Cognitive Health In Older Adults Research Articles

A cross-sectional survey of a public, evidence-based multimodal program for cognitive health in older adults

BackgroundIn recent decades, the proportion of older adults in the population has continued to rise, and with it, the need for intervention programs to maintain cognitive functions into old age. Multiple lifestyle factors, including physical, cognitive, and social activities, are crucial to forestalling a decline in cognitive functions. However, Covid-19 curtailed most activities, and therefore, strategies are needed to support older adults in remaining cognitively healthy. This study describes a newly developed and publicly available multimodal program, called “brain coach”, to support and stimulate cognitive activity in older adults. The autonomy supportive program integrates into daily life recommendations for evidence-based physical, cognitive, social, mindful, and creative activation exercises.MethodsThe study design corresponds to a correlational, analytical, and cross-sectional study with 660 older adults, who participated in the program for at least 3 months and completed an online survey.ResultsThe survey results demonstrate that the average age of the participants was 71 years and 75 % were female. Participants experienced benefits in memory, well-being, attitudes towards the brain, and lifestyle habits. Importantly, time invested in the intervention and participant’s positive attitude toward brain health and neuroplasticity, show positive relationships with the experienced benefits.ConclusionsThe results reveal the potential of a public program with a multimodal approach to increase cognitive health and promote an active lifestyle. Further research will explore the effects of such a multimodal intervention in a longitudinal randomized controlled trial study.

Spousal bereavement and the cognitive health of older adults in the US: New insights on channels, single items, and subjective evidence

This study provides novel insights into older adults’ cognitive functioning before and after widowhood onset and possible effect channels. It further examines gender heterogeneity in the adaptation to (anticipated or actual) spousal bereavement, comparing objective evidence with subjective evidence of cognitive abilities. We used longitudinal data of up to 26,584 participants of the Health and Retirement Study, aged over 50 at recruitment, assessed biennially between 1998 and 2016. Two-way fixed effects with dynamic treatment effects were estimated for various cognitive measures, including six aggregated indices and six single item scales. After adjusting for effect channels including depression, social vulnerability, and stress, there remained significant widowhood effects on older adults’ cognitive health. Using single item scales, we established the adverse contemporaneous and adaptation effects on bereaved older females’ short-term memory, semantic memory, and numeracy. For bereaved older males, working memory and focus-of-attention deteriorated after widowhood onset. Meanwhile, subjective memory rating remained intact, contrary to objective evidence. We conclude that cognitive transitions to and from widowhood can exhibit distinctive patterns across objective and subjective cognitive domains. With the effect channels in mind, cognitive intervention for widowed older adults should be tailored to the temporal distance to spousal loss, gender, and task.

Moderate-Intensity Physical Activity, Music and Art Activities Preserved Cognitive Health in Older Adults: An Argument for Social Prescribing Solution.

Introduction: Rates of dementia are projected to increase over the coming years as global populations age. Without a treatment to slow the progression of dementia, many health policies are focusing on preventing dementia by slowing the rate of cognitive decline with age. However, it is unclear which lifestyle changes in old age meaningfully reduce the rate of cognitive decline associated with aging.Objectives: Use existing, multi-year longitudinal health data to determine if engagement in a variety of different lifestyle activities can slow the rate of cognitive decline as older adults age.Method: Data from the English Longitudinal Study of Aging was analyzed using a quasi-experimental, efficient matched-pair design inspired by the clinical trial methodology. Changes in short-term memory scores were assessed over a multi-year interval for groups who undertook one of 11 different lifestyle activities, compared to control groups matched across confounding socioeconomic and lifestyle factors.Results: Two factors, moderate-intensity physical activity and learning activities, resulted in significant positive impact on cognitive function.Conclusion: Our analysis brings cognitive benefit arguments in favor of two lifestyle activities, moderate-intensity physical activity and learning activities, while rejecting other factors advanced by the literature such as vigorous-intensity physical activity. Those findings justify and encourage the development of new lifestyle health programs by health authorities and bring forward the new health system solution, social prescribing.

