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Rebok GW, Gellert A, Coe NB, Clay OJ, Wallace G, Parisi JM, Aiken-Morgan AT, Crowe M, Ball K, Thorpe RJ, Marsiske M, Zahodne LB, Felix C, Willis SL. Effects of Cognitive Training on Alzheimer's Disease and Related Dementias: The Moderating Role of Social Determinants of Health. J Aging Health 2023; 35:40S-50S. [PMID: 37994850 DOI: 10.1177/08982643231203755] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Objective: We examined whether social determinants of health (SDoH) are associated with Alzheimer's disease and related dementias (ADRD) risk and the effects of cognitive training over a 20-year follow-up period. Methods: Data were obtained from 1605 participants in ACTIVE. SDoH measures were created using baseline data at the individual and neighborhood level. Incident ADRD was defined using administrative claims data (1999-2019). Cause-specific hazard models estimated associations between SDoH and claims-based diagnosed ADRD. Results: Higher scores on neighborhood and built environment were associated with lower ADRD risk. Trained participants obtained a greater degree of protection from ADRD when they had higher scores for SDoH domains associated with health care and education access. However, there were fewer significant SDoH moderation effects on cognitive training than expected. Discussion: Future work should continue to explore culturally tailored cognitive training interventions to reduce ADRD risk associated with SDoH that disproportionately affects racially diverse aging populations.
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Affiliation(s)
- George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Norma B Coe
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Olivio J Clay
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
- Deep South Resource Center for Minority Aging Research, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gail Wallace
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Johns Hopkins University, Baltimore, MD, USA
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Johns Hopkins University, Baltimore, MD, USA
| | | | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
- Deep South Resource Center for Minority Aging Research, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karlene Ball
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
- Deep South Resource Center for Minority Aging Research, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Roland J Thorpe
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Cynthia Felix
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sherry L Willis
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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Steinberg N, Parisi JM, Feger DM, Clay OJ, Willis SL, Ball KK, Marsiske M, Harrell ER, Sisco SM, Rebok GW. Rural-Urban Differences in Cognition: Findings From the Advanced Cognitive Training for Independent and Vital Elderly Trial. J Aging Health 2023; 35:107S-118S. [PMID: 35604034 DOI: 10.1177/08982643221102718] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
ObjectivesWe examined associations between three geographic areas (urban, suburban, rural) and cognition (memory, reasoning, processing speed) over a 10-year period. Methods: Data were obtained from 2539 participants in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial. Multilevel, mixed-effects linear regression was used to estimate cognitive trajectories by geographical areas over 10 years, after adjusting for social determinants of health. Results: Compared to urban and suburban participants, rural participants fared worse on all cognitive measures-memory (B = -1.17 (0.17)), reasoning (B = -1.55 (0.19)), and processing speed (B = 0.76 (0.19)) across the 10-year trajectory. Across geographic areas, greater economic stability, health care access and quality, and neighborhood resources were associated with better cognition over time. Discussion: Findings highlight the importance of geographical location when examining cognition later in life. More research examining place-based life experiences is needed to make the greatest impact on geographically diverse communities.
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Affiliation(s)
- Nessa Steinberg
- Marcus Institute for Aging, Hebrew SeniorLife, Boston, MA, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Baltimore, MD, USA
| | - Danielle M Feger
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Olivio J Clay
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
- Deep South Resource Center for Minority Aging Research, Birmingham, AL, USA
- University of Alabama Alzheimer's Disease Research Center, Birmingham, AL, USA
| | - Sherry L Willis
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Karlene K Ball
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
- Deep South Resource Center for Minority Aging Research, Birmingham, AL, USA
| | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Erin R Harrell
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | | | - George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
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Aiken-Morgan AT, McDonough IM, Parisi JM, Clay OJ, Thomas KR, Rotblatt LJ, Thorpe RJ, Marsiske M. Associations Between Body Mass Index and Cognitive Change in the ACTIVE Study: Variations by Race and Social Determinants of Health. J Aging Health 2023; 35:59S-73S. [PMID: 37994849 DOI: 10.1177/08982643221109645] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Objectives: The current study examines relationships between Body Mass Index (BMI) and cognitive performance and change in processing speed, memory, and reasoning, while accounting for variations by race and the influence of social determinants of health. Methods: Secondary data analysis of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, which included participants who self-identified as African American or Black (n = 728) and White (n = 2028). Latent growth curve modeling was used to assess study aims. Results: Increases in BMI were associated with less cognitive decline over 10 years across each cognition domain. Race moderation effects were noted for speed and memory. Relationships between BMI and cognitive trajectories were mediated by economic stability for speed and reasoning. Discussion: Overall, these findings are consistent with the "obesity paradox." Further research is needed to elucidate patterns of results by race.
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Affiliation(s)
- Adrienne T Aiken-Morgan
- Department of Psychiatry, University of North Carolina - Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Ian M McDonough
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Olivio J Clay
- Department of Psychology, University of Alabama, Birmingham, AL, USA
| | - Kelsey R Thomas
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Lindsay J Rotblatt
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Roland J Thorpe
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Han HR, Lee JW, Saylor MA, Parisi JM, Hornstein E, Agarwalla V, Jajodia A, Li Q, Weikert M, Davidson PM, Szanton SL. Methods and operational aspects of human-centred design into research processes for individuals with multiple chronic conditions: A survey study. Nurs Open 2022; 10:3075-3083. [PMID: 36515006 PMCID: PMC10077392 DOI: 10.1002/nop2.1554] [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] [Received: 06/29/2022] [Revised: 10/22/2022] [Accepted: 11/23/2022] [Indexed: 12/15/2022] Open
Abstract
AIM To examine ways in which human-centred design was integrated into a nursing school's research processes involving individuals with multiple chronic conditions. DESIGN Cross-sectional survey study. METHODS Three surveys were sent out, with surveys 1 and 2 involving faculty who had worked closely with design strategists and survey 3 as a school-wide survey eliciting experience with human-centred design, respectively. RESULTS Survey respondents (n = 7 for surveys 1 and 2 and n = 36 for survey 3) had no or minimal experience with human-centred design. Faculty respondents indicated it helped engaging various stakeholders, particularly in intervention development. Key lessons learned included: (1) the importance of designer involvement from study conception, (2) distinguishing a design strategist's skillset from strictly visual design, (3) challenges during the ethical review processes, and (4) sustainability of resources. The dynamic approach of human-centred design has benefited our efforts to advance the science of caring for individuals with multiple chronic conditions.
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Affiliation(s)
- Hae-Ra Han
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA.,Johns Hopkins School of Public Health, Baltimore, Maryland, USA.,Center for Community Programs, Innovation and Scholarship, Baltimore, Maryland, USA
| | - Ji Won Lee
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | | | | | | | | | - Anushka Jajodia
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA.,Center for Community Programs, Innovation and Scholarship, Baltimore, Maryland, USA
| | - Qiwei Li
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Mike Weikert
- Center for Social Design & Master of Arts in Social Design, MICA, Baltimore, Maryland, USA
| | | | - Sarah L Szanton
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA.,Johns Hopkins School of Public Health, Baltimore, Maryland, USA
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5
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Rebok GW, Huang A, Smail E, Brichko R, Parisi JM, Marsiske M, Roth DL, Thorpe RJ, Felix C, Jones RN, Willis SL. Long-Term Effects of Cognitive Training on All-Cause Mortality in US Older Adults. J Aging Health 2022; 34:1135-1143. [PMID: 35510611 PMCID: PMC10069226 DOI: 10.1177/08982643221097681] [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] [Indexed: 11/17/2022]
Abstract
Objectives: Cognitive abilities have been implicated as predictors of mortality in older adults. This study examines the effects of cognitive training on mortality 20 years post-intervention. Methods: Data come from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized control trial (N = 2802). Participants were cognitively and physically healthy, community-dwelling adults aged 65 and older. Cox proportional hazard models were used to investigate (1) the association between baseline cognition and mortality risk and (2) the effect of ACTIVE cognitive training (memory, reasoning, and speed of processing) on mortality risk 20 years post-intervention. Results: Higher baseline cognition predicted lower mortality risk 20 years post-intervention. No significant effects of ACTIVE cognitive training in memory, reasoning, or speed of processing on mortality risk were observed. Discussion: More work is needed to identify cognitive training interventions that may lead to lower mortality risks in later adulthood.
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Affiliation(s)
- George W. Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
- Johns Hopkins Alzheimer’s Disease Resource Center for Minority Aging Research, Baltimore, MD, USA
| | - Alison Huang
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily Smail
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rostislav Brichko
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Jeanine M. Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael Marsiske
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - David L. Roth
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Roland J. Thorpe
- Johns Hopkins Alzheimer’s Disease Resource Center for Minority Aging Research, Baltimore, MD, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cynthia Felix
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Richard N. Jones
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Sherry L. Willis
- Department of Psychiatry, University of Washington, Seattle, WA, USA
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Nkimbeng M, Han HR, Szanton SL, Alexander KA, Davey-Rothwell M, Giger JT, Gitlin LN, Joo JH, Koeuth S, Marx KA, Mingo CA, Samuel LJ, Taylor JL, Wenzel J, Parisi JM. Exploring Challenges and Strategies in Partnering With Community-Based Organizations to Advance Intervention Development and Implementation With Older Adults. Gerontologist 2022; 62:1104-1111. [PMID: 34958098 PMCID: PMC9451017 DOI: 10.1093/geront/gnab190] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Indexed: 12/30/2022] Open
Abstract
Minoritized older adults face multiple health inequities and disparities, but are less likely to benefit from evidence-based health care interventions. With the increasing diversity of the U.S. aging population, there is a great promise for gerontology researchers to partner with racial/ethnic minority organizations and underrepresented communities to develop and implement evidence-based health interventions. Community-Based Participatory Research and Implementation Science offer guidance and strategies for researchers to develop and sustain community partnerships. However, researchers partnering with community organizations continue to face challenges in these collaborations, study outcomes, and sustainability. This may be especially true for those junior in their career trajectory or new to community-engaged research. The purpose of this forum article is to detail critical challenges that can affect gerontology researcher-community partnerships and relationships from the perspective of researchers. Seven challenges (pre- or mid-intervention design, implementation, and postimplementation phases) described within the Equity-focused Implementation Research for health programs framework are identified and discussed. Potential solutions are also presented. Planning for potential obstacles of the researcher-community partnerships can inform innovative solutions that will facilitate successful partnerships, thereby promoting the advancement of collaborative research between academic institutions and community organizations to improve older adult health outcomes.
