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Guan Z, Weng X, Zhang L, Feng P. Association between polycyclic aromatic hydrocarbon exposure and cognitive performance in older adults: a cross-sectional study from NHANES 2011-2014. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2024; 26:1348-1359. [PMID: 38954438 DOI: 10.1039/d4em00290c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
Background: polycyclic aromatic hydrocarbons (PAHs) are classified as neurotoxins, but the relationship between exposure to PAHs and cognition in adults is unclear, and their non-linear and mixed exposure association hasn't been explored. Objective: to evaluate the non-linear and joint association between co-exposure to PAHs and multiple cognitive tests in U.S. older people. Methods: restricted cubic spline (RCS) and Bayesian kernel machine regression (BKMR) were conducted to evaluate the non-linear and mixed exposure association, based on the cross-sectional data from NHANES 2011-2014: 772 participants over 60 years old, 4 cognitive test scores, including the Immediate Recall Test (IRT), Delayed Recall Test (DRT), Animal Fluency Test (AFT), and Digit Symbol Substitution test (DSST), and 5 urinary PAH metabolites. Results: a V-shaped nonlinear relationship was found between 3-hydroxyfluorene (3-FLUO), 2-hydroxyfluorene (2-FLUO), and DRT. Negative trends between mixed PAH exposure and IRT, DRT, and DSST scores were observed. 2-FLUO contributed the most to the negative association of multiple PAHs with IRT and DRT scores and 2-hydroxynaphthalene (2-NAP) played the most important role in the decreasing relationship between mixed PAH exposure and DSST scores. Conclusion: our study suggested that PAH exposure in the U.S. elderly might be related to their poor performances in IRT, DRT and DSST. Further prospective studies are needed to validate the association.
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Affiliation(s)
- Zerong Guan
- The First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Xueqiong Weng
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ligang Zhang
- School of Medicine, Foshan University, Foshan 528225, China
| | - Peiran Feng
- The First Affiliated Hospital, Jinan University, Guangzhou 510630, China
- Guangdong Provincial Key Laboratory of Spine and Spinal Cord Reconstruction, The Fifth Affiliated Hospital of Jinan University (Heyuan Shenhe People's Hospital), Jinan University, Heyuan 517000, China
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Ly TK, Allen RS, Cundiff JM, DeCaro JA. Investigating the Effects of Discrimination Experiences on Everyday Metamemory Accuracy. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae089. [PMID: 38841817 DOI: 10.1093/geronb/gbae089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Indexed: 06/07/2024] Open
Abstract
OBJECTIVES Lifetime and daily experiences of discrimination contribute to impaired performance on cognitive assessments. However, the underlying mechanism by which discrimination negatively affects cognition is unclear. Recent research investigating stress-induced impairment of metamemory may address the relationship between discrimination experiences and cognitive impairment. METHODS The aim of this study was to determine the relationship of lifetime and daily experiences of discrimination, daily affect balance, baseline objective cognitive performance, and sociodemographic variables (age, race, ethnicity, and sex) with metamemory accuracy across the lifespan (ages 20-75). Impaired metamemory accuracy was defined by the number of subjective cognitive complaints. Diary data from the Midlife in the United States (MIDUS Refresher 1) Daily Diary Project (N = 782) was used for these analyses. RESULTS Results from linear mixed model analyses showed significant within-person effects of daily discrimination, where people who reported more daily discrimination also reported lower metamemory accuracy, and daily affect balance, where people who reported very negative affect also reported lower metamemory accuracy. Additionally, linear mixed model analyses revealed significant between-person effects of race on metamemory accuracy, with individuals from minoritized racial groups generally reporting poorer metamemory accuracy. Daily discrimination experiences also interacted with other variables in predicting day-to-day metamemory accuracy. DISCUSSION These findings add to our understanding of how psychosocial stress in the form of daily discrimination experiences may impair metamemory processes contributing to increased subjective cognitive complaints. Future research should consider the contribution of daily experiences of discrimination across the lifespan to poor cognitive outcomes in later life.
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Affiliation(s)
- Timothy K Ly
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Rebecca S Allen
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Jeanne M Cundiff
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Jason A DeCaro
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA
- Department of Anthropology, The University of Alabama, Tuscaloosa, Alabama, USA
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Suchy-Dicey AM, Vo TT, Oziel K, Buchwald DS, Rhoads K, French BF. Psychometric Reliability, Validity, and Generalizability of MoCA in American Indian Adults: The Strong Heart Study. Assessment 2024:10731911241261436. [PMID: 39046194 DOI: 10.1177/10731911241261436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Standardized neuropsychological instruments are used to evaluate cognitive impairment, but few have been psychometrically evaluated in American Indians. We collected Montreal Cognitive Assessment (MoCA) in 403 American Indians 70 to 95 years, as well as age, sex, education, bilingual status, depression symptoms, and other neuropsychological instruments. We evaluated inferences of psychometric validity, including scoring inference using confirmatory factor analysis and structural equation modeling, generalizability inference using reliability coefficient, and extrapolation inference by examining performance across different contexts and substrata. The unidimensional (total score) model had good fit criteria. Internal consistency reliability was high. MoCA scores were positively associated with crystallized cognition (ρ = 0.48, p < .001) and inversely with depression symptoms (ρ = -0.27, p < .001). Significant differences were found by education (d = 0.79, p < .05) depression (d = 0.484, p < .05), and adjudicated cognitive status (p = .0001) strata; however, MoCA was not sensitive or specific in discriminating cognitive impairment from normal cognition (area under the curve <0.5). MoCA scores had psychometric validity in older American Indians, but education and depression are important contextual features for score interpretability. Future research should evaluate cultural or community-specific adaptations, to improve test discriminability in this underserved population.
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Affiliation(s)
- Astrid M Suchy-Dicey
- Huntington Medical Research Institutes, Pasadena, CA, USA
- Washington State University Elson S. Floyd College of Medicine, Spokane, USA
- University of Washington Alzheimer's Disease Research Center, Seattle, USA
| | - Thao T Vo
- Washington State University College of Education, Pullman, USA
| | - Kyra Oziel
- Washington State University Elson S. Floyd College of Medicine, Spokane, USA
| | - Dedra S Buchwald
- Washington State University Elson S. Floyd College of Medicine, Spokane, USA
| | - Kristoffer Rhoads
- University of Washington Alzheimer's Disease Research Center, Seattle, USA
| | - Brian F French
- Washington State University College of Education, Pullman, USA
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Lane JM, Zimmer A, Quiñones-Cordero MM, Sörensen S. Racial differences in the effect of verbal and nonverbal memory on concrete planning for future care needs among older adults: a multi-group structural equation modeling approach. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:587-604. [PMID: 37317954 PMCID: PMC10721738 DOI: 10.1080/13825585.2023.2223902] [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: 10/11/2022] [Accepted: 06/07/2023] [Indexed: 06/16/2023]
Abstract
Concrete planning for future care needs may positively impact older adults' subsequent mental health and quality of life. However, the cognitive factors that facilitate concrete planning among Black and White older adults are still poorly understood. We investigated whether there are significant differences between Black (n = 159) and White (n = 262) older adults in concrete planning and explored racial differences in the relationship between verbal and nonverbal episodic memory and concrete planning. Results revealed that Blacks showed lower engagement in concrete planning and lower scores than Whites on each verbal and nonverbal memory task. For Blacks, but not Whites, verbal memory and nonverbal memory performance predicted concrete planning with higher nonverbal memory relating to less concrete planning and higher verbal memory associated with more concrete planning. Our findings suggest racial differences exist in how episodic verbal and nonverbal memory affect concrete planning, a crucial factor for older adults' preparation for future care.
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Affiliation(s)
- Jamil M Lane
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Alexis Zimmer
- Department of Counseling and Human Development, University of Rochester, Rochester, USA
| | - Maria M Quiñones-Cordero
- Elaine Hubbard Center for Nursing Research on Aging, University of Rochester School of Nursing, Rochester, NY, USA
| | - Silvia Sörensen
- Department of Counseling and Human Development, University of Rochester, Rochester, USA
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Zahodne LB, Sol K, Scambray K, Lee JH, Palms JD, Morris EP, Taylor L, Ku V, Lesniak M, Melendez R, Elliott MR, Clarke PJ. Neighborhood racial income inequality and cognitive health. Alzheimers Dement 2024. [PMID: 38934219 DOI: 10.1002/alz.13911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/01/2024] [Accepted: 04/27/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Neighborhood socioeconomic status (SES) has been linked to dementia, but the distribution of SES within a neighborhood may also matter. METHODS Data from 460 (47% Black, 46% White) older adults from the Michigan Cognitive Aging Project were linked to census tract-level data from the National Neighborhood Data Archive (NaNDA). Neighborhood SES included two composites reflecting disadvantage and affluence. Neighborhood racial income inequality was the ratio of median incomes for White versus Black residents. Generalized estimating equations examined associations between neighborhood factors and cognitive domains. RESULTS Neighborhood racial income inequality was uniquely associated with worse cognitive health, and these associations did not differ by participant race. Neighborhood disadvantage was only associated with worse cognitive health among Black participants. DISCUSSION Both the level and racial distribution of SES within a neighborhood may be relevant for dementia risk. Racial differences in the level and impact of neighborhood SES contribute to dementia inequalities. HIGHLIGHTS Black participants lived in neighborhoods with lower socioeconomic status (SES) than White participants, on average. Neighborhood SES and racial income inequality were associated with worse cognition. Effects of neighborhood racial income inequality did not differ across racial groups. Effects of neighborhood SES were only evident among Black participants.