Association between indoor air pollution and cognitive function of older adults in India: a cross-sectional multilevel analysis

Over half the world’s population, mostly from developing countries, use solid fuel for domestic purposes and are exposed to very high concentrations of harmful air pollutants with potential health effects. The effect of indoor air pollution becomes much more severe for older adults because of their weakened immune system with multiple health risk factors. Compared with ambient air pollution, little is known about cognitive health in relation to indoor air pollution. Therefore, this study explores the association between indoor air pollution due to solid fuel use and cognitive function of older adults in India. The study used data from wave 1 of the WHO Study on global AGEing and adult health (SAGE). Bivariate analysis and a two-stage multilevel linear regression model were applied. Our findings indicated that indoor air pollution is strongly associated with cognitive function. Results show lower cognitive function scores among older adults in households using solid fuel, women with lower or no education, and belonging to the disadvantaged section of the society. Older adults from poor socioeconomic backgrounds were more exposed to indoor air pollution compared to their counterparts, which indirectly increases the risk of poor cognitive function. Indoor air pollution from solid fuel use may be a salient factor for the cognitive health of older adults in India. A large proportion of India’s population relies on solid fuel pointing to the need for urgent intervention programmes to reduce the usage of solid fuel in the country.

Five-Year Change in Body Mass Index Predicts Conversion to Mild Cognitive Impairment or Dementia Only in APOE ɛ4 Allele Carriers.

Body mass index (BMI) has been identified as an important modifiable lifestyle risk factor for dementia, but less is known about how BMI might interact with Apolipoprotein E ɛ4 (APOE ɛ4) carrier status to predict conversion to mild cognitive impairment (MCI) and dementia. The aim of this study was to investigate the interaction between APOE ɛ4 status and baseline (bBMI) and five-year BMI change (ΔBMI) on conversion to MCI or dementia in initially cognitively healthy older adults. The associations between bBMI, ΔBMI, APOE ɛ4 status, and conversion to MCI or dementia were investigated among 1,289 cognitively healthy elders from the National Alzheimer's Coordinating Center (NACC) database. After five years, significantly more carriers (30.6%) converted to MCI or dementia than noncarriers (17.6%), p < 0.001, OR = 2.06. Neither bBMI (OR = 0.99, 95%CI = 0.96-1.02) nor the bBMI by APOE interaction (OR = 1.02, 95%CI = 0.96-1.08) predicted conversion. Although ΔBMI also did not significantly predict conversion (OR = 0.90, 95%CI = 0.78-1.04), the interaction between ΔBMI and carrier status was significant (OR = 0.72, 95%CI = 0.53-0.98). For carriers only, each one-unit decline in BMI over five years was associated with a 27%increase in the odds of conversion (OR = 0.73, 95%CI = 0.57-0.94). A decline in BMI over five years, but not bBMI, was strongly associated with conversion to MCI or dementia only for APOE ɛ4 carriers. Interventions and behaviors aimed at maintaining body mass may be important for long term cognitive health in older adults at genetic risk for AD.

The Neurocognitive Effects of Bacopa monnieri and Cognitive Training on Markers of Brain Microstructure in Healthy Older Adults

Bacopa monnieri (BM) is a herbal supplement that increases signaling molecules implicated in synaptogenesis. Combined with cognitive stimulation, it may be a viable supplement to enhance long-term potentiation (LTP) and improve cognitive health in older adults. This randomized, double-blind, placebo-controlled trial asked 28 healthy adults aged over 55 years to complete cognitive training (CT) 3 hours weekly for 12 weeks. Fifteen consumed a standardized extract of BM and 13 consumed a placebo daily. Cognitive tasks, life-satisfaction, memory complaints and mood were assessed, and bloods analyzed for serum brain-derived neurotrophic factor (BDNF) before and after 12-weeks of the intervention. Diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) in gray (GM) and white matter (WM) were also analyzed. Results demonstrated slower reaction time in an image discrimination task in the BM group and faster reaction time in a spatial working memory task (SWM-O RT) in the placebo group. Mean accuracy was higher in the BM group for these tasks, suggesting a change in the speed accuracy trade-off. Exploratory neuroimaging analysis showed increased WM mean diffusivity (MD) and GM dispersion of neurites (orientation dispersion index, ODI) and decreased WM fractional anisotropy (FA) and GM neurite density (ND) in the BM group. No other outcomes reached statistical significance. An increase in ODI with a decrease in MD and ND in the BM group may indicate an increase in network complexity (through higher dendritic branching) accompanied by dendritic pruning to enhance network efficiency. These neuroimaging outcomes conflict with the behavioral results, which showed poorer reaction time in the BM group. Given the exploratory outcomes and inconsistent findings between the behavioral and neuroimaging data, a larger study is needed to confirm the synaptogenic mechanisms of BM.

