LONELINESS, MARITAL STATUS, AND COGNITIVE IMPAIRMENT AMONG OLDER AMERICANS

Abstract Loneliness has been linked to increased risk of mortality and morbidity, and emergent research has identified a negative association between loneliness and cognitive functioning. While the determinants of loneliness are wide in scope, loneliness is closely tied to marital status in later life. At the same time, research has shown that those who are married have lower risk of cognitive impairment. The aim of this study was to determine the association between loneliness and cognitive impairment, and examine whether it is moderated by marital status. Data come from 9 waves of the RAND version of the HRS (1998 - 2014). Consistent with previous research, results from random effects logit models showed that loneliness is associated with greater risk of cognitive impairment [Odds-ratio (OR) = 1.41, p < 0.01]. Additionally, those who are widowed (OR = 1.29, p < 0.01), separated/divorced (OR = 1.33, p < 0.01), or never married (OR = 1.70, p < 0.01) are also more likely to have a cognitive impairment, compared to those who are married. However, the association between loneliness and cognitive function was found to only differ among those who are widowed. Contrary to expectations, widows who report feeling lonely are 29% (p < 0.01) less likely to have a cognitive impairment. In sum, while loneliness and marital status are closely linked with one another, they are both independent determinants of cognitive impairment. The distinct theoretical mechanisms linking loneliness and marital status to cognitive function in later life are discussed.

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Dementia associated with alcohol and other drug use

International Psychogeriatrics ◽

10.1017/s1041610205001985 ◽

2005 ◽

Vol 17 (s1) ◽

pp. S109-S127 ◽

Cited By ~ 50

Author(s):

Gary K. Hulse ◽

Nicola T. Lautenschlager ◽

Robert J. Tait ◽

Osvaldo P. Almeida

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Drug Use ◽

Negative Impact ◽

Diagnostic Category ◽

Later Life ◽

Increased Risk ◽

Causal Pathway ◽

Chronic Use

The acute use of alcohol and several other licit and illicit drugs can affect mental state and cognitive function. The chronic use of certain drugs may also increase the risk of cognitive impairment and perhaps dementia in later life. This paper focuses on the long-term cognitive consequences of using alcohol, benzodiazepines, tobacco and cannabis. Currently available evidence indicates that mild to moderate alcohol consumption is not associated with increased risk of cognitive decline and may in fact have a protective effect against dementia, although heavy, long-term consumption is likely to have a negative impact on cognitive function. The degree that alcohol-related cognitive impairment must reach to be classified as dementia is currently obscure. Longer-term smoking is associated with increased risk of cognitive impairment and possibly dementia. The chronic use of benzodiazepines has been associated with increased risk of cognitive impairment but information relating to dementia remains inconclusive. The chronic use of cannabis may impair intellectual abilities but data on this topic remain sparse and difficult to interpret. In conclusion, there is evidence that some drugs contribute to the causal pathway that leads to the development of cognitive impairment but currently available data do not support the introduction of a separate diagnostic category of drug-induced dementia (such as alcohol-related dementia). Health promotion programs designed to decrease tobacco smoking and “harmful” alcohol use (and possibly other drug use) may decrease the burden of cognitive impairment and perhaps dementia in later life.

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Association of Circulating Cholesterol Level with Cognitive Function and Mild Cognitive Impairment in the Elderly: A Community-based Population Study

Current Alzheimer Research ◽

10.2174/1567205017666200810165758 ◽

2020 ◽

Vol 17 (6) ◽

pp. 556-565

Author(s):

Yujie Guo ◽

Pengfei Li ◽

Xiaojun Ma ◽

Xiaochen Huang ◽

Zhuoheng Liu ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Function ◽

Cholesterol Level ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Cross Sectional ◽

Increased Risk ◽

Aging Adults ◽

Female Subjects

Background: The present study was designed to examine the association of circulating cholesterol with cognitive function in non-demented community aging adults. Methods: This was a cross-sectional study including 1754 Chinese adults aged 55-80 years. The association between serum cholesterol levels and cognitive function was examined. Participants were categorized into four groups according to the quartile of circulating TC (total cholesterol), High Density Lipoprotein Cholesterol (HDL-c), Low Density Lipoprotein Cholesterol (LDL-c) levels and HDLc/ LDL-c ratio. The difference in cognitive performance among the groups was compared. Logistic regression model was used to determine the association of circulating cholesterol level with the risk of Mild Cognitive Impairment (MCI). Results: Mild increase of serum LDL-c level correlated with better visual and executive, language, memory and delayed recall abilities. Higher circulating TC and HDL-c levels were found to be associated with poorer cognitive function, especially in aging female subjects. Higher circulating TC, HDL-c and HDL/LDL ratio indicated an increased risk of MCI, especially in female subjects. Conclusion: Slight increase in circulating LDL-c level might benefit cognitive function in aging adults. However, higher circulating TC and HDL-c levels might indicate a decline of cognitive function, especially in aging female subjects.

