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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. Key Words: Cognition--Social support.

ABSTRACT Numerous studies show that the pathology of Alzheimer's disease is present decades before a clinical diagnosis of dementia can be made. Given the likelihood that agents will become available [...]

Guided by a stress and coping model, we explored determinants of depressive symptoms among community samples of older African Americans (n = 255) and older Whites (n = 452). We gave focus to the effects of demographic variables, physical health constraints (chronic conditions and functional disability), and psychosocial attributes (sense of mastery, religiosity, social support, and satisfaction with support), along with their interactive roles. We identified lower education, greater functional disability, lower sense of mastery, and poorer satisfaction with support as common risk factors for depressive symptoms in both groups; in contrast, the effects of age, gender, and religiosity were race specific. In addition, we obtained significant interactions among predictor variables in each group, identifying risk-reducing and risk-enhancing factors within each group.

We examined the association between risk of dementia or Alzheimer's disease (AD) and occupation by using measures of complexity of work with data, people, and things. The study included 10,079 members of the population-based Swedish Twin Registry who were participants in the HARMONY study. We diagnosed dementia by means of a two-stage procedure--cognitive impairment screening followed by full clinical evaluation. We analyzed data with case-control and cotwin control designs. The cotwin control design provides control over genetic and familial factors. In the case-control study, controlling for age, gender, and level of education, we found that more complex work with people was associated with reduced risk of AD. Greater complexity of work with people and data was protective in twin pairs discordant for AD. Findings suggest that greater complexity of work, and particularly complex work with people, may reduce the risk of AD.

Objectives. This study compares determinants of a sense of mastery in African American and White older adults. Methods. The association between predictor variables (sociodemographic variables, health conditions, social resources, and religiosity) and feelings of mastery was assessed by using representative community-dwelling samples of 250 African American (mean age = 71.6) and 452 White (mean age = 73.0) older adults. Results. African American older adults had a lower sense of mastery than White older adults. Significant modification by race was found in the associations of age, self-rated health, and religiosity with feelings of mastery. The negative effects of old age and poor health on feelings of mastery were stronger in the White sample, whereas the positive effect of religiosity on feelings of mastery was observed only in the African American sample. Discussion. Although African American older adults had a lower sense of mastery than Whites, their feelings of mastery were less likely to be diminished by old age and poor health and more likely to be enhanced by religiosity. Possible explanations for cross-racial differences are discussed, as are implications.

The present study examined the comparative roles of vision and hearing in different aspects of older individuals' lives. The significance of vision and hearing on physical, social, and emotional functioning (disability, social activity, and depressive symptoms) was assessed along with the role of personality traits and social resources, using a stratified sample of 425 community-dwelling older individuals (M age = 72.2). Vision was a significant factor for disability, while hearing was significantly associated with social activity, implying the unique contribution of vision and hearing. The association between sensory performance and depressive symptoms became nonsignificant in multivariate analysis. After adjusting for vision and hearing, psychosocial factors increased the amount of explained variance in physical, social, and emotional outcomes. The findings demonstrate the important roles of personality and social resources along with vision and hearing and suggest a need to consider them when planning interventions. Keywords: vision; hearing; personality; social resources

Purpose: Although disability is widely acknowledged as a risk factor for late-life depression, few studies have studied the potential of psychosocial factors to alter the association between disability and depression. The present study assessed the impacts of mastery and social resources (social network, social support, and satisfaction with support) on depression and, in particular, whether they modify the link between disability and depression. Design and Methods: The direct and moderating effects of mastery and social resources were empirically tested using a sample of 406 community-dwelling older adults who were cognitively intact (mean age = 72.3). Results: Higher level of mastery and greater satisfaction with support had significant direct effects on depression and also buffered the adverse impact of disability on depression. Implications: The findings support the importance of psychosocial factors in modifying the association between disability and depression and suggest that efforts to enhance positive psychosocial attributes should be emphasized in interventions far older adults. Key Words: Disability, Depression, Mastery, Social resources

Background. The present study explored factors that influenced older individuals' subjective perception of hearing problems. In addition to objectively screened hearing ability, nonauditory factors such as stressful life conditions (visual impairment, chronic disease, disability, and recent stressful life events), neuroticism, and social resources were hypothesized to be predictors of self-perceived hearing problems. Methods. These hypotheses were tested with a hierarchical regression model using a stratified sample of 425 community-dwelling older individuals (mean age = 72.2). Results. Individuals with more recent stressful life events, higher levels of neuroticism, and less emotional support reported greater hearing problems after controlling for objectively screened hearing. In addition to the main effects, a significant interaction was observed between neuroticism and screened hearing, indicating that the combination of poor hearing and high neuroticism increased the level of self-perceived hearing problems. Conclusions. The findings suggest that the effects of nonauditory factors should be taken into account in the application of self-assessed measures of hearing problems.

