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Kallianpur KJ, Obhi HK, Donlon T, Masaki K, Willcox B, Martin P. Cross-sectional and longitudinal associations between late-life depressive symptoms and cognitive deficits: 20-year follow-up of the Kuakini Honolulu-Asia aging study. Arch Gerontol Geriatr 2024; 127:105551. [PMID: 38968756 PMCID: PMC11401759 DOI: 10.1016/j.archger.2024.105551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 06/15/2024] [Accepted: 06/24/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVE To examine depressed affect, somatic complaints, and positive affect as longitudinal predictors of fluid, crystallized and global cognitive performance in the Kuakini Honolulu-Asia Aging Study (HAAS), a large prospective cohort study of Japanese-American men. METHODS We assessed 3,088 dementia-free Kuakini-HAAS participants aged 71-93 (77.1 ± 4.2) years at baseline (1991-1993). Depressive symptoms were evaluated by the Center for Epidemiologic Studies Depression (CES-D) Scale. Baseline CES-D depression subscales (depressed and positive affects; somatic complaints) were computed. The Cognitive Abilities Screening Instrument (CASI) measured cognitive performance on a 100-point scale; fluid and crystallized cognitive abilities were derived from CASI factor analysis. Cognition was also evaluated at 4 follow-up examinations over a 20-year period. Multiple regression assessed baseline CES-D subscales as predictors of cognitive change. The baseline covariates analyzed were CASI, age, education, prevalent stroke, APOE ε4 presence, and the longevity-associated FOXO3 genotype. RESULTS Cross-sectionally, baseline CES-D subscales were related to cognitive measures; e.g., higher depressed affect was associated with lower crystallized ability (β = -0.058, p ≤ 0.01), and somatic complaints were linked to poorer fluid ability (β = -0.045, p ≤ 0.05) and to worse global cognitive function as measured by total CASI score (β = -0.038, p ≤ 0.05). However, depression subscales did not significantly or consistently predict fluid ability, crystallized ability, or global cognitive performance over time. CONCLUSION Psychological and physical well-being were associated with contemporaneous but not subsequent cognitive functioning. Assessment of depressive symptoms may identify individuals who are likely to benefit from interventions to improve mood and somatic health and thereby maintain or enhance cognition.
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Affiliation(s)
- Kalpana J Kallianpur
- Kuakini Center for Translational Research on Aging, Kuakini Medical Center, Honolulu, HI, United States; Department of Tropical Medicine, Medical Microbiology and Pharmacology, University of Hawaii-Manoa, Honolulu, HI, United States; Kamehameha Schools-Kapālama, Honolulu, HI, United States.
| | - Hardeep K Obhi
- School of Medicine Office of Research, University of California Davis, Sacramento, CA, United States
| | - Timothy Donlon
- Kuakini Center for Translational Research on Aging, Kuakini Medical Center, Honolulu, HI, United States; Department of Geriatric Medicine, University of Hawaii-Manoa, Honolulu, HI, United States
| | - Kamal Masaki
- Kuakini Center for Translational Research on Aging, Kuakini Medical Center, Honolulu, HI, United States; Department of Geriatric Medicine, University of Hawaii-Manoa, Honolulu, HI, United States
| | - Bradley Willcox
- Kuakini Center for Translational Research on Aging, Kuakini Medical Center, Honolulu, HI, United States; Department of Geriatric Medicine, University of Hawaii-Manoa, Honolulu, HI, United States
| | - Peter Martin
- Department of Human Development and Family Studies, Iowa State University, Ames, IA, United States
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Maximiano-Barreto MA, Alves LCDS, Monteiro DQ, Matias M, Montayre J, Luchesi BM. Factors associated with low health literacy in unpaid caregivers of older people: a systematic review. Health Promot Int 2024; 39:daae118. [PMID: 39292532 DOI: 10.1093/heapro/daae118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2024] Open
Abstract
Health literacy is a public health issue. Unpaid caregivers of older people with low health literacy may have difficulties providing care, exerting a negative impact on the care process. The aim of the present study was to perform a systematic review of the literature on factors associated with low health literacy in unpaid caregivers of older people. Searches for relevant articles were conducted in the Cochrane Library, Embase, LILACS, PubMed and Web of Science databases. A total of 1440 articles were identified, nine of which met the eligibility criteria and were included in the systematic review, which was registered in PROSPERO (CRD42024522986). A total of 2209 unpaid caregivers participated in the studies selected for this review. Most were women (67.2%). The average frequency of inadequate health literacy was 27.1%. Sociodemographic characteristics (i.e. advanced age, low educational level, the female sex), factors related to the care process (i.e. low acculturation, low empowerment, poor ability to read medication package inserts, lower care capacity, greater disease severity, hospitalization of care recipients), cognitive factors and factors related to quality of life/well-being (i.e. less social support, poorer quality of life, greater cognitive impairment, higher levels of burden) were associated with low health literacy. In conclusion, low health literacy in unpaid caregivers of older people is associated with sociodemographic, care-related and cognitive factors as well as factors related to quality of life/well-being. Low health literacy may exert a negative impact on the health of caregivers and, consequently, the quality of care provided to older people.
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Affiliation(s)
- Madson Alan Maximiano-Barreto
- Department of Neuroscience and Behavioral Sciences, Research Group on Mental Health, Cognition and Ageing, University of São Paulo, Av. Tenente Catão Roxo, 2650, Ribeirão Preto, São Paulo, CEP: 14051-140, Brazil
| | - Ludmyla Caroline de Souza Alves
- Department of Nursing, Postgraduate Programme in Nursing, Federal University of São Carlos, Rodovia Washington Luís, km 235, São Carlos, São Paulo, CEP: 13565-905, Brazil
| | - Diana Quirino Monteiro
- Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luís, km 235, São Carlos, São Paulo, CEP: 13565-905, Brazil
| | - Marisa Matias
- Centre for Psychology at University of Porto, R. Alfredo Allen, 4200-135, Porto, Portugal
| | - Jed Montayre
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, China
| | - Bruna Moretti Luchesi
- Department of Neuroscience and Behavioral Sciences, Research Group on Mental Health, Cognition and Ageing, University of São Paulo, Av. Tenente Catão Roxo, 2650, Ribeirão Preto, São Paulo, CEP: 14051-140, Brazil
- Três Lagoas Campus, Federal University of Mato Grosso do Sul, Av. Ranulpho Marques Leal, 3484, Três Lagoas, Mato Grosso do Sul, CEP: 79613-000, Brazil
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Owens JH, Fiala J, Jones RN, Marsiske M. The Mediating Effects of Education and Occupational Complexity Between Race and Longitudinal Change in Late Life Cognition in ACTIVE. Res Aging 2024; 46:492-508. [PMID: 38648193 DOI: 10.1177/01640275241248825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
This study examined educational and occupational inequality as two aspects of social determinants of health that might mediate the longitudinal relationship between racialization and late life cognitive level and change. Participants were 2371 individuals racialized as Black and White from the ACTIVE study who provided occupational data. Data were analyzed from baseline and five assessments over 10-years using structural equation modeling. Black/White race served as the predictor, occupational complexity (OC) and years of education as mediators, and cognitive (memory, reasoning, and speed of processing) intercept, linear slope, and quadratic slope as the dependent variables. Black/White race showed significant indirect associations through education and OC on level of performance in cognition, linear change in reasoning and memory, and quadratic change in reasoning. Education and OC accounted for 11-16% of the association between race and cognitive level and represent modifiable social determinants of health that are associated with disparities in cognitive aging.
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Affiliation(s)
- Joshua H Owens
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Jacob Fiala
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Richard N Jones
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, USA
| | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Sizaret E, Brachet M, Launay A, Destrieux C, Zemmoura I, Angel L. Norms for neuropsychological tests in cognitively healthy French oldest old adults. J Int Neuropsychol Soc 2024:1-15. [PMID: 39291410 DOI: 10.1017/s1355617724000390] [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] [Indexed: 09/19/2024]
Abstract
OBJECTIVE Normal aging often leads to cognitive decline, and oldest old people, over 80 years old, have a 15% risk of developing neurodegenerative diseases. Therefore, it is important to have appropriate tools to assess cognitive function in old age. The study aimed to provide new norms for neuropsychological tests used to evaluate the cognitive abilities in people aged 80 years and older in France, focusing on the impact of education and gender differences. METHOD 107 healthy participants with an average age of 85.2 years, with no neurological history or major cognitive deficits were included. A comprehensive neuropsychological assessment was performed, covering several cognitive functions such as memory, visuospatial abilities, executive functions, attention, processing speed, and praxis. RESULTS Individuals with lower levels of education performed poorly on some tests and took longer to complete. Gender differences were observed, with women outperforming men in verbal episodic memory, while men showed better performance in visuoconstructive tasks. The participants showed lower performance in verbal episodic memory compared to norms established in previous French studies. In relation to executive functions, participants were slower to perform complex tasks than participants in previous studies. CONCLUSION This study provides cognitive norms specifically adapted to the oldest old population, which differ from established norms for younger aging adults. It highlights the importance of including these norms in future clinical and scientific investigations. The findings underscore the importance of education on cognitive abilities and emphasize the need to consider gender differences when assessing cognitive functions in aging populations.
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Affiliation(s)
- Eva Sizaret
- UMR 1253 iBraiN, Université de Tours, Inserm, Tours, France
- UMR 7295 CeRCA, Université de Tours, Université de Poitiers, CNRS, Tours, France
| | | | - Alix Launay
- UMR 7295 CeRCA, Université de Tours, Université de Poitiers, CNRS, Tours, France
- CMRR, CHRU de Tours, Tours, France
| | - Christophe Destrieux
- UMR 1253 iBraiN, Université de Tours, Inserm, Tours, France
- Service de Neurochirurgie, CHRU de Tours, Tours, France
| | - Ilyess Zemmoura
- UMR 1253 iBraiN, Université de Tours, Inserm, Tours, France
- Service de Neurochirurgie, CHRU de Tours, Tours, France
| | - Lucie Angel
- UMR 7295 CeRCA, Université de Tours, Université de Poitiers, CNRS, Tours, France
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Henneghan AM, Van Dyk KM, Haywood D, Patel M, Franco-Rocha OY, Bang S, Longley T, Tasker R, Kaufmann T, Paolillo EW, Moore RC, Hart NH. Characterizing cancer-related cognitive impairments and impact on quality of life in women with metastatic breast cancer. Breast Cancer Res Treat 2024:10.1007/s10549-024-07479-4. [PMID: 39269553 DOI: 10.1007/s10549-024-07479-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 08/25/2024] [Indexed: 09/15/2024]
Abstract
PURPOSE Little is known about cancer-related cognitive impairments (CRCI) in women with metastatic breast cancer (MBC). The purpose of this study is to (1) comprehensively describe CRCI and any associated psychosocial and behavioral symptoms, (2) determine observable sociodemographic and clinical risk factors for CRCI, and (3) explore cognitive and psychosocial predictors of quality of life and social functioning in women living with MBC. METHODS Using a cross-sectional design, women with MBC completed assessments (objective and subjective measures of CRCI including 3 open-ended questions, measures of psychosocial and behavioral factors, and assessments of quality of life and social function), and data were analyzed using descriptive statistics, qualitative content analysis, correlation analyses, t tests, analysis of variance, and linear regression models. RESULTS Data from 52 women were analyzed. 69.2% of the sample reported clinically significant CRCI and 46% of the sample scored < 1 standard deviation below the standardized mean on one or more cognitive tests. Those with triple-negative MBC (compared to HER2+), recurrent MBC (compared to de novo), and no history of chemotherapy had worse subjective CRCI, and those without history of surgery and older age had worse objective CRCI. Subjective CRCI, but not objective CRCI, was significantly associated with quality of life and social functioning. CONCLUSION Subjective and objective CRCI are likely a common problem for those with MBC. Subjective CRCI is associated with poorer quality of life and lower social functioning. Healthcare providers should acknowledge cognitive symptoms, continually assess cognitive function, and address associated unmet needs across the MBC trajectory.
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Affiliation(s)
- Ashley M Henneghan
- School of Nursing, University of Texas at Austin, Austin, TX, USA.
- Dell Medical School, University of Texas at Austin, Austin, TX, USA.
| | - Kathleen M Van Dyk
- Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Darren Haywood
- Faculty of Health, Human Performance Research Centre, INSIGHT Research Institute, , University of Technology Sydney (UTS), Sydney, NSW, Australia
- Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- Department of Psychiatry, Melbourne Medical School, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
- Faculty of Health Sciences, School of Population Health, Curtin University, Bentley, WA, Australia
| | - Mansi Patel
- Department of Neuroscience, College of Natural Sciences, University of Texas at Austin, Austin, TX, USA
| | | | - Soyeong Bang
- School of Nursing, Columbia University, New York, NY, USA
| | | | - Rebecca Tasker
- School of Nursing, University of Texas at Austin, Austin, TX, USA
| | - Tara Kaufmann
- Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Emily W Paolillo
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Raeanne C Moore
- UC San Diego Health Sciences, University of California San Diego, San Diego, CA, USA
| | - Nicolas H Hart
- Faculty of Health, Human Performance Research Centre, INSIGHT Research Institute, , University of Technology Sydney (UTS), Sydney, NSW, Australia
- School of Medical and Health Sciences, Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Faculty of Health, Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia
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Liu S, Xu D. Causal relationship between educational attainment and chronic pain: A Mendelian randomization study. Medicine (Baltimore) 2024; 103:e39301. [PMID: 39287318 PMCID: PMC11404962 DOI: 10.1097/md.0000000000039301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2024] Open
Abstract
Educational attainment (EA) is often used as a symbol of socioeconomic status and is associated with several diseases. However, uncertainty remains regarding the potential relationship between EA and chronic pain. This study aimed to evaluate the potential causal association between EA and chronic pain. The primary method employed in Mendelian randomization (MR) analysis was inverse-variance weighted method. Additionally, MR-Egger intercept, Cochran Q, and MR-PRESSO statistical analyses were conducted to assess potential pleiotropy and heterogeneity. The MR analysis provided evidence that genetically predicted additional education significantly reduced the risk of chronic pain. Specifically, this genetic factor may reduce multisite chronic pain by 27.6%, and chronic widespread pain by 3.8%. The results of sensitivity analysis indicated the reliability of our causal estimates. Higher levels of EA may provide protection against chronic pain risk. Enhancing education, narrowing social and economic disparities may help alleviate the burden of chronic pain.
