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Tu L, Lv X, Yuan C, Chen H, Yu X, Wang H, Zhang Q. Sex differences in cognitive function trajectories and their determinants in older adults: Evidence from the Chinese longitudinal healthy longevity survey. Int J Geriatr Psychiatry 2024; 39:e6072. [PMID: 38488836 DOI: 10.1002/gps.6072] [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: 08/24/2023] [Accepted: 02/14/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES To examine sex differences in the cognitive trajectories of a nationally representative sample of older people living in China and to explore potential determinants of these trajectories. METHODS The study included 2230 women and 2171 men who were cognitively healthy and aged over 60 at the first observation from the Chinese Longitudinal Healthy Longevity Survey based on the 2008-2018 cohort. Cognitive function was measured using the Chinese version of the Mini-Mental State Examination (MMSE). Group-based trajectory modeling was used to identify potential heterogeneity of longitudinal changes over the 10 years in each gender. Logistic regression was used to investigate associations between baseline characteristics (age, education, fertility history, sleep length, physical activity, and health status and behaviors) and trajectory classes. RESULTS Three trajectories (labeled stable, slow decline, and rapid decline) were identified according to the changes in MMSE scores for both women and men. For the women, both the slow and rapid decline groups accounted for a larger proportion (14.7% and 11.0%, respectively) than the male decline groups (8.1% and 6.6%, respectively), and the women had a lower baseline MMSE score with a faster decline. In the multivariable logistic regression analyses, older age, less education, older age at first birth, poorer functional abilities, hearing impairment, and lower baseline MMSE scores were significantly associated with cognitive decline in both the female and male groups compared to the stable group. For the women, sleeping over 9 h was also associated with a rapid cognitive decline trajectory, while current exercise and being overweight/obese were protective factors against cognitive decline. CONCLUSIONS The women had an overall more serious cognitive decline than men. The potential determinants of cognitive decline identified in this study could be considered for developing specific intervention strategies aimed at promoting a healthy brain and preventing cognitive decline in different sexes, especially in low-income and developing countries.
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Affiliation(s)
- Lihui Tu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiaozhen Lv
- Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University), Beijing, China
| | - Changzheng Yuan
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hui Chen
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xin Yu
- Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University), Beijing, China
| | - Huali Wang
- Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University), Beijing, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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Light SW, Tomasino F, Wescott A, Sideman AB, Vela A, Possin KL, Penedo FJ, Wolf MS. Perceptions, beliefs, attitudes, and knowledge of US Latino adults pertaining to dementia and brain health: a systematic review. Aging Ment Health 2024; 28:396-407. [PMID: 37874117 PMCID: PMC10983845 DOI: 10.1080/13607863.2023.2268050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/30/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVES Latinos in the USA are 1.5 times more likely to develop Alzheimer's Disease and Related Dementias (ADRD) than non-Latino Whites. This systematic review aims to summarize current understanding of the perceptions, knowledge, beliefs, and attitudes about ADRD and brain health of Latinos to inform public health efforts addressing disparities. METHODS Searches were completed across six databases (Medline, PsycINFO, WoS, LILACS, ProQUEST, and CINAHL). Studies were required to capture attitudes and/or knowledge of ADRD or brain health among US-based Latino adults who were not cognitively impaired and were not caregivers or healthcare providers. Results were synthesized narratively. RESULTS A total of 5528 unique records were identified. Following de-duplication and screening, 24 articles met the inclusion criteria for this review. Overall, knowledge about brain health and ADRD among Latinos is quite mixed. A consistent finding was that participants recognized memory loss as a symptom of cognitive impairment, but demonstrated limited recognition of other signs of impairment. The studies also highlighted variable knowledge of protective factors for maintaining brain health. CONCLUSIONS Opportunities exist to increase knowledge of ADRD signs and symptoms, and awareness of risk and protective factors. Given the heterogeneity of Latinos in the USA, more research is warranted to better elucidate nuances in conceptualizations of brain health and aging among diverse Latino subgroups.
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Affiliation(s)
- Sophia W. Light
- Center for Applied Health Research on Aging and the Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Francesca Tomasino
- Center for Applied Health Research on Aging and the Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Annie Wescott
- Galter Health Sciences Library & Learning Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alissa Bernstein Sideman
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
- Global Brain Health Institute, University of California, San Francisco and Trinity College Dublin, San Francisco, CA, USA
- Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Alyssa Vela
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Katherine L. Possin
- Global Brain Health Institute, University of California, San Francisco and Trinity College Dublin, San Francisco, CA, USA
- Weill Institute for Neurosciences, Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA
| | - Frank J. Penedo
- Departments of Psychology and Medicine, University of Miami, Coral Gables, FL, USA
| | - Michael S. Wolf
- Center for Applied Health Research on Aging and the Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Henderson R, Furlano JA, Claringbold SS, Cornect-Benoit A, Ly A, Walker J, Zaretsky L, Roach P. Colonial drivers and cultural protectors of brain health among Indigenous peoples internationally. Front Public Health 2024; 12:1346753. [PMID: 38425465 PMCID: PMC10903363 DOI: 10.3389/fpubh.2024.1346753] [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: 12/04/2023] [Accepted: 01/24/2024] [Indexed: 03/02/2024] Open
Abstract
Despite relatively higher rates of dementia among Indigenous populations internationally, research into drivers of disparities in brain health and cognitive function has tended to focus on modifiable risk factors over cultural understandings and contextual determinants. By seeking to characterize social and cultural factors that shape brain health and cognition in Indigenous populations, this mini scoping review expands prevailing schools of thought to include Indigenous knowledge systems. This reveals important gaps in culturally aligned care. It also reclaims horizons for research important to Indigenous Peoples that have garnered diminished attention in biomedical approaches. Twenty-three sources were included for data extraction. This synthesis of 23 sources includes health communication about dementia, health provider knowledge about Indigenous health, culturally relevant screening and assessment tools, and culturally grounded care models. Much of the focus is currently still on modifiable risk factors that reside at individual factors, whereas attention to wider social factors that impact populations is needed, as stressors through isolation, discrimination, and unequal care are widely reported. Going forward, identifying structural barriers to living well and recognizing the importance of connection to culture will benefit both Indigenous and non-Indigenous understandings of brain health.
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Affiliation(s)
- Rita Henderson
- Department of Family Medicine, University of Calgary, Calgary, AB, Canada
| | - Joyla A. Furlano
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | | | | | - Anh Ly
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Jennifer Walker
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Lisa Zaretsky
- Department of Family Medicine, University of Calgary, Calgary, AB, Canada
| | - Pamela Roach
- Department of Family Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
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Borson S, Small GW, O'Brien Q, Morrello A, Boustani M. Understanding barriers to and facilitators of clinician-patient conversations about brain health and cognitive concerns in primary care: a systematic review and practical considerations for the clinician. BMC PRIMARY CARE 2023; 24:233. [PMID: 37932666 PMCID: PMC10626639 DOI: 10.1186/s12875-023-02185-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/16/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Primary care clinicians (PCCs) are typically the first practitioners to detect cognitive impairment in their patients, including those with Alzheimer's disease or related dementias (ADRD). However, conversations around cognitive changes can be challenging for patients, family members, and clinicians to initiate, with all groups reporting barriers to open dialogue. With the expanding array of evidence-based interventions for ADRD, from multidomain care management to novel biotherapeutics for early-stage AD, incorporating conversations about brain health into routine healthcare should become a standard of care. We conducted a systematic review to identify barriers to and facilitators of brain health conversations in primary care settings. METHODS We systematically searched PubMed, Scopus, Web of Science, and the Cochrane Library for qualitative or quantitative studies conducted in the US between January 2000 and October 2022 that evaluated perceptions of cognition and provider-patient brain health conversations prior to formal screening for, or diagnosis of, mild cognitive impairment or ADRD. We assessed the quality of the included studies using the Mixed Methods Appraisal Tool. RESULTS In total, 5547 unique abstracts were screened and 22 articles describing 19 studies were included. The studies explored perceptions of cognition among laypersons or clinicians, or provider-patient interactions in the context of a patient's cognitive concerns. We identified 4 main themes: (1) PCCs are hesitant to discuss brain health and cognitive concerns; (2) patients are hesitant to raise cognitive concerns; (3) evidence to guide clinicians in developing treatment plans that address cognitive decline is often poorly communicated; and (4) social and cultural context influence perceptions of brain health and cognition, and therefore affect clinical engagement. CONCLUSIONS Early conversations about brain health between PCCs and their patients are rare, and effective tools, processes, and strategies are needed to make these vital conversations routine.
