Cognitive Health In Later Life Research Articles

Integrating accelerometry, GPS, GIS and molecular data to investigate mechanistic pathways of the urban environmental exposome and cognitive outcomes in older adults: a longitudinal study protocol

IntroductionMaintaining cognitive health in later life is a global priority. Encouraging individuals to make health behaviour changes, such as regular physical activity, and providing supportive urban environments can help maintain...

The Intersecting Effects of Lifetime Experiences of Homelessness and Incarceration on Cognitive Aging and Dementia Risk Factors in the United States.

Alzheimer's disease and related dementias (ADRD) remain a pressing concern in the US, which also has one of the highest incarceration rates worldwide. Existing research has analyzed dementia risk and care among currently incarcerated and homeless populations; this paper fills a gap by examining later-life cognitive disparities facing formerly incarcerated and/or homeless individuals. Using Health and Retirement Study data (HRS; 1998-2018), we tested whether formerly homeless and/or incarcerated people had earlier onset of cognitive decline, and whether they were more likely to have modifiable risk factors for ADRD than those without such experiences. We estimated prevalence of mild cognitive impairment (MCI), dementia, and self-reported ADRD diagnosis. We also used repeated observations of cognitive functioning coupled with nested nonlinear regression to examine the onset of accelerated cognitive decline. Adjusting for demographic variables, formerly homeless and/or incarcerated participants have increased odds of having risk factors for dementia, including smoking, drinking alcohol, depression, mental illness, and discrimination from healthcare providers and police. Diagnosis of MCI and ADRD were more common among participants reporting a history of incarceration or homelessness. Nested nonlinear regression revealed that previous experiences of incarceration or homelessness-alone or together-are associated with earlier onset of accelerated cognitive decline compared to those who experienced neither. This study suggests that, even if they occur earlier in life, homelessness and incarceration experiences may increase risk of poorer cognitive health in late life. Future work is warranted to understand the lifelong consequences linked to this adversity.

Exercise-induced cortical disinhibition mediates the relationship between fitness and memory in older adults.

Regular exercise benefits learning and memory in older adults, but the neural mechanisms mediating these effects remain unclear. Evidence in young adults indicates that acute exercise creates a favourable environment for synaptic plasticity by enhancing cortical disinhibition. As such, we investigated whether plasticity-related disinhibition mediated the relationship between cardiorespiratory fitness and memory function in healthy older adults (n=16, mean age=66.06). Participants completed a graded maximal exercise test and assessments of visual and verbal memory, followed by two counterbalanced sessions involving 20min of either high-intensity interval training exercise or rest. Disinhibition was measured following intermittent theta burst stimulation via paired-pulse transcranial magnetic stimulation. In line with our hypotheses, we observed a positive correlation between cardiorespiratory fitness and verbal memory, which was mediated by plasticity-related cortical disinhibition. Our novel finding implicates cortical disinhibition as a mechanism through which the effects of acute bouts of exercise may translate to improved memory in older adults. This finding extends current understanding of the physiological mechanisms underlying the positive influence of cardiorespiratory fitness for memory function in older adults, and further highlights the importance of promoting exercise engagement to maintain cognitive health in later life. KEY POINTS: There are well established benefits of regular exercise for memory function in older adults, but the mechanisms are unclear. Cortical disinhibition is important for laying down new memories, and is enhanced following acute exercise in young adults, suggesting it is a potential mechanism underlying these benefits in ageing. Older adults completed a fitness test and assessments of memory, followed by two sessions involving either 20min of exercise or rest. Disinhibition was measured following intermittent theta burst stimulation via paired-pulse transcranial magnetic stimulation. Cardiorespiratory fitness was positively associated with memory performance. Higher fitness was associated with enhanced cortical disinhibition following acute exercise. Cortical disinhibition completely mediated the relationship between fitness and memory. This novel finding provides a mechanistic account for the positive influence of cardiorespiratory fitness on memory in later life, and emphasises the importance of regular exercise for cognitive health in older populations.

Perceived Discrimination and Incident Dementia Among Older Adults in the United States: The Buffering Role of Social Relationships.

