scholarly journals Pain Management and Cognitive Function Among Older Adults in China

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 527-527
Author(s):  
Xi Pan ◽  
Hongdao Meng

Abstract Chronic pain and cognitive decline are common age-related conditions affecting a large segment of older populations. Little is known about the pathway of cognitive functioning during the course of pain management in older adults. The current study aimed to examine the association between chronic body pain management and cognitive function over time among Chinese older adults. A total of 792 respondents aged 60 and above from urban and rural households in 28 provinces, 150 counties/districts, and 450 communities were selected from the China Health and Retirement Longitudinal Study (2013–2015). Cognitive function was measured in three domains: episodic memory, mental status, and global cognitive function. Difference-indifferences approach and mixed-effects linear regression models were employed to assess the association between chronic body pain management and cognitive function over time. Scores of mental status were found to decline slower by 0.49 unit (SE = 0.22, p < 0.05) in respondents who received pain management using analgesics, complementary and alternative medicine, or both from 2013 to 2015 after controlling for basic demographic and health confounders. Chronic pain management was associated with slower decline in domain-specific cognitive function, mental status over time. Findings of the study may contribute to understanding the mechanism of change in diverse cognitive abilities attributable to pain symptoms. More research is needed to elucidate the mediating effect of pain on cognitive decline, which could lead to testing of the impact of pain management on cognitive function among older population in both clinical and community settings.

2021 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.


2022 ◽  
pp. 109980042110651
Author(s):  
Tingting Liu ◽  
Hongjin Li ◽  
Yvette P. Conley ◽  
Brian A. Primack ◽  
Jing Wang ◽  
...  

Introduction Aging is associated with subtle cognitive decline in attention, memory, executive function, processing speed, and reasoning. Although lower brain-derived neurotrophic factor (BDNF) has been linked to cognitive decline among older adults, it is not known if the association differs among individuals with various BDNF Val66Met (rs6265) genotypes. In addition, it is not clear whether these associations vary by hand grip strength or physical activity (PA). Methods A total of 2904 older adults were included in this study using data from the Health and Retirement Study. Associations between serum BDNF and measures of cognitive function were evaluated using multivariable linear regression models stratified by Met allele status. PA and hand grip strength were added to the model to evaluate whether including these variables altered associations between serum BDNF and cognition. Results Mean age was 71.4 years old, and mean body mass index was 28.3 kg/m2. Serum BDNF levels were positively associated with higher total cognitive score (beta = 0.34, p = .07), mental status (beta = 0.16, p = .07), and word recall (beta = 0.22, p =.04) among Met carriers, while serum BDNF levels were negatively associated with mental status (beta = −0.09, p = .07) among non-Met carriers. Furthermore, associations changed when hand grip strength was added to the model but not when PA was added to the model. Conclusions The BDNF Val66Met variant may moderate the association between serum BDNF levels and cognitive function in older adults. Furthermore, such associations differ according to hand grip strength but not PA.


2020 ◽  
Author(s):  
Sarah J Richardson ◽  
Daniel H J Davis ◽  
Blossom C M Stephan ◽  
Louise Robinson ◽  
Carol Brayne ◽  
...  

Abstract Background Delirium is common, distressing and associated with poor outcomes. Previous studies investigating the impact of delirium on cognitive outcomes have been limited by incomplete ascertainment of baseline cognition or lack of prospective delirium assessments. This study quantified the association between delirium and cognitive function over time by prospectively ascertaining delirium in a cohort aged ≥ 65 years in whom baseline cognition had previously been established. Methods For 12 months, we assessed participants from the Cognitive Function and Ageing Study II-Newcastle for delirium daily during hospital admissions. At 1-year, we assessed cognitive decline and dementia in those with and without delirium. We evaluated the effect of delirium (including its duration and number of episodes) on cognitive function over time, independently of baseline cognition and illness severity. Results Eighty two of 205 participants recruited developed delirium in hospital (40%). One-year outcome data were available for 173 participants: 18 had a new dementia diagnosis, 38 had died. Delirium was associated with cognitive decline (−1.8 Mini-Mental State Examination points [95% CI –3.5 to –0.2]) and an increased risk of new dementia diagnosis at follow up (OR 8.8 [95% CI 1.9–41.4]). More than one episode and more days with delirium (&gt;5 days) were associated with worse cognitive outcomes. Conclusions Delirium increases risk of future cognitive decline and dementia, independent of illness severity and baseline cognition, with more episodes associated with worse cognitive outcomes. Given that delirium has been shown to be preventable in some cases, we propose that delirium is a potentially modifiable risk factor for dementia.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 474-474
Author(s):  
Alison Huang ◽  
George Rebok ◽  
Bonnielin Swenor ◽  
Jayant Pinto ◽  
Linda Waite ◽  
...  

