1
|
Bergman YS, Weissberger GH. Ageist attitudes and psychological distress in older adults: The moderating role of reflective functioning. Stress Health 2024:e3408. [PMID: 38661019 DOI: 10.1002/smi.3408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/09/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
Ageist attitudes have been associated with various aspects of psychological functioning in older adults. According to Terror Management Theory, older adults may be seen as a reminder of human demise and death, and research has demonstrated links between ageist attitudes and compromised abilities to seek and maintain close personal relationships, which ward off awareness of one's mortality. Accordingly, the current work examined whether reflective functioning, or the ability to comprehend one's own and others' mental states, mitigates the negative psychological manifestations of ageist attitudes in older adults. Data was collected from 686 participants aged 60-94 (Mage = 72.64, SD = 6.28), who completed scales assessing ageist attitudes, reflective functioning, and psychological distress, as well as relevant socio-demographic information. Results indicated that ageist attitudes were linked with low levels of reflective functioning and enhanced psychological distress. Moreover, reflective functioning moderated the ageist attitudes-distress link, which was not significant in individuals reporting high levels of reflective functioning. This study provides insight into how the ability to comprehend others' mental states mitigates the adverse psychological effects of ageist attitudes and highlights the importance of examining relationship-enhancing personal factors within the context of negative ageing perceptions and psychological distress.
Collapse
Affiliation(s)
- Yoav S Bergman
- Faculty of Social Work, Ashkelon Academic College, Ashkelon, Israel
| | - Gali H Weissberger
- Department of Social and Health Sciences, Bar-Ilan University, Ramat-Gan, Israel
| |
Collapse
|
2
|
Weissberger GH, Bergman YS. Reflective Functioning and Financial Exploitation Vulnerability in Older Adults: The Importance of Significant Others. Clin Gerontol 2024:1-10. [PMID: 38389427 DOI: 10.1080/07317115.2024.2320921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
OBJECTIVES Financial exploitation of older adults results in devastating economic, social, and psychological losses to older adults, their families, and society at large. This study examined the relationship between reflective functioning and financial exploitation vulnerability (FEV) and whether relationship status moderated the association. METHODS A community-based sample of 156 Israeli older adults age 60 and over responded to demographic questions and questionnaires assessing reflective functioning and FEV. RESULTS A hierarchical linear regression analysis covarying for age, sex, education, income, and sum of illnesses, revealed that higher reflective functioning was associated with lower FEV (p = .011). A main effect of relationship status was not found, but a significant interaction of reflective functioning × relationship status was discovered (p = .008), adding 4.2% to the total variance of the model. Probing the interaction revealed that the reflective functioning-FEV association was significant only for older adults not in a relationship. CONCLUSIONS Findings suggest that low reflective functioning may be associated with increased risk of financial exploitation, specifically in certain populations of older adults. CLINICAL IMPLICATIONS Care providers of older adults may consider assessing for, and identifying older adults with low reflective functioning, in order to prevent or intervene in the event of a potentially exploitative situation.
Collapse
Affiliation(s)
- Gali H Weissberger
- Department of Social and Health Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Yoav S Bergman
- Faculty of Social Work, Ashkelon Academic College, Ashkelon, Israel
| |
Collapse
|
3
|
Weissberger GH, Lim AC, Mosqueda L, Nguyen AL, Fenton L, Han SD. Subjective Age Moderates the Relationship Between Global Cognition and Susceptibility to Scams. J Appl Gerontol 2024:7334648241229879. [PMID: 38323997 DOI: 10.1177/07334648241229879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
This study examined the interactive effect of subjective age on the relationship between global cognition and susceptibility to scams. Sixty-five participants underwent an assessment of global cognition (Mini Mental State Examination; MMSE), reported their perceived age (i.e., subjective age), and responded to a self-report questionnaire assessing scam susceptibility. A main effect of global cognition on scam susceptibility was found (p = .028); there was no main effect of subjective age (p = .819). An interaction between global cognition and subjective age was found (p = .016). Examination of conditional effects demonstrated that the relationship between cognition and scam susceptibility was not significant amongst those with subjective ages below one standard deviation of the mean, but was significant for those whose subjective ages fell around or above the mean. Findings suggest that individuals with older subjective ages may be particularly vulnerable to the negative effects of lower cognition on scam susceptibility.
Collapse
Affiliation(s)
| | - Aaron C Lim
- USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA
| | - Laura Mosqueda
- Keck School of Medicine of the University of Southern California, Alhambra, CA, USA
- USC Leonard Davis School of Gerontology, Los Angeles, CA, USA
| | | | - Laura Fenton
- USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA
| | - S Duke Han
- USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA
- Keck School of Medicine of the University of Southern California, Alhambra, CA, USA
- USC Leonard Davis School of Gerontology, Los Angeles, CA, USA
- Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
4
|
Weissberger GH, Bensimon M, Shrira A. Financial exploitation and mental health among Holocaust survivors: the moderating role of posttraumatic symptoms. Int Psychogeriatr 2023:1-13. [PMID: 37622336 DOI: 10.1017/s1041610223000625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVES We examined whether anxiety and depressive symptoms associated with self-reported history of financial exploitation (FE) are more pronounced among Holocaust survivors (HS), especially those with high-level posttraumatic stress disorder (PTSD) symptoms. DESIGN Self-report questionnaires completed online via Qualtrics. SETTING An online-based survey conducted in Israel. PARTICIPANTS A community-based cohort of 137 Israeli older adults born prior to 1945 were included in the study sample. HS (n = 61) were participants who reported living in a European country occupied or dominated by Nazi or pro-Nazi regimes between 1939 and 1945. Groups were further subdivided into survivors with low or high levels of PTSD symptoms (≥31 on the PTSD Checklist; PCL-5). MEASUREMENTS Questionnaires assessed FE history, posttraumatic symptoms (PCL-5), depressive symptoms (PHQ-9), and anxiety (GAD-7). Age, education, self-rated health, and non-Holocaust lifetime adversity were also measured and included as covariates. RESULTS Hierarchical linear regression models revealed that relationships between FE and depressive and anxiety symptoms were significant only among survivors (p = 0.005 and p = 0.008, respectively). The interaction between PTSD symptom level group and FE was also significant for both depressive (p = 0.007) and anxiety (p = 0.012) symptoms, such that survivors with PTSD who reported FE had significantly greater symptoms of depression and anxiety compared to all other groups. CONCLUSIONS Findings suggest that the experience of FE may be particularly impactful among survivors who continue to struggle with posttraumatic symptoms related to the Holocaust. Future studies may consider examining whether findings are relevant to other groups with PTSD.
Collapse
Affiliation(s)
- Gali H Weissberger
- Department of Social and Health Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Moshe Bensimon
- Department of Criminology, Bar-Ilan University, Ramat Gan, Israel
| | - Amit Shrira
- Department of Social and Health Sciences, Bar-Ilan University, Ramat Gan, Israel
| |
Collapse
|
5
|
Lim AC, Barnes LL, Weissberger GH, Lamar M, Nguyen AL, Fenton L, Herrera J, Han SD. Quantification of race/ethnicity representation in Alzheimer's disease neuroimaging research in the USA: a systematic review. Commun Med (Lond) 2023; 3:101. [PMID: 37491471 PMCID: PMC10368705 DOI: 10.1038/s43856-023-00333-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/05/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Racial and ethnic minoritized groups are disproportionately at risk for Alzheimer's Disease (AD), but are not sufficiently recruited in AD neuroimaging research in the United States. This is important as sample composition impacts generalizability of findings, biomarker cutoffs, and treatment effects. No studies have quantified the breadth of race/ethnicity representation in the AD literature. METHODS This review identified median race/ethnicity composition of AD neuroimaging US-based research samples available as free full-text articles on PubMed. Two types of published studies were analyzed: studies that directly report race/ethnicity data (i.e., direct studies), and studies that do not report race/ethnicity but used data from a cohort study/database that does report this information (i.e., indirect studies). RESULTS Direct studies (n = 719) have median representation of 88.9% white or 87.4% Non-Hispanic white, 7.3% Black/African American, and 3.4% Hispanic/Latino ethnicity, with 0% Asian American, Native Hawaiian/Pacific Islander, and American Indian/Alaska Native, Multiracial, and Other Race participants. Cohort studies/databases (n = 44) from which indirect studies (n = 1745) derived are more diverse, with median representation of 84.2% white, 83.7% Non-Hispanic white, 11.6% Black/African American, 4.7% Hispanic/Latino, and 1.75% Asian American participants. Notably, 94% of indirect studies derive from just 10 cohort studies/databases. Comparisons of two time periods using a median split for publication year, 1994-2017 and 2018-2022, indicate that sample diversity has improved recently, particularly for Black/African American participants (3.39% from 1994-2017 and 8.29% from 2018-2022). CONCLUSIONS There is still underrepresentation of all minoritized groups relative to Census data, especially for Hispanic/Latino and Asian American individuals. The AD neuroimaging literature will benefit from increased representative recruitment of ethnic/racial minorities. More transparent reporting of race/ethnicity data is needed.