Recent studies have found that perceived discrimination as a chronic stressor predicts poorer cognitive health. However, little research has investigated how social relationships as potential intervening mechanisms may mitigate or exacerbate this association. Using a nationally representative sample of U.S. older adults, this study examined how the existence and quality of 4 types of relationships-with a partner, children, other family members, and friends-may modify the impact of perceived discrimination on incident dementia. We analyzed data from the 2006 to 2016 Health and Retirement Study (N = 12,236) using discrete-time event history models with competing risks. We used perceived discrimination, social relationships, and their interactions at the baseline to predict the risk of incident dementia in the follow-ups. Perceived discrimination predicted a higher risk of incident dementia in the follow-ups. Although having a partner or not did not modify this association, partnership support attenuated the negative effects of discrimination on incident dementia. Neither the existence nor quality of relationships with children, other family members, or friends modified the association. Our findings imply that intimate partnership plays a critical role in coping with discrimination and, consequently, influencing the cognitive health of older adults. Although perceived discrimination is a significant risk factor for the incidence of dementia, better partnership quality may attenuate this association. Policies that eliminate discrimination and interventions that strengthen intimate partnerships may facilitate better cognitive health in late life.

ROLE CAPTIVITY, DAILY SOCIAL ISOLATION, AND THE MENTAL HEALTH OF DEMENTIA CAREGIVERS

Abstract Family members providing informal care to individuals living with Alzheimer’s disease and related dementias (ADRDs) have an increased risk of poor mental and cognitive health. Social connection has been proposed as an intervention target to support the health and well-being of ADRD caregivers; however, little is known about daily variation in social connection, contextual factors that impact social connection, and its association with caregiver mental health experiences. Thus, the purpose of this study was to examine the relationship between role captivity and daily social isolation (i.e., lack of social connection) among dementia caregivers, as well as associations between social isolation and depression and anxiety-related symptoms. A sample of community-dwelling ADRD caregivers (N=30) completed a baseline survey followed by 14 days of daily diaries (n=323 data points). Participants were asked about role captivity, social isolation, and daily depression and anxiety-related symptoms. Data were analyzed using mixed-level modeling. Role captivity reported at baseline was significantly associated with daily social isolation (B=0.82, 95% CI [0.68, 0.96], p <0.001). Further, daily social isolation was significantly associated with both depression (B=0.69, 95% CI [0.61, 0.77], p <0.001) and anxiety (B=0.55, 95% CI [0.48, 0.62], p <0.001) related symptoms reported on a given day. The findings from this study contribute knowledge on ecologically valid interventions that target daily experiences of social isolation and support the mental health of dementia caregivers. Such interventions are critically important given the proposed links between mental health, social isolation, and cognitive health in later life.

THE DYNAMIC AND RECIPROCAL RELATIONSHIP BETWEEN PERCEIVED DISCRIMINATION AND COGNITIVE FUNCTION IN LATER LIFE

Abstract Studies have suggested that perceived discrimination is a potentially modifiable risk factor for cognitive health in later life. However, there is a lack of focus in the literature on the changes and directionality of the relationship between these two constructs. This study, based on socioemotional selectivity theory, investigates the dynamic and reciprocal relationship between perceived discrimination and cognitive function in later life. Data were drawn from four waves of the Health and Retirement Study (HRS; 2006, 2010, 2014, and 2018). We utilized a subsample of respondents who completed the psychosocial and lifestyle questionnaire in at least three waves. A total of 4,101 people who were 51 and older were included. Cognitive function was measured by the abbreviated version of the telephone interview for cognitive status (TICS-27). Perceived discrimination was measured using scores of the perceived everyday discrimination scale. Random intercept cross-lagged panel model (RI-CLPM) was utilized. Age was associated with lower perceived discrimination (b=-0.224, p<.0001). While lower cognitive function was cross-sectionally associated with higher perceived discrimination in all racial/ethnic groups, higher everyday discrimination predicted subsequent lower cognitive function only among White respondents. The model fit statistics were favorable: CFI=0.968; SRMR=0.045. Results suggested that a decline in cognitive function may exacerbate perceived discrimination which may result in further reduction of cognitive function in general. Lifetime experience of discrimination was discussed as a possible source of the racial/ethnic variations in the relationship. Further study is needed to examine whether this relationship holds among people with cognitive impairment or dementia.