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Affiliation(s)
- Shuning Liu
- School of Marxism, Changchun University of Chinese Medicine, Changchun, Jilin, China
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7
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Song Y, Yuan Q, Liu H, Gu K, Liu Y. Machine learning algorithms to predict mild cognitive impairment in older adults in China: A cross-sectional study. J Affect Disord 2024; 368:117-126. [PMID: 39271065 DOI: 10.1016/j.jad.2024.09.059] [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: 04/08/2024] [Revised: 08/29/2024] [Accepted: 09/10/2024] [Indexed: 09/15/2024]
Abstract
OBJECTIVE This study aimed to explore the predictive value of machine learning (ML) in mild cognitive impairment (MCI) among older adults in China and to identify important factors causing MCI. METHODS In this study, 6434 older adults were selected based on the data of the China Health and Elderly Care Longitudinal Survey (CHARLS) in 2020, and the dataset was subsequently divided into the training set and the test set, with a ratio of 6:4. To construct a prediction model for MCI in older adults, six ML algorithms were used, including logistic regression, KNN, SVM, decision tree (DT), LightGBM, and random forest (RF). The Delong test was used to compare the differences of ROC curves of different models, while decision curve analysis (DCA) was used to evaluate the model performance. The important contributions of the prediction results were then used to explain the model by the SHAP value.The Matthews correlation coefficient (MCC) was calculated to evaluate the performance of the models on imbalanced datasets. Additionally, causal analysis and counterfactual analysis were conducted to understand the feature importance and variable effects. RESULTS The area under the ROC curve of each model range from 0.71 to 0.77, indicating significant difference (P < 0.01). The DCA results show that the net benefits of LightGBM is the largest within various probability thresholds. Among all the models, the LightGBM model demonstrated the highest performance and stability. The five most important characteristics for predicting MCI were educational level, social events, gender, relationship with children, and age. Causal analysis revealed that these variables had a significant impact on MCI, with an average treatment effect of -0.144. Counterfactual analysis further validated these findings by simulating different scenarios, such as improving educational level, increasing age, and increasing social events. CONCLUSION The ML algorithm can effectively predict the MCI of older adults in China and identify the important factors causing MCI.
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Affiliation(s)
- Yanliqing Song
- College of Sports, Nanjing Tech University, Nanjing, China
| | - Quan Yuan
- College of Sports, Nanjing Tech University, Nanjing, China
| | - Haoqiang Liu
- College of Sports, Nanjing Tech University, Nanjing, China
| | - KeNan Gu
- College of Sports, Nanjing Tech University, Nanjing, China
| | - Yue Liu
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China.
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Lam JO, Whitmer RA, Corrada MM, Kawas CH, Vieira KE, Quesenberry CP, Gilsanz P. Gender differences in the association between education and late-life cognitive function in the LifeAfter90 Study: A multiethnic cohort of the oldest-old. Alzheimers Dement 2024. [PMID: 39254234 DOI: 10.1002/alz.14217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 07/03/2024] [Accepted: 08/02/2024] [Indexed: 09/11/2024]
Abstract
INTRODUCTION Few studies have examined the relationship between education and cognition among the oldest-old. METHODS Cognitive assessments were conducted biannually for 803 participants (62.6% women) of LifeAfter90, a longitudinal study of individuals ≥ 90 years old. Gender differences in associations between education (< high school, high school, some college, and ≥ college) and cognition (verbal episodic memory, semantic memory, and executive function) were examined at baseline and longitudinally using linear mixed models. RESULTS Higher education levels were associated with better cognitive performance at baseline for both men and women. College completion was more strongly associated with better baseline executive function among women. Education-cognition associations for baseline verbal episodic memory and baseline semantic memory did not differ by gender. Education was not associated with a decline in any domain-specific cognitive scores, regardless of gender. DISCUSSION Education is associated with cognitive function among the oldest-old and varies by gender and cognitive domain at baseline but not over time. HIGHLIGHTS In the oldest-old, higher education was associated with better cognitive function. College completion was more strongly associated with executive function in women. Education was not associated with cognitive decline after age 90 regardless of gender. Improving education could decrease gaps in cognitive level among older individuals.
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Affiliation(s)
- Jennifer O Lam
- Division of Research, Kaiser Permanente Northern California, Pleasanton, California, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
| | - Rachel A Whitmer
- Division of Research, Kaiser Permanente Northern California, Pleasanton, California, USA
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis, California, USA
| | - Maria M Corrada
- Department of Neurology, University of California Irvine, Orange, California, USA
- Department of Epidemiology and Biostatistics, University of California Irvine, Irvine, California, USA
| | - Claudia H Kawas
- Department of Neurology, University of California Irvine, Orange, California, USA
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, California, USA
| | - Katherine E Vieira
- Division of Research, Kaiser Permanente Northern California, Pleasanton, California, USA
| | - Charles P Quesenberry
- Division of Research, Kaiser Permanente Northern California, Pleasanton, California, USA
| | - Paola Gilsanz
- Division of Research, Kaiser Permanente Northern California, Pleasanton, California, USA
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Blumen HM, Jayakody O, Ayers E, Barzilai N, Habeck C, Milman S, Stern Y, Weiss EF, Verghese J. Cognitive reserve proxies are associated with age-related cognitive decline - Not age-related gait speed decline. Neurobiol Aging 2024; 141:46-54. [PMID: 38820770 DOI: 10.1016/j.neurobiolaging.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/02/2024]
Abstract
Cognition and gait share brain substrates in aging and dementia. Cognitive reserve (CR) allows individuals to cope with brain pathology and delay cognitive impairment and dementia. Yet, evidence for that CR is associated with age-related cognitive decline is mixed, and evidence for that CR is associated with age-related gait decline is limited. In 1,079 older (M Age = 75.4 years; 56.0% women) LonGenity study participants without dementia at baseline and up to 12 years of annual follow-up (M follow-up = 3.9 years, SD = 2.5 years), high CR inferred from cognitive (education years), physical (number of blocks walked per day; weekly physical activity days), and social (volunteering/working; living with someone) proxies were associated with slower rates of age-related decline in global cognition - not gait speed decline. Thus, cognitive, physical, and social CR proxies are associated with cognitive decline in older adults without dementia. The multifactorial etiology and earlier decline in gait than cognition may render it less modifiable by CR proxies later in life.
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Affiliation(s)
- Helena M Blumen
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Oshadi Jayakody
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Emmeline Ayers
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nir Barzilai
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Sofiya Milman
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yaakov Stern
- Department of Neurology, Columbia University, New York, NY, USA
| | - Erica F Weiss
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Joe Verghese
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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Lee AR, Torres J, Flores Romero KR. Adult Child Financial Disadvantage and the Cognitive Trajectories Among Older Parents in the United States. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae123. [PMID: 39021093 PMCID: PMC11304953 DOI: 10.1093/geronb/gbae123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVES Adult child socioeconomic status (SES) has been identified as a predictor of older parents' cognitive aging. However, studies have primarily relied on educational attainment as the sole measure of adult child SES. We evaluated the relationship between adult children's financial disadvantage and cognitive outcomes of older parents in the United States. METHODS We used data from U.S. Health and Retirement Study (2000-2014, n = 15,053 respondents ≥51 years with at least 1 adult child). Adult child financial disadvantage was measured with 3 indicators of extremely low income, unemployment, and lack of homeownership. We used linear mixed models to estimate the association between adult child financial disadvantage and the rate of decline in verbal memory scores, controlling for respondents' sociodemographic characteristics. RESULTS Having at least 1 adult child (vs no adult children) with extremely low income was found to be associated with lower verbal memory (b = -0.041, 95% confidence interval [CI]: -0.043, -0.039) at baseline. There was a small but significant association with the rate of decline in verbal memory z-scores (b = 0.004, 95% CI: 0.000, 0.008) and some evidence of heterogeneity by parent gender, marital status, and SES. DISCUSSION Offspring financial disadvantage may be influential for older parents' initial level of memory function, although evidence of associations with memory decline was weak. Public policy interventions aimed at improving the economic conditions of adult children may indirectly benefit the cognitive performance of disadvantaged parents in their later life.
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Affiliation(s)
- Ah-Reum Lee
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Jacqueline Torres
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Karla Renata Flores Romero
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
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Guardiano M, Matthews TA, Liu S, Arah OA, Siegrist J, Li J. Longitudinal associations of effort and reward at work with changes in cognitive function: evidence from a national study of U.S. workers. Int Arch Occup Environ Health 2024; 97:745-755. [PMID: 39212748 DOI: 10.1007/s00420-024-02081-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/07/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE This study aimed to examine longitudinal associations of workplace effort and reward with changes in cognitive function among United States workers. METHODS Data from the national, population-based Midlife in the United States (MIDUS) study with a 9-year follow-up were used. Validated workplace effort and reward scales were measured at baseline, and cognitive outcomes (including composite cognition, episodic memory, and executive functioning) were measured with the Brief Test of Adult Cognition by Telephone (BTACT) at baseline and follow-up. Multivariable linear regression analyses based on generalized estimating equations (GEE) examined the longitudinal associations under study. RESULTS Among this worker sample of 1,399, after accounting for demographics, socioeconomics, lifestyle behaviors, health conditions, and job control, high reward at baseline was associated with increased composite cognition (regression coefficient: 0.118 [95% CI: 0.049, 0.187]), episodic memory (0.106 [0.024, 0.188]), and executive functioning (0.123 [0.055, 0.191]) during follow-up. The joint exposure of 'high effort and high reward' was also associated with increased composite cognition (0.130 [0.030, 0.231]), episodic memory (0.131 [0.012, 0.250]), and executive functioning (0.117 [0.017, 0.216]), while the combination of 'low effort and high reward' was associated with increased composite cognition (0.106 [0.009, 0.204]) and executive functioning (0.139 [0.042, 0.235]). CONCLUSION Findings suggest that workplace high reward is related to improved cognitive scores among United States workers. Future research should investigate larger cohorts over longer timespans and expand into disease outcomes such as dementia. If these findings emerge as causal, relevant workplace rewards to promote worker cognitive health should be considered.
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Affiliation(s)
- Megan Guardiano
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Timothy A Matthews
- Department of Environmental and Occupational Health, College of Health & Human Development, California State University Northridge, Northridge, CA, USA
| | - Sunny Liu
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
- Department of Statistics and Data Science, College of Letters and Science, University of California Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA, USA
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Johannes Siegrist
- Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Jian Li
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA.
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Bangkok, Thailand.
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12
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Livingston G, Huntley J, Liu KY, Costafreda SG, Selbæk G, Alladi S, Ames D, Banerjee S, Burns A, Brayne C, Fox NC, Ferri CP, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Nakasujja N, Rockwood K, Samus Q, Shirai K, Singh-Manoux A, Schneider LS, Walsh S, Yao Y, Sommerlad A, Mukadam N. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet 2024; 404:572-628. [PMID: 39096926 DOI: 10.1016/s0140-6736(24)01296-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/08/2024] [Accepted: 06/16/2024] [Indexed: 08/05/2024]
Affiliation(s)
- Gill Livingston
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK.
| | - Jonathan Huntley
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Kathy Y Liu
- Division of Psychiatry, University College London, London, UK
| | - Sergi G Costafreda
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Geriatric Department, Oslo University Hospital, Oslo, Norway
| | - Suvarna Alladi
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - David Ames
- National Ageing Research Institute, Melbourne, VIC, Australia; University of Melbourne Academic Unit for Psychiatry of Old Age, Melbourne, VIC, Australia
| | - Sube Banerjee
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | | | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Nick C Fox
- The Dementia Research Centre, Department of Neurodegenerative Disease, University College London, London, UK
| | - Cleusa P Ferri
- Health Technology Assessment Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil; Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Laura N Gitlin
- College of Nursing and Health Professions, AgeWell Collaboratory, Drexel University, Philadelphia, PA, USA
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Helen C Kales
- Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, Sacramento, CA, USA
| | - Mika Kivimäki
- Division of Psychiatry, University College London, London, UK; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eric B Larson
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Noeline Nakasujja
- Department of Psychiatry College of Health Sciences, Makerere University College of Health Sciences, Makerere University, Kampala City, Uganda
| | - Kenneth Rockwood
- Centre for the Health Care of Elderly People, Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Quincy Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview, Johns Hopkins University, Baltimore, MD, USA
| | - Kokoro Shirai
- Graduate School of Social and Environmental Medicine, Osaka University, Osaka, Japan
| | - Archana Singh-Manoux
- Division of Psychiatry, University College London, London, UK; Université Paris Cité, Inserm U1153, Paris, France
| | - Lon S Schneider
- Department of Psychiatry and the Behavioural Sciences and Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Sebastian Walsh
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Yao Yao
- China Center for Health Development Studies, School of Public Health, Peking University, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
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13
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Valenzuela Y, Luna K, Uribe-Kirby R, Pawlak A, Pitman L, Cuellar-Rocha P, Lucatero GR, Santos MM, Jones JD. Cognitive Performance Between Latino and White Non-Latino Individuals With Parkinson's Disease. J Neuropsychiatry Clin Neurosci 2024:appineuropsych20240006. [PMID: 39113494 DOI: 10.1176/appi.neuropsych.20240006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
OBJECTIVE Cognitive impairment is a common nonmotor symptom in Parkinson's disease (PD). Individuals of Latino background are traditionally underrepresented in research on PD. Despite the fact that Latinos comprise 18% of the U.S. population, they commonly make up less than 5% of samples in studies of PD. Emerging evidence suggests that Latino individuals with PD may experience disparities relative to White non-Latinos in terms of having more severe motor symptoms, more severe depressive symptoms, and worse health-related quality of life. The purpose of the present study was to investigate differences in cognitive performance between Latino and White non-Latino individuals with PD and examine correlates of cognitive performance. METHODS Data were obtained from the Parkinson's Progression Markers Initiative. Participants included 60 Latino individuals with PD and 1,009 White non-Latino individuals with PD, all of whom were followed annually for up to 5 years. Participants completed neuropsychological tests of attention and working memory, processing speed, visuospatial functioning, verbal fluency, and immediate and delayed memory and recall. RESULTS Relative to White non-Latino individuals with PD, Latino individuals with PD had significantly lower scores on the global measure of cognitive functioning, a test of processing speed, and tests of working memory and attention. Years of education was the strongest correlate of performance in these three cognitive domains among individuals in the Latino group. CONCLUSIONS These findings provide initial evidence of disparities in cognitive functioning among Latino individuals with PD. Educational disadvantages may be one potential driver of these disparities.
