TY - RPRT T1 - 2016 HCAP Weighting Summary Y1 - Forthcoming A1 - Richard N Jones ER - TY - JOUR T1 - Factor structure of the Harmonized Cognitive Assessment Protocol neuropsychological battery in the Health and Retirement Study JF - Neuropsychology Y1 - Forthcoming A1 - Richard N Jones A1 - Jennifer J Manly A1 - Kenneth M. Langa A1 - Lindsay H Ryan A1 - Deborah A Levine A1 - Ryan J McCammon A1 - David R Weir KW - Cognitive Ability KW - Confirmatory Factor Analysis KW - HCAP KW - Older Adults AB - Objectives: The Harmonized Cognitive Assessment Protocol (HCAP) describes an assessment battery and a family of population-representative studies measuring neuropsychological performance. We describe the factorial structure of the HCAP battery in the US Health and Retirement Study (HRS).Method: The HCAP battery was compiled from existing measures by a cross-disciplinary and international panel of researchers. The HCAP battery used in the 2016 wave of the HRS. We used factor analysis methods to assess and refine a theoretically-driven single and multiple domain factor structure for tests included in the HCAP battery among 3,347 participants with evaluable performance data. Results: For the eight domains of cognitive functioning identified theoretically (orientation, memory [immediate, delayed, & recognition], set shifting, attention/speed, language/fluency, andvisuospatial), all single factor models fit reasonably well, although four of these domains had either 2 or 3 indicators where good fit is axiomatic. Multidimensional models suggested the eight-domain model was overly complex. A five-domain model (orientation, memory delayed and recognition, executive functioning, language/fluency, visuospatial) was identified as a reasonable model for summarizing performance in this sample (standardized root mean square residual = 0.05, root mean square error of approximation = 0.05, confirmatory fit index = 0.94). Discussion: The HCAP battery conforms adequately to a multidimensional structure of neuropsychological performance. The derived measurement models can be used as anchors for calibrating cross-national studies of cognitive performance, and to identify persons performing atthe low end as part of an algorithmic classification of probable dementia ER - TY - JOUR T1 - Harmonization of Later-Life Cognitive Function Across National Contexts: Results from the Harmonized Cognitive Assessment Protocols (HCAPs). JF - medRxiv Y1 - Forthcoming A1 - Gross, Alden L A1 - LI, CHIHUA A1 - Briceño, Emily M A1 - Rentería, Miguel Arce A1 - Richard N Jones A1 - Kenneth M. Langa A1 - Jennifer J Manly A1 - Nichols, Emma L A1 - David R Weir A1 - Wong, Rebeca A1 - Berkman, Lisa A1 - Lee, Jinkook A1 - Lindsay C Kobayashi KW - Cognition KW - Education KW - harmonization KW - HCAP AB -

BACKGROUND: The Harmonized Cognitive Assessment Protocol (HCAP) is an innovative instrument for cross-national comparisons of later-life cognitive function, yet its suitability across diverse populations is unknown. We aimed to harmonize general and domain-specific cognitive scores from HCAPs across six countries, and evaluate precision and criterion validity of the resulting harmonized scores.

METHODS: We statistically harmonized general and domain-specific cognitive function across the six publicly available HCAP partner studies in the United States, England, India, Mexico, China, and South Africa (N=21,141). We used an item banking approach that leveraged common cognitive test items across studies and tests that were unique to studies, as identified by a multidisciplinary expert panel. We generated harmonized factor scores for general and domain- specific cognitive function using serially estimated graded-response item response theory (IRT) models. We evaluated precision of the factor scores using test information plots and criterion validity using age, gender, and educational attainment.

FINDINGS: IRT models of cognitive function in each country fit well. We compared measurement reliability of the harmonized general cognitive function factor across each cohort using test information plots; marginal reliability was high (r> 0·90) for 93% of respondents across six countries. In each country, general cognitive function scores were lower with older ages and higher with greater levels of educational attainment.

INTERPRETATION: We statistically harmonized cognitive function measures across six large, population-based studies of cognitive aging in the US, England, India, Mexico, China, and South Africa. Precision of the estimated scores was excellent. This work provides a foundation for international networks of researchers to make stronger inferences and direct comparisons of cross-national associations of risk factors for cognitive outcomes.

FUNDING: National Institute on Aging (R01 AG070953, R01 AG030153, R01 AG051125, U01 AG058499; U24 AG065182; R01AG051158).

ER - TY - RPRT T1 - Protocols for Missing Data in HCAP Y1 - Forthcoming A1 - Richard N Jones ER - TY - JOUR T1 - A cultural neuropsychological approach to harmonization of cognitive data across culturally and linguistically diverse older adult populations. JF - Neuropsychology Y1 - 2023 A1 - Briceño, Emily M A1 - Arce Rentería, Miguel A1 - Gross, Alden L A1 - Richard N Jones A1 - Gonzalez, Christopher A1 - Wong, Rebeca A1 - David R Weir A1 - Kenneth M. Langa A1 - Jennifer J Manly KW - cognitive data KW - HCAP KW - Mex-Cog KW - neuropsychology AB -

OBJECTIVE: To describe a cultural neuropsychological approach to prestatistical harmonization of cognitive data across the United States (U.S.) and Mexico with the Harmonized Cognitive Assessment Protocol (HCAP).

METHOD: We performed a comprehensive review of the administration, scoring, and coding procedures for each cognitive test item administered across the English and Spanish versions of the HCAP in the Health and Retirement Study (HRS) in the U.S. and the Ancillary Study on Cognitive Aging in Mexico (Mex-Cog). For items that were potentially equivalent across studies, we compared each cognitive test item for linguistic and cultural equivalence and classified items as confident or tentative linking items, based on the degree of confidence in their comparability across cohorts and language groups. We evaluated these classifications using differential item functioning techniques.

RESULTS: We evaluated 132 test items among 21 cognitive instruments in the HCAP across the HRS and Mex-Cog. We identified 72 confident linking items, 46 tentative linking items, and 14 items that were not comparable across cohorts. Measurement invariance analysis revealed that 64% of the confident linking items and 83% of the tentative linking items showed statistical evidence of measurement differences across cohorts.

