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Objective The purpose of the current study is to examine the association between subjective memory complaints and sleep (quantity and quality) in African American older adults. Method Participants from the Baltimore Study of Black Aging (BSBA; n = 351; mean age = 71.99) completed a self-report sleep scale, subjective memory complaint scale, global cognitive status measure, and demographic questionnaire. Results Worse overall sleep quality was significantly associated with subjective reports of difficulty recalling the placement of objects, recalling specific facts from reading materials, and worse memory currently compared to the past. Specific sleep parameters (e.g. longer sleep latency and shorter sleep duration) were associated with negative appraisals of participants' ability to do specific tasks involving memory (e.g. difficulty recalling placement of objects). Participants classified as poor sleepers (Pittsburgh Sleep Quality Index [PSQI] total score > 5) were more likely to report worse memory now compared to the past than participants classified as good sleepers (PSQI total score ≤ 5). Conclusions Evaluation of sleep may be warranted when older adults, particularly African Americans, communicate concerns regarding their memory. Insufficient sleep may be a useful marker of acute daytime dysfunction and, perhaps, cognitive decline. Given memory problems are the hallmark of dementia, our findings support further evaluation of whether poor sleep can aid in the diagnosis of cognitive impairment. [ABSTRACT FROM AUTHOR]

We proposed a mediation model to examine the effects of age, education, computer knowledge, and computer anxiety on computer interest in older adults. We hypothesized that computer knowledge and computer […]

Objective: This study examined whether there are daily fluctuations in everyday cognition that are consistent with daily fluctuations often observed in traditional measures of basic cognitive abilities. Method: Two hundred six independently living older adults (age range = 60-91 years) were asked to complete a computerized cognitive battery over eight occasions within a 2- to 3-week period. Results: Using multilevel model, significant within-person variability was observed across the Daily Everyday Cognition Assessment (DECA; 46%), with 54% between-person variability. At each occasion, better performance on the DECA was significantly associated with better performance on simple reaction time ( p < .01) and memory (Auditory Verbal Learning Task, p < .01) even after accounting for time, age, education, and performance on other cognitive measures. Conclusion: These findings demonstrate that within-person performance fluctuations can be observed for everyday cognition tasks, and these fluctuations are consistent with daily changes in basic cognitive abilities. [ABSTRACT FROM AUTHOR]

Objective Vascular burden has been linked to future depression and cognitive change in predominately European American samples. This study investigated these relationships in older African Americans. Methods To examine the connection between vascular risk factors, depression, and cognitive change, this study utilized data from 435 older African Americans. Specifically, the study examined the link between vascular risk at baseline with depression and cognitive functioning at a 2.5-year follow-up visit. Results High baseline vascular risk was associated with increased odds of future depression while controlling for age and current depression. A series of path analyses demonstrated links between baseline vascular risk, increases in depression, and decreases in processing speed. Conclusions These findings suggest that African Americans with greater vascular burden are at greater risk for depression and cognitive change. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Outliers are typically regarded as data anomalies that should be discarded. However, dynamic or “innovative” outliers can be appropriately utilized to capture unusual but substantively meaningful shifts in a system's dynamics. We extend De Jong and Penzer's 1998 approach for representing outliers in single-subject state-space models to a group-based framework. The group-based model enables model predictions concerning the group as a whole while individualized change points are incorporated to capture discrete shifts in each individual's trajectory. An illustrative example using cognitive performance data from N = 38 older adults over 60 days is presented. Results indicated that a subset of older adults showed sudden shifts in learning dynamics in several forms, including sudden jumps in level, slope, and linkage between perceived control and actual performance level. The broader implications of incorporating innovative outliers into studies of intraindividual change are discussed. [ABSTRACT FROM AUTHOR]

Manufacturing environments are becoming increasingly technological while the work force is aging, thus, many older workers will find themselves in new roles. Traditional methods of evaluating overall system human reliability via task analysis are equipped to qualitatively accommodate knowledge regarding the relationship between age and the abilities required in advanced manufacturing technology systems. Combining task analysis with knowledge of age-related changes will allow system designers to recognize potential problems for older workers and design accommodation into the system. [ABSTRACT FROM AUTHOR]

The article offers information on a study which examined the effects of blood pressure on the memory of older African Americans. Results of the study, which gathered information from 631 African American adults, showed links between levels of systolic blood pressure and cognitive functioning and the importance of blood pressure in aging and health processes.