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Gender Differences in the Link Between Marital Status and the Risk of Cognitive Impairment: Results From the Korean Longitudinal Study of Aging

The International Journal of Aging and Human Development ◽

10.1177/00914150211024181 ◽

2021 ◽

pp. 009141502110241

Author(s):

Yujin Kim

Keyword(s):

Cognitive Impairment ◽

Longitudinal Study ◽

Marital Status ◽

Event History Analysis ◽

Population Aging ◽

Event History ◽

Never Married ◽

History Analysis ◽

Married Men ◽

And Gender

In the context of South Korea, characterized by increasing population aging and a changing family structure, this study examined differences in the risk of cognitive impairment by marital status and investigated whether this association differs by gender. The data were derived from the 2006–2018 Korean Longitudinal Study of Aging. The sample comprised 7,568 respondents aged 45 years or older, who contributed 30,414 person-year observations. Event history analysis was used to predict the odds of cognitive impairment by marital status and gender. Relative to their married counterparts, never-married and divorced people were the most disadvantaged in terms of cognitive health. In addition, the association between marital status and cognitive impairment was much stronger for men than for women. Further, gender-stratified analyses showed that, compared with married men, never-married men had a higher risk of cognitive impairment, but there were no significant effects of marital status for women.

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Multinomial Logistic Regression Model of Demographic Predictors and Confounders of Binge Alcohol Use among Adults with Major Depression

10.31234/osf.io/5bfrg ◽

2021 ◽

Author(s):

Areen Omary

Keyword(s):

Alcohol Use ◽

Marital Status ◽

Multinomial Logistic Regression ◽

Future Research ◽

Middle Income ◽

Never Married ◽

Increased Risk ◽

Assessment And Treatment ◽

Potential Risk Factors ◽

At Risk Populations

Identifying sociodemographic populations with a major depressive episode (MDE) who are at increased risk for binge alcohol use (BAU) is critical for developing focused prevention programs to meet the particular needs of each population. Thus, the goal of the current exploratory retrospective study is to examine sex, race, age, education, marital status, and income as risk predictors for BAU among adults with MDE; and if the risk for BAU changes after adjusting for demographic confounders. To achieve the study goal, data from the Substance Abuse and Mental Health Services Administration’s 2018 National Survey for Drug Use and Health were extracted and analyzed. The unweighted sample included 6,999 adults representing a weighted population size of 33,900,452.122 in the US. Results revealed that age and marital status significantly predicted BAU in the past month among adults with MDE. Adults under the age of 50, with a college degree, never married, divorced/separated, and with a high-middle income level or higher were at higher risk for BAU. The study's clinical implications are that understanding demographics of individuals with MDE at increased risk for BAU can inform improved tailored assessment and treatment of alcohol abuse and MDE among at-risk populations. Future research should consider examining additional potential risk factors for BAU among adults with MDE.

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Abstract WP482: Early Life Exposure to the Stroke Belt and Later Life Incident Cognitive Impairment: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Stroke ◽

10.1161/str.51.suppl_1.wp482 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Virginia J Howard ◽

George Howard ◽

Jennifer J Manly ◽

M M Glymour ◽

Laura B Zahodne ◽

...

