Aging & Mental Health

Jester, Dylan J.; Lee, Soomi; Molinari, Victor; Volicer, Ladislav

doi: 10.1080/13607863.2019.1660852pmid: 31478402

AbstractObjectives: This systematic review synthesizes the most recent literature on neuropsychological deficits in adults with Parkinson’s disease who experience excessive daytime sleepiness (EDS). Confounds and methodological limitations are explored. A framework entitled the Cascade Model of Excessive Daytime Sleepiness (CMEDS) is proposed to explain the role of EDS in contributing to cognitive impairment for patients with Parkinson’s disease.Method: Systematic search through PubMed, PsychInfo and citation records. In total, 175 articles were screened for possible inclusion. Eight studies were included, encompassing 1373 patients with Parkinson’s disease − 442 of whom had Parkinson’s disease with EDS.Results: For Parkinson’s disease patients with EDS, global deficits, executive dysfunction and deficits in processing speed were found beyond the typical cognitive phenotype of patients without EDS. Language skills, memory and visuospatial skills appeared to be similar between those with and without EDS. In untreated, de novo, patients, there were no cognitive differences between the EDS groups.Conclusion: This review suggests that Parkinson’s disease patients suffering from EDS may have additional cognitive deficits globally, in executive control, and in processing speed. As suggested by the CMEDS framework, the impact of EDS on cognition may be related to Parkinson’s disease pathology, comorbidities and medication use.

Tang, Jennifer Yee Man; Wong, Gloria Hoi Yan; Luo, Hao; Liu, Tianyin; Lum, Terry Yat Sang

doi: 10.1080/13607863.2019.1636204pmid: 31274010

AbstractObjectives: Mentally stimulating leisure activities and cognitive interventions are associated with delayed cognitive decline, although evidence has not been unequivocal, possibly due to differential contribution of the two types of activities. This study aimed to examine the respective contributions of mentally active lifestyle and structured cognitive programs on cognitive changes in older adults.Methods: This was a 2-year prospective cohort study of 1,793 healthy older adults. We recorded mentally active lifestyle and participation in cognitive program. Cognitive function was assessed using the Montreal Cognitive Assessment. Physical frailty was also screened for the potential effect on cognition.Results: Compared to the mentally inactive group, the mentally active group had better baseline cognitive functioning (standardized mean difference of 0.08, t = −3.8; p < 0.001), but both groups showed a mild cognitive decline over time (both p < 0.05). The mentally active group were less physical frail, more physical independent, and less depressed. Participation in structured cognitive programs was associated with cognition improvement, in older persons who had a mentally active or inactive lifestyle (standardized mean differences of 0.22 and 0.27, respectively; both p < 0.01), but these gains significantly diminished at year 2 in the latter group. Lower baseline cognitive function and higher level of physical frailty predicted greater cognitive gains from structured cognitive programs.Conclusion: Both a mentally active lifestyle and structured cognitive programs contributed to better cognition. Structured cognitive programs appeared to add on to the benefits of a mentally active lifestyle, and predicted cognitive changes regardless of lifestyle.

Sharifian, Neika; Kraal, A. Zarina; Zaheed, Afsara B.; Sol, Ketlyne; Zahodne, Laura B.

doi: 10.1080/13607863.2019.1660850pmid: 33076685

AbstractObjectives: The composition of one’s social network has been associated with cognition such that a greater proportion of family is associated with worse cognition compared to a greater proportion of friends. It is not clear whether this association between network composition and cognitive aging is driven by potential negative effects of family interactions or positive effects of friend interactions.Methods: Using the Health and Retirement Study (T1: 2006/2008, T2: 2010/2012, T3: 2012/2014), a longitudinal mediation model was conducted to test the effects of composition on episodic memory and latent change in memory through contact frequency with friends and family.Results: Analyses revealed indirect effects of composition on both T2 memory and latent change in memory through contact frequency with friends. A greater proportion of family in one’s network was associated with lower contact frequency with friends and in turn lower memory. Composition was also associated with higher contact frequency with family; however, contact frequency with family was not associated with memory.Conclusions: These findings suggest that spending time with family may not affect episodic memory in older adulthood, but spending time with friends may be beneficial. Potential mechanisms and implications regarding the importance of friendships in later life are discussed.

