scholarly journals Memory Aging Phenotypes Among Older Cancer Survivors: A Latent Growth Analysis of the Health and Retirement Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 691-691
Author(s):  
Ashly Westrick ◽  
Kenneth Langa ◽  
Lindsay Kobayashi
Keyword(s):  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Word List ◽  
Health And Retirement Study ◽  
Latent Growth ◽  
Non Melanoma Skin Cancer ◽  
Incident Cancer ◽  
Health Related ◽  
Memory Group ◽  
Retirement Study

Abstract While cancer survivors experience many long-term health effects, there is limited evidence on the potentially heterogeneous memory aging of older cancer survivors. We identified memory aging phenotypes of older US cancer survivors, and determined sociodemographic and health-related predictors of membership. Data were from 2,755 survivors aged ≥50 in the U.S. Health and Retirement Study (1998 – 2016). Self-reported first incident cancer diagnosis (except non-melanoma skin cancer) and memory (composite immediate and delayed word-list recall score, combined with proxy-reported cognition) were assessed at biennial interviews. Memory aging phenotypes were identified using latent growth curve (LGC) models, with baseline being time of cancer diagnosis. Logistic regression evaluated predictors of group membership. 5 distinct memory aging groups were identified: low memory (n=165, 6.16%); medium-low memory (n=459, 17.1%); medium-high memory (n=733, 27.4%); high memory (n=750, 28.0%); and very high memory (n=571, 21.3%). The low memory group received less chemotherapy compared to the other groups (20.0% vs. 25.5%, 31.7%, 36.8%, 41.5%%, respectively), and had the shortest mean survival time after diagnosis (1.08 vs 2.10, 2.76, 3.37, 4.31 years, respectively). Older age at diagnosis (OR: 1.71, 95%CI: 1.61-1.82), being male (OR: 4.10, 95%CI: 2.82-6.51), having a history of stroke (OR: 4.62, 95%CI: 2.57-8.30) and depression prior to diagnosis (OR: 1.19, 95%CI: 1.05-1.34) were independently associated with being in the low memory group vs. the medium-high memory group. We identified distinct memory aging phenotypes among older cancer survivors. Further research should evaluate the influence of pre-cancer memory and how these phenotypes differ from the general population.

scholarly journals Validation of Self-Reported Cancer Diagnosis by Cognitive Status in the Health and Retirement Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 165-166
Author(s):  
Megan Mullins ◽  
Jasdeep Kler ◽  
Marissa Eastman ◽  
Mohammed Kabeto ◽  
Lauren Wallner ◽  
...  
Keyword(s):  
Older Adults ◽  
Cancer Diagnosis ◽  
Cognitive Status ◽  
Health And Retirement Study ◽  
Fee For Service ◽  
Incident Cancer ◽  
The Us ◽  
Sensitivity Specificity ◽  
The Relationship ◽  
Retirement Study

Abstract Exploring the relationship between cognition and cancer is increasingly important as the number of older adults in the US grows. The Health and Retirement Study (HRS) has longitudinal data on cognitive status and self-reported cancer diagnoses, but these self-reports have not been validated. Using HRS linked to Medicare Fee for Service (FFS) claims (1998-2016), we evaluated the validity of self-reported cancer diagnoses (excluding non-melanoma skin) against Medicare claims by respondent cognitive status. We included 8,280 Medicare-eligible HRS participants aged ≥67 with at least 90% FFS coverage. Cognitive status was ascertained from the HRS interview following the date of cancer diagnosis (or reference claim date) using the Langa-Weir method and was classified as normal, cognitive impairment no dementia (CIND), or dementia. We calculated the sensitivity, specificity, and Cohen's kappa for first incident malignant cancer diagnosis by cognitive status group. The majority (76.4%) of participants scored as cognitively normal, 9.6% had CIND, 14.0% had dementia and, overall, 1,478 had an incident cancer diagnosis. Among participants with normal cognition, sensitivity of self-reported cancer diagnosis was 70.2% and specificity was 99.8% (kappa=0.79). Among participants with CIND, sensitivity was 56.7% and specificity was 99.8% (kappa=0.66). Among participants with dementia, sensitivity was 53.0% and specificity was 99.6% (kappa=0.64). Results indicate poor validity of self-reported cancer diagnoses for older adults with CIND or dementia. These findings suggest researchers interested in cancer and cognition should use the HRS-Medicare linkage to ascertain cancer diagnosis from claims, and they highlight the importance of cognitive status in research among older adults.

scholarly journals Changes in life expectancy and disability-free life expectancy in successive birth cohorts of older cancer survivors: a longitudinal modeling analysis of the US Health and Retirement Study

2021 ◽  
Author(s):  
Collin F Payne ◽  
Lindsay C Kobayashi
Keyword(s):  
Life Expectancy ◽  
Cancer Survivors ◽  
Early Period ◽  
Population Level ◽  
Health And Retirement Study ◽  
Birth Cohorts ◽  
Incident Cancer ◽  
The Us ◽  
Using Data ◽  
Retirement Study