Collapse
Affiliation(s)
- Aaron C Lim
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Gali H Weissberger
- The Interdisciplinary Department of Social Sciences, Bar-Ilan University, Raman Gat, Israel
| | - Melissa Lamar
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Annie L Nguyen
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
| | - Laura Fenton
- Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA
| | - Jennifer Herrera
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
| | - S Duke Han
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA.
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
- Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA.
- USC School of Gerontology, Los Angeles, CA, USA.
- Department of Neurology, Keck School of Medicine of USC, Los Angeles, CA, USA.
| |
Collapse
|
6
|
Weissberger GH, Nguyen AL, Lim AC, Fenton L, Mosqueda L, Han SD. The Cognitive Correlates of Financial Literacy in Older Adults. Clin Gerontol 2023:1-9. [PMID: 37246781 PMCID: PMC10684819 DOI: 10.1080/07317115.2023.2217190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES This study examined the cognitive correlates of financial literacy using a comprehensive neuropsychological battery, and whether education modifies the relationship between cognition and financial literacy. METHODS Sixty-six participants completed sociodemographic questionnaires, an assessment of financial literacy, and a neuropsychological assessment. Multiple linear regression models that controlled for age, sex, and education examined the main effects of cognitive measures that showed a significant bivariate association with financial literacy. RESULTS After correcting for multiple comparisons, the Crystallized Composite score (p = .002) and the Picture Vocabulary test (p = .002) from the NIH Toolbox, and the Multilingual Naming Test (p > .001) from the Uniform Data Set 3 were associated with financial literacy. Contrary to our hypothesis, education did not interact with cognitive measures when considering financial literacy scores. CONCLUSIONS Findings suggest that vocabulary knowledge and semantic memory may play an important role in financial literacy in older age. CLINICAL IMPLICATIONS Assessing vocabulary knowledge and semantic processes may help to identify older adults with lower financial literacy skills. Additionally, financial literacy interventions may consider targeting individuals with lower vocabulary knowledge and semantic processing skills.
Collapse
Affiliation(s)
- Gali H. Weissberger
- Interdisciplinary Department of Social and Health Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Annie L. Nguyen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California, USA
| | - Aaron C. Lim
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, Alhambra, California, USA
| | - Laura Fenton
- Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, California, USA
| | - Laura Mosqueda
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, Alhambra, California, USA
- USC Leonard Davis School of Gerontology, Los Angeles, California, USA
| | - S. Duke Han
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, Alhambra, California, USA
- Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, California, USA
- USC Leonard Davis School of Gerontology, Los Angeles, California, USA
- Department of Neurology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Behavioral Sciences and Psychiatry, Rush University Medical Center, Chicago, Illinois, USA
| |
Collapse
|
7
|
Weissberger GH, Samek A, Mosqueda L, Nguyen A, Lim A, Fenton LE, Han D. Financial Altruism is Associated with Alzheimer’s Disease Neurocognitive Profile in Older Adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.059963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - Anya Samek
- University of Southern California Los Angeles CA USA
| | | | - Annie Nguyen
- University of Southern California Alhambra CA USA
| | - Aaron Lim
- University of Southern California Alhambra CA USA
| | | | - Duke Han
- University of Southern California Alhambra CA USA
| |
Collapse
|
8
|
Weissberger GH, Han SD, Yu L, Barnes LL, Lamar M, Bennett DA, Boyle PA. Subjective socioeconomic status is associated with risk aversion in a community-based cohort of older adults without dementia. Front Psychol 2022; 13:963418. [PMID: 36420395 PMCID: PMC9677106 DOI: 10.3389/fpsyg.2022.963418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022] Open
Abstract
Attitudes towards risk impact financial decisions that are critical in older adulthood. Socioeconomic status (SES) influences an individual’s level of risk aversion; however, the association of subjective SES (i.e., social standing relative to others) with risk aversion has not been explored. We examined whether subjective SES is associated with risk aversion independent of objective SES (i.e., income, education). Participants were 933 older adults without dementia from the Rush Memory and Aging Project (MAP) or Minority Aging Research Study (MARS), two longitudinal epidemiologic studies of aging. Participants completed assessments of risk aversion, subjective SES, and cognition. We examined associations of subjective SES with risk aversion using mixed models adjusting for participant characteristics, objective markers of SES and global cognition. In bivariate analyses, lower global cognitive functioning, lower income, female sex, Black race, and lower subjective SES were associated with greater risk aversion. Results of the nonlinear mixed effects model revealed that higher subjective SES was associated with less risk aversion (Estimate = −0.238, SE = 0.083, p = 0.004), after controlling for covariates. Age, sex, race, and global cognition were also associated with risk aversion in the mixed effects model (ps ≤0.03), although income and education were not (ps ≥ 0.27) The relationship between subjective SES and risk aversion did not differ by sex or race (ps ≥ 0.31). Findings suggest that subjective SES contributes to risk aversion regardless of sex or race. Findings support the importance of considering subjective indicators of SES as they may impact an older adult’s economic preferences.
Collapse
Affiliation(s)
- Gali H. Weissberger
- Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat Gan, Israel
- *Correspondence: Gali H. Weissberger,
| | - S. Duke Han
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, United States
- Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, United States
- USC School of Gerontology, Los Angeles, CA, United States
- Department of Neurology, USC Keck School of Medicine, Los Angeles, CA, United States
| | - Lei Yu
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical 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
| | - Melissa Lamar
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Patricia A. Boyle
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| |
Collapse
|
9
|
Fenton L, Weissberger GH, Boyle PA, Mosqueda L, Yassine HN, Nguyen AL, Lim AC, Han SD. Cognitive and neuroimaging correlates of financial exploitation vulnerability in older adults without dementia: Implications for early detection of Alzheimer's disease. Neurosci Biobehav Rev 2022; 140:104773. [PMID: 35811006 PMCID: PMC9815424 DOI: 10.1016/j.neubiorev.2022.104773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/30/2022] [Accepted: 07/05/2022] [Indexed: 01/11/2023]
Abstract
Neuropathology characteristic of Alzheimer's disease (AD) begins to accumulate years to decades before cognitive changes are clinically detectable on standard neuropsychological tests. This presents a challenge for early intervention efforts and has spurred research on the identification of behavioral correlates of early neuropathological changes. Recent evidence suggests that financial exploitation vulnerability (FEV) due to impaired decision making may serve as an early behavioral manifestation of AD neuropathology, thereby indicating an increased likelihood for subsequent cognitive decline. An understanding of the underlying mechanisms of FEV is therefore warranted for the identification of individuals at risk for cognitive decline due to AD, and for empowering and protecting older adults vulnerable to financial exploitation. In the current review, we first highlight the devastating consequences of financial exploitation of older adults. We then summarize research on the cognitive, neuroimaging, and neuropathological correlates of FEV in older adults without dementia and propose a theoretical model in which early accumulation of AD pathology manifests as FEV. We conclude with clinical implications and directions for future research.
Collapse
Affiliation(s)
- Laura Fenton
- Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA
| | - Gali H Weissberger
- The Interdisciplinary Department of Social Sciences, Bar-Ilan University, Raman Gat, Israel
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Laura Mosqueda
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA; USC School of Gerontology, Los Angeles, CA, USA
| | - Hussein N Yassine
- Department of Medicine, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Annie L Nguyen
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
| | - Aaron C Lim
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
| | - S Duke Han
- Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA; Department of Medicine, Keck School of Medicine of USC, Los Angeles, CA, USA; Department of Neurology, Keck School of Medicine of USC, Los Angeles, CA, USA; USC School of Gerontology, Los Angeles, CA, USA.
| |
Collapse
|
10
|
Weissberger GH, Lim AC, Mosqueda L, Schoen J, Axelrod J, Nguyen AL, Wilber KH, Esquivel RS, Han SD. Elder abuse in the COVID-19 era based on calls to the National Center on Elder Abuse resource line. BMC Geriatr 2022; 22:689. [PMID: 35987616 PMCID: PMC9392067 DOI: 10.1186/s12877-022-03385-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/12/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has exacerbated circumstances that place older adults at higher risk for abuse, neglect, and exploitation. Identifying characteristics of elder abuse during COVID-19 is critically important. This study characterized and compared elder abuse patterns across two time periods, a one-year period during the pandemic, and a corresponding one-year period prior to the start of the pandemic. METHODS Contacts (including social media contacts, and email; all referred to as "calls" for expediency) made to the National Center on Elder Abuse (NCEA) resource line were examined for differences in types of reported elder abuse and characteristics of alleged perpetrators prior to the pandemic (Time 1; March 16, 2018 to March 15, 2019) and during the pandemic (Time 2; March 16, 2020 to March 15, 2021). Calls were examined for whether or not abuse was reported, the types of reported elder abuse, including financial, physical, sexual, emotional, and neglect, and characteristics of callers, victims, and alleged perpetrators. Chi-square tests of independence compared frequencies of elder abuse characteristics between time periods. RESULTS In Time 1, 1401 calls were received, of which 795 calls (56.7%) described abuse. In Time 2, 1009 calls were received, of which 550 calls (54.5%) described abuse. The difference between time periods in frequency of abuse to non-abuse calls was not significant ([Formula: see text]). Time periods also did not significantly differ with regard to caller, victim, and perpetrator characteristics. Greater rates of physical abuse ([Formula: see text] and emotional abuse ([Formula: see text] were reported during Time 2 after adjustment for multiple comparisons. An increased frequency of multiple forms of abuse was also found in Time 2 compared to Time 1 ([Formula: see text]. CONCLUSIONS Findings suggest differences in specific elder abuse subtypes and frequency of co-occurrence between subtypes between time periods, pointing to a potential increase in the severity of elder abuse during COVID-19.