CONCLUSIONS: Prestatistical harmonization of cognitive data, performed by a multidisciplinary and multilingual team including cultural neuropsychologists, can identify differences in cognitive construct measurement across languages and cultures that may not be identified by statistical procedures alone. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

VL - 37 IS - 3 ER - TY - JOUR T1 - Harmonization of cognitive screening tools for dementia across diverse samples: A simulation study. JF - Alzheimers Dement (Amst) Y1 - 2023 A1 - Gavett, Brandon E A1 - Ilango, Sindana D A1 - Koscik, Rebecca A1 - Ma, Yue A1 - Helfand, Benjamin A1 - Eng, Chloe W A1 - Gross, Alden A1 - Trittschuh, Emily H A1 - Richard N Jones A1 - Mungas, Dan KW - cognitive screening KW - Dementia KW - Simulation AB -

INTRODUCTION: Research focusing on cognitive aging and dementia is a global endeavor. However, cross-national differences in cognition are embedded in other sociocultural differences, precluding direct comparisons of test scores. Such comparisons can be facilitated by co-calibration using item response theory (IRT). The goal of this study was to explore, using simulation, the necessary conditions for accurate harmonization of cognitive data.

METHOD: Neuropsychological test scores from the US Health and Retirement Study (HRS) and the Mexican Health and Aging Study (MHAS) were subjected to IRT analysis to estimate item parameters and sample means and standard deviations. These estimates were used to generate simulated item response patterns under 10 scenarios that adjusted the quality and quantity of linking items used in harmonization. IRT-derived factor scores were compared to the known population values to assess bias, efficiency, accuracy, and reliability of the harmonized data.

RESULTS: The current configuration of HRS and MHAS data was not suitable for harmonization, as poor linking item quality led to large bias in both cohorts. Scenarios with more numerous and higher quality linking items led to less biased and more accurate harmonization.

DISCUSSION: Linking items must possess low measurement error across the range of latent ability for co-calibration to be successful.

HIGHLIGHTS: We developed a statistical simulation platform to evaluate the degree to which cross-sample harmonization accuracy varies as a function of the quality and quantity of linking items.Two large studies of aging-one in Mexico and one in the United States-use three common items to measure cognition.These three common items have weak correspondence with the ability being measured and are all low in difficulty.Harmonized scores derived from the three common linking items will provide biased and inaccurate estimates of cognitive ability.Harmonization accuracy is greatest when linking items vary in difficulty and are strongly related to the ability being measured.

VL - 15 IS - 2 ER - TY - JOUR T1 - Memory and language cognitive data harmonization across the United States and Mexico. JF - Alzheimer's & Dementia (Amsterdam, Netherlands) Y1 - 2023 A1 - Arce Rentería, Miguel A1 - Briceño, Emily M A1 - Chen, Diefei A1 - Saenz, Joseph A1 - Lindsay C Kobayashi A1 - Gonzalez, Christopher A1 - Vonk, Jet M J A1 - Richard N Jones A1 - Jennifer J Manly A1 - Wong, Rebeca A1 - David R Weir A1 - Kenneth M. Langa A1 - Gross, Alden L KW - Alzheimer's disease KW - cognitive aging KW - cross‐cultural KW - cultural neuropsychology KW - harmonization AB -

INTRODUCTION: We used cultural neuropsychology-informed procedures to derive and validate harmonized scores representing memory and language across population-based studies in the United States and Mexico.

METHODS: Data were from the Health and Retirement Study Harmonized Cognitive Assessment Protocol (HRS-HCAP) and the Mexican Health and Aging Study (MHAS) Ancillary Study on Cognitive Aging (Mex-Cog). We statistically co-calibrated memory and language domains and performed differential item functioning (DIF) analysis using a cultural neuropsychological approach. We examined relationships among harmonized scores, age, and education.

RESULTS: We included 3170 participants from the HRS-HCAP (age = 76.6 [standard deviation (SD): 7.5], 60% female) and 2042 participants from the Mex-Cog (age = 68.1 [SD: 9.0], 59% female). Five of seven memory items and one of twelve language items demonstrated DIF by study. Harmonized memory and language scores showed expected associations with age and education.

DISCUSSION: A cultural neuropsychological approach to harmonization facilitates the generation of harmonized measures of memory and language function in cross-national studies.

HIGHLIGHTS: We harmonized memory and language scores across studies in the United States and Mexico.A cultural neuropsychological approach to data harmonization was used.Harmonized scores showed minimal measurement differences between cohorts.Future work can use these harmonized scores for cross-national studies of Alzheimer's disease and related dementias.

VL - 15 IS - 3 ER - TY - JOUR T1 - Shifting of Cognitive Assessments Between Face-to-Face and Telephone Administration: Measurement Considerations. JF - The Journals of Gerontology, Series B Y1 - 2023 A1 - Smith, Jason R A1 - Gibbons, Laura E A1 - Crane, Paul K A1 - Mungas, Dan M A1 - Glymour, M Maria A1 - Jennifer J Manly A1 - Zahodne, Laura B A1 - Mayeda, Elizabeth Rose A1 - Richard N Jones A1 - Gross, Alden L KW - Cognition KW - Mode effects KW - Psychometrics KW - Telephone AB -

OBJECTIVES: Telephone-administered cognitive assessments are a cost-effective and sometimes necessary alternative to face-to-face assessments. There is limited information in large studies concerning mode effects, or differences in cognition attributable to assessment method, as a potential measurement threat. We evaluated mode effects on cognitive scores using a population-based sample of community-living older adults.

METHODS: We used data from participants aged 65-79 in the 2014 Health and Retirement Study for whom interview mode was randomized (n=6825). We assessed mode differences in test means, whether mode modifies associations of cognition with criterion variables, and formal measurement invariance testing.