Associations between exercising in a group and physical and cognitive functions in community-dwelling older adults: a cross-sectional study using data from the Kasama Study.

[Purpose] To examine the associations of exercise habits, particularly exercising in a group, with physical and cognitive functions in community-dwelling older adults. [Participants and Methods] A total of 615 older adults participated in this cross-sectional study. We conducted three physical performance tests (grip strength, five times sit-to-stand, and 5-meter walk tests) and the Five-Cog test (attention, memory, visuospatial, language, and reasoning). We investigated exercise habits using questionnaires and classified the participants into three groups as follows: those who did not exercise (n=86), those who exercised alone (n=168), and those who exercised in a group (n=362). To clarify the associations of exercise habits with physical and cognitive functions, we used the analysis of covariance with adjustment for potential confounders. [Results] The participants who exercised in a group had better lower limb strength than those who exercised alone and better scores for all the variables than the non-exercisers. Furthermore, those who exercised in a group scored significantly higher on the attention, memory, visuospatial, and overall cognitive function tests than those who exercised alone. [Conclusion] Our results highlight the importance of the social aspects associated with exercising, such as the presence of exercise peers, to improve the physical and cognitive health of older adults.

Dietary Patterns and Cognitive Health in Older Adults: Findings from the Sydney Memory and Ageing Study.

Systematic reviews report dietary patterns may be associated with cognitive health in older adults. However, inconsistent findings have been reported and relevant research lacks large scale studies. This study aims to examine the associations of dietary patterns and cognitive function among older adults in an Australian ageing cohort. A population-based, cross-sectional analysis of the baseline phase of the Sydney Memory and Ageing Study, a well-characterised Australian ageing study. The Sydney Memory and Ageing Study was initiated in 2005 to examine the clinical characteristics and prevalence of mild cognitive impairment (MCI). Non-demented community-dwelling individuals from English-speaking background (N = 819) aged 70-90 recruited from two areas of Sydney, following a random approach to 8914 individuals on the electoral roll in the Sydney Memory and Ageing study. The Cancer Council of Victoria Food Frequency Questionnaire was used to assess dietary intake. Scores for Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH) diet and the Dietary Guidelines Index (DGI 2013) were generated. Two patterns - a Prudent healthy and a Western dietary pattern - were derived using principal components analysis (PCA). Neuropsychological tests were used to assess global cognition and six cognitive domains. Multivariate linear modelling assessed the relationship between dietary patterns and cognitive domain scores. Mediterranean diet and DASH diet were both positively linked to visuospatial cognition (P=0.002 and P=0.001 respectively). Higher intake of legumes and nuts was related to better performance in global cognition (β=0.117; 95% CI:0.052, 0.181; P<0.001) and language and visuospatial cognitive domains. The Prudent healthy diet was associated with better global cognition (β=0.307; 95% CI: 0.053, 0.562; P=0.019) in women and a Western diet was related to poorer global function (β=-0.242; 95% CI: -0.451,-0.034; P=0.023) and executive function (β=-0.325; 95% CI: -0.552,-0.099; P=0.005) in men. In this analysis, higher adherence to the Mediterranean diet, DASH diet, Prudent healthy diet and greater consumption of legumes and nuts were associated with better cognition among older adults.

Psychosocial Factors Associated with Cognitive Function Among Middle-Aged and Older Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos and its Sociocultural Ancillary Study.

