No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Urban-rural variation in the association between social support availability and cognitive function in middle-aged and older adults: Results from the baseline Tracking Cohort of the Canadian Longitudinal Study on Aging
Abstract
The purpose of this study was to investigate if and how the associations between social support availability (SSA) and cognitive function varied across urban, rural, and geographical regions in Canada. Data from a population-level sample of community-dwelling adults aged 45–85 years were obtained from the baseline Tracking Cohort of the Canadian Longitudinal Study on Aging. The associations between SSA and two domains of cognitive function, memory and executive function, were analyzed using multilevel regression models. SSA was positively and significantly associated with both executive function and memory. We found SSA had stronger positive associations with executive function among participants living in rural areas compared to urban areas in all geographical regions; however, geographical variation in the associations between SSA and memory were not supported by model results. Understanding how the associations between cognitive function and modifiable risk factors, including SSA, vary across geographical contexts is important for developing policies and programs to support healthy aging.
... To the best of our knowledge, no prior studies have explored cognitive function disparities based on residence and region in Indonesia. However, studies from other countries consistently showed that elderly individuals living in urban areas tend to have a lower prevalence of poor cognitive function compared to their rural counterparts; this pattern has been observed in China [27], Canada [28], and Chicago [29]. One plausible explanation for this discrepancy is that urban-dwelling older individuals have greater access to social activities and healthcare resources. ...
Cognitive decline poses a significant challenge for the elderly population globally. The aim of this study was to determine the prevalence of cognitive function and its associated factors among the elderly in the Indonesian family life survey’s fifth wave (IFLS-5) conducted from 2014 to 2015. The study included elderly individuals aged 60 and above, excluding proxy respondents and those with missing data. Various socio-demographic, cognitive function and health-related variables were analyzed, including age, sex, education level, marital status, residence, region, economic status, current employment, self-rated health status, happiness, sleep quality, depression, loneliness, and chronic conditions. Multivariate logistic regression analysis was used to identify the factors associated with cognitive functions among the 2,929 elderly respondents. The results revealed that 44.6% of the respondents reported poor cognitive function. In the unadjusted model, residence (OR: 0.81; 95%CI: 0.70–0.94), region of other islands (OR: 0.66; 95%CI: 0.54–0.81), sleep quality (OR: 0.53; 95%CI: 0.42–0.68), self-rated health status (OR: 1.38; 95%CI: 1.19–1.61), happiness (OR: 1.48; 95%CI: 1.22–1.79), and depression (OR: 1.22; 95%CI: 1.04–1.44) showed significant associations with cognitive function. After adjusting for confounding factors, the association remained significant for residence (OR: 0.77; 95%CI: 0.66–0.89), regions other than Java, Bali, and Sumatra (OR: 0.61; 95%CI: 0.50–0.76), self-rated health (OR: 1.28; 95%CI: 1.09–1.51), happiness (OR: 1.30; 95%CI: 1.06–1.59), and sleep quality (OR: 0.60; 95%CI: 0.47–0.78). These findings emphasize the necessity of interventions aimed at enhancing sleep quality and overall health in order to preserve cognitive function among the elderly, thus potentially improving their quality of life. Implementing comprehensive health programs could significantly enhance the overall quality of life for the aging population, especially the elderly population.
... Among environmental factors, social support availability showed a negative correlation with dyspnea when lying down, indicating that individuals experiencing dyspnea may prioritize symptom management over participating in social activities (Quick et al., 2022). ...
Background
Somatic symptoms and related factors in patients with chronic heart failure have been extensively researched. However, more insight into the complex interconnections among these constructs is needed, as most studies focus on them independently from each other.
Aims
The aim of this study is to gain a comprehensive understanding of how somatic symptoms and related factors are interconnected among patients with chronic heart failure.
Methods
A total of 379 patients were enrolled. Network analysis was used to explore the interconnections among the somatic symptoms and related risk factors.
Results
The four core symptoms of chronic heart failure were daytime dyspnea, dyspnea when lying down, fatigue and difficulty sleeping. Within the network, the edge weights of depression–anxiety, subjective social support–objective social support, and subjective social support–social support availability were more significant than others. Among physiological, psychological and environmental factors, the edge weights of NYHA–dyspnea, depression–difficulty sleeping, and social support availability–dyspnea when lying down were more significant than others. Depression and anxiety had the highest centrality, indicating stronger and closer connections with other nodes.
Conclusions
Psychological and environmental factors stood out in the network, suggesting the potential value of interventions targeting these factors to improve overall health.
Chronotype and cognitive ability are two human phenotypes with an uneven geographic distribution due to both selective migration and causal environmental effects. In our study, we aimed to examine the relationship between geographic variables, cognitive ability and chronotype. We used a large anonymized sample (n = 25,700, mostly from the USA, UK, Canada and Australia) of dating site users to estimate chronotype and cognitive ability from questionnaire responses using item response theory. We matched each user to geographic coordinates and city size using the reported locations and geographic databases. In line with previous research we found that male sex, younger age, residence in a more populous locale, higher cognitive ability and more westward position within the same time zone were associated with later chronotype. Male sex, younger age, residence in a more populous locale, later chronotype and higher latitude were associated with higher cognitive ability, but the effect of population on chronotype and latitude on cognitive ability was only present in the USA. The relationship between age and chronotype was stronger in males, and the relationship between chronotype and cognitive ability was stronger in males and in older participants. Population density had an independent association with cognitive ability, but not chronotype. Our results confirm the uneven geographic distribution of chronotype and cognitive ability. These findings generalize across countries, but they are moderated by age and sex, suggesting both biological and cultural effects.
The lack of knowledge and skills for transitioning to motherhood places first‐time mothers at greater risk of depression and stress, may lower their perceived self‐efficacy and satisfaction with the maternal role, and potentially affects the mother–infant bond. The purpose of this study was to test the efficacy of a multimodal nursing intervention (AMACOMPRI), based on Mercer's Becoming a Mother Theory, in supporting the process of becoming a mother in first‐time mothers of term infants. This study was a parallel‐group, double‐blind, randomized, controlled trial with a 4‐month postpartum follow‐up. The outcome measures were the process of becoming a mother, functional social support, mother–infant bond, and perceived maternal self‐efficacy. Sixty‐six first‐time mothers completed the study: 33 in the intervention group and 33 in the control group. The intervention was effective in supporting the process of becoming a mother, with a large effect size (Cohen's d = 1.50) and higher scores on the Becoming‐a‐Mother Scale in the intervention group compared with the control group (intergroup difference 13.04 points; 95% confidence interval: 8.72–17.34). Participants in the intervention group demonstrated higher scores in functional social support, perceived maternal self‐efficacy, and mother–infant bond. This study provides evidence for the efficacy of an innovative nursing intervention that supports the process of becoming a mother. Further testing of the intervention is required in different settings and first‐time mothers of low and high risk newborns.
Adolescents living with perinatally acquired HIV in South Africa face significant barriers to successful transition from pediatric to adult care. We performed in-depth qualitative interviews with 41 adolescents living with HIV and 18 of their caregivers to investigate modifiable factors to improve engagement in care prior to transition to adult care. Based on dyadic, inductive content analysis, findings suggest that HIV status disclosure, social support, and mental health are targets for improvement in engagement in care. Early disclosure and a sense of belonging facilitated engagement in care, while barriers included delayed or inadequate disclosure, denial, and lack of disclosure to others. Adherence support improved by having a biological mother as a direct supervisor. Barriers to care included changing caregivers, abandonment, undiagnosed mental health problems and learning difficulties. Despite these factors, the majority of adolescents showed resilience and remained engaged in care despite difficult circumstances.
