Housing, Neighborhood Factors, and Cognitive Status of Older Adults Living in Houses Versus Apartments

Abstract This study examines associations between housing, neighborhood factors and cognitive status among community-dwelling older adults, and how the associations differ between older adults who live in houses and in apartment buildings. Specifically, using the neighborhood stressor theory, three research questions are examined: 1) What individual-level factors predict late-life cognitive status? 2) After controlling for individual-level factors, what housing and neighborhood factors are significant in predicting older adults’ cognitive status? 3) How do individual, housing, neighborhood predictors of cognitive status differ between house and apartment residents? Using data from the Wave 3 NSHAP, multilevel linear regression analyses are conducted with the total sample. Results suggest that individual-level factors including young-age, female, white, and having a bachelor’s degree are associated with better cognitive status. After controlling for individual-level factors, housing and neighborhood factors including quality maintenance and high level of community safety are associated with higher cognitive scores. In addition to the additive model, we also test the interactive effect between housing type and three level of factors –individual level, housing, and neighborhood factors. Findings suggest that the joint effect of depression and housing type on cognitive status is significant. To explore the last research question, we conduct parallel regression analyses by housing type. Findings suggest that quality maintenance and high level of community safety are associated with higher cognitive scores among house residents only. Findings highlight the predictors of cognitive health vary between older adults living in different residential environments.

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Prediction of 11-year incidence of psychophysically dependent status or death among community-dwelling younger elderlies: from an age-specified community-based cohort study (the NISSIN project)

Environmental Health and Preventive Medicine ◽

10.1186/s12199-021-00968-8 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Satoe Okabayashi ◽

Takashi Kawamura ◽

Hisashi Noma ◽

Kenji Wakai ◽

Masahiko Ando ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Cohort Study ◽

Prediction Model ◽

Nursing Care ◽

Family Members ◽

Limited Resource ◽

Community Dwelling ◽

Older Individuals ◽

Regression Analyses

Abstract Background Predicting adverse health events and implementing preventative measures are a necessary challenge. It is important for healthcare planners and policymakers to allocate the limited resource to high-risk persons. Prediction is also important for older individuals, their family members, and clinicians to prepare mentally and financially. The aim of this study is to develop a prediction model for within 11-year dependent status requiring long-term nursing care or death in older adults for each sex. Methods We carried out age-specified cohort study of community dwellers in Nisshin City, Japan. The older adults aged 64 years who underwent medical check-up between 1996 and 2005 were included in the study. The primary outcome was the incidence of the psychophysically dependent status or death or by the end of the year of age 75 years. Univariable logistic regression analyses were performed to assess the associations between candidate predictors and the outcome. Using the variables with p-values less than 0.1, multivariable logistic regression analyses were then performed with backward stepwise elimination to determine the final predictors for the model. Results Of the 1525 female participants at baseline, 105 had an incidence of the study outcome. The final prediction model consisted of 15 variables, and the c-statistics for predicting the outcome was 0.763 (95% confidence interval [CI] 0.714–0.813). Of the 1548 male participants at baseline, 211 had incidence of the study outcome. The final prediction model consisted of 16 variables, and the c-statistics for predicting the outcome was 0.735 (95% CI 0.699–0.771). Conclusions We developed a prediction model for older adults to forecast 11-year incidence of dependent status requiring nursing care or death in each sex. The predictability was fair, but we could not evaluate the external validity of this model. It could be of some help for healthcare planners, policy makers, clinicians, older individuals, and their family members to weigh the priority of support.

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Self-Perceived Hearing Loss, Hearing-Help Seeking and Hearing Aid Adoption Among Older Adults in Malaysia

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489418795982 ◽

2018 ◽

Vol 127 (11) ◽

pp. 798-805 ◽

Cited By ~ 1

Author(s):

Siti Zamratol Mai Sarah Mukari ◽

Wan Fazlina Wan Hashim

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Help Seeking ◽

Hearing Aid ◽

Pure Tone Audiometry ◽

Cognitive Status ◽

Community Dwelling ◽

Hearing Level ◽

Low Sensitivity ◽

Single Question

Introduction: The aims of this study were to examine the validity of self-perceived hearing loss in detecting hearing loss and factors associated with self-perceived hearing loss and hearing-help seeking and to report hearing aid adoption among a group of community-dwelling older adults in Malaysia. Methods: A total of 301 older adults (⩾60 years of age) participating in a study on aging had their hearing tested using pure-tone audiometry. Self-perceived hearing loss was assessed using a single question. Sociodemographic profile, otologic history, and general cognitive status were also obtained. Results: A single question had low sensitivity in detecting actual hearing loss: 31.3% for 4-frequency average > 25 dBHL and 48.8% for 4-frequency average > 40 dBHL. Besides hearing level, history of otorrhea and tinnitus were factors that were associated with self-perceived hearing loss among older adults with at least mild hearing loss. Hearing-help-seeking behavior was not associated with any of the tested variables. The hearing aid adoption rate was 2.7% and 7.3% among participants with 4-frequency averages > 25 dBHL and > 40 dBHL, respectively. Conclusion: The underestimation of hearing loss in the majority of older adults in this study poses a potential barrier to hearing loss intervention.

