Positive Psychosocial Factors and Cognition in Ethnically Diverse Older Adults

AbstractObjectives: Cross-sectional and longitudinal evidence from largely non-Hispanic White cohorts suggests that positive psychosocial factors, particularly self-efficacy and social support, may protect against late-life cognitive decline. Identifying potentially protective factors in racial/ethnic minority elders is of high importance due to their increased risk of Alzheimer’s disease. The overall goal of this study was to characterize cross-sectional associations between positive psychosocial factors and cognitive domains among Black, Hispanic, and White older adults. Methods: A total of 548 older adults (41% Black, 28% Hispanic, 31% White) in the Washington Heights-Inwood Columbia Aging Project completed cognitive and psychosocial measures from the NIH Toolbox and standard neuropsychological tests. Multiple-group regressions were used to compare cross-sectional associations between positive psychosocial factors and cognition across racial/ethnic groups, independent of demographics, depressive symptoms, and physical health. Results: Positive associations between self-efficacy and language did not significantly differ across race/ethnicity, although the bivariate association between self-efficacy and language was not significant among Hispanics. Additional positive associations were observed for Whites and Blacks, but not Hispanics. Negative associations between emotional support and purpose in life and working memory were seen only in Hispanics. Conclusions: Results confirm and extend the link between self-efficacy and cognition in late life, particularly for White and Black older adults. Previous studies on positive psychosocial factors in cognitive aging may not be generalizable to Hispanics. Longitudinal follow-up is needed to determine whether negative relationships between certain psychosocial factors and cognition in Hispanics reflect reverse causation, threshold effects, and/or negative aspects of having a strong social network. (JINS, 2018, 24, 294–304)

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Socioeconomic and Psychosocial Mechanisms Underlying Racial and Ethnic Disparities in Cognition Among Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.2829 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 782-782

Author(s):

Laura Zahodne ◽

Neika Sharifian ◽

A Zarina Kraal ◽

Emily Morris ◽

Afsara Zaheed ◽

...

Keyword(s):

Older Adults ◽

Psychosocial Factors ◽

Cognitive Aging ◽

Perceived Control ◽

Ethnic Disparities ◽

Psychosocial Risk Factor ◽

Socioeconomic Indicators ◽

Cross Sectional ◽

Racial Ethnic ◽

Hispanic White

Abstract Racial/ethnic disparities in cognitive aging are only partly attributable to socioeconomic indicators. Emerging literature highlights psychosocial factors, such as related constructs of discrimination and perceived control. Using data from 1,463 older adults (51% Hispanic, 27% non-Hispanic Black, 22% non-Hispanic White) in the Washington Heights-Inwood Columbia Aging Project, cross-sectional mediation models quantified separate indirect effects of Black race and Hispanic ethnicity on global cognitive composite scores. Socioeconomic status explained approximately 50% of Black-White and Hispanic-White disparities in cognition. Perceived control explained an additional 5-8%. Discrimination was not associated with cognition. Significant racial/ethnic disparities remained after accounting for the included socioeconomic and psychosocial factors, indicating that future studies should consider additional potential mediators. Lower perceived control, which likely reflects chronic exposure to interpersonal and institutional marginalization, may be a particularly salient psychosocial risk factor for poorer cognitive aging among certain racial/ethnic minority groups.

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Positive Psychosocial Factors and Cognitive Decline in Ethnically Diverse Older Adults

Journal of the International Neuropsychological Society ◽

10.1017/s1355617720000648 ◽

2020 ◽

pp. 1-10

Author(s):

Laura B. Zahodne ◽

Neika Sharifian ◽

Ann Zarina Kraal ◽

Ketlyne Sol ◽

Afsara B. Zaheed ◽

...