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Affiliation(s)
- Manka Nkimbeng
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Hae-Ra Han
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sarah L Szanton
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health
| | | | - Melissa Davey-Rothwell
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jarod T Giger
- University of Kentucky College of Social Work, Lexington, Kentucky, USA
| | - Laura N Gitlin
- Drexel University, College of Nursing and Health Professions, Philadelphia, Pennsylvania, USA
| | - Jin Hui Joo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Sokha Koeuth
- Drexel University, College of Nursing and Health Professions, Philadelphia, Pennsylvania, USA
| | - Katherine A Marx
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Chivon A Mingo
- Georgia State University, College of Arts & Sciences, Atlanta, Georgia, USA
| | - Laura J Samuel
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Janiece L Taylor
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jennifer Wenzel
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Ma Q, Gallo JJ, Parisi JM, Joo JH. Development of the Mental Health Peer Support Questionnaire in colleges and vocational schools in Singapore. Int J Ment Health Syst 2022; 16:45. [PMID: 36056370 PMCID: PMC9438123 DOI: 10.1186/s13033-022-00555-6] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background A nation-wide mental health peer support initiative was established in college and vocational schools in Singapore. The purpose of this cross-sectional study was to develop and validate a 20-item self-report instrument, the Mental Health Peer Support Questionnaire (MHPSQ), to assess young adults’ perceived knowledge and skills in mental health peer support. Methods We administered the questionnaire to 102 students who were trained as peer supporters, and 306 students who were not trained as peer supporters (denoted as non-peer supporters), in five college and vocational schools. Exploratory factor analysis and descriptive statistics were conducted. Cronbach’s α was used to assess reliability, and independent sample t-tests to assess criterion validity. Results Exploratory factor analysis indicated a three-factor structure with adequate internal reliability (discerning stigma [α = .76], personal mastery [α = .77], skills in handling challenging interpersonal situations [α = .74]; overall scale [α = .74]). Consistent with establishing criterion validity, peer supporters rated themselves as significantly more knowledgeable and skilled than non-peer supporters on all items except two: (1) letting peer support recipients make their own mental health decisions, and (2) young adults’ self-awareness of feeling overwhelmed. Peer supporters who had served the role for a longer period of time had significantly higher perceived awareness of stigma affecting mental health help-seeking. Peer supporters who had reached out to more peer support recipients reported significantly higher perceived skills in handling challenging interpersonal situations, particularly in encouraging professional help-seeking and identifying warning signs of suicide. Conclusions The MHPSQ may be a useful tool for obtaining a baseline assessment of young adults’ perceived knowledge and skills in mental health peer support, prior to them being trained as peer supporters. This could facilitate tailoring of training programs based on young adults’ initial understanding of mental health peer support. Subsequent to young adults’ training and application of skills, the MHPSQ could also be applied to evaluate the effectiveness of peer programs and mental health training. Supplementary Information The online version contains supplementary material available at 10.1186/s13033-022-00555-6.
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Affiliation(s)
- QianHui Ma
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway Street, 8Th Floor, Baltimore, MD, 21205, USA.
| | - Joseph J Gallo
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway Street, Baltimore, MD, 21205, USA
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624. North Broadway Street, Baltimore, MD, 21205, USA
| | - Jin Hui Joo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, 5300 Alpha Commons Dr, Baltimore, MD, 21224, USA
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Harrington YA, Parisi JM, Duan D, Rojo-Wissar DM, Holingue C, Spira AP. Sex Hormones, Sleep, and Memory: Interrelationships Across the Adult Female Lifespan. Front Aging Neurosci 2022; 14:800278. [PMID: 35912083 PMCID: PMC9331168 DOI: 10.3389/fnagi.2022.800278] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 06/09/2022] [Indexed: 01/26/2023] Open
Abstract
As the population of older adults grows, so will the prevalence of aging-related conditions, including memory impairments and sleep disturbances, both of which are more common among women. Compared to older men, older women are up to twice as likely to experience sleep disturbances and are at a higher risk of cognitive decline and Alzheimer's disease and related dementias (ADRD). These sex differences may be attributed in part to fluctuations in levels of female sex hormones (i.e., estrogen and progesterone) that occur across the adult female lifespan. Though women tend to experience the most significant sleep and memory problems during the peri-menopausal period, changes in memory and sleep have also been observed across the menstrual cycle and during pregnancy. Here, we review current knowledge on the interrelationships among female sex hormones, sleep, and memory across the female lifespan, propose possible mediating and moderating mechanisms linking these variables and describe implications for ADRD risk in later life.
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Affiliation(s)
- Yasmin A. Harrington
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Jeanine M. Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Daisy Duan
- Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Darlynn M. Rojo-Wissar
- The Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Center for Behavioral and Preventive Medicine, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Calliope Holingue
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Adam P. Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
- Johns Hopkins Center on Aging and Health, Baltimore, MD, United States
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Moored KD, Parisi JM, Snitz BE, DeKosky ST, Williamson JD, Fitzpatrick AL, Carlson MC. Levels and trajectories of domain‐specific cognition differ across lifestyle engagement subgroups of older adults. Alzheimers Dement 2021. [DOI: 10.1002/alz.050773] [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: 11/10/2022]
Affiliation(s)
| | - Jeanine M Parisi
- Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - Beth E Snitz
- University of Pittsburgh Pittsburgh PA USA
- Alzheimer's Disease Research Center Pittsburgh PA USA
| | - Steven T DeKosky
- McKnight Brain Institute, University of Florida Gainesville FL USA
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10
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Parisi JM, Sharifian N, Rebok GW, Aiken-Morgan AT, Gross AL, Zahodne LB. Subjective memory, objective memory, and race over a 10-year period: Findings from the ACTIVE study. Psychol Aging 2021; 36:572-583. [PMID: 34351184 DOI: 10.1037/pag0000622] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The longitudinal associations between subjective and objective memory functioning in later life remain unclear. This may be due, in part, to sociodemographic differences across studies, given the hypothesis that these associations differ across racial groups. Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE; N = 2,694; 26% African American), multiple-group, parallel-process latent growth curve models were used to explore relationships between subjective and objective memory over 10 years and assess racial differences in these associations. Across African Americans and whites, we found bidirectional associations between subjective and objective memory such that greater self-reported forgetting at baseline predicted faster subsequent verbal episodic memory declines, and higher baseline objective memory scores predicted less increase in self-reported forgetting over time. However, rates of change in self-reported frequency of forgetting were correlated with rates of change in verbal episodic memory in whites, but not in African Americans. Subjective memory complaints may be a harbinger of future memory declines across African Americans and whites but may not track with objective memory in the same way across these racial groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University
| | | | - George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University
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11
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Ma Q, Parisi JM, Joo JH, Gallo JJ. Singapore young adults' perception of mental health help-seeking from mental health professionals and peer supporters. Asian J Psychiatr 2021; 61:102687. [PMID: 34004461 DOI: 10.1016/j.ajp.2021.102687] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Affiliation(s)
- QianHui Ma
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway Street, 8th Floor, Baltimore, MD, 21205, United States.
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624. North Broadway Street, Baltimore, MD, 21205, United States.
| | - Jin Hui Joo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, 5300 Alpha Commons Dr., Baltimore, MD, 21224, United States.
| | - Joseph J Gallo
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway Street, Baltimore, MD, 21205, United States.
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12
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Rebok GW, Tzuang M, Parisi JM. Comparing Web-Based and Classroom-Based Memory Training for Older Adults: The ACTIVE Memory Works™ Study. J Gerontol B Psychol Sci Soc Sci 2021; 75:1132-1143. [PMID: 31429912 DOI: 10.1093/geronb/gbz107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/01/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To compare the efficacy of a web-based versus a classroom-based memory training program in enhancing cognition and everyday functioning in older adults, and program satisfaction and acceptability. METHOD Participants (N = 208; mean age = 71.1) were randomly assigned to a web-based or classroom-based training, or to a wait-list control condition. Cognitive and everyday functioning measures were administered at baseline, immediate, and 6 months post-training; both training groups evaluated program satisfaction and acceptability at immediate post-training. Repeated-measures analyses of variance assessed training effects on cognitive and functioning outcomes; independent-samples t tests assessed group differences in program satisfaction and acceptability. RESULTS Compared to controls, neither training group showed a significant improvement on measures of memory or everyday functioning as assessed by dependence or difficulty on instrumental activities of daily living over time. Training effects did not transfer to non-trained cognitive abilities. The web-based group was as satisfied with the training as the classroom-based group (p > .05). DISCUSSION Although no significant training effects were found, we demonstrated that a web-based platform is an acceptable and feasible mode to provide memory training to healthy older adults. Further studies are needed to investigate the potential of web-based memory training programs for improving cognition and function in cognitively healthy older adults.
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Affiliation(s)
- George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Marian Tzuang
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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13
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Regier NG, Parisi JM, Perrin N, Gitlin LN. Engagement in Favorite Activity and Implications for Cognition, Mental Health, and Function in Persons Living With and Without Dementia. J Appl Gerontol 2021; 41:441-449. [PMID: 33733908 DOI: 10.1177/0733464821999199] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/17/2022] Open
Abstract
Little is known about the impact of engagement in personally meaningful activities for older adults. Thus, this study examines the impact of engagement in one's favorite activity on cognitive, emotional, functional, and health-related outcomes in older adults with and without cognitive impairment. Data were obtained from 1,397 persons living with dementia (PLWD) and 4,719 cognitively healthy persons (CHP) who participated in wave 2 of the National Health and Aging Trends Study (NHATS). Sociodemographic characteristics were examined by cognitive status. A multivariate analysis of variance indicated that, for PLWD, engagement in favorite activity was associated with greater functional independence and decreased depression. For CHP, engagement in favorite activity was associated with greater functional independence, decreased depression and anxiety, and better performance on memory measures. Findings suggest that engagement in valued activities that are considered personally meaningful may have significant and distinct benefits for persons with and without dementia.
