Comparing Cognitive and Physical Limitations as Predictors of Depression Among Older Adults

Abstract Depression in older adults is associated with loss of functioning and increased mortality. While many factors contribute to depression among this population, activities of daily living (ADL) limitations and cognitive impairment have been identified as key risk factors. However, no study, to our knowledge, has examined the extent to which physical and cognitive limitations independently and jointly contribute to the risk of depression. The current study describes the prevalence and compares the independent and joint associations of these limitations with depression in a nationally representative sample of adults aged 51 and older in the US. Analyses are based on a sample of 17,044 repeated observations on 6,636 unique primary respondents from three waves of pooled data from the Health and Retirement Study. We estimate linear and logistic multivariate regression models investigating the association between ADL limitations (any limitation on Katz ADL scale), cognitive impairment (<12 on the TICS-27 scale), and depressive symptoms (8-item CES-D), controlling for a standard set of socioeconomic and health factors. First, we find that 66% of respondents report no limitations, 16% report only cognitive impairment, 11% report only ADL limitations, and 7% report both types of limitations. Multivariate analyses suggest that ADL limitations have a much stronger association with depression compared to cognitive impairment, and this association is robust across alternative specifications. In next steps, we will take advantage of the longitudinal nature of these data to estimate changes in these characteristics over time and within individuals and explore heterogeneity in associations across relevant groups.

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Correlates of tobacco product initiation among youth and adults in the USA: findings from the PATH Study Waves 1–3 (2013–2016)

Tobacco Control ◽

10.1136/tobaccocontrol-2020-055671 ◽

2020 ◽

Vol 29 (Suppl 3) ◽

pp. s191-s202 ◽

Cited By ~ 9

Author(s):

Karin A Kasza ◽

Kathryn C Edwards ◽

Zhiqun Tang ◽

Cassandra A Stanton ◽

Eva Sharma ◽

...

Keyword(s):

Older Adults ◽

Tobacco Product ◽

Health Study ◽

Product Use ◽

Frequent Use ◽

The Us ◽

The Usa ◽

Nationally Representative ◽

Tobacco Initiation

ObjectiveTo report on demographic and tobacco product use correlates of tobacco product initiation (cigarettes, electronic nicotine delivery systems (ENDS), cigars, hookah and smokeless tobacco) among the US population.DesignData were from the first three waves (2013–2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth (aged 12–17 years) and adults (aged 18+ years). Never users of at least one type of tobacco product at Wave 1 (W1, 2013/14) or Wave 2 (W2, 2014/15) were included (n=12 987 youth; n=25 116 adults). Generalised estimating equations were used to evaluate the association between demographic and tobacco product use characteristics at baseline, and tobacco product initiation at follow-up (ever, past 30 day (P30D), frequent (use on 20 or more of thepast 30 days)) over two 1-year periods (W1–W2 and W2–Wave 3).ResultsYouth aged 15–17 years were more likely than youth aged 12–14 years and adults aged 18–24 years were more likely than older adults to initiate P30D tobacco use across products; non-heterosexuals were more likely than heterosexuals to initiate P30D cigarette and ENDS use. Older adults were more likely than young adults, and males were more likely than females, to be frequent users of ENDS on initiation. Ever use of another tobacco product predicted P30D initiation of each tobacco product.DiscussionOther tobacco product use and age predict P30D tobacco initiation across products whereas associations with other demographic characteristics vary by product. Continued contemporary evaluation of initiation rates within the changing tobacco product marketplace is important.