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Affiliation(s)
- Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Ketlyne Sol
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Kiana Scambray
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ji Hyun Lee
- Department of Human Development and Community Health, Montana State University, Bozeman, Montana, USA
| | - Jordan D Palms
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily P Morris
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Lauren Taylor
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Vivian Ku
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mary Lesniak
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Robert Melendez
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Michael R Elliott
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Philippa J Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
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Ding K, Ruksakulpiwat S, Wang Y, Voss JG. The effects of residential segregation on cognition among U.S. older adults: a systematic review based on the social determinants of health model. Aging Ment Health 2024:1-9. [PMID: 38840518 DOI: 10.1080/13607863.2024.2360016] [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: 08/24/2023] [Accepted: 05/19/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVES This systematic review aims to advance the understanding of the complicated effects of segregation on older adults' cognition and provide guidance for future research. METHOD A systematic review using the Social Determinants of Health framework to examine the relationship between segregation and cognition across the selected literature. RESULTS Eight papers met the criteria for inclusion. All selected studies examined the influence of living in a segregated area on older adults' cognition, covering older adults from different racial/ethnic groups. The association between segregation and cognition was found in different directions across different racial/ethnic groups. The effects can be varied depending on race/ethnicity, level of education, neighborhood socioeconomic status, or social context. CONCLUSION This review identified existing gaps in understanding the relationship between segregation and cognition. Future studies should carefully adopt the segregation measures, acknowledge the varying segregation experience among different racial/ethnic groups, and consider more social determinant factors in research.
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Affiliation(s)
- Kedong Ding
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Suebsarn Ruksakulpiwat
- Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Yi Wang
- School of Social Work, University of Iowa, Iowa City, IW, USA
| | - Joachim G Voss
- College of Nursing - Omaha Division, University of Nebraska Medical Center, Ohama, NE, USA
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Suchy-Dicey AM, Vo TT, Oziel K, Buchwald DS, Nelson LA, Verney SP, French BF. Psychometric reliability, validity, and generalizability of 3MSE scores among American Indian adults: the Strong Heart Study. J Int Neuropsychol Soc 2024; 30:454-463. [PMID: 38263740 DOI: 10.1017/s1355617723011438] [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] [Indexed: 01/25/2024]
Abstract
OBJECTIVE Modified Mini-Mental State Examination (3MSE) is often used to screen for dementia, but little is known about psychometric validity in American Indians. METHODS We recruited 818 American Indians aged 65-95 for 3MSE examinations in 2010-2013; 403 returned for a repeat examination in 2017-2019. Analyses included standard psychometrics inferences for interpretation, generalizability, and extrapolation: factor analysis; internal consistency-reliability; test-retest score stability; multiple indicator multiple cause structural equation models. RESULTS This cohort was mean age 73, majority female, mean 12 years education, and majority bilingual. The 4-factor and 2nd-order models fit best, with subfactors for orientation and visuo-construction (OVC), language and executive functioning (LEF), psychomotor and working memory (PMWM), verbal and episodic memory (VEM). Factor structure was supported for both research and clinical interpretation, and factor loadings were moderate to high. Scores were generally consistent over mean 7 years. Younger participants performed better in overall scores, but not in individual factors. Males performed better on OVC and LEF, females better on PMWM. Those with more education performed better on LEF and worse on OVC; the converse was true for bilinguals. All differences were significant, but small. CONCLUSION These findings support use of 3MSE for individual interpretation in clinic and research among American Indians, with moderate consistency, stability, reliability over time. Observed extrapolations across age, sex, education, and bilingual groups suggest some important contextual differences may exist.
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Affiliation(s)
- Astrid M Suchy-Dicey
- Huntington Medical Research Institutes, Pasadena, CA, USA
- Washington State University, Elson S Floyd College of Medicine, Seattle, WA, USA
| | - Thao T Vo
- Washington State University, College of Education, Pullman, WA, USA
| | - Kyra Oziel
- Washington State University, Elson S Floyd College of Medicine, Seattle, WA, USA
| | - Dedra S Buchwald
- Washington State University, Elson S Floyd College of Medicine, Seattle, WA, USA
| | - Lonnie A Nelson
- Washington State University, College of Nursing, Spokane, WA, USA
| | | | - Brian F French
- Washington State University, College of Education, Pullman, WA, USA
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Suchy-Dicey AM, Vo TT, Oziel K, King R, Barbosa-Leiker C, Rhoads K, Verney S, Buchwald DS, French BF. Psychometric Properties of Controlled Oral Word Association (COWA) Test and Associations With Education and Bilingualism in American Indian Adults: The Strong Heart Study. Assessment 2024; 31:745-757. [PMID: 37338127 PMCID: PMC10840386 DOI: 10.1177/10731911231180127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
The Controlled Oral Word Association (COWA) test is used to assess phonemic fluency and executive function. Formal validation of test scores is important for accurate cognitive evaluation. However, there is a dearth of psychometric validation among American Indian adults. Given high burden of dementia risk and key contextual factors associated with cognitive assessments, this represents a critical oversight. In a large, longitudinal population-based cohort study of adult American Indians, we examined several validity inferences for COWA, including scoring, generalization, and extrapolation inferences, by investigation of factor structure, internal consistency, test-retest reliability, and differential test functioning. We found adequate unidimensional model fit, with high factor loadings. Internal consistency reliability and test-retest reliability were 0.88 and 0.77, respectively, for the full group. COWA scores were lowest among the oldest, lowest education, bilingual speakers; group effects for sex and bilingual status were small; age effect was medium; and education effect was largest. However, Wide Range Achievement Test (WRAT) score effect was stronger than education effect, suggesting better contextualization may be needed. These results support interpretation of total COWA score, including across sex, age, or language use strata.
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Affiliation(s)
| | - Thao T. Vo
- Washington State University, Seattle, USA
| | - Kyra Oziel
- Washington State University, Seattle, USA
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Van Etten EJ, Bharadwaj PK, Grilli MD, Raichlen DA, Hishaw GA, Huentelman MJ, Trouard TP, Alexander GE. Impact of age and apolipoprotein E ε4 status on regional white matter hyperintensity volume and cognition in healthy aging. J Int Neuropsychol Soc 2024:1-11. [PMID: 38515367 DOI: 10.1017/s1355617724000122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
OBJECTIVE White matter hyperintensity (WMH) volume is a neuroimaging marker of lesion load related to small vessel disease that has been associated with cognitive aging and Alzheimer's disease (AD) risk. METHOD The present study sought to examine whether regional WMH volume mediates the relationship between APOE ε4 status, a strong genetic risk factor for AD, and cognition and if this association is moderated by age group differences within a sample of 187 healthy older adults (APOE ε4 status [carrier/non-carrier] = 56/131). RESULTS After we controlled for sex, education, and vascular risk factors, ANCOVA analyses revealed significant age group by APOE ε4 status interactions for right parietal and left temporal WMH volumes. Within the young-old group (50-69 years), ε4 carriers had greater right parietal and left temporal WMH volumes than non-carriers. However, in the old-old group (70-89 years), right parietal and left temporal WMH volumes were comparable across APOE ε4 groups. Further, within ε4 non-carriers, old-old adults had greater right parietal and left temporal WMH volumes than young-old adults, but there were no significant differences across age groups in ε4 carriers. Follow-up moderated mediation analyses revealed that, in the young-old, but not the old-old group, there were significant indirect effects of ε4 status on memory and executive functions through left temporal WMH volume. CONCLUSIONS These findings suggest that, among healthy young-old adults, increased left temporal WMH volume, in the context of the ε4 allele, may represent an early marker of cognitive aging with the potential to lead to greater risk for AD.