RECIPROCAL RELATIONSHIP BETWEEN FAMILY, FRIENDS, AND COGNITIVE HEALTH AMONG OLDER ADULTS IN CHINA

Abstract Existing research links perceived social support from family and friends to cognitive health in later life. Yet we know less about how cognitive functioning may also shape social support and whether these reciprocal relationships vary between rural and urban areas, especially in China where rural-urban migration is common. This study investigates: (1) whether family support and friendship support help maintaining cognitive functioning, (2) whether cognitive functioning improves perceived family support and friendship support, and (3) whether and how these relationships differ between rural and urban areas. I estimate cross-lagged panel models with a sample including 9,553 adults aged 60 years and above, from two waves of the China Longitudinal Aging Social Survey (CLASS). Results show that cognitive functioning was positively associated with perceived friendship support, regardless of the area of residence. There was a reciprocal relationship between friendship support and cognitive functioning only for rural older adults, with friendship support predicting lower cognitive functioning for urban older adults. Findings suggest that rural and urban context matter – perceived social support, whether from friends or family, may have different implications for the cognitive health of older Chinese adults depending on where they live.

ESPO AND HEALTH SCIENCES SECTION SYMPOSIUM: BUILDING BRIDGES: LEVERAGING SOCIAL CONNECTIONS AND ENVIRONMENTS TO IMPROVE HEALTH IN LATER LIFE

Abstract The COVID-19 pandemic has renewed focus on social connections as fundamental contributors to health across the lifespan. Social connections have been studied in numerous ways (e.g., social network size, daily social interactions, engagement in social activities) and may facilitate health via multiple, dynamic biopsychosocial mechanisms. In line with this year’s theme, we review novel insights from early-career scholars into how “building bridges” with others throughout life may promote mental and cognitive health in later life. Further, we emphasize how bridging disciplines (e.g., social and neurocognitive sciences) is vital to understanding how social environments may “get under the skin” to impact health. Presentations will span multiple social-ecological levels (community, institutional, interpersonal). Beginning at the community/institutional level, Dr. Moored will discuss how the quantity of neighborhood social destinations contributes to GPS measures of community mobility in older adults. Dr. Britt will then describe how religious participation, a specific social institutional activity, is associated with an inflammatory biomarker predictive of cognitive impairments. The remaining talks will then report on daily social experiences. Dr. Ng will highlight links between daily support exchanges and life satisfaction in older adults and how these relationships differ by marital status. Extending to the caregiving context, Dr. Puga will present on how role captivity and daily changes in social isolation contribute to mood symptoms in family caregivers of individuals living with dementia. Our Discussant, Dr. Cudjoe, will provide a critical review in the context of new directions for research on social connections and environments.

Association of periodontal condition with cognitive impairment and the mediating role of accelerated biological aging among US older adults

AbstractBackgroundIncreasing evidence has shown the associations between periodontitis and cognitive impairment or dementia; however, few studies have explored the role of accelerated biological aging that affects this association. Biological aging is the gradual and progressive decline in system integrity that occurs with advancing age. In this study, we examined the mediating effect of biological aging on the association between periodontal conditions and cognitive impairment in US older adults.MethodWe analyzed data from 2,186 participants aged 60 and older from the US National Health and Nutrition Examination Survey 2011‐2014. Data included sociodemographic, behavioral, and health‐related characteristics, periodontal status (measured by mean clinical attachment loss and pocket depth), blood‐chemistry measures of biological age (using KDM‐biological age and PhenoAge algorithms), and cognitive functioning (measured by Digit Symbol Substitution Test). We created an accelerated biological aging measure using residuals from regressing each blood‐chemistry measure on chronological age. The biological ages’ residual discrepancies with chronological age were defined as the biological age accelerations (BAA). Mediation analysis, weighted for complex survey design, assessed the effect of BAA on the association between periodontal conditions and cognitive functioning.ResultAfter adjusting for covariates, participants with periodontitis exhibited greater KDM BAA (β [SE] = ‐0.40 [0.17]), PhenoAge BAA (β [SE] = ‐0.57 [0.21]), and lower level of cognitive function (β [SE] = ‐1.50 [0.33]) than those without periodontitis. Both KDM and PhenoAge BAA were significantly associated with lower cognitive functioning (β [SE] = ‐0.27 [0.10] and β [SE] = ‐0.29 [0.07]), mediating 11.0% and 9.7% of the total effects of periodontitis on cognitive functioning, respectively. Furthermore, KDM and PhenoAge BAA mediated 11.7% and 5.8% of the association between mean pocket depth and DSST, respectively.ConclusionOur findings suggest that periodontitis is partially associated with worse cognitive functioning through accelerating the biological aging process. Efforts to improve oral health or slow biological aging have the potential to help reserve cognitive health in later life.

