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Abstract: This study examines the impact of mental health services on arrests of offenders with a serious mental Illness (SMI) by assessing changes in associations between receipt of outpatient and emergency room/inpatient services and arrests one, two, and three quarters later. A variety of data sets were used for identifying 3,769 offenders who were in the Pinellas County Florida jail between 7/1/2003 and 6/30/2004, and 7,755 offenders who were in the Harris County Texas jail between 10/1/2005 and 9/30/2006. Arrests, outpatient and emergency room/inpatient services were assigned to one of 16 ninety-day periods between 7/1/2002 and 6/10/2006 in Pinellas County and one of 12 such periods between 10/1/2004 and 9/15/2007 in Harris County. Generalized estimating equations were used. Covariates were age, gender, race, diagnosis, and homelessness. The results were also adjusted for exposure to arrests. In Pinellas County, outpatient services significantly reduced the risks of arrests 1 quarter later by 17% (odds ratio [OR] = 0.83, 95% confidence interval [CI]: 0.78–0.87, p < .001), two quarters later by 11% (OR = 0.89, 95% CI: 0.84–0.94, p < .001), and three quarters later by 9% (OR = 0.91, 95% CI: 0.86–0.96, p = .001). In Harris County, these services reduced the risk of arrest 1 quarter later by 5% (OR = 0.95, 95% CI: 0.91–0.99, p = .028), but not two and three quarters later. In Pinellas County, ER/inpatient services increased the risk of arrests by 22% (OR = 1.23, 95% CI: 1.15–1.30, p < .001), 8% (OR = 1.08, 95% CI: 1.02–1.15, p = .010) and 11% (OR = 1.11, 95% CI: 1.02–1.16, p = .001) one, two, and three quarters later. In Harris County, these services increased the risk of arrest only 1 quarter later (OR = 1.16, 95% CI: 1.11–1.22, p < .001). Results suggest that service receipt and its timing may have had some impact on the arrests of adults with a SMI and criminal justice involvement.

It has been reported that job demands affect sleep, but how different levels of job demands affect sleep remains unclear. We examined whether curvilinear relationships exist between job demands and multiple sleep health outcomes.

Learning to play a musical instrument is commonly recommended to avoid cognitive decline and dementia, but experimental evidence is lacking. In this Keys to Staying Sharp study, we investigated the efficacy of piano training as compared to music listening instruction to improve auditory processing, cognition, and everyday function among older adults with and without mild cognitive impairment (MCI). Older adult participants with and without MCI (n=268) included 58% females; 16% identified as Black race and 8.2% reported Hispanic ethnicity. Education ranged from 11 to 20 years. Participants were randomly assigned to either piano training (n=133) or an active control group of music listening instruction (n=135). Group training sessions were led by an instructor for 90 min twice a week for 20 sessions. Measures of auditory processing (time compressed speech, words-in-noise, dichotic digits test, dichotic sentence identification, adaptive tests of temporal resolution), cognition (trail making test, digit coding, verbal fluency), and everyday function (timed instrumental activities of daily living, test of everyday attention) were administered at baseline and immediately post the intervention phase. Analyses were registered at Open Science Frameworkhttps://osf.io/sh27y/on April 25, 2018. Relative to music listening, no significant effects of piano training on auditory processing, cognition, or everyday function were found (ps>0.265). Future research should continue to examine the connection of impaired auditory processing with subsequent dementia and investigate whether effectively enhancing auditory processing by intervention may reduce dementia risk.

Background: This study examines satisfaction across life domains (condition of the home, city of residence, daily life/leisure, family life, current financial situation, total household income, health, and life as a whole) among Black adults. The study also explores the association between satisfaction in each life domain and sociodemographic, personality, and mental/physical health measures. Methods: A community-dwelling sample of Black adults (n= 93, age range = 55–80) residing in the Tampa, FL area, completed a life satisfaction scale and measures of sociodemographic factors, personality, and mental/physical health between October 2014 and June 2016. Results: Better life satisfaction was observed in the oldest-old (80+) compared with the middle-aged (55–64; p&lt; .05). Less education, less financial strain, lower depressive symptoms, and better self-rated physical health were associated with higher satisfaction although the pattern of results varied by domain. Conclusions: Our findings suggest that the evaluation of life satisfaction domains may be a useful approach for identifying specific individual needs, which may inform age-friendly community initiatives.