RESULTS: Relative to face-to-face assessment, telephone assessment was associated with higher scores for memory and calculation (0.06 to 0.013 standard deviations (SD)) and lower scores for non-memory items (-0.09 to -0.01 SD). Cognition was significantly differentially related to IADL difficulty depending on assessment mode. Measurement invariance testing identified evidence of mode differences in certain tests as a function of mode: adjusting for underlying cognition, the largest mode differences in memory and attention: immediate noun recall, delayed word recall, and serial-7s scores were higher given telephone administration.

DISCUSSION: Differences by mode of administration are apparent in cognitive measurement in older adults albeit to a small degree in our study, and most pronounced for tests of memory and attention. The importance of accounting for mode differences ultimately depends on one's research question and study sample: not all associations may be affected by mode differences and such modification may only be apparent among those with lower cognitive functioning.

VL - 78 IS - 2 ER - TY - JOUR T1 - Cross-national harmonization of cognitive measures across HRS HCAP (USA) and LASI-DAD (India). JF - PLoS One Y1 - 2022 A1 - Vonk, Jet M J A1 - Gross, Alden L A1 - Zammit, Andrea R A1 - Bertola, Laiss A1 - Avila, Justina F A1 - Jutten, Roos J A1 - Gaynor, Leslie S A1 - Suemoto, Claudia K A1 - Lindsay C Kobayashi A1 - O'Connell, Megan E A1 - Elugbadebo, Olufisayo A1 - Amofa, Priscilla A A1 - Staffaroni, Adam M A1 - Arce Rentería, Miguel A1 - Turney, Indira C A1 - Richard N Jones A1 - Jennifer J Manly A1 - Lee, Jinkook A1 - Zahodne, Laura B KW - Cognition KW - cognitive aging KW - Episodic KW - HCAP KW - India KW - Language KW - LASI-DAD KW - Memory KW - Neuropsychological tests AB -

BACKGROUND: As global populations age, cross-national comparisons of cognitive health and dementia risk are increasingly valuable. It remains unclear, however, whether country-level differences in cognitive function are attributable to population differences or bias due to incommensurate measurement. To demonstrate an effective method for cross-national comparison studies, we aimed to statistically harmonize measures of episodic memory and language function across two population-based cohorts of older adults in the United States (HRS HCAP) and India (LASI-DAD).

METHODS: Data for 3,496 HRS HCAP (≥65 years) and 3,152 LASI-DAD (≥60 years) participants were statistically harmonized for episodic memory and language performance using confirmatory factor analysis (CFA) methods. Episodic memory and language factor variables were investigated for differential item functioning (DIF) and precision.

RESULTS: CFA models estimating episodic memory and language domains based on a priori adjudication of comparable items fit the data well. DIF analyses revealed that four out of ten episodic memory items and five out of twelve language items measured the underlying construct comparably across samples. DIF-modified episodic memory and language factor scores showed comparable patterns of precision across the range of the latent trait for each sample.

CONCLUSIONS: Harmonization of cognitive measures will facilitate future investigation of cross-national differences in cognitive performance and differential effects of risk factors, policies, and treatments, reducing study-level measurement and administrative influences. As international aging studies become more widely available, advanced statistical methods such as those described in this study will become increasingly central to making universal generalizations and drawing valid conclusions about cognitive aging of the global population.

VL - 17 IS - 2 ER - TY - JOUR T1 - Estimating the Prevalence of Dementia and Mild Cognitive Impairment in the US: The 2016 Health and Retirement Study Harmonized Cognitive Assessment Protocol Project JF - JAMA Neurology Y1 - 2022 A1 - Jennifer J Manly A1 - Richard N Jones A1 - Kenneth M. Langa A1 - Ryan, Lindsay H. A1 - Levine, Deborah A. A1 - McCammon, Ryan A1 - Heeringa, Steven G. A1 - David R Weir KW - Dementia KW - HCAP KW - mild cognitive impairment AB - Nationally representative data are critical for understanding the causes, costs, and outcomes associated with dementia and mild cognitive impairment (MCI) in the US and can inform policies aimed at reducing the impact of these conditions on patients, families, and public programs. The nationally representative Health and Retirement Study (HRS) is an essential resource for such data, but the HRS substudy providing dementia diagnostic information was fielded more than 20 years ago and more recent data are needed.The Harmonized Cognitive Assessment Protocol (HCAP) was developed to update national estimates of the prevalence of MCI and dementia in the US and examine differences by age, race, ethnicity, and sex.HRS is an ongoing longitudinal nationally representative study of people 51 years and older with staggered entry dates from 1992 to 2022 and follow-up ranging from 4 to 30 years. HCAP is a cross-sectional random sample of individuals in HRS who were 65 years or older in 2016. Of 9972 age-eligible HRS participants, 4425 were randomly selected for HCAP, and 3496 completed a comprehensive neuropsychological test battery and informant interview, none of whom were excluded. Dementia and MCI were classified using an algorithm based on standard diagnostic criteria and comparing test performance to a robust normative sample.Groups were stratified by age, sex, education, race, and ethnicity.National prevalence estimates using population weights.The mean (SD) age of the study population sample (N = 3496) was 76.4 (7.6) years, and 2095 participants (60\%) were female. There were 551 participants who self-identified as Black and not Hispanic (16\%), 382 who self-identified as Hispanic regardless of race (16\%), 2483 who self-identified as White and not Hispanic (71\%), and 80 who self-identified as another race (2\%), including American Indian or Alaska Native, Asian, Native Hawaiian or Pacific Islander, or another self-described race. A total of 393 individuals (10\%; 95\% CI, 9-11) were classified as having dementia and 804 (22\%; 95\% CI, 20-24) as having MCI. Every 5-year increase in age was associated with higher risk of dementia (weighted odds ratio [OR], 1.95 per 5-year age difference; 95\%, CI, 1.77-2.14) and MCI (OR, 1.17 per 5-year age difference, 95\% CI, 1.09-1.26). Each additional year of education was associated with a decrease in risk of dementia (OR, 0.93 per year of school, 95\% CI, 0.89-0.97) and MCI (OR, 0.94, 95\% CI, 0.91-0.97). Dementia was more common among non-Hispanic Black individuals (OR, 1.81; 95\% CI, 1.20-2.75) and MCI in Hispanic individuals (OR, 1.42; 95\% CI, 1.03-1.96) compared with non-Hispanic White individuals. Other group comparisons by race and ethnicity were not possible owing to small numbers. No differences in prevalence were found between female individuals and male individuals.Using a comprehensive neuropsychological test battery and large sample, the national prevalence of dementia and MCI in 2016 found in this cross-sectional study was similar to that of other US-based studies, indicating a disproportionate burden of dementia and MCI among older Black and Hispanic adults and those with lower education. VL - 79 IS - 12 ER - TY - JOUR T1 - Linear linking for related traits (LLRT): A novel method for the harmonization of cognitive domains with no or few common items. JF - Methods Y1 - 2022 A1 - Nichols, Emma L A1 - Cadar, Dorina A1 - Lee, Jinkook A1 - Richard N Jones A1 - Gross, Alden L KW - Cognition KW - HCAP KW - Research Design AB -