Keyword(s):

Older Adults ◽

Longitudinal Study ◽

Episodic Memory ◽

Cognitive Decline ◽

Ethnic Groups ◽

Psychosocial Factors ◽

Disease Risk ◽

Late Life ◽

Cross Sectional ◽

Standard Deviation Increase

Abstract Objectives: Previous cross-sectional studies have documented associations between positive psychosocial factors, such as self-efficacy and emotional support, and late-life cognition. Further, the magnitudes of concurrent associations may differ across racial and ethnic groups that differ in Alzheimer’s disease risk. The goals of this longitudinal study were to characterize prospective associations between positive psychosocial factors and cognitive decline and explicitly test for differential impact across race and ethnicity. Methods: 578 older adults (42% non-Hispanic Black, 31% non-Hispanic White, and 28% Hispanic) in the Washington Heights-Inwood Columbia Aging Project completed cognitive and psychosocial measures from the NIH Toolbox and standard neuropsychological tests over 2.4 years. Latent difference scores were used to model associations between positive psychosocial factors and cognitive decline controlling for baseline cognition, sociodemographics, depressive symptoms, physical health, and other positive psychosocial factors. Multiple-group modeling was used to test interactions between the positive psychosocial factors and race/ethnicity. Results: Higher NIH Toolbox Friendship scores predicted less episodic memory decline. One standard deviation increase in friendship corresponded to 6 fewer years of memory aging. This association did not significantly differ across racial/ethnic groups. Conclusions: This longitudinal study provides support for the potential importance of friendships for subsequent episodic memory trajectories among older adults from three ethnic groups. Further study into culturally informed interventions is needed to investigate whether and how friend networks may be targeted to promote cognitive health in late life.

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Social Engagement and Episodic Memory in Non-Hispanic Black and White Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1101 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 343-343

Author(s):

Abbey Hamlin ◽

A Zarina Kraal ◽

Laura Zahodne

Keyword(s):

Social Support ◽

Older Adults ◽

Episodic Memory ◽

Cognitive Aging ◽

Social Engagement ◽

Future Research ◽

Social Activities ◽

Linear Regression Models ◽

Significant Positive Association ◽

Cross Sectional

Abstract Social engagement may confer cognitive benefits in older adulthood, but studies have typically been restricted to largely non-Hispanic White (NHW) samples. Levels of social engagement vary across race such that NHW report larger social networks, more frequent participation in social activities, and greater social support than non-Hispanic Blacks (NHB). Associations between social engagement and cognition may also vary by race, but research is sparse. The current cross-sectional study examined associations between different aspects of social engagement and episodic memory performance, as well as interactions between social engagement and race among NHB and NHW participants in the Michigan Cognitive Aging Project (N = 247; 48.4% NHB; age = 64.19 ± 2.92). Social engagement (network size, activities, support) was self-reported. Episodic memory was a z-score composite of immediate, delayed, and recognition trials of a list-learning task. Separate hierarchical linear regression models quantified interactions between race and each of the three social engagement variables on episodic memory, controlling for sociodemographics, depressive symptoms, and health conditions. Results showed a main effect of more frequent social activity on better episodic memory, as well as an interaction between race and social support indicating a significant positive association in NHB but not NHW. These preliminary findings suggest that participating in social activities may be equally beneficial for episodic memory across NHB and NHW older adults and that social support may be particularly beneficial for NHB. Future research is needed to determine the potential applications of these results in reducing cognitive inequalities through the development of culturally-relevant interventions.

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What is the impact of multimorbidity on the risk of hospitalisation in older adults? A systematic review study protocol

BMJ Open ◽

10.1136/bmjopen-2021-049974 ◽

2021 ◽

Vol 11 (6) ◽

pp. e049974

Author(s):

Luciana Pereira Rodrigues ◽

Andréa Toledo de Oliveira Rezende ◽

Letícia de Almeida Nogueira e Moura ◽

Bruno Pereira Nunes ◽

Matias Noll ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Study Protocol ◽

