TY - JOUR T1 - Longitudinal study of cognitive decline among women with and without urinary incontinence. JF - American Journal of Obstetrics and Gynecology Y1 - Forthcoming A1 - High, Rachel A A1 - Alvarez, Miriam A1 - Champion, Brachel A1 - Anger, Jennifer A1 - Handa, Victoria L KW - Aging KW - Cognitive decline KW - Dementia KW - Memory KW - Urinary incontinence AB -

BACKGROUND: Cross-sectional and short-term cohort studies have demonstrated an association between urinary incontinence and dementia as well as lower performance on cognitive testing. The Health and Retirement Study, a longitudinal study of community-dwelling older adults, offers an opportunity to assess the temporal association between these conditions, as this study included an assessment of incontinence symptoms as well as biennial assessments of cognitive function.

OBJECTIVES: This study aimed to evaluate if urinary incontinence before age 70 had an effect on changes in cognitive function among women participating in the Health and Retirement Study.

STUDY DESIGN: This secondary analysis included data from female respondents in the Health and Retirement Study ages 58 to 67 years with ≥2 cognitive assessments. Urinary incontinence was defined as any involuntary loss of any urine in the preceding 12 months. A control group without incontinence was reweighted for better comparability using coarsened exact matching for age and comorbidities. Validated methods, including neuropsychological test data, estimated a Memory score and DP for each participant biennially. Coprimary outcomes were the changes in Memory score and dementia probability. Linear regression models were used to estimate the association of urinary incontinence with change in Memory score and dementia probability, adjusting for baseline demographics and comorbidities. A subgroup analysis was performed to assess the effects of urinary incontinence frequency on these outcomes. The infrequent subgroup reported less than fifteen days of leakage per month and the frequent subgroup reported fifteen or more days of leakage per month.

RESULTS: Among eligible female respondents, 40.6% reported urinary incontinence between ages 58 to 69 years. Baseline Memory scores and dementia probability were similar between those with urinary incontinence (n=1706) and controls (n=2507). Memory score declined significantly in both cohorts, indicating poorer memory over time -0.222 among those with incontinence (95% confidence interval (CI) -0.245, -0.199) versus -0.207 in controls (95% CI: -0.227, -0.188). The decline of Memory score was not statistically different between cases and controls (mean difference -0.015, 95% CI: -0.045, 0.015). Dementia probability increased significantly in both groups, indicating a greater probability of dementia: 0.018 among those with incontinence (95% CI: 0.015, 0.020) and by 0.020 among controls (95% CI: 0.017, 0.022). The change in DEMENTIA PROBABILITY was not significantly different between groups (mean difference -0.002, 95% CI: -0.006, 0.002). Frequent urinary incontinence was reported in 105/1706 (6%) with urinary incontinence. Memory score declined and dementia probability increased with time (p<0.001) in frequent and infrequent UI subgroups. There was no dose-response relationship.

CONCLUSIONS: Measures of cognitive performance declined with approximately 10 years of observation; the changes in performance were not associated with the presence of urinary incontinence in their younger years.

ER - TY - JOUR T1 - Memory trajectories and disability among older couples: the mediating role of depressive symptoms. JF - Journal of Applied Gerontology, Series B, Psychological Sciences and social sciences Y1 - Forthcoming A1 - Kong, Dexia A1 - Lu, Peiyi A1 - Jiang, Da A1 - Chan, Helen Yue Lai KW - Dyad research KW - latent class growth analysis KW - Memory KW - Older couples KW - trajectory AB -

OBJECTIVE: Using a dyadic approach, this study examined the mediating effect of depressive symptoms on the longitudinal relationships between husbands' and wives' memory trajectories and their prospective disability status.

METHODS: Longitudinal data from the Health and Retirement Study 2004-2018 were used. Older (aged 50+) heterosexual couples who had no limitations in activity of daily living at the baseline (2004) were included (N = 1,310). Latent class growth analysis grouped wives and husbands into distinct memory trajectories in 2004-2014. A structural equation model examined the actor and partner effects of memory trajectories on depressive symptoms in 2016 and disability status in 2018. The mediating effect of depressive symptoms was tested.

RESULTS: Four distinct memory trajectories were found: persistently high, high and slow decline, moderate and slow decline, and low and rapid decline. Only the wife's low and rapid decline memory trajectory predicted her own more depressive symptoms (β = 0.588, 95% CI = 0.209, 0.967) and her husband's more depressive symptoms (β = 0.326, 95% CI = 0.004, 0.648). Meanwhile, depressive symptoms had strong and significant actor effects on disability (β = 0.046, 95% CI = 0.036, 0.057 for wives; β = 0.060, 95% CI = 0.046, 0.074 for husbands).

DISCUSSION: The wife's low and rapid decline trajectory was associated with her own and her husband's more depressive symptoms, which in turn increased the disability risk for both partners. Timely identification and treatment of memory decline among wives have the potential to mitigate couples' depressive symptoms and, ultimately, disability risks.

ER - TY - JOUR T1 - A comparison of cognitive performances based on differing rates of DNA methylation GrimAge acceleration among older men and women. JF - Neurobiology & Aging Y1 - 2023 A1 - O'Shea, Deirdre M A1 - Alaimo, Hannah A1 - Davis, Jennifer D A1 - Galvin, James E A1 - Tremont, Geoffrey KW - Aging KW - Cognition KW - DNA Methylation KW - Executive function KW - GrimAge KW - Memory KW - sex/gender differences AB -

Cognitive heterogeneity increases with age rendering sex differences difficult to identify. Given established sex differences in biological aging, we examined whether comparisons of men and women on neuropsychological test performances differed as a function of age rate. Data were obtained from 1921 adults enrolled in the 2016 wave of the Health and Retirement Study. The residual from regressing the DNA methylation GrimAge clock on chronological age was used as the measure of aging rate. Slow and fast age rates were predefined as 1 standard deviation below or above the sex-specific mean rates, respectively. ANCOVAs were used to test group differences in test performances. Pairwise comparisons revealed that slow aging men outperformed fast aging women (and vice versa) on measures of executive function/speed, visual memory and semantic fluency; however, when groups were matched by aging rates, no significant differences remained. In contrast, women, regardless of their aging rates, education or depressive symptoms maintained their advantage on verbal learning and memory. Implications for research on sex differences in cognitive aging are discussed.

VL - 123 ER - TY - JOUR T1 - Depressive Symptom Trajectories and Cognition Among Older American Couples: A Dyadic Perspective. JF - Journal of Aging and Health Y1 - 2023 A1 - Kong, Dexia A1 - Lu, Peiyi A1 - Solomon, Phyllis A1 - Woo, Jean A1 - Shelley, Mack KW - Couples KW - depressive symptom trajectory KW - dyadic data KW - latent class growth analysis KW - Memory AB -

OBJECTIVES: This study examined whether trajectories of depressive symptoms of one spouse are associated with the other spouse's memory.

METHODS: Longitudinal data from the Health and Retirement Study (2004-2016) were used ( = 5690 heterosexual couples). Latent-class growth analysis and structural equation models examined the actor and partner effects of depressive symptom trajectories on memory.

RESULTS: Four depressive symptom trajectories were identified (i.e., persistently low, increasing, decreasing, and persistently high). Compared to the low trajectory group, the increasing and persistently high trajectories were associated with worse memory for both men and women. While none of the wives' depressive symptom trajectories was significantly associated with husbands' memory ( > .05), husbands' decreasing trajectory was linked to wives' better memory (β = 0.498, 95% CI = 0.106, 0.890).

DISCUSSION: Older adults with increasing and persistently high depressive symptoms may experience worse memory. Psychosocial interventions targeting depressive symptoms among older men may be beneficial to their spouses' memory.

ER - TY - JOUR T1 - Functional aging trajectories of older cancer survivors: A latent growth analysis of the US Health and Retirement Study. JF - Journal of Cancer Survivorship Y1 - 2023 A1 - Westrick, Ashly C A1 - Kenneth M. Langa A1 - Eastman, Marisa A1 - Ospina-Romero, Monica A1 - Mullins, Megan A A1 - Lindsay C Kobayashi KW - Activities for daily living KW - Aging KW - Cancer KW - Memory AB -

PURPOSE: We aimed to identify prototypical functional aging trajectories of US cancer survivors aged 50 and older, overall and stratified by sociodemographic and health-related characteristics.

METHODS: Data were from 2986 survivors of a first incident cancer diagnosis (except non-melanoma skin cancer) after age 50 in the population representative U.S. Health and Retirement Study from 1998-2016. Cancer diagnoses, episodic memory function, and activity of daily living (ADL) limitations were assessed at biennial study interviews. Using time of cancer diagnosis as the baseline, we used group-based trajectory modeling to identify trajectories of memory function and ADL limitations following diagnosis.

RESULTS: We identified five memory loss trajectories (high: 8.4%; medium-high: 18.3%; medium-low: 21.5%; low: 25.5%; and, very low: 26.2%), and four ADL limitation trajectories (high/increasing limitations: 18.7%; medium limitations: 18.7%; low limitations: 8.14%; no limitations: 60.0). The high memory loss and high/increasing ADL limitation trajectories were both characterized by older age, being female (52% for memory, 58.9% for ADL), having lower pre-cancer memory scores, and a higher prevalence of pre-cancer comorbidities including stroke (30.9% for memory and 29.7% for ADL), hypertension (64.7% for memory and 69.8 for ADL), and depressive symptoms. In joint analyses, we found that generally those with higher memory were more likely to have fewer ADL limitations and vice versa.

CONCLUSION: Older cancer survivors experience heterogeneous trajectories of functional aging that are largely characterized by comorbidities prior to diagnosis.

IMPLICATION FOR CANCER SURVIVORS: Results can help identify older cancer survivors at increased risk for accelerated functional decline.

VL - 17 IS - 5 ER - TY - JOUR T1 - The Mediating Role of Biomarkers in the Association between Subjective Aging and Episodic Memory. JF - The Journals of Gerontology, Series B Y1 - 2023 A1 - Stephan, Yannick A1 - Sutin, Angelina R A1 - Luchetti, Martina A1 - Aschwanden, Damaris A1 - Terracciano, Antonio KW - biological factors KW - longitudinal KW - mechanisms KW - Memory KW - self-perceptions of aging KW - Subjective age AB -

OBJECTIVES: Subjective aging, indexed by subjective age and self-perceptions of aging (SPA), is consistently related to cognition in adulthood. The present study examined whether blood biomarkers mediate the longitudinal associations between subjective aging indices and memory.

METHODS: Data of 5,369 individuals aged 50 to 94 years (Mean= 66.89 years, SD= 9.22; 60% women) were drawn from the Health and Retirement Study (HRS). Subjective age, SPA, and demographic factors were assessed in 2012/2014. Interleukin-6, C-reactive protein, albumin, cystatin C, N-terminal pro B-type natriuretic peptide (NT-proBNP), fasting glucose, Vitamin D, hemoglobin, red cells distribution width, and epigenetic aging were assessed as part of the HRS Venuous Blood Study in 2016. Memory was measured in 2018. The mediators (except for epigenetic aging, which was assessed in a subsample) were tested simultaneously in models that accounted for demographic covariates.

RESULTS: An older subjective age was related to worse memory partially through higher fasting glucose, higher cystatin C, higher NT-proBNP, and accelerated epigenetic aging. Negative SPA were related to worse memory through lower Vitamin D3, higher fasting glucose, higher cystatin C, higher NT-proBNP, and accelerated epigenetic aging. The biomarkers explained between 2% and 10% of subjective age and between 1% and 8% of SPA associations with memory. Additional analysis revealed that biomarkers continued to be significant mediators when physical inactivity and depressive symptoms were included as additional mediators.

CONCLUSION: The present study adds to existing research on the association between subjective aging and memory by providing new evidence on the biological mediators of this association.

VL - 78 IS - 2 ER - TY - JOUR T1 - The Association Between Facets of Conscientiousness and Performance-based and Informant-Rated Cognition, Affect, and Activities in Older Adults. JF - Journal of Personality Y1 - 2022 A1 - Angelina R Sutin A1 - Damaris Aschwanden A1 - Yannick Stephan A1 - Antonio Terracciano KW - attention KW - cognitive function KW - Conscientiousness KW - Facets KW - Five factor model KW - Memory AB -

OBJECTIVE: To identify facets of Conscientiousness associated with objective cognitive performance, informant-rated cognitive decline, and informant-rated affect and activities implicated in cognitive health.

METHOD: Health and Retirement Study participants (N=2,516) reported on their personality, completed a comprehensive cognitive assessment, and had knowledgeable informants report on their cognition, affect, and activities.

RESULTS: Industriousness and responsibility were associated with better cognitive performance; order was associated with less informant-rated cognitive decline. The facets were also associated with more positive affect, less negative affect, greater engagement in cognitive activities and activities outside the house, and less engagement in passive activities, as rated by a knowledgeable informant. Informant-rated engagement in cognitive activities mediated the association between self-reported responsibility and objective cognitive performance.

CONCLUSIONS: Tendencies toward achievement and accountability were associated with healthier cognitive performance and daily profiles that support cognitive health, whereas organization was associated with cognition as reported by a knowledgeable informant. The differential pattern of correlates is informative for the theoretical processes that link distinct facets of Conscientiousness to healthier cognitive aging.

VL - 90 IS - 2 ER - TY - JOUR T1 - Association of Low Hourly Wages in Middle Age With Faster Memory Decline in Older Age: Evidence From the Health and Retirement Study. JF - American Journal of Epidemiology Y1 - 2022 A1 - Kezios, Katrina L A1 - Zhang, Adina A1 - Kim, Soohyun A1 - Lu, Peiyi A1 - Glymour, M Maria A1 - Elfassy, Tali A1 - Al Hazzouri, Adina Zeki KW - Employment KW - low-wage workers KW - Memory KW - occupational groups KW - salaries KW - wages AB -

Little research has investigated the long-term relationship between low wages and memory decline, despite the growing share of low-wage workers in the US labor market. Here, we examined whether cumulative exposure to low wages over 12 years in midlife is associated with memory decline in later life. Using 1992-2016 data from the Health and Retirement Study, we analyzed data from 2,879 individuals born in 1936-1941 using confounder-adjusted linear mixed-effects models. Low-wage work was defined as an hourly wage lower than two-thirds of the federal median wage for the corresponding year and was categorized into "never," "intermittent," and "sustained" based on wages earned from 1992 to 2004. Memory function was measured at each study visit from 2004 to 2016 via a memory composite score. The confounder-adjusted annual rate of memory decline among "never" low-wage earners was -0.12 standard units (95% confidence interval: -0.13, -0.10). Compared with this, memory decline among workers with sustained earning of low midlife wages was significantly faster (βtime×sustained = -0.014, 95% confidence interval: -0.02, -0.01), corresponding to an annual rate of -0.13 standard units for this group. Sustained low-wage earning in midlife was significantly associated with a downward trajectory of memory performance in older age. Enhancing social policies to protect low-wage workers may be especially beneficial for their cognitive health.

VL - 191 IS - 12 ER - TY - JOUR T1 - Black-White variation in the relationship between early educational experiences and trajectories of cognitive function among US-born older adults JF - SSM - Population Health Y1 - 2022 A1 - Katrina M. Walsemann A1 - Eleanor M. Kerr A1 - Jennifer A Ailshire A1 - Pamela Herd KW - cognitive impairment KW - Dementia KW - Early Life KW - Memory KW - school segregation AB - Black adults face a substantially higher risk for dementia in later life compared to their White peers. Given the critical role of educational attainment and cognitive function in later life dementia risk, this paper aims to determine if early educational experiences and educational attainment are differentially related to trajectories of cognitive status across race and if this further varies by education cohort. We use data from the Life History Mail Survey (LHMS) and prospective data on cognition from the Health and Retirement Study (HRS). We restrict our sample to Black and White US-born adults who provided at least one measure of cognitive status from 1995/6–2016. We find evidence of Black-White differences in the association between educational experiences and level of cognitive function, episodic memory, and working memory, but little evidence of Black-White differences in these associations with decline. Having a learning problem was associated with lower levels of cognitive function, episodic memory, and working memory for White and Black older adults, but was more strongly related to these outcomes among Black older adults. Further, the Black-White difference in this association was generally found in older cohorts that completed schooling after enactment of federal policies that improved educational resources for children with learning disabilities. Attending racially discordant schools was positively associated with level of these cognitive outcomes for Black older adults but not for White older adults. We also find that the educational gradient in level of cognitive function was larger for Black compared to White older adults in older cohorts not benefiting from the Brown v Board of Education decision but was similar for Black and White older adults attending school in the post-Brown era. VL - 19 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 - Does a Cancer Diagnosis in Mid-to-Later Life Modify Racial Disparities in Memory Aging? JF - Alzheimer Disease & Associated Disorders Y1 - 2022 A1 - Eastman, Marisa R A1 - Ospina-Romero, Monica A1 - Westrick, Ashly C A1 - Jasdeep S Kler A1 - M. Maria Glymour A1 - Abdiwahab, Ekland A1 - Lindsay C Kobayashi KW - cancer diagnosis KW - Memory KW - Racial Disparities AB -

BACKGROUND: It is unknown whether an incident cancer diagnosis differentially impacts acute and long-term memory aging between older White and Black Americans.