Background: Insurance benefit design influences whether individuals with diabetes who require a continuous glucose monitor (CGM) to provide real-time feedback on their blood glucose levels can obtain the CGM device from either a pharmacy or a durable medical equipment supplier. The impact of the acquisition channel on device adherence and health care costs has not been systematically evaluated., Objective: This study aims to compare the adherence rates for patients new to CGM therapy and the costs of care for individuals who obtained CGM devices from a pharmacy versus acquisition through a durable medical equipment supplier using retrospective claims analysis., Methods: Using the Mariner commercial claims database, individuals aged >18 years with documented diabetes and an initial CGM claim during the first quarter of 2021 (2021 Q1, index date) were identified. Patients had to maintain uninterrupted enrollment for a duration of 15 months but file no CGM claim during the 6 months preceding the index date. We used direct matching to establish comparable pharmacy and durable medical equipment cohorts. Outcomes included quarterly adherence, reinitiation, and costs for the period from 2021 Q1 to the third quarter of 2022 (2022 Q3). Between-cohort differences in adherence rates and reinitiation rates were analyzed using z tests, and cost differences were analyzed using 2-tailed t tests., Results: Direct matching was used to establish comparable pharmacy and durable medical equipment cohorts. A total of 2356 patients were identified, with 1178 in the pharmacy cohort and 1178 in the durable medical equipment cohorts. Although adherence declined over time in both cohorts, the durable medical equipment cohort exhibited significantly superior adherence compared to the pharmacy cohort at 6 months (pharmacy n=615, 52% and durable medical equipment n=761, 65%; P<.001), 9 months (pharmacy n=579, 49% and durable medical equipment cohorts n=714, 61%; P<.001), and 12 months (pharmacy 48% and durable medical equipment n=714, 59%; P<.001). Mean annual total medical costs for adherent patients in the pharmacy cohort were 53% higher than the durable medical equipment cohort (pharmacy US $10,635 and durable medical equipment US $6967; P<.001). In nonadherent patients, the durable medical equipment cohort exhibited a significantly higher rate of therapy reinitiation during the period compared to the pharmacy cohort (pharmacy 61/613, 10% and durable medical equipment 108/485, 22%; P<.001)., Conclusions: The results from this real-world claims analysis demonstrate that, in a matched set, individuals who received their CGM through a durable medical equipment supplier were more adherent to their device. For individuals who experienced a lapse in therapy, those whose supplies were provided through the durable medical equipment channel were more likely to resume use after an interruption than those who received their supplies from a pharmacy. In the matched cohort analysis, those who received their CGM equipment through a durable medical equipment supplier demonstrated a lower total cost of care., (©Jason C Allaire, Consuela Dennis, Arti Masturzo, Steven Wittlin. Originally published in JMIR Diabetes (https://diabetes.jmir.org), 22.07.2024.)

Social support and functional ability are related to a number of outcomes in later life among African Americans, including cognitive performance. This study examined how providing and receiving social support was related to fluid and crystallized cognitive abilities among aging African American adults after accounting for functional limitations, age, education, sex, income, and self-reported health. Data from 602 African American adults (M = 69.08, SD = 9.74; 25% male) were analyzed using latent variable modeling. Fluid ability was a second-order factor indicated by measures that assessed verbal memory, working memory, perceptual speed, and inductive reasoning. Crystallized ability was a first-order factor indicated by three measures that assessed vocabulary (Shipley Verbal Meaning Test and parts A and B of the ETS Vocabulary Test). Results indicated that the receipt of social support was negatively related to both fluid and crystallized abilities, while the provision of support was positively related to fluid and crystallized ability. Follow-up tests found that the receipt of support was more strongly related to fluid ability than crystallized ability. There was no significant difference regarding the relationship of provision of support with fluid ability compared to crystallized ability. Results discuss the importance of considering the social context of older adults when examining cognitive ability.

We examined the mediating role of health literacy in the relationships between participant demographic characteristics and health information recall. Baseline data from two studies that focused on hypertensive adults (N = 1190; M = 62.28 years, SD = 11.98; 35.5% female; 45.9% African-American) were analyzed. The final model, which adjusted for recruitment site, indicated that financial status, race, and education were indirectly related to health information recall through health literacy. Increasing education was also directly related to better health information recall. Increasing age was not related to health literacy, but was related to poorer health information recall. The final model fit the data very well, chi(2)(3) = 0.69, p = .36, RMSEA = .000 (90% CI = .000 to .024), CFI = 1.00. The results suggest that health literacy might be one of the mechanisms underlying the relationships between participant demographic characteristics and poor health outcomes due to inaccurate recall of instructions.

This study examined the association of a performance-based measure of everyday functioning with clinically meaningful outcomes. Elderly participants in a prospective study of dementia were assessed at two occasions on the Everyday Problems Test for Cognitively Challenged Elderly (EPCCE), a performance-based measure of everyday functioning. Older adults who remained cognitively intact performed approximately 0.66 SD units higher on the EPCCE at both occasions than elders rated as impaired, when covarying on age, education, gender, and cognitive status. Relative to the nonimpaired participants, decline in EPCCE performance over a 2-year interval was significantly greater for impaired participants and those participants who transitioned from nonimpaired to impaired over the course of the study. Increased risk of mortality was associated with lower baseline scores and decline in EPCCE performance even after controlling for demographic variables and performance on the Mini-Mental State Examination. Given the clinical importance of identifying "at risk" elders for impairment, the findings from this study provide initial evidence for the predictive utility of performance-based measures of everyday functioning.