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Chronic stress is associated with negative health outcomes, including poorer cognition. Some studies found stress from caregiving associated with worse cognitive functioning; however, findings are mixed. The present study examined the relationship between caregiving, caregiving strain, and cognitive functioning. We identified participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who were family caregivers at baseline assessment and used propensity matching on 14 sociodemographic and health variables to identify matched noncaregivers for comparison. Data included up to 14 years of repeated assessments of global cognitive functioning, learning and memory, and executive functioning. Our results showed that when compared to noncaregivers, caregivers had better baseline scores on global cognitive functioning and word list learning (WLL). Among caregivers, a lot of strain was associated with better WLL and delayed word recall in the unadjusted model only. Caregivers with a lot of strain had higher depressive symptoms but not significantly higher high-sensitivity c-reactive protein (hsCRP) at baseline compared to caregivers with no or some strain after covariate adjustment. Although caregiving can be highly stressful, we found caregiving status and caregiving strain were not associated with cognitive decline. More methodologically rigorous studies are needed, and conclusions that caregiving has negative effects on cognition should be viewed with caution. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objectives: The present study examines the associations between mental, social, and physical demands of work and cognitive functioning among older adults in the United States., Method: Data from 3,176 respondents in the Health and Retirement Study were analyzed using growth curve modeling (2004-2014). The study investigated differences by gender, race, ethnicity, and education., Results: Higher mental and social demands of work were associated with higher levels of initial cognitive functioning, but were not significantly associated with slower cognitive decline over time. Physical demands of work were negatively associated with initial cognitive functioning and were also marginally associated with a slower rate of decline in cognitive functioning going into older adulthood. In stratified analyses, results varied by sociodemographic characteristics., Discussion: The results partially support the environmental complexity hypothesis and the productive aging framework in that higher mental and social demands and lower physical demands relate to better cognitive functioning at baseline, with the differences appearing stable throughout older adulthood. The stratified results shed light on addressing disparities in cognitive aging and work environments., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Musculoskeletal pain alters physiological function, which may be evidenced as early as middle age. Previous research has concluded that middle-aged adults are a high-risk group for musculoskeletal pain and report functional limitations similar to older adults. However, few studies have examined the relationships between musculoskeletal pain and physical function, using objective performance measures in a sample of racially and socioeconomically diverse adults. Thus, this study examined musculoskeletal pain in relation to physical function in middle-aged (30-64 years) White and Black adults and investigated whether the relationship varied by sociodemographic characteristics., Methods: This cross-sectional examination incorporated data from the Healthy Aging in Neighborhoods of Diversity across the Life-Span Study. Participants (n = 875) completed measures of musculoskeletal pain and objective measures of physical performance (ie, lower and upper body strength, balance, and gait abnormalities). Physical performance measures were standardized to derive a global measure of physical function as the dependent variable., Results: Approximately, 59% of participants identified at least 1 pain sites (n = 518). Multivariable regression analyses identified significant relationships between greater musculoskeletal pain and poorer physical function (β = -0.07, p = .031), in mid midlife (β = -0.04, p = .041; age 40-54) and late midlife (β = -0.05, p = .027; age 55-64)., Conclusions: This study observed that musculoskeletal pain was associated with poorer physical function within a diverse group of middle-aged adults. Future research should longitudinally explore whether chronic musculoskeletal pain identified at younger ages is associated with greater risk for functional limitation and dependence in later life., (Published by Oxford University Press on behalf of The Gerontological Society of America 2020.)

This study evaluated beliefs regarding 25 content areas essential to the primary care of older adults and attitudes toward aging held by first-yearmedical students and Internal Medicine residents. A survey of 136 medical students and 61 Internal Medicine residents was conducted at an academic health-center. Beliefs were assessed by the 25-item Geriatrics Clinician-Educator Survey. Gap scores reflecting the difference in ratings between self-rated importance and knowledge were calculated. Attitudes toward aging was assessed by the Images of Aging Scale. Students and residents expressed similar beliefs about the importance of content areas, but students provided lower ratings in knowledge. Students reported larger gap scores in areas that reflected general primary care (e.g., chronic conditions, medications), whereas residents reported larger gap scores in areas that reflected specialists' expertise (e.g., driving risk, cognition, psychiatric symptoms). Attitudes toward aging did not differ appreciably between students and residents. Our findings suggest that primary care topics applicable for any age demographic were rated as most important by first-year medical students and Internal Medicine residents. Topics relevant to older populations--particularly those requiring specialists' knowledge of or requiring sensitive discussion with older adults-were rated as less important and were less well-mastered.

