CARDIOVASCULAR DISEASE AND CUMULATIVE INCIDENCE OF COGNITIVE IMPAIRMENT: LONGITUDINAL FINDINGS FROM THE HEALTH AND RETIREMENT STUDY

Abstract Background We sought to examine whether people with a diagnosis of cardiovascular disease (CVD) experienced a greater incidence of subsequent cognitive impairment (CI) compared to people without CVD, as suggested by prior studies, using a large longitudinal cohort. Methods We employed Health and Retirement Study (HRS) data collected biennially from 1998 to 2014 in 1305 U.S. adults age ≥ 65 newly diagnosed with CVD vs. 2610 age- and gender-matched controls. Diagnosis of CVD was adjudicated with an established HRS methodology and included self-reported coronary heart disease, angina, heart failure, myocardial infarction, or other heart conditions. CI was defined as a score < 11 on the 27-point modified Telephone Interview for Cognitive Status. We examined incidence of CI over an 8-year period using a cumulative incidence function accounting for the competing risk of death. Results Mean age at study entry was 73 years, 55% were female, and 13% were non-white. Cognitive impairment developed in 1029 participants over 8 years. The probability of death over the study period was greater in the CVD group (19.8% vs. 13.8%, absolute difference 6.0, 95% confidence interval 2.2 to 9.7%). The cumulative incidence analysis, which adjusted for the competing risk of death, showed no significant difference in likelihood of cognitive impairment between the CVD and control groups (29.7% vs. 30.6%, absolute difference − 0.9, 95% confidence interval − 5.6 to 3.7%). This finding did not change after adjusting for relevant demographic and clinical characteristics using a proportional subdistribution hazard regression model. Conclusions Overall, we found no increased risk of subsequent CI among participants with CVD (compared with no CVD), despite previous studies indicating that incident CVD accelerates cognitive decline.

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Cardiovascular Disease and Cumulative Incidence of Cognitive Impairment in The Health and Retirement Study

10.21203/rs.3.rs-123071/v1 ◽

2020 ◽

Author(s):

Allyson Covello ◽

Leora Horwitz ◽

Shreya Singhal ◽

Caroline Blaum ◽

Yi Li ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cognitive Impairment ◽

Cumulative Incidence ◽

Cognitive Status ◽

Competing Risk ◽

Health And Retirement Study ◽

Risk Of Death ◽

Increased Risk ◽

Significant Difference ◽

Retirement Study

Abstract Background: We sought to examine whether people with a diagnosis of cardiovascular disease (CVD) experienced a greater incidence of subsequent cognitive impairment (CI) compared to people without CVD, as suggested by prior studies, using a large longitudinal cohort. Methods: We employed Health and Retirement Study (HRS) data collected biennially from 1998-2014 in 1,305 U.S. adults age ≥65 newly diagnosed with CVD vs. 2,610 age- and gender-matched controls. Diagnosis of CVD was adjudicated with an established HRS methodology and included self-reported coronary heart disease, angina, heart failure, myocardial infarction, or other heart conditions. CI was defined as a score <11 on the 27-point modified Telephone Interview for Cognitive Status. We examined incidence of CI over an 8-year period using a cumulative incidence function accounting for the competing risk of death.Results: Mean age at study entry was 73 years, 55% were female, and 13% were non-white. Cognitive impairment developed in 1,029 participants over 8 years. The probability of death over the study period was greater in the CVD group (19.8% vs. 13.8%, p <.001). The cumulative incidence analysis, which adjusted for the competing risk of death, showed no significant difference in likelihood of cognitive impairment between the CVD and control groups (29.7% vs. 30.6%, p = 0.64). This finding did not change after adjusting for relevant demographic and clinical characteristics using a proportional subdistribution hazard regression model.Conclusions: Overall, we found no increased risk of subsequent CI among participants with CVD (compared with no CVD), despite previous studies indicating that incident CVD accelerates cognitive decline.

