scholarly journals Perception Versus Reality: Subjective and Objective Neighborhood Characteristics and Cognitive Function in REGARDS

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 703-703
Author(s):  
Jessica Finlay ◽  
Philippa Clarke ◽  
Lisa Barnes

Abstract Does the world shrink as we age? The neighborhood captures a spatial area someone inhabits and moves through on a daily basis. It reflects a balance between internal perceptions and abilities, and the external environment which may enable or restrict participation in everyday life. We frequently hear that older adults have shrinking neighborhoods given declining functional mobility. This is associated with declines in physical and cognitive functioning, depression, poorer quality of life, and mortality. Knowledge of the interplay between objective and subjective neighborhood measurement remains limited. This symposium will explore these linked yet distinct constructs based on secondary data analyses of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a racially diverse sample of 30,000+ aging Americans. Finlay investigates how someone’s perceived neighborhood size (in number of blocks) varies by individual and geographic characteristics including age, cognitive function, self-rated health, and urban/rural context. Esposito’s analyses focus on neighborhood size in relation to race and residential segregation. Clarke compares subjective perceptions of neighborhood parks and safety from crime to objective indicators, and examines variations by health and cognitive status. Barnes will critically consider implications for how older adults interpret and engage with their surrounding environments. The symposium questions the validity of neighborhood-based metrics to reflect the perspectives and experiences of older residents, particularly those navigating cognitive decline. It informs policy-making efforts to improve physical neighborhood environments and social community contexts, which are critical to the health and well-being of older adults aging in place.

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S26-S26
Author(s):  
Philippa J Clarke ◽  
Jessica M Finlay

Abstract Environmental factors may significantly increase the risk of, or buffer against, age-related cognitive decline, yet policies and practices to improve cognitive health outcomes to date largely overlook the role of neighborhoods and socio-physical environmental contexts. Residence in socioeconomically advantaged neighborhoods may promote cognitive function through greater density of physical and social resources (e.g., libraries, parks, coffee shops, air conditioning, community centers) that promote physical activity, facilitate mental stimulation, and encourage social engagement. This symposium will identify natural, built, and social environmental factors linked to changes in cognitive function over time (assessed by animal naming and world list learning tests) based on secondary data analyses of a national, racially diverse (42% Black), population-based sample of over 30,000 Americans aged 45+ in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study followed annually since 2003. The first two papers investigate the roles of racial residential segregation and education on cognitive function disparities at the neighborhood and city scale. The third paper explores fast-food restaurants as socially interactive community spaces for older adults that may help buffer against cognitive decline. The fourth paper investigates effects of local air temperature on cognitive testing performance, and discusses how regional differences and seasonality may buffer or exacerbate temperature-cognition associations. Altogether, the symposium elucidates how cognitive health is impacted by a complex interplay of individual and geographic factors. The papers inform policy-making efforts to improve physical neighborhood environments and social community contexts, which are critical to the well-being of older adults aging in place.


Author(s):  
Joy Bohyun Jang ◽  
Margaret T Hicken ◽  
Megan Mullins ◽  
Michael Esposito ◽  
Ketlyne Sol ◽  
...  

Abstract Objectives Residential segregation is one of the fundamental features of health disparities in the United States. Yet little research has examined how living in segregated metropolitan areas is related to cognitive function and cognitive decline with age. We examined the association between segregation at the Metropolitan Statistical Area (MSA) level and trajectories of age-related cognitive function. Method Using data from Black and White older adults in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study (n=18,913), we employed linear growth curve models to examine how living in racially segregated MSAs at baseline, measured by the degree of Non-Hispanic Black [NHB] isolation and NHB dissimilarity, was associated with trajectories of age-related cognitive function and how the associations varied by race and education. Results Living in MSAs with greater levels of isolation was associated with lower cognitive function (b=-0.093, p<0.05) but was not associated with rates of change in cognitive decline with age. No effects of living in isolated MSAs were found for those with at least a high school education, but older adults with less than a high school education had lower cognitive function in MSAs with greater isolation (b=-0.274, p<0.05). The degree of dissimilarity was not associated with cognitive function. The association between segregation and cognitive function did not vary by race. Discussion Metropolitan segregation was associated with lower cognitive function among older adults, especially for those with lower education living in racially isolated MSAs. This suggests complex associations between individual socioeconomic status, place, and cognitive health.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 598-598
Author(s):  
Ruixue Zhaoyang ◽  
Stacey Scott ◽  
Eric Cerino ◽  
Martin Sliwinski

