Dyadic Relationships Between Self-Rated Health and Cognition Among Older Adults and Their Spousal Caregivers

Abstract This study examines spouses who are in a caregiving situation to discern how they influence each other’s health. Previous studies reported health concordance and cross-domain effects among caregiver and care-recipient dyads. However, it is less understood of the health dyadic relationships among spouses who are in a caregiving situation. No studies have specifically looked into the relationship between self-rated health (SRH) and cognitive functioning among spousal caregiving dyads over time. In this study we analyzed the longitudinal reciprocal relationships between SRH and cognitive functioning measured by the Telephone Interview for Cognitive Status among older adults and their spousal caregivers, and whether the relationship differed by whether husband or wife was the caregiver. Longitudinal data from the Health and Retirement Study (2010-2016) on 540 dyads were pooled and analyzed using structural equation modeling under an actor-partner interdependence model. Results revealed cognitive concordance among older spouses in which caregivers’ cognition is associated with care-recipients’ cognition subsequently (β=0.05, p<.05). SRH concordance was not significant. Cross-domain results showed only one significant direction, that is, care-recipients’ cognition in the subsequent time was significantly correlated with caregivers’ SRH, regardless of whether husband (β=0.09, p<.05) or wife (β=0.08, p<.05) was the caregiver. Our study found that married couples in a spousal caregiving situation displayed cognitive but not overall health concordance, and cross-domain effects of caregiver’s SRH on spousal care recipient’s cognition subsequently. The reciprocal associations suggest that addressing and improving either partner’s physical health and cognition may benefit both dyad members.

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The Relationship Between Daily Rapid-Eye Movement Sleep and Cognitive Functioning in Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.518 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 159-159

Author(s):

Tiana Broen ◽

Tomiko Yoneda ◽

Jonathan Rush ◽

Jamie Knight ◽

Nathan Lewis ◽

...

Keyword(s):

Older Adults ◽

Working Memory ◽

Cognitive Functioning ◽

Eye Movement ◽

Rem Sleep ◽

Cognitive Tests ◽

Rapid Eye Movement ◽

Targeted Interventions ◽

The Impact ◽

The Relationship

Abstract Previous cross-sectional research suggests that age-related decreases in Rapid-Eye Movement (REM) sleep may contribute to poorer cognitive functioning (CF); however, few studies have examined the relationship at the intraindividual level by measuring habitual sleep over multiple days. Applying a 14-day daily diary design, the current study examines the dynamic relationship between REM sleep and CF in 69 healthy older adults (M age=70.8 years, SD=3.37; 73.9% female; 66.6% completed at least an undergraduate degree). A Fitbit device provided actigraphy indices of REM sleep (minutes and percentage of total sleep time), while CF was measured four times daily on a smartphone via ambulatory cognitive tests that captured processing speed and working memory. This research addressed the following questions: At the within-person level, are fluctuations in quantity of REM sleep associated with fluctuations in next day cognitive measures across days? Do individuals who spend more time in REM sleep on average, perform better on cognitive tests than adults who spend less time in REM sleep? A series of multilevel models were fit to examine the extent to which each index of sleep accounted for daily fluctuations in performance on next day cognitive tests. Results indicated that during nights when individuals had more REM sleep minutes than was typical, they performed better on the working memory task the next morning (estimate = -.003, SE = .002, p = .02). These results highlight the impact of REM sleep on CF, and further research may allow for targeted interventions for earlier treatment of sleep-related cognitive impairment.

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Cognitive Functioning and Late-Life Depression

Journal of the International Neuropsychological Society ◽

10.1017/s1355617714000198 ◽

2014 ◽

Vol 20 (5) ◽

pp. 461-467 ◽

Cited By ~ 47

Author(s):

Aaron M. Koenig ◽

Rishi K. Bhalla ◽

Meryl A. Butters

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Cognitive Functioning ◽

Neuropsychological Assessment ◽

Cognitive Deficits ◽

Late Life ◽

Cognitive Outcomes ◽

Review Of The Literature ◽

Late Life Depression ◽

The Relationship

AbstractThis brief report provides an introduction to the topic of cognitive functioning in late-life depression (LLD). In addition to providing a review of the literature, we present a framework for understanding the heterogeneity of cognitive outcomes in this highly prevalent disorder. In addition, we discuss the relationship between LLD and dementia, and highlight the importance of regularly assessing cognitive functioning in older adults who present with depressive symptoms. If cognitive deficits are discovered during a neuropsychological assessment, we recommend referral to a geriatric psychiatrist or cognitive neurologist, for evaluation and treatment of the patient’s symptoms. (JINS, 2014, 20, 1–7)

