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Dixon JS, Coyne AE, Duff K, Ready RE. Predictors of cognitive decline in a multi-racial sample of midlife women: A longitudinal study. Neuropsychology 2021; 35:514-528. [PMID: 34014752 PMCID: PMC8352567 DOI: 10.1037/neu0000743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objective: Hypertension, diabetes, depressive symptoms, and smoking are predictors of cognitive decline in late life. It is unknown if these risk factors are associated with cognition during midlife or if the associations between these risk factors and cognition vary by race. This longitudinal study examined (a) risk factors for decline in episodic memory, processing speed, and working memory in midlife women and (b) if the associations between risk factors and cognitive decline were moderated by race. Method: Participants (aged 42-52) were European American (n = 1,000), African American (n = 516), and Asian American (n = 437) women from the Study of Women's Health Across the Nation. Two-level hierarchical linear models tested risk factors, race, and their interactions as predictors of cognitive change over time. Results: African Americans had poorer baseline episodic memory, processing speed, and working memory and greater episodic memory decline compared to European Americans. Asian Americans had poorer episodic memory and working memory, but better processing speed than European Americans. Depressive symptoms were associated with poorer episodic memory and processing speed at baseline; further, diabetes was associated with poorer processing speed at baseline. Greater depressive symptoms were associated with poorer episodic memory at baseline for African Americans but not European Americans. Conclusions: Our study results highlight racial disparities in cognition during midlife. Depressive symptoms may be particularly detrimental to the cognitive health of African Americans. Clinical and public health interventions for healthy cognitive aging should be tailored to the unique risks of racial groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Jasmine S. Dixon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA
| | - Alice E. Coyne
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA
| | - Kevin Duff
- Department of Neurology, University of Utah, Salt Lake City, UT
| | - Rebecca E. Ready
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA
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2
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Lim S, Mohaimin S, Min D, Roberts T, Sohn YJ, Wong J, Sivanesathurai R, Kwon SC, Trinh-Shevrin C. Alzheimer's Disease and its Related Dementias among Asian Americans, Native Hawaiians, and Pacific Islanders: A Scoping Review. J Alzheimers Dis 2020; 77:523-537. [PMID: 32675416 PMCID: PMC8638681 DOI: 10.3233/jad-200509] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The Asian American, Native Hawaiian, and Pacific Islander (AANHPI) aging population is rapidly growing and the burden of Alzheimer's disease and its related dementias (ADRD) will likely mirror this demographic growth. AANHPIs face significant barriers in obtaining timely ADRD diagnosis and services; yet little is known about ADRD in this population. OBJECTIVE The study objective is to conduct a systematic review on the published literature on ADRD among AANHPIs to identify gaps and priorities to inform future research and action plans. METHODS The systematic review was conducted following the PRISMA Protocol for Systematic Reviews. Co-author (TR), an experienced Medical Librarian, searched PubMed, EMBASE, PsycINFO, Cochrane Central of Clinical Trials, Ageline, and Web of Science for peer-reviewed articles describing ADRD among AANHPIs. The search was not limited by language or publication date. Each citation was reviewed by two trained independent reviewers. Conflicts were resolved through consensus. RESULTS The title/abstract and full texts of 1,447 unique articles were screened for inclusion, yielding 168 articles for analysis. Major research topics included prevalence, risk factors, comorbidities, interventions and outreach, knowledge and attitudes, caregiving, and detection tools. A limited number of studies reported on national data, on NHPI communities generally, and on efficacy of interventions targeting AANHPI communities. CONCLUSION To our knowledge, this is the first systematic review on ADRD among AANHPI populations. Our review provides a first step in mapping the extant literature on ADRD among this underserved and under-researched population and will serve as a guide for future research, policy, and intervention.
