scholarly journals Diabetes, Disability, and Dementia Risk: Results From the HEPESE

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 574-574
Author(s):  
Elizabeth Vasquez ◽  
Meghana Gadgil ◽  
Weihu Zhang ◽  
Jacqueline L Angel
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
Oldest Old ◽  
Epidemiologic Study ◽  
The Elderly ◽  
Cox Proportional Hazards ◽  
Mexican Origin ◽  
Foreign Born ◽  
Dementia Risk ◽  
Diabetes Status

Abstract The relationship between cognitive function, diabetes and disability among the oldest-old remains largely unexplored, particularly in the Latino population. This study examines dementia risk and diabetes status in a Mexican-origin older adult sample. The data are drawn from eight waves (1993 -2013) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE; N=3,039, mean age at baseline=73.6 (±6.8)). We use multivariable Cox proportional hazards models to predict the relation between diabetes and time to incident dementia (MMSE<24, 1+ IADL), with risk adjustment for age of migration, socioeconomic status, acculturation, and health. Diabetes prevalence at baseline was 27.8 %. Diabetes was associated with a higher risk of developing dementia (HR)=1.22, p<0.001). Foreign-born older adults who migrated at ages 20- 49 had a higher survival probability of being dementia-free (HR=0.84, p=0.001). Our results further highlight the importance of evaluating differences in the cognitive outcomes of Mexican origin older adults.

Diabetes, disability, and dementia risk: Results from the Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE)

2021 ◽  
pp. 002076402110377
Author(s):  
Elizabeth Vásquez ◽  
Meghana A Gadgil ◽  
Weihui Zhang ◽  
Jacqueline L Angel
Keyword(s):  
Cognitive Impairment ◽  
Proportional Hazards ◽  
Epidemiologic Study ◽  
The Elderly ◽  
Epidemiologic Studies ◽  
Cox Proportional Hazards ◽  
Self Report ◽  
Dementia Risk ◽  
Incident Dementia ◽  
Diabetes Status

Background: Emerging research has elucidated pathophysiological relationships among diabetes, disability, cognitive impairment, and incident dementia. However, the relationships between diabetes, disability, and dementia have been largely underexamined in Latino populations, which have a disproportionate prevalence of diabetes and its complications. Aims: This study examines diabetes as a risk factor for subsequent disability and dementia risk in a Mexican-origin older adult sample. Methods: The data are drawn from eight waves (1993–2013) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE; N = 3,050, mean age at baseline = 73.6 (±6.8)). Respondents’ diabetes status at baseline was ascertained by self-report. Disability was assessed using eight functional domains assessed through the Lawton Instrumental Activities of Daily Living (IADL) Scale. Dementia risk was assessed using a Mini-Mental Status Exam (MMSE) score below 18 and the need for aid with at least two IADLs. We used multivariable Cox proportional hazards models to predict the relation between diabetes and time to disability, cognitive impairment, and incident dementia, adjusting for age at migration, socioeconomic status, acculturation, and health status. Results: At baseline, diabetes prevalence was 28.1%, and 37.7% had IADL disability. Diabetes was associated with a higher risk of developing dementia (Hazard Ratio (HR) = 1.22, p < .001) over the approximetely 20 year study period. In addition, immigrants who migrated at age 50 or older had a higher dementia risk (HR = 1.35, p = .01) when compared to their US-born counterpart. Conclusion: Our results highlight the importance of better characterizing the role of diabetes and nativity in the co-occurrence of disability and dementia risk.

scholarly journals Illiteracy, dementia risk, and cognitive trajectories among older adults with low education

Neurology ◽  
2019 ◽  
Vol 93 (24) ◽  
pp. e2247-e2256 ◽  
Author(s):  
Miguel Arce Rentería ◽  
Jet M.J. Vonk ◽  
Gloria Felix ◽  
Justina F. Avila ◽  
Laura B. Zahodne ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Independent Effect ◽  
Growth Curve Models ◽  
Cox Proportional Hazards Models ◽  
Dementia Risk ◽  
Incident Dementia ◽  
Low Education