Sensory and cognitive function both tend to decline with increasing age. Sensory impairments are risk factors for age-related cognitive decline and dementia. One hypothesis about sensory-cognitive associations is that sensory loss results in social isolation which, in turn, is a risk factor for cognitive decline. We tested whether social factors are associated with cognitive and sensory function, and whether sensory-cognitive associations are mediated or moderated by social factors. We used cross-sectional data from 30,029 participants in the Canadian Longitudinal Study of Aging, aged 45–85 years, who had no reported cognitive impairment or diagnosis of dementia. We found strong independent associations of self-reported social variables with hearing (pure-tone audiometry), vision (pinhole-corrected visual acuity), and executive function and weaker associations with memory. The moderating and mediating effects of social variables on sensory-cognitive associations were weak and mostly non-significant, but social factors could be slightly more important for females and older people. Partial retirement (relative to full retirement or not being retired) may have protective effects on cognition in the presence of hearing loss. These findings confirm the association between social factors and sensory and cognitive measures. However, support is weak for the hypothesis that social factors shape sensory-cognitive associations.
Abstract Background Social participation is a modifiable health determinant influenced by physical and social aspects of the environment. Little is known about aging women’s and men’s community activities and barriers according to region and population size. This study compared social participation, desire to participate more, and perceived barriers of aging women and men by Canadian region and population size. Methods A secondary analysis of the 2008–2009 cross-sectional Canadian Community Health Survey - Healthy Aging was done with 16,274 respondents aged 65+. Respondents were grouped into five regions [Atlantic, Quebec, Ontario, Prairies and British Columbia] and five population size groups [rural (
Objective: We present descriptive information on the cognitive measures used in the Canadian Longitudinal Study on Aging (CLSA) Comprehensive Cohort, relate this to information on these measures in the extant literature, and identify key considerations for their use in research and clinical practice.
Method: The CLSA Comprehensive Cohort is composed of 30,097 participants aged 45–85 years at baseline who provided a broad range of sociodemographic, physical, social, and psychological health information via questionnaire and took part in detailed physical and cognitive assessments. Cognitive measures included: the Rey Auditory Verbal Learning Test – immediate and 5-min delayed recall, Animal Fluency, Mental Alternation Test (MAT), Controlled Oral Word Association Test (COWAT), Stroop Test – Victoria Version, Miami Prospective Memory Test (MPMT), and a Choice Reaction Time (CRT) task.
Results: CLSA Comprehensive Cohort sample sizes were far larger than previous studies, and performances on the cognitive measures were similar to comparable groups. Within the CLSA Comprehensive Cohort, main effects of age were observed for all cognitive measures, and main effects of language were observed for all measures except the CRT. Interaction effects (language × age) were observed for the MAT, MPMT Event-based score, all time scores on the Stroop Test, and most COWAT scores. Main effects of education were observed for all measures except for the MPMT Time score in the French sample, and interaction effects (age × education) were observed for the RAVLT (immediate and delayed) for the English sample and the Stroop Dot time for the French sample.
Conclusion: This examination of the cognitive measures used in the CLSA Comprehensive Cohort lends support to their use in large studies of health and aging. We propose further exploration of the cognitive measures within the CLSA to make this information relevant to and available for clinical practice.
Objectives:
Cross-sectional and longitudinal evidence from largely non-Hispanic White cohorts suggests that positive psychosocial factors, particularly self-efficacy and social support, may protect against late-life cognitive decline. Identifying potentially protective factors in racial/ethnic minority elders is of high importance due to their increased risk of Alzheimer's disease. The overall goal of this study was to characterize cross-sectional associations between positive psychosocial factors and cognitive domains among Black, Hispanic, and White older adults.
Methods:
A total of 548 older adults (41% Black, 28% Hispanic, 31% White) in the Washington Heights-Inwood Columbia Aging Project completed cognitive and psychosocial measures from the NIH Toolbox and standard neuropsychological tests. Multiple-group regressions were used to compare cross-sectional associations between positive psychosocial factors and cognition across racial/ethnic groups, independent of demographics, depressive symptoms, and physical health.
Results:
Positive associations between self-efficacy and language did not significantly differ across race/ethnicity, although the bivariate association between self-efficacy and language was not significant among Hispanics. Additional positive associations were observed for Whites and Blacks, but not Hispanics. Negative associations between emotional support and purpose in life and working memory were seen only in Hispanics.
Conclusions:
Results confirm and extend the link between self-efficacy and cognition in late life, particularly for White and Black older adults. Previous studies on positive psychosocial factors in cognitive aging may not be generalizable to Hispanics. Longitudinal follow-up is needed to determine whether negative relationships between certain psychosocial factors and cognition in Hispanics reflect reverse causation, threshold effects, and/or negative aspects of having a strong social network. (JINS, 2017, 23, 1-11).
Background:
We investigated the association of subjective (perceived) and objective (geographical information system [GIS]-based) measures of the neighborhood built environment (BE) attributes with cognitive function among older persons, and the mediating effect of transportation physical activity (TPA) and leisure time (physical, social and productive) activities (LTA).
Method:
A cross-sectional study of 402 residents aged 55 years and above in the Singapore Longitudinal Ageing Study. Perceived neighborhood BE attributes (residential density, street connectivity, land use mix - diversity, land use mix - access, infrastructure for walking or cycling, aesthetics, traffic safety, and crime safety) and objective GIS measures of walkability and accessibility were related to participants' cognitive global and domain-specific performance measured by Repeatable Battery for the Assessment of Neurocognitive Status (RBANS).
Results:
Controlling for age, sex, education, race, chronic medical illnesses, self-rated health, Geriatric Depression Scale depression score, POMA measures of balance and gait, and other BE attributes, the subjective measure of land use mix-diversity (standardized coefficient β = 0.161, p = 0.008) and GIS measure of walkability (β = 0.163, p = 0.002) were positively and significantly associated with RBANS global z-score, and immediate and delayed memory recall, visuospatial/ constructional ability and language, except attention. In hierarchical modeling, TPA and LTA attenuated the effect estimates, but the associations remained significant.
Conclusion:
BE features which increase opportunities and easy access to a diversity of destinations for services and facilities that promote physical, social and cognitively stimulating activities is associated with better cognitive functioning in older people.
Background
Limited research is available on the relationship between social support, social strain, and cognitive function among community-dwelling U.S. Chinese older adults. This study aims to examine the associations between social support/strain and cognitive outcomes.
Methods
Data were drawn from the Population-Based Study of Chinese Elderly (N = 3,159). Cognitive function was measured by a battery of tests including the East Boston Memory Test, the Digit Span Backwards assessment, and the Symbol Digit Modalities Test. Social support and strain were measured by the scales drawn from the Health and Retirement study. Multiple regression analyses were conducted.
Results
Social support was significantly associated with global cognitive function (β = .11, SE = .02, p < .001), episodic memory (β = .11, SE = .03, p < .001), working memory (β = .18, SE = .08, p < .05), and executive function (β = 1.44, SE = .37, p < .001). Social strain was significantly associated with global cognitive function (β = .23, SE = .05, p < .001), episodic memory (β = .27, SE = .07, p < .001), working memory (β = .34, SE = .17, p < .05), and executive function (β = 2.75, SE = .85, p < .01). In terms of sources of social support/strain, higher support from friends was significantly associated with higher global cognitive function (β = .04, SE = .02, p < .05), higher episodic memory (β = .05, SE = .02, p < .05), and higher executive function (β = .71, SE = .29, p < .05). Higher strain from spouse was significantly associated with higher global cognitive function (β = .10, SE = .03, p < .01), higher episodic memory (β = .11, SE = .04, p < .01), and higher executive function (β = 1.28, SE = .49, p < .01). Higher strain from friends was significantly associated with higher executive function (β = 3.59, SE = 1.17, p < .01).
