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Grandparenting predicts late-life cognition: Results from the Women's Healthy Ageing Project
... Studies were punctuated with a score considered fair/medium, of 14 to 17 point on a possible total of 27. This result consensual between the two reviewers on three-17 points to Arpino and Bordone, 33 17 to Burn and Szoeke, 35 16 to Burn et al. 34 -and differed on two but maintaining the same level-17 and 14 to Jun, 36 17 ...
... Burn and Szoeke, 35 had a sample with a mean age of 65.55 years old (SD=2.61). Also, 72.2% of grandmothers minded their grandchildren and had a mean of 3.17 (SD 2.04) grandchildren, were 0.94 years younger (p<0.05) and more likely to have ≥12 years of education (p<0.01) ...
... Cross-sectional studies can limit the ability to find an accurate relationship between grandparenting and cognition. [33][34][35] Arpino and Bordone 33 and Reinkowski 37 had an Instrumental Variable Approach as statistic methodology to correct for confounding, what can be an advantage. 41 Lastly, considering our principal question, in all studies there seems to be a trend towards a positive effect on grandparents' cognition associated with taking care of their grandchildren. ...
Objective:
To evaluate the relationship between grandparenting and the cognitive impairment in older persons.
Methods:
The protocol was submitted to the International Prospective Register of Systematic Reviews (PROSPERO), registration number: CRD42018105849. Authors conducted a systematic review, following "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) recommendations. Electronic databases were accessed through august 2018: PubMed, ISI Web of Knowledge, Scopus, and EBSCOhost. Selection of records and quality appraisal were made by two reviewers, independently.
Results:
A total of 178 records was found, after removing duplicates. From those, 17 were considered eligible for integral text reading and eight were included: five original studies, one classic review and two editorials. From the five original studies included, four suggested a positive effect on cognition resulting from grandparenting and one suggested that there was no evidence for a causal effect. Though the boundary was not consensual, some studies suggested that a higher frequency of grandparenting has a negative impact on cognition.
Conclusion:
Overall, studies suggested a trend towards a positive effect of grandchild care on grandparents' cognition. However, there was a significant heterogeneity between methodologies and a significant risk of bias which can hamper conclusions, indicating the need for further and more robust research.
... Only a handful of studies have investigated the association between grandparenting and cognitive health. Unlike the mixed findings on physical and mental health outcomes, these studies have consistently shown a positive association between caring for grandchildren and grandparents' cognitive functioning in the United States (Sneed and Schulz 2019), Europe (Arpino and Bordone 2014), Australia (Burn and Szoeke 2015a;, and East Asia (Jun 2014;Pan et al. 2020). ...
... Therefore, this study adopted a more holistic perspective and combined time spent on caregiving and intergenerational living arrangements to characterize different patterns of grandparenting. Second, some prior studies were cross-sectional (Burn and Szoeke 2015a;Jun 2014), whereas others conducted longitudinal analyses using random-effects models (Sneed and Schulz 2019;Pan et al. 2020). These approaches are susceptible to endogeneity issues such as self-selection into caregiving and reverse causality between caregiving and cognitive function (for exceptions, see Arpino and Bordone 2014;Ahn and Choi 2019). ...
... However, empirical findings remain mixed. In a small sample of grandmothers in Melbourne, Australia, two studies found that spending 1 day per week caring for grandchildren was associated with better episodic memory and executive function, but spending 5 days or more per week was associated with poorer working memory and processing speed (Burn and Szoeke 2015a;. In contrast, using data from the Health and Retirement Study, one study found that American grandparents who spent more hours caring for grandchildren showed less decline in episodic memory over a 4-year period (Sneed and Schulz 2019). ...
Caring for grandchildren provides grandparents an opportunity to sustain an active lifestyle and remain socially engaged in older age. Studies have examined the association between providing care to grandchildren and grandparents’ cognitive function. However, these studies had several limitations and yielded mixed findings. Using data from the China Health and Retirement Longitudinal Study, this study examined the longitudinal association between caregiving and cognitive functioning in grandparents aged 50–75 years. Grandparents’ caregiving status and cognitive functioning were assessed in 2011, 2013, and 2015. Random-effects and fixed-effects regression models were estimated and compared. The full sample (20,000 + person-year observations) was divided into four subgroups to examine gender and rural–urban variations. Being a part-time noncoresident caregiver was associated with higher scores on episodic memory for grandfathers but not for grandmothers. Compared with their noncaregiving counterparts, rural part-time multigenerational caregiving grandmothers had significantly better mental intactness and global cognitive functioning, while rural full-time noncoresident caregiving grandmothers had significantly better episodic memory. Caregiving status was not associated with any cognitive measure among urban grandmothers. Taken together, these findings suggest that Chinese grandparents enjoy cognitive benefits from providing casual or intensive care to grandchildren, but these benefits vary substantially by gender and rural–urban status.
... This study provides evidence regarding causal effects of grandparent caregiving on grandparents' cognitive functioning in Korea. To the best of our knowledge, only a handful of studies have hitherto examined the relationship between caregiving for grandchildren and grandparents' cognitive functioning (Arpino and Bordone 2014;Burn and Szoeke 2015;Jun 2015). Although previous studies consistently find that caregiving for grandchildren is related to better cognitive functioning, endogeneity in caregiving decision is not fully accounted for. ...
... Indeed, only a handful of studies have explored the association between caregiving for grandchildren and cognitive functioning. Among them, Burn and Szoeke (2015) and Jun (2015) find positive correlations between caregiving for grandchildren and cognitive functioning without controlling for endogeneity. However, considering the endogeneity in caregiving decision is important in robustly determining whether the relationship is causal. ...
... Caregiving for grandchildren increases the K-MMSE score by 0.643 points, orientation score by 0.172 points, immediate recall score by 0.099 points, and language ability score by 0.230 points. These results, which represent positive correlation between cognitive functioning and caregiving for grandchildren, are consistent with previous findings (Arpino and Bordone 2014; Burn and Szoeke 2015;Jun 2015). Work, regular exercise, frequency of meeting close associates, and participation in social groups, which are indicators of an active lifestyle, are also positively correlated with cognitive functioning. ...
Caregiving for grandchildren is becoming common and plays an important role in the childcare system in many countries. This study examines whether caregiving for grandchildren has a causal effect on grandparents’ cognitive functioning, using a longitudinal survey of older Koreans. To assess the causal relationship, we estimate a fixed-effects instrumental variable model by using the presence of a married child and a child aged 31–40 years as instruments. The estimation results reveal that caregiving for grandchildren significantly improves grandparents’ cognitive functioning. Caregiving for grandchildren is predicted to improve global cognitive functioning score by 30.05%, orientation score by 19.85%, delayed recall score by 95.58%, and language ability score by 30.10%. In addition, the effect of grandparent caregiving is salient among females as well as lower-income and less educated groups. Our findings suggest that caregiving for grandchildren, which is one of the most common forms of informal care, may play a complementary role to formal care.
... Aging populations as well as social and demographic change have led to the modification and reorganization of family relationships and particularly those taking place between grandparents and their grandchildren [1]. Previous studies [2][3][4] show increased involvement of grandmothers in the care of grandchildren, a shared experience among the elderly. [2][3][4]. ...
... Previous studies [2][3][4] show increased involvement of grandmothers in the care of grandchildren, a shared experience among the elderly. [2][3][4]. ...
Objectives
The aim of this study was to describe grandmothers’ experiences of taking care of their grandchildren in terms of their care-giving tasks, motivations and emotions.
Methods
A qualitative phenomenological study was conducted. Purposive sampling was used, based on the relevance of the research question. Seventeen participants were included, women ≥ 65 years old, grandmothers who care for their grandchildren at least 10 h per week and who attended the Nursing units of the Primary Care Health Centers (Madrid Public Health Service). Seventeen in-depth interviews were conducted. The interviews were audio-recorded, transcribed verbatim and thematic analysis was carried out from the perspective of hermeneutic phenomenology. For the analysis, the Excel program was used to organize and share the coding process. Also, we followed COREQ guidelines.
Results
Four main themes were identified: (a) Care out of obligation, where participants feel an obligation to help their children by caring for grandchildren, regardless of their number, and prefer to do so voluntarily; (b) Care out of responsibility, where grandmothers see their role as a responsibility that includes saving costs by caring for grandchildren and facilitating their children’s work life balance; (c) Care as a social duty, reflecting a moral commitment inherited from their mothers to help future generations; and (d) Construction of care from a gender perspective, where grandmothers, as women, primarily assume the care and upbringing of grandchildren.
Discussion
Our results contribute to increase knowledge about childcare provided by grandmothers to their grandchildren. Grandmothers become fundamental pillars of families by helping their children balance family and work. Behind this care there is a strong sense of obligation, duty and generational responsibility. Grandmothers’ help presents differences in the distribution of tasks and care by sex. Identifying factors that motivate grandmothers to care for their grandchildren helps nurses to perform higher quality comprehensive care.
... For example, some research reports negative health effects of caring for grandchildren Szinovacz et al., 1999;Minkler and Fuller-Thomson, 2001;Blustein et al., 2004;Lo and Liu, 2009;Lou, 2011;Chen and Liu, 2012). On the contrary, other studies find health benefits for grandparents who provide care to grandchildren, such as reduced depressive symptoms (Silverstein et al., 2006;Cong and Silverstein, 2008;Tsai et al., 2013), better self-rated health (Ku et al., 2013), greater life satisfaction (Silverstein et al., 2006;Grundy et al., 2012;Xu et al., 2012), and even improved cognition (Arpino and Bordone, 2014;Burn and Szoeke, 2015;Ahn and Choi, 2019;Sneed and Schulz, 2019). Moreover, the underlying mechanism of how grandparental caregiving affects caregivers' health has yet to be identified and described. ...