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Long-Term Exposure to Air Pollutants and Cognitive Function in Taiwanese Community-Dwelling Older Adults: A Four-Year Cohort Study

Advances in Alzheimer’s Disease - Alzheimer’s Disease and Air Pollution ◽

10.3233/aiad210022 ◽

2021 ◽

Author(s):

Jen-Hau Chen ◽

Tsung-Yu Kuo ◽

Hwa-Lung Yu ◽

Charlene Wu ◽

Su-Ling Yeh ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Executive Function ◽

Verbal Fluency ◽

Air Pollutants ◽

Community Dwelling ◽

High Concentrations ◽

High Level ◽

Community Dwelling Older Adults

Background: Previous studies have assessed limited cognitive domains with relatively short exposure to air pollutants, and studies in Asia are limited. Objective: This study aims to explore the association between long-term exposure to air pollutants and cognition in community-dwelling older adults. Methods: This four-year prospective cohort study recruited 605 older adults at baseline (2011–2013) and 360 participants remained at four-year follow-up. Global and domain-specific cognition were assessed biennially. Data on PM2.5 (particulate matter ≤ 2.5 μm diameter, 2005–2015), PM10 (1993–2015), and nitrogen dioxide (NO2, 1993–2015) were obtained from Taiwan Environmental Protection Administration (TEPA). Bayesian Maximum Entropy was utilized to estimate the spatiotemporal distribution of levels of these pollutants. Results: Exposure to high-level PM2.5 (>29.98 μg/m3) was associated with an increased risk of global cognitive impairment (adjusted odds ratio = 4.56; β = −0.60). High-level PMcoarse exposure (>26.50 μg/m3) was associated with poor verbal fluency (β = −0.19). High-level PM10 exposure (>51.20 μg/m3) was associated with poor executive function (β = −0.24). Medium-level NO2 exposure (>28.62 ppb) was associated with better verbal fluency (β = 0.12). Co-exposure to high concentrations of PM2.5, PMcoarse or PM10 and high concentration of NO2 were associated with poor verbal fluency (PM2.5 and NO2: β = −0.17; PMcoarse and NO2: β = −0.23; PM10 and NO2: β = −0.21) and poor executive function (PM10 and NO2: β = −0.16). These associations became more evident in women, apolipoprotein ε4 non-carriers, and those with education > 12 years. Conclusion: Long-term exposure to PM2.5 (higher than TEPA guidelines), PM10 (lower than TEPA guidelines) or co-exposure to PMx and NO2 were associated with poor global, verbal fluency, and executive function over 4 years.

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THE RELATIONSHIP BETWEEN COGNITION, FUNCTIONAL ABILITIES, AND THE LATENT DEMENTIA PHENOTYPE AMONG CENTENARIANS

Innovation in Aging ◽

10.1093/geroni/igz038.3498 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S965-S965

Author(s):

Jonathan Sober ◽

John L Woodard ◽

L Stephen Miller ◽

Adam Davey ◽

Peter Martin ◽

...

Keyword(s):

Older Adults ◽

Cognitive Abilities ◽

Latent Variable ◽

Structural Equation ◽

Cognitive Status ◽

Community Dwelling ◽

Self Report ◽

Functional Abilities ◽

Cognitive Changes ◽

Dementia Severity

Abstract Adequate assessment of cognitive abilities and functional capacity is essential for a diagnosis of dementia. However, cognition is only moderately related to functional status, and this relationship is poorly understood among centenarians, a group of older adults with high risk for dementia. A bifactor structural equation model can be used to delineate the variance attributed to dementia-specific related cognitive changes (i.e., the latent variable delta) and the variance due to general intelligence (i.e., g’). This study aimed to determine the validity of delta as a marker of cognitive decline among centenarians. It was hypothesized that delta was correlated with cognitive status, functional abilities and, dementia severity. Overall, 244 community dwelling centenarians (Mage = 100.58, 84.8% female) were recruited through the Georgia Centenarian Study, a population-based study of octogenarians and centenarians from northern Georgia. Older adults were administered measures of cognition and a self-report measure of functional abilities. Latent variable scores (i.e., g’ and delta) were modeled and correlated with standard global cognitive screening measures (i.e., MMSE) and measures of dementia severity. Results indicate that delta was significantly correlated with functional ability and cognitive abilities. Consistent with our hypotheses, delta was also significantly related to dementia severity. Overall, estimates of the latent dementia phenotype, delta, were significantly related to cognitive and functional abilities among centenarians, providing validation of delta as a useful index of dementia severity.