METHODS: Incident cancer diagnoses and memory (immediate and delayed recall, combined with proxy-reported memory) were assessed at biennial study interviews in the US Health and Retirement Study (N=14,235, 1998-2016). We used multivariable segmented linear mixed-effects models to evaluate the rate of change in standardized memory score (SD/decade) in the years before, acutely at the time of, and in the years following an incident cancer diagnosis, compared to cancer-free adults, by race.

RESULTS: Black participants experienced faster memory decline than White participants (cancer-free group: -1.211 vs. -1.077; P<0.0001). An incident cancer diagnosis was associated with an acute memory drop in White, but not Black participants (-0.065 vs. 0.024; P<0.0001). However, White cancer survivors experienced slower memory decline than cancer-free White adults before and after diagnosis, but this memory advantage was not observed among Black cancer survivors.

CONCLUSIONS: Racial disparities in memory aging are not modified by an incident cancer diagnosis. The acute cancer-related memory decline and long-term memory advantage experienced by White, but not Black, cancer survivors relative to cancer-free older adults, requires further investigation.

VL - 36 IS - 2 ER - TY - JOUR T1 - DOES NEIGHBORHOOD DISADVANTAGE ALTER MEMORY AFTER A CANCER DIAGNOSIS? A US HEALTH AND RETIREMENT STUDY JF - Innovation in Aging Y1 - 2022 A1 - Ashly Westrick A1 - Monica Ospina-Romero A1 - Philippa Clarke A1 - Lindsay C Kobayashi KW - Cancer KW - Memory AB - We aimed to determine the influence of neighborhood socioeconomic status (NSES) on long-term cancer-related memory decline of older adults. Incident cancer diagnosis and memory were assessed in the U.S. Health and Retirement Study (N=15,074, 1998-2016). Proportion of female-headed households with children, households with public assistance income, people with income below poverty, and proportion 16+ years unemployed was categorized into NSES tertiles. Linear mixed-effects models compared the standardized memory trajectories by cancer status and NSES. Cancer-free individuals living in more disadvantaged neighborhoods had worse mean memory function at age 75 and steeper memory declines than participants from less disadvantaged neighborhoods. An incident cancer diagnosis was associated with an acute memory drop at diagnosis for those living in the least disadvantaged neighborhoods. Cancer survivors had better memory prior to but not after diagnosis compared to cancer-free individuals across NSES. These findings could inform future interventions to promote cancer survivor’s long-term aging. VL - 6 IS - Supplement_1 ER - TY - JOUR T1 - Genome-wide meta-analyses reveal novel loci for verbal short-term memory and learning. JF - Molecular Psychiatry Y1 - 2022 A1 - Lahti, Jari A1 - Tuominen, Samuli A1 - Yang, Qiong A1 - Pergola, Giulio A1 - Ahmad, Shahzad A1 - Amin, Najaf A1 - Armstrong, Nicola J A1 - Beiser, Alexa A1 - Bey, Katharina A1 - Bis, Joshua C A1 - Boerwinkle, Eric A1 - Bressler, Jan A1 - Campbell, Archie A1 - Campbell, Harry A1 - Chen, Qiang A1 - Corley, Janie A1 - Cox, Simon R A1 - Davies, Gail A1 - De Jager, Philip L A1 - Derks, Eske M A1 - Jessica Faul A1 - Fitzpatrick, Annette L A1 - Fohner, Alison E A1 - Ford, Ian A1 - Fornage, Myriam A1 - Gerring, Zachary A1 - Grabe, Hans J A1 - Grodstein, Francine A1 - Gudnason, Vilmundur A1 - Simonsick, Eleanor A1 - Holliday, Elizabeth G A1 - Joshi, Peter K A1 - Kajantie, Eero A1 - Kaprio, Jaakko A1 - Karell, Pauliina A1 - Kleineidam, Luca A1 - Knol, Maria J A1 - Kochan, Nicole A A1 - Kwok, John B A1 - Leber, Markus A1 - Lam, Max A1 - Lee, Teresa A1 - Li, Shuo A1 - Loukola, Anu A1 - Luck, Tobias A1 - Marioni, Riccardo E A1 - Mather, Karen A A1 - Medland, Sarah A1 - Mirza, Saira S A1 - Nalls, Mike A A1 - Nho, Kwangsik A1 - O'Donnell, Adrienne A1 - Oldmeadow, Christopher A1 - Painter, Jodie A1 - Pattie, Alison A1 - Reppermund, Simone A1 - Risacher, Shannon L A1 - Rose, Richard J A1 - Sadashivaiah, Vijay A1 - Scholz, Markus A1 - Satizabal, Claudia L A1 - Schofield, Peter W A1 - Schraut, Katharina E A1 - Scott, Rodney J A1 - Simino, Jeannette A1 - Smith, Albert V A1 - Smith, Jennifer A A1 - Stott, David J A1 - Surakka, Ida A1 - Teumer, Alexander A1 - Thalamuthu, Anbupalam A1 - Trompet, Stella A1 - Turner, Stephen T A1 - van der Lee, Sven J A1 - Villringer, Arno A1 - Völker, Uwe A1 - Wilson, Robert S A1 - Wittfeld, Katharina A1 - Vuoksimaa, Eero A1 - Xia, Rui A1 - Yaffe, Kristine A1 - Yu, Lei A1 - Zare, Habil A1 - Zhao, Wei A1 - Ames, David A1 - Attia, John A1 - Bennett, David A A1 - Brodaty, Henry A1 - Chasman, Daniel I A1 - Goldman, Aaron L A1 - Hayward, Caroline A1 - Ikram, M Arfan A1 - Jukema, J Wouter A1 - Sharon L R Kardia A1 - Lencz, Todd A1 - Loeffler, Markus A1 - Mattay, Venkata S A1 - Palotie, Aarno A1 - Psaty, Bruce M A1 - Ramirez, Alfredo A1 - Ridker, Paul M A1 - Riedel-Heller, Steffi G A1 - Sachdev, Perminder S A1 - Saykin, Andrew J A1 - Scherer, Martin A1 - Schofield, Peter R A1 - Sidney, Stephen A1 - Starr, John M A1 - Trollor, Julian A1 - Ulrich, William A1 - Wagner, Michael A1 - David R Weir A1 - Wilson, James F A1 - Wright, Margaret J A1 - Weinberger, Daniel R A1 - Debette, Stéphanie A1 - Eriksson, Johan G A1 - Mosley, Thomas H A1 - Launer, Lenore J A1 - van Duijn, Cornelia M A1 - Deary, Ian J A1 - Seshadri, Sudha A1 - Räikkönen, Katri KW - Genome KW - health outcomes KW - Memory KW - neurocognitive outcomes KW - polygenic score KW - Verbal Learning AB -

Understanding the genomic basis of memory processes may help in combating neurodegenerative disorders. Hence, we examined the associations of common genetic variants with verbal short-term memory and verbal learning in adults without dementia or stroke (N = 53,637). We identified novel loci in the intronic region of CDH18, and at 13q21 and 3p21.1, as well as an expected signal in the APOE/APOC1/TOMM40 region. These results replicated in an independent sample. Functional and bioinformatic analyses supported many of these loci and further implicated POC1. We showed that polygenic score for verbal learning associated with brain activation in right parieto-occipital region during working memory task. Finally, we showed genetic correlations of these memory traits with several neurocognitive and health outcomes. Our findings suggest a role of several genomic loci in verbal memory processes.

ER - TY - JOUR T1 - Music Engagement and Episodic Memory among Middle-Aged and Older Adults: A National Cross-Sectional Analysis. JF - The Journals of Gerontology: Series B Y1 - 2022 A1 - Rouse, Hillary J A1 - Jin, Ying A1 - Hueluer, Gizem A1 - Huo, Meng A1 - Bugos, Jennifer A A1 - Veal, Britney A1 - Torres, Mia A1 - Peterson, Lindsay A1 - Dobbs, Debra A1 - Meng, Hongdao KW - age norms KW - healthcare policy KW - lifestyle KW - Memory KW - Music KW - regression methods AB -

OBJECTIVES: To determine whether music engagement influences middle-aged and older adults' performance on episodic memory tasks.

METHODS: Secondary data analysis of a sample (N = 4,592) of cognitively healthy adults from the 2016 Health and Retirement Study were used for this study. Multivariable regression models were used to analyze the cross-sectional differences in performance on tasks of episodic memory between participants who listened to music (n= 3,659) or sang or played an instrument (n= 989).

RESULTS: On average, participants recalled 10.3 words out of a possible 20. Regression analyses showed that both music listening and singing or playing an instrument were independently associated with significantly better episodic memory.

DISCUSSION: The findings provide the first population-based evidence that music engagement is associated with better episodic memory among middle-aged and older adults. Future studies should examine whether the association is causal or has a dose response.

VL - 77 IS - 3 ER - TY - JOUR T1 - The Role of Race-Gender Intersectionality in Associations between Insomnia Patterns and Late-Life Memory Trajectories JF - Sleep Y1 - 2022 A1 - Zaheed, Afsara A1 - Ronald D Chervin A1 - Laura B Zahodne KW - depressive disorders KW - gender KW - insomnia KW - Latinos/Hispanics KW - Memory KW - Mental Recall KW - Racial Disparities KW - Sleep AB - Introduction Difficulty initiating sleep (DIS) may be a stronger predictor of neurodegenerative risk than other insomnia symptoms. This study examined whether longitudinal patterns of DIS are associated with subsequent memory trajectories, and whether associations differ across non-Hispanic Black and White men and women. Methods 12,565 participants in the Health and Retirement Study (Mage=67.8±9.1, 59.1% women) who self-identified as non-Hispanic Black (14.5%) or non-Hispanic White were included. DIS (“How often do you have trouble falling asleep?”) at three biennial waves (2002-2006) was dichotomized (“never/rarely/sometimes”=0, “often”=1). Participants were categorized into three mutually exclusive groups: low (reference group), persistent, and variable DIS. Episodic memory was assessed using a 10-item word list recall test at five biennial waves (2008-2016). Latent growth curves modeled associations between DIS patterns and subsequent memory level and change, adjusting for sociodemographics (model 1), health conditions (model 2), and depressive symptoms (model 3) in 2002. Stratified models compared associations across White men, Black men, White women, and Black women. Results Compared to low DIS, persistent (β=-0.03, p<.001) or variable (β=-0.07, p<.001) DIS was associated with worse subsequent memory in models 1 and 2. The effect of variable (β=-0.05, p<.001), but not persistent (β=-0.01, p=.271), DIS remained in model 3. Persistent DIS was most prevalent among White women (5.4% vs. 2.4-4%), and variable DIS was most prevalent among Black women (24.1% vs. 14-22.2%). Persistent DIS was only significantly associated with memory among White women (β=-0.04, p=.003 vs. β=-0.04, p=.324 for Black Men; β=-0.03, p=.087 for White men; and β=0.01, p=.859 for Black women). Variable DIS was most strongly associated with memory among Black men (β=-0.141, p=.003), followed by White men (β=-0.09, p<.001), White women (β=-0.06, p<.001) and Black women (β=-0.06, p=.064). There were no associations between DIS patterns and memory change. Conclusion While links between persistent DIS and subsequent memory may reflect negative cognitive effects of depression, variable DIS may presage worse memory above and beyond depression. Race/gender differences in the prevalence and predictive value of DIS patterns for subsequent cognitive function highlight the value of an intersectional lens. Gender disparities in DIS may be more prominent than racial disparities. VL - 45 IS - Suppl _1 ER - TY - JOUR T1 - Screening recall in older cancer survivors detects differences in balance and mobility. JF - Supportive Care In Cancer Y1 - 2022 A1 - Blackwood, Jennifer A1 - Sweeney, Robert A1 - Rybicki, Kateri KW - Cognition KW - Memory KW - Neoplasms KW - Orientation KW - Postural Balance KW - Short-term KW - walking speed AB -

PURPOSE: Cognitive impairments have been reported by up to two-thirds of cancer survivors whose primary cancer did not occur in the central nervous system. Physical impairments as sequelae of cancer-related cognitive impairment (CRCI) have not been well described in previous studies. Furthermore, there is scarcity of literature describing differences among physical performance in those with and without CRCI. The purpose of this study is to examine the differences in physical function of older cancer survivors based on cognitive ability to determine if physical performance differs when different cognitive screening measures are employed.

METHODS: Adults age 65 + with a history of cancer from the 2010 Health and Retirement Study (n = 1,953) were assigned to groups according to their cognitive ability. Between-group demographic, mobility, and cognitive differences were analyzed using chi-squared and t tests. Recall and orientation were used as cognitive variables, and physical performance outcomes included gait speed, balance, and grip strength.

RESULTS: Respondents with Low Recall had more impaired balance (semi-tandem, tandem) (p < .05) and slower gait speeds (p < .05). Respondents that were Not-Oriented had slower gait speed (p < .05). Between-group differences in demographics were found by recall and orientation groups.

CONCLUSIONS: Impairments in balance and gait speed are able to be detected when recall is screened in a population of older cancer survivors. When assessing how physical mobility is related to fall risk, a screen of cognition should go beyond just orientation.

VL - 30 IS - 3 ER - TY - JOUR T1 - Trans-ethnic Meta-analysis of Interactions between Genetics and Early Life Socioeconomic Context on Memory Performance and Decline in Older Americans. JF - The Journals of Gerontology, Series A Y1 - 2022 A1 - Jessica Faul A1 - Kho, Minjung A1 - Zhao, Wei A1 - Rumfelt, Kalee E A1 - Yu, Miao A1 - Colter Mitchell A1 - Smith, Jennifer A KW - Childhood SES KW - Cognition KW - Education KW - Epidemiology KW - Gene-Environment Interaction KW - Genetics KW - Memory KW - Rare Variant AB -

Later life cognitive function is influenced by genetics as well as early- and later-life socioeconomic context. However, few studies have examined the interaction between genetics and early childhood factors. Using gene-based tests (iSKAT/iSKAT-O), we examined whether common and/or rare exonic variants in 39 gene regions previously associated with cognitive performance, dementia, and related traits had an interaction with childhood socioeconomic context (parental education and financial strain) on memory performance or decline in European ancestry (EA, N=10,468) and African ancestry (AA, N=2,252) participants from the Health and Retirement Study. Of the 39 genes, 22 in EA and 19 in AA had nominally significant interactions with at least one childhood socioeconomic measure on memory performance and/or decline; however, all but one (father's education by SLC24A4 in AA) were not significant after multiple testing correction (FDR <0.05). In trans-ethnic meta-analysis, two genes interacted with childhood socioeconomic context (FDR <0.05): mother's education by MS4A4A on memory performance, and father's education by SLC24A4 on memory decline. Both interactions remained significant (p<0.05) after adjusting for respondent's own educational attainment, APOE ε4 status, lifestyle factors, BMI, and comorbidities. For both interactions in EA and AA, the genetic effect was stronger in participants with low parental education. Examination of common and rare variants in genes discovered through GWAS shows that childhood context may interact with key gene regions to jointly impact later life memory function and decline. Genetic effects may be more salient for those with lower childhood socioeconomic status.