ObjectiveTo investigate whether illiteracy was associated with greater risk of prevalent and incident dementia and more rapid cognitive decline among older adults with low education.MethodsAnalyses included 983 adults (≥65 years old, ≤4 years of schooling) who participated in a longitudinal community aging study. Literacy was self-reported (“Did you ever learn to read or write?”). Neuropsychological measures of memory, language, and visuospatial abilities were administered at baseline and at follow-ups (median [range] 3.49 years [0–23]). At each visit, functional, cognitive, and medical data were reviewed and a dementia diagnosis was made using standard criteria. Logistic regression and Cox proportional hazards models evaluated the association of literacy with prevalent and incident dementia, respectively, while latent growth curve models evaluated the effect of literacy on cognitive trajectories, adjusting for relevant demographic and medical covariates.ResultsIlliterate participants were almost 3 times as likely to have dementia at baseline compared to literate participants. Among those who did not have dementia at baseline, illiterate participants were twice as likely to develop dementia. While illiterate participants showed worse memory, language, and visuospatial functioning at baseline than literate participants, literacy was not associated with rate of cognitive decline.ConclusionWe found that illiteracy was independently associated with higher risk of prevalent and incident dementia, but not with a more rapid rate of cognitive decline. The independent effect of illiteracy on dementia risk may be through a lower range of cognitive function, which is closer to diagnostic thresholds for dementia than the range of literate participants.

Long-Term Exposure to Ambient Hydrocarbons Increases Dementia Risk in People Aged 50 Years and above in Taiwan

2020 ◽  
Vol 16 (14) ◽  
pp. 1276-1289
Author(s):  
Han-Wei Zhang ◽  
Victor C. Kok ◽  
Shu-Chun Chuang ◽  
Chun-Hung Tseng ◽  
Chin-Teng Lin ◽  
...  
Keyword(s):  
Air Pollutants ◽  
Proportional Hazards ◽  
The Elderly ◽  
Cox Proportional Hazards ◽  
Proportional Hazards Regression ◽  
Hazard Ratios ◽  
Dementia Risk ◽  
Disease Exposure ◽  
Total Hydrocarbons

Background: Alzheimer’s disease, the most common cause of dementia among the elderly, is a progressive and irreversible neurodegenerative disease. Exposure to air pollutants is known to have adverse effects on human health, however, little is known about hydrocarbons in the air that can trigger a dementia event. Objective: We aimed to investigate whether long-term exposure to airborne hydrocarbons increases the risk of developing dementia. Method: The present cohort study included 178,085 people aged 50 years and older in Taiwan. Cox proportional hazards regression analysis was used to fit the multiple pollutant models for two targeted pollutants, including total hydrocarbons and non-methane hydrocarbons, and estimated the risk of dementia. Results: Before controlling for multiple pollutants, hazard ratios with 95% confidence intervals for the overall population were 7.63 (7.28-7.99, p <0.001) at a 0.51-ppm increases in total hydrocarbons, and 2.94 (2.82-3.05, p <0.001) at a 0.32-ppm increases in non-methane hydrocarbons. The highest adjusted hazard ratios for different multiple-pollutant models of each targeted pollutant were statistically significant (p <0.001) for all patients: 11.52 (10.86-12.24) for total hydrocarbons and 9.73 (9.18-10.32) for non-methane hydrocarbons. Conclusion: Our findings suggest that total hydrocarbons and non-methane hydrocarbons may be contributing to dementia development.

scholarly journals 1135 Longer And More Frequent Naps Predict Incident Alzheimer’s Dementia In Community-based Older Adults

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A432-A432
Author(s):  
P Li ◽  
L Gao ◽  
A Gaba ◽  
L Yu ◽  
A S Buchman ◽  
...  
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
The Elderly ◽  
Sleep Time ◽  
Cox Proportional Hazards ◽  
Alzheimer’S Dementia ◽  
Alzheimer's Dementia ◽  
Cox Proportional Hazards Models ◽  
Motor Activities ◽  
Underlying Mechanisms