Collapse
Affiliation(s)
- Gali H. Weissberger
- grid.22098.310000 0004 1937 0503Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Aaron C. Lim
- grid.42505.360000 0001 2156 6853Department of Family Medicine, USC Keck School of Medicine, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, Alhambra, CA 91803 USA
| | - Laura Mosqueda
- grid.42505.360000 0001 2156 6853Department of Family Medicine, USC Keck School of Medicine, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, Alhambra, CA 91803 USA ,grid.42505.360000 0001 2156 6853USC Keck School of Medicine, 1975 Zonal Ave, Los Angeles, CA 90033 USA ,National Center On Elder Abuse, Department of Family Medicine and Geriatrics, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, Alhambra, CA 91803 USA ,grid.42505.360000 0001 2156 6853USC Leonard Davis School of Gerontology, Los Angeles, CA 90089 USA
| | - Julie Schoen
- grid.42505.360000 0001 2156 6853Department of Family Medicine, USC Keck School of Medicine, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, Alhambra, CA 91803 USA ,National Center On Elder Abuse, Department of Family Medicine and Geriatrics, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, Alhambra, CA 91803 USA
| | - Jenna Axelrod
- grid.240372.00000 0004 0400 4439NorthShore University HealthSystem, 909 Davis, Evanston, IL 60201 USA
| | - Annie L. Nguyen
- grid.42505.360000 0001 2156 6853Department of Family Medicine, USC Keck School of Medicine, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, Alhambra, CA 91803 USA
| | - Kathleen H. Wilber
- grid.42505.360000 0001 2156 6853USC Leonard Davis School of Gerontology, Los Angeles, CA 90089 USA
| | - Richard S. Esquivel
- grid.42505.360000 0001 2156 6853Department of Family Medicine, USC Keck School of Medicine, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, Alhambra, CA 91803 USA ,National Center On Elder Abuse, Department of Family Medicine and Geriatrics, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, Alhambra, CA 91803 USA
| | - S. Duke Han
- grid.42505.360000 0001 2156 6853Department of Family Medicine, USC Keck School of Medicine, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, Alhambra, CA 91803 USA ,grid.42505.360000 0001 2156 6853USC Leonard Davis School of Gerontology, Los Angeles, CA 90089 USA ,grid.240684.c0000 0001 0705 3621Rush Alzheimer’s Disease Center, Rush University Medical Center, 600 S. Paulina St, Chicago, IL 60612 USA ,grid.42505.360000 0001 2156 6853Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA 90089 USA ,grid.42505.360000 0001 2156 6853Department of Neurology, USC Keck School of Medicine, Los Angeles, CA 90033 USA
| |
Collapse
|
11
|
Weissberger GH, Samek A, Mosqueda L, Nguyen AL, Lim AC, Fenton L, Han SD. Increased Financial Altruism is Associated with Alzheimer's Disease Neurocognitive Profile in Older Adults. J Alzheimers Dis 2022; 88:995-1005. [PMID: 35723104 DOI: 10.3233/jad-220187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Older age is associated with an increase in altruistic behaviors such as charitable giving. However, few studies have investigated the cognitive correlates of financial altruism in older adults. OBJECTIVE This study investigated the cognitive correlates of financial altruism measured using an altruistic choice paradigm in a community-based sample of older adults. METHODS In the present study, a sample of older adults (N = 67; M age = 69.21, SD = 11.23; M education years = 15.97, SD = 2.51; 58.2% female; 71.6% Non-Hispanic White) completed a comprehensive neuropsychological assessment and an altruistic choice paradigm in which they made decisions about allocating money between themselves and an anonymous person. RESULTS In multiple linear regression analyses that controlled for age, education, and sex, financial altruism was negatively associated with performance on cognitive measures typically sensitive to early Alzheimer's disease (including word list learning and recall, delayed story recall, and animal fluency). CONCLUSION Findings of this study point to a negative relationship between financial altruism and cognitive functioning in older adults on measures known to be sensitive to Alzheimer's disease. Findings also point to a potential link between financial exploitation risk and Alzheimer's disease in older age.
Collapse
Affiliation(s)
- Gali H Weissberger
- Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Anya Samek
- Department of Economics, University of California San Diego, San Diego, CA, USA
| | - Laura Mosqueda
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, Alhambra, CA, USA.,USC Leonard Davis School of Gerontology, Los Angeles, CA, USA
| | - Annie L Nguyen
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, Alhambra, CA, USA
| | - Aaron C Lim
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, Alhambra, CA, USA
| | - Laura Fenton
- Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA
| | - S Duke Han
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, Alhambra, CA, USA.,Department of Neurology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.,Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA.,USC Leonard Davis School of Gerontology, Los Angeles, CA, USA.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Behavioral Sciences and Psychiatry, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
12
|
Lim AC, Mosqueda L, Nguyen AL, Mason TB, Weissberger GH, Fenton L, Lichtenberg P, Han SD. Interpersonal dysfunction predicts subsequent financial exploitation vulnerability in a sample of adults over 50: a prospective observational study. Aging Ment Health 2022; 27:983-991. [PMID: 35583043 PMCID: PMC9672139 DOI: 10.1080/13607863.2022.2076210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES The goal of this study was to test whether interpersonal dysfunction, characterized by loneliness and/or dissatisfaction with relationships, is an imminent predictor of financial exploitation vulnerability (FEV) among adults age 50+ within a 6-month observation period. This study also tests whether FEV prospectively predicts interpersonal dysfunction. METHODS Twenty-six adults aged 50 or older completed a study involving baseline data collection and 13 follow-ups over 6 months. Linear mixed models were used for primary analyses. RESULTS After adjustment for demographic, psychological and cognitive covariates, there were between-person effects of FEV and interpersonal dysfunction across follow-ups, suggesting that those with generally higher interpersonal dysfunction compared to other participants also reported greater FEV (B(SE) = 1.09(.33), p = .003). There was a within-person effect (B(SE) = .08(.03), p = .007) of elevated interpersonal dysfunction predicting greater FEV two weeks later across all follow-ups. Within-person effect of FEV was not predictive of interpersonal dysfunction (B(SE) = .25(.15), p = .10). There was also a significant effect of age (B(SE) = -.06(.02), p = .007), such that older individuals had lower FEV throughout follow-ups. CONCLUSION Among adults age 50+, individuals with higher interpersonal dysfunction relative to others in the study reported greater FEV throughout the 6-month observation period. Increased loneliness and social dissatisfaction, relative to one's average level, predicts subsequent increases in FEV, and may be an imminent risk factor for exploitation.
Collapse
Affiliation(s)
- Aaron C. Lim
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
| | - Laura Mosqueda
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
| | - Annie L. Nguyen
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
| | - Tyler B. Mason
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Los Angeles, CA USA
| | - Gali H. Weissberger
- The Interdisciplinary Department of Social Sciences, Bar-Ilan University, Raman Gat, Israel
| | - Laura Fenton
- Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA
| | | | - S. Duke Han
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA,Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA,USC School of Gerontology, Los Angeles, CA, USA,Department of Neurology, Keck School of Medicine of USC, Los Angeles, CA, USA
| |
Collapse
|
13
|
Weissberger GH. Anxiety and Depressive Symptoms are Associated with Perceived Financial Exploitation in Israeli Older Adults. Clin Gerontol 2022; 45:715-721. [PMID: 35306962 DOI: 10.1080/07317115.2022.2053022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES There are no studies that have investigated mental health correlates of financial exploitation (FE) in Israel. Israel has diverse cultural traditions that emphasize strong family ties and social embeddedness, factors which may impact FE correlates. This study aimed to examine mental health correlates of perceived FE in Israel. METHODS Israeli older adults (N = 137; mean age = 67.86, SD = 6.86, 51.5% female) were surveyed for history of FE, demographic measures, and depressive (CES-D) and anxiety symptoms (GAD-7). RESULTS Twenty-one participants self-reported a FE history (perceived FE group), and 115 denied a history (non-FE group). After controlling for age, sex, and education, the perceived FE group reported significantly more anxiety (F(1, 108) = 7.16, p = .009) and depressive symptoms (F(1, 103) = 13.90, p < .001) than the non-FE group. A greater frequency of perceived FE participants surpassed clinical cutoffs of anxiety and depression. CONCLUSIONS Perceived FE was associated with anxiety and depressive symptoms, and in some cases at clinically significant levels. Future studies aimed at understanding mechanisms of these relationships are needed. CLINICAL IMPLICATIONS Findings support the need for clinical evaluations for those who have experienced FE in order to provide mental health services when appropriate.