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Affiliation(s)
- Emily J Van Etten
- Department of Psychology, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Pradyumna K Bharadwaj
- Department of Psychology, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Matthew D Grilli
- Department of Psychology, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Department of Neurology, University of Arizona, Tucson, AZ, USA
| | - David A Raichlen
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, Los Angeles, CA, USA
| | - Georg A Hishaw
- Department of Neurology, University of Arizona, Tucson, AZ, USA
| | - Matthew J Huentelman
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Theodore P Trouard
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Arizona Alzheimer's Consortium, Phoenix, AZ, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
| | - Gene E Alexander
- Department of Psychology, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Arizona Alzheimer's Consortium, Phoenix, AZ, USA
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
- Neuroscience Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA
- Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA
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Westrick AC, Esiaka DK, Meier HCS, Rooks RN, Manning M, Tarraf W. Cognition and Wealth Changes in Mid-to-later Life: A Latent Class Trajectories Approach Using the Health and Retirement Study. J Aging Health 2024:8982643241232003. [PMID: 38356174 DOI: 10.1177/08982643241232003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
ObjectivesTo assess how cognitive trajectories from mid-to-later life relate to wealth change, overall and by mid-life income. Methods: Data were from participants (51-64 years) in the 2000-2018 U.S. Health and Retirement Study who were cognitively healthy at baseline (year 2000; unweighted n = 3821). Longitudinal latent class analyses generated cognitive and wealth trajectories, independently, and multinomial logistic regressions estimated the association between cognitive trajectories and wealth profiles, overall and by median income. Results: We identified three cognitive: cognitively healthy (CH), increasing cognitive impairment (ICI), and increasing dementia (ID) and four wealth profiles: stable wealth loss (SWL), delayed gradual wealth loss (DGWL), stable wealth gain (SWG), and gradual wealth gain (GWG). The ID group had higher probability of being in the SWL group and lower probability of SWG, which was more pronounced in respondents with greater median income. Discussion: Individuals with ID may be vulnerable to wealth loss, particularly for middle-class households.
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Affiliation(s)
- Ashly C Westrick
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Darlingtina K Esiaka
- Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Helen C S Meier
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Ronica N Rooks
- Department of Health and Behavioral Sciences, University of Colorado Denver, Denver, CO, USA
| | - Mark Manning
- Department of Psychology, Oakland University, Rochester, MI, USA
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, MI, USA
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Rahmani A, Najand B, Sonnega A, Akhlaghipour G, Mendez MF, Assari S. Intersectional Effects of Race and Educational Attainment on Memory Function of Middle-Aged and Older Adults With Alzheimer's Disease. J Racial Ethn Health Disparities 2024; 11:81-91. [PMID: 36576695 DOI: 10.1007/s40615-022-01499-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND High educational attainment may protect individuals, particularly middle-aged and older adults, against a wide range of health risks, including memory decline with age; however, this protection is less clear in patients with Alzheimer's disease (AD). In addition, this effect may differ across racial groups. According to the Marginalized-Related Diminished Return (MDR) theory, for example, the protective effect of high educational attainment on mental and physical health shows a weaker protective effect for racial minority groups, particularly Black people compared to White individuals. OBJECTIVES This longitudinal study used data of middle-aged and older adults with AD with two aims: first, to test the association between educational attainment and memory, and second, to explore racial differences in this association in the USA. METHODS Data came from the Alzheimer's Disease Neuroimaging Initiative (ADNI) study. The total sample was 1673 American middle-aged and older adults. The independent variable was educational attainment measured as years of education. The main outcome was memory operationalized as Rey Auditory Verbal Learning Test (RAVLT) Verbal Forgetting percentage (VF%). Age, gender, and follow-up duration were covariates. Race was the effect modifier. Linear regression model was utilized to analyze the data. RESULTS Of all participants, 68 (4.1%) were Black, and the remaining were White, with a mean age of 75 years old. In the pooled sample, educational attainment did not show a significant association with memory, independent of confounders. Educational attainment showed a significant interaction with race on memory, with higher educational attainment having a different effect on memory in White patients compared to Black patients. CONCLUSION The effect of higher educational attainment on memory differs for Black patients with AD compared to White patients. To prevent cognitive disparities by race, we need to go beyond racial inequality in access to resources (e.g., education) and minimize diminished returns of educational attainment for racial minorities. To tackle health inequalities, social policies should not be limited to equalizing socioeconomic status but also help minority groups leverage their available resources, such as educational attainment, and secure tangible outcomes.
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Affiliation(s)
- Arash Rahmani
- Marginalized-Related Diminished Returns (MDRs) Research Center, Los Angeles, CA, USA
| | - Babak Najand
- Marginalized-Related Diminished Returns (MDRs) Research Center, Los Angeles, CA, USA
| | - Amanda Sonnega
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Golnoush Akhlaghipour
- Marginalized-Related Diminished Returns (MDRs) Research Center, Los Angeles, CA, USA
| | - Mario F Mendez
- Department of Neurology, University of California Los Angeles (UCLA), Los Angeles, CA, USA
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Shervin Assari
- Marginalized-Related Diminished Returns (MDRs) Research Center, Los Angeles, CA, USA.
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA.
- Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA.
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12
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Gutchess A, Cho I. Memory and aging across cultures. Curr Opin Psychol 2024; 55:101728. [PMID: 38029643 PMCID: PMC10842239 DOI: 10.1016/j.copsyc.2023.101728] [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: 09/26/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023]
Abstract
Memory declines are commonly reported with age, but the majority of research has been conducted with narrow segments of the world's population. We argue for the importance of considering culture in the study of cognitive aging in order to have a representative, accurate understanding of the effects of aging on memory. Limited research thus far investigates the effects of culture on the use of categories and the self in memory with age, finding that cultural differences tend to be larger for older than younger adults. Frameworks drawing on top-down and bottom-up processes may account for when more or less cultural variation would be expected in cognitive performance. Promising future research directions include socio-emotional memory and expanding samples to address global inequities.
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Affiliation(s)
- Angela Gutchess
- Brandeis University, 415 South Street, Waltham, MA 02453, USA.
| | - Isu Cho
- Brandeis University, 415 South Street, Waltham, MA 02453, USA
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Peterson RL, Pejak R, George KM, Gilsanz P, Ko M, Meyer OL, Mayeda ER, Kind A, Whitmer RA. Race, community disadvantage, and cognitive decline: Findings from KHANDLE and STAR. Alzheimers Dement 2024; 20:904-913. [PMID: 37817548 PMCID: PMC10917037 DOI: 10.1002/alz.13511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/24/2023] [Accepted: 09/19/2023] [Indexed: 10/12/2023]
Abstract
INTRODUCTION Community disadvantage is associated with late-life cognition. Few studies examine its contribution to racial disparities in cognition/cognitive change. METHODS Inverse probability weighted models estimated expected mean differences in cognition/cognitive change attributed to residing in less advantaged communities, defined as cohort top quintile of Area Deprivation Indices (ADI): childhood 66-100; adulthood ADI 5-99). Interactions by race tested. RESULTS More Black participants resided in less advantaged communities. Semantic memory would be lower if all participants had resided in less advantaged childhood (b = -0.16, 95% confidence interval [CI] = -0.30, -0.03) or adulthood (b = -0.14, 95% CI = -0.22, -0.04) communities. Race interactions indicated that, among Black participants, less advantaged childhood communities were associated with higher verbal episodic memory (interaction p-value = 0.007) and less advantaged adulthood communities were associated with lower semantic memory (interaction p-value = 0.002). DISCUSSION Examining racial differences in levels of community advantage and late-life cognitive decline is a critical step toward unpacking community effects on cognitive disparities.
