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Rehnberg J, Fors S, Ford KJ, Leist AK. Cognitive performance trends among European older adults: exploring variations across cohorts, gender, and educational levels (2007-2017). BMC Public Health 2024; 24:1646. [PMID: 38902637 PMCID: PMC11188163 DOI: 10.1186/s12889-024-19123-3] [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: 03/25/2024] [Accepted: 06/12/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND This study explores recent cohort trends in cognitive performance among older Europeans from 2007 to 2017, addressing three key questions: (1) Did cognitive performance improve universally and across the performance distribution during this period? (2) Did these improvements occur across educational levels and for both men and women? (3) Can established risk factors explain these performance gains? METHODS Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) across 12 European countries, we assessed immediate recall, delayed recall, and verbal fluency in individuals aged 60 to 94 in both 2007 and 2017 (n = 32 773). Differences between the two time points were estimated with linear mixed effects regression models and quantile regression. RESULTS Cognitive performance improved in all age groups, across educational levels, and for both men and women between 2007 and 2017. Notably, improvements were more pronounced at the upper end of the performance distribution for delayed recall and verbal fluency. Education explained approximately 20% of the observed improvements. Risk factors did not explain the observed improvements. CONCLUSIONS European cohorts of both younger-old and older adults continue to exhibit improvements in cognitive performance. Variation in the size of the cohort improvements across the performance distributions in delayed recall and in verbal fluency may contribute to growing inequalities in cognitive outcomes. Future research should further investigate the potential heterogeneity in cognitive performance gains. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Johan Rehnberg
- Aging Research Center, Karolinska Institutet and Stockholm University, Tomtebodavägen 18A, Solna, Solna, SE-171 65, Sweden.
| | - Stefan Fors
- Aging Research Center, Karolinska Institutet and Stockholm University, Tomtebodavägen 18A, Solna, Solna, SE-171 65, Sweden
- Department of Public Health, Stockholm University, Albanovägen 12, Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Solnavägen, 1E, Sweden
| | - Katherine J Ford
- Department of Psychology, Carleton University, Ottawa, K1S 5B6, Canada
| | - Anja K Leist
- Department of Social Sciences, University of Luxembourg, Esch-sur-Alzette, 4366, Luxembourg
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Gutierrez S, Meza E, Glymour MM, Torres JM. My Parent, Myself, or My Child: Whose Education Matters Most for Trajectories of Cognitive Aging in Middle Age? Am J Epidemiol 2024; 193:695-706. [PMID: 37116072 DOI: 10.1093/aje/kwad108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 02/10/2023] [Accepted: 04/25/2023] [Indexed: 04/30/2023] Open
Abstract
The growing body of evidence linking intergenerational education and late-life cognitive decline is almost exclusively from high-income countries, despite rapid intergenerational changes in education in low- and middle-income countries (LMICs). We used data from the Mexican Health and Aging Study (n = 8,822), a cohort study of Mexican adults aged ≥50 years (2001-2018), to evaluate whether parental education (none vs. any formal schooling), one's own education (less than primary school vs. completion of primary school), or an adult child's education (less than high school vs. completion of high school) was associated with verbal memory z scores. We used linear mixed models with inverse probability of attrition weights. Educational attainment in all 3 generations was associated with baseline verbal memory scores, independent of the prior generation's education. Lower parental (β = -0.005, 95% confidence interval: -0.009, -0.002) and respondent (β = -0.013, 95% confidence interval: -0.017, -0.010) educational level were associated with faster decline in delayed (but not immediate) verbal memory z scores. Associations between adult child's education and respondent's verbal memory decline varied by exposure specification. The educational attainment of parents and adult children may influence the cognitive aging of middle-aged and older adults in LMICs. These results have important implications given recent structural shifts in educational attainment in many LMICs.
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Grasset L, Bouteloup V, Cacciamani F, Pellegrin I, Planche V, Chêne G, Dufouil C. Associations Between Blood-Based Biomarkers and Cognitive and Functional Trajectories Among Participants of the MEMENTO Cohort. Neurology 2024; 102:e209307. [PMID: 38626384 PMCID: PMC11175638 DOI: 10.1212/wnl.0000000000209307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/05/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Elevated levels of Alzheimer disease (AD) blood-based biomarkers are associated with accelerated cognitive decline. However, their distinct relationships with specific cognitive and functional domains require further investigation. We aimed at estimating the associations between AD blood-based biomarkers and the trajectories of distinct cognitive and functional domains over a 5-year follow-up period. METHODS We conducted a clinic-based prospective study using data from the MEMENTO study, a nationwide French cohort. We selected dementia-free individuals at baseline aged 60 years or older. Baseline measurements of β-amyloid (Aβ) 40 and 42, phosphorylated tau (p-tau181), and neurofilament light chain (NfL) concentrations were obtained using the Simoa HD-X analyzer. Mini-Mental State Examination (MMSE), Free and Cued Selective Reminding Test (FCSRT), animal fluency, Trail Making Tests A and B, Short Physical Performance Battery (SPPB), and Instrumental Activities of Daily Living were administered annually for up to 5 years. We used linear mixed models, adjusted for potential confounders, to model AD biomarkers' relation with cognitive and functional decline. RESULTS A total of 1,938 participants were included in this study, with a mean (SD) baseline age of 72.8 (6.6) years, and 62% were women. Higher baseline p-tau181 and NfL were associated with significantly faster decline in most cognitive, physical, and functional outcomes (+1 SD p-tau181: βMMSE = -0.055, 95% CI -0.067 to -0.043, βFCSRT = -0.034, 95% CI -0.043 to -0.025, βfluency = -0.029, 95% CI -0.038 to -0.020, βSPPB = -0.040, 95% CI -0.057 to -0.022, and β4IADL = -0.115, 95% CI 0.091-0.140. +1 SD NfL: βMMSE = -0.039, 95% CI -0.053 to -0.025, βFCSRT = -0.022, 95% CI -0.032 to -0.012, βfluency = -0.014, 95% CI -0.024 to -0.004, and β4IADL = 0.077, 95% CI 0.048-0.105). A multiplicative association of p-tau181 and NfL with worsening cognitive and functional trajectories was evidenced. Lower Aβ42/40 ratio was only associated with slightly faster cognitive decline in FCSRT and semantic fluency (+1 SD: β = 0.011, 95% CI 0.002-0.020, and β = 0.011, 95% CI 0.003-0.020, respectively). These associations were not modified by APOE ε4, sex, nor education level. DISCUSSION In a memory clinic sample, p-tau181 and NfL, both independently and jointly, are linked to more pronounced cognitive, physical and functional declines. Blood-based biomarker measurement in AD research may provide useful insights regarding biological processes underlying cognitive, physical, and functional declines in at-risk individuals.
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Affiliation(s)
- Leslie Grasset
- From the UMR 1219 (L.G., V.B., F.C., G.C., C.D.), Bordeaux Population Health Center, University of Bordeaux, Inserm; CIC 1401-EC (L.G., V.B., F.C., G.C., C.D.), Inserm, University of Bordeaux, CHU de Bordeaux; Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), Pole de sante publique; ARAMISLab (F.C.), Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière; Qairnel SAS (F.C.), Paris; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164; and Univ. Bordeaux (V.P.), CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, France
| | - Vincent Bouteloup
- From the UMR 1219 (L.G., V.B., F.C., G.C., C.D.), Bordeaux Population Health Center, University of Bordeaux, Inserm; CIC 1401-EC (L.G., V.B., F.C., G.C., C.D.), Inserm, University of Bordeaux, CHU de Bordeaux; Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), Pole de sante publique; ARAMISLab (F.C.), Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière; Qairnel SAS (F.C.), Paris; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164; and Univ. Bordeaux (V.P.), CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, France
| | - Federica Cacciamani
- From the UMR 1219 (L.G., V.B., F.C., G.C., C.D.), Bordeaux Population Health Center, University of Bordeaux, Inserm; CIC 1401-EC (L.G., V.B., F.C., G.C., C.D.), Inserm, University of Bordeaux, CHU de Bordeaux; Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), Pole de sante publique; ARAMISLab (F.C.), Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière; Qairnel SAS (F.C.), Paris; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164; and Univ. Bordeaux (V.P.), CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, France
| | - Isabelle Pellegrin
- From the UMR 1219 (L.G., V.B., F.C., G.C., C.D.), Bordeaux Population Health Center, University of Bordeaux, Inserm; CIC 1401-EC (L.G., V.B., F.C., G.C., C.D.), Inserm, University of Bordeaux, CHU de Bordeaux; Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), Pole de sante publique; ARAMISLab (F.C.), Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière; Qairnel SAS (F.C.), Paris; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164; and Univ. Bordeaux (V.P.), CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, France
| | - Vincent Planche
- From the UMR 1219 (L.G., V.B., F.C., G.C., C.D.), Bordeaux Population Health Center, University of Bordeaux, Inserm; CIC 1401-EC (L.G., V.B., F.C., G.C., C.D.), Inserm, University of Bordeaux, CHU de Bordeaux; Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), Pole de sante publique; ARAMISLab (F.C.), Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière; Qairnel SAS (F.C.), Paris; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164; and Univ. Bordeaux (V.P.), CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, France
| | - Geneviève Chêne
- From the UMR 1219 (L.G., V.B., F.C., G.C., C.D.), Bordeaux Population Health Center, University of Bordeaux, Inserm; CIC 1401-EC (L.G., V.B., F.C., G.C., C.D.), Inserm, University of Bordeaux, CHU de Bordeaux; Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), Pole de sante publique; ARAMISLab (F.C.), Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière; Qairnel SAS (F.C.), Paris; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164; and Univ. Bordeaux (V.P.), CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, France
| | - Carole Dufouil
- From the UMR 1219 (L.G., V.B., F.C., G.C., C.D.), Bordeaux Population Health Center, University of Bordeaux, Inserm; CIC 1401-EC (L.G., V.B., F.C., G.C., C.D.), Inserm, University of Bordeaux, CHU de Bordeaux; Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), Pole de sante publique; ARAMISLab (F.C.), Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière; Qairnel SAS (F.C.), Paris; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164; and Univ. Bordeaux (V.P.), CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, France
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Liu J, Roberts AL, Lawn RB, Jha SC, Sampson L, Sumner JA, Kang JH, Rimm EB, Grodstein F, Liang L, Haneuse S, Kubzansky LD, Koenen KC, Chibnik LB. Post-traumatic stress disorder symptom remission and cognition in a large cohort of civilian women. Psychol Med 2024; 54:419-430. [PMID: 37577959 PMCID: PMC10947504 DOI: 10.1017/s0033291723001915] [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: 08/15/2023]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is associated with cognitive impairments. It is unclear whether problems persist after PTSD symptoms remit. METHODS Data came from 12 270 trauma-exposed women in the Nurses' Health Study II. Trauma and PTSD symptoms were assessed using validated scales to determine PTSD status as of 2008 (trauma/no PTSD, remitted PTSD, unresolved PTSD) and symptom severity (lifetime and past-month). Starting in 2014, cognitive function was assessed using the Cogstate Brief Battery every 6 or 12 months for up to 24 months. PTSD associations with baseline cognition and longitudinal cognitive changes were estimated by covariate-adjusted linear regression and linear mixed-effects models, respectively. RESULTS Compared to women with trauma/no PTSD, women with remitted PTSD symptoms had a similar cognitive function at baseline, while women with unresolved PTSD symptoms had worse psychomotor speed/attention and learning/working memory. In women with unresolved PTSD symptoms, past-month PTSD symptom severity was inversely associated with baseline cognition. Over follow-up, both women with remitted and unresolved PTSD symptoms in 2008, especially those with high levels of symptoms, had a faster decline in learning/working memory than women with trauma/no PTSD. In women with remitted PTSD symptoms, higher lifetime PTSD symptom severity was associated with a faster decline in learning/working memory. Results were robust to the adjustment for sociodemographic, biobehavioral, and health factors and were partially attenuated when adjusted for depression. CONCLUSION Unresolved but not remitted PTSD was associated with worse cognitive function assessed six years later. Accelerated cognitive decline was observed among women with either unresolved or remitted PTSD symptoms.
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Affiliation(s)
- Jiaxuan Liu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Andrea L. Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rebecca B. Lawn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Shaili C. Jha
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Laura Sampson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jennifer A. Sumner
- Department of Psychology, University of California, Los Angeles, CA, Los Angeles, CA, USA
| | - Jae H. Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Eric B. Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Francine Grodstein
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Liming Liang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Lori B. Chibnik
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston MA, USA
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Wood ME, Xiong LY, Wong YY, Buckley RF, Swardfager W, Masellis M, Lim ASP, Nichols E, Joie RL, Casaletto KB, Kumar RG, Dams-O'Connor K, Palta P, George KM, Satizabal CL, Barnes LL, Schneider JA, Binet AP, Villeneuve S, Pa J, Brickman AM, Black SE, Rabin JS. Sex differences in associations between APOE ε2 and longitudinal cognitive decline. Alzheimers Dement 2023; 19:4651-4661. [PMID: 36994910 PMCID: PMC10544702 DOI: 10.1002/alz.13036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION We examined whether sex modifies the association between APOE ε2 and cognitive decline in two independent samples. METHODS We used observational data from cognitively unimpaired non-Hispanic White (NHW) and non-Hispanic Black (NHB) adults. Linear mixed models examined interactive associations of APOE genotype (ε2 or ε4 carrier vs. ε3/ε3) and sex on cognitive decline in NHW and NHB participants separately. RESULTS In both Sample 1 (N = 9766) and Sample 2 (N = 915), sex modified the association between APOE ε2 and cognitive decline in NHW participants. Specifically, relative to APOE ε3/ε3, APOE ε2 protected against cognitive decline in men but not women. Among APOE ε2 carriers, men had slower decline than women. Among APOE ε3/ε3 carriers, cognitive trajectories did not differ between sexes. There were no sex-specific associations of APOE ε2 with cognition in NHB participants (N = 2010). DISCUSSION In NHW adults, APOE ε2 may protect men but not women against cognitive decline. HIGHLIGHTS We studied sex-specific apolipoprotein E (APOE) ε2 effects on cognitive decline. In non-Hispanic White (NHW) adults, APOE ε2 selectively protects men against decline. Among men, APOE ε2 was more protective than APOE ε3/ε3. In women, APOE ε2 was no more protective than APOE ε3/ε3. Among APOE ε2 carriers, men had slower decline than women. There were no sex-specific APOE ε2 effects in non-Hispanic Black (NHB) adults.
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Affiliation(s)
- Madeline E Wood
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Lisa Y Xiong
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Yuen Yan Wong
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Florey Institute, University of Melbourne, Parkville, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Walter Swardfager
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Mario Masellis
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Andrew S P Lim
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Emma Nichols
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, California, USA
| | - Kaitlin B Casaletto
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, California, USA
| | - Raj G Kumar
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Priya Palta
- Departments of Medicine and Epidemiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Kristen M George
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis, California, USA
| | - Claudia L Satizabal
- Department of Population Health Science and Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Alexa Pichette Binet
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Sylvia Villeneuve
- Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Judy Pa
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Sandra E Black
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer S Rabin
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Lespinasse J, Dufouil C, Proust-Lima C. Disease progression model anchored around clinical diagnosis in longitudinal cohorts: example of Alzheimer's disease and related dementia. BMC Med Res Methodol 2023; 23:199. [PMID: 37670234 PMCID: PMC10478286 DOI: 10.1186/s12874-023-02009-0] [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: 01/27/2023] [Accepted: 08/04/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Alzheimer's disease and related dementia (ADRD) are characterized by multiple and progressive anatomo-clinical changes including accumulation of abnormal proteins in the brain, brain atrophy and severe cognitive impairment. Understanding the sequence and timing of these changes is of primary importance to gain insight into the disease natural history and ultimately allow earlier diagnosis. Yet, modeling changes over disease course from cohort data is challenging as the usual timescales (time since inclusion, chronological age) are inappropriate and time-to-clinical diagnosis is available on small subsamples of participants with short follow-up durations prior to diagnosis. One solution to circumvent this challenge is to define the disease time as a latent variable. METHODS We developed a multivariate mixed model approach that realigns individual trajectories into the latent disease time to describe disease progression. In contrast with the existing literature, our methodology exploits the clinical diagnosis information as a partially observed and approximate reference to guide the estimation of the latent disease time. The model estimation was carried out in the Bayesian Framework using Stan. We applied the methodology to the MEMENTO study, a French multicentric clinic-based cohort of 2186 participants with 5-year intensive follow-up. Repeated measures of 12 ADRD markers stemmed from cerebrospinal fluid (CSF), brain imaging and cognitive tests were analyzed. RESULTS The estimated latent disease time spanned over twenty years before the clinical diagnosis. Considering the profile of a woman aged 70 with a high level of education and APOE4 carrier (the main genetic risk factor for ADRD), CSF markers of tau proteins accumulation preceded markers of brain atrophy by 5 years and cognitive decline by 10 years. However we observed that individual characteristics could substantially modify the sequence and timing of these changes, in particular for CSF level of A[Formula: see text]. CONCLUSION By leveraging the available clinical diagnosis timing information, our disease progression model does not only realign trajectories into the most homogeneous way. It accounts for the inherent residual inter-individual variability in dementia progression to describe the long-term anatomo-clinical degradations according to the years preceding clinical diagnosis, and to provide clinically meaningful information on the sequence of events. TRIAL REGISTRATION clinicaltrials.gov, NCT01926249. Registered on 16 August 2013.
