scholarly journals Cognition-Mortality Associations Are More Pronounced When Estimated Jointly in Longitudinal and Time-to-Event Models

2021 ◽  
Vol 12 ◽  
Author(s):  
Stephen Aichele ◽  
Sezen Cekic ◽  
Patrick Rabbitt ◽  
Paolo Ghisletta
Keyword(s):  
Cognitive Decline ◽  
Mortality Risk ◽  
Repeated Measures ◽  
Later Life ◽  
Joint Estimation ◽  
Longitudinal Change ◽  
Survival Models ◽  
Joint Models ◽  
Modeling Framework ◽  
Crystallized Abilities

With aging populations worldwide, there is growing interest in links between cognitive decline and elevated mortality risk—and, by extension, analytic approaches to further clarify these associations. Toward this end, some researchers have compared cognitive trajectories of survivors vs. decedents while others have examined longitudinal changes in cognition as predictive of mortality risk. A two-stage modeling framework is typically used in this latter approach; however, several recent studies have used joint longitudinal-survival modeling (i.e., estimating longitudinal change in cognition conditionally on mortality risk, and vice versa). Methodological differences inherent to these approaches may influence estimates of cognitive decline and cognition-mortality associations. These effects may vary across cognitive domains insofar as changes in broad fluid and crystallized abilities are differentially sensitive to aging and mortality risk. We compared these analytic approaches as applied to data from a large-sample, repeated-measures study of older adults (N = 5,954; ages 50–87 years at assessment; 4,453 deceased at last census). Cognitive trajectories indicated worse performance in decedents and when estimated jointly with mortality risk, but this was attenuated after adjustment for health-related covariates. Better cognitive performance predicted lower mortality risk, and, importantly, cognition-mortality associations were more pronounced when estimated in joint models. Associations between mortality risk and crystallized abilities only emerged under joint estimation. This may have important implications for cognitive reserve, which posits that knowledge and skills considered well-preserved in later life (i.e., crystallized abilities) may compensate for declines in abilities more prone to neurodegeneration, such as recall memory and problem solving. Joint longitudinal-survival models thus appear to be important (and currently underutilized) for research in cognitive epidemiology.

scholarly journals Cognition-Mortality Associations Are Stronger When Estimated Jointly in Longitudinal and Time-to-Event Models

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 308-309
Author(s):  
Stephen Aichele ◽  
Sezen Cekic ◽  
Patrick Rabbitt ◽  
Paolo Ghisletta
Keyword(s):  
Cognitive Decline ◽  
Adult Development ◽  
Mortality Risk ◽  
Repeated Measures ◽  
Joint Estimation ◽  
Longitudinal Change ◽  
Joint Models ◽  
Modeling Framework ◽  
Crystallized Abilities ◽  
Aging Populations

Abstract Objectives With aging populations worldwide, there is growing interest in links between cognitive decline and elevated mortality risk—and, by extension, analytic approaches to further clarify these associations. Toward this end, some researchers have compared cognitive trajectories of survivors vs. decedents while others have examined longitudinal changes in cognition as predictive of mortality risk. A two-stage modeling framework is typically used in this latter approach; however, several recent studies have used joint longitudinal-survival modeling (i.e., estimating longitudinal change in cognition conditionally on mortality risk, and vice versa). Methodological differences inherent to these approaches may influence estimates of cognitive decline and cognition-mortality associations. These effects may vary across cognitive domains insofar as changes in broad fluid and crystallized abilities are differentially sensitive to aging and mortality risk. Methods We applied each of the above analytic approaches to data from a large-sample repeated-measures study of older adults (N = 5,954, of whom 4,453 deceased; ages 50–87 years at assessment). Results Cognitive trajectories indicated worse performance in decedents and when estimated jointly with mortality risk, but this was attenuated after adjustment for health-related covariates. Better cognitive performance predicted lower mortality risk, and, importantly, cognition-mortality associations were stronger when estimated in joint models. Associations between mortality risk and crystallized abilities only emerged under joint estimation, confirming the greater power of this statistical approach. Discussion These results suggest that joint estimation of cognition-mortality associations may be beneficial for research in cognitive epidemiology and cognitive reserve in adult development.

scholarly journals Joint Modeling of Longitudinal Change and Survival

GeroPsych ◽  
2011 ◽  
Vol 24 (4) ◽  
pp. 177-185 ◽  
Author(s):  
Graciela Muniz Terrera ◽  
Andrea M. Piccinin ◽  
Fiona Matthews ◽  
Scott M. Hofer
Keyword(s):  
Repeated Measures ◽  
Memory Performance ◽  
Joint Modeling ◽  
Disease Diagnosis ◽  
Careful Consideration ◽  
Survival Model ◽  
Longitudinal Change ◽  
Survival Models ◽  
Time Data ◽  
Aging Research

