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As rates of obesity continue to rise, so does the impact of obesity on cognitive function. Engaging in physical activity is one pathway through which individuals can help maintain cognitive function. This study examined whether any link between exercise and cognitive function was associated with weight characteristics. Data from 6,012 participants in the Health and Retirement Study were used. The association between participation in light or moderate physical activity and better cognitive function was particularly strong for overweight or obese adults and less so for those who were normal weight. Overall, the findings suggested that while being physically active is associated with better cognitive function regardless of weight, the associations were stronger for individuals who were overweight/obese compared with those who were normal weight. Given the results were particularly pronounced for waist circumference (relative to body mass index), further research should be conducted to examine if individuals with greater abdominal adiposity may benefit most from staying active in terms of their cognitive function.

Objectives: We examined associations between job strain and trajectories of change in cognitive functioning (general cognitive ability plus verbal, spatial, memory, and speed domains) before and after retirement., Methods: Data on indicators of job strain, retirement age, and cognitive factors were available from 307 members of the Swedish Adoption/Twin Study of Aging. Participants were followed up for up to 27 years (mean = 15.4, SD = 8.5)., Results: In growth curve analyses controlling for age, sex, education, depressive symptoms, cardiovascular health, and twinness, greater job strain was associated with general cognitive ability (estimate = -1.33, p = .002), worse memory (estimate = -1.22, p = .007), speed (estimate = -1.11, p = .012), and spatial ability (estimate = -0.96, p = .043) at retirement. Greater job strain was also associated with less improvement in general cognitive ability before retirement and a somewhat slower decline after retirement. The sex-stratified analyses showed that the smaller gains of general cognitive ability before retirement (estimate = -1.09, p = .005) were only observed in women. Domain-specific analyses revealed that greater job strain was associated with less improvement in spatial (estimate = -1.35, p = .010) and verbal (estimate = -0.64, p = .047) ability before retirement in women and a slower decline in memory after retirement in women (estimate = 0.85, p = .008) and men (estimate = 1.12, p = .013). Neither preretirement nor postretirement speed was affected significantly by job strain., Discussion: Greater job strain may have a negative influence on overall cognitive functioning prior to and at retirement, while interrupting exposure to job strain (postretirement) may slow the rate of cognitive aging. Reducing the level of stress at work should be seen as a potential target for intervention to improve cognitive aging outcomes., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America.)

Retirement has been associated with cognitive decline. However, the influence of specific job characteristics like occupational complexity on post-retirement cognitive outcomes is not well understood. Data from the Midlife in the United States (MIDUS) study were used to examine occupational complexity in relation to cognitive performance and cognitive change after retirement. Initial sample included 471 workers between 45 and 75 years of age. At 9-year follow-up (T2), 149 were retired and 322 were still working. All six tasks from the Brief Test of Adult Cognition by Telephone (BTACT) were used. Hierarchical regression with workers at T1 indicated that, controlling for sociodemographic variables, complexity of work with people significantly contributed to explaining variance in overall cognitive performance (1.7%) and executive function (2%). In Latent Change Score (LCS) models, complexity of work with people was the only significant predictor of cognitive change in retirees, with those retiring from high-complexity jobs showing less decline. In conclusion, high complexity of work with people is related to better executive functioning and overall cognition during working life and slower decline after retirement. The finding that more intellectually stimulating work carries cognitive advantage into retirement fits the cognitive reserve concept, where earlier intellectual stimulation brings about lower risks of cognitive problems later. Study results also go along with the unengaged lifestyle hypothesis, whereby people may slip into so-called "mental retirement," leading to post-retirement cognitive loss, which may be most apparent among those retiring from jobs with low complexity of work with people. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Apolipoprotein (APOE) ɛ4 is a well-known risk factor for late-onset Alzheimer's disease (AD), but other AD-related gene polymorphisms might also be important, such as the polymorphism within the brain-derived neurotrophic factor (BDNF) gene. Carriage of BDNF Val66Met has been associated with faster cognitive decline and greater hippocampal atrophy in cognitively normal elderly. Thus, we examined the effects of the concurrent presence of APOE and BDNF polymorphisms on cognitive functions and brain morphometry in amnestic mild cognitive impairment (aMCI) patients. 107 aMCI patients (mean age = 72.2) were recruited from the Czech Brain Aging Study and, based on APOE and BDNF genes polymorphisms, were divided into four groups: ɛ4-BDNFVal/Val (n = 37), ɛ4-BDNFMet (n = 19), ɛ4+BDNFVal/Val (n = 35), and ɛ4+BDNFMet (n = 16). All patients underwent clinical examination, magnetic resonance imaging, and complex neuropsychological battery. The combination of APOEɛ4+ and BDNF Met was associated with significantly worse memory performance in immediate and delayed recall compared to other polymorphism groups. We did not observe increased atrophy in areas related to memory function in the ɛ4+BDNFMet group. Our findings suggest that carriage of ɛ4+BDNFMet is associated with more pronounced memory dysfunction, a typical feature of early AD, but not with structural brain changes in aMCI patients. These findings suggest that in APOEɛ4/BDNF Met carriers, synaptic dysfunction affecting memory may precede pronounced structural changes.