VL - 77 IS - 11 ER - TY - JOUR T1 - WORKING MEMORY MODERATES DEPRESSIVE SYMPTOMS AFTER PARTNER MORTALITY: HEALTH AND RETIREMENT STUDY JF - Innovation in Aging Y1 - 2022 A1 - Brush, David A1 - Paulson, Daniel A1 - Dvorak, Robert KW - Depressive symptoms KW - Memory KW - partner mortality AB - Grief is conceptualized as a process after which the individual becomes better adapted to changed living conditions after a loss. The Selection, Optimization, and Compensation with Emotion Regulation (SOC-ER) model posits that working memory may be necessary for mitigation and resolution of grief. This study examined the hypothesis that working memory facilitates successful grieving following the loss of an intimate partner. Participants include 3,599 respondents of the longitudinal Health and Retirement Study (HRS) who experienced spousal mortality between 1994 and 2014. Working memory was measured assessed using Serial 7’s, and depressive symptoms were assessed using the 8-question CES-D. Latent-growth models were used to estimate rate of change in depressive symptoms up to loss-of-spouse (baseline event), and then subsequent to that loss. Missing data were handled using full-information maximum likelihood. Sample participants had an average age 78.04 (SD = 7.32) at the time of their spouse’s death and were disproportionately female (69.10%), White/Caucasian (82.30%), non-Hispanic (92.37%), and completed an average of 11.61 (SD = 3.42) years of education. The hypothesized level 2 model fit the data very well: χ2(56)=61.323, p=.29 RMSEA=0.005 [0.000 0.012]; CFI=0.998, SRMR=0.028. Initial depressive symptom endorsement was significantly related to working memory ability. Working memory also moderated the relationship between depressive symptom endorsement and time, where individuals with better working memory tended to report lower depressive symptoms and demonstrated a lesser increase in depressive symptoms. In conclusion, working memory may be one determinant of successful bereavement. Findings support application of the SOC-ER model to the study of grief. VL - 6 ER - TY - JOUR T1 - Genetic effects and gene-by-education interactions on episodic memory performance and decline in an aging population. JF - Social Science & Medicine Y1 - 2021 A1 - Jennifer A Smith A1 - Kho, Minjung A1 - Wei Zhao A1 - Yu, Miao A1 - Colter Mitchell A1 - Jessica Faul KW - Education KW - Genetics KW - GWAS KW - Memory AB - Both social and genetic factors contribute to cognitive impairment and decline, yet genetic factors identified through genome-wide association studies (GWAS) explain only a small portion of trait variability. This "missing heritability" may be due to rare, potentially functional, genetic variants not assessed by GWAS, as well as gene-by-social factor interactions not explicitly modeled. Gene-by-social factor interactions may also operate differently across race/ethnic groups. We selected 39 genes that had significant, replicated associations with cognition, dementia, and related traits in published GWAS. Using gene-based analysis (SKAT/iSKAT), we tested whether common and/or rare variants were associated with episodic memory performance and decline either alone or through interaction with education in >10,000 European ancestry (EA) and >2200 African ancestry (AA) respondents from the Health and Retirement Study (HRS). Nine genes in EA and five genes in AA were associated with memory performance or decline (p < 0.05), and these effects did not attenuate after adjusting for education. Interaction between education and CLPTM1 on memory performance was significant in AA (p = 0.003; FDR-adjusted p = 0.038) and nominally significant in EA (p = 0.026). In both ethnicities, low memory performance was associated with CLPTM1 genotype (rs10416261) only for those with less than high school education, and effects persisted after adjusting for APOE ε4. For over 70% of gene-by-education interactions across the genome that were at least nominally significant in either ethnic group (p < 0.05), genetic effects were only observed for those with less than high school education. These results suggest that genetic effects on memory identified in this study are not mediated by education, but there may be important gene-by-education interactions across the genome, including in the broader APOE genomic region, which operate independently of APOE ε4. This work illustrates the importance of developing theoretical frameworks and methodological approaches for integrating social and genomic data to study cognition across ethnic groups. VL - 271 U1 - http://www.ncbi.nlm.nih.gov/pubmed/30449520?dopt=Abstract ER - TY - JOUR T1 - Memory and Personality Development in Adulthood: Evidence From Four Longitudinal Studies. JF - The Journals of Gerontology, Series B Y1 - 2021 A1 - Yannick Stephan A1 - Angelina R Sutin A1 - Martina Luchetti A1 - Antonio Terracciano KW - Adulthood KW - longitudinal KW - Memory KW - Personality Development AB -

OBJECTIVES: Personality traits have been related to concurrent memory performance. Most studies, however, have focused on personality as a predictor of memory; comparatively less is known about whether memory is related to personality development across adulthood. Using 4 samples, the present study tests whether memory level and change are related to personality change in adulthood.

METHOD: Participants were drawn from 2 waves of the Wisconsin Longitudinal Study Graduates (WLSG; N = 3,232, mean age = 64.28, SD = 0.65) and Wisconsin Longitudinal Study Siblings (WLSS; N = 1,570, mean age = 63.52, SD = 6.69) samples, the Midlife in the United States (MIDUS; N = 1,901, mean age = 55.43, SD = 10.98), and the Health and Retirement Study (HRS; N = 6,038, mean age = 65.47, SD = 8.28). Immediate and delayed recall and the 5 major personality traits were assessed at baseline and follow-up.

RESULTS: There was heterogeneity in the associations across samples. A meta-analysis of latent change in the four samples indicated that lower baseline memory performance was related to an increase in neuroticism (B = -0.002; 95% CI = -0.004, -0.0008) and a decrease in agreeableness (B = 0.004; 95% CI = 0.002, 0.007) and conscientiousness (B = 0.005; 95% CI = 0.0008, 0.010). In addition, declines in memory were related to steeper declines in extraversion (B = 0.06; 95% CI = 0.003, 0.11), openness (B = 0.04; 95% CI = 0.007, 0.069), and conscientiousness (B = 0.05; 95% CI = 0.019, 0.09).

DISCUSSION: The present study indicates that poor memory and declines in memory over time are related to maladaptive personality change. These associations, however, were small and inconsistent across samples.

VL - 76 IS - 1 ER - TY - JOUR T1 - Objective and subjective memory: Impact on the financial behavior of older adults in the United States JF - The Journal of the Economics of Ageing Y1 - 2021 A1 - Su Hyun Shin KW - asset allocation KW - asset holdings KW - Financial Health KW - Memory AB - This study adds to the literature on adverse effects of cognitive decline among older adults focusing on financial decisions. This study investigates the impact of objective and subjective memory on the financial decisions of older adults, such as asset holdings, allocation, and financial health. In general, older adults with higher objective memory have better financial outcomes. A higher objective memory leads to greater financial assets including stocks, cash-equivalent, individual retirement accounts, bonds, and thus total financial assets. It also leads to a smaller share in cash-equivalent. Older adults with better objective memory are more likely to have sufficient liquid assets to cover short-term expenses and they save enough to meet retirement adequacy. On the other hand, a higher subjective memory leads to fewer financial assets, retirement inadequacy, and insolvency. These findings have important implications for older adults who experience memory loss, and their families. VL - 19 SN - 2212-828X ER - TY - THES T1 - Relationship Between Cannabis Use and Immediate, Delayed, and Working Memory Performance Among Older Adults T2 - Psychology Y1 - 2021 A1 - Maynard, Madison H KW - Cannabis KW - Memory AB - Cannabis is increasingly accessible in the United States for recreational and/or medical use. Additionally, the Baby Boomer birth cohort exhibits a greater prevalence of cannabis use than prior generations of older adults. Past research has most frequently addressed the potential cognitive effects of cannabis use in populations of adolescents and young adults. Some of these studies suggest that cannabis use is chronically associated with worse performance on tasks of verbal working memory and executive functioning, however, due to methodological variation and a wide variety of potential confounds including duration of abstinence and frequency of use, results are still inconclusive. Through use of a longitudinal, publicly available secondary dataset, the Health and Retirement Study, immediate, delayed, and working memory were evaluated in older adults who have used cannabis within the past year, within their lifetime but not the past year, and those who have never used. Uncontrolled, one-way ANOVAs and controlled ANCOVAs were used to examine these effects. When controlling for age, gender, education, and race, current frequent users demonstrated significantly worse immediate memory performance than past and non-users. Results suggest that greater than weekly cannabis use may result in attentional and short-term memory deficits. Further, these effects may be mitigated by sustained abstinence over time. Certain limitations including sample size and measures of cannabis use warrant future studies to replicate and build upon these findings. JF - Psychology PB - University of Central Florida CY - Orlando, FL UR - https://stars.library.ucf.edu/cgi/viewcontent.cgi?article=2094&context=honorstheses ER - TY - JOUR T1 - Subjective age and multiple cognitive domains in two longitudinal samples JF - Journal of Psychosomatic Research Y1 - 2021 A1 - Yannick Stephan A1 - Angelina R Sutin A1 - Martina Luchetti A1 - Damaris Aschwanden A1 - Antonio Terracciano KW - Adulthood KW - Cognition KW - Executive function KW - Memory KW - numeric reasoning KW - Subjective age KW - verbal fluency KW - Visuospatial ability AB - Objective Subjective age is consistently related to memory performance and global cognitive function among older adults. The present study examines whether subjective age is prospectively related to specific domains of cognitive function. Method Participants were drawn from the Health and Retirement Study (HRS, N = 2549, Mean Age = 69.66, SD = 7.36) and the Midlife in the United States Survey (MIDUS, N = 2499, Mean Age = 46.24, SD = 11.25). In both samples, subjective age, depressive symptoms, chronic conditions, and demographic factors were assessed at baseline. Four domains of cognition were assessed 8 years later in the HRS and almost 20 years later in the MIDUS: episodic memory, speed-attention-executive, verbal fluency, and numeric reasoning. HRS also assessed visuospatial ability. Results Regression analysis revealed that an older subjective age was related to worse performance in the domains of episodic memory and speed-attention-executive in both samples. The effect size for the difference between a younger and an older subjective age was d = 0.14 (MIDUS) and d = 0.24 (HRS) for episodic memory and d = 0.25 (MIDUS) and d = 0.33 (HRS) for speed-attention-executive. Feeling older was related to lower verbal fluency in HRS (d = 0.30) but not in MIDUS, whereas no association was found with numeric reasoning in either sample. An older subjective age was related to lower visuospatial ability in HRS (d = 0.25). Conclusion Subjective age is prospectively related to performance in different cognitive domains. The associations between subjective age and both episodic memory and speed-attention-executive functions were replicable and robust over up to 20 years of follow-up. VL - 150 ER - TY - JOUR T1 - Temporal Trends in Stroke-Related Memory Change: Results From a US National Cohort 1998-2016. JF - Stroke Y1 - 2021 A1 - Chloe W Eng A1 - Elizabeth R Mayeda A1 - Paola Gilsanz A1 - Rachel A Whitmer A1 - Kim, Anthony S A1 - M. Maria Glymour KW - Dementia KW - Incidence KW - Memory KW - Survivors AB -

BACKGROUND AND PURPOSE: Findings from the Framingham Heart Study suggest that declines in dementia incidence rates over recent decades are partially due to decreases in stroke incidence and mortality; however, whether trends of declining dementia rates extend to survivors of incident stroke remains unclear. We investigated evidence for temporal trends in memory change related to incident stroke in a nationally representative cohort.

METHODS: Adults age 50+ in the HRS (Health and Retirement Study) were followed across three successive 6-year epochs (epoch 1: 1998-2004, n=16 781; epoch 2: 2004-2010, n=15 345; and epoch 3: 2010-2016; n=15 949). Participants were included in an epoch if they were stroke-free at the start of that epoch. Annual rates of change in a composite z-standardized memory score were compared using demographic-adjusted linear regression models for stroke-free participants, those who survived after stroke, and those who died after stroke, considering memory change before stroke, at the time of stroke, and for years following stroke.

RESULTS: Crude stroke incidence rates decreased from 8.5 per 1000 person-years in epoch 1 to 6.8 per 1000 person-years in epoch 3. Rates of memory change before and following stroke onset were similar across epochs. Memory decrement immediately after stroke onset attenuated from -0.37 points (95% CI, -0.44 to -0.29) in epoch 1 to -0.26 (95% CI, -0.33 to -0.18) points in epoch 2 and -0.25 (95% CI, -0.33 to -0.17) points in epoch 3 ( value for linear trend=0.02).

CONCLUSIONS: Decreases in stroke-related dementia in recent years may be partially attributable to smaller memory decrements immediately after stroke onset. Findings suggest reductions in stroke incidence and improvements in stroke care may also reduce population burden of dementia. Further investigations into whether temporal trends are attributable to improvements in stroke care are needed.

VL - 52 IS - 5 ER - TY - JOUR T1 - Verbal memory is associated with adherence to COVID-19 protective behaviors in community dwelling older adults. JF - Aging Clinical and Experimental Research Y1 - 2021 A1 - O'Shea, Deirdre M A1 - Davis, Jennifer D A1 - Tremont, Geoffrey KW - Adherence KW - Aging KW - community living KW - COVID-19 KW - Memory AB -

BACKGROUND: Adherence to protective behaviors is central to limiting the spread of COVID-19 and associated risk of serious illness and mortality in older populations. Whether cognition predicts adherence to protective behaviors has not been examined in older adults.

AIMS: To examine whether specific cognitive abilities predict adherence to COVID-19 protective behaviors in older adults, independent of other relevant factors.

METHODS: Data from 431 older adults (i.e., ≥ 65 years) who took part in the COVID-19 module of the Health and Retirement Study were included in the present study. Separate binary logistic regression models were used to examine whether performance on measures of immediate and delayed recall and working memory predicted adherence to COVID-19 protective behaviors, controlling for demographics, level of COVID-19 concern, depressive symptoms, and medical conditions.

RESULTS: For every unit increase in immediate and delayed recall, the probability of adhering to COVID-19 protective behaviors increased by 47% and 69%, respectively. There was no association between the measure of working memory and adherence.

DISCUSSION: It is of public interest to understand the factors that reduce adherence to protective behaviors so that we can better protect those most vulnerable and limit community spread. Our findings demonstrate that reduced memory predicts non-adherence to COVID-19 protective behaviors, independent of virus concern, and other relevant demographic and health factors.

CONCLUSIONS: Public health strategies aimed at increasing adherence to COVID-19 protective behaviors in community dwelling older adults, should account for the role of reduced cognitive function in limiting adherence.

