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Objectives Cognition consists of specific domains that are differentially linked to health outcomes. We provide guidance on how to derive cognitive domains in the National Social Life, Health, and Aging Project (NSHAP) study. We suggest the use of a bifactor analysis to derive cognitive domains. To support our view that a bifactor analysis is necessary, we created cognitive domains from a bifactor analysis and created cognitive domains through summing the cognitive items; we then regressed the cognitive domains created through both methods with functional health (activites of daily living [ADLs] and instrumental activities of daily living [IADLs]) and compared the regression results. Methods NSHAP is a nationally representative longitudinal study of U.S. older adults that started in 2005. Data from Round 3 (2015–2016) were used. The MoCA-SA contains 18 cognitive items to represent 6 cognitive domains: modified trail-making test-B, clock drawing test (3 items), rhinoceros naming, digit span (2 items), serial 7 subtractions, sentence repetition, phonemic fluency, abstraction, delayed recall (5 items), and orientation (2 items). We created cognitive domains through a bifactor analysis and through summing up the cognitive items. We used linear regression to examine how global cognition and each cognitive domain derived from both methods were associated with ADLs and IADLs. Analyses were restricted to respondents aged 50+ without dementia. Results The global cognition score derived from both methods was statistically significantly associated with ADLs and with IADLs. All but the memory domain constructed from summing the cognitive items were associated with IADLs; only the visuospatial domain was associated with ADLs. None of the domains derived from a bifactor analysis were associated with ADLs or IADLs. Discussion Researchers should derive cognitive domains using a bifactor analysis to reduce spurious associations. [ABSTRACT FROM AUTHOR]

Background and Objectives The role of social factors in diabetes onset has been obscured by wide variation in their conceptualization and operationalization. We apply 3 theoretical frameworks to categorize social relationship variables along several dimensions and identify which dimension(s) are robustly associated with incident diabetes in the older adult population. Research Design and Methods The National Social Life, Health, and Aging Project (n = 2,365) and the Health and Retirement Study (n =11,824) provided longitudinal data from 57 to 90-year-old respondents over a 4- to 5-year period. Logistic regression models were used to test associations of 15 social variables measured identically in both data sets with diabetes onset measured as respondents' first report of a physician's diagnosis. Results In both studies, not being married, experiencing strain in a spousal relationship, and feeling lonely were associated with increased risk for diabetes onset at follow-up. Inconsistent or null findings were observed for social support, social activity, network size, number of friends and relatives, living alone, and closeness to network members. Discussion and Implications Robust findings in 2 large-scale surveys support the importance of the valence dimension (i.e. positive and negative); specifically, alleviating negative aspects of social life might more effectively reduce risk for diabetes than augmenting positive ones. Findings were not aligned with social variables differing on the subjectivity dimension (i.e. structural, functional, and qualitative aspects of social connections). Future work needs consistent conceptualization and measurement of social factors to correctly identify and categorize risk factors for diabetes onset and other health conditions in older adults. [ABSTRACT FROM AUTHOR]

Background: Sensory disability in older adults is associated with increased rates of depressive symptoms and loneliness. Here, we examined the impact of hearing, vision, and olfaction disability on mental health outcomes in older US adults. Methods: We studied respondents from the first three rounds (2005/6, 2010/11, and 2015/16) of the National Social Life, Health and Aging Project, a nationally representative, longitudinal study of older US adults. Sensory function was assessed by structured interviewer ratings (hearing and vision) and objective assessment (olfaction). Cox proportional hazards models and one degree of freedom tests for trend were utilized to analyze the relationships between sensory disability and self‐rated mental health, frequent depressive symptoms, frequent perceived stress, frequent anxiety symptoms, and frequent loneliness symptoms over time, adjusting for demographics, health behaviors, comorbidities, and cognitive function. Results: We analyzed data from 3940 respondents over 10 years of follow‐up. A greater number of sensory disabilities was associated with greater hazard of low self‐rated mental health, frequent depressive symptoms, frequent perceived stress, and frequent loneliness symptoms over time (p ≤ 0.003, all). After adjusting for covariates, older adults with a greater number of sensory disabilities had greater hazard of low self‐rated mental health (HR = 1.22, CI = [1.08, 1.38], p = 0.002) and loneliness symptoms (HR = 1.13, CI = [1.05, 1.22], p = 0.003) over time in our tests for trend. In our Cox proportional hazards model, older adults with vision disability had greater hazard of low self‐rated mental health (HR = 1.34, 95% CI = [1.05, 1.72], p = 0.02) and loneliness symptoms (HR = 1.21, CI = [1.04, 1.41], p = 0.01). Conclusions: Older US adults with greater numbers of sensory disabilities face worse subsequent mental health. Future longitudinal studies dissecting the relationship of all five classical senses will be helpful in further understanding how improving sensory function might improve mental health in older adults. [ABSTRACT FROM AUTHOR]