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Affiliation(s)
- Soo Borson
- Department of Family Medicine, Keck School of Medicine, University of Southern California, 31 E. MacArthur Crescent B414, Santa Ana, Los Angeles, CA, USA.
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.
| | - Gary W Small
- Department of Psychiatry and Behavioral Health, Hackensack Meridian School of Medicine, Hackensack, NJ, USA
| | - Quentin O'Brien
- Scientific and Medical Services, Health & Wellness Partners, LLC, Upper Saddle River, NJ, USA
- The School of Medicine and Health Sciences, George Washington University, Washington, DC, USA
| | - Andrea Morrello
- Scientific and Medical Services, Health & Wellness Partners, LLC, Upper Saddle River, NJ, USA
| | - Malaz Boustani
- Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN, USA
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Curran E, Chong TWH, Godbee K, Abraham C, Lautenschlager NT, Palmer VJ. General population perspectives of dementia risk reduction and the implications for intervention: A systematic review and thematic synthesis of qualitative evidence. PLoS One 2021; 16:e0257540. [PMID: 34534250 PMCID: PMC8448319 DOI: 10.1371/journal.pone.0257540] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 09/06/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Evidence for the potential prevention of dementia through lifestyle risk factor modification is growing and has prompted examination of implementation approaches. Understanding the general population's perspectives regarding dementia risk reduction is key to implementation. This may provide useful insights into more effective and efficient ways to help people change relevant beliefs, motivations and behaviour patterns. We conducted a systematic review and thematic synthesis of qualitative evidence to develop an integrated model of general population dementia risk reduction perspectives and the implications for intervention in research and implementation contexts. METHODS AND FINDINGS We searched electronic databases, supplemented by lateral search techniques, to identify studies published since 1995 reporting qualitative dementia risk reduction perspectives of the non-expert general population who do not have dementia. Thematic synthesis, incorporating an expert panel discussion, was used to identify overarching themes and develop an integrated model to guide intervention to support individuals to adopt and maintain dementia risk reduction behaviour patterns. Quality of included studies and confidence in review findings were systematically appraised. We included 50 papers, reflecting the views of more than 4,500 individuals. Main themes were: 1) The need for effective education about a complex topic to prevent confusion and facilitate understanding and empowerment; 2) Personally relevant short- and long-term benefits of dementia risk reduction behaviour patterns can generate value and facilitate action; 3) Individuals benefit from trusted, reliable and sensitive support to convert understanding to personal commitment to relevant behaviour change; 4) Choice, control and relevant self-regulatory supports help individuals take-action and direct their own progress; 5) Collaborative and empowering social opportunities can facilitate and propagate dementia risk reduction behaviour change; 6) Individual behaviour patterns occur in social contexts that influence beliefs through heuristic processes and need to be understood. Findings indicate that, for intervention: 1) education is key, but both content and delivery need to be tailored; 2) complementary interventions to support self-regulation mechanisms and social processes will increase education effectiveness; 3) co-design principles should guide intervention design and delivery processes; 4) all interventions need to be supported by context-specific data. CONCLUSIONS This systematic review and thematic synthesis provides a comprehensive, integrated model of the dementia risk reduction perspectives of the general population and intervention approaches to support behaviour change that can be applied in clinical trial and real-world implementation settings. Findings extend existing knowledge and may assist more effective intervention design and delivery.
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Affiliation(s)
- Eleanor Curran
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
- NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, Victoria, Australia
- St Vincent’s Hospital Melbourne, Kew, Victoria, Australia
| | - Terence W. H. Chong
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
- NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, Victoria, Australia
- St Vincent’s Hospital Melbourne, Kew, Victoria, Australia
| | - Kali Godbee
- Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Charles Abraham
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Nicola T. Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
- NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Victoria J. Palmer
- Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
- The Centre for Digital Transformation of Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
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Nakhla MZ, Cohen L, Salmon DP, Smirnov DS, Marquine MJ, Moore AA, Schiehser DM, Zlatar ZZ. Self-reported subjective cognitive decline is associated with global cognition in a community sample of Latinos/as/x living in the United States. J Clin Exp Neuropsychol 2021; 43:663-676. [PMID: 34709141 PMCID: PMC8720066 DOI: 10.1080/13803395.2021.1989381] [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: 04/11/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Although subjective cognitive decline (SCD) may be an early risk marker of Alzheimer's Disease (AD), research on SCD among Hispanics/Latinos/as/x (henceforth Latinos/as) living in the U.S. is lacking. We investigated if the cross-sectional relationship of self-reported SCD with objective cognition varies as a function of ethnic background (Latinos/as versus Non-Hispanic Whites [NHWs]). Secondary analyses conducted solely within the Latino/a group investigated if informant reported SCD is associated with objective cognition and whether self-reported SCD is related to markers of brain health in a sub-sample of Latinos/as with available MRI data. METHODS Eighty-three participants (≥60 years of age) without dementia (35 Latinos/as; 48 NHWs) completed the Mattis Dementia Rating Scale (MDRS) and the Subjective Cognitive Decline-Questionnaire (SCD-Q). Additionally, 22 Latino/a informants completed the informant-version of the SCD-Q. Hierarchical regression models investigated if ethnicity moderates the association of MDRS and SCD-Q scores after adjusting for demographics and depressive symptoms. Correlational analyses within the Latino/a group investigated self- and informant-reported associations of SCD-Q scores with objective cognition, and associations of self-reported SCD-Q scores with medial temporal lobe volume and thickness. RESULTS Latinos/as had lower education and MDRS scores than NHWs. Higher SCD-Q scores were associated with lower MDRS scores only in Latinos/as. Within the Latino/a group, self, but not informant reported SCD was related to objective cognition. Medium to large effect sizes were found whereby higher self-reported SCD was associated with lower entorhinal cortex thickness and left hippocampal volume in Latinos/as. CONCLUSIONS The association of SCD and concurrent objectively measured global cognition varied by ethnic background and was only significant in Latinos/as. Self-reported SCD may be an indicator of cognitive and brain health in Latinos/as without dementia, prompting clinicians to monitor cognition. Future studies should explore if SCD predicts objective cognitive decline in diverse groups of Latinos/as living in the U.S.
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Affiliation(s)
- Marina Z. Nakhla
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Ct, San Diego, CA
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Research Service, VA San Diego Healthcare System, La Jolla, California, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Lynn Cohen
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
| | - David P. Salmon
- Department of Neurosciences; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
| | - Denis S. Smirnov
- Department of Neurosciences; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
| | - María J. Marquine
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Department of Medicine, Division of Geriatrics, Gerontology and Palliative Care; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
| | - Alison A. Moore
- Department of Medicine, Division of Geriatrics, Gerontology and Palliative Care; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
| | - Dawn M. Schiehser
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Research Service, VA San Diego Healthcare System, La Jolla, California, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Zvinka Z. Zlatar
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
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Perceived Nutrition and Health Concerns: Do They Protect against Unhealthy Dietary Patterns in Polish Adults? Nutrients 2021; 13:nu13010170. [PMID: 33429889 PMCID: PMC7827032 DOI: 10.3390/nu13010170] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/25/2022] Open
Abstract
The aim of the study was to explore the associations between perceived health and nutrition concerns, sociodemographic characteristics and unhealthy dietary patterns in a representative group of Polish adults. The data were collected in 2017 through a cross-sectional quantitative survey under the National Health Program 2016-2020. Logistic regression models were used to analyze the data. It was found that higher health concerns decreased the chances of adhering to upper tertiles of "Fast food & alcohol" and "Refined food & sweetened beverages" dietary patterns (DPs), thus displaying less frequent consumption of such foods. No relationship was found between health concerns and adhering to the "Fat food" and "Butter" DPs. Nutrition concerns increased the likelihood of frequent consumption of foods from "Fast food & alcohol" DP. Women were less likely to adhere to unhealthy eating patterns than men, while older people were less likely to often consume fast food, alcohol, or refined food and sweetened beverages. Findings of this study showed that concerns about health or nutrition were differently associated with dietary patterns and consumption of unhealthy foods. These relationships should be considered when developing interventions to address health-related lifestyle changes. However, further research is needed to identify cause-effect relationships between these variables.
