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Clark AL, Weigand AJ, Clay OJ, Owens J, Fiala J, Crowe M, Marsiske M, Thomas KR. Associations between social determinants of health and 10-year change in everyday functioning within Black/African American and White older adults enrolled in ACTIVE. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12385. [PMID: 36514539 PMCID: PMC9732812 DOI: 10.1002/dad2.12385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/31/2022] [Accepted: 11/10/2022] [Indexed: 12/13/2022]
Abstract
Introduction Given prior work showing racial differences on baseline social determinants of health (SDoH) and 10-year trajectories of everyday functioning, we examined associations between SDoH and longitudinal everyday functioning performance in Black/African American and White older adults. Methods Participants were 2505 older adults (Mage = 73.5; 28% Black/African American) without dementia. SDoH included economic stability/status, education access/quality, health-care access, neighborhood/built environment, and social/community contexts. The Observed Tasks of Daily Living (OTDL) measured everyday functioning and was administered at baseline and 1-, 2-, 3-, 5-, and 10-year visits. Results Across the sample, social and community context and economic stability/status were associated with steeper age-related OTDL declines (βs = 0.05 to 0.07, Ps < 0.001). Lower levels of social and community context (β = 0.08, P = 0.002) and economic stability/status (β = 0.07, P = 0.04) were associated with OTDL linear age declines in Black/African American participants, but not in White participants (Ps > 0.30). Discussion Inequities across SDoH accelerate age-related declines in everyday functioning among Black/African American older adults.
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Affiliation(s)
- Alexandra L. Clark
- Department of PsychologyCollege of Liberal ArtsUniversity of Texas at AustinAustinTexasUSA
| | - Alexandra J. Weigand
- Department of PsychiatrySchool of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Olivio J. Clay
- Department of Psychology, College of Arts and SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Joshua Owens
- Department of Clinical and Health Psychology, College of Public Health and Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
| | - Jacob Fiala
- Department of Clinical and Health Psychology, College of Public Health and Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
| | - Michael Crowe
- Department of Psychology, College of Arts and SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Michael Marsiske
- Department of Clinical and Health Psychology, College of Public Health and Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
| | - Kelsey R. Thomas
- Department of PsychiatrySchool of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
- Research Services, VA San Diego Healthcare System (VASDHS)San DiegoCaliforniaUSA
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Parisi JM, Sharifian N, Rebok GW, Aiken-Morgan AT, Gross AL, Zahodne LB. Subjective memory, objective memory, and race over a 10-year period: Findings from the ACTIVE study. Psychol Aging 2021; 36:572-583. [PMID: 34351184 DOI: 10.1037/pag0000622] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The longitudinal associations between subjective and objective memory functioning in later life remain unclear. This may be due, in part, to sociodemographic differences across studies, given the hypothesis that these associations differ across racial groups. Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE; N = 2,694; 26% African American), multiple-group, parallel-process latent growth curve models were used to explore relationships between subjective and objective memory over 10 years and assess racial differences in these associations. Across African Americans and whites, we found bidirectional associations between subjective and objective memory such that greater self-reported forgetting at baseline predicted faster subsequent verbal episodic memory declines, and higher baseline objective memory scores predicted less increase in self-reported forgetting over time. However, rates of change in self-reported frequency of forgetting were correlated with rates of change in verbal episodic memory in whites, but not in African Americans. Subjective memory complaints may be a harbinger of future memory declines across African Americans and whites but may not track with objective memory in the same way across these racial groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University