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As Goes the City? Older Americans’ Home Upkeep in the Aftermath of the Great Recession

Social Problems ◽

10.1093/socpro/spz022 ◽

2019 ◽

Vol 67 (2) ◽

pp. 379-397

Author(s):

Markus H Schafer ◽

Jason Settels ◽

Laura Upenieks

Keyword(s):

Older Adults ◽

Great Recession ◽

Fixed Effects ◽

Physical Space ◽

Community Dwelling ◽

Older Americans ◽

Individual Level ◽

The Great Recession ◽

Fixed Effects Regression ◽

Community Dwelling Older Adults

Abstract The private home is a crucial site in the aging process, yet the upkeep of this physical space often poses a challenge for community-dwelling older adults. Previous efforts to explain variation in disorderly household conditions have relied on individual-level characteristics, but ecological perspectives propose that home environments are inescapably nested within the dynamic socioeconomic circumstances of surrounding spatial contexts, such as the metro area. We address this ecological embeddedness in the context of the Great Recession, an event in which some U.S. cities saw pronounced and persistent declines across multiple economic indicators while other areas rebounded more rapidly. Panel data (2005–6 and 2010–11) from a national survey of older adults were linked to interviewer home evaluations and city-level economic data. Results from fixed-effects regression support the hypothesis that older adults dwelling in struggling cities experienced an uptick in disorderly household conditions. Findings emphasize the importance of city-specificity when probing effects of a downturn. Observing changes in home upkeep also underscores the myriad ways in which a city’s most vulnerable residents— older adults, in particular—are affected by its economic fortunes.

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Clinical and Ambulatory Gait Speed in Older Adults: Associations With Several Physical, Mental, and Cognitive Health Outcomes

Physical Therapy ◽

10.1093/ptj/pzz186 ◽

2020 ◽

Vol 100 (4) ◽

pp. 718-727

Author(s):

Miguel Á De la Cámara ◽

Sara Higueras-Fresnillo ◽

Kabir P Sadarangani ◽

Irene Esteban-Cornejo ◽

David Martinez-Gomez ◽

...

Keyword(s):

Older Adults ◽

Health Outcomes ◽

Predictive Validity ◽

Gait Speed ◽

Well Being ◽

Cognitive Status ◽

Community Dwelling ◽

Walk Test ◽

Physical And Mental Health ◽

Cognitive Health

Abstract Background Although clinical gait speed may indicate health and well-being in older adults, there is a lack of studies comparing clinical tests with ambulatory gait speed with regard to several health outcomes. Objective The objective of this study was to examine the associations of clinical gait speed, measured by the 2.44-m walk test and the ambulatory gait speed with several physical, mental, and cognitive health outcomes in older adults. Design A cross-sectional design was used. Methods The study population comprised 432 high-functioning, community-dwelling older adults (287 women) aged between 65 and 92 years. Clinical and ambulatory gait speeds were measured using the 2.44-m walk test and a portable gait analysis device, respectively. Multiple linear regressions were used to examine the association of clinical and ambulatory gait speeds with several health outcomes (body mass index, waist circumference, systolic and diastolic blood pressure, chronic conditions, self-rated health, exhaustion, upper- and lower-body strength, physical and mental health status, cognitive status, and self-rated cognitive status). Results The results showed that the average gait speed for clinical and ambulatory measures cannot be directly compared. Clinical gait speed was associated with 7 health outcomes, and the ambulatory gait speed was associated with 6 health outcomes. The significant associations between measures of gait speed and the health outcomes converged in 5 of the 13 health outcomes studied; however, the strength of associations was singly different between measures. Limitations The short monitoring time, the inability to distinguish between the ambulatory gait speed inside the home and outdoor gait speed, and the under-representative sample are limitations of the study. Conclusion The results indicated differences in the number and strength of associations between clinical and ambulatory gait speed. Both measures have construct validity because they have been associated with physical and health outcomes; however, they may have different predictive validity. Further research should be conducted to compare their predictive validity in longitudinal designs.

