scholarly journals Subjective social position and cognitive function in a longitudinal cohort of older, rural South African adults, 2014–2019

2021 ◽  
pp. jech-2021-217059
Author(s):  
Lindsay C Kobayashi ◽  
Emily P Morris ◽  
Guy Harling ◽  
Meagan T Farrell ◽  
Mohammed U Kabeto ◽  
...  
Keyword(s):  
South Africa ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Low Income ◽  
Social Position ◽  
Rural South ◽  
Cognitive Score ◽  
Subjective Social Position ◽  
The Relationship

BackgroundThe relationship between subjective social position (SSP) and cognitive ageing unclear, especially in low-income settings. We aimed to investigate the relationship between SSP and cognitive function over time among older adults in rural South Africa.MethodsData were from 3771 adults aged ≥40 in the population-representative ‘Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa’ from 2014/2015 (baseline) to 2018/2019 (follow-up). SSP was assessed at baseline with the 10-rung MacArthur Network social position ladder. Outcomes were composite orientation and episodic memory scores at baseline and follow-up (range: 0–24). Mortality- and attrition-weighted linear regression estimated the associations between baseline SSP with cognitive scores at each of the baseline and follow-up. Models were adjusted for age, age2, sex, country of birth, father’s occupation, education, employment, household assets, literacy, marital status and health-related covariates.ResultsSSP responses ranged from 0 (bottom ladder rung/lowest social position) to 10 (top ladder rung/highest social position), with a mean of 6.6 (SD: 2.3). SSP was positively associated with baseline cognitive score (adjusted β=0.198 points per ladder rung increase; 95% CI 0.145 to 0.253) and follow-up cognitive score (adjusted β=0.078 points per ladder rung increase; 95% CI 0.021 to 0.136).ConclusionIndependent of objective socioeconomic position measures, SSP is associated with orientation and episodic memory scores over two time points approximately 3 years apart among older rural South Africans. Future research is needed to establish the causality of the observed relationships, whether they persist over longer follow-up periods and their consistency in other populations.

scholarly journals Disparity in Educational Attainment Partially Explains Cognitive Gender Differences in Older Rural South Africans

2020 ◽  
Vol 75 (7) ◽  
pp. e161-e173 ◽  
Author(s):  
Meagan T Farrell ◽  
Lindsay C Kobayashi ◽  
Livia Montana ◽  
Ryan G Wagner ◽  
Nele Demeyere ◽  
...  
Keyword(s):  
South Africa ◽  
Gender Differences ◽  
Executive Function ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Structural Equation Models ◽  
Gender Effects ◽  
Rural South ◽  
Visual Spatial

Abstract Objectives Direction and magnitude of gender differences in late-life cognitive function are inextricably tied to sociocultural context. Our study evaluates education and literacy as primary drivers of gender equality in cognitive performance among middle-aged and older adults in rural South Africa. Method Data were collected on 1,938 participants aged 40–79 from Agincourt, South Africa. Cognitive function was measured via the Oxford Cognitive Screen-Plus, a tablet-based assessment with low literacy demands. Four cognitive domains were derived through confirmatory factor analysis: episodic memory, executive function, visual spatial, and language. Structural equation models tested domain-specific gender effects, incrementally controlling for demographic, education, health, and socioeconomic variables. Results In the model adjusting only for demographic factors, men outperformed women on executive function and visual-spatial domains. Adding education and literacy to the model revealed a robust female advantage in episodic memory, and reduced the magnitude of male advantage in executive function and visual and spatial by 47% and 42%, respectively. Health and socioeconomic factors did not alter patterns of gender associations in subsequent models. Discussion In this older South African cohort, gender inequality in cognitive performance was partially attributable to educational differences. Understanding biopsychosocial mechanisms that promote cognitive resilience in older women is critically important given the predominantly female composition of aging populations worldwide.

scholarly journals DISCERNING STATUS: SUBJECTIVE SOCIAL POSITION AND COGNITIVE HEALTH AMONG OLDER ADULTS IN RURAL SOUTH AFRICA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S816-S816
Author(s):  
Lindsay C Kobayashi ◽  
Guy Harling ◽  
Meagan T Farrell ◽  
Ryan G Wagner ◽  
Lisa F Berkman
Keyword(s):  
South Africa ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Aging ◽  
Household Wealth ◽  
Social Position ◽  
Word Recall ◽  
Z Score ◽  
Absolute Poverty ◽  
Subjective Social Position