Abstract The population of older cancer survivors in the US is rapidly growing. However, little is currently known about how the health of older cancer survivors has changed over time and across successive birth cohorts. Using data from the US Health and Retirement Study, we parameterized a demographic microsimulation model to compare partial cohort life expectancy (LE) and disability-free LE for US men and women without cancer and with prevalent and incident cancer diagnoses for four successive 10-year birth cohorts born 1918-1927 to 1948-1957. Disability was defined as being disabled in ≥1 activity of daily living. These cohorts had mid-point ages of 55-64, 65-74, and 75-84 years during the periods 1998-2008 (the “early” period) and 2008-2018 (the “later” period). Across all cohorts and periods, those with incident cancer had the lowest LE, followed by those with prevalent cancer and cancer-free individuals. We observed declines in partial LE and an expansion of life spent disabled among more recent birth cohorts of prevalent cancer survivors. Our findings suggest that advances in treatments that prolong life for individual cancer patients may have led to population-level declines in conditional LE and disability-free LE across successive cohorts of older cancer survivors.

Population differences in health-related quality of life between cancer survivors and controls: Does low educational attainment widen the gap?

2020 ◽  
pp. 140349482090875
Author(s):  
Finn Breinholt Larsen ◽  
Jes Bak Sørensen ◽  
Claus Vinther Nielsen ◽  
Anne-Mette Hedeager Momsen ◽  
Karina Friis ◽  
...  
Keyword(s):  
Educational Attainment ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Population Level ◽  
Health Related Quality ◽  
High Educational Attainment ◽  
Related Quality ◽  
Health Related ◽  
High Educational

Aims: This study aimed to compare health-related quality of life (HRQOL) among cancer survivors and controls in the Danish population, with special attention given to the impact of low educational attainment. Comparisons were made at population level and for subgroups stratified by education. Furthermore, comparisons were made for all cancer diagnoses combined and for the 14 most prevalent cancer sites and ‘other cancer sites’. Finally, the importance of time since initial diagnosis was examined. Methods: HRQOL was measured using the physical component score (PCS) and mental component score (MCS) of the 12-item Short-Form Health Survey version 2 in a population-based survey. By linking data with the Danish Cancer Registry, 11,166 cancer survivors and 151,117 individuals with no history of cancer were identified. Results: HRQOL was reduced in cancer survivors for all cancers combined and most cancer sites. Differences were found at population level and stratified by educational attainment. PCS was reduced to a similar extent in the three educational groups, whereas MCS was reduced slightly more in the low than in the high educational attainment group. HRQOL increased with time since initial diagnosis during the first years. Conclusions: Cancer survivors had lower HRQOL than controls, and HRQOL was lower in the low than in the high educational attainment group. However, low educational attainment did not widen the gap in HRQOL following a cancer diagnosis. Despite this, the combined effect of low educational attainment and a cancer diagnosis markedly reduced HRQOL in some cancer survivors. The study identified groups of cancer survivors with low HRQOL who may have unmet rehabilitation needs.

scholarly journals Associations of Age, Sex, Race/Ethnicity, and Education With 13 Epigenetic Clocks in a Nationally Representative U.S. Sample: The Health and Retirement Study

2021 ◽  
Author(s):  
Eileen M Crimmins ◽  
Bharat Thyagarajan ◽  
Morgan E Levine ◽  
David R Weir ◽  
Jessica Faul
Keyword(s):  
Dna Methylation ◽  
Health Outcomes ◽  
Second Generation ◽  
Health And Retirement Study ◽  
Data Set ◽  
Epigenetic Aging ◽  
Health Related ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Retirement Study

Abstract Background Many DNA methylation-based indicators have been developed as summary measures of epigenetic aging. We examine the associations between 13 epigenetic clocks, including 4 second generation clocks, as well as the links of the clocks to social, demographic, and behavioral factors known to be related to health outcomes: sex, race/ethnicity, socioeconomic status, obesity, and lifetime smoking pack-years. Methods The Health and Retirement Study is the data source which is a nationally representative sample of Americans over age 50. Assessment of DNA methylation was based on the EPIC chip and epigenetic clocks were developed based on existing literature. Results The clocks vary in the strength of their relationships with age, with each other and with independent variables. Second generation clocks trained on health-related characteristics tend to relate more strongly to the sociodemographic and health behaviors known to be associated with health outcomes in this age group. Conclusions Users of this publicly available data set should be aware that epigenetic clocks vary in their relationships to age and to variables known to be related to the process of health change with age.

scholarly journals Evaluating Eight-Year Trajectories for Sense of Purpose in the Health and Retirement Study

2021 ◽  
Author(s):  
Patrick Hill ◽  
Sara J Weston
Keyword(s):  
Growth Models ◽  
Individual Variability ◽  
Future Research ◽  
Health And Retirement Study ◽  
Latent Growth ◽  
Cross Sectional ◽  
Latent Growth Models ◽  
Sense Of Purpose ◽  
Retirement Study ◽  
Over Time