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Affiliation(s)
- Sahnah Lim
- Department of Population Health, New York University Grossman School of Medicine
| | - Sadia Mohaimin
- Department of Population Health, New York University Grossman School of Medicine
| | - Deborah Min
- Department of Population Health, New York University Grossman School of Medicine
| | - Timothy Roberts
- Health Science Library, New York University Grossman School of Medicine
| | - Young-Jin Sohn
- Department of Population Health, New York University Grossman School of Medicine
| | - Jazmine Wong
- Department of Population Health, New York University Grossman School of Medicine
| | | | - Simona C. Kwon
- Department of Population Health, New York University Grossman School of Medicine
| | - Chau Trinh-Shevrin
- Department of Population Health, New York University Grossman School of Medicine
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3
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Ng KP, Chiew HJ, Lim L, Rosa-Neto P, Kandiah N, Gauthier S. The influence of language and culture on cognitive assessment tools in the diagnosis of early cognitive impairment and dementia. Expert Rev Neurother 2018; 18:859-869. [DOI: 10.1080/14737175.2018.1532792] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Kok Pin Ng
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Hui Jin Chiew
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Levinia Lim
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Pedro Rosa-Neto
- Alzheimer’s Disease Research Unit, The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | - Nagaendran Kandiah
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Serge Gauthier
- Alzheimer’s Disease Research Unit, The McGill University Research Centre for Studies in Aging, Montreal, Canada
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Shi C, Kang L, Yao S, Ma Y, Li T, Liang Y, Cheng Z, Xu Y, Shi J, Xu X, Zhang C, Franklin DR, Heaton RK, Jin H, Yu X. The MATRICS Consensus Cognitive Battery (MCCB): Co-norming and standardization in China. Schizophr Res 2015; 169:109-115. [PMID: 26441005 PMCID: PMC4916953 DOI: 10.1016/j.schres.2015.09.003] [Citation(s) in RCA: 173] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 08/31/2015] [Accepted: 09/01/2015] [Indexed: 01/10/2023]
Abstract
MATRICS Consensus Cognitive Battery (MCCB), packaging 10 tests selected from more than 90 nominated tests, is a method developed by the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) group to evaluate the efficacy of treatments targeting cognitive impairments in schizophrenia. MCCB had been translated into a number of languages, but only the US and Spain had normative data reported. Inconsistency in translation and cultural differences make direct application of MCCB in China problematic. In this study, we administered the battery to a representative community sample based on Chinese population census in 2005 and obtained normative data. The effects of age, gender, education level, and scale of residence area on test performance were examined. The sample included 656 healthy volunteers from six sites in China. At each site, sample was stratified according to age, gender, and educational level, and scale of the area one was born in, grew up in and currently living in was recorded. We found age, gender, and education had significant effects on the normative data for MCCB in China, which are comparable to those found for the original standardized English version in the U.S. and the Spanish version in Spain. Remarkably, the residence scale effects on neuropsychological performance were significant, which should be taking into account when calculating the standardized T score for each subject. The practice effects were minor and test-retest reliability of MCCB was good, which suggests MCCB as an appropriate measure for clinical and research usage in China.
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Affiliation(s)
- Chuan Shi
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital) Beijing, China, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Lan Kang
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital) Beijing, China, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Shuqiao Yao
- The Medical Psychological Research Center, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yibin Ma
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital) Beijing, China, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Tao Li
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital) Beijing, China, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Ying Liang
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital) Beijing, China, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Zhang Cheng
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital) Beijing, China, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Yifeng Xu
- Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianguo Shi
- Xian Mental Health Center, New Qujiang District, Xian, Shanxi, China
| | - Xiufeng Xu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Congpei Zhang
- The First Haerbin Psychiatric Hospital, Haerbin, Heilongjiang, China
| | - Donald R. Franklin
- Department of Psychiatry, University of California at San Diego, San Diego, CA, USA
| | - Robert K. Heaton
- Department of Psychiatry, University of California at San Diego, San Diego, CA, USA
| | - Hua Jin
- Department of Psychiatry, University of California at San Diego, San Diego, CA, USA.
| | - Xin Yu
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital) Beijing, China; Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China.