| | | | - George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University
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Zahodne LB, Sharifian N, Kraal AZ, Zaheed AB, Sol K, Morris EP, Schupf N, Manly JJ, Brickman AM. Socioeconomic and psychosocial mechanisms underlying racial/ethnic disparities in cognition among older adults. Neuropsychology 2021; 35:265-275. [PMID: 33970660 DOI: 10.1037/neu0000720] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective: Racial/ethnic disparities in cognitive aging are only partly attributable to socioeconomic indicators. Psychosocial factors, such as discrimination and perceived control, also differ across racial/ethnic groups, and emerging literature highlights their potential role in contributing to cognitive disparities in addition to socioeconomic status. Method: 1,463 older adults (51% Hispanic, 27% non-Hispanic Black, and 22% non-Hispanic White) in the Washington Heights-Inwood Columbia Aging Project completed cognitive and psychosocial measures, including a comprehensive neuropsychological battery, Everyday and Major Experiences of Lifetime Discrimination scales, and the Perceived Control scale. Mediation models quantified separate indirect effects of Black race and Hispanic ethnicity on global cognitive composite scores through education, income, discrimination, and external perceived control. Results: Educational attainment, income, and perceived control each mediated racial/ethnic disparities in global cognition. Socioeconomic indicators (i.e., lower education and lower income) explained approximately 50% of the Black-White and Hispanic-White disparities in global cognition, and more external perceived control explained an additional 5%-8%. Hispanics reported the lowest levels of discrimination, while non-Hispanic Blacks reported the highest levels. However, neither everyday nor major lifetime discrimination was associated with global cognition. Significant racial/ethnic disparities in global cognition remained after accounting for the included socioeconomic and psychosocial factors. Conclusions: This study suggests that psychosocial factors may explain racial/ethnic disparities in cognitive aging above and beyond socioeconomic indicators. More external perceived control, which could reflect chronic exposure to interpersonal and institutional marginalization, may be a particularly salient psychosocial risk factor for poorer cognitive aging among non-Hispanic Black and Hispanic older adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | - Ketlyne Sol
- Department of Psychology, University of Michigan
| | | | - Nicole Schupf
- Department of Neurology, Gertrude H. Sergievsky Center, Columbia University
| | - Jennifer J Manly
- Department of Neurology, Gertrude H. Sergievsky Center, Columbia University
| | - Adam M Brickman
- Department of Neurology, Gertrude H. Sergievsky Center, Columbia University
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Byrd DR, Gonzales E, Moody DLB, Marshall GL, Zahodne LB, Thorpe RJ, Whitfield KE. Interactive Effects of Chronic Health Conditions and Financial Hardship on Episodic Memory among Older Blacks: Findings from the Health and Retirement Study. RESEARCH IN HUMAN DEVELOPMENT 2020; 17:41-56. [PMID: 33192185 PMCID: PMC7665222 DOI: 10.1080/15427609.2020.1746159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Previous research links chronic health conditions and financial hardship to cognitive outcomes among older Blacks. However, few studies have explored the moderating effect of financial hardship on chronic disease burden and specific cognitive domains. This study examined whether financial hardship (as measured by difficulty paying monthly bills) modifies the impact of self-reported chronic health conditions (e.g., diabetes, stroke) on episodic memory among 871 older Blacks (50+ years) in the Health and Retirement Study (2006). Financial hardship modified the association between chronic disease burden and episodic memory performance such that individuals who reported very little difficulty paying their monthly bills had significantly lower memory scores at high levels of disease burden compared to those reporting high financial difficulty after controlling for age, gender and education (F 2, 49 = 5.03, p= 0.010). This cross-sectional study suggests that both financial and physical wellbeing may have joint effects on cognitive health in older Blacks.
