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Fleischman DA, Arfanakis K, Leurgans SE, Zhang S, Lamar M, Han SD, Poole VN, Kim N, Bennett DA, Barnes LL. Late-life depressive symptoms and white matter structural integrity within older Black adults. Front Aging Neurosci 2023; 15:1138568. [PMID: 37205056 PMCID: PMC10186351 DOI: 10.3389/fnagi.2023.1138568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/12/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction Older Black adults experience a high burden of depressive symptoms and cerebrovascular disease but the specific neurobiological substrates underlying the association between late-life depressive symptoms and brain integrity are understudied, particularly in within-group designs. Methods Using the Center for Epidemiologic Studies Depression Scale and diffusion-tensor imaging, within-Black variation in the association between late-life depressive symptoms and white matter structural integrity was examined in 297 older Black participants without dementia that were enrolled across three epidemiological studies of aging and dementia. Linear regression models were used to test associations with DTI metrics (fractional anisotropy, trace of the diffusion tensor) as the outcomes and depressive symptoms as the predictor, while adjusting for age, sex, education, scanner, serotonin-reuptake inhibitor use, total volume of white-matter hyperintensities normalized by intracranial volume, and presence of white-matter hyperintensities at the voxel level. Results Higher level of self-reported late-life depressive symptoms was associated with greater diffusion-tensor trace (reduced white matter integrity) in connections between commissural pathways and contralateral prefrontal regions (superior and middle frontal/dorsolateral prefrontal cortex), association pathways connecting dorsolateral prefrontal cortex with insular, striatal and thalamic regions, and association pathways connecting the parietal, temporal and occipital lobes and the thalamus. Discussion This study demonstrated a discernable pattern of compromised white matter structural integrity underlying late-life depressive symptoms within older Black adults.
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Affiliation(s)
- Debra A. Fleischman
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, United States
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, United States
| | - Sue E. Leurgans
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Preventive Medicine, Rush University Medical Center, Chicago IL, United States
| | - Shengwei Zhang
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
| | - Melissa Lamar
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - S. Duke Han
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Family Medicine and Neurology, Keck School of Medicine, Los Angeles, CA, United States
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
- School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Victoria N. Poole
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Namhee Kim
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
| | | | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
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Moazzami K, Garcia M, Young A, Almuwaqqat Z, Lima BB, Martini A, Alkhalaf M, Shah AJ, Goldstein FC, Hajjar I, Levey AI, Bremner JD, Quyyumi AA, Vaccarino V. Association between symptoms of psychological distress and cognitive functioning among adults with coronary artery disease. Stress Health 2021; 37:538-546. [PMID: 33319483 PMCID: PMC8395370 DOI: 10.1002/smi.3018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 12/14/2022]
Abstract
Greater psychological distress is associated with cognitive impairment in healthy adults. Whether such associations also exist in patients with coronary artery disease (CAD) is uncertain. We assessed cognitive function in 496 individuals with CAD using the verbal and visual memory subtests of the Wechsler Memory Scale and executive functioning measured by the Trail Making Test Parts A and B. We used a composite score of psychological distress derived through summation of Z-transformed psychological distress symptom scales (depression, posttraumatic stress, anxiety, anger, hostility and perceived stress) and scores for each individual psychological scale. Multivariable linear regression models were used to determine the association between memory scores (as outcomes) and the psychological distress scores (both composite score and individual scales). After adjusting for demographic and cardiovascular risk factors, a higher psychological distress score was independently associated with worse memory and executive functioning. Each standard deviation increase in psychological distress score was associated with 3% (95% confidence interval [CI], 1%-5%) to 5% (95% CI, 3-7%) worse cognitive performance (higher Trail A and Trail B, and lower verbal and visual memory scores). Among individuals with CAD, a higher level of psychological distress is independently associated with worse cognitive performance. These findings suggest that psychological risk factors play a role in cognitive trajectories of persons with CAD.