Otuyama, Leonardo J.; Oliveira, Déborah; Locatelli, Danilo; Machado, Danusa de A.; Noto, Ana Regina; Galduróz, José Carlos Fernandes; Prince, Martin J.; Ferri, Cleusa P.

doi: 10.1080/13607863.2019.1647140pmid: 31512501

AbstractObjective: This study aimed to estimate the association between tobacco smoking and risk for dementia in seven low- and middle-income countries.Methods: Secondary analysis of the 10/66 population-based cohort study was conducted with 11,143 dementia-free individuals aged 65 years and older who were followed-up for an average of 3.8 years totalling 42,715 person-years. Cox regression with competing-risk analyses was used, controlling for age, gender, number of assets, past hazardous drinking, exercise and self-report of heart disease. Exposure was measured in packyears and smoking status. The number of packyears was calculated by multiplying the average number of packs per day by years of consumption up to 50 years old and up to age at baseline.Results: Meta-analysis of the results from each country yielded non-significant pooled relative risk ratios for all comparisons. There was no difference in risk for any dementia between ‘ever smokers’ compared to ‘never smokers’ (HR 0.96; 95% CI 0.82–1.13); ‘current smokers’ compared to ‘never smokers’ (HR 0.83; 95% CI 0.66–1.06); ‘former smokers’ compared to ‘never smokers’ (HR 1.06; 95% CI 0.88–1.27); ‘current smokers’ compared to ‘former smokers’ (HR 0.86; 95% CI 0.66–1.13). Results were similar for Alzheimer’s disease (AD) and Vascular Dementia (VaD) as outcomes. Lifetime tobacco consumption (packyears) was not associated with any dementia (HR 1.00; 95% CI 0.99–1.00), nor with AD or VaD.Conclusion: Pooled results from all the countries showed no significant association between smoking and the onset of any dementia. Selective quitting in later-life might have biased the results towards no effect.

Farina, Marianne; Breno Costa, Dalton; Webber de Oliveira, João André; Polidoro Lima, Manuela; Machado, Wagner De Lara; Moret-Tatay, Carmen; Fernandes Lopes, Regina Maria; Argimon, Irani Iracema De Lima; Irigaray, Tatiana Quarti

doi: 10.1080/13607863.2019.1636203

Wang, Hanyuying; Lee, Caroline; Hunter, Sally; Fleming, Jane; Brayne, Carol; ,

doi: 10.1080/13607863.2019.1655704pmid: 31429312

AbstractBackground: Loneliness and cognitive impairment are both commonly experienced by older old people, but evidence for the association between these has been inconsistent. Moreover, most evidence has been cross-sectional in nature and largely based on studies with relatively young later life age groups rather than ‘the oldest old’. We aimed to test the potential impact of loneliness amongst older old people on their cognitive function over a 20-year period.Method: Data were drawn from wave 3 to wave 10 of the Cambridge City over-75s Cohort (CC75C) study. The impact of loneliness on transition between normal and impaired cognitive states was examined by multi-state modelling. The associations between loneliness changes and cognitive function decline were tested by using generalized estimating equation (GEE) with an independent working correlation structure. Missing data were imputed by using multiple imputation chained equations.Results: At wave 3, 713 participants were interviewed, of whom 657 (92%) had Mini-Mental State Examination (MMSE) assessments. Of individuals who had an MMSE score, approximately one quarter reported feeling lonely, and another 16% felt slightly lonely. The prevalence of feeling lonely or slightly lonely varied between waves. Results from multi-state modelling indicated that loneliness was not related to cognitive function transitions, and results from the GEE model showed that loneliness was not significantly associated with cognitive function decline after adjusting for cohort effects, follow-up time, sex, education, and interaction terms for sex, education and time.Conclusions: Loneliness did not exert long-term harmful effects on cognitive function in the oldest old.