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Educational Attainment and Self-Rated Oral Health among American Older Adults: Hispanics’ Diminished Returns

Dentistry Journal ◽

10.3390/dj7040097 ◽

2019 ◽

Vol 7 (4) ◽

pp. 97 ◽

Cited By ~ 4

Author(s):

Shervin Assari ◽

Mohsen Bazargan

Keyword(s):

Older Adults ◽

Oral Health ◽

Educational Attainment ◽

Healthy Aging ◽

University Of Michigan ◽

Single Item ◽

National Poll ◽

The Us ◽

Nationally Representative ◽

The University

Background: Minorities’ diminished returns (MDRs) refer to systemically weaker effects of socioeconomic status (SES), particularly educational attainment, on the health of non-Whites compared to Whites. Aim: Using a nationally representative sample, we aimed to investigate ethnic differences in the effect of SES (educational attainment) on the self-rated oral health of Hispanic older adults in the US. Methods: This study analyzed the University of Michigan National Poll on Healthy Aging (UM-NPHA) 2017 data, which included 2131 older adults who were 50 to 80 years old (202 Hispanics and 1929 non-Hispanics). Ethnicity, race, educational attainment (SES), age, gender, employment, retirement, and self-rated oral health (single item) were measured. Logistic regressions were applied for data analysis. Results: High educational attainment was associated with lower odds of poor oral health in the pooled sample, net of all covariates. The effect of educational attainment on poor self-rated oral health was found to be weaker for Hispanics than for non-Hispanics. Conclusion: We observed MDRs of educational attainment (SES) on oral health for Hispanic older adults. In other words, compared to non-Hispanics, Hispanics gain less oral health from their educational attainment (SES).

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Evaluating an accessible web interface for older adults – the impact of mild cognitive impairment (MCI)

Journal of Assistive Technologies ◽

10.1108/jat-11-2014-0032 ◽

2015 ◽

Vol 9 (4) ◽

pp. 219-232 ◽

Cited By ~ 5

Author(s):

Marten Haesner ◽

Anika Steinert ◽

Julie Lorraine O'Sullivan ◽

Elisabeth Steinhagen-Thiessen

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Human Interaction ◽

Cognitive Changes ◽

Content Type ◽

Web Performance ◽

Cognitive Limitations ◽

Usability Data ◽

The Impact

Purpose – Cognitive changes occur with age and cognitive limitations can negatively influence computer use. Human-interaction studies show that especially older adults benefit considerably from using web platforms. The purpose of this paper is to measure the possible impact of cognitive impairment in web usability and to analyse the differences between older adults with and without cognitive impairment. Design/methodology/approach – In the presented pilot study, 50 older adults tested a web-based interface on a PC and tablet computer that was designed based on a styleguide for this specific user group. In two sessions participants had to conduct six tasks. In a third session older adults were left unsupervised in the laboratory where they were confronted with unexpected events triggered by a principal investigator. Findings – The performance results differed significantly between the two groups. Older adults with mild cognitive impairment (MCI) needed more time and were more likely to make mistakes when using a web platform. After analysing error data, it became apparent that errors made by older adults with MCI occurred due to a lack of orientation in websites. Originality/value – Little is known about web performance of older adults with cognitive impairment. The authors present valid data of this interesting target group and reveal their specific problems when handling a new online platform. The importance of a flat website hierarchy can be essential in developing senior friendly web pages. The authors also highlight methodological issues and illustrate the importance of qualitative information of the usability data, e.g. the different types of problems or errors.

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Education Differences in the Adverse Impact of PM2.5 on Incident Cognitive Impairment Among U.S. Older Adults

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

10.3233/aiad210023 ◽

2021 ◽

Author(s):

Jennifer Ailshire ◽

Katrina M. Walsemann

Keyword(s):