Conclusions
Social support and strain were associated with cognitive outcomes. Future longitudinal studies should be conducted.
We examined whether between-person differences (PM) and within-person change in levels of social support were associated with age-related cognitive decline, and whether these associations varied by sex and by relationship type. Executive function and memory scores over eight years (2002-2010) were analysed by mixture models (10,241 adults' aged≥50 years) in the English Longitudinal Study of Ageing. PM and within-person change in positive social support and negative social support were independently associated with cognitive decline in different ways by sex and relationship type. Among men, higher-than-others positive social support from spouse/partner was associated with slower cognitive decline (executive function: βPM*time-in-study = 0.005, 95%CI: 0.001, 0.010; memory: βPM*time-in-study = 0.006, 95%CI 0.000, 0.012); whereas high negative social support from all relationship types was associated with accelerated decline in executive function (all-relationships-combined: βPM* time-in-study = -0.005, 95%CI: -0.008, -0.002). For women, higher-than-others positive social support from children (β = 0.037, 95%CI: 0.010, 0.064) and friends (β = 0.115, 95%CI: 0.081, 0.150) but not from spouse/partner (β = -0.034, 95%CI: -0.059, -0.009) or extended family (β = -0.035, 95%CI: -0.064, -0.006) was associated with higher executive function. Associations between social support and age-related cognitive decline vary across different relationship types for men and women.
Objective:
We describe the implementation of cognitive measures within the Canadian Longitudinal Study on Aging (CLSA), a nationwide, epidemiological study of aging, and relate CLSA Tracking cohort data (n over 20,000) to previous studies using these measures.
Method:
CLSA participants (aged 45-85, n over 50,000) provided demographic, social, physical/clinical, psychological, economic, and health service utilization information relevant to health and aging through telephone interviews (Tracking cohort, n over 20,000) or in-person (i.e. Comprehensive cohort, n over 30,000) in both official languages (i.e. English, French). Cognitive measures included: the Rey Auditory Verbal Learning Test (RAVLT) - Trial 1 and five-minute delayed recall; Animal Fluency (AF), the Mental Alternation Test (MAT) (both cohorts); Controlled Oral Word Association Test, Stroop Test, Prospective Memory Test, and Choice reaction times (Comprehensive Cohort).
Results:
Performance on the RAVLT Trial 1 and AF were very similar to comparable groups studied previously; CLSA sample sizes were far larger. Within the CLSA Tracking cohort, main effects of age and language were observed for all cognitive measures except RAVLT delayed recall. Interaction effects (language × age) were observed for AF.
Conclusion:
This preliminary examination of the CLSA Tracking cognitive measures lends support to their use in large studies of aging. The CLSA has the potential to provide the 'best' comparison data for adult Canadians generated to date and may also be applicable more broadly. Future studies examining relations among the psychological, biological, health, lifestyle, and social measures within the CLSA will make unique contributions to understanding aging.
In an aging world, there is increased need to identify places and characteristics of places that promote health among older adults. This study examines whether there are rural-urban differences in older adult social participation and its relationship with health. Using the 2003 and 2011 waves of the Wisconsin Longitudinal Study (n=3006), I find that older adults living in rural counties are less socially active than their counterparts in more-urban counties. I also find that relationships between social participation and health vary by the type of activity and rural-urban context.
Objective: Stimulating environments foster cognitive vitality in older age. However, it is not known whether and how geographical and physical characteristics of lived environments contribute to cognitive aging. Evidence of higher prevalence of dementia in rural rather than urban contexts suggests that urban environments may be more stimulating either cognitively, socially, or in terms of lifestyle. The present study explored urban/rural differences in cognition for healthy community-dwelling older people while controlling for a comprehensive spectrum of confounding factors. Method: Cognitive performance of 3,765 healthy Irish people aged 50+ years participating in Wave 1 of The Irish Longitudinal Study on Aging was analyzed in relation to current location of residence—urban, other settlements, or rural areas—and its interaction with childhood residence. Regression models controlled for sociodemographic, health, and lifestyle factors. Results: Urban residents showed better performance than the other 2 residence groups for global cognition and executive functions after controlling for covariates. Childhood urban residence was associated with a cognitive advantage especially for currently rural participants. Conclusion: Our findings suggest higher cognitive functioning for urban residents, although childhood residence modulates this association. Suggestions for further developments of these results are discussed.
Objectives:
We compared the social participation of older adults living in metropolitan, urban, and rural areas, and identified associated environmental factors.
Methods:
From 2004 to 2006, we conducted a cross-sectional study using an age-, gender-, and area-stratified random sample of 1198 adults (aged 67-82 years). We collected data via interviewer-administered questionnaires and derived from Canadian censuses.
Results:
Social participation did not differ across living areas (P = .09), but after controlling for potential confounding variables, we identified associated area-specific environmental variables. In metropolitan areas, higher social participation was associated with greater proximity to neighborhood resources, having a driver's license, transit use, and better quality social network (R(2) = 0.18). In urban areas, higher social participation was associated with greater proximity to neighborhood resources and having a driver's license (R(2) = 0.11). Finally, in rural areas, higher social participation was associated with greater accessibility to key resources, having a driver's license, children living in the neighborhood, and more years lived in the current dwelling (R(2) = 0.18).
Conclusions:
To enhance social participation of older adults, public health interventions need to address different environmental factors according to living areas.
Purposes
The aim of this study is to review the published evidence on the association between community environment and cognitive function in older people, focusing on the findings and a critique of the existing studies.
Methods
A literature search was conducted to identify studies linking the community environment and cognitive function in older people. The results and methodological factors, including the definition of community, individual level characteristics and the measurements of cognitive function and community environment were extracted from each study. The measurements of community environment were mainly categorized into two types: compositional, generated by aggregating individual and household data (community-level socioeconomic status, deprivation index) and contextual, targeting at the features of built or social environment in local areas (green space, street conditions, crime rate).
Results
Fourteen of the fifteen studies used compositional measurements such as community-level socioeconomic status and deprivation index and significant associations were found in eleven studies. Some individual level factors (ethnicity, genotype and socioeconomic status) were found to modify the association between community environment and cognitive function. Few contextual measurements were included in the existing studies. A conceptual framework for the pathway from community environment to cognitive function of older people is provided in this review.
Conclusions
To disentangle the additional effect of place from individual risk factors and investigate the casual direction of community environment and cognition in later life, longitudinal studies with measurements targeting built and social environments of community and change of cognitive functions over time need to be included in future studies.
Negative affect (e.g., depression) is associated with accelerated age-related cognitive decline and heightened dementia risk. Fewer studies examine positive psychosocial factors (e.g., emotional support, self-efficacy) in cognitive aging. Preliminary reports suggest that these variables predict slower cognitive decline independent of negative affect. No reports have examined these factors in a single model to determine which best relate to cognition. Data from 482 individuals 55 and older came from the normative sample for the NIH Toolbox for the Assessment of Neurological and Behavioral Function. Negative and positive psychosocial factors, executive functioning, working memory, processing speed, and episodic memory were measured with the NIH Toolbox Emotion and Cognition modules. Confirmatory factor analysis and structural equation modeling characterized independent relations between psychosocial factors and cognition. Psychosocial variables loaded onto negative and positive factors. Independent of education, negative affect and health status, greater emotional support was associated with better task-switching and processing speed. Greater self-efficacy was associated with better working memory. Negative affect was not independently associated with any cognitive variables. Findings support the conceptual distinctness of negative and positive psychosocial factors in older adults. Emotional support and self-efficacy may be more closely tied to cognition than other psychosocial variables. (JINS, 2014, 20, 1-9).
