scholarly journals Early-Life Circumstances and Racial Disparities in Cognition among US Older Adults

2021 ◽  
Author(s):  
Zhuoer Lin ◽  
Justin Ye ◽  
Heather Allore ◽  
Thomas M. Gill ◽  
Xi Chen
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Racial Disparities ◽  
Early Life ◽  
Genetic Factors ◽  
Cognitive Outcomes ◽  
Cognitive Score ◽  
Racial Gaps ◽  
Life Circumstances ◽  
Hispanic White

AbstractImportanceExisting studies concentrate on exploring mid-life to late-life risk factors on racial disparities in cognition. Given the critical role of neurocognitive development in early life, understanding contributions of early-life circumstances has important implications for early-stage interventions.ObjectiveTo evaluate the association between early-life circumstances and racial disparities in cognition, and to determine their overall and respective contributions.Design, Setting, and ParticipantsWe assembled three analytic samples from the Health and Retirement Study (HRS) (1995-2018), a nationally representative longitudinal survey of Americans 50 years or older. 17,092 participants, with 13,907 identifying as non-Hispanic White (White) and 3,185 as non-Hispanic Black (Black), were included in the Core sample. The Trauma and PGS samples respectively included 6,533 participants (5,696 White, 837 Black) and 5,532 participants (4,893 White, 639 Black).Main Outcomes and MeasuresThe main outcomes were cognitive score and cognitive impairment, as assessed by the Telephone Interview for Cognitive Status (TICS). We used the Blinder-Oaxaca Decomposition (BOD) to evaluate disparities in cognitive outcomes between White and Black participants attributable to differences in early-life circumstances.ResultsAmong all White and Black participants at initial survey, their respective average age were 58.1 (95% CI, 58.0-58.3) years and 55.8 (95% CI, 55.5-56.0) years; their respective average cognitive score were 17.3 (95% CI, 17.2-17.3) points and 14.6 (95% CI, 14.4-14.7) points; and their respective proportion with cognitive impairment were 7.2 (95% CI, 6.8-7.6) percentage points (pp) and 22.9 (95% CI, 21.5-24.4) pp. Across three analytic samples, overall differences in early-life circumstances respectively explained 23.5%–40.4% and 33.8%–65.3% of the racial gaps in cognitive score and proportion of cognitive impairment between White and Black participants. Difference in educational attainment contributed the most. In the Trauma sample, for example, years of education explained 3.1 (95% CI, 1.9-4.3) pp or 18.6% of the racial gap in proportion of cognitive impairment using the baseline assessment, and 3.3 (95% CI, 2.0-4.5) pp or 26.9% using the latest assessment. Additional early-life contributors included educational environments (e.g., ownership of books, parental education, time spent with mothers) and socioeconomic status (e.g., financial difficulty). However, childhood trauma and selected genetic factors were not significant contributors.Conclusions and RelevanceLess favorable early-life circumstances are associated with clinically meaningful and statistically significant racial gaps in cognition.Key PointsQuestionsHow much do differences in early-life circumstances explain late-life disparities in cognitive outcomes between non-Hispanic Black (Black) and non-Hispanic White (White) older adults? What are the key early-life contributors to these racial disparities?FindingsEarly-life circumstances contribute substantially to racial disparities in cognitive outcomes over age 50. Educational attainment and early-life educational environment are the most important contributors, even after accounting for a rich set of other early-life socioeconomic, demographic, health, traumatic, and genetic factors.MeaningExposure to less favorable early-life circumstances for Black than White adults was associated with large racial gaps in cognitive outcomes.

scholarly journals Association of Early-Life Family and Nieghborhood Circumstances With Depressive Symptoms in Chinese Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 441-442
Author(s):  
Yan Chen ◽  
Jie Tan
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Old Age ◽  
Early Life ◽  
Strong Association ◽  
Community Dwelling ◽  
Bivariate Analysis ◽  
Life Circumstances ◽  
Community Dwelling Older Adults