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Affiliation(s)
- Kasra Moazzami
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Mariana Garcia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - An Young
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Zakaria Almuwaqqat
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Bruno B Lima
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Afif Martini
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Mhmtjamil Alkhalaf
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Amit J Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA.,Atlanta VA Medical Center, Decatur, Georgia, USA
| | - Felicia C Goldstein
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA.,Goizuetta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ihab Hajjar
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA.,Goizuetta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, Georgia, USA.,Division of General Internal Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Allan I Levey
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA.,Goizuetta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - J Douglas Bremner
- Atlanta VA Medical Center, Decatur, Georgia, USA.,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.,Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Arshed A Quyyumi
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
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3
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Han SD, Barnes LL, Leurgans S, Yu L, Bennett DA, Boyle PA. Literacy Mediates Racial Differences in Financial and Healthcare Decision Making in Older Adults. J Am Geriatr Soc 2020; 68:1279-1285. [PMID: 32092157 PMCID: PMC8324307 DOI: 10.1111/jgs.16381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND/OBJECTIVES Decision making in financial and healthcare matters is of critical importance for well-being in old age. Preliminary work suggests racial differences in decision making; however, the factors that drive racial differences in decision making remain unclear. We hypothesized literacy, particularly financial and health literacy, mediates racial differences in decision making. DESIGN Community-based epidemiologic cohort study. SETTING Communities in northeastern Illinois. PARTICIPANTS Nondemented Black participants (N = 138) of the Rush Alzheimer's Disease Center Minority Aging Research Study and the Rush Memory and Aging Project who completed decision-making and literacy measures were matched to White participants (N = 138) according to age, education, sex, and global cognition using Mahalanobis distance (total N = 276). MEASUREMENTS All participants completed clinical assessments, a decision-making measure that resembles real-world materials relevant to finance and healthcare, and a financial and health literacy measure. Regression models were used to examine racial differences in decision making and test the hypothesis that literacy mediates this association. In secondary analyses, we examined the impact of literacy in specific domains of decision making (financial and healthcare). RESULTS In models adjusted for age, education, sex, and global cognition, older Black adults performed lower than older White adults on literacy (β = -8.20; SE = 1.34; 95% CI = -10.82 to -5.57; P < .01) and separately on decision making (β = -.80; SE = .23; 95% CI = -1.25 to -.34; P < .01). However, when decision making was regressed on both race and literacy, the association of race was attenuated and became nonsignificant (β = -.45; SE = .24; 95% CI = -.93 to .02; P = .06), but literacy remained significantly associated with decision making (β = .04; SE = .01; 95% CI = .02-.06; P < .01). In secondary models, a similar pattern was observed for both financial and healthcare decision making. CONCLUSIONS Racial differences in decision making are largely mediated by literacy. These findings suggest that efforts to improve literacy may help reduce racial differences in decision making and improve health and well-being for diverse populations. J Am Geriatr Soc 68:1279-1285, 2020.
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Affiliation(s)
- S Duke Han
- Department of Family Medicine, University of Southern California, Los Angeles, California
- Department of Neurology, University of Southern California, Los Angeles, California
- Department of Psychology, University of Southern California, Los Angeles, California
- School of Gerontology, University of Southern California, Los Angeles, California
- Department of Behavioral Sciences and Psychiatry, Rush University Medical Center, Chicago, Illinois
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Lisa L Barnes
- Department of Behavioral Sciences and Psychiatry, Rush University Medical Center, Chicago, Illinois
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Sue Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Patricia A Boyle
- Department of Behavioral Sciences and Psychiatry, Rush University Medical Center, Chicago, Illinois
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois
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Gottesman RT, Stern Y. Behavioral and Psychiatric Symptoms of Dementia and Rate of Decline in Alzheimer's Disease. Front Pharmacol 2019; 10:1062. [PMID: 31616296 PMCID: PMC6768941 DOI: 10.3389/fphar.2019.01062] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/20/2019] [Indexed: 12/20/2022] Open
Abstract
Alzheimer’s disease causes both cognitive and non-cognitive symptoms. There is increasing evidence that the presentation and course of Alzheimer’s disease is highly heterogenous. This heterogeneity presents challenges to patients, their families, and clinicians due to the difficulty in prognosticating future symptoms and functional impairment. Behavioral and psychiatric symptoms are emerging as a significant contributor to this clinical heterogeneity. These symptoms have been linked to multiple areas of neurodegeneration, which may suggest that they are representative of network-wide dysfunction in the brain. However, current diagnostic criteria for Alzheimer’s disease focus exclusively on the cognitive aspects of disease. Behavioral and psychiatric symptoms have been found in multiple studies to be related to disease severity and to contribute to disease progression over time. A better understanding of how behavioral and psychiatric symptoms relate to cognitive aspects of Alzheimer’s disease would help to refine the models of disease and hopefully lead to improved ability to develop therapeutic options for this devastating disease.