Keyword(s):

Cognitive Impairment ◽

Racial Differences ◽

Early Adulthood ◽

Later Life ◽

Logistic Regression Models ◽

Early Life Exposure ◽

Increased Risk ◽

Regards Study ◽

Adjusted Logistic Regression ◽

Stroke Belt

Introduction: Incidence of cognitive impairment is higher for residents of the Stroke Belt (SB) compared to those living outside it, but the importance of timing of SB residence is unclear. Methods: Participants were aged 45+ yrs, and enrolled in 2003-2007 in REGARDS. Cognition was assessed annually, by telephone, using the Six-Item Screener (SIS) in 11,488 black or white stroke-free participants currently living in the SB, and 8,949 currently living outside of the SB. Incident cognitive impairment was defined as SIS score of < 4 at last assessment among participants with initial SIS >4. Exposures were defined as SB residence all years, some years, or no years of childhood (ages 0-18) and early adulthood (ages 19-30). Demographic adjusted logistic regression models were stratified by SB residence at enrollment, and were used to estimate the demographic-adjusted odds of incident cognitive impairment. Results: Among those currently residing in the SB, childhood residence outside the SB for some (OR = 0.82; 95% CI: 0.68 - 0.99) or all (OR = 0.76; 95% CI: 0.65 - 0.90) of the time predicted lower odds of incident cognitive impairment. Similarly, early adulthood residence outside the SB for some (OR = 0.86; 95% CI: 0.74 - 0.98) or all (OR = 0.70; 95% CI: 0.58 - 0.84) of the time predicted lower incident cognitive impairment. Conversely, for those currently living outside the SB, the risk of incident cognitive impairment was higher for those who had spent their entire early adulthood in the SB (OR = 1.51; 95% CI: 1.01 - 2.57), with non-significant increased risk for childhood exposure or some early adulthood exposure to the SB (table). Conclusions: These findings suggest that early residence in the SB during childhood or early adulthood increases the risk of cognitive impairment regardless of place of residence in later adulthood. Further research is needed to determine the characteristics of early SB life that are linked to later adult cognitive impairment.

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Risks and subgroups of cognitive impairment under different marital status among older adults: a latent profile analysis

10.31083/jomh.2021.092 ◽

2021 ◽

pp. 1

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Linear Regression ◽

Marital Status ◽

Latent Profile Analysis ◽

Profile Analysis ◽

Empirical Typology ◽

Males And Females ◽

Older Subjects ◽

Latent Profile

Background and objective: With aging, cognitive impairment is severe in the aging society. This paper aimed to investigate the association between cognitive impairment and marital status and the empirical typology of cognitive impairment in Chinese aging population. Methods: Descriptive statistics were performed by retrieving data from the China Health and Retirement Longitudinal Study (CHARLS) to test the relation between cognitive impairment and marital status with univariate linear regression and multivariate linear regression. The subgroups of cognitive impairment for included older subjects were identified with latent profile analysis (LPA). Results: The sample included 13,149 participants aged 40 years or older. Both unmarried males and females suffer lower cognitive function than married males and females (P < 0.001). The declining trend remained consistent (P < 0.05) after adjustment for covariates. The participants who were illiterate or older or agricultural hukou had lower cognitive functions than their counterparts. LPA results showed that the cognitive function of participants could be divided into three subgroups. Conclusions: Unmarried males and females had lower cognitive function than that of married counterparts due to the declined percentage of class two, who have high mental intactness and episodic memory.

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The Association Between Diabetes and Cognitive Function in Later Life

Current Aging Science ◽

10.2174/1874609812666190614104328 ◽

2019 ◽

Vol 12 (1) ◽

pp. 62-66

Author(s):

Yadollah A. Momtaz ◽

Tengku A. Hamid ◽

Mohamad F. Bagat ◽

Maryam Hazrati

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Decline ◽

Linear Regression Analysis ◽

Later Life ◽

Multiple Linear Regression Analysis ◽

Population Based ◽

Term Treatment ◽

Diabetic Patients ◽

Long Term Treatment

Introduction: Although diabetes through several possible mechanisms such as increased microvascular pathology and inefficiency of glucose utilization during cognitive tasks can be associated with cognitive impairment, there is inconclusive evidence that shows elderly diabetic patients under therapy have higher cognitive function compared to their non-diabetics counterparts. The present study was conducted to elucidate the association between diabetes and cognitive function in later life. Methods: Data for this study, consisting of 2202 older adults aged 60 years and above, were taken from a population-based survey entitled “Identifying Psychosocial and Identifying Economic Risk Factor of Cognitive Impairment among Elderly. Data analysis was conducted using the IBM SPSS Version 23.0. Results: The mean of MMSE was found to be 22.67 (SD = 4.93). The overall prevalence of selfreported diabetes was found to be 23.6% (CI95%: 21.8% - 25.4%). The result of independent t-test showed diabetic subjects had a higher mean score of MMSE (M = 23.05, SD =4 .55) than their counterparts without diabetes (M = 22.55, SD = 5.04) (t = -2.13 p<.05). The results of multiple linear regression analysis showed that diabetes was not significantly associated with cognitive function, after controlling the possible confounding factors. Conclusions: The findings from the current study revealed that diabetes is not associated with cognitive decline. This study supports the findings that long-term treatment of diabetes may reduce the risk of cognitive decline. This finding may provide new opportunities for the prevention and management of cognitive decline.