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Same-Sex Couples and Cognitive Impairment: Evidence From the Health and Retirement Study

The Journals of Gerontology Series B ◽

10.1093/geronb/gbaa202 ◽

2020 ◽

Author(s):

Hui Liu ◽

Ning Hsieh ◽

Zhenmei Zhang ◽

Yan Zhang ◽

Kenneth M Langa

Keyword(s):

Cognitive Impairment ◽

The United States ◽

Population Based ◽

Cognitive Status ◽

Health And Retirement Study ◽

Sex Partners ◽

Physical And Mental Health ◽

Same Sex ◽

Same Sex Couples ◽

Retirement Study

Abstract Objectives We provide the first nationally representative population-based study of cognitive disparities among same-sex and different-sex couples in the United States. Methods We analyzed data from the Health and Retirement Study (2000–2016). The sample included 23,669 respondents (196 same-sex partners and 23,473 different-sex partners) aged 50 and older who contributed to 85,117 person-period records (496 from same-sex partners and 84,621 from different-sex partners). Cognitive impairment was assessed using the modified version of the Telephone Interview for Cognitive Status. Mixed-effects discrete-time hazard regression models were estimated to predict the odds of cognitive impairment. Results The estimated odds of cognitive impairment were 78% (p < .01) higher for same-sex partners than for different-sex partners. This disparity was mainly explained by differences in marital status and, to a much lesser extent, by differences in physical and mental health. Specifically, a significantly higher proportion of same-sex partners than different-sex partners were cohabiting rather than legally married (72.98% vs. 5.42% in the study sample), and cohabitors had a significantly higher risk of cognitive impairment than their married counterparts (odds ratio = 1.53, p < .001). Discussion The findings indicate that designing and implementing public policies and programs that work to eliminate societal homophobia, especially among older adults, is a critical step in reducing the elevated risk of cognitive impairment among older same-sex couples.

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Effect of cognitive impairment on risk of death in Hispanic/Latino adults over the age of 50 residing in the United States with and without diabetes: Data from the Health and Retirement Study 1995–2014

Alzheimer s & Dementia ◽

10.1002/alz.12521 ◽

2021 ◽

Author(s):

Martin Martinez ◽

Aprill Z. Dawson ◽

Kevin Lu ◽

Rebekah J. Walker ◽

Leonard E. Egede

Keyword(s):

United States ◽

Cognitive Impairment ◽

The United States ◽

Health And Retirement Study ◽

Risk Of Death ◽

Latino Adults ◽

Retirement Study

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Job Stress and Incidence of Cardiovascular Disease among Older Workers in the Health and Retirement Study

American Journal of Epidemiology ◽

10.1093/aje/163.suppl_11.s215-a ◽

2006 ◽

Vol 163 (suppl_11) ◽

pp. S215-S215

Author(s):

J Li ◽

J Grosch ◽

T Alterman

Keyword(s):

Cardiovascular Disease ◽

Job Stress ◽

Older Workers ◽

Health And Retirement Study ◽

Retirement Study

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A non-APOE Polygenic score for Alzheimer’s disease and APOE-ε4 have independent associations with dementia in the Health and Retirement Study

10.1101/2020.02.10.20021667 ◽

2020 ◽

Author(s):

Kelly M. Bakulski ◽

Harita S. Vadari ◽

Jessica D. Faul ◽

Steven G. Heeringa ◽

Sharon LR Kardia ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Cognitive Impairment ◽

Genetic Risk ◽

Population Based ◽

Health And Retirement Study ◽

Polygenic Score ◽

Genetic Region ◽

Apoe Ε4 ◽

Normal Cognition ◽

Retirement Study

AbstractINTRODUCTIONAlzheimer’s disease (AD) is a common and costly neurodegenerative disorder. A large proportion of risk is heritable and many genetic risk factors for AD have been identified. The cumulative genetic risk of known markers has not been benchmarked for dementia in a population-based sample.METHODSIn the United States population-based Health and Retirement Study (HRS) (waves 1995-2014), we evaluated the role of cumulative genetic risk for AD, with and without the APOE-ε4 alleles, on dementia status (dementia, cognitive impairment without dementia, borderline cognitive impairment without dementia, cognitively normal). We used logistic regression, accounting for demographic covariates and genetic principal components, and analyses were stratified by European and African genetic ancestry.RESULTSIn the European ancestry sample (n=8399), both AD polygenic score excluding the APOE genetic region (odds ratio (OR)=1.10; 95% confidence interval (CI): 1.00, 1.20) and the presence of any APOE-ε4 alleles (OR=2.42; 95% CI: 1.99, 2.95) were associated with the odds of dementia relative to normal cognition in a mutually-adjusted model. In the African ancestry sample (n=1605), the presence of any APOE-ε4 alleles was associated with 1.77 (95% CI: 1.20, 2.61) times higher odds of dementia, while the AD polygenic score excluding the APOE genetic region was not significantly associated with the odds of dementia relative to normal cognition 1.06 (95% CI: 0.97, 1.30).DISCUSSIONCumulative genetic risk for AD and APOE-ε4 are both independent predictors of dementia. This study provides important insight into the polygenic nature of dementia and demonstrates the utility of polygenic scores in dementia research.