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Affiliation(s)
- Jérémie Lespinasse
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, BPH, U1219, 33000, Bordeaux, France
- Inserm, CIC1401-EC, 33000, Bordeaux, France
- Pôle de santé publique, Centre Hospitalier Universitaire (CHU) de Bordeaux, 33000, Bordeaux, France
| | - Carole Dufouil
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, BPH, U1219, 33000, Bordeaux, France
- Inserm, CIC1401-EC, 33000, Bordeaux, France
- Pôle de santé publique, Centre Hospitalier Universitaire (CHU) de Bordeaux, 33000, Bordeaux, France
| | - Cécile Proust-Lima
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, BPH, U1219, 33000, Bordeaux, France.
- Inserm, CIC1401-EC, 33000, Bordeaux, France.
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7
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Chen R, Calmasini C, Swinnerton K, Wang J, Haneuse S, Ackley SF, Hirst AK, Hayes-Larson E, George KM, Peterson R, Soh Y, Barnes LL, Mayeda ER, Gilsanz P, Mungas DM, Whitmer RA, Corrada MM, Glymour MM. Pragmatic approaches to handling practice effects in longitudinal cognitive aging research. Alzheimers Dement 2023; 19:4028-4036. [PMID: 37199336 PMCID: PMC10524983 DOI: 10.1002/alz.13067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 05/19/2023]
Abstract
INTRODUCTION The challenge of accounting for practice effects (PEs) when modeling cognitive change was amplified by the COVID-19 pandemic, which introduced period and mode effects that may bias the estimation of cognitive trajectory. METHODS In three Kaiser Permanente Northern California prospective cohorts, we compared predicted cognitive trajectories and the association of grip strength with cognitive decline using three approaches: (1) no acknowledgment of PE, (2) inclusion of a wave indicator, and (3) constraining PE based on a preliminary model (APM) fit using a subset of the data. RESULTS APM-based correction for PEs based on balanced, pre-pandemic data, and with current age as the timescale produced the smallest discrepancy between within-person and between-person estimated age effects. Estimated associations between grip strength and cognitive decline were not sensitive to the approach used. DISCUSSION Constraining PEs based on a preliminary model is a flexible, pragmatic approach allowing for meaningful interpretation of cognitive change. HIGHLIGHTS The magnitude of practice effects (PEs) varied widely by study. When PEs were present, the three PE approaches resulted in divergent estimated age-related cognitive trajectories. Estimated age-related cognitive trajectories were sometimes implausible in models that did not account for PEs. The associations between grip strength and cognitive decline did not differ by the PE approach used. Constraining PEs based on estimates from a preliminary model allows for a meaningful interpretation of cognitive change.
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Affiliation(s)
- Ruijia Chen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Camilla Calmasini
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Kaitlin Swinnerton
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Jingxuan Wang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sarah F Ackley
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Andrew K Hirst
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Eleanor Hayes-Larson
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Kristen M George
- Department of Public Health Sciences, University of California, Davis, California, USA
| | - Rachel Peterson
- School of Public Health and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Yenee Soh
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Lisa L Barnes
- Department of Neurological Sciences and Rush Alzheimer's Disease Center, Rush Medical College, Chicago, Illinois, USA
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Paola Gilsanz
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Dan M Mungas
- Department of Neurology, University of California, Davis, California, USA
| | - Rachel A Whitmer
- Department of Public Health Sciences, University of California, Davis, California, USA
| | - Maria M Corrada
- Department of Neurology, University of California, Irvine, California, USA
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
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8
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Thomas MD, Calmasini C, Khela H, Mobley TM, Rose Mayeda E, Mangurian C, Barnes LL, Gilsanz P, Whitmer RA, Glymour MM. The impact of attending historically Black colleges and universities on cognitive decline in Black adults: A longitudinal analysis in the KHANDLE and STAR cohorts. Alzheimers Dement 2023; 19:3426-3434. [PMID: 36800287 PMCID: PMC10432571 DOI: 10.1002/alz.12983] [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: 10/04/2022] [Revised: 01/12/2023] [Accepted: 01/15/2023] [Indexed: 02/18/2023]
Abstract
INTRODUCTION Black students attending predominantly White institutions (PWIs) versus historically Black colleges and universities (HBCUs) report more harmful discrimination and develop worse mental health outcomes, potentially offsetting the established benefits of college for lowering dementia incidence. METHODS Black participants in two cohorts (the Kaiser Healthy Aging and Diverse Life Experiences [KHANDLE] and the Study of Healthy Aging in African Americans [STAR]) who had attended college (N = 716) self-reported the college name (classified as HBCU vs. PWI) and completed three waves of executive function (EF) and verbal episodic memory (VEM) assessments. HBCU effects on cognitive level and decline were estimated using adjusted linear mixed-effects models. RESULTS HBCU (vs. PWI) attendees averaged better EF (β = 0.05 [-0.22, 0.32]) and VEM (β = 0.21 [-0.06, 0.46]) at age 70 though neither association was statistically significant. HBCU attendance was associated with slightly faster VEM decline (β = -0.03 [-0.05, 0.00]). DISCUSSION Harmonized analyses with larger studies are needed to estimate important effects of HBCU attendance. HIGHLIGHTS Higher education is robustly linked to lower dementia risk, yet Black-White inequities persist among college-educated adults. Black students attending predominantly White institutions (PWIs) versus historically Black colleges and universities (HBCUs) report more harmful discrimination and develop worse mental health outcomes, which may offset the established benefits of college for lowering dementia incidence. HBCU (vs. non-HBCU) attendees averaged better executive function and verbal episodic memory (VEM) at average age 70, though confidence intervals were wide and associations were not statistically significant, and averaged slightly faster decline in VEM. Harmonized analyses using larger nationally representative studies are likely needed to avoid underestimating the health effects of HBCU attendance.
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Affiliation(s)
- Marilyn D. Thomas
- University of California, San Francisco, School of Medicine, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, San Francisco, CA, USA
- University of California, San Francisco, School of Medicine, Department of Epidemiology and Biostatistics, San Francisco, CA, USA
| | - Camilla Calmasini
- University of California, San Francisco, School of Medicine, Department of Epidemiology and Biostatistics, San Francisco, CA, USA
| | - Harmon Khela
- Johns Hopkins University, Departments of Biology and of Public Health Studies, Baltimore, MD, USA
| | - Taylor M. Mobley
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Christina Mangurian
- University of California, San Francisco, School of Medicine, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, San Francisco, CA, USA
- University of California, San Francisco, School of Medicine, Department of Epidemiology and Biostatistics, San Francisco, CA, USA
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Paola Gilsanz
- University of California, San Francisco, School of Medicine, Department of Epidemiology and Biostatistics, San Francisco, CA, USA
- Kaiser Permanente Division of Research, Oakland, CA, USA
| | - Rachel A. Whitmer
- Kaiser Permanente Division of Research, Oakland, CA, USA
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA, USA
- Alzheimer’s Disease Research Center, University of California Davis Health, Sacramento, CA, USA
| | - M. Maria Glymour
- University of California, San Francisco, School of Medicine, Department of Epidemiology and Biostatistics, San Francisco, CA, USA
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9
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Sanderson-Cimino M, Chen R, Tu XM, Elman JA, Jak AJ, Kremen WS. Misinterpreting cognitive change over multiple timepoints: When practice effects meet age-related decline. Neuropsychology 2023; 37:568-581. [PMID: 37079809 PMCID: PMC10313772 DOI: 10.1037/neu0000903] [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: 04/22/2023] Open
Abstract
OBJECTIVE Practice effects (PE) on cognitive testing have been shown to delay detection of impairment and impede our ability to assess change. When decline over time is expected, as with older adults or progressive diseases, failure to adequately address PEs may lead to inaccurate conclusions because PEs artificially boost scores while pathology- or age-related decline reduces scores. Unlike most methods, a participant-replacement approach can separate pathology- or age-related decline from PEs; however, this approach has only been used across two timepoints. More than two timepoints make it possible to determine if PEs level out after the first follow-up, but it is analytically challenging because individuals may not be assessed at every timepoint. METHOD We examined 1,190 older adults who were cognitively unimpaired (n = 809) or had mild cognitive impairment (MCI; n = 381). Participants completed six neuropsychological measures at three timepoints (baseline, 12-month, 24-month). We implemented a participant-replacement method using generalized estimating equations in comparisons of matched returnees and replacements to calculate PEs. RESULTS Without accounting for PEs, cognitive function appeared to improve or stay the same. However, with the participant-replacement method, we observed significant PEs within both groups at all timepoints. PEs did not uniformly decrease across time; some-specifically on episodic memory measures-continued to increase beyond the first follow-up. CONCLUSION A replacement method of PE adjustment revealed significant PEs across two follow-ups. As expected in these older adults, accounting for PEs revealed cognitive decline. This, in turn, means earlier detection of cognitive deficits, including progression to MCI, and more accurate characterization of longitudinal change. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Mark Sanderson-Cimino
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco
- Center for Behavior Genetics of Aging, University of California, San Diego
| | - Ruohui Chen
- Division of Biostatistics and Bioinformatics, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
| | - Xin M. Tu
- School of Medicine, University of California, San Diego
- Family Medicine and Public Health, University of California San Diego
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
| | - Jeremy A. Elman
- Center for Behavior Genetics of Aging, University of California, San Diego
- School of Medicine, University of California, San Diego
| | - Amy J. Jak
- Center for Behavior Genetics of Aging, University of California, San Diego
- Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System
| | - William S. Kremen
- Center for Behavior Genetics of Aging, University of California, San Diego
- School of Medicine, University of California, San Diego
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10
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Josefsson M, Daniels MJ, Pudas S. A Bayesian semiparametric approach for inference on the population partly conditional mean from longitudinal data with dropout. Biostatistics 2023; 24:372-387. [PMID: 33880509 PMCID: PMC10102880 DOI: 10.1093/biostatistics/kxab012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 11/14/2022] Open
Abstract
Studies of memory trajectories using longitudinal data often result in highly nonrepresentative samples due to selective study enrollment and attrition. An additional bias comes from practice effects that result in improved or maintained performance due to familiarity with test content or context. These challenges may bias study findings and severely distort the ability to generalize to the target population. In this study, we propose an approach for estimating the finite population mean of a longitudinal outcome conditioning on being alive at a specific time point. We develop a flexible Bayesian semiparametric predictive estimator for population inference when longitudinal auxiliary information is known for the target population. We evaluate the sensitivity of the results to untestable assumptions and further compare our approach to other methods used for population inference in a simulation study. The proposed approach is motivated by 15-year longitudinal data from the Betula longitudinal cohort study. We apply our approach to estimate lifespan trajectories in episodic memory, with the aim to generalize findings to a target population.
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Affiliation(s)
- Maria Josefsson
- Department of Statistics, USBE, Umeå University, Sweden and Centre for Demographic & Ageing Research, Umeå University, Sweden
| | | | - Sara Pudas
- Department of Integrative Medical Biology, Umeå University, Sweden and Center for Functional Brain Imaging, Umeå University, Sweden
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11
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Ghaznawi R, Vonk JM, Zwartbol MH, Bresser JD, Rissanen I, Hendrikse J, Geerlings MI. Low-grade carotid artery stenosis is associated with progression of brain atrophy and cognitive decline. The SMART-MR study. J Cereb Blood Flow Metab 2023; 43:309-318. [PMID: 36250500 PMCID: PMC9903227 DOI: 10.1177/0271678x221133859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Asymptomatic low-grade carotid artery stenosis (LGCS) is a common finding in patients with manifest arterial disease, however its relationship with brain MRI changes and cognitive decline is unclear. We included 902 patients (58 ± 10 years; 81% male) enrolled in the Second Manifestations of Arterial Disease - Magnetic Resonance (SMART-MR) study without a history of cerebrovascular disease. LGCS was defined as 1-49% stenosis on baseline carotid ultrasound, whereas no LGCS (reference category) was defined as absence of carotid plaque. Brain and white matter hyperintensity (WMH) volumes and cognitive function were measured at baseline and after 4 (n = 480) and 12 years (n = 222) of follow-up. Using linear mixed-effects models, we investigated associations of LGCS with progression of brain atrophy, WMH, and cognitive decline. LGCS was associated with greater progression of global brain atrophy (estimate -0.03; 95%CI, -0.06 to -0.01; p = 0.002), and a greater decline in executive functioning (estimate -0.02; 95%CI, -0.031 to -0.01; p < 0.001) and memory (estimate -0.012; 95%CI, -0.02 to -0.001; p = 0.032), independent of demographics, cardiovascular risk factors, and incident brain infarcts on MRI. No association was observed between LGCS and progression of WMH. Our results indicate that LGCS may represent an early marker of greater future brain atrophy and cognitive decline.
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Affiliation(s)
- Rashid Ghaznawi
- Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Jet Mj Vonk
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Maarten Ht Zwartbol
- Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Jeroen de Bresser
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ina Rissanen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Jeroen Hendrikse
- Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
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- Listed in the Acknowledgements
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12
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Yu W, Esposito M, Li M, Clarke P, Judd S, Finlay J. Neighborhood 'Disamenities': local barriers and cognitive function among Black and white aging adults. BMC Public Health 2023; 23:197. [PMID: 36717795 PMCID: PMC9885664 DOI: 10.1186/s12889-023-15026-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/11/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND This study examined the association between cognitive function and three neighborhood 'disamenities' that may pose local barriers to utilizing community resources and increase risk for cognitive decline. METHOD Using national data from 21,165 urban- and suburban-dwelling Black and white adults (mean age: 67 years) in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study, we assessed global cognitive function through a factor score of five cognitive screening tests. General Additive Mixed Models (GAMM) tested whether residing in areas with more polluting sites, highways, and limited walkability was associated with worse cognitive function. RESULTS Limited walkability and the presence of polluting sites had a significant negative association with cognitive function after controlling for individual and neighborhood factors. CONCLUSION Neighborhood disamenities may be linked to cognitive function among aging residents. Identifying neighborhood factors that pose barriers to accessing community resources may inform upstream policy applications to reduce risk for cognitive decline.