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Affiliation(s)
- Rachel L. Peterson
- School of Public and Community Health SciencesUniversity of MontanaMissoulaMontanaUSA
| | - Rebecca Pejak
- School of Public and Community Health SciencesUniversity of MontanaMissoulaMontanaUSA
| | - Kristen M. George
- Department of Public Health SciencesUniversity of California DavisDavisCaliforniaUSA
| | - Paola Gilsanz
- Division of ResearchKaiser Permanente Northern CaliforniaOaklandCaliforniaUSA
| | - Michelle Ko
- Department of Public Health SciencesUniversity of California DavisDavisCaliforniaUSA
| | - Oanh L. Meyer
- Department of NeurologyUniversity of California DavisDavisCaliforniaUSA
| | - Elizabeth Rose Mayeda
- Fielding School of Public HealthUniversity of California Los AngelesLos AngelesCaliforniaUSA
| | - Amy Kind
- University of Wisconsin Center for Health Disparities ResearchMadisonWisconsinUSA
| | - Rachel A. Whitmer
- Departments of Public Health Sciences and NeurologyUniversity of California DavisDavisCaliforniaUSA
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Estrella ML, Tarraf W, Kuwayama S, Gallo LC, Wu B, Marquine MJ, Perreira KM, Vasquez PM, Isasi CR, Lipton RB, Mattei J, González HM, Daviglus ML, Lamar M. Psychosocial factors associated with 7-year change in cognition among middle-aged and older Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) and Sociocultural ancillary studies. Alzheimers Dement 2024; 20:1137-1148. [PMID: 37897802 PMCID: PMC10916974 DOI: 10.1002/alz.13527] [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: 04/26/2023] [Revised: 08/02/2023] [Accepted: 10/06/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION Few studies have examined the associations of psychosocial factors with cognitive change in Hispanics/Latinos. METHODS Data from the Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (HCHS/SOL INCA) and Sociocultural studies were used (n = 2,155; ages ≥45 years). Psychosocial exposures included intrapersonal (ethnic identity, optimism, purpose in life), interpersonal (family cohesion, familism, social networks, social support), and social factors (ethnic discrimination, loneliness, subjective social status). Survey-linear regression models examined associations between psychosocial exposures and 7-year cognitive change (global cognition [GC], verbal learning, memory, word fluency [WF], and digit symbol substitution [DSS]). RESULTS Familism predicted decline in GC, verbal learning, and memory; family cohesion predicted DSS decline; and loneliness predicted memory decline. Ethnic identity was protective against decline in GC and memory, optimism and social support were protective against decline in memory, and purpose in life was protective against WF decline. DISCUSSION Psychosocial factors are differentially related to cognitive changes. Culturally relevant factors should be explored in Hispanic/Latino cognitive aging research. HIGHLIGHTS Psychosocial factors are differentially related to cognitive changes in Latinos. Role of culturally relevant factors on cognition should be further explored. Familism predicted decline in global cognition, verbal learning, and memory. Ethnic identity predicted increase in global cognition and memory.
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Affiliation(s)
- Mayra L. Estrella
- Department of EpidemiologyHuman Genetics and Environmental SciencesUniversity of Texas Health Sciences Center at Houston (UTHealth Houston) School of Public HealthBrownsvilleTexasUSA
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare SciencesWayne State UniversityDetroitMichiganUSA
| | - Sayaka Kuwayama
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Linda C. Gallo
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Benson Wu
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - María J. Marquine
- Departments of Medicine and PsychiatryDuke Center for the Study of Aging and Human DevelopmentDuke UniversityDurhamNorth CarolinaUSA
| | - Krista M. Perreira
- Department of Social MedicineUniversity of North Carolina School of MedicineChapel HillNorth CarolinaUSA
| | - Priscilla M. Vasquez
- Department of Urban Public HealthCharles R. Drew University of Medicine and ScienceLos AngelesCaliforniaUSA
| | - Carmen R. Isasi
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Richard B. Lipton
- Department of NeurologyAlbert Einstein College of MedicineNew YorkNew YorkUSA
| | - Josiemer Mattei
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Hector M. González
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Martha L. Daviglus
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Melissa Lamar
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Rush Alzheimer's Disease Center and the Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
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Morgan KA, Putnam M, Espin-Tello SM, Keglovits M, Campbell M, Yan Y, Wehmeier A, Stark S. Aging with long-term physical disability: Cohort analysis of survey sample in the U.S. F1000Res 2023; 11:68. [PMID: 38779460 PMCID: PMC11109573 DOI: 10.12688/f1000research.74532.2] [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] [Accepted: 12/13/2023] [Indexed: 05/25/2024] Open
Abstract
Background Chronic health conditions, secondary conditions, and decreasing functional ability related to aging and/or changes in underlying impairment may influence participation for persons aging with long-term physical disability (AwD). Objective To examine sample integrity and baseline findings through exploration of associations of sociodemographic, health, and disability factors with social participation for persons AwD. Methods This is a longitudinal cohort study following persons AwD over three years, reporting baseline cohort study data. A convenience sample of 474 persons AwD aged 45-65 reporting physical disability of ≥5 years' duration was recruited through community organizations and social media. The cohort was majority female (66.7%) and single (62.0%), and over one-third (38.6%) was non-White. Pain, fatigue, depression, ability to participate in, and satisfaction with, social roles and activities were measured with the Patient Reported Outcomes Measurement Information System. Results were manually compared against AwD study samples identified through a focused literature review and national census data. Results Participants aged 55-60 and 61-65 had significantly lower rates of employment and marriage and higher rates of living alone than participants aged 45-54. Participants reported higher rates of fatigue, pain, and depression and lower ability to participate in, and satisfaction with, participation in, social roles and activities than the general population. Ability to participate and satisfaction with participation were highest among Black/African American participants. Conclusions Participants reported higher rates of common AwD symptoms and lower ability to participate and satisfaction with participation than the general population, consistent with prior studies of AwD samples. This cohort reflects the AwD population and can be considered an AwD sample, comparable to those found in existing literature. The focus of future analyses will be to gain a greater understanding of chronic health conditions, incidence of falls, engagement in everyday life activities, and the impact of the environment.
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Affiliation(s)
- Kerri A. Morgan
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
| | - Michelle Putnam
- School of Social Work, Simmons University, Boston, Massachusetts, 02115, USA
| | - Sandra M. Espin-Tello
- EGOKITUZ, Universidad del País Vasco/Euskal Herriko Unibertsitatea, Lejona, Bizkaia, Spain
| | - Marian Keglovits
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
| | | | - Yan Yan
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
| | | | - Susan Stark
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
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16
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Morgan KA, Putnam M, Espin-Tello SM, Keglovits M, Campbell M, Yan Y, Wehmeier A, Stark S. Aging with long-term physical disability: Cohort analysis of survey sample in the U.S. F1000Res 2023; 11:68. [PMID: 38779460 PMCID: PMC11109573 DOI: 10.12688/f1000research.74532.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Chronic health conditions, secondary conditions, and decreasing functional ability related to aging and/or changes in underlying impairment may influence participation for persons aging with long-term physical disability (AwD). OBJECTIVE To examine sample integrity and baseline findings through exploration of associations of sociodemographic, health, and disability factors with social participation for persons AwD. METHODS This is a longitudinal cohort study following persons AwD over three years, reporting baseline cohort study data. A convenience sample of 474 persons AwD aged 45-65 reporting physical disability of ≥5 years' duration was recruited through community organizations and social media. The cohort was majority female (66.7%) and single (62.0%), and over one-third (38.6%) was non-White. Pain, fatigue, depression, ability to participate in, and satisfaction with, social roles and activities were measured with the Patient Reported Outcomes Measurement Information System. Results were manually compared against AwD study samples identified through a focused literature review and national census data. RESULTS Participants aged 55-60 and 61-65 had significantly lower rates of employment and marriage and higher rates of living alone than participants aged 45-54. Participants reported higher rates of fatigue, pain, and depression and lower ability to participate in, and satisfaction with, participation in, social roles and activities than the general population. Ability to participate and satisfaction with participation were highest among Black/African American participants. CONCLUSIONS Participants reported higher rates of common AwD symptoms and lower ability to participate and satisfaction with participation than the general population, consistent with prior studies of AwD samples. This cohort reflects the AwD population and can be considered an AwD sample, comparable to those found in existing literature. The focus of future analyses will be to gain a greater understanding of chronic health conditions, incidence of falls, engagement in everyday life activities, and the impact of the environment.