Joint longitudinal-survival models are useful when repeated measures and event time data are available and possibly associated. The application of this joint model in aging research is relatively rare, albeit particularly useful, when there is the potential for nonrandom dropout. In this article we illustrate the method and discuss some issues that may arise when fitting joint models of this type. Using prose recall scores from the Swedish OCTO-Twin Longitudinal Study of Aging, we fitted a joint longitudinal-survival model to investigate the association between risk of mortality and individual differences in rates of change in memory. A model describing change in memory scores as following an accelerating decline trajectory and a Weibull survival model was identified as the best fitting. This model adjusted for random effects representing individual variation in initial memory performance and change in rate of decline as linking terms between the longitudinal and survival models. Memory performance and change in rate of memory decline were significant predictors of proximity to death. Joint longitudinal-survival models permit researchers to gain a better understanding of the association between change functions and risk of particular events, such as disease diagnosis or death. Careful consideration of computational issues may be required because of the complexities of joint modeling methodologies.

scholarly journals The Characteristics of Social Network Structure in Later Life in Relation to Incidence of Mild Cognitive Impairment and Conversion to Probable Dementia

2021 ◽  
pp. 1-12
Author(s):  
Yun Zhang ◽  
Ginny Natale ◽  
Sean Clouston
Keyword(s):  
Cognitive Impairment ◽  
Social Network ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Family Member ◽  
Later Life ◽  
Survival Models ◽  
Social Network Structure ◽  
Risk Of Mortality ◽  
College Educated

Background: Larger, or more active social networks are estimated to be associated with lower risks of cognitive decline. However, roles of various social relationships in a broad social network in protecting against cognitive decline remain to be elucidated. Objective: We aimed to investigate how social roles within a social network and number of social network members are associated with cognitive decline. Methods: Six waves of National Health and Aging Trends Study (2011-2016, NHATS) were utilized to examine the development of mild cognitive impairment (MCI) and probable dementia determined using validated criteria. Multivariable-adjusted multi-state survival models were used to model incidences and transitions, jointly with misclassification errors. Results: A total of 6,078 eligible NHATS participants were included (average age: 77.49±7.79 years; female: 58.42%; non-Hispanic white: 68.99%). Multivariable-adjusted analyses revealed that having more social network members was associated with lower hazards of conversion from MCI to probable dementia (adjusted Hazard Ratio; aHR = 0.82; 95%confidence intervals; 95%CI = [0.67–0.99]), meanwhile having at least one college-educated family member within a social network was associated with lower incidence of probable dementia (aHR = 0.37 [0.26–0.51]). Having at least one friend within a social network was associated with a lower hazard of incidence of probable dementia (aHR = 0.48 [0.33–0.71]), but a higher risk of mortality in the MCI group (aHR = 2.58 [1.47–4.51]). Conclusion: Having more social network members, having at least one friend, and having at least one college-educated family member within a social network, were associated with lower risks of incidence of dementia or conversion from MCI to dementia.

scholarly journals Longitudinal Change of Mental Health among Active Social Media Users in China during the COVID-19 Outbreak

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 833
Author(s):  
Tianli Liu ◽  
Sijia Li ◽  
Xiaochun Qiao ◽  
Xinming Song
Keyword(s):  
Mental Health ◽  
Social Media ◽  
Repeated Measures ◽  
Mainland China ◽  
Longitudinal Change ◽  
Symptom Checklist ◽  
Learning Models ◽  
Online Data ◽  
Repeated Measures Analysis ◽  
Machine Learning Models

During the COVID-19 pandemic, every day, updated case numbers and the lasting time of the pandemic became major concerns of people. We collected the online data (28 January to 7 March 2020 during the COVID-19 outbreak) of 16,453 social media users living in mainland China. Computerized machine learning models were developed to estimate their daily scores of the nine dimensions of the Symptom Checklist—90 (SCL-90). Repeated measures analysis of variance (ANOVA) was used to compare the SCL-90 dimension scores between Wuhan and non-Wuhan residents. Fixed effect models were used to analyze the relation of the estimated SCL-90 scores with the daily reported cumulative case numbers and lasting time of the epidemic among Wuhan and non-Wuhan users. In non-Wuhan users, the estimated scores for all the SCL-90 dimensions significantly increased with the lasting time of the epidemic and the accumulation of cases, except for the interpersonal sensitivity dimension. In Wuhan users, although the estimated scores for all nine SCL-90 dimensions significantly increased with the cumulative case numbers, the magnitude of the changes was generally smaller than that in non-Wuhan users. The mental health of Chinese Weibo users was affected by the daily updated information on case numbers and the lasting time of the COVID-19 outbreak.

