The Moderating Role of Race and Ethnicity in the Association Between Cognitive Performance and Functional Abilities in Later Life

This study examined ethnic/racial influences on the relationship of cognitive performance and functional abilities of 2,713 older individuals from the National Health and Nutrition Examination Survey (NHANES). Functional domains included activities of daily living (ADL), instrumental ADL, and leisure and social activities. In adjusted logistic regression models, low cognitive performance as assessed by the Digit Symbol Substitution Test was found significantly associated with functional limitation in each domain. However, moderation analysis revealed that being Hispanic and non-Hispanic Black may weaken this association demonstrating protective effects of underrepresented ethnic/racial status. Future studies should investigate perceived discrimination and resilience.

Is Acculturation Associated with the Cognitive Performance of Older Hispanics?

BACKGROUND

Hispanics in the United Statues are disproportionately affected by Alzheimer's disease and related dementias. Little is known about the impact of acculturation on cognitive performance.

OBJECTIVE

This study examined the association between acculturation and cognitive performance among older Hispanics.

METHODS

We analyzed cross-sectional data of 616 Hispanic participants in the National Health and Nutrition Examination Survey (NHANES) 2011-2014 [average age = 67.15 years, %Female = 51.46, %less than high-school graduate = 52.60]. Cognitive performance was measured by two neuropsychological tests: Animal Fluency Test (AFT) and Digit Symbol Substitution Test (DSST). We used two single-item proxy measures to quantify acculturation: nativity status (non-US-born residing <  15 years in the US (low acculturation), non-US-born residing ≥15 years in the US, and US-born (high acculturation)); and language acculturation (only/mostly Spanish (low acculturation), Spanish and English, only/mostly English (high acculturation)). We used adjusted linear regression to evaluate associations between acculturation and cognitive performance.

RESULTS

Results indicated poorer cognitive performance among the low-acculturated groups for both nativity and linguistic measures. Participants who were non-US-born living ≥15 years (p = 0.02) and speaking only/mostly Spanish or Spanish and English (p = 0.01 and 0.006 respectively) had significantly lower AFT scores compared to US-born and only/mostly English-speaking groups. Participants who were non-US-born living <  15 years (p <  0.0001) or non-US-born living ≥15 years (p <  0.0001) and speaking only/mostly Spanish (p = 0.0008) scored lower on the DSST than the US-born and only/mostly English-speaking participants.

CONCLUSION

In summary, low acculturation is associated with poorer cognitive performance among older Hispanics. Acculturation might be an important attribute to help understand cognitive decline and dementias among Hispanics.

The Association of Family Eating Behaviors With Children's Cognitive Functioning: A Cross-Sectional Study Among 3–6-Year-Old Mexican Children

Objectives

Little is known about the association of family eating behaviors with young children's cognitive development, particularly among non-White populations. The objective of this study is to determine if healthier family eating behaviors are associated with young Mexican children's cognitive functioning.

Methods

We used cross-sectional data from a convenience sample of low-income child-mother dyads recruited from a public preschool in San Luis Potosi, S.L.P., Mexico. Using the Family Nutrition and Physical Activity (FNPA) questionnaire, mothers were asked to report the frequency of ten family eating behaviors (e.g., frequency of breakfast intake, family mealtimes, etc.). Children completed two cognitive tests: a working memory test of their ability to recall four words after a timed distraction (i.e., delayed recall); and a verbal fluency test, examined with a 60-second trial of word retrieval in response to “things people eat”. The associations of family eating behaviors with children's working memory and verbal fluency were examined using multiple linear regression models adjusting for child sex, age, mother's age, education, and subjective socioeconomic status.

Results

Study included 85 child-mother dyads; children's ages ranged from 3 to 6 years (4.58 ± 0.58) and mothers from 19 to 55 years (30.92 ± 8.49). Children had a mean working memory score of 2.24 ± 0.99 words recalled and retrieved a mean of 20.06 ± 5.26 words in the verbal fluency tests. Higher frequency of breakfast intake was associated with higher working memory scores (β = 0.56, P = 0.013). No other family eating practices were significantly associated with children's working memory. Children's verbal fluency scores were not significantly associated with family eating practices.

Conclusions

Frequent breakfast intake was associated with young children's memory maintenance. Future research is needed to examine the mechanisms through which breakfast intake could benefit children's neurodevelopmental health.

Funding Sources

This study was supported by the training grant “Illinois Transdisciplinary Obesity Prevention Program (I-TOPP)” funded by the National Institute of Food and Agriculture, United States Department of Agriculture (USDA) and support from the NIDDK.

Role of Community Health Workers in Addressing Dementia: A Scoping Review and Global Perspective

The current increase in global dementia prevalence deserves public health intervention. While limited access to health care and a shortage of health care workers are significant shortcomings, utilizing community health workers (CHWs) could be a promising way to improve dementia care through cost-effective approaches. This scoping review synthesizes existing research on roles of CHWs in dementia-related services. PubMed, CINAHL, Scopus, CABI Global Health, Web of Science, PsycINFO, and Cochrane Library were searched from inception to October 2, 2019, and yielded 1,594 articles. Five broad areas emerged as potential roles of CHWs from 10 eligible articles: educational and community awareness, screening for dementia, screening for HIV-associated dementia, utilization of health care systems and other dementia-related resources by patients, and services to dementia caregivers. This scoping review sheds light on important contributions of CHWs in addressing dementia among vulnerable communities/groups around the world.