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Byrd DR, Gonzales E, Moody DLB, Marshall GL, Zahodne LB, Thorpe RJ, Whitfield KE. Interactive Effects of Chronic Health Conditions and Financial Hardship on Episodic Memory among Older Blacks: Findings from the Health and Retirement Study. RESEARCH IN HUMAN DEVELOPMENT 2020; 17:41-56. [PMID: 33192185 PMCID: PMC7665222 DOI: 10.1080/15427609.2020.1746159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Previous research links chronic health conditions and financial hardship to cognitive outcomes among older Blacks. However, few studies have explored the moderating effect of financial hardship on chronic disease burden and specific cognitive domains. This study examined whether financial hardship (as measured by difficulty paying monthly bills) modifies the impact of self-reported chronic health conditions (e.g., diabetes, stroke) on episodic memory among 871 older Blacks (50+ years) in the Health and Retirement Study (2006). Financial hardship modified the association between chronic disease burden and episodic memory performance such that individuals who reported very little difficulty paying their monthly bills had significantly lower memory scores at high levels of disease burden compared to those reporting high financial difficulty after controlling for age, gender and education (F 2, 49 = 5.03, p= 0.010). This cross-sectional study suggests that both financial and physical wellbeing may have joint effects on cognitive health in older Blacks.
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Affiliation(s)
| | - Ernest Gonzales
- New York University, Silver School of Social Work, New York, NY, USA
| | | | | | | | - Roland J. Thorpe
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Byrd DR, Thorpe RJ, Whitfield KE. Greater Disease Burden, Greater Risk? Exploring Cognitive Change and Health Status Among Older Blacks. J Aging Health 2019; 32:807-816. [PMID: 31165660 DOI: 10.1177/0898264319853138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: The objective of study is to examine the relationships between health status and changes in cognition over time among middle to older aged Blacks. Method: Data come from the Baltimore Study of Black Aging-Patterns of Cognitive Aging. At baseline, 602 Black participants, ranging from ages 48 to 95 years, were enrolled. At follow-up, approximately 3 years later, 450 participants were re-interviewed. Results: After accounting for baseline cognition, age, sex, and education, a greater number of health conditions was associated with slower perceptual speed (b = -5.099, p = .022). Average peak expiratory flow was also associated with improvements in working memory (b = 0.029, p = .019) and perceptual speed (b = 0.026, p = .026), controlling for model covariates. Discussion: Study findings demonstrate that greater disease burden is associated with declines in specific fluid cognitive abilities in middle to later life among Blacks. This finding highlights the importance of reducing health disparities that disproportionately affect Blacks.
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Affiliation(s)
| | - Roland J Thorpe
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Wang XJ, Xu W, Li JQ, Cao XP, Tan L, Yu JT. Early-Life Risk Factors for Dementia and Cognitive Impairment in Later Life: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2019; 67:221-229. [PMID: 30636739 DOI: 10.3233/jad-180856] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Xue-Jie Wang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Wei Xu
- College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China
| | - Jie-Qiong Li
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Xi-Peng Cao
- Clinical Research Center, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
- College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China
| | - Jin-Tai Yu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
- Department of Neurology, Huashan Hospital, Fudan University, China
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4
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Prince MJ, Acosta D, Guerra M, Huang Y, Jimenez-Velazquez IZ, Llibre Rodriguez JJ, Salas A, Sosa AL, Dewey ME, Guerchet MM, Liu Z, Llibre Guerra JJ, Prina AM. Leg length, skull circumference, and the incidence of dementia in Latin America and China: A 10/66 population-based cohort study. PLoS One 2018; 13:e0195133. [PMID: 29649337 PMCID: PMC5896923 DOI: 10.1371/journal.pone.0195133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 03/01/2018] [Indexed: 11/18/2022] Open
Abstract
Background Adult leg length is influenced by nutrition in the first few years of life. Adult head circumference is an indicator of brain growth. Cross-sectional studies indicate inverse associations with dementia risk, but there have been few prospective studies. Methods Population-based cohort studies in urban sites in Cuba, Dominican Republic Puerto Rico and Venezuela, and rural and urban sites in Peru, Mexico and China. Sociodemographic and risk factor questionnaires were administered to all participants, and anthropometric measures taken, with ascertainment of incident dementia, and mortality, three to five years later. Results Of the original at risk cohort of 13,587 persons aged 65 years and over, 2,443 (18.0%) were lost to follow-up; 10,540 persons with skull circumference assessments were followed up for 40,466 person years, and 10,400 with leg length assessments were followed up for 39,954 person years. There were 1,009 cases of incident dementia, and 1,605 dementia free deaths. The fixed effect pooled meta-analysed adjusted subhazard ratio (ASHR) for leg length (highest vs. lowest quarter) was 0.80 (95% CI, 0.66–0.97) and for skull circumference was 1.02 (95% CI, 0.84–1.25), with no heterogeneity of effect between sites (I2 = 0%). Leg length measurements tended to be shorter at follow-up, particularly for those with baseline cognitive impairment and dementia. However, leg length change was not associated with dementia incidence (ASHR, per cm 1.006, 95% CI 0.992–1.020), and the effect of leg length was little altered after adjusting for baseline frailty (ASHR 0.82, 95% CI 0.67–0.99). A priori hypotheses regarding effect modification by gender or educational level were not supported. However, the effect of skull circumference was modified by gender (M vs F ASHR 0.86, 95% CI 0.75–0.98), but in the opposite direction to that hypothesized with a greater protective effect of larger skull dimensions in men. Conclusions Consistent findings across settings provide quite strong support for an association between adult leg length and dementia incidence in late-life. Leg length is a relatively stable marker of early life nutritional programming, which may confer brain reserve and protect against neurodegeneration in later life through mitigation of cardiometabolic risk. Further clarification of these associations could inform predictive models for future dementia incidence in the context of secular trends in adult height, and invigorate global efforts to improve childhood nutrition, growth and development.