Evidence suggests that psychosocial factors are associated with cognitive health in older adults; however, associations of psychosocial factors with cognition remain largely unexamined in middle-aged and older Hispanics/Latinos. To examine the cross-sectional associations of psychosocial factors with cognitive function among middle-aged and older Hispanics/Latinos living in the US. Baseline (2008-2011) data from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (n = 2,818; ages 45-74) were used to examine the associations of each psychosocial factor with global cognition (GC), verbal learning, verbal memory, verbal fluency, and processing speed independent of age, sex, education, Hispanic/Latino background, income, language, and depressive symptoms. Psychosocial variables included: intrapersonal factors (ethnic identity, optimism, and purpose in life), interpersonal factors (family cohesion, familism, social network embeddedness, and social support), and social stressors (perceived ethnic discrimination, loneliness, and subjective social status). In fully-adjusted models, purpose in life and social support were each positively associated with all five cognitive variables. Loneliness was negatively associated with GC, verbal learning, memory, and processing speed. Ethnic identity was positively and familism negatively associated with GC, verbal fluency, and processing speed. Family cohesion was positively associated with verbal learning. These findings extend previous evidence from older, largely non-Hispanic White cohorts to show that higher purpose in life and social support are also strongly associated with cognitive health among middle-aged and older Hispanics/Latinos. We also highlight that intrapersonal factors, interpersonal factors, and social stressors have differential relationships with individual cognitive tests.

Depressive symptoms with cognitive dysfunction increase the risk of cognitive impairment: analysis of the Korean Longitudinal Study of Aging (KLoSA), 2006-2018.

Geriatric depression complicates cognitive health in older adults. This study aims to investigate the impact of depressive symptoms on cognitive impairment in community-dwelling older adults, depending on whether cognitive dysfunction accompanied. A community-based longitudinal cohort study. This study analyzed data from the Korean Longitudinal Study of Aging (KLoSA) from 2006 to 2018. Among 10,254 individuals who were registered in the KLoSA study, a total of 9119 subjects met the criteria, and 4547 subjects were included in the final analysis. The subjects were grouped into 4 categories based on depressive symptoms and cognitive dysfunction at baseline assessment: "normal control" (NC, n = 3341), "depression only" (Dep-only, n = 652), "cognitive dysfunction only" (CD-only, n = 393), and "depression with cognitive dysfunction" (Dep-CD, n = 161). Cognitive impairment 10 years later was defined as K-MMSE scores below two percentile on demographically adjusted norms. Ten-year survival, that is, not experiencing cognitive impairment, was 80 $$ \pm \,$$1% in NC group, 72 $$ \pm $$ 2% in Dep-only group, 52 $$ \pm $$ 3% in CD-only group, and 44 $$ \pm $$ 5% in Dep-CD group. The hazard ratio (HR) of the Dep-only group (HR = 1.18, 95% CI, 0.97-1.43, n.s.) did not differ from that of the NC group, but the HR of the Dep-CD group was significantly higher (HR = 2.85, 95% CI, 2.23-3.66, p < 0.001) than the NC group. When the Dep-CD group was compared to the CD-only group, the HR was 1.13 (95% CI, 0.85-1.49, n.s.), which indicates that it did not significantly differ from the CD-only group. Our findings suggest that depressive symptoms with cognitive dysfunction are associated with a higher risk of cognitive impairment. Furthermore, cognitive dysfunction occurring with depressive symptoms is as much a risk for cognitive impairment as is pure cognitive dysfunction. Thus, healthcare providers should pay close attention to the community-dwelling elderly when depressive symptoms occur with cognitive dysfunction.

Social network type and subsequent cognitive health among older Europeans.