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Affiliation(s)
- Wenshan Yu
- Program in Survey and Data Science, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104, USA. .,Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan 426 Thompson Street, Ann Arbor, MI, United States, 48104.
| | - Michael Esposito
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan 426 Thompson Street, Ann Arbor, MI United States 48104 ,grid.4367.60000 0001 2355 7002Department of Sociology, Washington University in St. Louis, St. Louis, MO 63130 USA
| | - Mao Li
- Program in Survey and Data Science, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104 USA ,Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan 426 Thompson Street, Ann Arbor, MI United States 48104
| | - Philippa Clarke
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan 426 Thompson Street, Ann Arbor, MI United States 48104 ,grid.214458.e0000000086837370Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109 USA
| | - Suzanne Judd
- grid.265892.20000000106344187School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL 35233 USA
| | - Jessica Finlay
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan 426 Thompson Street, Ann Arbor, MI United States 48104 ,grid.214458.e0000000086837370Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109 USA
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13
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Chu NM, Bae S, Chen X, Ruck J, Gross AL, Albert M, Neufeld KJ, Segev DL, McAdams-DeMarco MA. Delirium, changes in cognitive function, and risk of diagnosed dementia after kidney transplantation. Am J Transplant 2022; 22:2892-2902. [PMID: 35980673 PMCID: PMC10138281 DOI: 10.1111/ajt.17176] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/25/2022] [Accepted: 08/15/2022] [Indexed: 01/25/2023]
Abstract
Kidney transplant (KT) recipients with delirium, a preventable surgical complication, are likely to reap cognitive benefits from restored kidney function, but may be more vulnerable to longer-term neurotoxic stressors post-KT (i.e., aging, immunosuppression). In this prospective cohort study, we measured delirium (chart-based), global cognitive function (3MS), and executive function (Trail Making Test Part B minus Part A) in 894 recipients (2009-2021) at KT, 1/3/6-months, 1-year, and annually post-KT. Dementia was ascertained using linked Medicare claims. We described repeated measures of cognitive performance (mixed effects model) and quantified dementia risk (Fine & Gray competing risk) by post-KT delirium. Of 894 recipients, 43(4.8%) had post-KT delirium. Delirium was not associated with global cognitive function at KT (difference = -3.2 points, 95%CI: -6.7, 0.4) or trajectories post-KT (0.03 points/month, 95%CI: -0.27, 0.33). Delirium was associated with worse executive function at KT (55.1 s, 95%CI: 25.6, 84.5), greater improvements in executive function <2 years post-KT (-2.73 s/month, 95%CI: -4.46,-0.99), and greater decline in executive function >2 years post-KT (1.72 s/month, 95%CI: 0.22, 3.21). Post-KT delirium was associated with over 7-fold greater risk of dementia post-KT (adjusted subdistribution hazard ratio = 7.84, 95%CI: 1.22, 50.40). Transplant centers should be aware of cognitive risks associated with post-KT delirium and implement available preventative interventions to reduce delirium risk.
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Affiliation(s)
- Nadia M. Chu
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Sunjae Bae
- Department of Surgery, New York University Grossman School of Medicine, New York, New York, USA
| | - Xiaomeng Chen
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jessica Ruck
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alden L. Gross
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Marilyn Albert
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Karin J. Neufeld
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dorry L. Segev
- Department of Surgery, New York University Grossman School of Medicine, New York, New York, USA
| | - Mara A. McAdams-DeMarco
- Department of Surgery, New York University Grossman School of Medicine, New York, New York, USA
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14
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Torres JM, Glymour MM. Future Directions for the HRS Harmonized Cognitive Assessment Protocol. Forum Health Econ Policy 2022; 25:7-27. [PMID: 35254747 DOI: 10.1515/fhep-2021-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/07/2022] [Indexed: 01/05/2023]
Abstract
In the absence of effective pharmacological treatment to halt or reverse the course of Alzheimer's disease and related dementias (ADRDs), population-level research on the modifiable determinants of dementia risk and outcomes for those living with ADRD is critical. The Harmonized Cognitive Assessment Protocol (HCAP), fielded in 2016 as part of the U.S. Health and Retirement Study (HRS) and multiple international counterparts, has the potential to play an important role in such efforts. The stated goals of the HCAP are to improve our ability to understand the determinants, prevalence, costs, and consequences of cognitive impairment and dementia in the U.S. and to support cross-national comparisons. The first wave of the HCAP demonstrated the feasibility and value of the more detailed cognitive assessments in the HCAP compared to the brief cognitive assessments in the core HRS interviews. To achieve its full potential, we provide eight recommendations for improving future iterations of the HCAP. Our highest priority recommendation is to increase the representation of historically marginalized racial/ethnic groups disproportionately affected by ADRDs. Additional recommendations relate to the timing of the HCAP assessments; clinical and biomarker validation data, including to improve cross-national comparisons; dropping lower performing items; enhanced documentation; and the addition of measures related to caregiver impact. We believe that the capacity of the HCAP to achieve its stated goals will be greatly enhanced by considering these changes and additions.
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Affiliation(s)
- Jacqueline M Torres
- Department of Epidemiology and Biostatistics, UC San Francisco, San Francisco, CA, USA
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, UC San Francisco, San Francisco, CA, USA
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15
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Comfort N, Wu H, De Hoff P, Vuppala A, Vokonas PS, Spiro A, Weisskopf M, Coull BA, Laurent LC, Baccarelli AA, Schwartz J. Extracellular microRNA and cognitive function in a prospective cohort of older men: The Veterans Affairs Normative Aging Study. Aging (Albany NY) 2022; 14:6859-6886. [PMID: 36069796 PMCID: PMC9512498 DOI: 10.18632/aging.204268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/17/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Aging-related cognitive decline is an early symptom of Alzheimer's disease and other dementias, and on its own can have substantial consequences on an individual's ability to perform important everyday functions. Despite increasing interest in the potential roles of extracellular microRNAs (miRNAs) in central nervous system (CNS) pathologies, there has been little research on extracellular miRNAs in early stages of cognitive decline. We leverage the longitudinal Normative Aging Study (NAS) cohort to investigate associations between plasma miRNAs and cognitive function among cognitively normal men. METHODS This study includes data from up to 530 NAS participants (median age: 71.0 years) collected from 1996 to 2013, with a total of 1,331 person-visits (equal to 2,471 years of follow up). Global cognitive function was assessed using the Mini-Mental State Examination (MMSE). Plasma miRNAs were profiled using small RNA sequencing. Associations of expression of 381 miRNAs with current cognitive function and rate of change in cognitive function were assessed using linear regression (N = 457) and linear mixed models (N = 530), respectively. RESULTS In adjusted models, levels of 2 plasma miRNAs were associated with higher MMSE scores (p < 0.05). Expression of 33 plasma miRNAs was associated with rate of change in MMSE scores over time (p < 0.05). Enriched KEGG pathways for miRNAs associated with concurrent MMSE and MMSE trajectory included Hippo signaling and extracellular matrix-receptor interactions. Gene targets of miRNAs associated with MMSE trajectory were additionally associated with prion diseases and fatty acid biosynthesis. CONCLUSIONS Circulating miRNAs were associated with both cross-sectional cognitive function and rate of change in cognitive function among cognitively normal men. Further research is needed to elucidate the potential functions of these miRNAs in the CNS and investigate relationships with other neurological outcomes.
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Affiliation(s)
- Nicole Comfort
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY 10032, USA
| | - Haotian Wu
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY 10032, USA
| | - Peter De Hoff
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA 92093, USA
| | - Aishwarya Vuppala
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA 92093, USA
| | - Pantel S. Vokonas
- VA Normative Aging Study, VA Boston Healthcare System, Boston, MA 02130, USA
- Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA
| | - Avron Spiro
- Massachusetts Veterans Epidemiology and Research Information Center, VA Boston Healthcare System, Boston, MA 02130, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA 02118, USA
| | - Marc Weisskopf
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Brent A. Coull
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Louise C. Laurent
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA 92093, USA
| | - Andrea A. Baccarelli
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY 10032, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
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Whitfield T, Demnitz-King H, Schlosser M, Barnhofer T, Frison E, Coll-Padros N, Dautricourt S, Requier F, Delarue M, Gonneaud J, Klimecki OM, Lutz A, Paly L, Salmon E, Schild AK, Walker Z, Jessen F, Chételat G, Collette F, Wirth M, Marchant NL, Michon A, Sanchez-Valle R, Schwars C, Lai C, Coueron R, Arenaza-Urquijo EM, Poisnel G, Delphin-Combe F, Asselineau J, Krolak-Salmon P, Molinuevo JL, Allais F, Bachelet R, Belleoud V, Benson C, Bosch B, Casanova MP, Espérou H, Goldet K, Hamdidouche I, Leon M, Meiberth D, Mueller H, Mueller T, Ourry V, Reyrolle L, Salinero A, Sannemann L, Satgunasingam Y, Steinhauser H, Vuilleumier P, Wallet C, Wingrove J. Effects of a mindfulness-based versus a health self-management intervention on objective cognitive performance in older adults with subjective cognitive decline (SCD): a secondary analysis of the SCD-Well randomized controlled trial. Alzheimers Res Ther 2022; 14:125. [PMID: 36068621 PMCID: PMC9446839 DOI: 10.1186/s13195-022-01057-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 07/29/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Older individuals with subjective cognitive decline (SCD) perceive that their cognition has declined but do not show objective impairment on neuropsychological tests. Individuals with SCD are at elevated risk of objective cognitive decline and incident dementia. Non-pharmacological interventions (including mindfulness-based and health self-management approaches) are a potential strategy to maintain or improve cognition in SCD, which may ultimately reduce dementia risk.
Methods
This study utilized data from the SCD-Well randomized controlled trial. One hundred forty-seven older adults with SCD (MAge = 72.7 years; 64% female) were recruited from memory clinics in four European countries and randomized to one of two group-based, 8-week interventions: a Caring Mindfulness-based Approach for Seniors (CMBAS) or a health self-management program (HSMP). Participants were assessed at baseline, post-intervention (week 8), and at 6-month follow-up (week 24) using a range of cognitive tests. From these tests, three composites were derived—an “abridged” Preclinical Alzheimer’s Cognitive Composite 5 (PACC5Abridged), an attention composite, and an executive function composite. Both per-protocol and intention-to-treat analyses were performed. Linear mixed models evaluated the change in outcomes between and within arms and adjusted for covariates and cognitive retest effects. Sensitivity models repeated the per-protocol analyses for participants who attended ≥ 4 intervention sessions.
Results
Across all cognitive composites, there were no significant time-by-trial arm interactions and no measurable cognitive retest effects; sensitivity analyses supported these results. Improvements, however, were observed within both trial arms on the PACC5Abridged from baseline to follow-up (Δ [95% confidence interval]: CMBAS = 0.34 [0.19, 0.48]; HSMP = 0.30 [0.15, 0.44]). There was weaker evidence of an improvement in attention but no effects on executive function.
Conclusions
Two non-pharmacological interventions conferred small, non-differing improvements to a global cognitive composite sensitive to amyloid-beta-related decline. There was weaker evidence of an effect on attention, and no evidence of an effect on executive function. Importantly, observed improvements were maintained beyond the end of the interventions. Improving cognition is an important step toward dementia prevention, and future research is needed to delineate the mechanisms of action of these interventions and to utilize clinical endpoints (i.e., progression to mild cognitive impairment or dementia).
Trial registration
ClinicalTrials.gov, NCT03005652.
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17
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Scholes S, Liao J. Social support, social strain and declines in verbal memory: sex-specific associations based on 16-year follow-up of the English Longitudinal Study of Ageing cohort. Aging Ment Health 2022; 27:780-788. [PMID: 35735097 DOI: 10.1080/13607863.2022.2089628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Previous investigations of cognitive aging have mainly focused on structural aspects of social relations (e.g. network size and composition), thereby neglecting the role of qualitative aspects of social relations. The current longitudinal study examined sex-specific differences in verbal memory decline by measures of perceived relationship quality (social support/strain) by relationship type. METHOD In the English Longitudinal Study of Ageing (ELSA), 10,109 participants aged 50-89 years were assessed at wave 1 (baseline: 2002-03) and followed to wave 9 (2017-18). Verbal memory was assessed by immediate and delayed word-recall tasks. Social support/strain was measured by relationship type (spouse; children; family; friends). Random effects within-between (REWB) modelling was used to separate between- and within-person effects. We estimated associations between social support/strain and (1) baseline levels of memory (main effects), and (2) rate of decline in memory (interaction with time-since-baseline). RESULTS Longitudinal associations were most prominent for men, specific to relationship type, and showed between- rather than within-person effects. Among men, higher spousal strain was associated with faster memory decline (βbetween-effect×time = -0.043; 95% CI [-0.084, -0.002]; p = .039), whilst greater support from children was associated with slower decline (βbetween-effect×time = 0.020; 95% CI [0.002, 0.039]; p = .033). Men with higher strain from friends showed lower baseline memory (βbetween-effect = -0.382; 95% CI [-0.627, -0.137]; p=.002) and faster decline (βbetween-effect×time = -0.047; 95% CI [-0.095, 0.000]; p = .051). CONCLUSION Between-person differences in social support/strain were modestly associated with memory decline, especially among men.
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Affiliation(s)
- Shaun Scholes
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jing Liao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, P.R. China.,Sun Yat-Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, P.R. China
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18
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Zeng Y, Lum TYS, Chen YC. The intersectionality of life course socioeconomic status, race, and cognitive decline: An 18-year follow-up. Int J Geriatr Psychiatry 2022; 37. [PMID: 35775714 DOI: 10.1002/gps.5774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 06/20/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Studies have documented the impact of childhood socioeconomic status (SES) on cognition. However, research that simultaneously considers SES in varied life stages, the multidimensional mechanisms, and racial differences is relatively understudied. This study examines the intersectionality across age, SES, and race and its impact on cognitive trajectories. METHODS Using 8376 respondents aged 65+ from the 1998-2016 Health and Retirement Study, we used latent growth curve modeling to examine the effects of four life course models (latency, pathway, accumulation, and mobility) on 18-year trajectories of mental status and episodic memory. We further tested for differences in the links between SES and cognitive trajectories between black and white respondents. RESULTS Cognitive function declines with age and is interrelated with SES and race. Adulthood has a stronger effect on cognitive performance than childhood. However, linked positive childhood and adulthood SES contributes to positive cognition. Accumulated SES disadvantages were associated with lower cognition. Older adults with downward mobility and low SES throughout their lifespans had the lowest cognition scores. Life course models operated differently on trajectories of cognitive decline, yet the effects were particularly evident among older black respondents. Overall, those with socioeconomic advantages tended to have a slower decline in cognition, while a faster decline occurred for those with accrued disadvantages. CONCLUSIONS Cognitive performance is a complex, longitudinal process intertwined with socioeconomic conditions and population heterogeneity shaped by life course contexts. Policies that facilitate healthy cognitive performance and address SES inequality could equalize health opportunities and address racial cognitive disparities later in life.
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Affiliation(s)
- Yue Zeng
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Terry Yat Sang Lum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Yu-Chih Chen
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong SAR
- Social Policy Institute, Washington University in St. Louis, St. Louis, Missouri, USA
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19
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Roberts AL, Liu J, Lawn RB, Jha SC, Sumner JA, Kang JH, Rimm EB, Grodstein F, Kubzansky LD, Chibnik LB, Koenen KC. Association of Posttraumatic Stress Disorder With Accelerated Cognitive Decline in Middle-aged Women. JAMA Netw Open 2022; 5:e2217698. [PMID: 35771577 PMCID: PMC9247738 DOI: 10.1001/jamanetworkopen.2022.17698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Posttraumatic stress disorder (PTSD) has been hypothesized to lead to impaired cognitive function. However, no large-scale studies have assessed whether PTSD is prospectively associated with cognitive decline in middle-aged adults. OBJECTIVE To assess the association between PTSD and decline in cognitive function over time. DESIGN, SETTING, AND PARTICIPANTS This cohort study included participants from the Nurses' Health Study II, an ongoing longitudinal cohort study involving community-dwelling middle-aged female nurses residing in the US who had at least a 2-year nursing degree at the time of enrollment in 1989. The present study included 12 270 trauma-exposed women who were enrolled in the PTSD substudy of the Nurses' Health Study II and completed 1 to 5 cognitive assessments. Data were collected from March 1, 2008, to July 30, 2019. EXPOSURES Lifetime PTSD symptoms, assessed using a validated questionnaire between March 1, 2008, and February 28, 2010. MAIN OUTCOMES AND MEASURES The main outcome was evaluated using the Cogstate Brief Battery, a self-administered online cognitive battery. Cognitive function was measured by a psychomotor speed and attention composite score and a learning and working memory composite score. Women completed the Cogstate Brief Battery every 6 or 12 months (up to 24 months) from October 3, 2014, to July 30, 2019. Linear mixed-effects models were used to evaluate the association of PTSD symptoms with the rate of change in cognition over follow-up, considering a broad range of relevant covariates, including the presence of depression symptoms and history of clinician-diagnosed depression. The rate of cognitive change was adjusted for potential practice effects (ie, potential changes in test results that occur when a test is taken more than once) by including indicators for the number of previous tests taken. RESULTS Among 12 270 women, the mean (SD) age at the baseline cognitive assessment was 61.1 (4.6) years; 125 women (1.0%) were Asian, 75 (0.6%) were Black, 156 (1.3%) were Hispanic, 11 767 (95.9%) were non-Hispanic White, and 147 (1.2%) were of other race and/or ethnicity. A higher number of PTSD symptoms was associated with worse cognitive trajectories. Compared with women with no PTSD symptoms, women with the highest symptom level (6-7 symptoms) had a significantly worse rate of change in both learning and working memory (β = -0.08 SD/y; 95% CI, -0.11 to -0.04 SD/y; P < .001) and psychomotor speed and attention (β = -0.05 SD/y; 95% CI, -0.09 to -0.01 SD/y; P = .02), adjusted for demographic characteristics. Associations were unchanged when additionally adjusted for behavioral factors (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.08 SD/y; 95% CI, -0.11 to -0.04 SD/y; P < .001) and health conditions (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.08 SD/y; 95% CI, -0.11 to -0.04 SD/y; P < .001) and were partially attenuated but still evident when further adjusted for practice effects (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.07 SD/y; 95% CI, -0.10 to -0.03 SD/y; P < .001) and comorbid depression (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.07 SD/y; 95% CI, -0.11 to -0.03 SD/y; P < .001). CONCLUSIONS AND RELEVANCE In this large-scale prospective cohort study, PTSD was associated with accelerated cognitive decline in middle-aged women, suggesting that earlier cognitive screening among women with PTSD may be warranted. Given that cognitive decline is strongly associated with subsequent Alzheimer disease and related dementias, better understanding of this association may be important to promote healthy aging.