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Affiliation(s)
- Yenny Valenzuela
- Department of Psychology (all authors) and Center on Aging (Jones), California State University, San Bernardino, San Bernardino
| | - Kenya Luna
- Department of Psychology (all authors) and Center on Aging (Jones), California State University, San Bernardino, San Bernardino
| | - Ruth Uribe-Kirby
- Department of Psychology (all authors) and Center on Aging (Jones), California State University, San Bernardino, San Bernardino
| | - Alejandra Pawlak
- Department of Psychology (all authors) and Center on Aging (Jones), California State University, San Bernardino, San Bernardino
| | - Lauren Pitman
- Department of Psychology (all authors) and Center on Aging (Jones), California State University, San Bernardino, San Bernardino
| | - Priscilla Cuellar-Rocha
- Department of Psychology (all authors) and Center on Aging (Jones), California State University, San Bernardino, San Bernardino
| | - Guadalupe Romero Lucatero
- Department of Psychology (all authors) and Center on Aging (Jones), California State University, San Bernardino, San Bernardino
| | - Maria M Santos
- Department of Psychology (all authors) and Center on Aging (Jones), California State University, San Bernardino, San Bernardino
| | - Jacob D Jones
- Department of Psychology (all authors) and Center on Aging (Jones), California State University, San Bernardino, San Bernardino
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14
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Clouston SAP, Hanes DW, Smith DM, Richmond LL, Richards M, Link B. Inequalities in accelerated cognitive decline: Resolving observational window bias using nested non-linear regression. Alzheimers Dement 2024; 20:5540-5550. [PMID: 39001609 PMCID: PMC11350020 DOI: 10.1002/alz.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 08/29/2024]
Abstract
INTRODUCTION Limited observational windows lead to conflicting results in studies examining educational differences in Alzheimer's disease and related dementias (ADRD) risk, due to observational window bias relative to onset of accelerated cognitive decline. This study tested a novel model to address observational window bias and tested for the presence and sources of disparities in accelerated cognitive declines due to ADRD. METHODS The sample examined 167,314 cognitive assessments from 32,441 Health and Retirement Study participants. We implemented a parametric non-linear nested longitudinal regression and reported multivariable-adjusted nodal incidence ratios (aNIR). RESULTS University degrees were associated with lower incidence (aNIR = 0.253, 95% confidence interval [CI] = [0.221 to 0.289], p < 0.001), while black participants had a higher incidence (aNIR = 1.995, [1.858 to 2.141], p < 0.001) of accelerated cognitive decline, adjusting for demographic, sociobehavioral, and medical risk factors. Sex-stratified analyses identified diminished educational returns for women and increased incidence among minoritized women. DISCUSSION Addressing observational window bias reveals large social inequalities in the onset of accelerated cognitive declines indicative of ADRD. HIGHLIGHTS This study identifies observational window bias as a source of conflicting results among previous studies of educational achievement in Alzheimer's disease and related dementias (ADRD) disparities. The study locates preclinical accelerated cognitive decline, which is indicative of ADRD while occurring 10+ years prior to symptom onset, as a site to study ADRD disparities that mitigates observational window bias. A novel method, nested non-linear regression, is developed to test for differences in the onset of accelerated cognitive decline. Educational and racial/ethnic disparities are demonstrated in the onset of accelerated cognitive decline, as are their intersecting differences with sex/gender.
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Affiliation(s)
- Sean A. P. Clouston
- Program in Public Health, Renaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
- Department of Family, Population, and Preventive Medicine, Renaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | - Douglas W. Hanes
- Program in Public Health, Renaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | - Dylan M. Smith
- Program in Public Health, Renaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
- Department of Family, Population, and Preventive Medicine, Renaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | | | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCLUniversity College LondonLondonUK
| | - Bruce Link
- Department of SociologyUniversity of California at RiversideRiversideCaliforniaUSA
- Department of Public PolicyUniversity of California at RiversideRiversideCaliforniaUSA
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15
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Heiskanen MA, Nevalainen J, Pahkala K, Juonala M, Hutri N, Kähönen M, Jokinen E, Laitinen TP, Tossavainen P, Taittonen L, Viikari JSA, Raitakari OT, Rovio SP. Change in cognitive performance during seven-year follow-up in midlife is associated with sex, age, and education - The Cardiovascular Risk in Young Finns Study. J Neurol 2024; 271:5165-5176. [PMID: 38824491 PMCID: PMC11319598 DOI: 10.1007/s00415-024-12466-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVE Sex, age, and education are associated with the level of cognitive performance. We investigated whether these factors modulate the change in cognitive performance in midlife by leveraging the longitudinal data from the Cardiovascular Risk in Young Finns Study (YFS). METHODS Participants of the YFS cohort performed a computer-based Cambridge Neuropsychological Test Automated Battery (CANTAB) in 2011 and 2018 (n = 1671, age 41-56 years in 2018). Overall cognitive performance and domains representing learning and memory, working memory, reaction time, and information processing were extracted by common principal component analysis from the longitudinal cognitive data. Linear models adjusted for baseline cognitive performance were used to study the association of sex, age, and education with changes in overall cognitive performance and in the cognitive domains. RESULTS Cognitive performance decreased in all domains (overall cognition -0.56 SD, p < 0.001; working memory -0.81 SD, p < 0.001; learning and memory -0.70 SD, p < 0.001; reaction time -0.06 SD, p = 0.019; information processing -0.03 SD, p = 0.016). The decrease in working memory and information processing was greater in females compared to males. Cognitive performance decreased more in older participants in all domains. Education alleviated the decrease in cognitive performance in all domains except reaction time. The beneficial effect of education was greater for males. CONCLUSIONS This study describes the natural course of aging-related changes in cognitive performance in midlife, the critical time window for early prevention of clinical cognitive decline. These findings provide a reference for studies focusing on determinants of pathological cognitive decline deviating from normal changes in cognitive performance.
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Affiliation(s)
- Marja A Heiskanen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, FI-20520, Turku, Finland.
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
| | | | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, FI-20520, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Paavo Nurmi Centre, Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Nina Hutri
- Tampere Centre for Skills Training and Simulation, Tampere University, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Eero Jokinen
- Department of Pediatric Cardiology, Hospital for Children and Adolescents, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tomi P Laitinen
- Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Päivi Tossavainen
- Department of Pediatrics, Research Unit of Clinical Medicine, MRC Oulu, University of Oulu, Oulu, Finland
- Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
| | - Leena Taittonen
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, FI-20520, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Suvi P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, FI-20520, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
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16
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Porricelli D, Tecilla M, Pucci V, Di Rosa E, Mondini S, Cappelletti M. Cognitive reserve modulates mental health in adulthood. Aging Clin Exp Res 2024; 36:139. [PMID: 38954168 PMCID: PMC11219466 DOI: 10.1007/s40520-024-02776-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/13/2024] [Indexed: 07/04/2024]
Abstract
Cognitive Reserve (CR) reflects acquired knowledge, skills, and abilities throughout life, and it is known for modulating cognitive efficiency in healthy and clinical populations. CR, which was initially proposed to explain individual differences in the clinical presentation of dementia, has subsequently been extended to healthy ageing, showing its role in cognitive efficiency also during middle age. Recently, CR has been linked to affective processes in psychiatric conditions such as schizophrenia, major depressive and anxiety symptoms, and psychological distress, suggesting its potential role in emotional expression and regulation. Whether the role of CR in mental health extends to non-pathological adults, and whether this is only relevant in older age is not yet clear. The aim of this work was therefore to explore the relationship between CR and mental health in healthy adults, with a focus on middle adulthood (40-60). In a sample of 96 participants, we found a positive association between CR and mental health outcomes, such that a higher cognitive reserve index corresponded to fewer mental health reported symptoms. Specifically, a higher CR reflecting professional activities was associated with lower stress levels, especially in middle agers. Taken together, these data therefore suggest that engaging occupations may help maintain a robust mental health, especially by reducing stress symptoms during middle age. These results broaden previous findings suggesting that CR relates to affective components of mental health in middle aged and older adults.
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Affiliation(s)
| | | | - Veronica Pucci
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
- Human Inspired Technology Centre (HIT), University of Padua, Padua, Italy
| | - Elisa Di Rosa
- Department of General Psychology, University of Padua, Padua, Italy
| | - Sara Mondini
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
- Human Inspired Technology Centre (HIT), University of Padua, Padua, Italy
- Department of Developmental Psychology and Socialization (DPSS), University of Padua, Padua, Italy
- IRCCS San Camillo Hospital, Venice, Italy
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17
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Wezowski K, Penton-Voak IS. Relationship between low mood and micro-expression processing: evidence of negative bias in interpreting fleeting facial expressions. ROYAL SOCIETY OPEN SCIENCE 2024; 11:231944. [PMID: 39086818 PMCID: PMC11288663 DOI: 10.1098/rsos.231944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 06/02/2024] [Accepted: 07/11/2024] [Indexed: 08/02/2024]
Abstract
Depression affects the recognition of emotion in facial expressions by reducing the detection accuracy and adding a bias towards negativity. However, no study has examined associations between depression and the recognition of microfacial expressions (fleeting facial cues of emotions in people's faces). Thus, we investigated associations between low mood and micro-expression processing using video stimuli of micro-expressions. We examined whether (i) individuals with low mood had trouble recognizing emotions, (ii) were more likely to perceive happy facial expressions as neutral and neutral facial expressions as sad, and (iii) recognized sad emotional expressions better than control subjects (n = 349). We found that participants with low mood showed poorer performance when judging emotions in faces (p = 0.03). Furthermore, there was a specific deficit among them in recognizing happiness. Lastly, participants with low moods were more likely to perceive neutral faces as sad (p = 0.042). However, no evidence was found that individuals with low moods confused happy faces as neutral or were better than the control group at recognizing sad faces. Our results show that mood affects the perception of emotions in facial expressions, which has the potential to negatively affect interpersonal interactions and ultimately quality of life.
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Affiliation(s)
- Kasia Wezowski
- School of Psychological Science, University of Bristol, 12a Priory Road, BristolBS8 1TU, UK
| | - Ian S. Penton-Voak
- School of Psychological Science, University of Bristol, 12a Priory Road, BristolBS8 1TU, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
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18
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Cochar-Soares N, de Oliveira DC, Luiz MM, Aliberti MJR, Suemoto CK, Steptoe A, de Oliveira C, Alexandre T. Sex Differences in the Trajectories of Cognitive Decline and Affected Cognitive Domains Among Older Adults With Controlled and Uncontrolled Glycemia. J Gerontol A Biol Sci Med Sci 2024; 79:glae136. [PMID: 38775400 PMCID: PMC11181940 DOI: 10.1093/gerona/glae136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND We aimed to analyze the trajectories of cognitive decline as a function of the presence of type 2 diabetes and glycemic control in analyzes stratified by sex in an 8-year follow-up period. METHODS A total of 1 752 men and 2 232 women aged ≥50 years who participated in the English Longitudinal Study of Ageing (ELSA), conducted from 2004 to 2012, were analyzed. The outcomes of interest were performance on the cognitive domains of memory, executive function, and temporal orientation as well as the global cognition score. Cognitive performance was standardized in z-scores in strata based on schooling and age. The participants were classified as without diabetes, with controlled glycemia, and with uncontrolled glycemia, according to medical diagnosis, glucose-lowering medications use and HbA1c levels. Generalized linear mixed models controlled by sociodemographic, behavioral, and health-related characteristics were used for the trajectory analyses. RESULTS No differences in z-scores were found for global cognition or cognitive domains based on diabetes classification in men and women at baseline. More than 8 years of follow up, women with uncontrolled glycemia had a greater decline in z-scores for global cognition (-0.037 SD/year [95% CI: -0.073; -0.001]) and executive function (-0.049 SD/year [95% CI: -0.092; -0.007]) compared with those without diabetes. No significant difference in trajectories of global cognition or any cognitive domain was found in men as a function of diabetes classification. CONCLUSIONS Women with uncontrolled glycemia are at greater risk of a decline in global cognition and executive function than those without diabetes.
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Affiliation(s)
| | - Dayane C de Oliveira
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Mariane M Luiz
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Márlon J R Aliberti
- Laboratory of Medical Research in Aging (LIM-66), Servico de Geriatria, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Claudia K Suemoto
- Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
| | - Andrew Steptoe
- Department of Behavioral Science and Health, University College London, London, UK
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Tiago S Alexandre
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
- Department of Epidemiology and Public Health, University College London, London, UK
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19
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Ourry V, Binette AP, St-Onge F, Strikwerda-Brown C, Chagnot A, Poirier J, Breitner J, Arenaza-Urquijo EM, Rabin JS, Buckley R, Gonneaud J, Marchant NL, Villeneuve S. How Do Modifiable Risk Factors Affect Alzheimer's Disease Pathology or Mitigate Its Effect on Clinical Symptom Expression? Biol Psychiatry 2024; 95:1006-1019. [PMID: 37689129 DOI: 10.1016/j.biopsych.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/11/2023] [Accepted: 09/03/2023] [Indexed: 09/11/2023]
Abstract
Epidemiological studies show that modifiable risk factors account for approximately 40% of the population variability in risk of developing dementia, including sporadic Alzheimer's disease (AD). Recent findings suggest that these factors may also modify disease trajectories of people with autosomal-dominant AD. With positron emission tomography imaging, it is now possible to study the disease many years before its clinical onset. Such studies can provide key knowledge regarding pathways for either the prevention of pathology or the postponement of its clinical expression. The former "resistance pathway" suggests that modifiable risk factors could affect amyloid and tau burden decades before the appearance of cognitive impairment. Alternatively, the resilience pathway suggests that modifiable risk factors may mitigate the symptomatic expression of AD pathology on cognition. These pathways are not mutually exclusive and may appear at different disease stages. Here, in a narrative review, we present neuroimaging evidence that supports both pathways in sporadic AD and autosomal-dominant AD. We then propose mechanisms for their protective effect. Among possible mechanisms, we examine neural and vascular mechanisms for the resistance pathway. We also describe brain maintenance and functional compensation as bases for the resilience pathway. Improved mechanistic understanding of both pathways may suggest new interventions.
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Affiliation(s)
- Valentin Ourry
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
| | - Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Clinical Memory Research Unit, Department of Clinical Sciences, Lunds Universitet, Malmö, Sweden
| | - Frédéric St-Onge
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Cherie Strikwerda-Brown
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Audrey Chagnot
- UK Dementia Research Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Judes Poirier
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - John Breitner
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Eider M Arenaza-Urquijo
- Environment and Health over the Lifecourse Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Jennifer S Rabin
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Rachel Buckley
- Melbourne School of Psychological Sciences University of Melbourne, Parkville, Victoria, Australia; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Julie Gonneaud
- Normandie University, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, Caen, France
| | - Natalie L Marchant
- Division of Psychiatry, University College London, London, United Kingdom
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
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20
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Eliasen EH, Weihe P, Debes F, Tróndarson M, Petersen MS. 10-Year Cognitive Change in the Faroese Septuagenarian Cohort and Impact of Sociodemographic, Lifestyle, and Health Factors. J Aging Health 2024:8982643241255405. [PMID: 38819787 DOI: 10.1177/08982643241255405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
OBJECTIVES To investigate cognitive change in multiple cognitive domains in a population-based cohort of 713 Faroese older adults. METHODS Participants were cognitively tested at baseline (70-74 years) and re-evaluated after 10 years. Changes in cognitive performance and the impact of sociodemographic factors, lifestyle, and health conditions were analysed using mixed-effect models. Participants free from dementia were studied in separate analyses. RESULTS A significant decline over 10 years was observed in most of the neuropsychological tests. People living in rural areas, married or cohabiting people, people without professional education, slightly older persons, smokers, teetotalers, and people with heart disease and abnormal electrocardiogram (ECG) had a steeper decline in cognitive ability. Conflicting results were found for sex and people with myocardial infarction (MI). DISCUSSION There are modifiable factors that contribute to cognitive decline which should be addressed in future public health efforts.