Abstract Introduction Excessive napping duration has been associated with cognitive decline. The effect of napping frequency is less understood, and little is known about the development of Alzheimer’s dementia associated with napping. We tested whether longer or more frequent naps in the elderly are linked to the development of incident Alzheimer’s dementia. Methods We studied 1,180 older adults (age: 81.0±7.3 [SD]) in the Rush Memory and Aging Project who have been followed for up to 14 years. Motor activities of up to 10 days were recorded at baseline to assess napping characteristics objectively. We defined daytime napping episodes as motor activity segments between 10AM and 7PM with continuous zero-activity for ≥10min but &lt;1h (to avoid off-wrist periods). Segments that were &lt;5min apart were merged. Alzheimer’s dementia diagnosis was determined using the criteria of the National Institute of Neurological and Communicative Disorders and Strone and the Alzheimer’s Disease and Related Disorders Association. Cox proportional hazards models were performed to examine the associations of daily napping duration and frequency with incident AD. Results Of 1,180 non-demented participants at baseline (including 264 with mild cognitive impairment), 277 developed Alzheimer’s dementia within 5.74±3.36 years. On average, participants napped for 38.3±1.0 (SE) min and1.56±0.04 (SE) times per day at baseline. After adjustment for age, sex, and education, every 30-min increase in daily napping duration was associated with a 20% increase in the risk of incident AD (95% confidence interval [CI]: 9%-31%; p=0.0002). One more nap per day was associated with a 19% increase in the risk of AD (95% CI: 8%-30%; p=0.0003). These associations remained after further adjustment for total sleep time. Conclusion Longer and more frequent daytime naps predict a higher risk of incident Alzheimer’s dementia. Future studies are needed to examine specific underlying mechanisms. Support This work was supported by NIH grants RF1AG064312, RF1AG059867, R01AG017917, and R01AG56352.

scholarly journals Neighborhood greenspace exposure as a protective factor in dementia risk among U.S. adults 75 years or older: a cohort study

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Erik D. Slawsky ◽  
Anjum Hajat ◽  
Isaac C. Rhew ◽  
Helen Russette ◽  
Erin O. Semmens ◽  
...  
Keyword(s):  
Older Adults ◽  
Protective Factor ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Future Research ◽  
Cox Proportional Hazards Models ◽  
Linear Distance ◽  
Dementia Risk ◽  
Normalized Difference Vegetative Index ◽  
Multiple Covariates

Abstract Background Research suggests that greenspace may confer neurocognitive benefits. This study examines whether residential greenspace is associated with risk of dementia among older adults. Methods Greenspace exposure was computed for 3047 participants aged 75 years and older enrolled in the Gingko Evaluation of Memory Study (GEMS) across four U.S. sites that prospectively evaluated dementia and its subtypes, Alzheimer’s disease (AD), vascular dementia (VaD), and mixed pathologies, using neuropsychiatric evaluations between 2000 and 2008. After geocoding participant residences at baseline, three greenspace metrics—Normalized Difference Vegetative Index, percent park overlap within a 2-km radius, and linear distance to nearest park—were combined to create a composite residential greenspace measure categorized into tertiles. Cox proportional hazards models estimated the associations between baseline greenspace and risk of incident all-cause dementia, AD, and Mixed/VaD. Results Compared to low residential greenspace, high residential greenspace was associated with a reduced risk of dementia (HR = 0.76 95% CI: 0.59,0.98) in models adjusted for multiple covariates. After additional adjustment for behavioral characteristics, Apolipoprotein E ɛ4 status, and other covariates, the association was slightly attenuated (HR = 0.82; 95% CI:0.63,1.06). Those exposed to medium levels of greenspace also had 28% lower risk (HR = 0.72; CI: 0.55, 0.95) of dementia compared to those with low greenspace in adjusted models. Subtype associations between high residential greenspace and AD were not statistically significant. Greenspace was not found to be significantly associated with mixed/vascular pathologies. Conclusions This study showed evidence for an association between residential greenspace and all-cause dementia among older adults. Future research with larger sample size, precise characterization of different dementia subtypes, and assessment of residential greenspace earlier in life may help clarify the role between exposure to greenspace and dementia risk.