Harmonization means to make data comparable. Recent efforts to generate comparable data on cognitive performance of older adults from many different countries around the world have presented challenges for direct comparison. Neuropsychological instruments vary in many respects, including language, administration techniques and cultural differences, which all present important obstacles to assumptions regarding the presence of linking items. Item response theory (IRT) methods have been previously used to harmonize cross-national data on cognition, but these methods rely on linking items to establish the shared metric. We introduce an alternative approach for linking cognitive performance across two (or more) groups when the fielded assessments contain no items that can be reasonably considered linking items: Linear Linking for Related Traits (LLRT). We demonstrate this methodological approach in a sample from a single United States study split by educational attainment, and in two sets of cross-national comparisons (United States to England, and United States to India). All data were collected as part of the Harmonized Cognitive Assessment Protocol (HCAP) and are publicly available. Our method relies upon strong assumptions, and we offer suggestions for how the method can be extended to relax those assumptions in future work.

VL - 204 ER - TY - JOUR T1 - Estimating the effects of Mexico to U.S. migration on elevated depressive symptoms: evidence from pooled cross-national cohorts. JF - Annals of Epidemiology Y1 - 2021 A1 - Audrey R Murchland A1 - Adina Zeki Al Hazzouri A1 - Zhang, Lanyu A1 - Elfassy, Tali A1 - Grasset, Leslie A1 - Riley, Alicia A1 - Wong, Rebecca A1 - Mary Haan A1 - Richard N Jones A1 - Jacqueline M Torres A1 - M. Maria Glymour KW - depression KW - Immigration KW - Mental Health KW - MHAS KW - Selection AB -

BACKGROUND: Migrating from Mexico to the U.S. is a major, stressful life event with potentially profound influences on mental health. However, estimating the health effects of migration is challenging because of differential selection into migration and time-varying confounder mediators of migration effects on health.

METHODS: We pooled data from the Mexican Health and Aging Study (N=17,771) and Mexican-born U.S. Health and Retirement Study (N=898) participants to evaluate the effects of migration to the U.S. (at any age and in models for migration in childhood or adulthood) on depressive symptom-count, measured with a modified Centers for Epidemiologic Studies-Depression scale. We modeled probability of migrating in each year of life from birth to either age at initial migration to the U.S. or enrollment and used these models to calculate inverse probability of migration weights. We applied the weights to covariate-adjusted negative binomial GEE models, estimating the ratio of average symptom-count associated with migration.

RESULTS: Mexico to U.S. migration was unrelated to depressive symptoms among men (ratio of average symptom-count= 0.98 [95% CI: 0.89, 1.08]) and women (ratio of average symptom-count=1.00 [95% CI: 0.92, 1.09]). Results were similar for migration in childhood, early adulthood, or later adulthood.

CONCLUSIONS: In this sample of older Mexican-born adults, migration to the U.S. was unrelated to depressive symptoms.

VL - 64 ER - TY - JOUR T1 - Quantifying Lifecourse Drivers of International Migration: A Cross-national Analysis of Mexico and the United States. JF - Epidemiology Y1 - 2021 A1 - Adina Zeki Al Hazzouri A1 - Zhang, Lanyu A1 - Audrey R Murchland A1 - Grasset, Leslie A1 - Jacqueline M Torres A1 - Richard N Jones A1 - Rebeca Wong A1 - M. Maria Glymour KW - long-term health consequences KW - MHAS KW - migrants AB -

BACKGROUND: Evaluating the long-term health consequences of migration requires longitudinal data on migrants and non-migrants to facilitate adjustment for time-varying confounder-mediators of the effect of migration on health.

METHODS: We merged harmonized data on subjects aged 50+ from the US-based Health and Retirement Study (HRS) and the Mexican Health and Aging Study (MHAS). Our exposed group includes MHAS-return migrants (n = 1555) and HRS Mexican-born migrants (n = 924). Our unexposed group includes MHAS-never migrants (n = 16,954). We constructed a lifecourse data set from birth (age 0) until either age at migration to the United States or age at study entry. To account for confounding via inverse probability of treatment weights (IPTW), we modeled the probability of migration at each year of life using time-varying pre-migration characteristics. We then evaluated the effect of migration on mortality hazard estimated with and without IPTW.

RESULTS: Mexico to the United States migration was predicted by time-varying factors that occurred before migration. Using measured covariates at time of enrollment to account for selective migration, we estimated that, for women, migrating reduces mortality risk by 13%, although this estimate was imprecise and results were compatible with either large protective or deleterious associations (hazard ratio [HR] =0.87, 95% confidence interval [CI]: 0.60, 1.27). When instead using IPTWs, the estimated effect on mortality was similarly imprecise (HR = 0.98, 95% CI: 0.77, 1.25). The relationship among men was similarly uncertain in both models.

CONCLUSIONS: Although time-varying social factors predicted migration, IPTW weighting did not affect our estimates. Larger samples are needed to precisely estimate the health effects of migration.