Collapse
Affiliation(s)
- Gali H Weissberger
- Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat Gan, Israel
| |
Collapse
|
14
|
Weissberger GH, Bodner E, Palgi Y, Kavé G, Shmotkin D, Shrira A. The Association Between Views of Aging and Subjective Cognitive Complaints in Older Adults: Findings From Two Samples. Res Aging 2022; 44:531-544. [PMID: 35229687 DOI: 10.1177/01640275211065150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This cross-sectional study examined whether views of aging (VoA) relate to subjective cognitive complaints in two separate cohorts of older adults. Ageist attitudes, attitudes to aging (psychological loss, physical change, and psychological growth), subjective age, and subjective successful aging were examined. A moderating effect of chronological age was also examined. Samples included 572 adults aged 50 or older (Sample 1; mean age = 67.63, SD = 11.39, 49.4% female) and 224 adults aged 65 or older (Sample 2; mean age = 81.50, SD = 6.61, 75.3% female). More negative VoA (higher ageist attitudes, lower psychological growth, lower physical change, older subjective age, and less successful aging) were associated with more subjective cognitive complaints after controlling for covariates. An increase in chronological age strengthened some of these associations. Findings suggest that improving dimensions of VoA may have a complementary positive effect on subjective cognitive complaints in older adults.
Collapse
Affiliation(s)
- Gali H Weissberger
- Interdisciplinary Department of Social Sciences, 26731Bar-Ilan University, Ramat Gan, Israel
| | - Ehud Bodner
- Interdisciplinary Department of Social Sciences, 26731Bar-Ilan University, Ramat Gan, Israel
| | - Yuval Palgi
- 26748Department of Gerontology, University of Haifa, Mount Carmel, Israel
| | - Gitit Kavé
- Department of Education and Psychology, 42715The Open University of Israel, Raanana, Israel
| | - Dov Shmotkin
- School of Psychological Sciences, 26731Tel Aviv University, Tel Aviv, Israel
| | - Amit Shrira
- Interdisciplinary Department of Social Sciences, 26731Bar-Ilan University, Ramat Gan, Israel
| |
Collapse
|
15
|
Weissberger GH, Han SD, Yu L, Barnes LL, Lamar M, Bennett DA, Boyle PA. Impact of Early Life Socioeconomic Status on Decision Making in Older Adults Without Dementia. Arch Gerontol Geriatr 2021; 95:104432. [PMID: 34034033 DOI: 10.1016/j.archger.2021.104432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 04/20/2021] [Accepted: 05/03/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES A growing body of evidence points to the negative impact of early life socioeconomic status (SES) on health and cognitive outcomes in later life. However, the effect of early life SES on decision making in old age is not well understood. This study investigated the association of early life SES with decision making in a large community-based cohort of older adults without dementia from the Rush Memory and Aging Project. MATERIALS AND METHODS Cross-sectional data from the Rush Alzheimer's Disease Center Memory and Aging Project was analyzed. Participants were 1044 community-dwelling older adults without dementia (M age = 81.15, SD = 7.49; 75.8% female; 5.4% non-White). Measures of financial and healthcare decision making and early life SES were collected, along with demographics, global cognition, and financial and health literacy. RESULTS Early life SES was positively associated with decision making (estimate = 0.218, p = 0.027), after adjustments for demographic covariates and global cognition, such that a one-unit increase in early life SES was equivalent to the effect of being four years younger in age as it pertains to decision making. A subsequent model demonstrated that the relationship was strongest in those with low literacy, and weakest for those with high literacy (estimate = -0.013, p = 0.029). CONCLUSIONS Findings from this study suggest that early life SES is associated with late life decision making and that improving literacy, a modifiable target for intervention, may buffer the negative impact of low early life SES on decision making in older adulthood.
Collapse
Affiliation(s)
- Gali H Weissberger
- Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat Gan, Israel 5290002
| | - S Duke Han
- Department of Family Medicine, USC Keck School of Medicine, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, 4th Floor, Room 6437A, Alhambra, CA, 91803, USA; Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, 90089, CA, USA; USC School of Gerontology, Los Angeles, CA, 90089, USA; Department of Neurology, USC Keck School of Medicine, Los Angeles, 90033, CA, USA.
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 West Harrison St. Suite 1000, Chicago, IL 60612; Department of Neurological Sciences, Rush University Medical Center, 600 S. Paulina St., Chicago, IL 60612
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 West Harrison St. Suite 1000, Chicago, IL 60612; Department of Psychiatry and Behavioral Sciences; Department of Neurological Sciences, Rush University Medical Center, 600 S. Paulina St., Chicago, IL 60612
| | - Melissa Lamar
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 West Harrison St. Suite 1000, Chicago, IL 60612; Department of Psychiatry and Behavioral Sciences
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 West Harrison St. Suite 1000, Chicago, IL 60612; Department of Neurological Sciences, Rush University Medical Center, 600 S. Paulina St., Chicago, IL 60612
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 West Harrison St. Suite 1000, Chicago, IL 60612; Department of Psychiatry and Behavioral Sciences
| |
Collapse
|
16
|
Weissberger GH, Núñez RA, Tureson K, Gold A, Thames AD. Socioeconomic Mobility and Psychological and Cognitive Functioning in a Diverse Sample of Adults With and Without HIV. Psychosom Med 2021; 83:218-227. [PMID: 33793453 DOI: 10.1097/psy.0000000000000929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This cross-sectional study examined the effects of socioeconomic status (SES) mobility from childhood to adulthood on psychological and cognitive well-being in African American and non-Hispanic White HIV-positive (HIV+) and HIV-seronegative (HIV-) adults who are part of an ongoing study investigating psychosocial and neurobehavioral effects of HIV. METHODS Participants (N = 174, 24.1% female, 59.2% African American, 67.8% HIV+) were categorized into four groups (upward mobility, downward mobility, stable-not-poor, chronic-poverty) based on self-reported childhood and current community SES (which were correlated with objective measures of SES and proxies of childhood SES). SES groups were compared on self-report measures of psychological well-being, subjective executive functioning ratings, and performance across six cognitive domains. Primary analyses were stratified by HIV status. RESULTS For the HIV+ group, SES mobility was associated with psychological well-being (chronic burden of stress: F(7,101) = 3.17, mean squared error [MSE] = 49.42, p = .030, η2 = 0.14; depressive symptoms: F(7,101) = 4.46, MSE = 70.49, p = .006,η2 = 0.14), subjective ratings of executive dysfunction (F(7,101) = 6.11, MSE = 114.29, p = .001,η2 = 0.18), and objective performance in executive functioning (F(9,99) = 3.22, MSE = 249.52, p = .030, η2 = 0.15) and learning (F(9,99) = 3.01, MSE = 220.52, p = .034, η2 = 0.13). In the control group, SES mobility was associated with chronic stress burden (F(5,49) = 4.677, p = .025, η2 = 0.15); however, no other relationships between SES mobility and outcomes of interest were observed (all p values > .20). In general, downward mobility and chronic poverty were associated with worse ratings across psychological well-being measures and cognitive performance. CONCLUSIONS Findings within the HIV+ group are consistent with previous studies that report downward mobility to be associated with poor psychological outcomes. People living with HIV may be particularly vulnerable to the adverse effects of socioeconomic instability.
Collapse
Affiliation(s)
- Gali H Weissberger
- From the Department of Family Medicine (Weissberger), USC Keck School of Medicine, Alhambra, California; Interdisciplinary Department of Social Sciences (Weissberger), Bar Ilan University, Ramat Gan, Israel; Department of Psychology (Núñez, Tureson, Gold, Thames), USC Dornsife College of Letters, Arts, and Sciences; and Department of Psychiatry and Behavioral Sciences (Thames), USC Keck School of Medicine, Los Angeles, California
| | | | | | | | | |
Collapse
|
17
|
Weissberger GH, Mosqueda L, Nguyen AL, Axelrod J, Nguyen CP, Boyle PA, Spreng N, Han SD. Functional Connectivity Correlates of Perceived Financial Exploitation in Older Adults. Front Aging Neurosci 2020; 12:583433. [PMID: 33304266 PMCID: PMC7693621 DOI: 10.3389/fnagi.2020.583433] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/14/2020] [Indexed: 12/28/2022] Open
Abstract
Financial exploitation (FE) in old age is devastating and common; however, the neural correlates of FE are poorly understood. Previous studies of FE in older adults have implicated declines in decision making and social cognition as two risk factors for FE in later life. Here we examined whether functional connectivity among brain regions implicated in decision making and social cognition differed for those with an experience of FE vs. those without. Participants included 16 older adults without cognitive impairment who reported FE (Mean age = 70.5, 62.5% female, Mean education = 16.0 years) and 16 demographically and cognitively matched adults who denied a history of FE (Mean age = 65.1, 37.5% female, Mean education = 15.1 years). Measures of whole-brain resting-state functional connectivity in the hippocampus, insula, and medial frontal cortex were derived for each group. Compared to the non-FE group, FE was associated with greater functional connectivity between the right hippocampus and bilateral temporal regions, and less functional connectivity between the right hippocampus and the right cerebellum and bilateral lingual gyri. The FE group showed less connectivity between the right and left insula and cingulate cortex, and between the right insula and regions of the left lateral temporal gyrus and dorsolateral prefrontal cortex. Finally, the FE group showed greater functional connectivity between the medial frontal cortex and the right lateral temporal gyrus and orbitofrontal cortex, and less functional connectivity with the right pre- and postcentral gyri. Results suggest that perceived FE in old age is associated with whole-brain functional connectivity differences involving the hippocampus, insula, and medial frontal cortex, consistent with models implicating age-associated changes in decision making and social cognition in FE.