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Affiliation(s)
- Kerri A. Morgan
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
| | - Michelle Putnam
- School of Social Work, Simmons University, Boston, Massachusetts, 02115, USA
| | - Sandra M. Espin-Tello
- EGOKITUZ, Universidad del País Vasco/Euskal Herriko Unibertsitatea, Lejona, Bizkaia, Spain
| | - Marian Keglovits
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
| | | | - Yan Yan
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
| | | | - Susan Stark
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
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17
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Zahodne LB, Brauer S, Tarraf W, Morris EP, Antonucci TC, Ajrouch KJ. Measurement and structural invariance of a neuropsychological battery among Middle Eastern/North African, Black, and White older adults. Neuropsychology 2023; 37:975-984. [PMID: 36996172 PMCID: PMC10544699 DOI: 10.1037/neu0000902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
OBJECTIVE There is a lack of guidance on common neuropsychological measures among Arabic speakers and individuals who identify as Middle Eastern/North African (MENA) in the United States. This study evaluated measurement and structural invariance of a neuropsychological battery across race/ethnicity (MENA, Black, White) and language (Arabic, English). METHOD Six hundred six older adults (128 MENA-English, 74 MENA-Arabic, 207 Black, 197 White) from the Detroit Area Wellness Network were assessed via telephone. Multiple-group confirmatory factor analyses examined four indicators corresponding to distinct cognitive domains: episodic memory (Consortium to Establish a Registry for Alzheimer's Disease [CERAD] Word List), language (Animal Fluency), attention (Montreal Cognitive Assessment [MoCA] forward digit span), and working memory (MoCA backward digit span). RESULTS Measurement invariance analyses revealed full scalar invariance across language groups and partial scalar invariance across racial/ethnic groups suggesting a White testing advantage on Animal Fluency; yet this noninvariance did not meet a priori criteria for salient impact. Accounting for measurement noninvariance, structural invariance analyses revealed that MENA participants tested in English demonstrated lower cognitive health than Whites and Blacks, and MENA participants tested in Arabic demonstrated lower cognitive health than all other groups. CONCLUSIONS Measurement invariance results support the use of a rigorously translated neuropsychological battery to assess global cognitive health across MENA/Black/White and Arabic/English groups. Structural invariance results reveal underrecognized cognitive disparities. Disaggregating MENA older adults from other non-Latinx Whites will advance research on cognitive health equity. Future research should attend to heterogeneity within the MENA population, as the choice to be tested in Arabic versus English may reflect immigrant, educational, and socioeconomic experiences relevant to cognitive aging. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Simon Brauer
- Institute for Social Research, University of Michigan
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18
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Dark HE, Huang A, Cordon J, Deal JA, Palta P, Windham BG, Barnes LL, Kucharska-Newton A, Mosley T, Gottesman RF, Sims M, Griswold M, Rentería MA, Manly JJ, Walker KA. The association of perceived discrimination with dementia risk in Black older adults. Alzheimers Dement 2023; 19:4346-4356. [PMID: 37218405 PMCID: PMC10734390 DOI: 10.1002/alz.13135] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION Non-Hispanic Black, compared to non-Hispanic White, older adults are at increased risk for dementia. This may be due partly to greater exposure to psychosocial stressors, such as discrimination; however, few studies have examined this association. METHODS We examined the association of perceived discrimination (e.g., everyday, lifetime, and discrimination burden) with dementia risk in 1583 Black adults co-enrolled in the Atherosclerosis Risk in Communities (ARIC) Study and the Jackson Heart Study (JHS). Perceived discrimination (defined continuously and using tertiles) was assessed at JHS Exam 1 (2000-2004; mean age ± SD:66.2 ± 5.5) and related to dementia risk through ARIC visit 6 (2017) using covariate-adjusted Cox proportional hazards models. RESULTS Associations of perceived everyday, lifetime, and burden of discrimination with dementia risk were not supported in age-adjusted models or demographic- and cardiovascular health-adjusted models. Results were similar across sex, income, and education. DISCUSSION In this sample, associations between perceived discrimination and dementia risk were not supported. HIGHLIGHTS In Black older adults perceived discrimination not associated with dementia risk. Younger age and greater education linked to greater perceived discrimination. Older age and less education among factors associated with dementia risk. Factors increasing exposure to discrimination (education) are also neuroprotective.
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Affiliation(s)
- Heather E. Dark
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, 21224
| | - Alison Huang
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
- Cochlear Center for Hearing & Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, 21205, USA
| | - Jenifer Cordon
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, 21224
| | - Jennifer A. Deal
- Cochlear Center for Hearing & Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, 21205, USA
| | - Priya Palta
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, 10032, USA
- Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY, 10032, USA
| | - B. Gwen Windham
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, 39216, USA
| | - Lisa L. Barnes
- Department of Neurological Sciences at Rush University Medical Center, Chicago, IL, 60612, USA
- Rush Alzheimer’s Disease Center at Rush University Medical Center, Chicago, IL, 60612, USA
| | - Anna Kucharska-Newton
- University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC, 27599, USA
| | - Thomas Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, 39216, USA
| | - Rebecca F. Gottesman
- National Institute of Neurological Disorders and Stroke Intramural Program, NIH, Bethesda, MD, 20892, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, 39216, USA
| | - Michael Griswold
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, 39216, USA
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Miguel Arce Rentería
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
| | - Jennifer J. Manly
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
| | - Keenan A. Walker
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, 21224
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Jester DJ, Palmer BW, Thomas ML, Brown LL, Tibiriçá L, Jeste DV, Gilmer T. Impact of educational attainment on time to cognitive decline among marginalized older adults: Cohort study of 20,311 adults. J Am Geriatr Soc 2023; 71:2913-2923. [PMID: 37073606 PMCID: PMC10523883 DOI: 10.1111/jgs.18340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/06/2023] [Accepted: 02/24/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND The effect of years of education on the maintenance of healthy cognitive functioning may differ by race and ethnicity given historical and ongoing inequities in educational quality. METHODS We examined 20,311 Black, Latinx, and White adults aged 51-100 from the Health and Retirement Study (2008-2016). Telephone Interview for Cognitive Status-27 data was used to measure cognitive functioning. Generalized additive mixed models were stratified by race and ethnicity and educational attainment (≥12 vs. <12 years). Selected social determinants of health, all-cause mortality, time-varying health and healthcare utilization characteristics, and study wave were included as covariates. RESULTS On average, Black and Latinx adults scored lower at baseline compared to White adults regardless of educational attainment (p < 0.001), with a significant overlap in the distributions of scores. The rate of cognitive decline was non-linear for Black, Latinx, and White adults (p < 0.001), and a period of stability was witnessed for those with higher educational attainment irrespective of race and ethnicity. Compared to Black, Latinx, and White adults with lower educational attainment, higher-educated White adults received the greatest protection from cognitive decline (13 years; 64 vs. 51), followed by Latinx (12 years; 67 vs. 55), and Black adults (10 years; 61 vs. 51). Latinx adults experienced cognitive decline beginning at a later age. CONCLUSIONS The extent to which higher educational attainment protects adults from cognitive decline differs by race and ethnicity, such that higher-educated White adults received a greater benefit than higher-educated Black or Latinx adults.
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Affiliation(s)
- Dylan J. Jester
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Barton W. Palmer
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
- Psychology Division, Veterans Affairs San Diego Healthcare System, San Diego, CA
| | - Michael L. Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO
| | - Lauren L. Brown
- Division of Health Management and Policy, School of Public Health, San Diego State University, San Diego, CA
| | - Lize Tibiriçá
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Dilip V. Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - Todd Gilmer
- Herbert Wertheim School of Public Health, University of California San Diego, San Diego, California
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Ferreira NV, Bertola L, Santos IS, Goulart AC, Bittencourt MS, Barreto SM, Giatti L, Caramelli P, Pereira A, Lotufo PA, Bensenor IM, Suemoto CK. Association between carotid intima-media thickness and cognitive decline differs by race. Alzheimers Dement 2023; 19:3528-3536. [PMID: 36825689 DOI: 10.1002/alz.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
INTRODUCTION Common carotid intima-media thickness (cIMT) is a marker of subclinical atherosclerosis and is associated with cognitive decline. Although carotid atherosclerosis is more frequent in White than in Black participants, little is known whether race modifies the association between cIMT and cognitive decline. METHODS In this longitudinal analysis of the ELSA-Brasil, we assessed cIMT using ultrasound and cognitive performance using different domain tests. We used linear mixed models, interaction analysis, and race stratified analyses. RESULTS Baseline high IMT values were associated with memory (p < 0.001), verbal fluency (p < 0.001), TMT-B (p < 0.001)), and global cognitive decline (p < 0.001). Race was an effect modifier in the association between IMT and global cognitive decline (0.043), with stronger association in White (p < 0.001) than in Black (p = 0.009) participants. DISCUSSION Baseline IMT was associated with global and domain-specific cognitive decline and race modified this relationship, with stronger associations in White participants. HIGHLIGHTS Carotid intima-media thickness (cIMT) was associated with cognitive decline. cIMT and cognitive decline association was stronger in White than in Black participants. We used inverse probability weighting to address attrition bias.