scholarly journals The Role of Stressful Childhood Experiences in Shaping Later-Life Memory Loss Among Black and White U.S. Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 296-296
Author(s):  
Caroline Hartnett
Keyword(s):  
Cognitive Decline ◽  
Memory Loss ◽  
Later Life ◽  
Behavioral Risk ◽  
Black Adults ◽  
Childhood Experiences ◽  
White Children ◽  
Black And White ◽  
Stressful Experiences ◽  
White Adults

Abstract Cognitive decline common in the U.S. and greatly impacts quality of life, both for those who experience it and for those who care for them. Black Americans experience higher burdens of cognitive decline but the mechanisms underlying this disparity have not been fully elucidated. Stress experienced in early life is a promising explanatory factor, since stress and cognition are linked, childhood stressors been shown to have a range of negative implications later in life, and Black children experience more childhood stressors than White children, on average. In this paper, we use data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine whether stressful experiences in childhood help explain Black-White disparities in memory loss. These data were available for 5 state-years between 2011 and 2017 (n=11,708). Preliminary results indicate that, while stressful childhood experiences are strongly associated with memory loss, stressful experiences do not mediate the association between race and memory loss. However, race does appear to moderate the association between stressful childhood experiences and memory loss. Specifically, stressful experiences are associated with a higher likelihood of memory loss for Black adults compared to White adults.In addition, there seem to be some noteworthy patterns across different types of experiences (i.e. parental drinking may predict later memory loss more strongly for Black adults than White adults, but parental hitting may predict memory loss more strongly for White adults than Black adults).

scholarly journals Cognitive reserve in amyotrophic lateral sclerosis (ALS): a population-based longitudinal study

2021 ◽  
pp. jnnp-2020-324992
Author(s):  
Emmet Costello ◽  
James Rooney ◽  
Marta Pinto-Grau ◽  
Tom Burke ◽  
Marwa Elamin ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Reserve ◽  
Population Based ◽  
Protective Role ◽  
Drop Out ◽  
Longitudinal Change ◽  
Activity Data ◽  
Lateral Sclerosis

BackgroundAmyotrophic lateral sclerosis (ALS) is often associated with cognitive and/or behavioural impairment. Cognitive reserve (CR) may play a protective role in offsetting cognitive impairment. This study examined the relationship between CR and longitudinal change in cognition in an Irish ALS cohort.MethodsLongitudinal neuropsychological assessment was carried out on 189 patients over 16 months using the Edinburgh cognitive and behavioural ALS screen (ECAS) and an additional battery of neuropsychological tests. CR was measured by combining education, occupation and physical activity data. Joint longitudinal and time-to-event models were fitted to investigate the associations between CR, performance at baseline and decline over time while controlling for non-random drop-out.ResultsCR was a significant predictor of baseline neuropsychological performance, with high CR patients performing better than those with medium or low CR. Better cognitive performance in high CR individuals was maintained longitudinally for ECAS, social cognition, executive functioning and confrontational naming. Patients displayed little cognitive decline over the course of the study, despite controlling for non-random drop-out.ConclusionsThese findings suggest that CR plays a role in the presentation of cognitive impairment at diagnosis but is not protective against cognitive decline. However, further research is needed to examine the interaction between CR and other objective correlates of cognitive impairment in ALS.

scholarly journals Perception of Neighborhood Characteristics During Childhood and Cognitive Health Among Older Adults in China

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 439-439
Author(s):  
Changmin Peng ◽  
Sae Hwang Han ◽  
Jeffrey Burr
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Cognitive Functioning ◽  
Social Cohesion ◽  
Later Life ◽  
Neighborhood Characteristics ◽  
Neighborhood Safety ◽  
Cognitive Health ◽  
Childhood Conditions ◽  
Neighborhood Environments

Abstract Neighborhood environments shape the availability of resources for social engagement and social interaction, which are associated with better health outcomes. However, these contextual factors are also considered sources of potential social distress and tension, increasing the risk of subsequent health deficits, including cognitive decline. Our understanding of the linkage between childhood neighborhood environments and cognitive functioning in later life is limited. This study employed three waves of nationally representative data from the China Health and Retirement Longitudinal Study (2011-2015; N = 11,105) to investigate the relationship between self-reported neighborhood social cohesion during childhood (i.e., neighborhood safety, neighbors willing to help, and close-knit neighborhood) and cognitive functioning (Chinese version of TICS). We employed latent growth curve modeling to test hypotheses relating to life course models of childhood conditions and later life cognitive functioning (the long arm of childhood). The results showed that perceptions regarding the willingness of neighbors to help and close-knit neighborhood characteristics during childhood were positively associated with levels of later life cognitive function. Further, growing up in a neighborhood characterized by the willingness of neighbors to help others was negatively associated with the rate of cognitive decline, net of childhood and adulthood covariates. Self-report of neighborhood safety during childhood was unrelated to cognitive function (level and change). These findings underscored the long-term ramifications of childhood conditions as potential risk factors for later-life cognitive health. Social cohesion at the neighborhood level as experienced during childhood may be a protective factor for healthy cognitive aging among older Chinese adults.

