Cumulative Stress Burden and Cognitive Function in African American Adults Living in Low-Income Neighborhoods

Abstract African Americans (AA) are more likely to experience stressors due to racial discrimination and segregated neighborhoods, potentially contributing to higher risk for dementia. We investigated the association between stressors and cognitive function in older AA adults through cumulative stress burden (CSB) indices. Stressors and cognitive domains were measured in 253 participants >50 years, recruited from primarily AA neighborhoods in Pittsburgh, PA. CSB included perceived and psychological distress, unfair treatment, post-traumatic stress disorder, and neighborhood-level stressors such as walkability, safety, satisfaction, and social cohesion. Indices were formed by dichotomizing stressor scores and summing. Cognitive domains were z-scores adjusted for age, sex, and education. Adjusted generalized linear models assessed the relation between CSB indices and cognition, and between specific stressors and cognition. Interactions with age were tested. Greater individual-level CSB index was associated with lower language (□= -0.11, p= 0.03) and executive function (□= -0.087, p=0.04). The neighborhood-level CSB index was not associated with any cognitive domain. The combined index was marginally associated with language in adjusted models (□= -0.07, p= 0.05). There were no significant associations between specific stressors and cognition, except for neighborhood safety with 3MS (□= -0.28, p= 0.001) and language (□= -0.16, p= 0.02). Age interactions indicate that findings were stronger for younger participants. Greater cumulative stress is associated with poorer cognitive function in some domains in older AA. A comprehensive assessment of cumulative stress is vital in understanding the dimensionality of racialized stress for older adults potentially experiencing cognitive decline.

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Adjunctive cognitive remediation for schizophrenia using yoga: an open, non-randomised trial

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2011.00587.x ◽

2012 ◽

Vol 24 (2) ◽

pp. 91-100 ◽

Cited By ~ 32

Author(s):

Triptish Bhatia ◽

Akhilesh Agarwal ◽

Gyandeepak Shah ◽

Joel Wood ◽

Jan Richard ◽

...

Keyword(s):

Cognitive Function ◽

Randomised Trial ◽

Cognitive Remediation ◽

Cognitive Domain ◽

Medium Effect ◽

Major Depressive ◽

Treatment As Usual ◽

Cognitive Domains ◽

Yoga Therapy ◽

Persons With Schizophrenia

Background:Yoga therapy (YT) improves cognitive function in healthy individuals, but its impact on cognitive function among persons with schizophrenia (SZ) has not been investigated.Objective:To evaluate the adjunctive YT for cognitive domains impaired in SZ.Methods:Patients with SZ received YT or treatment as usual (TAU;n= 65,n= 23, respectively). Accuracy and speed for seven cognitive domains were assessed using a computerised neurocognitive battery (CNB), thus minimising observer bias. Separately, YT was evaluated among patients with bipolar I disorder (n= 40), major depressive disorder (n= 37) and cardiology outpatients (n= 68). All patients also received routine pharmacotherapy. Patients were not randomised to YT or TAU.Results:In comparison with the SZ/TAU group, the SZ/YT group showed significantly greater improvement with regard to measures of attention following corrections for multiple comparisons; the changes were more prominent among the men. In the other diagnostic groups, differing patterns of improvements were noted with small-to-medium effect sizes.Conclusions:Our initial analyses suggest nominally significant improvement in cognitive function in SZ with adjunctive therapies such as YT. The magnitude of the change varies by cognitive domain and may also vary by diagnostic group.

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Neighborhood Context, Police Behavior and Satisfaction with Police

Justice Research and Policy ◽

10.3818/jrp.5.1.2003.37 ◽

2003 ◽

Vol 5 (1) ◽

pp. 37-65 ◽

Cited By ~ 25

Author(s):

Michael D. Reisig ◽

Roger B. Parks

Keyword(s):

Linear Models ◽

Structural Characteristics ◽

Neighborhood Context ◽

Police Behavior ◽

Neighborhood Structure ◽

Physical Force ◽

Individual Level ◽

Perceived Quality Of Life ◽

Satisfaction With Police ◽

Neighborhood Level

Residents in neighborhoods characterized by concentrated poverty and high violent crime rates report lower levels of satisfaction with police. The prevailing neighborhood-level explanation posits that such outcomes are a product of ecologically structured unconventional norms and values regarding crime and criminal justice. What remains unanswered, however, is whether variation in police behavior affects citizens' attitudes independent of neighborhood structural characteristics (e.g., concentrated disadvantage). To address this question, we use four independent sources of data from the Project on Policing Neighborhoods (POPN) to estimate a series of hierarchical linear models to assess the influence of neighborhood-level police behavior. Our results suggest that alternative patrol strategies advocated by proponents of community policing—foot and bike patrols—have a direct positive effect on citizens' satisfaction, net of neighborhood structure and known individual-level correlates (e.g., perceived quality of life). In contrast, the use of physical force is (at best) only weakly associated with neighborhood-level satisfaction.