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Affiliation(s)
- Natalie G Regier
- Johns Hopkins University School of Nursing, Baltimore, MD, USA.,Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA
| | - Jeanine M Parisi
- Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nancy Perrin
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Laura N Gitlin
- Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA.,Drexel College of Nursing and Health Professions, Philadelphia, PA, USA
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14
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Moored KD, Chan T, Varma VR, Chuang YF, Parisi JM, Carlson MC. Engagement in Enriching Early-Life Activities Is Associated With Larger Hippocampal and Amygdala Volumes in Community-Dwelling Older Adults. J Gerontol B Psychol Sci Soc Sci 2021; 75:1637-1647. [PMID: 30561728 DOI: 10.1093/geronb/gby150] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 08/27/2018] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Numerous studies show benefits of mid- and late-life activity on neurocognitive health. Yet, few studies have examined how engagement in enriching activities during childhood, when the brain is most plastic, may confer long-term neurocognitive benefits that may be especially important to individuals raised in low-income settings. We examined associations between enriching early-life activities (EELAs) and hippocampal and amygdala volumes in a sample of predominantly African-American, community-dwelling older adults. We further assessed whether these associations were independent of current activity engagement. METHODS Ninety participants from the baseline Brain Health Substudy of the Baltimore Experience Corps Trial (mean age: 67.4) completed retrospective activity inventories and an magnetic resonance imaging scan. Volumes were segmented using FreeSurfer. RESULTS Each additional EELA was associated with a 2.3% (66.6 mm3) greater amygdala volume after adjusting for covariates. For men, each additional EELA was associated with a 4.1% (278.9 mm3) greater hippocampal volume. Associations were specific to these regions when compared with the thalamus, used as a control region. DISCUSSION Enriching lifestyle activities during an important window of childhood brain development may be a modifiable factor that impacts lifelong brain reserve, and results highlight the importance of providing access to such activities in historically underserved populations.
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Affiliation(s)
- Kyle D Moored
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Thomas Chan
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Vijay R Varma
- Clinical and Translational Neuroscience Unit, Laboratory of Behavioral Neuroscience, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, Maryland
| | - Yi-Fang Chuang
- Clinical and Translational Neuroscience Unit, Laboratory of Behavioral Neuroscience, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, Maryland.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, Maryland
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15
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Moored KD, Parisi JM, Snitz BE, DeKosky ST, Williamson JD, Fitzpatrick AL, Carlson MC. Examining risk of dementia in lifestyle engagement subgroups of community‐dwelling older adults: A latent class approach. Alzheimers Dement 2020. [DOI: 10.1002/alz.043167] [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: 11/10/2022]
Affiliation(s)
| | - Jeanine M Parisi
- Johns Hopkins University Bloomberg School of Public Health Baltimore MD USA
| | | | - Steven T DeKosky
- McKnight Brain Institute University of Florida Gainesville FL USA
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16
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Abstract
Relatively few studies have examined the reasons older individuals participate in activities that may benefit cognition with aging. Personality traits, particularly, openness to experience, are likely to influence how activities are selected. Openness to experience has also reliably shown to relate to cognitive and intellectual capacities. The current study tested whether diversity in activity helped to explain the overlap between openness to experience and cognitive functioning in an older adult sample (n = 476, mean age: 72.5 years). Results suggest that openness is a better predictor of activity diversity than of time spent engaged in activities or time spent in cognitively challenging activities. Further, activity diversity explained significant variance in the relationship between openness and cognitive ability for most constructs examined. This relationship did not vary with age, but differed as a function of education level, such that participating in a more diverse array of activities was most beneficial for those with less formal education. These results suggest that engagement with a diverse behavioral repertoire in late life may compensate for lack of early life resources.
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Affiliation(s)
- Joshua J. Jackson
- Department of Psychological and Brain Sciences; Washington University in St. Louis
| | - Patrick L. Hill
- Department of Psychological and Brain Sciences; Washington University in St. Louis
| | | | - Jeanine M. Parisi
- Department of Mental Health; Johns Hopkins Bloomberg School of Public Health
| | - Elizabeth A. L. Stine-Morrow
- Department of Educational Psychology and the Beckman Institute for Advanced Science and Technology; University of Illinois at Urbana-Champaign
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17
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Chan T, Parisi JM, Moored KD, Carlson MC. Variety of Enriching Early-Life Activities Linked to Late-Life Cognitive Functioning in Urban Community-Dwelling African Americans. J Gerontol B Psychol Sci Soc Sci 2019; 74:1345-1356. [PMID: 29741714 PMCID: PMC6777772 DOI: 10.1093/geronb/gby056] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 01/24/2018] [Accepted: 05/05/2018] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES The early environment is thought to be a critical period in understanding the cognitive health disparities African Americans face today. Much is known about the positive role enriching environments have in mid- and late-life and the negative function adverse experiences have in childhood; however, little is known about the relationship between enriching childhood experiences and late-life cognition. The current study examines the link between a variety of enriching early-life activities and late-life cognitive functioning in a sample of sociodemographic at-risk older adults. METHOD This study used data from African Americans from the Brain and Health Substudy of the Baltimore Experience Corps Trial (M = 67.2, SD = 5.9; N = 93). Participants completed a battery of neuropsychological assessments and a seven-item retrospective inventory of enriching activities before age 13. RESULTS Findings revealed that a greater enriching early-life activity score was linked to favorable outcomes in educational attainment, processing speed, and executive functioning. DISCUSSION Results provide promising evidence that enriching early environments are associated with late-life educational and cognitive outcomes. Findings support the cognitive reserve and engagement frameworks, and have implications to extend life-span prevention approaches when tackling age-related cognitive declines, diseases, and health disparities.
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Affiliation(s)
- Thomas Chan
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kyle D Moored
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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18
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Armstrong NM, Gitlin LN, Parisi JM, Roth DL, Gross AL. Association of physical functioning of persons with dementia with caregiver burden and depression in dementia caregivers: an integrative data analysis. Aging Ment Health 2019; 23:587-594. [PMID: 29469590 PMCID: PMC6172154 DOI: 10.1080/13607863.2018.1441263] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 10/18/2022]
Abstract
OBJECTIVES To determine whether caregiver relationship and race modify associations between physical functioning of persons with dementia (PWD) and their caregiver's burden and general depressive symptoms. METHOD We pooled data from four behavioral intervention trials (N = 1,211). Using latent growth modeling, we evaluated associations of PWD physical functioning with the level and rate of change in caregiver burden and caregivers' general depressive symptoms and stratified these associations by caregiver relationship and race. RESULTS PWD were, on average, 81 years old (68% female) with mean follow-up of 0.5 years. More baseline PWD physical impairment was associated with less worsening in caregiver burden over time (β = -0.23, 95% CI: -0.29, -0.14), but this relationship was not modified by caregiver characteristics. More impaired baseline PWD physical functioning was not associated with changes in depressive symptoms (β = -0.08, 95% CI: -0.17, 0.00), but was associated with less worsening in depressive symptoms among spousal (β = -0.08, 95% CI: -0.17, 0.00) and non-white (β = -0.08, 95% CI: -0.17, 0.00) caregivers. CONCLUSIONS Dementia caregivers may experience reduced caregiver-related burden because of adjustment to PWD functional status, while spousal and non-white caregivers may experience less depressive symptoms resultant of adjustment to functional status.
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Affiliation(s)
- Nicole M. Armstrong
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Johns Hopkins University Center on Aging and Health, Baltimore, MD, USA
| | - Laura N. Gitlin
- Division of Geriatrics and Gerontology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA,Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD USA
| | - Jeanine M. Parisi
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD USA,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David L. Roth
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Johns Hopkins University Center on Aging and Health, Baltimore, MD, USA
| | - Alden L. Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Johns Hopkins University Center on Aging and Health, Baltimore, MD, USA,Division of Geriatrics and Gerontology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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19
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Rebok GW, Parisi JM, Barron JS, Carlson MC, Diibor I, Frick KD, Fried LP, Gruenewald TL, Huang J, McGill S, Ramsey CM, Romani WA, Seeman TE, Tan E, Tanner EK, Xing L, Xue QL. Impact of Experience Corps® Participation on Children's Academic Achievement and School Behavior. Prev Sci 2019; 20:478-487. [PMID: 30627854 DOI: 10.1007/s11121-018-0972-8] [Citation(s) in RCA: 3] [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] [Indexed: 11/24/2022]
Abstract
This article reports on the impact of the Experience Corps® (EC) Baltimore program, an intergenerational, school-based program aimed at improving academic achievement and reducing disruptive school behavior in urban, elementary school students in Kindergarten through third grade (K-3). Teams of adult volunteers aged 60 and older were placed in public schools, serving 15 h or more per week, to perform meaningful and important roles to improve the educational outcomes of children and the health and well-being of volunteers. Findings indicate no significant impact of the EC program on standardized reading or mathematical achievement test scores among children in grades 1-3 exposed to the program. K-1st grade students in EC schools had fewer principal office referrals compared to K-1st grade students in matched control schools during their second year in the EC program; second graders in EC schools had fewer suspensions and expulsions than second graders in non-EC schools during their first year in the EC program. In general, both boys and girls appeared to benefit from the EC program in school behavior. The results suggest that a volunteer engagement program for older adults can be modestly effective for improving selective aspects of classroom behavior among elementary school students in under-resourced, urban schools, but there were no significant improvements in academic achievement. More work is needed to identify individual- and school-level factors that may help account for these results.
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Affiliation(s)
- George W Rebok
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Room 891, Baltimore, MD, 21205-1901, USA.
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Room 891, Baltimore, MD, 21205-1901, USA
| | - Jeremy S Barron
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Room 891, Baltimore, MD, 21205-1901, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Ike Diibor
- Office of Assessment and Accountability, Baltimore City Public School System, Baltimore, MD, USA
| | - Kevin D Frick
- The John Hopkins Carey Business School, Baltimore, MD, USA
| | - Linda P Fried
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Jin Huang
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Sylvia McGill
- Greater Homewood Community Corporation, Baltimore, MD, USA
| | - Christine M Ramsey
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Room 891, Baltimore, MD, 21205-1901, USA
| | - William A Romani
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Erwin Tan
- The University of California at Los Angeles, Los Angeles, CA, USA
| | - Elizabeth K Tanner
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
- Policy, Research and International Affairs, AARP, Washington, DC, USA
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Li Xing
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Qian-Li Xue
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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20
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Parisi JM, Roberts L, Szanton SL, Hodgson NA, Gitlin LN. Valued activities among individuals with and without functional impairments: Findings from the National Health and Aging Trends study (NHATS). Act Adapt Aging 2019; 43:259-275. [PMID: 32362702 DOI: 10.1080/01924788.2018.1521254] [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] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Using the National Health and Aging Trends Study (NHATS), we examined baseline activity and functional status. Respondents were classified as High (n=1,662), Moderate (n=1,973), or Low (n=989) Function and rated importance of and actual participation in four activities. Transportation and health were also examined. Individuals classified as low function were less likely to engage in valued activities and more likely to report that poor health and transportation limited participation, compared to individuals with no or moderate functional impairments. Data suggest the importance of developing interventions which bridge the gap between activity preferences and participation for older adults with functional limitations.