Objectives: 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., Design: Daily telephone interviews., Setting: US information technology workplaces., Participants: 130 middle-aged employees., Measurements: On 8 consecutive days, participants reported the frequency of experiencing off-task and distracting thoughts during the day (0 = never to 4 = very often) and multiple sleep characteristics (bedtimes, wake times, sleep duration, sleep quality, and sleep latency). Covariates included sociodemographic characteristics and work hours., Results: Multilevel models revealed that, on days following earlier wake times (B = -0.32, P < .01), shorter sleep duration (B = -0.27, P < .01), or poorer sleep quality (B = -0.17, P < .01), participants reported more cognitive interference than usual. That is, waking 19 minutes earlier and sleeping 16 minutes less were associated with one additional point on the cognitive interference scale the next day. With cognitive interference predicting nightly sleep, more same day's cognitive interference was associated with earlier bedtimes (B = -0.19, P < .05) and earlier wake times (B = -0.30, P < .01) than usual. The temporal associations of nightly sleep duration and sleep quality with the following day's cognitive interference were significant on work days, but not on non-work days., Conclusion: Our results suggest bidirectional associations between poorer sleep and more cognitive interference, particularly on work days with implications for workday productivity and quality of life., (Copyright © 2019. Published by Elsevier Inc.)

Objectives: Previous research has shown that nutrition can influence cognitive abilities in older adults. We examined whether nutritional factors or inflammatory biomarkers moderate the age-cognition association., Method: Analyses included 1,308 participants (age ≥60) from the National Health and Nutrition Examination Survey III. Macronutrients (% of calories from fat, protein, and carbohydrates), micronutrients/amino acids (blood serum values: Vitamins B12, C, D, E, folate, iron, homocysteine, and β-carotene), and inflammatory biomarkers (serum C-reactive protein, plasma fibrinogen, and serum ferritin) were examined as moderators with cognition. Cognition was measured by six tasks: immediate and delayed story recall, immediate and delayed word memory, digit subtraction, and questions about place/orientation., Results: Higher values of serum folate were significantly associated with better cognitive scores. Specifically, the interaction between age-cognition and folate indicated the associations of higher age and lower global cognition and lower immediate story recall were weaker in those with higher folate values (p's < .05). A significant interaction between age and plasma fibrinogen indicated that the association between age and worse digit subtraction was stronger with values >3.1 g/L., Discussion: Folate and fibrinogen were significant moderators between age and cognition. Further research into the relationship between nutrition, inflammation, and cognitive aging is needed.

Objectives: This study examines the role of personality in cognitive performance, adherence, and satisfaction with regular cognitive self-monitoring., Materials and Methods: One hundred fifty-seven cognitively healthy older adults, age 55+, completed the 44-item Big-Five Inventory and were subsequently engaged in online monthly cognitive monitoring using the Cogstate Brief Battery for up to 35 months (M=14 mo, SD=7 mo). The test measures speed and accuracy in reaction time, visual learning, and working memory tasks., Results: Neuroticism, although not related to cognitive performance overall (P>0.05), was related to a greater increase in accuracy (estimate=0.07, P=0.04) and speed (estimate=-0.09, P=0.03) on One Card Learning. Greater conscientiousness was related to faster overall speed on Detection (estimate=-1.62, P=0.02) and a significant rate of improvement in speed on One Card Learning (estimate=-0.10, P<0.03). No differences in satisfaction or adherence to monthly monitoring as a function of neuroticism or conscientiousness were observed., Conclusions: Participants volunteering for regular cognitive monitoring may be quite uniform in terms of personality traits, with personality traits playing a relatively minor role in adherence and satisfaction. The more neurotic may exhibit better accuracy and improve in speed with time, whereas the more conscientious may perform faster overall and improve in speed on some tasks, but the effects appear small.

ABSTRACTBackground:To expand on prior literature by examining how various education parameters (performance-based reading literacy, years of education, and self-rated quality of education) relate to a cognitive screening measure's total and subscale scores of specific cognitive abilities., Methods: Black adults (age range: 55-86) were administered self-rated items years of education and quality of education, and a measure of performance-based reading literacy. The Mini-Mental State Examination (MMSE) was used to screen for overall cognitive functioning as well as performance on specific cognitive abilities., Results: Sixty-nine percent of the sample had reading grade levels that were less than their reported years of education. Lower years of education and worse reading literacy are associated with poorer MMSE performance, particularly on the attention and calculation subscales., Conclusions: Years of education, a commonly used measure for education, may not be reflective of Black adults' educational experiences/qualities. Thus, it is important to account for the unique educational experiences of adults that could influence their MMSE performance. Incorporating quality and quantity of education will provide a more comprehensive understanding of the individual's performance on cognitive measures, specifically as it relates to sociocultural differences.