VL - 33 IS - 7 ER - TY - JOUR T1 - Considering self-reported baseline function and cognition in predicting post-operative complications among older adults JF - Annals of palliative medicine Y1 - 2020 A1 - Shnayder, Michelle M A1 - Montgomery, John R A1 - Abrahamse, Paul A1 - Suwanabol, Pasithorn A KW - cognitive impairment KW - Memory KW - Postoperative Complications AB - BACKGROUND:Older adults experience high rates of postoperative complications and poorer outcomes. Current perioperative risk assessments lack specific measures and are too time-consuming for busy surgeons. METHODS:Using data from the Health and Retirement Study Survey linked with Medicare data, we performed a cross-sectional study, evaluating all adults ≥65 years old who underwent high-risk elective surgery between 1992-2012. Primary exposure variables included self-reported preoperative functional and cognitive abilities using activities of daily living (ADLs), instrumental activities of daily living (IADLs), and a 27-point self-administered test of memory and mental processing. Primary outcome was the development of a serious postoperative complication within 30-days following index operation. RESULTS:Overall, 42% (n=501) developed at least one serious postoperative complication. Patients with moderate (aOR 1.52, 95% CI: 1.14-2.04) and severe (aOR 1.55, 95% CI: 1.00-2.46) baseline functional limitations were at higher risk of serious postoperative complications compared to those with no functional limitation. Cognitive impairment was not associated with serious postoperative complications. CONCLUSIONS:Self-reported functional measures may help to quickly identify patients at high-risk for surgical complications and better inform pre-operative discussions including earlier initiation of palliative care services. ER - TY - JOUR T1 - Dietary lutein and zeaxanthin are associated with working memory in an older population JF - Public Health Nutrition Y1 - 2020 A1 - Krystle E Zuniga A1 - Nicholas J Bishop A1 - Turner, Alexandria S KW - Carotenoid KW - Cognition KW - Episodic Memory KW - Lutein KW - Memory KW - Older adult KW - Zeaxanthin AB - Objective: The purpose of the study was to examine the association between dietary lutein and zeaxanthin (L + Z) intake and immediate word recall (IWR) and delayed word recall (DWR), and to identify the major contributors to dietary L + Z intake in a recent and representative sample of the older US population. Design: In this cross-sectional analysis, multivariate path analytic models estimated the association between L + Z consumption and cognitive performance while adjusting for covariates. Setting: Observations were drawn from the 2014 Health and Retirement Study, a nationally representative panel study of older US adults, and the 2013 Health Care and Nutrition Study, which assessed dietary intake via FFQ in a subsample of respondents. Participants: The analytic sample included 6390 respondents aged ≥50 years. Results: L + Z intake was 2·44 ± 2·32 mg/d on average, and L + Z intake differed significantly across quartiles (P < 0·001). For example, average L + Z intake in Q1 was 0·74 ± 0·23 mg/d and in Q4 was 5·46 ± 2·88 mg/d. In covariate adjusted models, older adults in the highest quartiles of L + Z intake had significantly greater IWR and DWR scores than those in the lowest quartile. Leafy vegetables, cruciferous vegetables, dark yellow vegetables, fish and seafood, legumes, eggs and fruit were significant and meaningful predictors of dietary L + Z intake. Conclusion: A high consumption of vegetables, fish and seafood, legumes, eggs and fruit is associated with a higher intake of L + Z and greater word recall among older adults. ER - TY - JOUR T1 - Life-Course Religious Attendance and Cognitive Functioning in Later Life JF - Research on Aging Y1 - 2020 A1 - Terrence D. Hill A1 - Dawn C Carr A1 - Amy M. Burdette A1 - Benjamin Dowd-Arrow KW - Cognitive health KW - Memory KW - Mental Status KW - Religion AB - Although several studies suggest that religious attendance is associated with better cognitive functioning in later life, researchers have generally failed to connect with any established life-course perspectives or theories of cognitive aging. Building on previous work, we examine the effects of life-course religious attendance on a range of cognitive functioning outcomes. We employ data from the religious life histories module of the 2016 Health and Retirement Study, a subsample of 516 adults aged 65 and older. Our key findings demonstrate that older adults who attended religious services for more of their life course tend to exhibit poorer working memory and mental status and better self-rated memory than older adults who attended less often. We contribute to previous research by reconceptualizing religious attendance as a cumulative life-course exposure, exploring the effects of religious attendance net of secular social engagement, and examining a wider range of cognitive functioning outcomes. N1 - PMID: 32266864 ER - TY - JOUR T1 - Cognitive Change After Cardiac Surgery Versus Cardiac Catheterization: A Population-Based Study. JF - The Annals of Thoracic Surgergy Y1 - 2019 A1 - Elizabeth L Whitlock A1 - L Grisell Diaz-Ramirez A1 - Alexander K Smith A1 - W John Boscardin A1 - Michael S. Avidan A1 - M. Maria Glymour KW - Cardiac surgery KW - Cardiovascular disease KW - Cognition & Reasoning KW - Memory AB -

BACKGROUND: Despite concern that cardiac surgery may adversely affect cognition, little evidence is available from population-based studies using presurgery data. With the use of the Health and Retirement Study, we compared memory change after participant-reported cardiac catheterization or cardiac surgery.

METHODS: Participants were community-dwelling adults aged 65 years and older who self-reported cardiac catheterization or "heart surgery" at any biennial Health and Retirement Study interview between 2000 and 2014. Participants may have undergone the index procedure any time in the preceding 2 years. We modeled preprocedure to postprocedure change in composite memory score, derived from objective memory testing, using linear mixed effects models. We modeled postprocedure subjective memory decline with logistic regression. To quantify clinical relevance, we used the predicted memory change to estimate impact on ability to manage medications and finances independently.

RESULTS: Of 3,105 participants, 1,921 (62%) underwent catheterization and 1,184 (38%) underwent operation. In adjusted analyses, surgery participants had little difference in preprocedure to postprocedure memory change compared with participants undergoing cardiac catheterization (-0.021 memory units; 95% confidence interval: -0.046 to 0.005 memory units, p = 0.12). If the relationship were causal, the point estimate for memory decline would confer an absolute 0.26% or 0.19% decrease in ability to manage finances or medications, respectively, corresponding to 4.6 additional months of cognitive aging. Cardiac surgery was not associated with subjective memory decline (adjusted odds ratio 0.93, 95% confidence interval: 0.74 to 1.18).

CONCLUSIONS: In this large, population-based cohort, memory declines after heart surgery and cardiac catheterization were similar. These findings suggest intermediate-term population-level adverse cognitive effects of cardiac surgery, if any, are likely subtle.

VL - 107 IS - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/30578068?dopt=Abstract ER - TY - JOUR T1 - The Effects Video Gameplay on Memory and Need for Cognition in Adults and Older Adults JF - Proceedings of the Human Factors and Ergonomics Society Annual Meeting Y1 - 2019 A1 - Parker, Jason A. A1 - Barclay, Paul A. A1 - Sims, Valerie K. KW - Cognition KW - Memory KW - video games AB - The purpose of this study was to examine the effect of video gameplay and biological sex on memory and the Need for Cognition in adults and aging adults. A sample of adults who played video games were identified from the Health and Retirement Study (HRS). The final poststrata sample included 242 respondents in the 2012 HRS wave. Of these respondents, 121 indicated engagement with video games (videogamers), and 121 were a match sample of non-videogamers on age, sex, and HRS cohort. Results revealed no difference in memory or the Need for Cognition between adults who played video games and those who did not play video games. There was an effect of biological sex on general memory performance. Implications of the results are further discussed. VL - 63 SN - 2169-5067 UR - https://doi.org/10.1177/1071181319631482 IS - 1 N1 - doi: 10.1177/1071181319631482 JO - Proceedings of the Human Factors and Ergonomics Society Annual Meeting ER - TY - JOUR T1 - EVALUATING ITEM NONRESPONSE IN A LIFE HISTORY CALENDAR: AN ANALYSIS OF MEMORY EFFECTS JF - Innovation in Aging Y1 - 2019 A1 - Hu, Mengyao A1 - Melipillán, Roberto A1 - Zhang, Xinyu A1 - Jacqui Smith KW - Memory AB - Memory decline contributes to response inaccuracy and can produce item missing data, especially in retrospective surveys with older adults. Event history calendars, or the life grid approaches, are commonly used to obtain retrospective life history data. As indicated in previous literature, this approach can assist respondents’ memory retrieval. Despite its wide use, the important issue of item nonresponse due to memory effects in life grid questions has received little attention. Autobiographical memory (AM) research has shown that there are two interconnected long-term memory systems: episodic memories of event details from specific remote times in an individual’s life; and semantic memories of the important facts and themes that define an individual’s life history. Episodic and semantic AM may introduce different levels of difficulty in retrieving memory and thus contribute to different levels of missing data. This study examines the effects of both item-level predictors (e.g., types of memories) and respondent-level predictors (e.g., cognitive status, age, and health status) on the likelihood of item missing data in life grid questions. We analyzed missing data in the 2017 Health and Retirement Study (HRS) Life History Mail Survey (n = 3,844), using multilevel logistic regression. The results revealed higher rates of item missing for episodic memories, and that overall respondents’ cognitive status was significantly associated with their likelihood of providing item missing data. Recent residential information was better recalled than childhood information. These results have implications for life course analysis of exposures linked to residential histories. VL - 3 UR - https://doi.org/10.1093/geroni/igz038.3138 ER - TY - JOUR T1 - Inflammatory mechanisms underlying the effects of everyday discrimination on age-related memory decline. JF - Brain, Behavior & Immunity Y1 - 2019 A1 - Laura B Zahodne A1 - A Zarina Kraal A1 - Sharifian, Neika A1 - Afsara B. Zaheed A1 - Sol, Ketlyne KW - Ageism KW - C-reactive protein KW - Discrimination KW - Inflammation KW - Memory AB -

BACKGROUND/OBJECTIVES: Previous research suggests that everyday discrimination is associated with worse episodic memory and partially mediates Black-White disparities in memory aging. The biological mechanisms underlying the link between everyday discrimination and memory are unclear but may involve inflammatory processes. This study aimed to determine whether systemic inflammation, indexed by blood levels of C-reactive protein (CRP), mediates associations between everyday discrimination and episodic memory over 6 years.

DESIGN: A longitudinal mediation model quantified associations between baseline everyday discrimination, 4-year change in CRP, and 6-year change in episodic memory.

SETTING: The Health and Retirement Study (HRS).

PARTICIPANTS: 12,624 HRS participants aged 51 and older.

MEASUREMENTS: Everyday Discrimination Scale, high-sensitivity CRP assays of dried blood spots, composite scores of immediate and delayed recall of a word list.

RESULTS: Black participants reported greater everyday discrimination. Greater discrimination was associated with lower baseline memory and faster memory decline. Higher CRP at baseline partially mediated the negative association between discrimination and baseline memory, but CRP change did not mediate the association between discrimination and memory decline.

CONCLUSION: This U.S.-representative longitudinal study provides evidence for deleterious effects of discrimination on subsequent episodic memory. The fact that elevated CRP only partially explained the concurrent association between discrimination and memory highlights the need for more comprehensive investigations of biological mechanisms underlying the link between social stress and age-related memory decline in order to better characterize potential intervention targets to reduce racial inequalities in memory aging.

VL - 75 U1 - http://www.ncbi.nlm.nih.gov/pubmed/30367930?dopt=Abstract ER - TY - JOUR T1 - 'It is nothing more than a senior moment': The moderating role of subjective age in the effect of change in memory on self-rated memory. JF - Aging & Mental Health Y1 - 2019 A1 - Dikla Segel-Karpas A1 - Yuval Palgi KW - Memory KW - Self-reported health KW - Subjective age AB -

OBJECTIVE: The association between memory performance and self-rated memory is yet to be understood. More specifically, little is known about the factors that lie at the base of self-evaluations of memory in relation to actual changes in memory. In this study, we suggest that subjective age modifies the effect of objective change in memory on self-rated memory.

METHOD: We used two waves of the Health and Retirement Study (N = 4624) to examine whether subjective age moderates the effect of experienced changes in memory between T1 and T2 on self-rated memory at T2.

RESULTS: Our results suggest that subjective age is a significant moderator of the effect of change in memory on self-rated memory. The effect is weaker among those with younger subjective age, and stronger for those with older subjective age.

CONCLUSION: While preserving a young subjective age is usually considered an adaptive strategy, it also has potential negative effects, masking changes in memory performance.

VL - 23 IS - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/29125316?dopt=Abstract ER - TY - THES T1 - Linking Communicative Interaction to Cognitive Functioning: Implications for Older Adults T2 - Education and Psychology Y1 - 2019 A1 - Denise Calhoun KW - 0351:Gerontology KW - 0493:Aging KW - 0516:Adult education KW - Adult education KW - Aging KW - Cognition KW - Communication KW - Communicative interaction KW - Dementia KW - Gerontology KW - Memory KW - Neuroscience AB - As the percentage of older adults within the U.S. steadily increases, long-term care options are being impacted with growing numbers of seniors to provide for. The reality of these elevated numbers have sparked an interest in researchers to conduct studies on human development, plasticity in the brain, and training and intervention programs in search for ways to halt or lessen the cognitive and communicative decline, in older adults.As an alternative path to help older adults maintain quality of life, this study proposes to examine the link between communicative interaction and cognitive functioning to educate family members and healthcare providers on how communicative interactions and language influence cognition. Data (n = 3130) used in this study was retrieved from the University of Michigan’s Health and Retirement Study (HRS) 2014 for participants 65 years and older. Examination of the link between communicative interaction and cognition encompassed all factors of the learning process such as socio-emotional influences, environmental experiences, health and nutrition, and cognitive and physical development. Analysis of the study also included exploratory studies on social cognitive neuroscience and how brain training affects dementia.Findings in this study revealed that cognitive functioning declines with age, but rises with higher levels of education. Results also indicate that increased communicative interaction is significantly associated with improved cognitive functioning, when controlling for age, gender, and education. Considering other influential factors, determining the degree of association may require further investigation. JF - Education and Psychology PB - Pepperdine University VL - Doctor of Education in Organizational Leadership SN - 9781085631990 UR - https://search.proquest.com/docview/2284211091?pq-origsite=gscholar N1 - Copyright - Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works; Last updated - 2019-09-19 ER - TY - NEWS T1 - Low grip strength linked to impaired cognition, memory loss in older Americans T2 - Michigan News Y1 - 2019 A1 - Bailey, Laura KW - Cognition KW - Cognitive health KW - Grip strength KW - Memory AB - For older Americans, poor handgrip may be a sign of impaired cognition and memory, a new study suggests. Researchers from the University of Michigan and North Dakota State University followed nearly 14,000 participants from the 2006 Health and Retirement Study, age 50 and older, for eight years. They found that every 5-kg reduction in handgrip strength was associated with 10% greater odds for any cognitive impairment and 18% greater odds for severe cognitive impairment. They assessed handgrip with a hand-held dynamometer, and cognitive function with a modified Mini-Mental State Examination, a widely used test among the elderly that includes tests of orientation, attention, memory, language and visual-spatial skills. JF - Michigan News CY - Ann Arbor UR - https://news.umich.edu/low-grip-strength-linked-to-impaired-cognition-memory-loss-in-older-americans/ ER - TY - JOUR T1 - Psychosocial Pathways to Racial/Ethnic Inequalities in Late-Life Memory Trajectories. JF - Journals of Gerontology Series B: Psychological Sciences & Social Sciences Y1 - 2019 A1 - Laura B Zahodne A1 - Sol, Ketlyne A1 - A Zarina Kraal KW - Cognitive Ability KW - Inequality KW - Memory KW - Psychosocial KW - Racial/ethnic differences AB -

Objectives: Blacks and Hispanics are at increased risk for dementia, even after socioeconomic and vascular factors are taken into account. This study tests a comprehensive model of psychosocial pathways leading to differences in longitudinal cognitive outcomes among older blacks and Hispanics, compared to non-Hispanic whites.

Methods: Using data from 10,173 participants aged 65 and older in the Health and Retirement Study, structural equation models tested associations among race/ethnicity, perceived discrimination, depressive symptoms, external locus of control, and 6-year memory trajectories, controlling for age, sex, educational attainment, income, wealth, and chronic diseases.

Results: Greater perceived discrimination among blacks was associated with lower initial memory level via depressive symptoms and external locus of control, and with faster memory decline directly. Greater depressive symptoms and external locus of control among Hispanics were each independently associated with lower initial memory, but there were no pathways from Hispanic ethnicity to memory decline.

Discussion: Depression and external locus of control partially mediate racial/ethnic differences in memory trajectories. Perceived discrimination is a major driver of these psychosocial pathways for blacks, but not Hispanics. These results can inform the development of policies and interventions to reduce cognitive morbidity among racially/ethnically diverse older adults.

VL - 74 IS - 3 U1 - http://www.ncbi.nlm.nih.gov/pubmed/28958051?dopt=Abstract ER - TY - JOUR T1 - Rate of memory change before and after cancer diagnosis. JF - JAMA Network Open Y1 - 2019 A1 - Ospina-Romero, Monica A1 - Abdiwahab, Ekland A1 - Lindsay C Kobayashi A1 - Teresa Filshtein A1 - Willa D Brenowitz A1 - Elizabeth R Mayeda A1 - M. Maria Glymour KW - Alzheimer's disease KW - Cancer KW - Cognitive Ability KW - Memory AB -

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.