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Long-Term Exposure to Air Pollutants and Cognitive Function in Taiwanese Community-Dwelling Older Adults: A Four-Year Cohort Study

Journal of Alzheimer s Disease ◽

10.3233/jad-200614 ◽

2020 ◽

Vol 78 (4) ◽

pp. 1585-1600

Author(s):

Jen-Hau Chen ◽

Tsung-Yu Kuo ◽

Hwa-Lung Yu ◽

Charlene Wu ◽

Su-Ling Yeh ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Executive Function ◽

Verbal Fluency ◽

Air Pollutants ◽

Community Dwelling ◽

Short Exposure ◽

High Level ◽

Community Dwelling Older Adults

Background: Previous studies have assessed limited cognitive domains with relatively short exposure to air pollutants, and studies in Asia are limited. Objective: This study aims to explore the association between long-term exposure to air pollutants and cognition in community-dwelling older adults. Methods: This four-year prospective cohort study recruited 605 older adults at baseline (2011–2013) and 360 participants remained at four-year follow-up. Global and domain-specific cognition were assessed biennially. Data on PM2.5 (particulate matter≤2.5μm diameter, 2005–2015), PM10 (1993–2015), and nitrogen dioxide (NO2, 1993–2015) were obtained from Taiwan Environmental Protection Administration (TEPA). Bayesian Maximum Entropy was utilized to estimate the spatiotemporal distribution of levels of these pollutants. Results: Exposure to high-level PM2.5 (>29.98μg/m3) was associated with an increased risk of global cognitive impairment (adjusted odds ratio = 4.56; β= –0.60). High-level PMcoarse exposure (>26.50μg/m3) was associated with poor verbal fluency (β= –0.19). High-level PM10 exposure (>51.20μg/m3) was associated with poor executive function (β= –0.24). Medium-level NO2 exposure (>28.62 ppb) was associated with better verbal fluency (β= 0.12). Co-exposure to high concentrations of PM2.5, PMcoarse or PM10 and high concentration of NO2 were associated with poor verbal fluency (PM2.5 and NO2: β= –0.17; PMcoarse and NO2: β= –0.23; PM10 and NO2: β= –0.21) and poor executive function (PM10 and NO2: β= –0.16). These associations became more evident in women, apolipoprotein ɛ4 non-carriers, and those with education > 12 years. Conclusion: Long-term exposure to PM2.5 (higher than TEPA guidelines), PM10 (lower than TEPA guidelines) or co-exposure to PMx and NO2 were associated with poor global, verbal fluency, and executive function over 4 years.

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P4-097: FRAILTY TRANSITIONS OVER 6 MONTHS IN RELATION TO COGNITIVE STATUS IN COMMUNITY-DWELLING OLDER ADULTS IN A TERTIARY MEMORY CLINIC SETTING

Alzheimer s & Dementia ◽

10.1016/j.jalz.2014.05.1612 ◽

2014 ◽

Vol 10 ◽

pp. P819-P820

Author(s):

Mei Sian Chong ◽

Laura Tay ◽

Peng Chew Mark Chan ◽

Wee Shiong Lim ◽

Ruijing Ye ◽

...

Keyword(s):

Older Adults ◽

Cognitive Status ◽

Community Dwelling ◽

Memory Clinic ◽

Clinic Setting ◽

Community Dwelling Older Adults

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Association of Neighborhood Social Capital With Quality of Life Among Older People in Singapore

Journal of Aging and Health ◽

10.1177/0898264319857990 ◽

2019 ◽

Vol 32 (7-8) ◽

pp. 841-850 ◽

Cited By ~ 1

Author(s):

Anna P. Lane ◽

Chek Hooi Wong ◽

Špela Močnik ◽

Siqi Song ◽

Belinda Yuen

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Social Capital ◽

Social Cohesion ◽

Well Being ◽

Cognitive Status ◽

Community Dwelling ◽

Neighborhood Social Capital ◽

Community Dwelling Older Adults

Objective: To examine how neighborhood-based cognitive and structural social capital are associated with individual quality of life among a sample of community-dwelling older adults in Singapore. Method: Using survey data from 981 older adults (aged 55 years and above) in nine residential neighborhoods, multilevel models simultaneously estimated the effects of independent variables at the individual and neighborhood levels on quality of life (CASP-12). Results: Social cohesion (β = 1.39, p < .01) and associational membership (β = 19.16, p < .01) were associated with higher quality of life in models adjusted for neighborhood facilities and individual sociodemographics, social networks, functional limitations, global cognitive status, and medical conditions. Discussion: The results suggest that place-based or neighborhood social capital may be important for older person’s well-being. It identifies the contribution of structural (associational membership) and cognitive (social cohesion) social capital to the well-being of community-dwelling older adults in Singapore.

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