians with a baseline MMSE score < 26 points had a mortality of  42% per annual year (p = 0.003). The cohort was 2.1-fold enriched with the neuroprotective APOE-ε2 allele relative to 60-80 year-old population controls (p = 4.8 × 10-7), APOE-ε3 was unchanged and the APOE-ε4 allele was 2.3-fold depleted (p = 6.3 × 10-7). Comprehensive characterization of the 100-plus cohort of cognitively healthy centenarians might reveal protective factors that explain the physiology of long-term preserved cognitive health.

A Randomized Effectiveness Trial of a Behavioral Teacher Program Targeting ADHD Symptoms.

OBJECTIVE: This study investigated the effectiveness of the Positivity & Rules Program (PR program), a behavioral teacher program targeting ADHD symptoms in the classroom involving both student-focused and classroom-focused programs. METHOD: Primary school children with ADHD symptoms ( N = 114) were randomly assigned to the PR program ( n = 58) or control group ( n = 56). Teacher and parent ratings were used to assess behavioral, social, and emotional functioning at baseline, during and after the intervention. Intervention effects were assessed using intention-to-treat multilevel analyses. RESULTS: Teachers reported positive effects on ADHD symptoms and social skills (.01 < f2 > .36). Effects did not generalize to the home setting. CONCLUSION: The PR program holds promise for improving classroom behavior in children with ADHD symptoms and might prevent escalation of problem behavior.