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5
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Chen CW, Chu H, Tsai CF, Yang HL, Tsai JC, Chung MH, Liao YM, Chi MJ, Chou KR. The reliability, validity, sensitivity, specificity and predictive values of the Chinese version of the Rowland Universal Dementia Assessment Scale. J Clin Nurs 2015; 24:3118-28. [DOI: 10.1111/jocn.12941] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Chia-Wei Chen
- Graduate Institute of Nursing; College of Nursing; Taipei Medical University; Taipei Taiwan
| | - Hsin Chu
- Institute of Aerospace and Undersea Medicine; School of Medicine; National Defense Medical Center; Taipei Taiwan
- Department of Neurology; Tri-Service General Hospital; National Defense Medical Center; Taipei Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry; Taipei Veterans General Hospital; Taipei Taiwan
- Institute of Brain Science; National Yang-Ming University Schools of Medicine; Taipei Taiwan
- Faculty of Medicine; National Yang-Ming University Schools of Medicine; Taipei Taiwan
| | - Hui-Ling Yang
- Graduate Institute of Nursing; College of Nursing; Taipei Medical University; Taipei Taiwan
| | - Jui-Chen Tsai
- Department of Nursing; Taipei Medical University-Shuang Ho Hospital; Taipei Taiwan
| | - Min-Huey Chung
- Graduate Institute of Nursing; College of Nursing; Taipei Medical University; Taipei Taiwan
| | - Yuan-Mei Liao
- Graduate Institute of Nursing; College of Nursing; Taipei Medical University; Taipei Taiwan
| | - Mei-ju Chi
- School of Gerontology Health Management; College of Nursing; Taipei Medical University; Taipei Taiwan
- Master Program in Long-term Care; College of Nursing; Taipei Medical University; Taipei Taiwan
| | - Kuei-Ru Chou
- Graduate Institute of Nursing; College of Nursing; Taipei Medical University; Taipei Taiwan
- Department of Nursing; Taipei Medical University-Shuang Ho Hospital; Taipei Taiwan
- School of Gerontology Health Management; College of Nursing; Taipei Medical University; Taipei Taiwan
- Psychiatric Research Center; Taipei Medical University Hospital; Taipei Taiwan
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6
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Barnes LL, Wilson RS, Hebert LE, Scherr PA, Evans DA, Mendes de Leon CF. Racial differences in the association of education with physical and cognitive function in older blacks and whites. J Gerontol B Psychol Sci Soc Sci 2011; 66:354-63. [PMID: 21402644 DOI: 10.1093/geronb/gbr016] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Few studies have explicitly tested whether the health disadvantage among older blacks is consistent across the entire range of education. We examined racial differences in the cross-sectional association of education with physical and cognitive function performance in older adults. METHODS Participants included over 9500 blacks and whites, aged ≥ 65 years, from the Chicago Health and Aging Project {64% black, 60% women, mean age = 73.0 (standard deviation [SD] = 6.9), mean education = 12.2 (SD = 3.5)}. Physical function was assessed using 3 physical performance tests, and cognitive function was assessed with 4 performance-based tests; composite measures were created and used in analyses. RESULTS In multiple regression models that controlled for age, age-squared, sex, and race, and their interactions, whites and those with higher education (>12 years) performed significantly better on both functional health measures. The association of education with each indicator of functional health was similar in older blacks and whites with low levels (≤ 12 years) of education. However, at higher levels of education, there was a significantly more positive association between years of education and these functional health outcomes among blacks than whites. DISCUSSION Results from this biracial population-based sample in the Midwest suggest that blacks may enjoy greater returns in functional health for additional education beyond high school.
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Affiliation(s)
- Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, 600 South Paulina, Suite 1038, Chicago, IL 60612, USA.