One's personal social network constitutes a contextual framing factor for late-life cognitive function. This study examined the association between network type at baseline and changes in three cognitive measures: immediate recall, delayed recall, and fluency, two years hence, among Europeans aged 50 and older. Data were taken from Waves four and five of the Survey of Health, Ageing, and Retirement in Europe of adults aged 50 and above (N = 50,071). The latent class analysis was applied to a set of criterion variables. The procedure yielded five distinct network types: multi-tie (6%), family-rich (23%), close-family (49%), family-poor (12%), and friend-enhanced (10%). The network types were then regressed on the cognition measures at follow-up, controlling for the respective baseline cognition scores, as well as for age, gender, education, self-rated health, mobility difficulty, and country. Respondents in family-poor network types had poorer cognition scores at follow-up, compared to those in the modal close-family network, while those in multi-tie networks had consistently better scores. The family-rich network and the friend-enhanced network also had a somewhat better cognitive function. Having varied sources of network ties, e.g. friendship ties and/or several types of family relationships, is beneficial to the cognitive health of older adults over time. Networks based mainly on ties with relatives other than spouse and children, on the other hand, have poorer cognitive outcomes. Older people in this latter group face an increased risk for cognitive decline and should receive assistance in enhancing their interpersonal environments.

Development of a group conversation support robot Bono-05 for cognitive health of older adults

Development of a group conversation support robot Bono-05 for cognitive health of older adults

Sedentary behaviours and cognitive function among community dwelling adults aged 50+ years: Results from the Irish longitudinal study of ageing

BackgroundSedentary behaviours (SB) are risk factors for poor cardiovascular health and all-cause mortality. However, their role in cognitive health in older adults is unclear. A few studies have examined associations between sedentary behaviours and cognition, but are limited by heterogeneity and insufficient longitudinal analyses. Therefore more robust studies, which would address identified limitations, are needed to accurately determine associations. MethodThis study analysed data collected from participants aged 50+ years of The Irish Longitudinal Study of Ageing (TILDA). We conducted cross-sectional linear regression with multivariate imputation analyses of baseline data from wave 1 (N = 8163, weekday-sitting time), and wave 3 (N = 6400, weekday-television viewing); longitudinal analyses between waves 1–3 (sitting) and waves 3–4 (television). Sedentary behaviours were analysed as both categorical and continuous variables. Outcome of cross-sectional analyses was standardised regression co-efficient of associations between sedentary exposures and cognitive function in respective waves, while for longitudinal analyses was cognitive change (verbal memory, verbal fluency, and global cognition) between waves based on standardised residuals. ResultStudy found significant but mild cross-sectional associations between 1-h increase in weekday-television viewing and poorer verbal memory (b = −0.02, CI: −0.04, −0.003, P < 0.05) and verbal fluency (b = −0.02, CI: −0.04, −0.002, P < 0.05). Baseline television viewing of 3.5+ h/day had mild but significant association with a decline in verbal fluency 2 years later in participants aged 65+ years, when compared with a reference category of <1.5 h of TV viewing (b = −0.12, CI: −0.23, −0.001, P < 0.05). ConclusionOur study findings indicated some association between increased levels of weekday-television viewing time, independent of physical activity, and poor cognition cross-sectionally and longitudinally in middle-aged and older adults. Intervention studies are needed to confirm the effects of SB on cognition in older adults. Public health campaigns should be targeted at displacing high levels of television viewing, in excess of 3.5 h/day among older adults.

Home-Based Cognitively Assistive Robots: Maximizing Cognitive Functioning and Maintaining Independence in Older Adults Without Dementia.

Promoting health and prolonging independence in the home is a priority for older adults, caregivers, clinicians, and society at large. Rapidly developing robotics technology provides a platform for interventions, with the fields of physically and socially assistive robots expanding in recent years. However, less attention has been paid to using robots to enhance the cognitive health of older adults. The goal of this review is to synthesize the current literature on home-based cognitively assistive robots (CAR) in older adults without dementia and to provide suggestions to improve the quality of the scientific evidence in this subfield. First, we set the stage for CAR by: a) introducing the field of robotics to improve health, b) summarizing evidence emphasizing the importance of home-based interventions for older adults, c) reviewing literature on robot acceptability in older adults, d) highlighting important ethical issues in healthcare robotics, and e) reviewing current findings on socially assistive robots, with a focus on translating findings to the CAR context. With this foundation in place, we then review the literature on CAR, identifying gaps and limitations of current evidence, and proposing future directions for research. We conclude that CAR is promising and feasible and that there is a need for more methodologically rigorous evaluations of CAR to promote prolonged home-based independence in older adults.