Abstract Social relationships play an important role in cognitive health and aging. However, it is unclear how older adult’s cognitive function affects their everyday social interactions, especially for those with mild cognitive impairment (MCI). This study examined whether older adults with intact cognition vs. MCI differed in their daily social interactions. Community-dwelling older adults from the Einstein Aging Study (N=244, 70-91 yrs) reported their social interactions five times daily for 14 consecutive days using smartphones. Compared to those with normal cognitive function, older adults with MCI reported less frequent positive social interactions (p=0.012) and in-person social activities (p=0.006) on a daily basis. These two groups, however, did not show significant differences in their social relationships assessed by a conventional global questionnaire. The results support that, relative to global social relationships, daily social interactions are more sensitive, ecologically valid social markers that can facilitate the early detection of MCI.


Author(s):  
Jongnam Hwang ◽  
Sangmin Park ◽  
Sujin Kim

Cognitive function is a critical health issue in later life, the decline of which disrupts well-being and daily life function. Cognitive decline in older ages can also be understood in the context of the social environment such as social connectedness and engagement in personal life. This study aimed to examine: (1) whether participation in social activities contributes to preventing cognitive decline, and (2) what type of social activities are beneficial to maintaining cognitive function. Data from the Korean Longitudinal Study of Aging (KLOSA) 2006–2014, a longitudinal survey of the household-dwelling population aged 45 and older in Korea were used. The results revealed that Mini-Mental State Examination (MMSE) scores decreased with increasing age, at a rate of approximately 0.18 units across all age-gender groups, and the decrease was steeper for adults aged 65 and over. Participation in social gatherings was likely to delay the decline in cognitive function after the age of 65. In a gender-stratified model, social activity may not have an impact on the decline of cognitive function for men, whereas participation in social gatherings was negatively related to the decline of MMSE scores in women. This study suggests the need for a gender-stratified policy for preventing the decline of cognitive function while promoting engagement in social activities in Korean older adults.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 622-622
Author(s):  
Burcu Demiray ◽  
Minxia Luo ◽  
Matthew Grilli

Abstract The healthy aging model of the World Health Organization (2015) highlights the value of assessing and monitoring everyday activities in understanding health in old age. This symposium includes four studies that used the Electronically Activated Recorder (EAR), a portable recording device that periodically collects sound snippets in everyday life, to assess various real-life cognitive activities in the context of healthy aging. The four studies collected over 100,000 sound snippets (30-seconds long) over a few days from young and older adults in the US and Switzerland. Participants’ speech in the sound snippets were transcribed and coded for different cognitive activity information. Specifically, Haas and Kliegel have investigated the “prospective memory paradox” by examining the commonality and differences in utterances about retrospective and prospective memory failure in young and older adults’ everyday conversations. Demiray and colleagues investigated the relation between autobiographical memory functions and conversation types in young and older adults in relation to well-being. Luo and colleagues have identified the compensatory function of real-world contexts in cognitive aging: Their study showed that older adults benefited from talking with their spouse in producing complex grammatical structures. Finally, Polsinelli and colleagues found robust associations between language markers (e.g., prepositions, more numbers) and executive functions, highlighting the potential use of spontaneous speech in predicting cognitive status in healthy older adults. Finally, Prof. Matthew Grilli will serve as a discussant and provide an integrative discussion of the papers, informed by his extensive work on clinical and cognitive neuroscience of memory in relation to real-life contexts.