Collapse
Affiliation(s)
- Gali H Weissberger
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, United States.,Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Laura Mosqueda
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, United States.,USC School of Gerontology, Los Angeles, CA, United States
| | - Annie L Nguyen
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, United States
| | - Jenna Axelrod
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, United States
| | - Caroline P Nguyen
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, United States
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.,Department of Behavioral Sciences and Psychiatry, Rush University Medical Center, Chicago, IL, United States
| | - Nathan Spreng
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.,Departments of Psychiatry and Psychology, McGill University, Montreal, QC, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - S Duke Han
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, United States.,USC School of Gerontology, Los Angeles, CA, United States.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.,Department of Behavioral Sciences and Psychiatry, Rush University Medical Center, Chicago, IL, United States.,Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, United States.,Department of Neurology, USC Keck School of Medicine, Los Angeles, CA, United States
| |
Collapse
|
18
|
Axelrod J, Mosqueda L, Weissberger GH, Nguyen AL, Boyle PA, Parunakian E, Han SD. Frailty and Perceived Financial Exploitation: Findings from the Finance, Cognition, and Health in Elders Study. Gerontol Geriatr Med 2020; 6:2333721420971073. [PMID: 33225020 PMCID: PMC7649910 DOI: 10.1177/2333721420971073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 12/25/2022] Open
Abstract
Objective: Many older adults who are cognitively intact experience financial exploitation (FE), and the reasons for this are poorly understood. Methods: Data were gathered from 37 older adults (M age = 69.51, M education = 15.89, 62% female) from the Finance, Cognition, and Health in Elders Study (FINCHES). Twenty-four older adults who self-reported FE were demographically-matched according to age, education, race, and MoCA performance to thirteen older adults who denied experiencing FE. Participants completed the Tilburg Frailty Inventory. Results: FE participants reported greater total frailty (t = 2.06, p = .04) when compared to non-FE participants. Post-hoc analyses revealed that FE participants endorsed greater physical frailty (U = 89, p = .03), specifically poorer sensory functioning (hearing and vision). Discussion: Findings suggest frailty is associated with FE in old age and may represent a target for intervention programs for the financial wellbeing of older adults.
Collapse
Affiliation(s)
| | - Laura Mosqueda
- USC Keck School of Medicine, Alhambra, CA, USA.,USC School of Gerontology, Los Angeles, CA, USA
| | | | | | | | | | - S Duke Han
- USC Keck School of Medicine, Alhambra, CA, USA.,Rush University Medical Center, Chicago, IL, USA.,USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA.,USC School of Gerontology, Los Angeles, CA, USA
| |
Collapse
|
19
|
Weissberger GH, Mosqueda L, Nguyen AL, Samek A, Boyle PA, Nguyen CP, Han SD. Physical and mental health correlates of perceived financial exploitation in older adults: Preliminary findings from the Finance, Cognition, and Health in Elders Study (FINCHES). Aging Ment Health 2020; 24:740-746. [PMID: 30739493 PMCID: PMC6933096 DOI: 10.1080/13607863.2019.1571020] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Financial exploitation (FE) in old age is poorly understood, particularly among those without significant cognitive impairment. The Finance, Cognition, and Health in Elders Study (FINCHES) aims to identify factors associated with FE among cognitively-healthy older adults. Preliminary findings regarding physical and mental health correlates in the pilot phase of FINCHES are reported.Method: Sixteen older adults who self-reported FE were demographically-matched on age, education, sex, and race/ethnicity to eighteen older adults who did not report past FE.Results: Those who believed they were exploited endorsed significantly greater symptoms of depression (p = 0.014) and marginally greater symptoms of anxiety (p = 0.062). Participants trended towards lower perceived successful aging (p = 0.094). Perceived FE participants also endorsed greater medical conditions (p = 0.047), but follow-up individual item analyses suggest that this was driven by problems with sleep (p = 0.030).Conclusions: These preliminary findings from the pilot phase of FINCHES highlight negative mental health factors associated with perceived FE among cognitively-intact older adults.
Collapse
Affiliation(s)
- Gali H. Weissberger
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, USA
| | - Laura Mosqueda
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, USA
| | - Annie L. Nguyen
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, USA
| | - Anya Samek
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Patricia A. Boyle
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;,Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Caroline P. Nguyen
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, USA
| | - S. Duke Han
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, USA;,Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;,Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA;,USC School of Gerontology, Los Angeles, CA, USA;,Department of Neurology, USC Keck School of Medicine, Los Angeles, CA, USA
| |
Collapse
|
20
|
Weissberger GH, Gollan TH, Bondi MW, Nation DA, Hansen LA, Galasko D, Salmon DP. Neuropsychological Deficit Profiles, Vascular Risk Factors, and Neuropathological Findings in Hispanic Older Adults with Autopsy-Confirmed Alzheimer's Disease. J Alzheimers Dis 2020; 67:291-302. [PMID: 30636736 DOI: 10.3233/jad-180351] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This study aimed to determine if patterns of neuropsychological deficits, vascular risk factors, and neuropathology differ in Hispanic and Non-Hispanic patients with autopsy-confirmed Alzheimer's disease (AD). Participants were enrolled in a longitudinal study at the Shiley-Marcos AD Research Center at the University of California, San Diego. Hispanic (n = 14) and Non-Hispanic (n = 20) patients with autopsy-confirmed AD who scored ≥95 on the Dementia Rating Scale (DRS) were included. Patient groups were matched on age, education, global mental status, and severity of functional decline; they were compared to Hispanic (n = 14) or Non-Hispanic (n = 20) cognitively-normal controls of similar age and education. Ethnicity (Hispanic, Non-Hispanic) by disease state (autopsy-confirmed AD or cognitively normal) comparisons were made for cognitive test performance and vascular risk factors. Patient groups were further compared on measures of AD (Braak stage, neuritic plaques, neurofibrillary tangles), vascular neuropathology, and performance across cognitive domains of memory, language, attention, executive functions, and visuospatial abilities after scores were z-transformed based on respective culturally-appropriate control groups. Patient groups had similar overall AD pathology burden, whereas Hispanics with AD had more small parenchymal arteriolar disease and amyloid angiopathy than Non-Hispanics with AD. Despite largely similar pathology, Hispanics with AD were less cognitively impaired (relative to respective NC groups) than Non-Hispanics with AD, and exhibited a different pattern of deficits across cognitive domains. Findings suggest that cognitive deficits that are usually prominent in AD may be less salient in Hispanic patients and this may adversely impact the ability to clinically detect the disease in mild to moderate stages.
Collapse
Affiliation(s)
- Gali H Weissberger
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, USA
| | - Tamar H Gollan
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.,Department of Psychology, University of California, San Diego, La Jolla, CA, USA
| | - Mark W Bondi
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.,Neurology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Daniel A Nation
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Lawrence A Hansen
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA.,Department of Neuropathology, University of California, San Diego, La Jolla, CA, USA
| | - Douglas Galasko
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA.,Neurology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - David P Salmon
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| |
Collapse
|
21
|
Weissberger GH, Goodman MC, Mosqueda L, Schoen J, Nguyen AL, Wilber KH, Gassoumis ZD, Nguyen CP, Han SD. Elder Abuse Characteristics Based on Calls to the National Center on Elder Abuse Resource Line. J Appl Gerontol 2019; 39:1078-1087. [PMID: 31364442 DOI: 10.1177/0733464819865685] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Characterizing the types of elder abuse and identifying the characteristics of perpetrators are critically important. This study examined the types of elder abuse reported to the National Center on Elder Abuse (NCEA) resource line. Calls were coded with regard to whether abuse was reported, types of abuse alleged, whether multiple abuse subtypes occurred, and who perpetrated the alleged abuse. Of the 1,939 calls, 818 (42.2%) alleged abuse, with financial abuse being the most commonly reported (449 calls, 54.9%). A subset of calls identified multiple abuse types (188, 23.0%) and multiple abusers (149, 18.2%). Physical abuse was most likely to co-occur with another abuse type (61/93 calls, 65.6%). Family members were the most commonly identified perpetrators (309 calls, 46.8%). This study reports the characteristics of elder abuse from a unique source of frontline data, the NCEA resource line. Findings point to the importance of supportive resources for elder abuse victims and loved ones.