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Künzi M, Joly-Burra E, Zuber S, Haas M, Tinello D, Da Silva Coelho C, Hering A, Ihle A, Laera G, Mikneviciute G, Stringhini S, Draganski B, Kliegel M, Ballhausen N. The Relationship between Life Course Socioeconomic Conditions and Objective and Subjective Memory in Older Age. Brain Sci 2021; 11:brainsci11010061. [PMID: 33418943 PMCID: PMC7825056 DOI: 10.3390/brainsci11010061] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/20/2020] [Accepted: 12/25/2020] [Indexed: 11/30/2022] Open
Abstract
While objective memory performance in older adults was primarily shown to be affected by education as indicator of life course socioeconomic conditions, other life course socioeconomic conditions seem to relate to subjective memory complaints. However, studies differ in which life course stages were investigated. Moreover, studies have explored these effects in an isolated way, but have not yet investigated their unique effect when considering several stages of the life course simultaneously. This study, therefore, examined the respective influence of socioeconomic conditions from childhood up to late-life on prospective memory (PM) performance as an objective indicator of everyday memory as well as on subjective memory complaints (SMC) in older age using structural equation modeling. Data came from two waves of the Vivre-Leben-Vivere aging study (n=993, Mage=80.56). The results indicate that only socioeconomic conditions in adulthood significantly predicted late-life PM performance. PM performance was also predicted by age and self-rated health. In contrast, SMC in older age were not predicted by socioeconomic conditions at any stage of the life course but were predicted by level of depression. In line with the cognitive reserve hypothesis, present results highlight the significance of education and occupation (adulthood socioeconomic conditions) for cognitive functioning in later life.
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Affiliation(s)
- Morgane Künzi
- Cognitive Aging Lab (CAL), Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (E.J.-B.); (S.Z.); (M.H.); (D.T.); (C.D.S.C.); (G.L.); (G.M.); (M.K.)
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (A.H.); (A.I.); (N.B.)
- LIVES, Overcoming Vulnerability: Life Course Perspective, Swiss National Centre of Competence in Research, University of Lausanne, Géopolis Building, 1015 Lausanne, Switzerland
- Correspondence:
| | - Emilie Joly-Burra
- Cognitive Aging Lab (CAL), Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (E.J.-B.); (S.Z.); (M.H.); (D.T.); (C.D.S.C.); (G.L.); (G.M.); (M.K.)
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (A.H.); (A.I.); (N.B.)
- LIVES, Overcoming Vulnerability: Life Course Perspective, Swiss National Centre of Competence in Research, University of Lausanne, Géopolis Building, 1015 Lausanne, Switzerland
| | - Sascha Zuber
- Cognitive Aging Lab (CAL), Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (E.J.-B.); (S.Z.); (M.H.); (D.T.); (C.D.S.C.); (G.L.); (G.M.); (M.K.)
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (A.H.); (A.I.); (N.B.)
- LIVES, Overcoming Vulnerability: Life Course Perspective, Swiss National Centre of Competence in Research, University of Lausanne, Géopolis Building, 1015 Lausanne, Switzerland
| | - Maximilian Haas
- Cognitive Aging Lab (CAL), Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (E.J.-B.); (S.Z.); (M.H.); (D.T.); (C.D.S.C.); (G.L.); (G.M.); (M.K.)
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (A.H.); (A.I.); (N.B.)
| | - Doriana Tinello
- Cognitive Aging Lab (CAL), Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (E.J.-B.); (S.Z.); (M.H.); (D.T.); (C.D.S.C.); (G.L.); (G.M.); (M.K.)
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (A.H.); (A.I.); (N.B.)
| | - Chloé Da Silva Coelho
- Cognitive Aging Lab (CAL), Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (E.J.-B.); (S.Z.); (M.H.); (D.T.); (C.D.S.C.); (G.L.); (G.M.); (M.K.)
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (A.H.); (A.I.); (N.B.)
| | - Alexandra Hering
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (A.H.); (A.I.); (N.B.)
- Department of Developmental Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Simon Building, Warandelaan 2, 5037 AB Tilburg, The Netherlands
| | - Andreas Ihle
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (A.H.); (A.I.); (N.B.)
- LIVES, Overcoming Vulnerability: Life Course Perspective, Swiss National Centre of Competence in Research, University of Lausanne, Géopolis Building, 1015 Lausanne, Switzerland
| | - Gianvito Laera
- Cognitive Aging Lab (CAL), Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (E.J.-B.); (S.Z.); (M.H.); (D.T.); (C.D.S.C.); (G.L.); (G.M.); (M.K.)
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (A.H.); (A.I.); (N.B.)
- LIVES, Overcoming Vulnerability: Life Course Perspective, Swiss National Centre of Competence in Research, University of Lausanne, Géopolis Building, 1015 Lausanne, Switzerland
| | - Greta Mikneviciute
- Cognitive Aging Lab (CAL), Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (E.J.-B.); (S.Z.); (M.H.); (D.T.); (C.D.S.C.); (G.L.); (G.M.); (M.K.)
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (A.H.); (A.I.); (N.B.)
- LIVES, Overcoming Vulnerability: Life Course Perspective, Swiss National Centre of Competence in Research, University of Lausanne, Géopolis Building, 1015 Lausanne, Switzerland
| | - Silvia Stringhini
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Rue du Bugnon 44, 1011 Lausanne, Switzerland;
- Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Bogdan Draganski
- Laboratory of Research in Neuroimaging (LREN), Department of Clinical Neuroscience, Lausanne University Hospital, University of Lausanne, Champ de l’Air Building, Rue du Bugnon 21, 1011 Lausanne, Switzerland;
- Neurology Department, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstrasse 1A, D-04103 Leipzig, Germany
| | - Matthias Kliegel
- Cognitive Aging Lab (CAL), Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (E.J.-B.); (S.Z.); (M.H.); (D.T.); (C.D.S.C.); (G.L.); (G.M.); (M.K.)
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (A.H.); (A.I.); (N.B.)
- LIVES, Overcoming Vulnerability: Life Course Perspective, Swiss National Centre of Competence in Research, University of Lausanne, Géopolis Building, 1015 Lausanne, Switzerland
| | - Nicola Ballhausen
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland; (A.H.); (A.I.); (N.B.)
- Department of Developmental Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Simon Building, Warandelaan 2, 5037 AB Tilburg, The Netherlands
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9
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Werner P, AboJabel H, Maxfield M. Conceptualization, measurement and correlates of dementia worry: A scoping review. Arch Gerontol Geriatr 2020; 92:104246. [PMID: 32980573 DOI: 10.1016/j.archger.2020.104246] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The combination of a growing population of older adults and increasing prevalence and awareness of dementia diagnoses suggests that dementia worry may also intensify. As a relatively new area of investigation, the dementia worry literature is growing, but variability in definitions and measurement continue. A scoping review was conducted to gather and examine existing research, as well as assist in guiding future studies in this area. The review focused on characterizing the conceptualization, measurement, and correlates of dementia worry. METHODS Using PubMed, CINAHL, AgeLine, and PsycINFO, a search of literature concerning dementia worry was completed. RESULTS A total of 45 articles examining dementia worry fulfilled the inclusion criteria. Most studies were cross-sectional (n = 39), quantitative (n = 38), and conducted in the United States (n = 22). Inconsistencies in the conceptualization, measurement, and correlates examined make it difficult to determine the meaning and true levels of dementia worry. CONCLUSIONS Recent attention to dementia worry has increased awareness of the basic concept and its correlates. However, the lack of unity in the definition and measurement of dementia worry impedes advancement in this research area, as well as in establishing its clinical significance.