2016 ◽  
Vol 5 ◽  
Author(s):  
Keith E. Pearson ◽  
Virginia G. Wadley ◽  
Leslie A. McClure ◽  
James M. Shikany ◽  
Fred W. Unverzagt ◽  
...  

AbstractIdentifying factors that contribute to the preservation of cognitive function is imperative to maintaining quality of life in advanced years. Of modifiable risk factors, diet quality has emerged as a promising candidate to make an impact on cognition. The objective of this study was to evaluate associations between empirically derived dietary patterns and cognitive function. This study included 18 080 black and white participants aged 45 years and older from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort. Principal component analysis on data from the Block98 FFQ yielded five dietary patterns: convenience, plant-based, sweets/fats, Southern, and alcohol/salads. Incident cognitive impairment was defined as shifting from intact cognitive status (score >4) at first assessment to impaired cognitive status (score ≤4) at latest assessment, measured by the Six-Item Screener. Learning, memory and executive function were evaluated with the Word List Learning, Word List Delayed Recall, and animal fluency assessments. In fully adjusted models, greater consumption of the alcohol/salads pattern was associated with lower odds of incident cognitive impairment (highest quintile (Q5)v. lowest quintile (Q1): OR 0·68; 95 % CI 0·56, 0·84;Pfor trend 0·0005). Greater consumption of the alcohol/salads pattern was associated with higher scores on all domain-specific assessments and greater consumption of the plant-based pattern was associated with higher scores in learning and memory. Greater consumption of the Southern pattern was associated with lower scores on each domain-specific assessment (allP < 0·05). In conclusion, dietary patterns including plant-based foods and alcohol intake were associated with higher cognitive scores, and a pattern including fried food and processed meat typical of a Southern diet was associated with lower scores.


Author(s):  
Jessica R. Andrews-Hanna ◽  
Matthew D. Grilli ◽  
Muireann Irish

The brain’s default network (DN) has received considerable interest in the context of so-called “normal” and pathological aging. Findings have generally been couched in support of a pessimistic view of brain aging, marked by substantial loss of structural brain integrity accompanied by a host of impairments in brain and cognitive function. A critical look at the literature, however, reveals that the standard loss of integrity, loss of function (LILF) view in normal aging may not necessarily hold with respect to the DN and the internally guided functions it supports. Many internally guided processes subserved by the DN are preserved or enhanced in cognitively healthy older adults. Moreover, differences in motivational, contextual, and physiological factors between young and older adults likely influence the extant neuroimaging and cognitive findings. Accordingly, normal aging can be viewed as a series of possibly adaptive cognitive and DN-related alterations that bolster cognitive function and promote socioemotional well-being and stability in a stage of life noted for change. On the other hand, the available evidence reveals strong support for the LILF view of the DN in neurodegenerative disorders, whereby syndromes such as Alzheimer’s disease (AD) and semantic dementia (SD), characterized by progressive atrophy to distinct DN subsystems, display distinct aberrations in autobiographical and semantic cognition. Taken together, these findings call for more naturalistic, age-appropriate, and longitudinal paradigms when investigating neurocognitive changes in aging and to adequately assess and control for differences in non-neural factors that may obscure “true” effects of normal and pathological aging. A shift in the framework with which age-related alterations in internally guided cognition are interpreted may shed important light on the neurocognitive mechanisms differentiating healthy and pathological aging, leading to a more complete picture of the aging brain in all its complexity.


2020 ◽  
Vol 13 (11) ◽  
Author(s):  
Ozan Unlu ◽  
Emily B. Levitan ◽  
Evgeniya Reshetnyak ◽  
Jerard Kneifati-Hayek ◽  
Ivan Diaz ◽  
...  

