Antidepressant Use and Cognitive Decline: The Health and Retirement Study

Abstract Relationship status is thought to be associated with cognitive health in older adults, with married persons performing better on memory assessments than unmarried-cohabitating, single, divorced, and widowed persons. However, questions remain about whether relationship termination causes cognitive decline, is a result of it, or whether they share a cause; and the mechanisms by which such a relationship might operate. To address this gap in the literature, we hypothesized that relationship termination could affect cognition via the following five pathways: (1) post-termination depression; (2) loss of distributed-cognition partner; (3) cognitive depletion from caring for partner in declining and ultimately terminal health; (4) divorce to preserve assets to qualify for Medicaid to cover healthcare for cognitive decline; and (5) post-termination changes in neuropsychiatric symptoms alongside a pre-existing neurodegenerative condition that also causes cognitive decline. Using data from the 2000–2016 waves of the Health and Retirement Study (HRS; N = 23,393), we found that relationship termination, whether due to divorce or widowhood, was associated with cognitive decline. Using mixed-effects regression we found that the rate of cognitive decline increased after relationship termination (widowhood: □ = -0.587, p <0.001; divorce: □ = -0.221, p <0.001), supporting mechanism (5). Using HRS data for respondents and their spouses’ mental and physical health, health insurance, and activities of daily living, we also find support for mechanisms (1) and (3). Relationship termination is a critical juncture in a person’s life course that has multiple implications and may, ultimately, worsen patients’ conditions.

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Associations Between Self-Reported Sensory Impairment and Risk of Cognitive Decline and Impairment in the Health and Retirement Study Cohort

The Journals of Gerontology Series B ◽

10.1093/geronb/gbz043 ◽

2019 ◽

Vol 75 (6) ◽

pp. 1230-1242 ◽

Cited By ~ 13

Author(s):

Asri Maharani ◽

Piers Dawes ◽

James Nazroo ◽

Gindo Tampubolon ◽

Neil Pendleton ◽

...

Keyword(s):

Cognitive Decline ◽

Visual Impairment ◽

Hearing Impairment ◽

Health And Retirement Study ◽

Study Cohort ◽

Sensory Impairment ◽

Cox Proportional Hazard ◽

Adjusted Incidence ◽

Retirement Study ◽

Dual Sensory Impairment

Abstract Objectives We aimed to determine whether self-assessed single (hearing or visual) and dual sensory (hearing and visual) impairments are associated with cognitive decline and incident possible cognitive impairment, no dementia (CIND) and probable dementia. Method Data were drawn from the 1996–2014 surveys of the Health and Retirement Study (HRS), involving 19,618 respondents who had no probable dementia and who were aged 50 years or older at the baseline. We used linear mixed models to test the association between self-assessed sensory impairment and cognitive decline followed by a Cox proportional hazard model to estimate the relative risk of incident possible CIND and probable dementia associated with the presence of sensory impairment. Results Respondents with self-assessed single and dual sensory impairment performed worse in cognitive tests than those without sensory impairment. The fully adjusted incidence of developing possible CIND was 17% higher for respondents with hearing impairment than those without hearing impairment. Respondents with visual impairment had 35% and 25% higher risk for developing possible CIND and probable dementia, respectively, than those without visual impairment. Respondents with dual sensory impairment at baseline were 38% and 26% more likely to develop possible CIND and probable dementia, respectively, than those with no sensory impairment. Discussion Self-assessed sensory impairment is independently associated with cognitive decline and incident possible CIND and probable dementia. Further studies are needed to identify the mechanism underlying this association and to determine whether treatment of sensory impairment could ameliorate cognitive decline and delay the onset of dementia among older adults.

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Cognitive Performance Trajectories Before and After Sleep Treatment Initiation in Middle-Aged and Older Adults: Results from the Health and Retirement Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glab164 ◽

2021 ◽

Author(s):

Christopher N Kaufmann ◽

Mark W Bondi ◽

Wesley K Thompson ◽

Adam P Spira ◽

Sonia Ancoli-Israel ◽

...