Multiple socioeconomic risks and cognitive impairment among older men and women in India.

Socioeconomic status (SES) is negatively associated with innumerable health outcomes, including cognitive functioning. Yet much remains undiscovered about SES patterns in later-life cognition in low-and middle-income countries (LMICs). The purpose of this study was to examine the association between separate and combined socioconomic risks and cognitive impairment among older adults in India. Further, given gender disparities in later life cognitive functioning and SES, the study examines the associations between socioeconomic risks and cognitive impairment separately, for older men and women. Data come from the 2017-18, first wave of the Longitudinal Aging Study in India (LASI), with 31,464 older adults aged 60years and above. Cognitive impairment was assessed using multiple broad measures of memory, orientation, arithmetic function, and visuo-spatial construction skills. We present descriptive statistics along with cross-tabulation of the outcome variable. Additionally, binary logistic regression analysis was used to test the association between outcome and explanatory variables. SES is measured using education, paid work status, and household wealth measured using monthly per-capita consumption expenditure (MPCE). A proportion of 7.14% of the older men and 20.03% of older women reported cognitive impairment. The odds of cognitive impairment were higher among uneducated older men and women, and older men and women in lowest wealth quintile. Surprisingly, older women without current or prior work history report lower odds of cognitive impairment compared to their peers in labor force. While odds of cognitive impairment are higher among non-working older men, this association is not statistically significant. In older men, the odds of cognitive impairment were 5.34, 7.14, and 13.05 times higher with one, two, and three risk factors, respectively, compared with those with no risk exposure. A similar trend was observed for women but with comparatively lower odds. Our findings underscore the need to distinguish between varying elements of SES to construct "upstream" health policies and programs that redistribute resources. In particular, the findings support the use of multiple SES indicators in identifying older adults most susceptible to cognitive deficits, and planning gender-based interventions to improve cognitive health in late life.

The association between air pollution and dementia: results from the Cognitive Function and Ageing Study II and Wales

AbstractBackgroundAir pollution has been recognised as one of the key modifiable risk factors for dementia. In the UK, there is a lack of evidence from population‐based cohort studies including older people from different backgrounds and living environments. Using two multicentre ageing cohorts in England and Wales, the aim of this study is to investigate the potential impact of air pollution on dementia in later life.MethodThis study was based on the Cognitive Function and Ageing Study (CFAS) II (2008‐2011) and Wales (2011‐2013), two longitudinal studies of people aged 65 or above across five centres in England (Cambridgeshire, Newcastle upon Tyne, Nottingham) and Wales (Gwynedd, Neath Port Talbot). A two‐year follow‐up wave was carried out for both studies. Dementia was identified using the Geriatric Mental State and its diagnostic algorithm, Automated Geriatric Examination for Computer Assisted Taxonomy (GMS‐AGEACT). Based on the participants’ postcodes at the baseline, exposure to four air pollutants in 2012, including nitrogen dioxide (NO2), ozone (O3), particulate matter with a diameter ≤10 microns (PM10) and ≤2.5 microns (PM2.5), was estimated using the Community Multiscale Air Quality pollution modelling at a resolution of 20×20 m. Multistate modelling was used to investigate the effects of air pollution exposure on risk of developing dementia over the follow‐up period, incorporating mortality (from national death certification) and adjusting for age, sex, education, study centre and area deprivation.ResultAmong the 11329 participants in CFAS II (N = 7753) and Wales (N = 3576), the median exposure was 17.7 (IQR = 11.6) µg/m3 for NO2, 43.8 (IQR = 11.1) µg/m3 for O3, 15.5 (IQR = 3.1) µg/m3 for PM10 and 10.1 (IQR = 2.8) µg/m3 for PM2.5 and large variation was observed across the five centres. Per unit increase in NO2 exposure was associated with a higher risk of dementia in CFAS II (HR: 1.07; 95%CI: 1.03, 1.12) but not the Welsh cohort (HR: 0.93; 95%CI: 0.86, 1.00) after adjustment. For the other air pollutants, the associations were unclear.ConclusionOur study suggests limited evidence for the impacts of air pollution on dementia. Other environmental factors may influence individual exposure to air pollution and altogether have a complex effect on cognitive health in later life.