Collapse
Affiliation(s)
| | | | - Laura Mosqueda
- Keck School of Medicine of USC, Los Angeles, USA.,National Center on Elder Abuse, Alhambra, CA, USA
| | - Julie Schoen
- Keck School of Medicine of USC, Alhambra, USA.,National Center on Elder Abuse, Alhambra, CA, USA
| | | | | | | | | | - S Duke Han
- Keck School of Medicine of USC, Alhambra, USA.,Keck School of Medicine of USC, Los Angeles, USA.,USC Leonard Davis School of Gerontology, Los Angeles, USA.,Rush University Medical Center, Chicago, IL, USA.,USC Dornsife College of Letters, Arts and Sciences, Los Angeles, USA
| |
Collapse
|
22
|
Weissberger GH, Han SD, Yu L, Barnes LL, Bennett DA, Boyle PA. Financial and health literacy discrepancies with cognition in older adults. Neuropsychology 2019; 33:975-985. [PMID: 31204814 DOI: 10.1037/neu0000565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Greater financial and health literacy are associated with better cognition; however, research suggests that some individuals exhibit differences, or discrepancies, in these abilities in old age. We investigated discrepancies between literacy and cognition and factors associated with such discrepancies in older adults without dementia. METHOD Participants (N = 714; Mage = 81.4; education: M = 15.4; 75.4% female; 5.2% non-White) from the Rush Memory and Aging Project completed cognitive assessments and a financial and health literacy measure that yielded a total literacy score. Participants were characterized into three groups: (a) total literacy scores that are more than one standard deviation (1 SD) above cognition (L > C), (b) total literacy scores falling more than 1 SD below cognition (L < C), and (c) total literacy within 1 SD of cognition (L = C). Logistic regressions were employed to investigate associations between demographic and psychosocial variables and discrepancy group status. RESULTS Of the 714 participants, 24% showed significant discrepancies. In fully adjusted models, in reference to the L = C group, male sex was associated with greater odds of being in the L > C group (odds ratio [OR] = 2.32, 95% CI [1.33, 4.03], p = .003) and lower odds of being in the L < C group (OR = 0.31, 95% CI [0.14, 0.66], p = .002), higher income was associated with lower odds of being in either discrepancy group (L < C OR = 0.87, 95% CI [0.79, 0.96], p = .004; L > C OR = 0.86, 95% CI [0.76, 0.96], p = .007), and higher trust was associated with lower odds of being in the L > C group (OR = 0.92, 95% CI [0.85, 0.99], p = .030). CONCLUSIONS Findings support literacy and cognition as partially dissociable constructs and highlight important factors associated with discrepancies between literacy and cognition. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
Affiliation(s)
| | | | - Lei Yu
- Rush Alzheimer's Disease Center
| | | | | | | |
Collapse
|
23
|
Weissberger GH, Nation DA, Nguyen CP, Bondi MW, Han SD. Meta-analysis of cognitive ability differences by apolipoprotein e genotype in young humans. Neurosci Biobehav Rev 2018; 94:49-58. [PMID: 30125600 DOI: 10.1016/j.neubiorev.2018.08.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/21/2018] [Accepted: 08/16/2018] [Indexed: 12/14/2022]
Abstract
The apolipoprotein (APOE) ε4 allele has been proposed as an example of an antagonistic pleiotropy gene, conferring a beneficial effect on cognition in early life and a detrimental impact on cognition during later years. However, findings on the cognitive associations of the ε4 allele in younger persons are mixed. This PRISMA conforming study aimed to investigate APOE genotype (e4/non-e4) associations across seven cognitive domains (intelligence/achievement, attention/working memory, executive functioning, memory, language, processing speed and visuospatial abilities) in younger humans using a meta-analytic approach. Of 689 records reviewed, 29 studies (34 data-points) were selected for the quantitative synthesis. Participants' ages ranged from 2-40. Results showed that young ε4 carriers did not statistically differ from non-ε4 carriers across any cognitive domains. Overall, findings do not provide compelling support for an antagonistic pleiotropic effect of the ε4 allele across the lifespan.
Collapse
Affiliation(s)
- Gali H Weissberger
- Department of Family Medicine, USC Keck School of Medicine, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, 4thFloor, Room 6437A, Alhambra, CA, 91803, USA.
| | - Daniel A Nation
- Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, 90089, CA, USA
| | - Caroline P Nguyen
- Department of Family Medicine, USC Keck School of Medicine, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, 4thFloor, Room 6437A, Alhambra, CA, 91803, USA
| | - Mark W Bondi
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive #9116-B, La Jolla, CA, 92093, USA
| | - S Duke Han
- Department of Family Medicine, USC Keck School of Medicine, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, 4thFloor, Room 6437A, Alhambra, CA, 91803, USA; Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, 90089, CA, USA; USC School of Gerontology, Los Angeles, CA, 90089, USA; Department of Neurology, USC Keck School of Medicine, Los Angeles, 90033, CA, USA
| |
Collapse
|
24
|
Weissberger GH, Yarns BC, Chen ST, Narvaez T, Bussel N, Sultzer DL. Sertraline for the Treatment of Depression in Vascular Cognitive Impairment. Am J Geriatr Psychiatry 2018; 26:908-909. [PMID: 29779907 DOI: 10.1016/j.jagp.2018.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 04/19/2018] [Accepted: 04/19/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Gali H Weissberger
- Brain Behavior and Aging Research Center, Geriatric Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Brandon C Yarns
- Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles
| | - Stephen T Chen
- Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles
| | - Theresa Narvaez
- Brain Behavior and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Natalya Bussel
- Brain Behavior and Aging Research Center, Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - David L Sultzer
- Brain Behavior and Aging Research Center, Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles
| |
Collapse
|
25
|
Jurick SM, Weissberger GH, Clark LR, Wierenga CE, Chang YL, Schiehser DM, Han SD, Jak AJ, Dev SI, Bondi MW. Faulty Adaptation to Repeated Face-Name Associative Pairs in Mild Cognitive Impairment is Predictive of Cognitive Decline. Arch Clin Neuropsychol 2018; 33:168-183. [PMID: 28655152 PMCID: PMC6093342 DOI: 10.1093/arclin/acx056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 04/24/2017] [Accepted: 06/09/2017] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE We examined BOLD (Blood-Oxygen-Level Dependent) activity reduction upon stimuli repetition of face-name pairs in older adults with amnestic (aMCI) and non-amnestic (naMCI) mild cognitive impairment diagnosed using a comprehensive actuarial method, and relationships between activity reduction and behavioral indices. METHOD Twenty-nine cognitively healthy older adults (CHs) and 20 with MCI (n = 12 aMCI; n = 8 naMCI) underwent functional MRI event-related imaging, a comprehensive neuropsychological battery, and 1-year follow-up exam. During scanning, participants were shown face-name pairs 1-3 times and administered a post-scan recognition task. RESULTS The MCI group demonstrated less activity reduction upon repetition of face-name pairs within the MTL and other regions compared to CHs. Less activity reduction was associated with poorer Time 1 neuropsychological performance for the CH group and poorer post-scan recognition performance for the MCI group. Less activity reduction was related to poorer neuropsychological performance at Time 2 in the MCI group. Within MCIs, those with aMCI demonstrated less activity reduction upon repetition of face-name pairs than those with naMCI. CONCLUSIONS Distinct patterns of brain activity were identified in the MCI group compared to CHs, and aMCI compared to naMCI. Activated regions were not restricted to traditional memory circuitry, implicating a wider network of regions involved in the encoding of associative tasks. Findings add support to the hypothesis that lack of reduced BOLD activity reflects "faulty adaptation" to repeated stimuli and that reduction in activity represents successful encoding processes. They also provide further support for use of the face-name paradigm as a marker of prodromal Alzheimer's disease, and method to distinguish between MCI subtypes.