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Affiliation(s)
- Perla Werner
- Department of Community Mental Health, University of Haifa, Israel.
| | - Hanan AboJabel
- Department of Community Mental Health, University of Haifa, Israel.
| | - Molly Maxfield
- Edson College of Nursing and Health Innovation, Arizona State University, USA.
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10
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An Q, Wang K, Sun F, Zhang A. The effectiveness of modified, group-based CBT for dementia worry among Chinese elders. J Affect Disord 2020; 274:76-84. [PMID: 32469835 DOI: 10.1016/j.jad.2020.05.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 04/15/2020] [Accepted: 05/10/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Dementias are highly prevalent among Chinese elders. This study examined the effectiveness of a modified group cognitive behavioral therapy (CBT) on dementia worry among Chinese older adults. METHODS Eighty-two older adults recruited from four elder group homes were randomly assigned to either intervention or control group. The intervention group (n= 44) received eight weekly 60-minute face-to-face CBT, while the control group (n=38) received treatment-as-usual. RESULTS Outcomes indicated that the modified group CBT has significantly reduced dementia worry and culturally biased beliefs about dementia (p<.001). Study findings supported both statistically and clinically significant effect of modified group CBT on dementia worry [g=-1.52, 95% CI (-2.01, -1.03)] and biased beliefs about dementia [g=-.95, 95% CI (-1.40, -.49)]. DISCUSSION The culturally adapted CBT is promising in alleviating worries and anxiety over dementia among Chinese older adults. Future research needs to include larger samples and participants from different regions to replicate findings.
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Affiliation(s)
- Qiuling An
- East China Normal University, School of Social Development, 500 DongChuan Rd., Shanghai, China
| | - Kaipeng Wang
- University of Denver, Graduate School of Social Work, Denver, CO, USA.
| | - Fei Sun
- Michigan State University, School of Social Work, East Lansing, MI, USA
| | - Anao Zhang
- University of Michigan, School of Social Work, Ann Arbor, MI, USA
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11
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Corlier FW, Shaw C, Hayes-Larson E, Mungas D, Tomaszewski Farias S, Glymour MM, Whitmer RA, Mayeda ER. Association Between Cognitive Test Performance and Subjective Cognitive Decline in a Diverse Cohort of Older Adults: Findings From the KHANDLE Study. Alzheimer Dis Assoc Disord 2020; 34:198-205. [PMID: 32427599 PMCID: PMC7528733 DOI: 10.1097/wad.0000000000000383] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Subjective cognitive decline (SCD) may represent a low-burden indicator of dementia risk. The value of SCD as a proxy marker, however, depends on the consistency of associations between subjective and objective cognitive measures across sociodemographic and psychological factors. METHODS We evaluated baseline data from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study (n=1615). SCD was measured using the 12-item Everyday Cognition (ECog) scale. Using linear regression models with interaction terms, we evaluated 6 potential modifiers (age, sex, race/ethnicity, educational attainment, family history of dementia, and depressive symptoms) of the association between cognitive performance (episodic memory, executive function) and SCD. RESULTS Lower episodic memory and executive function scores were associated with higher log(ECog scores) (more SCD). Older age and elevated depressive symptoms were associated with higher log(ECog scores). Age (interaction P=0.002) and education (interaction P=0.01) modified the association between executive function and log(ECog scores). Specifically, associations between executive function and log(ECog scores) were stronger among participants with more education and less pronounced among older participants. CONCLUSIONS The association between cognitive performance and log(ECog scores) differed little across sociodemographic and psychological factors. SCD as measured by the ECog may be a valuable proxy for cognitive performance in diverse older adults.
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Affiliation(s)
- Fabian W. Corlier
- University of California, Los Angeles Fielding School of
Public Health, Department of Epidemiology
| | - Crystal Shaw
- University of California, Los Angeles Fielding School of
Public Health, Department of Epidemiology
| | - Eleanor Hayes-Larson
- University of California, Los Angeles Fielding School of
Public Health, Department of Epidemiology
| | - Dan Mungas
- University of California, Davis Alzheimer’s Disease
Research Center
- University of California, Davis Department of
Neurology
| | - Sarah Tomaszewski Farias
- University of California, Davis Alzheimer’s Disease
Research Center
- University of California, Davis Department of
Neurology
| | - M. Maria Glymour
- University of California, San Francisco Department of
Epidemiology and Biostatistics
| | - Rachel A. Whitmer
- University of California, Davis Alzheimer’s Disease
Research Center
- University of California, Davis Department of Public
Health Sciences, Division of Epidemiology
- Kaiser Permanente Division of Research, Oakland, CA
| | - Elizabeth Rose Mayeda
- University of California, Los Angeles Fielding School of
Public Health, Department of Epidemiology
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12
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Trajectories of cognitive function and their determinants in older people: 12 years of follow-up in the Chinese Longitudinal Healthy Longevity Survey. Int Psychogeriatr 2020; 32:765-775. [PMID: 32336299 DOI: 10.1017/s1041610220000538] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cognitive decline in advanced age is closely related to dementia. The trajectory of cognitive function in older Chinese is yet to be fully investigated. We aimed to investigate the trajectories of cognitive function in a nationally representative sample of older people living in China and to explore the potential determinants of these trajectories. METHODS This study included 2,038 cognitively healthy persons aged 65-104 years at their first observation in the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2014. Cognitive function was measured using the Chinese version of the Mini-Mental State Examination (MMSE). Group-based trajectory modeling was used to identify potential heterogeneity of longitudinal changes over the 12 years and to investigate associations between baseline predictors of group membership and these trajectories. RESULTS Three trajectories were identified according to the following types of changes in MMSE scores: slow decline (14.0%), rapid decline (4.5%), and stable function (81.5%). Older age, female gender, having no schooling, a low frequency of leisure activity, and a low baseline MMSE score were associated with the slow decline trajectory. Older age, body mass index (BMI) less than 18.5 kg/m2, and having more than one cardiovascular disease (CVD) were associated with the rapid decline trajectory. CONCLUSION Three trajectories of cognitive function were identified in the older Chinese population. The identified determinants of these trajectories could be targeted for developing prevention and intervention strategies for dementia.
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13
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Lim S, Mohaimin S, Min D, Roberts T, Sohn YJ, Wong J, Sivanesathurai R, Kwon SC, Trinh-Shevrin C. Alzheimer's Disease and its Related Dementias among Asian Americans, Native Hawaiians, and Pacific Islanders: A Scoping Review. J Alzheimers Dis 2020; 77:523-537. [PMID: 32675416 PMCID: PMC8638681 DOI: 10.3233/jad-200509] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The Asian American, Native Hawaiian, and Pacific Islander (AANHPI) aging population is rapidly growing and the burden of Alzheimer's disease and its related dementias (ADRD) will likely mirror this demographic growth. AANHPIs face significant barriers in obtaining timely ADRD diagnosis and services; yet little is known about ADRD in this population. OBJECTIVE The study objective is to conduct a systematic review on the published literature on ADRD among AANHPIs to identify gaps and priorities to inform future research and action plans. METHODS The systematic review was conducted following the PRISMA Protocol for Systematic Reviews. Co-author (TR), an experienced Medical Librarian, searched PubMed, EMBASE, PsycINFO, Cochrane Central of Clinical Trials, Ageline, and Web of Science for peer-reviewed articles describing ADRD among AANHPIs. The search was not limited by language or publication date. Each citation was reviewed by two trained independent reviewers. Conflicts were resolved through consensus. RESULTS The title/abstract and full texts of 1,447 unique articles were screened for inclusion, yielding 168 articles for analysis. Major research topics included prevalence, risk factors, comorbidities, interventions and outreach, knowledge and attitudes, caregiving, and detection tools. A limited number of studies reported on national data, on NHPI communities generally, and on efficacy of interventions targeting AANHPI communities. CONCLUSION To our knowledge, this is the first systematic review on ADRD among AANHPI populations. Our review provides a first step in mapping the extant literature on ADRD among this underserved and under-researched population and will serve as a guide for future research, policy, and intervention.