Developing a DNAm Surrogate to Predict Cognitive Functioning among Older Adults

AbstractBackgroundBlood‐based epigenetic measures are being developed and used to predict aging‐related health outcomes. Specifically, researchers have developed “epigenetic clocks” based on predictions of chronological age and age‐related health declines by DNA methylation. However, these markers are meant to predict aging per se and are not disease specific. Recently, scholars have developed “DNAm surrogates” to predict specific outcomes. This methodological technique has yet to be applied to cognitive functioning despite its potential to improve prediction of cognitive health in later life and provide insight into the role of biological aging.MethodThis study developed a novel DNAm surrogate measure for cognitive functioning (DNAmCogScore) based on an elastic net approach linking using 833,865 CpG sites predicting the Telephone Interview Cognitive Status score (TICS) available in the Health and Retirement Study (HRS), a nationally representative sample of older adults in the United States. Additionally, we evaluate the association of this DNAm surrogate and other neuropathology biomarkers. We used used ridge regression to create DNAmCogScore with 50% of the sample for training and 50% for testing (N = 2009 for each subsample). The Irish Longitudinal Study of Aging (TILDA) will be used for validation (results forthcoming).ResultWe find a positive association and modest predictive value between DNAmCogScore and TICS (see Figure 1, r = .4). Table 1 shows the strong associations with the DNAmCogScore and demographic characteristics. Overall, we find a strong positive coefficient between DNAmCogScore with attenuation after controlling for demographic characteristics, from 1.12 in Model 1 to .20 in Model 3, but remaining statistically significant throughout. Table 3 shows modest negative correlations between DNAmCogScore and NfL, pTau181, and GFAP (ranging from ‐.24 to ‐.36) and no correlation with AB42:40.ConclusionThis study is among the first to create a DNA methylation surrogate measure of cognitive functioning. Our measure is associated with cognitive functioning, even after adjusting for key demographic characteristics. And it has the expected association with other more neuropathology biomarkers. Overall, it suggests that changes in DNA methylation may be a molecular‐level mechanisms by which biological aging impacts cognitive health, and this measure may provide useful prediction of cognitive impairment before the onset of symptoms.

Cumulative exposure to extreme heat and trajectories of cognitive decline among older adults in the USA

BackgroundThe projected increase in extreme heat days is a growing public health concern. While exposure to extreme heat has been shown to negatively affect mortality and physical health, very little...

Association of Lifelong Cognitive Reserve with Dementia and Mild Cognitive Impairment among Older Adults with Limited Formal Education: A Population-Based Cohort Study

Introduction: Early-life educational attainment contributes to cognitive reserve (CR). We investigated the associations of lifelong CR with dementia and mild cognitive impairment (MCI) among older people with limited formal education. Methods: This population-based cohort study included 2,127 dementia-free participants (≥60 years; 59.4% women; 81.5% with no or elementary school) who were examined at baseline (August-December 2014) and follow-up (March-September 2018). Lifelong CR score at baseline was generated from six lifespan intellectual factors. Dementia, MCI, and their subtypes were defined according to the international criteria. Data were analyzed using Cox proportional-hazards models. Results: During the total of 8,330.6 person-years of follow-up, 101 persons were diagnosed with dementia, including 74 with Alzheimer's disease (AD) and 26 with vascular dementia (VaD). The high (vs. low) tertile of lifelong CR score was associated with multivariable-adjusted hazards ratios (95% confidence interval) of 0.28 (0.14–0.55) for dementia and 0.18 (0.07–0.48) for AD. The association between higher CR and reduced AD risk was significant in people aged 60–74 but not in those aged ≥75 years (p for interaction = 0.011). Similarly, among MCI-free people at baseline (n = 1,635), the high (vs. low) tertile of lifelong CR score was associated with multivariable-adjusted hazard ratios of 0.51 (0.38–0.69) for MCI and 0.46 (0.33–0.64) for amnestic MCI. Lifelong CR was not related to VaD or non-amnestic MCI. Discussion: High lifelong CR is associated with reduced risks of dementia and MCI, especially AD and amnestic MCI. It highlights the importance of lifelong CR in maintaining late-life cognitive health even among people with no or limited education.