VL - 32 IS - 1 ER - TY - JOUR T1 - You say tomato, I say radish: can brief cognitive assessments in the US Health Retirement Study be harmonized with its International Partner Studies? JF - The Journals of Gerontology, Series B Y1 - 2021 A1 - Lindsay C Kobayashi A1 - Alden L Gross A1 - Laura E Gibbons A1 - Tommet, Doug A1 - Sanders, R Elizabeth A1 - Choi, Seo-Eun A1 - Mukherjee, Shubhabrata A1 - M. Maria Glymour A1 - Jennifer J Manly A1 - Lisa F Berkman A1 - Paul K Crane A1 - Mungas, Dan M A1 - Richard N Jones KW - cognitive function KW - health survey KW - international comparison KW - item response theory KW - statistical harmonization AB -

OBJECTIVES: To characterize the extent to which brief cognitive assessments administered in the population-representative US Health and Retirement Study (HRS) and its International Partner Studies can be considered to be measuring a single, unidimensional latent cognitive function construct.

METHOD: Cognitive function assessments were administered in face-to-face interviews in 12 studies in 26 countries (N=155,690), including the US HRS and selected International Partner Studies. We used the time point of first cognitive assessment for each study to minimize differential practice effects across studies, and documented cognitive test item coverage across studies. Using confirmatory factor analysis models, we estimated single factor general cognitive function models, and bifactor models representing memory-specific and non-memory-specific cognitive domains for each study. We evaluated model fits and factor loadings across studies.

RESULTS: Despite relatively sparse and inconsistent cognitive item coverage across studies, all studies had some cognitive test items in common with other studies. In all studies, the bifactor models with a memory-specific domain fit better than single factor general cognitive function models. The data fit the models at reasonable thresholds for single factor models in six of the 12 studies, and for the bifactor models in all 12 of the 12 studies.

DISCUSSION: The cognitive assessments in the US HRS and its International Partner Studies reflect comparable underlying cognitive constructs. We discuss the assumptions underlying our methods, present alternatives, and future directions for cross-national harmonization of cognitive aging data.

VL - 76 IS - 9 ER - TY - JOUR T1 - The Health and Retirement Study Harmonized Cognitive Assessment Protocol Project: Study Design and Methods JF - Neuroepidemiology Y1 - 2020 A1 - Kenneth M. Langa A1 - Lindsay H Ryan A1 - Ryan J McCammon A1 - Richard N Jones A1 - Jennifer J Manly A1 - Deborah A Levine A1 - Amanda Sonnega A1 - Farron, M. A1 - David R Weir KW - Cognition KW - cognitive assessment KW - study design AB - Introduction: The Harmonized Cognitive Assessment Protocol (HCAP) Project is a substudy within the Health and Retirement Study (HRS), an ongoing nationally representative panel study of about 20,000 adults aged 51 or older in the United States. The HCAP is part of an international research collaboration funded by the National Institute on Aging to better measure and identify cognitive impairment and dementia in representative population-based samples of older adults, in the context of ongoing longitudinal studies of aging in high-, middle-, and low-income countries around the world. Methods: The HCAP cognitive test battery was designed to measure a range of key cognitive domains affected by cognitive aging (including attention, memory, executive function, language, and visuospatial function) and to allow harmonization and comparisons to other studies in the United States and around the world. The HCAP included a pair of in-person interviews, one with the target HRS respondent (a randomly selected HRS sample member, aged 65+) that lasted approximately 1 h and one with an informant nominated by the respondent that lasted approximately 20 min. The final HRS HCAP sample included 3,496 study subjects, representing a 79% response rate among those invited to participate. Conclusion: Linking detailed HCAP cognitive assessments to the wealth of available longitudinal HRS data on cognition, health, biomarkers, genetics, health care utilization, informal care, and economic resources and behavior will provide unique and expanded opportunities to study cognitive impairment and dementia in a nationally representative US population-based sample. The fielding of similar HCAP projects in multiple countries around the world will provide additional opportunities to study international differences in the prevalence, incidence, and outcomes of dementia globally with comparable data. Like all HRS data, HCAP data are publicly available at no cost to researchers. SN - 0251-5350 ER - TY - JOUR T1 - The English are healthier than the Americans: really? JF - International Journal of Epidemiology Y1 - 2015 A1 - Cieza, Alarcos A1 - Oberhauser, Cornelia A1 - Bickenbach, Jerome A1 - Richard N Jones A1 - Tevfik Bedirhan Üstün A1 - Kostanjsek, Nenad A1 - John N Morris A1 - Chatterji, Somnath KW - Cross-National KW - Health Conditions and Status KW - Healthcare KW - Methodology AB - Background: When comparing the health of two populations, it is not enough to compare the prevalence of chronic diseases. The objective of this study is therefore to propose a metric of health based on domains of functioning to determine whether the English are healthier than the Americans.Methods: We analysed representative samples aged 50 to 80 years from the 2008 wave of the Health and Retirement Study (N = 10 349) for the US data, and wave 4 of the English Longitudinal Study of Ageing (N = 9405) for English counterpart data. We first calculated the age-standardized disease prevalence of diabetes, hypertension, all heart diseases, stroke, lung disease, cancer and obesity. Second, we developed a metric of health using Rasch analyses and the questions and measured tests common to both surveys addressing domains of human functioning. Finally, we used a linear additive model to test whether the differences in health were due to being English or American.Results: The English have better health than the Americans when population health is assessed only by prevalence of selected chronic health conditions. The English health advantage disappears almost completely, however, when health is assessed with a metric that integrates information about functioning domains.Conclusions: It is possible to construct a metric of health, based on data directly collected from individuals, in which health is operationalized as domains of functioning. Its application has the potential to tackle one of the most intractable problems in international research on health, namely the comparability of health across countries. VL - 44 UR - http://ije.oxfordjournals.org/content/early/2014/09/16/ije.dyu182.abstract IS - 1 U4 - Health Care Use/functioning/health state/cross-cultural comparison/cross-cultural comparison/Rasch model/health metric/ELSA_/cross-national comparison ER - TY - BOOK T1 - Longitudinal Data Analysis: a Practical Guide for Researchers In Aging, Health, And Social Sciences Y1 - 2012 A1 - Jason T Newsom A1 - Richard N Jones A1 - Scott M Hofer KW - Cross-National KW - Health Conditions and Status KW - Methodology AB - This book provides accessible treatment to state-of-the-art approaches to analyzing longitudinal studies. Comprehensive coverage of the most popular analysis tools allows readers to pick and choose the techniques that best fit their research. The analyses are illustrated with examples from 12 major longitudinal data sets including practical information about their content and design. Illustrations from popular software packages offer tips on how to interpret the results. Each chapter features suggested readings fur further study and a list of articles that further illustrate how to implement the analysis and report the results. An accompanying website provides syntax examples for several software packages for each of the chapter examples. Although many of the examples address health or social science questions related to aging, readers from other disciplines will find the analyses relevant to their work. In addition to demonstrating statistical analysis of longitudinal data, the book shows how to interpret and analyze the results within the context of the research design. Although most chapters emphasize the use of large studies collected over long term periods, much of the book is also relevant to researchers who analyze data collected in shorter time periods. The book opens with issues related to using publicly available data sets including a description of the goals, designs, and measures of the data. The next 10 chapters provide non-technical, practical introductions to the concepts and issues relevant to longitudinal analysis, including: weighting samples and adjusting designs for longitudinal studies; missing data and attrition; measurement issues related to longitudinal research; the use of ANOVA and regression for averaging change over time; mediation analysis for analyzing causal processes; growth curve models using multilevel regression; longitudinal hypotheses using structural equation modeling (SEM); latent growth curve models for evaluating individual trajectories of change; dynamic SEM models of change; and survival (event) analysis. Examples from longitudinal data sets such as the Health and Retirement Study, the Longitudinal Study of Aging, and Established Populations for Epidemiologic Studies of the Elderly as well as international data sets such as the Canadian National Population Health Survey and the English Longitudinal Study of Aging, illustrate key concepts. An ideal supplement for graduate level courses on data analysis and/or longitudinal modeling taught in psychology, gerontology, human development, family studies, medicine, sociology, social work, and other behavioral, social, and health sciences, this multidisciplinary book will also appeal to researchers in these fields. PB - Routledge CY - New York U4 - Methodology/longitudinal Studies/cross-national/Statistical analysis/Aging ER - TY - JOUR T1 - Development and validation of a brief cognitive assessment tool: the sweet 16. JF - Arch Intern Med Y1 - 2011 A1 - Tamara G Fong A1 - Richard N Jones A1 - James L Rudolph A1 - Frances Margaret Yang A1 - Tommet, Douglas A1 - Habtemariam, Daniel A1 - Edward R Marcantonio A1 - Kenneth M. Langa A1 - Sharon K Inouye KW - Aged KW - Aged, 80 and over KW - Cognition Disorders KW - Cohort Studies KW - Dementia KW - Female KW - Humans KW - Male KW - Neuropsychological tests KW - Surveys and Questionnaires AB -