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Affiliation(s)
- Eina H Eliasen
- Department of Research, The National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
- Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Pál Weihe
- Department of Research, The National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
- Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
- Center of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Fróði Debes
- Department of Research, The National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - Marjun Tróndarson
- Department of Research, The National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - Maria Skaalum Petersen
- Department of Research, The National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
- Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
- Center of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
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Chen S, Ling Y, Zhou F, Qiao X, Reinhardt JD. Trajectories of cognitive function among people aged 45 years and older living with diabetes in China: Results from a nationally representative longitudinal study (2011~2018). PLoS One 2024; 19:e0299316. [PMID: 38787866 PMCID: PMC11125531 DOI: 10.1371/journal.pone.0299316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/08/2024] [Indexed: 05/26/2024] Open
Abstract
OBJECTIVES Diabetes is associated with decline of cognitive function. Exploring different trajectories of cognitive function occurring in people with diabetes is important to improved prognosis. This study aimed to investigate differential patterns of trajectories of cognitive function and baseline determinants of trajectory group membership utilizing data from middle-aged and older Chinese adults with diabetes. METHODS Participants of the Chinese Health And Retirement Longitudinal Study (CHARLS) aged 45 years and above received biennial assessments between 2011 and 2018. The primary outcome was overall cognitive function score operationalized as sum of mental intactness and episodic memory scores derived from the Telephone Interview of Cognitive Status (TICS). A weighted growth mixture model was used to estimate cognitive function trajectories of CHARLS participants with diabetes, and baseline factors associated with trajectory group membership were investigated with weighted multinomial logistic regression. RESULTS Data from 1,463 participants with diabetes aged 45 years and above were analyzed, a three-group trajectory model showed the best fit for overall cognitive scores: low baseline, linear declining (22.1%); moderate baseline, linear declining (37.5%) and high-stable (40.3%). Older participants, females, participants with low education, with nighttime sleep <6 h, without daytime napping habits, and with depressive symptoms were at a higher risk of unfavorable cognitive function trajectories. CONCLUSIONS We identified heterogeneous trajectories of cognitive function among middle-aged and older people living with diabetes in China. Socially vulnerable groups including females, rural residents, and those with low education were at a higher risk for unfavorable trajectories. In health programs aimed at preventing and mitigating cognitive decline in individuals with diabetes more attention should be given to vulnerable groups. Reduced nighttime sleep, lack of daytime napping, and depressive symptoms appear to be modifiable risk factors.
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Affiliation(s)
- Shi Chen
- Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuewei Ling
- Department of Management Science and Engineering, Stanford University, Stanford, CA, United States of America
| | - Faquan Zhou
- Department of Vascular Surgery, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xu Qiao
- Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jan D Reinhardt
- Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu, China
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Rehabilitation Medicine Centre, Jiangsu Province Hospital/Nanjing Medical University First Affiliated Hospital, Nanjing, China
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Jin T, Huang T, Zhang T, Li Q, Yan C, Wang Q, Chen X, Zhou J, Sun Y, Bo W, Luo Z, Li H, An Y. A Bayesian benchmark concentration analysis for urinary fluoride and intelligence in adults in Guizhou, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 925:171326. [PMID: 38460703 DOI: 10.1016/j.scitotenv.2024.171326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/11/2024]
Abstract
Environmental fluoride exposure has been linked to numerous cases of fluorosis worldwide. Previous studies have indicated that long-term exposure to fluoride can result in intellectual damage among children. However, a comprehensive health risk assessment of fluorosis-induced intellectual damage is still pending. In this research, we utilized the Bayesian Benchmark Dose Analysis System (BBMD) to investigate the dose-response relationship between urinary fluoride (U-F) concentration and Raven scores in adults from Nayong, Guizhou, China. Our research findings indecate a dose-response relationship between the concentration of U-F and intelligence scores in adults. As the benchmark response (BMR) increased, both the benchmark concentration (BMCs) and the lower bound of the credible interval (BMCLs) increased. Specifically, BMCs for the association between U-F and IQ score were determined to be 0.18 mg/L (BMCL1 = 0.08 mg/L), 0.91 mg/L (BMCL5 = 0.40 mg/L), 1.83 mg/L (BMCL10 = 0.83 mg/L) when using BMRs of 1 %, 5 %, and 10 %. These results indicate that U-F can serve as an effective biomarker for monitoring the loss of IQ in population. We propose three interim targets for public policy in preventing interllectual harm from fluoride exposure.
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Affiliation(s)
- Tingxu Jin
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou 215123, Jiangsu, China; School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China.
| | - Tongtong Huang
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou 215123, Jiangsu, China
| | - Tianxue Zhang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Quan Li
- Center for Disease Control and Prevention, Nayong County, 553300 Bijie City, Guizhou Province, China
| | - Cheng Yan
- School of Environmental Studies, China University of Geosciences, Wuhan 430074, China; Hubei Key Laboratory of Environmental Water Science in the Yangtze River Basin, China University of Geosciences, Wuhan 430074, China
| | - Qian Wang
- Center for Disease Control and Prevention, Nayong County, 553300 Bijie City, Guizhou Province, China
| | - Xiufang Chen
- Center for Disease Control and Prevention, Nayong County, 553300 Bijie City, Guizhou Province, China
| | - Jing Zhou
- Center for Disease Control and Prevention, Nayong County, 553300 Bijie City, Guizhou Province, China
| | - Yitong Sun
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Wenqing Bo
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Ziqi Luo
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Haodong Li
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Yan An
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou 215123, Jiangsu, China.
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Gutierrez S, Meza E, Glymour MM, Torres JM. My Parent, Myself, or My Child: Whose Education Matters Most for Trajectories of Cognitive Aging in Middle Age? Am J Epidemiol 2024; 193:695-706. [PMID: 37116072 DOI: 10.1093/aje/kwad108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 02/10/2023] [Accepted: 04/25/2023] [Indexed: 04/30/2023] Open
Abstract
The growing body of evidence linking intergenerational education and late-life cognitive decline is almost exclusively from high-income countries, despite rapid intergenerational changes in education in low- and middle-income countries (LMICs). We used data from the Mexican Health and Aging Study (n = 8,822), a cohort study of Mexican adults aged ≥50 years (2001-2018), to evaluate whether parental education (none vs. any formal schooling), one's own education (less than primary school vs. completion of primary school), or an adult child's education (less than high school vs. completion of high school) was associated with verbal memory z scores. We used linear mixed models with inverse probability of attrition weights. Educational attainment in all 3 generations was associated with baseline verbal memory scores, independent of the prior generation's education. Lower parental (β = -0.005, 95% confidence interval: -0.009, -0.002) and respondent (β = -0.013, 95% confidence interval: -0.017, -0.010) educational level were associated with faster decline in delayed (but not immediate) verbal memory z scores. Associations between adult child's education and respondent's verbal memory decline varied by exposure specification. The educational attainment of parents and adult children may influence the cognitive aging of middle-aged and older adults in LMICs. These results have important implications given recent structural shifts in educational attainment in many LMICs.
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Mashinchi GM, McFarland CP, Hall S, Strongin DL, Williams GA, Cotter KA. Handicraft art leisure activities and cognitive reserve. Clin Neuropsychol 2024; 38:683-714. [PMID: 37674299 DOI: 10.1080/13854046.2023.2253993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023]
Abstract
ObjectiveOlder individuals face a higher likelihood of developing dementia. The rate of cognitive decline resulting from dementia is not equivalent for all, as some patients with dementia are able to function independently longer than others, despite having similar disease burden. The cognitive reserve (CR) theory provides one explanation for the differing rate of decline. CR suggests that there are factors-most notably, educational attainment and occupational attainment-that can protect against the cognitive decline. Although the beneficial effects of these notable CR factors are clear, not all are easily modifiable. Participation in leisure activities may represent a more easily modifiable factor. Some research hints at beneficial effects of leisure activities, although specific leisure activities have not been well examined. The present study examined the relations between handicraft art leisure activities (HALAs) and multiple cognitive domains. MethodArchival WAIS-IV and demographic data for 50 California retirement community residents were examined. ResultsHALA participation accounted for statistically significant variance in working memory performance (R2 = .40, β = .24%) over and above the established CR factors of age, depression, educational attainment, and occupational attainment. In addition, HALA participation was related to a better ability to perform abstract visual information tasks (Block Design subtest, r = .28, p = .05) and non-verbal reasoning tasks (Visual Puzzles subtest, r = .38, p = .008). ConclusionsHALA participation among older adults could contribute to the retention of cognitive function, supporting the role of HALA participation as a CR factor.
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Grønkjær M, Mortensen EL, Wimmelmann CL, Flensborg-Madsen T, Osler M, Okholm GT. The Danish Aging and Cognition (DanACo) cohort. BMC Geriatr 2024; 24:238. [PMID: 38454360 PMCID: PMC10921587 DOI: 10.1186/s12877-024-04841-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND With aging populations worldwide, identification of predictors of age-related cognitive decline is becoming increasingly important. The Danish Aging and Cognition Cohort (DanACo) including more than 5000 Danish men was established to investigate predictors of age-related cognitive decline from young adulthood to late mid-life. CONSTRUCTION AND CONTENT The DanACo cohort was established through two separate data collections with identical designs involving a follow-up examination in late mid-life of men for whom intelligence test scores were available from their mandatory conscription board examination. The cohort consists of 5,183 men born from 1949 through 1961, with a mean age of 20.4 years at baseline and a mean age of 64.4 years at follow-up. The baseline measures consisted of height, weight, intelligence test score and educational level collected at the conscription board examination. The follow-up assessment consisted of a re-administration of the same intelligence test and a comprehensive questionnaire covering socio-demographic factors, lifestyle, and health-related factors. The data were collected in test sessions with up to 24 participants per session. Using the unique personal identification number assigned to all Danes, the cohort has been linked to data from national administrative and health registers for prospectively collected data on socioeconomic and health-related factors. UTILITY AND DISCUSSION The DanACo cohort has some major strengths compared to existing cognitive aging cohorts such as a large sample size (n = 5,183 men), a validated global measure of cognitive ability, a long retest interval (mean 44.0 years) and the availability of prospectively collected data from registries as well as comprehensive questionnaire data. The main weakness is the low participation rate (14.3%) and that the cohort consists of men only. CONCLUSION Cognitive decline is a result of a summary of factors across the life-course. The DanACo cohort is characterized by a long retest interval and contains data on a wealth of factors across adult life which is essential to establish evidence on predictors of cognitive decline. Moreover, the size of the cohort ensures sufficient statistical power to identify even relatively weak predictors of cognitive decline.
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Affiliation(s)
- Marie Grønkjær
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, Unit of Medical Psychology, Section of Environmental Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, 1353, Denmark
- Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Cathrine Lawaetz Wimmelmann
- Department of Public Health, Unit of Medical Psychology, Section of Environmental Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, 1353, Denmark
- Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
- Centre for Childhood Health, Islands Brygge 41, 2300, Copenhagen S, Denmark
| | - Trine Flensborg-Madsen
- Department of Public Health, Unit of Medical Psychology, Section of Environmental Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, 1353, Denmark
- Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Merete Osler
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, 1353, Denmark
| | - Gunhild Tidemann Okholm
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark.
- Department of Public Health, Unit of Medical Psychology, Section of Environmental Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, 1353, Denmark.
- Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark.
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Batra R, Kumar DA, Rao A, Kaloiya GS, Khan MA, Satapathy S, Chakrawarty A, Soni N, Kumar P, Chatterjee P. Clinical and neuropsychological characterization of SuperAgers residing in Delhi and National Capital Region of India-A cross-sectional study. Aging Med (Milton) 2024; 7:67-73. [PMID: 38571668 PMCID: PMC10985767 DOI: 10.1002/agm2.12285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/02/2024] [Accepted: 01/11/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction SuperAgers (SA) are older adults who exhibit cognitive capacities comparable to individuals who are three or more decades younger than them. The current study aimed to identify the characteristics of Indian SA by categorizing 55 older adults into SA and Typical Older Adults (TOA) and comparing their performance with a group of 50 younger participants (YP) (aged 25-50). Methods A total of 105 participants were recruited after obtaining informed written consent. The cognitive abilities of the participants were assessed using Wechsler Adult Intelligence Scale (WAIS)-IVINDIA, Color Trails Test, Boston Naming Test (BNT), and Rey Auditory Verbal Learning Test. Results SA outperformed TOA in all cognitive assessments (P < 0.001) and surpassed YP in BNT and WAIS-IV. SA's delayed recall scores were notably higher (12.29 ± 1.51) than TOA (6.32 ± 1.44). Conclusion SA excelled in all cognitive domains demonstrating resilience to age-related cognitive decline. This study highlights Indian SuperAgers' exceptional cognitive prowess.