Background: The hippocampus, entorhinal cortex, and basal forebrain are among the first brain structures affected by Alzheimer's disease (AD). They play an essential role in spatial pattern separation, a process critical for accurate encoding of similar spatial information., Objective: Our aim was to examine spatial pattern separation and its association with volumetric changes of the hippocampus, entorhinal cortex, and basal forebrain nuclei projecting to the hippocampus (the medial septal nuclei and vertical limb of the diagonal band of Broca - Ch1-2 nuclei) in the biomarker-defined early clinical stages of AD., Methods: A total of 98 older adults were recruited from the Czech Brain Aging Study cohort. The participants with amnestic mild cognitive impairment (aMCI) due to AD (n = 44), mild AD dementia (n = 31), and cognitively normal older adults (CN; n = 23) underwent spatial pattern separation testing, comprehensive cognitive assessment, and MRI brain volumetry., Results: Spatial pattern separation accuracy was lower in the early clinical stages of AD compared to the CN group (p < 0.001) and decreased with disease severity (CN > aMCI due to AD > AD dementia). Controlling for general memory and cognitive performance, demographic characteristics and psychological factors did not change the results. Hippocampal and Ch1-2 volumes were directly associated with spatial pattern separation performance while the entorhinal cortex operated on pattern separation indirectly through the hippocampus., Conclusion: Smaller volumes of the hippocampus, entorhinal cortex, and basal forebrain Ch1-2 nuclei are linked to spatial pattern separation impairment in biomarker-defined early clinical AD and may contribute to AD-related spatial memory deficits.

The Philippines is a diverse country that will experience an increase in its aging population in the near future. The aim of this article is to provide an overview of the main issues surrounding population aging, as well as family caregiving and policies that are of concern to older adults in the Philippines. Policymakers and government leaders must plan for the expected growth in the numbers of older adults, which is likely to increase the demand for services and support for elders and their caregiving families. The Philippines' unique history and rich culture shapes its citizens' views on aging and bolsters expectations of informal caregiving for older family members. Research on aging in the Philippines and current policies must be enhanced to adequately address the needs of the country's aging citizens.

Spatial navigation (SN) impairment is present early in Alzheimer's disease (AD). We tested whether SN performance, self-centered (egocentric) and world-centered (allocentric), was distinguishable from performance on established cognitive functions-verbal and nonverbal memory, executive and visuospatial function, attention/working memory, and language function. 108 older adults (53 cognitively normal [CN] and 55 with amnestic mild cognitive impairment [aMCI]) underwent neuropsychological examination and real-space navigation testing. Subset (n = 63) had automated hippocampal volumetry. In a factor analysis, allocentric and egocentric navigation tasks loaded highly onto the same factor with low loadings on other factors comprising other cognitive functions. In linear regression, performance on other cognitive functions was not, or was only marginally, associated with spatial navigation performance in CN or aMCI groups. After adjustment for age, gender, and education, right hippocampal volume explained 26% of the variance in allocentric navigation in aMCI group. In conclusion, spatial navigation, a known cognitive marker of early AD, may be distinguished from other cognitive functions. Therefore, its assessment along with other major cognitive functions may be highly beneficial in terms of obtaining a comprehensive neuropsychological profile., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: High plasma homocysteine (Hcy) level is related to higher risk of Alzheimer's disease (AD) and lower cognitive performance in older adults., Objective: To assess the association between plasma Hcy level and real-space navigation performance and the role of vascular risk and protective factors, APOE status, and white matter lesions (WML) on this association., Methods: Ninety-two non-demented older adults (29 with amnestic mild cognitive impairment, 46 with subjective cognitive decline, and 17 cognitively normal older adults) underwent spatial navigation testing of egocentric, allocentric, and mixed navigation in a real-space analogue of the Morris water maze, neuropsychological examination, blood collection, and MRI brain scan with evaluation of WML., Results: In the regression analyses controlling for age, gender, education, and depressive symptoms, higher plasma Hcy level was related to worse mixed and egocentric (β= 0.31; p = 0.003 and β= 0.23; p = 0.017) but not allocentric (p > 0.05) navigation performance. Additional controlling for vascular risk and protective factors, WML, and APOE status did not modify the results. High total cholesterol and low vitamin B12 and folate levels increased the adverse effect of Hcy on egocentric and mixed navigation. WML did not explain the association between plasma Hcy level and navigation performance., Conclusion: Elevated plasma Hcy level may affect real-space navigation performance above and beyond vascular brain changes. This association may be magnified in the presence of high total cholesterol and low folate or vitamin B12 levels. Attention to the level of plasma Hcy may be a viable intervention strategy to prevent decline in spatial navigation in non-demented older adults.

Background: Subjective cognitive complaints (SCCs) may be an early marker of prodromal Alzheimer's disease., Objectives: Using a 10-item yes/no SCCs questionnaire (Le Questionnaire de Plainte Cognitive [QPC]), we evaluated the prevalence and distribution of SCCs in cognitively healthy Czech older adults and examined total score and specific QPC items in relation to depressive symptomology and cognitive performance., Methods: A sample of 340 cognitively healthy older community-dwelling volunteers aged 60 or older from the third wave of the longitudinal project National Normative Study of Cognitive Determinants of Healthy Aging, who underwent a comprehensive neuropsychological assessment and completed the QPC and the 15-item Geriatric Depression Scale (GDS-15). Regression analysis was controlled for age when GDS-15 was the outcome and for age and GDS-15 with cognitive domains as the outcome., Results: 71% reported 1 + SCCs, with prevalence of individual complaints ranging from 4% to 40%. The number of SCCs was associated with GDS-15 (p < 0.001). Personality change (p < 0.001) and Limitation in daily activities (p = 0.002) were significantly associated with higher GDS-15 score and Spatial orientation difficulties (p = 0.019) and Impression of worse memory in comparison to peers (p = 0.012) were significantly associated with lower memory performance., Conclusions: We identified some cognitive complaints that were very common in our sample. Overall, a higher number of SCCs in well cognitively functioning individuals was most closely related to depressive symptomatology, while some specific complaints reflected lower memory performance and should be considered when screening for people at risk of cognitive decline.