Average Length ◽

Length Of Hospital Stay ◽

Case Control Studies ◽

Cross Sectional ◽

Increased Risk ◽

Review Study ◽

The Impact

IntroductionThe development of multiple coexisting chronic diseases (multimorbidity) is increasing globally, along with the percentage of older adults affected by it. Multimorbidity is associated with the concomitant use of multiple medications, a greater possibility of adverse effects, and increased risk of hospitalisation. Therefore, this systematic review study protocol aims to analyse the impact of multimorbidity on the occurrence of hospitalisation in older adults and assess whether this impact changes according to factors such as sex, age, institutionalisation and socioeconomic status. This study will also review the average length of hospital stay and the occurrence of hospital readmission.Methods and analysisA systematic review of the literature will be carried out using the PubMed, Embase and Scopus databases. The inclusion criteria will incorporate cross-sectional, cohort and case–control studies that analysed the association between multimorbidity (defined as the presence of ≥2 and/or ≥3 chronic conditions and complex multimorbidity) and hospitalisation (yes/no, days of hospitalisation and number of readmissions) in older adults (aged ≥60 years or >65 years). Effect measures will be quantified, including ORs, prevalence ratios, HRs and relative risk, along with their associated 95% CI. The overall aim of this study is to widen knowledge and to raise reflections about the association between multimorbidity and hospitalisation in older adults. Ultimately, its findings may contribute to improvements in public health policies resulting in cost reductions across healthcare systems.Ethics and disseminationEthical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete.PROSPERO registration numberCRD42021229328.

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Gender Differences in Phytoestrogens and the Relationship with Speed of Processing in Older Adults: A Cross-Sectional Analysis of NHANES, 1999–2002

Nutrients ◽

10.3390/nu11081780 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1780 ◽

Cited By ~ 1

Author(s):

Alwerdt ◽

Patterson ◽

Sliwinski

Keyword(s):

Older Adults ◽

Gender Differences ◽

Cognitive Aging ◽

Linear Models ◽

Speed Of Processing ◽

Cross Sectional ◽

Health And Nutrition ◽

Performance Results ◽

Sectional Analysis ◽

The Relationship

Sex hormone changes in adults are known to play a part in aging, including cognitive aging. Dietary intake of phytoestrogens can mimic estrogenic effects on brain function. Since sex hormones differ between genders, it is important to examine gender differences in the phytoestrogen–cognition association. Therefore, the goal of this study is to examine the relationship between urinary phytoestrogens and speed of processing (SOP) and the variation of the association between genders in older adults. Participants were drawn from the 1999–2002 National Health and Nutrition Examination Survey and included 354 individuals aged 65–85 years old. General linear models (GLMs) were used to test for significant gender differences in the relationship between phytoestrogens and SOP. Results from the GLMs showed significant gender differences in the relationship between genistein and SOP. Higher levels of genistein were associated with better SOP in women. This relationship was reversed in men: higher genistein levels were associated with worse performance. Results indicate that there are distinct gender differences in the relationship between genistein and SOP. These results emphasize the importance of considering gender differences when devising dietary and pharmacologic interventions that target phytoestrogens to improve brain health.

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Vascular lesions and functional limitations among older adults: does depression make a difference?

International Psychogeriatrics ◽

10.1017/s1041610214000829 ◽

2014 ◽

Vol 26 (9) ◽

pp. 1501-1509 ◽

Cited By ~ 5

Author(s):

Celia F. Hybels ◽

Carl F. Pieper ◽

Lawrence R. Landerman ◽

Martha E. Payne ◽

David C. Steffens

Keyword(s):