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Affiliation(s)
- Sahnah Lim
- Department of Population Health, New York University Grossman School of Medicine
| | - Sadia Mohaimin
- Department of Population Health, New York University Grossman School of Medicine
| | - Deborah Min
- Department of Population Health, New York University Grossman School of Medicine
| | - Timothy Roberts
- Health Science Library, New York University Grossman School of Medicine
| | - Young-Jin Sohn
- Department of Population Health, New York University Grossman School of Medicine
| | - Jazmine Wong
- Department of Population Health, New York University Grossman School of Medicine
| | | | - Simona C. Kwon
- Department of Population Health, New York University Grossman School of Medicine
| | - Chau Trinh-Shevrin
- Department of Population Health, New York University Grossman School of Medicine
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14
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Hill NL, Mogle J, Bell TR, Bhargava S, Wion RK, Bhang I. Predicting current and future anxiety symptoms in cognitively intact older adults with memory complaints. Int J Geriatr Psychiatry 2019; 34:1874-1882. [PMID: 31468598 PMCID: PMC6854282 DOI: 10.1002/gps.5204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 08/24/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Memory complaints are a common concern for older adults and may co-occur with anxiety symptoms. Although both memory complaints and anxiety are associated with heightened cognitive decline risk, little is known about how these symptoms develop over time. The purpose of this study was to examine the differential concurrent and longitudinal relationships among anxiety symptoms and two types of memory complaints in cognitively intact older adults. METHODS/DESIGN The current study sample was drawn from two longitudinal, nationally representative datasets, the National Health and Aging Trends Study (NHATS) and the Health and Retirement Study (HRS). Cognitively intact older adults aged 65 and over were included, representing six (n = 5069; NHATS) and two (n = 5284; HRS) waves of data, respectively. Using multilevel linear modeling, we tested bidirectional relationships between anxiety and two types of memory complaints: current rating of memory performance and perceived memory decline. RESULTS Concurrent associations between anxiety symptoms and memory complaints were found in both datasets: At times when current memory performance was rated more poorly or perceived memory decline was reported, anxiety symptoms tended to be higher, and vice versa. A longitudinal relationship was identified in NHATS such that perceived memory decline, and not current memory rating, predicted future anxiety symptoms. CONCLUSION This study provides a better understanding of the relationships between memory complaints and anxiety symptoms over time. Cognitively intact older adults with perceived memory decline are at greater risk for current as well as future anxiety symptoms.
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Affiliation(s)
- Nikki L. Hill
- College of Nursing, Pennsylvania State University, University Park, USA,Corresponding author: Nikki L. Hill, PhD, RN, College of Nursing at Pennsylvania State University, 201 Nursing Sciences Building, University Park, PA 16802, USA, , Telephone: (814) 867-3265
| | - Jacqueline Mogle
- College of Health and Human Development, Pennsylvania State University, University Park, USA
| | - Tyler Reed Bell
- College of Nursing, Pennsylvania State University, University Park, USA
| | - Sakshi Bhargava
- College of Nursing, Pennsylvania State University, University Park, USA
| | - Rachel K. Wion
- College of Nursing, Pennsylvania State University, University Park, USA
| | - Iris Bhang
- College of Nursing, Pennsylvania State University, University Park, USA
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15
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Babulal GM, Quiroz YT, Albensi BC, Arenaza-Urquijo E, Astell AJ, Babiloni C, Bahar-Fuchs A, Bell J, Bowman GL, Brickman AM, Chételat G, Ciro C, Cohen AD, Dilworth-Anderson P, Dodge HH, Dreux S, Edland S, Esbensen A, Evered L, Ewers M, Fargo KN, Fortea J, Gonzalez H, Gustafson DR, Head E, Hendrix JA, Hofer SM, Johnson LA, Jutten R, Kilborn K, Lanctôt KL, Manly JJ, Martins RN, Mielke MM, Morris MC, Murray ME, Oh ES, Parra MA, Rissman RA, Roe CM, Santos OA, Scarmeas N, Schneider LS, Schupf N, Sikkes S, Snyder HM, Sohrabi HR, Stern Y, Strydom A, Tang Y, Terrera GM, Teunissen C, Melo van Lent D, Weinborn M, Wesselman L, Wilcock DM, Zetterberg H, O'Bryant SE. Perspectives on ethnic and racial disparities in Alzheimer's disease and related dementias: Update and areas of immediate need. Alzheimers Dement 2019; 15:292-312. [PMID: 30555031 PMCID: PMC6368893 DOI: 10.1016/j.jalz.2018.09.009] [Citation(s) in RCA: 334] [Impact Index Per Article: 66.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/12/2018] [Accepted: 09/13/2018] [Indexed: 02/07/2023]
Abstract
Alzheimer's disease and related dementias (ADRDs) are a global crisis facing the aging population and society as a whole. With the numbers of people with ADRDs predicted to rise dramatically across the world, the scientific community can no longer neglect the need for research focusing on ADRDs among underrepresented ethnoracial diverse groups. The Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment (ISTAART; alz.org/ISTAART) comprises a number of professional interest areas (PIAs), each focusing on a major scientific area associated with ADRDs. We leverage the expertise of the existing international cadre of ISTAART scientists and experts to synthesize a cross-PIA white paper that provides both a concise "state-of-the-science" report of ethnoracial factors across PIA foci and updated recommendations to address immediate needs to advance ADRD science across ethnoracial populations.