BACKGROUND: Cognitive impairment is often unrecognized among older adults. Meanwhile, current assessment instruments are underused, lack sensitivity, or may be restricted by copyright laws. To address these limitations, we created a new brief cognitive assessment tool: the Sweet 16.

METHODS: The Sweet 16 was developed in a cohort from a large post-acute hospitalization study (n=774) and compared with the Mini-Mental State Examination (MMSE). Equipercentile equating identified Sweet 16 cut points that correlated with widely used MMSE cut points. Sweet 16 performance characteristics were independently validated in a cohort from the Aging, Demographics, and Memory Study (n=709) using clinical consensus diagnosis, the modified Blessed Dementia Rating Scale, and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE).

RESULTS: The Sweet 16 correlated highly with the MMSE (Spearman r, 0.94; P<.001). Validated against the IQCODE, the area under the curve was 0.84 for the Sweet 16 and 0.81 for the MMSE (P=.06). A Sweet 16 score of less than 14 (approximating an MMSE score <24) demonstrated a sensitivity of 80% and a specificity of 70%, whereas an MMSE score of less than 24 showed a sensitivity of 64% and a specificity of 86% against the IQCODE. When compared with clinical diagnosis, a Sweet 16 score of less than 14 showed a sensitivity of 99% and a specificity of 72% in contrast to an MMSE score with a sensitivity of 87% and a specificity of 89%. For education of 12 years or more, the area under the curve was 0.90 for the Sweet 16 and 0.84 for the MMSE (P=.03).

CONCLUSIONS: The Sweet 16 is simple, quick to administer, and will be available open access. The performance of the Sweet 16 is equivalent or superior to that of the MMSE.

PB - 171 VL - 171 IS - 5 U1 - http://www.ncbi.nlm.nih.gov/pubmed/21059967?dopt=Abstract U3 - 21059967 U4 - Older people/Cognition/reasoning/Correlation analysis/Medical diagnosis/Dementia/Hospitalization ER - TY - JOUR T1 - Physical health and depression: a dyadic study of chronic health conditions and depressive symptomatology in older adult couples. JF - J Gerontol B Psychol Sci Soc Sci Y1 - 2010 A1 - Brian J Ayotte A1 - Frances Margaret Yang A1 - Richard N Jones KW - Age Factors KW - Aged KW - Chi-Square Distribution KW - Chronic disease KW - Cohort Studies KW - depression KW - Female KW - Health Status KW - Humans KW - Hypertension KW - Least-Squares Analysis KW - Male KW - Marriage KW - Middle Aged KW - Psychiatric Status Rating Scales KW - Risk Factors KW - Sex Factors KW - Socioeconomic factors KW - Spouses KW - Stroke AB -

This study examined the associations among chronic health conditions, sociodemographic factors, and depressive symptomatology in older married couples. Data from the 2004 wave of the Health and Retirement Study (n = 2,184 couples) were analyzed. Results indicated a reciprocal relationship in depressive symptoms between spouses. Additionally, post hoc analyses indicated that husbands' stroke and high blood pressure were related to increased depressive symptomatology among wives. Beyond the reciprocal relationship, husbands were unaffected by wives' health. These results suggest sex differences underlying psychological distress in the context of physical health among older adults and that older women with husbands who have high levels of depressive symptomatology, high blood pressure, or a history of stroke may be at particular risk of experiencing depressive symptoms.