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Subclassifications for mild cognitive impairment: prevalence and predictive validity

Psychological Medicine ◽

10.1017/s0033291703007839 ◽

2003 ◽

Vol 33 (6) ◽

pp. 1029-1038 ◽

Cited By ~ 78

Author(s):

A. BUSSE ◽

J. BISCHKOPF ◽

S. G. RIEDEL-HELLER ◽

M. C. ANGERMEYER

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Function ◽

Community Sample ◽

Neuropsychological Testing ◽

High Sensitivity ◽

High Specificity ◽

Cognitive Complaint ◽

Increased Risk ◽

Multiple Domains

Background. Mild cognitive impairment (MCI) is associated with an increased risk of developing dementia. Recently published results of the Current Concepts in MCI Conference suggested subclassifications for MCI (MCI-amnestic, MCI-multiple domains slightly impaired, MCI-single nonmemory domain) based on the recognized heterogeneity in the use of the term. These subclassifications have not been empirically validated to date.Method. A community sample of 1045 dementia-free individuals aged 75 years and over was examined by neuropsychological testing in a three-wave longitudinal study. The prevalences and the predictive validities for the subclassifications of MCI and their modifications (original criteria except for the report of subjective decline in cognitive function) were determined.Results. The prevalence was 1 to 15% depending on the subset employed. Subjects with a diagnosis of MCI progressed to dementia at a rate of 10 to 55% over 2·6 years, depending on the subset employed. MCI-amnestic achieved the highest positive predictive power (PPP). ROC curves of the subclassifications for MCI indicate that all but one subset for MCI failed to predict dementia (MCI-multiple domains slightly impaired-modified: AUC=0·585, P<0·01, 95% CI, 0·517–0·653). The use of modified criteria for MCI (original criteria except for the report of subjective decline in cognitive function) is associated with a higher diagnostic sensitivity but also with a reduction in diagnostic specificity and PPP.Conclusions. Modified criteria should be applied if a concept for MCI with a high sensitivity is required and the original criteria (including subjective cognitive complaint) if a concept with high specificity and high PPP is required.

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Income and Marital Status Interact on Obesity Among Black and White Men

American Journal of Men s Health ◽

10.1177/1557988319829952 ◽

2019 ◽

Vol 13 (1) ◽

pp. 155798831982995 ◽

Cited By ~ 3

Author(s):

Caryn N. Bell ◽

Roland J. Thorpe

Keyword(s):

Marital Status ◽

Black Men ◽

Low Income ◽

Positive Association ◽

White Men ◽

Poverty Line ◽

High Income ◽

Never Married ◽

Black And White ◽

Increased Risk

Racial disparities in obesity among men are accompanied by positive associations between income and obesity among Black men only. Race also moderates the positive association between marital status and obesity. This study sought to determine how race, income, and marital status interact on obesity among men. Using data from the 2007 to 2014 National Health and Nutrition Examination Survey, obesity was measured as body mass index ≥30 kg/m2 among 6,145 Black and White men. Income was measured by percentage of the federal poverty line and marital status was categorized as currently, formerly, or never married. Using logistic regression and interaction terms, the associations between income and obesity were assessed by race and marital status categories adjusted for covariates. Black compared to White (OR = 1.19, 95% CI [1.03, 1.38]), currently married compared to never married (OR = 1.45, 95% CI [1.24, 1.69]), and high-income men compared to low income men (OR = 1.26, 95% CI [1.06, 1.50]) had higher odds of obesity. A three-way interaction was significant and analyses identified that income was positively associated with obesity among currently married Black men and never married White men with the highest and lowest probabilities of obesity, respectively. High-income, currently married Black men had higher obesity rates and may be at increased risk for obesity-related morbidities.

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