Cognitive Impairment and the Trajectory of Loneliness in Older Adulthood: Evidence from the Health and Retirement Study.
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ABSTRACT:
SUBMITTER: Lee JH
PROVIDER: S-EPMC8606613 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectivesWe provide the first nationally representative population-based study of cognitive disparities among same-sex and different-sex couples in the United States.MethodsWe analyzed data from the Health and Retirement Study (2000-2016). The sample included 23,669 respondents (196 same-sex partners and 23,473 different-sex partners) aged 50 and older who contributed to 85,117 person-period records (496 from same-sex partners and 84,621 from different-sex partners). Cognitive impairment was assessed using the modified version of the Telephone Interview for Cognitive Status. Mixed-effects discrete-time hazard regression models were estimated to predict the odds of cognitive impairment.ResultsThe estimated odds of cognitive impairment were 78% (p < .01) higher for same-sex partners than for different-sex partners. This disparity was mainly explained by differences in marital status and, to a much lesser extent, by differences in physical and mental health. Specifically, a significantly higher proportion of same-sex partners than different-sex partners were cohabiting rather than legally married (72.98% vs. 5.42% in the study sample), and cohabitors had a significantly higher risk of cognitive impairment than their married counterparts (odds ratio = 1.53, p < .001).DiscussionThe findings indicate that designing and implementing public policies and programs that work to eliminate societal homophobia, especially among older adults, is a critical step in reducing the elevated risk of cognitive impairment among older same-sex couples.
| S-EPMC8499509 | biostudies-literature
Project description:IntroductionPrevious studies have suggested that cognitive impairment is associated with falls in older adults. However, the consistency of results among different subgroups defined by multiple characteristics of the elderly has not yet been tested. Additionally, results are inconsistent regarding the effects of different cognitive domains on falls. Therefore, this study sought to use representative data from a nationwide study to better understand the longitudinal association between cognitive impairment and subsequent falls in older adults.MethodsThe current study was conducted based on the China Health and Retirement Longitudinal Study (CHARLS) data of respondents aged ≥60 years in 2015 and the fall data in 2018. The respondents were divided into subgroups according to different demographic characteristics. Multiple logistic regression analysis was conducted to adjust for various confounding factors and evaluate the association between cognitive impairment and falls.ResultsOf the 5,110 respondents included in this study, 1,093 (21.39%) had falls within the last 2 years. A significant association was found between cognitive impairment and subsequent falls (OR = 0.97, 95% CI 0.95-0.99, P = 0.001) after adjusting for all of the covariates related to falls. Analysis of different cognitive domains showed that orientation (OR = 0.94, 95% CI 0.90-0.99, P = 0.013) and memory (OR = 0.93, 95% CI 0.90-0.97, P = 0.001) were significantly associated with falls. In subgroup analysis, the ORs of people aged 60-74 years, male, with lower education level were 0.97 (95% CI 0.95-0.99, P = 0.008), 0.96 (95% CI 0.93-0.98, P = 0.001), and 0.97 (95% CI 0.95-0.99, P = 0.001), respectively, suggesting that the associations were also statistically significant in these subgroups. There was also a significant association both in urban (OR = 0.97, 95% CI 0.95-0.99, P = 0.001) and in rural residents (OR = 0.97, 95% CI 0.95-0.99, P = 0.003).ConclusionsOur results suggest that the associations between cognition and falls vary depending on the different demographic characteristics of older adults. These findings may be useful for designing more accurate identification and intervention for the fall risk for specific high-risk groups.
| S-EPMC9240660 | biostudies-literature
Project description:BackgroundPrevious studies have demonstrated the associations between loneliness and frailty in late life. However, there is a lack of consensus on the direction of the relationship. The present study aimed to examine the interdependencies between loneliness and frailty over time.MethodsData on participants aged 60 years old and above were collected from the 2011, 2013, and 2015 samples of the China Health and Retirement Longitudinal Study (CHARLS). Loneliness was measured by a single question from the Centre for Epidemiological Studies Depression scale, and frailty was assessed by the Physical Frailty Phenotype (PFP) scale. Cross-lagged panel models were utilized to examine the potential bidirectional relationship between loneliness and frailty.ResultsReciprocal associations were found between loneliness and frailty. Furthermore, we found that baseline frailty and early change in frailty had a significant predictive effect on late change in loneliness. Higher baseline loneliness in older adults may create a potentially vicious cycle that influenced early change in frailty and continued to cause late change in loneliness.ConclusionA bidirectional relationship may exist between loneliness and frailty among older Chinese adults over 60 years old. Lonely older adults should be alerted to the potential self-reinforcing cycle of loneliness that affects their health.