Collapse
Affiliation(s)
- Sarah M Jurick
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Gali H Weissberger
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Lindsay R Clark
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Christina E Wierenga
- VA San Diego Healthcare System, Research Service, San Diego, CA, USA
- University of California, San Diego Department of Psychiatry, La Jolla, CA, USA
| | - Yu-Ling Chang
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
| | - Dawn M Schiehser
- VA San Diego Healthcare System, Research Service, San Diego, CA, USA
- University of California, San Diego Department of Psychiatry, La Jolla, CA, USA
| | - S Duke Han
- VA San Diego Healthcare System, Research Service, San Diego, CA, USA
- University of California, San Diego Department of Psychiatry, La Jolla, CA, USA
| | - Amy J Jak
- VA San Diego Healthcare System, Research Service, San Diego, CA, USA
- University of California, San Diego Department of Psychiatry, La Jolla, CA, USA
| | - Sheena I Dev
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Mark W Bondi
- VA San Diego Healthcare System, Research Service, San Diego, CA, USA
- University of California, San Diego Department of Psychiatry, La Jolla, CA, USA
| |
Collapse
|
26
|
Weissberger GH, Strong JV, Stefanidis KB, Summers MJ, Bondi MW, Stricker NH. Diagnostic Accuracy of Memory Measures in Alzheimer's Dementia and Mild Cognitive Impairment: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2017; 27:354-388. [PMID: 28940127 PMCID: PMC5886311 DOI: 10.1007/s11065-017-9360-6] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 08/16/2017] [Indexed: 11/26/2022]
Abstract
With an increasing focus on biomarkers in dementia research, illustrating the role of neuropsychological assessment in detecting mild cognitive impairment (MCI) and Alzheimer's dementia (AD) is important. This systematic review and meta-analysis, conducted in accordance with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) standards, summarizes the sensitivity and specificity of memory measures in individuals with MCI and AD. Both meta-analytic and qualitative examination of AD versus healthy control (HC) studies (n = 47) revealed generally high sensitivity and specificity (≥ 80% for AD comparisons) for measures of immediate (sensitivity = 87%, specificity = 88%) and delayed memory (sensitivity = 89%, specificity = 89%), especially those involving word-list recall. Examination of MCI versus HC studies (n = 38) revealed generally lower diagnostic accuracy for both immediate (sensitivity = 72%, specificity = 81%) and delayed memory (sensitivity = 75%, specificity = 81%). Measures that differentiated AD from other conditions (n = 10 studies) yielded mixed results, with generally high sensitivity in the context of low or variable specificity. Results confirm that memory measures have high diagnostic accuracy for identification of AD, are promising but require further refinement for identification of MCI, and provide support for ongoing investigation of neuropsychological assessment as a cognitive biomarker of preclinical AD. Emphasizing diagnostic test accuracy statistics over null hypothesis testing in future studies will promote the ongoing use of neuropsychological tests as Alzheimer's disease research and clinical criteria increasingly rely upon cerebrospinal fluid (CSF) and neuroimaging biomarkers.
Collapse
Affiliation(s)
- Gali H Weissberger
- Brain, Behavior, and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
| | - Jessica V Strong
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- New England Geriatric Research, Education and Clinical Center (GRECC), Boston VA Healthcare System, Boston, MA, USA
| | - Kayla B Stefanidis
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Mathew J Summers
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Mark W Bondi
- VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Nikki H Stricker
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA.
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| |
Collapse
|
27
|
Melrose RJ, Young S, Weissberger GH, Natta L, Harwood D, Mandelkern M, Sultzer DL. Cerebral metabolic correlates of attention networks in Alzheimer's Disease: A study of the Stroop. Neuropsychologia 2017; 106:383-389. [PMID: 29055679 PMCID: PMC5708591 DOI: 10.1016/j.neuropsychologia.2017.10.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 01/09/2023]
Abstract
Patients with Alzheimer's Disease (AD) show difficulties with attention. Cognitive neuroscience models posit that attention can be broken down into alerting, orienting, and executive networks. We used the Stroop Color-Word test to interrogate the neural correlates of attention deficits in AD. We hypothesized that the Word, Color, and Color-Word conditions of the Stroop would all tap into the alerting and orienting networks. The Color-Word condition would additionally tap into the executive network. A ratio of Color-Word to Color naming performance would isolate the executive network from the others. To identify the neural underpinnings of attention in AD we correlated performance on the Stroop with brain metabolic activity. Sixty-six patients with probable AD completed [18F] fluorodeoxyglucose PET scanning and neuropsychological testing. Analysis was conducted with SPM12 (p<0.001 uncorrected, extent threshold 50 voxels). Performance on the Word, Color, and Color-Word conditions directly correlated with metabolic rate in right inferior parietal lobules/intraparietal sulci. The Color-Word/Color ratio revealed associations with metabolic rate in right medial prefrontal cortex and insula/operculum. Overall findings were largely consistent with the hypothesized neuroanatomical substrates of the alerting, orienting, and executive networks. As such, attention deficits in AD reflect compromise to multiple large-scale networks.
Collapse
Affiliation(s)
- Rebecca J Melrose
- Brain, Behavior & Aging Research Center, VA Greater Los Angeles Healthcare System, Building 158, Room 167, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA; Dept. of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 300 Medical Plaza, Los Angeles, CA 90095, USA.
| | - Stephanie Young
- Brain, Behavior & Aging Research Center, VA Greater Los Angeles Healthcare System, Building 158, Room 167, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA; UCLA Department of Medicine, Section of Medicine-Pediatrics, UCLA Santa Clarita Primary and Specialty Care, 25775 McBean Parkway, Suite 202, Valencia, CA 91355, USA
| | - Gali H Weissberger
- Brain, Behavior & Aging Research Center, VA Greater Los Angeles Healthcare System, Building 158, Room 167, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
| | - Laura Natta
- Brain, Behavior & Aging Research Center, VA Greater Los Angeles Healthcare System, Building 158, Room 167, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
| | - Dylan Harwood
- Brain, Behavior & Aging Research Center, VA Greater Los Angeles Healthcare System, Building 158, Room 167, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA; Dept. of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 300 Medical Plaza, Los Angeles, CA 90095, USA
| | - Mark Mandelkern
- Nuclear Medicine Service, VA Greater Los Angeles Healthcare System, Building 500, Room 0061, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA; Dept. of Physics, University of California, Irvine 4129 Frederick Reines Hall, Irvine, CA 92697-4575, USA
| | - David L Sultzer
- Brain, Behavior & Aging Research Center, VA Greater Los Angeles Healthcare System, Building 158, Room 167, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA; Dept. of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 300 Medical Plaza, Los Angeles, CA 90095, USA
| |
Collapse
|
28
|
Weissberger GH, Melrose RJ, Fanale CM, Veliz JV, Sultzer DL. Cortical Metabolic and Cognitive Correlates of Disorientation in Alzheimer’s Disease. J Alzheimers Dis 2017; 60:707-719. [DOI: 10.3233/jad-170420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Gali H. Weissberger
- Brain Behavior and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Geriatric Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Rebecca J. Melrose
- Brain Behavior and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Geriatric Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Candace M. Fanale
- Brain Behavior and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Joseph V. Veliz
- Brain Behavior and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - David L. Sultzer
- Brain Behavior and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| |
Collapse
|
29
|
Weissberger GH, Melrose RJ, Narvaez TA, Harwood D, Mandelkern MA, Sultzer DL. 18F-Fluorodeoxyglucose Positron Emission Tomography Cortical Metabolic Activity Associated with Distinct Agitation Behaviors in Alzheimer Disease. Am J Geriatr Psychiatry 2017; 25:569-579. [PMID: 28215899 DOI: 10.1016/j.jagp.2017.01.017] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/23/2016] [Accepted: 01/26/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study aimed to investigate the neurobiologic correlates of two distinct clusters of agitation symptoms to identify the unique biologic substrates underlying agitated behaviors. METHODS Eighty-eight outpatients with mild to moderate Alzheimer disease (AD) were recruited from the VA Greater Los Angeles Healthcare System Geropsychiatry Outpatient Program. A cross-sectional investigation was conducted of the relationship between cerebral glucose metabolism measured via 18F-fluorodeoxyglucose positron emission tomography and agitated symptoms from the Neuropsychiatric Inventory (NPI) in patients with AD. Two empirically derived clusters of agitation symptoms were investigated: an Agitation factor comprising agitation/aggression and irritability/lability items of the NPI, and a Behavioral Dyscontrol factor comprising elation/euphoria, disinhibition, aberrant motor behavior, sleep, and appetite items of the NPI. Mean cerebral metabolism for patients who scored positively on each of the two factors was compared with mean cerebral metabolism for those who did not. RESULTS Patients with AD who scored positively on the Agitation factor showed reduced glucose metabolism of the right temporal, right frontal, and bilateral cingulate cortex. In contrast, the Behavioral Dyscontrol factor did not show specific neurobiologic correlates. CONCLUSION Symptoms encompassed within the Agitation factor have distinct neurobiologic underpinnings. The precipitants, course, and outcomes related to these symptoms may be unique from other neuropsychiatric symptoms characteristic of AD. Special attention to treatment of agitated behaviors involving anger, aggressiveness, hostility, and irritability/emotional lability is warranted, because they appear to reflect a clinically relevant symptom cluster with unique underlying neurobiologic correlates.