Abstract A growing body of literature suggests that early life circumstances can influence mental health throughout the lifespan. However, how these early life circumstances cumulatively contribute to depression in old age is not completely understood. The present study examined the associations of eight factors representing multifaceted early life experience at individual, family, and community levels with depression among community-dwelling older adults. Data were from the China Health and Retirement Longitudinal Study. We included 8,239 community-dwelling individuals who were ≥60 years, completed the life history questionnaire, and had assessment of depression. Chi-square test was used to examine the unadjusted associations between each of the eight early life risk factors and depression. An early life disadvantage index was established using risk factors that were significantly associated with depression. Logistic regression was used to examine the association of each early life risk factor and the index with depression. Of 8,239 individuals included, 2,055 (24.9%) had depression. In bivariate analysis, each of eight early life risk factors was significantly associated with depression. Except for maternal and paternal education, all risk factors persisted to be associated with depression after multivariable adjustment. In the multivariable-adjusted model, a one-point higher in the early life disadvantage index (range: 0-6) was associated with a 45% (95% CI: 37%, 53%) higher odds of depression. There was a strong association between early life environments and depressive symptoms among Chinese community-dwelling older adults. Adverse early life circumstances could contribute cumulatively to depression in old age.

scholarly journals Role of Place in Explaining Racial Heterogeneity in Cognitive Outcomes among Older Adults

2015 ◽  
Vol 21 (9) ◽  
pp. 677-687 ◽  
Author(s):  
Sze Yan Liu ◽  
M. Maria Glymour ◽  
Laura B. Zahodne ◽  
Christopher Weiss ◽  
Jennifer J. Manly
Keyword(s):  
Older Adults ◽  
African American ◽  
African Americans ◽  
Racial Disparities ◽  
Racial Differences ◽  
Cognitive Aging ◽  
School Attendance ◽  
Cognitive Outcomes ◽  
Older Americans ◽  
Years Of Schooling

AbstractRacially patterned disadvantage in Southern states, especially during the formative years of primary school, may contribute to enduring disparities in adult cognitive outcomes. Drawing on a lifecourse perspective, we examine whether state of school attendance affects cognitive outcomes in older adults and partially contributes to persistent racial disparities. Using data from older African American and white participants in the national Health and Retirement Study (HRS) and the New York based Washington Heights Inwood Cognitive Aging Project (WHICAP), we estimated age-and gender-adjusted multilevel models with random effects for states predicting years of education and cognitive outcomes (e.g., memory and vocabulary). We summarized the proportion of variation in outcomes attributable to state of school attendance and compared the magnitude of racial disparities across states. Among WHICAP African Americans, state of school attendance accounted for 9% of the variance in years of schooling, 6% of memory, and 12% of language. Among HRS African Americans, state of school attendance accounted for 13% of the variance in years of schooling and also contributed to variance in cognitive function (7%), memory (2%), and vocabulary (12%). Random slope models indicated state-level African American and white disparities in every Census region, with the largest racial differences in the South. State of school attendance may contribute to racial disparities in cognitive outcomes among older Americans. Despite tremendous within-state heterogeneity, state of school attendance also accounted for some variability in cognitive outcomes. Racial disparities in older Americans may reflect historical patterns of segregation and differential access to resources such as education. (JINS, 2015, 21, 677–687)

scholarly journals Self-reported sleep disturbances are associated with poorer cognitive performance in older adults with hypertension: a multi-parameter risk factor investigation

2019 ◽  
Vol 32 (7) ◽  
pp. 815-825 ◽  
Author(s):  
Jordan N. Kohn ◽  
Emily Troyer ◽  
Robert N. Guay-Ross ◽  
Kathleen Wilson ◽  
Amanda Walker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Sleep Disturbances ◽  
Depressive Symptomatology ◽  
Cognitive Outcomes ◽  
Cognitive Domain ◽  
Increased Risk