Abstract Hearing and vision impairment have been independently linked to accelerated cognitive decline in older adults, however there is limited evidence on the effect of dual sensory impairment (DSI) (both hearing and vision impairment) on cognition. Additionally, the impact of social isolation and loneliness, both correlates of DSI and independent risk factors for cognitive decline, on the DSI-cognition relationship has yet to be studied. Using data from the National Social Life, Health, and Aging Project (N=3,091), multivariable linear regression models were used to describe the cross-sectional relationship between self-reported functional sensory impairment (none, hearing only, vision only, DSI) and cognitive function, measured by the survey adapted Montreal Cognitive Assessment. We also included an interaction term in the model to investigate whether cognition is worse among older adults with sensory impairment who also are socially isolated or lonely. Participants in this sample are between 62-91 years with 15% reporting hearing impairment, 11% reporting vision impairment, and 7% reporting DSI. DSI was associated with significantly lower global cognitive function compared to no sensory impairment (-0.31 standard deviations (SD), 95% CI:-0.44 to-0.18), hearing impairment alone (-0.29 SD, 95% CI: -0.44 to -0.15), and vision impairment alone (-0.22 SD, 95% CI: -0.39 to -0.06). Furthermore, cognitive function was significantly worse among older adults with both DSI and smaller social networks (p-interaction &lt;0.05). No differences in the DSI-cognition relationship were observed by level of loneliness. These findings add to the limited research on the relationship between DSI, social isolation and loneliness, and cognition.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 206-206
Author(s):  
Bei Wu ◽  
Susie Keepper ◽  
Michèle Saunders

Abstract Poor oral health, diabetes mellitus (DM), and cognitive impairment are common problems in older adults. Using national surveys, this symposium aims to present new findings regarding the impact of the co-occurrence of DM and poor oral health on cognitive function, cognitive decline, and mortality. This symposium will also cover the topic of dental care use among adult populations in the U.S. Using data from the Health and Retirement Study (HRS) (2006- 2018), the first study shows that adults with both DM and edentulism had the worst cognitive function, followed by those with edentulism alone, and those with DM alone. Using the same HRS data, the second study found that co-occurrence of DM and edentulism had a higher risk of more rapid cognitive decline with advancing age than the presence of each condition alone. The third study used data from the 2006-2016 HRS linked with mortality files, and revealed that the risk of diabetes and edentulism on mortality may vary across racial/ethnic groups. Using the Behavioral Risk Factor Surveillance System survey (2002-2018), the fourth study examined disparities of dental service utilization among racial/ethnic groups (Whites, Hispanics, Blacks, Asians, American Indians or Alaska Natives, and Native Hawaiian or other Pacific Islanders). Age differences in dental services were also compared between older adults and other younger and middle-aged populations. This symposium highlights the role of oral health in improving cognitive health. Policies and programs are needed to increase dental care access, a critical way to help maintain good oral health.


