Resilience to cognitive impairment in the oldest-old: design of the EMIF-AD 90+ study

Nienke Legdeur, Maryam Badissi, Stephen F Carter, Sophie de Crom, Aleid van de Kreeke, Ralph Vreeswijk, Marijke C Trappenburg, Mardien L Oudega, Huiberdina L Koek, Jos P van Campen, Carolina J P W Keijsers, Chinenye Amadi, Rainer Hinz, Mark F Gordon, Gerald Novak, Jana Podhorna, Erik Serné, Frank Verbraak, Maqsood Yaqub, Arjan HillebrandAlessandra Griffa, Neil Pendleton, Sophia E Kramer, Charlotte E Teunissen, Adriaan Lammertsma, Frederik Barkhof, Bart N M van Berckel, Philip Scheltens, Majon Muller, Andrea B Maier, Karl Herholz, Pieter Jelle Visser

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: The oldest-old (subjects aged 90 years and older) population represents the fastest growing segment of society and shows a high dementia prevalence rate of up to 40%. Only a few studies have investigated protective factors for cognitive impairment in the oldest-old. The EMIF-AD 90+ Study aims to identify factors associated with resilience to cognitive impairment in the oldest-old. In this paper we reviewed previous studies on cognitive resilience in the oldest-old and described the design of the EMIF-AD 90+ Study.

METHODS: The EMIF-AD 90+ Study aimed to enroll 80 cognitively normal subjects and 40 subjects with cognitive impairment aged 90 years or older. Cognitive impairment was operationalized as amnestic mild cognitive impairment (aMCI), or possible or probable Alzheimer's Disease (AD). The study was part of the European Medical Information Framework for AD (EMIF-AD) and was conducted at the Amsterdam University Medical Centers (UMC) and at the University of Manchester. We will test whether cognitive resilience is associated with cognitive reserve, vascular comorbidities, mood, sleep, sensory system capacity, physical performance and capacity, genetic risk factors, hallmarks of ageing, and markers of neurodegeneration. Markers of neurodegeneration included an amyloid positron emission tomography, amyloid β and tau in cerebrospinal fluid/blood and neurophysiological measures.

DISCUSSION: The EMIF-AD 90+ Study will extend our knowledge on resilience to cognitive impairment in the oldest-old by extensive phenotyping of the subjects and the measurement of a wide range of potential protective factors, hallmarks of aging and markers of neurodegeneration.

TRIAL REGISTRATION: Nederlands Trial Register NTR5867 . Registered 20 May 2016.

Original languageEnglish
Article number28
JournalBMC Geriatrics [E]
Issue number1
Publication statusPublished - 26 Nov 2018


  • Alzheimer’s disease
  • Amnestic mild cognitive impairment
  • Amyloid
  • Cognitive impairment
  • Dementia
  • Magnetoencephalography (MEG)
  • Oldest-old
  • Positron emission tomography
  • Resilience


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