The objective of this study is to explore the relationship between personality traits and sleep in community-dwelling older Blacks, and to examine whether conscientiousness moderates relationships between neuroticism and sleep (quality and duration) within this cohort.

This study examined the effectiveness of two commercially available cognitive interventions to enhance memory performance among older adults, an adaptive computerized program, Dakim BrainFitness, and a non-adaptive program of pencil-and-paper exercises, Mind Your Mind. Older adults were randomized to Dakim BrainFitness(n= 18), Mind Your Mind(n= 17), or a control (n= 17) condition. Memory outcomes were administered at baseline and post-training. Analyses included 52 older adults with an average age of 82 years old who completed baseline and post-training visits. The Dakim BrainFitnessprogram improved memory as indicated by one measure of immediate recall and both indices of delayed recall (ps < .05). There were no significant differences between the Mind Your Mindand control conditions in memory performance (ps > .05). Dakim BrainFitnesstraining showed potential effectiveness to improve some aspects of memory, while the Mind Your Mindprogram did not. The effectiveness of different types of cognitive interventions varies. Investigations to delineate the underlying mechanisms of effective techniques are needed.

Studies have reported bidirectional associations of sleep with daily stressors and negative mood. Yet we know little about how sleep is associated with workers' daily cognitive interference, or the experience of off-task and distracting thoughts. This study examined whether nightly sleep was associated with next-day cognitive interference, and vice versa, during workdays and non-work days.

Background: Great effort has been put into developing simple and feasible tools capable to detect Alzheimer's disease (AD) in its early clinical stage. Spatial navigation impairment occurs very early in AD and is detectable even in the stage of mild cognitive impairment (MCI). Objective: The aim was to describe the frequency of self-reported spatial navigation complaints in patients with subjective cognitive decline (SCD), amnestic and non-amnestic MCI (aMCI, naMCI) and AD dementia and to assess whether a simple questionnaire based on these complaints may be used to detect early AD. Method: In total 184 subjects: patients with aMCI (n=61), naMCI (n=27), SCD (n=63), dementia due to AD (n=20) and normal controls (n=13) were recruited. The subjects underwent neuropsychological examination and were administered a questionnaire addressing spatial navigation complaints. Responses to the 15 items questionnaire were scaled into four categories (no, minor, moderate and major complaints). Results: 55% of patients with aMCI, 64% with naMCI, 68% with SCD and 72% with AD complained about their spatial navigation. 38-61% of these complaints were moderate or major. Only 33% normal controls expressed complaints and none was ranked as moderate or major. The SCD, aMCI and AD dementia patients were more likely to express complaints than normal controls (p's<0.050) after adjusting for age, education, sex, depressive symptoms (OR for SCD=4.00, aMCI=3.90, AD dementia=7.02) or anxiety (OR for SCD=3.59, aMCI=3.64, AD dementia=6.41). Conclusion: Spatial navigation complaints are a frequent symptom not only in AD, but also in SCD and aMCI and can potentially be detected by a simple and inexpensive questionnaire.

The current study examined the association of family accommodation (i.e., assisting the child to avoid experiencing anxiety and/or removing demands secondary to anxiety) and treatment remission and response among 72 youth (ages 7 to 13 years) who participated in a randomized clinical trial of a computer-assisted cognitive-behavioral therapy for pediatric anxiety. Measures of family accommodation, anxiety, treatment improvement, and functional impairment were administered. Results suggest that every one unit increase in the level of impact of accommodation on child functioning at baseline was associated with a 26% decrease in the odds of remission at the end of treatment. None of the accommodation subscales predicted treatment response. Findings support the practitioner assessing family accommodation at baseline and further research on family accommodation and treatment outcomes.

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.

Cognitive reserve (CR) and BDNFVal66Met are independently associated with the rate of cognitive decline in preclinical Alzheimer's disease. This study was designed to investigate the interactive effects of these variables on 36-month cognitive change in cognitively intact older adults.