Introduction: Monitoring for various health conditions (e.g., breast cancer, hypertension) has become common practice. However, there is still no established tool for regular monitoring of cognition. In this pilot longitudinal study, we examined the utility and feasibility of internet-based cognitive self-monitoring using data from the first 12 months of this ongoing study., Method: Cognitively healthy community-dwelling older adults (Montreal Cognitive Assessment ≥ 26) were enrolled on a rolling basis and were trained in self-administration of the internet-based version of the CogState Brief Battery. The battery uses playing cards and includes Detection, Identification, One Back, and One Card Learning subtasks., Results: Of the 118 participants enrolled, 26 dropped out, mostly around first in-home session. Common reasons for participant attrition were internet browser problems, health problems, and computer problems. Common reasons for delayed session completion were being busy, being out of town, and health problems. Participants needed about one reminder phone call per four completed sessions or one reminder email per five completed sessions. Performance across the monthly sessions showed slight (but significant) improvement on three of the four tasks. Change in performance was unaffected by individual characteristics with the exception of previous computer use, with less frequent users showing greater improvement on One Card Learning. We also found low intraindividual variability in monthly test scores beyond the first self-administered testing session., Conclusions: Internet-based self-monitoring offers a potentially feasible and effective method of continuous cognitive monitoring among older adults.

Background: Psychosocial work characteristics may predict cognitive functioning after retirement. However, little research has explored specific cognitive domains associated with psychosocial work environments. Our study tested whether exposure to job demands, job control and their combination during working life predicted post-retirement performance on eight cognitive tests., Methods: We used data from French GAZEL cohort members who had undergone post-retirement cognitive testing (n=2149). Psychosocial job characteristics were measured on average for 4 years before retirement using Karasek's Job Content Questionnaire (job demands, job control and demand-control combinations). We tested associations between these exposures and post-retirement performance on tests for executive function, visual-motor speed, psychomotor speed, verbal memory, and verbal fluency using ordinary least squares regression., Results: Low job control during working life was negatively associated with executive function, psychomotor speed, phonemic fluency and semantic fluency after retirement (p's<0.05), even after adjustment for demographics, socioeconomic status, health and social behaviours and vascular risk factors. Both passive (low-demand, low-control) and high-strain (high-demand, low-control) jobs were associated with lower scores on phonemic and semantic fluency when compared to low-strain (low-demand, high-control) jobs., Conclusions: Low job control, in combination with both high and low-job demands, is associated with post-retirement deficits in some, but not all, cognitive domains. In addition to work stress, associations between passive work and subsequent cognitive function may implicate lack of cognitive engagement at work as a risk factor for future cognitive difficulties., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Objectives: We examined the influence of postretirement leisure activity on longitudinal associations between work complexity in main lifetime occupation and trajectories of cognitive change before and after retirement., Methods: Information on complexity of work with data, people, and things, leisure activity participation in older adulthood, and four cognitive factors (verbal, spatial, memory, and speed) was available from 421 individuals in the longitudinal Swedish Adoption/Twin Study of Aging. Participants were followed for an average of 14.2 years (SD = 7.1 years) and up to 23 years across eight cognitive assessments. Most of the sample (88.6%) completed at least three cognitive assessments., Results: Results of growth curve analyses indicated that higher complexity of work with people significantly attenuated cognitive aging in verbal skills, memory, and speed of processing controlling for age, sex, and education. When leisure activity was added, greater cognitive and physical leisure activity was associated with reduced cognitive aging in verbal skills, speed of processing, and memory (for cognitive activity only)., Discussion: Engagement in cognitive or physical leisure activities in older adulthood may compensate for cognitive disadvantage potentially imposed by working in occupations that offer fewer cognitive challenges. These results may provide a platform to encourage leisure activity participation in those retiring from less complex occupations., (© The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Hearing loss has been well-documented as a risk factor for cognitive impairment, but the simple presence of hearing loss is not a sufficient predictor of cognitive decline. Although auditory behavioral research has not revealed an effective indicator of early cognitive impairment, a limited number of studies using cortical auditory evoked potentials (CAEPs) have shown promising evidence of an auditory neurophysiological indicator of early-stage cognitive impairment. The purpose of this study was to examine the P1-N1-P2 complex for indicators of cognitive impairment., Methods: The latency and amplitude of the P1-N1-P2 complex was measured for two stimuli (pure tone, speech) in two groups: cognitively normal older adults (CNOAs) and older adults with probable mild cognitive impairment (MCI), based on the Montreal Cognitive Assessment., Results: Significantly smaller P2 amplitudes were found for those with probable MCI compared to CNOA across stimulus conditions. Stimulus effects were found for P1 and P2 latency., Conclusion: P2 amplitude may be a useful indicator of early-stage cognitive impairment., Significance: As effective treatments become available, early identification of cognitive impairment can facilitate the prescription of treatment at the earliest juncture. CAEPs have the potential to serve as efficient, non-invasive, cost-effective indicators of future cognitive decline and impairment., (Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)