Unlabelled:
BACKGROUND/STUDY CONTEXT: Social support has been shown to buffer cognitive decline in older adults; however, few studies have examined the association of distinct functions of perceived social support and cognitive function. The current study examined the relations between distinct functions of social support and numerous cognitive domains in older adults.
Methods:
Data were derived from a cross-sectional, correlational study of cardiovascular risk factors, cognitive function, and neuroimaging. The participants were 175 older adults with a mean age of 66.32. A number of neuropsychological tests and the Interpersonal Support Evaluation List were administered. Multiple linear regression analyses were conducted to determine cross-sectional relations of social support to cognitive function after controlling for age, gender, education, depressive symptomatology, systolic blood pressure, body mass index, total cholesterol, and fasting glucose.
Results:
No significant positive relations were found between distinct functions of social support and cognitive function in any domain; however, inverse relations emerged such that greater social support across several functions was associated with poorer nonverbal memory and response inhibition.
Conclusion:
Results suggest that the receipt of social support may be a burden for some older adults. Within the current study, fluid cognitive abilities reflected this phenomenon. The mechanism through which social support is associated with poorer cognitive function in some domains deserves further exploration.
High levels of education, occupational complexity, and/or premorbid intelligence are associated with lower levels of cognitive impairment than would be expected from a given brain pathology. This has been observed across a range of conditions including Alzheimer's disease (Roe et al., 2010), stroke (Ojala-Oksala et al., 2012), traumatic brain injury (Kesler et al., 2003), and penetrating brain injury (Grafman, 1986). This cluster of factors, which seemingly protect the brain from expressing symptoms of damage, has been termed "cognitive reserve" (Stern, 2012). The current review considers one possible neural network, which may contribute to cognitive reserve. Based on the evidence that the neurotransmitter, noradrenaline mediates cognitive reserve's protective effects (Robertson, 2013) this review identifies the neurocognitive correlates of noradrenergic (NA) activity. These involve a set of inter-related cognitive processes (arousal, sustained attention, response to novelty, and awareness) with a strongly right hemisphere, fronto-parietal localization, along with working memory, which is also strongly modulated by NA. It is proposed that this set of processes is one plausible candidate for partially mediating the protective effects of cognitive reserve. In addition to its biological effects on brain structure and function, NA function may also facilitate networks for arousal, novelty, attention, awareness, and working memory, which collectively provide for a set of additional, cognitive, mechanisms that help the brain adapt to age-related changes and disease. It is hypothesized that to the extent that the lateral surface of the right prefrontal lobe and/or the right inferior parietal lobe maintain structural (white and gray matter) and functional integrity and connectivity, cognitive reserve should benefit and behavioral expression of pathologic damage should thus be mitigated.
Background:
Social networks and support have been proposed as cognitively protective in old age. As studies often consider these social factors in isolation the question of which characteristics of the social environment are beneficial remains.
Objective:
The current study examined associations between measures of social networks (including contact with friends/family, marital status and living arrangement), feelings of loneliness and social support, and a range of cognitive outcomes.
Methods:
Social network, loneliness and support data were available in the Lothian Birth Cohort 1936 (LBC1936, n = 1,091) at age 70. Participants completed a battery of cognitive tests, and factor scores were available for general cognitive ability, and the cognitive domains of processing speed and memory. Childhood cognitive ability data from age 11 were also available.
Results:
When examined in separate ANCOVAs, lower loneliness and more social support were significantly associated with better cognitive abilities at age 70, though not memory (independently of age, sex, childhood cognitive ability and social class), accounting for about 0.5-1.5% of the variance. When the social factors were considered simultaneously, higher loneliness remained associated with lower general cognitive ability (ηp(2) = 0.005, p = 0.046), and those living alone (ηp(2) = 0.007, p = 0.014) or with less social support (ηp(2) = 0.007, p = 0.016) had slower processing speed. When these final models were repeated including a depression symptoms score as a covariate, the associations between loneliness and general cognitive ability, and social support and processing speed, were no longer significant. However, the association between living alone and processing speed remained (ηp(2) = 0.006, p = 0.031).
Conclusions:
Of the social factors considered, loneliness, social support and living arrangement were most consistently associated with aspects of cognitive ability in older people, and these associations appeared to be partly, though not wholly, accounted for by symptoms of depression. Although longitudinal follow-up is required to examine the causal direction of the effects more definitively, it may be beneficial to promote the development of interventions to reduce loneliness and social isolation, and to increase social support.
Low neighborhood-level socioeconomic status has been associated with poorer health, reduced physical activity, increased psychological stress, and less neighborhood-based social support. These outcomes are correlates of late life cognition, but few studies have specifically investigated the neighborhood as a unique source of explanatory variance in cognitive aging. This study supplemented baseline cognitive data from the ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) study with neighborhood-level data to investigate (1) whether neighborhood socioeconomic position (SEP) predicts cognitive level, and if so, whether it differentially predicts performance in general and specific domains of cognition and (2) whether neighborhood SEP predicts differences in response to short-term cognitive intervention for memory, reasoning, or processing speed. Neighborhood SEP positively predicted vocabulary, but did not predict other general or specific measures of cognitive level, and did not predict individual differences in response to cognitive intervention.
This study aimed to explore whether walking in nature may be beneficial for individuals with major depressive disorder (MDD). Healthy adults demonstrate significant cognitive gains after nature walks, but it was unclear whether those same benefits would be achieved in a depressed sample as walking alone in nature might induce rumination, thereby worsening memory and mood.
Twenty individuals diagnosed with MDD participated in this study. At baseline, mood and short term memory span were assessed using the PANAS and the backwards digit span (BDS) task, respectively. Participants were then asked to think about an unresolved negative autobiographical event to prime rumination, prior to taking a 50-min walk in either a natural or urban setting. After the walk, mood and short-term memory span were reassessed. The following week, participants returned to the lab and repeated the entire procedure, but walked in the location not visited in the first session (i.e., a counterbalanced within-subjects design).
Participants exhibited significant increases in memory span after the nature walk relative to the urban walk, p<.001, η(p)(2)=.53 (a large effect-size). Participants also showed increases in mood, but the mood effects did not correlate with the memory effects, suggesting separable mechanisms and replicating previous work.
Sample size and participants' motivation.
These findings extend earlier work demonstrating the cognitive and affective benefits of interacting with nature to individuals with MDD. Therefore, interacting with nature may be useful clinically as a supplement to existing treatments for MDD.
Social support has been suggested to positively influence cognition and mortality in old age. However, this suggestion has been questioned due to inconsistent operationalisations of social support among studies and the small number of longitudinal studies available. This study aims to investigate the influence of perceived social support, understood as the emotional component of social support, on cognition and mortality in old age as part of a prospective longitudinal multicentre study in Germany.
A national subsample of 2,367 primary care patients was assessed twice over an observation period of 18 months regarding the influence of social support on cognitive function and mortality. Perceived social support was assessed using the 14-item version of the FSozU, which is a standardised and validated questionnaire of social support. Cognition was tested by the neuropsychological test battery of the Structured Interview for the Diagnosis of Dementia (SIDAM). The influence of perceived support on cognitive change was analysed by multivariate ANCOVA; mortality was analysed by multivariate logistic and cox regression.
