Dataset Information

Secular Trends in Cognitive Performance in Older Black and White U.S. Adults, 1993-2012: Findings From the Chicago Health and Aging Project.

ABSTRACT: Objective:To characterize secular trends from 1993 to 2012 in cognitive performance using a cohort of older black and white U.S. adults, and compare trends by race. Method:Our data come from 8,906 participants of the Chicago Health and Aging Project (CHAP), a longitudinal, population-based cohort (age ? 67, 60% black). Participants underwent cognitive assessments in six 3-year study cycles from 1993 to 1996 through 2010 to 2012. We computed 3 measures of cognitive performance: global cognition, episodic memory, and perceptual speed. Results:Mean performance in terms of global cognitive score followed a secular pattern of modest decline over the 6 study cycles. The trend was most pronounced for perceptual speed. Mean scores among black participants were consistently lower than those for whites; these disparities in mean performance narrowed over time, especially on perceptual speed, but appeared to widen at the last cycle. Global scores among the upper quartile of performers rose slightly, but scores among the lowest quartile of performers dropped precipitously. Discussion:Between 1993 and 2012, secular trends in cognitive performance in this established cohort did not follow a clear pattern of improvement, contrasting with previous research. But patterns differed by cognitive domain, performance level, and race.

SUBMITTER: Weuve J

PROVIDER: S-EPMC6019012 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Secular Trends in Cognitive Performance in Older Black and White U.S. Adults, 1993-2012: Findings From the Chicago Health and Aging Project.

Weuve Jennifer J Rajan Kumar B KB Barnes Lisa L LL Wilson Robert S RS Evans Denis A DA

The journals of gerontology. Series B, Psychological sciences and social sciences 20180401 suppl_1

<h4>Objective</h4>To characterize secular trends from 1993 to 2012 in cognitive performance using a cohort of older black and white U.S. adults, and compare trends by race.<h4>Method</h4>Our data come from 8,906 participants of the Chicago Health and Aging Project (CHAP), a longitudinal, population-based cohort (age ≥ 67, 60% black). Participants underwent cognitive assessments in six 3-year study cycles from 1993 to 1996 through 2010 to 2012. We computed 3 measures of cognitive performance: glo ...[more]

PMID: 29669103

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Project description:IMPORTANCE:Extremely preterm infants contribute disproportionately to neonatal morbidity and mortality. OBJECTIVE:To review 20-year trends in maternal/neonatal care, complications, and mortality among extremely preterm infants born at Neonatal Research Network centers. DESIGN, SETTING, PARTICIPANTS:Prospective registry of 34,636 infants, 22 to 28 weeks' gestation, birth weight of 401 to 1500 g, and born at 26 network centers between 1993 and 2012. EXPOSURES:Extremely preterm birth. MAIN OUTCOMES AND MEASURES:Maternal/neonatal care, morbidities, and survival. Major morbidities, reported for infants who survived more than 12 hours, were severe necrotizing enterocolitis, infection, bronchopulmonary dysplasia, severe intracranial hemorrhage, cystic periventricular leukomalacia, and/or severe retinopathy of prematurity. Regression models assessed yearly changes and were adjusted for study center, race/ethnicity, gestational age, birth weight for gestational age, and sex. RESULTS:Use of antenatal corticosteroids increased from 1993 to 2012 (24% [348 of 1431 infants]) to 87% (1674 of 1919 infants]; P?<?.001), as did cesarean delivery (44% [625 of 1431 births] to 64% [1227 of 1921]; P?<?.001). Delivery room intubation decreased from 80% (1144 of 1433 infants) in 1993 to 65% (1253 of 1922) in 2012 (P?<?.001). After increasing in the 1990s, postnatal steroid use declined to 8% (141 of 1757 infants) in 2004 (P?<?.001), with no significant change thereafter. Although most infants were ventilated, continuous positive airway pressure without ventilation increased from 7% (120 of 1666 infants) in 2002 to 11% (190 of 1756 infants) in 2012 (P?<?.001). Despite no improvement from 1993 to 2004, rates of late-onset sepsis declined between 2005 and 2012 for infants of each gestational age (median, 26 weeks [37% {109 of 296} to 27% {85 of 320}]; adjusted relative risk [RR], 0.93 [95% CI, 0.92-0.94]). Rates of other morbidities declined, but bronchopulmonary dysplasia increased between 2009 and 2012 for infants at 26 to 27 weeks' gestation (26 weeks, 50% [130 of 258] to 55% [164 of 297]; P?<?.001). Survival increased between 2009 and 2012 for infants at 23 weeks' gestation (27% [41 of 152] to 33% [50 of 150]; adjusted RR, 1.09 [95% CI, 1.05-1.14]) and 24 weeks (63% [156 of 248] to 65% [174 of 269]; adjusted RR, 1.05 [95% CI, 1.03-1.07]), with smaller relative increases for infants at 25 and 27 weeks' gestation, and no change for infants at 22, 26, and 28 weeks' gestation. Survival without major morbidity increased approximately 2% per year for infants at 25 to 28 weeks' gestation, with no change for infants at 22 to 24 weeks' gestation. CONCLUSIONS AND RELEVANCE:Among extremely preterm infants born at US academic centers over the last 20 years, changes in maternal and infant care practices and modest reductions in several morbidities were observed, although bronchopulmonary dysplasia increased. Survival increased most markedly for infants born at 23 and 24 weeks' gestation and survival without major morbidity increased for infants aged 25 to 28 weeks. These findings may be valuable in counseling families and developing novel interventions. TRIAL REGISTRATION:clinicaltrials.gov Identifier: NCT00063063.