Objective: this study investigates the role of social and mental occupational characteristics in cognitive decline after retirement., Methods: the study included 1,048 subjects aged ≥65 years from the Three City cohort. Participants were evaluated at home at the initial visit and at 2-year intervals for a period of 12 years. The study includes detailed assessments of cognition, health and information about the subjects' main occupation. The four cognitive tests have been grouped into one latent factor. Three independent raters specialised in employment were asked to evaluate the level of social and intellectual stimulation for each occupation, which was then rated as low, medium and high., Results: after controlling for potential confounding factors, no association was found between higher levels of social stimulation at work and baseline cognition (medium score, P = 0.440; high score, P = 0.700) as compared with a low level. While cognitive trajectories were initially similar between high and medium levels of social stimulation compared with that of a low level, with advancing age this association diverged whereby more social stimulation during work years was related to accelerated cognitive decline that further grew in magnitude with older age. For mental stimulation, differences were only observed at baseline, with greater levels of mental stimulation during work years being associated with better cognitive performance (medium score, β = 0.573, P = 0.015; and high score, β = 0.510; P = 0.090) compared with a low level of mental stimulation., Conclusion: workers retiring from occupations characterised by high levels of social stimulation may be at risk of accelerated cognitive decline with advancing age., (© The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com)

Introduction: Recent research indicated that cognitive speed of processing training (SPT) improved Useful Field of View (UFOV) among individuals with Parkinson's disease (PD). The effects of SPT in PD have not been further examined. The objectives of the current study were to investigate use, maintenance and dose effects of SPT among individuals with PD., Methods: Participants who were randomized to SPT or a delayed control group completed the UFOV at a six-month follow-up visit. Use of SPT was monitored across the six-month study period. Regression explored factors affecting SPT use. Mixed effect models were conducted to examine the durability of training gains among those randomized to SPT (n = 44), and training dose effects among the entire sample (n = 87)., Results: The majority of participants chose to continue to use SPT (52%). Those randomized to SPT maintained improvements in UFOV performance. A significant dose effect of SPT was evident such that more hours of training were associated with greater UFOV performance improvements. The cognitive benefits derived from SPT in PD may be maintained for up to three months., Conclusion: Future research should determine how long gains endure and explore if such training gains transfer.

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.)

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.

Physical activity (PA) is believed to preserve cognitive function in older adulthood, though little is known about these relationships within the context of daily life. The present microlongitudinal pilot study explored within- and between-person relationships between daily PA and cognitive function and also examined within-person effect sizes in a sample of community-dwelling older adults. Fifty-one healthy participants (mean age = 70.1 years) wore an accelerometer and completed a cognitive assessment battery for five days. There were no significant associations between cognitive task performance and participants' daily or average PA over the study period. Effect size estimates indicated that PA explained 0-24% of within-person variability in cognitive function, depending on cognitive task and PA dose. Results indicate that PA may have near-term cognitive effects and should be explored as a possible strategy to enhance older adults' ability to perform cognitively complex activities within the context of daily living.

Background: Research shows that lipid levels may be associated with cognitive function, particularly among women. We aimed to examine total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), high-density lipoprotein (HDL), and HDL/LDL ratio in relation to cognitive performance, measured with six well-established cognitive domains and a composite cognitive score (CCS)., Methods: In this cross-sectional study, biomarkers and neuropsychological assessment were available for 141 adults with MMSE scores ≥ 24 (mean age = 69 years, 47% female, mean education = 14.4 years) attending a neuropsychological evaluation. Ordinary least squares regressions were adjusted for age, gender, education, and depressive symptoms in Model 1 and also for apolipoprotein E4 (APOE4) status in Model 2., Results: High-density lipoprotein cholesterol (HDL-C) was associated with better CCS (β = 0.24; p = 0.014). This association was significant among women (β = 0.30; p = 0.026) and not among men (β = 0.20; p = 0.124). HDL-C was also related to attention/working memory (β = 0.24; p = 0.021), again only among women (β = 0.37; p = 0.012) and not men (β = 0.15; p = 0.271). Adjusting for APOE4 yielded significance for high HDL-C and CCS (β = 0.24; p = 0.022)., Conclusions: HDL-C was the main lipoprotein affecting cognitive function, with results somewhat more pronounced among women. Research should investigate the possibility of finding ways to boost HDL-C levels to potentially promote cognitive function.