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Affiliation(s)
- Andrea L. Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jiaxuan Liu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Rebecca B. Lawn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Shaili C. Jha
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Jae H. Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Eric B. Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Francine Grodstein
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Lori B. Chibnik
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Neurology, Massachusetts General Hospital, Boston
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston
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20
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Wolfova K, Creese B, Aarsland D, Ismail Z, Corbett A, Ballard C, Hampshire A, Cermakova P. Gender/Sex Differences in the Association of Mild Behavioral Impairment with Cognitive Aging. J Alzheimers Dis 2022; 88:345-355. [PMID: 35599483 DOI: 10.3233/jad-220040] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND While the gender/sex differences in neuropsychiatric symptoms in dementia population are well described, gender/sex differences in mild behavioral impairment (MBI) in dementia-free populations and the relationship to cognitive performance and to subsequent cognitive decline have not been studied. OBJECTIVE We aimed to explore gender/sex differences in the association of MBI with the level of cognitive performance and its rate of decline in a dementia-free cohort. METHODS We studied 8,181 older adults enrolled in the online PROTECT UK Study. MBI was assessed using the MBI Checklist and cognition was measured by digit span, paired associate learning, spatial working memory, and verbal reasoning. Statistical analysis was conducted using linear regression models and linear mixed-effects models. RESULTS Out of 8,181 individuals (median age 63 years, 73% females), 11% of females and 14% of males had MBI syndrome. Females exhibited less often symptoms of decreased motivation (45% versus 36% in males), impulse dyscontrol (40% versus 44% in males; p = 0.001) and social inappropriateness (12% versus 15% ; p < 0.001), while they showed more often symptoms of emotional dysregulation (45% versus 36% ; p < 0.001). The associations of MBI domains with some measures of cognitive performance and decline were stronger in males than females, with the exception of the association of emotional dysregulation with the rate of cognitive decline in verbal reasoning, which was present exclusively in females. CONCLUSION MBI may influence cognition to a greater extent in males than in females. We propose that predictors and biomarkers of dementia should consider gender/sex as an effect modifier.
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Affiliation(s)
- Katrin Wolfova
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.,National Institute of Mental Health, Klecany, Czech Republic.,Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Byron Creese
- University of Exeter Medical School, College of Medicine and Health, RD&E Hospital Wonford, Barrack Road, Exeter, UK
| | - Dag Aarsland
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Zahinoor Ismail
- Departments of Psychiatry and Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Canada.,University of Exeter Medical School, College of Medicine and Health, St Luke's Campus, University of Exeter, Exeter, UK
| | - Anne Corbett
- South Cloisters, College of Medicine & Health, St Luke's Campus, University of Exeter, Exeter, UK
| | - Clive Ballard
- University of Exeter Medical School, College of Medicine and Health, St Luke's Campus, University of Exeter, Exeter, UK
| | - Adam Hampshire
- Faculty of Medicine, Department of Medicine, Imperial College London, London, UK
| | - Pavla Cermakova
- National Institute of Mental Health, Klecany, Czech Republic.,Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
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21
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Bertola L, Benseñor IJM, Brunoni AR, Caramelli P, Barreto SM, Moreno AB, Griep RH, Viana MC, Lotufo PA, Suemoto CK. Retest effects in a diverse sample: sociodemographic predictors and possible correction approaches. Dement Neuropsychol 2022; 16:171-180. [PMID: 35720646 PMCID: PMC9173799 DOI: 10.1590/1980-5764-dn-2021-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 10/13/2021] [Indexed: 11/21/2022] Open
Abstract
Repeated cognitive assessment in longitudinal studies favors the occurrence of retest effects, usually increasing the scores obtained at the follow-up assessments when compared to baseline. Therefore, retest effects can compromise the evaluation of cognitive decline in older adults.
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Affiliation(s)
- Laiss Bertola
- Universidade de São Paulo, Faculdade de Medicina, São Paulo SP, Brazil
| | - Isabela Judith Martins Benseñor
- Universidade de São Paulo, Hospital Universitário, Centro de Pesquisa Epidemiológica e Clínica, São Paulo SP, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Interna, São Paulo SP, Brazil
| | - Andre Russowsky Brunoni
- Universidade de São Paulo, Hospital Universitário, Centro de Pesquisa Epidemiológica e Clínica, São Paulo SP, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Interna, São Paulo SP, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Departamento e Instituto de Psiquiatria, Laboratório de Neurociências, São Paulo SP, Brazil
| | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
| | - Sandhi Maria Barreto
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Hospital das Clínicas, Belo Horizonte MG, Brazil
| | - Arlinda Barbosa Moreno
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sérgio Arouca, Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Rio de Janeiro RJ, Brazil
| | - Rosane Harter Griep
- Fundação Oswaldo Cruz, Istituto Oswaldo Cruz, Laboratório de Educação em Saúde e Meio Ambiente, Rio de Janeiro RJ, Brazil
| | - Maria Carmen Viana
- Universidade Federal do Espírito Santo, Departamento de Medicina Social, Vitória ES, Brazil
| | - Paulo Andrade Lotufo
- Universidade de São Paulo, Hospital Universitário, Centro de Pesquisa Epidemiológica e Clínica, São Paulo SP, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Interna, São Paulo SP, Brazil
| | - Claudia Kimie Suemoto
- Universidade de São Paulo, Faculdade de Medicina, Divisão de Geriatria, São Paulo SP, Brazil
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22
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Vonk JMJ, Ghaznawi R, Zwartbol MHT, Stern Y, Geerlings MI. The role of cognitive and brain reserve in memory decline and atrophy rate in mid and late-life: The SMART-MR study. Cortex 2022; 148:204-214. [PMID: 35189525 PMCID: PMC11018269 DOI: 10.1016/j.cortex.2021.11.022] [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: 03/09/2021] [Revised: 07/25/2021] [Accepted: 11/17/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Investigate associations of cognitive and brain reserve with trajectories of memory decline in mid-life and late-life, and whether the relationship of memory decline with atrophy differs as a function of reserve. METHODS Participants were 989 Dutch middle-aged to older adults from the SMART-MR prospective cohort, followed up to 12 years with up to 3 measurements of memory and brain MRI. Education and Dutch National Adult Reading Test (DART) were used as proxies of cognitive reserve, and intracranial volume (ICV) and baseline brain parenchymal fraction (BPF) for brain reserve. Univariate growth curve models analyzed associations of reserve with memory decline, and multiple-group bivariate growth curve models tested the longitudinal brain-memory relationship as a function of reserve. Models were additionally stratified by mid-life and late-life. RESULTS Higher DART, education, and BPF were related to a slower rate of memory decline, particularly in late-life, but ICV was not. A positive covariance indicated that an individual who undergoes atrophy also undergoes memory decline-this relationship did not differ across cognitive or brain reserve, but was not present in mid-life. Memory declined slower than brain volume, yet rates were more similar in the low DART, education, and BPF groups. DISCUSSION Higher cognitive (DART, education) and brain reserve (BPF) work protectively in longitudinal memory change. ICV is an inappropriate proxy of brain reserve, failing to show any association with memory performance at baseline or over time. Deconstructing relationships of reserve capacities with longitudinal cognitive and brain outcomes may identify focus areas with potential for intervention.
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Affiliation(s)
- Jet M J Vonk
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands; Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Rashid Ghaznawi
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands; Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Maarten H T Zwartbol
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands; Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Yaakov Stern
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Mirjam I Geerlings
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands.
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23
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Rouanet A, Avila-Rieger J, Dugravot A, Lespinasse J, Stuckwisch R, Merrick R, Anderson E, Long L, Helmer C, Jacqmin-Gadda H, Dufouil C, Judd S, Manly J, Sabia S, Gross A, Proust-Lima C. How Selection Over Time Contributes to the Inconsistency of the Association Between Sex/Gender and Cognitive Decline Across Cognitive Aging Cohorts. Am J Epidemiol 2022; 191:441-452. [PMID: 34521111 DOI: 10.1093/aje/kwab227] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 07/26/2021] [Accepted: 08/24/2021] [Indexed: 02/06/2023] Open
Abstract
The association between sex/gender and aging-related cognitive decline remains poorly understood because of inconsistencies in findings. Such heterogeneity could be attributable to the cognitive functions studied and study population characteristics, but also to differential selection by dropout and death between men and women. We aimed to evaluate the impact of selection by dropout and death on the association between sex/gender and cognitive decline. We first compared the statistical methods most frequently used for longitudinal data, targeting either population estimands (marginal models fitted by generalized estimating equations) or subject-specific estimands (mixed/joint models fitted by likelihood maximization) in 8 studies of aging: 6 population-based studies (the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Study (1996-2009), Personnes Âgées QUID (PAQUID; 1988-2014), the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study (2003-2016), the Three-City Study (Bordeaux only; 1999-2016), the Washington Heights-Inwood Community Aging Project (WHICAP; 1992-2017), and the Whitehall II Study (2007-2016)) and 2 clinic-based studies (the Alzheimer's Disease Neuroimaging Initiative (ADNI; 2004-2017) and a nationwide French cohort study, MEMENTO (2011-2016)). We illustrate differences in the estimands of the association between sex/gender and cognitive decline in selected examples and highlight the critical role of differential selection by dropout and death. Using the same estimand, we then contrast the sex/gender-cognitive decline associations across cohorts and cognitive measures suggesting a residual differential sex/gender association depending on the targeted cognitive measure (memory or animal fluency) and the initial cohort selection. We recommend focusing on subject-specific estimands in the living population for assessing sex/gender differences while handling differential selection over time.
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24
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Healthier over time? Period effects in health among older Europeans in a step-wise approach to identification. Soc Sci Med 2022; 297:114791. [DOI: 10.1016/j.socscimed.2022.114791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 01/24/2022] [Accepted: 02/06/2022] [Indexed: 11/21/2022]
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25
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Sanderson‐Cimino M, Elman JA, Tu XM, Gross AL, Panizzon MS, Gustavson DE, Bondi MW, Edmonds EC, Eglit GM, Eppig JS, Franz CE, Jak AJ, Lyons MJ, Thomas KR, Williams ME, Kremen WS. Cognitive practice effects delay diagnosis of MCI: Implications for clinical trials. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12228. [PMID: 35128027 PMCID: PMC8804942 DOI: 10.1002/trc2.12228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/12/2021] [Accepted: 11/15/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Practice effects (PEs) on cognitive tests obscure decline, thereby delaying detection of mild cognitive impairment (MCI). Importantly, PEs may be present even when there are performance declines, if scores would have been even lower without prior test exposure. We assessed how accounting for PEs using a replacement-participants method impacts incident MCI diagnosis. METHODS Of 889 baseline cognitively normal (CN) Alzheimer's Disease Neuroimaging Initiative (ADNI) participants, 722 returned 1 year later (mean age = 74.9 ± 6.8 at baseline). The scores of test-naïve demographically matched "replacement" participants who took tests for the first time were compared to returnee scores at follow-up. PEs-calculated as the difference between returnee follow-up scores and replacement participants scores-were subtracted from follow-up scores of returnees. PE-adjusted cognitive scores were then used to determine if individuals were below the impairment threshold for MCI. Cerebrospinal fluid amyloid beta, phosphorylated tau, and total tau were used for criterion validation. In addition, based on screening and recruitment numbers from a clinical trial of amyloid-positive individuals, we estimated the effect of earlier detection of MCI by accounting for cognitive PEs on a hypothetical clinical trial in which the key outcome was progression to MCI. RESULTS In the ADNI sample, PE-adjusted scores increased MCI incidence by 19% (P < .001), increased proportion of amyloid-positive MCI cases (+12%), and reduced proportion of amyloid-positive CNs (-5%; P's < .04). Additional calculations showed that the earlier detection and increased MCI incidence would also substantially reduce necessary sample size and study duration for a clinical trial of progression to MCI. Cost savings were estimated at ≈$5.41 million. DISCUSSION Detecting MCI as early as possible is of obvious importance. Accounting for cognitive PEs with the replacement-participants method leads to earlier detection of MCI, improved diagnostic accuracy, and can lead to multi-million-dollar cost reductions for clinical trials.
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Affiliation(s)
- Mark Sanderson‐Cimino
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical PsychologySan DiegoCaliforniaUSA
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | - Jeremy A. Elman
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | - Xin M. Tu
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Family Medicine and Public HealthUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Sam and Rose Stein Institute for Research on AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | - Alden L. Gross
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Matthew S. Panizzon
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | - Daniel E. Gustavson
- Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Mark W. Bondi
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Psychology ServiceVA San Diego Healthcare SystemSan DiegoCaliforniaUSA
| | - Emily C. Edmonds
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Research ServiceVA San Diego Healthcare SystemSan DiegoCaliforniaUSA
| | - Graham M.L. Eglit
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Sam and Rose Stein Institute for Research on AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | | | - Carol E. Franz
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | - Amy J. Jak
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Center of Excellence for Stress and Mental HealthVeterans Affairs San Diego Healthcare SystemSan DiegoCaliforniaUSA
| | - Michael J. Lyons
- Department of Psychological and Brain SciencesBoston UniversityBostonMassachusettsUSA
| | - Kelsey R. Thomas
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Research ServiceVA San Diego Healthcare SystemSan DiegoCaliforniaUSA
| | - McKenna E. Williams
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical PsychologySan DiegoCaliforniaUSA
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
| | - William S. Kremen
- Center for Behavior Genetics of AgingUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
- Department of PsychiatrySchool of MedicineUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA
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26
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Hannigan C, Hanly P, Kee F, Lawlor B, Holton E, Walsh C, Scharf T, Coen R, Leatham V, Moynihan S, Lane K, McHugh Power J. HALO: Study protocol for a single-case experimental design study evaluating the moderating impact of a befriending intervention on the association between loneliness and health in older adults. HRB Open Res 2022; 3:60. [PMID: 35187395 PMCID: PMC8825647 DOI: 10.12688/hrbopenres.13104.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Loneliness in later life is often addressed with befriending interventions, yet evidence for their effectiveness is limited. Meanwhile it is known that loneliness has a deleterious impact on health. The aim of the study is to evaluate whether a befriending service for older adults mitigates the impact of loneliness on health outcomes, and to identify mechanisms through which befriending interventions might impact upon health. Methods: A mixed methods design is used. The quantitative component utilises an AB single-case experimental design, to gather intensive longitudinal data. These data will be analysed using a generalised additive modelling approach. The qualitative component of the study uses semi-structured dyadic interviews, structured and analysed according to the principles of constructivist grounded theory. Findings will then be triangulated according to an existing mixed methods integration protocol. Discussion: This mixed methods design has the potential to inform national and international policy in relation to befriending interventions for older adults. In addition, there is the potential for study results to inform our theoretical understanding of the nature of the relationship between loneliness and health. Trial registration: ClinicalTrials.gov identifier
NCT04301167 (10
th March 2020). Protocol version 1.1, 26
th June 2020.