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Affiliation(s)
| | - Ernest Gonzales
- New York University, Silver School of Social Work, New York, NY, USA
| | | | | | | | - Roland J. Thorpe
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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5
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Byrd DR, Thorpe RJ, Whitfield KE. Special Issue: Race and Mental Health Among Older Adults: Do Depressive Symptoms Shape Blacks' Perceptions of Stress Over Time? Innov Aging 2020; 4:igaa022. [PMID: 33094172 PMCID: PMC7566362 DOI: 10.1093/geroni/igaa022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives Previous studies have linked stress to multiple negative mental health outcomes, including depression. This established stress–depression association is typically examined in one direction and cross-sectionally. This study examined the bidirectional relationships between depressive symptoms and changes in perceived stress over time in Blacks. Research Design and Methods The present study uses a community-dwelling sample of 450 Black adults, aged 51–96 years old, who participated in the Baltimore Study of Black Aging—Patterns of Cognitive Aging. Perceived stress—measured by the Perceived Stress Scale—and depressive symptoms—measured using the Center for Epidemiologic Studies Depression scale—were both assessed at baseline and follow-up 33 months later. Ordinary least squares regression was used to examine 2 bidirectional longitudinal relationships between (1) stress–depression and (2) depression–stress, and whether these associations are modified by age. Results Initial analyses testing the typical stress–depression relationship showed an effect in the expected direction, that is stress leading to more depressive symptoms over time, adjusting for model covariates, but the effect was not statistically significant (b = 0.014, p = .642). After accounting for baseline perceived stress level, age, sex, education, and chronic health conditions, depressive symptoms were positively associated with follow-up stress (b = 0.210, p < .000). The depression–stress association further varied by age group such that the impact of baseline depression on changes in perceived stress was greatest in Blacks in their 60s versus those in their 50s (b = 0.267, p = .001), controlling for model covariates. Discussion and Implications Contrary to previous work, the results suggest that an individual’s mental health shapes his/her perception of stressful events and this relationship varies by age group. While the typical finding (stress impacting depression) was not significant, the findings reported here highlight the importance of considering the possible bidirectional nature of the relationships between psychosocial measures of stress and mental health in later life among Blacks.
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Affiliation(s)
- DeAnnah R Byrd
- Institute of Gerontology, Wayne State University, Detroit, Michigan
| | - Roland J Thorpe
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Byrd DR, Thorpe RJ, Whitfield KE. Greater Disease Burden, Greater Risk? Exploring Cognitive Change and Health Status Among Older Blacks. J Aging Health 2019; 32:807-816. [PMID: 31165660 DOI: 10.1177/0898264319853138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: The objective of study is to examine the relationships between health status and changes in cognition over time among middle to older aged Blacks. Method: Data come from the Baltimore Study of Black Aging-Patterns of Cognitive Aging. At baseline, 602 Black participants, ranging from ages 48 to 95 years, were enrolled. At follow-up, approximately 3 years later, 450 participants were re-interviewed. Results: After accounting for baseline cognition, age, sex, and education, a greater number of health conditions was associated with slower perceptual speed (b = -5.099, p = .022). Average peak expiratory flow was also associated with improvements in working memory (b = 0.029, p = .019) and perceptual speed (b = 0.026, p = .026), controlling for model covariates. Discussion: Study findings demonstrate that greater disease burden is associated with declines in specific fluid cognitive abilities in middle to later life among Blacks. This finding highlights the importance of reducing health disparities that disproportionately affect Blacks.
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Affiliation(s)
| | - Roland J Thorpe
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Wright RS, Waldstein SR, Gerassimakis CS, Sprung MR, Moody DLB, Taylor AD, Al'Najjar E, McNeely JM, Zhang Z, Evans MK, Zonderman AB. Multiple Influences on Cognitive Function Among Urban-Dwelling African Americans. J Racial Ethn Health Disparities 2019; 6:851-860. [PMID: 30915683 DOI: 10.1007/s40615-019-00584-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/14/2019] [Accepted: 03/18/2019] [Indexed: 10/27/2022]
Abstract
This study examined multiple influences on cognitive function among African Americans, including education, literacy, poverty status, substance use, depressive symptoms, and cardiovascular disease (CVD) risk factors. Baseline data were analyzed from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Participants were 987 African Americans (mean age 48.5 years, SD = 9.17) who completed cognitive measures assessing verbal learning and memory, nonverbal memory, working memory, verbal fluency, perceptuo-motor speed, attention, and cognitive flexibility. Using preplanned hierarchical regression, cognitive performance was regressed on the following: (1) age, sex, education, poverty status; (2) literacy; (3) cigarette smoking, illicit substance use; (4) depressive symptoms; and (5) number of CVD risk factors. Results indicated that literacy eliminated the influence of education and poverty status in select instances, but added predictive utility in others. In fully adjusted models, results showed that literacy was the most important influence on cognitive performance across all cognitive domains (p < .001); however, education and poverty status were related to attention and cognitive flexibility. Depressive symptoms and substance use were significant predictors of multiple cognitive outcomes, and CVD risk factors were not associated with cognitive performance. Overall, findings underscore the need to develop cognitive supports for individuals with low literacy, educational attainment, and income, and the importance of treating depressive symptoms and thoroughly examining the role of substance use in this population.
