scholarly journals Spousal Caregiving and Cognitive Trajectories: Does Care Recipient Dementia Status Matter?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 359-360
Author(s):  
Taylor Atkinson ◽  
Dylan Jester ◽  
William Haley
Keyword(s):  
Cognitive Decline ◽  
Population Based ◽  
Cognitive Status ◽  
Spousal Caregivers ◽  
Care Recipient ◽  
Spousal Caregiving ◽  
Before And After ◽  
Race Ethnicity ◽  
Home Placement ◽  
Retirement Study

Abstract Caregiving is often considered stressful, even more so if the care recipient has been diagnosed with dementia. The current study examines the rate of cognitive decline of spousal caregivers of persons with dementia (CG-D) when compared to spousal caregivers of persons without dementia (CG) before and after the death of the care recipient. Health and Retirement Study (HRS) data from 1998-2016 were used to examine cognitive trajectories of CG-D (n=364) and CG (n=1,649) before and after the care recipient death. Cognition was measured through the HRS’s shortened Telephone Interview of Cognitive Status and separated into measures of total cognition and memory. Covariates included age, education, sex, race, ethnicity, care hours, frailty, socioeconomic status, nursing home placement of the recipient, and whether the death was expected. Piecewise mixed models were constructed to examine two two-year periods of decline leading up to the death of the care recipient, and two two-year periods of decline after the death of the care recipient. CG-D and CG declined at equivalent rates on measures of total cognition and memory (ps > .05). In all caregivers, total cognition and memory declined at a stable rate before the death of the care recipient. However, an accelerated decline was evident after the death of the care recipient (ps < .001). Our results suggest that cognitive decline is not differentially affected by care recipient dementia diagnosis. We find evidence that the death of a spousal care recipient is accompanied by hastened cognitive decline in our population-based sample.

scholarly journals The Differential Effects of Caregiving Intensity on Overnight Hospitalization in the Previous 2 Years

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 76-76
Author(s):  
Kylie Meyer ◽  
Zachary Gassoumis ◽  
Kathleen Wilber
Keyword(s):  
Health Services ◽  
Fixed Effects ◽  
Regression Models ◽  
P Value ◽  
Logistic Regression Models ◽  
Spousal Caregiving ◽  
Health Insurance Status ◽  
Race Ethnicity ◽  
Self Assessed Health ◽  
Retirement Study

Abstract Caregiving for a spouse is considered a major stressor many Americans will encounter during their lifetimes. Although most studies indicate caregiving is associated with experiencing diminished health outcomes, little is known about how this role affects caregivers’ use of acute health services. To understand how spousal caregiving affects the use of acute health services, we use data from the Health and Retirement Study. We apply fixed effects (FE) logistic regression models to examine odds of experiencing an overnight hospitalization in the previous two years according to caregiving status, intensity, and changes in caregiving status and intensity. Models controlled for caregiver gender, age, race, ethnicity, educational attainment, health insurance status, the number of household residents, and self-assessed health. Overall, caregivers were no more likely to experience an overnight hospitalization compared to non-caregivers (OR 0.92; CI 0.84 to 1.00; p-value=0.057). However, effects varied according to the intensity of caregiving and the time spent in this role. Compared to non-caregivers, for example, spouses who provided care to someone with no need for assistance with activities of daily living had lower odds of experiencing a hospitalization (OR 0.77; CI 0.66 to 0.89). In contrast, caregivers who provided care to someone with dementia for 4 to <6 years had 3.29 times the odds of experiencing an overnight hospitalization (CI 1.04 to 10.38; p-value=0.042). Findings indicate that, although caregivers overall appear to use acute health services about as much as non-caregivers, large differences exist between caregivers. Results emphasize the importance of recognizing diversity within caregiving experiences.

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

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.

scholarly journals Marital Status and Dementia: Evidence from the Health and Retirement Study

2019 ◽  
Vol 75 (8) ◽  
pp. 1783-1795 ◽  
Author(s):  
Hui Liu ◽  
Zhenmei Zhang ◽  
Seung-won Choi ◽  
Kenneth M Langa
Keyword(s):  
Marital Status ◽  
The United States ◽  
Population Based ◽  
Cognitive Status ◽  
Baseline Survey ◽  
Health And Retirement Study ◽  
Related Factors ◽  
Never Married ◽  
Vulnerable Subpopulations ◽  
Retirement Study

Abstract Objectives We provide one of the first population-based studies of variation in dementia by marital status in the United States. Method We analyzed data from the Health and Retirement Study (2000–2014). The sample included 15,379 respondents (6,650 men and 8,729 women) aged 52 years and older in 2000 who showed no evidence of dementia at the baseline survey. Dementia was assessed using either the modified version of the Telephone Interview for Cognitive Status (TICS) or the proxy’s assessment. Discrete-time hazard regression models were estimated to predict odds of dementia. Results All unmarried groups, including the cohabiting, divorced/separated, widowed, and never married, had significantly higher odds of developing dementia over the study period than their married counterparts; economic resources and, to a lesser degree, health-related factors accounted for only part of the marital status variation in dementia. For divorced/separated and widowed respondents, the differences in the odds of dementia relative to married respondents were greater among men than among women. Discussion These findings will be helpful for health policy makers and practitioners who seek to better identify vulnerable subpopulations and to design effective intervention strategies to reduce dementia risk.