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.)

Background: Olfactory identification impairment in amnestic mild cognitive impairment (aMCI) patients is well documented and considered to be caused by underlying Alzheimer's disease (AD) pathology, contrasting with less clear evidence in non-amnestic MCI (naMCI). The aim was to (a) compare the degree of olfactory identification dysfunction in aMCI, naMCI, controls and mild AD dementia and (b) assess the relation between olfactory identification and cognitive performance in aMCI compared to naMCI., Methods: 75 patients with aMCI and 32 with naMCI, 26 patients with mild AD and 27 controls underwent the multiple choice olfactory identification Motol Hospital Smell Test with 18 different odors together with a comprehensive neuropsychological examination., Results: Controlling for age and gender, patients with aMCI and naMCI did not differ significantly in olfactory identification and both performed significantly worse than controls (p<0.001), albeit also better than patients with mild AD (p<.001). In the aMCI group, higher scores on MMSE, verbal and non-verbal memory and visuospatial tests were significantly related to better olfactory identification ability. Conversely, no cognitive measure was significantly related to olfactory performance in naMCI., Conclusion: Olfactory identification is similarly impaired in aMCI and naMCI. Olfactory impairment is proportional to cognitive impairment in aMCI but not in naMCI., (Copyright © 2015. Published by Elsevier B.V.)

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.)

Background: Life-space, a measure of movement through one's environment, may be viewed as one aspect of environmental complexity for older adults. We examined the relationship between life-space and subsequent change in cognitive function., Methods: Participants were 624 community-dwelling Medicare beneficiaries (49% African American) who completed in-home assessments at baseline and follow-up 4 years later. The Life-Space Assessment was used at baseline to measure extent, frequency, and independence of participants' movement within and outside the home. Cognitive decline was measured with the Mini-Mental State Examination (MMSE)., Results: In a regression model adjusted for baseline MMSE, age, gender, race, residence (rural/urban), and education, greater life-space at baseline predicted reduced cognitive decline (beta = -.177, p <.001). This association remained statistically significant in subsequent models that examined what proportion of the observed association was explained by baseline physical activity, physical function, vascular risk factors, comorbidity, and psychosocial factors. Physical function accounted for the largest proportion (37.3%) of the association between life-space and cognitive decline. There was no significant interaction between life-space and race, gender, or age in predicting cognitive decline. In a logistic regression analysis, participants in the highest quartile of life-space had 53% reduced odds of substantial cognitive decline (> or =4 points on MMSE) compared to those in the lowest quartile., Conclusions: These preliminary findings suggest that life-space may be a useful identifier of older adults at risk for cognitive decline. Future research should investigate the potential reciprocal relationship between life-space and cognitive function as well as the interrelationship between these factors and physical function.

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.

Objective: 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.

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.

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 and Objectives Sleep disorders often predict or co-occur with cognitive decline. Yet, little is known about how the relationship unfolds among older adults at risk for cognitive decline. To examine the associations of sleep disorders with cognitive decline in older adults with unimpaired cognition or impaired cognition (mild cognitive impairment and dementia). Research Design and Methods A total of 5,822 participants (M age = 70) of the National Alzheimer's Coordinating Center database with unimpaired or impaired cognition were followed for 3 subsequent waves. Four types of clinician-diagnosed sleep disorders were reported: sleep apnea, hyposomnia/insomnia, REM sleep behavior disorder, or "other." Cognition over time was measured by the Montreal Cognitive Assessment (MoCA) or an estimate of general cognitive ability (GCA) derived from scores based on 12 neuropsychological tests. Growth curve models were estimated adjusting for covariates. Results In participants with impaired cognition, baseline sleep apnea was related to better baseline MoCA performance (b  = 0.65, 95% confidence interval [95% CI] = [0.07, 1.23]) and less decline in GCA over time (b  = 0.06, 95% CI = [0.001, 0.12]). Baseline insomnia was related to better baseline MoCA (b  = 1.54, 95% CI = [0.88, 2.21]) and less decline in MoCA over time (b  = 0.56, 95% CI = [0.20, 0.92]). Furthermore, having more sleep disorders (across the 4 types) at baseline predicted better baseline MoCA and GCA, and less decline in MoCA and GCA over time. These results were only found in those with impaired cognition and generally consistent when using self-reported symptoms of sleep apnea or insomnia. Discussion and Implications Participants with sleep disorder diagnoses may have better access to healthcare, which may help maintain cognition through improved sleep. [ABSTRACT FROM AUTHOR]