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Affiliation(s)
- Jeanine M Parisi
- Johns Hopkins Bloomberg School of Public Health; Center for Innovative Care in Aging
| | - Laken Roberts
- Johns Hopkins University School of Nursing; Center for Innovative Care in Aging
| | - Sarah L Szanton
- Johns Hopkins University School of Nursing; Center for Innovative Care in Aging
| | - Nancy A Hodgson
- University of Pennsylvania School of Nursing;Center for Innovative Care in Aging
| | - Laura N Gitlin
- Drexel University;College of Nursing and Health Professions; Center for Innovative Care in Aging
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21
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Armstrong N, Gitlin LN, Parisi JM, Carlson MC, Rebok GW, Gross AL. STANDARDIZED PHYSICAL FUNCTIONING THROUGH ITEM RESPONSE THEORY ACROSS STUDIES OF OLDER ADULTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1491] [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: 11/14/2022] Open
Affiliation(s)
- N Armstrong
- National Institute on Aging, Baltimore, Maryland, United States
| | - L N Gitlin
- Division of Geriatrics and Gerontology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - J M Parisi
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - M C Carlson
- Johns Hopkins University Center on Aging and Health, Baltimore, MD, USA
| | - G W Rebok
- Johns Hopkins University Center on Aging and Health, Baltimore, MD, USA
| | - A L Gross
- Johns Hopkins University Center on Aging and Health, Baltimore, MD, USA
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22
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Owusu JT, Ramsey CM, Tzuang M, Kaufmann CN, Parisi JM, Spira AP. Napping Characteristics and Restricted Participation in Valued Activities Among Older Adults. J Gerontol A Biol Sci Med Sci 2018; 73:367-373. [PMID: 28958012 PMCID: PMC5861910 DOI: 10.1093/gerona/glx166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 02/02/2017] [Accepted: 08/23/2017] [Indexed: 11/13/2022] Open
Abstract
Background Napping is associated with both positive and negative health outcomes among older adults. However, the association between particular napping characteristics (eg, frequency, duration, and whether naps were intentional) and daytime function is unclear. Methods Participants were 2,739 community-dwelling Medicare beneficiaries aged ≥65 years from the nationally representative National Health and Aging Trends Study. Participants reported napping frequency, duration, and whether naps were intentional versus unintentional. Restricted participation in valued activities was measured by self-report. Results After adjusting for potential confounders and nighttime sleep duration, those who took intentional and unintentional naps had a greater odds of any valued activity restriction (ie, ≥1 valued activity restriction), compared to those who rarely/never napped (unintentional odds ratio [OR] = 1.34, 95% confidence interval [CI] 1.01, 1.79, intentional OR = 1.49, 95% CI 1.09, 2.04). There was no difference between unintentional napping and intentional napping with respect to any valued activity restriction after adjustment for demographics. Compared to participants napping "some days," those napping most days/every day had a greater odds of any valued activity restriction (OR = 1.68, 95% CI 1.30, 2.16). Moreover, each 30-minute increase in average nap duration was associated with a 25% greater odds of any valued activity restriction (OR = 1.25, 95% CI 1.10, 1.43). Conclusion Older adults who took more frequent or longer naps were more likely to report activity restrictions, as were those who took intentional or unintentional naps. Additional longitudinal studies with objective measures of sleep are needed to further our understanding of associations between napping characteristics and daytime dysfunction.
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Affiliation(s)
- Jocelynn T Owusu
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Christine M Ramsey
- Program on Aging, Yale School of Medicine, New Haven, CT
- Department of Medical Informatics, Yale School of Medicine, New Haven, CT
| | - Marian Tzuang
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Christopher N Kaufmann
- Department of Psychiatry, University of California, San Diego
- Stein Institute for Research on Aging, University of California, San Diego
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD
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23
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Gitlin LN, Parisi JM, Huang J, Winter L, Roth DL. Valuation of Life as outcome and mediator of a depression intervention for older African Americans: the Get Busy Get Better Trial. Int J Geriatr Psychiatry 2018; 33:e31-e39. [PMID: 28401587 PMCID: PMC5788279 DOI: 10.1002/gps.4710] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 03/06/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Previously, we showed that Get Busy Get Better (GBGB), a 10-session multicomponent home-based, behavioral intervention, reduced depressive symptom severity in older African Americans. As appraising the value of life is associated with depressive symptoms, this study examined whether GBGB enhanced positive appraisals of life and if, in turn, this mediated treatment effects on depressive symptoms. METHODS Data were from a single-blind parallel randomized trial involving 208 African Americans (≥55 years old) with depressive symptoms (Patient Health Questionnaire, PHQ-9 ≥5). GBGB involved five components: care management, referral/linkage, stress reduction, depression education, and behavioral activation. A 13-item Valuation of Life (VOL) scale with two subfactors (optimism and engagement) was examined as an outcome and as mediating GBGB effects on PHQ-9 scores at 4 months. RESULTS Of 208 enrolled African Americans, 180 completed the 4-month interview (87 = GBGB; 93 = control). At 4 months, compared with wait-list control group participants, the GBGB group had improved VOL (difference in mean changes from baseline = 4.67, 95% confidence interval 2.53, 6.80). Structural equation models indicated that enhanced VOL mediated a significant proportion of GBGB's impact on depressive symptoms, explaining 71% of its total effect, and its subfactors (optimism, explaining 67%; engagement, 52%). CONCLUSION Valuation of Life appears malleable through an intervention providing resources and activation skills. GBGB's impact on depressive symptoms is attributed in large part to participants' enhanced attachment to life. Attention to VOL as mediator and outcome and the reciprocal relationship between mood and attachment to life is warranted. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Laura N. Gitlin
- Professor/Director, Center for Innovative Care in Aging, Johns Hopkins University, 525 North Wolfe Street, Suite 316, Baltimore, MD 21205
| | - Jeanine M. Parisi
- Associate Scientist, Johns Hopkins University Bloomberg School of Public Health, Principal Faculty, Center for Innovative Care in Aging, 525 N Wolfe Street, Suite 424, Baltimore, MD 21205, T: 410-955-0412, F:410-955-9088
| | - Jin Huang
- Biostatistician, Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University. 2024 E. Monument Street, Suite 2-700, Baltimore, MD 21205
| | - Laraine Winter
- Senior Research Associates, School of Nursing, Villanova University, 800 E. Lancaster Ave., Villanova, PA.19085
| | - David L. Roth
- Professor, Director, Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, 2024 E. Monument Street, Suite 2-700, Baltimore, MD 21205, T: 410-955-0491
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24
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Armstrong NM, Gitlin LN, Parisi JM, Carlson MC, Rebok GW, Gross AL. E pluribus unum: Harmonization of physical functioning across intervention studies of middle-aged and older adults. PLoS One 2017; 12:e0181746. [PMID: 28753644 PMCID: PMC5533461 DOI: 10.1371/journal.pone.0181746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 07/06/2017] [Indexed: 11/23/2022] Open
Abstract
Common scales for physical functioning are not directly comparable without harmonization techniques, complicating attempts to pool data across studies. Our aim was to provide a standardized metric for physical functioning in adults based on basic and instrumental activities of daily living scaled to NIH PROMIS norms. We provide an item bank to compare the difficulty of various physical functioning activities. We used item response theory methods to place 232 basic and instrumental activities of daily living questions, administered across eight intervention studies of middle-aged and older adults (N = 2,556), on a common metric. We compared the scale’s precision to an average z-score of items and evaluated criterion validity based on objective measures of physical functioning and Fried’s frailty criteria. Model-estimated item thresholds were widely distributed across the range of physical functioning. From test information plots, the lowest precision in each dataset was 0.80. Using power calculations, the sample size needed to detect 25% physical functional decline with 80% power based on the physical functioning factor was less than half of what would be needed using an average z-score. The physical functioning factor correlated in expected directions with objective measurements from the Timed Up and Go task, tandem balance, gait speed, chair stands, grip strength, and frailty status. Item-level harmonization enables direct comparison of physical functioning measures across existing and potentially future studies and across levels of function using a nationally representative metric. We identified key thresholds of physical functioning items in an item bank to facilitate clinical and epidemiologic decision-making.
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Affiliation(s)
- Nicole M Armstrong
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.,Johns Hopkins University Center on Aging and Health, Baltimore, Maryland, United States of America
| | - Laura N Gitlin
- Division of Geriatrics and Gerontology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America.,Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, Maryland, United States of America
| | - Jeanine M Parisi
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, Maryland, United States of America.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Michelle C Carlson
- Johns Hopkins University Center on Aging and Health, Baltimore, Maryland, United States of America.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - George W Rebok
- Johns Hopkins University Center on Aging and Health, Baltimore, Maryland, United States of America.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.,Johns Hopkins University Center on Aging and Health, Baltimore, Maryland, United States of America
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Payne BR, Gross AL, Hill PL, Parisi JM, Rebok GW, Stine-Morrow EAL. Decomposing the relationship between cognitive functioning and self-referent memory beliefs in older adulthood: what's memory got to do with it? Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2017; 24:345-362. [PMID: 27685541 PMCID: PMC5918409 DOI: 10.1080/13825585.2016.1218425] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
With advancing age, episodic memory performance shows marked declines along with concurrent reports of lower subjective memory beliefs. Given that normative age-related declines in episodic memory co-occur with declines in other cognitive domains, we examined the relationship between memory beliefs and multiple domains of cognitive functioning. Confirmatory bi-factor structural equation models were used to parse the shared and independent variance among factors representing episodic memory, psychomotor speed, and executive reasoning in one large cohort study (Senior Odyssey, N = 462), and replicated using another large cohort of healthy older adults (ACTIVE, N = 2802). Accounting for a general fluid cognitive functioning factor (comprised of the shared variance among measures of episodic memory, speed, and reasoning) attenuated the relationship between objective memory performance and subjective memory beliefs in both samples. Moreover, the general cognitive functioning factor was the strongest predictor of memory beliefs in both samples. These findings are consistent with the notion that dispositional memory beliefs may reflect perceptions of cognition more broadly. This may be one reason why memory beliefs have broad predictive validity for interventions that target fluid cognitive ability.