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Affiliation(s)
- Caoimhe Hannigan
- School of Business, National College of Ireland, Mayor St, Dublin 1, Ireland
| | - Paul Hanly
- School of Business, National College of Ireland, Mayor St, Dublin 1, Ireland
| | - Frank Kee
- Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - Brian Lawlor
- School of Medicine, Trinity College Dublin, University of Dublin, Dublin 2, Ireland
| | - Eimile Holton
- School of Medicine, Trinity College Dublin, University of Dublin, Dublin 2, Ireland
| | - Cathal Walsh
- Department of Maths and Statistics, University of Limerick, Limerick, Ireland
| | - Thomas Scharf
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | | | | | | | - Keith Lane
- ALONE, Pleasants Street, Dublin 8, Ireland
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27
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Wagner M, Grodstein F, Leffondre K, Samieri C, Proust-Lima C. Time-varying associations between an exposure history and a subsequent health outcome: a landmark approach to identify critical windows. BMC Med Res Methodol 2021; 21:266. [PMID: 34837966 PMCID: PMC8627635 DOI: 10.1186/s12874-021-01403-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 09/17/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Long-term behavioral and health risk factors constitute a primary focus of research on the etiology of chronic diseases. Yet, identifying critical time-windows during which risk factors have the strongest impact on disease risk is challenging. To assess the trajectory of association of an exposure history with an outcome, the weighted cumulative exposure index (WCIE) has been proposed, with weights reflecting the relative importance of exposures at different times. However, WCIE is restricted to a complete observed error-free exposure whereas exposures are often measured with intermittent missingness and error. Moreover, it rarely explores exposure history that is very distant from the outcome as usually sought in life-course epidemiology. METHODS We extend the WCIE methodology to (i) exposures that are intermittently measured with error, and (ii) contexts where the exposure time-window precedes the outcome time-window using a landmark approach. First, the individual exposure history up to the landmark time is estimated using a mixed model that handles missing data and error in exposure measurement, and the predicted complete error-free exposure history is derived. Then the WCIE methodology is applied to assess the trajectory of association between the predicted exposure history and the health outcome collected after the landmark time. In our context, the health outcome is a longitudinal marker analyzed using a mixed model. RESULTS A simulation study first demonstrates the correct inference obtained with this approach. Then, applied to the Nurses' Health Study (19,415 women) to investigate the association between body mass index history (collected from midlife) and subsequent cognitive decline (evaluated after age 70), the method identified two major critical windows of association: long before the first cognitive evaluation (roughly 24 to 12 years), higher levels of BMI were associated with poorer cognition. In contrast, adjusted for the whole history, higher levels of BMI became associated with better cognition in the last years prior to the first cognitive interview, thus reflecting reverse causation (changes in exposure due to underlying disease). CONCLUSIONS This approach, easy to implement, provides a flexible tool for studying complex dynamic relationships and identifying critical time windows while accounting for exposure measurement errors.
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Affiliation(s)
- Maude Wagner
- BPH Research Center, Inserm U1219, Bordeaux University, 146 rue Léo-Saignat, Bordeaux, France.
| | - Francine Grodstein
- RUSH Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Karen Leffondre
- BPH Research Center, Inserm U1219, Bordeaux University, 146 rue Léo-Saignat, Bordeaux, France
| | - Cécilia Samieri
- BPH Research Center, Inserm U1219, Bordeaux University, 146 rue Léo-Saignat, Bordeaux, France
| | - Cécile Proust-Lima
- BPH Research Center, Inserm U1219, Bordeaux University, 146 rue Léo-Saignat, Bordeaux, France
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28
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Kolli A, Hood MM, Karvonen-Gutierrez C, Moroi SE, Ehrlich JR, Gillespie BW, Dougherty Wood S, Musch DC. Midlife Vision Impairment and Cognitive Function in Later Life: The Study of Women's Health Across the Nation, Michigan Cohort. J Gerontol A Biol Sci Med Sci 2021; 76:2178-2186. [PMID: 34153092 PMCID: PMC8598988 DOI: 10.1093/gerona/glab180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND In older adults, vision impairment (VI) is associated with worse cognitive function. However, the relationship between midlife vision and future cognitive function remains unknown. METHODS The Study of Women's Health Across the Nation, Michigan site, is a longitudinal cohort of midlife women aged 42-52 years at baseline. Presenting Titmus visual acuity (VA) in the better-seeing eye was assessed at baseline and categorized as no or mild VI (VA ≥20/60), or moderate or worse VI (VA <20/60). Cognitive function was measured 8 times over 15 years using the East Boston Memory Test immediate (EBMTi) and delayed (EBMTd) recall and the Digit Span Backwards (DSB) test. Linear mixed models with a random intercept and slope for age were constructed to detect associations between VI at baseline and future repeated measures of cognitive function, adjusting for age, race, education, financial strain, alcohol use, and tobacco use. RESULTS About 394 women aged 42-52 at baseline with a maximum follow-up of 20 years were included in this analysis. After covariate adjustment, moderate or worse VI was associated with lower EMBTi (β = -0.56, p = .012), EBMTd (β = -0.60, p = .009), and DSB (β = -0.84, p = .04). While we detected significant associations between VI and levels of cognitive function scores, rates of cognitive decline as individuals aged did not vary by VI status. CONCLUSION Moderate or worse VI, assessed during midlife, was associated with lower scores on measures of cognitive function over a 15-year period during which women transitioned from midlife to older adulthood.
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Affiliation(s)
- Ajay Kolli
- University of Michigan Medical School, University of Michigan, Ann Arbor, USA
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Michelle M Hood
- Department of Epidemiology, University of Michigan School of Public Health, University of Michigan, Ann Arbor, USA
| | - Carrie Karvonen-Gutierrez
- Department of Epidemiology, University of Michigan School of Public Health, University of Michigan, Ann Arbor, USA
| | - Sayoko E Moroi
- Department of Ophthalmology and Visual Sciences, Michigan Medicine, University of Michigan, Ann Arbor, USA
- Department of Ophthalmology and Visual Sciences, Ohio State University Wexner Medical Center, The Ohio State University, Columbus, USA
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, Michigan Medicine, University of Michigan, Ann Arbor, USA
- Institute for Social Research, University of Michigan, Ann Arbor, USA
| | - Brenda W Gillespie
- Department of Biostatistics, University of Michigan School of Public Health, University of Michigan, Ann Arbor, USA
| | - Sarah Dougherty Wood
- Department of Ophthalmology and Visual Sciences, Michigan Medicine, University of Michigan, Ann Arbor, USA
| | - David C Musch
- Department of Epidemiology, University of Michigan School of Public Health, University of Michigan, Ann Arbor, USA
- Department of Ophthalmology and Visual Sciences, Michigan Medicine, University of Michigan, Ann Arbor, USA
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29
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Kobayashi LC, Gross AL, Gibbons LE, Tommet D, Sanders RE, Choi SE, Mukherjee S, Glymour M, Manly JJ, Berkman LF, Crane PK, Mungas DM, Jones RN. You Say Tomato, I Say Radish: Can Brief Cognitive Assessments in the U.S. Health Retirement Study Be Harmonized With Its International Partner Studies? J Gerontol B Psychol Sci Soc Sci 2021; 76:1767-1776. [PMID: 33249448 DOI: 10.1093/geronb/gbaa205] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To characterize the extent to which brief cognitive assessments administered in the population-representative U.S. Health and Retirement Study (HRS) and its International Partner Studies can be considered to be measuring a single, unidimensional latent cognitive function construct. METHODS Cognitive function assessments were administered in face-to-face interviews in 12 studies in 26 countries (N = 155,690), including the U.S. HRS and selected International Partner Studies. We used the time point of the first cognitive assessment for each study to minimize differential practice effects across studies and documented cognitive test item coverage across studies. Using confirmatory factor analysis models, we estimated single-factor general cognitive function models and bifactor models representing memory-specific and nonmemory-specific cognitive domains for each study. We evaluated model fits and factor loadings across studies. RESULTS Despite relatively sparse and inconsistent cognitive item coverage across studies, all studies had some cognitive test items in common with other studies. In all studies, the bifactor models with a memory-specific domain fit better than single-factor general cognitive function models. The data fit the models at reasonable thresholds for single-factor models in 6 of the 12 studies and for the bifactor models in all 12 of the 12 studies. DISCUSSION The cognitive assessments in the U.S. HRS and its International Partner Studies reflect comparable underlying cognitive constructs. We discuss the assumptions underlying our methods, present alternatives, and future directions for cross-national harmonization of cognitive aging data.
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Affiliation(s)
- Lindsay C Kobayashi
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.,Harvard Center for Population and Development Studies, Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health and Johns Hopkins University Center on Aging and Health, Baltimore, Maryland
| | - Laura E Gibbons
- Department of Medicine, School of Medicine, University of Washington, Seattle
| | - Doug Tommet
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island
| | - R Elizabeth Sanders
- Department of Medicine, School of Medicine, University of Washington, Seattle
| | - Seo-Eun Choi
- Department of Medicine, School of Medicine, University of Washington, Seattle
| | | | - Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Jennifer J Manly
- Department of Neurology and the Taubman Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York
| | - Lisa F Berkman
- Harvard Center for Population and Development Studies, Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts
| | - Paul K Crane
- Department of Medicine, School of Medicine, University of Washington, Seattle
| | - Dan M Mungas
- Department of Neurology, University of California, Davis, Sacramento
| | - Richard N Jones
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island
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30
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Finlay J, Esposito M, Li M, Colabianchi N, Zhou H, Judd S, Clarke P. Neighborhood active aging infrastructure and cognitive function: A mixed-methods study of older Americans. Prev Med 2021; 150:106669. [PMID: 34087319 PMCID: PMC8316307 DOI: 10.1016/j.ypmed.2021.106669] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/20/2021] [Accepted: 05/29/2021] [Indexed: 01/22/2023]
Abstract
Physical exercise benefits cognitive functioning and can protect against neurodegeneration. Neighborhood environments may be pivotal to physically active aging, and thus help shape older adults' cognitive function. This mixed-methods study investigated where older adults exercised outside the home, and whether availability of these neighborhood sites was associated with cognitive function. We thematically analyzed qualitative data from semi-structured interviews in 2015 with 125 older adults (mean age = 71) in the Minneapolis (MN) metropolitan area. Results identified nearby public parks, fitness/sports amenities, and walkable destinations as motivators for recreational exercise and active transit among participants. These findings informed quantitative analysis of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national sample of older Black and white Americans (n = 21,151; mean age at assessment = 67; data collected 2006-2017). We used generalized additive multilevel models to examine whether neighborhood features that qualitative participants identified as encouraging physical activity were associated with elevated levels of cognitive function. Results indicated that residing in neighborhoods with greater availability of local parks, access to recreational amenities, and business density was associated with higher levels of cognitive function. We found no evidence to suggest a significant association between availability of these neighborhood resources and rate of cognitive decline. This study identifies specific neighborhood active aging infrastructure that may support cognitive function among older adults aging in place.
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Affiliation(s)
- Jessica Finlay
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States; Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Michael Esposito
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States; Department of Sociology, Washington University of St. Louis, St. Louis, MO 63130, United States
| | - Mao Li
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States; Survey Methodology Program, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States
| | - Natalie Colabianchi
- School of Kinesiology, University of Michigan, 1402 Washington Heights, Ann Arbor, MI 48109, United States
| | - Huajun Zhou
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States; Biostatistics Program, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Suzanne Judd
- School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL 35233, United States
| | - Philippa Clarke
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, United States; Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
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31
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Kucera M, Wolfova K, Cermakova P. Association Between Season of Birth and Cognitive Aging in Older Adults: Pan-European Population-Based Study on 70,000 Individuals. J Alzheimers Dis 2021; 82:1703-1713. [PMID: 34219722 DOI: 10.3233/jad-210289] [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: 11/15/2022]
Abstract
BACKGROUND Several early-life factors have been associated with higher risk of developing dementia. It is unclear whether season of birth (SOB) can affect cognitive aging in older adults or not. OBJECTIVE We aimed to study the association of SOB with the level of cognitive performance as well as with the rate of cognitive decline. METHODS We studied 70,203 individuals who participated in the Survey of Health, Aging and Retirement in Europe. Cognition was measured with tests on verbal fluency and immediate and delayed recall. We assessed the association of SOB with the level of cognitive performance using multiple linear regression and with the rate of cognitive decline using linear mixed-effects models. RESULTS When compared to individuals born in winter and adjusted for sociodemographic and health-related characteristics, being born in summer was associated with a higher level of delayed recall (B 0.05; 95%CI 0.01 to 0.09) and verbal fluency (B 0.15; 95%CI 0.00 to 0.29) and being born in fall with a higher level of immediate recall (B 0.04; 95%CI 0.01 to 0.08) and verbal fluency (B 0.15; 95%CI 0.01 to 0.29). Individuals born in summer had a higher yearly decline in delayed recall (B -0.005; 95%CI -0.009 to 0.000), while the scores in delayed recall in participants born in spring showed an inverse trend (B 0.005; 95%CI 0.000 to 0.010). CONCLUSION Individuals born in winter seem to carry a life-long disadvantage in a lower level of cognitive performance; however, being born in winter does not seem to affect the rate of cognitive decline.
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Affiliation(s)
- Matej Kucera
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.,National Institute of Mental Health, Klecany, Czech Republic.,Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Katrin Wolfova
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.,National Institute of Mental Health, Klecany, Czech Republic.,Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavla Cermakova
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.,National Institute of Mental Health, Klecany, Czech Republic.,Second Faculty of Medicine, Charles University, Prague, Czech Republic
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32
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Xue B, Pai M, Luo M. Working beyond SPA and the trajectories of cognitive and mental health of UK pensioners: Do gender, choice, and occupational status matter? Eur J Ageing 2021; 19:423-436. [PMID: 36052194 PMCID: PMC9424372 DOI: 10.1007/s10433-021-00644-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 11/01/2022] Open
Abstract
AbstractWe assessed the association between work status beyond state pension age (SPA) and the long-term trajectories of cognitive and mental health for men and women separately, and the extent to which this relationship is conditioned by their occupational status and whether the choice to retire or continue working is voluntary or involuntary. Data are pensioners (aged between SPA and SPA + 9) from the English Longitudinal Study of Ageing waves 4 (2008/09) through 9 (2018/19). The analytic sample includes 959 men and 1217 women when considering cognitive outcomes and 1131 men and 1434 women when evaluating depression. Findings based on growth curve models reveal that, compared to women who retired at SPA and without any particular reason, their peers who retired due to frailing health reported a more precipitous decline in memory over time (coefficient = −0.10). However, analysis stratified by occupation shows that this association between ill-health retirement and long-term memory decline was concentrated among older women of the highest occupational status. We also found that men who retired or worked past SPA voluntarily reported a better baseline verbal fluency and were less likely to report depression over time (coefficient for work = 0.80; coefficient for retired = 0.87). Women who worked past SPA voluntarily were less likely to report depression at baseline (OR = 0.53). Policies that extend work life should offer older people more personal control over decision surrounding retirement.