VL - 2 IS - 6 U1 - http://www.ncbi.nlm.nih.gov/pubmed/31225893?dopt=Abstract ER - TY - JOUR T1 - RETROSPECTIVE LIFE HISTORY SURVEY REVEALED AUTOBIOGRAPHICAL MEMORY BUMP JF - Innovation in Aging Y1 - 2019 A1 - Larkina, Marina A1 - Lindsey Meister A1 - Jacqui Smith KW - autobiographical memory bump KW - life history survey KW - Memory AB - The reminiscence bump is a well-documented autobiographical memory phenomenon characterized by middle-aged and older adults reporting a disproportionate number of memories from adolescence and early adulthood (Rubin, Wetzler, & Nebes, 1986). It is typically assessed through either cue word or important memory techniques. The Life History Mail Survey (LHMS) in the Health and Retirement Study affords unique data to investigate this phenomenon among a representative US sample of older adults. At the beginning of the LHMS, participants (N=3088, M age=70, range 50-107) completed a calendar noting the important things that happened to them in seven life decades, starting with ages 0-9 and ending by ages 70-79 (or their actual age). For each life period, we coded the number of events respondents reported. We observed significantly more memories reported for the age decade 20-29, compared with other life periods (80% vs 47-66%). Our results are consistent with previous findings in the autobiographical memory literature. Follow-up analyses evaluated existing theoretical accounts of the bump, such as cultural life script theory which suggests that life events occur in a specific order and are characterized by a prototypical life course. For example, we determined whether respondents’ sociodemographic characteristics, such as age cohort, gender, marital and educational histories (information available in LHMS) influenced the size and temporal location of the reminiscence bump. We also analyzed the content of reported important life events to investigate whether types of events included in each decade of life are consistent with the cultural life script account of the phenomenon. VL - 3 SN - 2399-5300 UR - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6841349/ IS - Suppl 1 JO - Innov Aging ER - TY - JOUR T1 - Retrospective memories of parental care and health from mid- to late life. JF - Health Psychology Y1 - 2019 A1 - William J. Chopik A1 - Robin S. Edelstein KW - Childhood KW - Cognitive Ability KW - Health Conditions and Status KW - Memory VL - 38 UR - http://doi.apa.org/getdoi.cfm?doi=10.1037/hea0000694http://psycnet.apa.org/psycarticles/2018-55763-001.pdf IS - 1 JO - Health Psychology ER - TY - JOUR T1 - Social relations and age-related change in memory. JF - Psychology and Aging Y1 - 2019 A1 - Laura B Zahodne A1 - Kristine J. Ajrouch A1 - Sharifian, Neika A1 - Toni C Antonucci KW - Cognitive Ability KW - Family Roles/Relationships KW - Memory KW - Social Support AB - Previous research suggests that social relations are associated with age-related memory change. However, social relations are complex and multidimensional, and it is not yet clear which aspects (structure, quality) may be beneficial over time. Further, the strength and direction of associations may differ depending on relationship type (partner, children, other family, friends). Using longitudinal data from the Health and Retirement Study (n = 10,390; Mage = 69, SD = 9.53 at baseline), latent growth curve models tested which aspects of social relations predicted 6-year episodic memory trajectories. Both structure and quality of social relations were associated with initial memory level, such that being married/partnered, reporting more frequent contact with children and friends, reporting less support from family members other than partners and children, and reporting less strain across relationship types were each independently associated with better initial memory. In contrast, only structure was associated with subsequent memory decline. Specifically, being married/partnered and reporting more frequent contact with friends were each independently associated with slower memory decline. No evidence of bidirectionality was found, as baseline memory did not predict subsequent changes in social relations. This longitudinal study helps to clarify which aspects of social relations are most likely to influence late-life episodic memory trajectories. Future intervention studies may focus on increasing social interactions with nonfamily members to minimize memory decline with age. (PsycINFO Database Record (c) 2019 APA, all rights reserved). VL - 34 IS - 6 ER - TY - JOUR T1 - Unique effects of perceived neighborhood physical disorder and social cohesion on episodic memory and semantic fluency. JF - Archives of Clinical Neuropsychology Y1 - 2019 A1 - Afsara B. Zaheed A1 - Sharifian, Neika A1 - A Zarina Kraal A1 - Sol, Ketlyne A1 - Hence, Alyssia A1 - Laura B Zahodne KW - Memory KW - Neighborhoods KW - Perception KW - Social Support AB -

Objective: Objective measures of neighborhood quality are associated with physical and mental health outcomes for older adults, but the relationship between perceived neighborhood quality and cognitive health has not been fully explored. Furthermore, positive and negative neighborhood characteristics may influence cognition through different mechanisms. The present study aimed to determine whether perceptions of neighborhood quality predict cognitive functioning in two domains, above and beyond individual-level risk factors, in a nationally representative sample of older adults.

Method: Using cross-sectional weighted data from 13,919 participants aged 51 and older from the Health and Retirement Study, linear regression models tested independent associations between perceived neighborhood quality (physical disorder and social cohesion) and cognition (episodic memory and semantic verbal fluency), controlling for sociodemographic characteristics, chronic disease burden, and depressive symptoms. Interaction terms tested whether neighborhood social cohesion moderated the relationship between neighborhood physical disorder and each cognitive outcome.

Results: Perception of greater neighborhood physical disorder was significantly associated with worse episodic memory, while perception of lower neighborhood social cohesion was significantly associated with worse semantic fluency. There were no significant interactions between physical disorder and social cohesion.

Conclusions: Results provide preliminary evidence for different mechanisms underlying associations between aspects of neighborhood quality and cognition (e.g., stress vs. social interaction). Additional intervention work is needed to determine whether improving neighborhood physical conditions and promoting social cohesion at the neighborhood level could reduce cognitive morbidity among older adults.

U1 - http://www.ncbi.nlm.nih.gov/pubmed/30715092?dopt=Abstract ER - TY - JOUR T1 - Wealth Management While Dealing with Memory Loss JF - Journal of Family and Economic Issues Y1 - 2019 A1 - Cheung, Cheuk Hee A1 - Tansel Yilmazer KW - Cognition & Reasoning KW - Dementia KW - Memory KW - Mortality AB - This study aims to understand the mechanisms through which severe memory problems could affect portfolio choice of older households. We focus on two potential mediators, cognitive ability and survival expectations, which are both expected to be adversely affected by memory disorders. Using data from the Health and Retirement Study, our findings show that cognitive ability and survival expectations are negatively associated with severe memory problems. Through the mediating role of cognitive ability, memory problems negatively affect the probability of holding risky assets, the amount of risky assets in the investment portfolios and financial wealth. Survival expectations, on the other hand, do not play a significant mediating role in portfolio allocation. In addition, the financial burden of severe memory problems does not seem to directly affect portfolio decisions. VL - 40 UR - https://link.springer.com/article/10.1007%2Fs10834-019-09610-w JO - J Fam Econ Iss ER - TY - NEWS T1 - Women who work for a salary see slower memory decline in old age, reducing their risk of dementia, a new study suggests T2 - The Washington Post Y1 - 2019 A1 - Natanson, Hannah KW - Cognitive Ability KW - Dementia KW - Memory KW - Women and Minorities JF - The Washington Post CY - Washington, DC UR - https://www.washingtonpost.com/local/social-issues/women-who-work-for-a-salary-see-slower-memory-decline-in-old-age-reducing-their-risk-of-dementia-a-new-study-suggests/2019/07/15/c1819880-a72a-11e9-9214-246e594de5d5_story.html?utm_term=.be88fc18ce2a ER - TY - JOUR T1 - Alzheimer's disease risk factors as mediators of subjective memory impairment and objective memory decline: protocol for a construct-level replication analysis. JF - BMC Geriatrics Y1 - 2018 A1 - Nikki L Hill A1 - Mogle, Jacqueline KW - Alzheimer's disease KW - Cognition & Reasoning KW - Memory KW - Self-reported health AB -

BACKGROUND: Subjective memory impairment (SMI), or the perception of memory problems in the absence of objective memory deficits, is associated with negative outcomes of individual and societal significance, including a substantially increased risk of Alzheimer's disease (AD). However, little is known regarding the mediators that link SMI and memory decline in some individuals, or which older adults with SMI are at greatest risk for memory decline. In this study, we will examine modifiable AD risk factors (specifically affective symptoms and activity participation) as mediators underlying linkages among SMI and memory decline over time; furthermore, we will characterize SMI subgroups at highest risk for memory decline via this pathway.

METHODS: This study utilizes a series of construct-level replication analyses across four large longitudinal datasets to maximize the unique aspects of each dataset as well as test the reproducibility of findings across multiple populations to establish generalizability. The current study's sample (n > 40,000) is drawn from the Einstein Aging Study, Health and Retirement Study, Minority Aging Research Study, and National Health and Aging Trends Study. Participants must meet the following basic criteria for inclusion: age 55 or older and no evidence of cognitive impairment at baseline. We will use multilevel modeling to determine whether higher levels of SMI are related to increased affective symptoms and decreased activity participation, as well as whether this relationship is moderated by neuroticism, family history of AD, and race/ethnicity. Finally, we will test our full conceptual model that examines whether changes in affective symptoms and activity participation mediate the relationship between SMI and objective memory decline. Specifically, we will test moderated mediation as we hypothesize these relationships to hold among subgroups of older adults.

DISCUSSION: Discovery of modifiable AD risk factors that mediate the association between SMI and memory decline (the earliest and most central deficit in AD) will provide explicit, and potentially novel, targets for intervention. Additionally, identifying individuals at highest risk for negative reactions to SMI will serve to enrich samples for future research as well as to help guide the development of SMI assessment tools to identify older adults at greatest risk for debilitating outcomes.

VL - 18 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/30373526?dopt=Abstract ER - TY - JOUR T1 - Demographic factors and retrieval of object and proper names after age 70 JF - PLOS ONE Y1 - 2018 A1 - Kavé, Gitit A1 - Fridkin, Shimon A1 - Liat Ayalon ED - Vigliecca, Nora Silvana KW - Cognitive Ability KW - Education KW - Memory AB - Purpose This research aimed to investigate whether demographic factors are similarly related to retrieval of object and proper names. Methods The sample included 5,907 individuals above age 70 who participated in the Health and Retirement Study between 2004 and 2012. Participants were asked to name two objects as well as the US President and Vice President. Latent growth curve models examined the associations of age, education, and self-rated health with baseline levels and change trajectories in retrieval. Results Age and education were more strongly related to retrieval of proper names than to retrieval of object names, both for baseline scores and for change trajectory. Similar effects of selfrated health emerged for both types of stimuli. Conclusions The results show that examining object names and proper names together as indication of cognitive status in the HRS might overlook important differences between the two types of stimuli, in both baseline performance and longitudinal change. VL - 13 IS - 1 JO - PLoS ONE ER - TY - JOUR T1 - The impact of changes in episodic memory surrounding retirement on subsequent risk of disability, cardiovascular disease, and mortality JF - Work, Aging and Retirement Y1 - 2018 A1 - Frank J Infurna A1 - Andel, Ross KW - Cardiovascular disease KW - Cognitive Ability KW - Disabilities KW - Memory KW - Mortality AB - Retirement is a key hallmark of life for many in modern society. The Baby Boom generation has resulted in increasing numbers of retirees. Given this trend, it is important to identify key factors that promote better health and longevity in the years following retirement. We used data from 4,266 participants of the Health and Retirement Study who retired over the course of the study to examine whether levels of episodic memory at retirement and rates of change before and after retirement would be associated with disability, cardiovascular disease, and mortality risk following retirement, above and beyond socio-demographics and known risk factors. Individuals who exhibited higher levels of episodic memory at the time of retirement and relative stability in episodic memory prior to and following retirement had a decreased likelihood for disability, cardiovascular disease incidence, and mortality following retirement. The effects of disability remained when controlling for socio-demographics and known risk factors, whereas the effects of level and change prior to retirement on cardiovascular disease incidence and mortality were no longer significant with the inclusion of known risk factors. Better episodic memory was consistently associated with lower risk of disability, cardiovascular disease, and mortality following retirement. Less decline or stability in episodic memory during the time prior to retirement was also associated with lower risk of disability and cardiovascular disease, but not with mortality risk, during the period after retirement. Our discussion focuses on the importance of maintaining episodic memory and possible mechanisms through which it affects health following retirement. VL - 4 UR - http://academic.oup.com/workar/article/doi/10.1093/workar/wax020/4085175/The-Impact-of-Changes-in-Episodic-Memoryhttp://academic.oup.com/workar/article-pdf/doi/10.1093/workar/wax020/19539531/wax020.pdf IS - 1 ER - TY - JOUR T1 - Mother's education and late-life disparities in memory and dementia risk among US military veterans and non-veterans. JF - Journal of Epidemiology and Community Health Y1 - 2018 A1 - Anusha M Vable A1 - Chloe W Eng A1 - Elizabeth R Mayeda A1 - Basu, Sanjay A1 - Jessica R Marden A1 - Hamad, Rita A1 - M. Maria Glymour KW - Cognitive Ability KW - Dementia KW - Education KW - Memory KW - Veterans AB -

BACKGROUND: Adverse childhood socioeconomic status (cSES) predicts higher late-life risk of memory loss and dementia. Veterans of U.S. wars are eligible for educational and economic benefits that may offset cSES disadvantage. We test whether cSES disparities in late-life memory and dementia are smaller among veterans than non-veterans.

METHODS: Data came from US-born men in the 1995-2014 biennial surveys of the Health and Retirement Study (n=7916 born 1928-1956, contributing n=38 381 cognitive assessments). Childhood SES was represented by maternal education. Memory and dementia risk were assessed with brief neuropsychological assessments and proxy reports. Military service (veteran/non-veteran) was evaluated as a modifier of the effect of maternal education on memory and dementia risk. We employed linear or logistic regression models to test whether military service modified the effect of maternal education on memory or dementia risk, adjusted for age, race, birthplace and childhood health.

RESULTS: Low maternal education was associated with worse memory than high maternal education (β = -0.07 SD, 95% CI -0.08 to -0.05), while veterans had better memory than non-veterans (β = 0.03 SD, 95% CI 0.02 to 0.04). In interaction analyses, maternal education disparities in memory were smaller among veterans than non-veterans (difference in disparities = 0.04 SD, 95% CI 0.01 to 0.08, p = 0.006). Patterns were similar for dementia risk.

CONCLUSIONS: Disparities in memory by maternal education were smaller among veterans than non-veterans, suggesting military service and benefits partially offset the deleterious effects of low maternal education on late-life cognitive outcomes.