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Affiliation(s)
- Brennan R Payne
- a Department of Psychology , University of Illinois at Urbana-Champaign , Urbana , IL , USA
- b The Beckman Institute for Advanced Science and Technology , University of Illinois at Urbana-Champaign , Urbana , IL , USA
| | - Alden L Gross
- c Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD , USA
- d Center on Aging and Health , Johns Hopkins University , Baltimore , MD , USA
| | - Patrick L Hill
- e Department of Psychology , Carleton University , Ottawa , Canada
| | - Jeanine M Parisi
- f Department of Mental Health, Johns Hopkins Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD , USA
| | - George W Rebok
- d Center on Aging and Health , Johns Hopkins University , Baltimore , MD , USA
- f Department of Mental Health, Johns Hopkins Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD , USA
| | - Elizabeth A L Stine-Morrow
- b The Beckman Institute for Advanced Science and Technology , University of Illinois at Urbana-Champaign , Urbana , IL , USA
- g Department of Educational Psychology , University of Illinois at Urbana-Champaign , Urbana , IL , USA
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Parisi JM, Roberts L, Szanton SL, Hodgson NA, Gitlin LN. Valued Activities among Individuals with and without Cognitive Impairments: Findings from the National Health and Aging Trends Study. Gerontologist 2017; 57:309-318. [PMID: 26608334 PMCID: PMC6074869 DOI: 10.1093/geront/gnv144] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 05/07/2015] [Accepted: 09/08/2015] [Indexed: 11/14/2022] Open
Abstract
Purpose of the study Using the National Health and Aging Trends Study (NHATS), we examined activity preferences and participation among individuals with and without cognitive impairments. Design and methods Respondents were classified as having No Dementia (n = 5,264), Possible Dementia (n = 893), or Probable Dementia (n = 518). Respondents rated importance of and actual participation (yes/no) in four activities (visiting friends/family, religious services, clubs/classes, going out for enjoyment). We also examined whether transportation or health limited participation. Results Overall, visiting friends/family was most important (64.03%); although relative importance of activities varied with cognitive status. Compared to cognitively healthy individuals, those with possible and probable dementia were less likely to indicate activities were important and engage in valued activities (ps < .0001). Additionally, poor health limited participation in activities for those cognitively intact or with possible dementia; this was not true for those with probable dementia. Transportation difficulty limited going out for enjoyment for a greater percentage of those with cognitive impairment than those without impairment. Implications Regardless of cognitive level, older adults highly value activities; however, actual participation may decrease with greater impairment in cognitive and physical health and with transportation challenges. Developing tailored interventions for specific populations to achieve desired activity goals is needed.
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Affiliation(s)
- Jeanine M Parisi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center for Innovative Care in Aging, Baltimore, Maryland
| | - Laken Roberts
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Sarah L Szanton
- Center for Innovative Care in Aging, Baltimore, Maryland
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Nancy A Hodgson
- Center for Innovative Care in Aging, Baltimore, Maryland
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Laura N Gitlin
- Center for Innovative Care in Aging, Baltimore, Maryland
- Johns Hopkins University School of Nursing, Baltimore, Maryland
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Coe WH, Redmond L, Parisi JM, Bowie JV, Liu EY, Ng TY, Onyuka AMA, Cort M, Cheskin LJ. Motivators, Barriers, and Facilitators to Weight Loss and Behavior Change Among African American Adults in Baltimore City: A Qualitative Analysis. J Natl Med Assoc 2017; 109:79-85. [PMID: 28599760 DOI: 10.1016/j.jnma.2017.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 12/22/2016] [Accepted: 01/24/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND African American adults achieve smaller amounts of weight loss than their white counterparts when exposed to the same intervention and are more likely to regain weight during long-term follow-up. OBJECTIVE To identify perceived motivators, barriers, and facilitators to weight loss and behavior change among African American adults. METHODS Two focus groups were conducted between April and May 2015 at an urban community health center in Baltimore City, Maryland. A total of 13 participants took part in the discussions. Eligible participants were obese (BMI 30+) African American adults aged 21-70 who had at least one obesity-related comorbidity. Discussion questions were designed to identify the personal, social, and environmental factors that influence weight loss and behavior change among urban minority populations. RESULTS Statements were first classified as a motivator, barrier, or facilitator, then divided further as a personal, social, or environmental factor influencing weight loss and behavior change. Among the findings, several novel motivators (reducing or eliminating medication, improving physical intimacy) and barriers (personal transportation, lack of access to scales) emerged that were not previously characterized in the existing literature. CONCLUSIONS This study was intended to provide preliminary evidence that may be used to guide the development of innovative and culturally relevant weight-loss interventions in the future. Results are applicable to similar urban minority populations.
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Affiliation(s)
- William H Coe
- Johns Hopkins School of Medicine, 733 North Broadway, Baltimore, MD, USA
| | - Leslie Redmond
- Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe, Baltimore, MD, USA
| | - Jeanine M Parisi
- Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe, Baltimore, MD, USA
| | - Janice V Bowie
- Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe, Baltimore, MD, USA
| | - Elizabeth Y Liu
- Johns Hopkins University, 3400 North Charles, Baltimore, MD, USA
| | - Tin Yee Ng
- Johns Hopkins University, 3400 North Charles, Baltimore, MD, USA
| | | | - Marcia Cort
- Total Health Care, 1601 Division, Baltimore, MD, USA
| | - Lawrence J Cheskin
- Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe, Baltimore, MD, USA.
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Parisi JM, Gross AL, Marsiske M, Willis SL, Rebok GW. Control beliefs and cognition over a 10-year period: Findings from the ACTIVE trial. Psychol Aging 2017; 32:69-75. [PMID: 28182498 DOI: 10.1037/pag0000147] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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]
Abstract
We examined two facets of control beliefs and cognition over 10 years within the Advanced Cognitive Training for Independent and Vital Elderly study. Intellectual Self-Efficacy decreased (β = -0.32 units/year; SE = 0.03) and Concern About Intellectual Aging increased (β = 0.26 units/year; SE = 0.02) over time, with older age being the only predictor of increases in Concern About Intellectual Aging. Although baseline cognitive performance was related to control beliefs over time, the reverse was not supported. Findings were not altered by participation in the ACTIVE training programs, suggesting the need for including intervention components that lead to long-term maintenance or improvements in such beliefs. (PsycINFO Database Record
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Affiliation(s)
- Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
| | - Michael Marsiske
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida
| | - Sherry L Willis
- Department of Psychiatry and Behavioral Science, University of Washington
| | - George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
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Skarupski KA, Parisi JM, Thorpe R, Tanner E, Gross D. The association of adverse childhood experiences with mid-life depressive symptoms and quality of life among incarcerated males: exploring multiple mediation. Aging Ment Health 2017; 20:655-66. [PMID: 25897485 DOI: 10.1080/13607863.2015.1033681] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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: 10/23/2022]
Abstract
OBJECTIVES To explore the association of experiencing death, trauma, and abuse during childhood with depressive symptoms and quality of life at mid-life among incarcerated men and to understand how current social support and coping strategies mediate the impact of childhood trauma histories on mental health. METHODS Study participants were 192 male inmates in a maximum security prison. Participants completed measures of adverse childhood experiences related to death, trauma, and abuse, and depressive symptoms and quality of life. Data were analyzed using multiple mediation modeling. RESULTS Men who reported having experienced adverse childhood experiences reported more depressive symptoms and lower quality of life than their counterparts. The results showed that in models both unadjusted and adjusted for age, race, education, number of years served, and whether the inmate had a life sentence, the association between adverse childhood experiences and quality of life were partially explained by the total of the indirect effects (point estimate = -.5052; CI.95 = -1.0364, -.0429 and point estimate = -.7792; CI.95 = -1.6369, -.0381), primarily via social support. However, the associations between adverse childhood experiences and depressive symptoms were not explained by social support and coping. CONCLUSION Adverse childhood experiences are associated with deleterious mental health effects in later life. Social support and coping partially mediate the association between adverse childhood experiences and quality of life. The high prevalence of childhood trauma among aging prison inmates warrants attention to increasing social support mechanisms to improve mental health.
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Affiliation(s)
- Kimberly A Skarupski
- a Center on Aging and Health , School of Medicine, The Johns Hopkins University, Baltimore , MD , USA
| | - Jeanine M Parisi
- b Department of Mental Health, Bloomberg School of Public Health , The Johns Hopkins University , Baltimore , MD , USA
| | - Roland Thorpe
- c Department of Health, Behavior and Society, Bloomberg School of Public Health , The Johns Hopkins University , Baltimore , MD , USA
| | - Elizabeth Tanner
- d Department of Community-Public Health, School of Nursing , The Johns Hopkins University , Baltimore , MD , USA
| | - Deborah Gross
- e Department of Acute and Chronic Care, School of Nursing , The Johns Hopkins University , Baltimore , MD , USA
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Noh SR, Shake MC, Parisi JM, Joncich AD, Morrow DG, Stine-Morrow EA. Age differences in learning from text: The effects of content preexposure on reading. International Journal of Behavioral Development 2016. [DOI: 10.1177/0165025407073581] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated age differences in the way in which attentional resources are allocated to expository text and whether these differences are moderated by content preexposure. The organization of the preexposure materials was manipulated to test the hypothesis that a change in organization across two presentations would evoke more processing effort (i.e., a “mismatch effect”). After preexposure, reading time was measured as younger and older adults read a target text to produce recall, answer comprehension questions, and solve a novel problem. Relative to the young, older readers allocated more time as they encountered new discourse entities and showed a stronger serial position effect, which are patterns of resource allocation that suggest more extensive processing of the discourse situation. Younger adults took advantage of repeated exposure to produce more extensive reproduction of text content, as well as more text-specific solutions to solve a problem. Older adults generated more elaborated inferences and were similar to young adults in terms of the dimensional complexity of problem solutions. Whereas younger readers showed weak evidence for a mismatch effect, older readers did not. These data are consistent with the proposal that older readers favor the situation model over textbase content in allocating resources to text, but this effect was not enhanced by introducing organizational difficulty in reprocessing.