... In the case of migrant grandparents, it has been argued that grandparental caregiving could be regarded as a means of social engagement and social activity (Waldrop and Weber, 2001;Nyland et al., 2009;Arpino and Bordone, 2014;Burn and Szoeke, 2015;Bulanda and Jendrek, 2016), which could fulfill the need for social connectedness. As argued by disengagement theory, people gradually disengage from social life as they grow older (Cumming et al., 1960), making them more likely to lose social ties that were previously available to them. ...
Objective
The purpose of the present study is twofold: (1) to investigate the differences in terms of physical and mental health between those who provide grandparental care and those who do not and (2) to explore the mechanism that connects grandparental caregiving and health-related outcomes.
Methods
Two studies (a cross-sectional and a short-term longitudinal follow-up) were conducted. The cross-sectional study (Study 1) examined 148 older adults who provided grandparental care and another 150 older adults who did not. A small longitudinal follow-up study (Study 2) was conducted among 102 older adults randomly selected from Study 1, of which 52 were older adults who provided grandparental care, and another 50 older adults were those who did not. Health status (measured by SF-36), lonely dissatisfaction (measured by Lonely Dissatisfaction Subscale of PGC-MS), and cognitive functions (measured by subscales of WAIS) as well as demographics were measured in both studies.
Results
Results of both the cross-sectional and longitudinal studies showed that, compared with older adults who did not provide grandparental care, those providing grandparental care had significantly better physical and mental health as well as reduced lonely dissatisfaction. Further path analysis showed that lonely dissatisfaction mediated the association between providing grandparental care and enhancement in functions such that providing grandparental care could reduce lonely dissatisfaction, which, in turn, could improve their physical and mental health even after controlling for their cognitive functions.
Discussion
These results suggest that providing grandparental care can improve older adults’ physical and mental health through reduced lonely dissatisfaction.
... Earlier empirical studies on family relationships and cognitive function tended to focus on a single dimension of intergenerational solidarity (Crooks et al., 2008;Kim & Chon, 2018). Among the six dimensions of intergenerational solidarity, the relationships between structural, associational, and functional solidarity and cognitive function have been well documented in literature (Burn & Szoeke, 2015;Ihle et al., 2018;Kim & Chon, 2018). ...
... Previous research found a significant association between emotional support from children and reduced cognitive impairment among those who are without a spouse (Okabayashi et al., 2004). With respect to downward family support, grandparental child care had an intellectually stimulating component, benefiting executive function (Burn & Szoeke, 2015) and verbal fluency (Arpino & Bordone, 2014). ...
A broad literature has explored racial disparities in cognitive aging. Research incorporating sociocultural factors would provide a more comprehensive understanding of minority aging. This study aims to investigate the role of family typology in cognition among U.S. Chinese immigrants. Data were derived from the Population Study of Chinese Elderly in Chicago (PINE). Family typology included tight-knit, unobligated ambivalent, commanding conflicted, and detached typologies. Cognition was evaluated by global cognition, episodic memory, working memory, executive function, and mini-mental state examination (MMSE). Linear and quantile regressions were used. Older adults with detached and commanding conflicted typologies reported lower global cognition than those with unobligated ambivalent typology. Detached, commanding conflicted, and tight-knit typologies were associated with poorer performance in episodic memory, working memory and MMSE than unobligated ambivalent typology, respectively. Social service providers could be aware of multifaceted family relationships when developing interventions for cognitive function and understand family typology as a whole.
... Earlier empirical studies on family relationships and cognitive function tended to focus on a single dimension of intergenerational solidarity (Crooks et al., 2008;Kim & Chon, 2018). Among the six dimensions of intergenerational solidarity, the relationships between structural, associational, and functional solidarity and cognitive function have been well documented in literature (Burn & Szoeke, 2015;Ihle et al., 2018;Kim & Chon, 2018). ...
... Previous research found a significant association between emotional support from children and reduced cognitive impairment among those who are without a spouse (Okabayashi et al., 2004). With respect to downward family support, grandparental child care had an intellectually stimulating component, benefiting executive function (Burn & Szoeke, 2015) and verbal fluency (Arpino & Bordone, 2014). ...
A broad literature has explored racial and ethnic disadvantages in cognitive aging. Migration and acculturation created additional challenges on cognitive aging of minority older immigrants. Asian Americans are the fastest growing minority group in the United States. Chinese Americans constitute the largest segment of Asian Americans. Family is a core social value in Chinese culture. Less is known regarding the impact of family relationship on cognitive function for US Chinese older immigrants. Data were derived from the Population Study of Chinese Elderly (PINE), a community-engaged, population-based epidemiological study of 3,157 US Chinese older adults aged 60 and above in the greater Chicago area from 2011-2013. A typology approach is a useful tool to operationalize multifaceted family relationships. Our prior study used Latent Class Analysis to cluster family typologies, evaluating structural, associational, affectual, functional and normative aspects of family relationship. Cognitive function was evaluated by global cognition, episodic memory, executive function, working memory, and Chinese Mini-Mental State Examination (C-MMSE). Linear regression and quantile regression were used. The findings showed detached and commanding conflicted typologies were associated with lower global cognitive function compared with unobligated ambivalent typology. Wish respect to cognitive domains, detached, commanding conflicted, and tight-knit typologies were associated with lower episodic memory, working memory, and C-MMSE than unobligated ambivalent typology, respectively. Commanding conflicted typology, featured by high intergenerational conflicts, was associated with lowest cognitive function among all typologies. Health care professionals and social service providers should focus on older adults with commanding conflicted typology and prevent them from cognitive impairment.
... (15,18) Useat tutkimukset osoittavat perheenjäsenten keskinäisen sosiaalisen sitoutumisen, kontaktien ylläpitämisen ja toiminnan lastenlasten kanssa suojaavan vaikutuksen kognitiivisten toimintojen ylläpitämisessä ja ennaltaehkäisevän vaikutuksen dementiaa vastaan. (19)(20)(21)(22). Aktiivinen isovanhemmuus lievittää stressiä, lisää liikkumista ja päivittäistä toimintakykyä sekä tuo mielekkyyttä vapaa-aikaan (10). ...
Ryhmärakentaminen tarkoittaa rakennushanketta, jossa joukko yksityishenkilöitä tai perheitä yhdistää voimavaransa suunnitellakseen, rakennuttaakseen ja rahoittaakseen asuinrakennuksia yhdessä. Tavoitteena on usein luoda yhteisöllisiä asuinympäristöjä ja mahdollistaa yksilölliset ratkaisut kustannustehokkaasti. Väestörakenteen ikääntyessä on noussut tarve kestäville ja innovatiivisille ratkaisuille vanhusten hoivan ja asumisen järjestämiseksi. Perinteiset hoitolaitokset eivät aina pysty vastaamaan yksilöllisiin tarpeisiin, sillä monet ikääntyneet ihmiset haluavat säilyttää sekä mahdollisimman suuren autonomian että yhteisöllisyyden elämässään. Nykyiset hoitolaitokset eivät tarjoa riittävää tilaa suuremman jälkikasvun kokoontumiselle ja altistavat vanhusten sulkeutumiselle ainoastaan oman ikäistensä seuraan. Suuri ajankohtainen haaste on myös laitosrakenteen purkaminen ja kotona asumisen mahdollistaminen. Nykyiset asunnot eivät sovellu laadukkaaseen senioriasumiseen. Ikäihmiset tulevat kuitenkin jatkossa asumaan omissa kodeissaan nykyistäkin pidempään. Ryhmärakentaminen on noussut esiin mielenkiintoisena vaihtoehtona, joka tarjoaa mahdollisuuden yhteisölliseen asumiseen ja hoivaan. Ennakoivassa ryhmärakentamisessa henkilö voi itse suunnitella seniorivaiheen asumistarpeensa ja huomioida samalla ekologisen rakentamisen. Energiatehokkaat rakennukset, uusiutuvien energialähteiden käyttö, veden säästöön tähtäävät ratkaisut sekä viherrakentaminen edistävät lisäksi kestävää kehitystä. Keski-iässä aloitettu ennakoiva suunnittelu tarjoaa yhden tehokkaan keinon vastata tulevaisuuden senioriasumisen taloudellisiin, yhteiskunnallisiin ja globaaleihin haasteisiin.
... The interpretation re ects the purport of role enhancement theory. For the elderly who are gradually withdrawing from the labor market, the family sector has occupied an increasingly long time in their lives, and "being grandparents" has become an important part of their lives [24]. ...
Objectives: This study examines the influence of caring for grandchildren on Chinese elderly’s life satisfaction to elucidate the informal cultural institutions.
Background: Intergenerational care is an important mean for ensuring family security in China in the face of deficient childcare services. However, the impact of caregiving on grandparents’ quality of life is uncertain. This study bridged the role tension and role enhancement theories which were a pair of competitive hypothesesto explain the impact of intergenerational care.
Methods: This study used the China Longitudinal Aging Social Survey(http://class.ruc.edu.cn/) 2018 database obtained by probability sampling method and sorted out 5,773 eligible elderly samples. Multiple linear regressions and polynomial models were used to analyze the data. Endogeneity was solved through propensity score matching.
Results: The grandparents caring for grandchildren scored significantly high for life satisfaction. The relationship between the duration of care and the life satisfaction of grandparents was inversely U-shaped. Caring for grandchildren and advanced age elderly, such as respondents’ parents, inhibited the benefits of intergenerational care.
Conclusions: Caring for grandchildren moderately improves Chinese elderly’s quality of life. The intensity of care is an important factor determining the direction of the influence of intergenerational care on grandparents’ quality of life.
Implications: For the sake of the mental health of the elderly and family unity, the older adults should be ensured to care for their grandchildren under conditions of low care intensity and high care willingness.