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7
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Mehta KM, Stewart AL, Langa KM, Yaffe K, Moody-Ayers S, Williams BA, Covinsky KE. "Below average" self-assessed school performance and Alzheimer's disease in the Aging, Demographics, and Memory Study. Alzheimers Dement 2009; 5:380-7. [PMID: 19751917 DOI: 10.1016/j.jalz.2009.07.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2008] [Revised: 07/10/2009] [Accepted: 07/20/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND A low level of formal education is becoming accepted as a risk factor for Alzheimer's disease (AD). Although increasing attention has been paid to differences in educational quality, no previous studies addressed participants' own characterizations of their overall performance in school. We examined whether self-assessed school performance is associated with AD beyond the effects of educational level alone. METHODS Participants were drawn from the population-representative Aging, Demographics, and Memory Study (ADAMS, 2000-2002). The ADAMS participants were asked about their performance in school. Possible response options included "above average," "average," or "below average." The ADAMS participants also underwent a full neuropsychological battery, and received a research diagnosis of possible or probable AD. RESULTS The 725 participants (mean age, 81.8 years; 59% female; 16% African-American) varied in self-assessed educational performance: 29% reported "above average," 64% reported "average," and 7% reported "below average" school performance. Participants with a lower self-assessed school performance had higher proportions of AD: 11% of participants with "above average" self-assessed performance had AD, as opposed to 12% of participants with "average" performance and 26% of participants with "below average" performance (P < 0.001). After controlling for subjects' years in school, a literacy test score (Wide-Range Achievement Test), age, sex, race/ethnicity, apolipoprotein E-epsilon4 status, socioeconomic status, and self-reported comorbidities, respondents with "below average" self-assessed school performance were four times more likely to have AD compared with those of "average" performance (odds ratio, 4.0; 95% confidence interval, 1.2-14). "Above average" and "average" self-assessed school performance did not increase or decrease the odds of having AD (odds ratio, 0.9; 95% confidence interval, 0.5-1.7). CONCLUSIONS We suggest an association between "below average" self-assessed school performance and AD beyond the known association with formal education. Efforts to increase cognitive reserve through better school performance, in addition to increasing the number of years of formal education in early life, may be important in reducing vulnerability throughout the life course.
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Affiliation(s)
- Kala M Mehta
- Division of Geriatric Medicine, University of California at San Francisco, San Francisco, CA, USA.
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8
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Mungas D, Reed BR, Farias ST, Decarli C. Age and education effects on relationships of cognitive test scores with brain structure in demographically diverse older persons. Psychol Aging 2009; 24:116-28. [PMID: 19290743 DOI: 10.1037/a0013421] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined how age and education influence the relationship between neuropsychological test scores and brain structure in demographically diverse older adults spanning the range from normal cognition to dementia. A sample of 351 African Americans, 410 Hispanics, and 458 Whites underwent neuropsychological testing. Volumetric magnetic resonance imaging (MRI) measures of total brain, white matter hyperintensity, and hippocampus were available for 79 African Americans, 102 Hispanics, and 134 Whites. The authors used latent variable modeling to examine effects of age, education, and brain volumes on test scores and determine how much variance brain volumes explained in unadjusted and age- and education-adjusted scores. Age adjustment resulted in weaker relationships of test scores with MRI variables; adjustment for ethnicity yielded stronger relationships. Education adjustment increased relationships with MRI variables in the combined sample and Hispanics, made no difference in Whites, but decreased some associations in African Americans. Results suggest that demographic adjustment is beneficial when demographic variables are strongly related to test scores independent of measures of brain structure, but adjustment has negative consequences when effects of demographic characteristics are mediated by brain structure.
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Affiliation(s)
- Dan Mungas
- Department of Neurology, School of Medicine, University of California, Davis, Sacremento, CA 95817, USA.