ABSTRACTObjectives:Given the evidence of multi-parameter risk factors in shaping cognitive outcomes in aging, including sleep, inflammation, cardiometabolism, and mood disorders, multidimensional investigations of their impact on cognition are warranted. We sought to determine the extent to which self-reported sleep disturbances, metabolic syndrome (MetS) factors, cellular inflammation, depressive symptomatology, and diminished physical mobility were associated with cognitive impairment and poorer cognitive performance.Design:This is a cross-sectional study.Setting:Participants with elevated, well-controlled blood pressure were recruited from the local community for a Tai Chi and healthy-aging intervention study.Participants:One hundred forty-five older adults (72.7 ± 7.9 years old; 66% female), 54 (37%) with evidence of cognitive impairment (CI) based on Montreal Cognitive Assessment (MoCA) score ≤24, underwent medical, psychological, and mood assessments.Measurements:CI and cognitive domain performance were assessed using the MoCA. Univariate correlations were computed to determine relationships between risk factors and cognitive outcomes. Bootstrapped logistic regression was used to determine significant predictors of CI risk and linear regression to explore cognitive domains affected by risk factors.Results:The CI group were slower on the mobility task, satisfied more MetS criteria, and reported poorer sleep than normocognitive individuals (all p < 0.05). Multivariate logistic regression indicated that sleep disturbances, but no other risk factors, predicted increased risk of evidence of CI (OR = 2.00, 95% CI: 1.26–4.87, 99% CI: 1.08–7.48). Further examination of MoCA cognitive subdomains revealed that sleep disturbances predicted poorer executive function (β = –0.26, 95% CI: –0.51 to –0.06, 99% CI: –0.61 to –0.02), with lesser effects on visuospatial performance (β = –0.20, 95% CI: –0.35 to –0.02, 99% CI: –0.39 to 0.03), and memory (β = –0.29, 95% CI: –0.66 to –0.01, 99% CI: –0.76 to 0.08).Conclusions:Our results indicate that the deleterious impact of self-reported sleep disturbances on cognitive performance was prominent over other risk factors and illustrate the importance of clinician evaluation of sleep in patients with or at risk of diminished cognitive performance. Future, longitudinal studies implementing a comprehensive neuropsychological battery and objective sleep measurement are warranted to further explore these associations.

Intrusion Errors and Progression of Cognitive Deficits in Older Adults with Mild Cognitive Impairment and PreMCI States

2021 ◽  
pp. 1-8
Author(s):  
Elizabeth A. Crocco ◽  
Rosie Curiel Cid ◽  
Marcela Kitaigorodsky ◽  
Gabriella A. Grau ◽  
Jessica M. Garcia ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Stress Test ◽  
Cognitive Outcomes ◽  
Semantic Interference ◽  
Cross Sectional ◽  
Cognitive Stress ◽  
Intrusion Errors

<b><i>Introduction:</i></b> Among persons with amnestic mild cognitive impairment (aMCI), intrusion errors on subscales that measure proactive semantic interference (PSI) may be among the earliest behavioral markers of elevated Alzheimer’s disease brain pathology. While there has been considerable cross-sectional work in the area, it is presently unknown whether semantic intrusion errors are predictive of progression of cognitive impairment in aMCI or PreMCI (not cognitively normal but not meeting full criteria for MCI). <b><i>Methods:</i></b> This study examined the extent to which the percentage of semantic intrusion errors (PIE) based on total responses on a novel cognitive stress test, the Loewenstein-Acevedo Scales for Semantic Interference and Learning (LASSI-L), could predict clinical/cognitive outcomes over an average 26-month period in older adults initially diagnosed with aMCI, PreMCI, and normal cognition. <b><i>Results:</i></b> On the LASSI-L subscale sensitive to PSI, a PIE cut point of 44% intrusion errors distinguished between those at-risk individuals with PreMCI who progressed to MCI over time compared to individuals with PreMCI who reverted to normal on longitudinal follow-up. Importantly, PIE was able to accurately predict 83.3% of aMCI individuals who later progressed to dementia. <b><i>Discussion:</i></b> These preliminary findings indicate that PIE on LASSI-L subscales that measure PSI may be a useful predictor of clinical progression overtime in at-risk older adults.

scholarly journals Cognition-oriented treatments for older adults: A systematic overview of systematic reviews

2019 ◽  
Author(s):  
Hanna Malmberg Gavelin ◽  
Amit Lampit ◽  
Harry Hallock ◽  
Julieta Sabates ◽  
Alex Bahar-Fuchs
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Training ◽  
Systematic Reviews ◽  
Cognitive Stimulation ◽  
Cognitive Outcomes ◽  
Effect Estimate ◽  
Systematic Overview ◽  
Overview Of Systematic Reviews ◽  
Meta Analyses