Multisensory, physical, and cognitive dysfunction share age-related physiologic disturbances and may have common health effects. We determined whether the effect of multisensory impairment on physical activity (PA) is explained by physical (timed up and go) or cognitive (Short Portable Mental Status Questionnaire) dysfunction. A National Social Life, Health, and Aging Project participant subset (n = 507) underwent objective sensory testing in 2005–2006 and wrist accelerometry in 2010–2011. We related multisensory impairment to PA using multivariate mixed-effects linear regression and compared the effect magnitude after adjusting for physical then cognitive dysfunction. Worse multisensory impairment predicted lower PA across three scales (Global Sensory Impairment: β = −0.04, 95% confidence interval [−0.07, −0.02]; Total Sensory Burden: β = −0.01, 95% confidence interval [−0.03, −0.003]; and Number of Impaired Senses: β = −0.02, 95% confidence interval [−0.04, −0.004]). Effects were similar after accounting for physical and cognitive dysfunction. Findings suggest that sensory, physical, and cognitive dysfunction have unique mechanisms underlying their PA effects. [ABSTRACT FROM AUTHOR]

Background: Frailty is prevalent among older adults with asthma or chronic obstructive pulmonary disease (obstructive lung diseases [OLDs]). Frailty and OLD's co‐occurrence is associated with increased hospitalization/mortality. Chemosensory dysfunction is closely connected to both OLD and frailty. We evaluated the utility of olfactory decline as a biomarker of frailty in the setting of OLD. Methods: We performed a prospective, longitudinal, nationally representative study of community‐dwelling older US adults in the National Social Life, Health and Aging Project, an omnibus in‐home survey. Respondents reported a physician's diagnosis of OLD. Decline in odor identification and sensitivity over 5 years and frailty (adapted fried frailty phenotype criteria) were measured using standard tools. Multivariate logistic regressions evaluated the association between OLD status, olfactory decline, and frailty. Results: We compared individuals with OLD (n = 98; mean age 71.2 years, 59.2% women) and those without OLD (n = 1036; mean age 69.5 years, 58.9% women). Olfactory identification decline was associated with developing frailty over the 5‐year follow‐up period in individuals with OLD (odds ratio [OR] = 9.1, 95% confidence interval [CI] = 2.1–38.6, p = 0.003). Olfactory decline predicted incidence of frailty in individuals with OLD (identification: OR = 4.8, 95% CI = 1.3–17.5, P = 0.018; sensitivity: OR = 6.1, 95%CI = 1.2–31.0, p = 0.030) but not in those without OLD adjusting for demographics, heavy alcohol use, current smoking, and comorbidity. Results were robust to different thresholds for olfactory decline and frailty development. Conclusions: Older adults with OLD who experience olfactory decline face higher odds of developing frailty. Use of olfactory decline as a biomarker to identify frailty could allow earlier intervention and decrease adverse outcomes for high‐risk older adults with OLD. [ABSTRACT FROM AUTHOR]