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Religiosity and self-rated health among older adults in Colombia

Colombia Medica ◽

10.25100/cm.v50i2.4012 ◽

2019 ◽

pp. 67-76

Author(s):

Carlos A Reyes Ortiz ◽

Claudia Payan ◽

Geraldine Altamar ◽

Jose F Gomez Montes ◽

Harold G Koenig

Keyword(s):

Older Adults ◽

Rural Areas ◽

Community Dwelling ◽

Cross Sectional Survey ◽

Significant Interaction Effect ◽

Cross Sectional ◽

Self Rated Health ◽

Urban And Rural Areas ◽

Fair Poor ◽

The Relationship

Objective: To identify the relationship between religiosity and self-rated health among older adults in Colombia. Methods: Data are drawn from the SABE (Salud, Bienestar y Envejecimiento) Colombia Study, a cross-sectional survey conducted in 2015 involving 18,871 community-dwelling adults aged 60 years and older living in urban and rural areas of Colombia. Religiosity was assessed by self-rated religiosity (how religious are you: not at all, somewhat or very). Self-rated health during previous 30 days was assessed as very good, good, fair, poor or very poor, analyzed as an ordinal variable(1-5) using weighted logistic regression, adjusting for confounders. Results: Those who were more religious were older, female, had lower socioeconomic status, and were more likely to be married. Multivariate analyses demonstrated that older adults who were more religious had better self-rated health (OR 0.92 95% CI 0.86- 0.99, p= 0.038); however, there was a significant interaction effect between gender and religiosity on self-rated health (p= 0.002), such that the relationship between religiosity and health was stronger in men (OR 0.86, 95% CI: 0.79-0.94, p= 0.001) but not significant in women. Conclusion: Older adults in Colombia who consider themselves more religious, especially men, are less likely to perceive their physical health as poor compared to those who are less religious.

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Religiousness and health-related quality of life of older adults

Revista de Saúde Pública ◽

10.1590/s0034-8910.2015049005416 ◽

2015 ◽

Vol 49 (0) ◽

Cited By ~ 7

Author(s):

Gina Andrade Abdala ◽

Miako Kimura ◽

Yeda Aparecida de Oliveira Duarte ◽

Maria Lúcia Lebrão ◽

Bernardo dos Santos

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Family Functioning ◽

Equation Modeling ◽

Health Related Quality ◽

Intrinsic Religiousness ◽

Related Quality ◽

Health Related ◽

The Relationship

OBJECTIVE To examine whether religiousness mediates the relationship between sociodemographic factors, multimorbidity and health-related quality of life of older adults. METHODS This population-based cross-sectional study is part of the Survey on Health, Well-Being, and Aging (SABE). The sample was composed by 911 older adults from Sao Paulo, SP, Southeastern Brazil. Structural equation modeling was performed to assess the mediator effect of religiousness on the relationship between selected variables and health-related quality of life of older adults, with models for men and women. The independent variables were: age, education, family functioning and multimorbidity. The outcome variable was health-related quality of life of older adults, measured by SF-12 (physical and mental components). The mediator variables were organizational, non-organizational and intrinsic religiousness. Cronbach’s alpha values were: physical component = 0.85; mental component = 0.80; intrinsic religiousness = 0.89 and family APGAR (Adaptability, Partnership, Growth, Affection, and Resolve) = 0.91. RESULTS Higher levels of organizational and intrinsic religiousness were associated with better physical and mental components. Higher education, better family functioning and fewer diseases contributed directly to improved performance in physical and mental components, regardless of religiousness. For women, organizational religiousness mediated the relationship between age and physical (β = 2.401, p < 0.01) and mental (β = 1.663, p < 0.01) components. For men, intrinsic religiousness mediated the relationship between education and mental component (β = 7.158, p < 0.01). CONCLUSIONS Organizational and intrinsic religiousness had a beneficial effect on the relationship between age, education and health-related quality of life of these older adults.