| S-EPMC9247968 | biostudies-literature
Project description:BackgroundCardiometabolic risk (CMR) is a key indicator of physiological decline with age, but age-related declines in a nationally representative older US population have not been previously examined.MethodsWe examined the trajectory of CMR over 8 years of aging, from 2006/2008 to 2014/2016, among 3528 people older than age 50 in the Health and Retirement Study. We used growth curve models to examine change in total CMR as well as in individual cardiometabolic biomarkers to understand how baseline differences and rates of change vary across sociodemographic characteristics, by smoking status, and medication use.ResultsTotal CMR did not change among respondents who survived over 8 years. Despite significant differences in CMR across demographic and education groups at baseline, the pace of change with age did not differ by these characteristics. Among individual biomarkers, risk levels of diastolic blood pressure, resting heart rate, and total cholesterol decreased over 8 years while glycosylated hemoglobin, waist circumference, and pulse pressure increased over that time. Both the statistical significance levels and the magnitudes of the reduction over time with age in diastolic blood pressure, resting heart rate, and total cholesterol in models adjusted for age, race/ethnicity, gender, smoking, and education were reduced after controlling for blood pressure and cholesterol medication.ConclusionsThe relatively constant total CMR level over 8 years occurred because some indicators improved with age while some deteriorated in this period. Medication use contributed to the improvement in blood pressure, resting heart rate, and total cholesterol.
| S-EPMC8599082 | biostudies-literature
Project description:ObjectivesCognitive impairment is a precursor of dementia. This study aimed to examine the association of social engagement with cognitive decline during the process of normal ageing.MethodsWe used data from the China Health and Retirement Longitudinal Study. The cognitive functions were tested at baseline, and 2-year and 4-year follow-up visits. Social engagement was constructed as a comprehensive measure including the quantity and frequency of social activities. Activities of social engagement were classified into three types. Multilevel logistic model was fitted to evaluate the prospective association between social engagement and cognitive impairment.ResultsAfter 2-year follow-up, compared with participants with the lowest level of social engagement, those with level-2, level-3 and level-4 social engagement had a 12% (OR=0.88, 95% CI 0.71 to 1.09, p=0.242), 17% (OR=0.83, 95% CI 0.71 to 0.97, p=0.020) and 25% (OR=0.75, 95% CI 0.61 to 0.93, p=0.008) lower risk for developing cognitive impairment, respectively. A similar pattern of significantly protective association was found at 4-year follow-up. Combined effect analysis showed that participants who attended one type of social engagement had a lower risk of developing cognitive impairment and the protective effect was even larger with those who attended two or three types of social engagement.ConclusionsSocial engagement had a protective effect on cognitive impairment among middle-aged and older adults in China. Given the growing epidemic of dementia and rapid pace of ageing in low-income and middle-income countries, our study shed lights on comprehensive and tailored public health programmes for improving social engagement, to delay cognitive impairment at mid-age and later life.
| S-EPMC7677353 | biostudies-literature
Project description:ObjectivesTo test whether loneliness is associated with the risk of cognitive impairment up to 11 years later in a European sample of middle-aged and older adults. The study examines whether this association is independent of measures of social isolation, depression, and other risk factors for cognitive impairment and dementia.MethodsParticipants (N = 14 114) from the Survey of Health, Ageing and Retirement in Europe (SHARE) answered a single item on loneliness at baseline and were assessed for cognitive impairment every 2-to-3 years for 11 years. Participants who scored at least 1.5 standard deviations below the age-graded mean on both a memory recall task and verbal fluency task were classified as impaired. A three-item measure of loneliness was available for a sample of respondents followed up to 4 years.ResultsFeeling lonely was associated with increased risk of incident cognitive impairment (HR = 1.31, 95%CI = 1.19-1.44), after accounting for age, sex, education, and SHARE country strata. The association was robust but reduced in magnitude when controlling for clinical and behavioral risk factors, health-related activity limitations, social isolation, social disengagement, and depressive symptoms. The association was not moderated by socio-demographic factors and was also apparent when using the three-item loneliness scale instead of the single-item measure.ConclusionsThese findings expand the extant literature on loneliness and the risk of cognitive impairment in older adulthood. Loneliness is one modifiable factor that can be intervened prior to the development of severe impairment or dementia.