Background: Although evidence indicates that Type II Diabetes is related to abnormal brain aging, the influence of elevated blood glucose on long-term cognitive change is unclear. In addition, the relationship between diet-based glycemic load and cognitive aging has not been extensively studied. The focus of this study was to investigate the influence of diet-based glycemic load and blood glucose on cognitive aging in older adults followed for up to 16 years., Methods: Eight-hundred and thirty-eight cognitively healthy adults aged ≥50 years (M = 63.1, SD = 8.3) from the Swedish Adoption/Twin Study of Aging were studied. Mixed effects growth models were utilized to assess overall performance and change in general cognitive functioning, perceptual speed, memory, verbal ability, and spatial ability as a function of baseline blood glucose and diet-based glycemic load., Results: High blood glucose was related to poorer overall performance on perceptual speed as well as greater rates of decline in general cognitive ability, perceptual speed, verbal ability, and spatial ability. Diet-based glycemic load was related to poorer overall performance in perceptual speed and spatial ability., Conclusion: Diet-based glycemic load and, in particular, elevated blood glucose appear important for cognitive performance/cognitive aging. Blood glucose control (perhaps through low glycemic load diets) may be an important target in the detection and prevention of age-related cognitive decline., (© The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Perspective taking is the ability to imagine what a scene looks like from a different viewpoint, which has been reported to be impaired in Alzheimer's disease (AD). This study compared overhead and first-person view perspective taking abilities in patients with mild cognitive impairment (MCI) and AD. A newly developed Arena Perspective Taking Task (APTT), using an environment of a circular arena, was used to compare 23 AD patients and 38 amnestic MCI patients with 18 healthy controls. The results were contrasted with a published perspective taking test (Standardized Road-Map Test of Direction Sense, RMTDS). The AD group was impaired in both overhead and first-person view APTT versions, but the impairment in the overhead view version applied specifically to women. Patients with aMCI were impaired in the first-person view but not in the overhead view version. Substantial sexual differences were found in the overhead but not in the first-person view APTT version. The RMTDS resembled both APTT versions: patients with aMCI were impaired in this test and also women in both patient groups were less accurate than men. Using the receiver operating characteristic analysis, the highest predictive power for MCI and AD patients diagnosis versus controls was observed for their success rate in the first-person view version. The results suggest distinction between overhead and first-person view perspective taking in the impairment of aMCI patients and the sex differences. The first-person view perspective taking is a potentially important candidate psychological marker for AD., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Objective: To examine whether occupational complexity of working with data or people, and cognitive or social leisure activity at midlife predicted cognition in advanced old age., Methods: We used 810 eligible participants from Longitudinal Study of Living Conditions of the Oldest Old, a Swedish nationally representative study of individuals aged 77+ with cognitive assessments (an abridged version of the Mini-Mental State Exam) administered in 1992 and 2002 and linked to information about their midlife occupation and leisure activities collected in 1968 and 1981. A bootstrapping technique was applied to examine the direct and interactive associations of occupational complexity and leisure activity with late-life cognition., Results: Controlling for demographic and health-related factors from childhood, midlife, and late life, we found that greater work complexity, both with people and with data, and greater participation in cognitive or social leisure activities independently related to better late-life cognitive scores. The complexity-cognition link was moderated by leisure activity such that the cognitive benefit related to the complexity of work-especially complexity of working with people-was rendered insignificant when participation in leisure activities-especially social activities-was above average., Discussion: Results are discussed in terms of using work complexity to compensate for lack of leisure activity as well as in terms of promoting leisure engagement to compensate for long-term cognitive disadvantage imposed by working in less challenging occupations., (© The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The goal was to provide an overview of main issues relevant to aging in the Czech Republic. The Czech Republic is a former Eastern Bloc nation of about 10.5 million. Older adults are overrepresented relative to those under age 15. Life expectancy currently hovers around 78 years (75 for men/81 for women), a number slightly higher than most of Eastern Europe but lower than most of Western Europe. Cardiovascular diseases account for about 50% of all mortality, which is one of the highest rates in Europe and therefore of particular concern. Lifestyle habits, especially high alcohol consumption, a high rate of smokers, and high-fat diet relative to most other European countries and the United States, combined with relatively low expenditures for health promotion, appear important in the context of high cardiovascular mortality. Long-term care is funded mostly by state and local governments. The country has tried to address issues associated with insufficient capacity and low quality in long-term care, a particularly prominent problem in the Czech Republic compared with other European countries. The recently established International Clinical Research Center brings new possibilities for collaborative research in the Czech Republic, including research specific to aging. Improving long-term care and establishing methodologically sound longitudinal data sets are among the most pressing issues, although sustaining the pension system strained by increasing life expectancy, low retirement age, and extensive government-sponsored benefits has also recently emerged as a critical issue., (© The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background and Objective: Cognitive deficits in older adults attributable to Alzheimer's disease (AD) pathology are featured early on by hippocampal impairment. Among tests used to evaluate memory, verbal memory tests with controlled encoding and cued recall are believed to be specific for hippocampal impairment. The objective of this study was to assess the relation between left and right hippocampal volumes and several frequently used memory tests., Methods: Fifty six nondemented older adults (30 with amnestic mild cognitive impairment and 26 cognitively healthy older adults) underwent neuropsychological testing including: (1) The Enhanced Cued Recall test (ECR), a memory test with controlled encoding and recall; (2) the Auditory Verbal Learning Test (AVLT), a verbal memory test without controlled encoding and with delayed recall; and (3) The Rey-Osterrieth Complex Figure test (ROCF), a visuospatial memory test-recall condition. 1.5T brain MRI scans were used to measure estimated total intracranial volume (eTIV) along with hippocampal right and left volumes, which were measured with quantitative volumetry using FreeSurfer package (version 4.4.0). Spearman partial correlation controlled for age was used to correct for non-normal score distribution and effect of age., Results: We found moderate correlations of hippocampal volumes with AVLT 1-5 scores, AVLT delayed recall, ECR free and total recall, and ROCF reproduction. Total recall in ECR using cued recall was not superior to any of the free recall tests. No correlation in any memory test was achieved with eTIV., Conclusion: Verbal memory tests, either with controlled encoding and cued delayed recall (ECR), or without it (AVLT), as well as nonverbal memory test with delayed recall (ROCF), equally reflect hippocampal atrophy in nondemented older adults.