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

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.

scholarly journals LONGITUDINAL INTERRELATIONSHIP BETWEEN SENSORY LOSS, SOCIAL SUPPORT, LONELINESS, AND COGNITION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S818-S818
Author(s):  
Shaoqing Ge ◽  
Wei Pan ◽  
Bei Wu ◽  
Brenda Plassman ◽  
Eleanor S McConnell
Keyword(s):  
Social Support ◽  
Cognitive Decline ◽  
Psychosocial Factors ◽  
Vision Loss ◽  
Cognitive Status ◽  
Mediation Effect ◽  
Sensory Loss ◽  
Longitudinal Associations ◽  
Parsimonious Model ◽  
Retirement Study

Abstract This study aims to understand the roles that psychosocial factors play on the longitudinal associations between sensory (including hearing and vision) loss and cognitive decline. Specifically, we hypothesized that (1) loneliness mediates the associations between sensory loss and cognitive decline; and (2) social support moderates the associations between sensory loss and cognitive decline. We used longitudinal parallel process (LPP) modeling with data from the Health and Retirement Study (HRS) and the Aging, Demographics, and Memory study (ADAMS). Age variable centered at its mean age of 82. In the most parsimonious model, loneliness fully mediated the associations between vision loss and the average cognitive status at age 82 (p < .05). Social support moderated the associations between vision loss and the average cognitive status at age 82 (β= .14, p < .05). No moderation or mediation effect was found for the psychosocial factors on the associations between hearing loss and cognition.

Isolation, Not Loneliness or Cynical Hostility, Predicts Cognitive Decline in Older Americans

2018 ◽  
Vol 32 (1-2) ◽  
pp. 52-60 ◽  
Author(s):  
Sarah C. Griffin ◽  
Briana Mezuk ◽  
Allison Baylor Williams ◽  
Paul B. Perrin ◽  
Bruce D. Rybarczyk
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Functional Limitations ◽  
Cognitive Status ◽  
Older Americans ◽  
Frequency Of Contact ◽  
Cynical Hostility ◽  
Reported Health ◽  
Retirement Study

Objective: To jointly examine isolation, loneliness, and cynical hostility as risk factors for cognitive decline in older adults. Method: Data came from the 2006 to 2012 waves of the Health and Retirement Study (HRS), a longitudinal study of U.S. older adults (age ⩾ 65 years, n = 6,654). Measures included frequency of contact with social network (objective isolation), the Hughes Loneliness Scale (loneliness), a modified version of the Cook–Medley Hostility Inventory (cynical hostility), and a modified version of the Telephone Interview for Cognitive Status (cognitive function). Multilevel modeling (random slope + intercept) was used to examine the association between these factors and trajectories of cognitive function. Results and Discussion: After controlling for demographic characteristics, self-reported health, and functional limitations, loneliness (β = −.34, 95% confidence interval [CI] = [−0.56, −0.11), and cynical hostility (β = −.14, 95% CI = [−0.24, −0.04) correlated with lower cognitive function, but none predicted change in cognitive function. Objective social isolation was associated with lower cognitive function (β = −.27, 95% CI = [−0.41, −0.12]) and steeper decline in cognitive function (β = −.09, 95% CI = [−0.16, −0.01]).

scholarly journals Caregiver personality predicts rate of cognitive decline in a community sample of persons with Alzheimer's disease. The Cache County Dementia Progression Study

2013 ◽  
Vol 25 (10) ◽  
pp. 1629-1637 ◽  
Author(s):  
Maria C. Norton ◽  
Christine Clark ◽  
Elizabeth B. Fauth ◽  
Kathleen W. Piercy ◽  
Roxane Pfister ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Personality Traits ◽  
Adult Children ◽  
Community Sample ◽  
Management Strategies ◽  
Adult Child ◽  
Population Based ◽  
Cognitive Status

ABSTRACTBackground:Environmental influences on the rate of Alzheimer's disease (AD) progression have received little attention. Our objective was to test hypotheses concerning associations between caregiver personality traits and the rate of AD progression.Methods:Care receivers (CR) were 161 persons with AD from a population-based dementia progression study; 55 of their caregivers were spouses and 106 were adult children. Cognitive status of the CR was measured with the Mini-Mental State Examination every six months, over an average of 5.6 (range: 1–14) years. Linear mixed models tested rate of cognitive decline as a function of caregiver personality traits from the NEO Five-Factor Inventory.Results:Significantly faster cognitive decline was observed with higher caregiver Neuroticism overall; however, in stratified models, effects were significant for adult child but not spouse caregivers. Neuroticism facets of depression, anxiety, and vulnerability to stress were significantly associated with faster decline. Higher caregiver Extraversion was associated with slower decline in the CR when caregivers were adult children but not spouses.Conclusions:For adult child caregivers, caregiver personality traits are associated with rate of cognitive decline in CRs with AD regardless of co-residency. Results suggest that dementia caregiver interventions promoting positive care management strategies and ways to react to caregiving challenges may eventually become an important complement to pharmacologic and other approaches aimed at slower rate of decline in dementia.