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Affiliation(s)
- Naomi Vidal Ferreira
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Adventist University of Sao Paulo, Engenheiro Coelho, Sao Paulo, Brazil
- Amazonia Adventist College, Benevides, Pará, Brazil
| | - Laiss Bertola
- Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Marcio S Bittencourt
- Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sandhi Maria Barreto
- Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luana Giatti
- School of Medicine and Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Alexandre Pereira
- Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Paulo Andrade Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Isabela M Bensenor
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Claudia Kimie Suemoto
- Division of Geriatrics, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Sao Paulo, Brazil
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Rodriguez TM, Sheffler P, Ferguson LE, Rebok GW, Wu R. Cognitive and Functional Improvement via Novel Skill Learning for Low-Income Minoritized Middle-Aged and Older Adults. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:926-935. [PMID: 35895188 DOI: 10.1007/s11121-022-01413-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 11/25/2022]
Abstract
Prior research has demonstrated beneficial outcomes for learning new skills in older adulthood, including increased cognitive and functional abilities, which help prevent age-related declines and foster healthy aging. However, these studies largely have included participants not typically considered at risk for cognitive and functional decline (i.e., White, highly educated, higher income). Cognitive and functional disparities exist among minoritized racial and ethnic individuals, particularly Black and Latinx populations, because of a lifetime of inequalities associated with low socioeconomic status, low education, and discrimination. This theoretical paper proposes a potential pathway in which such disparities could be mitigated by increasing cognitive and functional abilities via novel skill learning in these at-risk populations in middle and later life to prevent decline. We also discuss indirect barriers (e.g., financial and health issues), direct barriers (e.g., limited learning opportunities), and motivational barriers (e.g., self-beliefs, values) that these adults may encounter. We further highlight that addressing these barriers to novel skill learning by providing appropriate resources is necessary to maximize the feasibility and potential effectiveness of this pathway. Lastly, we encourage future research to test this pathway and help inform policymakers and existing learning programs to implement better ways of promoting lifelong learning in an inclusive and equitable manner to prevent decline.
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Affiliation(s)
| | - Pamela Sheffler
- Department of Psychology, University of California, Riverside, USA
| | - Leah E Ferguson
- Department of Psychology, University of California, Riverside, USA
| | - George W Rebok
- Department of Mental Health, Bloomberg School of Public Health, Baltimore, USA
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Baltimore, USA
- Johns Hopkins Center on Aging and Health, Johns Hopkins University, Baltimore, USA
| | - Rachel Wu
- Department of Psychology, University of California, Riverside, USA
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22
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Suchy-Dicey A, Su Y, Buchwald DS, Manson SM, Reiman EM. Volume atrophy in medial temporal cortex and verbal memory scores in American Indians: Data from the Strong Heart Study. Alzheimers Dement 2023; 19:2298-2306. [PMID: 36453775 PMCID: PMC10232670 DOI: 10.1002/alz.12889] [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: 06/30/2022] [Revised: 10/06/2022] [Accepted: 10/25/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Distinguishing Alzheimer's disease (AD) patient subgroups may optimize positive clinical outcomes. Cortical atrophy is correlated with memory deficits, but these associations are understudied in American Indians. METHODS We collected imaging and cognition data in the Strong Heart Study (SHS), a cohort of 11 tribes across three regions. We processed 1.5T MRI using FreeSurfer and iterative principal component analysis. Linear mixed models estimated volumetric associations with diabetes. RESULTS Over mean 7 years follow-up (N = 818 age 65-89 years), overall volume loss was 0.5% per year. Significant losses associated with diabetes were especially strong in the right hemisphere. Annualized hippocampal, parahippocampal, entorhinal atrophy were worse for men, older age, diabetes, hypertension, stroke; and associated with both encoding and retrieval memory losses. DISCUSSION Our findings suggest that diabetes is an important risk factor in American Indians for cortical atrophy and memory loss. Future research should examine opportunities for primary prevention in this underserved population.
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Affiliation(s)
- Astrid Suchy-Dicey
- Elson S Floyd College of Medicine, Washington State University, Spokane, Washington, USA
| | - Yi Su
- Banner Alzheimer's Institute, Phoenix, Arizona, USA
| | - Dedra S Buchwald
- Elson S Floyd College of Medicine, Washington State University, Spokane, Washington, USA
| | - Spero M Manson
- Colorado School of Public Health, University of Colorado Anschutz, Aurora, Colorado, USA
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23
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Lee J, Sol K, Zaheed A, Morris E, Meister L, Palms J, Zahodne L. Coping Styles and Cognitive Function in Older Non-Hispanic Black and White Adults. J Gerontol B Psychol Sci Soc Sci 2023; 78:789-798. [PMID: 36630289 PMCID: PMC10174202 DOI: 10.1093/geronb/gbad005] [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: 07/12/2022] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Coping styles refer to cognitive and behavioral patterns used to manage the demands of stressors, and effective coping represents a psychological resource. Some studies have linked coping styles to executive functioning, but less is known about coping styles and their associations with cognition across social groups known to differ in stress exposure and dementia risk. This study aimed to characterize associations between coping styles and cognitive functioning across non-Hispanic Black and non-Hispanic White older adults. METHODS Participants were drawn from the Michigan Cognitive Aging Project (N = 453; age mean (SD) = 63.6 (3.2); 53% non-Hispanic Black). Problem-focused and emotion-focused coping were measured using the Coping Orientation to Problems Experienced Inventory. Global cognition was a composite of 5 cognitive domain scores derived from comprehensive neuropsychological tests. Cross-sectional associations between coping styles and cognition were examined using race-stratified regressions controlling for demographic and health covariates. RESULTS Black older adults reported more emotion-focused coping than White older adults, but there were no race differences in problem-focused coping. Among Black older adults, less problem-focused coping and more emotion-focused coping were each associated with worse cognition. Among White older adults, emotion-focused coping was marginally linked to cognition. DISCUSSION Greater emotion-focused coping among Black older adults may reflect greater exposure to stressors that are uncontrollable. Patterns of racial differences in coping-cognition links are in line with the social vulnerabilities hypothesis. Coping style may be a particularly important psychosocial resource for cognitive health among Black older adults that could be incorporated into culturally relevant interventions.
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Affiliation(s)
- Ji Hyun Lee
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ketlyne Sol
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Afsara B Zaheed
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily P Morris
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Lindsey M Meister
- Department of Biostatistics, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jordan D Palms
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
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24
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Caldwell JZ, Isenberg N. The aging brain: risk factors and interventions for long term brain health in women. Curr Opin Obstet Gynecol 2023; 35:169-175. [PMID: 36912325 PMCID: PMC10023345 DOI: 10.1097/gco.0000000000000849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
PURPOSE OF REVIEW Poor cognitive aging and dementia pose a significant public health burden, and women face unique risks compared to men. Recent research highlights the role of genetics, menopause, chronic disease, and lifestyle in risk and resilience in women's cognitive aging. This work suggests avenues for clinical action at midlife that may change the course of brain health in aging. RECENT FINDINGS Studies indicate women's risk for poor cognitive aging relates in part to hormone changes at menopause, a time when memory, brain structure and function, and Alzheimer's pathology may be observed in women and not men. Medical and lifestyle risks including diabetes, hypertension, and low physical activity also contribute to women's unique risks. At the same time, literature on resilience suggests women may benefit from lifestyle and chronic disease intervention, possibly more than men. Current studies emphasize the importance of interacting genetic and lifestyle risks, and effects of social determinants of health. SUMMARY Women have greater risk than men for poor cognitive aging; however, by treating the whole person, including genetics, lifestyle, and social environment, clinicians have an opportunity to support healthy cognitive aging in women and reduce the future public health burden of dementia.
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Affiliation(s)
- Jessica Z.K. Caldwell
- Cleveland Clinic Lou Ruvo Center for Brain Health, 888 W. Bonneville Ave., Las Vegas, NV 89106
| | - Nancy Isenberg
- Providence Swedish Center for Healthy Aging, Swedish Neuroscience Institute, 1600 E. Jefferson St. A Level, Seattle, WA 98122
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25
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Al-Rousan T, Kamalyan L, Bernstein Sideman A, Miller B, AlHeresh R, Moore A, Marquine MJ, Argeros G, Ajrouch KJ. Migration and Cognitive Health Disparities: The Arab American and Refugee Case. J Gerontol B Psychol Sci Soc Sci 2023; 78:111-123. [PMID: 36056890 PMCID: PMC9890904 DOI: 10.1093/geronb/gbac129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES This study investigates whether the year of arrival to the United States (U.S.) and birthplace relate to postmigration cognitive difficulties among foreign- and U.S.-born Arab Americans in later life. METHODS We analyzed 19 years (2000-2019) of data from the American Community Survey Public Use Microdata Samples (weighted N = 393,501; ages ≥ 50 years). Cognitive difficulty was based on self-reported data, and weighted means, percentages, adjusted prevalence estimates, and adjusted odds ratio were calculated. RESULTS Controlling only for demographics, foreign-born Arabs reported higher odds of cognitive difficulty compared to U.S.-born Arabs across all arrival cohorts (p < .001). After accounting for economic and integration factors, those who arrived between 1991 and 2000 had higher odds (odds ratio [OR] = 1.06, 95% confidence interval [CI] =1.00, 1.19, p < .01), while those who arrived after 2001 had lower odds (OR = 0.87, 95% CI = 0.78, 0.97, p < .001) of cognitive difficulty. Lacking English proficiency (OR = 1.90, 95% CI = 1.82, 1.98, p < .001) was related to higher odds, whereas not being a U.S. citizen was significantly associated with lower odds (OR = 0.89, 95% CI = 0.52, 0.94, p < .001) of cognitive difficulty. Yet, results varied by birthplace. Migrants born in Iraq consistently reported the highest odds of cognitive difficulty across all arrival cohorts. DISCUSSION Migration history and birthplace may be important factors explaining cognitive disparities among the diverse group of Arab migrants and Arab Americans. Future research examining mechanisms underlying these associations and the impact of migration on cognitive health is needed to address cognitive disparities in migrants.
