@article {11186, title = {The Association Between Cancer and Spousal Rate of Memory Decline: A Negative Control Study to Evaluate (Unmeasured) Social Confounding of the Cancer-memory Relationship.}, journal = {Alzheimer Disease \& Associated Disorders}, volume = {35}, year = {2021}, pages = {271-274}, abstract = {

Cancer diagnoses are associated with better long-term memory in older adults, possibly reflecting a range of social confounders that increase cancer risk but improve memory. We used spouse{\textquoteright}s memory as a negative control outcome to evaluate this possible confounding, since spouses share social characteristics and environments, and individuals{\textquoteright} cancers are unlikely to cause better memory among their spouses. We estimated the association of an individual{\textquoteright}s incident cancer diagnosis (exposure) with their own (primary outcome) and their spouse{\textquoteright}s (negative control outcome) memory decline in 3601 couples from 1998 to 2014 in the Health and Retirement Study, using linear mixed-effects models. Incident cancer predicted better long-term memory for the diagnosed individual. We observed no association between an individual{\textquoteright}s cancer diagnosis and rate of spousal memory decline. This negative control study suggests that the inverse association between incident cancer and rate of memory decline is unlikely to be attributable to social/behavioral factors shared between spouses.

}, keywords = {Cancer, Cognition, Spouses}, issn = {1546-4156}, doi = {10.1097/WAD.0000000000000398}, author = {Ospina-Romero, Monica and Willa D Brenowitz and M. Maria Glymour and Elizabeth R Mayeda and Graff, Rebecca E and Witte, John S and Ackley, Sarah F and Lu, Kun Ping and Lindsay C Kobayashi} } @article {10868, title = {Difficulty and help with activities of daily living among older adults living alone with cognitive impairment}, journal = {Alzheimer{\textquoteright}s \& DementiaAlzheimer{\textquoteright}s \& DementiaAlzheimer{\textquoteright}s Dement.}, year = {2020}, month = {2020/06/26}, abstract = {Abstract Introduction There is limited research on difficulties with activities of daily living (I/ADLs) among older adults living alone with cognitive impairment, including differences by race/ethnicity. Methods For U.S. Health and Retirement Study (2000?2014) participants aged 55+ living alone with cognitive impairment (4,666 individuals; 9,091 observations), we evaluated I/ADL difficulty and help. Results Among 4.3 million adults aged 55+ living alone with cognitive impairment, an estimated 46\% reported an I/ADL difficulty; 72\% reported not receiving help with an I/ADL. Women reported more difficulty than men. Compared to white women, black women were 22\% more likely to report a difficulty without help, and Latina women were 36\% more likely to report a difficulty with help. Among men, racial/ethnic differences in outcomes were not significant. Patterns of difficulty without help by race/ethnicity were similar among Medicaid beneficiaries. Discussion Findings call for targeted efforts to support older adults living alone with cognitive impairment.}, keywords = {Activities of Daily Living, Aging in place, CIND, Dementia, Disability, limitations, Living arrangement, population-based study, service gaps}, isbn = {1552-5260}, doi = {10.1002/alz.12102}, author = {Ryan D. Edwards and Willa D Brenowitz and Portacolone, Elena and Kenneth E Covinsky and Bindman, Andrew and M. Maria Glymour and Jacqueline M Torres} } @article {10120, title = {Rate of memory change before and after cancer diagnosis.}, journal = {JAMA Network Open}, volume = {2}, year = {2019}, pages = {e196160}, abstract = {

Importance: Patients with a history of cancer, even nonfatal cancers, have lower subsequent Alzheimer disease incidence. An inverse biological link between carcinogenesis and neurodegeneration has been hypothesized, although survival and detection biases are possible explanations.

Objective: To compare long-term memory trajectories before and after incident cancer with memory trajectories of similarly aged individuals not diagnosed with cancer.

Design, Setting, and Participants: This population-based cohort study included 14 583 US adults born before 1949 with no cancer history from the Health and Retirement Study. Biennial assessments were performed for up to 16 years from 1998 to 2014. Data analysis was performed from January 8 to October 5, 2018.

Exposures: Self-reported physician diagnosis of any cancer (excluding nonmelanoma skin cancer) during follow-up.

Main Outcomes and Measures: A composite memory score standardized to a mean (SD) of 0 (1) at baseline was based on immediate and delayed word-list recall and proxy assessments. The rate of memory change among people diagnosed with cancer during follow-up before and after diagnosis was compared with rate of memory change in individuals who remained cancer free during follow-up using linear mixed-effect models with random intercepts and slopes.

Results: A total of 14 583 participants were included in the sample (mean [SD] age, 66.4 [10.4] years; 8453 [58.0\%] female). The mean (SD) follow-up was 11.5 (5.1) years; 2250 had a cancer diagnosis during follow-up, and 12 333 had no cancer diagnosis during follow-up. The rate of memory decline in the decade before a cancer diagnosis was 10.5\% (95\% CI, 6.2\%-14.9\%), which was slower than memory decline in similarly aged cancer-free individuals. For individuals diagnosed at 75 years of age, mean memory function immediately before diagnosis was 0.096 SD units (95\% CI, 0.060-0.133 SD units) higher compared with that among similarly aged cancer-free individuals. A new cancer diagnosis was associated with a short-term decline in memory of -0.058 (95\% CI, -0.084 to -0.032) SD units compared with memory before diagnosis. After diagnosis, the rate of memory decline was 3.9\% (95\% CI, 0.9\%-6.9\%) slower in individuals with cancer than in those without a cancer diagnosis.

Conclusions and Relevance: In this study, older individuals who developed cancer had better memory and slower memory decline than did similarly aged individuals who remained cancer free. These findings support the possibility of a common pathologic process working in opposite directions in cancer and Alzheimer disease.

}, keywords = {Alzheimer{\textquoteright}s disease, Cancer, Cognitive Ability, Memory}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2019.6160}, author = {Ospina-Romero, Monica and Abdiwahab, Ekland and Lindsay C Kobayashi and Teresa Filshtein and Willa D Brenowitz and Elizabeth R Mayeda and M. Maria Glymour} }