... Nastawienie do wnuków nie zawsze jest pozytywne, osoby w wieku podeszłym mogą bowiem nie mieć wystarczającej cierpliwości, a ich stan zdrowia może nie być na tyle dobry, aby mogli oni podjąć się wychowywania wnuków (Pieńkoś, 2015). Niestety w obecnych czasach może to generować konflikty rodzinne, ponieważ aktywni zawodowo rodzice wywierają presję na seniorów, by zajmowali się oni wnukami (Burn, Szoeke, 2015). ...
b>Wprowadzenie. Rodzina jest pierwszą grupą społeczną, w jakiej funkcjonuje człowiek. Większość osób starszych odczuwa silną potrzebę posiadania dobrych więzów rodzinnych. Jeśli pozwala im na to stan zdrowia, mogą oni odpowiadać za wiele obowiązków domowych. Dziadkowie wyręczają młodsze pokolenie, które jest aktywne zawodowo, co daje im poczucie użyteczności w funkcjonowaniu rodziny. Rodzice często decydują się na oddanie potomstwa pod opiekę dziadków z wielu różnych powodów, często nie zastanawiając się, jaki wpływ ma to na zdrowie osób starszych. Cel. Celem teoretycznym artykułu jest przedstawienie wyników badań polskich i międzynarodowych z zakresu pozytywnych i negatywnych stron opieki nad wnukami przez osoby powyżej 65. roku życia oraz ich wpływu na relacje rodzinne. Celem praktycznym artykułu jest natomiast poszukiwanie rozwiązań uzyskania satysfakcji w opiece nad wnukami, które nie wpływają negatywnie na jakość życia osób starszych. Materiały i metody. Przegląd i analiza literatury przedmiotu. Wyniki. Dziadkowie w wielu rodzinach są angażowani do pomocy przy dzieciach; może to być ich własna inicjatywa, lecz także mogą być do tego nakłaniani przez rodzinę wywierającą na nich presję. Opieka nad wnukami może mieć wpływ zarówno pozytywny, jak i negatywny. Wnioski. Osoby starsze często podejmują się opieki nad swoimi wnukami, niekoniecznie licząc się z konsekwencjami. Ograniczenie negatywnych skutków może odbywać się poprzez tworzenie akcji edukacyjnych, które miałby za zadanie ukazywanie właściwych form tej opieki.
... Family members may have more importance for older people because, as individuals age, their other social connections become less central in their lives, and their need for caregiving increases [7]. Among older adults, those who had 2 of 12 a large number of family members [8], frequent contact with their children [9], intergenerational support from children [10], or downward family support (e.g., grandparental child care) performed better on cognitive, executive function [11], and verbal fluency tests [12]. Among family members, the spouse may have the greatest effect on their partners' cognitive function. ...
The aim of this study was to investigate the association between cognitive function and depressive symptoms in older couples while also examining the relationship between cognitive performance and the frequency of contact with adult children. A total of 96 couples volunteered for this study and provided their informed consent at enrollment. Participants completed a neuropsychological test battery consisting of five cognitive domains: attention, language and related functions, visuospatial functions, memory, and frontal/executive functions. Symptoms of depression were assessed using the short version of the Geriatric Depression Scale. The number of contacts with children was categorized into ≥1 per month and <1 per month. We found that the cognitive functions of husbands with depressed wives were significantly lower in the frontal/executive functions. In contrast, the wives’ cognitive performance was not associated with the husbands’ depressive symptoms. For couples who had contact with their adult children less than once a month, the odds of the husbands with lower cognitive performance were significantly higher, which was reflected in their scores in visuospatial and executive functions. Among older married couples, the cognitive functions of husbands may be influenced more by their wives’ mental health and degree of contact with their adult children. This infers that wives and offspring may act as a buffer against the cognitive impairment of older married men.
... For example, Arpino et al. (2018) found that being a grandparent in Europe is associated with increased subjective well-being, and that active grandparenting -i.e., spending time with grandchildren and looking after them -is the primary source of this positive association. Other research has also demonstrated that for grandparents, spending time with their grandchildren can have positive effects on their physical and mental health, and on their cognitive functioning (Arpino and Bordone 2014;Burn and Szoeke 2015;Condon et al. 2018;Di Gessa et al. 2016;Szinovacz and Davey 2005). However, as caring for grandchildren may also involve stress, grandparenting responsibilities can be detrimental to older people's health outcomes (Minkler and Fuller-Thomson 1999), particularly when the care demands are high (e.g., in skipped-generation households in which the grandparents take on the primary care obligations), and when the grandparents have competing roles (Hughes et al. 2007;Musil et al. 2011). ...
Research on grandparenthood and the multigenerational family has been greatly expanding. However, surprisingly little is known about how the demographic fabric of multigenerational relations has been changing over time. Focusing on the grandparent-grandchild type of multigenerational relationship, the aim of this chapter is twofold. First, I review the rather sparse literature on the demography of grandparenthood, and conclude that most of what we know about grandparenthood and multigenerational family demographics applies to the North American context. Therefore, in a second part, I study the changes in the demography of grandparenthood in Europe from the middle of the 20th century until today. I then develop multigenerational indicators based on kinship models and combined with period data on fertility and mortality to assess the time trends in nine European countries. The results suggest that there have been profound changes in the demographic contexts in which grandparent-grandchild relations are experienced in Europe. However, the findings also reveal important non-linear trends and considerable heterogeneity in these relationships.
... Most studies on family relationships and cognitive function have been conducted in western countries. Empirical evidence has shown that larger family size (structural), more frequent intergenerational interactions (associational), and higher upward and downward family support (functional) were associated with better cognitive health among older adults in the United States, Australia, and Europe (Barnes, De Leon, Wilson, Bienias, & Evans, 2004;Burn & Szoeke, 2015;Ihle et al., 2018). A few studies were conducted in Asian countries. ...
Objectives: Acculturation to the mainstream culture and the settlement contexts could shape cognitive function of older immigrants. Guided by ecological theory, this study examines the interaction effect between individual acculturation and ecology of family on cognitive function among older Chinese Americans. Methods: Data were derived from the Population Study of Chinese Elderly in Chicago (n = 3,019). Family types included tight-knit (high solidarity and low conflicts), unobligated-ambivalent (high solidarity and conflicts), commanding-conflicted (low solidarity and high conflicts), and detached (low solidarity and low conflicts). Acculturation was measured via language ability, media use, and ethnic social relations. Cognitive function was evaluated by global cognition, episodic memory, working memory, processing speed, and mini-mental state examination. Multiple regression analyses and interaction terms were used. Results: Older adults in the commanding-conflicted type had the lowest cognitive function. After controlling confounding variables, higher levels of acculturation (b = 0.009, SE = 0.003, p < .01) were associated with higher levels of global cognition. Acculturation buffered the negative impact of having a commanding-conflicted relationship with children on global cognition (b = 0.070, SE = 0.016, p <.001). Language ability, media use, and ethnic social relations played a unique role in the relationships between family types and cognitive domains. Conclusion: Acculturation to the dominant culture is identified as a cultural asset for cognitive function in older Chinese Americans. Social services could protect cognitive function of older immigrants in the commanding-conflicted type through enhancing cultural participation. Future research could test how affective and cognitive aspects of acculturation affect health.
... Most studies on family relationships and cognitive function have been conducted in western countries. Empirical evidence has shown that larger family size (structural), more frequent intergenerational interactions (associational), and higher upward and downward family support (functional) were associated with better cognitive health among older adults in the United States, Australia, and Europe (Barnes, De Leon, Wilson, Bienias, & Evans, 2004;Burn & Szoeke, 2015;Ihle et al., 2018). A few studies were conducted in Asian countries. ...
Objectives
Acculturation to the mainstream culture and the settlement contexts could shape cognitive function of older immigrants. Guided by ecological theory, this study examines the interaction effect between individual acculturation and ecology of family on cognitive function among older Chinese Americans.
Methods
Data were derived from the Population Study of Chinese Elderly in Chicago (n = 3,019). Family types included tight-knit (high solidarity and low conflicts), unobligated-ambivalent (high solidarity and conflicts), commanding-conflicted (low solidarity and high conflicts), and detached (low solidarity and low conflicts). Acculturation was measured via language ability, media use, and ethnic social relations. Cognitive function was evaluated by global cognition, episodic memory, working memory, processing speed, and mini-mental state examination. Multiple regression analyses and interaction terms were used.
Results
Older adults in the commanding-conflicted type had the lowest cognitive function. After controlling confounding variables, higher levels of acculturation (b = 0.009, SE = 0.003, p < .01) were associated with higher levels of global cognition. Acculturation buffered the negative impact of having a commanding-conflicted relationship with children on global cognition (b = 0.070, SE = 0.016, p < .001). Language ability, media use, and ethnic social relations played a unique role in the relationships between family types and cognitive domains.
Conclusion
Acculturation to the dominant culture is identified as a cultural asset for cognitive function in older Chinese Americans. Social services could protect cognitive function of older immigrants in the commanding-conflicted type through enhancing cultural participation. Future research could test how affective and cognitive aspects of acculturation affect health.
... The present study found a significantly positive association between grandparent caregiving and cognitive function. Similar findings can be retrieved from previous studies [37,76]. We explain our findings based on three potential cognitive mechanisms: first, enhance cognition by improving physiological functionality [77]. ...
Grandchild caregiving is suggested to improve the elderly’s cognitive function, but the specific relationship remains under-investigated. Considering gender disparity, this study aimed to understand the relationship between grandchild caregiving and cognition. In total, 7236 Chinese residents (≥45 years old) were selected from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The China Health and Retirement Longitudinal Study Harmonized Cognitive Assessment Protocol (CHARLS-HCAP) was used to measure cognition. Grandparenting was measured from three dimensions: caregiving frequency, intensity, and the number of grandchildren cared for. The relationship was examined by multivariate linear regression, with age as a moderator. The results showed that the majority of respondents provided care to their grandchildren, especially grandmothers. Grandchild caregiving was positively associated with cognition (β = 0.686, 95% CI = 0.334–1.038), especially in the older-aged group. Moderate, not regular grandparenting, or caring for one grandchild was more positively associated with cognitive function. However, intensive and regular grandchild care was significantly associated with cognition only in men. No moderating effects of age were found in women. The study confirmed that moderate intensity and frequency of caregiving was related to better cognitive function in middle-aged and older Chinese population, whereas cultural context and gender differences could be considered when designing targeted policies.