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9
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Accelerated hippocampal atrophy rates in stable and progressive amnestic mild cognitive impairment. Psychiatry Res 2009; 171:221-31. [PMID: 19217759 DOI: 10.1016/j.pscychresns.2008.05.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2007] [Revised: 03/17/2008] [Accepted: 05/07/2008] [Indexed: 11/22/2022]
Abstract
Studies suggest that smaller hippocampal volume predicts Alzheimer's disease (AD) in mild cognitive impairment (MCI). However, few studies have demonstrated decline rates in cognition and hippocampal volume in MCI subjects with stable clinical presentation. Furthermore, the effects of apolipoprotein E (ApoE) on the change rates of medial temporal structures and cognition in MCI are rarely investigated. Fifty-eight subjects with amnestic MCI and 20 normal aging elderly controls received annual neuropsychological and magnetic resonance imaging (MRI) assessments. Annual decline rates in neuropsychological test scores, hippocampal and amygdalar volumes were calculated. ApoE genotypes were examined. Nineteen (32.7%) MCI subjects converted to AD during an average 22.5-month follow-up period. The annual hippocampal atrophy rate was correlated with a decline in memory test scores. The presence of the ApoE varepsilon4 allele did not affect the change rates in neuropsychological test scores and medial temporal structures volume. Compared to subjects with stable MCI (MCI-S) and normal aging, progressive MCI (MCI-P) had the highest annual decline rates in cognition and hippocampal volume. Logistic regression analysis showed that higher annual decline rates in hippocampal volume and global cognitive test scores were associated with conversion to AD. Furthermore, although MCI-S subjects had little cognitive decline, their hippocampal atrophy rates were higher than those of normal aging controls. Therefore, accelerated hippocampal atrophy rates may be an early and important presentation in MCI subjects.
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Bossen AL, Pringle Specht JK, McKenzie SE. Needs of People with Early-Stage Alzheimer’s Disease: Reviewing the Evidence. J Gerontol Nurs 2009; 35:8-15. [DOI: 10.3928/00989134-20090301-01] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Plitas A, Tucker A, Kritikos A, Walters I, Bardenhagen F. Comparative study of the cognitive performance of Greek Australian and Greek national elderly: Implications for neuropsychological practice. AUSTRALIAN PSYCHOLOGIST 2009. [DOI: 10.1080/00050060802587694] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Areti Plitas
- School of Psychology, Victoria University, Melbourne, Victoria, Australia
| | - Alan Tucker
- School of Psychology, Victoria University, Melbourne, Victoria, Australia
| | - Ada Kritikos
- School of Psychology, Victoria University, Melbourne, Victoria, Australia
| | - Izabela Walters
- School of Psychology, Victoria University, Melbourne, Victoria, Australia
| | - Fiona Bardenhagen
- School of Psychology, Victoria University, Melbourne, Victoria, Australia
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Ng TP, Niti M, Chiam PC, Kua EH. Ethnic and educational differences in cognitive test performance on mini-mental state examination in Asians. Am J Geriatr Psychiatry 2007; 15:130-9. [PMID: 17272733 DOI: 10.1097/01.jgp.0000235710.17450.9a] [Citation(s) in RCA: 150] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study is to examine ethnic differences in Mini-Mental State Examination (MMSE) test performance in discriminating between demented and nondemented elderly Asians. METHODS A nationally representative population sample (N = 1,092) of community-living elderly, comprising Chinese, Malays, and Indians in Singapore, was interviewed using MMSE, Geriatric Mental State, and demographic and health questionnaires. RESULTS There were significant ethnic differences in mean MMSE scores among Chinese (26.2), Indians (25.0), and Malays (23.6), but only in noneducated subjects. No ethnic differences in MMSE were observed in higher educated subjects. The sample proportion of subjects with dementia was 4.2% in Chinese, 9.4% in Malays, and 8.8% in Indians. Overall, MMSE discriminated well between subjects with and without dementia (cutoff: 23/24, area under the curve: 95%, sensitivity: 97.5%, specificity: 75.6%). MMSE test performance was much better in higher educated subjects (higher specificity: 85.2%). Lower specificities were shown in less educated subjects (57.3%), and in Malays (62.8%), and especially in less educated Malays (35.3%) and Indians (50.0%). Significant differences in MMSE scores in less educated subjects persisted after adjusting for differences in sociodemographic, health, and behavioral variables CONCLUSION Ethnic nonequivalence in MMSE test performance should be taken into account in dementia screening in Asians in less educated subjects. Known correlates of cognitive functioning did not sufficiently explain these differences.
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Affiliation(s)
- Tze-Pin Ng
- Gerontological Research Programme, National University of Singapore, Department of Psychological Medicine, National University Hospital, Singapore.