Impact of anemia on hospitalization and mortality in older adults

Blood ◽  
2006 ◽  
Vol 107 (10) ◽  
pp. 3841-3846 ◽  
Author(s):  
Bruce F. Culleton ◽  
Braden J. Manns ◽  
Jianguo Zhang ◽  
Marcello Tonelli ◽  
Scott Klarenbach ◽  
...  
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
Prognostic Significance ◽  
The Elderly ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Normal Kidney ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Community Dwelling Older Adults

Although anemia is common in older adults, its prognostic significance is uncertain. A total of 17 030 community-dwelling subjects 66 years and older were identified between July 1 and December 31, 2001, and followed until December 31, 2004. Cox proportional hazards analyses were performed to determine the associations between anemia (defined as hemoglobin < 110 g/L) and hemoglobin and all-cause mortality, all-cause hospitalization, and cardiovascular-specific hospitalization. Overall, there were 1983 deaths and 7278 first hospitalizations. In patients with normal kidney function, adjusting for age, sex, diabetes mellitus, and comorbidity, anemia was associated with an increased risk for death (hazard ratio [HR], 4.29; 95% confidence interval [CI], 3.55-5.12), first all-cause hospitalization (HR, 2.16; 95% CI, 1.88-2.48), and first cardiovascular-specific hospitalization (HR, 2.49; 95% CI, 1.99-3.12). An inverse J-shaped relationship between hemoglobin and all-cause mortality was observed; the lowest risk for mortality occurred at hemoglobin values between 130 to 150 g/L for women and 140 to 170 g/L for men. Anemia is associated with an increased risk for hospitalization and death in community-dwelling older adults. Consideration should be given to redefine “normal” hemoglobin values in the elderly. Clinical trials are also necessary to determine whether anemia correction improves quality or quantity of life in this population.

The Modified Healthy Ageing Index Is Associated with Mortality and Disability: The Rugao Longevity and Ageing Study

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Hui Zhang ◽  
Yinsheng Zhu ◽  
Meng Hao ◽  
Jiucun Wang ◽  
Zhengdong Wang ◽  
...  
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
Predictive Ability ◽  
The Elderly ◽  
Cox Proportional Hazards ◽  
Adverse Outcomes ◽  
Healthy Ageing ◽  
Sensitivity Analyses ◽  
Logistic Regression Models ◽  
Ageing Study

<b><i>Introduction:</i></b> The Healthy Ageing Index (HAI) has been shown not only to have wider applicability and predictive ability but also to adequately predict mortality in Western populations. There is still a lack of studies validating the applicability of the HAI in China. <b><i>Objective:</i></b> To evaluate the applicability of the HAI and validate whether the HAI is suitable for monitoring ageing in the elderly population in China. <b><i>Methods:</i></b> Data were obtained from the Rugao Longevity and Ageing Study. The modified HAI was constructed based on systolic blood pressure, chronic pulmonary diseases, cognitive function, fasting glucose, and kidney function. It was calculated in 1719 individuals aged 70–84 years at baseline. The adverse outcomes were mortality and disability. Demographic, physiologic, and clinical data were collected. Cox proportional hazards and logistic regression models were used to analyze the relationship between the modified HAI and adverse outcomes. <b><i>Results:</i></b> A total of 1,719 older adults were analyzed in our study. A total of 793 (46.13%) males were recruited. The mean age was 75.69 ± 3.93 years. At the 5-year follow-up, there were 266 deaths and 275 individuals with disabilities. In the multivariable models, the modified HAI was associated with mortality (hazard ratio = 1.11, 95% confidence interval [CI]: 1.03–1.20) and disability (odds ratio = 1.11, 95% CI: 1.05–1.18). In the sensitivity analyses, similar associations remained after imputing missing data using multiple imputation and excluding participants with major cardiovascular disease at baseline. <b><i>Conclusion:</i></b> The modified HAI was a robust and independent predictor of adverse outcomes. It is a valid and feasible tool for monitoring ageing in older adults.