... Grandparenting have been related to less depression and loneliness, as well as better cognitive function. 7,8 The purpose of the present study was to evaluate the prevalence of grandparents providing grandchild care in a South Korean population and examine the severity of depression and suicidal ideation of the older adults according to the amount of involvement in grandchild care. ...
The purpose of the present study was to examine the severity of suicidal ideation of the older adults according to the amount of involvement in grandchild care. Data for this research were drawn from a cross-sectional study conducted on community-dwelling adults aged 65 years or older. The 922 participants were divided into three groups according to their involvement in grandchild care: 18.5% had provided daily care, 12.4% had provided occasional care, and 69.1% had never cared for their grandchildren. ANCOVA analysis showed that the scores for depression was significantly lower in the group which took care of their grandchildren occasionally compared to the other two groups. The scores for suicidal ideation was significantly higher in the group which had never taken care of their grandchildren compared to the other two groups. Current study suggests that grandparenting may have a positive effect on suicidal ideation of the older adults.
... Among the different avenues for participation in social activities in these adults >57 years of age, those with CKD Stages 3b-5 most often cared for grandchildren, although the frequency of caring for grandchildren was lower in those with CKD Stages 3b-5 compared with those without, presumably due to the poorer functional capacity of those with CKD. In the general population, studies have shown that caring for grandchildren helps prevent cognitive decline [30], although it is unclear if the same would be observed in the presence of CKD. Notably, social isolation has also been associated with an inflammatory state in communitydwelling individuals [31,32]. ...
Background:
Chronic kidney disease (CKD) is associated with multiple comorbidities, hospitalizations and mortality. In older adults, social isolation and poor mobility contribute to these outcomes. We tested the hypothesis that a glomerular filtration rate (GFR) <45 mL/min/1.73 m2 (CKD Stages 3b-5) is associated with social isolation and that mobility limitation is a key driver of social isolation in patients with CKD.
Methods:
Data from 9119 participants, ages 57-107 years, from the 2016 wave of the Health and Retirement Study's Venous Blood Study were used for this cross-sectional analysis. Kidney function measured by estimated GFR (eGFR) was the predictor and patients were classified as CKD Stages 3b-5 or non-CKD Stages 3b-5 (eGFR ≤45 or >45 mL/min/1.73 m2). The outcomes tested were mobility limitation assessed by self-report and social contact and participation measures assessed by the Psychosocial Life Questionnaire. The associations among kidney function, mobility and social isolation were examined with logistic and ordinary least squares regression, adjusted for covariates and testing for interaction with gender.
Results:
Participants with CKD Stages 3b-5 (N = 999) compared with non-CKD Stages 3b-5 were older (74.9 versus 68.2 years, P < 0.001) and fewer were female (15% versus 58%, P < 0.001). CKD Stages 3b-5 were associated with higher odds of difficulty walking several blocks [odds ratio 1.44 (95% confidence interval 1.16-1.78)]. Participants with CKD Stages 3b-5 had reduced social contact and social participation (B = -0.23, P < 0.05; B = -0.62, P < 0.05, respectively). Women with CKD Stages 3b-5 were 2.7 times more likely to report difficulty walking several blocks than men with CKD Stages 3b-5, but social isolation in CKD Stages 3b-5 did not vary by gender. In CKD Stages 3b-5 patients, mobility limitation was a risk factor for reduced social contact and participation but did not explain the poor social contact and participation.
Conclusion:
CKD Stages 3b-5 was associated with both mobility limitation and social isolation in a population-based study of older adults. In contrast to older adults without CKD Stages 3b-5, mobility limitation did not explain the lack of social contact and poor social participation, suggesting other factors are more important.
... [18] Elderly are prone for abuse in families as verbal abuses were the most common followed by financial abuse and physical abuse. [19] A previous study pointed out that immobility, misconception, inaccessibility, high cost of medicine family nuclearization, and poverty were associated with poor utilization of health-care services. [20] ...
... First, very extensive interaction may introduce cognitive or emotional demand that outweighs the benefits seen for lower levels. Recent research exploring potential cognitively stimulating effects of grandparenting found that the relationship between days of childcare and cognitive function is parabolic, suggesting that beneficial engagement may reach a critical threshold, with additional activity representing a cognitively detrimental stressor (Burn, Henderson, Ames, Dennerstein, & Szoeke, 2014;Burn & Szoeke, 2015). Reverse causality is another possibility, with people experiencing declines in cognition possibly spending increased time interacting with family members or other caregivers. ...
Social engagement is associated with healthy aging and preserved cognition. Two dimensions of engagement, verbal interactions and perceived support, likely impact cognition via distinct mechanistic pathways. We explored the cognitive benefit of each construct among enrollees (N = 1,052, mean age = 60.2 years) in the Wisconsin Registry for Alzheimer's Prevention study, who provide neuropsychological and sociobehavioral data at two-year intervals. Outcomes included six cognitive factor scores representing key domains of executive function and memory. Key predictors included self-reported perceived social support and weekly verbal interaction. Results indicated that after adjusting for lifestyle covariates, social support was positively associated with Speed and Flexibility and that verbal interactions were associated with Verbal Learning and Memory. These findings suggest that support, which may buffer stress, and verbal interaction, an accessible, aging-friendly form of environmental enrichment, are uniquely beneficial. Both are integral in the design of clinical and community interventions and programs that promote successful aging.
... This relationship has a great value as grandmothers minding grandchildren maintained higher executive function compared to those who do not. 17 JPHNs identified caregiver burn out, in-laws quarrel and disrespect of elderly by youngsters in the family as some of the reasons for conflicts in family. JPHNs identified home-bound elderly as a vulnerable group for abuse. ...
Background: Population is ageing in India. Health care and other needs associated with ageing have risen. The study objectives were to explore the concept of ‘healthy ageing’; health problems of elderly; and felt needs in the care of elderly perceived by the community.Methods: Total of five focus group discussions was conducted. Three Focus group discussions were conducted with family members of homebound elderly and one discussion each were conducted with primary health workers and residents of old age home to supplement the qualitative information gathered from the family members.Results: The participant could make a long list of geriatric health problems. But, their knowledge and attitude towards them was grossly incorrect. All the problems were regarded as part and parcel of ageing for which help was not sought proactively. Mental health problems were regarded as ‘behavioural’ and ‘psychological’ problems. The health problems had its bad effect on family relationships. The perceived healthcare needs were mostly of palliative nature. Day care centres were proposed to improve social interaction of elderly. The community could not afford the level of services which they need. Home care visits by a health team were regarded highly useful.Conclusions: Wide spectrum of barriers to healthcare access of elderly exists in the community. In this regard, a comprehensive community based geriatric health care program including health promotive, preventive, curative and palliative services needs to be formulated with a strong component of health education.
... The WHAP cognitive database is unique in the world with the availability of longitudinal prospective measures from 45 years of age (including blood and imaging biomarkers) combined with neuropsychiatric evaluations from participants in their 50s and the availability of latelife specialized neuro-imaging including fMRI and measurement of cerebral amyloidosis [20]. Earliest changes in cognitive decline from age 50 have been examined, and the importance of social engagement [33,[134][135][136][137] and minimizing vascular risk [138] to improve cognitive health have been reported. These findings are important in the context of the paucity of cognitive data in those under 60 in conjunction with recent research noting that the earliest changes of brain pathology associated with dementia can already be found in 50 year olds [139]. ...
Background
The cohort was commenced to examine women’s health from midlife (45–55 years) before the menopausal transition and into ageing. Methods
Randomised selection and assessment of 2,001 women living in the Melbourne metropolitan area was conducted by the Roy Morgan Centre in 1990/91. Of the 779 women who met the entry criteria for the longitudinal follow-up (aged 45–55 years, menstruating, having a uterus and at least one ovary and not taking hormone therapy) 438 agreed to be seen annually across the menopausal transition from 1992 to 1999. Longitudinal prospective follow-up since 2000 has continued intermittently (2002/03, 2004/05, 2012/13, 2014/15). Data collection has included fasting biomarkers in each year since 1992, clinical assessment, lifestyle and quality of life data, physical measures and validated questionnaire data. Participants have consented to data linkage and, to date, mammogram and BioGrid data have been accessed. Biobank storage including serum, deoxyribonucleic acid (DNA) storage and PAXgene tubes are maintained. DiscussionThe WHAP has contributed to over 200 published research findings, several books, and book chapters in a variety of areas, including: health and wellbeing; mental and cognitive health; bone health; lifestyle, vascular risk and prevention; women’s health and hormonal transition; and cross-cultural research.With all participants now aged over 70 years, the cohort is ideally placed to answer key questions of healthy ageing in women. With more than 25 years of longitudinal prospective follow-up this Australian dataset is unique in its duration, breadth and detail of measures including clinical review and specialized disease-specific testing and biomarkers. Ongoing follow-up into older ages for this long-running cohort will enable the association between mid to late-life factors and healthy ageing to be determined. This is particularly valuable for the examination of chronic diseases which have a 20–30 year prodrome and to provide knowledge on multiple morbidities. The dataset has a unique opportunity to improve our understanding of temporal relationships and the interactions between risk factors and comorbidities.