Objectives: Though cross-sectional research has suggested that sense of purpose declines intoolder adulthood, it remains unclear whether inter-individual variability occurs in these trajectories, and what factors predict these trajectories. The current study provides one of the first longitudinal investigations into how individuals’ sense of purpose fluctuates in older adulthood. Method: Participants from the Health and Retirement Study (n = 4,234, mean age = 65 years), completed assessments of sense of purpose over three years, along with multiple potential predictors (health, personality, demographics) at the start.Results: Second-order latent growth models demonstrated both mean-level declines on purpose over time, as well as the capacity for inter-individual variability in change patterns for retired adults. Among this cohort, health status, educational attainment, and marital status were significant predictors of purpose trajectories over time, though broad personality trait dimensions failed to uniquely predict change in sense of purpose. However, measurement invariance tests suggest that the scale did not operate similarly across work status groups.Conclusion: Findings advance the previous literature by demonstrating inter-individual variability in sense of purpose for those participants who had retired. Future research should consider that purpose inventories may operate differently for those in the workplace versus retired adults.

scholarly journals Relationship of Cannabis Use With Immediate, Delayed, and Working Memory: The Health and Retirement Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 708-708
Author(s):  
Madison Maynard ◽  
Daniel Paulson ◽  
Michael Dunn ◽  
Robert Dvorak
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Word List ◽  
Past Research ◽  
Cannabis Use ◽  
Health And Retirement Study ◽  
Immediate Memory ◽  
Gender Education ◽  
Predominantly Female ◽  
Retirement Study

Abstract Past research has examined relationship between cannabis use and cognition among adolescents and young adults, but less is known about older adults despite rapidly increasing recreational and therapeutic cannabis use by this demographic. These relationships were explored cross-sectionally using data from the 2018 wave of the Health and Retirement Study (HRS). Dependent variables included immediate and delayed memory (10-item word list) and working memory (serial sevens; range 0-5). Cannabis use was categorized as non-user (n=886), past-user (n=334), current moderate (<52 uses/year; n=36), and current heavy (52+ uses/year; n=92). Mean age was 67.59 years (range: 50-98, SD=10.76). The sample was predominantly female (59%), and Caucasian (67%). Uncontrolled analyses found that cannabis use group was associated with immediate memory (F=6.14, p<.001), delayed memory (F=3.75, p=.01), and working memory (F=6.91, p<.001). Analyses controlled for gender, education, age, and race found that cannabis use group was no longer associated with delayed memory (F=1.74, p=.16) or working memory (F=1.66, p=.17); however, cannabis use was associated with immediate memory (F=3.75, p=.01) in controlled analyses. Current heavy users’ (M=4.94, SE=.16) immediate memory worse than that of both non-users (M=5.48, SE=.06) and past users (M=5.49, SE=.09; p<.05 for both). Gender, education, age, and race significantly associated with immediate, delayed, and working memory, respectively (p<.05 for all). In conclusion, relative deficits in immediate memory, but not delayed memory or working memory, were associated with current heavy cannabis use among older adults. In combination with other findings, these results may inform development of safe-use guidelines for older adults.

scholarly journals Risk of stroke in cancer survivors using a propensity score-matched cohort analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eiko Saito ◽  
◽  
Manami Inoue ◽  
Norie Sawada ◽  
Yoshihiro Kokubo ◽  
...  
Keyword(s):  
Propensity Score ◽  
Intracerebral Hemorrhage ◽  
Cerebral Infarction ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Cohort Analysis ◽  
Incident Cancer ◽  
The Status ◽  
Subsequent Risk

AbstractLittle is known about the risk of cerebrovascular disease in cancer survivors. We aimed to assess the association between incident cancer and the subsequent risk of stroke using a large-scale, population-based prospective study. 74,530 Japanese aged between 40 and 69 years at baseline study were matched by the status of cancer diagnosis during follow-up using propensity score nearest-neighbor matching with allowance for replacement. A total of 2242 strokes were reported during 557,885 person-years of follow-up. Associations between incident cancer and the subsequent risk of all strokes, cerebral infarction, and intracerebral hemorrhage were assessed using a Cox proportional hazards model stratified on the propensity score-matched pairs. No significant association was observed between the status of cancer diagnosis of all types, gastric, colorectal and lung cancer, and subsequent occurrence of all strokes, cerebral infarction, and intracerebral hemorrhage. However, analysis by discrete time periods suggested an elevated risk in cancer patients for one to three months after a cancer diagnosis in all stroke (HR, 2.24; 95% CI, 1.06, 4.74) and cerebral infarction (HR, 2.62; 95% CI, 1.05, 6.53). This prospective cohort study found no association between the status of cancer diagnosis and the subsequent occurrence of all strokes and its subtypes during the entire follow-up period but suggested an increase in stroke risk during the active phase of malignancy.

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