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Affiliation(s)
- Martin J. Prince
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- * E-mail:
| | - Daisy Acosta
- Universidad Nacional Pedro Henriquez Ureña (UNPHU), Internal Medicine Department, Geriatric Section, Santo Domingo, Dominican Republic
| | - Mariella Guerra
- Psychogeriatric Unit, National Institute of Mental Health “Honorio Delgado Hideyo Noguchi”, Lima, Peru and Instituto de la Memoria y Desordenes Relacionados, Lima, Perú
| | - Yueqin Huang
- Peking University, Institute of Mental Health. Beijing, China
| | - Ivonne Z. Jimenez-Velazquez
- Internal Medicine Dept., Geriatrics Program, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | | | - Aquiles Salas
- Medicine Department, Caracas University Hospital, Faculty of Medicine, Universidad Central de Venezuela, Caracas, Venezuela
| | - Ana Luisa Sosa
- Laboratory of the Dementias, National Institute of Neurology and Neurosurgery of Mexico, Autonomous National University of Mexico. Delegacion Tlalpan, Mexico City, Mexico
| | - Michael E. Dewey
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Maelenn M. Guerchet
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Zhaorui Liu
- Peking University, Institute of Mental Health. Beijing, China
| | | | - A. Matthew Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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5
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Chang S, Ong HL, Abdin E, Vaingankar JA, Jeyagurunathan A, Shafie S, Mahendran R, Subramaniam M, Chong SA. Head circumference, leg length and its association with dementia among older adult population in Singapore. Int J Geriatr Psychiatry 2017; 32:e1-e9. [PMID: 28052429 DOI: 10.1002/gps.4643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 10/27/2016] [Accepted: 11/16/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND Head circumference and leg length serve as reliable proxy indicators of early-life environment. Research studies have shown that these anthropometric measurements are associated with cognitive impairment and dementia among older adults. The aim of the present study was to assess the associations between dementia with head circumference and leg length among the older adult population in Singapore. This study also aimed to examine the sociodemographic correlates of these anthropometric measurements. METHODS Data were collected from 2565 older adults aged 60 years and above, in a population study on the Well-being of the Singapore Elderly. Head circumference and leg length measurements were obtained, and sociodemographic information was recorded. Dementia diagnosis was made using the 10/66 dementia algorithm. Anthropometric measurements were first stratified into quarters, and then logistic regression analysis was used to examine factors associated with head circumference and leg length, as well as to examine the association between dementia with these measurements. RESULTS Sociodemographic correlates of head circumference and leg length include age, gender, ethnicity and education level. Smaller head circumference was independently associated with higher odds of 10/66 dementia (OR = 2.173-2.709). When the regression analysis was stratified by gender, the association was found only in the male sample. Leg length was not significantly associated with dementia after controlling for sociodemographic variables. CONCLUSION Smaller head circumference is independently associated with dementia among older adults in Singapore. Findings from this study suggest that risk factors for dementia begin their influence in early life. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore
| | - Hui Lin Ong
- Research Division, Institute of Mental Health, Singapore
| | | | | | | | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University Hospital, Singapore
| | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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West RK, Ravona-Springer R, Heymann A, Schmeidler J, Leroith D, Koifman K, Guerrero-Berroa E, Preiss R, Hoffman H, Silverman JM, Beeri MS. Shorter adult height is associated with poorer cognitive performance in elderly men with type II diabetes. J Alzheimers Dis 2015; 44:927-35. [PMID: 25374105 DOI: 10.3233/jad-142049] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We studied the relationship of adult body height with five cognitive outcomes (executive functioning, semantic categorization, attention/working memory, episodic memory, and an overall cognition measure) in 897 cognitively normal elderly with type 2 diabetes. Regression analyses controlling for sociodemographic, cardiovascular, and diabetes-related risk factors and depression demonstrated that in males, shorter stature was associated with poorer executive functioning (p = 0.001), attention/working memory (p = 0.007), and overall cognition (p = 0.016), but not with episodic memory (p = 0.715) or semantic categorization (p = 0.948). No relationship between height and cognition was found for females. In cognitively normal type 2 diabetes male subjects, shorter stature, a surrogate for early-life stress and poor nutrition, was associated with cognitive functions.