Although the influence of mobility on place attachment has received attention in the literature, this relationship varies between groups. Unlike those who move to enjoy their retirement, for example, older migrants arriving in Shenzhen come to the city ‘passively,’ drawn by the needs of their children. This paper advances understanding of the concept of place attachment by illustrating the relationships between its components. Analysis of interview and questionnaire responses revealed the following relationships between three focal components of place attachment. Place dependence first directly influenced affective attachment and then indirectly affected place identity. Leisure involvement had a positive impact on place dependence and affective attachment but no direct effect on place identity. Residential satisfaction was an antecedent of all three focal dimensions of place attachment. No direct relationship was found between leisure involvement and residential satisfaction.
Whether grandparenting is associated with improved health or well-being among older adults is a salient question in present-day aging societies. This systematic review compiles studies that consider the health or well-being outcomes of grandparenting, concerning (1) custodial grandparent families, where grandparents are raising grandchildren without parental presence; (2) three-generation households, where grandparents are living with adult children and grandchildren; and (3) non-coresiding grandparents, who are involved in the lives of their grandchildren. Review was based on literature searches conducted in September 2019 via Web of Science, PubMed, PsycINFO, and Ebsco. We screened 3868 abstracts across four databases, and by following the PRISMA guidelines, we identified 92 relevant articles (117 studies) that were published between 1978 and 2019. In 68% of cases, custodial grandparenting was associated with decreased health or well-being of grandparents. The few studies considering the health or well-being of grandparents living in three-generation households provided mixed findings (39% positive; 39% negative). Finally, in 69% of cases, involvement of non-coresiding grandparents was associated with improved grandparental outcomes; however, there was only limited support for the prediction that involved grandparenting being causally associated with grandparental health or well-being. Despite this, after different robustness checks (counting all nonsignificant results, taking into account the representativeness of the data and causal methodology), the main finding remains the same: the most negative results are found among custodial grandparents and three-generation households and most positive results among non-coresiding grandparents.
Background and Objectives: Whether grandparenting is associated with improved health and well-being among older adults is a salient question in present-day aging societies. This systematic review compiles studies that consider the health and well-being outcomes of grandparenting, concerning (i) custodial grandparent families, where grandparents are raising children without parental presence; (ii) three-generation households, where grandparents are living with adult children and grandchildren; and (iii) non-coresiding grandparents, who are involved in the lives of their grandchildren.Research Design and Methods: This systematic review was based on literature searches conducted in September 2019 via Web of Science, PubMed, PsycINFO, and Ebsco. We screened 3,868 abstracts across four databases, and by following the PRISMA guidelines, we identified ninety-two relevant articles (117 studies) that were published between 1978 and 2019.Results: In 68% of cases custodial grandparenting was associated with decreased health and wellbeing of grandparents. The few studies considering the health and well-being of grandparents living in three-generation households provided mixed findings (39% positive; 39% negative). Finally, in 69% of cases involvement of non-coresiding grandparents was associated with improved grandparental outcomes; however, there was only limited support for the prediction that involved grandparenting being causally associated with grandparental health and well-being.Discussion and Implications: The findings are discussed separately among these three groups of grandparents, including reference to possible causal relations between involved grandparenting and grandparental health and well-being. The article concludes by considering the scope for future studies.
Contemporary grandparents are active people, not only in the social but also professional field. Regardless of other duties, one of the socially assigned tasks in the role of grandparent is to take care for grandchildren. As various studies have reported, this task may bring caregivers more losses than benefits (eg Goodman & Silverstein, 2002). In the present study, data from 148 people over 57 years who have looked after grandchildren have been analyzed, to determine whether the amount of time devoted by grandparents to care for grandchildren will affect their sense of quality of life. Grandparents gender, age, and locus of control was controlled. The obtained results confirmed that with the increase of the number of hours devoted to grandchildren care, the sense of quality of life of the grandparents drops. This effect is stronger among grandfathers. The sense of the location of control plays the role of a mediator and suppressor in the relationship of care time over grandchildren with a sense of quality of life. The results are discussed in the context of potential family burden and work load among grandparents.
Grandparenting: Contemporary Perspectives is one of the first books of its kind to offer a dedicated account of the social and psychological research on this important life stage. Reflecting the contemporary positive approach to ageing, it covers many of the issues that impact the grandparent experience today, such as care-giving and changing family structures, to reveal the health and wellbeing benefits of the grandparent role. It examines biological, psychological, social/familial, gender, cultural and economic dimensions to map out the current landscape in this emerging field. Moore and Rosenthal draw on quantitative and qualitative, experimental, survey, observation and case study research, including unique data on grandfathers. They examine how people respond to the challenges and possibilities of grandparenting, and how this influences intergenerational relationships and adapting to growing older. The book provides a comprehensive, up-to-date evidence base for students in health, sociology and psychology and those interested in gerontology and the lifespan.
Cognitive reserve(CR) is the ability to optimize or maximize performance through complementary brain networks. CR is relevant to normal aging in cognitive-linguistic abilities. There are few domestic systematic reviews or meta-analyses that analyze the relationships between multiple CR and cognitive-linguistic domains in healthy older people. This meta-analysis included 32 studies published since 2000. In result, education level topped the list, followed by the occupation, cognitively stimulating activities, and the multilingualism. Most studies were related to memory, global cognition, and language. CR had a modest positive association with cognitive-linguistic performance. Multiple domains including memory and language also showed the significant correlations across most measures of CR. This study provides evidence-based information to support cognitive-linguistic ability in normal aging.
High amyloid has been associated with substantial episodic memory decline over 18 and 36 months in healthy older adults and individuals with mild cognitive impairment. However, the nature and magnitude of amyloid-related memory and non-memory change from the preclinical to the clinical stages of Alzheimer's disease has not been evaluated over the same time interval. Healthy older adults (n = 320), individuals with mild cognitive impairment (n = 57) and individuals with Alzheimer's disease (n = 36) enrolled in the Australian Imaging, Biomarkers and Lifestyle study underwent at least one positron emission tomography neuroimaging scan for amyloid. Cognitive assessments were conducted at baseline, and 18- and 36-month follow-up assessments. Compared with amyloid-negative healthy older adults, amyloid-positive healthy older adults, and amyloid-positive individuals with mild cognitive impairment and Alzheimer's disease showed moderate and equivalent decline in verbal and visual episodic memory over 36 months (d's = 0.47-0.51). Relative to amyloid-negative healthy older adults, amyloid-positive healthy older adults showed no decline in non-memory functions, but amyloid-positive individuals with mild cognitive impairment showed additional moderate decline in language, attention and visuospatial function (d's = 0.47-1.12), and amyloid-positive individuals with Alzheimer's disease showed large decline in all aspects of memory and non-memory function (d's = 0.73-2.28). Amyloid negative individuals with mild cognitive impairment did not show any cognitive decline over 36 months. When non-demented individuals (i.e. healthy older adults and adults with mild cognitive impairment) were further dichotomized, high amyloid-positive non-demented individuals showed a greater rate of decline in episodic memory and language when compared with low amyloid positive non-demented individuals. Memory decline does not plateau with increasing disease severity, and decline in non-memory functions increases in amyloid-positive individuals with mild cognitive impairment and Alzheimer's disease. The combined detection of amyloid positivity and objectively-defined decline in memory are reliable indicators of early Alzheimer's disease, and the detection of decline in non-memory functions in amyloid-positive individuals with mild cognitive impairment may assist in determining the level of disease severity in these individuals. Further, these results suggest that grouping amyloid data into at least two categories of abnormality may be useful in determining the disease risk level in non-demented individuals.
Background
Autobiographical memory (ABM) refers to the recollection of individual experiences, while personal semantic memory (PSM) refers to personally relevant, but shared, facts. Mild cognitive impairment (MCI) is routinely diagnosed with the aid of neuropsychological tests, which do not tap the ABM and PSM domains.
Objective
We aimed to characterize the nature of ABM and PSM retrieval in cognitively healthy (HC) memory complainers, non-memory complainers, and MCI participants, and to investigate the relationship between neuropsychological tests and personal memory.
Methods
Gender- and education-matched participants (HC = 80 and MCI = 43) completed the Episodic ABM Interview (EAMI) and a battery of neuropsychological tests.
Results
ABM and PSM did not differ between complainers and non-complainers, but were poorer in MCI participants, after accounting for age and depressive symptomatology. There were significant associations between personal memory and objective memory measures were found in MCI participants, but standard cognitive measures were more sensitive to MCI.
Conclusion
Personal memory was compromised in MCI, reflected by lower scores on the EAMI. Memory complaining, assessed by current approaches, did not have an impact on personal memory. Standard subjective questionnaires might not reflect the sorts of concerns that bring individuals to clinical attention. Understanding personal memory function in the elderly may aid in the development of a more sensitive measure of subjective memory concerns.
Normative data for tests of working memory and executive function (a term adopted to cover a range of cognitive skills) are primarily based on the U.S. population and are not always specific for gender or education levels. The diagnosis of, and research into, cognitive diseases rely on the use of relevant normative data. This study presents normative data for an ageing, female, Australian-born population, and an analysis of the factors that contribute to variation in performance. Three tasks of executive function: Trail Making Test, Part B (Trails-B); Tower of London, and the oral version of the Symbol Digit Modalities Test (SDMT), and a working memory task (Letter-Number Sequencing, LNS) were administered as part of a 14-item neuropsychological battery to 257 participants (M age = 60 years, range = 56 – 67 years), who have been participating in the Melbourne Women's Midlife Health Project. The Center for Epidemiological Studies Depression Scale (CES-D) was also administered. A regression analysis incorporating age, years of education, CES-D score, current use of hormone therapy and menopausal status as independent variables demonstrated that education and age contributed to the variation in SDMT and the LNS but not in the Tower of London. Education alone contributed to variation in Trails-B, although there was a trend for performance to decrease with age. Mood, hormone therapy use, and menopausal status were unrelated to test scores. Tables of mean scores were constructed for age ranges and level of education, for each of the tests except the Tower of London, which was presented as education groups only. Partial correlations between test performances demonstrated significant correlations between all the major components of the tests. This study provides education- and age-based normative data for tests of executive function for the ageing female, Australian-born population.