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Sleep Disturbance ◽

Cognitive Performance ◽

Treatment Initiation ◽

Health And Retirement Study ◽

Middle Aged ◽

Before And After ◽

Sleep Treatment ◽

Retirement Study

Abstract BACKGROUND Sleep disturbances are associated with risk of cognitive decline but it is not clear if treating disturbed sleep mitigates decline. We examined differences in cognitive trajectories before and after sleep treatment initiation. METHODS Data came from the 2006-2014 Health and Retirement Study. At each of five waves, participants were administered cognitive assessments and scores were summed. Participants also reported if, in prior two weeks, they had taken medications or used other treatments to improve sleep. Our sample (N=3,957) included individuals who at HRS 2006 were >50 years, had no cognitive impairment, reported no sleep treatment, and indicated experiencing sleep disturbance. We identified differences between those receiving vs. not receiving treatment in subsequent waves, and among those treated (N=1,247), compared cognitive trajectories before and after treatment. RESULTS At baseline, those reporting sleep treatment at subsequent waves were more likely to be younger, female, Caucasian, to have more health conditions, to have higher BMI, and more depressive symptoms (all p’s≤0.015). Decline in cognitive performance was mitigated in periods after sleep treatment vs. periods before (B=-0.20, 95% CI=-0.25, -0.15, p<0.001; vs., B=-0.26, 95% CI=-0.32, -0.20, p<0.001), and this same trend was seen for self-initiated and doctor-recommended treatments. Trends were driven by those with higher baseline cognitive performance—those with lower performance saw cognitive declines following sleep treatment. CONCLUSIONS In middle-aged and older adults with sleep disturbance, starting sleep treatment may slow cognitive decline. Future research should assess types, combinations, and timing of treatments most effective in improving cognitive health in later life.

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A Markov Chain Model for the Dynamics of Cognitive Decline in an Elderly USA Population Using Data from the Health and Retirement Study

The International Journal of Aging and Society ◽

10.18848/2160-1909/cgp/v02i03/35171 ◽

2013 ◽

Vol 2 (3) ◽

pp. 9-21

Author(s):

Gerardo Soto-Campos ◽

Andrew Pavelyev ◽

Carlos A. Soto

Keyword(s):

Markov Chain ◽

Cognitive Decline ◽

Markov Chain Model ◽

Health And Retirement Study ◽

Chain Model ◽

Using Data ◽

Retirement Study

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Abstract P288: Association Between Vision Impairment and Cognitive Decline in Older Adults With Stroke: Health and Retirement Study

Stroke ◽

10.1161/str.52.suppl_1.p288 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Kimberly Hreha ◽

Brian Downer ◽

Joshua R Ehrlich ◽

Giulio Taglialatela

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Cognitive Decline ◽

Visual Impairment ◽

Vision Impairment ◽

Health And Retirement Study ◽

Stroke Survivors ◽

Fair Poor ◽

Retirement Study ◽

Good Vision

Introduction: Nearly 800,000 people in the United States sustain a stroke each year. Up to 60% of stroke survivors have visual impairments and/or ocular deficits, which may negatively impact functional performance, quality of life, and increase the risk for depression. Poor vision has been associated with cognitive decline in older adults, but little is known if vision impairment is a risk factor for cognitive decline among older adults who have survived a stroke. The purpose of this study was to evaluate the association between vision impairment and cognitive decline among stroke survivors and compare the cognitive trajectories of stroke survivors with and without visual impairment. Methods: We used data from four waves (2010-2016) of the Health and Retirement Study to investigate the cognitive health of stroke survivors with and without visual impairment. Vision (excellent-very good [ref], good, fair-poor) and stroke diagnosis were self-reported. Cognition was measured using the Telephone Interview for Cognitive Status. Linear mixed effects regression was used to model the association between overall, near, and far vision and change in cognitive function, adjusting for confounders. Results: The final sample included 1,475 stroke survivors. A majority were female (55.6%) and white (66.3%) and the mean age was 71.0 (11.7). Fair-poor overall ( B =-1.30, p <0.01), near ( B =-1.53, p <0.001), and far ( B =-1.27, p <0.001) vision, as well as good near ( B =-0.82, p <0.001) and far ( B =-0.48, p <0.05) vision were associated with significantly lower baseline cognitive function compared to excellent-very good vision. The association between self-rated vision and cognition decline was not statistically significant. Conclusions: We found that people with worst vision had lower cognitive functioning but not greater cognitive decline than stroke survivors with excellent-to-very good vision. Further research should investigate if specific types of vision impairment potentiate the risk of cognitive impairment and dementia in stroke survivors.

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