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Affiliation(s)
- Rebecca K West
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - James Schmeidler
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Derek Leroith
- Division of Medicine, Endocrinology, Diabetes, and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Keren Koifman
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Israel
| | | | - Rachel Preiss
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Israel
| | - Hadas Hoffman
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Israel
| | - Jeremy M Silverman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Michal Schnaider Beeri
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Israel
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Stewart R, Hardy R, Richards M. Associations between skeletal growth in childhood and cognitive function in mid-life in a 53-year prospective birth cohort study. PLoS One 2015; 10:e0124163. [PMID: 25875444 PMCID: PMC4398360 DOI: 10.1371/journal.pone.0124163] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 03/13/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Several studies have found that shorter stature (height and limb length) in late life is associated with dementia and cognitive impairment. The extent to which childhood environment and early life cognitive function accounts for these associations is not clear. METHODS We investigated associations of adult trunk height and leg length with cognitive function in middle age, analysing data from the MRC National Survey of Health and Development: a cohort followed from birth to age 53, 1677 of whom had data on all covariates. The four cognitive tests measured verbal ability, word list memory, verbal fluency and speed/concentration. Early life environmental measures included parental education, poverty, parental divorce, physical health, cognitive ability at age 15, own education and own adult social class. RESULTS After adjusting for gender, shorter trunk length was associated with lower cognitive function on all four tests and shorter leg length with lower verbal intelligence and word list memory. These associations were only partially attenuated following adjustment for childhood adversity/health but were substantially accounted for by cognitive ability at age 15. CONCLUSIONS Shorter stature was associated with lower cognitive function at age 53, the majority of this association being accounted for by cognitive function at age 15. Reduced cognitive reserve may well account for later associations between anthropometric measures and dementia.
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Affiliation(s)
- Robert Stewart
- King’s College London (Institute of Psychiatry), London, United Kingdom
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing, and MRC National Survey of Health and Development, London, United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing, and MRC National Survey of Health and Development, London, United Kingdom
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Russ TC, Kivimäki M, Starr JM, Stamatakis E, Batty GD. Height in relation to dementia death: individual participant meta-analysis of 18 UK prospective cohort studies. Br J Psychiatry 2014; 205:348-54. [PMID: 25368359 PMCID: PMC4217025 DOI: 10.1192/bjp.bp.113.142984] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND That risk factors measured in middle age may not fully explain future dementia risk implicates exposures acting earlier in life. Height may capture early-life illness, adversity, nutrition and psychosocial stress. AIMS To investigate the little-explored association between height and dementia death. Method Individual participant meta-analysis using 18 prospective general population cohort studies with identical methodologies (1994-2008; n = 181 800). RESULTS Mean follow-up of 9.8 years gave rise to 426 and 667 dementia deaths in men and women respectively. The mean heights were 174.4 cm (s.d. = 7.3) for men and 161.0 cm (s.d. = 6.8) for women. In analyses taking into account multiple covariates, increasing height was related to lower rates of death from dementia in a dose-response pattern (P ⩽ 0.01 for trend). There was evidence of a differential effect by gender (P = 0.016 for interaction). Thus, the association observed in men (hazard ratio per s.d. decrease in height 1.24, 95% CI 1.11-1.39) was markedly stronger than that apparent in women (HR = 1.13, 95% CI 1.03-1.24). CONCLUSIONS Early-life circumstances, indexed by adult height, may influence later dementia risk.
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Brewster PWH, Melrose RJ, Marquine MJ, Johnson JK, Napoles A, MacKay-Brandt A, Farias S, Reed B, Mungas D. Life experience and demographic influences on cognitive function in older adults. Neuropsychology 2014; 28:846-58. [PMID: 24933483 PMCID: PMC4227962 DOI: 10.1037/neu0000098] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE We examined the influence of a broad spectrum of life experiences on longitudinal cognitive trajectories in a demographically diverse sample of older adults. METHOD Participants were 333 educationally, ethnically, and cognitively diverse older adults enrolled in a longitudinal aging study. Mixed-effects regression was used to measure baseline status in episodic memory, executive functioning, and semantic memory and change in a global cognition factor defined by change in these 3 domain-specific measures. We examined effects of life experience variables (literacy, childhood socioeconomic status, morphometric measures of physical development, life course physical and recreational activity) on longitudinal cognitive trajectories, covarying for age, apolipoprotein E (APOE) genotype and demographics (education, ethnicity, language). RESULTS Non-Latino Whites had higher baseline cognition, but life experience variables attenuated ethnic differences in cognitive scores. Age, literacy, childhood socioeconomic status, and physical activity significantly influenced baseline cognition. Age, APOE ε4, and decline in intellectually and socially stimulating recreational activity from mid to late life were independently associated with increased late life cognitive decline. Higher literacy and late life recreational activity were associated with less decline. Literacy had similar effects for English and Spanish readers/speakers. Bilingual English and Spanish speakers did not differ from English Speakers in cognitive performance. CONCLUSIONS Life experience variables, especially literacy level, were strongly related to baseline cognition and substantially attenuated effects of race/ethnicity and education. Cognitive change was best explained by age, APOE ε4, literacy, and current recreational activities. Literacy had robust associations with baseline cognition and cognitive change in both English and Spanish speakers.