2020 ◽  
Author(s):  
Jinhee Shin ◽  
Eunhee Cho

Abstract Background Dementia prevalence is increasing worldwide, and thus, the global impact of cognitive impairment and dementia has become a priority public health issue. This study aimed to assess the patterns of and risk factors for cognitive decline over time in community-dwelling Korean adults aged ≥ 65 years. Methods Older adults with normal cognitive function at baseline in 2006 were evaluated, and changes in their cognitive function were followed over time. The data were obtained from the 2006–2016 Korean Longitudinal Study of Aging. Cognitive function in 2016 was classified based on the Korean-Mini-Mental State Examination score as normal, mild dementia, and moderate and severe dementia. The t-test, ANOVA, and linear mixed models were used to analyse the patterns and risk factors f cognitive decline over time. Results Of the 1,262 participants examined, 752 maintained normal cognitive function, 267 older adults showed a change from normal cognitive function to mild dementia, and 243 older adults showed a decline from normal cognitive function to moderate and severe dementia between 2006 and 2016. There were significant differences in cognitive function over time among the three groups, and these were influenced by age, gender, education level, religion, activities of daily living, instrumental activities of daily living, regular exercise, number of meetings with friends, and depression. The differences have gradually increased over 10 years. Conclusions This study identified the patterns of cognitive decline over time and important factors related to cognitive decline. Individualised interventions such as improving physical function through regular exercise, increasing social activity, and managing depression by early detection and treatment may contribute to maintain cognitive function.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S976-S976
Author(s):  
Feng Zhao ◽  
Peter Martin ◽  
Gina Lee

Abstract This study examined the trajectories of depression and cognitive function in the transition to widowhood and investigated the temporal and causal relationship between these two closely related constructs. Respondents were 1,822 widowed adults aged 51 to 91 from a restructured data set (Wave 3 to Wave 12) of the Health and Retirement Study. The results of cross-lagged panel analysis indicated a bidirectional relationship between depressive symptoms and cognition decline, but the effects of cognitive impairment at earlier time points on later depression were larger than the effects of previous depressive symptoms on later cognition. The latent growth curve analysis showed that the cognitive function declined over time, whereas the initial level of depressive symptoms first increased following widowhood and gradually decreased over time. Significant negative associations were found between the initial levels of depression and cognitive function (p &lt; .001) and between the rates of change of these two variables (p = .025). Older adults tended to have lower initial level of cognitive function and they showed faster cognitive decline over time. Female respondents were more likely to report more depressive symptoms and higher cognitive function. White respondents were more likely to report fewer depressive symptoms and higher levels of cognitive function. Higher levels of education were protective for one’s cognitive function but not for depressive symptoms. The study highlighted the reciprocal relationship between depression and cognitive function following widowhood and pointed out that accelerated cognitive decline may precede elevated levels of depression.


2020 ◽  
pp. 101053952096171 ◽  
Author(s):  
Jongnam Hwang ◽  
Seongju Kim ◽  
Sujin Kim

This study aimed to investigate whether (1) depression is associated with cognitive decline in Korean older adults and (2) the relationship between depression and cognitive function varies by gender. Using Korean Longitudinal Study of Aging data of 2006 to 2014, we studied 1787 adults aged 65 years or older who had normal cognitive function at baseline. This study examined the effects of depression on cognitive decline by using an interaction term of baseline depression and time, and compared relationships by gender. Among male participants, K-MMSE (Korean-Mini-Mental Status Examination) scores decreased with age, at an annual rate of approximately 0.465 points. Baseline depression was found to accelerate the decline in cognitive function, by approximately 0.184 points per year. Among female participants, K-MMSE scores decreased with age, at an annual rate of approximately 0.585 points. Baseline depression was not related to the decline in cognitive function. These results suggest the need for community-based programs to increase awareness of mental health problems need to be developed to encourage the use of health services to prevent or delay cognitive decline in older Korean males.


2020 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study (CHARLS) and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 827-827
Author(s):  
Jaime Hughes ◽  
Susan Hughes ◽  
Mina Raj ◽  
Janet Bettger

Abstract Behavior change is an inherent aspect of routine geriatric care. However, most research and clinical programs emphasis how to initiate behavior change with less emphasis placed on skills and strategies to maintain behaviors over time, including after an intervention has concluded. This presentation will provide an introduction to the symposium, including a review of prior work and our rationale for studying the critical yet overlooked construct of maintenance in older adults. Several key considerations in our work include the impact of multiple chronic conditions, declines in cognitive and functional capacity over time, changes in environmental context and/or social support, and sustainability of community and population-level programs and services.


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