The path between socioeconomic inequality and cognitive function: A mediation analysis based on the HAALSI cohort in rural South Africa.

Socioeconomic position (SEP) strongly predicts late-life cognitive health, yet the pathways between SEP and cognitive function remain unclear. This study assessed whether and to what extent the association between SEP and cognitive function in the adult population in rural South Africa is mediated by some health conditions, behavioral factors, and social capital factors. In this cross-sectional study, we used data from the 2014-15 "Health and Aging Africa: A Longitudinal Study of an INDEPTH Community in South Africa" (HAALSI) cohort, including 5,059 adults aged 40+ years from the Agincourt sub-district in Mpumalanga Province, South Africa. SEP, the independent variable, was measured based on ownership of household goods. Cognitive function, the dependent variable, was assessed using questions related to time orientation and immediate and delayed word recall. We used the multiple-mediation analysis on 4125 individuals with complete values on all variables to assess the mediating roles of health conditions (hypertension, diabetes, obesity, and disability), behavioral factors (leisure physical activity, alcohol consumption, and tobacco smoking), and social capital factors (community's willingness to help, trust, sense of safety, and social network contact) in the association between SEP and cognitive function. Compared to adults in the poorest wealth quintile, those in the richest wealth quintile had better cognition (β = 0.903, p < 0.001). The mediation analysis revealed that health conditions mediated 20.7% of the total effect of SEP on cognitive function. In comparison, 3.3% was mediated by behavioral factors and only 0.7% by social capital factors. In the multiple-mediator model, 17.9% of the effect of SEP on cognitive function was jointly mediated by health conditions, behavioral factors, and social capital factors. Low socioeconomic position is a significant factor associated with poor cognitive function among adults aged 40 years and above in South Africa. Health conditions mainly mediate the effects between SEP and cognitive function. Therefore, actions to prevent and control chronic health conditions can serve as the entry point for intervention to prevent poor cognitive function among people with low socioeconomic status.

Arterial Aging and Cerebrovascular Function: Impact of Aerobic Exercise Training in Older Adults.

Advanced age is the major risk factor for dementia including Alzheimer's disease. The clinical effects of recently developed anti-amyloid therapy for Alzheimer's disease were modest and the long-term outcome is unknown. Thus, an in-depth understanding of the mechanisms of brain aging is essential to develop preventive interventions to maintain cognitive health in late life. Mounting evidence suggests that arterial aging manifested as increases in central arterial stiffness is associated closely with cerebrovascular dysfunction and brain aging while improvement of cerebrovascular function with aerobic exercise training contributes to brain health in older adults. We summarized evidence in this brief review that 1) increases in central arterial stiffness and arterial pulsation with age are associated with increases in cerebrovascular resistance, reduction in cerebral blood flow, and cerebrovascular dysfunction, 2) aerobic exercise training improves cerebral blood flow by modifying arterial aging as indicated by reductions in cerebrovascular resistance, central arterial stiffness, arterial pulsation, and improvement in cerebrovascular function, and 3) improvement in cerebral blood flow and cerebrovascular function with aerobic exercise training may lead to improvement in cognitive function. These findings highlight the associations between arterial aging and cerebrovascular function and the importance of aerobic exercise in maintaining brain health in older adults.

PSYCHOSOCIAL RESILIENCE, FAMILY SUPPORT, AND COGNITIVE STATUS: FROM EVIDENCE TO ACTION

Abstract Increasing evidence suggests the important role of social connections and family support in maintaining optimal cognitive status among older adults. This symposium includes four studies from China and the U.S with a focus on generating actionable evidence to inform the development of strategies that target psychosocial resilience and family support to promote cognitive health. Using data from the 2006, 2010, and 2014 waves of the Health and Retirement Study, the first study assessed the impact of social isolation on cognitive function, and how sleep disturbance mediated the association on cognitive decline. The study findings suggest addressing sleep disturbance might be a viable way to mitigate the negative effect of social isolation on cognitive function. Companion piece includes another HRS-based study that assessed the impact of loneliness on psychological resilience and cognitive health in later life. Findings from this study show loneliness is indirectly associated with baseline cognitive status and accelerated cognitive decline through deteriorating phycological resources. The third study used a prospective longitudinal design and applied group-based trajectory modeling to identify distinct family functions among 170 Chinese stroke survivors. Four family function trajectories were identified; healthy and stable family function was associated with better cognition and quality of life. Lastly, the fourth study aimed to use an experienced-based co-design approach to develop a cognitive training intervention to promote cognitive health in older Chinese immigrants in the U.S. This approach allows researchers to engage end-users early and to optimize the development of a culturally and linguistically relevant cognitive training intervention.