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Affiliation(s)
- Ganesh M Babulal
- Department of Neurology and Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Yakeel T Quiroz
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Benedict C Albensi
- Division of Neurodegenerative Disorders, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, Manitoba, Canada; Department of Pharmacology & Therapeutics, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Arlene J Astell
- Department of Occupational Sciences & Occupational Therapy, University of Toronto, CA; School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy; Department of Neuroscience, IRCCS-Hospital San Raffaele Pisana of Rome and Cassino, Rome and Cassino, Italy
| | - Alex Bahar-Fuchs
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, the University of Melbourne, Australia
| | | | - Gene L Bowman
- Nutrition and Brain Health Laboratory, Nestlé Institute of Health Sciences, Lausanne, Switzerland; Department of Neurology, Layton Aging & Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Adam M Brickman
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA
| | - Gaël Chételat
- Inserm, Inserm UMR-S U1237, Université de Caen-Normandie, GIP Cyceron, Caen, France
| | - Carrie Ciro
- Department of Occupational Therapy Education, University of Kansas Medical Center, Kansas City, KS, USA
| | - Ann D Cohen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Hiroko H Dodge
- Department of Neurology, Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Simone Dreux
- Undergraduate Program of History and Science, Harvard College, Cambridge, MA, USA
| | - Steven Edland
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Anna Esbensen
- Department of Pediatrics, University of Cincinnati College of Medicine & Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Lisbeth Evered
- Melbourne Medical School, University of Melbourne, Australia
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Munich, Germany
| | - Keith N Fargo
- Medical & Scientific Relations, Alzheimer's Association, Chicago, IL, USA
| | - Juan Fortea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Barcelona Down Medical Center, Fundació Catalana de Síndrome de Down, Barcelona, Spain
| | - Hector Gonzalez
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of San Diego, CA, USA
| | - Deborah R Gustafson
- Department of Neurology, Section for NeuroEpidemiology, State University of New York - Downstate Medical Center, Brooklyn, NY, USA
| | - Elizabeth Head
- Sanders Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - James A Hendrix
- Medical & Scientific Relations, Alzheimer's Association, Chicago, IL, USA
| | - Scott M Hofer
- Adult Development and Aging, University of Victoria, British Columbia, CA, USA
| | - Leigh A Johnson
- Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Roos Jutten
- VU University Medical Center, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Kerry Kilborn
- Department of Psychology, University of Glasgow, Glasgow, Scotland, UK
| | - Krista L Lanctôt
- Sunnybrook Research Institute of Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Jennifer J Manly
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA
| | - Ralph N Martins
- Aging and Alzheimer's Disease, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Michelle M Mielke
- Department of Epidemiology, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Esther S Oh
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mario A Parra
- School of Social Sciences, Department of Psychology, Heriot-Watt University, UK; Universidad Autónoma del Caribe, Barranquilla, Colombia; Neuroprogressive and Dementia Network, UK
| | - Robert A Rissman
- Department of Neurosciences, University of California San Diego School of Medicine, CA, USA
| | - Catherine M Roe
- Department of Neurology and Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Octavio A Santos
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | - Nikolaos Scarmeas
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA; Aiginition Hospital, 1st Neurology Clinic, Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Lon S Schneider
- Department of Psychiatry and The Behavioral Sciences, University of Southern California, CA, USA
| | - Nicole Schupf
- Department of Epidemiology, Mailman School of Public Health Columbia University, New York, NY, USA
| | - Sietske Sikkes
- Massachusetts General Hospital, Department of Neurology, Boston, MA, USA
| | - Heather M Snyder
- Medical & Scientific Relations, Alzheimer's Association, Chicago, IL, USA
| | - Hamid R Sohrabi
- Aging and Alzheimer's Disease, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Yaakov Stern
- Department of Neurology, Columbia University, New York, NY, USA; Department of Psychiatry, Columbia University, New York, NY, USA
| | - Andre Strydom
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Yi Tang
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Graciela Muniz Terrera
- Centers for Clinical Brain Sciences and Dementia Prevention, University in Edinburgh, Scotland, UK
| | - Charlotte Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit University Medical Center, Amsterdam, the Netherlands
| | - Debora Melo van Lent
- Department of Clinical Research, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Michael Weinborn
- Aging and Alzheimer's Disease, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | | | - Donna M Wilcock
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit University Medical Center, Amsterdam, the Netherlands
| | - Henrik Zetterberg
- UK Dementia Research Institute at UCL, London, UK; Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Sid E O'Bryant
- Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA.
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16
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Li M, Dong X. Is Social Network a Protective Factor for Cognitive Impairment in US Chinese Older Adults? Findings from the PINE Study. Gerontology 2017; 64:246-256. [DOI: 10.1159/000485616] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 11/23/2017] [Indexed: 11/19/2022] Open
Abstract
Background: Social network has been identified as a protective factor for cognitive impairment. However, the relationship between social network and global and subdomains of cognitive function remains unclear. Objective: This study aims to provide an analytic framework to examine quantity, composition, and quality of social network and investigate the association between social network, global cognition, and cognitive domains among US Chinese older adults. Methods: Data were derived from the Population Study of Chinese Elderly (PINE), a community-engaged, population-based epidemiological study of US Chinese older adults aged 60 and above in the greater Chicago area, with a sample size of 3,157. Social network was assessed by network size, volume of contact, proportion kin, proportion female, proportion co-resident, and emotional closeness. Cognitive function was evaluated by global cognition, episodic memory, executive function, working memory, and Chinese Mini-Mental State Examination (C-MMSE). Linear regression and quantile regression were performed. Results: Every 1-point increase in network size (b = 0.048, p < 0.001) and volume of contact (b = 0.049, p < 0.01) and every 1-point decrease in proportion kin (b = -0.240, p < 0.01) and proportion co-resident (b = -0.099, p < 0.05) were associated with higher level of global cognition. Similar trends were observed in specific cognitive domains, including episodic memory, working memory, executive function, and C-MMSE. However, emotional closeness was only significantly associated with C-MMSE (b = 0.076, p < 0.01). Social network has differential effects on female versus male older adults. Conclusion: This study found that social network dimensions have different relationships with global and domains of cognitive function. Quantitative and structural aspects of social network were essential to maintain an optimal level of cognitive function. Qualitative aspects of social network were protective factors for C-MMSE. It is necessary for public health practitioners to consider interventions that enhance different aspects of older adults' social network.
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17
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Ajrouch KJ, Zahodne LB, Antonucci TC. Arab American Cognitive Aging: Opportunities for Advancing Research on Alzheimer's Disease Disparities. Innov Aging 2017; 1:igx034. [PMID: 30480122 PMCID: PMC6243697 DOI: 10.1093/geroni/igx034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This article highlights the dearth of and need for research on Arab American cognitive aging. We propose that studying cognitive health issues among older Arab Americans provides an innovative opportunity to advance knowledge about causes and consequences of Alzheimer's disease (AD) disparities and refine understanding of factors linked to immigrant health in the United States. RESEARCH DESIGN AND METHODS Demographic information is provided on Arab Americans, who are on the cusp of being recognized by the U.S. government as a distinct ethnic group separate from whites. In the tradition of minority aging, we present a broad review of specific issues in the contemporary case of Arab Americans. RESULTS We detail how including Arab Americans provides unique information on the importance of: (i) extending racial/ethnic group comparisons; (ii) linking social experiences to late-life cognitive health; and (iii) incorporating ethnic factors related to immigration and religion in the study of AD disparities. DISCUSSION AND IMPLICATIONS Studying Arab American cognitive aging provides an innovative opportunity to more fully delineate factors that create and sustain health disparities, with special insights into both causes and consequences.
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Affiliation(s)
- Kristine J Ajrouch
- Department of Sociology, Anthropology and Criminology, Eastern Michigan University
- Institute for Social Research, University of Michigan
| | - Laura B Zahodne
- Institute for Social Research, University of Michigan
- Department of Psychology, University of Michigan
| | - Toni C Antonucci
- Institute for Social Research, University of Michigan
- Department of Psychology, University of Michigan
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Barber SJ. An Examination of Age-Based Stereotype Threat About Cognitive Decline. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2017; 12:62-90. [PMID: 28073332 DOI: 10.1177/1745691616656345] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
"Stereotype threat" is often thought of as a singular construct, with moderators and mechanisms that are stable across groups and domains. However, this is not always true. To illustrate this, the current review focuses on the stereotype threat that older adults face about their cognitive abilities. Drawing upon the multithreat framework, I first provide evidence that this is a self-concept threat and not a group-reputation threat. Because this differs from the forms of stereotype threat experienced by other groups (e.g., the threat that minority students face about their intellectual abilities), the moderators of stereotype threat observed in other groups (i.e., group identification) do not always generalize to age-based stereotype threat about cognitive decline. Looking beyond the forms of stereotype threat elicited, this review also provides evidence that the mechanisms underlying stereotype-threat effects may vary across the adult life span. Because of age-related improvements in emotion-regulation abilities, stereotype threat does not seem to reduce older adults' executive-control resources. Overall, this review highlights the need to approach the concept of stereotype threat with more granularity, allowing researchers to design more effective stereotype-threat interventions. It will also shed light on why certain stereotype threat effects "fail to replicate" across domains or groups.