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Affiliation(s)
| | - Rebecca J Melrose
- Brain, Behavior, and Aging Research Center, VA Greater Los Angeles Healthcare System
| | | | | | - Anna Napoles
- Center for Aging in Diverse Communities, Department of Medicine, University of California
| | - Anna MacKay-Brandt
- Department of Outpatient Research, Nathan Kline Institute for Psychiatric Research
| | | | - Bruce Reed
- Department of Neurology, School of Medicine
| | - Dan Mungas
- Department of Neurology, School of Medicine
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Maternal education, anthropometric markers of malnutrition and cognitive function (ELSA-Brasil). BMC Public Health 2014; 14:673. [PMID: 24989981 PMCID: PMC4087199 DOI: 10.1186/1471-2458-14-673] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 06/25/2014] [Indexed: 01/19/2023] Open
Abstract
Background The early exposure to poor social and nutritional conditions may influence cognitive function during adult age. However, the relative impact of these factors has not yet been established and they can vary during the course of life. Methods Analysis of data from 12,997 participants (35-64 years) of the baseline exams (2008-2010) of the Longitudinal Study of Adult Health (ELSA-Brasil), a cohort of Brazilian civil servants. Four cognitive tests were applied: learning, recall and word recognition; semantic and phonemic verbal fluency; trail-making test version B. The markers of early nutritional and social conditions were maternal educational level, birth weight, and length of trunk and leg. The presence of independent association between every early marker and the poor performance in each cognitive test was investigated by multiple logistic regression, after mutual adjustment and considering the effects of gender, age and participant’s schooling level. The cut off for poor performance was the worst age-specific percentile of the final score distribution for each test. Results After full adjustments, lower maternal education increased the chances of poor performance in all cognitive tests, with a dose-response gradient; low birth-weight was related to poor performance in the trail-making test B (OR = 1.63, 95% IC = 1.29-2.06); and greater trunk length decreased the chances of poor performance in the semantic and phonemic verbal fluency (OR = 0.96, 95% IC = 0.94-0.97) and in the trail-making test B (OR = 0.94, 95% IC = 0.92-0.95). Leg length was not associated with any of the tests examined. The associations found were not modified by the educational attainment of the participants. Conclusions Early exposure to adverse social and nutritional conditions appear detrimental to semantic memory, learning, concentration, executive control and language among adults, independent of adulthood educational achievement.
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Melrose RJ, Brewster P, Marquine MJ, MacKay-Brandt A, Reed B, Farias ST, Mungas D. Early life development in a multiethnic sample and the relation to late life cognition. J Gerontol B Psychol Sci Soc Sci 2014; 70:519-31. [PMID: 24389122 DOI: 10.1093/geronb/gbt126] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 11/12/2013] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Poor quality of early life conditions has been associated with poorer late life cognition and increased risk of dementia. Early life physical development can be captured using adult measures of height and head circumference. Availability of resources may be reflected by socioeconomic indicators, such as parental education and family size. We sought to determine the association between early life development and experience and late life semantic memory, episodic memory, and executive functioning abilities, as well as rate of cognitive decline. METHOD This study was conducted using the UC Davis Aging Diversity cohort, an ethnically diverse sample of Caucasian, African American, and Hispanic individuals from northern California. We used latent variable modeling to measure growth and childhood socioeconomic environment (SES) and examine their associations with longitudinal cognitive outcomes using mixed effects modeling. RESULTS Growth was positively related to higher childhood SES. Higher childhood SES was associated with better semantic memory. Both low growth and low SES were associated with increased rate of cognitive decline. DISCUSSION These findings demonstrate that early life experiences influence the trajectory of cognitive aging. Early life development and experience appears to provide a distal basis upon which additional risk and protective factors interact in the development of dementia.
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Affiliation(s)
- Rebecca J Melrose
- VA Greater Los Angeles Healthcare System, California. Department of Psychiatry & Biobehavioral Sciences at the David Geffen School of Medicine, University of California, Los Angeles.