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Affiliation(s)
- Reena T Gottesman
- Division of Aging and Dementia, Department of Neurology, Columbia University Medical Center, New York, NY, United States
| | - Yaakov Stern
- Division of Cognitive Neuroscience, Department of Neurology, Columbia University Medical Center, New York, NY, United States
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Sutin AR, Stephan Y, Terracciano A. Psychological Distress, Self-Beliefs, and Risk of Cognitive Impairment and Dementia. J Alzheimers Dis 2019; 65:1041-1050. [PMID: 30103318 DOI: 10.3233/jad-180119] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Depressive symptoms and a history of mental disorders are associated with increased risk for dementia. Less is known about whether other aspects of psychological distress and negative self-beliefs also increase risk. The purpose of this research is to examine 1) whether eight aspects of psychological distress and self-beliefs (anxiety, negative affect, hostility, anger-in, anger-out, hopelessness, pessimism, perceived constraints) are associated with risk of incident dementia and cognitive impairment not dementia (CIND), 2) whether the associations are independent of depressive symptoms and history of a mental health diagnosis, and 3) whether the associations are also independent of behavioral, clinical, and genetic risk factors. A total of 9,913 participants (60% female) from the Health and Retirement Study completed the baseline measures, scored in the non-impaired range of cognition at baseline, and had cognitive status assessed across the 6-8-year follow-up. Baseline measures included eight aspects of psychological distress and self-beliefs, cognitive performance, depressive symptoms, and genetic, clinical, and behavioral risk factors. Participants who scored higher on anxiety, negative affect, hostility, pessimism, hopelessness, and perceived constraints were at a 20-30% increased risk of dementia and a 10-20% increased risk of CIND. The associations held controlling for baseline depressive symptoms, history of a mental health diagnosis, clinical and behavioral risk factors, and genetic risk. Anger-in and anger-out were unrelated to risk of either dementia or CIND. Independent of the core experience of depressed affect, other aspects of negative emotionality and self-beliefs increase risk of mild and severe cognitive impairment, which suggests additional targets of intervention.
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Affiliation(s)
- Angelina R Sutin
- Florida State University College of Medicine, Tallahassee, FL, USA
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6
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Stavrova O, Ehlebracht D. The Cynical Genius Illusion: Exploring and Debunking Lay Beliefs About Cynicism and Competence. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2019; 45:254-269. [PMID: 29993325 PMCID: PMC6328999 DOI: 10.1177/0146167218783195] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 05/20/2018] [Indexed: 12/14/2022]
Abstract
Cynicism refers to a negative appraisal of human nature-a belief that self-interest is the ultimate motive guiding human behavior. We explored laypersons' beliefs about cynicism and competence and to what extent these beliefs correspond to reality. Four studies showed that laypeople tend to believe in cynical individuals' cognitive superiority. A further three studies based on the data of about 200,000 individuals from 30 countries debunked these lay beliefs as illusionary by revealing that cynical (vs. less cynical) individuals generally do worse on cognitive ability and academic competency tasks. Cross-cultural analyses showed that competent individuals held contingent attitudes and endorsed cynicism only if it was warranted in a given sociocultural environment. Less competent individuals embraced cynicism unconditionally, suggesting that-at low levels of competence-holding a cynical worldview might represent an adaptive default strategy to avoid the potential costs of falling prey to others' cunning.
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7
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Griffin SC, Mezuk B, Williams AB, Perrin PB, Rybarczyk BD. Isolation, Not Loneliness or Cynical Hostility, Predicts Cognitive Decline in Older Americans. J Aging Health 2018; 32:52-60. [PMID: 30289338 DOI: 10.1177/0898264318800587] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To jointly examine isolation, loneliness, and cynical hostility as risk factors for cognitive decline in older adults. Method: Data came from the 2006 to 2012 waves of the Health and Retirement Study (HRS), a longitudinal study of U.S. older adults (age ⩾ 65 years, n = 6,654). Measures included frequency of contact with social network (objective isolation), the Hughes Loneliness Scale (loneliness), a modified version of the Cook-Medley Hostility Inventory (cynical hostility), and a modified version of the Telephone Interview for Cognitive Status (cognitive function). Multilevel modeling (random slope + intercept) was used to examine the association between these factors and trajectories of cognitive function. Results and Discussion: After controlling for demographic characteristics, self-reported health, and functional limitations, loneliness (β = -.34, 95% confidence interval [CI] = [-0.56, -0.11), and cynical hostility (β = -.14, 95% CI = [-0.24, -0.04) correlated with lower cognitive function, but none predicted change in cognitive function. Objective social isolation was associated with lower cognitive function (β = -.27, 95% CI = [-0.41, -0.12]) and steeper decline in cognitive function (β = -.09, 95% CI = [-0.16, -0.01]).