Objectives: The present study investigated patterns of self-reported driving habits among healthy older adults over 5 years, as well as characteristics that distinguished subgroups with different patterns., Methods: Participants were drivers from the control group of the Advanced Cognitive Training for Independent and Vital Elderly study at the baseline assessment (N = 597). The outcome was a composite of driving frequency, driving space, and perceived driving difficulty. Growth mixture models identified classes of participants with different baseline scores and change trajectories, and classes were compared in terms of baseline sensory, physical, and cognitive functioning., Results: A 3-class model was indicated, consisting of 2 classes with intercept differences and stability over time, "above-average stable" (39%) and "average stable" drivers (44%), and 1 class with a lower intercept and negative slope, "decreasers" (17%). Relative to stable drivers, decreasers exhibited significantly more depressive symptoms and poorer self-rated health, balance, everyday functioning, and speed of processing after controlling for age and education (p < .05)., Discussion: The majority of older drivers maintained their driving over time at different levels, whereas a subgroup of individuals with poorer baseline functioning self-regulated by reducing their driving. Future studies should determine how such patterns affect driving safety.

We examined the association between complexity of the main lifetime occupation and changes in cognitive ability in later life. Data on complexity of work with data, people, and things and on 4 cognitive factors (verbal, spatial, memory, and speed) were available from 462 individuals in the longitudinal Swedish Adoption/Twin Study of Aging. Mean age at the first measurement wave was 64.3 years (SD = 7.2), and 65% of the sample had participated in at least three waves of data collection. Occupational complexity with people and data were both correlated with cognitive performance. Individuals with more complex work demonstrated higher mean performance on the verbal, spatial, and speed factors. Latent growth curve analyses indicated that, after correcting for education, only complexity with people was associated with differences in cognitive performance and rate of cognitive change. Continued engagement as a result of occupational complexity with people helped to facilitate verbal function before retirement, whereas a previous high level of complexity of work with people was associated with faster decline after retirement on the spatial factor., ((c) 2009 APA, all rights reserved.)

The Useful Field of View Test (UFOV) has been used as an examination of age-related changes in visual processing and cognition and as an indicator of everyday performance outcomes, particularly driving, for over 20 years. How UFOV performance changes with age and what may impact such changes have not previously been investigated longitudinally. Predictors of change in UFOV performance over a 5-year period among control group participants (N=690) from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study were examined. Random effects models were estimated with 4-subtest-total UFOV as the outcome and with baseline age, education, gender, race, visual acuity, depressive symptoms, mental status, and self-rated health, as well as attrition, as predictors. UFOV performance generally followed a curvilinear pattern, improving and then declining over time. Only increased age was consistently related to greater declines in UFOV performance over time. UFOV and Digit Symbol Substitution subtest, a standard measure of cognitive speed, had similar trajectories of change. The implications of these results are discussed., (Copyright (c) 2009 APA, all rights reserved.)

We examined associations between multiple aspects of social resources and 5-year change in performance on different domains of cognitive function. Results indicated that lower satisfaction with support was associated with decline in episodic memory performance over 5 years. We also found significant interactions between age and social networks of family and friends and satisfaction with support for the separate cognitive domains. The results suggest that social resources may be differentially important for cognitive change but that different cognitive domains respond in a similar pattern to social resources.