Background To examine cross-sectional differences and longitudinal changes in cognitive performance based on the presence of mild behavioral impairment (MBI) among older adults who are cognitively healthy or have mild cognitive impairment (MCI). Methods Secondary data analysis of participants (n = 17 291) who were cognitively healthy (n = 11 771) or diagnosed with MCI (n = 5 520) from the National Alzheimer's Coordinating Center database. Overall, 24.7% of the sample met the criteria for MBI. Cognition was examined through a neuropsychological battery that assessed attention, episodic memory, executive function, language, visuospatial ability, and processing speed. Results Older adults with MBI, regardless of whether they were cognitively healthy or diagnosed with MCI, performed significantly worse at baseline on tasks for attention, episodic memory, executive function, language, and processing speed and exhibited greater longitudinal declines on tasks of attention, episodic memory, language, and processing speed. Cognitively healthy older adults with MBI performed significantly worse than those who were cognitively healthy without MBI on tasks of visuospatial ability at baseline and on tasks of processing speed across time. Older adults with MCI and MBI performed significantly worse than those with only MCI on executive function at baseline and visuospatial ability and processing speed tasks across time. Conclusions This study found evidence that MBI is related to poorer cognitive performance cross-sectionally and longitudinally. Additionally, those with MBI and MCI performed worse across multiple tasks of cognition both cross-sectionally and across time. These results provide support for MBI being uniquely associated with different aspects of cognition. [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]

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. [ABSTRACT FROM AUTHOR]

In response to the rising financial pressure on old-age pension systems in industrialised economies, many European countries plan to increase the eligibility age for retirement pensions. We used data from Sweden to examine whether (and if so, how) retirement after age 65 – the eligibility age for basic pension – compared to retiring earlier affects older adults' (between ages 70 and 85) cognitive functioning. Using a propensity score matching (PSM) approach, we addressed the selection bias potentially introduced by non-random selection into either early or late retirement. We also examined average and heterogeneous treatment effects (HTEs). HTEs were evaluated for different levels of cognitive stimulation from occupational activities before retirement and from leisure activities after retirement. We drew from a rich longitudinal data-set linking two nationally representative Swedish surveys with a register data-set and found that, on average, individuals who retire after age 65 do not have a higher level of cognitive functioning than those who retire earlier. Similarly, we did not observe HTEs from occupational activities. With respect to leisure activities, we found no systematic effects on cognitive functioning among those working beyond age 65. We conclude that, in general, retirement age does not seem to affect cognitive functioning in old age. Yet, the rising retirement age may put substantial pressure on individuals who suffer from poor health at the end of their occupational career, potentially exacerbating social- and health-related inequalities among older people. [ABSTRACT FROM AUTHOR]

Traditional neuropsychological batteries may account for disparities in education and may produce testing anxiety, particularly for older Black adults. Computerized batteries may be more amenable to use. The current study used mixed-methods content analysis to explore the perceptions of middle-aged and older Black adults (N = 92) about the CogState Brief Battery (CSBB) and Joggle® computerized battery and a traditional paper-and-pencil neuropsychological battery. The data was analyzed using Atlas.ti. Themes were developed and qualitative responses were converted to quantitative counts to make comparisons to thematic differences based on demographics. Results: The majority of participants liked all three batteries. There were no differences based on demographics. Two prevalent themes across all three measures for what participants liked were 1) mental stimulation and memory, and 2) challenging. A disliked theme specific to the computerized batteries was personal competence. In summary, an array of accessible cognitive batteries is necessary to address individual preferences. [ABSTRACT FROM AUTHOR]

Background and Objectives We examined quality of education, literacy, and years of education in relation to late-life cognitive function and decline in older Puerto Ricans. Research Design and Methods Our sample consisted of 3,385 community-dwelling adults aged 60 years and older from the Puerto Rican Elderly: Health Conditions study. Quality of education was based on principal component analysis of variables gathered from Department of Education and Census reports. Literacy (yes/no) and years of education were self-reported. Cognitive function was assessed in participants' homes at baseline and 4 years later using a previously validated Spanish-language 20-point global screening measure for dementia, the minimental Cabán. Regression models were adjusted for sociodemographic and life course covariates. Results Quality of education was positively correlated with both educational attainment and cognitive performance. Independent of years of education, literacy, childhood economic hardship, and adult economic hardship, compared to participants in the lowest quartile of education quality, those in the highest quartile had significantly better baseline cognitive performance (β = 0.09, p <.001). Quality of education did not consistently show an association with change in cognitive function over 4 years. Literacy and greater educational attainment were each independently associated with better cognitive function at baseline and less cognitive decline. Discussion and Implications Quality of education, literacy, and years of education, while interrelated, also show independent associations with cognitive functioning in older Puerto Ricans. The downstream factors of literacy and years of education were more closely related to age-related cognitive decline than quality of education. [ABSTRACT FROM AUTHOR]