Sample cognitive change (N = 1,869): Mean age was 82.4 years (SD 3.3) at the beginning of the observation period, 65.9% were female, mean cognition was 49 (SD 4.4) in the SIDAM. Over the observation period cognitive function declined in 47.2% by a mean of 3.4 points. Sample mortality (N = 2,367): Mean age was 82.5 years (SD 3.4), 65.7% were female and 185 patients died during the observation period. Perceived social support showed no longitudinal association with cognitive change (F = 2.235; p = 0.135) and mortality (p = 0.332; CI 0.829-1.743).
Perceived social support did not influence cognition and mortality over an 18 months observation period. However, previous studies using different operationalisations of social support and longer observation periods indicate that such an influence may exist. This influence is rather small and the result of complex interaction mechanisms between different components of social support; the emotional component seems to have no or only a limited effect. Further research is needed to describe the complex interactions between components of social support. Longer observation periods are necessary and standardised operationalisations of social support should be applied.
This study examines the association of cognitive functioning with urban neighborhood socioeconomic disadvantage and racial/ethnic segregation for a U.S. national sample of persons in late middle age, a time in the life course when cognitive deficits begin to emerge. The key hypothesis is that effects of neighborhood on cognitive functioning are not uniform but are most pronounced among subgroups of the population defined by socioeconomic status and race/ethnicity. Data are from the third wave of the Health and Retirement Survey for the birth cohort of 1931 to 1941, which was 55 to 65 years of age in 1996 (analytic N = 4,525), and the 1990 U.S. Census. Neighborhood socioeconomic disadvantage has an especially large negative impact on cognitive functioning among persons who are themselves poor, an instance of compound disadvantage. These findings have policy implications supporting "upstream" interventions to enhance cognitive functioning, especially among those most adversely affected by neighborhood socioeconomic disadvantage.
Studies comparing the access to health care of rural and urban populations have been contradictory and inconclusive. These studies are complicated by the influence of other factor which have been shown to be related to access and utilization. This study assesses the equity of access to health care services across the rural-urban continuum in Canada before and after taking other determinants of access into account.
This is a cross-sectional study of the population of the 10 provinces of Canada using data from the Canadian Community Health Survey (CCHS 2.1). Five different measures of access and utilization are compared across the continuum of rural-urban. Known determinants of utilization are taken into account according to Andersen's Health Behaviour Model (HBM); location of residence at the levels of province, health region, and community is also controlled for.
This study found that residents of small cities not adjacent to major centres, had the highest reported utilisation rates of influenza vaccines and family physician services, were most likely to have a regular medical doctor, and were most likely to report unmet need. Among the rural categories there was a gradient with the most rural being least likely to have had a flu shot, use specialist physicians services, or have a regular medical doctor. Residents of the most urban centres were more likely to report using specialist physician services. Many of these differences are diminished or eliminated once other factors are accounted for. After adjusting for other factors those living in the most urban areas were more likely to have seen a specialist physician. Those in rural communities had a lower odds of receiving a flu shot and having a regular medical doctor. People residing in the most urban and most rural communities were less likely to have a regular medical doctor. Those in any of the rural categories were less likely to report unmet need.
Inequities in access to care along the rural-urban continuum exist and can be masked when evaluation is done at a very large scale with gross indicators of rural-urban. Understanding the relationship between rural-urban and other determinants will help policy makers to target interventions appropriately: to specific demographic, provincial, community, or rural categories.
Social participation is a key determinant of successful and healthy aging and therefore an important emerging intervention goal for health professionals. Despite the interest shown in the concept of social participation over the last decade, there is no agreement on its definition and underlying dimensions. This paper provides an inventory and content analysis of definitions of social participation in older adults. Based on these results, a taxonomy of social activities is proposed. Four databases (Medline, CINAHL, AgeLine and PsycInfo) were searched with relevant keywords (Aging OR Ageing OR Elderly OR Older OR Seniors AND Community involvement/participation OR Social engagement/involvement/participation) resulting in the identification of 43 definitions. Using content analysis, definitions were deconstructed as a function of who, how, what, where, with whom, when, and why dimensions. Then, using activity analysis, we explored the typical contexts, demands and potential meanings of activities (main dimension). Content analysis showed that social participation definitions (n = 43) mostly focused on the person's involvement in activities providing interactions with others in society or the community. Depending on the main goal of these social activities, six proximal to distal levels of involvement of the individual with others were identified: 1) doing an activity in preparation for connecting with others, 2) being with others, 3) interacting with others without doing a specific activity with them, 4) doing an activity with others, 5) helping others, and 6) contributing to society. These levels are discussed in a continuum that can help distinguish social participation (levels 3 through 6) from parallel but different concepts such as participation (levels 1 through 6) and social engagement (levels 5 and 6). This taxonomy might be useful in pinpointing the focus of future investigations and clarifying dimensions specific to social participation.
Despite worldwide recognition of the burden of dementia, no epidemiological data is yet available in Portugal. The objective of this study is to estimate the prevalence and describe the pattern of cognitive impairment with dementia or no dementia (CIND) in rural and urban populations from Northern Portugal.
Two random samples of residents aged 55 to 79 years in rural and urban communities were drawn from the health centres registries to be screened for cognitive impairment. The screening criteria for dementia were an abnormal Mini-Mental State Examination (MMSE) score or a Blessed Dementia Scale score. After excluding those who tested positive for dementia, cut-off points for CIND were set at 1 standard deviation below the mean of the MMSE according to educational level. All those who screened positive either for dementia or CIND were examined by a neurologist for establishing a definitive diagnosis.
The prevalence of cognitive impairment was higher in rural than in urban populations, 16.8% (95% CI: 14.3-19.8%) vs. 12.0% (95%CI: 9.3-15.4%), with a rural/urban prevalence ratio (PR) of 2.16 (95% CI: 1.04-4.50) in the eldest and 2.19 (95% CI: 1.01-4.76) in persons with vascular risk factors. The prevalence of dementia was 2.7% (95% CI: 1.9-3.8%) with a rural/urban PR = 2.1 and the prevalence of CIND was 12.3% (95% CI: 10.4-14.4%) and PR = 1.3. The prevalence of dementia increases exponentially with age and in those with cerebrovascular disease or other comorbid conditions while the prevalence of CIND, besides these factors, is also higher in persons with low levels of education or vascular risk factors. Alzheimer's and vascular disease were equally likely aetiologies of dementia (38.7%), the later more common in men PR(F:M = 0.3) as opposed to the former PR(F:M = 2.0). Vascular CIND, associated either with cerebrovascular disease or vascular risk factors was more frequent (39.7%) then depression (18.4%) or any other aetiology.
The prevalence of cognitive impairment is higher in rural compared with urban populations. This is shown in the synergy between age and rurality, with the rural/urban prevalence ratio increasing with age. In this relatively young population from Northern Portugal, cerebrovascular disease as well as vascular risk factors account for 48% of overall cognitive impairment.
RÉSUMÉ
Cette étude a fourni une analyse exploratoire des principaux déterminants sociaux de la santé des femmes âgées canadiennes, en se concentrant sur les différences entre la résidence dans régions rurals et urbaines, étant donné que le statut socio-économique (SES) et le capital social ont été démontrés diffèrent selon la résidence rurale-urbaine. Une analyse secondaire a été effectuée en utilisant l’Enquête de la santé communautaire canadienne, 2000/2001. Une analyse comparative de régression logistique a inopinément révélé que les variables de statut socio-économique et capital social étaient plus fortement associés à la santé des femmes plus âgées urbaines qu’avec leurs homologues rurales. Les associations entre les mesures de revenu de ménage et l’état de santé, de l’insécurité alimentaire et d’appartenance au communauté n’ont pas été pris en charge, pour la plupart, parmi les femmes rurales, mais ont été pris en charge pour leurs homologues urbains. Les conclusions concernant les applications du modèle social-déterminants-de-santé sont discutées pour expliquer les motifs de santé parmi les femmes âgées urbaines et rurales.