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Affiliation(s)
- Tala Al-Rousan
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Global Brain Health Institute, University of California, San Francisco, California, USA
| | - Lily Kamalyan
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego, California, USA
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Alissa Bernstein Sideman
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA
- Department of Humanities and Social Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Bruce Miller
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Rawan AlHeresh
- Mass General Health Institute of Health Professions, Boston, Massachusetts, USA
| | - Alison Moore
- Division of Geriatrics, Gerontology and Palliative Care, Department of Medicine, University of California, San Diego, California, USA
| | - María J Marquine
- Division of Geriatrics, Gerontology and Palliative Care, Department of Medicine, University of California, San Diego, California, USA
| | - Grigoris Argeros
- Department of Sociology, Anthropology, and Criminology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Kristine J Ajrouch
- Department of Sociology, Anthropology, and Criminology, Eastern Michigan University, Ypsilanti, Michigan, USA
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
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26
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Wagle J, Selbæk G, Benth JŠ, Gjøra L, Rønqvist TK, Bekkhus-Wetterberg P, Persson K, Engedal K. The CERAD Word List Memory Test: Normative Data Based on a Norwegian Population-Based Sample of Healthy Older Adults 70 Years and Above. The HUNT Study. J Alzheimers Dis 2023; 91:321-343. [PMID: 36404547 DOI: 10.3233/jad-220672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The CERAD Word List Memory Test (WLMT) is widely used in the assessment of older adults with suspected dementia. Although normative data of the WLMT exist in many different regions of the world, normative data based on large population-based cohorts from the Scandinavian countries are lacking. OBJECTIVE To develop normative data for the WLMT based on a large population-based Norwegian sample of healthy older adults aged 70 years and above, stratified by age, gender, and education. METHODS A total of 6,356 older adults from two population-based studies in Norway, HUNT4 70 + and HUNT4 Trondheim 70+, were administered the WLMT. Only persons with normal cognitive function were included. We excluded persons with a diagnosis of mild cognitive impairment (MCI) and dementia, and persons with a history of stroke and/or depression. This resulted in 3,951 persons aged between 70 and 90 years, of whom 56.2% were females. Regression-based normative data were developed for this sample. RESULTS Age, gender, and education were significant predictors of performance on the WLMT list-learning subtests and the delayed recall subtest, i.e., participants of younger age, female sex, and higher education level attained higher scores compared to participants of older age, male sex, and lower level of education. CONCLUSION Regression-based normative data from the WMLT, stratified by age, gender, and education from a large population-based Norwegian sample of cognitively healthy older adults aged 70 to 90 years are presented. An online norm calculator is available to facilitate scoring of the subtests (in percentiles and z-scores).
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Affiliation(s)
- Jørgen Wagle
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Geir Selbæk
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Linda Gjøra
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Psychiatry, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Thale Kinne Rønqvist
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | | | - Karin Persson
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Knut Engedal
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
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27
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Araujo-Menendez CE, Saelzler UG, Stickel AM, Sundermann EE, Banks SJ, Paipilla A, Barnes ML, Panizzon MS. Associations Between Parity and Cognition: Race/Ethnic Differences. J Alzheimers Dis 2023; 94:1157-1168. [PMID: 37393496 PMCID: PMC10473123 DOI: 10.3233/jad-221210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Race/ethnicity is associated with differences in reproductive history and cognition individually, yet it remains an understudied factor in the relationship between parity and later-life cognition. OBJECTIVE To evaluate if the association between parity and cognition differs between racial/ethnic groups. METHODS Participants included 778 older, postmenopausal women from the Health and Nutrition Examination Survey (Latina: n = 178, Non-Latino Black [NLB]: n = 169, Non-Latino White [NLW]: n = 431) who self-reported at least one birth. Cognitive outcomes included working memory, learning memory, and verbal fluency. Covariates included age, education, cardiovascular and other reproductive health factors, adult socioeconomic status (SES) and depressive symptoms. We fit a series of linear models to examine a) whether parity was associated with cognitive functioning, b) if this association varied by race/ethnicity through parity by race/ethnicity interactions, and c) individual parity with cognition associations stratified by race/ethnicity. RESULTS In the full sample, parity was significantly negatively associated with Digit Symbol Substitution Test (DSST) performance (b = -0.70, p = 0.024) but not Animal Fluency or word-list learning and memory. Tests of race/ethnicity-by-parity interactions were not statistically significant (ps > 0.05). However, stratified analyses by race/ethnicity showed a differential effect of parity on DSST performance, such that parity was significantly negatively associated with DSST performance (b = -1.66, p = 0.007) among Latinas but not in NLWs (b = -0.16, p = 0.74) or NLBs (b = -0.81, p = 0.191). CONCLUSION Among Latina, but not NLB or NLW women, greater parity was associated with worse processing speed/executive functioning later in life. Further research is needed to understand the mechanisms driving racial/ethnic differences.
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Affiliation(s)
| | - Ursula G. Saelzler
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Ariana M. Stickel
- Department of Psychology, San Diego State University, La Jolla, CA, USA
| | - Erin E. Sundermann
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Sarah J. Banks
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
| | - Andrea Paipilla
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - McKinna L. Barnes
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Matthew S. Panizzon
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA
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28
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Vásquez PM, Tarraf W, Chai A, Doza A, Sotres-Alvarez D, Diaz KM, Zlatar ZZ, Durazo-Arvizu RA, Gallo LC, Estrella ML, Vásquez E, Evenson KR, Khambaty T, Thyagarajan B, Singer RH, Schneiderman N, Daviglus ML, González HM. Accelerometer-Measured Latent Physical Activity Profiles and Neurocognition Among Middle-Aged and Older Hispanic/Latino Adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Gerontol B Psychol Sci Soc Sci 2022; 77:e263-e278. [PMID: 36219450 PMCID: PMC9799203 DOI: 10.1093/geronb/gbac161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Derive latent profiles of accelerometry-measured moderate-vigorous physical activity (MVPA) for Hispanic/Latino adults, examine associations between latent MVPA profiles and neurocognition, and describe profiles via self-reported MVPA. METHODS Complex survey design methods were applied to cross-sectional data from 7,672 adults ages 45-74 years in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL; 2008-2011). MVPA was measured via hip-worn accelerometers. Latent profile analysis was applied to derive latent MVPA profiles (minutes/day of week). Neurocognition was assessed with the Brief-Spanish English Verbal Learning Test (B-SEVLT) Sum, B-SEVLT Recall, Controlled Oral Word Association Test (word fluency), and Digit Symbol Substitution (DSS) test. All tests were z-scored, and a global neurocognition score was generated by averaging across scores. Survey linear regression models were used to examine associations between latent MVPA profiles and neurocognitive measures. Self-reported MVPA domains were estimated (occupational, transportation, and recreational) for each latent profile. RESULTS Four latent MVPA profiles from the overall adult target population (18-74 years) were derived and putatively labeled: No MVPA, low, moderate, and high. Only the high MVPA profile (compared to moderate) was associated with lower global neurocognition. Sensitivity analyses using latent MVPA profiles with only participants aged 45-74 years showed similar profiles, but no associations between latent MVPA profiles and neurocognition. The occupational MVPA domain led in all latent MVPA profiles. DISCUSSION We found no consistent evidence to link accelerometry-measured MVPA profiles to neurocognitive function. Research to better characterize the role of high occupational MVPA in relation to neurocognition among Hispanic/Latino adults are needed.