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Affiliation(s)
- Ritika Batra
- Department of Geriatric MedicineAll India Institute of Medical SciencesNew DelhiIndia
| | - Deepa Anil Kumar
- Department of Geriatric MedicineAll India Institute of Medical SciencesNew DelhiIndia
| | - Abhijith Rao
- Department of Geriatric MedicineAll India Institute of Medical SciencesNew DelhiIndia
| | | | - Maroof Ahmad Khan
- Department of BiostatisticsAll India Institute of Medical SciencesNew DelhiIndia
| | - Sujata Satapathy
- Department of PsychiatryAll India Institute of Medical SciencesNew DelhiIndia
| | - Avinash Chakrawarty
- Department of Geriatric MedicineAll India Institute of Medical SciencesNew DelhiIndia
| | - Nidhi Soni
- Department of Geriatric MedicineAll India Institute of Medical SciencesNew DelhiIndia
| | - Pramod Kumar
- Department of Geriatric MedicineAll India Institute of Medical SciencesNew DelhiIndia
| | - Prasun Chatterjee
- Department of Geriatric MedicineAll India Institute of Medical SciencesNew DelhiIndia
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Rajabli F, Seixas AA, Akgun B, Adams LD, Inciute J, Hamilton KL, Whithead PG, Konidari I, Gu T, Arvizu J, Golightly CG, Starks TD, Laux R, Byrd GS, Haines JL, Beecham GW, Griswold AJ, Vance JM, Cuccaro ML, Pericak-Vance MA. African Ancestry Individuals with Higher Educational Attainment Are Resilient to Alzheimer's Disease Measured by pTau181. J Alzheimers Dis 2024; 98:221-229. [PMID: 38393909 PMCID: PMC11091636 DOI: 10.3233/jad-231116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2023] [Indexed: 02/25/2024]
Abstract
Background Cognitive and functional abilities in individuals with Alzheimer's disease (AD) pathology (ADP) are highly variable. Factors contributing to this variability are not well understood. Previous research indicates that higher educational attainment (EA) correlates with reduced cognitive impairments among those with ADP. While cognitive and functional impairments are correlated, they are distinguishable in their manifestations. Objective To investigate whether levels of education are associated with functional impairments among those with ADP. Methods This research involved 410 African American (AA) individuals (Institutional Review Boards 20070307, 01/27/2023) to ascertain whether EA correlates with functional resilience and if this effect varies between APOE ɛ4 carriers and non-carriers. Utilizing EA as a cognitive reserve proxy, CDR-FUNC as a functional difficulties measure, and blood pTau181 as an ADP proxy, the non-parametric Mann-Whitney U test assessed the relationship between EA and CDR-FUNC in individuals with advanced pTau181 levels. Results The results showed that EA correlated with functional difficulties in AA individuals with high levels of pTau181, such that individuals with high EA are more likely to have better functional ability compared to those with lower EA (W = 730.5, p = 0.0007). Additionally, we found that the effect of high EA on functional resilience was stronger in ɛ4 non-carriers compared to ɛ4 carriers (W = 555.5, p = 0.022). Conclusion This study extends the role of cognitive reserve and EA to functional performance showing that cognitive reserve influences the association between ADP burden and functional difficulties. Interestingly, this protective effect seems less pronounced in carriers of the strong genetic risk allele ɛ4.
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Affiliation(s)
- Farid Rajabli
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Human Genetics, Dr. John T. Macdonald Foundation, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Azizi A. Seixas
- Department of Informatics and Health Data Science, Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Bilcag Akgun
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Larry D. Adams
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jovita Inciute
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Kara L. Hamilton
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Patrice G. Whithead
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ioanna Konidari
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Tianjie Gu
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jamie Arvizu
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Charles G. Golightly
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Takiyah D. Starks
- Maya Angelou Center for Health Equity, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Renee Laux
- Department of Population and Quantitative Health Sciences, Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA, USA
| | - Goldie S. Byrd
- Maya Angelou Center for Health Equity, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Jonathan L. Haines
- Department of Population and Quantitative Health Sciences, Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA, USA
| | - Gary W. Beecham
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Human Genetics, Dr. John T. Macdonald Foundation, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Anthony J. Griswold
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Human Genetics, Dr. John T. Macdonald Foundation, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jeffery M. Vance
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Human Genetics, Dr. John T. Macdonald Foundation, Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Michael L. Cuccaro
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Human Genetics, Dr. John T. Macdonald Foundation, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Margaret A. Pericak-Vance
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Human Genetics, Dr. John T. Macdonald Foundation, Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
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Scholz MP, Donders J. Cognitive complaints in older adults: relationships between self and informant report, objective test performance, and symptoms of depression. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:263-278. [PMID: 36345862 DOI: 10.1080/13825585.2022.2144617] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 11/01/2022] [Indexed: 11/10/2022]
Abstract
This study explored the relationships between objective measures of cognitive functioning, self and informant reports of cognitive problems in daily life, and depression screening in older adults who had been referred because of reported or suspected cognitive changes. We used archival data from 100, predominantly White (97%), typically educated (M = 13.25 years), older adults (M = 70.38 years) who received an outpatient neuropsychological evaluation. We characterized the cognitive performance using the CVLT-II Total score. We characterized patient and collateral reports using the BRIEF-A MI index, a normed scale of cognitive problems in daily life. We also incorporated a depression screener (PHQ-9) into our analyses. Multiple linear regression analysis revealed that only the informant reported problems in daily life, using the BRIEF-A MI index, was a significant predictor of objective cognitive deficits, as defined by CVLT-II Total scores. Self BRIEF-A MI index scores were not significant predictors of CVLT-II Total performance after we accounted for depression using the patient's PHQ-9 score. Additionally, elevated depression widened the discrepancy between raters, with elevated depression associated with worsening sself-report scores compared to informant-reported scores. As informant-reported problems were the strongest predictor of cognitive deficits, we recommend routine collection of collateral informant reports in the neuropsychological evaluation of older adults referred for cognitive concerns. We also recommend incorporating self-ratings of daily life functioning and screening for depression to contextualize patient complaints and address their concerns, even in the absence of objective cognitive dysfunction.
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Affiliation(s)
- Michael P Scholz
- Psychology Department, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Jacobus Donders
- Psychology Department, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
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Amaral-Carvalho V, Bento Lima-Silva T, Inácio Mariano L, Cruz de Souza L, Cerqueira Guimarães H, Santoro Bahia V, Nitrini R, Tonidandel Barbosa M, Sanches Yassuda M, Caramelli P. Improved Accuracy of the Addenbrooke's Cognitive Examination-Revised in the Diagnosis of Mild Cognitive Impairment, Mild Dementia Due to Alzheimer's Disease and Behavioral Variant Frontotemporal Dementia Using Mokken Scale Analysis. J Alzheimers Dis 2024; 100:S45-S55. [PMID: 39031367 DOI: 10.3233/jad-240554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
Background The Addenbrooke's Cognitive Examination-Revised (ACE-R) is an accessible cognitive tool that supports the early detection of mild cognitive impairment (MCI), Alzheimer's disease (AD), and behavioral variant frontotemporal dementia (bvFTD). Objective To investigate the diagnostic efficacy of the ACE-R in MCI, AD, and bvFTD through the identification of novel coefficients for differentiation between these diseases. Methods We assessed 387 individuals: 102 mild AD, 37 mild bvFTD, 87 with amnestic MCI patients, and 161 cognitively unimpaired controls. The Mokken scaling technique facilitated the extraction out of the 26 ACE-R items that exhibited a common latent trait, thereby generating the Mokken scales for the AD group and the MCI group. Subsequently, we performed logistic regression, integrating each Mokken scales with sociodemographic factors, to differentiate between AD and bvFTD, as well as between AD or MCI and control groups. Ultimately, the Receiver Operating Characteristic curve analysis was employed to assess the efficacy of the coefficient's discrimination. Results The AD-specific Mokken scale (AD-MokACE-R) versus bvFTD exhibited an Area Under the Curve (AUC) of 0.922 (88% sensitivity and specificity). The AD-MokACE-R versus controls achieved an AUC of 0.968 (93% sensitivity, 94% specificity). The MCI-specific scale (MCI-MokACE-R) versus controls demonstrated an AUC of 0.859 (78% sensitivity, 79% specificity). Conclusions The ACE-R's capacity is enhanced through statistical methods and demographic integration, allowing for accurate differentiation between AD and bvFTD, as well as between MCI and controls. This new method not only reinforces its clinical value in early diagnosis but also surpasses traditional approaches noted in prior studies.
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Affiliation(s)
- Viviane Amaral-Carvalho
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thais Bento Lima-Silva
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Escola de Artes, Ciências e Humanidades da Universidade de São Paulo, São Paulo, Brazil
| | - Luciano Inácio Mariano
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Leonardo Cruz de Souza
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Valéria Santoro Bahia
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ricardo Nitrini
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Mônica Sanches Yassuda
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Escola de Artes, Ciências e Humanidades da Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Caramelli
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Soh Y, Whitmer RA, Mayeda ER, Glymour MM, Eng CW, Peterson RL, George KM, Chen R, Quesenberry CP, Mungas DM, DeCarli CS, Gilsanz P. Timing and level of educational attainment and late-life cognition in the KHANDLE study. Alzheimers Dement 2024; 20:593-600. [PMID: 37751937 PMCID: PMC10842991 DOI: 10.1002/alz.13475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/07/2023] [Accepted: 08/23/2023] [Indexed: 09/28/2023]
Abstract
INTRODUCTION The timing of educational attainment may modify its effects on late-life cognition, yet most studies evaluate education only at a single time point. METHODS Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study cohort participants (N = 554) reported educational attainment (dichotomized at any college education) at two time points, and we classified them as having low, high, or later-life high educational attainment. Linear mixed-effects models estimated associations between educational attainment change groups and domain-specific cognitive outcomes (z-standardized). RESULTS Compared to low educational attainment, high (β= 0.59 SD units; 95% confidence interval [CI]: 0.39, 0.79) and later-life high educational attainment (β = 0.22; 95% CI: 0.00, 0.44) were associated with higher executive function. Only high educational attainment was associated with higher verbal episodic memory (β = 0.27; 95% CI: 0.06, 0.48). DISCUSSION Level and timing of educational attainment are both associated with domain-specific cognition. A single assessment for educational attainment may inadequately characterize protective associations with late-life cognition. HIGHLIGHTS Few studies have examined both level and timing of educational attainment on cognition. Marginalized populations are more likely to attain higher education in adulthood. Higher educational attainment in late life is also associated with higher cognition.
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Affiliation(s)
- Yenee Soh
- Kaiser Permanente Division of ResearchOaklandCaliforniaUSA
| | - Rachel A. Whitmer
- Kaiser Permanente Division of ResearchOaklandCaliforniaUSA
- Department of NeurologySchool of MedicineUniversity of CaliforniaDavisCaliforniaUSA
- Department of Public Health SciencesUniversity of CaliforniaDavisCaliforniaUSA
| | - Elizabeth Rose Mayeda
- Department of EpidemiologyUniversity of California, Los Angeles Fielding School of Public HealthLos AngelesCaliforniaUSA
| | - M. Maria Glymour
- Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Chloe W. Eng
- Department of Epidemiology and Population HealthStanford UniversityStanfordCaliforniaUSA
| | - Rachel L. Peterson
- School of Public and Community Health SciencesUniversity of MontanaMissoulaMontanaUSA
| | - Kristen M. George
- Department of Public Health SciencesUniversity of CaliforniaDavisCaliforniaUSA
| | - Ruijia Chen
- Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | | | - Dan M. Mungas
- Department of NeurologySchool of MedicineUniversity of CaliforniaDavisCaliforniaUSA
| | - Charles S. DeCarli
- Department of NeurologySchool of MedicineUniversity of CaliforniaDavisCaliforniaUSA
| | - Paola Gilsanz
- Kaiser Permanente Division of ResearchOaklandCaliforniaUSA
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Carrión CI, Rivera D, Forte A, Olabarrieta-Landa L, Moreno O, Usuga DR, Morel Valdés GM, López M, Rodriguez MJ, Lequerica AH, Drago CI, García P, Rivera PM, Perrin PB, Arango-Lasprilla JC. Attention and processing speed tests: Normative data for Spanish-speaking adults in the United States. NeuroRehabilitation 2024; 55:169-182. [PMID: 39331117 DOI: 10.3233/nre-240086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2024]
Abstract
BACKGROUND Hispanics/Latinos are the largest racial/ethnic group among underrepresented populations in the U.S. and multiple sociodemographic, cultural, and linguistic factors have been found to impact their performances on cognitive testing. Despite this, few normative data are available for the heterogeneous Spanish-speaking population in the U.S. OBJECTIVE To generate normative data on the Trail-Making Test (TMT), Bells Test, Symbol-Digit Modalities Test (SDMT), and the Brief Test of Attention (BTA) for Spanish speakers residing in the U.S. METHODS The sample included 245 Spanish-speaking individuals aged 18- 80 from eight states across the U.S. (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin). Participants were administered attention and processing speed measures as part of a comprehensive neuropsychological battery. We used a Bayesian regression approach to estimate normative data, including covariates found to be important for predicting performances on measures of attention and processing speed. RESULTS Sociodemographic factors including education, time in the U.S., acculturation, age, and/or sex had differential effects on the TMT-A, TMT-B, SDMT, and the BTA whereas the Bells Test was not influenced by any of these sociodemographic factors. CONCLUSION Our findings indicate that while sex, age, and educational attainment are important factors to consider, language and acculturation can also influence attention and processing speed performances among Spanish speakers in the U.S.
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Affiliation(s)
- Carmen I Carrión
- Department of Neurology, School of Medicine, Yale University, New Haven, CT, USA
| | - Diego Rivera
- Department of Health Science, Public University of Navarre, Pamplona, Spain
- Instituto de Investigacióanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Anabel Forte
- Department of Statistics and Operations Research, University of Valencia, Valencia, Spain
| | - Laiene Olabarrieta-Landa
- Department of Health Science, Public University of Navarre, Pamplona, Spain
- Instituto de Investigacióanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Oswaldo Moreno
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Daniela Ramos Usuga
- Biomedical Research Doctorate Program, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Gloria M Morel Valdés
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Miriam J Rodriguez
- Clinical Psychology Program, Carlos Albizu University, Miami Campus, Miami, FL, USA
- Department of Health and Wellness Design, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Anthony H Lequerica
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | | | - Patricia García
- Department of Neurology, School of Medicine, Indiana University, Indianapolis, IN, USA
- Department of Physical Medicine and Rehabilitation, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Patricia M Rivera
- Mental Health Department - Neuropsychology, Kaiser Permanente Northwest, Portland, OR, USA
| | - Paul B Perrin
- School of Data Science, University of Virginia, Charlottesville, VA, USA
- Department of Psychology, University of Virginia, Charlottesville, VA, USA
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Tomás AM, Bento-Torres NVO, Jardim NYV, Moraes PM, da Costa VO, Modesto AC, Khayat AS, Bento-Torres J, Picanço-Diniz CW. Risk Polymorphisms of FNDC5, BDNF, and NTRK2 and Poor Education Interact and Aggravate Age-Related Cognitive Decline. Int J Mol Sci 2023; 24:17210. [PMID: 38139046 PMCID: PMC10743741 DOI: 10.3390/ijms242417210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/07/2023] [Accepted: 11/17/2023] [Indexed: 12/24/2023] Open
Abstract
Cognitive abilities tend to decline with aging, with variation between individuals, and many studies seek to identify genetic biomarkers that more accurately anticipate risks related to pathological aging. We investigated the influence of BDNF, NTRK2, and FNDC5 single nucleotide polymorphisms (SNPs) on the cognitive performance of young and older adults with contrasting educational backgrounds. We addressed three questions: (1) Is education associated with reduced age-related cognitive decline? (2) Does the presence of SNPs explain the variation in cognitive performance observed late in life? (3) Is education differentially associated with cognition based on the presence of BDNF, NTRK2, or FNDC5 polymorphisms? We measured the cognitive functions of young and older participants, with lower and higher education, using specific and sensitive tests of the Cambridge Automated Neuropsychological Test Assessment Battery. A three-way ANOVA revealed that SNPs were associated with differential performances in executive functions, episodic memory, sustained attention, mental and motor response speed, and visual recognition memory and that higher educational levels improved the affected cognitive functions. The results revealed that distinct SNPs affect cognition late in life differentially, suggesting their utility as potential biomarkers and emphasizing the importance of cognitive stimulation that advanced education early in life provides.