Objectives: We examined associations between job strain and cognitive aging in a sample of older Puerto Ricans. Methods: Members of the Puerto Rican Elderly: Health Conditions study, aged 60–100 years at baseline, participated. Job strain indicators were quantified from O*NET (n = 1632) and a matrix of Job Content Questionnaire scores (JCQ; n = 1467). Global cognition was assessed twice across 4 years. Results: Controlling for age, sex, depressive symptoms, financial problems, hypertension, diabetes, childhood economic hardship, low job control and high job strain were consistently associated with greater cognitive decline. Adding education attenuated these associations. High education strengthened the JCQ job control-cognitive change link. Discussion: Low job control and high job strain may accelerate cognitive aging in this population. However, it may be more difficult to disentangle the intersecting roles of education and job strain in cognitive aging among older Puerto Ricans relative to older adults from contiguous United States or Europe. [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]

Background and Objectives Based on the Minority Stress Theory, this article examines the associations between sexual orientation and self-reported measures of physical, mental, and cognitive health, as well as health risk behaviors. Research Design and Methods The analytical sample included members of the 2016 wave of the Health and Retirement Study aged 50+ years. Binary and ordered logistic regressions were conducted to assess whether being a sexual minority was associated with poorer self-rated physical, mental, and cognitive health, as well as being more likely to engage in health risk behaviors. Results In analyses using overall and propensity-matched samples, lesbian, gay, and bisexual (LGB) participants were about twice as likely to report ever having depression as their heterosexual counterparts but were also more likely to report better self-rated health. The LGB group was more likely to report ever having smoked but were not significantly different in any of the other health risk behaviors. Discussion and Implications LGB individuals appear to be at greater risk of ever experiencing depression than heterosexual individuals but, at the same time, report better physical health. This may suggest a tendency for resilience. Differences in health risk behavior may also exist. Mental health and other medical professionals should receive special training to better understand the unique problems of LGB individuals. [ABSTRACT FROM AUTHOR]

The article discusses research which investigated occupational complexity in main lifetime occupation in relation to cognitive impairment in older adults in Puerto Rico. Topics covered include the method used for measuring cognition, the results for subjects with less childhood economic hardship or education, and the association of favorable childhood economic conditions and higher educational attainment on the reduced risk of cognitive impairment among older Puerto Ricans.

Objective: To examine whether changes in memory over a 10-year period could predict a change in C-reactive protein (CRP) levels. Method: A mixed model analysis was first conducted to obtain the estimates for change in memory over the 10-year period using data from the Health and Retirement Study. Then a multivariate regression to determine whether a change in episodic memory could predict subsequent CRP levels was conducted. Furthermore, a general linear model was conducted to determine differences in CRP levels among different rates of change in episodic memory. Results: Greater declines in episodic memory were associated with higher levels of subsequent CRP (Estimate = −0.32, SE = 0.12, β = −.03, p =.008). The general linear model revealed that those with greater memory declines were more likely to have higher levels of CRP, F = 26.50, p <.001. Discussion: These results highlight the notion that memory decline and inflammation may be intertwined, and we discuss various avenues that warrant further investigation. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate and contrast 25 content areas essential to the primary care of older adults by medical faculty, thus identifying faculty beliefs and areas of possible improvement. DESIGN: Using measures from the Healthcare Effectiveness Data and Information Set, the Consumer Assessment of Healthcare Providers and Systems, and Healthy People 2020, nine practicing clinical faculty identified 25 content areas essential to the primary care of older adults. SETTING: A large academic health center in southeastern United States. PARTICIPANTS: Eighty‐two university medical faculty. MEASUREMENTS: Faculty rated importance, knowledge, and confidence in teaching the 25 content areas on a scale from 1 (low) to 10 (high). Gap scores reflecting the difference in ratings for importance and confidence in teaching were calculated and assessed. The survey had high internal consistency within each of the three domains—Cronbach's α >.94. RESULTS: The most important content areas were being able to explain details about patient's condition and taking medication clearly, followed by taking age‐appropriate history. The three largest gaps were: "evaluating sensory impairment," "identifying and counseling at‐risk drivers," and "evaluating cognition." The three smallest gaps were: "explaining prescribed medications," "explaining health conditions in easy‐to‐understand language," and "taking an age‐appropriate patient history and performing a physical assessment." CONCLUSION: Medical faculty were comfortable with topics reflecting primary care expertise but expressed less confidence with more specialized topics, such as sensory or cognitive impairment and driving. This may represent key areas for geriatrics training applicable to all those involved in education and training of future healthcare professionals. Integration of specialists (eg, neurologists, psychiatrists) may improve the geriatrics curricula. J Am Geriatr Soc 67:576–580, 2019. [ABSTRACT FROM AUTHOR]