| | - Paul Brewster
- Department of Psychology, University of Victoria, British Columbia, Canada
| | | | - Anna MacKay-Brandt
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York
| | - Bruce Reed
- Department of Neurology, School of Medicine, University of California, Davis
| | - Sarah T Farias
- Department of Neurology, School of Medicine, University of California, Davis
| | - Dan Mungas
- Department of Neurology, School of Medicine, University of California, Davis
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Skogen JC, Øverland S, Smith AD, Mykletun A, Stewart R. The impact of early life factors on cognitive function in old age: The Hordaland Health Study (HUSK). BMC Psychol 2013; 1:16. [PMID: 25566368 PMCID: PMC4270022 DOI: 10.1186/2050-7283-1-16] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 09/12/2013] [Indexed: 01/01/2023] Open
Abstract
Background Previous studies have shown that adverse conditions during fetal and early life are associated with lower performance on neurocognitive tests in childhood, adolescence and adult life. There is, however, a paucity in studies investigating these associations into old age. The aim was to investigate the impact of early life factors on cognitive function in old age by taking advantage of the potential for a linkage between a community survey and historical birth records. Methods A historical cohort study employing a linkage between a community survey of people aged 72–74 years with the participants’ birth records (n=346). Early life factors included anthropometric measures taken at birth, birth complications, parental socioeconomic status, and maternal health status. The main outcome was a z-scored composite cognitive score, based on test scores from Kendrick Object Learning Test, Trail Making Test A, a modified version of the Digit Symbol Test, Block Design, a modified version of Mini-Mental State Examination and an abridged version of the Controlled Oral Word Association Test (COWAT). The separate cognitive tests were also individually analysed in relation to measures identified at birth. Results Higher parental socioeconomic status (SES; based on father’s occupation) was associated with a higher value on the composite cognitive score (by 0.25 SD, p=0.0146) and higher Digit Symbol and Trail Making Test A performance. Higher head circumference at birth was associated with higher COWAT and Trail Making Test A performance. Both higher parental SES and head circumference at birth predicted cognitive function in old age independently of each other. There were no other consistent associations. Conclusions In general we found little evidence for a substantial role of early life factors on late-life cognitive function. However, there was some evidence for an association with parental SES status and head circumference on certain cognitive domains.
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Affiliation(s)
- Jens Christoffer Skogen
- Faculty of Psychology, Department of Health Promotion and Development, University of Bergen, Bergen, Norway ; Division of Mental Health, Department of Public Mental Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Simon Øverland
- Faculty of Psychology, Department of Health Promotion and Development, University of Bergen, Bergen, Norway ; Division of Mental Health, Department of Public Mental Health, Norwegian Institute of Public Health, Bergen, Norway
| | - A David Smith
- Department of Pharmacology, University of Oxford, Oxford, UK
| | - Arnstein Mykletun
- Faculty of Psychology, Department of Health Promotion and Development, University of Bergen, Bergen, Norway ; Division of Mental Health, Department of Public Mental Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Robert Stewart
- King's College London (Institute of Psychiatry), London, UK
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Quan SA, Jeong JY, Kim DH. The Relationship between Height and Cognitive Function among Community-dwelling Elderly: Hallym Aging Study. Epidemiol Health 2013; 35:e2013002. [PMID: 23682335 PMCID: PMC3654091 DOI: 10.4178/epih/e2013002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 02/06/2013] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Height is known as an index that reflects the environment of the fetal, childhood, and adolescent periods, which affect adult health. This study was conducted to elucidate whether height is associated with cognitive impairment in community-dwelling elders in Korea. METHODS The study subjects were recruited among community dwelling elderly individuals aged 65 or over who participated in the 2004 Hallym Aging Study. They were invited to a general hospital and were evaluated for socioeconomic status, smoking history, and various clinical measures. Cognitive function measurement was performed using the Korean-Mini Mental State Examination. Logistic regression was used to evaluate the association between height and cognitive function. RESULTS After adjusting for potential covariates such as age and education, the smallest group was associated with higher risk of cognitive impairment compared with the tallest group among elderly men (odds ratio [OR], 4.20; 95% confidence interval [CI], 1.02-17.36), but not among elderly women (OR,1.65; 95% CI, 0.62-4.40). CONCLUSIONS The reason for this difference according to sex may be explained by the differential effects of education on cognitive function by sex. A larger population-based prospective cohort study is needed to examine the association between height and cognitive function according to sex.
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Affiliation(s)
- Shan Ai Quan
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea. ; Hallym Research Institute of Clinical Epidemiology, Chuncheon, Korea
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Abstract
Afro-Caribbean sprinters often reach high performance levels at an early age. Adolescence is a time of morphological and physiological changes. This study was designed to analyze the evolution in parameters of short sprint performance during adolescence in Afro-Caribbean boys, especially the stride number/body height ratio (SN/BH), which is at the interface of technical and morphological factors. Seventy-one 13-year-old boys performed vertical jumps and short sprint races. The races were filmed with a view to determine stride variables. Anthropometric parameters were also measured. The same tests were performed two years later. Body height and SN/BH were the main predictors of sprint performance. The delta of performance was principally explained by stride length and stride number. Although deterioration in technical parameters was expected, the parameters related to body size and stride length were the main sprint performance predictors rather than explosive force. These results could be useful in developing tests to detect sprint potential in youth.