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Affiliation(s)
- R S Wright
- School of Nursing, University of Delaware, Newark, DE, USA.
| | - S R Waldstein
- Department of Psychology, University of Maryland Baltimore County, Baltimore, MD, USA.,Geriatric Research Education & Clinical Center, Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA
| | - C S Gerassimakis
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - M R Sprung
- Department of Psychology, University of Maryland Baltimore County, Baltimore, MD, USA
| | - D L Beatty Moody
- Department of Psychology, University of Maryland Baltimore County, Baltimore, MD, USA
| | - A D Taylor
- Department of Psychology, University of Maryland Baltimore County, Baltimore, MD, USA
| | - E Al'Najjar
- Department of Psychology, University of Maryland Baltimore County, Baltimore, MD, USA
| | - J M McNeely
- Department of Psychology, University of Maryland Baltimore County, Baltimore, MD, USA
| | - Z Zhang
- Christiana Care Value Institute, Newark, DE, USA
| | - M K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - A B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
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Aiken-Morgan AT, Gamaldo AA, Wright RS, Allaire JC, Whitfield KE. Stability and Change in Cognitive Status Classification of Black Older Adults. J Am Geriatr Soc 2017; 66:179-183. [PMID: 29194573 DOI: 10.1111/jgs.15225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The purpose of this study was to determine whether stability and change in cognitive status are associated with sociodemographic characteristics and health function. DESIGN Secondary analysis of data. SETTING Baltimore Study of Black Aging-Patterns of Cognitive Aging. PARTICIPANTS Community-dwelling black adults (N = 407; mean age 68.6 ± 9.1). MEASUREMENTS Baseline (n = 602) and 33-month follow-up (n = 450) assessments of cognition, health, and psychosocial function. RESULTS For the present analyses, participants were grouped as being cognitively normal (n = 249), having stable mild cognitive impairment (MCI) (n = 32), or being MCI converters (n = 72; normal at baseline, MCI at follow-up) or reverters (n = 54; MCI at baseline, normal at follow-up). Multivariate analysis of variance showed that the groups differed significantly in education and lung function (P < .010). Post hoc analyses indicated that converters had fewer years of education than the other groups, whereas those who were cognitively normal had better lung function than converters and reverters (P < .050). CONCLUSION These results suggest that education and lung health are associated with patterns of cognitive status change and stability. Future research should account for sociodemographic and health factors when examining stability of cognitive status classifications.