Abstract Rapid population aging in high absolute poverty settings, such as much of South Africa, demands new research on the social context factors that affect cognitive aging in these settings. We investigated the relationships between subjective social position within one’s village and cognitive function and impairment, with the rationale that psychosocial stress induced by low relative social position may affect cognitive aging outcomes independently of absolute socioeconomic conditions. Data were from the population-representative HAALSI study of 5,059 adults aged 40+ in rural Agincourt, South Africa. Subjective social position was assessed using the MacArthur Network social ladder, which asks respondents to indicate how high up a ladder they stand, relative to others, in their village. Cognitive function was a composite z-score of time orientation and word recall tests; scores ≤1.5 standard deviations (SD) below the mean indicated cognitive impairment. Twenty percent of those on the bottom rung had cognitive impairment, declining to 2% on the top rung. In regression models adjusted for age, sex, country of birth, education, literacy, marital status, employment, and asset-based household wealth, each ladder rung increase was associated with an 0.05 SD increase in cognitive z-score (95% CI: 0.04-0.06), and a 17% decrease in odds of cognitive impairment (OR=0.83; 95% CI: 0.79-0.88); these associations were greater in magnitude than those for years of education with these cognitive outcomes. Future work should examine if these relationships persist longitudinally, and investigate the mechanisms of these relationships, including village-level contextual factors that may contribute to subjective social position in this setting.

scholarly journals Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study

2021 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Social Isolation ◽  
Mental Status ◽  
Chinese Older Adults ◽  
Confounding Variables

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.

scholarly journals Cognitive Function in Adults with Enduring Anorexia Nervosa

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 859
Author(s):  
Maria Seidel ◽  
Helen Brooker ◽  
Kamilla Lauenborg ◽  
Keith Wesnes ◽  
Magnus Sjögren
Keyword(s):  
Anorexia Nervosa ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Reaction Times ◽  
Assessment System ◽  
Cognitive Test ◽  
Attention Tasks ◽  
Inclusion Study ◽  
Prospective Longitudinal

Anorexia Nervosa (AN) is a severe and often enduring disorder characterized by restriction of food intake, low body weight, fear of weight gain, and distorted body image. Investigations on cognition performance in AN patients have yielded conflicting results. Using an established and sensitive computerized cognitive test battery, we aimed to assess core aspects of cognitive function, including attention span, information processing, reasoning, working and episodic memory, in AN patients and controls. Patients were recruited from the Danish Prospective Longitudinal all-comer inclusion study in Eating Disorders (PROLED). Included were 26 individuals with AN and 36 healthy volunteers (HV). All were tested with CogTrack (an online cognitive assessment system) at baseline, and AN patients were tested again at a follow-up time point after weight increase (n = 13). At baseline, AN patients showed faster reaction times in the attention tasks, as well as increased accuracy in grammatical reasoning compared to HV. There were no differences in cognitive function between AN patients and HV in the other cognitive domains measured (sustained attention, working and episodic memory, speed of retrieval, and speed of grammatical reasoning). No differences were visible in the AN sample between baseline and follow-up. Performance did not correlate with any clinical variables in the AN sample. These findings supplement results from other studies suggesting increased concentration and reasoning accuracy in patients suffering from AN, who showed increased performance in cognitive tasks despite their illness.

Abstract P014: Lower eGFR and Proteinuria Were Independently Associated With Lower Cognitive Abilities in Community-dwelling Men in Japan: SESSA study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Akira Fujiyoshi ◽  
Takayoshi Ohkubo ◽  
Katsuyuki Miura ◽  
Akihiko Shiino ◽  
Naoko Miyagawa ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Abilities ◽  
Estimated Glomerular Filtration Rate ◽  
Subclinical Atherosclerosis ◽  
Community Dwelling ◽  
Community Based ◽  
Lower Egfr ◽  
The Mean ◽  
The Relationship

Introduction: The relationship between chronic kidney disease (CKD) and cognitive function remains to be determined. Existing studies focused primarily on estimated glomerular filtration rate (eGFR) but not proteinuria in relation to cognitive function. Hypothesis: In a community-based sample, lower eGFR and presence of proteinuria are cross-sectionally independently associated with lower cognition. Methods: The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA) randomly recruited and examined participants from Shiga, Japan in 2006-08 at baseline. Among 824 male participants in the follow-up exam (2010-12), we restricted our analyses to those who underwent the Cognitive Abilities Screening Instrument (CASI), age ≥65 years-old, free of stroke, with no missing pertinent covariates. We calculated eGFR (creatinine-based) according to the 2012-guideline by the Japanese Society of Nephrology. We then divided the participants into three groups by eGFR of ≥60, 59-40, and <40 (mL/min/1.73m 2 ), and separately divided into three groups according to proteinuria using urine dipstick: (-), (-/+), and ≥(1+). We defined CKD as either eGFR <60 or proteinuria ≥ (-/+). In linear regression with CASI score being a dependent variable, we computed the score adjusted for age, highest education attained, smoking, drinking, body mass index, hypertension, diabetes, and dyslipidemia. Results: We analyzed 541 men. The mean [standard deviation] of age and unadjusted score were 72.6 [4.3] years and 89.7 [6.0]. Prevalence of CKD was 56%. The score was significantly lower in participants with CKD than those without it (P=0.03). eGFR and proteinuria categories were separately and jointly associated with lower CASI score in a graded fashion (Ps for trend <0.05 in all the models tested. Table 1 ). Conclusions: Lower eGFR and higher degree of proteinuria were independently associated with lower cognitive function in the community-based men. CKD even in its early phase may predispose to lower cognitive function.

scholarly journals Cognitive Function and Impairment in Older, Rural South African Adults: Evidence from “Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in Rural South Africa”