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Sloan FA, Wang J. Disparities Among Older Adults in Measures of Cognitive Function by Race or Ethnicity. J Gerontol B Psychol Sci Soc Sci 2005; 60:P242-50. [PMID: 16131618 DOI: 10.1093/geronb/60.5.p242] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study examined racial or ethnic differences in cognitive function, cross-sectionally and longitudinally, using survey data from the Asset and Health Dynamics Among the Oldest Old. A version of the Telephone Interview for Cognitive Status (TICS), proxy assessments of cognition, and difficulties in performing daily tasks were assessed. Blacks performed below Whites on the TICS at baseline and on proxy assessments of cognition. TICS score declined with age for Whites and Blacks, with some relative gains for Blacks. At baseline, Blacks more often had difficulties in performing daily tasks, with some increase in difficulties relative to Whites with age. Differences between other groups and Whites were smaller than those between Blacks and Whites.
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Affiliation(s)
- Frank A Sloan
- Center for Health Policy, Law and Management, Duke University, Box 90253, Old Chemistry Building 125, Durham, NC 27708, USA.
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Shadlen MF, Larson EB, Wang L, Phelan EA, McCormick WC, Jolley L, Teri L, van Belle G. Education modifies the effect of apolipoprotein epsilon 4 on cognitive decline. Neurobiol Aging 2005; 26:17-24. [PMID: 15585342 DOI: 10.1016/j.neurobiolaging.2004.03.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2003] [Revised: 02/26/2004] [Accepted: 03/01/2004] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess the influence of education on the association between apolipoprotein E and cognitive change. DESIGN Prospective cohort. PARTICIPANTS HMO-based sample of 2168 non-demented community-dwelling elderly followed over 6 years. MEASUREMENTS Generalized estimating equations were used with the difference between baseline and follow-up cognitive abilities screening instrument (CASI) as the outcome variable. RESULTS At follow-up, 6% of the sample had a decline of 1.5 S.D. or greater on the CASI. Compared to individuals without an APOE4 allele, individuals with a single APOE4 allele did not have greater CASI decline. By contrast, individuals with two APOE4 alleles experienced greater decline in cognitive performance and the magnitude of that decline decreased as years of educational attainment increased. These relationships held after adjusting for age, gender, ethnicity, depression, diabetes, and history of vascular disease. CONCLUSION Lower education was associated with steep 4-year cognitive decline for APOE4 homozygotes but not for APOE4 heterozygotes. Potentially modifiable host factors such as education could influence the association of high-risk genotypes and cognitive decline.
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Affiliation(s)
- Marie-Florence Shadlen
- Department of Medicine, Division of Gerontology and Geriatric Medicine, Harborview Medical Center, University of Washington School of Medicine, 325 9th Avenue, Box 359755, Seattle, WA 98104-2499, USA.
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Bond GE, Burr R, Rice MM, McCurry SM, Graves AB, Teri L, Bowen JD, McCormick WC, Larson EB. Alcohol, aging, and cognitive performance: a cross-cultural comparison. J Aging Health 2003; 15:371-90. [PMID: 12795279 DOI: 10.1177/0898264303015002003] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigated the relationship between alcohol consumption and cognitive performance in two culturally diverse community-based populations. METHODS. A cross-sectional analysis was used including Japanese Americans (n = 1,836) and Caucasians (n = 2,581) aged 65 and older. Cognitive performance was measured using the Cognitive Abilities Screening Instrument (CASI) (0 to 100 point scale) and reaction time. RESULTS. Multivariate analysis revealed significant cultural and gender differences with cognitive performance. Compared to abstainers, Caucasian drinkers scored higher than Japanese American drinkers on the CASI (adjusted means = 93.4 versus 91.6). In contrast, Japanese American drinkers scored faster than Caucasian drinkers on choice reaction time (adjusted means = 505 versus 579 milliseconds). DISCUSSION. Results showed that current drinking was associated with better cognition in both the Caucasian and Japanese American groups. Longitudinal studies are needed to support the possible protective effects of alcohol on cognition and explore whether culture may modify this apparent benefit.
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