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Hill NL, Mogle J, Wion R, Munoz E, DePasquale N, Yevchak AM, Parisi JM. Subjective Cognitive Impairment and Affective Symptoms: A Systematic Review. Gerontologist 2016; 56:e109-e127. [PMID: 27342440 DOI: 10.1093/geront/gnw091] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [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: 11/12/2015] [Accepted: 04/15/2016] [Indexed: 11/13/2022] Open
Abstract
PURPOSE OF STUDY Subjective cognitive impairment (SCI) has been argued to reflect affective symptoms (i.e., depression and anxiety) rather than actual cognitive issues. Although a number of studies exist that look at the associations between SCI and affective symptoms, no review is available to aggregate this disparate literature. We addressed this gap by conducting a systematic review to better understand the relationships among SCI and affective symptoms among older adults in both community and clinical settings. DESIGN AND METHODS We reviewed available literature per the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Weight of evidence (WoE) ratings and narrative synthesis were completed for 58 articles. RESULTS A majority of studies focused on community-based samples (n = 40). Approximately half (53%) of the articles reviewed met high WoE criteria for the current review. Cross-sectional findings consistently identified a positive relationship among SCI and affective symptoms. Findings from available longitudinal studies (n = 9) were mixed but suggested a possible reciprocal relationship among SCI and depression. The relationship between SCI and anxiety appeared to be driven by fears over loss of function. Following consultation with health professionals, the association between SCI and anxiety was diminished or eliminated. IMPLICATIONS Although SCI is consistently related to affective symptoms in older adults cross-sectionally, more longitudinal work is needed to understand their temporal relationship. Improved measurement of SCI would support a deeper understanding of the impact of SCI on psychological well-being.
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Affiliation(s)
- Nikki L Hill
- College of Nursing, The Pennsylvania State University, University Park.
| | - Jacqueline Mogle
- College of Nursing, The Pennsylvania State University, University Park
| | - Rachel Wion
- College of Nursing, The Pennsylvania State University, University Park
| | - Elizabeth Munoz
- Department of Psychology, University of California, Riverside
| | - Nicole DePasquale
- Center for Healthy Aging and Department of Human Development & Family Studies, The Pennsylvania State University, University Park
| | - Andrea M Yevchak
- College of Nursing, The Pennsylvania State University, University Park
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Abstract
Research suggests that school climate can have a great impact on student, teacher, and school outcomes. However, it is often assessed as a summary measure, without taking into account multiple perspectives (student, teacher, parent) or examining subdimensions within the broader construct. In this study, we assessed school climate from the perspective of students, staff, and parents within a large, urban school district using multilevel modeling techniques to examine within- and between-school variance. After adjusting for school-level demographic characteristics, students reported worse perceptions of safety and connectedness compared to both parent and staff ratings (all p < 0.05). Parents gave the lowest ratings of parental involvement, and staff gave the lowest ratings of academic emphasis (ps < 0.05). Findings demonstrate the importance of considering the type of informant when evaluating climate ratings within a school. Understanding how perceptions differ between informants can inform interventions to improve perceptions and prevent adverse outcomes.
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Affiliation(s)
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
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Ramsey CM, Parisi JM, Rebok GW, Gross A, Tanner EK, Carlson MC, Seeman TE, Roth DL, Spira AP. Attendance and Retention of Older Adults in School-Based Volunteer Activities: The Role of School Climate. Journal of Intergenerational Relationships 2016. [DOI: 10.1080/15350770.2016.1138274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zahodne LB, Meyer OL, Choi E, Thomas ML, Willis SL, Marsiske M, Gross AL, Rebok GW, Parisi JM. External locus of control contributes to racial disparities in memory and reasoning training gains in ACTIVE. Psychol Aging 2015; 30:561-72. [PMID: 26237116 DOI: 10.1037/pag0000042] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [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]
Abstract
Racial disparities in cognitive outcomes may be partly explained by differences in locus of control. African Americans report more external locus of control than non-Hispanic Whites, and external locus of control is associated with poorer health and cognition. The aims of this study were to compare cognitive training gains between African American and non-Hispanic White participants in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study and determine whether racial differences in training gains are mediated by locus of control. The sample comprised 2,062 (26% African American) adults aged 65 and older who participated in memory, reasoning, or speed training. Latent growth curve models evaluated predictors of 10-year cognitive trajectories separately by training group. Multiple group modeling examined associations between training gains and locus of control across racial groups. Compared to non-Hispanic Whites, African Americans evidenced less improvement in memory and reasoning performance after training. These effects were partially mediated by locus of control, controlling for age, sex, education, health, depression, testing site, and initial cognitive ability. African Americans reported more external locus of control, which was associated with smaller training gains. External locus of control also had a stronger negative association with reasoning training gain for African Americans than for Whites. No racial difference in training gain was identified for speed training. Future intervention research with African Americans should test whether explicitly targeting external locus of control leads to greater cognitive improvement following cognitive training.
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Affiliation(s)
- Laura B Zahodne
- Cognitive Neuroscience Division, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University
| | - Oanh L Meyer
- Alzheimer's Disease Center, Department of Neurology, University of California, Davis
| | - Eunhee Choi
- School of Social Work, Health and Human Sciences, Colorado State University
| | | | - Sherry L Willis
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida
| | - Alden L Gross
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
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Gruenewald TL, Tanner EK, Fried LP, Carlson MC, Xue QL, Parisi JM, Rebok GW, Yarnell LM, Seeman TE. The Baltimore Experience Corps Trial: Enhancing Generativity via Intergenerational Activity Engagement in Later Life. J Gerontol B Psychol Sci Soc Sci 2015; 71:661-70. [PMID: 25721053 DOI: 10.1093/geronb/gbv005] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [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: 07/29/2014] [Accepted: 12/22/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Being and feeling generative, defined as exhibiting concern and behavior to benefit others, is an important developmental goal of midlife and beyond. Although a growing body of evidence suggests mental and physical health benefits of feeling generative in later life, little information exists as to the modifiability of generativity perceptions. The present study examines whether participation in the intergenerational civic engagement program, Experience Corps (EC), benefits older adults' self-perceptions of generativity. METHOD Levels of generativity were compared in older adults randomized to serve as EC volunteers or controls (usual volunteer opportunities) in the Baltimore Experience Corps Trial at 4-, 12-, and 24-month evaluation points over the 2-year trial. Analyses utilized intention-to-treat and complier average causal effects (CACE) analyses which incorporate degree of intervention exposure in analytic models. RESULTS Participants randomized to the EC group had significantly higher levels of generative desire and perceptions of generative achievement than controls at each follow-up point; CACE analyses indicate a dose-response effect with a greater magnitude of intervention effect with greater exposure to the EC program. DISCUSSION Results provide the first-ever, large-scale experimental demonstration that participation in an intergenerational civic engagement program can positively alter self-perceptions of generativity in older adulthood.
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Affiliation(s)
- Tara L Gruenewald
- Davis School of Gerontology, University of Southern California, Los Angeles.
| | - Elizabeth K Tanner
- Department of Community-Public Health at the Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Linda P Fried
- Mailman School of Public Health, Columbia University, New York, New York
| | - Michelle C Carlson
- Departments of Mental Health and Epidemiology, Johns Hopkins University, Baltimore, Maryland
| | - Qian-Li Xue
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins University, Baltimore, Maryland
| | - George W Rebok
- Department of Mental Health, Johns Hopkins University, Baltimore, Maryland
| | - Lisa M Yarnell
- American Institutes for Research, Washington, District of Columbia
| | - Teresa E Seeman
- Department of Medicine, Division of Geriatrics, Geffen School of Medicine, University of California, Los Angeles
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Parisi JM, Kuo J, Rebok GW, Xue QL, Fried LP, Gruenewald TL, Huang J, Seeman TE, Roth DL, Tanner EK, Carlson MC. Increases in lifestyle activities as a result of experience Corps® participation. J Urban Health 2015; 92:55-66. [PMID: 25378282 PMCID: PMC4338117 DOI: 10.1007/s11524-014-9918-z] [Citation(s) in RCA: 34] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Experience Corps® (EC) was designed to simultaneously increase cognitive, social, and physical activity through high-intensity volunteerism in elementary school classrooms. It is, therefore, highly likely that EC participation may alter pre-existing patterns of lifestyle activity. This study examined the impact of "real-world" volunteer engagement on the frequency of participation in various lifestyle activities over a 2-year period. Specifically, we examined intervention-related changes on reported activity levels at 12 and 24 months post-baseline using Intention-to-Treat (ITT) and Complier Average Causal Effect (CACE) analyses, which account for the amount of program exposure. ITT analyses indicated that, compared to the control group, EC participants reported modest increases (approximately half a day/month) in overall activity level, especially in intellectual and physical activities 12 months post-baseline. Increases in activity were not found at the 24-month assessment. CACE models revealed similar findings for overall activity as well as for intellectual and physical activities at 12 months. Additionally, CACE findings suggested modest increases in social activity at 12 months and in intellectual and passive activities at 24 months post-baseline. This community-based, health promotion intervention has the potential to impact lifestyle activity, which may lead to long-term increases in activity and to other positive cognitive, physical, and psychosocial health outcomes.
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Affiliation(s)
- Jeanine M Parisi
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA,
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Hill NL, Lin FV, Parisi JM, Kolanowski A. The Moderating Effect of Personality Type on the Relationship between Leisure Activity and Executive Control in Older Adults. Act Adapt Aging 2015; 39:153-176. [PMID: 27087715 PMCID: PMC4833400 DOI: 10.1080/01924788.2015.1025659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We examined the moderating effect of personality on the association between leisure activities and executive control in healthy community-dwelling older adults. We found two distinct personality typologies: individuals with a Resilient personality were characterized by emotional stability and self-confidence; whereas, those who resembled an Overcontrolled personality tended to be introverted, but also low on neuroticism. Resilient individuals were more likely than Overcontrolled individuals to demonstrate higher executive function and attention as a result of participation in mental activities. These results suggest that personality might be important to include in studies that test the efficacy of activity interventions for improving cognition.