Older Adults ◽

Air Pollution ◽

Cognitive Impairment ◽

Cognitive Decline ◽

Protective Factor ◽

Fine Particulate Matter ◽

Aging Brain ◽

Logistic Regression Models ◽

Nationally Representative ◽

Background Air

Background: Air pollution is linked to worse cognitive function in older adults, but whether differences in this relationship exist by education, a key risk factor for cognitive decline, remains unknown. Objective: To determine if the association between fine particulate matter air pollution (PM2.5) and incident cognitive impairment varies by level of education in two cohorts assessed a decade apart. Methods: We used data on adults ages 60 and older from the nationally representative Health and Retirement Study (HRS) linked with tract-level annual average PM2.5. We used mixed-effects logistic regression models to examine education differences in the association between PM2.5 and incident cognitive impairment in two cohorts: 2004 (n = 9,970) and 2014 (n = 9,185). Cognitive impairment was determined with tests of memory and processing speed for self-respondents and proxy and interviewer assessments of cognitive functioning in non-self-respondents. Results: PM2.5 was unrelated to incident cognitive impairment among those with 13 or more years of education, but the probability of impairment increased with greater concentrations of PM2.5 among those with 8 or fewer years of education. The interaction between education and PM2.5 was only found in 2004, possibly because PM2.5 concentrations were much lower in 2014. Conclusion: Education is a key determinant of cognitive decline and impairment, and in higher pollution contexts may serve as a protective factor against the harms of air pollution on the aging brain. Additionally, because air pollution is ubiquitous, and particularly harmful to vulnerable populations, even small improvements in air quality may have large impacts on population health.

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ASSOCIATION BETWEEN FRAILTY AND DEVELOPMENT OF COGNITIVE IMPAIRMENT: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.2521 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S683-S683

Author(s):

Nicholas V Resciniti ◽

Jaleel McNiel ◽

Matthew Lohman

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Smoking Status ◽

Health And Retirement Study ◽

Health Issues ◽

Frailty Status ◽

Early Markers ◽

Phenotype Model ◽

Nationally Representative ◽

Retirement Study

Abstract Research has shown there is currently an increasing prevalence of cognitive impairment and dementia in older adults. To date, there remains a paucity of research to explain this increase and research on early markers and risk factors are warranted. This study aims to assess the association of cognitively normal older adults who are frail and the development of cognitive impairment four years later. Data from the Health and Retirement Study – a nationally representative sample of older US adults – was used from 2004-2008 for individuals 65 and older (n=8,377). Frailty was categorized by using Fried’s phenotype model: individuals were grouped into frail, pre-frail, and robust. Cognitive impairment – a composite score that assessed memory recall and global mental status – was classified as scoring eight or less on a 35-point scale. After restricting to cognitively healthy individuals, logistic regression with weights was used to assess the association between frailty status and the development of cognitive impairment four years later. The model was adjusted for baseline age, gender, race, education years, smoking status, and chronic health issues (high blood pressure, diabetes, cancer, lung disease, heart disease, stroke, psychiatric problems, and arthritis). Frail individuals, compared to those who were robust, had increased odds of cognitive impairment (OR=1.74; 95% CI: 1.48-2.16), after fully adjusting. Evidence from this study suggest that frail individuals are more likely to become cognitively impaired over time. This provides a potential pathway of intervention to help delay or prevent the development of cognitive impairment in older US adults.

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Measurement of Sitting Time in Older Adults With and Without Alzheimer’s Disease

Journal for the Measurement of Physical Behaviour ◽

10.1123/jmpb.2018-0002 ◽

2018 ◽

Vol 1 (2) ◽

pp. 70-78

Author(s):

Amber Watts ◽

Mauricio Garnier-Villarreal ◽

Paul Gardiner

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Sedentary Time ◽

Early Stage ◽

Living Environment ◽

Sitting Time ◽

Free Living ◽

Physical Limitations

Time spent being sedentary is associated with poorer cognitive function and risk of developing Alzheimer’s disease (AD). The present study aimed to compare patterns of sitting in a free-living environment among older adults with and without early stage AD who were similar in physical limitations, body mass, and cardiorespiratory capacity. We also compared estimates of sitting patterns between two different monitors (postural and non-postural) with different body placements (thigh-worn vs. hip-worn). Comparing older adults without cognitive impairment to those with early AD, we found that although there was no difference in the total amount of daily sitting time (p = .52), the AD group tended to have longer durations of sitting than those without AD. Inclinometry data from the hip-worn ActiGraph GT3X+ consistently underestimated time spent sitting compared to the thigh worn monitor activPAL™ (hours per day, proportion of waking hours, number of sitting bouts greater than 30 minutes, and duration of sitting bouts). Our results have implications for prevention strategies to reduce sedentary time, which is predominantly sitting, in persons with cognitive impairment and highlight the importance of monitor selection and placement for the accurate assessment of sitting patterns in this population.