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Affiliation(s)
- Priscilla M Vásquez
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Services, Wayne State University, Detroit, Michigan, USA
| | - Albert Chai
- Department of Neuroscience, University of California San Diego, La Jolla, California, USA
| | - Adit Doza
- Institute of Gerontology and Department of Healthcare Services, Wayne State University, Detroit, Michigan, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Keith M Diaz
- Department of Medicine, Columbia University Medical Center, New York, New York, USA
| | - Zvinka Z Zlatar
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Ramon A Durazo-Arvizu
- Department of Pediatrics, University of Southern California, Los Angeles, California, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Mayra L Estrella
- Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Elizabeth Vásquez
- School of Public Health, University at Albany, State University of New York, Rensselaer, New York, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Tasneem Khambaty
- Department of Psychology, University of Maryland Baltimore County, Baltimore, Maryland, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Richard H Singer
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, Ft. Lauderdale, Florida, USA
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Hector M González
- Department of Neuroscience, University of California San Diego, La Jolla, California, USA
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29
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McSorley VE, Howard C, Shah RC, James BD, Boyle P, Barnes LL. The Relationship of John Henryism With Cognitive Function and Decline in Older Black Adults. Psychosom Med 2022; 84:766-772. [PMID: 35980784 PMCID: PMC9437121 DOI: 10.1097/psy.0000000000001113] [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] [Indexed: 10/15/2022]
Abstract
OBJECTIVE This study aimed to investigate the relationship between John Henryism, a psychological trait typified by high-effort active coping that has been associated with adverse health outcomes among Blacks, and cognitive decline. METHODS In a cohort of community-dwelling older Black adults ( N = 611), we investigated the relationship between John Henryism and cognitive decline. John Henryism was measured using the John Henryism Active Coping Scale (JHACS), a nine-item validated measure of self-reported high-effort coping (mean [standard deviation] = 16.9 [4.8]; range, 4-27). We implemented a three-step modeling process using mixed-effects models to assess the relationship between the JHACS and global cognitive function as well as five cognitive domains. We adjusted for demographics and for factors known to be associated with cognitive function and decline including vascular risk factors, discrimination, and income. RESULTS The trait of high-effort active coping was associated with lower-average cognitive function ( β = -0.07, 95% confidence interval = -0.10 to -0.03), but not with decline. The results remained after further adjustment for experiences of discrimination, income, and vascular risk factors. In domain-specific analyses, we found that the JHACS was associated with baseline levels of working memory, semantic memory, and visuospatial ability, but not decline. CONCLUSIONS These results highlight the importance of using culturally specific measures in considering the heterogeneity of cognitive health outcomes in minoritized populations. Understanding how stress responses relate to late-life cognition among older Black adults could help promote aspects of behavioral resilience along with healthful coping responses.
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Affiliation(s)
- V. Eloesa McSorley
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Christopher Howard
- Department of Psychology, Utah State Hospital
- Department Brigham Young University
| | - Raj C. Shah
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Family Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Bryan D. James
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Patricia Boyle
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
- Department Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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30
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Franzen S, Smith JE, van den Berg E, Rivera Mindt M, van Bruchem‐Visser RL, Abner EL, Schneider LS, Prins ND, Babulal GM, Papma JM. Diversity in Alzheimer's disease drug trials: The importance of eligibility criteria. Alzheimers Dement 2022; 18:810-823. [PMID: 34590409 PMCID: PMC8964823 DOI: 10.1002/alz.12433] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/14/2021] [Accepted: 06/24/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION To generalize safety and efficacy findings, it is essential that diverse populations are well represented in Alzheimer's disease (AD) drug trials. In this review, we aimed to investigate participant diversity in disease-modifying AD trials over time, and the frequencies of participant eligibility criteria. METHODS A systematic review was performed using Medline, Embase, the Cochrane Library, and Clinicaltrials.gov, identifying 2247 records. RESULTS In the 101 included AD trials, participants were predominantly White (median percentage: 94.7%, interquartile range: 81.0-96.7%); and this percentage showed no significant increase or decrease over time (2001-2019). Eligibility criteria such as exclusion of persons with psychiatric illness (78.2%), cardiovascular disease (71.3%) and cerebrovascular disease (68.3%), obligated caregiver attendance (80.2%), and specific Mini-Mental State Examination scores (90.1%; no significant increase/decrease over time) may have led to a disproportionate exclusion of ethnoracially diverse individuals. DISCUSSION Ethnoracially diverse participants continue to be underrepresented in AD clinical trials. Several recommendations are provided to broaden eligibility criteria.
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Affiliation(s)
- Sanne Franzen
- Department of NeurologyErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Jade Emily Smith
- Department of NeurologyErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Esther van den Berg
- Department of NeurologyErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Monica Rivera Mindt
- Department of Psychology and Latin American Latino Studies InstituteFordham UniversityThe BronxNew YorkUSA,Department of NeurologyThe Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | | | - Erin L. Abner
- Sanders‐Brown Center on Aging and Alzheimer's Disease CenterUniversity of KentuckyLexingtonKentuckyUSA,College of Public HealthDepartment of EpidemiologyUniversity of KentuckyLexingtonKentuckyUSA,College of Public HealthDepartment of BiostatisticsUniversity of KentuckyLexingtonKentuckyUSA
| | - Lon S. Schneider
- Keck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Niels D. Prins
- Alzheimer CenterDepartment of NeurologyVU University Medical CenterAmsterdamthe Netherlands,Brain Research CenterAmsterdamthe Netherlands
| | - Ganesh M. Babulal
- Department of Neurology and Knight Alzheimer's Disease Research CenterWashington University School of MedicineSt. LouisMissouriUSA,Department of PsychologyUniversity of JohannesburgJohannesburgSouth Africa
| | - Janne M. Papma
- Department of NeurologyErasmus MC University Medical CenterRotterdamthe Netherlands
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31
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Desaire H, Stepler KE, Robinson RAS. Exposing the Brain Proteomic Signatures of Alzheimer's Disease in Diverse Racial Groups: Leveraging Multiple Data Sets and Machine Learning. J Proteome Res 2022; 21:1095-1104. [PMID: 35276041 PMCID: PMC9097891 DOI: 10.1021/acs.jproteome.1c00966] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Recent studies have highlighted that the proteome can be used to identify potential biomarker candidates for Alzheimer's disease (AD) in diverse cohorts. Furthermore, the racial and ethnic background of participants is an important factor to consider to ensure the effectiveness of potential biomarkers for representative populations. A promising approach to survey potential biomarker candidates for diagnosing AD in diverse cohorts is the application of machine learning to proteomics data sets. Herein, we leveraged six existing bottom-up proteomics data sets, which included non-Hispanic White, African American/Black, and Hispanic participants, to study protein changes in AD and cognitively unimpaired participants. Machine learning models were applied to these data sets and resulted in the identification of amyloid-β precursor protein (APP) and heat shock protein β-1 (HSPB1) as two proteins that have high ability to distinguish AD; however, each protein's performance varied based upon the racial and ethnic background of the participants. HSPB1 particularly was helpful for generating high areas under the curve (AUCs) for African American/Black participants. Overall, HSPB1 improved the performance of the machine learning models when combined with APP and/or participant age and is a potential candidate that should be further explored in AD biomarker discovery efforts.
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Affiliation(s)
- Heather Desaire
- Department of Chemistry, University of Kansas, Lawrence, Kansas 66045, United States
| | - Kaitlyn E Stepler
- Department of Chemistry, Vanderbilt University, Nashville, Tennessee 37235, United States
| | - Renã A S Robinson
- Department of Chemistry, Vanderbilt University, Nashville, Tennessee 37235, United States.,Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, Tennessee 37212, United States.,Vanderbilt Institute of Chemical Biology, Vanderbilt University, Nashville, Tennessee 37232, United States.,Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee 37232, United States.,Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37232, United States
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Zahodne LB. Psychosocial Protective Factors in Cognitive Aging: A Targeted Review. Arch Clin Neuropsychol 2021; 36:1266-1273. [PMID: 34244708 DOI: 10.1093/arclin/acab051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The lack of disease-modifying pharmacological agents for dementia highlights the critical importance of prevention, but known modifiable factors (e.g., education, physical health and health behaviors, depression, and social isolation) do not fully represent potential intervention targets. Positive psychosocial factors predict cognitive aging outcomes above and beyond known risk factors and may also correspond to upstream determinants that open up new avenues for prevention and intervention, as well as for reducing racial/ethnic inequalities in dementia. In this brief report, I summarize contemporary evidence for three positive psychosocial factors that appear to be particularly relevant to cognitive aging: perceived control, religious involvement, and social relations. METHODS Targeted review and synthesis of published studies. RESULTS Each of the multidimensional constructs appears to contain "active ingredients" that could help to optimize cognitive aging through disparate mechanisms. Although historically marginalized racial/ethnic groups face disproportionate barriers to accessing certain psychosocial protective factors (e.g., perceived control), these same groups also exhibit naturally occurring sources of psychosocial resilience (e.g., religious involvement) that allow them to achieve better late-life cognitive health than would be otherwise expected. With regard to social relations, converging evidence from disparate studies shows that fostering late-life friendships in particular may have high potential for building cognitive reserve and promoting healthy cognitive aging. CONCLUSIONS Positive psychosocial factors represent culturally relevant resources that, through careful research, could ultimately be harnessed to promote better cognitive aging for a growing and increasingly diverse population of older adults.
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Affiliation(s)
- Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
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