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Affiliation(s)
- Nikki L. Hill
- College of Nursing, The Pennsylvania State University
| | - Feng Vankee Lin
- School of Nursing and School of Medicine and Dentistry, University of Rochester
| | - Jeanine M. Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
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Spira AP, Kaufmann CN, Kasper JD, Ohayon MM, Rebok GW, Skidmore E, Parisi JM, Reynolds CF. Association between insomnia symptoms and functional status in U.S. older adults. J Gerontol B Psychol Sci Soc Sci 2015; 69 Suppl 1:S35-41. [PMID: 25342821 DOI: 10.1093/geronb/gbu116] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [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: 01/18/2023] Open
Abstract
OBJECTIVES We studied the association between insomnia symptoms and late-life functioning, including physical capacity, limitations in household activities, and participation in valued activities. METHODS Participants were 6,050 adults independent in self-care activities from a representative sample of older Medicare beneficiaries. They completed objective measures of physical capacity and self-report measures of insomnia symptoms, help and difficulty with household activities, and participation in valued activities. RESULTS After adjustment, insomnia symptoms were associated with a greater odds of receiving help or having difficulty with selected household activities (laundry, shopping), greater odds of help or difficulty with ≥ 1 household activity [1 symptom vs. 0, odds ratio (OR)=1.27, p < .05; 2 symptoms vs. 0, OR = 1.35, p < .01), and of restricted participation in specific valued activities (attending religious services, going out for enjoyment) and in ≥ 1 valued activity (1 symptom vs. 0, OR = 1.29, p < .05; 2 symptoms vs. 0, OR = 1.50, p < .01). There was no independent association between insomnia symptoms and physical capacity. DISCUSSION Among older adults, insomnia symptoms are associated with a greater odds of limitation in household activities and of restricted participation in valued activities. Insomnia interventions may improve functioning and quality of life among elders.
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Affiliation(s)
- Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland.
| | - Christopher N Kaufmann
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Judith D Kasper
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Maurice M Ohayon
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
| | - Elizabeth Skidmore
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennysylvania
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh Medical Center and Graduate School of Public Health, Pittsburgh, Pennysylvania
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Stine-Morrow EAL, Payne BR, Roberts BW, Kramer AF, Morrow DG, Payne L, Hill PL, Jackson JJ, Gao X, Noh SR, Janke MC, Parisi JM. Training versus engagement as paths to cognitive enrichment with aging. Psychol Aging 2014; 29:891-906. [PMID: 25402337 DOI: 10.1037/a0038244] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
While a training model of cognitive intervention targets the improvement of particular skills through instruction and practice, an engagement model is based on the idea that being embedded in an intellectually and socially complex environment can impact cognition, perhaps even broadly, without explicit instruction. We contrasted these 2 models of cognitive enrichment by randomly assigning healthy older adults to a home-based inductive reasoning training program, a team-based competitive program in creative problem solving, or a wait-list control. As predicted, those in the training condition showed selective improvement in inductive reasoning. Those in the engagement condition, on the other hand, showed selective improvement in divergent thinking, a key ability exercised in creative problem solving. On average, then, both groups appeared to show ability-specific effects. However, moderators of change differed somewhat for those in the engagement and training interventions. Generally, those who started either intervention with a more positive cognitive profile showed more cognitive growth, suggesting that cognitive resources enabled individuals to take advantage of environmental enrichment. Only in the engagement condition did initial levels of openness and social network size moderate intervention effects on cognition, suggesting that comfort with novelty and an ability to manage social resources may be additional factors contributing to the capacity to take advantage of the environmental complexity associated with engagement. Collectively, these findings suggest that training and engagement models may offer alternative routes to cognitive resilience in late life.
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Affiliation(s)
| | - Brennan R Payne
- Department of Educational Psychology, University of Illinois
| | - Brent W Roberts
- Department of Educational Psychology, University of Illinois
| | - Arthur F Kramer
- Department of Educational Psychology, University of Illinois
| | - Daniel G Morrow
- Department of Educational Psychology, University of Illinois
| | - Laura Payne
- Department of Educational Psychology, University of Illinois
| | | | | | - Xuefei Gao
- Psychology of Language Department, Max Planck Institute for Psycholinguistics
| | - Soo Rim Noh
- Creative Design Institute, Sungkyunkwan University
| | - Megan C Janke
- Department of Recreation and Leisure Studies, East Carolina University
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Parisi JM, Franchetti MK, Rebok GW, Spira AP, Carlson MC, Willis SL, Gross AL. Depressive symptoms and inductive reasoning performance: findings from the ACTIVE reasoning training intervention. Psychol Aging 2014; 29:843-51. [PMID: 25244465 DOI: 10.1037/a0037670] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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]
Abstract
Within the context of the Advanced Cognitive Training for Independent and Vital Elderly study (ACTIVE; Ball et al., 2002; Jobe et al., 2001; Willis et al., 2006), we examined the longitudinal association of baseline depressive symptoms on inductive reasoning performance over a 10-year period between the reasoning training and control conditions (N = 1,375). At baseline, 322 participants (23%) reported elevated depressive symptoms, defined by a score ≥9 on the 12-item version of the Center for Epidemiological Studies Depression Scale (CES-D; Mirowsky & Ross, 2003; Radloff, 1977). Differences in baseline depressive status were not associated with immediate posttraining gains or with subsequent annual change in reasoning performance, suggesting that the presence of elevated baseline depressive symptoms does not impact the ability to benefit from reasoning training.
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Affiliation(s)
- Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | | | - George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Sherry L Willis
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
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Chen-Edinboro LP, Kaufmann CN, Augustinavicius JL, Mojtabai R, Parisi JM, Wennberg AMV, Smith MT, Spira AP. Neighborhood physical disorder, social cohesion, and insomnia: results from participants over age 50 in the Health and Retirement Study. Int Psychogeriatr 2014; 27:1-8. [PMID: 25222023 PMCID: PMC4362806 DOI: 10.1017/s1041610214001823] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [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: 02/01/2023]
Abstract
ABSTRACT Background: We determined the association between neighborhood socio-environmental factors and insomnia symptoms in a nationally representative sample of US adults aged >50 years. Methods: Data were analyzed from two waves (2006 and 2010) of the Health and Retirement Study using 7,231 community-dwelling participants (3,054 men and 4,177 women) in the United States. Primary predictors were neighborhood physical disorder (e.g. vandalism/graffiti, feeling safe alone after dark, and cleanliness) and social cohesion (e.g. friendliness of people, availability of help when needed, etc.); outcomes were insomnia symptoms (trouble falling asleep, night awakenings, waking too early, and feeling unrested). Results: After adjustment for age, income, race, education, sex, chronic diseases, body mass index, depressive symptoms, smoking, and alcohol consumption, each one-unit increase in neighborhood physical disorder was associated with a greater odds of trouble falling asleep (odds ratio (OR) = 1.09, 95% confidence interval (CI): 1.04-1.14), waking too early (OR = 1.05, 95% CI: 1.00-1.10), and, in adults aged ≥69 years (adjusting for all variables above except age), feeling unrested in the morning (OR = 1.11, 95% CI: 1.02-1.22 in 2006). Each one-unit increase in lower social cohesion was associated with a greater odds of trouble falling asleep (OR = 1.06, 95% CI: 1.01-1.11) and feeling unrested (OR = 1.09, 95% CI: 1.04-1.15). Conclusions: Neighborhood-level factors of physical disorder and social cohesion are associated with insomnia symptoms in middle-aged and older adults. Neighborhood-level factors may affect sleep, and consequently health, in our aging population.
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Affiliation(s)
- Lenis P Chen-Edinboro
- Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
| | - Christopher N Kaufmann
- Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
| | - Jura L Augustinavicius
- Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
| | - Ramin Mojtabai
- Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
| | - Jeanine M Parisi
- Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
| | - Alexandra M V Wennberg
- Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
| | - Michael T Smith
- Department of Psychiatry and Behavioral Sciences,Johns Hopkins School of Medicine,Baltimore,Maryland,USA
| | - Adam P Spira
- Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
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42
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Hock RS, Lee HB, Bienvenu OJ, Nestadt G, Samuels JF, Parisi JM, Costa PT, Spira AP. Personality and cognitive decline in the Baltimore Epidemiologic Catchment Area follow-up study. Am J Geriatr Psychiatry 2014; 22:917-25. [PMID: 23759291 PMCID: PMC4130898 DOI: 10.1016/j.jagp.2012.12.217] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 05/07/2012] [Revised: 12/11/2012] [Accepted: 12/14/2012] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To determine the association between personality domains and 11-year cognitive decline in a sample from a population-based study. METHOD Data from Waves 3 (1993-1996) and 4 (2003-2004) of the Baltimore cohort of the Epidemiologic Catchment Area (ECA) study were used for analyses. The sample included 561 adults (mean age ± SD: 45.2 ± 10.78 years) who completed the NEO Personality Inventory-Revised prior to Wave 4. Participants also completed the Mini-Mental State Examination (MMSE) and immediate and delayed word recall tests at Wave 3, and at Wave 4, 10.9 ± 0.6 years later. RESULTS In models adjusted for baseline cognitive performance, demographic characteristics, medical conditions, depressive symptoms, and psychotropic medication use, each 10-point increase in Neuroticism T-scores was associated with a 0.15-point decrease in MMSE scores (B = -0.15, 95% confidence interval [CI]: -0.30, -0.01), whereas each 10-point increase in Conscientiousness T-scores was associated with a 0.18-point increase on the MMSE (B = 0.18, 95% CI: 0.04, 0.32) and a 0.21-point increase in immediate recall (B = 0.21, 95% CI: 0.003, 0.41) between baseline and follow-up. CONCLUSION Findings suggest that greater Neuroticism is associated with decline, and greater Conscientiousness is associated with improvement in performance on measures of general cognitive function and memory in adults. Further studies are needed to determine the extent to which personality traits in midlife are associated with clinically significant cognitive outcomes in older adults, such as mild cognitive impairment and dementia, and to identify potential mediators of the association between personality and cognitive trajectories.
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Affiliation(s)
- Rebecca S. Hock
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health
| | | | - O. Joseph Bienvenu
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health,Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences
| | - Gerald Nestadt
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health,Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences
| | - Jack F. Samuels
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health,Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences
| | - Jeanine M. Parisi
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health
| | - Paul T. Costa
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health,Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences
| | - Adam P. Spira
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health
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Parisi JM, Xia J, Spira AP, Xue QL, Rieger ML, Rebok GW, Carlson MC. The Association Between Lifestyle Activities and Late-Life Depressive Symptoms. Act Adapt Aging 2014; 38:1-10. [PMID: 24683285 DOI: 10.1080/01924788.2014.878871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The association between lifestyle activities and incident depressive symptoms was examined within the Women's Health and Aging Study II. Measures of activity and depressive symptoms were collected on four occasions, spanning six-years. Discrete-time Cox proportional hazards models were employed to examine the effects of baseline activity on depressive symptoms over time. Overall, activity was not associated with incident depressive symptoms. When specific activity domains were examined, greater participation in creative activities was associated with a reduced risk of depressive symptoms (hazard ratio = 0.92; CI 95% 0.87, 0.98). Further longitudinal research between diverse activities and incident depressive symptoms is warranted.