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The Effect of Cumulative Anticholinergic Use on the Cognitive Function of Older Adults: Results from the Personality and Total Health (PATH) Through Life Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa145 ◽

2020 ◽

Vol 75 (9) ◽

pp. 1706-1714 ◽

Cited By ~ 1

Author(s):

Malinee Neelamegam ◽

Janice Zgibor ◽

Henian Chen ◽

Kathleen O’rourke ◽

Chighaf Bakour ◽

...

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Linear Models ◽

Vigorous Physical Activity ◽

Neuropsychological Battery ◽

Cognitive Measures ◽

Cognitive Domains ◽

Life Study ◽

Trail Making ◽

Study Population

Abstract Background Multiple comorbidities are common in older adults, resulting in polypharmacy that often includes medications with anticholinergic properties. These medications have multiple side effects, which are more pronounced in the older population. This study examined the association between the use of anticholinergics and changes in the cognitive function of older adults. Methods The study population consisted of 2,222 individuals aged 65–69 years at baseline from the Personality and Total Health (PATH) Through Life Study in Australia. Medication data were obtained from the Pharmaceutical Benefits Scheme (PBS). Cognitive measures were obtained from neuropsychological battery assessment. Exposure to cumulative anticholinergic use was quantified to a total standardized daily dose (TSDD). The association between change in cognitive measures between baseline and 4-year follow-up, and cumulative use of anticholinergic was assessed through generalized linear models. Results During the study period, 18.6% (n = 413) of participants filled at least one prescription for anticholinergics. Compared to those not on anticholinergics, participants on anticholinergics were more likely to be woman (62.7% compared to 45.1%) and spent lesser time engaging in vigorous physical activity (0.4 h/week compared to 0.9 h/week). Cumulative use of anticholinergic resulting in a TSDD exceeding 1,095 was significantly associated with poorer performance in Trail Making Test Part B (Model 1: β = 5.77, Model 2: β = 5.33, Model 3: β = 8.32, p < .01), indicating impairment in processing speed. Conclusions In our study, except for speed of processing, other cognitive domains measured were not affected by cumulative anticholinergic use over a 4-year period.

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Neighborhood-level and individual-level socioeconomic status and self-reported management of ischaemic heart disease: cross-sectional results from the Korea Health Examinees Study

BMJ Open ◽

10.1136/bmjopen-2018-021577 ◽

2019 ◽

Vol 9 (3) ◽

pp. e021577

Author(s):

Jongho Heo ◽

Juhwan Oh ◽

Hwa-Young Lee ◽

Ji-Yeob Choi ◽

Sujin Kim ◽

...

Keyword(s):

Socioeconomic Status ◽

Heart Disease ◽

Ischaemic Heart Disease ◽

Low Income ◽

The Self ◽

Cross Sectional ◽

Individual Level ◽

Income Status ◽

School Graduation ◽

Neighborhood Level

ObjectiveSeveral studies identified neighbourhood context as a predictor of prognosis in ischaemic heart disease (IHD). The present study investigates the relationships of neighborhood-level and individual-level socioeconomic status with the odds of ongoing management of IHD, using baseline survey data from the Korea Health Examinees-Gem study.DesignIn this cross-sectional study, we estimated the association of the odds of self-reported ongoing management with the neighborhood-level income status and percentage of college graduates after controlling for individual-level covariates using two-level multilevel logistic regression models based on the Markov Chain Monte Carlo function.SettingA survey conducted at 17 large general hospitals in major Korean cities and metropolitan areas during 2005–2013.Participants2932 adult men and women.Outcome measureThe self-reported status of management after incident angina or myocardial infarction.ResultsAt the neighbourhood level, residence in a higher-income neighbourhood was associated with the self-reported ongoing management of IHD, after controlling for individual-level covariates [OR: 1.22, 95% credible interval (CI): 1.01 to 1.61). At the individual level, higher education was associated with the ongoing IHD management (high school graduation, OR: 1.33, 95% CI: 1.08 to 1.65); college or higher, OR: 1.63, 95% CI: 1.22 to 2.12; reference, middle school graduation or below).ConclusionsOur study suggests that policies or interventions aimed at improving the quality and availability of medical resources in low-income areas may associate with ongoing IHD management. Moreover, patient-centred education is essential for ongoing IHD management, especially when targeted to patients with IHD with a low education level.

