scholarly journals Sleep Difficulties and Cognition for 10 Years in a National Sample of U.S. Older Adults

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Rebecca Robbins ◽  
Amanda Sonnega ◽  
Robert W Turner ◽  
Girardin Jean-Louis ◽  
Mark Butler ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
The United States ◽  
Early Morning ◽  
Sleep Difficulty ◽  
Waking Up ◽  
Time Varying Covariates ◽  
The Relationship ◽  
Sleep Difficulties ◽  
Over Time

Abstract Background and Objectives Sleep difficulties are common among older adults and are associated with cognitive decline. We used data from a large, nationally representative longitudinal survey of adults aged older than 50 in the United States to examine the relationship between specific sleep difficulties and cognitive function over time. Research Design and Methods Longitudinal data from the 2004–2014 waves of the Health and Retirement Study were used in the current study. We examined sleep difficulties and cognitive function within participants and across time (n = 16 201). Sleep difficulty measures included difficulty initiating sleep, nocturnal awakenings, early morning awakenings, and waking up feeling rested from rarely/never (1) to most nights (3). The modified Telephone Interview for Cognitive Status was used to measure cognitive function. Generalized linear mixed models were used with time-varying covariates to examine the relationship between sleep difficulties and cognitive function over time. Results In covariate-adjusted models, compared to “never” reporting sleep difficulty, difficulty initiating sleep “most nights” was associated with worse cognitive function over time (Year 2014: b = −0.40, 95% CI: −0.63 to −0.16, p < .01) as was difficulty waking up too early “most nights” (Year 2014: b = −0.31, 95% CI: −0.56 to −0.07, p < .05). In covariate-adjusted analyses, compared to “never” reporting waking up feeling rested, cognitive function was higher among those who reported waking up feeling rested “some nights” (Year 2010: b = 0.21, 95% CI: 0.02 to 0.40, p < .05). Discussion and Implications Our findings highlight an association between early morning awakenings and worse cognitive function, but also an association between waking up feeling rested and better cognitive function over time.

scholarly journals COGNITIVE IMPAIRMENT AND SLEEP DIFFICULTIES OVER 10 YEARS IN A NATIONAL SAMPLE OF OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S453-S453
Author(s):  
Rebecca Robbins ◽  
Amanda Sonnega ◽  
Robert W Turner II ◽  
Girardin Jean-Louis ◽  
Kenneth Langa
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Functioning ◽  
Summary Score ◽  
Linear Regression Models ◽  
Sleep Difficulty ◽  
Falling Asleep ◽  
Nationally Representative ◽  
Sleep Difficulties ◽  
Over Time

Abstract Prior studies suggest that sleep difficulties (e.g., trouble falling asleep) may be associated with cognitive impairment. We used a large, nationally representative longitudinal survey of adults over the age of 50 in the US to examine the relationship between sleep difficulties and cognitive functioning. Generalized estimation equation (GEE) linear regression models were used to analyze data from the 2004-2014 waves of the Health and Retirement Study. We examined sleep difficulties and cognitive functioning within participants and across time (n=17,642). Sleep difficulty was measured as trouble falling asleep, nocturnal awakenings, and waking too early scored as 1= rarely/never, 2=sometimes, and 3=most of the time. A summary score indicated cognitive functioning (range 0-27). Models controlled for age, gender, race/ethnicity, marital status, education, chronic medical conditions, depressive symptoms, and body mass index (BMI). Compared to those with no sleep difficulties, those who reported difficulty falling asleep [“sometimes” OR=0.83,95%CI:0.71-0.96 and “most of the time” OR=0.79,95%CI: 0.64-0.98] and waking too early [“most of the time” OR=0.79,95%CI: 0.63-0.98] had worse cognitive functioning. Compared to those with no sleep difficulties, those who reported nocturnal awakenings [“most of the time” OR=1.29,95%CI:1.08-1.54] had higher cognitive functioning. Over time, lower cognitive function was more likely among those reporting difficulty falling asleep (OR=0.73,95%CI:0.54-0.97), nocturnal awakenings (OR=0.77,95%CI:0.61-0.97) and waking too early (OR=0.65,95%CI: 0.47-0.88). In this nationally representative, longitudinal sample of older US adults, we found that over time lower cognitive function was more likely among those who reported difficulty falling asleep, nocturnal awakenings, and waking too early.

scholarly journals THE BIDIRECTIONAL RELATIONSHIP BETWEEN AGING IN PLACE AND COGNITIVE FUNCTIONING OVER TIME

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S414-S414
Author(s):  
Jonathan Platt ◽  
Yvonne Michael ◽  
Gina Lovasi ◽  
Andrea Rosso
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Functioning ◽  
Aging In Place ◽  
Cardiovascular Health Study ◽  
Residential Stability ◽  
Bidirectional Relationship ◽  
Time Varying Covariates ◽  
Over Time