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Affiliation(s)
- Alessandra Mendonça Tomás
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-000, Brazil; (A.M.T.); (N.Y.V.J.); (P.M.M.); (V.O.d.C.); (J.B.-T.); (C.W.P.-D.)
- Department of Physical Education, Federal University of Pará Application School, Belém 66095-780, Brazil
| | - Natáli Valim Oliver Bento-Torres
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-000, Brazil; (A.M.T.); (N.Y.V.J.); (P.M.M.); (V.O.d.C.); (J.B.-T.); (C.W.P.-D.)
- Graduate Program in Human Movement Sciences, Federal University of Pará, Belém 66095-780, Brazil
| | - Naina Yuki Vieira Jardim
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-000, Brazil; (A.M.T.); (N.Y.V.J.); (P.M.M.); (V.O.d.C.); (J.B.-T.); (C.W.P.-D.)
- Graduate Program in Neuroscience and Cell Biology, Federal University of Pará, Belém 66050-160, Brazil
| | - Patrícia Martins Moraes
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-000, Brazil; (A.M.T.); (N.Y.V.J.); (P.M.M.); (V.O.d.C.); (J.B.-T.); (C.W.P.-D.)
- Graduate Program in Human Movement Sciences, Federal University of Pará, Belém 66095-780, Brazil
| | - Victor Oliveira da Costa
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-000, Brazil; (A.M.T.); (N.Y.V.J.); (P.M.M.); (V.O.d.C.); (J.B.-T.); (C.W.P.-D.)
- Graduate Program in Neuroscience and Cell Biology, Federal University of Pará, Belém 66050-160, Brazil
| | - Antônio Conde Modesto
- Oncology Research Center (NPO), Graduate Program in Oncology and Medical Sciences, Federal University of Pará, Belém 66073-000, Brazil; (A.C.M.); (A.S.K.)
| | - André Salim Khayat
- Oncology Research Center (NPO), Graduate Program in Oncology and Medical Sciences, Federal University of Pará, Belém 66073-000, Brazil; (A.C.M.); (A.S.K.)
| | - João Bento-Torres
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-000, Brazil; (A.M.T.); (N.Y.V.J.); (P.M.M.); (V.O.d.C.); (J.B.-T.); (C.W.P.-D.)
- Graduate Program in Human Movement Sciences, Federal University of Pará, Belém 66095-780, Brazil
| | - Cristovam Wanderley Picanço-Diniz
- Neurodegeneration and Infection Research Laboratory, Institute of Biological Science, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-000, Brazil; (A.M.T.); (N.Y.V.J.); (P.M.M.); (V.O.d.C.); (J.B.-T.); (C.W.P.-D.)
- Graduate Program in Neuroscience and Cell Biology, Federal University of Pará, Belém 66050-160, Brazil
- Oncology Research Center (NPO), Graduate Program in Oncology and Medical Sciences, Federal University of Pará, Belém 66073-000, Brazil; (A.C.M.); (A.S.K.)
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Oz M, Ozel Asliyuce Y, Demirel A, Cetin H, Ulger O. Determination of cognitive status and influencing variables in patients with chronic neck pain: A cross-sectional study. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:764-771. [PMID: 34597197 DOI: 10.1080/23279095.2021.1980795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aimed to evaluate cognitive function in individuals with chronic neck pain (CNP) and investigate the effects of different variables on cognition. METHODS The sociodemographic characteristics of the individuals who participated in this study were recorded. Pain intensity of the individuals was evaluated using the Visual Analog Scale, pain-related disability was evaluated with the Neck Disability Index and cognitive function was evaluated using Montreal Cognitive Assessment (MoCA). RESULTS For this study, 95 patients with CNP were recruited. The mean age was 45.61 ± 11.14, and the median MoCA score was 24 (20-26), and 64.2% of the patients scored below the original cutoff (<26/30 points). The regression analysis showed that higher age and lower education levels were associated with lower MoCA scores. Education appeared to be the most influential variable. Younger participants (18-45) performed systematically better on naming, attention and language domains than their older counterparts (over 45). CONCLUSIONS The findings suggest that age and education play an important role in MoCA total and domain scores in these patients. While treating these patients, assessment of cognitive function can be useful for effective pain management.
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Affiliation(s)
- Muzeyyen Oz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Yasemin Ozel Asliyuce
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Aynur Demirel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Hatice Cetin
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ozlem Ulger
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Owens J, Jones R, Marsiske M. The Effects of Occupational Complexity on Late Life Cognition in ACTIVE: Examining the Mediating and Moderating Effects of Race. J Aging Health 2023; 35:95S-106S. [PMID: 37994851 PMCID: PMC11160436 DOI: 10.1177/08982643211038837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Objectives: This article sought to determine (1) whether occupational complexity (OC) explains individual differences in cognition at baseline, (2) whether this relationship is differentially related to cognition by Black/White race, and (3) whether OC mediates some or all of the Black/White race-related variance in late life cognition. Methods: 2371 participants from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study reported longest held jobs and received OC ratings based on a factor analysis of 63 variables from the Dictionary of Occupational Titles. Results: We found that multiple dimensions of OC are related to cognition, but there were relatively few Black/White differences in these associations. Across all cognitive dimensions except for useful field of view, a history of having jobs lower in substantive complexity and fine motor skills and higher in physical demands may explain some of the Black/White race differences in elder's cognition. Discussion: We conclude that occupations can be a target to reduce social disparities in late life cognition.
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Affiliation(s)
- Joshua Owens
- Department of Clinical and Health Psychology, University of Florida
| | | | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida
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Staudt J, Kok T, de Haan HA, Walvoort SJW, Egger JIM. Neurocognitive Recovery in Abstinent Patients with Alcohol Use Disorder: A Scoping Review for Associated Factors. Neuropsychiatr Dis Treat 2023; 19:2039-2054. [PMID: 37790802 PMCID: PMC10544223 DOI: 10.2147/ndt.s424017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/25/2023] [Indexed: 10/05/2023] Open
Abstract
Objective Studies have reported inconsistent results regarding the extent to which neurocognitive recovery occurs in abstinent patients with alcohol use disorder (AUD). In addition to abstinence, other factors may have influenced this process and contributed to the inconsistencies. This review examines the factors investigated in this regard and describes the possible influence of each factor based on the evidence collected. Methodology PubMed was systematically searched for articles published between January 2000 and July 2023. Longitudinal humane studies investigating neurocognitive recovery in abstinent adult AUD patients were included. Studies with a cross-sectional design were excluded, as were studies that did not classify AUD according to the DSM-IV or 5 criteria, only examined binge use, did not report neuropsychological outcomes or duration of abstinence, or where neurological disorders were present. Results Sixteen categories of factors were distinguished from 31 full-text articles. Consistent patterns were found, indicating an association between neurocognitive recovery and the "smoking" and 'brain volume" factors. Consistent patterns were also found indicating that there is no relationship with "quantities of alcohol used" and "education level." A similar consistent pattern was also found for "polysubstance use", "gender" and "verbal reading", but the number of studies is considered limited. The association with "age" is studied frequently but with inconsistent findings. The remaining eight factors were regarded as understudied. Conclusion The clearest patterns emerging from the evidence are a predominantly negative influence of smoking on neurocognitive recovery, associations between changes in brain area volume and neurocognitive recovery, and no association between neurocognitive recovery and the amount of alcohol consumed, as measured by self-report, nor with educational attainment. Future research on the understudied factors and factors with inconsistent evidence is needed, preferably through longitudinal designs with multiple assessment periods starting after at least two weeks of abstinence.
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Affiliation(s)
- Jeroen Staudt
- Tactus Addiction Treatment, Deventer, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Tim Kok
- Tactus Addiction Treatment, Deventer, the Netherlands
| | - Hein A de Haan
- Tactus Addiction Treatment, Deventer, the Netherlands
- Nijmegen Institute for Scientist Practitioners in Addiction, Radboud University, Nijmegen, the Netherlands
| | | | - Jos I M Egger
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
- Centre of Excellence for Korsakoff and Alcohol Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
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Smit AP, Beran M, Twait EL, Geerlings MI, Vonk JMJ. Bear in mind: the role of personal background in semantic animal fluency - The SMART-MR study. Front Psychol 2023; 14:1227053. [PMID: 37809288 PMCID: PMC10556661 DOI: 10.3389/fpsyg.2023.1227053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives Semantic fluency is a prominent neuropsychological task, typically administered within the category 'animals'. With the increasing development of novel item-level metrics of semantic fluency, a concern around the validity of item-level analyses could be that personal background factors (e.g., hobbies like birdwatching or fishing) may disproportionally influence performance. We analyzed animal fluency performance at the item level and investigated the prevalence of individuals with abundant knowledge in specific classes of animals (e.g., birds, fish, insects) and the relationship of such knowledge with personal background factors and other cognitive tasks (episodic memory and executive functioning). Method Participants included 736 Dutch middle-aged to older adults from the SMART-MR cohort (mean age 58 ± 9.4 years, 18% women). Individuals were asked to name as many animals as possible for 2 min. Number of people with abundant animal class knowledge was calculated for the ability to recall a series of minimum ≥5 and up to ≥15 animals within a specific class with at most one interruption by an animal from another class. Subsequent analyses to investigate relationships of abundant class knowledge with sociodemographic characteristics (t-tests and chi-square tests) and cognitive performance (linear regressions) were performed for a cut-off of ≥10 animals within a specific class (90th percentile), with a sensitivity analysis for ≥7 animals (67th percentile). Results A total of 416 (56.2%) participants recalled a series of ≥5 animals from a specific class, 245 (33.3%) participants recalled ≥7, 78 (10.6%) participants recalled ≥10, and 8 (1.1%) participants recalled ≥15. Those who recalled a series of at least 10 animals within a class were older, more often men, and more often retired than those who did not. Moreover, they had a higher total score on animal fluency, letter fluency (i.e., executive functioning), and episodic memory tasks compared to those who did not. Discussion Our results suggest that the benefit of abundant animal class knowledge gained by personal background does not disproportionally influence animal fluency performance as individuals with such knowledge also performed better on other cognitive tasks unrelated to abundant knowledge of animal classes.
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Affiliation(s)
- Annelot P Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
| | - Magdalena Beran
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
| | - Emma L Twait
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
- Amsterdam UMC, Department of General Practice, Vrije Universiteit, Amsterdam, Netherlands
- Research Institute Amsterdam Public Health, Research Programme Aging and Later Life, and Research Programme Personalized Medicine, Amsterdam, Netherlands
- Research Institute Amsterdam Neuroscience, Research Programme Neurodegeneration, and Research Programme Mood, Anxiety, Psychosis, Stress, and Sleep, Amsterdam, Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
- Research Institute Amsterdam Public Health, Research Programme Aging and Later Life, and Research Programme Personalized Medicine, Amsterdam, Netherlands
- Research Institute Amsterdam Neuroscience, Research Programme Neurodegeneration, and Research Programme Mood, Anxiety, Psychosis, Stress, and Sleep, Amsterdam, Netherlands
- Amsterdam UMC, Department of General Practice, University of Amsterdam, Amsterdam, Netherlands
| | - Jet M J Vonk
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, CA, United States
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Towfighi A, Berger RP, Corley AMS, Glymour MM, Manly JJ, Skolarus LE. Recommendations on Social Determinants of Health in Neurologic Disease. Neurology 2023; 101:S17-S26. [PMID: 37580147 DOI: 10.1212/wnl.0000000000207562] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 05/09/2023] [Indexed: 08/16/2023] Open
Abstract
Social determinants of health (SDOH) are increasingly recognized as important drivers of inequities in neurologic disease and outcomes. However, our understanding of the biopsychosocial mechanisms by which SDOH affect neurologic disease remains in its infancy. The most robust epidemiologic research has been on the associations between education, schooling, and place-based social determinants on cognition, dementia, and cerebrovascular disease later in life. Further research is needed to more deeply understand the complex interplay of SDOH on neurologic disease. Few SDOH screening tools have been validated in populations with neurologic disease. In addition, comparison across studies and populations is hampered by lack of standardized common data elements. Experiences of populations historically underrepresented in research should be centered in future research studies, and changes should be made in recruitment expectations and measurement choices. For research on inequities, it is critical to support and incentivize institutional infrastructure to foster meaningful engagement with populations affected by research. Finally, it remains to be seen whether individual-level health or behavioral interventions or place-level, systemic or policy interventions to reduce population burden will be most effective in reducing inequities in neurologic disease and outcomes. Although numerous clinical trials have focused on addressing downstream SDOH such as health literacy and health behaviors (e.g., medication adherence, physical activity, diet), few have addressed upstream, structural determinants which may have a more profound impact on addressing inequities in neurologic disease. Ultimately, further research is needed to determine which specific SDOH should be targeted and how, when, and by whom they should be addressed to improve neurologic outcomes.