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.
We examined associations between multiple aspects of social resources and 5-year change in performance on different domains
of cognitive function. Results indicated that lower satisfaction with support was associated with decline in episodic memory
performance over 5 years. We also found significant interactions between age and social networks of family and friends and
satisfaction with support for the separate cognitive domains. The results suggest that social resources may be differentially
important for cognitive change but that different cognitive domains respond in a similar pattern to social resources.
This study investigated the association between subtypes of social support availability (SSA) and memory in persons aged 45 to 85 years (n = 24,719). We examined two memory outcomes using a modified Rey Auditory Verbal Learning Test (RAVLT)-immediate recall (RAVLT I) and delayed recall (RAVLT II)-and five subtypes of SSA: affectionate, emotional/informational, positive interactions, tangible, overall. We found statistically significant and adjusted positive associations between all SSA subtypes and memory, except for positive interactions and delayed recall memory.For RAVLT I, the regression coefficients (βˆs) anged from 0.03 to 0.07; the βˆs for RAVLT II ranged from 0.02 to 0.05. The differences in βˆs for each SSA subtype (βˆ RAVLT I - βˆ RAVLT II) ranged from 0.00 to 0.02 (mean difference = 0.01; 95% confidence interval = -0.01 to 0.03). All effect sizes, regardless of SSA subtype or memory outcome, were small and clinically unimportant.
Background
Longitudinal studies predictably experience non-random attrition over time. Among older adults, risk factors for attrition may be similar to risk factors for outcomes such as cognitive decline and dementia, potentially biasing study results.
Objective
To characterize participants lost to follow-up which can be useful in the study design and interpretation of results.
Methods
In a longitudinal aging population study with 10 years of annual follow-up, we characterized the attrited participants (77%) compared to those who remained in the study. We used multivariable logistic regression models to identify attrition predictors. We then implemented four machine learning approaches to predict attrition status from one wave to the next and compared the results of all five approaches.
Results
Multivariable logistic regression identified those more likely to drop out as older, male, not living with another study participant, having lower cognitive test scores and higher clinical dementia ratings, lower functional ability, fewer subjective memory complaints, no physical activity, reported hobbies, or engagement in social activities, worse self-rated health, and leaving the house less often. The four machine learning approaches using areas under the receiver operating characteristic curves produced similar discrimination results to the multivariable logistic regression model.
Conclusions
Attrition was most likely to occur in participants who were older, male, inactive, socially isolated, and cognitively impaired. Ignoring attrition would bias study results especially when the missing data might be related to the outcome (e.g. cognitive impairment or dementia). We discuss possible solutions including oversampling and other statistical modeling approaches.
Objectives:
This study examines the association between a modifiable psychosocial factor, social support availability (SSA), and the memory domain of cognitive function in persons aged 45-85 years.
Methods:
We used baseline data from the Canadian Longitudinal Study on Aging (CLSA) (n = 21,241) to conduct multiple linear regression analyses of the association between SSA (overall and four subscales) and memory. The CLSA assessed immediate and delayed recall memory using the Rey Auditory Verbal Learning Test (RAVLT).
Results:
Higher levels of each type of SSA were positively associated with better performance on both immediate and delayed recall memory. The largest associations (β coefficients [95% confidence intervals]) for z-score differences on the RAVLT were observed for overall SSA (immediate: 0.07 [0.04-0.10]; delayed recall: 0.06 [0.02-0.09]) and the emotional/informational subscale (immediate: 0.06 [0.03-0.09]; delayed recall: 0.05 [0.02-0.08]).
Conclusion:
SSA is modifiable and positively associated with memory. Public health initiatives to provide support resources such as material aid, emotional support, or companionship may entail positive benefits for memory. Promotion of SSA is also important for policies encouraging early diagnosis and intervention in dementia.
This study examines (1) whether subjective memory problems (SMP) influence perceived emotional support from and frequency of contact with family and friends; and, (2) the extent to which this relationship is moderated by gender, education, and functional limitations. We use the 2014 wave of the Health and Retirement Study, a nationally representative panel survey of adults aged 51 and over in the United States. While SMP does not affect perceived emotional support for younger group (YG; aged 51-64), in older group (OG; aged 65+), SMP is associated with reduced perceived support from friends. Also, SMP is predictive of fewer writing-based contact with children and friends among OG but not among YG. Lastly, we find that the effect of SMP on support from children is contingent upon activity of daily living (YG) and gender (OG), while the effect of SMP on writing-based contact with both children and friends is contingent upon education (YG only).
The construct of cognitive reserve has primarily been defined in terms of a single proxy measure, education. There may, however, be alternative, potentially additive, proxy measures of cognitive reserve, such as rural or urban residence. Using a large sample of 10,263 older Canadians, ranging in age between 64 and 99 years (mean age = 75.7 years, SD = 7.1), residents of rural and urban areas were compared using the Modified Mini-Mental State (3MS) examination as a dependent variable. Within this sample, subsamples of demented and non-demented individuals were investigated. The 3MS data were analyzed using a linear mixed model with years of education and residence as proxies of cognitive reserve and time of testing (linear and quadratic) as a within-groups variable. All predictor variables in the model (i.e., gender, age, education, residence, and time of testing) had a significant impact on cognitive functioning. The results showed that, although urban residents and higher educated individuals performed better than rural residents and lower educated individuals at baseline, these performance benefits were nullified at 10-year follow-up. The disappearance of these initial performance benefits suggests that urban dwellers and higher educated individuals are not protected against age-related cognitive decline. Thus, no support was found for the cognitive reserve hypothesis.
Acting now on dementia prevention, intervention, and care will vastly improve living and dying for individuals with dementia and their families, and in doing so, will transform the future for society. Dementia is the greatest global challenge for health and social care in the 21st century. It occurs mainly in people older than 65 years, so increases in numbers and costs are driven, worldwide, by increased longevity resulting from the welcome reduction in people dying prematurely. The Lancet Commission on Dementia Prevention, Intervention, and Care met to consolidate the huge strides that have been made and the emerging knowledge as to what we should do to prevent and manage dementia. Globally, about 47 million people were living with dementia in 2015, and this number is projected to triple by 2050. Dementia affects the individuals with the condition, who gradually lose their abilities, as well as their relatives and other supporters, who have to cope with seeing a family member or friend become ill and decline, while responding to their needs, such as increasing dependency and changes in behaviour. Additionally, it affects the wider society because people with dementia also require health and social care. The 2015 global cost of dementia was estimated to be US$818 billion, and this figure will continue to increase as the number of people with dementia rises. Nearly 85% of costs are related to family and social, rather than medical, care. It might be that new medical care in the future, including public health measures, could replace and possibly reduce some of this cost.