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Affiliation(s)
- Adrienne T Aiken-Morgan
- Department of Psychology, North Carolina A&T State University, Greensboro, North Carolina.,Center on Biobehavioral Health Disparities Research, Duke University, Durham, North Carolina
| | - Alyssa A Gamaldo
- Human Development and Family Studies, Pennsylvania State University, State College, Pennsylvania
| | | | - Jason C Allaire
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
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Wright RS, Ford C, Sniscak CR. Older adult awareness of the influence of cardiovascular disease risk factors on cognitive function. Int J Older People Nurs 2016; 12. [PMID: 27297254 DOI: 10.1111/opn.12123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 04/20/2016] [Indexed: 01/21/2023]
Abstract
AIMS AND OBJECTIVES The aims of the current study were to (i) assess older people's awareness of the association between CVD risk factors and cognitive function; and (ii) examine whether awareness varies as a function of demographic factors. BACKGROUND Cardiovascular disease (CVD) risk factors have been linked to subtle deficits in cognitive function. CVD risk factors increase the risk of cognitive decline and dementia. The association between cardiovascular disease (CVD) risk factors and cognitive decrements has been well documented among older people; however, we are unaware of any studies that have measured older people's awareness of this relationship in an effort to assess educational needs. DESIGN A descriptive, cross-sectional survey design was employed. METHODS Community-based older adults aged 60 and older completed a survey that assessed their knowledge of the association between CVD risk factors and cognitive function. RESULTS One hundred fifty older adults, with a mean age of 72.88 years, completed the survey. Results showed that over 75% of the sample was aware that CVD risk factors affect cognitive function. White older adults and older adults with greater perceived financial well-being tended to be more aware of these relationships than non-White participants with less perceived financial well-being. CONCLUSIONS Results suggest that many, but not all older people have awareness of this relationship. As such, there is a need for increased education about the cognitive effects of CVD risk factors, particularly among older people who are already at risk for developing CVD and those with lesser financial well-being. IMPLICATIONS FOR PRACTICE Appropriate educational strategies can expose older patients to the importance of healthy lifestyle and self-care to maintain cognitive function. Nurses can incorporate education into care by identifying patients that would benefit from tailored interventions and providing information to at-risk patients about how to maintain their cognitive function through management of specific CVD risk factors.
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Affiliation(s)
| | - Cassandra Ford
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL, USA
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10
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Thomas KR, Marsiske M. Age trajectories of everyday cognition in African American and White older adults under prompted and unprompted conditions. Neuropsychol Rehabil 2015; 27:522-539. [PMID: 26480946 DOI: 10.1080/09602011.2015.1092453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We investigated how race and verbal prompting interacted with age to predict age trajectories on a performance-based measure of everyday cognition. African American (n = 727) and White (n = 2052) older adults from the ACTIVE clinical trial were given the Observed Tasks of Daily Living (OTDL; a performance-based measure of medication management/finances/telephone use) at baseline and 1-, 2-, 3-, 5-, and 10-year follow-ups. When participants said "I don't know" or did not respond, they received a standardised verbal prompt, which served only as a cue to initiate the first step. At each occasion, unprompted (sum of items correct without prompting) and prompted (sum of correct prompted and unprompted items) scores were derived for each participant. Mixed effects models for change were used to determine the age trajectories of OTDL performance by race. When not prompted, African Americans demonstrated more rapid decline in OTDL performance than Whites, especially after age 80. When prompted, both groups had improved performance and evinced shallower decline, although African Americans continued to demonstrate a slightly more rapid decline. Simple prompting attenuated age-related changes of African Americans and Whites on a measure of everyday cognition. Prompting may be especially helpful for older African Americans.
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Affiliation(s)
- Kelsey R Thomas
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , USA
| | - Michael Marsiske
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , USA
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Opdebeeck C, Martyr A, Clare L. Cognitive reserve and cognitive function in healthy older people: a meta-analysis. AGING NEUROPSYCHOLOGY AND COGNITION 2015; 23:40-60. [PMID: 25929288 DOI: 10.1080/13825585.2015.1041450] [Citation(s) in RCA: 263] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The associations between proxy measures of cognitive reserve (CR) and cognition vary across studies and cognitive domains. This meta-analysis aimed to assess the relationship between CR and cognition in multiple domains (memory, executive function, visuospatial ability, and language). CR was considered in terms of three key proxy measures - educational level, occupational status, and engagement in cognitively stimulating activities - individually and in combination. One-hundred and thirty-five studies representing 128,328 participants were included. Of these, 109 used a measure of education, 19 used a measure of occupation, 31 used a measure of participation in cognitively stimulating activities, and 6 used a combination of these. All three proxy measures had a modest positive association with cognition; occupational status and cognitive activities showed the most variation across cognitive domains. This supports the view that the commonly used proxy measures of CR share an underlying process but that each additionally provides a unique contribution to CR.