Objective We examined changes in participation in cognitive, social, and physical leisure activities across middle and older adulthood and tested moderation of trajectories of change in participation by gender. Method In all, 1,398 participants in the Swedish Adoption/Twin Study of Aging (SATSA) completed a 7-item leisure activity questionnaire up to 4 times over 17 years. Mean baseline age was 64.9 years (range = 36–91); 59% were women. Factor analysis identified physical, social, and cognitive/sedentary leisure activity participation factors. Age-based latent growth curve models adjusted for marital status, gender, education, depressive symptoms, and physical health were used. Results Overall, results indicated stability in social activities, increase in cognitive/sedentary activities, and decrease in physical activities, as well as accelerated decline in all three types of activities after about the age of 70 years. Social activity remained mostly stable for women and declined for men. Women reported higher levels of cognitive/sedentary leisure activity across the study. Both men and women declined in physical leisure activity. Variance in leisure activities increased with age; men demonstrated more variance in social activities and women in physical activities. Conclusions Understanding change in leisure activities with age and by gender can have important implications for interventions and for use of leisure activity data in epidemiological research. [ABSTRACT FROM AUTHOR]

Background: Identifying protective factors that promote healthy cognitive aging is of importance due to the growing older adult population. Preventing chronic hyperglycemia may be one such way to preserve cognitive abilities, as high blood glucose levels have been associated with cognitive impairment and decline.Objective: To evaluate the influence of blood glucose levels on cognition among older adults using common neuropsychological tests and a spatial navigation task.Methods: The association between cognitive performance and blood glucose levels was assessed among 117 older adults classified as cognitively healthy, subjective cognitive decline, amnestic mild cognitive impairment, or Alzheimer's disease dementia from the Czech Brain Aging Study. Cognitive abilities were measured by tests of verbal memory, nonverbal memory, working memory, visuospatial skills, and executive function. A test of spatial navigation known as the Hidden Goal Task was also used. Blood glucose levels were measured by glycosylated hemoglobin A1c (HbA1c). Analyses were performed using multiple linear regression controlling for age, gender, education, depressive symptoms, diabetes, and cognitive status.Results: A significant relationship was observed for HbA1c and executive function performance (beta = -2.46, SE = 0.92, p = 0.008). Following moderation analysis, this relationship was significant only among those with cognitive impairment (beta = -4.37, SE = 1.28, p = 0.001, 95% CI [-6.91, -1.83]). Associations between HbA1c and other cognitive domains were not significant (ps > 0.05).Conclusions: Higher HbA1c was associated with poorer executive function among persons with cognitive impairment, but not with performance on other cognitive domains. Maintaining proper glucoregulation may help preserve executive function performance among cognitively impaired older adults. [ABSTRACT FROM AUTHOR]

Background: Long-term protective associations proposed between previous complex occupational tasks and cognitive functioning in later life point to work roles contributing to cognitive reserve.Objective: To examine occupational complexity involving data, people, and things in relation to the level of, and rate of change in, cognitive functioning.Methods: Participants were 1,290 members of the Australian Longitudinal Study of Ageing and initially aged 65-102 years (mean = 79). Information about main lifetime occupation was collected retrospectively. Cognition was assessed 4 times over a 13-year interval.Results: In multilevel models adjusted for demographics, medical conditions, and depressive symptoms, higher complexity involving data was associated with faster speed (β = 0.73, p < 0.001), better memory (β = 0.32, p < 0.05), and mental status (β = 0.40, p < 0.001) at baseline. These associations remained statistically reliable after adjusting for complexity with people and things, sedentary and heavy physical work, retirement age, and leisure activity. Complexity with things was associated with slower speed (β = -0.50, p < 0.001) and poorer mental status (β = -0.26, p < 0.01) and was not explained by other variables. There were no associations of occupational complexity with rates of cognitive decline over time.Conclusion: Older individuals retired from occupations characterized by higher complexity with data maintain their cognitive advantage over those with lower complexity into older adulthood, although without additional moderation of this advantage in terms of less postretirement cognitive decline. Complexity of work with things confers a negative relation to cognition whilst also not affecting postretirement cognitive change. Although the relative contributions of occupation or other early life influences for cognition remain to be established, it nevertheless may be beneficial to promote workplace design strategies and interventions that incorporate complex activities, particularly tasks involving data. [ABSTRACT FROM AUTHOR]