Positive associations of neighborhood socioeconomic characteristics and older adults' cognitive functioning have been demonstrated in previous studies, but overall results have been mixed and evidence from European countries and particularly the Netherlands is scarce. We investigated the effects of socioeconomic status (SES) and urbanity of neighborhoods on four domains of cognitive functioning in a sample of 985 Dutch older adults aged 65–88 years from the Longitudinal Aging Study Amsterdam. Besides cross-sectional level differences in general cognitive functioning, processing speed, problem solving and memory, we examined cognitive decline over a period of six years. Growth models in a multilevel framework were used to simultaneously assess levels and decline of cognitive functioning. In models not adjusting for individual SES, we found some evidence of higher levels of cognitive functioning in neighborhoods with a higher SES. In the same models, urbanity generally showed positive or inversely U-shaped associations with levels of cognitive functioning. Overall, effects of neighborhood urbanity remained significant when adjusting for individual SES. In contrast, level differences by neighborhood SES were largely explained by the respondents’ individual SES. This suggests that neighborhood SES does not influence levels of cognitive functioning beyond the fact that individuals with a similar SES tend to self-select into neighborhoods with a corresponding SES. No evidence of systematically faster decline in neighborhoods with lower SES or lower degrees of urbanity was found. The findings suggest that neighborhood SES has no independent effect on older adults cognitive functioning in the Netherlands. Furthermore, the study reveals that neighborhood urbanity should be considered a determinant of cognitive functioning. This finding is in line with theoretical approaches that assume beneficial effects of exposure to complex environments on cognitive functioning. We encourage further investigations into the effect of urbanity in other contexts before drawing firm conclusions.
Recent evidence suggests that living in a neighborhood with a greater percentage of older adults is associated with better individual health, including lower depression, better self-rated health, and a decreased risk of overall mortality. However, much of the work to date suffers from four limitations. First, none of the U.S.-based studies examine the association at the national level. Second, no studies have examined three important hypothesized mechanisms - neighborhood socioeconomic status and neighborhood social and physical characteristics - which are significantly correlated with both neighborhood age structure and health. Third, no U.S. study has longitudinally examined cognitive health trajectories. We build on this literature by examining nine years of nationally-representative data from the Health and Retirement Study (2002–2010) on men and women aged 51 and over linked with Census data to examine the relationship between the percentage of adults 65 and older in a neighborhood and individual cognitive health trajectories. Our results indicate that living in a neighborhood with a greater percentage of older adults is related to better individual cognition at baseline but we did not find any significant association with cognitive decline. We also explored potential mediators including neighborhood socioeconomic status, perceived neighborhood cohesion and perceived neighborhood physical disorder. We did not find evidence that neighborhood socioeconomic status explains this relationship; however, there is suggestive evidence that perceived cohesion and disorder may explain some of the association between age structure and cognition. Although more work is needed to identify the precise mechanisms, this work may suggest a potential contextual target for public health interventions to prevent cognitive impairment.
Objective:
Poor social functioning is associated with cognitive decline in older adults. It is unclear whether social functioning is also associated with subjective memory complaints (SMC). We investigated the association between social functioning and incident SMC and SMC recovery.
Methods:
A population-based sample of 8762 older adults (aged ≥65 years) with good objective cognitive functioning at baseline (MMSE ≥26) from the LifeLines Cohort Study were followed for 1.5 years. Self-reported SMC were measured at baseline and after 1.5 years follow-up. Aspects of social functioning included marital status, household composition, social network size, social activity, quality of social relationships, social support, affection, behavioral confirmation, and status.
Results:
Thirteen percent (513/3963) developed SMC during follow-up (incident SMC). Multivariate logistic regression analyses (adjusted for age, gender, education level, physical activity, alcohol use, smoking status, depression, arrhythmia, myocardial infarction, heart failure, stroke) showed that participants with better feelings of affection, behavioral confirmation and stable good social support had a lower risk of incident SMC. Thirty-four percent (1632/4799) reported recovery. Participants with good social functioning at baseline on all determinants reported more SMC recovery. People who remained stable in a relationship, stable in good quality of social relationships or increased in quality of social relationships more often report SMC recovery.
Conclusions:
Good social functioning is associated with less incident SMC and more SMC recovery over a follow-up period of 1.5 years. Albeit future confirmative studies are needed, we argue for targeting also social functioning when designing multidomain interventions to prevent or slow down cognitive decline. Copyright © 2016 John Wiley & Sons, Ltd.
Objectives.
To assess the relations between 11 aspects of social support and five cognitive abilities (vocabulary, reasoning, spatial visualization, memory, and speed of processing) and to determine whether these relations between social support and cognition are moderated by age or sex.
Method.
A sample of 2,613 individuals between the ages of 18 and 99 years completed a battery of cognitive tests and a questionnaire assessing aspects of social support. A measure of general intelligence was computed using principal components analysis. Multiple regressions were used to evaluate whether each aspect of support and/or its interactions with age or sex predicted each cognitive ability and g.
Results.
Several aspects of social support were significantly related to all five cognitive abilities and to g. When g was included as a predictor, there were few relations with specific cognitive abilities. Age and sex did not moderate any of the relations.
Discussion.
These results suggest that contact with family and friends, emotional and informational support, anticipated support, and negative interactions are related to cognition, whereas satisfaction with and tangible support were not. In addition, these aspects of support were primarily related to g, with the exception of family contact. Social support– cognition relations are comparable across the life span and the sexes.
Research has extensively examined the relationship of social support and cognition. Theories on social support suggest that it is a multidimensional construct including perceptions, actual assistance, and level of integration into a social network. Little is known, however, about the differential associations between distinct dimensions of perceived social support and cognition. This study examined whether four empirically validated dimensions of perceived social support were differentially related to cognitive function in aging, and whether this association was moderated by gender.
The sample included 355 community-residing older adults (mean age = 77 years; %female = 55) enrolled in a longitudinal cohort study. Social support was assessed using the Medical Outcomes Study-Social Support Survey. Cognition was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).
Principal component analysis yielded four factors capturing different dimensions of social support: emotional/informational support, positive social interaction, tangible support, and affectionate support. Linear regression analyses revealed that both perceived emotional/informational support (beta = 1.41, p = 0.03; 95% Confidence Interval (CI) = .156-2.669) and positive social interaction (beta = 1.71, p = 0.01; 95% CI = .428-2.988) were significantly associated with RBANS total index score. Further analyses revealed that gender moderated the relationship between emotional/informational support (beta = 1.266, p = 0.04), demonstrating that higher levels of perceived emotional support were associated with higher index scores in females but not in males.
The associations between perceived emotional/informational support and positive social interaction suggest that social engagement may be an important target for intervention procedures for individuals at risk of cognitive decline and dementia.
Reports an error in "Neuropsychological assessment of memory in the elderly" by Donald E. Read (Canadian Journal of Psychology Revue Canadienne de Psychologie, 1987[Jun], Vol 41[2], 158-174). On p. 171: The last sentence of the first paragraph should read "This finding has now been replicated in a follow-up study with the same subjects (Read, 1986)." (The following abstract of the original article appeared in record 1988-30166-001.) Administered 3 tests designed for the neuropsychological assessment of older people. The tests focus on evaluating the storage abilities of the brain for both explicit and implicit aspects of memory. Ss were volunteers in 3 age groups: 89 males and 153 females (aged 50–59 yrs); 122 males and 181 females (aged 60–69 yrs); and 77 males and 112 females (aged 70–79 yrs). The tests were (1) the Supermarket Test, designed to measure both immediate and delayed episodic memory for test items, plus episodic recall of the spatial location of the same items; (2) the Visual Closure Test, designed to measure implicit and explicit memory; and (3) the Sequential Geometric Design Test, designed to measure visuoperceptual ability and nonverbal memory. Findings show the tests to work well with patients suffering from mild to severe memory loss and with those in the early stages of dementia. (French abstract) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
In general, executive function can be thought of as the set of abilities required to effortfully guide behavior toward a goal, especially in nonroutine situations. Psychologists are interested in expanding the understanding of executive function because it is thought to be a key process in intelligent behavior, it is compromised in a variety of psychiatric and neurological disorders, it varies across the life span, and it affects performance in complicated environments, such as the cockpits of advanced aircraft. This article provides a brief introduction to the concept of executive function and discusses how it is assessed and the conditions under which it is compromised. A short overview of the diverse theoretical viewpoints regarding its psychological and biological underpinnings is also provided. The article concludes with a consideration of how a multilevel approach may provide a more integrated account of executive function than has been previously available.