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8
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Albanese E, Matthews KA, Zhang J, Jacobs DR, Whitmer RA, Wadley VG, Yaffe K, Sidney S, Launer LJ. Hostile attitudes and effortful coping in young adulthood predict cognition 25 years later. Neurology 2016; 86:1227-34. [PMID: 26935891 DOI: 10.1212/wnl.0000000000002517] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 12/14/2015] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE We studied the relation of early-life (mean age 25 years) and mid-life (mean age 50 years) cognitive function to early measures of hostile attitudes and effortful coping. METHODS In 3,126 black and white men and women (born in 1955-1968) from the Coronary Artery Risk Development in Young Adults Study (CARDIA), we used linear regression to examine the association of hostile attitudes (Cook-Medley questionnaire) and effortful coping assessed at baseline (1985-1986) to cognitive ability measured in 1987 and to a composite cognitive Z score of tests of verbal memory, psychomotor speed, and executive function ascertained in midlife (2010-2011). RESULTS Baseline hostility and effortful coping were prospectively associated with lower cognitive function 25 years later, controlling for age, sex, race, education, long-term exposure to depression, discrimination, negative life events, and baseline cognitive ability. Compared to the lowest quartile, those in the highest quartile of hostility performed 0.21 SD units lower (95% confidence interval [CI] -0.39, -0.02). Those in the highest quartile of effortful coping performed 0.30 SD units lower (95% CI -0.48, -0.12) compared to those in the lowest quartile. Further adjustment for cumulative exposure to cardiovascular risk factors attenuated the association with the cognitive composite Z score for hostility. CONCLUSIONS Worse cognition in midlife was independently associated with 2 psychological characteristics measured in young adulthood. This suggests that interventions that promote positive social interactions may have a role in reducing risk of late-age cognitive impairment.
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Affiliation(s)
- Emiliano Albanese
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Karen A Matthews
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Julia Zhang
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - David R Jacobs
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Rachel A Whitmer
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Virginia G Wadley
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Kristine Yaffe
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Stephen Sidney
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Lenore J Launer
- From the Laboratory of Epidemiology and Population Sciences (E.A., J.Z., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Department of Psychiatry (E.A.), University of Geneva, School of Medicine, Switzerland; Department of Psychiatry and Psychology (K.A.M.), University of Pittsburgh, PA; Division of Epidemiology School of Public Health (D.R.J.), University of Minnesota, Minneapolis; Kaiser Permanente (R.A.W., S.S.), Division of Research, Oakland, CA; Department of Medicine (V.G.W.), University of Alabama at Birmingham; and Department of Psychiatry, Neurology, and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco.
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Tomey K, Greendale GA, Kravitz HM, Bromberger JT, Burns JW, Dugan SA, de Leon CFM. Associations between aspects of pain and cognitive performance and the contribution of depressive symptoms in mid-life women: a cross-sectional analysis. Maturitas 2014; 80:106-12. [PMID: 25466300 DOI: 10.1016/j.maturitas.2014.10.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 10/20/2014] [Accepted: 10/21/2014] [Indexed: 11/17/2022]
Abstract
Pain has been associated with cognitive problems in pain patients. This study evaluated the extent to which experiences of pain are associated with cognitive performance in a community sample of mid-life women, and the contribution of depressive symptoms to this association. A cross-sectional analysis was used with data from the Study of Women's Health Across the Nation (SWAN). Associations between aspects of pain and cognitive performance were evaluated using statistical models with and without depressive symptoms. The cognitive performance score was a composite of three cognitive tests, the Digit Span Backward Test, the Symbol Digit Modalities Test and the East Boston Memory Test. Greater pain experiences that interfered with daily work were independently associated with poorer cognitive performance, [β (SE) -0.074 (0.021); p value<0.01] and this association was partially explained by depressive symptoms [β (SE) -0.061 (0.022); p value<0.01 after adjusting for depressive symptoms]. Additionally, an independent association between a greater composite pain score and poorer cognitive performance was identified without adjusting for depressive symptoms, [β (SE) -0.002 (0.0009); p value<0.05] but was no longer significant after adjusting for depressive symptoms. Our results suggest that in mid-life women, greater pain is associated with poorer cognitive performance, and depressive symptoms play an important role in this association. Clinicians should be aware of these relationships when evaluating patients.