Alzheimer’s disease (AD) is the sixth leading cause of all deaths in the United States, and the fifth leading cause of death in Americans aged 65 and older. Whereas other major causes of death have been on the decrease, deaths attributable to AD have been rising dramatically. Between 2000 and 2006, heart disease deaths decreased nearly 12%, stroke deaths decreased 18%, and prostate cancer-related deaths decreased 14%, whereas deaths attributable to AD increased 47%. An estimated 5.3 million Americans have AD; the approximately 200,000 persons under age 65 years with AD comprise the younger-onset AD population. Every 70 seconds, someone in America develops AD; by 2050, this time is expected to decrease to every 33 seconds. Over the coming decades, the "baby-boom" population is projected to add 10 million people to these numbers. In 2050, the incidence of AD is expected to approach nearly a million people per year, with a total estimated prevalence of 11 to 16 million people. Significant cost implications related to AD and other dementias include an estimated 94 billion in unpaid services to individuals with AD provided annually by an estimated 10 million caregivers. Mild cognitive impairment (MCI) is an important component in the continuum from healthy cognition to dementia. Understanding which individuals with MCI are at highest risk for eventually developing AD is key to our ultimate goal of preventing AD. This report provides information meant to increase an understanding of the public-health impact of AD, including incidence and prevalence, mortality, lifetime risks, costs, and impact on family caregivers. This report also sets the stage for a better understanding of the relationship between MCI and AD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
In this article, we review both theoretical and empirical advancements in retirement adjustment research. After reviewing and integrating current theories about retirement adjustment, we propose a resource-based dynamic perspective to apply to the understanding of retirement adjustment. We then review empirical findings that are associated with the key research questions in this literature: (a) What is the general impact of retirement on the individual? and (b) What are the factors that influence retirement adjustment quality? We also highlight important future research directions that may be fruitful for psychologists to pursue in this area.
We examined the association of diverse measures of social engagement with level of function in multiple cognitive domains in 838 persons without dementia who had a mean age of 80.2 (SD = 7.5). Social network size, frequency of social activity, and level of perceived social support were assessed in linear regression models adjusted for age, sex, education, and other covariates. Social activity and social support were related to better cognitive function, whereas social network size was not strongly related to global cognition. The results confirm that higher level of social engagement in old age is associated with better cognitive function but the association varies across domains of social engagement.
A cross-sectional study into age-related decline of psychomotor speed is reported. A newly introduced choice response task was used, involving three conditions: simple reaction time (SRT), choice reaction time (CRT), and CRT with stimulus-response incompatibility. Subjects were 247 volunteers, aged 20 to 80 yr. in seven age levels. Although all subjects thought themselves to be normal and healthy, a post hoc division could be made based on biological life events (BLE, mild biological or environmental factors that can hamper optimal brain functioning, such as repeated general anesthesia). Performance was poorer by subjects who had experienced one or more such event: slowing was comparable to the effect of age, especially in the more difficult task conditions. There were significant effects of sex and education, men being consistently faster than women, and more highly educated subjects performing better than subjects with only low or medium education. These findings replicate observations from other test methods. They are also in line with several other studies giving interactions between the effects of aging and physical fitness. This study questions the validity of much research on aging, as the data suggest that a more rigorous health screening for biological life events in subjects recruited from the normal, healthy population can reduce performance effects normally ascribed to aging.
Cerebral white matter of asymptomatic people frequently exhibits circumscribed areas of hyperintensity on magnetic resonance (MR) images and hypodensity on computed tomography scans. However, behavioral implications of this phenomenon remain unclear. In this meta-analysis, the authors examine cumulative evidence regarding the cognitive sequelae of white matter abnormalities in adults without dementia. The influence of potential moderator variables, such as neuroimaging technique, location of the lesions, rating scale, and demographic characteristics of the sample on the association between the burden of white matter hyperintensities and cognitive performance was also examined. Results indicate that white matter abnormalities observed on MR images are associated with attenuated performance on tasks of processing speed, immediate and delayed memory, executive functions, and indices of global cognitive functioning. There was no significant link between the white matter hyperintensities and psychometric indices of intelligence or fine motor performance.
This study examines the relationship of social ties and support to patterns of cognitive aging in the MacArthur Studies of Successful Aging (see L. F. Berkman et al., 1993), a cohort study of 1,189 initially high-functioning older adults. Baseline and longitudinal data provide information on initial levels as well as changes in cognitive performance over a 7.5-year period. Linear regression analyses revealed that participants receiving more emotional support had better baseline performance, as did those who were unmarried and those reporting greater conflict with network members. Greater baseline emotional support was also a significant predictor of better cognitive function at the 7.5-year follow-up, controlling for baseline cognitive function and known sociodemographic, behavioral, psychological, and health status predictors of cognitive aging. The findings suggest the potential value of further research on the role of the social environment in protecting against cognitive declines at older ages.
Social support is important in daily activities of the elderly. This study tests the hypothesis that there is an association between social support and cognitive function among the elderly in a community setting.
Face-to-face interviews were conducted in a cross-sectional stratified random sample of 4,993 elderly (> or =65 years) city residents. Using multiple regression analysis, we investigated the influence of social support on cognitive function.
12% were over 80 years old. 53.28% were men. 67.14% were married. Higher Short Portable Mental Status Questionnaire (SPMSQ) scores (higher score means better cognitive function) were associated with strong social support, as measured by marital status and perceived positive support from friends. Lower cognitive function was associated with older and with female respondents. Only instrumental activities of daily living (IADL) were statistically and negatively related to SPMSQ. Lower functional status was associated with lower cognitive function. Elders with grade school educations had lower SPMSQ scores than did elders with high school educations.
In Taiwan, higher cognitive function in community-living elderly was associated with increased social support. Life-style management should provide social activities for the elderly to promote a better quality of life.
This report evaluates whether a program for older volunteers, designed for both generativity and health promotion, leads to short-term improvements in multiple behavioral risk factors and positive effects on intermediary risk factors for disability and other morbidities. The Experience Corps(R) places older volunteers in public elementary schools in roles designed to meet schools' needs and increase the social, physical, and cognitive activity of the volunteers. This article reports on a pilot randomized trial in Baltimore, Maryland. The 128 volunteers were 60-86 years old; 95% were African American. At follow-up of 4-8 months, physical activity, strength, people one could turn to for help, and cognitive activity increased significantly, and walking speed decreased significantly less, in participants compared to controls. In this pilot trial, physical, cognitive, and social activity increased, suggesting the potential for the Experience Corps to improve health for an aging population and simultaneously improve educational outcomes for children.
The central executive component of working memory has been argued to play an important role in the performance of span tasks, particularly backward span. Age-related decline in central executive function has also been reported, and yet there have been inconsistent findings to indicate that with increasing age, the discrepancy between forward and backward span increases. A secondary analysis of the Wechsler Memory Scale-Third Edition standardization sample (N = 1030) was performed to investigate this relationship. It was hypothesized on the basis of past research indicating an age-related decline in central executive performance, that backward digit and spatial span performance would decrease at a greater rate than forward span performance. However, the results indicated that the rate of age-related performance decline was equivalent for both measures. It is proposed that both forward and backward span tasks recruit central executive resources for successful task performance.
We examined the relationship between social network characteristics and global cognitive status in a community-based sample of 354 adults aged 50+ and with Mini-Mental State Examination (MMSE) scores of 28+ at baseline. Multivariate analyses indicated that interaction in larger social networks related to better maintenance of MMSE scores and reduced odds of decline to population-based lower quartile MMSE scores at follow-up 12 years later. At follow-up, higher levels of interpersonal activity (more frequent contacts in larger social networks) and exposure to emotional support independently related positively to MMSE. The findings suggest that interaction in larger social networks is a marker that portends less cognitive decline, and that distinct associational paths link interpersonal activity and emotional support to cognitive function.
We examined the relationship between social network characteristics and global cognitive status in a community-based sample of 354 adults aged 50+ and with Mini-Mental State Examination (MMSE) scores of 28+ at baseline. Multivariate analyses indicated that interaction in larger social networks related to better maintenance of MMSE scores and reduced odds of decline to population-based lower quartile MMSE scores at follow-up 12 years later. At follow-up, higher levels of interpersonal activity (more frequent contacts in larger social networks) and exposure to emotional support independently related positively to MMSE. The findings suggest that interaction in larger social networks is a marker that portends less cognitive decline, and that distinct associational paths link interpersonal activity and emotional support to cognitive function.
Using the data from the waves of the survey “Well-being of Elderly in Anhui Province, China” conducted in 2001, 2003, 2006, 2009 and 2012 respectively, this study examines the impact of grandchild-caring on Chinese rural grandparents’ cognitive functioning through constructing multi-level growth curve model. The results show that, comparing to the low intensity care for grandchildren, high intensity care has protective effect for the grandparents’ cognitive aging, however, the effects of high intensity care depend on the age and gender of grandparents. The grandfathers’ cognitive aging are protected by the high intensity care for grandchildren, while the cognitive functioning of grandmothers are suffered from intensive care; and this gender difference tends to be widened as aging. These results support the hypothesis of “use-it-or-lose-it”, and imply the significance of gender roles and norms in the Chinese rural families.
Little is known about why parents choose kin-provided child care and less is known about how kin-provided child care is related to other forms of in-kind support from relatives close-at-hand. Previous models of the choice of kin-provided child care assumed that the presence of other forms of in-kind support from relatives nearby was inconsequential to estimating effects of economic and demographic factors on the decision to use kin-provided child care. Using data from the National Longitudinal Survey of the Class of 1972, this study shows that this assumption is incorrect because use of kin-provided child care and intrafamily in-kind resource exchanges are interrelated. When the association between use of kin-provided child care and the presence of other family in-kind exchanges is ignored, the study shows that estimated effects for income, the price of child care, and maternal characteristics are underestimated. The findings provide a better understanding of why parents choose kin-provided child care by confirming that this decision is a part of a larger set of parental decisions about involvement in resource exchanges within extended families. My findings support recent child care bills aiming to increase parental choice of child care provider, broaden the definition of a provider to include non-coresident relatives, and expand price subsidies for kin-provided child care.