| S-EPMC7755119 | biostudies-literature
Project description:BackgroundChildhood experience has been suggested to affect cognitive function in later life. However, the association between childhood friendship status and cognitive ageing trajectory in middle-aged and older adults has not been fully assessed. This study examined the association between childhood friendship status and cognitive ageing trajectory and identified factors modifying this association.MethodsWe used four waves of data from the China Health and Retirement Longitudinal Study (CHARLS), a national representative longitudinal study of adults aged 45 years or older, 2011-2018. The CHARLS included surveys on childhood friendship and cognitive assessments. Childhood friendship status was categorised as poor, fair, and good. To examine the association between childhood friendship and cognitive ageing trajectory in later life, we applied multilevel linear regression models, and explored potential influences of sociodemographic factors, health status and behaviours, and childhood conditions on this association.ResultsOf the 4,350 participants, 1,919 (44.1%) were women. The mean age was 56.29 ± 7.80 years. We found childhood friendship was significantly associated with cognitive ageing trajectory in later life, with a dose-response relationship. After adjusting for covariates, comparing to participants with poor childhood friendships, those with better childhood friendships had lower rates of cognitive decline (β = 0.12, 95% confidence interval [CI]: 0.03 to 0.22 [interaction term of fair friendship and time]; β = 0.19, 95% CI: 0.10 to 0.28 [interaction term of good friendship and time]) and higher level of cognitive functions (β = 0.40, 95% CI: 0.22 to 0.58 [fair friendships]; β = 0.61, 95% CI: 0.43 to 0.79 [good friendships]). These associations were stronger for those who were female, less educated, and had experienced more adverse childhood experiences.ConclusionsChildhood friendship is associated with cognitive ageing in later life. Enhancing childhood friendships can play an important role to promote healthy ageing in the future.
| S-EPMC9178862 | biostudies-literature
Project description:ObjectivesMigration and gender are important factors that differentiate the Latino immigrant experience in the United States. We investigate the association between nativity status, age of migration, and cognitive life expectancies among a nationally representative sample of Latino adults aged 50 and older to explore whether age of migration and gender influence cognitive aging across the life course.MethodsThis study used data from the Health and Retirement Study (1998-2016) to estimate Sullivan-based life tables of cognitive life expectancies by nativity, age of migration, and gender for older Latino adults. Cognitive status was based on the Langa-Weir algorithm. We test for both within-group (i.e., nativity and age of migration) and gender differences to explore the overall burden of disease among this rapidly growing population.ResultsForeign-born Latinos, regardless of age of migration or gender, spend a greater number of years after age 50 with cognitive impairment/no dementia than U.S.-born Latinos. However, the number of years spent with dementia varied by subgroup with midlife immigrant men and late-life immigrant men and women exhibiting a significant disadvantage relative to the U.S.-born. Furthermore, we document a gender disadvantage for all Latino women, regardless of immigrant status.DiscussionThe robust relationship between nativity, age of migration, and cognitive aging suggests that older foreign-born Latinos experiencing cognitive decline may place serious burdens on families. Future research should target the needs of different subgroups of older Latinos who are entering their last decades of life to develop culturally appropriate long-term care programs.
| S-EPMC9799185 | biostudies-literature
Project description:BackgroundWe sought to examine whether people with a diagnosis of cardiovascular disease (CVD) experienced a greater incidence of subsequent cognitive impairment (CI) compared to people without CVD, as suggested by prior studies, using a large longitudinal cohort.MethodsWe employed Health and Retirement Study (HRS) data collected biennially from 1998 to 2014 in 1305 U.S. adults age ≥ 65 newly diagnosed with CVD vs. 2610 age- and gender-matched controls. Diagnosis of CVD was adjudicated with an established HRS methodology and included self-reported coronary heart disease, angina, heart failure, myocardial infarction, or other heart conditions. CI was defined as a score < 11 on the 27-point modified Telephone Interview for Cognitive Status. We examined incidence of CI over an 8-year period using a cumulative incidence function accounting for the competing risk of death.ResultsMean age at study entry was 73 years, 55% were female, and 13% were non-white. Cognitive impairment developed in 1029 participants over 8 years. The probability of death over the study period was greater in the CVD group (19.8% vs. 13.8%, absolute difference 6.0, 95% confidence interval 2.2 to 9.7%). The cumulative incidence analysis, which adjusted for the competing risk of death, showed no significant difference in likelihood of cognitive impairment between the CVD and control groups (29.7% vs. 30.6%, absolute difference - 0.9, 95% confidence interval - 5.6 to 3.7%). This finding did not change after adjusting for relevant demographic and clinical characteristics using a proportional subdistribution hazard regression model.ConclusionsOverall, we found no increased risk of subsequent CI among participants with CVD (compared with no CVD), despite previous studies indicating that incident CVD accelerates cognitive decline.
| S-EPMC8074515 | biostudies-literature
Project description:OBJECTIVE:Personality is known to predict alcohol consumption, but how alcohol use is related to personality change is less clear, especially at older ages. The present study examined the effects of level of alcohol consumption and history of dependence on change in the Five-Factor Model personality traits in a national cohort of Americans aged over 50. METHOD:Over 10,000 adults who participated in 2006-2008 waves of the Health and Retirement Study reported on personality and alcohol use and were followed over 4 years. RESULTS:Latent difference score models indicated decreases in Extraversion to be attenuated for individuals categorized as light-to-moderate drinkers at baseline, whereas decreases in Conscientiousness were accentuated by having experienced alcohol dependence symptoms. Moreover, personality difference scores correlated with changes in the amount of alcohol consumed at follow-up. CONCLUSIONS:The findings suggest that patterns of alcohol consumption are associated with changes in personality across the second half of the life span.
| S-EPMC6054906 | biostudies-literature