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Affiliation(s)
- Carol Opdebeeck
- a Research in Ageing and Cognitive Health, School of Psychology , Bangor University , Bangor , UK
| | - Anthony Martyr
- b Centre for Research in Ageing and Cognitive Health, School of Psychology , University of Exeter , Exeter EX4 4QG , UK
| | - Linda Clare
- b Centre for Research in Ageing and Cognitive Health, School of Psychology , University of Exeter , Exeter EX4 4QG , UK
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12
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Aiken-Morgan AT, Gamaldo AA, Sims RC, Allaire JC, Whitfield KE. Education Desegregation and Cognitive Change in African American Older Adults. J Gerontol B Psychol Sci Soc Sci 2015; 70:348-56. [PMID: 25361918 PMCID: PMC4580551 DOI: 10.1093/geronb/gbu153] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 09/25/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The present study examined the relationship between desegregated schooling and cognitive change in a sample of 420 community-dwelling African American elders (mean age = 68.6; SD = 9.1). METHOD Participants were recruited for the Baltimore Study of Black Aging - Patterns of Cognitive Aging. Cognitive measures from six domains of function were administered at baseline and follow-up 33 months later. Repeated measures multivariate analysis of covariance was conducted; the between subjects factors were schooling type and age cohort, and the within subjects factor was time. Analyses controlled for age, years of education, and sex, and follow-up univariate analyses were used to determine which individual cognitive scores drove the multivariate effects. RESULTS There were significant multivariate within-group, between-group, and interaction effects (p < .05). Univariate analyses indicated that the desegregated schooling group scored significantly better on Language and Perceptual Speed (p < .01), and the youngest age cohort (50- to 59-year-olds) performed better on measures of Perceptual Speed. There were no significant univariate interactions between schooling group or age cohort and cognitive change over time. DISCUSSION Overall, these findings suggest a slight advantage of desegregated schooling for cognitive performance, but no advantage of desegregated schooling on the rate of cognitive change over time in this sample.
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Affiliation(s)
- Adrienne T Aiken-Morgan
- Center on Biobehavioral Health Disparities Research, Duke University, Durham, North Carolina.
| | | | | | - Jason C Allaire
- Department of Psychology, North Carolina State University, Raleigh
| | - Keith E Whitfield
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
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13
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Sims RC, Thorpe RJ, Gamaldo AA, Aiken-Morgan AT, Hill LK, Allaire JC, Whitfield KE. Cognition and health in African American men. J Aging Health 2015; 27:195-219. [PMID: 25053802 PMCID: PMC4439206 DOI: 10.1177/0898264314543474] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Despite high rates of poor health outcomes, little attention has been focused on associations between prominent health factors and cognitive function in African American men, exclusively. The objective was to examine relationships between cardiovascular and pulmonary health, and cognitive function in African American men. METHOD Data from 257 men were pooled from two studies of African American aging. The mean age of participants was 58.15 and mean educational attainment was 11.78 years. Participants provided self-reported health and demographic information, completed cognitive measures, and had their blood pressure and peak expiratory flow assessed. RESULTS After adjustment, significant relationships were found between average peak expiratory flow rate (APEFR) and cognitive performance measures. DISCUSSION Results suggest that lung function is important to consider when examining cognitive function in African American men. Understanding the role of health in cognition and implications for quality of life in this population will be critical as life expectancies increase.