Background: Despite potential harm that can result from polypharmacy, real-world data on polypharmacy in the setting of heart failure (HF) are limited. We sought to address this knowledge gap by studying older adults hospitalized for HF derived from the REGARDS study (Reasons for Geographic and Racial Differences in Stroke). Methods: We examined 558 older adults aged ≥65 years with adjudicated HF hospitalizations from 380 hospitals across the United States. We collected and examined data from the REGARDS baseline assessment, medical charts from HF-adjudicated hospitalizations, the American Hospital Association annual survey database, and Medicare’s Hospital Compare website. We counted the number of medications taken at hospital admission and discharge; and classified each medication as HF-related, non-HF cardiovascular-related, or noncardiovascular-related. Results: The vast majority of participants (84% at admission and 95% at discharge) took ≥5 medications; and 42% at admission and 55% at discharge took ≥10 medications. The prevalence of taking ≥10 medications (polypharmacy) increased over the study period. As the number of total medications increased, the number of noncardiovascular medications increased more rapidly than the number of HF-related or non-HF cardiovascular medications. Conclusions: Defining polypharmacy as taking ≥10 medications might be more ideal in the HF population as most patients already take ≥5 medications. Polypharmacy is common both at admission and hospital discharge, and its prevalence is rising over time. The majority of medications taken by older adults with HF are noncardiovascular medications. There is a need to develop strategies that can mitigate the negative effects of polypharmacy among older adults with HF.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S814-S814
Author(s):  
XinQi Dong ◽  
Melissa Simon

Abstract The increasing diversity in the aging population warrants systematic investigations regarding ethnic differences related to cognitive aging and ethnicity-unique risk factors. However, due to the great paucity of population-based longitudinal data on cognitive aging in racial/ethnic minority populations, our knowledge in this area remain limited. The purpose of this symposium is, therefore, to examine various psychological, socio-cultural, and physical factors associated with cognitive aging among U.S. Chinese older adults, representing one of the biggest and fastest growing older minority populations nationally. Using longitudinal data from a population-based prospective cohort study, namely The Population Study of ChINese Elderly in Chicago (PINE) with a sample size of 3,157, this symposium presents findings from five research projects. Session 1 investigates the relationship between psychological well-being and change of cognitive function over four years. Session 2 and 3 examine the relationships between two socio-cultural factors and cognitive function. Specifically, session 2 investigates the associations between immigration-related factors and the incidence of cognitive impairment. Session 3 explores the relationship between cognitive function and Tai-Chi practice. Session 4 and 5 examine the relationships between two physical health indicators and cognitive aging. Specifically, session 4 examines the relationship between physical function and change of cognitive function over two years. Session 5 explores the association between body mass index and cognitive function decline over two years. Taken together, this symposium aims to further our knowledge of cognitive aging among ethnically/culturally diverse populations. The research findings will identify unique factors related to cognitive aging in older minority populations.


Author(s):  
Ehud Bodner ◽  
Amit Shrira ◽  
Yaakov Hoffman ◽  
Yoav S Bergman

Abstract Objectives Evidence of daily fluctuations in subjective age and their association with older adults’ well-being was recently obtained. Yet, neither the simultaneous tracking of two daily views on aging (i.e., daily subjective age and daily ageist attitudes) nor their interactive effect on mental health (i.e., depressive symptoms) has been explored. We hypothesized that (a) at days on which older adults feel older or report high ageist attitudes they would report higher depressive symptoms, (b) combined older subjective age and high ageist attitudes will be associated with the highest daily depressive symptoms. Method Community-dwelling older adults (N = 134, mean age = 69.66) completed measures of subjective age, ageist attitudes, and depressive symptoms for 10 consecutive days. Results Daily older subjective age and higher ageist attitudes were related to higher depressive symptoms, but there was no combined effect of both on depressive symptoms. There was a significant three-way interaction between subjective age, ageist attitudes, and chronological age, demonstrating the interactive effect of subjective age and ageist attitudes on depressive symptoms only among the old-old respondents. Time-lagged analyses further showed that ageist attitudes during previous days predicted feeling older and more depressed on following days, but not vice versa. Discussion Results suggest that old-old individuals are more susceptible to a combination of negative views on aging on daily basis. Findings further support a daily assimilation process, whereby previous-day stereotypes are assimilated and manifested into one’s identity and mental health, so that one feels older and more depressed on subsequent days.


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