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INVESTIGATING THE RELATIONSHIP BETWEEN SOCIAL SUPPORT AND COGNITION AS MEDIATED BY HEALTH AND POSITIVE AFFECT

Innovation in Aging ◽

10.1093/geroni/igz038.2407 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S648-S648

Author(s):

Francesca Falzarano ◽

Karen L Siedlecki ◽

Timothy Salthouse

Keyword(s):

Social Support ◽

Social Networks ◽

Social Network ◽

Positive Affect ◽

Cognitive Performance ◽

Cognitive Aging ◽

Successful Aging ◽

Equation Modeling ◽

Self Rated Health ◽

The Relationship

Abstract Decreased social networks are common in old age after major life events such as retirement, loss of loved ones, and declining health (Shankar et al., 2013). Diminished social ties are associated with increased feelings of loneliness and perceived isolation, which can have negative effects on cognition and physical health. The current study examines the relationship between social support (assessed via the Social Network Questionnaire) and overall cognitive performance (assessed as a latent construct comprising indicators that represent mean verbal episodic memory, processing speed, reasoning, and spatial visualization), and investigates positive affect and self-rated health as mediators of this relationship. The current study included 5,125 participants between the ages of 18-99 years from the Virginia Cognitive Aging Project (VCAP). Cross-sectional analyses were conducted using structural equation modeling. After controlling for age and education, results showed that a social support construct (comprising indicators representing each social network subscale) significantly and positively predicted cognitive performance (.59, p< .001). This relationship was reduced to .22 (p <.001) when positive affect was included as a mediator, and to .14 (p< .001) when self-rated health was included as a mediator. When the variables were included in a joint mediation model the relationship between social support and cognition was .20 (p < .001). Thus, health and positive affect are partial mediators of the relationship between social support and cognition and may help explain the relationship between social support and cognition. Furthermore, these findings provide additional evidence that social networks may play an important role in successful aging.

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Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16101670 ◽

2019 ◽

Vol 16 (10) ◽

pp. 1670 ◽

Cited By ~ 4

Author(s):

Shervin Assari ◽

James Smith ◽

Mohsen Bazargan

Keyword(s):

Older Adults ◽

Gender Differences ◽

Los Angeles ◽

Social Relations ◽

Low Income ◽

Economically Disadvantaged ◽

African American Men ◽

Equation Modeling ◽

Men And Women ◽

Self Rated Health

Background. Although chronic medical conditions (CMCs), depression, and self-rated health (SRH) are associated, their associations may depend on race, ethnicity, gender, and their intersections. In predominantly White samples, SRH is shown to better reflect the risk of mortality and multimorbidity for men than it is for women, which suggests that poor SRH among women may be caused not only by CMCs, but also by conditions like depression and social relations—a phenomenon known as “the sponge hypothesis.” However, little is known about gender differences in the links between multimorbidity, depression, and SRH among African Americans (AAs). Objective. To study whether depression differently mediates the association between multimorbidity and SRH for economically disadvantaged AA men and women. Methods. This survey was conducted in South Los Angeles between 2015 to 2018. A total number of 740 AA older adults (age ≥ 55 years) were enrolled in this study, of which 266 were AA men and 474 were AA women. The independent variable was the number of CMCs. The dependent variable was SRH. Age and socioeconomic status (educational attainment and marital status) were covariates. Depression was the mediator. Gender was the moderator. Structural Equation Modeling (SEM) was used to analyze the data. Results. In the pooled sample that included both genders, depression partially mediated the effect of multimorbidity on SRH. In gender specific models, depression fully mediated the effects of multimorbidity on SRH for AA men but not AA women. For AA women but not AA men, social isolation was associated with depression. Conclusion. Gender differences exist in the role of depression as an underlying mechanism behind the effect of multimorbidity on the SRH of economically disadvantaged AA older adults. For AA men, depression may be the reason people with multimorbidity report worse SRH. For AA women, depression is only one of the many reasons individuals with multiple CMCs report poor SRH. Prevention of depression may differently influence the SRH of low-income AA men and women with multimorbidity.

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DNA methylation and cognitive functioning in healthy older adults

British Journal Of Nutrition ◽

10.1017/s0007114511003576 ◽

2011 ◽

Vol 107 (5) ◽

pp. 744-748 ◽

Cited By ~ 9

Author(s):

Olga J. G. Schiepers ◽

Martin P. J. van Boxtel ◽

Renate H. M. de Groot ◽

Jelle Jolles ◽

Frans J. Kok ◽

...