VL - 72 IS - 12 U1 - http://www.ncbi.nlm.nih.gov/pubmed/30082424?dopt=Abstract ER - TY - JOUR T1 - Recent cancer treatment and memory decline in older adults: An analysis of the 2002–2012 Health and Retirement Study JF - Journal of Geriatric Oncology Y1 - 2018 A1 - Krystle E Zuniga A1 - Nicholas J Bishop KW - Cancer screenings KW - Cognitive Ability KW - Memory AB - Objective: Few studies have examined the impact of cancer treatment on cognitive trajectories in the growing population of older adults diagnosed with and surviving cancer. This study examined whether recent cancer and its treatment accelerated memory decline in older adults.: Materials and Methods: We conducted a secondary analysis of observations drawn from the Health and Retirement Study (2002-2012), a population-based sample of older adults in the United States. Changes in immediate (IWR) and delayed word recall (DWR) scores were estimated by latent growth modeling in individuals who never had cancer (n = 10,939) or had been diagnosed with cancer between 2000 and 2002 and received treatment with some combination of radiation and/or surgery (n = 240), chemotherapy only (n = 34), or chemotherapy and some combination of radiation and/or surgery (n = 64).: Results: In the period immediately following treatment, individuals reporting a recent cancer treated with chemotherapy and surgery/radiation experienced significantly more rapid decline in IWR (b = -0.34, SE = 0.17, p = 0.047) and DWR (b = -0.38, SE = 0.19, p = 0.049) than the non-cancer group. Sensitivity analyses addressing mortality selection and memory-related disease at baseline attenuated the strength of these associations. There were no other statistically significant differences in estimated linear or quadratic slope by cancer status or treatment.: Conclusion: Our results support a potential association between recent cancer treatment and trajectories of memory decline in older adults and provide guidance on the interpretation of statistical estimates from panel studies of health and aging. VL - 9 UR - http://linkinghub.elsevier.com/retrieve/pii/S1879406817302291http://api.elsevier.com/content/article/PII:S1879406817302291?httpAccept=text/xmlhttp://api.elsevier.com/content/article/PII:S1879406817302291?httpAccept=text/plain IS - 3 JO - Journal of Geriatric Oncology ER - TY - JOUR T1 - Is subjective memory change in old age based on accurate monitoring of age-related memory change? Evidence from two longitudinal studies. JF - Psychology and Aging Y1 - 2018 A1 - Hertzog, Christopher A1 - Hülür, Gizem A1 - Denis Gerstorf A1 - Ann Pearman KW - Memory KW - Self Report KW - Subjective Expectations AB - Subjective memory change (SMC) in adulthood involves the perception that one's memory has declined from earlier levels of function. SMC has been conjectured to be more accurate than concurrent subjective memory because people use themselves as a standard of comparison. We used data from two longitudinal studies to contrast the accurate-monitoring-of-change hypothesis-actual memory change predicts SMC-against a constructed-judgment hypothesis that rated SMC is a function of rescaling concurrent memory beliefs without accessing actual memory change. It states that actual memory change has no predictive validity for SMC independent of concurrent memory beliefs. Data from both the Berlin Aging Study and the Health and Retirement Study (HRS) showed that older adults' current memory complaints strongly predicted current SMC, and that there was little relationship of longitudinally measured memory change to SMC, controlling on memory complaints. In the HRS there were reliable latent-growth-curve slope correlations of over .20 for change in episodic memory with both slopes of change in SMC and in memory complaints, yet little relationship of SMC slopes to episodic memory slopes, controlling on memory-complaint slopes. The results falsify the accurate-monitoring-of-change hypothesis regarding the origins of SMC in older adults. VL - 33 UR - http://doi.apa.org/getdoi.cfm?doi=10.1037/pag0000232http://psycnet.apa.org/journals/pag/33/2/273.pdf IS - 2 JO - Psychology and Aging ER - TY - JOUR T1 - Subjective memory problems and availability of emotional support JF - Research on Aging Y1 - 2018 A1 - Jung-Hwa Ha A1 - Pai, Manacy KW - Cognition & Reasoning KW - Depressive symptoms KW - Memory KW - Social Support AB - This study examines (1) whether subjective memory problems (SMP) influence perceived emotional support from and frequency of contact with family and friends; and, (2) the extent to which this relationship is moderated by gender, education, and functional limitations. We use the 2014 wave of the Health and Retirement Study, a nationally representative panel survey of adults aged 51 and over in the United States. While SMP does not affect perceived emotional support for younger group (YG; aged 51-64), in older group (OG; aged 65+), SMP is associated with reduced perceived support from friends. Also, SMP is predictive of fewer writing-based contact with children and friends among OG but not among YG. Lastly, we find that the effect of SMP on support from children is contingent upon activity of daily living (YG) and gender (OG), while the effect of SMP on writing-based contact with both children and friends is contingent upon education (YG only). VL - 40 IS - 10 JO - Res Aging ER - TY - JOUR T1 - Subjective Social Status Predicts Late-Life Memory Trajectories through Both Mental and Physical Health Pathways JF - Gerontology Y1 - 2018 A1 - Laura B Zahodne A1 - A Zarina Kraal A1 - Afsara B. Zaheed A1 - Sol, Ketlyne KW - Cognitive Ability KW - Depressive symptoms KW - Health Conditions and Status KW - Late-life Health KW - Memory AB - Background: Subjective social status (SSS) is associated with mental and physical health, independent of objective socioeconomic status (SES), but its association with late-life cognitive decline is unknown. Objective: This study characterizes the association between SSS and late-life memory trajectories in a large, nationally representative sample of older adults in the United States. Methods: Using data from 8,530 participants aged 65 years and older in the Health and Retirement Study, structural equation models tested associations between SSS, objective SES (i.e., educational attainment, occupation, income, and wealth), physical and mental health, and 6-year memory trajectories, controlling for sociodemographic characteristics. Results: Independent of objective SES, lower SSS was associated with worse initial memory but not subsequent memory decline. The association between SSS and initial memory was separately mediated by chronic diseases, stroke, and depressive symptoms. Conclusion: Results provide preliminary behavioral evidence for the deleterious effects of social stress on cognitive aging. These results may help inform the development of policies and interventions to reduce cognitive morbidity among older adults who perceive a low position on the social hierarchy. VL - 64 UR - https://www.karger.com/Article/FullText/487304https://www.karger.com/Article/Pdf/487304https://www.karger.com/Article/Pdf/487304 JO - Gerontology ER - TY - JOUR T1 - Association between persistent pain and memory decline and dementia in a longitudinal cohort of elders JF - JAMA Internal Medicine Y1 - 2017 A1 - Elizabeth L Whitlock A1 - L Grisell Diaz-Ramirez A1 - M. Maria Glymour A1 - W John Boscardin A1 - Kenneth E Covinsky KW - Chronic pain KW - Cognitive Ability KW - Memory AB - Importance: Chronic pain is common among the elderly and is associated with cognitive deficits in cross-sectional studies; the population-level association between chronic pain and longitudinal cognition is unknown. Objective: To determine the population-level association between persistent pain, which may reflect chronic pain, and subsequent cognitive decline. Design, Setting, and Participants: Cohort study with biennial interviews of 10 065 community-dwelling older adults in the nationally representative Health and Retirement Study who were 62 years or older in 2000 and answered pain and cognition questions in both 1998 and 2000. Data analysis was conducted between June 24 and October 31, 2016. Exposures: “Persistent pain,” defined as a participant reporting that he or she was often troubled with moderate or severe pain in both the 1998 and 2000 interviews. Main Outcomes and Measures: Coprimary outcomes were composite memory score and dementia probability, estimated by combining neuropsychological test results and informant and proxy interviews, which were tracked from 2000 through 2012. Linear mixed-effects models, with random slope and intercept for each participant, were used to estimate the association of persistent pain with slope of the subsequent cognitive trajectory, adjusting for demographic characteristics and comorbidities measures in 2000 and applying sampling weights to represent the 2000 US population. We hypothesized that persistent pain would predict accelerated memory decline and increased probability of dementia. To quantify the impact of persistent pain on functional independence, we combined our primary results with information on the association between memory and ability to manage medications and finances independently. Results: Of the 10,065 eligible HRS sample members, 60% were female, and median baseline age was 73 years (interquartile range, 67-78 years). At baseline, persistent pain affected 10.9% of participants and was associated with worse depressive symptoms and more limitations in activities of daily living. After covariate adjustment, persistent pain was associated with 9.2% (95% CI, 2.8%-15.0%) more rapid memory decline compared with those without persistent pain. After 10 years, this accelerated memory decline implied a 15.9% higher relative risk of inability to manage medications and an 11.8% higher relative risk of inability to manage finances independently. Adjusted dementia probability increased 7.7% faster (95% CI, 0.55%-14.2%); after 10 years, this translates to an absolute 2.2% increase in dementia probability for those with persistent pain. Conclusions and Relevance: Persistent pain was associated with accelerated memory decline and increased probability of dementia. VL - 177 UR - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2629448 IS - 8 ER - TY - JOUR T1 - Contribution of socioeconomic status at three lifecourse periods to late life memory function and decline: Early and late predictors of dementia risk. JF - American Journal of Epidemiology Y1 - 2017 A1 - Jessica R Marden A1 - Eric J. Tchetgen Tchetgen A1 - Ichiro Kawachi A1 - M. Maria Glymour KW - Cognitive Ability KW - Dementia KW - Memory KW - Risk Factors KW - Socioeconomic factors AB - Both early life and adult socioeconomic status (SES) predict late life level of memory; however, evidence is mixed on the relationship between SES and rate of memory decline. Further, the relative importance of different lifecourse periods for rate of late life memory decline has not been evaluated. We examined associations between lifecourse SES and late life memory function and decline. Health and Retirement Study participants (n = 10,781) were interviewed biennially from 1998-2012. SES measures for childhood (composite score including parents' educational attainment), early adulthood (high school or college completion), and older adulthood (income, mean age 66) were all dichotomized. Word list memory (non-responders retained via proxy assessments) was modeled via inverse probability weighted longitudinal models accounting for differential attrition, survival, and time-varying confounding. Compared to low SES at all three points (reference), stable high SES predicted the best memory function and slowest decline. High school completion had the largest estimated effect on memory (β = 0.19; 95% Confidence Interval = 0.15, 0.22), but high late life income had the largest estimated benefit for slowing declines (β for 10 year memory change = 0.35; 95% Confidence Interval = 0.24, 0.46). Both early and late life interventions are potentially relevant for reducing dementia risk by improving memory function or slowing decline. VL - 186 IS - 7 U1 - http://www.ncbi.nlm.nih.gov/pubmed/28541410?dopt=Abstract ER - TY - JOUR T1 - Functional Impairment and Decline in Middle Age: A Cohort Study. JF - Annals of Internal Medicine Y1 - 2017 A1 - Rebecca T Brown A1 - L Grisell Diaz-Ramirez A1 - W John Boscardin A1 - Sei J. Lee A1 - Michael A Steinman KW - Activities of Daily Living KW - Functional limitations KW - Memory KW - Older Adults AB -

Background: Difficulties with daily functioning are common in middle-aged adults. However, little is known about the epidemiology or clinical course of these problems, including the extent to which they share common features with functional impairment in older adults.

Objective: To determine the epidemiology and clinical course of functional impairment and decline in middle age.

Design: Cohort study.

Setting: The Health and Retirement Study.

Participants: 6874 community-dwelling adults aged 50 to 56 years who did not have functional impairment at enrollment.

Measurements: Impairment in activities of daily living (ADLs), defined as self-reported difficulty performing 1 or more ADLs, assessed every 2 years for a maximum follow-up of 20 years, and impairment in instrumental ADLs (IADLs), defined similarly. Data were analyzed by using multistate models that estimate probabilities of different outcomes.

Results: Impairment in ADLs developed in 22% of participants aged 50 to 64 years, in whom further functional transitions were common. Two years after the initial impairment, 4% (95% CI, 3% to 5%) of participants had died, 9% (CI, 8% to 11%) had further ADL decline, 50% (CI, 48% to 52%) had persistent impairment, and 37% (CI, 35% to 39%) had recovered independence. In the 10 years after the initial impairment, 16% (CI, 14% to 18%) had 1 or more episodes of functional decline and 28% (CI, 26% to 30%) recovered from their initial impairment and remained independent throughout this period. The pattern of findings was similar for IADLs.

Limitation: Functional status was self-reported.

Conclusion: Functional impairment and decline are common in middle age, as are transitions from impairment to independence and back again. Because functional decline in older adults has similar features, current interventions used for prevention in older adults may hold promise for those in middle age.

Primary Funding Source: National Institute on Aging and National Center for Advancing Translational Sciences through the University of California, San Francisco, Clinical and Translational Sciences Institute.

VL - 167 IS - 11 U1 - http://www.ncbi.nlm.nih.gov/pubmed/29132150?dopt=Abstract ER - TY - JOUR T1 - Genetic variants specific to aging-related verbal memory: Insights from GWASs in a population-based cohort. JF - PLoS One Y1 - 2017 A1 - Thalida E. Arpawong A1 - Pendleton, Neil A1 - Mekli, Krisztina A1 - John J McArdle A1 - Margaret Gatz A1 - Armoskus, Chris A1 - James A Knowles A1 - Carol A Prescott KW - Cognitive Ability KW - Genetics KW - GWAS KW - Memory AB - Verbal memory is typically studied using immediate recall (IR) and delayed recall (DR) scores, although DR is dependent on IR capability. Separating these components may be useful for deciphering the genetic variation in age-related memory abilities. This study was conducted to (a) construct individual trajectories in IR and independent aspects of delayed recall, or residualized-DR (rDR), across older adulthood; and (b) identify genetic markers that contribute to four estimated phenotypes: IR and rDR levels and changes after age 60. A cognitively intact sample (N = 20,650 with 125,164 observations) was drawn from the U.S. Health and Retirement Study, a nationally representative study of adults aged 50 and older. Mixed effects regression models were constructed using repeated measures from data collected every two years (1996-2012) to estimate level at age 60 and change in memory post-60 in IR and rDR. Genome-wide association scans (GWAS) were conducted in the genotypic subsample (N = 7,486) using ~1.2 million single nucleotide polymorphisms (SNPs). One SNP (rs2075650) in TOMM40 associated with rDR level at the genome-wide level (p = 5.0x10-08), an effect that replicated in an independent sample from the English Longitudinal Study on Ageing (N = 6,898 with 41,328 observations). Meta-analysis of rDR level confirmed the association (p = 5.0x10-11) and identified two others in TOMM40 (rs71352238 p = 1.0x10-10; rs157582 p = 7.0x10-09), and one in APOE (rs769449 p = 3.1 x10-12). Meta-analysis of IR change identified associations with three of the same SNPs in TOMM40 (rs157582 p = 8.3x10-10; rs71352238 p = 1.9x10-09) and APOE (rs769449 p = 2.2x10-08). Conditional analyses indicate GWAS signals on rDR level were driven by APOE, whereas signals on IR change were driven by TOMM40. Additionally, we found that TOMM40 had effects independent of APOE e4 on both phenotypes. Findings from this first U.S. population-based GWAS study conducted on both age-related immediate and delayed verbal memory merit continued examination in other samples and additional measures of verbal memory. VL - 12 IS - 8 U1 - http://www.ncbi.nlm.nih.gov/pubmed/28800603?dopt=Abstract ER - TY - JOUR T1 - High Hemoglobin A1c and Diabetes Predict Memory Decline in the Health and Retirement Study. JF - Alzheimer Disease and Associated Disorders Y1 - 2017 A1 - Jessica R Marden A1 - Elizabeth R Mayeda A1 - Eric J. Tchetgen Tchetgen A1 - Ichiro Kawachi A1 - M. Maria Glymour KW - Cognitive Ability KW - Diabetes KW - Memory KW - Older Adults AB -

BACKGROUND: Type 2 diabetes (T2D) is an established risk factor for dementia, but evidence for T2D and memory decline is less consistent. Understanding how T2D and blood glucose relate to memory decline is crucial to elucidating the mechanisms linking T2D and dementia.

MATERIALS AND METHODS: For 8888 Health and Retirement Study participants aged 50+, glycosylated hemoglobin (HbA1c) was measured in either 2006 or 2008 and physician's diagnosis of diabetes was self-reported in the same year. Composite memory (z scored) was assessed biennially through 2012 using immediate and delayed word list recall or the Informant Questionnaire for Cognitive Decline. Marginal mean regression models for repeated outcomes were specified to predict memory decline as a function of diabetes or HbA1c, using age as the timescale and adjusting for health and social confounders.

RESULTS: Diabetes was associated with a 10% faster rate of memory decline [β=-0.04 per decade; 95% confidence interval (CI), -0.06 to -0.01). A 1 U increase in HbA1c corresponded with a 0.05 SD decrease in memory score per decade (95% CI, -0.08 to -0.03). Even among individuals with HbA1c<6.5% (threshold for diabetes), higher HbA1c was associated with memory decline (β=-0.05 per decade; 95% CI, -0.08 to -0.03).

DISCUSSION: Diabetes accelerated memory loss and higher HbA1c predicted memory decline even in nondiabetics.

VL - 31 IS - 1 ER - TY - JOUR T1 - Is Memory Decline Associated With Inflammatory Response? JF - Journal of Aging and Health Y1 - 2017 A1 - Amber M Tetlow A1 - Andel, Ross A1 - Frank J Infurna KW - Biomarkers KW - Cognitive Ability KW - Inflammation KW - Memory AB -

OBJECTIVE: To examine whether changes in memory over a 10-year period could predict a change in C-reactive protein (CRP) levels.

METHOD: A mixed model analysis was first conducted to obtain the estimates for change in memory over the 10-year period using data from the Health and Retirement Study. Then a multivariate regression to determine whether a change in episodic memory could predict subsequent CRP levels was conducted. Furthermore, a general linear model was conducted to determine differences in CRP levels among different rates of change in episodic memory.

RESULTS: Greater declines in episodic memory were associated with higher levels of subsequent CRP (Estimate = -0.32, SE = 0.12, β = -.03, p = .008). The general linear model revealed that those with greater memory declines were more likely to have higher levels of CRP, F = 26.50, p < .001.

DISCUSSION: These results highlight the notion that memory decline and inflammation may be intertwined, and we discuss various avenues that warrant further investigation.

U1 - http://www.ncbi.nlm.nih.gov/pubmed/29254429?dopt=Abstract ER - TY - JOUR T1 - Mental retirement and health selection: Analyses from the U.S. Health and Retirement Study. JF - Social Science & Medicine Y1 - 2017 A1 - Sean A. P. Clouston A1 - Denier, Nicole KW - Cognitive Ability KW - Memory KW - Older Adults KW - Retirement Planning and Satisfaction AB -

BACKGROUND: Research has recently suggested that retirement may decrease cognitive engagement, resulting in cognitive aging. Few studies have systematically documented whether or how selectivity into retirement shapes the relationship between retirement and cognitive aging.