Abstract Residential stability (aging in place) in older adults may be either supportive or detrimental to cognitive aging, and may be dynamic over time. Using residential histories of 3608 older adults in the Cardiovascular Health Study, this study seeks to estimate the potentially bidirectional relationship between residential change and cognitive functioning. Residential data were recorded and georeferenced annually, and the Modified Mini-Mental State Examination assessed global cognitive functioning. Marginal structural models will be used to assess the effect of residential and cognitive exposures over time, in the presence of time-varying covariates that may act as confounders and mediators at different time points. We hypothesize that residential stability will have a bidirectional relationship with cognitive functioning over time. Aging in place will be associated with higher cognitive function during follow-up, and predict longer dementia-free survival. In turn, time to residential relocation during follow-up will be shorter among those with lower cognitive function.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

2018 ◽  
pp. 220-236
Author(s):  
Elliot Friedman ◽  
Beth LeBreton ◽  
Lindsay Fuzzell ◽  
Elizabeth Wehrpsann
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Outcomes ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Quality Of Life Research ◽  
Increased Risk ◽  
Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

scholarly journals Last Place of Care and End-of-Life Quality of Life in the United States: Evidence From a National Representative Data Set

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 17-17
Author(s):  
Yifan Lou ◽  
Nan Jiang ◽  
Katherine Ornstein
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
End Of Life ◽  
End Of Life Care ◽  
The United States ◽  
Life Care ◽  
Person Centered Care ◽  
Centered Care ◽  
The Relationship

Abstract Background: Quality of life (QoL) during last stage of life has raised expanded interests as an important aspect of person-centered care. Last place of care (LPC), refer to the last place decedents received their formal end-of-life care (EOLC), has been identified as a key indicator of older adults’ end-of-life QoL, but the relationship was understudied. This study explores the association between LPC and end-of-life QoL among American older adults. Methods: Data used seven waves of Last Month of Life data with a total sample of 3068 Medicare decedents in NHATS. Outcome is end-of-life QoL assessed by eleven measures on four domains: pain and symptoms management (SP), quality of healthcare encounter (HE), person-centered care (PC), and overall quality of care (QC). LPC was categorized into home, hospital, nursing home, and residential hospice. Multivariate logistic regression analyses were used to examine the relationship with covariates. Results: LPC varied by most demographic characteristics, except immigration status and education. Older adults whose LPC is hospital, compared to those who had home-care, were less likely to have great experiences on HE, PC, and QC. People dying at nursing homes are more likely to receive care meeting their dyspnea and spiritual needs. Residential hospice is negatively related to respected care, clear coordination, and keeping family informed, but are more likely to provide PS and spiritual care. Discussion: Home-based end-of-life care has certain advantages but still has room to improve on SP and religious concerns. Hospitals should keep reforming their service delivery structure to improve patients’ QoL.

Abstract 88: Increasing False Positive Diagnoses May Lead to Overestimation of Stroke Incidence, Particularly in the Young

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Abhinav J Appukutty ◽  
Lesli E Skolarus ◽  
Mellanie V Springer ◽  
William J Meurer ◽  
James F Burke
Keyword(s):  
Older Adults ◽  
False Positive ◽  
Age Groups ◽  
Vascular Risk Factor ◽  
The United States ◽  
Cross Sectional ◽  
Stroke Incidence ◽  
Ed Visits ◽  
Over Time

Introduction: Stroke incidence is reportedly increasing in younger adults. While increasing vascular risk factor prevalence has been suggested as a cause, the reasons for rising stroke incidence in the young are not clear. We explored several alternate explanations: trends in neurologically-focused emergency department (ED) visits, differential diagnostic classification of stroke and TIA over time, and changes in the use of advanced imaging in young and older adults. Methods: We performed a retrospective, serial, cross-sectional study on a nationally representative sample of all ED visits in the United States to quantify changes in patterns of neurologically-focused ED visits, stroke and TIA diagnoses, and rates of MRI utilization for young (18 – 44 years) and older (65+ years) adults over a 17-year period (1995 – 2000; 2005 – 2015) using National Hospital Ambulatory Medical Care Survey (NHAMCS) data. Results: In young adults, 0.4% (95% CI 0.3% – 0.5%) of neurologically-focused ED visits resulted in a primary diagnosis of stroke vs. 6.8% (95% CI 6.2% – 7.5%) for older adults. In both populations, the incidence of neurologically-focused ED visits has increased over time (+111/100,000 population/year, 95% CI +94 – +130 in the young vs. +70/100,000 population/year, 95% CI +34 – +108 in older adults). There was no evidence of differential classification of TIA to stroke over time (OR 1.001 per year, 95% CI 0.926 – 1.083 in the young; OR 1.003 per year, 95% CI 0.982 – 1.026 in older adults) and no evidence of disproportionate rise in MRI utilization for neurologically-focused ED visits in the young (OR 1.057 per year, 95% CI 1.028 – 1.086 in the young; OR 1.095 per year, 95% CI 1.066 – 1.125 in older adults). Conclusions: If the specificity of stroke diagnosis amongst ED visits is similar amongst young and older populations, then the combination of data observed here, including (1) a lower prior probability of stroke diagnoses in the young and (2) an increasing trend in neurologically-focused ED visits in both age groups, suggests that false positive diagnoses will increase over time, with a faster rise in the young compared to older adults. These data suggest a potential explanation that may contribute to higher stroke incidence in the young and merits further scrutiny.