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Affiliation(s)
- Kristin Tomey
- University of Michigan, School of Public Health, 1415 Washington Heights, Room 2667, SPH Tower, Ann Arbor, MI 48109-2029, United States.
| | - Gail A Greendale
- Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, United States.
| | - Howard M Kravitz
- Rush University Medical Center , 1653W Congress Pkwy, Chicago, IL 60612, United States.
| | - Joyce T Bromberger
- University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260, United States.
| | - John W Burns
- Rush University Medical Center , 1653W Congress Pkwy, Chicago, IL 60612, United States.
| | - Sheila A Dugan
- Rush University Medical Center , 1653W Congress Pkwy, Chicago, IL 60612, United States.
| | - Carlos F Mendes de Leon
- University of Michigan, School of Public Health, 1415 Washington Heights, Room 2667, SPH Tower, Ann Arbor, MI 48109-2029, United States.
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Abstract
OBJECTIVE Exposure to acute and chronic stress can affect learning and memory, but most evidence comes from animal studies or clinical observations. Almost no population-based studies have investigated the relation of stress to cognition or changes in cognition over time. We examined whether higher levels of perceived stress were associated with accelerated decline in cognitive function in older blacks and whites from a community-based population sample. METHODS Participants included 6207 black and white adults (65.7% black, 63.3% women) from the Chicago Health and Aging Project. Two to five in-home assessments were completed over an average of 6.8 years of follow-up and included sociodemographics, health behaviors, psychosocial measures, cognitive function tests, and health history. Perceived stress was measured by a six-item scale, and a composite measure of four tests of cognition was used to determine cognitive function at each assessment. RESULTS Mixed-effects regression models showed that increasing levels of perceived stress were related to lower initial cognitive scores (B = -0.0379, standard error = 0.0025, p < .001) and a faster rate of cognitive decline (stress × time interaction: B = -0.0015, standard error = 0.0004, p < .001). Results were similar after adjusting for demographic variables, smoking, systolic blood pressure, body mass index, chronic medical conditions, and psychosocial factors and did not vary by race, sex, age, or education. CONCLUSIONS Increasing levels of stress are independently associated with accelerated declines in cognitive function in black and white adults 65 years and older.
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Helmes E, Norton MC, Østbye T. Personality change in older adults with dementia: Occurrence and association with severity of cognitive impairment. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/aar.2013.21004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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12
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Do depressive traits and hostility predict age-related decline in general intelligence? J Aging Res 2012; 2012:973121. [PMID: 22973515 PMCID: PMC3437660 DOI: 10.1155/2012/973121] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 06/02/2012] [Accepted: 06/10/2012] [Indexed: 11/18/2022] Open
Abstract
Certain personality traits are likely to be associated with stress and distress through the lifespan, and as a consequence these traits may influence the rate of age-related cognitive decline. The present study uses data from the Glostrup 1914 cohort to analyze potential effects of personality on decline in general intelligence over a 30-year period. The Minnesota Multiphasic Personality Inventory was administered at a 50-year baseline exam, and from this inventory the Obvious Depression Scale and an abbreviated version of the Cook-Medley Hostility Scale were derived. At the 50-year baseline and at the 60-, 70-, and 80-year followups the full version of Wechsler's Adult Intelligence Scale (WAIS) was administered to 673, 513, 136, and 184 participants. Mixed effects statistical models were used to evaluate both the effect of the personality scores on level of intelligence and the interaction between the personality scores and the time since followup. Analyses were adjusted for demographic background and a wide range of lifestyle factors. Both obvious depression and hostility were negatively associated with level of intelligence, but personality scores did not influence rate of decline in general intelligence.
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Neighborhood socioeconomic conditions are associated with psychosocial functioning in older black and white adults. Health Place 2011; 17:793-800. [PMID: 21421335 DOI: 10.1016/j.healthplace.2011.02.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 01/27/2011] [Accepted: 02/27/2011] [Indexed: 11/21/2022]
Abstract
We examined neighborhood socioeconomic status (NSES) in relation to depressive symptoms, perceived stress, and hostility in 5770 community-dwelling older black and white adults (mean age=73 years; 62% female) from 3 contiguous neighborhoods covering 82 census block groups in Chicago, IL. NSES was an average of z-scores of four Census 2000 block-group variables: % public assistance, % households earning <$25,000 annually, % with >college degree, and % owner-occupied dwellings valued >$200,000. NSES was inversely related to hostility (beta=-0.305), stress (beta=-0.333), and depressive symptoms (beta=-0.223) (p<0.001) in multi-level mixed-effects regression models adjusted for age, sex, race, and the number of years in the neighborhood. With further adjustment for education, income, marital status, and health conditions, NSES remained associated with depressive symptoms (beta=-0.078) and hostility (beta=-0.133) (p<0.05); the association with hostility was strongest in non-black neighborhoods. Neighborhood social conditions contribute to the psychosocial well-being of older residents; research is needed to investigate pathways through which neighborhoods influence health outcomes in an aging population.
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