Keyword(s):

Older Adults ◽

Dna Methylation ◽

Folic Acid ◽

Cognitive Functioning ◽

Cognitive Performance ◽

Global Dna Methylation ◽

Older Individuals ◽

Healthy Older Adults ◽

Study Results ◽

The Relationship

Long-term supplementation with folic acid may improve cognitive performance in older individuals. The relationship between folate status and cognitive performance might be mediated by changes in methylation capacity, as methylation reactions are important for normal functioning of the brain. Although aberrant DNA methylation has been implicated in neurodevelopmental disorders, the relationship between DNA methylation status and non-pathological cognitive functioning in human subjects has not yet been investigated. The present study investigated the associations between global DNA methylation and key domains of cognitive functioning in healthy older adults. Global DNA methylation, defined as the percentage of methylated cytosine to total cytosine, was measured in leucocytes by liquid chromatography–MS/MS, in 215 men and women, aged 50–70 years, who participated in the Folic Acid and Carotid Intima-Media Thickness (FACIT) study (clinical trial registration number NCT00110604). Cognitive performance was assessed by means of the Visual Verbal Word Learning Task, the Stroop Colour-Word Interference Test, the Concept Shifting Test, the Letter–Digit Substitution Test and the Verbal Fluency Test. Using hierarchical linear regression analyses adjusted for age, sex, level of education, alcohol consumption, smoking status, physical activity, erythrocyte folate concentration and 5,10-methylenetetrahydrofolate reductase 677 C → T genotype, we found that global DNA methylation was not related to cognitive performance on any of the domains measured. The present study results do not support the hypothesis that global DNA methylation, as measured in leucocytes, might be associated with cognitive functioning in healthy older individuals.

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Modeling Longitudinal Relationships Between Habit and Physical Activity: Two Cross-Lagged Panel Design Studies in Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.2016-0212 ◽

2017 ◽

Vol 25 (3) ◽

pp. 464-473 ◽

Cited By ~ 3

Author(s):

Rob J.H. van Bree ◽

Catherine Bolman ◽

Aart N. Mudde ◽

Maartje M. van Stralen ◽

Denise A. Peels ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Structural Equation ◽

Functional Limitations ◽

Equation Modeling ◽

Design Studies ◽

Mediation Effects ◽

Measurement Results ◽

The Relationship ◽

Longitudinal Relationships

These longitudinal studies in older adults targeted mediated relationships between habit and physical activity (PA). In The Netherlands two independent studies were conducted among 1976 (Study 1: Mage = 63.63, SD = 8.66, 30% functional limitations) and 2140 (Study 2: Mage = 62.75, SD = 8.57, 45% functional limitations) adults aged 50 years or older. Cross-lagged panel designs were applied to examine whether habit mediates the relationship between prior and later PA and whether PA simultaneously mediates the relationship between prior and later habit. Data on habit and PA were collected by means of questionnaires at baseline (t0) and at 6 (t1) and 12 (t2) months after baseline measurement. Results of structural equation modeling analyses were not unambiguous. Indications for the existence of both hypothesized mediation effects were found, but no clear, unequivocal pattern appeared. Somewhat more support was found for the PA-habit-PA path than for the habit-PA-habit path. More research is needed to draw more definitive conclusions.

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Sarcopenic Obesity and Cognitive Functioning: The Mediating Roles of Insulin Resistance and Inflammation?

Current Gerontology and Geriatrics Research ◽

10.1155/2012/826398 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 26

Author(s):

M. E. Levine ◽

E. M. Crimmins

Keyword(s):

Insulin Resistance ◽

Older Adults ◽

Body Composition ◽

Cognitive Functioning ◽

Cognitive Performance ◽

Muscle Mass ◽

Significant Proportion ◽

Age Related ◽

Older Subjects ◽

The Relationship

This study examined the influence of insulin resistance and inflammation on the association between body composition and cognitive performance in older adults, aged 60–69 and aged 70 and older. Subjects included 1127 adults from NHANES 1999–2002. Body composition was categorized based on measurements of muscle mass and waist circumference as sarcopenic nonobese, nonsarcopenic obese, sarcopenic obese, and normal. Using OLS regression models, our findings suggest body composition is not associated with cognitive functioning in adults ages 60–69; however, for adults aged 70 and over, sarcopenia and obesity, either independently or concurrently, were associated with worse cognitive functioning relative to non-sarcopenic non-obese older adults. Furthermore, insulin resistance accounted for a significant proportion of the relationship between cognitive performance and obesity, with or without sarcopenia. Additionally, although high CRP was significantly associated with poorer cognitive functioning in adults ages 60–69, it did not influence the association between body composition and cognitive performance. This study provides evidence that age-related physiological maladaptations, such as metabolic deregulation, which are associated with abdominal fat, may simultaneously contribute to lower cognition and muscle mass, reflecting a degradation of multiple physiological systems.

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