METHODS: We draw on data from the Health and Retirement Study (1998-2012) to examine the relationship between cognition and retirement for 18,575 labor force participants. Longitudinal regression discontinuity modeling was used to examine performance and decline in episodic memory. Models differentiated three forms of selection bias: indirect and direct selection as well as reverse causation. To further interrogate the disuse hypothesis, we adjust for confounding from health and socioeconomic sources.

RESULTS: Results revealed that individuals who retired over the course of the panel were substantially different in terms of health, wealth and cognition when compared to those who remained employed. However, accounting for observed selection biases, significant associations were found linking longer retirement with more rapid cognitive decline.

DISCUSSION: This study examined respondents who were in the labor force at baseline and transitioned into retirement. Analyses suggested that those who retired over the course of the panel had worse overall functioning, but also experienced more rapid declines after retirement that increased the rate of aging by two-fold, resulting in yearly losses of 3.7% (95% CI = [3.5, 4.0]) of one standard deviation in functioning attributable to retirement. Results are supportive of the view that retirement is associated with more rapid cognitive aging.

VL - 178 ER - TY - THES T1 - Perceived Threat of Alzheimer's Disease and Help-seeking Behavior in Older Adults with Memory Complaints T2 - Health Behavior and Health Education Y1 - 2017 A1 - Jenny E Ostergren KW - Alzheimer's disease KW - Cognitive Ability KW - Memory AB - Alzheimer’s disease (AD) is a chronic disorder with a high burden of suffering for affected individuals, their caregivers, families, and communities. An increased emphasis on early AD detection may benefit affected individuals and their caregivers, especially where disparities already exist in health care and outcomes, but may also unnecessarily heighten perceived AD threat among healthy older adults. Relatively few studies have examined predictors of perceived AD threat and help-seeking behavior among a large and diverse sample that is broadly representative of the U.S. adult population. Informed by health behavior theory, my dissertation 1) identifies factors that influence formal help-seeking for memory complaints through a systematic review of the literature, 2) examines psychosocial and cognitive predictors of perceived AD threat, an understudied construct related to help-seeking, among a nationally representative sample of U.S. adults from the Health and Retirement Study, and 3) explores demographic, health care access, and health status predictors of help-seeking among older adults with memory complaints using Behavioral Risk Factor Surveillance System data. Findings from the systematic review suggest that individual, interpersonal, and structural/policy level factors each play a key role in help-seeking. Multivariate analyses of perceived AD threat revealed that perceived threat was significantly higher for respondents aged 50-64 and 65-74 than for those over 75. Higher perceived threat was also associated with a family history of AD (compared to no experience), stronger beliefs that stress or genetics are important AD risk factors, more depressive symptoms, poorer self-rated memory, and lower cognitive function. Respondents with lower education levels were significantly less likely to seek help. Those who reported more memory-related functional difficulty, more frequent days of poor mental health, and having a primary care provider, were more likely to seek help. These findings highlight the need for education and community outreach to raise awareness about early dementia symptoms, provide specific factors that health care providers should consider in clinical encounters, and highlight the need for careful initial cognitive screening of individuals with memory complaints. These findings also provide insight about the help-seeking process, and a starting point for interventions aimed at increasing timely AD diagnosis and treatment. JF - Health Behavior and Health Education PB - University of Michigan CY - Ann Arbor, MI VL - Doctor of Philosophy UR - https://deepblue.lib.umich.edu/handle/2027.42/136998 ER - TY - JOUR T1 - A cross-lagged model of the reciprocal associations of loneliness and memory functioning. JF - Psychol Aging Y1 - 2016 A1 - Liat Ayalon A1 - Sharon Shiovitz-Ezra A1 - Roziner, Ilan KW - Aged KW - Aging KW - depression KW - Female KW - Humans KW - Loneliness KW - Male KW - Memory KW - Models, Psychological KW - Social Behavior KW - Spouses KW - Surveys and Questionnaires KW - Time Factors AB -

The study was designed to evaluate the reciprocal associations of loneliness and memory functioning using a cross-lagged model. The study was based on the psychosocial questionnaire of the Health and Retirement Study, which is a U.S. nationally representative survey of individuals over the age of 50 and their spouses of any age. A total of 1,225 respondents had complete data on the loneliness measure in 2004 and at least in 1 of the subsequent waves (e.g., 2008, 2012) and were maintained for analysis. A cross-lagged model was estimated to examine the reciprocal associations of loneliness and memory functioning, controlling for age, gender, education, depressive symptoms, number of medical conditions, and the number of close social relationships. The model had adequate fit indices: χ2(860, N = 1,225) = 1,401.54, p < .001, Tucker-Lewis index = .957, comparative fit index = .963, and root mean square error of approximation = .023 (90% confidence interval [.021, .025]). The lagged effect of loneliness on memory functioning was nonsignificant, B(SE) = -.11(.08), p = .15, whereas the lagged effect of memory functioning on loneliness was significant, B(SE) = -.06(.02), p = .01, indicating that lower levels of memory functioning precede higher levels of loneliness 4 years afterward. Further research is required to better understand the mechanisms responsible for the temporal association between reduced memory functioning and increased loneliness. (PsycINFO Database Record

PB - 31 VL - 31 UR - http://psycnet.apa.org/journals/pag/31/3/255/ IS - 3 U1 - http://www.ncbi.nlm.nih.gov/pubmed/26974589?dopt=Abstract ER - TY - JOUR T1 - Older adults with poor self-rated memory have less depressive symptoms and better memory performance when perceived self-efficacy is high. JF - Int J Geriatr Psychiatry Y1 - 2016 A1 - O'Shea, Deirdre M A1 - Vonetta M Dotson A1 - Fieo, Robert A A1 - Tsapanou, Angeliki A1 - Laura B Zahodne A1 - Stern, Yaakov KW - Aged KW - Aged, 80 and over KW - depression KW - Female KW - Humans KW - Male KW - Memory KW - Middle Aged KW - Regression Analysis KW - Self Efficacy KW - Surveys and Questionnaires AB -

OBJECTIVE: To investigate whether self-efficacy moderates the association between self-rated memory and depressive symptoms in a large sample of older adults. The influence of self-efficacy and depressive symptoms on memory performance was also examined in a subsample of individuals who reported poor memory.

METHODS: Non-demented participants (n = 3766) were selected from the 2012 wave of the Health and Retirement Study. Depressive symptomatology was assessed with the 8-item Center for Epidemiologic Studies Depression Scale. A modified version of the Midlife Developmental Inventory Questionnaire was used as the measure of self-efficacy. Participants were asked to rate their memory presently on a five-point scale from Excellent (1) to Poor (5). Immediate memory and delayed memory (after a 5-min interval) were measured by the number of correct words recalled from a 10-item word list.

RESULTS: Multiple regression analyses revealed that negative ratings of memory were significantly associated with greater levels of depressive symptoms, with this effect being greatest in those with low levels of self-efficacy. Additionally, greater self-efficacy was associated with optimal objective memory performances but only when depressive symptoms were low in individuals who reported poor memory function (n = 1196).

CONCLUSION: Self-efficacy moderates the relationship between self-rated memory function and depressive symptoms. Higher self-efficacy may buffer against the impact of subjective memory difficulty on one's mood and thereby mitigating the effect of depressive symptoms on memory. Interventions should focus on increasing perceived self-efficacy in older adults reporting poor memory function to potentially minimize memory impairment.

VL - 31 UR - http://www.ncbi.nlm.nih.gov/pubmed/26679474 IS - 7 U1 - http://www.ncbi.nlm.nih.gov/pubmed/26679474?dopt=Abstract U4 - Depression Depressive symptoms Self-rated memory Memory Self-efficacy ER - TY - THES T1 - Three studies of the associations of cognitive ability, health, and wealth among the elderly T2 - School of Family Studies and Human Services Y1 - 2016 A1 - Fernatt, Frederick Ray KW - Cognitive Ability KW - Memory KW - Older Adults AB - This dissertation consists of three studies exploring the relationship between cognitive abilities, health, and wealth related variables among the elderly. For all three studies, the life cycle hypotheses provided the basis of the theoretical framework and utilized data from the 2000 through 2010 panels of the Health and Retirement Study (HRS). The first study compared the cognitive abilities of non-married households with the cognitive abilities of married households in order to examine the effect of marital status on household wealth. The second study examines the relationship of two aspects of cognitive ability (fluid intelligence and crystallized intelligence) and wealth for couples married to the same spouse for all HRS panels for 2000 to 2010. The third study examines the relationship of cognitive ability, emotional health, physical health, and wealth for couples married to the same spouse for all HRS panels for 2000 to 2010. Results identified significant associations among marital status, cognitive abilities, and health with wealth. These findings contribute to the field of financial planning by providing useful information about how marital status, cognitive functioning, and health affect the household wealth of the elderly. Financial service practitioners, regulators, researchers, and caregivers can apply these findings to develop approaches to assist the elderly manage their household wealth. Advisors/Committee Members: Maurice M. MacDonald. JF - School of Family Studies and Human Services PB - Kansas State University CY - Manhattan, Kansas VL - Ph.D. UR - http://hdl.handle.net/2097/34484 ER - TY - JOUR T1 - FASTKD2 is associated with memory and hippocampal structure in older adults. JF - Mol Psychiatry Y1 - 2015 A1 - Vijay K Ramanan A1 - Nho, Kwangsik A1 - Shen, Li A1 - Shannon L Risacher A1 - Brenna C McDonald A1 - Martin R Farlow A1 - Tatiana Foroud A1 - Gao, Sujuan A1 - Soininen, Hilkka A1 - Kloszewska, Iwona A1 - Mecocci, Patrizia A1 - Tsolaki, Magda A1 - Vellas, Bruno A1 - Lovestone, Simon A1 - Aisen, Paul S. A1 - Ronald C Petersen A1 - Jack, Clifford R. A1 - Shaw, Leslie M. A1 - Trojanowski, John Q. A1 - Weiner, Michael W. A1 - Green, Robert C. A1 - Arthur W. Toga A1 - Philip L de Jager A1 - Lei Yu A1 - David A Bennett A1 - Andrew J Saykin KW - Age Factors KW - Aged KW - Aged, 80 and over KW - Alzheimer disease KW - Female KW - Genetic Association Studies KW - Genome-Wide Association Study KW - Hippocampus KW - Humans KW - Longitudinal Studies KW - Male KW - Memory KW - Memory Disorders KW - Polymorphism, Single Nucleotide KW - Protein-Serine-Threonine Kinases KW - Structure-Activity Relationship AB -

Memory impairment is the cardinal early feature of Alzheimer's disease, a highly prevalent disorder whose causes remain only partially understood. To identify novel genetic predictors, we used an integrative genomics approach to perform the largest study to date of human memory (n=14 781). Using a genome-wide screen, we discovered a novel association of a polymorphism in the pro-apoptotic gene FASTKD2 (fas-activated serine/threonine kinase domains 2; rs7594645-G) with better memory performance and replicated this finding in independent samples. Consistent with a neuroprotective effect, rs7594645-G carriers exhibited increased hippocampal volume and gray matter density and decreased cerebrospinal fluid levels of apoptotic mediators. The MTOR (mechanistic target of rapamycin) gene and pathways related to endocytosis, cholinergic neurotransmission, epidermal growth factor receptor signaling and immune regulation, among others, also displayed association with memory. These findings nominate FASTKD2 as a target for modulating neurodegeneration and suggest potential mechanisms for therapies to combat memory loss in normal cognitive aging and dementia.

PB - 20 VL - 20 IS - 10 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25385369?dopt=Abstract U2 - PMC4427556 U4 - Genetic analysis/Alzheimer disease/Memory impairment/predictors/FASTKD2 ER - TY - JOUR T1 - Common genetic variants associated with cognitive performance identified using the proxy-phenotype method. JF - Proc Natl Acad Sci U S A Y1 - 2014 A1 - Cornelius A Rietveld A1 - Tõnu Esko A1 - Gail Davies A1 - Pers, Tune H A1 - Turley, Patrick A1 - Benyamin, Beben A1 - Chabris, Christopher F A1 - Emilsson, Valur A1 - Andrew D Johnson A1 - Lee, James J A1 - Christiaan de Leeuw A1 - Riccardo E Marioni A1 - Sarah E Medland A1 - Michael B Miller A1 - Rostapshova, Olga A1 - Sven J van der Lee A1 - Anna A E Vinkhuyzen A1 - Amin, Najaf A1 - Dalton C Conley A1 - Derringer, Jaime A1 - Cornelia M van Duijn A1 - Fehrmann, Rudolf A1 - Lude L Franke A1 - Edward L Glaeser A1 - Narelle K Hansell A1 - Caroline Hayward A1 - Iacono, William G A1 - Carla A Ibrahim-Verbaas A1 - Vincent Jaddoe A1 - Karjalainen, Juha A1 - David I Laibson A1 - Paul Lichtenstein A1 - David C Liewald A1 - Patrik K E Magnusson A1 - Nicholas G Martin A1 - McGue, Matt A1 - McMahon, George A1 - Nancy L Pedersen A1 - Pinker, Steven A1 - David J Porteous A1 - Posthuma, Danielle A1 - Fernando Rivadeneira A1 - Smith, Blair H A1 - John M Starr A1 - Henning Tiemeier A1 - Nicholas J Timpson A1 - Trzaskowski, Maciej A1 - André G Uitterlinden A1 - Verhulst, Frank C A1 - Mary E Ward A1 - Margaret J Wright A1 - George Davey Smith A1 - Ian J Deary A1 - Johannesson, Magnus A1 - Plomin, Robert A1 - Peter M Visscher A1 - Daniel J. Benjamin A1 - Cesarini, David A1 - Philipp D Koellinger KW - Cell Adhesion Molecules, Neuronal KW - Cognition KW - Female KW - Humans KW - Learning KW - Male KW - Memory KW - Multifactorial Inheritance KW - Nerve Tissue Proteins KW - Neuronal Plasticity KW - Octamer Transcription Factors KW - Polymorphism, Single Nucleotide KW - Synaptic Transmission AB -

We identify common genetic variants associated with cognitive performance using a two-stage approach, which we call the proxy-phenotype method. First, we conduct a genome-wide association study of educational attainment in a large sample (n = 106,736), which produces a set of 69 education-associated SNPs. Second, using independent samples (n = 24,189), we measure the association of these education-associated SNPs with cognitive performance. Three SNPs (rs1487441, rs7923609, and rs2721173) are significantly associated with cognitive performance after correction for multiple hypothesis testing. In an independent sample of older Americans (n = 8,652), we also show that a polygenic score derived from the education-associated SNPs is associated with memory and absence of dementia. Convergent evidence from a set of bioinformatics analyses implicates four specific genes (KNCMA1, NRXN1, POU2F3, and SCRT). All of these genes are associated with a particular neurotransmitter pathway involved in synaptic plasticity, the main cellular mechanism for learning and memory.

VL - 111 IS - 38 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25201988?dopt=Abstract ER - TY - JOUR T1 - Why do older people change their ratings of childhood health? JF - Demography Y1 - 2014 A1 - Vuolo, Mike A1 - Kenneth F Ferraro A1 - Patricia M Morton A1 - Ting-Ying Yang KW - Adaptation, Psychological KW - Age Factors KW - Aged KW - Aged, 80 and over KW - Aging KW - Female KW - Health Status KW - Humans KW - Male KW - Memory KW - Middle Aged KW - Retrospective Studies KW - Self Report KW - Sex Factors KW - Socioeconomic factors AB -

A growing number of studies in life course epidemiology and biodemography make use of a retrospective question tapping self-rated childhood health to assess overall physical health status. Analyzing repeated measures of self-rated childhood health from the Health and Retirement Study (HRS), this study examines several possible explanations for why respondents might change their ratings of childhood health. Results reveal that nearly one-half of the sample revised their rating of childhood health during the 10-year observation period. Whites and relatively advantaged older adults-those with more socioeconomic resources and better memory-were less likely to revise their rating of childhood health, while those who experienced multiple childhood health problems were more likely to revise their childhood health rating, either positively or negatively. Changes in current self-rated health and several incident physical health problems were also related to the revision of one's rating of childhood health, while the development of psychological disorders was associated with more negative revised ratings. We then illustrate the impact that these changes may have on an adult outcomes: namely, depressive symptoms. Whereas adult ratings of childhood health are likely to change over time, we recommend their use only if adjusting for factors associated with these changes, such as memory, psychological disorder, adult self-rated health, and socioeconomic resources.