VL - 65 IS - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/20498455?dopt=Abstract U2 - PMC2883871 U4 - Chronic Disease/depression/Stroke/Stress/Sex Differences ER - TY - JOUR T1 - Telephone interview for cognitive status: Creating a crosswalk with the Mini-Mental State Examination. JF - Alzheimers Dement Y1 - 2009 A1 - Tamara G Fong A1 - Michael A Fearing A1 - Richard N Jones A1 - Peilin Shi A1 - Edward R Marcantonio A1 - James L Rudolph A1 - Frances Margaret Yang A1 - Dan K Kiely A1 - Sharon K Inouye KW - Aged KW - Aged, 80 and over KW - Alzheimer disease KW - Cognition Disorders KW - Disability Evaluation KW - Female KW - Geriatric Assessment KW - Health Status KW - Humans KW - Interviews as Topic KW - Male KW - Mass Screening KW - Models, Statistical KW - Neuropsychological tests KW - Predictive Value of Tests KW - Psychiatric Status Rating Scales KW - Remote Consultation KW - Reproducibility of Results KW - Sensitivity and Specificity AB -

BACKGROUND: Brief cognitive screening measures are valuable tools for both research and clinical applications. The most widely used instrument, the Mini-Mental State Examination (MMSE), is limited in that it must be administered face-to-face, cannot be used in participants with visual or motor impairments, and is protected by copyright. Screening instruments such as the Telephone Interview for Cognitive Status (TICS) were developed to provide a valid alternative, with comparable cut-point scores to rate global cognitive function.

METHODS: The MMSE, TICS-30, and TICS-40 scores from 746 community-dwelling elders who participated in the Aging, Demographics, and Memory Study (ADAMS) were analyzed with equipercentile equating, a statistical process of determining comparable scores based on percentile equivalents for different forms of an examination.

RESULTS: Scores from the MMSE and TICS-30 and TICS-40 corresponded well, and clinically relevant cut-point scores were determined. For example, an MMSE score of 23 is equivalent to 17 and 20 on the TICS-30 and TICS-40, respectively.

CONCLUSIONS: These findings indicate that TICS and MMSE scores can be linked directly. Clinically relevant and important MMSE cut points and the respective ADAMS TICS-30 and TICS-40 cut-point scores are included, to identify the degree of cognitive impairment among respondents with any type of cognitive disorder. These results will help in the widespread application of TICS in both research and clinical practice.

PB - 5 VL - 5 IS - 6 U1 - http://www.ncbi.nlm.nih.gov/pubmed/19647495?dopt=Abstract U2 - PMC278332 U4 - Cognitive Function/Survey Methods ER - TY - JOUR T1 - Measurement differences in depression: chronic health-related and sociodemographic effects in older Americans. JF - Psychosom Med Y1 - 2008 A1 - Frances Margaret Yang A1 - Richard N Jones KW - Aged KW - Aged, 80 and over KW - Chronic disease KW - Cohort Studies KW - Comorbidity KW - Confounding Factors, Epidemiologic KW - Culture KW - depression KW - Diabetes Mellitus KW - Educational Status KW - ethnicity KW - Factor Analysis, Statistical KW - Female KW - Heart Diseases KW - Humans KW - Hypertension KW - Interviews as Topic KW - Lung Diseases KW - Male KW - Self-Assessment KW - Sex Factors KW - Stroke KW - United States AB -

OBJECTIVE: To evaluate the influence of five chronic health conditions (high blood pressure, heart conditions, stroke, diabetes, and lung diseases) and four sociodemographic characteristics (age, gender, education, and race/ethnicity) on the endorsement patterns of depressive symptoms in a sample of community-dwelling older adults.

METHOD: Participants were adults aged >or=65 years from the 2004 Health and Retirement Study (n = 9448). Depressive symptoms were measured with a nine-item Center for Epidemiologic Studies-Depression scale. Measurement differences attributable to health and sociodemographic factors were assessed with a multidimensional model based on item response theory.

RESULTS: Evidence for unidimensionality was equivocal. We used a bifactor model to express symptom endorsement patterns as resulting from a general factor and three specific factors ("dysphoria," "psychosomatic," and "lack of positive affect"). Even after controlling for the effects of health on the psychosomatic factor, heart conditions, stroke, diabetes, and lung diseases had significant positive effects on the general factor. Significant effects due to gender and educational levels were observed on the "lack of positive affect" factor. Older adults self-identifying as Latinos had higher levels of general depression. On the symptom level, meaningful measurement noninvariance due to race/ethnic differences were found in the following five items: depressed, effort, energy, happy, and enjoy life.

CONCLUSIONS: The increased tendency to endorse depressive symptoms among persons with specific health conditions is, in part, explained by specific associations among symptoms belonging to the psychosomatic domain. Differences attributable to the effects of health conditions may reflect distinct phenomenological features of depression. The bifactor model serves as a vehicle for testing such hypotheses.