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Affiliation(s)
- Amytis Towfighi
- From the Departments of Neurology and Population and Public Health Sciences (A.T.), University of Southern California, Los Angeles; Department of Pediatrics (R.P.B.), Children's Hospital of Pittsburgh, University of Pittsburg Medical Center (UPMC), PA; Division of General and Community Pediatrics (A.M.S.C.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; The Center for Health and Community (M.M.G.), University of California, San Francisco; Department of Neurology (J.J.M.), Vagelos College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology (L.S.), Northwestern University, Chicago, IL.
| | - Rachel P Berger
- From the Departments of Neurology and Population and Public Health Sciences (A.T.), University of Southern California, Los Angeles; Department of Pediatrics (R.P.B.), Children's Hospital of Pittsburgh, University of Pittsburg Medical Center (UPMC), PA; Division of General and Community Pediatrics (A.M.S.C.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; The Center for Health and Community (M.M.G.), University of California, San Francisco; Department of Neurology (J.J.M.), Vagelos College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology (L.S.), Northwestern University, Chicago, IL
| | - Alexandra M S Corley
- From the Departments of Neurology and Population and Public Health Sciences (A.T.), University of Southern California, Los Angeles; Department of Pediatrics (R.P.B.), Children's Hospital of Pittsburgh, University of Pittsburg Medical Center (UPMC), PA; Division of General and Community Pediatrics (A.M.S.C.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; The Center for Health and Community (M.M.G.), University of California, San Francisco; Department of Neurology (J.J.M.), Vagelos College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology (L.S.), Northwestern University, Chicago, IL
| | - M Maria Glymour
- From the Departments of Neurology and Population and Public Health Sciences (A.T.), University of Southern California, Los Angeles; Department of Pediatrics (R.P.B.), Children's Hospital of Pittsburgh, University of Pittsburg Medical Center (UPMC), PA; Division of General and Community Pediatrics (A.M.S.C.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; The Center for Health and Community (M.M.G.), University of California, San Francisco; Department of Neurology (J.J.M.), Vagelos College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology (L.S.), Northwestern University, Chicago, IL
| | - Jennifer J Manly
- From the Departments of Neurology and Population and Public Health Sciences (A.T.), University of Southern California, Los Angeles; Department of Pediatrics (R.P.B.), Children's Hospital of Pittsburgh, University of Pittsburg Medical Center (UPMC), PA; Division of General and Community Pediatrics (A.M.S.C.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; The Center for Health and Community (M.M.G.), University of California, San Francisco; Department of Neurology (J.J.M.), Vagelos College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology (L.S.), Northwestern University, Chicago, IL
| | - Lesli E Skolarus
- From the Departments of Neurology and Population and Public Health Sciences (A.T.), University of Southern California, Los Angeles; Department of Pediatrics (R.P.B.), Children's Hospital of Pittsburgh, University of Pittsburg Medical Center (UPMC), PA; Division of General and Community Pediatrics (A.M.S.C.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; The Center for Health and Community (M.M.G.), University of California, San Francisco; Department of Neurology (J.J.M.), Vagelos College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology (L.S.), Northwestern University, Chicago, IL
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Rajabli F, Seixas AA, Akgun B, Adams LD, Inciute J, Starks T, Laux R, Byrd GS, Haines JL, Beecham GW, Vance JM, Cuccaro ML, Pericak-Vance MA. African ancestry APOE e4 non-carriers with higher educational attainment are resilient to Alzheimer disease pathology-specific blood biomarker pTau181. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.06.23292263. [PMID: 37461667 PMCID: PMC10350130 DOI: 10.1101/2023.07.06.23292263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Cognitive and functional abilities in individuals with Alzheimer disease (AD) pathology (ADP) show greater than expected variability. While most individuals show substantial impairments in these abilities, a considerable number show little or no impairments. Factors contributing to this variability are not well understood. For instance, multiple studies have shown that higher levels of education are associated with reduced cognitive impairments among those with ADP. However, it remains unclear whether higher levels of education are associated with functional impairments among those with ADP. We studied 410 AA individuals with advanced levels of pTau181 (a biomarker for ADP; individuals as those having log 10 (pTau181) level greater than one standard deviation above the mean) to determine whether EA (categorized as low EA for individuals with ≤ 8 years of education and high EA for those with >8 years) promotes functional resilience and whether this effect varies between APOE ε4 carriers and non-carriers. We used the four non-memory components of the Clinical Dementia Rating (CDR) to create a composite score (CDR-FUNC) to evaluate functional difficulties (scored from 0=no impairment to 12=severe). We employed the non-parametric Mann-Whitney U test to assess the relationship between EA and CDR-FUNC in advanced levels of pTau181 individuals. The results showed that EA promotes resilience to functional problems in AA individuals with advanced levels of pTau181, such that individuals with high EA are more likely to have better functional ability compared to those with lower EA (W=730.5, p=0.0007). Additionally, we found that the effect of high EA on functional resilience was stronger in ε4 non-carriers compared to ε4 carriers (W=555.5, p=0.022). This study extends the role of cognitive reserve and EA to functional performance showing that cognitive reserve influences the association between ADP burden and functional difficulties. Interestingly, this protective effect seems less pronounced in carriers of the strong genetic risk allele ε4. The results highlight the intricate interplay of genetic and non-genetic factors in AD progression, suggesting a need for more personalized strategies to manage functional decline in AD.
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Gonçalves NG, Avila JC, Bertola L, Obregón AM, Ferri CP, Wong R, Suemoto CK. Education and cognitive function among older adults in Brazil and Mexico. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12470. [PMID: 37771429 PMCID: PMC10523452 DOI: 10.1002/dad2.12470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/06/2023] [Accepted: 07/31/2023] [Indexed: 09/30/2023]
Abstract
Education is protective against cognitive impairment. We used nationally representative data from Mexico and Brazil to assess the association between education and cognitive function. The sample included adults ≥ 50 years from the Brazilian Longitudinal Study of Aging (ELSI) and the Mexican Health and Aging Study (MHAS). Participants were classified as cognitively impaired or not impaired. We used logistic regression models to estimate the association between education and cognitive function. Education level was higher in MHAS than in ELSI. Participants with at least 1 year of education were less likely to have cognitive impairment than those with no formal education in both cohorts. Men in ELSI had higher odds for cognitive impairment compared to men in MHAS. In both cohorts, higher educational level was associated with lower odds of cognitive impairment compared to no formal education. Sex was an effect modifier in MHAS but not in ELSI. HIGHLIGHTS Cognitive test batteries were harmonized using a regression-based approach.Even very low levels of education were associated with reduced odds of cognitive impairment compared to no formal education.Brazilians were more likely to have cognitive impairment than Mexicans given the same education level.The differences in the association of education with cognition between Brazil and Mexico were only observed among men.
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Affiliation(s)
| | | | - Laiss Bertola
- Department of PsychiatryFederal University of São Paulo, São PaoloSão PauloBrazil
| | | | | | - Rebeca Wong
- Sealy Center on AgingUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Claudia Kimie Suemoto
- Division of GeriatricsUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
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Lövdén M, Pagin A, Bartrés-Faz D, Boraxbekk CJ, Brandmaier AM, Demnitz N, Drevon CA, Ebmeier KP, Fjell AM, Ghisletta P, Gorbach T, Lindenberger U, Plachti A, Walhovd KB, Nyberg L. No moderating influence of education on the association between changes in hippocampus volume and memory performance in aging. AGING BRAIN 2023; 4:100082. [PMID: 37457634 PMCID: PMC10338350 DOI: 10.1016/j.nbas.2023.100082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023] Open
Abstract
Contemporary accounts of factors that may modify the risk for age-related neurocognitive disorders highlight education and its contribution to a cognitive reserve. By this view, individuals with higher educational attainment should show weaker associations between changes in brain and cognition than individuals with lower educational attainment. We tested this prediction in longitudinal data on hippocampus volume and episodic memory from 708 middle-aged and older individuals using local structural equation modeling. This technique does not require categorization of years of education and does not constrain the shape of relationships, thereby maximizing the chances of revealing an effect of education on the hippocampus-memory association. The results showed that the data were plausible under the assumption that there was no influence of education on the association between change in episodic memory and change in hippocampus volume. Restricting the sample to individuals with elevated genetic risk for dementia (APOE ε4 carriers) did not change these results. We conclude that the influence of education on changes in episodic memory and hippocampus volume is inconsistent with predictions by the cognitive reserve theory.
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Affiliation(s)
- Martin Lövdén
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Amos Pagin
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - David Bartrés-Faz
- Department of Medicine, Faculty of Medicine and Health Sciences and Institute of Neurosciences, University of Barcelona, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Carl-Johan Boraxbekk
- Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
- Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital – Amager and Hvidovre, Copenhagen, Denmark
- Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Institute of Sports Medicine Copenhagen (ISMC) and Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Andreas M. Brandmaier
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - Naiara Demnitz
- Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital – Amager and Hvidovre, Copenhagen, Denmark
| | - Christian A. Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo & Vitas AS, Oslo Science Park, Norway
| | - Klaus P. Ebmeier
- Department of Psychiatry, Warneford Hospital, University of Oxford, UK
| | - Anders M. Fjell
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, POB 1094, 0317 Oslo, Norway
- ComputationalRadiology and Artificial Intelligence, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Norway
| | - Paolo Ghisletta
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland
- Faculty of Psychology, UniDistance Suisse, Brig, Switzerland
| | - Tetiana Gorbach
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - Ulman Lindenberger
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
| | - Anna Plachti
- Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital – Amager and Hvidovre, Copenhagen, Denmark
| | - Kristine B. Walhovd
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, POB 1094, 0317 Oslo, Norway
- ComputationalRadiology and Artificial Intelligence, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Norway
| | - Lars Nyberg
- Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland
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Valsdóttir V, Magnúsdóttir BB, Gylfason HF, Chang M, Aspelund T, Gudnason V, Launer LJ, Jónsdóttir MK. Exposure factors associated with dementia among older adults in Iceland: the AGES-Reykjavik study. GeroScience 2023:10.1007/s11357-023-00804-7. [PMID: 37160657 PMCID: PMC10400491 DOI: 10.1007/s11357-023-00804-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/20/2023] [Indexed: 05/11/2023] Open
Abstract
The study aimed to assess whether factors related to cognitive performance were associated with the development of dementia. Additionally, the study aimed to establish whether cognitive performance at baseline or change in cognition between baseline and follow-up (five-year period) had a stronger association with whether an individual would fulfill a dementia criterion at follow-up. The data was collected from 2002 to 2011. Logistic regression was applied to the AGES-Reykjavik Study epidemiological data. The analysis, which builds upon previous data analyses of the same dataset, included 1,491 participants between the ages of 66 and 90. All those included were considered to have normal cognition at baseline; 8.2% (n = 123) of them fulfilled a dementia criterion at follow-up five years later. The study's results indicated that being high on cognitive reserve factors reduced the risk of developing dementia. Compared to other known dementia risk factors, cognitive reserve factors (education level, participation in leisure activities, and self-reported health) were more likely than others to have an association with dementia. Additionally, the study's findings showed that cognitive performance at baseline, rather than change in cognition between baseline and follow-up five years later, had a stronger association with dementia at the follow-up assessment. Together, these findings support the notion that promoting high cognitive reserve throughout the lifespan and reaching high cognitive performance is important in reducing dementia risk.
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Affiliation(s)
- Vaka Valsdóttir
- Department of Psychology, Reykjavik University, Menntavegur 1, 102, Reykjavik, Iceland.
- RHLÖ - Icelandic Gerontological Research Center, Landspítali University Hospital, Reykjavik, Iceland.
| | - Brynja Björk Magnúsdóttir
- Department of Psychology, Reykjavik University, Menntavegur 1, 102, Reykjavik, Iceland
- Mental Health Services, Landspitali University Hospital, Reykjavik, Iceland
| | | | - Milan Chang
- RHLÖ - Icelandic Gerontological Research Center, Landspítali University Hospital, Reykjavik, Iceland
| | - Thor Aspelund
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- The Icelandic Heart Association, Kopavogur, Iceland
| | - Vilmundur Gudnason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- The Icelandic Heart Association, Kopavogur, Iceland
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, National Institutes of Health (NIH), Bethesda, MD, USA
| | - María K Jónsdóttir
- Department of Psychology, Reykjavik University, Menntavegur 1, 102, Reykjavik, Iceland
- Mental Health Services, Landspitali University Hospital, Reykjavik, Iceland
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Jin Y, Lin L, Xiong M, Sun S, Wu SC. Moderating effects of cognitive reserve on the relationship between brain structure and cognitive abilities in middle-aged and older adults. Neurobiol Aging 2023; 128:49-64. [PMID: 37163923 DOI: 10.1016/j.neurobiolaging.2023.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 05/12/2023]
Abstract
The cognitive reserve (CR) hypothesis is reinforced by negative moderating effects, suggesting that those with higher CR are less reliant on brain structure for cognitive function. Previous research on CR's moderating effects yielded inconsistent results, motivating our 3 studies using UK Biobank data. Study I examined five CR proxies' moderating effects on global, lobar, and regional brain-cognition models; study II extended study I by using a larger sample size; and study III investigated age-related moderating effects on the hippocampal regions. In study I, most moderating effects were negative and none survived the multiple comparison correction, but study II identified 13 global-level models with significant negative moderating effects that survived correction. Study III showed age influenced CR proxies' moderating effects in hippocampal regions. Our findings suggest that the effects of CR proxies on brain integrity and cognition varied depending on the proxy used, brain integrity indicators, cognitive domain, and age group. This study offers significant insights regarding the importance of CR for brain integrity and cognitive outcomes.
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Affiliation(s)
- Yue Jin
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Lan Lin
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China.
| | - Min Xiong
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Shen Sun
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Shui-Cai Wu
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
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Eraslan Boz H, Kırkım G, Koçoğlu K, Çakır Çetin A, Akkoyun M, Güneri EA, Akdal G. Cognitive function in Meniere's disease. PSYCHOL HEALTH MED 2023; 28:1076-1086. [PMID: 36369758 DOI: 10.1080/13548506.2022.2144637] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Meniere's disease is an otological disease characterized by various symptoms that include episodic peripheral vertigo, sensorineural hearing loss, tinnitus, and aural fullness, all of which deteriorate the maintenance of daily activities. We aimed to investigate cognitive function in Meniere's disease patients and compare their results to those of healthy controls. Eighteen patients diagnosed with definite Meniere's disease without any psychiatric, neurological or otological comorbidity, and 30 healthy controls with normal cognitive functions were included in the study. General cognitive status, attention, verbal memory, visual memory, executive and visuospatial function were measured by detailed neuropsychological tests in both groups. In the patients with Meniere's disease, pure-tone hearing thresholds, and speech discrimination scores were also measured. Patients with Meniere's disease showed lower levels of performance in the trail making test, Oktem verbal memory processes, Rey Complex Figure Test, Wisconsin Card Sorting Test, semantic and phonemic fluency than did healthy controls. In other words, there were deficits in attention, recognition and recall in verbal memory, recall in visual memory, visual spatial construction, and planning skills in patients with Meniere's disease. Education years and depression scores of participants had a significant effect on cognitive function in all groups. This study is an update and confirmation of the findings of studies showing cognitive impairment in patients with Meniere's disease. In addition to previous findings, this study found a decrease in executive function performance in patients with Meniere's disease compared to healthy controls. Unlike previous studies, this study comprehensively addressed all cognitive functions and included a control group. Our results emphasize that executive functions, which are high-level cognitive processes, may affect the compliance of patients with Meniere's disease treatment and follow-up processes.