Effects of social network diversity on mortality, cognition and physical function in the elderly: a longitudinal analysis of the Chicago Health and Aging Project (CHAP)

2018 ◽  
Vol 72 (11) ◽  
pp. 990-996 ◽  
Author(s):  
Talha Ali ◽  
Charlotte Juul Nilsson ◽  
Jennifer Weuve ◽  
Kumar B Rajan ◽  
Carlos F Mendes de Leon
Keyword(s):  
Older Adults ◽  
Social Networks ◽  
Social Network ◽  
Physical Function ◽  
Proportional Hazards ◽  
The Elderly ◽  
Network Size ◽  
Cox Proportional Hazards ◽  
Function Coefficient ◽  
Network Diversity

BackgroundHaving a larger social network has been shown to have beneficial effects on health and survival in adults, but few studies have evaluated the role of network diversity, in addition to network size. We explore whether social network diversity is associated with mortality, cognition and physical function among older black and white adults.MethodsData are obtained from the Chicago Health and Aging Project, a longitudinal, population-based study of adults aged 65 years and older at baseline. Using Cox proportional hazards regression, we estimate the hazard of mortality by network diversity (n=6497). The association between network diversity and cognition (n=6560) and physical function (n=6561) is determined using generalised estimating equations. Models were adjusted for age, gender, race, socioeconomic status, marital status and health-related variables.ResultsIn fully adjusted models, elderly with more diverse social networks had a lower risk of mortality (HR=0.93, p<0.01) compared with elderly with less diverse networks. Increased diversity in social networks was also associated with higher global cognitive function (coefficient=0.11, p<0.001) and higher physical function (coefficient=0.53, p<0.001).ConclusionsSocial networks are particularly important for older adults as they face the greatest threats to health and depend on network relationships, more than younger individuals, to meet their needs. Increasing diversity, and not just increasing size, of social networks may be essential for improving health and survival among older adults.

scholarly journals Gender differences in longevity in free-living older adults who eat-with-others: a prospective study in Taiwan

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016575 ◽  
Author(s):  
Yi-Chen Huang ◽  
Hsing-Ling Cheng ◽  
Mark L Wahlqvist ◽  
Yuan-Ting C Lo ◽  
Meei-Shyuan Lee
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
The Elderly ◽  
Health Condition ◽  
Cox Proportional Hazards ◽  
Dietary Quality ◽  
Secondary Outcome ◽  
Free Living ◽  
Dietary Recall ◽  
All Cause Mortality

ObjectivesSocial activities such as ‘eating-with-others’ can positively affect the ageing process. We investigated the gender-specific association between eating arrangements and risk of all-cause mortality among free-living older adults.SettingA representative sample from the Elderly Nutrition and Health Survey in Taiwan during 1999–2000.ParticipantsSome 1894 participants (955 men and 939 women) who aged ≥65 and completed eating arrangement question as well as confirmed survivorship information.Primary and secondary outcome measuresEating arrangements, health condition and 24-hour dietary recall information were collected at baseline. We classified eating arrangements as the daily frequency of eating-with-others (0–3). Survivorship was determined by the National Death Registry until the end of 2008. Cox proportional-hazards regression was used to assess the association between eating-with-others and mortality risk.ResultsOverall, 63.1% of men and 56.4% of women ate with others three times a day. Both men and women who ate with others were more likely to have higher meat and vegetable intakes and greater dietary quality than those who ate alone. The HRs (95% CI) for all-cause mortality when eating-with-others two and three times per day were 0.42 (0.28 to 0.61), 0.67 (0.52 to 0.88) in men and 0.68 (0.42 to 1.11), 0.86 (0.64 to 1.16) in women, compared with those who ate alone. Multivariable HRs (95% CI) adjusted for sociodemographic, nutritional and ‘activities of daily living’ covariates were 0.43 (0.25 to 0.73), 0.63 (0.41 to 0.98) in men and 0.68 (0.35 to 1.30), 0.69 (0.39 to 1.21) in women. With further adjustment for financial status, HR was reduced by 54% in men who ate with others two times a day. Pathway analysis shows this to be dependent on improved dietary quality by eating-with-others.ConclusionsEating-with-others is an independent survival factor in older men. Providing a social environment which encourages eating-with-others may benefit survival of older people, especially for men.

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