2018 ◽  
Vol 52 (1-2) ◽  
pp. 32-40 ◽  
Author(s):  
Lindsay C. Kobayashi ◽  
Farrah J. Mateen ◽  
Livia Montana ◽  
Ryan G. Wagner ◽  
Kathleen Kahn ◽  
...  
Keyword(s):  
South Africa ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
South African ◽  
Rural South ◽  
Rural South Africa

Abstract T P160: Influence of Polyunsaturated Fatty Acids on Cognition in Elderly Alzheimer's Disease Patients

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Takashi Yamazaki ◽  
Ken Nagata ◽  
Daiki Takano ◽  
Tetsuya Maeda
Keyword(s):  
Alzheimer’S Disease ◽  
Blood Pressure ◽  
Alzheimer's Disease ◽  
Cognitive Function ◽  
Mmse Score ◽  
Characteristic Curve ◽  
Follow Up Study ◽  
Cognitive Stability ◽  
The Relationship

Background: Many genes and environmental factors linked to Alzheimer’s disease (AD) risk affect lipid metabolism or the cardiovascular system, strongly implicating cerebrovascular and metabolic dysfunction in AD pathogenesis. Although some PUFAs may improve cognitive function in aging individuals, it is still unclear how different PUFAs influence AD neuropathology and cognitive function. Objective: To examine the influence of polyunsaturated fatty acid (PUFA) metabolism on AD-associated cognitive decline, we investigated the relationship between serum PUFA profile and neuropsychological test performance. Methods: Cognitive functioning in patients with probable AD (n = 174, mean age 77.6 years) was examined using the Mini-Mental State Exam (MMSE) and clock drawing test (CDT). Serum samples were obtained for PUFA profile, including the eicosapentaenoic acid/arachidonic acid (EPA/AA) ratio, and measurement of brain natriuretic peptide (BNP) concentration. In the follow-up study, 47 subjects repeated MMSE and CDT after 1 year, According to the second MMSE score, the subjects were divided into the following 2 groups: those with unchanged or improved MMSE score and those with lower MMSE score. A receiver operating characteristic curve was used to evaluate the relationship between the EPA/AA ratio and 1-year cognitive stability. Results: In the cross-sectional study, total MMSE score correlated positively with the EPA/AA ratio and systolic blood pressure (SBP), and negatively with age and diastolic blood pressure (DBP) (p < 0.05). In the follow-up study, the MMSE score was lower than baseline in 20 subjects, whereas it was improved or unchanged in 29 patients. The EPA/AA ratio in the stable group was significantly greater than that in the deteriorating group, suggesting an association between higher EPA/AA ratio and cognitive stability over 1 year. The EPA/AA ratio predicted stability of cognitive performance with a sensitivity of 66% and specificity of 70% (odds ratio = 4.43) when the cut-off was 0.67. Conclusion: Our results suggest that serum EPA concentration strongly influences cognitive performances in AD patients. The EPA/AA ratio was a sensitive indicator of cognitive stability in this patient group.

scholarly journals Relationship between children’s cognitions and later educational progress in rural South Africa: a longitudinal study

2019 ◽  
Vol 73 (5) ◽  
pp. 422-426
Author(s):  
Melissa Cortina ◽  
Helen E Jack ◽  
Rebecca Pearson ◽  
Kathleen Kahn ◽  
Stephen Tollman ◽  
...  
Keyword(s):  
South Africa ◽  
Longitudinal Study ◽  
Low Income ◽  
Psychological Functioning ◽  
Behavioural Therapy ◽  
Educational Progress ◽  
Rural South ◽  
Middle Income ◽  
Cognitive Triad ◽  
Rural South Africa

BackgroundChildren in low-income and middle-income countries (LMICs) who remain in school have better health and employment outcomes. South Africa, like many LMICs, has a secondary school completion rate under 50%, leaving room for improvement if we can identify factors that affect educational attainment. This is the first longitudinal study to examine the effects of childhood mental health and cognitions on educational outcomes in LMIC.MethodsUsing the Strengths and Difficulties Questionnaire (SDQ) and Cognitive Triad Inventory for Children (CTI-C), we assessed the psychological functioning and cognition of children aged 10–12 in rural South Africa. We linked that data with measures of educational progress collected 5 years later and examined associations between educational progress and (1) behavioural and emotional problems and (2) cognitive interpretations, adjusting for possible confounders.ResultsEducational data were available for 443 individuals. 92% (n=408) of individuals had advanced three or fewer grades in 7 years. Having more positive cognitions (CTIC-C) was positively associated with progressing at least three grade levels (adjusted OR 1.43, 95% CI 1.14 to 1.79). There was no evidence for an association between emotional and behavioural problems (SDQ) and educational progress (OR 0.90, 95% CI 0.72 to 1.11).ConclusionIf children in LMICs can develop more positive perspectives, they may be able to stay in school longer. Cognitions can be modified, and future studies should test interventions that work to improve cognition in childhood, guided, for example, by principles of cognitive–behavioural therapy.

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