Project description:AimsPrevious epidemiological evidence identified a concerning increase in behavioural problems among young children from 1997 to 2008 in Brazil. However, it is unclear whether behavioural problems have continued to increase, if secular changes vary between sociodemographic groups and what might explain changes over time. We aimed to monitor changes in child behavioural problems over a 22-year period from 1997 to 2019, examine changing social inequalities and explore potential explanations for recent changes in behavioural problems between 2008 and 2019.MethodsThe Child Behaviour Checklist was used to compare parent-reported behavioural problems in 4-year-old children across three Brazilian birth cohorts assessed in 1997 (1993 cohort, n = 633), 2008 (2004 cohort, n = 3750) and 2019 (2015 cohort, n = 577). Response rates across all three population-based cohorts were over 90%. Moderation analyses tested if cross-cohort changes differed by social inequalities (demographic and socioeconomic position), while explanatory models explored whether changes in hypothesized risk and protective factors in prenatal development (e.g., smoking during pregnancy) and family life (e.g., maternal depression and harsh parenting) accounted for changes in child behavioural problems from 2008 to 2019.ResultsInitial increases in child behavioural problems from 1997 to 2008 were followed by declines in conduct problems (mean change = -2.75; 95% confidence interval [CI]: -3.56, -1.94; P < 0.001), aggression (mean change = -1.84; 95% CI: -2.51, -1.17; P < 0.001) and rule-breaking behaviour (mean change = -0.91; 95% CI: -1.13, -0.69 P < 0.001) from 2008 to 2019. Sex differences in rule-breaking behaviour diminished during this 22-year period, whereas socioeconomic inequalities in behavioural problems emerged in 2008 and then remained relatively stable. Consequently, children from poorer and less educated families had higher behavioural problems, compared to more socially advantaged children, in the two more recent cohorts. Changes in measured risk and protective factors partly explained the reduction in behavioural problems from 2008 to 2019.ConclusionsFollowing a rise in child behavioural problems, there was a subsequent reduction in behavioural problems from 2008 to 2019. However, social inequalities increased and remained high. Continued monitoring of behavioural problems by subgroups is critical for closing the gap between socially advantaged and disadvantaged children and achieving health equity for the next generation.

Dataset Information

Secular Trends in Cognitive Performance in Older Black and White U.S. Adults, 1993-2012: Findings From the Chicago Health and Aging Project.

Publications

Secular Trends in Cognitive Performance in Older Black and White U.S. Adults, 1993-2012: Findings From the Chicago Health and Aging Project.

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