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Affiliation(s)
- Sarah J Barber
- Department of Psychology, San Francisco State University
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19
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Awang H, Mansor N, Nai Peng T, Nik Osman NA. Understanding ageing: fear of chronic diseases later in life. J Int Med Res 2017; 46:175-184. [PMID: 28760083 PMCID: PMC6011296 DOI: 10.1177/0300060517710857] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objectives Ageing is often associated with deteriorating mental and physical health and the need for long-term care, creating a fear of ageing. We investigated what people fear most in terms of disabling chronic diseases and their concerns regarding having long-term illnesses. Methods Data were obtained from an online survey of 518 respondents aged 40 years and older residing in Malaysia, which was based on a convenience sample collected in May 2015 to January 2016. Data were analyzed using chi-squared tests and multinomial logistic regression. Results Of the most dreaded diseases, heart disease and cancer are life-threatening; however, dementia, diabetes, and hypertension persist and have a disabling effect for a long time. While there were variations in the diseases feared most across sex, ethnicity, and place of residence, the biggest worry for all respondents with regard to having a long-term illness was that they would become a burden to their family, a concern that superseded fear of dying. Conclusions We found our survey respondents had a fear of chronic diseases and placing a burden on others. Thus, there is a need to provide motivation for people to adopt a healthy lifestyle, to remain healthy.
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Affiliation(s)
- Halimah Awang
- 1 Social Security Research Centre, University of Malaya, Malaysia
| | - Norma Mansor
- 1 Social Security Research Centre, University of Malaya, Malaysia.,2 Faculty of Economics and Administration, University of Malaya, Malaysia
| | - Tey Nai Peng
- 2 Faculty of Economics and Administration, University of Malaya, Malaysia
| | - Nik Ainoon Nik Osman
- 1 Social Security Research Centre, University of Malaya, Malaysia.,3 Faculty of Business and Accountancy, University of Malaya, Malaysia
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20
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Li LW, Ding D, Wu B, Dong X. Change of Cognitive Function in U.S. Chinese Older Adults: A Population-Based Study. J Gerontol A Biol Sci Med Sci 2017; 72:S5-S10. [PMID: 28575265 PMCID: PMC5861853 DOI: 10.1093/gerona/glx004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 01/02/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study aims to assess cognitive change in a 2-year period among U.S. Chinese older adults and examine sociodemographic characteristics associated with the change. METHODS Data were from the Population Study of Chinese Elderly (PINE) in which 2,713 participants (aged 60 and older) received in-home interviews at both the baseline and 2-year follow-up. A battery of cognitive tests that assessed episodic memory, working memory, perceptual speed, and overall cognitive status were administered in both times. A composite global cognition was constructed using all tests. Mixed-effect regression was conducted. RESULTS Older age was associated with worse baseline cognition (ie, in all cognitive abilities) and faster decline in global cognition, episodic memory, and perceptual speed-rates of decline increased by .006, .004, and .009 standard score units, respectively, for each year older. More education was associated with better baseline cognition, but each year of additional schooling increased rates of decline in global cognition and episodic memory by .004 and .012 standard score units, respectively. Men performed better than women in most cognitive abilities at baseline but had faster rates of decline in working memory. Higher income was associated with better cognition at baseline and reduced rates of decline in working memory. CONCLUSIONS Findings suggest differences in the rates of cognitive change by age, sex, education, and income. Those in advancing age are vulnerable to cognitive decline. The effects of education and sex on baseline performance versus change suggest a role for life experiences in cognition.
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Affiliation(s)
- Lydia W Li
- School of Social Work, University of Michigan, Ann Arbor
| | - Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, National Clinical Research Center for Aging Diseases, WHO Collaborating Center for Research and Training in Neurosciences, Shanghai, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University
| | - XinQi Dong
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
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21
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Armstrong B, Gallant SN, Li L, Patel K, Wong BI. Stereotype Threat Effects on Older Adults’ Episodic and Working Memory: A Meta-Analysis. THE GERONTOLOGIST 2017; 57:S193-S205. [DOI: 10.1093/geront/gnx056] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 04/14/2017] [Indexed: 11/13/2022] Open
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22
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Friedman DB, Gibson A, Torres W, Irizarry J, Rodriguez J, Tang W, Kannaley K. Increasing Community Awareness About Alzheimer's Disease in Puerto Rico Through Coffee Shop Education and Social Media. J Community Health 2016; 41:1006-12. [PMID: 26983930 PMCID: PMC5011439 DOI: 10.1007/s10900-016-0183-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Alzheimer's disease (AD) is the fourth leading cause of death in Puerto Rico. Using multi-media resources and in-person education may be an effective approach to improve knowledge and awareness of AD. The Un Café por el Alzheimer program in Puerto Rico incorporates an education component at coffee shops and a social media campaign using Facebook. The current study evaluates this initiative through an analysis of pre/post education survey results and social media content and use. Surveys contained close-ended and open-ended questions to understand participants' perceptions and knowledge about AD. Post-education surveys also included questions related to program satisfaction. Social media analysis of the Facebook community page examined posts from March 1 to September 30, 2015. Descriptive statistics were used to analyze survey and Facebook data. Four education sessions were conducted with a total of 212 participants. Fifty-one of the participants completed both pre- and post-surveys. Following the education program participants reported improved knowledge of risk and protective factors. All participants reported learning new information from the program. There were a total of 250 posts on the Un Café por el Alzheimer community Facebook page; 168 posts related to AD. The Facebook page reached 294,109 people, with 9963 page likes, 610 comments, 17,780 post clicks, and 3632 shares. There was an average increase of 64.8 % in number of people reached by the Facebook page following the education sessions. The approach of combining social media resources and in-person education is beneficial to increase public awareness of AD and disseminate health information.
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Affiliation(s)
- Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA.
| | - Andrea Gibson
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | | | | | | | - Weizhou Tang
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Kristie Kannaley
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
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23
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Ullmann G, Williams HG. The Feldenkrais Method(®) can enhance cognitive function in independent living older adults: A case-series. J Bodyw Mov Ther 2015; 20:512-7. [PMID: 27634072 DOI: 10.1016/j.jbmt.2015.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 10/13/2015] [Accepted: 11/15/2015] [Indexed: 11/25/2022]
Abstract
Poor cognitive health a major concern of aging individuals, can compromise independent living. More than 16 million people in the United States are affected by cognitive impairment. We have studied the effects of the Feldenkrais Method(®) on cognitive function. In this case series with three participants cognitive function was assessed with the Trail Making Test A and B at baseline and after the Feldenkrais intervention. All participants improved performance on Trail Making Test A and B after completing the Feldenkrais intervention indicating that Feldenkrais lessons may offset age-related decline in cognitive function. The results of this case series warrant larger scale studies on cognitive outcomes of Feldenkrais interventions in clinical and non-clinical populations.
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Affiliation(s)
- Gerhild Ullmann
- University of Memphis, School of Public Health, Memphis, TN 38152, USA.
| | - Harriet G Williams
- University of South Carolina, Arnold School of Public Health, Columbia, SC 29208, USA
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24
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Laditka SB, Laditka JN. More Education May Limit Disability and Extend Life For People With Cognitive Impairment. Am J Alzheimers Dis Other Demen 2014; 29:436-47. [PMID: 24413536 PMCID: PMC10852655 DOI: 10.1177/1533317513518648] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Education is associated with longer life and less disability. Living longer increases risks of cognitive impairment, often producing disability. We examined associations among education, disability, and life expectancy for people with cognitive impairment, following a 1992 cohort ages 55+ for 23 063 person-years (Panel Study of Income Dynamics, n = 2165). We estimated monthly probabilities of disability and death for 7 education levels, adjusting for age, gender, ethnicity, and cognitive status. We used the probabilities to simulate populations with age-specific cognitive impairment incidence and monthly disability status through death. For those with cognitive impairment, education was associated with longer life and less disability. Among them, college-educated white women lived 3.2 more years than those with <8 years education, disabled 24.4% of life from age 55 compared with 36.7% (P< .0001). Increasing education will lengthen lives. Living longer, more people will have cognitive impairment. Education may limit their risk of disability and its duration.