THE IMPACTS OF CHANGES IN DIABETES AND ORAL HEALTH CONDITIONS ON COGNITIVE TRAJECTORIES

Abstract Despite the emerging research studying the relationship between diabetes mellitus (DM), oral health problems, and cognitive function, little is known about how changes in DM and oral health status affected the trajectories of cognitive decline. Using data of 12,802 participants aged 51+ from the 2006-2018 English Longitudinal Study of Ageing, this study examined the longitudinal relationships of cognitive functions with time-varying DM and oral health status – measured by edentulism, self-rated dental condition, and oral impact on daily performance (OIDP) scale at five time-points from 2006 to 2018. Results showed that participants had DM and edentulism throughout the study period had an accelerated decline in verbal fluency (mean=20.9; b=-0.17, 95% CI=-0.28, -0.07); and those had both DM and OIDP-problem had an accelerated decline in memory function (mean=10.4; b=-0.09, 95% CI=-0.15, -0.03). Prevention and treatment of multiple chronic conditions are essential for cognitive health in later life.

IT'S ABOUT WHO YOU KNOW: RELATIONSHIPS BETWEEN SOCIAL NETWORKS, COGNITIVE FUNCTION, AND BRAIN HEALTH IN LATER LIFE

Abstract Evidence has been steadily increasing about the benefit of social connectedness for healthy aging. Yet, thanks to the complexity of human social interactions, it remains difficult to pinpoint specific benefits and mechanisms by which such benefits emerge. We offer this symposium to address this issue by presenting new findings from ongoing work at Indiana University in collaboration with the Indiana Alzheimer’s Disease Research Center. First, an overview of recent literature will be presented alongside a brief introduction to egocentric network analysis and its utility in probing social determinants of health. Next, we turn our attention to characteristics of social networks and their importance for cognitive health in later life. Different types of social enrichment will be evaluated in terms of their respective influence on cognitive reserve (i.e., neuropsychological evaluations, brain health). Additional attention will be paid to the comparison of emotionally supportive (i.e., social bonding) and more informationally supportive (i.e., social bridging) ties as promoters of brain health. Then, the final talks will describe potential avenues for increasing social connectedness in older adulthood. Individual differences in social cognitive function, namely Theory of Mind (i.e., reading another person’s thoughts, feelings, and intentions), has been implicated as mechanism by which older adults can maintain larger networks with more weak ties, in turn, promoting cognitive function. Separately, the presence of ambivalent ties (i.e., connections that beget positivity and negativity) may serve as a window of opportunity whereby older adults can leverage strengths in emotion regulation to maintain these ties without negative health consequences.

LONELINESS AND ACCELERATED COGNITIVE DECLINE: MEDIATION EFFECTS OF RESILIENCE AND PURPOSE OF LIFE

Abstract Drawing from the Conservation of Resources Theory, we aim to understand the implications of loneliness on psychological resources (i.e., resilience and purpose in life) and cognitive health in later life. This study utilizes data (2006-2018) from the Health and Retirement Study to examine pathways, both direct and indirect through psychological resilience and purpose in life, from loneliness to cognitive trajectories over time. Respondents reporting higher levels of loneliness had worse initial cognitive function (β=-0.43; P&amp;lt;0.01) and accelerated cognitive decline (β=-0.05; P&amp;lt;0.01). Feeling lonely is associated with reduced resilience (β=-0.23; P&amp;lt;0.01) and purposed in life (β=-0.17; P&amp;lt;0.01) which, in turn, are associated with worse cognitive health. Finally, pathway analyses confirm that loneliness is indirectly associated with initial cognitive health and accelerated cognitive decline through deteriorating phycological resources. Positive psychological interventions can be beneficial by promoting resilience and purpose in life and subsequently improve cognitive health.