PB - 70 VL - 70 IS - 9 U1 - http://www.ncbi.nlm.nih.gov/pubmed/18981269?dopt=Abstract U2 - PMC2746732 U4 - Chronic Disease/Demographics/Depressive Symptoms/Psychology ER - TY - JOUR T1 - Within-group differences in depression among older Hispanics living in the United States. JF - J Gerontol B Psychol Sci Soc Sci Y1 - 2008 A1 - Frances Margaret Yang A1 - Cazorla-Lancaster, Yamileth A1 - Richard N Jones KW - Aged KW - Culture KW - Depressive Disorder, Major KW - Female KW - Hispanic or Latino KW - Humans KW - Insurance, Health KW - Male KW - Middle Aged KW - Prevalence KW - Severity of Illness Index KW - Socioeconomic factors KW - United States AB -

Using the Health and Retirement Study, we examine the prevalence of depression in different groups of Hispanic older adults. Respondents (n = 759) were aged 59 and older and identified themselves as Mexican American (56%), Cuban American (13%), Puerto Rican (8%), other (8%), or not specified (15%). We used a modified version of the Center for Epidemiologic Studies-Depression scale and the Composite International Diagnostic Interview to assess depressive symptoms and the presence of major depression. Relative to Puerto Ricans, each Hispanic group had significantly lower levels of depressive symptoms, except for Cuban Americans; and each Hispanic group had lower prevalence rates for major depression, except for other Hispanics, even after we adjusted for sociodemographic, cultural factors, socioeconomic, functional limitations, and chronic health conditions.

PB - 63B VL - 63 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/18332191?dopt=Abstract U2 - PMC2366970 U4 - Hispanic Americans/Depression ER - TY - JOUR T1 - The Persistence of Depressive Symptoms in Older Workers Who Experience Involuntary Job Loss: Results from the Health and Retirement Study JF - Journals of Gerontology, Series B: Psychological and Social Sciences Y1 - 2006 A1 - William T Gallo A1 - Elizabeth H Bradley A1 - J. A. Dubin A1 - Richard N Jones A1 - Tracy Falba A1 - Teng, H.M. A1 - Stanislav V Kasl KW - Employment and Labor Force KW - Health Conditions and Status KW - Net Worth and Assets AB - Objectives. The purpose of this study was to investigate the association between involuntary job loss among workers nearing retirement and long-term changes in depressive symptoms. Methods. Analyzing data from the first four waves (1992 1998) of the Health and Retirement Survey, we used longitudinal multiple regression in order to assess whether involuntary job loss between Wave 1 and Wave 2 was associated with depressive symptoms at Wave 3 and Wave 4. The study sample included 231 workers who had experienced job loss in the Wave 1 Wave 2 interval and a comparison group of 3,324 nondisplaced individuals. We analyzed the effect of job loss on depressive symptoms both in the full study sample and in subsamples determined by wealth. Results. Among individuals with below median net worth, Wave 1 Wave 2 involuntary job loss was associated with increased depressive symptoms at Wave 3 and Wave 4. We found no effect of involuntary job loss for high net worth individuals at the later survey waves. Discussion. Our findings identify older workers with limited wealth as an important group for which the potential effect of involuntary job separation in the years preceding retirement is ongoing (enduring) adverse mental health. PB - 61 VL - 61 IS - 4 U4 - Job Loss/Depressive Symptoms/Wealth ER - TY - JOUR T1 - Use of an IRT-based latent variable model to link different forms of the CES-D from the Health and Retirement Study. JF - Soc Psychiatry Psychiatr Epidemiol Y1 - 2004 A1 - Richard N Jones A1 - Stephanie J. Fonda KW - Adult KW - Aged KW - Aging KW - Calibration KW - Depressive Disorder KW - Female KW - Humans KW - Longitudinal Studies KW - Male KW - Middle Aged KW - Models, Psychological KW - Psychological Tests KW - Psychometrics KW - United States AB -

BACKGROUND: The goal of this study was to calibrate depressive symptoms collected using different versions of the Centers for Epidemiologic Studies - Depression (CES-D) instrument in different waves of the Health and Retirement Study (HRS).

METHOD: The HRS is a prospective and nationally representative cohort study. This analysis included a sample of HRS participants, adults aged 23-85 years in 1992 who had complete data on depressive symptoms at initial 2- and 4-year follow-up interviews (N= 5,734). Depressive symptoms were assessed with the CES-D. Symptom coverage and response categories varied across study wave. The first wave (1992) used a four-category response, whereas subsequent waves (1994 and 1996) used a two-category response. A structural equations model (SEM) based in Item Response Theory (IRT) was used to calibrate symptoms and generate linked depressive symptom burden scores.

RESULTS: Linked depressive symptom burden scores, derived from calibrated symptoms, were distributed similarly across HRS wave.

CONCLUSION: Our results demonstrate the applicability of an IRT-based SEM to address a common challenge in prospective studies: changes in the content and context of symptom assessment. Future investigations may make use of our linked syndrome scores to further explore other aspects of depression from a longitudinal perspective.

PB - 39 VL - 39 IS - 10 U1 - http://www.ncbi.nlm.nih.gov/pubmed/15669664?dopt=Abstract U4 - Depression ER - TY - JOUR T1 - Racial Bias in the Assessment of Cognitive Functioning of Older Adults JF - Aging and Mental Health Y1 - 2003 A1 - Richard N Jones KW - Demographics KW - Health Conditions and Status AB - This study was undertaken to determine if the difference in assessed cognition between Black/African-American and White older adults was due differential item functioning (DIF)and/or differences in the effect of background variables. Participants were 15,257 adults aged 50 and older surveyed in the Study of Asset and Health Dynamics of the Oldest Old (AHEAD) and Health and Retirement Study (HRS). The cognitive measure was a modified telephone interview for cognitive status. The analytic strategy was a multiple group structural equation model grounded in item response theory. Results suggest that most (89 )of the group difference could be attributed to measurement or structural differences, the remainder being not significantly different from zero (p 0.193). Most items displayed racial DIF,accounting for most of the group difference. After controlling for DIF, the group difference that remained could be attributed to heterogeneity in the effect of background variables. For example, low education was more deleterious for Black/African-Americans,and high income conferred an advantage only for Whites.These findings underscore the importance of efforts to generate culture-fair measurement devices. However, culture-fair assessments may attenuate, but not eliminate, group differences in assessed cognition due to the incommensurate action of background variables. PB - 7 VL - 7 IS - 2 U4 - Cognitive Functioning/Racial Differences ER -