The gap between symptoms and pathology in Alzheimer's disease has been explained by the hypothetical construct of "cognitive reserve"-a set of variables including education, intelligence, and mental stimulation which putatively allow the brain to adapt to-and hence mask-underlying pathologies by maintaining cognitive function despite underlying neural changes. This review proposes a hypothesis that a biological mechanism may mediate between these social/psychological processes on the one hand, and apparently reduced risk of Alzheimer's disease on the other, namely repeated activation of the noradrenergic system over a lifetime by the processes implicated in cognitive reserve. Noradrenaline's neuroprotective effects both in vivo and in vitro, and its key role in mediating the neuroprotective effects of environmental enrichment on the brain, make noradrenaline's key role in mediating cognitive reserve-by disease compensation, disease modification, or a combination of both-a viable hypothesis.
WinBUGS is a fully extensible modular framework for constructing and analysing Bayesian full probability models. Models may be specified either textually via the BUGS language or pictorially using a graphical interface called DoodleBUGS. WinBUGS processes the model specification and constructs an object-oriented representation of the model. The software offers a user-interface, based on dialogue boxes and menu commands, through which the model may then be analysed using Markov chain Monte Carlo techniques. In this paper we discuss how and why various modern computing concepts, such as object-orientation and run-time linking, feature in the software's design. We also discuss how the framework may be extended. It is possible to write specific applications that form an apparently seamless interface with WinBUGS for users with specialized requirements. It is also possible to interface with WinBUGS at a lower level by incorporating new object types that may be used by WinBUGS without knowledge of the modules in which they are implemented. Neither of these types of extension require access to, or even recompilation of, the WinBUGS source-code.
Existing research has found a positive association between cognitive function and residence in a socioeconomically advantaged neighbourhood. Yet, the mechanisms underlying this relationship have not been empirically investigated.
To test the hypothesis that neighbourhood socioeconomic structure is related to cognitive function partly through the availability of neighbourhood physical and social resources (eg, recreational facilities, community centres and libraries), which promote cognitively beneficial activities such as exercise and social integration.
Using data from a representative survey of community-dwelling adults in the city of Chicago (N=949 adults aged 50 and over), cognitive function was assessed with a modified version of the Telephone Interview for Cognitive Status instrument. Neighbourhood socioeconomic structure was derived from US census indicators. Systematic social observation was used to directly document the presence of neighbourhood resources on the blocks surrounding each respondent's residence.
Using multilevel linear regression, residence in an affluent neighbourhood had a net positive effect on cognitive function after adjusting for individual risk factors. For white respondents, the effects of neighbourhood affluence operated in part through a greater density of institutional resources (eg, community centres) that promote cognitively beneficial activities such as physical activity. Stable residence in an elderly neighbourhood was associated with higher cognitive function (potentially due to greater opportunities for social interaction with peers), but long term exposure to such neighbourhoods was negatively related to cognition.
Neighbourhood resources have the potential to promote 'cognitive reserve' for adults who are ageing in place in an urban setting.
The relationship between stress, social support, and cognition in geriatric depression is complex. In this study, we sought to examine whether an increase in stressful life events or a decrease in social support would lead to subsequent cognitive decline among older adults with and without depression.
The sample consisted of 112 depressed and 101 non-depressed older adults who enrolled in the Neurocognitive Outcomes of Depression in the Elderly (NCODE) study. Participants were assessed clinically, agreed to interviews focusing on stressful life events and social support, and underwent a battery of neuropsychological tests annually. Our global measure of cognition was the Consortium to Establish a Registry in Alzheimer's disease Total Score (CERAD TS).
We found that a decline in the total number of stressors was associated with a subsequent improvement on CERAD TS. In terms of social support, decreased social interaction, and instrumental social support predicted decline in cognitive performance. These relationships were significant even after controlling for depression status, age, education, and sex.
These findings extend prior research on the importance of social factors in aging and depression which have largely focused on mood-related outcomes. Future confirmatory studies are needed. In addition, biological and other studies should be conducted to further our understanding of the relationship between stress, social support and cognition in older adults with and without depression.
RÉSUMÉ
Les Canadiens vivent plus longtemps et les personnes plus âgées composent une part croissante de la population (14% en 2006, projeté d’atteindre 20% d’ici 2021). L’Étude longitudinale canadienne sur le vieillissement (ÉLCV) est une étude longitudinale nationale portant sur le développement adulte et le vieillissement qui recrutera 50 000 Canadien(ne)s âgé(e)s de 45 à 85 ans et qui les suivra pendant au moins 20 ans. Tous les participants fourniront un ensemble d’informations communes sur plusieurs aspects de la santé et du vieillissement, et 30 000 passeront un examen approfondi couplé au don de spécimens biologiques (sang et urine). L’ÉLCV deviendra une source de données riches pour l’étude d’inter-relations complexes entre les facteurs biologiques, physiques, psychosociaux et sociaux qui affectent le vieillissement en santé.
Epidemiologists and public health researchers are studying neighborhood's effect on individual health. The health of older adults may be more influenced by their neighborhoods as a result of decreased mobility. However, research on neighborhood's influence on older adults' health, specifically, is limited.
Recent studies on neighborhood and health for older adults were identified. Studies were identified through searches of databases including PsycINFO, CINAHL, PubMed, Academic Search Premier, Ageline, Social Science Citation Index, and Health Source. Criteria for inclusion were as follows: human studies; English language; study sample included adults aged > or =55 years; health outcomes, including mental health, health behaviors, morbidity, and mortality; neighborhood as the primary exposure variable of interest; empirical research; and studies that included > or =10 neighborhoods. Air pollution studies were excluded. Five hundred thirty-eight relevant articles were published during 1997-2007; a total of 33 of these articles met inclusion criteria.
The measures of objective and perceived aspects of neighborhood were summarized. Neighborhood was primarily operationalized using census-defined boundaries. Measures of neighborhood were principally derived from objective sources of data; eight studies assessed perceived neighborhood alone or in combination with objective measures. Six categories of neighborhood characteristics were socioeconomic composition, racial composition, demographics, perceived resources and/or problems, physical environment, and social environment. The studies are primarily cross-sectional and use administrative data to characterize neighborhood.
These studies suggest that neighborhood environment is important for older adults' health and functioning.
This study examines the differences between rural and urban older adults on level of life satisfaction and depressive symptoms, focusing on the effect of social support. Data were collected through structured interviews at senior centers and senior meal sites in eastern and southeastern Iowa. The Duke Social Support Index (DSSI), the Life Satisfaction Index-Z (LSI-Z), and the Geriatric Depression Scale 15 (GDS15) were used. Correlations (Pearson's r), independent sample t-tests, and multiple regression were computed. Findings indicated that urban residents reported more depressive symptoms, as compared to rural residents. Subjective level of social support was a stronger predictor of life satisfaction and was more negatively related to depressive symptoms among rural than among urban older adults. Results suggest that social workers who work with aging people need to be aware of rural-urban differences in mental health. Furthermore, social workers need to have knowledge of older adults' social networks and work to ensure greater opportunity for social interaction.