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Cognitive function in schizophrenia: conflicting findings and future directions

Reviews in the Neurosciences ◽

10.1515/revneuro-2015-0060 ◽

2016 ◽

Vol 27 (4) ◽

pp. 435-448 ◽

Cited By ~ 10

Author(s):

Ahmed A. Moustafa ◽

Julia K. Garami ◽

Justin Mahlberg ◽

Jan Golembieski ◽

Szabolcs Keri ◽

...

Keyword(s):

Individual Differences ◽

Cognitive Function ◽

Negative Symptoms ◽

Cognitive Domain ◽

Antipsychotic Treatment ◽

Future Directions ◽

Cognitive Domains ◽

Memory And Attention ◽

Cognitive Studies ◽

Positive And Negative Symptoms

AbstractIntroduction: Schizophrenia is a severe mental disorder with multiple psychopathological domains being affected. Several lines of evidence indicate that cognitive impairment serves as the key component of schizophrenia psychopathology. Although there have been a multitude of cognitive studies in schizophrenia, there are many conflicting results. We reasoned that this could be due to individual differences among the patients (i.e. variation in the severity of positive vs. negative symptoms), different task designs, and/or the administration of different antipsychotics.Methods: We thus review existing data concentrating on these dimensions, specifically in relation to dopamine function. We focus on most commonly used cognitive domains: learning, working memory, and attention.Results: We found that the type of cognitive domain under investigation, medication state and type, and severity of positive and negative symptoms can explain the conflicting results in the literature.Conclusions: This review points to future studies investigating individual differences among schizophrenia patients in order to reveal the exact relationship between cognitive function, clinical features, and antipsychotic treatment.

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68 Cognitive Impairment in Schizophrenia. First-generation Long-acting Antipsychotics versus Aripiprazole Long-acting Injectable

CNS Spectrums ◽

10.1017/s1092852919000531 ◽

2019 ◽

Vol 24 (1) ◽

pp. 211-212 ◽

Cited By ~ 2

Author(s):

Samuel-Leopoldo Romero Guillena ◽

Beatriz-Oda Plasencia García de Diego

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Verbal Memory ◽

First Generation ◽

Motor Task ◽

Cognitive Domain ◽

Motor Speed ◽

Cross Sectional ◽

Cognitive Domains ◽

Long Acting

AbstractStudy ObjectivesTo assess differences in cognitive impairment in a group of patients with schizophrenia receiving first-generation long-acting antipsychotics (FG-LAI) versus Aripiprazole long-actinginjectable (ALAI).MethodA descriptive, cross-sectional, multi-centerstudy.Study sample: 28 outpatients with stable schizophrenia (18 men and 10 women) with ages ranging from 22 to 64years.Inclusion criteria were: Clinically stable patients with a diagnosis of schizophrenia (according to DSM-5 criteria) and without any changes to their antipsychotic or antidepressant therapy in the last six months.Simple stratified sampling was performed to collect data from patients with schizophrenia receiving FG-LAI (n=14) versus patients with schizophrenia receiving Aripiprazole long-acting injectable (ALAI) (n=14)Groups were matched by age, gender, years of evolution of the disease, and years on formal education.Functionality in the different cognitive domains was evaluated based on the Brief Assessment of cognition in Schizophrenia (BACS.), a hetero-applied instrument, which Spanish version has been validated. BACS evaluates the following cognitive domains:Verbal memory (V.M): Word list testWorking memory (W.M): Digit sequencing taskMotor speed (M.S): Token motor taskVerbal fluency (V.F): Semantic or category fluencyAttention (A): Symbol codingExecutive function (E.F): Tower of LondonThe data obtained were analyzed using the SPSS 22.0 statistical package Differences between the means of quantitative variables were assessed using the independent-sample Student-t test. Individual test scores were converted into standardized (T and Z) scores and composite scores that were corrected for age and gender.Informed consent was obtained from all patients according to the Declaration of Helsinki (World Medical Association).ResultsIn the group receiving ALAI, the most severely impaired cognitive domain was attention, whereas motor speed was barely affected. In contrast, verbal memory was most impaired, whereas motor speed was the least impaired cognitive domain in the group receiving FG-LAI.Patients with schizophrenia taking ALAI showed a better cognitive function in all domains (except for motor speed and attention) than patients receiving FG-LAI.Summarized results in Table1.ConclusionsIn our study, patients with schizophrenia receiving Aripiprazole long-acting injectable have better cognitive function than patients receiving first-generation long-acting antipsychotics.