scholarly journals Cognitive decline and alcohol consumption adjusting for functional status over a 3-year period in French speaking community living older adults

2018 ◽  
Vol 41 (2) ◽  
pp. e177-e184 ◽  
Author(s):  
Helen-Maria Vasiliadis ◽  
Marie-Christine Payette ◽  
Djamal Berbiche ◽  
Sébastien Grenier ◽  
Carol Hudon
Keyword(s):  
Older Adults ◽  
Alcohol Consumption ◽  
Cognitive Decline ◽  
Functional Status ◽  
Repeated Measures ◽  
Service Use ◽  
High Functioning ◽  
French Speaking ◽  
Changing Patterns

AbstractBackgroundThe effect of alcohol consumption on cognitive decline is not clear. We aimed to study the association between alcohol consumption and cognitive functioning controlling for functional heath status.MethodsA total of 1610 older adults with a score ≥26 on the Mini-Mental State Examination (MMSE) were followed to assess the change in scores at the 3-year follow-up. Information on alcohol consumption as well as socio-demographic, lifestyle, psychosocial and clinical factors, as well as health service use were assessed at baseline and 3-year follow-up interviews. Linear mixed models with repeated measures were used stratifying by functional status.ResultsClose to 73% reported consuming alcohol in the past 6 months, of which 11% were heavy drinkers (≥11 and ≥16 drinks for women and men). A significant decrease in MMSE scores was observed in low functioning non-drinkers (−1.48; 95% CI: −2.06, −0.89) and light to moderate drinkers (−0.99; 95% CI: −1.54, −0.44) and high functioning non-drinkers (−0.51; 95% CI: −0.91, −0.10).ConclusionsAlcohol consumption did not contribute to cognitive decline. Cognitive decline was greater in individuals reporting low functional status. Research should focus on the interaction between changing patterns of alcohol consumption and social participation in individuals with low and high functioning status.

scholarly journals Studying at university in later life slows cognitive decline: A long‐term prospective study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Aidan D. Bindoff ◽  
Mathew J. Summers ◽  
Edward Hill ◽  
Jane Alty ◽  
James C. Vickers
Keyword(s):  
Prospective Study ◽  
Cognitive Decline ◽  
Later Life

scholarly journals Psychosocial Telephone Counseling for Survivors of Cervical Cancer: Results of a Randomized Biobehavioral Trial

2015 ◽  
Vol 33 (10) ◽  
pp. 1171-1179 ◽  
Author(s):  
Lari Wenzel ◽  
Kathryn Osann ◽  
Susie Hsieh ◽  
Jo A. Tucker ◽  
Bradley J. Monk ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Repeated Measures ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Telephone Counseling ◽  
Longitudinal Change ◽  
Categorical Variables ◽  
Patient Reported ◽  
Cytokine Levels ◽  
Cancer Experience

Purpose Survivors of cervical cancer experience quality-of-life (QOL) disruptions that persist years after treatment. This study examines the effect of a psychosocial telephone counseling (PTC) intervention on QOL domains and associations with biomarkers. Patients and Methods We conducted a randomized clinical trial in survivors of cervical cancer, who were ≥ 9 and less than 30 months from diagnosis (n = 204), to compare PTC to usual care (UC). PTC included five weekly sessions and a 1-month booster. Patient-reported outcomes (PROs) and biospecimens were collected at baseline and 4 and 9 months after enrollment. Changes in PROs over time and associations with longitudinal change in cytokines as categorical variables were analyzed using multivariable analysis of variance for repeated measures. Results Participant mean age was 43 years; 40% of women were Hispanic, and 51% were non-Hispanic white. Adjusting for age and baseline scores, participants receiving PTC had significantly improved depression and improved gynecologic and cancer-specific concerns at 4 months compared with UC participants (all P < .05); significant differences in gynecologic and cancer-specific concerns (P < .05) were sustained at 9 months. Longitudinal change in overall QOL and anxiety did not reach statistical significance. Participants with decreasing interleukin (IL) -4, IL-5, IL-10, and IL-13 had significantly greater improvement in QOL than those with increasing cytokine levels. Conclusion This trial confirms that PTC benefits mood and QOL cancer-specific and gynecologic concerns for a multiethnic underserved population of survivors of cancer. The improvement in PROs with decreases in T-helper type 2 and counter-regulatory cytokines supports a potential biobehavioral pathway relevant to cancer survivorship.

Sign in / Sign up

Export Citation Format

Share Document