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33
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Dhana K, Aggarwal NT, Rajan KB, Barnes LL, Evans DA, Morris MC. Impact of the Apolipoprotein E ε4 Allele on the Relationship Between Healthy Lifestyle and Cognitive Decline: A Population-Based Study. Am J Epidemiol 2021; 190:1225-1233. [PMID: 33585904 DOI: 10.1093/aje/kwab033] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 02/02/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023] Open
Abstract
Adherence to a healthy lifestyle-characterized by abstaining from smoking, being physically and cognitively active, having a high-quality diet, and limiting alcohol use-is associated with slower cognitive decline in older adults, but whether this relationship extends to persons with a genetic predisposition (e.g., carriers of the ε4 allele of the apolipoprotein E gene (APOE*E4)) remains uncertain. Using data from a population-based study, the Chicago Health and Aging Project (Chicago, Illinois), we followed 3,886 individuals who underwent regular clinical and cognitive assessments from 1993 to 2012. Of 3,886 older adults, 1,269 (32.7%) were APOE*E4 carriers. Compared with noncarriers, APOE*E4 carriers had faster cognitive decline (β = -0.027 units/year, 95% confidence interval (CI): -0.032, -0.023). In contrast, persons with 2-3 and 4-5 healthy lifestyle factors had slower cognitive decline (β = 0.008 units/year (95% CI: 0.002, 0.014) and β = 0.019 units/year (95% CI: 0.011, 0.026), respectively) compared with those with 0-1 factor. In analyses stratified by APOE*E4 status, adherence to a healthy lifestyle (e.g., 4-5 factors vs. 0-1 factors) was associated with a slower rate of cognitive decline in both APOE*E4 carriers (β = 0.029, 95% CI: 0.013, 0.045) and noncarriers (β = 0.013, 95% CI: 0.005, 0.022). These results underscore the impact of a healthy lifestyle on cognition, particularly among persons with a genetic predisposition, who are more vulnerable to cognitive decline as they age.
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34
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Finlay J, Yu W, Clarke P, Lia M, Judd S, Esposito M. Neighborhood cognitive amenities? A mixed-methods study of intellectually-stimulating places and cognitive function among older Americans. WELLBEING, SPACE AND SOCIETY 2021; 2:100040. [PMID: 37396718 PMCID: PMC10312622 DOI: 10.1016/j.wss.2021.100040] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Neighborhoods structure health and wellbeing in later life. Local spaces can encourage physically active and socially engaged aging in place, and may also nurture opportunities for cognitively-stimulating creative and complex activities such as reading; playing and listening to music; learning; and engagement in galleries, performing arts, and museums. These activities are associated with better cognitive health outcomes. In this exploratory sequential mixed-methods study, thematic analysis of interviews and ethnographic fieldwork with 125 diverse older adults in the Minneapolis (MN) metropolitan area (mean age 71 years) explored how and where older adults participated in intellectually-stimulating neighborhood activities. Thematic analysis indicated that libraries, higher education campuses, and sites of arts and culture were frequented intellectually-stimulating places, with racial differences in perception and usage. The qualitative findings informed quantitative investigation of associations between these amenities and cognitive function in a large national sample of aging Black and white Americans (n=21,165, mean age 67 years) in the Reasons for Geographic and Racial Differences in Stroke Study. We used multilevel linear regression models to examine whether living in a neighborhood with higher kernel densities of libraries, higher education campuses, and arts/cultural sites had a net positive effect on cognitive function. Analysis identified statistically significant positive associations between arts/cultural sites and cognitive function, with a significantly larger effect size for white versus Black participants. The study contributes new evidence to the emerging ecological model of cognitive health. It critically considers racial disparities in access to health-promoting neighborhood infrastructure and opportunities to age well in place.
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Affiliation(s)
- Jessica Finlay
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, USA, 48104
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, USA, 48109
| | - Wenshan Yu
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, USA, 48104
- Survey Methodology Program, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, USA, 48104
| | - Philippa Clarke
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, USA, 48104
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, USA, 48109
| | - Mao Lia
- Survey Methodology Program, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, USA, 48104
| | - Suzanne Judd
- School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL, USA, 35233
| | - Michael Esposito
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, USA, 48104
- Department of Sociology, Washington University of St. Louis, St. Louis, MO, United States, 63130
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35
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Leist AK, Bar-Haim E, Chauvel L. Inequality of educational opportunity at time of schooling predicts cognitive functioning in later adulthood. SSM Popul Health 2021; 15:100837. [PMID: 34150980 PMCID: PMC8193135 DOI: 10.1016/j.ssmph.2021.100837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/19/2021] [Accepted: 06/01/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives Our understanding of how societal conditions and educational policies influence cognitive development across the life course is improving. We tested the extent to which inequality of educational opportunity (IEO), the country- and cohort-specific correlation of parents' and their offspring's length of schooling, offers systematically different opportunities to contribute to cognitive development, which in turn influences cognitive abilities up to older ages. Methods A total of 46,972 individuals of three cohorts born 1940-63 from 16 European countries and Israel provided up to six cognitive assessments and information on covariates in the SHARE survey 2004-2017. Individual-level data were linked to indicators of IEO at time of schooling, and economic, health, and human development, provided by World Bank, WHO, and the UN. Results In multilevel (mixed-effects) models with random individual and country-cohort effects and adjusted for a large set of confounders, higher IEO was associated with lower levels of cognitive functioning in men and women. Interaction analyses suggested lower cognitive levels particularly of women who were schooled in higher IEO contexts and had lower educational attainment. Associations with rate of change in cognitive functioning were present only in women, however there was little clinically relevant cognitive decline across the window of observation. Result patterns were mostly consistent after including additional contextual indicators, and in a subsample with childhood information. Discussion Findings suggest that IEO is able to substantially influence cognitive development with long-lasting impacts. Lower-educated women of the cohorts under investigation may have been particularly vulnerable to high-inequality educational contexts.
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Affiliation(s)
- Anja K. Leist
- University of Luxembourg, Department of Social Sciences, Institute for Research on Socio-Economic Inequality (IRSEI), Esch-sur-Alzette, Luxembourg
- Corresponding author. University of Luxembourg, Department of Social Sciences, Institute for Research on Socio-Economic Inequality, Campus Belval, 11, Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg.
| | - Eyal Bar-Haim
- Ben-Gurion University of the Negev, Department of Education, Beersheba, Israel
| | - Louis Chauvel
- University of Luxembourg, Department of Social Sciences, Institute for Research on Socio-Economic Inequality (IRSEI), Esch-sur-Alzette, Luxembourg
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Torres JM, Yahirun JJ, Sheehan C, Ma M, Sáenz J. Adult child socio-economic status disadvantage and cognitive decline among older parents in Mexico. Soc Sci Med 2021; 279:113910. [PMID: 33964589 PMCID: PMC8284312 DOI: 10.1016/j.socscimed.2021.113910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/01/2021] [Accepted: 04/04/2021] [Indexed: 12/15/2022]
Abstract
There is growing interest in the contribution of offspring educational attainment to parents' health outcomes. However, less is known about the impacts of offspring socio-economic status (SES) on parents' cognitive decline or about the role of offspring SES disadvantage. We used data from the Mexican Health and Aging Study (n = 10,426) to evaluate the impact of adult child SES disadvantage on parents' verbal memory trajectories over fourteen years (2001-2015). We estimated linear mixed models and used measures of adult child SES (educational, financial, and employment) disadvantage. Our most robust finding was that having an adult child with less than secondary education was associated with faster decline in verbal memory z-scores for older women (β: -0.009 [95% CI: -0.01, -0.001]) and men (β: -0.01 [95% CI: -0.02, -0.01]). Although poor adult child financial well-being was associated with a faster decline in parents' verbal memory z-scores, this finding was less consistent across model specifications. Additional analyses also suggested some evidence of heterogeneity by parents' own educational attainment and gender. These findings highlight the potential importance of children's socio-economic status for the cognitive aging of their older parents.
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Affiliation(s)
- Jacqueline M Torres
- Department of Epidemiology & Biostatistics, University of California San Francisco, USA.
| | | | - Connor Sheehan
- School of Social and Family Dynamics, Arizona State University, USA
| | - Mingming Ma
- Institute for Advanced Research, Shanghai University of Finance and Economics, China; Key Laboratory of Mathematical Economics (SUFE), Ministry of Education of China, China
| | - Joseph Sáenz
- Leonard Davis School of Gerontology, University of Southern California, USA
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Williams OA, An Y, Armstrong NM, Kitner-Triolo M, Ferrucci L, Resnick SM. Profiles of Cognitive Change in Preclinical and Prodromal Alzheimer's Disease Using Change-Point Analysis. J Alzheimers Dis 2021; 75:1169-1180. [PMID: 32390623 DOI: 10.3233/jad-191268] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is now understood to have a long preclinical phase in which pathology starts to accumulate in the absence of clinical symptoms. Identifying the temporal stages of accelerated cognitive decline in this phase may help in developing more sensitive neuropsychological tools for early screening of preclinical cognitive decline. Change-point analyses are increasingly used to characterize the temporal stages of accelerated cognitive decline in the preclinical stages of AD. However, statistical comparisons of change-points between specific cognitive measures have not been reported. OBJECTIVE To characterize and compare the temporal stages of accelerated decline in performance on multiple cognitive tests in a sample of participants from the Baltimore Longitudinal Study on Aging (BLSA) who later developed AD. METHODS 165 older adults (baseline age range: 61.1-91.2) from the BLSA developed AD during follow-up. Linear and non-linear mixed models were fit for 11 cognitive measures to determine change-points in rates of decline before AD diagnosis. Bootstrapping was used to compare the timing of change-points across cognitive measures. RESULTS Change-points followed by accelerated decline ranged from 15.5 years (Standard Error (S.E.) = 1.72) for Card Rotations to 1.9 years (S.E. = 0.68) for the Trail-Making Test Part A before AD diagnosis. Accelerated decline in Card Rotations occurred significantly earlier than all other measures, including learning and memory measures. CONCLUSION Results suggest that visuospatial ability, as assessed by Card Rotations, may have the greatest utility as an early predictive tool in identifying preclinical AD.
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Affiliation(s)
- Owen A Williams
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA.,Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Yang An
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Nicole M Armstrong
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Melissa Kitner-Triolo
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
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Armstrong NM, Tom SE, Harrati A, Casaletto K, Pa J, Arce Rentería M, Gu Y, Rajan KB, Schupf N, Fieo R, Weuve J, Simonsick EM, Manly JJ, Stern Y, Zahodne LB. Longitudinal Relationship of Leisure Activity Engagement with Cognitive Performance among Non-Demented, Community-Dwelling Older Adults. THE GERONTOLOGIST 2021; 62:352-363. [PMID: 33784376 DOI: 10.1093/geront/gnab046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Leisure activity engagement (LAE) may reduce the risk of incident dementia. However, cognitive performance may predict LAE change. We evaluated the temporal ordering of overall and subtypes of LAE (intellectual, physical, and social) and cognitive performance (global, language, memory, and visuospatial function) among non-demented older adults. RESEARCH DESIGN AND METHODS The Washington Heights-Inwood Columbia Aging Project concurrently administered a survey measure of 13 leisure activities and a neuropsychological battery every 18-24 months for up to 14 years to 5,384 racially and ethnically diverse participants. We used parallel process conditional latent growth curve models to examine temporal ordering in the overall sample and within baseline diagnostic groups (MCI vs. cognitively normal). RESULTS Levels and changes of overall and subtypes of LAE were positively correlated with cognitive performance in the overall sample and within each diagnostic group. In the overall sample, higher initial memory was associated with slower declines in social LAE (Estimate=0.019, 95% Confidence Interval, CI: 0.001, 0.037). Among MCI, higher initial physical LAE was associated with slower declines in memory (Estimate=0.034, 95% CI: 0.001, 0.067), but higher initial intellectual LAE was related to steeper declines in visuospatial function (Estimate=-0.028, 95% CI: -0.052, -0.004). Among cognitively normal, higher initial memory was associated with slower declines in intellectual LAE (Estimate=0.012, 95% CI: 0.002, 0.022). DISCUSSION AND IMPLICATIONS Dynamic interplay of LAE with cognitive performance was observed across diagnostic groups. Levels of LAE subtypes could be more predictive of change in certain cognitive domains within older adults with MCI.
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Affiliation(s)
- Nicole M Armstrong
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.,Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Sarah E Tom
- Department of Neurology and the Department of Epidemiology, Columbia University Medical Center, New York, New York, USA
| | - Amal Harrati
- Department of Primary Care and Population Health, Stanford University Medical School, Stanford, California, USA
| | - Kaitlin Casaletto
- Memory and Aging Center, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA
| | - Judy Pa
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Miguel Arce Rentería
- Cognitive Neuroscience Division and the Taub Institute, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Yian Gu
- Cognitive Neuroscience Division and the Taub Institute, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Kumar B Rajan
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis, California, USA
| | - Nicole Schupf
- Cognitive Neuroscience Division and the Taub Institute, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Robert Fieo
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles, California, USA.,US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Jennifer J Manly
- Cognitive Neuroscience Division and the Taub Institute, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Yaakov Stern
- Cognitive Neuroscience Division and the Taub Institute, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Laura B Zahodne
- Department of Psychology and Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
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Abstract
Supplemental Digital Content is available in the text. Background: Accumulating evidence suggests risk of cognitive impairment is declining in high-income countries. Much of this research uses longitudinal surveys in which learning over repeated tests may bias results. We analyze trends in cognitive impairment in the United States, accounting for prior test experience and selective mortality. Methods: We use the Health and Retirement Study, a population-based, nationally representative panel dataset and include individuals ages 50 years and older in 1996–2014 (n = 32,784). We measure cognitive impairment and dementia using standard cutpoints of the modified Telephone Interview for Cognitive Status. We estimate logistic regression models for any impairment and dementia over time, adjusting for age, sex, and race/ethnicity, comparing models with and without adjustment for practice effects and education. We examine heterogeneity in trends by age, sex, race/ethnicity, and education. Results: Models not controlling for test experience suggest that risk of cognitive impairment and dementia decreased over the study period. Controlling for test experience reverses the trend. In our primary models, prevalence of any cognitive impairment increased for women from 18.7% to 21.2% (annual change 0.7%, 95% confidence interval [CI], 0.1%, 1.3%) and for men from 17.6% to 21.0% (annual change 1.0%, CI, 0.5%, 1.4%). For dementia, women’s annual increase was 1.7% (CI, 0.8%, 2.6%) and men’s 2.0% (CI, 1.0%, 2.9%). If not for education, the increase would have been stronger. Increased risk was particularly rapid for Latinas, the least educated, and older ages. Conclusions: Risk of cognitive impairment increased from 1996 to 2014. Uncovering determinants of increasing cognitive impairment risk should become a research priority. See video abstract: http://links.lww.com/EDE/B702.
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Wolfova K, Csajbok Z, Kagstrom A, Kåreholt I, Cermakova P. Role of sex in the association between childhood socioeconomic position and cognitive ageing in later life. Sci Rep 2021; 11:4647. [PMID: 33633200 PMCID: PMC7907064 DOI: 10.1038/s41598-021-84022-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 02/05/2021] [Indexed: 11/09/2022] Open
Abstract
We aimed to explore sex differences in the association of childhood socioeconomic position (SEP) with the level of cognitive performance and the rate of cognitive decline. We studied 84,059 individuals (55% women; mean age 64 years) from the Survey on Health, Ageing and Retirement in Europe. Sex differences in the association of childhood SEP (household characteristics at age 10) with the level of cognitive performance (verbal fluency, immediate recall, delayed recall) were analysed using multilevel linear regression. Structural equation modelling tested education, depressive symptoms and physical state as mediators. The relationship between childhood socioeconomic advantage and disadvantage and the rate of cognitive decline was assessed using linear mixed-effects models. Higher childhood SEP was associated with a higher level of cognitive performance to a greater extent in women (B = 0.122; 95% CI 0.092–0.151) than in men (B = 0.109; 95% CI 0.084–0.135). The strongest mediator was education. Childhood socioeconomic disadvantage was related to a higher rate of decline in delayed recall in both sexes, with a greater association in women. Strategies to prevent impaired late-life cognitive functioning, such as reducing childhood socioeconomic disadvantages and improving education, might have a greater benefit for women.