The Foreclosure Crisis, Community Change, and the Cognitive Health of Older Adults.

While home foreclosures are often thought of as a household-level event, the consequences may be far-reaching, and spill over to the broader community. Older adults, in particular, could be affected by the spiral of community changes that result from foreclosures, but we know very little about how the foreclosure crisis is related to older adult health, in particular cognition. This article uses growth curve models and data from the Health and Retirement Study matched to Census and county-level foreclosure data to examine whether community foreclosures are related to older adults' cognitive health and the mechanisms responsible. We find that higher rates of county-level foreclosures are associated with a faster decline in individual cognition at older ages. Although we examined an extensive number of individual and community mechanisms, including individual housing wealth and depressive symptoms, community structural factors, social factors, and perceptions of physical disorder and cohesion, none of the mechanisms examined here explained this relationship. This study shows that the adverse consequences of home foreclosures spill over to the local community, with implications for the cognitive health of older adults.

The Associations Among Health-Promoting Lifestyle, eHealth Literacy, and Cognitive Health in Older Chinese Adults: A Cross-Sectional Study.

Background: Healthy lifestyles and health literacy are strongly associated with cognitive health in older adults, however, it is unclear whether this relationship can be generalized to health-promoting lifestyles and eHealth literacy. To date, no research has examined the interactive effect of health-promoting lifestyles and eHealth literacy on cognitive health. Objective: To examine the associations among health-promoting lifestyles, eHealth literacy, and cognitive health in older adults. Methods: Using a stratified cluster sampling method, we conducted a survey with older adults in four districts and two counties in Jinan (China). Older adults (n = 1201; age ≥ 60 years) completed our survey. We assessed health-promoting lifestyles, eHealth literacy, and cognitive health, and collected participants’ sociodemographic information. Results: Health-promoting lifestyles and eHealth literacy were significantly and positively associated with cognitive health (both p < 0.01). In addition, eHealth literacy was positively associated with health-promoting lifestyles. Moreover, the interaction of health-promoting lifestyle and eHealth literacy negatively predicted cognitive health (β = −0.465, p < 0.01). Conclusions: Health-promoting lifestyles and eHealth literacy were associated with the cognitive health of Chinese older adults, both independently and interactively. Further, eHealth literacy was associated with health-promoting lifestyles in older adults. Therefore, interventions regarding healthy lifestyles and eHealth literacy would benefit older adults.

The Education of Multiple Family Members and the Life-Course Pathways to Cognitive Impairment.

This article asks how the educational attainments of multiple family members, including parents and offspring, are associated with the cognitive health of older adults in the United States. We use panel data from the U.S. Health and Retirement Study (2000-2012) to examine how the education of an individual, their parent(s), and their offspring are associated with the prevalence of moderate/severe cognitive impairment and the onset of cognitive impairment among older adults using logistic regression and discrete-time event history analysis, respectively. We found that when combined, only the education of the individual is inversely associated with cognitive impairment at baseline. However, both the educational attainments of an individual and their offspring are negatively associated with the risk of becoming cognitively impaired, among individuals who were not already cognitively impaired. Conversely, parental education was not predictive of being cognitively impaired or the onset of impairment. Furthermore, we found that respondent gender did not moderate the relationship between a family member's education and respondent cognitive health. This study adds to current research by asking how resources from earlier and subsequent generations matter for older adults' cognitive health. Although we found little evidence that parental education matters at this life stage, results suggest that offspring education has a salient positive effect on later-life cognitive health. This finding underscores an overlooked source of health disparities-offspring resources-and highlights how a family perspective remains a powerful tool for understanding health inequalities in later life.