Background: Older Puerto Rican adults have particularly high risk of diabetes compared to the general US population. Diabetes is associated with both higher depressive symptoms and cognitive decline, but less is known about the longitudinal relationship between cognitive decline and incident depressive symptoms in those with diabetes. This study investigated the association between cognitive decline and incident depressive symptoms in older Puerto Rican adults with diabetes over a four-year period.Methods: Households across Puerto Rico were visited to identify a population-based sample of adults aged 60 years and over for the Puerto Rican Elderly: Health Conditions study (PREHCO); 680 participants with diabetes at baseline and no baseline cognitive impairment were included in analyses. Cognitive decline and depressive symptoms were measured using the Mini-Mental Cabán (MMC) and Geriatric Depression Scale (GDS), respectively. We examined predictors of incident depressive symptoms (GDS ≥ 5 at follow-up but not baseline) and cognitive decline using regression modeling.Results: In a covariate-adjusted logistic regression model, cognitive decline, female gender, and greater diabetes-related complications were each significantly associated with increased odds of incident depressive symptoms (p < 0.05). In a multiple regression model adjusted for covariates, incident depressive symptoms and older age were associated with greater cognitive decline, and higher education was related to less cognitive decline (p < 0.05).Conclusions: Incident depressive symptoms were more common for older Puerto Ricans with diabetes who also experienced cognitive decline. Efforts are needed to optimize diabetes management and monitor for depression and cognitive decline in this population. [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]

Objective. It is well established that cognitive speed of processing training (SOPT) improves Useful Field of View (UFOV) performance and transfers to enhanced performance of instrumental activities of daily living, including driving. InSight is a recently developed version of SOPT formatted for self-administration by older adults with exercises translated into a gaming format. The goal was to examine whether InSight training improves UFOV performance. Method. Participants ranged in age between 59-95 years and were randomized to InSight cognitive training or a control condition. Cognitive performance and self-perceptions were measured pre- and post-training, or for controls, after an equivalent delay. Participants completed training twice a week over a 12-week period with the goal of completing 20 sessions. Results. Participants randomized to InSight training experienced greater improvements in their UFOV performance relative to the control condition, F(1, 58) = 4.26, p = .043, but no changes in cognitive self-perceptions were found. Conclusions. The InSight program is a viable tool for enhancing older adults' UFOV performance. Future research should examine if training gains from the program endure and transfer to improved everyday function. [ABSTRACT FROM AUTHOR]

Background: The etiology of Parkinson's disease (PD) remains unclear, and environmental risk-factors such as occupation have attracted interest. Objective: The goal was to investigate occupational complexity in relation to PD. Methods: We conducted a population-based cohort study based on the Swedish Twin Registry that included 28,778 twins born between 1886 and 1950. We identified 433 PD cases during the study period. Data on occupation were collected from either the 1970 or 1980 Swedish census, and occupational complexity was assessed via a job exposure matrix. Cox proportional hazard regression analyses with age as the underlying time scale were used to assess PD risk as a function of the three domains of occupational complexity: data, people, and things. Sex and smoking were included as covariates. Analyses stratified by twin pair were conducted to test for confounding by familial factors. Results: High occupational complexity with data and people was associated with increased risk overall (Hazard Ratio [HR] = 1.07, 95% confidence interval [CI] 1.02–1.14, and HR = 1.10, 95% CI 1.01–1.21, respectively), and in men (HR = 1.08, 95% CI 1.01–1.16, and HR = 1.15, 95% CI 1.03–1.28, respectively). Complexity with things was not associated with risk of PD. When the analyses were stratified by twin pair, the HRs for occupational complexity with data and people were attenuated in men. Conclusions: High complexity of work with data and people is related to increased risk of PD, particularly in men. The attenuation of risk observed in the twin pair-stratified analyses suggests that the association may partly be explained by familial factors, such as inherited traits contributing to occupational selection or other factors shared by twins. [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. We used data from SWEOLD, a Swedish nationally representative study of individuals aged 77 years or older, to examine midlife indicators of job strain in relation to cognitive performance and impairment. Methods. In all, 827 participants completed an abridged 11-point version of the Mini-Mental State Examination in-person in 1992 and/or 2002 and had self-reported and/or occupation-based scores for job control and demands from data collected in 1968. Seventeen percent scored below the cutoff for cognitive impairment. Results. Controlling for age, sex, education, self-rated health, and year of cognitive screening, low self-reported and occupation-based job control at midlife was associated with poorer cognitive performance later (ps < .001). For the occupation-based measure, low job control was also associated with greater likelihood of impairment, whereas having an active job (high job control/high job demands) was associated with better cognitive performance and lower likelihood of impairment (ps < .01). Childhood environment, midlife depressive symptoms, and social activity had limited influence, whereas the influence of both adulthood socioeconomic position and work complexity on these results was more pronounced. Discussion. Job control at midlife, by itself and in combination with job demands, may influence cognitive functioning later above and beyond demographic variables and other occupational characteristics. [ABSTRACT FROM PUBLISHER]

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. [ABSTRACT FROM AUTHOR]