Chen, Lele; Cao, Qilong

doi: 10.1080/13607863.2019.1663491pmid: 31496262

AbstractObjectives: With a longitudinal design, we aimed to investigate the relationship between poverty and the risk of incident cognitive impairment in China.Methods: We used three waves of the Chinese Longitudinal Healthy Longevity Survey (2008–2014). Cognitive impairment was assessed using the Chinese version of the Mini Mental State Examination. Poverty was measured according to the latest national poverty line settled at an annual per-capita income of 2300 yuan (approximately equivalent to 1.25 dollar/day) in 2011 in China. A marginal structural model was utilized to explore the association between poverty and the risk of incident cognitive impairment. The subgroup analyses were also conducted in this study.Results: The cumulative incidence of cognitive impairment over 6 years was 30.69% (1936/6309). Poverty increased 34% risk of incident cognitive impairment in the elderly (odds ratio = 1.34, 95% confidence interval (CI): 1.15–1.56) after controlling behavioral factors and health status covariates. Participants who were male (OR = 1.38, 95% CI: 1.08–1.76), lived in urban areas (OR = 1.55, 95% CI: 1.22–1.98), and were married (OR = 1.72, 95% CI: 1.28–2.32) had higher poverty risks on incident cognitive impairment in subgroup analyses.Conclusions: Our results provide empirical support for the ongoing discussion about how economic hardship impacts of cognitive functioning, and highlight the negative health risks that economically disadvantaged individuals may experience.

Nabe-Nielsen, Kirsten; Rod, Naja Hulvej; Hansen, Åse Marie; Prescott, Eva; Grynderup, Matias Brødsgaard; Islamoska, Sabrina; Ishtiak-Ahmed, Kazi; Garde, Anne Helene; Gyntelberg, Finn; Mortensen, Erik Lykke; Phung, Thien Kieu Thi; Waldemar, Gunhild; Westendorp, Rudi G. J.

Mishra, Aura Ankita; Marceau, Kristine

doi: 10.1080/13607863.2019.1619166pmid: 31155911

AbstractObjectives: Objectives were to explore: 1) the association between sub-groups with different multi-type childhood maltreatment exposures and depressive symptoms in late adulthood, and 2) the mediating effects of dysregulated physiological stress system function and perceived stress in midlife on the aforementioned associations.Methods: Data come from the Biomarker project (n = 1,053) of the Midlife Development in the United States study. Latent profile analysis was used to identify sub-groups with differing childhood maltreatment type and chronicity. We then test our mediation hypothesis using a product of coefficients method procedure.Results: Two vulnerable sub-groups were identified (Class 2: Emotional and physical maltreatment class, n = 52, and Class 3: Sexual abuse class, n = 79) along with a normative sub-group (Class 1: Normative class, n = 922) comprising of a majority of adults. Both vulnerable sub-groups had higher levels of perceived stress in late adulthood. Perceived stress mediated the association between both vulnerable sub-groups and depressive symptoms. Physiological stress dysregulation mediated the association only between the emotional and physical maltreatment class and depressive symptoms in late adulthood.Conclusion: Therapeutic approaches targeted at prevention of perceived stress for both vulnerable sub-groups identified in this study and those targeting physiological dysregulation in addition for the emotional and physical maltreatment class could be critical for depressive symptom recovery.

Weitzner, Daniel; Calamia, Matthew; Stasik-O’Brien, Sara M.; De Vito, Alyssa; Pugh, Erika

doi: 10.1080/13607863.2019.1636206pmid: 31264444

AbstractObjective: Given the strong relationship often found between self-report measures of anxiety and depression, the Inventory of Depression and Anxiety Symptoms (IDAS) was created and then expanded (IDAS-II) to assess common and unique symptom dimensions of these emotional disorders. Limited research has focused on the use of the IDAS-II with older adults and the purpose of the current study was to provide data on the reliability and validity of the IDAS-II in this population.Method: A sample of 323 participants (age 55–80 years) were recruited online using Amazon’s Mechanical Turk (MTurk). They completed the IDAS-II and several other self-report questionnaires of internalizing symptoms, including widely used measures developed specifically for older adults. Internal consistency and validity of the IDAS-II were examined.Results: The IDAS-II demonstrated marginal to excellent internal consistency (α = .68–.91). An exploratory factor analysis indicated three factors: Distress, Positive Mood, and Obsessions. The IDAS-II explained a large amount of variance in the other measures of depression and anxiety (ranging from 52% to 76%) and the IDAS-II Dysphoria scale significantly related to all of the other measures of depression and anxiety (ranging from r = .69 to r = .81).Conclusion: These results support the use of the IDAS-II with older adults as it has good convergent validity with other commonly used measures of depression and anxiety, including those commonly used in the assessment of older adults. Further research can use the IDAS-II with both younger and older adults to examine age-related changes in depression and anxiety symptoms.