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Laitala VS, Hjelmborg J, Koskenvuo M, Räihä I, Rinne JO, Christensen K, Kaprio J, Silventoinen K. Shorter adult stature increases the impact of risk factors for cognitive impairment: a comparison of two Nordic twin cohorts. Twin Res Hum Genet 2012; 14:544-52. [PMID: 22506310 DOI: 10.1375/twin.14.6.544] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We analyzed the association between mean height and old age cognition in two Nordic twin cohorts with different childhood living conditions. The cognitive performance of 4720 twin individuals from Denmark (mean age 81.6 years, SD = 4.59) and Finland (mean age 74.4 years, SD = 5.26) was measured using validated cognitive screens. Taller height was associated with better cognitive performance in Finland (beta-estimates 0.18 SD/10cm, p value < .001, for men and 0.13 SD, p = .008, for women), but this association was not significant in Denmark (beta-estimates 0.0093 SD, p value = .16, for men and 0.0075 SD, p value = .016, for women) when adjusted for age and education/social class. Among Finnish participants higher variability of cognitive performance within shorter height quintiles was observed. Analysis using gene-environment interaction models showed that environmental factors exerted a greater impact on cognitive performance in shorter participants, whereas in taller participants' it was explained mainly by genetic factors. Our results suggest that shorter participants with childhood adversity are more vulnerable to environmental risk factors for cognitive impairment.
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Affiliation(s)
- Venla S Laitala
- Department of Public Health, University of Helsinki, Finland.
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16
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Genetic and environmental contributions to the association between anthropometric measures and iq: a study of Minnesota twins at age 11 and 17. Behav Genet 2011; 42:393-401. [PMID: 22139438 DOI: 10.1007/s10519-011-9521-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Accepted: 11/16/2011] [Indexed: 10/14/2022]
Abstract
Associations of height and head circumference with IQ are well documented, but much less is known about the association of IQ with other anthropometric measures or the mechanisms behind these associations. We therefore analyzed the associations between IQ and several anthropometric measures using a twin-study design. Twins born in Minnesota were assessed at either age 11 (756 complete pairs) or 17 (626 complete pairs) and analyzed using genetic modeling. Head circumference and height showed the most consistent positive associations with IQ, whereas more detailed anthropometric measures were not significantly better predictors of IQ. These associations were mainly due to common genetic factors. Our results suggest that the same genetic factors have an effect on physical and cognitive development. Head circumference and height capture information on children's physical development, which is partly associated also with cognitive development.
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Leg length, skull circumference, and the prevalence of dementia in low and middle income countries: a 10/66 population-based cross sectional survey. Int Psychogeriatr 2011; 23:202-13. [PMID: 20701817 PMCID: PMC5391848 DOI: 10.1017/s1041610210001274] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Adult leg length is influenced by nutrition in the first few years of life. Adult head circumference is an indicator of brain growth. There is a limited literature linking short legs and small skulls to an increased risk for cognitive impairment and dementia in late life. METHODS One phase cross-sectional surveys were carried out of all residents aged over 65 years in 11 catchment areas in China, India, Cuba, Dominican Republic, Venezuela, Mexico and Peru (n = 14,960). The cross-culturally validated 10/66 dementia diagnosis, and a sociodemographic and risk factor questionnaire were administered to all participants, and anthropometric measures taken. Poisson regression was used to calculate prevalence ratios for the effect of leg length and skull circumference upon 10/66 dementia, controlling for age, gender, education and family history of dementia. RESULTS The pooled meta-analyzed fixed effect for leg length (highest vs. lowest quarter) was 0.82 (95% CI, 0.68-0.98) and for skull circumference 0.75 (95% CI, 0.63-0.89). While point estimates varied between sites, the proportion of the variability attributable to heterogeneity between studies as opposed to sampling error (I2) was 0% for leg length and 22% for skull circumference. The effects were independent and not mediated by family history of dementia. The effect of skull circumference was not modified by educational level or gender, and the effect of leg length was not modified by gender. CONCLUSIONS Since leg length and skull circumference are said to remain stable throughout adulthood into old age, reverse causality is an unlikely explanation for the findings. Early life nutritional programming, as well as neurodevelopment may protect against neurodegeneration.
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Heys M, Jiang C, Cheng KK, Zhang W, Lam TH, Leung GM, Schooling CM. Does the Age of Achieving Pubertal Landmarks Predict Cognition in Older Men? Guangzhou Biobank Cohort Study. Ann Epidemiol 2010; 20:948-54. [DOI: 10.1016/j.annepidem.2010.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 05/25/2010] [Accepted: 06/16/2010] [Indexed: 10/19/2022]
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Zhang Z, Gu D, Hayward MD. Childhood nutritional deprivation and cognitive impairment among older Chinese people. Soc Sci Med 2010; 71:941-9. [PMID: 20591545 DOI: 10.1016/j.socscimed.2010.05.013] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Revised: 04/14/2010] [Accepted: 05/07/2010] [Indexed: 12/01/2022]
Abstract
Late-life cognitive impairment may have its origins in childhood. Here, we examine the associations between markers of childhood nutritional deprivation and cognitive impairment in older adults. We made use of the 2002 and 2005 waves of the Chinese Longitudinal Healthy Longevity Survey to examine these associations for persons aged 65-105 (N=15,444). Anthropometric measures (arm length, knee height) and self-reported hunger were used to measure early-life nutritional deficiencies. Cognitive impairment was measured using the Chinese version of the Mini Mental State Examination. Results from multivariate logistic regression models show that both anthropometric measures and self-report markers of early-life nutritional status were significantly associated with the odds of cognitive impairment at baseline for both men and women after controlling for age and ethnicity. Adjustments for childhood and adulthood socioeconomic status, adulthood health, and lifestyle habits had little effect on these associations except for the effect of hunger among men. Results from multinomial logistic regression models show that during the three-year follow-up period, arm length was significantly associated with the onset of cognitive impairment after controlling for various confounders in men, but not in women. Our findings suggest that early-life nutritional deprivation may contribute to cognitive impairment among older Chinese adults.