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Affiliation(s)
- Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Jin Xia
- Johns Hopkins University School of Medicine and Johns Hopkins Center on Aging and Health, Baltimore, MD
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Qian-Li Xue
- Johns Hopkins University School of Medicine and Johns Hopkins Center on Aging and Health, Baltimore, MD
| | | | - George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, and Johns Hopkins Center on Aging and Health, Baltimore, MD
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, and Johns Hopkins Center on Aging and Health, Baltimore, MD
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44
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Varma VR, Carlson MC, Parisi JM, Tanner EK, McGill S, Fried LP, Song LH, Gruenewald TL. Experience Corps Baltimore: Exploring the Stressors and Rewards of High-intensity Civic Engagement. Gerontologist 2014; 55:1038-49. [PMID: 24589989 DOI: 10.1093/geront/gnu011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 09/06/2013] [Accepted: 01/28/2014] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Experience Corps (EC) represents a high-intensity, intergenerational civic engagement activity where older adults serve as mentors and tutors in elementary schools. Although high-intensity volunteer opportunities are designed to enhance the health and well being of older adult volunteers, little is known about the negative and positive aspects of volunteering unique to intergenerational programs from the volunteer's perspective. DESIGN AND METHODS Stressors and rewards associated with volunteering in EC were explored in 8 focus group discussions with 46 volunteers from EC Baltimore. Transcripts were coded for frequently expressed themes. RESULTS Participants reported stressors and rewards within 5 key domains: intergenerational (children's problem behavior, working with and helping children, observing/facilitating improvement or transformation in a child, and developing a special connection with a child); external to EC (poor parenting and children's social stressors); interpersonal (challenges in working with teachers and bonding/making social connections); personal (enjoyment, self-enhancement/achievement, and being/feeling more active); and structural (satisfaction with the structural elements of the EC program). IMPLICATIONS Volunteers experienced unique intergenerational stressors related to children's problem behavior and societal factors external to the EC program. Overall, intergenerational, interpersonal, and personal rewards from volunteering, as well as program structure may have balanced the stress associated with volunteering. A better understanding of stressors and rewards from high-intensity volunteer programs may enhance our understanding of how intergenerational civic engagement volunteering affects well being in later life and may inform project modifications to maximize such benefits for future volunteers and those they serve.
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Affiliation(s)
- Vijay R Varma
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Sylvia McGill
- The Greater Homewood Community Corporation, Baltimore, Maryland
| | - Linda P Fried
- Mailman School of Public Health, Columbia University, New York
| | - Linda H Song
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Tara L Gruenewald
- Davis School of Gerontology, University of Southern California, Los Angeles
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Payne BR, Gross AL, Parisi JM, Sisco SM, Stine-Morrow EAL, Marsiske M, Rebok GW. Modelling longitudinal changes in older adults' memory for spoken discourse: findings from the ACTIVE cohort. Memory 2013; 22:990-1001. [PMID: 24304364 DOI: 10.1080/09658211.2013.861916] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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: 12/13/2022]
Abstract
Episodic memory shows substantial declines with advancing age, but research on longitudinal trajectories of spoken discourse memory (SDM) in older adulthood is limited. Using parallel process latent growth curve models, we examined 10 years of longitudinal data from the no-contact control group (N = 698) of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomised controlled trial in order to test (1) the degree to which SDM declines with advancing age, (2) the predictors of these age-related declines and (3) the within-person relationship between longitudinal changes in SDM and longitudinal changes in fluid reasoning and verbal ability over 10 years, independent of age. Individuals who were younger, were White, had more years of formal education, were male and had better global cognitive function and episodic memory performance at baseline demonstrated greater levels of SDM on average. However, only age at baseline uniquely predicted longitudinal changes in SDM, such that declines accelerated with greater age. Independent of age, within-person decline in reasoning ability over the 10-year study period was substantially correlated with decline in SDM (r = .87). An analogous association with SDM did not hold for verbal ability. The findings suggest that longitudinal declines in fluid cognition are associated with reduced spoken language comprehension. Unlike findings from memory for written prose, preserved verbal ability may not protect against developmental declines in memory for speech.
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Affiliation(s)
- Brennan R Payne
- a Department of Educational Psychology , Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign , Champaign , IL , USA
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Rebok GW, Langbaum JBS, Jones RN, Gross AL, Parisi JM, Spira AP, Kueider AM, Petras H, Brandt J. Memory training in the ACTIVE study: how much is needed and who benefits? J Aging Health 2012; 25:21S-42S. [PMID: 23103452 DOI: 10.1177/0898264312461937] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [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]
Abstract
OBJECTIVE AND METHOD Data from the memory training arm (n = 629) of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial were examined to characterize change in memory performance through 5 years of follow-up as a function of memory training, booster training, adherence to training, and other characteristics. RESULTS Latent growth model analyses revealed that memory training was associated with improved memory performance through Year 5 but that neither booster training nor training adherence significantly influenced this effect. Baseline age was associated with change in memory performance attributable to the passage of time alone (i.e., to aging). Higher education and better self-rated health were associated with greater change in memory performance after training. DISCUSSION These findings confirm that memory training can aid in maintaining long-term improvements in memory performance. Booster training and adherence to training do not appear to attenuate rates of normal age-related memory decline.
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Affiliation(s)
- George W Rebok
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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47
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Lohman MC, Rebok GW, Spira AP, Parisi JM, Gross AL, Kueider AM. Depressive symptoms and memory performance among older adults: results from the ACTIVE memory training intervention. J Aging Health 2012; 25:209S-29S. [PMID: 23006426 DOI: 10.1177/0898264312460573] [Citation(s) in RCA: 27] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cognitive performance benefits from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study may differ for individuals who exhibit a greater number of depressive symptoms. METHOD Using data from ACTIVE memory training and control conditions, we evaluated the effect of depressive symptomatology on memory scores across a 5-year period. Of 1,401 participants, 210 had elevated depressive symptoms at baseline, as measured by a 12-item version of the Center for Epidemiological Studies-Depression Scale (CES-D). RESULTS Participants with elevated depressive symptoms scored significantly lower at baseline and had faster decline in memory performance than those exhibiting fewer depressive symptoms. Memory score differences among depressive symptom categories did not differ between training conditions. DISCUSSION Findings suggest that elevated depressive symptoms may predict declines in memory ability over time, but do not attenuate gains from training. Training provides a potential method of improving memory which is robust to effects of depression.
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48
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Parisi JM, Rebok GW, Xue QL, Fried LP, Seeman TE, Tanner EK, Gruenewald TL, Frick KD, Carlson MC. The role of education and intellectual activity on cognition. J Aging Res 2012; 2012:416132. [PMID: 22928110 PMCID: PMC3423895 DOI: 10.1155/2012/416132] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 06/14/2012] [Accepted: 06/24/2012] [Indexed: 11/18/2022] Open
Abstract
Although educational attainment has been consistently related to cognition in adulthood, the mechanisms are still unclear. Early education, and other social learning experiences, may provide the skills, knowledge, and interest to pursue intellectual challenges across the life course. Therefore, cognition in adulthood might reflect continued engagement with cognitively complex environments. Using baseline data from the Baltimore Experience Corps Trial, multiple mediation models were applied to examine the combined and unique contributions of intellectual, social, physical, creative, and passive lifestyle activities on the relationship between education and cognition. Separate models were tested for each cognitive outcome (i.e., reading ability, processing speed, memory). With the exception of memory tasks, findings suggest that education-cognition relations are partially explained by frequent participation in intellectual activities. The association between education and cognition was not completely eliminated, however, suggesting that other factors may drive these associations.
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Affiliation(s)
- Jeanine M. Parisi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - George W. Rebok
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Johns Hopkins Center on Aging and Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Qian-Li Xue
- Johns Hopkins Center on Aging and Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Linda P. Fried
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Teresa E. Seeman
- David Geffen School of Medicine, University of California at Los Angeles, CA 90095, USA
| | - Elizabeth K. Tanner
- Johns Hopkins Center on Aging and Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Johns Hopkins School of Nursing, Baltimore, MD 21205, USA
| | - Tara L. Gruenewald
- Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Kevin D. Frick
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Michelle C. Carlson
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Johns Hopkins Center on Aging and Health, Johns Hopkins University, Baltimore, MD 21205, USA
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Abstract
A systematic review to examine the efficacy of computer-based cognitive interventions for cognitively healthy older adults was conducted. Studies were included if they met the following criteria: average sample age of at least 55 years at time of training; participants did not have Alzheimer's disease or mild cognitive impairment; and the study measured cognitive outcomes as a result of training. Theoretical articles, review articles, and book chapters that did not include original data were excluded. We identified 151 studies published between 1984 and 2011, of which 38 met inclusion criteria and were further classified into three groups by the type of computerized program used: classic cognitive training tasks, neuropsychological software, and video games. Reported pre-post training effect sizes for intervention groups ranged from 0.06 to 6.32 for classic cognitive training interventions, 0.19 to 7.14 for neuropsychological software interventions, and 0.09 to 1.70 for video game interventions. Most studies reported older adults did not need to be technologically savvy in order to successfully complete or benefit from training. Overall, findings are comparable or better than those from reviews of more traditional, paper-and-pencil cognitive training approaches suggesting that computerized training is an effective, less labor intensive alternative.
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Affiliation(s)
- Alexandra M Kueider
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
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50
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Abstract
A systematic review to examine the efficacy of computer-based cognitive interventions for cognitively healthy older adults was conducted. Studies were included if they met the following criteria: average sample age of at least 55 years at time of training; participants did not have Alzheimer's disease or mild cognitive impairment; and the study measured cognitive outcomes as a result of training. Theoretical articles, review articles, and book chapters that did not include original data were excluded. We identified 151 studies published between 1984 and 2011, of which 38 met inclusion criteria and were further classified into three groups by the type of computerized program used: classic cognitive training tasks, neuropsychological software, and video games. Reported pre-post training effect sizes for intervention groups ranged from 0.06 to 6.32 for classic cognitive training interventions, 0.19 to 7.14 for neuropsychological software interventions, and 0.09 to 1.70 for video game interventions. Most studies reported older adults did not need to be technologically savvy in order to successfully complete or benefit from training. Overall, findings are comparable or better than those from reviews of more traditional, paper-and-pencil cognitive training approaches suggesting that computerized training is an effective, less labor intensive alternative.
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Affiliation(s)
- Alexandra M Kueider
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
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