Cognition-oriented treatments (COTs) – commonly categorized as cognitive training, cognitive rehabilitation and cognitive stimulation – are promising approaches for the prevention of cognitive and functional decline in older adults. We conducted a systematic overview of meta-analyses investigating the efficacy of COTs on cognitive and non-cognitive outcomes in older adults with or without cognitive impairment. Review quality was assessed by AMSTAR 2. We identified 51 eligible reviews, 46 of which were included in the quantitative synthesis. The confidence ratings were “moderate” for 9 (20%), “low” for 13 (28%) and “critically low” for 24 (52%) of the 46 reviews. While most reviews provided pooled effect estimates for objective cognition, non-cognitive outcomes of potential relevance were more sparsely reported. The mean effect estimate on cognition was small for cognitive training in healthy older adults (Hedge’s g 0.32, range 0.13-0.64, 19 reviews), mild cognitive impairment (Hedge’s g 0.40, range 0.32-0.60, five reviews), and dementia (Hedge’s g 0.38, range 0.09-1.16, seven reviews), and small for cognitive stimulation in dementia (Hedge’s g 0.36, range 0.26-0.44, five reviews). Meta-regression revealed that higher AMSTAR score was associated with larger effect estimates for cognitive outcomes. The available evidence supports the efficacy of COTs improving cognitive performance in older adults. The extent to which such effects are of clinical value remains unclear, due to the scarcity of high-quality evidence and heterogeneity in reported findings. An important avenue for future trials is to include relevant non-cognitive outcomes in a more consistent way and, for meta-analyses in the field, there is a need for better adherence to methodological standards.PROSPERO registration number: CRD42018084490.Gavelin, H.M., Lampit, A., Hallock, H. et al. Cognition-Oriented Treatments for Older Adults: a Systematic Overview of Systematic Reviews. Neuropsychol Rev (2020). https://doi.org/10.1007/s11065-020-09434-8

scholarly journals Association between Cognitive Activity and Cognitive Function in Older Hispanics

2012 ◽  
Vol 18 (6) ◽  
pp. 1041-1051 ◽  
Author(s):  
María J. Marquine ◽  
Eisuke Segawa ◽  
Robert S. Wilson ◽  
David A. Bennett ◽  
Lisa L. Barnes
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Middle Age ◽  
Cognitive Activity ◽  
Reliability And Validity ◽  
Cognitive Resources ◽  
Multiethnic Cohort ◽  
Hispanic White ◽  
Adequate Reliability

AbstractThere is limited research on the association between participation in cognitively stimulating activity and cognitive function in older Hispanics. The main purpose of the present study was to explore whether frequency of cognitive activity and its association with cognitive function in Hispanics is comparable to that of non-Hispanics. In a multiethnic cohort of 1571 non-demented older adults, we assessed past and current cognitive activity, availability of cognitive resources in the home in childhood and middle age, and five domains of cognitive function. The measures of cognitive activity and cognitive resources had adequate reliability and validity in our subset of Hispanic participants (n = 81). Hispanics reported lower levels of education, lower frequency of cognitive activity and less cognitive resources than non-Hispanic White (n = 1102) and non-Hispanic Black (n = 388) participants. Despite these differences the strength of the association between cognitive activity and cognitive function was comparable across ethnic groups. Because Hispanics have lower frequency of cognitive activity, the benefit of cognitive activity to late life cognitive function may be potentially larger in this segment of the population. Thus, interventions aimed at increasing frequency of participation in cognitively stimulating activity may offer a potential target to reduce cognitive impairment in Hispanics. (JINS, 2012, 18, 1–11)

Toward Identifying Mild Cognitive Impairment in Hispanic and African American Adults

2017 ◽  
Vol 2 (2) ◽  
pp. 110-116
Author(s):  
Valarie B. Fleming ◽  
Joyce L. Harris
Keyword(s):  
Older Adults ◽  
African American ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Healthcare Access ◽  
Communication Disorders ◽  
Healthcare Systems ◽  
Prevention Education ◽  
Education Management ◽  
African American Adults

Across the breadth of acquired neurogenic communication disorders, mild cognitive impairment (MCI) may go undetected, underreported, and untreated. In addition to stigma and distrust of healthcare systems, other barriers contribute to decreased identification, healthcare access, and service utilization for Hispanic and African American adults with MCI. Speech-language pathologists (SLPs) have significant roles in prevention, education, management, and support of older adults, the population must susceptible to MCI.

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