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Affiliation(s)
- Hatice Eraslan Boz
- Department of Neurology, Unit of Neuropsychology, Dokuz Eylul University School of Medicine, Izmir, Türkiye.,Department of Neurosciences, Dokuz Eylul University, Institute of Health Sciences, Izmir, Türkiye
| | - Günay Kırkım
- Department of Otolaryngology, Unit of Hearing Speech and Balance, Dokuz Eylul University School of Medicine, Izmir, Türkiye
| | - Koray Koçoğlu
- Department of Neurosciences, Dokuz Eylul University, Institute of Health Sciences, Izmir, Türkiye
| | - Aslı Çakır Çetin
- Department of Otolaryngology, Dokuz Eylul University School of Medicine, Izmir, Türkiye
| | - Müge Akkoyun
- Department of Neurosciences, Dokuz Eylul University, Institute of Health Sciences, Izmir, Türkiye
| | - Enis Alpin Güneri
- Department of Otolaryngology, Dokuz Eylul University School of Medicine, Izmir, Türkiye
| | - Gülden Akdal
- Department of Neurosciences, Dokuz Eylul University, Institute of Health Sciences, Izmir, Türkiye.,Department of Neurology, Dokuz Eylul University School of Medicine, Izmir, Türkiye
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Sala G, Nishita Y, Tange C, Tomida M, Gondo Y, Shimokata H, Otsuka R. No Appreciable Effect of Education on Aging-Associated Declines in Cognition: A 20-Year Follow-Up Study. Psychol Sci 2023; 34:527-536. [PMID: 36962950 DOI: 10.1177/09567976231156793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2023] Open
Abstract
Education has been claimed to reduce aging-associated declines in cognitive function. Given its societal relevance, considerable resources have been devoted to this research. However, because of the difficulty of detecting modest rates of change, findings have been mixed. These discrepancies may stem from methodological shortcomings such as short time spans, few waves, and small samples. The present study overcame these limitations (N = 1,892, nine waves over a period of 20 years). We tested the effect of education level on baseline performance (intercept) and the rate of change (slope) in crystallized and fluid cognitive abilities (gc and gf, respectively) in a sample of Japanese adults. Albeit positively related to both intercepts, education had no impact on either the gc or the gf slope. Furthermore, neither intercept exhibited any appreciable correlation with either slope. These results thus suggest that education has no substantial role (direct or mediated) in aging-related changes in cognition.
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Affiliation(s)
- Giovanni Sala
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Ōbu, Japan
| | - Yukiko Nishita
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Ōbu, Japan
| | - Chikako Tange
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Ōbu, Japan
| | - Makiko Tomida
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Ōbu, Japan
| | | | - Hiroshi Shimokata
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Ōbu, Japan
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences
| | - Rei Otsuka
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Ōbu, Japan
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45
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Cadar D, Brocklebank L, Yan L, Zhao Y, Steptoe A. Socioeconomic and Contextual Differentials in Memory Decline: A Cross-Country Investigation Between England and China. J Gerontol B Psychol Sci Soc Sci 2023; 78:544-555. [PMID: 36625075 PMCID: PMC9985334 DOI: 10.1093/geronb/gbac163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Although cognitive functioning is strongly associated with biological changes in the brain during the aging process, very little is known about the role of sociocultural differentials between the western and eastern parts of the world. We examined the associations between individual socioeconomic markers (e.g., education, household wealth) and contextual levels characteristics (e.g., urbanicity) with memory performance and memory decline over up to 8 years of follow-up in England and China. METHODS The analytical samples included participants aged 50+ from the English Longitudinal Study of Aging (n = 6,687) and the China Health and Retirement Longitudinal Study (n = 10,252). Mixed linear models were employed to examine the association between baseline individual socioeconomic markers (education, wealth) and contextual-level characteristics (urbanicity) on the change in memory over time. RESULTS Our analyses showed that higher education and wealth were associated with better baseline memory in both England and China. Still, the impact of contextual-level characteristics such as urbanicity differed between the 2 countries. For English individuals, living in a rural area showed an advantage in memory, while the opposite pattern was observed in China. Memory decline appeared to be socioeconomically patterned by higher education, wealth, and urbanicity in China but not in England. DISCUSSION Our findings highlight substantial socioeconomic and contextual inequity in memory performance in both England and China, as well as in the rate of memory decline primarily in China. Public health strategies for preventing memory decline should target the socioeconomic gaps at the individual and contextual levels to protect those particularly disadvantaged.
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Affiliation(s)
- Dorina Cadar
- Centre for Dementia Studies, Department of Neuroscience, Brighton and Sussex Medical School, Sussex, UK
- Department of Primary Care, Brighton and Sussex Medical School, Sussex, UK
- Department of Behavioural Science and Health, University College London, London, UK
| | - Laura Brocklebank
- Department of Behavioural Science and Health, University College London, London, UK
| | - Li Yan
- National School of Development, Peking University, Beijing, China
| | - Yaohui Zhao
- National School of Development, Peking University, Beijing, China
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
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Corley J, Conte F, Harris SE, Taylor AM, Redmond P, Russ TC, Deary IJ, Cox SR. Predictors of longitudinal cognitive ageing from age 70 to 82 including APOE e4 status, early-life and lifestyle factors: the Lothian Birth Cohort 1936. Mol Psychiatry 2023; 28:1256-1271. [PMID: 36481934 PMCID: PMC10005946 DOI: 10.1038/s41380-022-01900-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022]
Abstract
Discovering why some people's cognitive abilities decline more than others is a key challenge for cognitive ageing research. The most effective strategy may be to address multiple risk factors from across the life-course simultaneously in relation to robust longitudinal cognitive data. We conducted a 12-year follow-up of 1091 (at age 70) men and women from the longitudinal Lothian Birth Cohort 1936 study. Comprehensive repeated cognitive measures of visuospatial ability, processing speed, memory, verbal ability, and a general cognitive factor were collected over five assessments (age 70, 73, 76, 79, and 82 years) and analysed using multivariate latent growth curve modelling. Fifteen life-course variables were used to predict variation in cognitive ability levels at age 70 and cognitive slopes from age 70 to 82. Only APOE e4 carrier status was found to be reliably informative of general- and domain-specific cognitive decline, despite there being many life-course correlates of cognitive level at age 70. APOE e4 carriers had significantly steeper slopes across all three fluid cognitive domains compared with non-carriers, especially for memory (β = -0.234, p < 0.001) and general cognitive function (β = -0.246, p < 0.001), denoting a widening gap in cognitive functioning with increasing age. Our findings suggest that when many other candidate predictors of cognitive ageing slope are entered en masse, their unique contributions account for relatively small proportions of variance, beyond variation in APOE e4 status. We conclude that APOE e4 status is important for identifying those at greater risk for accelerated cognitive ageing, even among ostensibly healthy individuals.
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Affiliation(s)
- Janie Corley
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK.
| | - Federica Conte
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Sarah E Harris
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Adele M Taylor
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Paul Redmond
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Tom C Russ
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - Ian J Deary
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Simon R Cox
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
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Early- to late-life environmental factors and late-life global cognition in septuagenarian and octogenarians: The SONIC study. Acta Psychol (Amst) 2023; 233:103844. [PMID: 36708625 DOI: 10.1016/j.actpsy.2023.103844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 01/06/2023] [Accepted: 01/20/2023] [Indexed: 01/27/2023] Open
Abstract
This study aimed to evaluate cognitively stimulating environments throughout life and to examine direct and indirect associations between these environments and late-life cognition. Early-life education, three domains of work complexity (data, people, and things) based on the longest-held occupation, and engagement in late-life leisure activities (LAs) were assessed. A structural equation model was developed using cross-sectional data of 1721 Japanese older adults in 70 ± 1 and 80 ± 1 years. The model confirmed significant direct effects of work complexity with data and late-life LAs on late-life cognitive performance. The associations of education and work complexity with late-life cognition were mediated through the subsequent environment(s). However, the total effects of work complexity with people and things on late-life cognition were insignificant. The findings suggest that cognitively stimulating activities in adulthood and beyond may lead to individual differences in late-life global cognition. In addition, antecedent complex environments might make subsequent life environments more cognitively stimulating. The results are discussed from the perspectives of cognitive plasticity and environmental complexity.
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Bernard C, Font H, Diallo Z, Ahonon R, Tine JM, Abouo FN, Tanon A, Messou E, Seydi M, Dabis F, Dartigues JF, de Rekeneire N. Factors associated with verbal fluency in older adults living with HIV in West Africa: A longitudinal study. Trop Med Int Health 2023; 28:35-42. [PMID: 36398852 PMCID: PMC9812871 DOI: 10.1111/tmi.13830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Verbal fluency decline, observed both in aging and HIV infection, has been related to lower quality of life. This study aimed to evaluate the factors associated with categorical fluency in people living with HIV (PLHIV) aged ≥60 years living in West Africa. METHODS In this longitudinal study, PLHIV aged ≥60 years, on antiretroviral therapy (ART) for ≥6 months were included in three clinics (two in Côte d'Ivoire, one in Senegal) participating in the West Africa International epidemiological Databases to Evaluate AIDS (IeDEA) collaboration. Categorical fluency was evaluated with the Isaacs Set Test at 60 s at baseline and 2 years later. Factors associated with verbal fluency baseline performance and annual rates of changes were evaluated using multivariate linear regression models. RESULTS Ninety-seven PLHIV were included with 41 of them (42%) having a 2-year follow-up visit. The median age was 64 (62-67), 45.4% were female, and 89.7% had an undetectable viral load. The median annual change in categorical fluency scores was -0.9 (IQR: -2.7 to 1.8). Low baseline categorical fluency performance and its decline were associated with older age and being a female. Low educational level was associated with low baseline categorical fluency performance but not with its decline. Categorical fluency decline was also associated with marital status and hypertension. CONCLUSIONS Among older West African PLHIV, usual socio-demographic variables and hypertension were the main factors associated with low categorical fluency performance and/or its decline. Interventions that focus on supporting cardiometabolic health are highly recommended to prevent cognitive disorders in PLHIV.
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Affiliation(s)
- Charlotte Bernard
- University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France
| | - Hélène Font
- University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France
| | - Zélica Diallo
- Service des maladies infectieuses et tropicales, CHU Treichville, Abidjan, Côte d'Ivoire
| | - Richard Ahonon
- Centre de prise en charge de recherche et de formation (CePReF), Yopougon Attié Hospital, Abidjan, Côte d'Ivoire
| | | | | | - Aristophane Tanon
- Service des maladies infectieuses et tropicales, CHU Treichville, Abidjan, Côte d'Ivoire
| | - Eugène Messou
- Centre de prise en charge de recherche et de formation (CePReF), Yopougon Attié Hospital, Abidjan, Côte d'Ivoire
| | - Moussa Seydi
- Service des maladies infectieuses et tropicales, CHNU de Fann, Dakar, Senegal
| | - François Dabis
- University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France
| | - Jean-François Dartigues
- University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France
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Valsdóttir V, Magnúsdóttir BB, Chang M, Sigurdsson S, Gudnason V, Launer LJ, Jónsdóttir MK. Cognition and brain health among older adults in Iceland: the AGES-Reykjavik study. GeroScience 2022; 44:2785-2800. [PMID: 35978066 PMCID: PMC9768066 DOI: 10.1007/s11357-022-00642-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/05/2022] [Indexed: 01/07/2023] Open
Abstract
The paper aimed to compare how factors previously identified as predictive factors for cognitive decline and dementia related to cognitive performance on the one hand and brain health on the other. To that aim, multiple linear regression was applied to the AGES-Reykjavik study epidemiological data. Additionally, a regression analysis was performed for change in cognition over 5 years, using the same exposure factors. The study ran from 2002 to 2011, and the sample analyzed included 1707 participants between the ages of 66 and 90. The data contains MR imaging, cognitive testing, background data, and physiological measurements. Overall, we conclude that risk factors linked to dementia relate differently to cognition and brain health. Mobility, physical strength, alcohol consumption, coronary artery disease, and hypertension were associated with cognition and brain volume. Smoking, depression, diabetes, and body fat percentage were only associated with brain volume, not cognitive performance. Modifiable factors previously linked to cognitive reserve, such as educational attainment, participation in leisure activities, multilingualism and good self-reported health, were associated with cognitive function but did not relate to brain volume. These findings show that, within the same participant pool, cognitive reserve proxy variables have a relationship with cognitive performance but have no association with relative brain volume measured simultaneously.
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Affiliation(s)
- Vaka Valsdóttir
- Department of Psychology, Reykjavik University, Menntavegur 1, 102 Reykjavik, Iceland
- RHLÖ – Icelandic Gerontological Research Center, Landspitali University Hospital, Reykjavik, Iceland
| | - Brynja Björk Magnúsdóttir
- Department of Psychology, Reykjavik University, Menntavegur 1, 102 Reykjavik, Iceland
- Mental Health Services, Landspitali University Hospital, Reykjavik, Iceland
| | - Milan Chang
- RHLÖ – Icelandic Gerontological Research Center, Landspitali University Hospital, Reykjavik, Iceland
| | | | - Vilmundur Gudnason
- The Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Lenore J. Launer
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, National Institutes of Health (NIH), Bethesda, MD USA
| | - María K. Jónsdóttir
- Department of Psychology, Reykjavik University, Menntavegur 1, 102 Reykjavik, Iceland
- Mental Health Services, Landspitali University Hospital, Reykjavik, Iceland
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50
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Torres JM, Glymour MM. Future Directions for the HRS Harmonized Cognitive Assessment Protocol. Forum Health Econ Policy 2022; 25:7-27. [PMID: 35254747 DOI: 10.1515/fhep-2021-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/07/2022] [Indexed: 01/05/2023]
Abstract
In the absence of effective pharmacological treatment to halt or reverse the course of Alzheimer's disease and related dementias (ADRDs), population-level research on the modifiable determinants of dementia risk and outcomes for those living with ADRD is critical. The Harmonized Cognitive Assessment Protocol (HCAP), fielded in 2016 as part of the U.S. Health and Retirement Study (HRS) and multiple international counterparts, has the potential to play an important role in such efforts. The stated goals of the HCAP are to improve our ability to understand the determinants, prevalence, costs, and consequences of cognitive impairment and dementia in the U.S. and to support cross-national comparisons. The first wave of the HCAP demonstrated the feasibility and value of the more detailed cognitive assessments in the HCAP compared to the brief cognitive assessments in the core HRS interviews. To achieve its full potential, we provide eight recommendations for improving future iterations of the HCAP. Our highest priority recommendation is to increase the representation of historically marginalized racial/ethnic groups disproportionately affected by ADRDs. Additional recommendations relate to the timing of the HCAP assessments; clinical and biomarker validation data, including to improve cross-national comparisons; dropping lower performing items; enhanced documentation; and the addition of measures related to caregiver impact. We believe that the capacity of the HCAP to achieve its stated goals will be greatly enhanced by considering these changes and additions.
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Affiliation(s)
- Jacqueline M Torres
- Department of Epidemiology and Biostatistics, UC San Francisco, San Francisco, CA, USA
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, UC San Francisco, San Francisco, CA, USA
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