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Subjective cognitive impairment of older adults: a comparison between the US and China

International Journal of Methods in Psychiatric Research ◽

10.1002/mpr.1499 ◽

2016 ◽

Vol 25 (1) ◽

pp. 68-75 ◽

Cited By ~ 5

Author(s):

Qiong Wu

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Subjective Cognitive Impairment ◽

The Us

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Trajectories of Social Engagement and Limitations in Late Life

Journal of Health and Social Behavior ◽

10.1177/0022146511411922 ◽

2011 ◽

Vol 52 (4) ◽

pp. 430-443 ◽

Cited By ~ 81

Author(s):

Patricia A. Thomas

Keyword(s):

Older Adults ◽

Social Relations ◽

Social Engagement ◽

Panel Study ◽

Integration Theory ◽

Cognitive Limitations ◽

Nationally Representative ◽

Life Course Framework ◽

Using Data ◽

Over Time

Although studies have established important links between social relations and health, much of this research does not take into account the dynamic nature of both social relations and health over time. The present study combines person-centered and variable-centered approaches and uses social integration theory within the life course framework to examine patterns of change in social engagement and how those patterns relate to trajectories of physical and cognitive limitations among older adults, using data from the Americans’ Changing Lives survey, a nationally representative panel study ( N = 1,667). Individuals who had trajectories of high and increasing social engagement experienced lower levels of physical and cognitive limitations over time. The findings suggest the importance of maintaining high levels of social engagement for the physical and cognitive health of older adults.

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Education Differences in the Adverse Impact of PM2.5 on Incident Cognitive Impairment Among U.S. Older Adults

Journal of Alzheimer s Disease ◽

10.3233/jad-200765 ◽

2020 ◽

pp. 1-11

Author(s):

Jennifer Ailshire ◽

Katrina M. Walsemann

Keyword(s):

Older Adults ◽

Air Pollution ◽

Risk Factor ◽

Cognitive Impairment ◽

Cognitive Decline ◽

Protective Factor ◽

Fine Particulate Matter ◽

Aging Brain ◽

Logistic Regression Models ◽

Nationally Representative

Background: Air pollution is linked to worse cognitive function in older adults, but whether differences in this relationship exist by education, a key risk factor for cognitive decline, remains unknown. Objective: To determine if the association between fine particulate matter air pollution (PM2.5) and incident cognitive impairment varies by level of education in two cohorts assessed a decade apart. Methods: We used data on adults ages 60 and older from the nationally representative Health and Retirement Study (HRS) linked with tract-level annual average PM2.5. We used mixed-effects logistic regression models to examine education differences in the association between PM2.5 and incident cognitive impairment in two cohorts: 2004 (n = 9,970) and 2014 (n = 9,185). Cognitive impairment was determined with tests of memory and processing speed for self-respondents and proxy and interviewer assessments of cognitive functioning in non-self-respondents. Results: PM2.5 was unrelated to incident cognitive impairment among those with 13 or more years of education, but the probability of impairment increased with greater concentrations of PM2.5 among those with 8 or fewer years of education. The interaction between education and PM2.5 was only found in 2004, possibly because PM2.5 concentrations were much lower in 2014. Conclusion: Education is an important risk factor for cognitive decline and impairment, and in higher pollution contexts may serve as a protective factor against the harms of air pollution on the aging brain. Additionally, because air pollution is ubiquitous, and particularly harmful to vulnerable populations, even small improvements in air quality may have large impacts on population health.

Download Full-text