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Neighborhood Deprivation and Risks of Autoimmune Disorders: A National Cohort Study in Sweden

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16203798 ◽

2019 ◽

Vol 16 (20) ◽

pp. 3798

Author(s):

Xinjun Li ◽

Jan Sundquist ◽

Tsuyoshi Hamano ◽

Kristina Sundquist

Keyword(s):

Low Income ◽

Hashimoto Thyroiditis ◽

Potential Effect ◽

Diabetes Mellitus Type 1 ◽

Autoimmune Disorders ◽

Swedish Population ◽

Neighborhood Deprivation ◽

Individual Level ◽

Deprived Neighborhoods ◽

Neighborhood Level

Background: No study to date, as far as we know, has analyzed the potential effect of neighborhood-level deprivation on autoimmune disorders (ADs), when adjusted for individual-level characteristics. Methods: A total of 5.4 million individuals from 8363 neighborhoods, comprising the whole Swedish population (ages 25–74 years), were followed for the period 1 January 2000, until admission due to diagnosis of ADs during the period of the study, or the conclusion of the study (31 December 2010). We used a neighborhood deprivation index, constructed from variables such as low education, low income, unemployment, and social welfare assistance, to assess the level of neighborhood deprivation. Multilevel logistic regression was used in the analysis with individual level characteristics at the first level and level of neighborhood deprivation at the second level. Results: A significant association between level of neighborhood deprivation and ADs was found. The crude odds were 1.32 (95% confidence interval 1.27–1.36) for those residing in the high-deprived neighborhoods compared to those living in low-deprivation neighborhoods. In the full model, where individual level characteristics were taken into account, the odds of ADs were 1.18 (1.14–1.22) in the most deprived neighborhoods. Certain Ads—angiitis hypersensitive (5.14), ankylosing spondylitis (1.66), celiac disease (1.65), Crohn’s disease (1.21), diabetes mellitus type 1 (1.45), Graves’s disease (1.13), Hashimoto thyroiditis (1.51), psoriasis (1.15), rheumatoid arthritis (1.15), sarcoidosis (1.20), and systemic sclerosis (1.27)—remained significantly associated with high level of neighborhood deprivation after adjustment for the individual-level variables. Conclusion: This study is the largest to date analyzing the potential influence of neighborhood deprivation on ADs. Our results indicate that neighborhood deprivation may affect risk of ADs, independent of individual level sociodemographic characteristics. For health care policies, both individual and neighborhood level approaches seem to be of importance.

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The effect of androgen deprivation therapy (ADT) on cognition in men with prostate cancer

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.14626 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 14626-14626

Author(s):

Z. Allibhai ◽

S. M. Alibhai

Keyword(s):

Prostate Cancer ◽

Cognitive Function ◽

English Language ◽

The Elderly ◽

Small Sample ◽

Cognitive Domain ◽

Cognitive Domains ◽

Medline Search ◽

The Impact

14626 Background: ADT plays a central role in the management of prostate cancer. However, there is emerging evidence that ADT use may adversely affect cognition. Given the long natural history of prostate cancer and the elderly population it predominantly affects, this may be an important survivorship issue in this population. Methods: We performed a MEDLINE search of English-language literature from 1966 to December 2005 and identified eight prospective studies that evaluated the effect of ADT on cognition and one study that investigated the effect of therapy on the cognition of patients receiving ADT. Due to differences in study design and outcomes, studies could not be combined meta-analytically. Results: Studies were small, ranging from 19–82 patients. ADT was used in the neoadjuvant setting in 2 studies, a neoadjuvant or adjuvant setting in 1 study, and in a palliative setting for high-risk disease in 5 studies. Controls were featured in 4 studies. Follow-up ranged from 6 to 13 months. A variety of cognitive domains were assessed (using traditional and computer-based neuropsychological tasks). Whereas 4 studies found worsening in one or more domains in patients over time, 4 studies showed either no worsening or improvement in one or more cognitive domains after ADT was instituted. No cognitive domain was consistently affected by ADT. Three of the studies included follow-up 3 months after ADT was stopped and all 3 showed at least some improvement in cognitive function. Short-term supplementation with estradiol did not improve cognitive function in 1 study. There were fundamental differences across studies in terms of patient populations, cognitive domains tested and specific tests used, and type of ADT. Other important limitations included small sample sizes, limited follow-up, and practice effects. Conclusions: The impact of ADT on cognitive function and its potential reversibility are unclear, and further studies are needed. In the meantime, clinicians and patients should continue to carefully weigh the potential benefits and risks of ADT when making treatment decisions. No significant financial relationships to disclose.

