Abstract P288: Association Between Vision Impairment and Cognitive Decline in Older Adults With Stroke: Health and Retirement Study

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Kimberly Hreha ◽  
Brian Downer ◽  
Joshua R Ehrlich ◽  
Giulio Taglialatela
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Visual Impairment ◽  
Vision Impairment ◽  
Health And Retirement Study ◽  
Stroke Survivors ◽  
Fair Poor ◽  
Retirement Study ◽  
Good Vision

Introduction: Nearly 800,000 people in the United States sustain a stroke each year. Up to 60% of stroke survivors have visual impairments and/or ocular deficits, which may negatively impact functional performance, quality of life, and increase the risk for depression. Poor vision has been associated with cognitive decline in older adults, but little is known if vision impairment is a risk factor for cognitive decline among older adults who have survived a stroke. The purpose of this study was to evaluate the association between vision impairment and cognitive decline among stroke survivors and compare the cognitive trajectories of stroke survivors with and without visual impairment. Methods: We used data from four waves (2010-2016) of the Health and Retirement Study to investigate the cognitive health of stroke survivors with and without visual impairment. Vision (excellent-very good [ref], good, fair-poor) and stroke diagnosis were self-reported. Cognition was measured using the Telephone Interview for Cognitive Status. Linear mixed effects regression was used to model the association between overall, near, and far vision and change in cognitive function, adjusting for confounders. Results: The final sample included 1,475 stroke survivors. A majority were female (55.6%) and white (66.3%) and the mean age was 71.0 (11.7). Fair-poor overall ( B =-1.30, p <0.01), near ( B =-1.53, p <0.001), and far ( B =-1.27, p <0.001) vision, as well as good near ( B =-0.82, p <0.001) and far ( B =-0.48, p <0.05) vision were associated with significantly lower baseline cognitive function compared to excellent-very good vision. The association between self-rated vision and cognition decline was not statistically significant. Conclusions: We found that people with worst vision had lower cognitive functioning but not greater cognitive decline than stroke survivors with excellent-to-very good vision. Further research should investigate if specific types of vision impairment potentiate the risk of cognitive impairment and dementia in stroke survivors.

scholarly journals A Systematic Review of Visual Impairment and Cognitive Decline Among Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 529-530
Author(s):  
Niranjani Nagarajan ◽  
Bonnielin Swenor ◽  
Lama Assi ◽  
Joshua Ehrlich ◽  
Heather Whitson
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Visual Impairment ◽  
Visual Fields ◽  
Well Being ◽  
Vision Impairment ◽  
Sensory Loss ◽  
Functional Changes

Abstract Cognitive and visual impairments frequently coexist. With the aging of populations worldwide, the prevalence of these conditions are projected to increase substantially over time. A number of studies suggest that cognitive function and vision impairment are associated, and it is hypothesized to be due to a (1) common cause etiology, where both share common risk factors, and/or (2) causal association, where visual impairment causes cognitive decline. Sensory loss can lead to increased cognitive load, structural and functional changes in the brain, and/or decreased emotional, social, and physical well-being, all of which could potentially increase the risk of cognitive impairment. We conducted a systematic review of the existing literature, examining the association between cognitive and visual impairment among older adults. A total of 80 observational studies that reported a measure of association between visual and cognitive function and met the following criteria were included: (1) cross-sectional or longitudinal study design, (2) baseline mean age of participants ≥50 years, and (3) sample size of ≥100 participants. Of these 80 studies, 56 found a positive, significant association between visual function and cognitive decline. Forty-nine of the 56 studies used objective measures to test for visual acuity, contrast sensitivity, or visual fields. The sample included participants from 14 countries, including the US, UK, China, and Australia among others. Converging evidence of an association between vision impairment and subsequent cognitive decline suggests that visual impairment is a possible modifiable risk factor for cognitive decline and dementia. This hypothesis should be tested in prospective, controlled studies.

scholarly journals Associations Between Self-Reported Sensory Impairment and Risk of Cognitive Decline and Impairment in the Health and Retirement Study Cohort

2019 ◽  
Vol 75 (6) ◽  
pp. 1230-1242 ◽  
Author(s):  
Asri Maharani ◽  
Piers Dawes ◽  
James Nazroo ◽  
Gindo Tampubolon ◽  
Neil Pendleton ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Visual Impairment ◽  
Hearing Impairment ◽  
Health And Retirement Study ◽  
Study Cohort ◽  
Sensory Impairment ◽  
Cox Proportional Hazard ◽  
Adjusted Incidence ◽  
Retirement Study ◽  
Dual Sensory Impairment