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Affiliation(s)
- Katrin Wolfova
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University in Prague, Ruska 87, 100 00, Prague 10, Czech Republic.,National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
| | - Zsofia Csajbok
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University in Prague, Ruska 87, 100 00, Prague 10, Czech Republic.,National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic.,Department of Philosophy and History of Science, Faculty of Science, Charles University in Prague, Vinicna 7, 128 00, Prague, Czech Republic
| | - Anna Kagstrom
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University in Prague, Ruska 87, 100 00, Prague 10, Czech Republic.,National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
| | - Ingemar Kåreholt
- Institute of Gerontology, Aging Research Network - Jönköping (ARN-J), School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Pavla Cermakova
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University in Prague, Ruska 87, 100 00, Prague 10, Czech Republic. .,National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic. .,Department of Epidemiology, Second Faculty of Medicine, Charles University in Prague, Plzenska 130/221, 150 00, Prague, Czech Republic.
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Disease progression modelling from preclinical Alzheimer's disease (AD) to AD dementia. Sci Rep 2021; 11:4168. [PMID: 33603015 PMCID: PMC7893024 DOI: 10.1038/s41598-021-83585-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 01/29/2021] [Indexed: 11/26/2022] Open
Abstract
To characterize the course of Alzheimer’s disease (AD) over a longer time interval, we aimed to construct a disease course model for the entire span of the disease using two separate cohorts ranging from preclinical AD to AD dementia. We modelled the progression course of 436 patients with AD continuum and investigated the effects of apolipoprotein E ε4 (APOE ε4) and sex on disease progression. To develop a model of progression from preclinical AD to AD dementia, we estimated Alzheimer’s Disease Assessment Scale-Cognitive Subscale 13 (ADAS-cog 13) scores. When calculated as the median of ADAS-cog 13 scores for each cohort, the estimated time from preclinical AD to MCI due to AD was 7.8 years and preclinical AD to AD dementia was 15.2 years. ADAS-cog 13 scores deteriorated most rapidly in women APOE ε4 carriers and most slowly in men APOE ε4 non-carriers (p < 0.001). Our results suggest that disease progression modelling from preclinical AD to AD dementia may help clinicians to estimate where patients are in the disease course and provide information on variation in the disease course by sex and APOE ε4 status.
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Mäcken J, Riley AR, Glymour MM. Cross-national Differences in the Association Between Retirement and Memory Decline. J Gerontol B Psychol Sci Soc Sci 2021; 76:620-631. [PMID: 33301002 PMCID: PMC7887730 DOI: 10.1093/geronb/gbaa223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Retirement is a potential trigger for cognitive aging as it may be a stressful life event accompanied by changes in everyday activities. However, the consequences of retirement may differ across institutional contexts which shape retirement options. Comparing memory trajectories before and after retirement in 17 European countries, this study aims to identify cross-national differences in the association between retirement and memory decline. METHOD Respondents to the longitudinal Survey of Health, Aging, and Retirement in Europe (SHARE; N = 8,646) aged 50+ who were in paid work at baseline and retired during the observation period completed up to 6 memory assessments (immediate and delayed word recall) over 13 years. Three-level (time points, individuals, and countries) linear mixed models with country-level random slopes for retirement were estimated to evaluate whether memory decline accelerated after retirement and if this association differed between countries. RESULTS On average, retirement was associated with a moderate decrement in word recall (b = -0.273, 95% CI -0.441, -0.104) and memory decline accelerated after retirement (b = -0.044, 95% CI -0.070, -0.018). Significant between-country heterogeneity in memory decline after retirement existed (variance = 0.047, 95% CI (0.013, 0.168). Memory decline after retirement was more rapid in Italy, Greece, Czech Republic, Poland, Portugal, and Estonia compared to Northern and Central European countries. DISCUSSION Memory decline postretirement was faster in Mediterranean and eastern European countries, which are characterized by less generous welfare systems with comparatively low pension benefits. Evaluation of resources that could protect retirees from memory decline would be valuable.
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Affiliation(s)
- Jana Mäcken
- Institute of Sociology and Social Psychology, University of Cologne, Albertus-Magnus-Platz, Germany
| | - Alicia R Riley
- Department of Epidemiology and Biostatistics, University of California San Francisco, USA
| | - Maria M Glymour
- Department of Epidemiology and Biostatistics, University of California San Francisco, USA
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Planche V, Bouteloup V, Mangin JF, Dubois B, Delrieu J, Pasquier F, Blanc F, Paquet C, Hanon O, Gabelle A, Ceccaldi M, Annweiler C, Krolak-Salmon P, Habert MO, Fischer C, Chupin M, Béjot Y, Godefroy O, Wallon D, Sauvée M, Bourdel-Marchasson I, Jalenques I, Tison F, Chêne G, Dufouil C. Clinical relevance of brain atrophy subtypes categorization in memory clinics. Alzheimers Dement 2020; 17:641-652. [PMID: 33325121 DOI: 10.1002/alz.12231] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/14/2020] [Accepted: 10/19/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The clinical relevance of brain atrophy subtypes categorization in non-demented persons without a priori knowledge regarding their amyloid status or clinical presentation is unknown. METHODS A total of 2083 outpatients with either subjective cognitive complaint or mild cognitive impairment at study entry were followed during 4 years (MEMENTO cohort). Atrophy subtypes were defined using baseline magnetic resonance imaging (MRI) and previously described algorithms. RESULTS Typical/diffuse atrophy was associated with faster cognitive decline and the highest risk of developing dementia and Alzheimer's disease (AD) over time, both in the whole analytic sample and in amyloid-positive participants. Hippocampal-sparing and limbic-predominant atrophy were also associated with incident dementia, with faster cognitive decline in the limbic predominant atrophy group. Lewy body dementia was more frequent in the hippocampal-sparing and minimal/no atrophy groups. DISCUSSION Atrophy subtypes categorization predicted different subsequent patterns of cognitive decline and rates of conversion to distinct etiologies of dementia in persons attending memory clinics.
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Affiliation(s)
- Vincent Planche
- Univ. Bordeaux, CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, Bordeaux, France
| | - Vincent Bouteloup
- Univ. Bordeaux, Inserm U1219, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Bordeaux, France
| | - Jean-François Mangin
- Univ. Paris-Saclay, CEA, CNRS, Baobab, Neurospin, CATI multicenter neuroimaging platform, Gif-sur-Yvette, France
| | - Bruno Dubois
- Sorbonne-Université, Service des maladies cognitives et comportementales et Institut de la mémoire et de la maladie d'Alzheimer (IM2A), Hôpital de la Salpêtrière, AP-PH, Paris, France
| | - Julien Delrieu
- Departement de Gériatrie, Univ. Toulouse, Inserm U1027, Gérontopôle, CHU Purpan, Toulouse, France
| | - Florence Pasquier
- Univ. Lille, Inserm U1171, Centre Mémoire de Ressources et de Recherches, CHU Lille, DISTAlz, Lille, France
| | - Frédéric Blanc
- ICube laboratory, Departement de Gériatrie, Univ. Strasbourg, CNRS, UMR 7357, Fédération de Médecine Translationnelle de Strasbourg, Centre Mémoire de Ressources et de Recherches, Strasbourg, France
| | - Claire Paquet
- Univ. Paris, Inserm U1144, Groupe Hospitalier Lariboisière Fernand-Widal, AP-HP, Paris, France
| | - Olivier Hanon
- Univ. Paris Descartes Sorbonne Paris Cité, EA 4468, Service de Gériatrie, AP-HP, Hôpital Broca, Paris, France
| | - Audrey Gabelle
- Département de Neurologie, Univ. Montpellier, i-site MUSE, Inserm U1061, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences, CHU de Montpellier, Montpellier, France
| | - Matthieu Ceccaldi
- Département de Neurologie et de Neuropsychologie, Univ. Aix Marseille, Inserm UMR 1106, Institut de Neurosciences des Systèmes, Centre Mémoire de Ressources et de Recherches, AP-HM, Marseille, France
| | - Cédric Annweiler
- Département de Gériatrie, CHU d'Angers, Univ. Angers, UPRES EA 4638, Centre Mémoire de Ressources et de Recherches, Angers, France
| | - Pierre Krolak-Salmon
- Univ. Lyon, Inserm U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Centre Mémoire Ressource et Recherche de Lyon (CMRR), Hôpital des Charpennes, Hospices Civils de Lyon, Lyon, France
| | - Marie-Odile Habert
- Laboratoire d'Imagerie Biomédicale, Sorbonne-Université, CNRS, Inserm, CATI multicenter neuroimaging platform, AP-HP, Hôpital Pitié-Salpêtrière, Médecine Nucléaire, Paris, France
| | - Clara Fischer
- Univ. Paris-Saclay, CEA, CNRS, Baobab, Neurospin, CATI multicenter neuroimaging platform, Gif-sur-Yvette, France
| | - Marie Chupin
- Sorbonne-Université, Inserm U1127, CNRS UMR 7225, CATI multicenter neuroimaging platform, Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Yannick Béjot
- Univ. Bourgogne, EA7460, Centre Mémoire de Ressources et de Recherches, CHU Dijon Bourgogne, Dijon, France
| | - Olivier Godefroy
- Laboratoire de Neurosciences Fonctionnelles et Pathologies, Univ. Picardie, UR UPJV4559, Service de Neurologie, CHU Amiens, Amiens, France
| | - David Wallon
- Departement de Neurologie, Univ. Normandie, UNIROUEN, Inserm U1245, CNR-MAJ, CHU de Rouen, Rouen, France
| | - Mathilde Sauvée
- Centre Mémoire de Ressources et de Recherches Grenoble Arc Alpin, Pôle de Psychiatrie et Neurologie, CHU Grenoble, Grenoble, France
| | - Isabelle Bourdel-Marchasson
- Univ. Bordeaux, Inserm U1219, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Bordeaux, France
- Univ. Bordeaux, CNRS UMR 5536, Centre de Résonance Magnétique des Systèmes Biologiques, Pole de gérontologie clinique, CHU de Bordeaux, Bordeaux, France
| | - Isabelle Jalenques
- Univ. Clermont Auvergne, Centre Mémoire de Ressources et de Recherches, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - François Tison
- Univ. Bordeaux, CNRS UMR 5293, Institut des Maladies Neurodégénératives, Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, Bordeaux, France
| | - Geneviève Chêne
- Univ. Bordeaux, Inserm U1219, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Pôle de Sante Publique, CHU de Bordeaux, Bordeaux, France
| | - Carole Dufouil
- Univ. Bordeaux, Inserm U1219, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Pôle de Sante Publique, CHU de Bordeaux, Bordeaux, France
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Mayeda ER, Mobley TM, Weiss RE, Murchland AR, Berkman LF, Sabbath EL. Association of work-family experience with mid- and late-life memory decline in US women. Neurology 2020; 95:e3072-e3080. [PMID: 33148811 PMCID: PMC7734924 DOI: 10.1212/wnl.0000000000010989] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 08/03/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To test the hypothesis that life course patterns of employment, marriage, and childrearing influence later-life rate of memory decline among women, we examined the relationship of work-family experiences between ages 16 and 50 years and memory decline after age 55 years among US women. METHODS Participants were women ages ≥55 years in the Health and Retirement Study. Participants reported employment, marital, and parenthood statuses between ages 16 and 50 years. Sequence analysis was used to group women with similar work-family life histories; we identified 5 profiles characterized by similar timing and transitions of combined work, marital, and parenthood statuses. Memory performance was assessed biennially from 1995 to 2016. We estimated associations between work-family profiles and later-life memory decline with linear mixed-effects models adjusted for practice effects, baseline age, race/ethnicity, birth region, childhood socioeconomic status, and educational attainment. RESULTS There were 6,189 study participants (n = 488 working nonmothers, n = 4,326 working married mothers, n = 530 working single mothers, n = 319 nonworking single mothers, n = 526 nonworking married mothers). Mean baseline age was 57.2 years; average follow-up was 12.3 years. Between ages 55 and 60, memory scores were similar across work-family profiles. After age 60, average rate of memory decline was more than 50% greater among women whose work-family profiles did not include working for pay after childbearing, compared with those who were working mothers. CONCLUSIONS Women who worked for pay in early adulthood and midlife experienced slower rates of later-life memory decline, regardless of marital and parenthood status, suggesting participation in the paid labor force may protect against later-life memory decline.
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Affiliation(s)
- Elizabeth Rose Mayeda
- From the Departments of Epidemiology (E.R.M., T.M.M.) and Biostatistics (R.E.W.), University of California, Los Angeles Fielding School of Public Health; Department of Epidemiology and Biostatistics (E.R.M., A.R.M.), University of California, San Francisco; Departments of Epidemiology (A.R.M., L.F.B.) and Social and Behavioral Sciences (L.F.B.), Harvard T.H. Chan School of Public Health, Boston; and School of Social Work (E.L.S.), Boston College, Chestnut Hill, MA.
| | - Taylor M Mobley
- From the Departments of Epidemiology (E.R.M., T.M.M.) and Biostatistics (R.E.W.), University of California, Los Angeles Fielding School of Public Health; Department of Epidemiology and Biostatistics (E.R.M., A.R.M.), University of California, San Francisco; Departments of Epidemiology (A.R.M., L.F.B.) and Social and Behavioral Sciences (L.F.B.), Harvard T.H. Chan School of Public Health, Boston; and School of Social Work (E.L.S.), Boston College, Chestnut Hill, MA
| | - Robert E Weiss
- From the Departments of Epidemiology (E.R.M., T.M.M.) and Biostatistics (R.E.W.), University of California, Los Angeles Fielding School of Public Health; Department of Epidemiology and Biostatistics (E.R.M., A.R.M.), University of California, San Francisco; Departments of Epidemiology (A.R.M., L.F.B.) and Social and Behavioral Sciences (L.F.B.), Harvard T.H. Chan School of Public Health, Boston; and School of Social Work (E.L.S.), Boston College, Chestnut Hill, MA
| | - Audrey R Murchland
- From the Departments of Epidemiology (E.R.M., T.M.M.) and Biostatistics (R.E.W.), University of California, Los Angeles Fielding School of Public Health; Department of Epidemiology and Biostatistics (E.R.M., A.R.M.), University of California, San Francisco; Departments of Epidemiology (A.R.M., L.F.B.) and Social and Behavioral Sciences (L.F.B.), Harvard T.H. Chan School of Public Health, Boston; and School of Social Work (E.L.S.), Boston College, Chestnut Hill, MA
| | - Lisa F Berkman
- From the Departments of Epidemiology (E.R.M., T.M.M.) and Biostatistics (R.E.W.), University of California, Los Angeles Fielding School of Public Health; Department of Epidemiology and Biostatistics (E.R.M., A.R.M.), University of California, San Francisco; Departments of Epidemiology (A.R.M., L.F.B.) and Social and Behavioral Sciences (L.F.B.), Harvard T.H. Chan School of Public Health, Boston; and School of Social Work (E.L.S.), Boston College, Chestnut Hill, MA
| | - Erika L Sabbath
- From the Departments of Epidemiology (E.R.M., T.M.M.) and Biostatistics (R.E.W.), University of California, Los Angeles Fielding School of Public Health; Department of Epidemiology and Biostatistics (E.R.M., A.R.M.), University of California, San Francisco; Departments of Epidemiology (A.R.M., L.F.B.) and Social and Behavioral Sciences (L.F.B.), Harvard T.H. Chan School of Public Health, Boston; and School of Social Work (E.L.S.), Boston College, Chestnut Hill, MA
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Vonk JMJ, Higby E, Nikolaev A, Cahana-Amitay D, Spiro A, Albert ML, Obler LK. Demographic Effects on Longitudinal Semantic Processing, Working Memory, and Cognitive Speed. J Gerontol B Psychol Sci Soc Sci 2020; 75:1850-1862. [PMID: 32609841 PMCID: PMC7759739 DOI: 10.1093/geronb/gbaa080] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES To better understand and compare effects of aging and education across domains of language and cognition, we investigated whether (a) these domains show different associations with age and education, (b) these domains show similar patterns of age-related change over time, and (c) education moderates the rate of decline in these domains. METHOD We analyzed data from 306 older adults aged 55-85 at baseline of whom 116 returned for follow-up 4-8 years later. An exploratory factor analysis identified domains of language and cognition across a range of tasks. A confirmatory factor analysis analyzed cross-sectional associations of age and education with these domains. Subsequently, mixed linear models analyzed longitudinal change as a function of age and moderation by education. RESULTS We identified 2 language domains, that is, semantic control and semantic memory efficiency, and 2 cognitive domains, that is, working memory and cognitive speed. Older age negatively affected all domains except semantic memory efficiency, and higher education positively affected all domains except cognitive speed at baseline. In language domains, a steeper age-related decline was observed after age 73-74 compared to younger ages, while cognition declined linearly with age. Greater educational attainment did not protect the rate of decline over time in any domain. DISCUSSION Separate domains show varying effects of age and education at baseline, language versus cognitive domains show dissimilar patterns of age-related change over time, and education does not moderate the rate of decline in these domains. These findings broaden our understanding of age effects on cognitive and language abilities by placing observed age differences in context.