Objectives. The (epsilon)4 allele of apolipoprotein E (APOE) has been associated with Alzheimer's disease and with milder forms of cognitive impairment. We investigated the possibility that the absence of the (epsilon)4 allele may predict the maintenance of high cognitive function among very old individuals. Methods. Our data are from the Nun Study, a longitudinal study of aging and Alzheimer's disease in 678 Catholic sisters. All sisters participate in annual functional exams that include the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) battery of cognitive tests. High cognitive function was defined as intact scores on five of the CERAD tests. A total of 241 participants aged 75 to 98 met this criterion at the first exam. Results. Findings showed that 62% of the 241 participants maintained intact scores on the five CERAD tests throughout their participation in the study. Life table analyses indicated that those without the APOE (epsilon)4 allele spent more time with intact cognitive function than those with the (epsilon)4 allele (p = .007). Cox regression analyses indicated that those without the (epsilon)4 allele had half the risk of losing their intact status during the study when compared with those with the (epsilon)4 allele (p < .01). Discussion. Our findings suggest that the APOE (epsilon)4 allele may be included among the variables that predict high cognitive function in cognitively intact, very old adults. Although the presence or absence of the (epsilon)4 allele is known to be related to the risk of dementia, it also appears to be related to maintaining high levels of cognitive function in old age.

Background. Alzheimer's disease has been thought to have familial and sporadic forms, and several genetic defects have been identified that chiefly explain early-onset familial cases. In this study, our purpose was to detect all cases of dementia in an established twin registry and to estimate total extent of genetic contribution to liability to Alzheimer's disease. Methods. At the first stage, members of the registry were screened for dementia, using in-person or telephone mental status testing. At the second stage, those who screened positively and their partners were referred for clinical work-ups, including neuropsychological assessment, physician examination, laboratory tests, and neuroimaging. Clinical diagnoses were assigned at a multidisciplinary consensus conference. Probandwise concordance rates were examined by zygosity, and structural modeling was applied to the data to estimate genetic and environmental influences, using both single- and multiple-threshold models. Results. Sixty-five pairs were identified in which one or both was demented. The probandwise concordance rate for Alzheimer's disease among monozygotic pairs was 67%; the corresponding figure for dizygotic pairs was 22%. Heritability of liability to Alzheimer's disease was estimated to be .74; to any dementia, .43. The other variance is attributable to environmental influences. Conclusions. Findings indicate a substantial genetic effect for these predominantly late-onset Alzheimer's disease cases. At the same time, structural modeling results and large intra-pair differences in age of onset suggest that environmental factors are also important in determining whether and when an individual may develop dementia.

There is a need to focus on various environmental risk factors that may lead to delay or prevention of dementia. The genetic basis of vulnerability to Alzheimer's disease is accompanied by environmental factors that trigger disease expression. The resources should be targeted at preventing disease onset in people with predispositions to the disease.

The association between dementia and education was studied in 143 twin pairs discordant for dementia, using a matched-pair design, and in 221 dementia cases and 442 unrelated controls from the same twin registry, using a case-control design. Low education was defined as 6 years or less of schooling. Case-control analyses with prevalent cases showed low education to be a risk for Alzheimer's disease but not dementia in general. Low education did not significantly predict incident cases. In the matched-pairs analysis, which controls for genetic and other familial influences, differences in education between demented twins and twin partners were not statistically significant. However, for Alzheimer's disease, odds ratios resulting from matched pairs and case-control analyses were similar. Twins' comparative reports about intellectual involvement earlier in their lives suggest a long-standing difference on this dimension, with less involvement by the twin who became demented.