Abstract Objectives We aimed to determine whether self-assessed single (hearing or visual) and dual sensory (hearing and visual) impairments are associated with cognitive decline and incident possible cognitive impairment, no dementia (CIND) and probable dementia. Method Data were drawn from the 1996–2014 surveys of the Health and Retirement Study (HRS), involving 19,618 respondents who had no probable dementia and who were aged 50 years or older at the baseline. We used linear mixed models to test the association between self-assessed sensory impairment and cognitive decline followed by a Cox proportional hazard model to estimate the relative risk of incident possible CIND and probable dementia associated with the presence of sensory impairment. Results Respondents with self-assessed single and dual sensory impairment performed worse in cognitive tests than those without sensory impairment. The fully adjusted incidence of developing possible CIND was 17% higher for respondents with hearing impairment than those without hearing impairment. Respondents with visual impairment had 35% and 25% higher risk for developing possible CIND and probable dementia, respectively, than those without visual impairment. Respondents with dual sensory impairment at baseline were 38% and 26% more likely to develop possible CIND and probable dementia, respectively, than those with no sensory impairment. Discussion Self-assessed sensory impairment is independently associated with cognitive decline and incident possible CIND and probable dementia. Further studies are needed to identify the mechanism underlying this association and to determine whether treatment of sensory impairment could ameliorate cognitive decline and delay the onset of dementia among older adults.

Cognitive Performance Trajectories Before and After Sleep Treatment Initiation in Middle-Aged and Older Adults: Results from the Health and Retirement Study

2021 ◽  
Author(s):  
Christopher N Kaufmann ◽  
Mark W Bondi ◽  
Wesley K Thompson ◽  
Adam P Spira ◽  
Sonia Ancoli-Israel ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Sleep Disturbance ◽  
Cognitive Performance ◽  
Treatment Initiation ◽  
Health And Retirement Study ◽  
Middle Aged ◽  
Before And After ◽  
Sleep Treatment ◽  
Retirement Study

Abstract BACKGROUND Sleep disturbances are associated with risk of cognitive decline but it is not clear if treating disturbed sleep mitigates decline. We examined differences in cognitive trajectories before and after sleep treatment initiation. METHODS Data came from the 2006-2014 Health and Retirement Study. At each of five waves, participants were administered cognitive assessments and scores were summed. Participants also reported if, in prior two weeks, they had taken medications or used other treatments to improve sleep. Our sample (N=3,957) included individuals who at HRS 2006 were &gt;50 years, had no cognitive impairment, reported no sleep treatment, and indicated experiencing sleep disturbance. We identified differences between those receiving vs. not receiving treatment in subsequent waves, and among those treated (N=1,247), compared cognitive trajectories before and after treatment. RESULTS At baseline, those reporting sleep treatment at subsequent waves were more likely to be younger, female, Caucasian, to have more health conditions, to have higher BMI, and more depressive symptoms (all p’s≤0.015). Decline in cognitive performance was mitigated in periods after sleep treatment vs. periods before (B=-0.20, 95% CI=-0.25, -0.15, p&lt;0.001; vs., B=-0.26, 95% CI=-0.32, -0.20, p&lt;0.001), and this same trend was seen for self-initiated and doctor-recommended treatments. Trends were driven by those with higher baseline cognitive performance—those with lower performance saw cognitive declines following sleep treatment. CONCLUSIONS In middle-aged and older adults with sleep disturbance, starting sleep treatment may slow cognitive decline. Future research should assess types, combinations, and timing of treatments most effective in improving cognitive health in later life.

scholarly journals Social Isolation and Loneliness: Moderators of the Relationship Between Sensory Impairment and Cognition

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 474-474
Author(s):  
Alison Huang ◽  
George Rebok ◽  
Bonnielin Swenor ◽  
Jayant Pinto ◽  
Linda Waite ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Hearing Impairment ◽  
Social Isolation ◽  
Social Life ◽  
Vision Impairment ◽  
Sensory Impairment ◽  
The Impact ◽  
The Relationship

Abstract Hearing and vision impairment have been independently linked to accelerated cognitive decline in older adults, however there is limited evidence on the effect of dual sensory impairment (DSI) (both hearing and vision impairment) on cognition. Additionally, the impact of social isolation and loneliness, both correlates of DSI and independent risk factors for cognitive decline, on the DSI-cognition relationship has yet to be studied. Using data from the National Social Life, Health, and Aging Project (N=3,091), multivariable linear regression models were used to describe the cross-sectional relationship between self-reported functional sensory impairment (none, hearing only, vision only, DSI) and cognitive function, measured by the survey adapted Montreal Cognitive Assessment. We also included an interaction term in the model to investigate whether cognition is worse among older adults with sensory impairment who also are socially isolated or lonely. Participants in this sample are between 62-91 years with 15% reporting hearing impairment, 11% reporting vision impairment, and 7% reporting DSI. DSI was associated with significantly lower global cognitive function compared to no sensory impairment (-0.31 standard deviations (SD), 95% CI:-0.44 to-0.18), hearing impairment alone (-0.29 SD, 95% CI: -0.44 to -0.15), and vision impairment alone (-0.22 SD, 95% CI: -0.39 to -0.06). Furthermore, cognitive function was significantly worse among older adults with both DSI and smaller social networks (p-interaction &lt;0.05). No differences in the DSI-cognition relationship were observed by level of loneliness. These findings add to the limited research on the relationship between DSI, social isolation and loneliness, and cognition.