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Affiliation(s)
| | - Roland J Thorpe
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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14
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Carmasin JS, Mast BT, Allaire JC, Whitfield KE. Vascular risk factors, depression, and cognitive change among African American older adults. Int J Geriatr Psychiatry 2014; 29:291-8. [PMID: 23877973 PMCID: PMC3900598 DOI: 10.1002/gps.4007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 06/20/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Vascular burden has been linked to future depression and cognitive change in predominately European American samples. This study investigated these relationships in older African Americans. METHODS To examine the connection between vascular risk factors, depression, and cognitive change, this study utilized data from 435 older African Americans. Specifically, the study examined the link between vascular risk at baseline with depression and cognitive functioning at a 2.5-year follow-up visit. RESULTS High baseline vascular risk was associated with increased odds of future depression while controlling for age and current depression. A series of path analyses demonstrated links between baseline vascular risk, increases in depression, and decreases in processing speed. CONCLUSIONS These findings suggest that African Americans with greater vascular burden are at greater risk for depression and cognitive change.
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Affiliation(s)
- Jeremy S Carmasin
- Psychological and Brain Sciences, University of Louisville, Louisville, KY, 40292, USA
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15
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Aiken-Morgan AT, Bichsel J, Allaire JC, Savla J, Edwards CL, Whitfield KE. Personality as a Source of Individual Differences in Cognition among Older African Americans. JOURNAL OF RESEARCH IN PERSONALITY 2012; 46:465-471. [PMID: 22962505 DOI: 10.1016/j.jrp.2012.04.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous research suggests that demographic factors are important correlates of cognitive functioning in African Americans; however, less attention has been given to the influence of personality. The present study explored how dimensions and facets of personality predicted individual variability in cognition in a sample of older African Americans from the Baltimore Study of Black Aging. Cognition was assessed by verbal learning and attention/working memory measures. Personality was measured by the NEO Personality Inventory. Linear regressions controlling for demographic factors showed that Neuroticism, Openness, and Agreeableness were significant regression predictors of cognitive performance. Individual facets of all five personality dimensions were also associated with cognitive performance. These findings suggest personality is important in understanding variability in cognition among older African Americans.
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Affiliation(s)
- Adrienne T Aiken-Morgan
- Center for the Study of Aging and Human Development, Duke University Medical Center, Box 3003, Durham, NC 27710 USA
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Elias MF, Dore GA, Goodell AL, Davey A, Zilioli MKC, Brennan S, Robbins MA. Normative Data for Elderly Adults: The Maine-Syracuse Study. Exp Aging Res 2011; 37:142-78. [DOI: 10.1080/0361073x.2011.554511] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Davey A, Elias MF, Siegler IC, Lele U, Martin P, Johnson MA, Hausman DB, Poon LW. Cognitive function, physical performance, health, and disease: norms from the georgia centenarian study. Exp Aging Res 2010; 36:394-425. [PMID: 20845120 PMCID: PMC2941913 DOI: 10.1080/0361073x.2010.509010] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study provides, for the first time, normative data on cognitive functioning and physical performance, health and health behaviors, and diseases from a population-based sample of 244 centenarians and near-centenarians (M age = 100.5 years, range 98-108, 84.8% women, 21.3% African American) from the Georgia Centenarian Study. Data are presented by the four key dimensions of gender, race, residence, and educational attainment. Results illustrate the profound range of functioning in this age group and indicate considerable differences as a function of each dimension. Bivariate models generally suggest that cognitive functioning and physical performance is higher for men than women; whites than African Americans; community than facility residents; and those with more than high school education than those with less than high school education. Multivariate models elaborate that differences in educational attainment generally account for the largest proportion of variance in cognitive functioning and residential status generally accounts for the largest proportion of variance in physical performance measures. Addition of health variables seldom increases variance accounted for in each domain beyond these four dimensions.
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Affiliation(s)
- Adam Davey
- Department of Public Health, Temple University, Philadelphia, Pennsylvania 19122, USA.
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