Function In Later Life Research Articles

Reading between the lines: the association between education, literacy, and dementia in a cohort of older South African adults

AbstractBackgroundThe relationship between education and cognitive function in later life has been widely studied, yet it remains uncertain whether the association is due to a true protective effect of education or to test‐taking skills developed through formal education. Literacy, as an objective measure of learning, may clarify this relationship, particularly in low‐ and middle‐income countries (LMIC) where the effect of education may be influenced by school attendance and quality. This study aimed to investigate: 1) the concordance between subjective and objective literacy measures and educational attainment, and 2) the ability of literacy to predict cognitive outcomes.MethodThis study utilized data from Wave 2 of the Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), a population‐based study in Agincourt, South Africa, and its dementia sub‐study (n = 559), collected in 2019‐2020 and 2018‐2019, respectively. Three measures of literacy (self‐report, short sentence reading, reading grade level test) were compared using Cohen’s kappa statistic. Multivariable seemingly unrelated regression (SUR) models were used to examine the association of literacy with cognitive test scores, adjusting for age, sex, and educational attainment. Additionally, multivariable logistic regression models were conducted to assess the independent effect of literacy on dementia risk, controlling for educational attainment.ResultThe Cohen’s kappa score between the three literacy measures was 0.615, indicating substantial agreement. The Cohen’s kappa score between the literacy measures and educational attainment was 0.608. SUR models revealed a statistically significant relationship (p‐value<0.05) between literacy and z‐standardized cognitive test scores in most tests. Literacy was associated with reduced risk of dementia beyond education, with a relative risk ratio of 0.13 (p‐value<0.001) for the literate vs. illiterate groups without education.ConclusionThis study highlights the importance of utilizing objective reading tests to measure literacy in populations, rather than relying solely on self‐reported literacy status. Results indicate that literacy is significantly associated with cognitive function, independent of educational attainment. This suggests that literacy skills acquired outside of formal education may reflect underlying protective factors, such as motivation and resilience, against dementia.

An exploration of the relationship between financial hardship and cognitive functioning in later life

AbstractBackgroundThere is a connection between stress and negative health outcomes including cognitive impairment. Few studies have examined the relationship between perceived financial hardship as a secondary stressor and cognitive function. This study aimed to test four indicators of perceived financial hardship and the impact on cognitive function among older adults.MethodsUsing data from four waves of the Health and Retirement Study of persons 65 years and older, we analyzed (N = 6612) across waves 1 and 2 using generalized linear regressions. There were four financial hardship variables (difficulty paying bills, food insecurity, taking less medication due to cost and ongoing financial strain). Cognitive status was conceptualized as a composite variable of episodic memory and mental status.ResultsResults suggests that all four financial hardships were associated with lower mental status scores with food insecurity having the strongest association of the four indicators.ConclusionThese findings highlight the negative effects of stress in later life. Even secondary stressors such as financial hardships do in fact tax the mental status of older persons. There are higher risks for cognitive impairments in older adults with financial hardships than those without financial hardships This study underlines the importance of interventions to reduce stress while also creating greater access to food and medications specifically.

Plasma glial fibrillary acidic protein mediated the association of midlife pulmonary function and cognition in later‐life: A causal mediation analysis in a longitudinal population‐based cohort

