Cognitive Disparities Research Articles

Abstract MP28: Life’s Simple 7 and Incident Cognitive Impairment: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

HYPOTHESIS. We hypothesized that higher scores on Life’s Simple 7 (LS7), a composite measure of cardiovascular health, are associated with lower incidence of cognitive impairment in the absence of stroke, and that this association differs by race and geographic region. METHODS. We included REGARDS participants aged 45+ who at baseline were cognitively normal by the Six-Item Screener (SIS) and free of stroke. We censored participants at incident stroke. We calculated baseline LS7 score, ranging from 0 points (worst) to 14 points (best), from smoking, BMI, physical activity, diet, cholesterol, blood pressure, and fasting glucose. We defined incident cognitive impairment as (1) scoring ≤4 of 6 points on the most recent follow-up SIS, or (2) scoring ≥1.5 standard deviations below age, sex, race, and education-adjusted means on the most recent of at least 2 of 3 domain-specific cognitive tests. We calculated age, sex, race, and education-standardized percentages of participants with incident impairment by LS7 score tertiles, and age, sex, race, education, and region-adjusted odds ratios by tertiles and per 1 point higher LS7 score. We repeated analyses by race (black/white) and region (southeastern US stroke belt/nonbelt). RESULTS. The distribution of LS7 scores was higher in whites than blacks and outside the stroke belt than within the stroke belt. Incidence of cognitive impairment was lower at higher LS7 scores (Table). This inverse association was stronger for cognitive domain testing than for SIS. For SIS, we observed an inverse association among whites and outside the stroke belt, but not among blacks or within the stroke belt. For cognitive domain testing, the inverse association was similar across race and region. CONCLUSIONS. Favorable LS7 scores are associated with lower incidence of cognitive impairment, particularly as assessed by cognitive domain testing. Racial and regional differences in cardiovascular health and its association with cognitive impairment may contribute to cognitive impairment disparities.

The Impact of Wealth on the Cognitive Development of Children Who Were Preterm Infants

: The purpose of this study was to explore the influence wealth has on cognitive development in 2-year-old children who were born preterm, and to determine whether racial/ethnic differences in wealth explained disparities in cognitive development. : A nationally representative sample of 1400 children who were born between 22 and 36 weeks' gestation. : Cohort study. : Secondary data analysis of the Early Childhood Longitudinal Survey-Birth Cohort (ECLS-B). The ECLS-B was a prospective national longitudinal study of infants born in the United States during the calendar year 2001 drawn from birth certificates in the United States. : The impact wealth (parental homeownership and investments) had on cognitive development at 2 years and whether wealth eliminated the cognitive disparity seen between white, African American, and Hispanic children. : Wealth (homeownership and investments) did not have an independent effect on cognitive development, but it did eliminate the disparity between white children and African American children (P ≥ .05). However, wealth did not eliminate the disparity in cognitive development between white children and Hispanic children. Hispanic children scored 3.91 points lower than white children (P ≤ .001). : In contrast to other follow-up studies showing persistent differences in cognitive development between white children and African American children, this study found that wealth indicators attenuated the difference. Wealth may be a more accurate proxy for socioeconomic status in studying factors influencing cognitive outcomes in children born preterm than just using measures such as maternal education and income. In future follow-up studies of multiracial preterm children, indicators that represent wealth should be included for an accurate representation of social economic status.

Cognitive disparities, lead plumbing, and water chemistry: Prior exposure to water-borne lead and intelligence test scores among World War Two U.S. Army enlistees

Higher prior exposure to water-borne lead among male World War Two U.S. Army enlistees was associated with lower intelligence test scores. Exposure was proxied by urban residence and the water pH levels of the cities where enlistees lived in 1930. Army General Classification Test scores were six points lower (nearly 1/3 standard deviation) where pH was 6 (so the water lead concentration for a given amount of lead piping was higher) than where pH was 7 (so the concentration was lower). This difference rose with time exposed. At this time, the dangers of exposure to lead in water were not widely known and lead was ubiquitous in water systems, so these results are not likely the effect of individuals selecting into locations with different levels of exposure.

Disparities in pain, cognition, and negative affect among African Americans, Hispanics and non-Hispanic Whites with Arthritis