Preserving aging cognition improves quality of life and delays dementia onset. Previous studies have shown that social engagement can maintain cognition; however, none has examined the effects of grandparenting, an important role among postmenopausal women. This study aims to examine the role of grandparenting in cognition among postmenopausal women.
Participants were 186 Australian women from the longitudinal prospective Women's Healthy Aging Project. Cognition was assessed using the Symbol-Digit Modalities Test (SDMT), California Verbal Learning Test, and Tower of London.
Amount of time spent minding grandchildren predicted differences in SDMT performance (P < 0.01). The highest cognitive scores for most tests were seen in participants who minded grandchildren for 1 day/week. Minding grandchildren for 1 day/week was also a significant positive predictor of California Verbal Learning Test immediate recall performance (P < 0.05). However, minding grandchildren for 5 days or more per week predicted lower SDMT performance (P < 0.05).
The data suggest that the highest cognitive performance is demonstrated by postmenopausal women who spend 1 day/week minding grandchildren; however, minding grandchildren for 5 days or more per week predicts lower working memory performance and processing speed. These results indicate that highly frequent grandparenting predicts lower cognitive performance.
Background:
The Australian Imaging, Biomarkers and Lifestyle (AIBL) Flagship Study of Ageing is a prospective study of 1,112 individuals (211 with Alzheimer's disease (AD), 133 with mild cognitive impairment (MCI), and 768 healthy controls (HCs)). Here we report diagnostic and cognitive findings at the first (18-month) follow-up of the cohort. The first aim was to compute rates of transition from HC to MCI, and MCI to AD. The second aim was to characterize the cognitive profiles of individuals who transitioned to a more severe disease stage compared with those who did not.
Methods:
Eighteen months after baseline, participants underwent comprehensive cognitive testing and diagnostic review, provided an 80 ml blood sample, and completed health and lifestyle questionnaires. A subgroup also underwent amyloid PET and MRI neuroimaging.
Results:
The diagnostic status of 89.9% of the cohorts was determined (972 were reassessed, 28 had died, and 112 did not return for reassessment). The 18-month cohort comprised 692 HCs, 82 MCI cases, 197 AD patients, and one Parkinson's disease dementia case. The transition rate from HC to MCI was 2.5%, and cognitive decline in HCs who transitioned to MCI was greatest in memory and naming domains compared to HCs who remained stable. The transition rate from MCI to AD was 30.5%.
Conclusion:
There was a high retention rate after 18 months. Rates of transition from healthy aging to MCI, and MCI to AD, were consistent with established estimates. Follow-up of this cohort over longer periods will elucidate robust predictors of future cognitive decline.
Abstract Alzheimer's disease neuropathology (amyloid, tauopathies) and brain atrophy are present decades prior to manifestation of clinical symptoms. With the failure of treatment trials it is becoming clearer that the window for prevention and therapeutic intervention is before significant neuronal loss and clinical deterioration of cognition has occurred. Early identification of those at risk of disease and optimizing their management to prevent disease in later life are crucial to delaying disease onset and improving people's quality of life. The Women's Healthy Aging Project (WHAP) is a longitudinal study of over 400 Australian-born women, epidemiologically randomly sampled in 1990. The WHAP aims to identify modifiable mid-life risk factors for the development of late-life cognitive decline, improve the understanding of the pathogenesis of dementia, and target early disease identification utilizing clinical, biomarker and health risk profiles. These aims are fortified by the ability to leverage the considerable database on health, lifestyle and socio-demographics collected prospectively from 1990 to date. This is the first study with a comprehensive neuropsychological battery, over a decade of cognitive follow-up, with all participants being offered amyloid imaging from 2012, and prospective longitudinal data including clinical and physical measures and bio-bank samples from over 20 years prior.
Verbal fluency tasks are commonly used in the assessment of dementia, although less is known about fluency characteristics in normal aging individuals. Category and letter fluency tasks were administered to four groups of healthy subjects who ranged in age from 50 to 90 years (N = 174). Despite similar educational and vocabulary levels, significant group differences were found on the majority of category fluency tasks, but not in letter fluency. Qualitative analysis revealed that perseveration and intrusion errors were rare and not associated with age. In contrast, analysis of the hierarchical structure of one category fluency task demonstrated age-related differences. Older subjects produced fewer exemplars per subcategory, and generated more category names in relation to specific exemplars. Gender effects were minimal across tasks. Category fluency appears to be disproportionately reduced compared with letter fluency in normal aging, which would be consistent with some degradation of semantic memory systems.
This study is based on a screening and in-depth interview with each of 114 grandparents who provide daily care to their grandchildren. Three categories of caregivers emerge from the data: grandparents whose grandchildren live with them and with whom they have a legal relationship, grandparents whose grandchildren live with them but with whom there is no legal relationship, and grandparents whose grandchildren do not live with them but for whom they provide day care. Questions about the impact of providing care on the caregivers' lives reveal effects in four categories: changes in lifestyle, changes in relationships with friends, changes in relationships with family, and changes in relationships with spouses. These effects differ according to the type of care provided.
The term executive function defines complex cognitive processing requiring the co-ordination of several subprocesses to achieve a particular goal. Neuropsychological evidence suggests that executive processing is intimately connected with the intact function of the frontal cortices. Executive dysfunction has been associated with a range of disorders, and is generally attributed to structural or functional frontal pathology. Neuroimaging, with PET and fMRI, has confirmed the relationship; however, attempts to link specific aspects of executive functioning to discrete prefrontal foci have been inconclusive. Instead, the emerging view suggests that executive function is mediated by dynamic and flexible networks, that can be characterised using functional integration and effective connectivity analyses. This view is compatible with the clinical presentation of executive dysfunction associated with a range of pathologies, and also with evidence that recovery of executive function can occur after traumatic brain injury, perhaps due to functional reorganisation within executive networks.
Background: While declining executive function and episodic memory are normal in healthy ageing, early Alzheimer’s disease (AD) usually involves impairment in these functions. Preserving these functions improves quality of life and delays the onset of AD. Cognitive maintenance can be influenced by environmental variation. Previous studies have shown that social factors can affect cognitive ageing; however, none have examined the effect of grandparenting, an important role in post-menopausal women.
Aim: To investigate the effects of grandmothering on cognition in post-menopausal women.
Hypothesis: Time spent minding grandchildren would be associated with cognitive performance.
Method: Participants were 204 women (mean age = 60) from the longitudinal prospective Women’s Healthy Ageing Project (WHAP). Participants completed the 2004 core questionnaire assessing grandparenting and self-rated memory. A subset of 186 participants completed the California Verbal Learning Test (CVLT), East Boston Memory Test (EBMT), Symbol-Digit Modalities Test (SDMT), and Tower of London (TOL) in 2002 and 2004.
Results: ANOVA revealed an association between time spent minding grandchildren and SDMT performance (p<0.05). Further analysis showed that participants who spent one day a week minding grandchildren performed better on the CVLT immediate recall, SDMT, and TOL (p<0.05) than those who spent more than one day a week in 2004. This was not seen in CVLT or TOL scores in 2002.
Conclusion: The data illustrates optimum cognitive performance in women who spend one day per week minding grandchildren. The results suggest a relationship between cognitive performance and caring for grandchildren, highlighting the importance of late-life social interaction for cognition.
The authors examined whether the provision of child care helps older adults maintain better cognitive functioning. Descriptive evidence from the Survey of Health, Ageing and Retirement in Europe (n = 5,610 women and n = 4,760 men, ages 50–80) shows that intensively engaged grandparents have lower cognitive scores than the others. The authors show that this result is attributable to background characteristics and not to child care per se. Using an instrumental variable approach, they found that providing child care has a positive effect on 1 of the 4 cognitive tests considered: verbal fluency. For the other cognitive tests, no statistically significant effect was found. Given the same level of engagement, they found very similar results for grandmothers and grandfathers. These findings point to the inclusion of grandparenting among other cognitively stimulating social activities and the need to consider such benefits when discussing the implications of this important type of nonmonetary intergenerational transfer.
Elements of episodic memory (Tulving 1983b) consists of three parts. Part I argues for the distinction between episodic and semantic memory as functionally separate albeit closely interacting systems. It begins with a review of the 1972 essay on the topic (Tulving 1972) and its shortcomings, presents a somewhat more complete characterization of the two forms of memory than the one that was possible in 1972, and proceeds to discuss empirical and theoretical reasons for a tentative acceptance of the functional distinction between the two systems and its possible extensions. Part II describes a framework for the study of episodic memory, dubbed General Abstract Processing System (GAPS). The basic unit in such study is an act of remembering. It begins with the witnessing of an event and ends with recollective experience of the event, with related memory performance, or both. The framework specifies a number of components (elements) of the act of remembering and their interrelations, classified under two broad categories of encoding and retrieval. Part III discusses experimental research under the label of “synergistic ecphory.” Ecphory is one of the central elements of retrieval; “synergistic” refers to the joint influence that the stored episodic information and the cognitively present retrieval information exert on the construction of the product of ecphory, the so-called ecphoric information. The concept of encoding specificity and the phenomenon of recognition failure of recallable words figure prominently in Part III. The final chapter of the book describes a model, named the synergistic ecphory model of retrieval, that relates qualitative characteristics of recollective experience and quantitative measures of memory performance in recall and recognition to the conjunction of episodic-memory traces and semantic-memory retrieval cues.