Objectives "SuperAgers" are generally defined as people 80+ years old with episodic memory performance comparable to those 20 years younger. Limited knowledge exists to describe characteristics of SuperAgers, with even less known about Hispanic SuperAgers. Methods We examined indicators of cognitive, physical, and psychological resilience in relation to the likelihood of being a SuperAger using data from 2 population-based studies of Hispanic older adults (Puerto Rican Elderly: Health Conditions [PREHCO] Study; Health and Retirement Study [HRS]). SuperAgers were defined as (1) ≥80 years old, (2) recall scores ≥ the median for Hispanic respondents aged 55–64, and (3) no cognitive impairment during the observation period. Overall, 640 PREHCO participants and 180 HRS participants were eligible, of whom 45 (7%) and 31 (17%) met SuperAging criteria. Results Logistic regressions controlling for age and sex demonstrated that higher education (PREHCO: odds ratio [OR] = 1.20, p  < .001; HRS: OR = 1.14, p  = .044) and fewer instrumental activities of daily living limitations (PREHCO: OR = 0.79, p  = .019; HRS: OR = 0.58, p  = .077; cognitive resilience), fewer activities of daily living limitations (PREHCO: OR = 0.72, p  = .031; HRS: OR = 0.67, p  = .068; physical resilience), and fewer depressive symptoms (PREHCO: OR = 0.84, p  = .015; HRS: OR = 0.69, p  = .007; psychological resilience) were associated with SuperAging, although not all results reached threshold for statistical significance, presumably due to low statistical power. Additionally, known indicators of physical health (e.g. chronic conditions and self-rated health) did not relate to SuperAging. Discussion Increasing access to education and recognizing/treating depressive symptoms represent potential pathways to preserve episodic memory among older Hispanic adults. [ABSTRACT FROM AUTHOR]

Background Having multiple sleep problems is common in adulthood. Yet, most studies have assessed single sleep variables at one timepoint, potentially misinterpreting health consequences of co-occurring sleep problems that may change over time. We investigated the relationship between multidimensional sleep health across adulthood and mortality. Methods Participants from the Midlife in the United States Study reported sleep characteristics in 2004–2006 (MIDUS-2; M2) and in 2013–2014 (MIDUS-3; M3). We calculated a composite score of sleep health problems across 5 dimensions: Regularity, Satisfaction, Alertness, Efficiency, and Duration (higher = more problems). Two separate models for baseline sleep health (n  = 5 140; median follow-up time = 15.3 years) and change in sleep health (n  = 2 991; median follow-up time = 6.4 years) to mortality were conducted. Cox regression models controlled for sociodemographics and key health risk factors (body mass index, smoking, depressive symptoms, diabetes, and hypertension). Results On average, 88% of the sample reported having one or more sleep health problems at M2. Each additional sleep health problem at M2 was associated with 12% greater risk of all-cause mortality (hazard ratio [HR] = 1.12, 95% confidence interval [CI] = 1.04–1.21), but not heart disease-related mortality (HR = 1.14, 95% CI = 0.99–1.31). An increase in sleep health problems from M2 to M3 was associated with 27% greater risk of all-cause mortality (HR = 1.27, 95% CI = 1.005–1.59), and 153% greater risk of heart disease mortality (HR = 2.53, 95% CI = 1.37–4.68). Conclusions More sleep health problems may increase the risk of early mortality. Sleep health in middle and older adulthood is a vital sign that can be assessed at medical checkups to identify those at greater risk. [ABSTRACT FROM AUTHOR]

Background: Dementia syndrome is one of the most devastating conditions in older adults. As treatments to stop neurodegeneration become available, accurate and timely diagnosis will increase in importance. One issue is that cognitive performance sometimes does not match the corresponding level of neuropathology, affecting diagnostic accuracy. Cognitive reserve (CR), which can preserve cognitive function despite underlying neuropathology, explains at least some variability in cognitive performance. We examined the influence of CR proxies (education and occupational position) on the relationship between hippocampal or total gray matter volume and cognition. Methods: We used data from the Czech Brain Aging Study. Participants were clinically confirmed to be without dementia (n = 457, including subjective cognitive decline and amnestic mild cognitive impairment) or with dementia syndrome (n = 113). Results: For participants without dementia, higher education magnified the associations between (a) hippocampal volume and executive control (b = 0.09, p = 0.033), (b) total gray matter volume and language (b = 0.12, p < 0.001), and (c) total gray matter volume and memory (b = 0.08, p = 0.018). Similarly, higher occupational position magnified the association between total gray matter volume and (a) attention/working memory (b = 0.09, p = 0.009), (b) language (b = 0.13, p = 0.002), and (c) memory (b = 0.10, p = 0.013). For participants with dementia, the associations between hippocampal (b = -0.26, p = 0.024) and total gray matter (b = -0.28, p = 0.024) volume and visuospatial skills decreased in magnitude with higher education. Conclusion: We found that the association between brain volume and cognitive performance varies based on CR, with greater CR related to a stronger link between brain volume and cognition before, and a weaker link after, dementia diagnosis. [ABSTRACT FROM AUTHOR]

Auditory processing predicts cognitive decline, including dementia, in older adults. Auditory processing involves the understanding, interpretation, and communication of auditory information. Cognition is linked to auditory processing; however, it is disputed whether auditory processing is a separate construct distinct from cognition. The purpose of this study was to determine if auditory processing is distinct from cognition in older adults. Participants completed 14 cognitive and auditory processing assessments. Assessments were subjected to exploratory factor analysis with principal components extraction and varimax rotation with Kaiser normalisation. Study sample: 213 community-dwelling older adults (M = 71.39 years, 57% female, 93% Caucasian, M = 16 years education) with and without mild cognitive impairment (MCI) participated. Four factors were identified, explaining 66.3% of the total variance: (1) executive functions, visual processing speed, and dichotic auditory processing, (2) auditory processing of degraded speech, (3) memory, and (4) auditory temporal processing of nonspeech. Two domains of auditory processing (processing degraded speech and temporal processing) account for unique variance to which cognitive measures are not sensitive, while measures of auditory dichotic processing appear to be tapping similar abilities as measures of cognition. Older adults who perform poorly on dichotic measures should be screened for cognitive impairment. [ABSTRACT FROM AUTHOR]