Risk Factors ◽

Older Adults ◽

White Matter ◽

Functional Impairment ◽

Functional Limitations ◽

Late Life ◽

Cognitive Status ◽

Cerebral White Matter ◽

Late Life Depression ◽

Increased Risk

ABSTRACTBackground:The association between disability and depression is complex, with disability well established as a correlate and consequence of late life depression. Studies in community samples report that greater volumes of cerebral white matter hyperintensities (WMHs) seen on brain imaging are linked with functional impairment. These vascular changes are also associated with late life depression, but it is not known if depression is a modifier in the relationship between cerebrovascular changes and functional impairment.Methods:The study sample was 237 older adults diagnosed with major depression and 140 never depressed comparison adults, with both groups assessed at study enrollment. The dependent variable was the number of limitations in basic activities of daily living (ADL), instrumental ADLs, and mobility tasks. The independent variable was the total volume of cerebral white matter lesions or hyperintensities assessed though magnetic resonance imaging.Results:In analyses controlling for age, sex, race, high blood pressure, and cognitive status, a greater volume of WMH was positively associated with the total number of functional limitations as well as the number of mobility limitations among those older adults with late life depression but not among those never depressed, suggesting the association between WMH volume and functional status differs in the presence of late life depression.Conclusions:These findings suggest older patients with both depression and vascular risk factors may be at an increased risk for functional decline, and may benefit from management of both cerebrovascular risk factors and depression.

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Dual Effects of Hearing Loss and Dementia on Functional Limitations in Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.690 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 214-214

Author(s):

Michael McKee ◽

Yunshu Zhou ◽

Joshua Ehrlich ◽

Elham Mahmoudi ◽

Jennifer Deal ◽

...

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Self Care ◽

Household Activity ◽

Cross Sectional ◽

Age Related ◽

Increased Risk ◽

Lower Mobility ◽

Independent Effects ◽

The Impact

Abstract Age-related hearing loss (HL) is both common and associated with elevated risk for cognitive decline and poorer health. To care for an aging population, it is critical to understand the effect of coexisting HL and dementia on functional activities. The effect of co-existing dementia and self-reported HL on daily functioning were assessed. A cross-sectional analysis was performed using nationally-representative data from the 2015 National Health and Aging Trends Study consisting of U.S. adults 65+. The sample included 1,829 adults with HL (22.8%) and 5,338 adults without HL. Multivariable Poisson regression was used to model the independent effects and interaction of self-reported HL and dementia status on three validated functional activity scales (self-care, mobility, and household). All analyses adjusted for sociodemographic and medical factors. HL participants were more likely to be white, older, male, less educated (p <0.01). 8.4% had possible dementia and 6.5% had probable dementia. Respondents with HL or possible or probable dementia had significantly lower mobility, self-care, and household activity scores (p<.001 for all comparisons) compared to their peers. A small yet significant interaction was present in all models, suggesting that HL respondents with co-occurring dementia had lower mobility, self-care, and household activity scores than predicted by the independent effects of dementia and self-reported HL (p<.001 for all comparisons). Older adults with co-occurring dementia and HL are at increased risk for poor functioning and should be screened by healthcare providers. Future work should consider the impact of intervention in this vulnerable/at-risk population.

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Love Hurts: The Influence of Social Relations on Exercise Self-Efficacy for Older Adults with Osteoarthritis

Journal of Aging and Physical Activity ◽

10.1123/japa.16.4.465 ◽

2008 ◽

Vol 16 (4) ◽

pp. 465-483 ◽

Cited By ~ 8

Author(s):

Kelly A. Cotter ◽

Aurora M. Sherman

Keyword(s):

Social Support ◽

Older Adults ◽

Social Relations ◽

Self Efficacy ◽

Structural Equation ◽

Physical Activity Behavior ◽

Well Being ◽

Equation Model ◽

Cross Sectional ◽

Social Strain

Exercise self-efficacy is a powerful predictor of physical activity behavior, which enhances health and well-being for older adults. Social relations have been proposed as influential precursors for exercise self-efficacy. In a longitudinal study of 160 older adults with osteoarthritis (76.9% women), the authors found that social support (but not social strain) significantly predicted exercise self-efficacy in a structural equation model examining cross-sectional data: χ2(178, N = 160) = 264.57, p < .01; RMSEA = .06; CFI = .92; TLI = .90. When data were examined longitudinally, however, social strain (but not social support) significantly predicted lower exercise self-efficacy 1 year later: χ2(233, N = 160) = 288.64, p < .01; RMSEA = .04; CFI = .96; TLI = .95. Results support the negativity effect, suggesting that social strain might be the more potent aspect of social relations and should be the target of interventions.