BackgroundAs the ageing population grows, it is important to identify strategies to moderate cognitive ageing.ObjectiveWe examined glycated haemoglobin (HbA1c) and diabetes in relation to level and change in episodic memory in older adults with and without diabetes.MethodsData from 4419 older adults with (n=950) and without (n=3469) diabetes participating in a nationally representative longitudinal panel study (the Health and Retirement Study) were examined. Average baseline age was 72.66 years and 58% were women. HbA1c was measured in 2006 and episodic memory was measured using immediate and delayed list recall over 4 biennial waves between 2006 and 2012. Growth curve models were used to assess trajectories of episodic memory change.ResultsIn growth curve models adjusted for age, sex, education, race, depressive symptoms and waist circumference, higher HbA1c levels and having diabetes were associated with poorer baseline episodic memory (p=0.036 and <0.001, respectively) and greater episodic memory decline (p=0.006 and 0.004, respectively). The effect of HbA1c on episodic memory decline was smaller than the effect of age. The results were stronger for women than men and were not modified by age or race. When the main analyses were estimated for those with and without diabetes separately, HbA1c was significantly linked to change in episodic memory only among those with diabetes.ConclusionsHigher HbA1c and diabetes were both associated with declines in episodic memory, with this relationship further exacerbated by having diabetes and elevated HbA1c. HbA1c appeared more important for episodic memory performance among women than men.

Matched pair study.

Although alcohol–stroke association is well known, the age-varying effect of alcohol drinking at midlife on subsequent stroke risk across older adulthood has not been examined. The effect of geneticearly-life factors is also unknown. We used cohort and twin analyses of data with 43 years of follow-up for stroke incidence to help address these gaps.

Sleep problems may adversely affect neuronal health. We examined a subjective report of change (reduced duration and/or depth) in sleep pattern in relation to subsequent risk of incident all-cause dementia and Alzheimer disease (AD) over 9 years.

We explored the effect of education and occupational complexity on the rate of cognitive decline (as measured by the Mini-Mental State Examination) in 171 patients with a confirmed Alzheimer's disease (AD) diagnosis. Complexity was measured as substantive complexity of work and complexity of work with data, people, and things. Average lifetime occupational complexity was calculated based on years at each occupation. Participants were followed for an average of 2.5 years and 3.7 visits. In multivariate mixed-effects models, high education, high substantive complexity, and high complexity of work with data and people predicted faster rates of cognitive decline, controlling for age, gender, native language, dementia severity, and entry into the analyses at initial versus follow-up testing. These results provide support for the concept of cognitive reserve according to which greater reserve may postpone clinical onset of AD but also accelerate cognitive decline after the onset. (JINS, 2006, 12, 147–152.)

Evaluation of patients for Alzheimer's disease often compares an individual's performance on cognitive tests to established norms. The purpose of this study was to compare performance on the CERAD Word List Memory tasks in normal controls from an Alzheimer's disease registry and in community volunteers. Scores on Word List Memory tasks were evaluated in cognitively intact participants enrolled in a university-based Alzheimer's disease registry (n = 103) and in a sample of community volunteers (n = 51). Scores for the two samples were also compared with previously published data from registry-based normal controls and from a representative community-based sample. University-based participants outperformed community volunteers, with most marked differences on Delayed Recall and on a Savings score that contrasted immediate to delayed recall. University-based participants performed similarly to previously published scores for normal controls from another university-based Alzheimer's disease registry, whereas community volunteers were consistent with published scores available from a representative community sample. Accurate neuropsychological assessment of Alzheimer's disease may require consideration of potentially subtle differences between older adults tested at university centers and those tested in the community.

Objective COVID-19 mortality varies across demographic groups at the national level, but little is known about potential differences in COVID-19 mortality across states. The objective of this study was to estimate the number of all-cause excess deaths associated with COVID-19 in Florida and Ohio overall and by sex, age, and race.Methods We calculated the number of weekly and cumulative excess deaths among adults aged ≥20 from March 15 through December 5, 2020, in Florida and Ohio as the observed number of deaths less the expected number of deaths, adjusted for population, secular trends, and seasonality. We based our estimates on death certificate data from the previous 10 years.Results The results were based on ratios of observed-to-expected deaths. The ratios were 1.17 (95% prediction interval, 1.14-1.21) in Florida and 1.15 (95% prediction interval, 1.11-1.19) in Ohio. Although the largest number of excess deaths occurred in the oldest age groups, in both states the ratios of observed-to-expected deaths were highest among adults aged 20-49 (1.21; 95% prediction interval, 1.11-1.32). The ratio of observed-to-expected deaths for the Black population was especially elevated in Florida.Conclusions Although excess deaths were largely concentrated among older cohorts, the high ratios of observed-to-expected deaths among younger age groups indicate widespread effects of COVID-19. The high levels of observed-to-expected deaths among Black adults may reflect in part disparities in infection rates, preexisting conditions, and access to care. The finding of high excess deaths among Black adults deserves further attention.