Isolation, Not Loneliness or Cynical Hostility, Predicts Cognitive Decline in Older Americans

2018 ◽  
Vol 32 (1-2) ◽  
pp. 52-60 ◽  
Author(s):  
Sarah C. Griffin ◽  
Briana Mezuk ◽  
Allison Baylor Williams ◽  
Paul B. Perrin ◽  
Bruce D. Rybarczyk
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Functional Limitations ◽  
Cognitive Status ◽  
Older Americans ◽  
Frequency Of Contact ◽  
Cynical Hostility ◽  
Reported Health ◽  
Retirement Study

Objective: To jointly examine isolation, loneliness, and cynical hostility as risk factors for cognitive decline in older adults. Method: Data came from the 2006 to 2012 waves of the Health and Retirement Study (HRS), a longitudinal study of U.S. older adults (age ⩾ 65 years, n = 6,654). Measures included frequency of contact with social network (objective isolation), the Hughes Loneliness Scale (loneliness), a modified version of the Cook–Medley Hostility Inventory (cynical hostility), and a modified version of the Telephone Interview for Cognitive Status (cognitive function). Multilevel modeling (random slope + intercept) was used to examine the association between these factors and trajectories of cognitive function. Results and Discussion: After controlling for demographic characteristics, self-reported health, and functional limitations, loneliness (β = −.34, 95% confidence interval [CI] = [−0.56, −0.11), and cynical hostility (β = −.14, 95% CI = [−0.24, −0.04) correlated with lower cognitive function, but none predicted change in cognitive function. Objective social isolation was associated with lower cognitive function (β = −.27, 95% CI = [−0.41, −0.12]) and steeper decline in cognitive function (β = −.09, 95% CI = [−0.16, −0.01]).

scholarly journals INTERNET USE AND LONELINESS OF OLDER ADULTS OVER TIME: THE MEDIATION EFFECT OF SOCIAL CONTACT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S194-S194
Author(s):  
Kexin Yu ◽  
Kexin Yu ◽  
Shinyi Wu ◽  
Iris Chi
Keyword(s):  
Older Adults ◽  
Older People ◽  
Internet Use ◽  
Social Contact ◽  
Total Effect ◽  
Mediation Effect ◽  
Health And Retirement Study ◽  
Longitudinal Association ◽  
Retirement Study ◽  
Over Time

Abstract Internet is increasingly popular among older adults and have changed interpersonal interactions. However, it remains controversial whether older people are more or less lonely with internet use. This paper tests the longitudinal association of internet use and loneliness among older people. One pathway that explains the association, the mediation effect of social contact, was examined. Data from the 2006, 2010 and 2014 waves of Health and Retirement Study was used. Hierarchical liner modeling results showed internet use was related to decreased loneliness over 12-year period of time (b=-0.044, p&lt;.001). Internet use was associated with more social contact with family and friends overtime (b=0.261, p&lt;.001), social contact was related to less perceived loneliness longitudinally (b=0.097, p&lt;.001). The total effect of internet use on loneliness is -0.054 and the mediated effect is -0.025. The findings imply that online activities can be effective for reducing loneliness for older people through increased social contact.

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 Everyday Discrimination and Kidney Function Among Older Adults: Evidence From the Health and Retirement Study

2019 ◽  
Vol 75 (3) ◽  
pp. 517-521
Author(s):  
Ryon J Cobb ◽  
Roland J Thorpe ◽  
Keith C Norris
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
The United States ◽  
Health And Retirement Study ◽  
Disease Epidemiology ◽  
Lower Egfr ◽  
Everyday Discrimination ◽  
Retirement Study

Abstract Background With advancing age, there is an increase in the time of and number of experiences with psychosocial stressors that may lead to the initiation and/or progression of chronic kidney disease (CKD). Our study tests whether one type of experience, everyday discrimination, predicts kidney function among middle and older adults. Methods The data were from 10 973 respondents (ages 52–100) in the 2006/2008 Health and Retirement Study, an ongoing biennial nationally representative survey of older adults in the United States. Estimated glomerular filtration rate (eGFR) derives from the Chronic Kidney Disease Epidemiology Collaboration equation. Our indicator of everyday discrimination is drawn from self-reports from respondents. Ordinary Least Squared regression (OLS) models with robust standard errors are applied to test hypotheses regarding the link between everyday discrimination and kidney function. Results Everyday discrimination was associated with poorer kidney function among respondents in our study. Respondents with higher everyday discrimination scores had lower eGFR after adjusting for demographic characteristics (B = −1.35, p &lt; .05), and while attenuated, remained significant (B = −0.79, p &lt; .05) after further adjustments for clinical, health behavior, and socioeconomic covariates. Conclusions Our study suggests everyday discrimination is independently associated with lower eGFR. These findings highlight the importance of psychosocial factors in predicting insufficiency in kidney function among middle-aged and older adults.

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