PB - 51 VL - 51 IS - 6 N1 - Times Cited: 0 0 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25359668?dopt=Abstract U2 - PMC4253875 U4 - Retrospective questions/Self-rated health/Life course epidemiology/Reliability/Childhood conditions ER - TY - JOUR T1 - Chemotherapy was not associated with cognitive decline in older adults with breast and colorectal cancer: findings from a prospective cohort study. JF - Med Care Y1 - 2012 A1 - Victoria A. Shaffer A1 - Edgar C. Merkle A1 - Angela Fagerlin A1 - Jennifer J Griggs A1 - Kenneth M. Langa A1 - Theodore J Iwashyna KW - Age Factors KW - Aged KW - Aged, 80 and over KW - Aging KW - Antineoplastic Agents KW - Antineoplastic Protocols KW - Bayes Theorem KW - Breast Neoplasms KW - Cognition Disorders KW - Colorectal Neoplasms KW - Female KW - Health Behavior KW - Humans KW - Interviews as Topic KW - Male KW - Memory KW - Prospective Studies AB -

OBJECTIVES: This study tested 2 hypotheses: (1) chemotherapy increases the rate of cognitive decline in breast and colorectal cancer patients beyond what is typical of normal aging and (2) chemotherapy results in systematic cognitive declines when compared with breast and colorectal cancer patients who did not receive chemotherapy.

SUBJECTS: Data came from personal interviews with a prospective cohort of patients with breast (n=141) or colorectal cancer (n=224) with incident disease drawn from the nationally representative Health and Retirement Study (1998-2006) with linked Medicare claims.

MEASURES: The 27-point modified Telephone Interview for Cognitive Status was used to assess cognitive functioning, focusing on memory and attention. We defined the smallest clinically significant change as 0.4 points per year.

RESULTS: We used Bayesian hierarchical linear models to test the hypotheses, adjusting for multiple possible confounders. Eighty-eight patients were treated with chemotherapy; 277 were not. The mean age at diagnosis was 75.5. Patients were followed for a median of 3.1 years after diagnosis, with a range of 0 to 8.3 years. We found no differences in the rates of cognitive decline before and after diagnosis for patients who received chemotherapy in adjusted models (P=0.86, one-sided 95% posterior intervals lower bound: 0.09 worse after chemotherapy), where patients served as their own controls. Moreover, the rate of cognitive decline after diagnosis did not differ between patients who had chemotherapy and those who did not (P=0.84, one-sided 95% posterior intervals lower bound: 0.11 worse for chemotherapy group in adjusted model).

CONCLUSIONS: There was no evidence of cognitive decline associated with chemotherapy in this sample of older adults with breast and colorectal cancer.

VL - 50 IS - 10 U1 - http://www.ncbi.nlm.nih.gov/pubmed/22683591?dopt=Abstract U2 - PMC3444668 U4 - chemotherapy/Cognitive decline/CANCER/Medicare claims/Linear Models/Linear Models ER - TY - JOUR T1 - Long-term rate of change in memory functioning before and after stroke onset. JF - Stroke Y1 - 2012 A1 - Qianyi Wang A1 - Benjamin D Capistrant A1 - Amy Ehntholt A1 - M. Maria Glymour KW - Aged KW - Aged, 80 and over KW - Cohort Studies KW - disease progression KW - Female KW - Follow-Up Studies KW - Humans KW - Linear Models KW - Longitudinal Studies KW - Male KW - Memory KW - Memory Disorders KW - Middle Aged KW - Stroke KW - Survivors KW - Time Factors AB -

BACKGROUND AND PURPOSE: Memory impairment is a predictor and a consequence of stroke, but memory decline is common even in healthy elderly individuals. We compared the long-term trajectory of memory functioning before and after stroke with memory change in stroke-free elderly individuals.

METHODS: Health and Retirement Study participants aged 50 years and older (n=17 340) with no stroke history at baseline were interviewed biennially up to 10 years for first self-reported or proxy-reported stroke (n=1574). Age-, sex-, and race-adjusted segmented linear regression models were used to compare annual rates of change in a composite memory score before and after stroke among 3 groups: 1189 stroke survivors; 385 stroke decedents; and 15 766 cohort members who remained stroke-free.

RESULTS: Before stroke onset, individuals who later survived stroke had significantly (P<0.001) faster average annual rates of memory decline (-0.143 points per year) than those who remained stroke-free throughout follow-up (-0.101 points per year). Stroke decedents had even faster prestroke memory decline (-0.212 points per year). At stroke onset, memory declined an average of -0.369 points among stroke survivors, comparable with 3.7 years of age-related decline in stroke-free cohort members. After stroke, memory in stroke survivors continued to decline at -0.142 points per year, similar to their prestroke rates (P=0.93). Approximately 50% of the memory difference between stroke survivors soon after stroke and age-matched stroke-free individuals was attributable to prestroke memory.

CONCLUSIONS: Although stroke onset induced large decrements in memory, memory differences were apparent years before stroke. Memory declines before stroke, especially among those who did not survive the stroke, were faster than declines among stroke-free adults.

VL - 43 IS - 10 U1 - http://www.ncbi.nlm.nih.gov/pubmed/22935399?dopt=Abstract U2 - PMC3675175 U4 - Cognition/Cognitive impairment/memory impairment/cognitive decline/stroke ER - TY - JOUR T1 - Dynamic links between memory and functional limitations in old age: longitudinal evidence for age-based structural dynamics from the AHEAD study. JF - Psychol Aging Y1 - 2011 A1 - Frank J Infurna A1 - Denis Gerstorf A1 - Lindsay H Ryan A1 - Jacqui Smith KW - Activities of Daily Living KW - Aged KW - Aged, 80 and over KW - Aging KW - Cognition KW - depression KW - Female KW - Health Status KW - Humans KW - Interviews as Topic KW - Longitudinal Studies KW - Male KW - Memory KW - Memory Disorders KW - Memory, Episodic KW - Models, Statistical KW - Neuropsychological tests AB -

This study examined competing substantive hypotheses about dynamic (i.e., time-ordered) links between memory and functional limitations in old age. We applied the Bivariate Dual Change Score Model to 13-year longitudinal data from the Asset and Health Dynamics Among the Oldest Old Study (AHEAD; N = 6,990; ages 70 - 95). Results revealed that better memory predicted shallower increases in functional limitations. Little evidence was found for the opposite direction that functional limitations predict ensuing changes in memory. Spline models indicated that dynamic associations between memory and functional limitations were substantively similar between participants aged 70-79 and those aged 80-95. Potential covariates (gender, education, health conditions, and depressive symptoms) did not account for these differential lead-lag associations. Applying a multivariate approach, our results suggest that late-life developments in two key components of successful aging are intrinsically interrelated. Our discussion focuses on possible mechanisms why cognitive functioning may serve as a source of age-related changes in health both among the young-old and the old-old.

PB - 26 VL - 26 IS - 3 U1 - http://www.ncbi.nlm.nih.gov/pubmed/21480716?dopt=Abstract U2 - PMC3575140 U4 - Memory/Aging/Cognitive ability/Multivariate analysis/Young adults/Personal health ER - TY - JOUR T1 - "Below average" self-assessed school performance and Alzheimer's disease in the Aging, Demographics, and Memory Study. JF - Alzheimers Dement Y1 - 2009 A1 - Kala M. Mehta A1 - Anita L Stewart A1 - Kenneth M. Langa A1 - Kristine Yaffe A1 - Sandra Y. Moody-Ayers A1 - Brie A Williams A1 - Kenneth E Covinsky KW - Aged KW - Aged, 80 and over KW - Aging KW - Alzheimer disease KW - Apolipoprotein E4 KW - Cognition Disorders KW - Educational Status KW - Female KW - Geriatric Assessment KW - Humans KW - Male KW - Memory KW - Neuropsychological tests KW - Risk Factors AB -

BACKGROUND: A low level of formal education is becoming accepted as a risk factor for Alzheimer's disease (AD). Although increasing attention has been paid to differences in educational quality, no previous studies addressed participants' own characterizations of their overall performance in school. We examined whether self-assessed school performance is associated with AD beyond the effects of educational level alone.

METHODS: Participants were drawn from the population-representative Aging, Demographics, and Memory Study (ADAMS, 2000-2002). The ADAMS participants were asked about their performance in school. Possible response options included "above average," "average," or "below average." The ADAMS participants also underwent a full neuropsychological battery, and received a research diagnosis of possible or probable AD.

RESULTS: The 725 participants (mean age, 81.8 years; 59% female; 16% African-American) varied in self-assessed educational performance: 29% reported "above average," 64% reported "average," and 7% reported "below average" school performance. Participants with a lower self-assessed school performance had higher proportions of AD: 11% of participants with "above average" self-assessed performance had AD, as opposed to 12% of participants with "average" performance and 26% of participants with "below average" performance (P < 0.001). After controlling for subjects' years in school, a literacy test score (Wide-Range Achievement Test), age, sex, race/ethnicity, apolipoprotein E-epsilon4 status, socioeconomic status, and self-reported comorbidities, respondents with "below average" self-assessed school performance were four times more likely to have AD compared with those of "average" performance (odds ratio, 4.0; 95% confidence interval, 1.2-14). "Above average" and "average" self-assessed school performance did not increase or decrease the odds of having AD (odds ratio, 0.9; 95% confidence interval, 0.5-1.7).

CONCLUSIONS: We suggest an association between "below average" self-assessed school performance and AD beyond the known association with formal education. Efforts to increase cognitive reserve through better school performance, in addition to increasing the number of years of formal education in early life, may be important in reducing vulnerability throughout the life course.

PB - 5 VL - 5 UR - http://www.sciencedirect.com/science?_ob=ArticleURLand_udi=B7W6D-4X6VH7W-7and_user=99318and_coverDate=09 2F30 2F2009and_rdoc=1and_fmt=highand_orig=searchand_origin=searchand_sort=dand_docanchor=andview=cand_acct=C000007678and_version=1and_urlVersion=0and_ IS - 5 U1 - http://www.ncbi.nlm.nih.gov/pubmed/19751917?dopt=Abstract U2 - PMC2787515 U4 - alzheimer disease/cognition Disorders/educational Status/Geriatric Assessment/neuropsychological Tests/risk Factors ER - TY - JOUR T1 - Does childhood schooling affect old age memory or mental status? Using state schooling laws as natural experiments. JF - J Epidemiol Community Health Y1 - 2008 A1 - M. Maria Glymour A1 - Ichiro Kawachi A1 - Jencks, Christopher A1 - Lisa F Berkman KW - Aged KW - Aging KW - Censuses KW - Child KW - Cognition KW - Education KW - Educational Status KW - Female KW - Health Status KW - Humans KW - Least-Squares Analysis KW - Male KW - Massachusetts KW - Memory KW - Schools KW - Socioeconomic factors AB -

BACKGROUND: The association between schooling and old age cognitive outcomes such as memory disorders is well documented but, because of the threat of reverse causation, controversy persists over whether education affects old age cognition. Changes in state compulsory schooling laws (CSL) are treated as natural experiments (instruments) for estimating the effect of education on memory and mental status among the elderly. Changes in CSL predict changes in average years of schooling completed by children who are affected by the new laws. These educational differences are presumably independent of innate individual characteristics such as IQ.

METHODS: CSL-induced changes in education were used to obtain instrumental variable (IV) estimates of education's effect on memory (n = 10,694) and mental status (n = 9751) for white, non-Hispanic US-born Health and Retirement Survey participants born between 1900 and 1947 who did not attend college.

RESULTS: After adjustment for sex, birth year, state of birth and state characteristics, IV estimates of education's effect on memory were large and statistically significant. IV estimates for mental status had very wide confidence intervals, so it was not possible to draw meaningful conclusions about the effect of education on this outcome.

CONCLUSIONS: Increases in mandatory schooling lead to improvements in performance on memory tests many decades after school completion. These analyses condition on individual states, so differences in memory outcomes associated with CSL changes cannot be attributed to differences between states. Although unmeasured state characteristics that changed contemporaneously with CSL might account for these results, unobserved genetic variation is unlikely to do so.

VL - 62 IS - 6 U1 - http://www.ncbi.nlm.nih.gov/pubmed/18477752?dopt=Abstract ER - TY - JOUR T1 - Memory complaint in a community sample aged 70 and older. JF - J Am Geriatr Soc Y1 - 2000 A1 - Carolyn L. Turvey A1 - Schultz, Susan K. A1 - Arndt, Stephan A1 - Robert B Wallace A1 - A. Regula Herzog KW - Activities of Daily Living KW - Aged KW - Aged, 80 and over KW - Cognition KW - Depressive Disorder KW - Educational Status KW - Female KW - Geriatric Assessment KW - Humans KW - Longitudinal Studies KW - Male KW - Marital Status KW - Memory KW - Self-Assessment AB -

OBJECTIVES: The ability of older people to estimate their own memory, often referred to as "metamemory," has been evaluated in previous studies with conflicting reports regarding accuracy. Some studies have suggested that an older person's metamemory is mostly accurate, whereas others have demonstrated little relationship between memory complaint and actual impairment. This study examines memory complaint in a large national sample of older people aged > or = 70.

DESIGN: A longitudinal cohort study with two waves of data collection spaced 2 years apart.

SETTING: A nationwide random sample of community-dwelling older persons.

PARTICIPANTS: A total of 5,444 community-dwelling persons aged > or = 70 and their spouses.

MEASUREMENTS: Participants were asked if they believed their memory was excellent, very good, good, fair, or poor. They were then administered a cognitive assessment derived from the Mini-Mental Status Exam.

RESULTS: In general, people's assessment of their memory corresponded with their actual performance on cognitive measures. However, large portions of the sample inaccurately assessed their memory skills. People who reported depressive symptoms and had impairment in activities of daily living were more likely to state that their memory was impaired, although they performed very well on cognitive measures.

CONCLUSIONS: The conditions that skew people's self-assessment are the ones most likely to bring them into contact with healthcare professionals. This may give clinicians the general impression that older people cannot assess their own cognitive skills. However, poor metamemory appears to be a characteristic of a specific subgroup of older persons, not necessarily characteristic of the general population.

PB - 48 VL - 48 IS - 11 U1 - http://www.ncbi.nlm.nih.gov/pubmed/11083320?dopt=Abstract U4 - Aged, 80 and Over/Cognition/Depressive Disorder/Educational Status/Gender/Geriatric Assessment/Longitudinal Studies/Marital Status/Memory/Self Assessment (Psychology)/Support, U.S. Government--PHS ER - TY - JOUR T1 - Measures of cognitive functioning in the AHEAD Study. JF - J Gerontol B Psychol Sci Soc Sci Y1 - 1997 A1 - A. Regula Herzog A1 - Robert B Wallace KW - Aged KW - Aged, 80 and over KW - Cognition KW - Geriatric Assessment KW - Health Status KW - Health Surveys KW - Humans KW - Longitudinal Studies KW - Memory KW - Mental Status Schedule KW - Psychological Tests KW - Socioeconomic factors KW - United States AB -

Decline in cognitive functioning and onset of cognitive impairment are potentially important predictors of elderly persons needing informal assistance and formal health care. This article describes the measures of cognitive functioning that were developed for the Asset and Health Dynamics Among the Oldest Old (AHEAD) study of some 6,500 Americans aged 70 years and older. The study was designed to investigate the impact of health on disbursement of family and economic resources. Evaluation of the cognitive measures in terms of psychometric properties and missing data, telephone administration, and formation of an aggregate index is encouraging. Their construct validity is evidenced by their correlations with sociodemographic characteristics and health indicators that replicate existing findings as well as by their prediction of IADL and ADL functioning that are consistent with theory.

PB - 52B VL - 52 Spec No UR - https://www.ncbi.nlm.nih.gov/pubmed/9215356 U1 - http://www.ncbi.nlm.nih.gov/pubmed/9215356?dopt=Abstract U4 - Psychological Tests/Survey Methods/Cognitive Functioning ER -