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Affiliation(s)
- Jet M J Vonk
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University Irving Medical Center, New York, New York
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Eve Higby
- Department of Speech, Language, and Hearing Sciences, California State University, East Bay, Hayward
- Department of Psychology, University of California, Riverside
| | - Alexandre Nikolaev
- Helsinki Collegium for Advanced Studies, University of Helsinki, Finland
- 6School of Languages and Cultures, University of Sheffield, Massachusetts
| | - Dalia Cahana-Amitay
- Department of Neurology, Boston University School of Medicine, Massachusetts
| | - Avron Spiro
- Veterans Affairs Boston Healthcare System, Massachusetts
- Department of Epidemiology, School of Public Health, Boston University, Massachusetts
| | - Martin L Albert
- Department of Neurology, Boston University School of Medicine, Massachusetts
- Veterans Affairs Boston Healthcare System, Massachusetts
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46
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Arendash G, Cao C, Abulaban H, Baranowski R, Wisniewski G, Becerra L, Andel R, Lin X, Zhang X, Wittwer D, Moulton J, Arrington J, Smith A. A Clinical Trial of Transcranial Electromagnetic Treatment in Alzheimer's Disease: Cognitive Enhancement and Associated Changes in Cerebrospinal Fluid, Blood, and Brain Imaging. J Alzheimers Dis 2020; 71:57-82. [PMID: 31403948 PMCID: PMC6839500 DOI: 10.3233/jad-190367] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Small aggregates (oligomers) of the toxic proteins amyloid-β (Aβ) and phospho-tau (p-tau) are essential contributors to Alzheimer’s disease (AD). In mouse models for AD or human AD brain extracts, Transcranial Electromagnetic Treatment (TEMT) disaggregates both Aβ and p-tau oligomers, and induces brain mitochondrial enhancement. These apparent “disease-modifying” actions of TEMT both prevent and reverse memory impairment in AD transgenic mice. Objective: To evaluate the safety and initial clinical efficacy of TEMT against AD, a comprehensive open-label clinical trial was performed. Methods: Eight mild/moderate AD patients were treated with TEMT in-home by their caregivers for 2 months utilizing a unique head device. TEMT was given for two 1-hour periods each day, with subjects primarily evaluated at baseline, end-of-treatment, and 2 weeks following treatment completion. Results: No deleterious behavioral effects, discomfort, or physiologic changes resulted from 2 months of TEMT, as well as no evidence of tumor or microhemorrhage induction. TEMT induced clinically important and statistically significant improvements in ADAS-cog, as well as in the Rey AVLT. TEMT also produced increases in cerebrospinal fluid (CSF) levels of soluble Aβ1-40 and Aβ1-42, cognition-related changes in CSF oligomeric Aβ, a decreased CSF p-tau/Aβ1-42 ratio, and reduced levels of oligomeric Aβ in plasma. Pre- versus post-treatment FDG-PET brain scans revealed stable cerebral glucose utilization, with several subjects exhibiting enhanced glucose utilization. Evaluation of diffusion tensor imaging (fractional anisotropy) scans in individual subjects provided support for TEMT-induced increases in functional connectivity within the cognitively-important cingulate cortex/cingulum. Conclusion: TEMT administration to AD subjects appears to be safe, while providing cognitive enhancement, changes to CSF/blood AD markers, and evidence of stable/enhanced brain connectivity.
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Affiliation(s)
| | - Chuanhai Cao
- College of Pharmacy, University of South Florida, Tampa, FL, USA
| | - Haitham Abulaban
- University of South Florida Health/Byrd Alzheimer's Institute, Tampa, FL, USA
| | | | | | | | - Ross Andel
- School of Aging Studies, University of South Florida, Tampa, FL, USA.,Department of Neurology, 2nd Faculty of Medicine, Charles University/Motol University Hospital, Prague, Czech Republic
| | - Xiaoyang Lin
- College of Pharmacy, University of South Florida, Tampa, FL, USA
| | - Xiaolin Zhang
- College of Pharmacy, University of South Florida, Tampa, FL, USA
| | | | | | | | - Amanda Smith
- University of South Florida Health/Byrd Alzheimer's Institute, Tampa, FL, USA
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47
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Hannigan C, Hanly P, Kee F, Lawlor B, Holton E, Walsh C, Scharf T, Coen R, Leatham V, Moynihan S, Lane K, McHugh Power J. HALO: Study protocol for a single-case experimental design study evaluating the moderating impact of a befriending intervention on the association between loneliness and health in older adults. HRB Open Res 2020; 3:60. [DOI: 10.12688/hrbopenres.13104.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Loneliness in later life is often addressed with befriending interventions, yet evidence for their effectiveness is limited. Meanwhile it is known that loneliness has a deleterious impact on health. The aim of the study is to evaluate whether a befriending service for older adults mitigates the impact of loneliness on health outcomes, and to identify mechanisms through which befriending interventions might impact upon health. Methods: A mixed methods design is used. The quantitative component utilises an AB single-case experimental design, to gather intensive longitudinal data. These data will be analysed using a generalised additive modelling approach. The qualitative component of the study uses semi-structured dyadic interviews, structured and analysed according to the principles of constructivist grounded theory. Findings will then be triangulated according to an existing mixed methods integration protocol. Discussion: This mixed methods design has the potential to inform national and international policy in relation to befriending interventions for older adults. In addition, there is the potential for study results to inform our theoretical understanding of the nature of the relationship between loneliness and health. Trial registration: ClinicalTrials.gov identifier NCT04301167 (10th March 2020). Protocol version 1.1, 26th June 2020.
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48
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Vonk JMJ, Bouteloup V, Mangin J, Dubois B, Blanc F, Gabelle A, Ceccaldi M, Annweiler C, Krolak‐Salmon P, Belin C, Rivasseau‐Jonveaux T, Julian A, Sellal F, Magnin E, Chupin M, Habert M, Chêne G, Dufouil C. Semantic loss marks early Alzheimer's disease-related neurodegeneration in older adults without dementia. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12066. [PMID: 32775598 PMCID: PMC7403823 DOI: 10.1002/dad2.12066] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To assess progression of semantic loss in early stages of cognitive decline using semantic and letter fluency performance, and its relation with Alzheimer's disease (AD)-specific neurodegeneration using longitudinal multimodal neuroimaging measures. METHODS Change in verbal fluency was analyzed among 2261 non-demented individuals with a follow-up diagnosis of no mild cognitive impairment (MCI), amnestic MCI (aMCI), non-amnestic MCI (naMCI), or incident dementia, using linear mixed models across 4 years of follow-up, and relations with magnetic resonance imaging (MRI; n = 1536) and 18F-fluorodeoxyglucose brain positron emission tomography (18F-FDG-PET) imaging (n = 756) using linear regression models across 2 years of follow-up. RESULTS Semantic fluency declined-fastest in those at higher risk for AD (apolipoprotein E [APOE] e4 carriers, Clinical Dementia Rating score of .5, aMCI, or incident dementia)-while letter fluency did not except for those with incident dementia. Lower baseline semantic fluency was associated with an increase in white matter hyperintensities and total mean cortical thinning over time, and regionally with less hippocampal volume as well as more cortical thinning and reduced 18F-FDG-PET uptake in the inferior parietal lobule, entorhinal cortex, isthmus cingulate, and precuneus-posterior cingulate area. In contrast, baseline letter fluency was not associated with change in total nor regional neurodegeneration. Whole-brain neurodegeneration over time was associated with faster decline in both fluencies, while AD-specific regions were associated with a faster rate of decline in semantic but not letter fluency. INTERPRETATION This study provides strong evidence of distinctive degeneration of semantic abilities early on in relation to both cognitive decline and AD-specific neurodegeneration.
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Affiliation(s)
- Jet M. J. Vonk
- Taub Institute for Research on Alzheimer's Disease and the Aging BrainDepartment of NeurologyCollege of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
- Julius Center for Health Sciences and Primary Care, Department of EpidemiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Vincent Bouteloup
- Centre Inserm U1219d'Epidémiologie et de Développement (ISPED)Bordeaux School of Public HealthInstitut de Santé PubliqueUniversité de BordeauxBordeauxFrance
- Pole de sante publiqueCentre Hospitalier Universitaire (CHU) de BordeauxBordeauxFrance
| | - Jean‐François Mangin
- CATI Multicenter Neuroimaging PlatformParisFrance
- NeurospinCEAParis Saclay UniversityGif‐sur‐YvetteFrance
| | - Bruno Dubois
- IM2AAP‐HPINSERMUMR‐S975Groupe Hospitalier Pitié‐SalpêtrièreInstitut de la Mémoire et de la Maladie d'AlzheimerInstitut du Cerveau et de la Moelle épinièreSorbonne UniversitéParisFrance
| | - Frédéric Blanc
- Hôpitaux Universitaire de StrasbourgCM2R (Centre Mémoire de Ressource et de Recherche)Hôpital de jourpôle de Gériatrieet CNRSlaboratoire ICube UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMISStrasbourgFrance
| | - Audrey Gabelle
- Centre Mémoire Ressources RechercheDépartement de NeurologieCHU Gui de ChauliacMontpellierFrance
- Inserm U1061La ColombièreUniversité de MontpellierMontpellierFrance
| | - Mathieu Ceccaldi
- CMMR PACA OuestCHU TimoneAPHM & Aix Marseille UnivINSERMINSInst Neurosci SystMarseilleFrance
| | - Cédric Annweiler
- Department of Geriatric MedicineAngers University HospitalAngersFrance
- Angers University Memory ClinicAngersFrance
- Research Center on Autonomy and LongevityAngersFrance
- UPRES EA 4638University of AngersAngersFrance
- Robarts Research InstituteDepartment of Medical BiophysicsSchulich School of Medicine and Dentistrythe University of Western Ontario, OntarioLondonCanada
| | - Pierre Krolak‐Salmon
- Institut du VieillissementCentre Mémoire Ressources Recherche de LyonHospices civils de LyonUniversité Lyon 1, Inserm U1048LyonFrance
| | | | - Thérèse Rivasseau‐Jonveaux
- Centre Mémoire de Ressources et de Recherche de Lorraine Unité Cognitivo Comportementale CHRU NancyLaboratoire Lorrain de Psychologie et de Neurosciences de la dynamique des comportements 2LPN EA 7489 Université de LorraineNancyFrance
| | - Adrien Julian
- Service de NeurologieCHU La MilétrieCentre Mémoire de Ressources et de RecherchePoitiersFrance
| | - François Sellal
- CMRR Département de NeurologieHôpitaux CivilsColmarFrance
- INSERM U‐1118Université de Strasbourg. Faculté de MédecineStrasbourgFrance
| | - Eloi Magnin
- Centre Mémoire Ressources et Recherche (CMRR)service de NeurologieCHRU BesançonBesançonFrance
- Neurosciences intégratives et cliniques EA481Univ. Bourgogne Franche‐ComtéBesançonFrance
| | - Marie Chupin
- CATI Multicenter Neuroimaging PlatformParisFrance
| | - Marie‐Odile Habert
- CATI Multicenter Neuroimaging PlatformParisFrance
- CNRSINSERMLaboratoire d'Imagerie BiomédicaleLIBSorbonne UniversitéParisFrance
- AP‐HPHôpital Pitié‐SalpêtrièreMédecine NucléaireParisFrance
| | - Geneviève Chêne
- Centre Inserm U1219d'Epidémiologie et de Développement (ISPED)Bordeaux School of Public HealthInstitut de Santé PubliqueUniversité de BordeauxBordeauxFrance
- Pole de sante publiqueCentre Hospitalier Universitaire (CHU) de BordeauxBordeauxFrance
| | - Carole Dufouil
- Centre Inserm U1219d'Epidémiologie et de Développement (ISPED)Bordeaux School of Public HealthInstitut de Santé PubliqueUniversité de BordeauxBordeauxFrance
- Pole de sante publiqueCentre Hospitalier Universitaire (CHU) de BordeauxBordeauxFrance
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Romero Starke K, Seidler A, Hegewald J, Klimova A, Palmer K. Retirement and decline in episodic memory: analysis from a prospective study of adults in England. Int J Epidemiol 2020; 48:1925-1936. [PMID: 31280313 DOI: 10.1093/ije/dyz135] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Work has been associated with cognitive health. We examined whether retirement from work is associated with a decrease in episodic memory and whether this effect differs when considering workers' occupational class. METHODS In this prospective study using the English Longitudinal Study of Ageing (ELSA), we examined 1629 persons aged 50-75 years who were in paid work at baseline. A two-slope random effects linear regression centred at retirement was used to study the effect of retirement on episodic memory. The potential effect modification by occupational class was examined. RESULTS While memory trajectories show slightly decreasing memory scores before and afterretirement, the decreasing rates for both periods were similar [episodic memory β2b-β2a= -0.03, 95% confidence interval (CI) -0.08, 0.02]. When stratifying by occupational class, there was also no substantial difference in episodic memory trajectories before and after retirement. However, the lower occupational class showed a clear decline in episodic memory with time (pre-retirement β2a = -0.11, 95% CI -0.19, -0.03; post-retirement β2b = -0.13, 95% CI -0.19, -0.07) which was not evident for the higher occupational classes. CONCLUSIONS Our results show no observable difference in trajectories of change in episodic memory before and after retirement. However, the steeper memory decline in workers belonging to the lower occupational class may limit their prospect of prolonging their working lives. Hence enrichment programmes for the prevention of memory decline for these workers should be considered.
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Affiliation(s)
- Karla Romero Starke
- Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Janice Hegewald
- Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Anna Klimova
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany.,Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Katie Palmer
- Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy
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50
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Jutten RJ, Grandoit E, Foldi NS, Sikkes SAM, Jones RN, Choi S, Lamar ML, Louden DKN, Rich J, Tommet D, Crane PK, Rabin LA. Lower practice effects as a marker of cognitive performance and dementia risk: A literature review. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12055. [PMID: 32671181 PMCID: PMC7346865 DOI: 10.1002/dad2.12055] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Practice effects (PEs) are improvements in performance after repeated exposure to test materials, and typically viewed as a source of bias in repeated cognitive assessments. We aimed to determine whether characterizing PEs could also provide a useful marker of early cognitive decline. METHODS We conducted a systematic review of the literature, searching PsycInfo (Ebsco) and PubMed databases for articles studying PEs in aging and dementia populations. Articles published between 1920 and 2019 were included. RESULT We identified 259 articles, of which 27 studied PEs as markers of cognitive performance. These studies consistently showed that smaller, less-robust PEs were associated with current diagnostic status and/or future cognitive decline. In addition, lower PEs were associated with Alzheimer's disease risk factors and neurodegeneration biomarkers. CONCLUSION PEs provide a potentially useful marker of cognitive decline, and could prove valuable as part of a cost-effective strategy to select individuals who are at-risk for dementia for future interventions.
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Affiliation(s)
- Roos J. Jutten
- Alzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam UMCVrije UniversiteitAmsterdamthe Netherlands
| | | | - Nancy S. Foldi
- Queens College and The Graduate Center of The City University of New YorkQueensNew YorkUSA
| | - Sietske A. M. Sikkes
- Alzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam UMCVrije UniversiteitAmsterdamthe Netherlands
| | - Richard N. Jones
- Warren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Seo‐Eun Choi
- School of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Melissa L. Lamar
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | | | - Joanne Rich
- University Libraries, University of WashingtonSeattleWashingtonUSA
| | - Douglas Tommet
- Warren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Paul K. Crane
- School of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Laura A. Rabin
- Brooklyn College and The Graduate Center of The City University of New YorkBrooklynNew YorkUSA
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