Background: Pathophysiology of rhinitis in older adults is largely unknown. We tested whether air pollution is associated with this condition and how immune mechanisms may play a role in this relationship. Methods: We analyzed cross‐sectional data from the National Social Life, Health, and Aging Project, a nationally representative study of older adults born between 1920 and 1947. Particulate matter ≤2.5 μm (PM2.5) air pollution exposure estimates were generated using validated spatiotemporal models. Presence of rhinitis was defined based on medication use (≥1: intranasal medications: steroids, antihistamines, lubricants, and/or decongestants, and/or oral medications: antihistamines and/or decongestants). K‐means cluster analysis (Jaccard method) was used to group 13 peripheral blood cytokines into 3 clusters to facilitate functional determination. We fitted multivariate logistic regressions to correlate PM2.5 exposure with presence of rhinitis, controlling for confounders, and then determined the role of cytokines in this relationship. Results: Long‐ (but not short‐) term exposure to PM2.5 was associated with presence of rhinitis: 3‐year exposure window, odds ratio (OR) = 1.32, 95% confidence interval (CI): 0.98, 1.80, per 1 standard deviation (SD) PM2.5 increase. Inclusion of cytokine cluster in the model led to a modestly stronger effect of PM2.5 exposure on rhinitis (OR = 1.37; 95% CI: 1.00, 1.87; 3‐year exposure window). The particular immune profile responsible for this result was composed of elevated IL‐3, IL‐12, and IFN‐γ (OR = 4.86, 95% CI: 1.10, 21.58, immune profile–PM2.5 exposure interaction term). Conclusion: We show for the first time that IL‐3, IL‐12, and IFN‐γ explain in part the relationship between PM2.5 exposure and rhinitis in older US adults. If confirmed, these immune pathways may be used as therapeutic targets. [ABSTRACT FROM AUTHOR]

Objectives During social isolation imposed by the coronavirus disease 2019 (COVID-19) pandemic, older adults with impaired hearing and vision potentially experienced more communication challenges, increasing their risk for poor mental health. Digital communication (e.g. video calls, e-mail/text/social media) may alleviate in-person isolation and protect against depression. We addressed this question using data from the National Social Life, Health, and Aging Project, a nationally representative panel study of community-dwelling older adults. Method Two thousand five hundred fifty-eight adults aged 55 and older comprised the analytic sample. Interviewer rating at baseline (2015–2016) classified those with vision impairment (VI) or hearing impairment (HI). Olfactory impairment (OI) was measured by objective testing. During COVID-19 (2020–2021), respondents reported how often they contacted nonhousehold family or friends and whether this was by phone, e-mail/text/social media, video, or in-person. They also quantified the frequency of depressive feelings. Results Older adults with VI or HI but not OI at baseline were significantly less likely to report regular use of video calling and e-mail/text/social media during the pandemic compared to those without impairment. Sensory impairments did not affect the frequency of phone or in-person communication. Adults with VI or HI were more likely to experience frequent depressive feelings during COVID-19. Video calls mitigated this negative effect of VI- and HI-associated depressive feelings in a dose-dependent manner. Discussion Among communication modalities, video calling had a protective effect against depressive feelings for people with sensory impairment during social isolation. Improving access to and usability of video communication for older adults with sensory impairment could be a strategy to improve their mental health. [ABSTRACT FROM AUTHOR]

Introduction: Longitudinal multivariable analyses are needed to determine if the rate of olfactory decline during normal cognition predicts subsequent Alzheimer's disease (AD) diagnoses and brain dysmorphology. Methods: Older adults (n = 515) were assessed annually for odor identification, cognitive function and dementia clinical diagnosis (max follow‐up 18 years). Regional gray matter volumes (GMV) were quantified (3T MRI) in a cross‐sectional subsample (n = 121). Regression models were adjusted for APOE‐ε4 genotype, dementia risk factors and demographics. Results: Faster olfactory decline during periods of normal cognition predicted higher incidence of subsequent MCI or dementia (OR 1.89, 95% CI: 1.26, 2.90, p < 0.01; comparable to carrying an APOE‐ε4 allele) and smaller GMV in AD and olfactory regions (β = −0.11, 95% CI −0.21, −0.00). Discussion: Rapid olfactory decline during normal cognition, using repeated olfactory measurement, predicted subsequent cognitive impairment, dementia, and smaller GMVs, highlighting its potential as a simple biomarker for early AD detection. Highlights: Rate of olfactory decline was calculated from olfactory testing over ≥3 time points.Rapid olfactory decline predicted impaired cognition and higher risk of dementia.Neurodegeneration on 3T magnetic resonance imaging was identical in those with olfactory decline and Alzheimer's disease. [ABSTRACT FROM AUTHOR]

This document is a response to a critique of a study on the association between air pollution exposure and rhinitis in older US adults. The authors address two points of contention raised by the critics. First, they defend their definition of rhinitis based on medication use, stating that alternative diagnoses are unlikely to significantly alter their main findings. Second, they argue that the use of intranasal steroids does not interfere with systemic cytokine measurements, as these steroids have little systemic bioavailability. The study was funded by the National Institute on Aging of the National Institutes of Health. [Extracted from the article]