Arthritis is a common, debilitating joint disease causing functional limitations in activities of daily living, and health-related quality of life. This study examined pain, cognition and negative affect among African Americans, Hispanics and non-Hispanic Whites with arthritis. A screened sample of 6364, community-dwelling adults, within Miami-Dade and Broward counties in Florida responded to a telephone survey. A total of 1280 respondents with rheumatoid or osteoarthritis participated in the study. The study was subset of a larger, longitudinal investigation examining race/ethnicity and gender associations underlying decisions to seek health care or self-manage pain. There was a significant difference for pain ratings by race/ethnicity (F=3.245, p.=.012). African Americans reported greater pain intensity from osteo and rheumatoid arthritis compared to Hispanics and non-Hispanic Whites; although there was no significant group difference between African Americans and Hispanics. Hispanics reported greater osteo and rheumatoid arthritis pain ratings compared to non-Hispanic Whites. Hispanics also reported greater negative emotions and cognition compared to non-Hispanic Whites (F= 10.425, p<.001) with osteoarthritis. Similarly, there was a significant difference in negative emotions among Black compared to Whites (F=5.014, p=.002). Black males reported greater negative emotions compared to non-Hispanic whites and females. There was a significant difference in pain ratings for women compared to males (F=8.661, p.<.001), with women reporting higher pain ratings. Women also reported greater negative emotions and cognition for rheumatoid arthritis when compared to males, although the difference was not significant, and also reported greater functional impairment compared to males (F=3.327, p.=.036). Pain has a debilitating functional and emotional impact upon women and minorities with osteo and rheumatoid arthritis. Such disparities suggest the need for continued research to explicate factors contributing to race/ethnic and gender/sex group differences in pain and arthritis-related health disparities. (This work was supported by NIH-NIDCR grant RO1-015581.) Arthritis is a common, debilitating joint disease causing functional limitations in activities of daily living, and health-related quality of life. This study examined pain, cognition and negative affect among African Americans, Hispanics and non-Hispanic Whites with arthritis. A screened sample of 6364, community-dwelling adults, within Miami-Dade and Broward counties in Florida responded to a telephone survey. A total of 1280 respondents with rheumatoid or osteoarthritis participated in the study. The study was subset of a larger, longitudinal investigation examining race/ethnicity and gender associations underlying decisions to seek health care or self-manage pain. There was a significant difference for pain ratings by race/ethnicity (F=3.245, p.=.012). African Americans reported greater pain intensity from osteo and rheumatoid arthritis compared to Hispanics and non-Hispanic Whites; although there was no significant group difference between African Americans and Hispanics. Hispanics reported greater osteo and rheumatoid arthritis pain ratings compared to non-Hispanic Whites. Hispanics also reported greater negative emotions and cognition compared to non-Hispanic Whites (F= 10.425, p<.001) with osteoarthritis. Similarly, there was a significant difference in negative emotions among Black compared to Whites (F=5.014, p=.002). Black males reported greater negative emotions compared to non-Hispanic whites and females. There was a significant difference in pain ratings for women compared to males (F=8.661, p.<.001), with women reporting higher pain ratings. Women also reported greater negative emotions and cognition for rheumatoid arthritis when compared to males, although the difference was not significant, and also reported greater functional impairment compared to males (F=3.327, p.=.036). Pain has a debilitating functional and emotional impact upon women and minorities with osteo and rheumatoid arthritis. Such disparities suggest the need for continued research to explicate factors contributing to race/ethnic and gender/sex group differences in pain and arthritis-related health disparities. (This work was supported by NIH-NIDCR grant RO1-015581.)

Does Conflict Shatter Trust or Does Trust Reduce Conflict in Teams? Revisiting the Relationships between Team Diversity, Conflict, Trust and Team

This paper explores the interplay between trust and conflict - two important emergent states in teams - as antecedents of team effectiveness. Two alternative path models are tested in a sample of 139 teams (729 respondents), with the emergent states (task conflict, relationship conflict and trust) acting as mediators between on the one hand team demographic variety (gender and nationality) and cognitive disparity (knowledge and cognitive motivation) and on the other perceived team effectiveness. In one model trust is considered as an antecedent for the two types of conflict, while in the other the two types of conflict precede the emergence of trust. Both models fitted the data well and received equally strong support. These results are interpreted using the complex adaptive system perspective. In line with this framework we argue that the interplay between these emergent states is much more complex than a simple unidirectional causation.

The effects of groups' variety and disparity on groups' cognitive complexity.

This study examined the influence of group diversity conceptualized as disparity and as variety on group cognitive complexity. Data on individual cognitive complexity and group cognitive complexity were collected in 44 groups using a conceptual mapping technique. Also data on the quality of teamwork processes and satisfaction were collected using an individual questionnaire. The results indicate that (a) gender variety has a positive impact on group cognitive complexity, (b) cognitive disparity has a negative impact on group cognitive complexity, and (c) groups with a high average individual cognitive complexity have the highest cognitive complexity as a group only if the quality of their interactions is high.

Cognitive disparity in schizophrenics with and without cocaine dependency

Although cognition has been investigated in individuals with schizophrenia and in non-schizophrenic cocaine abusers, few studies have focused on cocaine-abusing schizophrenics. Previous studies have shown contradictory results despite the fact that individuals with schizophrenia and cocaine dependence have worse long-term outcomes, and that each disorder separately is associated with neuropsychological impairment. The present study intended to clarify these inconsistencies with a comprehensive neuropsychological battery. Twenty-four cocaine-dependent schizophrenics and 23 non-drug abusing schizophrenics were recruited from the VA. Participants were administered tests focusing on motor skills, processing speed, attention, concentration, and executive functioning. While individuals with schizophrenia and cocaine dependence performed worse on the Grooved Peg Board and the Stroop A, the non-drug abusing schizophrenics performed worse on Trails Part A and B. However, a MANOVA failed to show group differences in overall neuropsychological performance. These findings are similar to the existing literature and suggest that cocaine may compromise motor functioning.