The primary objective was to investigate the life course hypotheses – sensitive period, chain of risks, and accumulation of risks – in relation to financial hardship and psychological distress in old age. We used two Swedish longitudinal surveys based on nationally representative samples. The first survey includes people 18–75 years old with multiple waves, the second survey is a longitudinal continuation, including people 76 + years old. The analytical sample included 2990 people at baseline. Financial hardship was assessed in childhood (retrospectively), at the mean ages of 54, 61, 70, and 81 years. Psychological distress (self-reported anxiety and depressive symptoms) was assessed at the same ages. Path analysis with WLSMV estimation was used. There was a direct path from financial hardship in childhood to psychological distress at age 70 (0.26, p = 0.002). Financial hardship in childhood was associated with increased risk of psychological distress and financial hardship both at baseline (age 54), and later. Financial hardship, beyond childhood, was not independently associated with psychological distress at age 81. Higher levels of education and employment decreased the negative effects of financial hardship in childhood on the risk of psychological distress and financial hardship later on. There was a bi-directional relationship between psychological distress and financial hardship; support for health selection was slightly higher than for social causation. We found that psychological distress in old age was affected by financial hardship in childhood through a chain of risks that included psychological distress earlier in life. In addition, financial hardship in childhood seemed to directly affect psychological distress in old age, independent of other measured circumstances (i.e., chains of risks). Education and employment could decrease the effect of an adverse financial situation in childhood on later-life psychological distress. We did not find support for accumulation of risks when including tests of all hypotheses in the same model. [ABSTRACT FROM AUTHOR]

Background: High plasma homocysteine (Hcy) level is related to higher risk of Alzheimer's disease (AD) and lower cognitive performance in older adults.Objective: To assess the association between plasma Hcy level and real-space navigation performance and the role of vascular risk and protective factors, APOE status, and white matter lesions (WML) on this association.Methods: Ninety-two non-demented older adults (29 with amnestic mild cognitive impairment, 46 with subjective cognitive decline, and 17 cognitively normal older adults) underwent spatial navigation testing of egocentric, allocentric, and mixed navigation in a real-space analogue of the Morris water maze, neuropsychological examination, blood collection, and MRI brain scan with evaluation of WML.Results: In the regression analyses controlling for age, gender, education, and depressive symptoms, higher plasma Hcy level was related to worse mixed and egocentric (β= 0.31; p = 0.003 and β= 0.23; p = 0.017) but not allocentric (p > 0.05) navigation performance. Additional controlling for vascular risk and protective factors, WML, and APOE status did not modify the results. High total cholesterol and low vitamin B12 and folate levels increased the adverse effect of Hcy on egocentric and mixed navigation. WML did not explain the association between plasma Hcy level and navigation performance.Conclusion: Elevated plasma Hcy level may affect real-space navigation performance above and beyond vascular brain changes. This association may be magnified in the presence of high total cholesterol and low folate or vitamin B12 levels. Attention to the level of plasma Hcy may be a viable intervention strategy to prevent decline in spatial navigation in non-demented older adults. [ABSTRACT FROM AUTHOR]

This review provides a description of age-related changes in hearing and cognition, the relationship between hearing and cognition, and several potential mechanisms that underlie the relationship. Several studies have shown a significant relationship between peripheral hearing loss and cognitive impairment/decline but other studies have not. Furthermore, poor performance on measures of central auditory processing has been significantly associated with cognitive impairment. Important to understanding these relationships are the nature of the underlying mechanisms. Possible mechanisms are overdiagnosis, widespread neural degeneration, sensory degradation/deprivation, cognitive resource allocation/depletion, and social isolation/depression. Overdiagnosis occurs when hearing loss impacts tests of cognitive function or vice versa. Widespread neural degeneration can impact hearing, cognition, or both. Sensory degradation/deprivation due to hearing loss can result in neural degradation and reduced cognitive function. Increased demands due to hearing loss can result in changes in neural resource allocation, reducing available resources for cognitive function. Finally, hearing difficulties can cause social isolation and even depression, increasing the risk for cognitive decline. Data from our laboratory provide support for cognitive resource allocation/depletion. Understanding all five of these mechanisms will advance the development of effective interventions and treatments, thereby enhancing the quality of life of older adults. [ABSTRACT FROM AUTHOR]