scholarly journals PURPOSE IN LIFE PROTECTS AGAINST COGNITIVE DECLINE AMONG OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S650-S651
Author(s):  
Giyeon Kim ◽  
Su Hyun Shin ◽  
Monica Scicolone ◽  
Patricia A Parmelee
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Cognitive Abilities ◽  
Protective Factor ◽  
Purpose In Life ◽  
Secondary Data ◽  
Curve Modeling ◽  
Race Ethnicity ◽  
The Relationship ◽  
Retirement Study

Abstract Objective: This study examined whether having a sense of purpose in life protects against cognitive decline among older adults and whether purpose in life moderates the relationship between selected risk factors (age, sex, and race/ethnicity) and cognitive abilities. Methods: This was a longitudinal analysis of existing secondary data of adults (N = 11,557) aged 50 or older using the 2006 −2012 waves of the Health and Retirement Study. The study measured purpose in life, cognitive functioning score, and various covariates. Results: Growth curve modeling revealed that, after adjusting for covariates, purpose in life was positively associated with participants’ total cognition scores. Purpose in life significantly moderated the relationship between age and race/ethnicity and cognitive decline. Further, purpose in life was a protective factor against cognitive decline for those who were older and black. There was no significant interaction between purpose in life and sex. Conclusion: Having a purposeful life protects against cognitive decline in older adults, and the associations varied by age and race/ethnicity, but not by sex. Potential ways to increase purpose in life are discussed in a clinical context.

scholarly journals Cognitive Impairment Is Associated with a Low Omega-3 Index in the Elderly: Results from the KORA-Age Study

2016 ◽  
Vol 42 (3-4) ◽  
pp. 236-245 ◽  
Author(s):  
Karoline Lukaschek ◽  
Clemens von Schacky ◽  
Johannes Kruse ◽  
Karl-Heinz Ladwig
Keyword(s):  
Risk Factors ◽  
Fatty Acids ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
The Elderly ◽  
Population Based ◽  
Cognitive Status ◽  
Omega 3 ◽  
Cross Sectional ◽  
Total Fatty Acids

Background: Omega-3 polyunsaturated fatty acids (PUFA) may affect the risk of cognitive decline in older adults. Methods: Cross-sectional analysis was conducted among 720 (50.4% women) participants aged 68-92 years (mean age: 77.6, SD ±6.2) of the population-based KORA-Age study. Eicosapentaenoic acid and docosahexaenoic acid (omega-3 index) were measured in erythrocytes as a percentage of total fatty acids. The categories low (<5.7), intermediate (5.7-6.8), and high (>6.8) levels of the omega-3 index were built using tertiles. The association between cognitive status and omega-3 levels was assessed by logistic regression analyses with adjustments for important concurrent risk factors of cognitive decline. Results: In the sex- and age-adjusted model (model 1), subjects with a low omega-3 index were at a significantly higher risk for cognitive impairment (OR: 1.77, 95% CI: 1.15-2.73, p = 0.009). This association remained stable after further adjusting for educational level (model 2; OR: 1.75, 95% CI: 1.13-2.71, p = 0.01) and metabolic risk factors (model 3; OR: 1.77, 95% CI: 1.14-2.75, p = 0.01). After further controlling for affective disorders (model 4), the association did not attenuate (OR: 1.77, 95% CI: 1.14-2.76, p = 0.01). Conclusion: A robust association was found between low omega-3 levels and cognitive impairment in an elderly population. Further research is needed to understand the link between omega-3 PUFA and cognitive functioning.

Depression Associated With Transitions Into and Out of Spousal Caregiving

2018 ◽  
Vol 88 (2) ◽  
pp. 127-149 ◽  
Author(s):  
Jennifer E. Kaufman ◽  
Yeonjung Lee ◽  
Wendy Vaughon ◽  
Aig Unuigbe ◽  
William T. Gallo
Keyword(s):  
Depressive Symptoms ◽  
Spousal Caregivers ◽  
Health And Retirement Study ◽  
Spousal Caregiving ◽  
Retirement Study ◽  
The U.S ◽  
Risk For Depression

This study investigates depressive symptoms among spousal caregivers in three groups: those who become caregivers, those who continue care, and those who exit caregiving, compared with those who remain non-caregivers. We also examine depressive symptoms among widowed caregivers by length of bereavement. We use four waves of the U.S. Health and Retirement Study (2006, 2008, 2010, and 2012), for a total of 43,262 observations. Findings show elevated levels of depressive symptoms for new caregivers, continuing caregivers, and exit caregivers. Among exit caregivers, symptoms were elevated when measured in the first 15 months after the spouse’s death but declined thereafter. These findings add to the evidence that spousal caregiving carries a risk for depression, and symptoms are likely to peak near the end of the caregiving episode. These results underscore the need to provide support to newly widowed individuals.

Sign in / Sign up

Export Citation Format

Share Document