Collapse
Affiliation(s)
- Gali H Weissberger
- Brain Behavior and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Geriatric Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA.
| | - Rebecca J Melrose
- Brain Behavior and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Geriatric Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Theresa A Narvaez
- Brain Behavior and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Dylan Harwood
- Brain Behavior and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Mark A Mandelkern
- Imaging Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - David L Sultzer
- Brain Behavior and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA
| |
Collapse
|
30
|
Weissberger GH, Gollan TH, Bondi MW, Clark LR, Wierenga CE. Language and task switching in the bilingual brain: Bilinguals are staying, not switching, experts. Neuropsychologia 2015; 66:193-203. [PMID: 25446970 PMCID: PMC4596720 DOI: 10.1016/j.neuropsychologia.2014.10.037] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 10/18/2014] [Accepted: 10/25/2014] [Indexed: 11/15/2022]
Abstract
Bilinguals' ability to control which language they speak and to switch between languages may rely on neurocognitive mechanisms shared with non-linguistic task switching. However, recent studies also reveal some limitations on the extent control mechanisms are shared across domains, introducing the possibility that some control mechanisms are unique to language. We investigated this hypothesis by directly comparing the neural correlates of task switching and language switching. Nineteen Spanish-English bilingual university students underwent a functional magnetic resonance imaging (fMRI) study employing a hybrid (event-related and blocked) design involving both color-shape switching and language switching paradigms. We compared the two switching tasks using within-subject voxel-wise t-tests for each of three trial types (single trials in single blocks, and stay and switch trials in mixed blocks). Comparing trial types to baseline in each task revealed widespread activation for single, stay, and switch trials in both color-shape and language switching. Direct comparisons of each task for each trial type revealed few differences between tasks on single and switch trials, but large task differences during stay trials, with more widespread activation for the non-linguistic than for the language task. Our results confirm previous suggestions of shared mechanisms of switching across domains, but also reveal bilinguals have greater efficiency for sustaining the inhibition of the non-target language than the non-target task when two responses are available. This efficiency of language control might arise from bilinguals' need to control interference from the non-target language specifically when not switching languages, when speaking in single- or mixed-language contexts.
Collapse
Affiliation(s)
- Gali H Weissberger
- San Diego State University/University of California, San Diego, Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Ct. #103, San Diego 92120-4913, United States
| | - Tamar H Gollan
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., MC: 0603, La Jolla, CA 92093-0603, United States
| | - Mark W Bondi
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego 92161, United States; Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., MC: 0603, La Jolla, CA 92093-0603, United States
| | - Lindsay R Clark
- San Diego State University/University of California, San Diego, Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Ct. #103, San Diego 92120-4913, United States
| | - Christina E Wierenga
- VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego 92161, United States; Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., MC: 0603, La Jolla, CA 92093-0603, United States.
| |
Collapse
|
31
|
Bangen KJ, Nation DA, Delano-Wood L, Weissberger GH, Hansen LA, Galasko DR, Salmon DP, Bondi MW. Aggregate effects of vascular risk factors on cerebrovascular changes in autopsy-confirmed Alzheimer's disease. Alzheimers Dement 2014; 11:394-403.e1. [PMID: 25022538 DOI: 10.1016/j.jalz.2013.12.025] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 11/21/2013] [Accepted: 12/17/2013] [Indexed: 01/02/2023]
Abstract
We examined the relationships of antemortem vascular risk factors to postmortem cerebrovascular and Alzheimer's disease (AD) pathologies. Eighty-four AD patients underwent an assessment of vascular risk (blood pressure, cholesterol, smoking, cardiovascular disease, diabetes, atrial fibrillation, transient ischemic attack [TIA], or stroke) and later underwent brain autopsy. Given our aim to examine mild cerebrovascular changes (CVCs), individuals were excluded if autopsy revealed large stroke. The most common forms of CVC were circle of Willis atherosclerosis followed by arteriosclerosis, lacunes, and microinfarcts. Excluding the history of TIA/clinical stroke, individual vascular risk factors were not associated with CVC. However, the presence of multiple vascular risk factors was associated with CVC. Furthermore, the presence of CVC was associated with lower Braak and Braak stage. These findings highlight the importance of aggregate risk in the vascular contribution to dementia. Interventions designed to maintain cerebrovascular health may represent important opportunities for preventing or delaying dementia, even when AD is the dominant pathology.
Collapse
Affiliation(s)
- Katherine J Bangen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Daniel A Nation
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Lisa Delano-Wood
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Gali H Weissberger
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Lawrence A Hansen
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA; Department of Pathology, University of California, San Diego, La Jolla, CA, USA
| | - Douglas R Galasko
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - David P Salmon
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Mark W Bondi
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
| |
Collapse
|
32
|
Abstract
OBJECTIVE To investigate which neuropsychological tests predict eventual progression to Alzheimer's disease (AD) in both Hispanic and non-Hispanic individuals. Although our approach was exploratory, we predicted that tests that underestimate cognitive ability in healthy aging Hispanics might not be sensitive to future cognitive decline in this cultural group. METHOD We compared first-year data of 22 older adults (11 Hispanic) who were diagnosed as cognitively normal but eventually developed AD (decliners), to 60 age- and education-matched controls (27 Hispanic) who remained cognitively normal. To identify tests that may be culturally biased in our sample, we compared Hispanic with non-Hispanic controls on all tests and asked which tests were sensitive to future decline in each cultural group. RESULTS Compared to age-, education-, and gender-matched non-Hispanic controls, Hispanic controls obtained lower scores on tests of language, executive function, and some measures of global cognition. Consistent with our predictions, some tests identified non-Hispanic, but not Hispanic, decliners (vocabulary, semantic fluency). Contrary to our predictions, a number of tests on which Hispanics obtained lower scores than non-Hispanics nevertheless predicted eventual progression to AD in both cultural groups (e.g., Boston Naming Test [BNT], Trails A and B). CONCLUSIONS Cross-cultural variation in test sensitivity to decline may reflect greater resistance of medium difficulty items to decline and bilingual advantages that initially protect Hispanics against some aspects of cognitive decline commonly observed in non-Hispanics with preclinical AD. These findings highlight a need for further consideration of cross-cultural differences in neuropsychological test performance and development of culturally unbiased measures.
Collapse
Affiliation(s)
| | - David P Salmon
- Department of Neurosciences, University of California, San Diego
| | | | - Tamar H Gollan
- Department of Psychiatry, University of California, San Diego
| |
Collapse
|
33
|
Abstract
The current study tested the hypothesis that bilinguals rely on domain-general mechanisms of executive control to achieve language control by asking if linguistic and nonlinguistic switching tasks exhibit similar patterns of aging-related decline. Thirty young and 30 aging bilinguals completed a cued language-switching task and a cued color-shape switching task. Both tasks demonstrated significant aging effects, but aging-related slowing and the aging-related increase in errors were significantly larger on the color-shape than on the language task. In the language task, aging increased language-switching costs in both response times and errors, and language-mixing costs only in response times. In contrast, the color-shape task exhibited an aging-related increase in costs only in mixing errors. Additionally, a subset of the older bilinguals could not do the color-shape task, but were able to do the language task, and exhibited significantly larger language-switching costs than matched controls. These differences, and some subtle similarities, in aging effects observed across tasks imply that mechanisms of nonlinguistic task and language control are only partly shared and demonstrate relatively preserved language control in aging. More broadly, these data suggest that age deficits in switching and mixing costs may depend on task expertise, with mixing deficits emerging for less-practiced tasks and switching deficits for highly practiced, possibly "expert" tasks (i.e., language).
Collapse
Affiliation(s)
- Gali H Weissberger
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | | | | | | |
Collapse
|
34
|
Gollan TH, Weissberger GH, Runnqvist E, Montoya RI, Cera CM. Self-ratings of Spoken Language Dominance: A Multi-Lingual Naming Test (MINT) and Preliminary Norms for Young and Aging Spanish-English Bilinguals. Biling (Camb Engl) 2012; 15:594-615. [PMID: 25364296 PMCID: PMC4212892 DOI: 10.1017/s1366728911000332] [Citation(s) in RCA: 208] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
This study investigated correspondence between different measures of bilingual language proficiency contrasting self-report, proficiency interview, and picture naming skills. Fifty-two young (Experiment 1) and 20 aging (Experiment 2) Spanish-English bilinguals provided self-ratings of proficiency level, were interviewed for spoken proficiency, and named pictures in a Multilingual Naming Test (MINT, and in Experiment 1 also the Boston Naming Test; BNT). Self-ratings, proficiency interview, and the MINT did not differ significantly in classifying bilinguals into language-dominance groups, but naming tests (especially the BNT) classified bilinguals as more English-dominant than other measures. Strong correlations were observed between measures of proficiency in each language and language-dominance, but not degree of balanced bilingualism (index scores). Depending on the measure, up to 60% of bilinguals scored best in their self-reported non-dominant language. The BNT distorted bilingual assessment by underestimating ability in Spanish. These results illustrate what self-ratings can and cannot provide, illustrate the pitfalls of testing bilinguals with measures designed for monolinguals, and invite a multi-measure goal driven approach to classifying bilinguals into dominance groups.
Collapse
Affiliation(s)
- Tamar H. Gollan
- University of California San Diego, Department of Psychiatry
| | - Gali H. Weissberger
- University of California San Diego, Department of Psychiatry
- San Diego State University
| | | | - Rosa I. Montoya
- University of California San Diego, Department of Psychiatry
| | - Cynthia M. Cera
- University of California San Diego, Department of Psychiatry
| |
Collapse
|