This article is based on a unique empirical investigation of the contribution that informal childcare makes in allowing parents to go out to work. There has been little research on either the use of such complementary childcare by parents, or of the carers who undertake it, and this is a review of a two-stage investigation of both. One of the earliest initiatives of the Labour government elected in 1997 was to put a National Childcare Strategy in place. The strategy recognised the importance of childcare both for the development of children and in enabling parents to go out to work. To date, however, childcare needs and provision have been assessed almost entirely in terms of formal childcare. A clear understanding of why working parents use complementary childcare (particularly from grandparents) is essential for any childcare policy that hopes to be attuned to what families actually want. The article argues that policy makers, lured by a simplistic vision of economic vitality into adopting a behavioural paradigm from economics are likely to find themselves distracted from important issues of the social well-being of working families with children. Childcare needs are related to dramatic changes in women's labour market participation over recent years, where the largest increase in female employment has been among mothers of children under the age of five. Neither mothers nor fathers may be in a position to provide the desired amount of childcare inside the nuclear household. This situation gives rise to the possibility of a . In failing to acknowledge and underpin the value which parents place upon complementary forms of childcare, policy makers are in danger of committing themselves to institutional arrangements which may make that deficit worse in the longer term.
The performances of groups of patients with left, right and bilateral frontal lesions were compared on a battery consisting of two tests presumed to be related specifically to left hemisphere function, two tests presumed to be related specifically to right hemisphere function, and two tests presumed to be related specifically to bilateral frontal lobe function. Eighteen predictions, based on both theoretical considerations and the indications of previous literature, were made concerning the differences in performance to be expected among the three groups.
When more than one statistical test is performed in analysing the data from a clinical study, some statisticians and journal editors demand that a more stringent criterion be used for “statistical significance” than the conventional P<0.05.1 Many well meaning researchers, eager for methodological rigour, comply without fully grasping what is at stake. Recently, adjustments for multiple tests (or Bonferroni adjustments) have found their way into introductory texts on medical statistics, which has increased their apparent legitimacy. This paper advances the view, widely held by epidemiologists, that Bonferroni adjustments are, at best, unnecessary and, at worst, deleterious to sound statistical inference.
#### Summary points
Adjusting statistical significance for the number of tests that have been performed on study data—the Bonferroni method—creates more problems than it solves
The Bonferroni method is concerned with the general null hypothesis (that all null hypotheses are true simultaneously), which is rarely of interest or use to researchers
The main weakness is that the interpretation of a finding depends on the number of other tests performed
The likelihood of type II errors is also increased, so that truly important differences are deemed non-significant
Simply describing what tests of significance have been performed, and why, is generally the best way of dealing with multiple comparisons
Bonferroni adjustments are based on the following reasoning.1-3 If a null hypothesis is true (for instance, two treatment groups in a randomised trial do not differ in terms of cure rates), a significant difference (P<0.05) will be observed by chance once in 20 trials. This is the type I error, or α. When 20 independent tests are performed (for example, study groups are compared with regard to 20 unrelated variables) and the null hypothesis holds for all 20 comparisons, the chance of at least one test being significant is no longer 0.05, but 0.64. …
The Cognitive and Emotional Health Project (CEHP) seeks to identify the demographic, social, and biological determinants of cognitive and emotional health in the older adult. As part of the CEHP, a critical evaluation study committee was formed to assess the state of epidemiological research on demographic, social, and biological determinants of cognitive and emotional health.
Criteria for inclusion in the survey were large cohort studies, longitudinal in design, participants predominantly 65 years or older, with measurements of both cognition and emotion, and information on a wide variety of demographic, psychosocial, and biological factors. North American and European studies, which met these criteria, were selected for the review. Outcome measures included cognition, cognitive decline, and cognitive function. For emotion, symptoms included depression and anxiety, positive and negative affect, subjective well being, mastery, and resilience.
Ninety-six papers were identified that addressed cognitive and emotional outcomes. A large variety of risk factors were consistently identified with cognitive outcomes, particularly those previously associated with increased risk of cardiovascular disease. There was considerable overlap between risk factors for cognitive and emotional outcomes.
This review identifies a large number of lifestyle and health behaviors that alter the risk for maintenance of cognitive and emotional health. Large longitudinal cohort studies are a unique source to explore factors associated with cognitive and emotional health. Secondary analyses of these studies should be encouraged as should the development of standardized questionnaires to measure cognitive and emotional health. Future research in this field should study cognitive and emotional health simultaneously.
We investigated the role of perceptual and motor factors in visuospatial impairment in 30 patients with Parkinson's disease (PD) and 30 matched controls. All subjects were administered visuospatial tests, which included "visuoperceptual" tasks, requiring minimal motor responses, and "visuomotor" tasks. The performance of patients with PD was considerably impaired on several tasks from both groups, and this impairment was not related to depression or intellectual impairment. Patients in stage 3 of the disease tended to show the greatest impairment. Those in stage 1 (unilateral symptoms), however, tended to show more impairment than those in stage 2.
Social engagement, which is defined as the maintenance of many social connections and a high level of participation in social activities, has been thought to prevent cognitive decline in elderly persons. However, few longitudinal studies of this relation have been done.
To determine the relation between social disengagement and incident cognitive decline in community-dwelling elderly persons.
Cohort study.
New Haven, Connecticut.
2812 noninstitutionalized elderly persons (65 years of age or older) who were interviewed in their homes in 1982, 1985, 1988, and 1994.
A global social disengagement scale was constructed from the following indicators: presence of a spouse, monthly visual contact with three or more relatives or friends, yearly nonvisual contact with 10 or more relatives or friends, attendance at religious services, group membership, and regular social activities. Cognitive function was assessed with the Short Portable Mental Status Questionnaire. Response to the questionnaire was scored as high, medium, or low. Cognitive decline was defined as a transition to a lower category.
Compared with persons who had five or six social ties, those who had no social ties were at increased risk for incident cognitive decline after adjustment for age, initial cognitive performance, sex, ethnicity, education, income, housing type, physical disability, cardiovascular profile, sensory impairment, symptoms of depression, smoking, alcohol use, and level of physical activity. The 3-year odds ratio was 2.24 (95% CI, 1.40 to 3.58; P < 0.001), the 6-year odds ratio was 1.91 (CI, 1.14 to 3.18; P = 0.01), and the 12-year odds ratio was 2.37 (CI, 1.07 to 4.88; P = 0.03).
Social disengagement is a risk factor for cognitive impairment among elderly persons.
This review considers the validity and suitability of neuropsychological and other tests of executive function for the detection of adult age differences in executive function. Executive function is typically assessed using tests which have been found to be sensitive to frontal lobe dysfunction because theory links executive function with the frontal lobes. However, any age-related decline in executive function is expected to be mild, or sub-clinical, compared to the deficits shown among those with frontal lesions. Therefore, in order to detect the type of mild executive dysfunction expected among older adults we need to employ tests sensitive enough to detect any age-related deficit, yet which are not too stressful or tiring for older adults to perform. This review discusses some commonly used neuropsychological tests of executive function as well as tests devised to assess theoretical aspects of executive function. Indications are given throughout as to which tests appear to be most suitable for detecting age differences in executive function.
Few data are available on the effect of social ties on dementia development. This study explored whether single social network components and different degrees of the social connections affect dementia incidence.
A community-based cohort of 1203 non-demented people, living at home in the Kungsholmen district of Stockholm, Sweden, and who had good cognition, was followed for an average period of 3 years. On the basis of medical and psychological data, 176 patients were diagnosed with dementia according to the criteria of the third edition revision of the Diagnostic and Statistical Manual of Mental Disorders. Information on social network was obtained by personal interview by trained nurses at baseline. The covariates included in the analysis were age, sex, education, cognitive and functional status, depressive symptoms, and vascular diseases.
Those individuals living alone, and those without any close social ties, both had an adjusted relative risk for developing dementia of 1.5 (95% CI 1.0-2.1 and 1.0-2.4, respectively). Compared with married people living with someone, single people and those living alone had an adjusted relative risk of 1.9 (95% CI 1.2-3.1). Infrequent contacts with network resources did not increase the risk of the disease if such contacts were experienced as satisfying. When all components were combined in an index, a poor or limited social network increased the risk of dementia by 60% (95% CI 1.2-2.1), and a significant gradient was found for the four degrees of social connections (p=0.0009).
An extensive social network seems to protect against dementia. Confirmation of this finding and further investigation to clarify the mechanisms are worthwhile due to the implications for prevention.
There has been controversy about the relationship between menopause and depression. This study utilizes a unique prospective population-based data set of middle-aged, Australian-born women to identify determinants of depressed mood.
The Melbourne Women's Midlife Health Project sample consisted of 438 women aged 45 to 55 at baseline; they were followed annually for 11 years. Of this group, 314 (72%) completed the Center for Epidemiologic Studies Depression Scale (CES-D) scale in year 11 to measure depressed mood. Variables measured at baseline and annually included negative mood (measured with Affectometer) and psychosocial, hormonal, health, and lifestyle factors.
Women who had the highest CES-D scores were those who by year 11 were still in the menopause transition stage (had not reached final menstrual period) or had experienced surgical menopause. CES-D correlated with negative mood measured concurrently (r = 0.63) and baseline negative mood (r = 0.37). There was a significant reduction in negative mood for all menopause status groups, but those who experienced surgical menopause showed less reduction than other women. Ever-use or number of years of use of hormone therapy made no difference to CES-D outcome. CES-D was associated with baseline negative attitudes toward aging, mood, and premenstrual complaint experience and annual mood, poor self-rated health, number of bothersome symptoms, and daily hassles.
Women most likely to have higher depressed mood in the age group 57 to 67 are those who have undergone surgical menopause or have menstruated within the last 12 months. Prior negative mood, history of premenstrual complaints, negative attitudes toward aging or menopause, poor health, and daily hassles predict depressed mood.