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Affiliation(s)
- Zhenmei Zhang
- Department of Sociology, Michigan State University, East Lansing, MI 48824, United States.
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Chen CH, Mizuno T, Elston R, Kariuki MM, Hall K, Unverzagt F, Hendrie H, Gatere S, Kioy P, Patel NB, Friedland RP, Kalaria RN. A comparative study to screen dementia and APOE genotypes in an ageing East African population. Neurobiol Aging 2010; 31:732-40. [PMID: 18703255 PMCID: PMC2857314 DOI: 10.1016/j.neurobiolaging.2008.06.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2007] [Revised: 06/22/2008] [Accepted: 06/27/2008] [Indexed: 11/27/2022]
Abstract
Previous studies have established cross-cultural methods to screen for ageing- related dementia and susceptibility genes, in particular Alzheimer's disease (AD) among the Canadian Cree, African Americans and Yoruba in Nigeria. We determined whether the Community Screening Interview for Dementia (CSID), translated into Kikuyu, a major language of Kenya, could be used to evaluate dementia of the Alzheimer type. Using two sets of coefficients of cognitive and informant scores, two discriminant function (DF) scores were calculated for each of 100 elderly (>65 years) Nyeri Kenyans. When the cut-off points were selected for 100% sensitivities, the specificities of the DF scores were remarkably similar (93.75%) in the Kenyan sample. We propose the adapted CSID can be utilised to detect dementia among East Africans. We also show that apolipoprotein E epsilon 4 allele frequencies were high (approximately 30%) and not different between normal subjects and those with probable AD. There was no evidence to suggest years of education or vascular factors were associated with dementia status.
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Affiliation(s)
- Chien-Hsiun Chen
- Laboratory of Neuro geriatrics, Department of Neurology and Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Toshiki Mizuno
- Department of Neurology, Kyoto Prefectural University, Kyoto, Japan
| | - Robert Elston
- Laboratory of Neuro geriatrics, Department of Neurology and Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | | | - Kathleen Hall
- Departments of Psychiatry and Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Fred Unverzagt
- Departments of Psychiatry and Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Hugh Hendrie
- Departments of Psychiatry and Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Samuel Gatere
- Avenue Hospital, First Avenue Parklands, Nairobi, Kenya
| | - Paul Kioy
- Department of Medical Physiology, University of Nairobi, Kenya
| | - Nilesh B. Patel
- Department of Medical Physiology, University of Nairobi, Kenya
| | - Robert P. Friedland
- Laboratory of Neuro geriatrics, Department of Neurology and Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Raj N. Kalaria
- Institute for Ageing and Health, Newcastle General Hospital, Newcastle upon Tyne NE4 6BE, United Kingdom
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Aiken Morgan AT, Sims RC, Whitfield KE. Cardiovascular Health and Education as Sources of Individual Variability in Cognitive Aging Among African Americans. J Aging Health 2010; 22:477-503. [DOI: 10.1177/0898264310361627] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To examine the interrelated effects of cardiovascular health, education, and cognitive functioning in African Americans. Method: The present study utilized data from the Baltimore Study of Black Aging to examine whether (a) cardiovascular health and educational attainment predicted cognitive functioning, after controlling for age, and (b) there was an interaction between cardiovascular health and education in predicting cognitive functioning. Results: Using hierarchical regression analyses, results showed education was significant for all cognitive measures; however, cardiovascular health was significant for only three. Discussion: These findings suggest that although self-reported cardiovascular health contributes to variability in late life cognition in African Americans, education is a more universal predictor that should be further examined.
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Abstract
SummaryThis review examines the demographic changes, the epidemiology of mental disorders and suicides, the potential risk and protective factors, access to secondary care old age psychiatry services (OAPSs) and the policy context pertaining to older people from ethnic minority groups in the United Kingdom. The number of older people from ethnic minority groups is increasing. The prevalence of mental disorders in older people from ethnic minority groups is either similar to or higher than that in the indigenous population. Therefore, the number of older people from ethnic minority groups with psychiatric morbidity is also increasing. Ethnic minority older people also have inequity of access to secondary care OAPSs. There is an urgent need to develop and implement practical strategies to improve access by older people from ethnic minority groups to OAPSs.