Older age is associated with changes in the brain, including the medial temporal lobe, which may result in mild spatial navigation deficits, especially in allocentric navigation. The aim of the study was to characterize the profile of real-space allocentric (world-centered, hippocampus-dependent) and egocentric (body-centered, parietal lobe dependent) navigation and learning in young vs. older adults, and to assess a possible influence of gender. We recruited healthy participants without cognitive deficits on standard neuropsychological testing, white matter lesions or pronounced hippocampal atrophy: 24 young participants (18-26 years old) and 44 older participants stratified as participants 60-70 years old (n = 24) and participants 71-84 years old (n = 20). All underwent spatial navigation testing in the real-space human analog of the MorrisWater Maze, which has the advantage of assessing separately allocentric and egocentric navigation and learning. Of the eight consecutive trials, trials 2-8 were used to reduce bias by a rebound effect (more dramatic changes in performance between trials 1 and 2 relative to subsequent trials). The participants who were 71-84 years old (p < 0.001), but not those 60-70 years old, showed deficits in allocentric navigation compared to the young participants. There were no differences in egocentric navigation. All three groups showed spatial learning effect (p' s ⩽ 0.01). There were no gender differences in spatial navigation and learning. Linear regression limited to older participants showed linear (β = 0.30, p = 0.045) and quadratic (β = 0.30, p = 0.046) effect of age on allocentric navigation.There was no effect of age on egocentric navigation. These results demonstrate that navigation deficits in older age may be limited to allocentric navigation, whereas egocentric navigation and learning may remain preserved. This specific pattern of spatial navigation impairment may help differentiate normal aging from prodromal Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Objective: To explore the role of working conditions in the association between socioeconomic position and health after retirement age using over 20 years follow-up. Method: Two Swedish nationally representative Level of Living Surveys (total N = 1,131) were used. Ordered logistic regression was used to assess the association between socioeconomic position and health (self-rated health, psychological distress, musculoskeletal pain, circulatory problems, physical and cognitive impairment). The role of physical and psychological working conditions was also assessed. Results: Lower socioeconomic position was associated with more adverse physical, but not psychological, working conditions. Physical working conditions partially explained the differences in physical impairment and musculoskeletal pain in old age attributed to socioeconomic position, but not differences in self-rated health, circulatory problems, psychological distress, and cognitive impairment. Socioeconomic position was a stronger correlate of health than psychological working conditions alone. Discussion: Improving physical working conditions may be important for reducing the influence of socioeconomic position on health after retirement. [ABSTRACT FROM PUBLISHER]

Objectives: The authors explored the association between complexity of primary lifetime occupation and cognition in older adulthood. Method: The study included 386 participants from the Swedish Panel Study of Living Conditions of the Oldest Old. a nationally representative sample aged 77 years or older. The authors examined complexity of work with data. people, and things in relation to cognitive functioning, measured with a shortened version of Mini-Mental State Examination (MMSE) and cognitive impairment based on MMSE score cutoff. Results: Complexity of work with data and people were associated with better MMSE scores, controlling for age, sex, childhood socioeconomic status, and education. The association between complexity of work with data and MMSE remained statistically significant when adult occupational status was substituted for education as a covariate. Discussion: Complexity of primary lifetime occupation may be reflected in cognitive functioning even in advanced old age. This effect may be independent of education or occupational status. [ABSTRACT FROM AUTHOR]

Exercise has been promoted as an essential component of a healthy lifestyle during aging. However, benefits of exercise may be partially offset by increased oxidative stress associated with higher oxygen consumption during physical activity. In this review, we discuss the significance of exercise-induced oxidative stress in the aging process. Evidence supports the free radical theory, which posits that the extent of oxidative damage (caused by oxygen metabolism) predicts biological aging. Although oxidative stress tends to increase during exercise, a mild increase appears to upregulate antioxidant defenses and, hence, provide health benefits. A similar phenomenon has been depicted by the hormesis theory. However, intense or prolonged bouts of exercise may overwhelm antioxidant capacity and accelerate the aging process, particularly in an older adult. The risk of exercise-induced oxidative damage may also increase when the exercise regimen is irregular or interrupted for several weeks. Practical implications for older adults are discussed. [ABSTRACT FROM AUTHOR]

We investigate the changes in the sociodemographic characteristics, clinical comorbidities, and transitions between care settings among residents of assisted living facilities. Repeated cross-sectional study. Linked, individual-level health system administrative data on residents of assisted living facilities in Ontario, Canada, from January 1, 2013, to December 31, 2019. Counts and proportions were calculated to describe the sociodemographic characteristics and clinical comorbidities. Relative changes and trend tests were calculated to quantify the longitudinal changes in the characteristics of residents of assisted living facilities between 2013 and 2019. A Sankey plot was graphed to display transitions between different care settings (ie, hospital admission, nursing home admission, died, or remained in the assisted living facility) each year from 2013 to 2019. There was a 34% relative increase in the resident population size of assisted living facilities (56,975 2019 vs 42,600 2013). These older adults had a mean age of 87 years, and women accounted for nearly two-thirds of the population across all years. The 5 clinical comorbidities that had the highest relative increases were renal disease (24.3%), other mental health conditions (16.8%), cardiac arrhythmias (9.6%), diabetes (8.5%), and cancer (6.9%). Nearly 20% of the original cohort from 2013 remained in an assisted living facility at the end of 2019, and approximately 10% of that cohort transitioned to a nursing home in any year from 2013 to 2019. Residents of assisted living facilities are an important older adult population that has progressively increased in clinical complexity within less than a decade. Clinicians and policy makers should advocate for the implementation of on-site medical care that is aligned with the needs of these older adults. [ABSTRACT FROM AUTHOR]