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An Evaluation of DNA Methyltransferase 1 (DNMT1) Single Nucleotide Polymorphisms and Chemotherapy-Associated Cognitive Impairment: A Prospective, Longitudinal Study

Scientific Reports ◽

10.1038/s41598-019-51203-y ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 4

Author(s):

Alexandre Chan ◽

Angie Yeo ◽

Maung Shwe ◽

Chia Jie Tan ◽

Koon Mian Foo ◽

...

Keyword(s):

Breast Cancer ◽

Cognitive Impairment ◽

Cognitive Function ◽

Cancer Patients ◽

Dna Methyltransferase ◽

Dna Methyltransferases ◽

Breast Cancer Patients ◽

Prospective Longitudinal Study ◽

Cognitive Domains ◽

Prospective Longitudinal

Abstract Strong evidence suggests that genetic variations in DNA methyltransferases (DNMTs) may alter the downstream expression and DNA methylation patterns of neuronal genes and influence cognition. This study investigates the association between a DNMT1 polymorphism, rs2162560, and chemotherapy-associated cognitive impairment (CACI) in a cohort of breast cancer patients. This is a prospective, longitudinal cohort study. From 2011 to 2017, 351 early-stage breast cancer patients receiving chemotherapy were assessed at baseline, the midpoint, and the end of chemotherapy. DNA was extracted from whole blood, and genotyping was performed using Sanger sequencing. Patients’ self-perceived cognitive function and cognitive performance were assessed at three different time points using FACT-Cog (v.3) and a neuropsychological battery, respectively. The association between DNMT1 rs2162560 and cognitive function was evaluated using logistic regression analyses. Overall, 33.3% of the patients reported impairment relative to baseline in one or more cognitive domains. Cognitive impairment was observed in various objective cognitive domains, with incidences ranging from 7.2% to 36.9%. The DNMT1 rs2162560 A allele was observed in 21.8% of patients and this was associated with lower odds of self-reported cognitive decline in the concentration (OR = 0.45, 95% CI: 0.25–0.82, P = 0.01) and functional interference (OR = 0.48, 95% CI: 0.24–0.95, P = 0.03) domains. No significant association was observed between DNMT1 rs2162560 and objective cognitive impairment. This is the first study to show a significant association between the DNMT1 rs2162560 polymorphism and CACI. Our data suggest that epigenetic processes could contribute to CACI, and further studies are needed to validate these findings.

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Pro-Environmental Behavior in an Aging World: Evidence from 31 Countries

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041748 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1748

Author(s):

Yan Wang ◽

Feng Hao ◽

Yunxia Liu

Keyword(s):

Linear Models ◽

Population Change ◽

Population Aging ◽

Environmental Behavior ◽

National Level ◽

The Elderly ◽

Human Beings ◽

Individual Level ◽

Contemporary World ◽

The Individual

Population change and environmental degradation have become two of the most pressing issues for sustainable development in the contemporary world, while the effect of population aging on pro-environmental behavior remains controversial. In this paper, we examine the effects of individual and population aging on pro-environmental behavior through multilevel analyses of cross-national data from 31 countries. Hierarchical linear models with random intercepts are employed to analyze the data. The findings reveal a positive relationship between aging and pro-environmental behavior. At the individual level, older people are more likely to participate in environmental behavior (b = 0.052, p < 0.001), and at the national level, living in a country with a greater share of older persons encourages individuals to behave sustainably (b = 0.023, p < 0.01). We also found that the elderly are more environmentally active in an aging society. The findings imply that the longevity of human beings may offer opportunities for the improvement of the natural environment.

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