scholarly journals Age Differences in the Relationship Between Daily Social Media Usage and Affect

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 410-410
Author(s):  
Xin Yao Lin ◽  
Margie Lachman
Keyword(s):  
Older Adults ◽  
Social Media ◽  
Negative Affect ◽  
Age Differences ◽  
Well Being ◽  
The United States ◽  
Future Research ◽  
Media Usage ◽  
The Relationship ◽  
Daily Time

Abstract Social media platforms allow people to connect and share content online (e.g., Facebook, Twitter). Although older adults are becoming more frequent users of social media, there continue to be mixed views on whether social media positively or negatively impacts well-being. Past studies have mainly focused on cross-sectional analyses for individual differences. However, both the time spent on social media and one’s affect can fluctuate on a daily basis. Thus, it is important to understand how the relationship between daily social media usage and affect varies within individuals from day to day. The current study adds to the literature by examining whether daily variations in time spent with social media are related to daily positive and negative affect and whether there are age differences in these relationships. The current study used an eight-day daily diary from the Midlife in the United States (MIDUS) Refresher dataset for 782 participants (ages 25-75). Multilevel modeling results revealed that age moderated the relationship between daily time spent on social media and negative affect: for younger adults, on days when they spent more time on social media, they had more negative affect. For older adults, on days when they spent more time on social media, they had less negative affect. Surprisingly, daily time spent on social media was not related to daily positive affect, nor did this relationship differ by age. Implications for future research are discussed with a focus on how social media usage can contribute to daily well-being for adults of different ages.

Longitudinal associations between insomnia symptoms and all-cause mortality among middle-aged and older adults: A population-based cohort study

SLEEP ◽  
2022 ◽  
Author(s):  
Asos Mahmood ◽  
Meredith Ray ◽  
Kenneth D Ward ◽  
Aram Dobalian ◽  
Sang Nam Ahn
Keyword(s):  
Older Adults ◽  
The United States ◽  
Early Morning ◽  
Time Varying ◽  
Middle Aged ◽  
Insomnia Symptom ◽  
All Cause Mortality ◽  
Longitudinal Associations ◽  
Insomnia Symptoms

Abstract To date, there is no scientific consensus on whether insomnia symptoms increase mortality risk. We investigated longitudinal associations between time-varying insomnia symptoms (difficulty initiating sleep, difficulty maintaining sleep, early-morning awakening, and non-restorative sleep) and all-cause mortality among middle-aged and older adults during 14 years of follow-up. Data were obtained from 2004 through 2018 survey waves of the Health and Retirement Study in the United States for a population-representative sample of 15,511 respondents who were ≥50 years old in 2004. Respondents were interviewed biennially and followed through the end of the 2018 survey wave for the outcome. Marginal structural discrete-time survival analyses were employed to account for time-varying confounding and selection bias. Of the 15,511 cohort respondents (mean [±SD] age at baseline, 63.7 [±10.2] years; 56.0% females), 5,878 (31.9%) died during follow-up. At baseline (2004), 41.6% reported experiencing at least one insomnia symptom. Respondents who experienced one (HR=1.11; 95% CI: 1.03–1.20), two (HR=1.12; 95% CI: 1.01–1.23), three (HR=1.15; 95% CI: 1.05–1.27), or four (HR=1.32; 95% CI: 1.12–1.56) insomnia symptoms had on average a higher hazard of all-cause mortality, compared to those who were symptom-free. For each insomnia symptom, respondents who experienced difficulty initiating sleep (HR=1.12; 95% CI: 1.02–1.22), early-morning awakening (HR=1.09; 95% CI: 1.01–1.18), and nonrestorative sleep (HR=1.17; 95% CI: 1.09–1.26), had a higher hazard of all-cause mortality compared to those not experiencing the symptom. The findings demonstrate significant associations between insomnia symptoms and all-cause mortality, both on a cumulative scale and independently, except for difficulty maintaining sleep. Further research should investigate the underlying mechanisms linking insomnia symptoms and mortality.

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