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Time-Varying Insomnia Symptoms and Incidence of Cognitive Impairment and Dementia among Older US Adults

Innovation in Aging ◽

10.1093/geroni/igab046.2464 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 656-656

Author(s):

Nicholas Resciniti ◽

Matthew Lohman ◽

Bezawit Kase ◽

Valerie Yelverton

Keyword(s):

Cognitive Impairment ◽

Sleep Disturbances ◽

Proportional Hazards ◽

Assessment Tool ◽

Cox Proportional Hazards ◽

Health And Retirement Study ◽

Time Varying ◽

Symptom Index ◽

Insomnia Symptoms ◽

Retirement Study

Abstract There is conflicting evidence regarding the association between insomnia and the onset of mild cognitive impairment (MCI) or dementia. This study aimed to evaluate if time-varying insomnia is associated with the development of MCI and dementia. Data from the Health and Retirement Study (n = 13,833) from 2002 to 2014 were used (59.4% female). The Brief Insomnia Questionnaire was used to identify insomnia symptoms compiled in an insomnia severity index, ranging from 0 to 4. In the analysis, participants’ symptoms could vary from wave-to-wave. Dementia was defined using results from the Health and Retirement Study (HRS) global cognitive assessment tool. Respondents were classified as either having dementia, MCI or being cognitively healthy. Cox proportional hazards models with time-dependent exposure using the counting process (start-stop time) were used for analysis. For each one-unit increase in the insomnia symptom index, there was a 5-percent greater hazard of MCI (HR = 1.05; 95% CI: 1.04–1.06) and dementia (HR = 1.05; 95% CI: 1.03–1.05), after fully adjusting. Using a nationally representative sample of adults aged 51 and older, this study found that time-varying insomnia symptoms are associated with the risk of MCI and dementia. This highlights the importance of identifying sleep disturbances and their change over time as potentially important risk factors for MCI and dementia.

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ASSOCIATION BETWEEN FRAILTY AND DEVELOPMENT OF COGNITIVE IMPAIRMENT: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.2521 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S683-S683

Author(s):

Nicholas V Resciniti ◽

Jaleel McNiel ◽

Matthew Lohman

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Smoking Status ◽

Health And Retirement Study ◽

Health Issues ◽

Frailty Status ◽

Early Markers ◽

Phenotype Model ◽

Nationally Representative ◽

Retirement Study

Abstract Research has shown there is currently an increasing prevalence of cognitive impairment and dementia in older adults. To date, there remains a paucity of research to explain this increase and research on early markers and risk factors are warranted. This study aims to assess the association of cognitively normal older adults who are frail and the development of cognitive impairment four years later. Data from the Health and Retirement Study – a nationally representative sample of older US adults – was used from 2004-2008 for individuals 65 and older (n=8,377). Frailty was categorized by using Fried’s phenotype model: individuals were grouped into frail, pre-frail, and robust. Cognitive impairment – a composite score that assessed memory recall and global mental status – was classified as scoring eight or less on a 35-point scale. After restricting to cognitively healthy individuals, logistic regression with weights was used to assess the association between frailty status and the development of cognitive impairment four years later. The model was adjusted for baseline age, gender, race, education years, smoking status, and chronic health issues (high blood pressure, diabetes, cancer, lung disease, heart disease, stroke, psychiatric problems, and arthritis). Frail individuals, compared to those who were robust, had increased odds of cognitive impairment (OR=1.74; 95% CI: 1.48-2.16), after fully adjusting. Evidence from this study suggest that frail individuals are more likely to become cognitively impaired over time. This provides a potential pathway of intervention to help delay or prevent the development of cognitive impairment in older US adults.

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