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Which Psychosocial Factors Best Predict Cognitive Performance in Older Adults?

Journal of the International Neuropsychological Society ◽

10.1017/s1355617714000186 ◽

2014 ◽

Vol 20 (5) ◽

pp. 487-495 ◽

Cited By ~ 21

Author(s):

Laura B. Zahodne ◽

Cindy J. Nowinski ◽

Richard C. Gershon ◽

Jennifer J. Manly

Keyword(s):

Older Adults ◽

Working Memory ◽

Negative Affect ◽

Cognitive Decline ◽

Psychosocial Factors ◽

Processing Speed ◽

Emotional Support ◽

Self Efficacy ◽

Equation Modeling ◽

Psychosocial Variables

AbstractNegative affect (e.g., depression) is associated with accelerated age-related cognitive decline and heightened dementia risk. Fewer studies examine positive psychosocial factors (e.g., emotional support, self-efficacy) in cognitive aging. Preliminary reports suggest that these variables predict slower cognitive decline independent of negative affect. No reports have examined these factors in a single model to determine which best relate to cognition. Data from 482 individuals 55 and older came from the normative sample for the NIH Toolbox for the Assessment of Neurological and Behavioral Function. Negative and positive psychosocial factors, executive functioning, working memory, processing speed, and episodic memory were measured with the NIH Toolbox Emotion and Cognition modules. Confirmatory factor analysis and structural equation modeling characterized independent relations between psychosocial factors and cognition. Psychosocial variables loaded onto negative and positive factors. Independent of education, negative affect and health status, greater emotional support was associated with better task-switching and processing speed. Greater self-efficacy was associated with better working memory. Negative affect was not independently associated with any cognitive variables. Findings support the conceptual distinctness of negative and positive psychosocial factors in older adults. Emotional support and self-efficacy may be more closely tied to cognition than other psychosocial variables. (JINS, 2014, 20, 1–9)

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SOCIAL ENGAGEMENT OF FRAIL ELDERS

Journal of Frailty & Aging ◽

10.14283/jfa.2012.29 ◽

2012 ◽

pp. 1-6

Author(s):

A. BARUSCH ◽

D.L. WATERS

Keyword(s):

Older Adults ◽

Self Efficacy ◽

Social Engagement ◽

Functional Independence ◽

Personal Attributes ◽

Social Activities ◽

Cross Sectional ◽

Frail Older Adults ◽

Home Based ◽

Home Based Care

Background:Social isolation is a significant problem for frail older adults and the determinants ofsocial engagement are poorly understood. Objectives:This study explored the social engagement of frail eldersto identify personal attributes associated with social engagement. Design, Setting and Participants:A cross-sectional sample of seventy-three people receiving home-based care in one town on the South Island of NewZealand (mean age 82 (7.2) yrs, n=51 Females, 21 Males). Measurements:Face-to-face semi-structuredinterviews and questionnaires. Functional independence was measured using Nottingham Extended Activities ofDaily Living (EADL), self-efficacy by General Self Efficacy Scale, and 2 open-ended questions were piloted onsocial activities and helping others. Results:Regression models identified two statistically associatedcomponents of social engagement: social activities and civic involvement. Contributions to families andcommunity organizations and exercise were important social activities. Personal attributes included perceivedfunctional independence and self-efficacy. Conclusions:In frail older adults, a measurement of socialengagement should address activities older adults identify as important, including exercise. Independence, self -efficacy, and social engagement may interact in reinforcing cycles of empowerment and could play a role indeveloping interventions to retain and maintain function in frail older adults.

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