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Adelman S, Blanchard M, Livingston G. A systematic review of the prevalence and covariates of dementia or relative cognitive impairment in the older African-Caribbean population in Britain. Int J Geriatr Psychiatry 2009; 24:657-65. [PMID: 19235788 DOI: 10.1002/gps.2186] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To collate evidence regarding the prevalence and predictors of dementia or relative cognitive impairment in older, African-Caribbean people in Britain, as compared to their white, British peers. DESIGN We conducted a systematic literature review by searching electronic databases, contacting experts in the field and searching the references of identified papers for studies fulfilling our predefined inclusion criteria. They were divided into those measuring the prevalence or incidence of dementia or cognitive impairment, and those investigating risk factors. Each study selected for inclusion, was evaluated by two of the three authors using a standardised checklist and assigned a numerical score for quality. RESULTS Eleven papers fulfilled the selection criteria. Two cross-sectional surveys had calculated prevalence of dementia in a sample of British African-Caribbean people. A further prevalence study had estimated dementia prevalence in a mixed sample of African and African-Caribbean participants. All the comparative studies found an excess of dementia in African-Caribbean people when compared to the indigenous, white population but in one study, this was not statistically significant. Seven studies investigated potential predictive factors for cognitive impairment or cognitive decline. One study investigated the association between hypertension, dementia and country of birth. CONCLUSIONS The published research in this area is limited. The available studies consistently indicate an excess of dementia in older African-Caribbean people when compared to the indigenous white population. However, the magnitude of this difference and the associated risk factors are not clear, and warrant further investigation.
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Affiliation(s)
- Simon Adelman
- Department of Mental Health Sciences, UCL, Royal Free Campus, Hampstead, London, UK.
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Llibre Rodríguez J, Valhuerdi A, Sanchez II, Reyna C, Guerra MA, Copeland JRM, McKeigue P, Ferri CP, Prince MJ. The prevalence, correlates and impact of dementia in Cuba. A 10/66 group population-based survey. Neuroepidemiology 2008; 31:243-51. [PMID: 18931519 DOI: 10.1159/000165362] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2008] [Accepted: 07/14/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND We aimed to estimate the prevalence, correlates and impact of dementia in Havana and Matanzas, Cuba. METHODS A 1-phase catchment area survey of all over 65-year-old residents of 7 catchment areas in Havana and 1 in Matanzas was conducted. Dementia diagnosis was established according to DSM-IV and our own, pre-validated 10/66 criteria. The impact of dementia was assessed through associations with needs for care, cutting back on work to care and caregiver psychological morbidity. RESULTS We interviewed 2,944 older people, a response proportion of 96.4%. The prevalence of DSM-IV dementia was 6.4% and that of 10/66 dementia 10.8%. Both dementia outcomes were associated with older age, less education, a family history of dementia, shorter leg length and smaller skull circumference. Dementia, rather than physical health problems or depression, was the main contributor to needs for care (population-attributable prevalence fraction = 64.6%) and caregiver cutting back on work (population-attributable prevalence fraction = 57.3%). CONCLUSION The prevalence of dementia in Cuba is similar to Europe. Among health conditions, dementia is the major contributor to dependency and caregiver economic and psychological strain. More attention needs to be given to it and other chronic diseases associated more with disability than premature mortality.
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Kalaria RN, Maestre GE, Arizaga R, Friedland RP, Galasko D, Hall K, Luchsinger JA, Ogunniyi A, Perry EK, Potocnik F, Prince M, Stewart R, Wimo A, Zhang ZX, Antuono P. Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors. Lancet Neurol 2008; 7:812-26. [PMID: 18667359 DOI: 10.1016/s1474-4422(08)70169-8] [Citation(s) in RCA: 707] [Impact Index Per Article: 44.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Despite mortality due to communicable diseases, poverty, and human conflicts, dementia incidence is destined to increase in the developing world in tandem with the ageing population. Current data from developing countries suggest that age-adjusted dementia prevalence estimates in 65 year olds are high (>or=5%) in certain Asian and Latin American countries, but consistently low (1-3%) in India and sub-Saharan Africa; Alzheimer's disease accounts for 60% whereas vascular dementia accounts for approximately 30% of the prevalence. Early-onset familial forms of dementia with single-gene defects occur in Latin America, Asia, and Africa. Illiteracy remains a risk factor for dementia. The APOE epsilon4 allele does not influence dementia progression in sub-Saharan Africans. Vascular factors, such as hypertension and type 2 diabetes, are likely to increase the burden of dementia. Use of traditional diets and medicinal plant extracts might aid prevention and treatment. Dementia costs in developing countries are estimated to be US$73 billion yearly, but care demands social protection, which seems scarce in these regions.
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Affiliation(s)
- Raj N Kalaria
- Institute for Ageing and Health, Newcastle General Hospital, Newcastle upon Tyne, UK.
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Scazufca M, Menezes PR, Araya R, Di Rienzo VD, Almeida OP, Gunnell D, Lawlor DA. Risk factors across the life course and dementia in a Brazilian population: results from the Sao Paulo Ageing & Health Study (SPAH). Int J Epidemiol 2008; 37:879-90. [DOI: 10.1093/ije/dyn125] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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