HEART FAILURE, ARRHYTHMIAS AND DEMENTIA IN THE “OLDEST OLD” OF SOUTH CENTRAL UNITED STATES

Heart failure and dementia are common age-related conditions. Heart failure and associated comorbidities of hypertension and arrhythmias may impact cognition. Retrospective data of 311 patients averaging 98 (±3.2) years who received treatment at the University of Arkansas for Medical Sciences were analyzed for diagnoses, prescribed medications and health conditions relevant to heart failure, hypertension, arrhythmias and dementia. 74% of the subjects were white, non-Hispanic, 24% were African American, and 2% were of unknown ethnicity. 83% were women and 17% were men. Only 251 (81%) of the reviewed charts had blood pressures recorded, of whom 43% (n=114) had systolic pressures >140mmHg. Furthermore, 50% (n=156) of patients had heart failure, and 29% (n=89) had dementia. Of those with dementia, 35% had an arrhythmia. For those without a diagnosis of dementia or any treatment for dementia, 25% had an arrhythmia. Heart failure and arrhythmias have not been well studied as an etiological factor for dementias. In our cohort, the presence of heart failure diagnoses was not different in those with dementia versus those without dementia. However, more patients with dementia had arrhythmias versus those without dementia, suggesting that arrhythmias may contribute to cognitive decline, even in the oldest old. Approximately 70% of the arrhythmias were atrial fibrillation. We did not have data on the management of these arrhythmias and whether anticoagulants were being used appropriately, especially for atrial fibrillation. Nevertheless this highlights the importance of close management of arrhythmias for maintaining cognitive health in older adults.

EARLY-LIFE INFLUENCES ON LATER-LIFE HEALTH

This symposium identifies risk and protective factors in childhood and adolescence that continue to influence the physical and cognitive health of older adults. Dimensions of early life inequality include geographic location, educational opportunities, and total amount of adversity faced. Papers in the symposium use data from three major U.S. longitudinal studies: the Health and Retirement Study (HRS), the MacArthur Study of Midlife in the U.S. (MIDUS), and the Wisconsin Longitudinal Study (WLS). Each paper focuses on the mechanisms (i.e., mediators and moderators) linking well-being in childhood and adolescence to health in older adulthood. Greenfield, Akincigil, and Moorman find that net of IQ, college education boosts later life cognition, especially for men who had a low probability of college attendance. Kemp and Montez further find that state economic policy and adult health behavior explain later life disparities in health by educational attainment. Herd, Sicinski, and Asthana continue the theme of geographic place, finding that rural children who were raised on farms are at a cognitive disadvantage in later life. Both Ferraro and Sauerteig and Homan and Kong generate indices of total childhood misfortune. Ferraro and Sauerteig conclude that childhood misfortune affects obesity by way of adult health behavior, specifically, physical activity. Homan and Kong find that childhood misfortune affects subjective and functional health by way of the psychological mechanism of purpose in life. Together, these five papers begin to identify the ways in which experiences in childhood and adolescence have long-lasting consequences for a variety of health outcomes in later life.

QUADRICEPS STRENGTH IS ASSOCIATED WITH COGNITION IN OLDER ADULTS WITH CHRONIC STROKE

Individuals who have suffered a stroke are at risk for developing cognitive impairment and dementia. Thus, it is important to identify modifiable risk factor for cognitive decline in this population. Among older adults without a history of stroke, greater muscle strength is associated with better cognitive function. Whether this relationship also exist in older adults with a history of stroke is not known. Thus, we aimed to examine whether cognition, as measured by both the Montreal Cognitive Assessment (MoCA) and the 13-item Alzheimer’s Disease Assessment Scale-Cognitive (ADAS-Cog 13), is associated with lower extremity muscle strength in adults with chronic stroke (> 1 year post stroke). Ninety-one community-dwelling adults, aged 55 years and older, with chronic stroke were included in this analysis. Isometric strength of the quadriceps was measured bilaterally in kilograms. Two linear regression models were constructed to determine the independent association of quadriceps strength (mean kilograms of both legs) with: 1) MoCA; and 2) ADAS-Cog 13, after controlling for age, sex, and mood. Mean quadriceps strength was independently associated with both MoCA and ADAS-Cog scores, after accounting for age, sex, and mood. Specifically, quadriceps strength explained an additional 5.6% of the variable in MoCA scores; total variance explained by the model was 12.0%. For ADAS-Cog 13, quadriceps strength explained an additional 5.4% of the variance; total variance explained by the model was 16.5%. Our current cross-sectional results suggest that the maintenance of muscle strength may be important for cognitive health in older adults who have suffered a stroke.