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Affiliation(s)
- Sarah B Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - James N Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
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25
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Friedman DB, Rose ID, Anderson LA, Hunter R, Bryant LL, Wu B, Deokar AJ, Tseng W. Beliefs and communication practices regarding cognitive functioning among consumers and primary care providers in the United States, 2009. Prev Chronic Dis 2013; 10:E58; quiz 8-13. [PMID: 23597396 PMCID: PMC3638613 DOI: 10.5888/pcd10.120249] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Limited research has examined primary care providers' communication with patients about maintaining cognitive functioning. Our study's objective was to compare the perceptions of consumers and primary care providers related to beliefs and communication practices about lifestyle behaviors beneficial for overall health and for maintaining cognitive functioning. METHODS In 2009, we submitted 10 questions to Porter Novelli's HealthStyles survey and 6 questions to their DocStyles survey. We compared consumers' (n = 4,728) and providers' (n = 1,250) beliefs, practices, and information sources related to maintaining health and cognitive functioning. We made comparisons using nonparametric statistics. RESULTS Approximately 76% of consumers considered their health to be good or very good; 73.4% were concerned or very concerned about the possibility that their memory may worsen with age. Women were significantly more concerned than men, and white consumers were more concerned than black and Hispanic consumers. Consumers reported they believed that intellectual stimulation (86.6%), physical activity (82.6%), and healthful diet (82.5%) prevented or delayed cognitive impairment. Providers reported advising patients to reduce cognitive impairment risk through physical activity (85.9%), intellectual stimulation (80.3%), and social involvement (67.4%). Few consumers (7.8%) reported receiving this information from providers but reported learning about strategies to maintain memory, primarily from television (50.1%), magazines (44.1%), and newspapers (33.7%). CONCLUSION Providers reported advising patients about how to reduce risks of cognitive impairment. Consumers reported receiving this information from other sources. Findings suggest a need to examine and assess media messages and to better understand patient-provider communication about cognitive functioning.
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Laditka SB, Tseng W, Price AE, Ivey SL, Friedman DB, Liu R, Wu B, Logsdon RG, Beard RL. Beliefs about promoting cognitive health among Filipino Americans who care for persons with dementia. Int J Aging Hum Dev 2013; 75:273-96. [PMID: 23350346 DOI: 10.2190/ag.75.3.d] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We examined beliefs about promoting cognitive health among Filipino Americans who care for persons with dementia, their awareness of media information about cognitive health, and their suggestions for communicating such information to other caregivers. We conducted three focus groups (25 participants). The constant comparison method compared themes across focus groups. Caregivers most frequently described cognitive health benefits of social engagement and leisure; next in emphasis were benefits of healthy diets. There was less emphasis on physical activity. Participants had heard from television that avoiding smoking, alcohol, and drugs might promote cognitive health. Ways to inform others about cognitive health included information in Filipino newspapers, and handouts in Filipino languages, distributed in Filipino stores, workplaces, community organizations, and health care facilities. Findings suggest an opportunity to develop public health messages promoting cognitive health that are in-language, published in ethnic-specific media, and that are culturally appropriate for Filipino and other Asian Americans.
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Affiliation(s)
- Sarah B Laditka
- University of North Carolina at Charlotte, Department of Public Health Sciences, NC 28223, USA.
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Laditka JN, Laditka SB, Lowe KB. Promoting cognitive health: a web site review of health systems, public health departments, and senior centers. Am J Alzheimers Dis Other Demen 2012; 27:600-8. [PMID: 23007288 PMCID: PMC10911579 DOI: 10.1177/1533317512460564] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
Growing evidence suggests that healthy behaviors such as being physically active, having a heart healthy diet, and being socially involved may promote cognitive health. The United States has recently begun encouraging such behaviors for that purpose. To help evaluate the diffusion of this policy, we sought to measure a baseline of activity in this area. We examined Web sites of 156 large health care systems, the health departments of all 50 states and the 20 largest US cities, and 181 nationally accredited senior centers, to identify information, products, programs, or services recommended for cognitive health. Among health care systems, 40% promoted cognitive health: 24% recommended mental activity, 20% healthy diets, 20% physical activity, and 16% social involvement. Among health departments, 30% promoted cognitive health in the same ways. Among senior centers, 21% offered strategies, primarily mental activity. Results suggest emerging activity in this area and opportunities for continued development.
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Affiliation(s)
- James N Laditka
- Department of Public Health Sciences, University of North Carolina, Charlotte, NC 28223, USA.
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Laditka JN, Laditka SB, Tait EM, Tsulukidze MM. Use of dietary supplements for cognitive health: results of a national survey of adults in the United States. Am J Alzheimers Dis Other Demen 2012; 27:55-64. [PMID: 22323831 PMCID: PMC10697390 DOI: 10.1177/1533317511435662] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We studied use of vitamins, minerals, herbs, and other dietary supplements for cognitive health. We refer to these products as supplements. Data were from the 2007 National Health Interview Survey, which asked about complementary and alternative medicine (n = 22 783). Chi-square and multivariate logistic analyses were weighted for national representativeness, accounting for the survey design. Among supplement users, about 8.8% of those without cognitive problems used them for cognitive health; 15.7% of those with cognitive problems did so. Fish oil, Ginkgo biloba, and vitamins were commonly used for cognitive health. Among supplement users, 38% did not tell health care providers. In adjusted results, adults reporting cognitive problems were more likely than others to use supplements for cognitive health (odds ratio 1.77, confidence interval 1.39-2.25). Adults are more likely to use supplements to treat or cure cognitive problems than to prevent them. Many do not discuss this use with health care providers.
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Affiliation(s)
- James N Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC 28223, USA.
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How do older people describe others with cognitive impairment? A multiethnic study in the United States. AGEING & SOCIETY 2012. [DOI: 10.1017/s0144686x11001255] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
ABSTRACTWe studied how older people describe others with cognitive impairment. Forty-two focus groups represented African Americans, American Indians, Chinese Americans, Latinos, Vietnamese Americans, and Whites other than Latinos (Whites) (N = 396, ages 50+), in nine locations in the United States of America. Axial coding connected categories and identified themes. The constant comparison method compared themes across ethnic groups. African Americans, American Indians and Whites emphasised memory loss. African Americans, American Indians, Latinos and Whites stressed withdrawal, isolation and repetitive speech. African Americans, American Indians, Vietnamese Americans and Whites emphasised ‘slow thinking’. Only Whites described mood swings and personality changes. Many participants attributed dementia to stress. Terms describing others with dementia included ‘Alzheimer's’, ‘dementia’, ‘senile’ and ‘crazy’. Euphemisms were common (‘senior moment’, ‘old timer's disease’). Responses focused on memory, with limited mention of other cognitive functions. Differences among ethnic groups in descriptions of cognitive health and cognitive impairment underscore the need to tailor public health messages about cognitive health to ways that people construe its loss, and to their interest in maintaining it, so that messages and terms used are familiar, understandable and relevant to the groups for which they are designed. Health promotion efforts should develop ethnically sensitive ways to address the widely held misperception that even serious cognitive impairment is a normal characteristic of ageing and also to address stigma associated with cognitive impairment.
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Day KL, Friedman DB, Laditka JN, Anderson LA, Hunter R, Laditka SB, Wu B, McGuire LC, Coy MC. Prevention of Cognitive Impairment. J Appl Gerontol 2011. [DOI: 10.1177/0733464811401354] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The public is increasingly inundated with suggestions on how they can reduce their risk of developing cognitive impairment or dementia and are turning to physicians for advice. This study examines physicians’ perceptions and practices related to reducing cognitive impairment or dementia risk. Data from Porter Novelli’s 2008 DocStyles survey are used to examine physicians’ perceptions and practices related to this issue. About 40% of physicians reported discussing concerns about cognitive impairment often or very often with adult patients without dementia. The majority advised patients to reduce risk through physical activity, mental stimulation, and healthy diet. These data shed light on physicians’ perceptions and practices related to reducing cognitive impairmentrisk among their patients. Increased information about this issue may inform development of and access to educational materials to meet physicians’ needs to address patient concerns related to reducing cognitive impairment or dementia risk.
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Affiliation(s)
- Kristine L. Day
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | | | | | - Bei Wu
- University of North Carolina, Greensboro, NC, USA
| | - Lisa C. McGuire
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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