AbstractBackgroundEpidemiological evidence indicates that poorer pulmonary function (PF) may be linked to faster cognitive decline and a greater risk of dementia. Inflammation is one possible mediator between poor PF and cognitive decline. Plasma glial fibrillary acidic protein (GFAP,) as a marker of neurodegeneration and inflammation, may mediate the association of poor PF to poor cognitive function. The APOE ε4 is a marker of Alzheimer’s disease (AD) genetic susceptibility and may modify the PF‐cognition association with mediating factors. We aimed to prospectively examine whether GFAP mediates the association of mid‐life PF with cognition and whether the mediation effects differ by APOE ε4 carriership.MethodWe studied 1,001 participants (average midlife age of 50.5 years, 45% men) in the Age, Gene/Environment Susceptibility‐Reykjavik Study with midlife PF measures [forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC)] and blood draw and cognition measured on average 23 years later. Plasma GFAP levels were assayed using a Simoa HD‐1 analyzer. A general cognition score was created by principle component analysis using multiple cognitive tests. Causal mediation regression models were constructed to estimate GFAP’s mediation effect on the association between mid‐life PF and cognitive function in later life. Analyses were stratified by APOE ε4 status (yes/no). Models were adjusted for age, sex, education, smoking, BMI, and estimated glomerular filtration rate.ResultLow midlife FEV1 and FVC were related to poor general cognition in later life [β = 0.44 (95% CI = 0.28, 0.62) and β = 0.38 (95% CI = 0.22, 0.54), respectively]. Higher PF was associated with lower plasma GFAP levels. The proportion of the association between FEV1 on cognition mediated by plasma GFAP was 4.4% (95% CI = 1.0%–10.0%), and between FVC and cognition was 4.9% (95% CI = 0.8%–14.6%). The mediation effect was greater in the APOE‐ε4 allele carriers [14.4% (95% CI = 0.04%–60.9%) and 14.6% (95% CI = 1.0%–54.5%) for FEV1 and FVC, respectively].ConclusionLow PF in midlife may increase the risk for later cognitive problems. This study suggests poor PF may contribute to neuroinflammation (as measured by GFAP) over the long term, especially in individuals at genetic risk of AD.

Can emotional acceptance buffer the link between executive functioning and mental health in late life?

Emotional acceptance is thought to play an important role in protecting mental health. However, few studies have examined emotional acceptance among older adults who may experience declines in functioning, including executive functioning. The present laboratory-based study examined whether emotional acceptance and (to determine specificity) detachment and positive reappraisal moderated links between executive functioning and mental health symptoms in a sample of healthy older adults. Emotion regulation strategies were measured using questionnaire-based measures (using established questionnaires) as well as performance-based measures (instructing individuals to use emotional acceptance, detachment, and positive reappraisal in response to sad film clips). Executive functioning was measured using a battery of working memory, inhibition, and verbal fluency tasks. Mental health symptoms were measured using questionnaires to assess anxiety and depressive symptoms. Results showed that (a) emotional acceptance moderated the link between executive functioning and mental health such that lower executive functioning predicted higher levels of anxiety and depressive symptoms at low but not at high levels of emotional acceptance. Moderation effects tended to be (b) stronger for emotional acceptance compared to the other emotion regulation strategies (though not all comparisons were statistically significant). Findings were (c) robust when controlling for age, gender, and education for questionnaire-based (but not performance-based) emotional acceptance. These findings contribute to the literature on emotion regulation specificity and highlight the mental health benefits of emotional acceptance in the face of low executive functioning. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

APOE Genotype Modifies the Association between Midlife Adherence to the Planetary Healthy Diet and Cognitive Function in Later Life among Chinese Adults in Singapore

BackgroundIt remains unclear if adherence to the planetary healthy diet (PHD), designed to improve human and environmental health, is associated with better cognitive function in aging, and if this association differs by apolipoprotein E (APOE) genotype. ObjectivesWe aimed to examine the association between the PHD pattern and risk of poor cognitive function, and to further assess whether the APOE ε4 allele could modify this association. MethodsThe study included 16,736 participants from the Singapore Chinese Health Study. The PHD score was calculated using data from a validated 165-item food frequency questionnaire at baseline (1993–1998), with higher scores indicating greater adherence to the PHD. Cognitive function was assessed by the Singapore-modified Mini-Mental State Examination at follow-up 3 visits (2014–2016). A subset of 9313 participants had APOE genotype data. Logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs), with adjustment for potential confounders. ResultsWe identified 2397 (14.3%) cases of poor cognitive function. In the total population, OR (95% CI) of poor cognitive function for each one-SD increment in the PHD score was 0.89 (0.85, 0.93). Carriers of APOE ε4 allele had increased risk of poor cognitive function (OR: 1.36, 95% CI: 1.15, 1.61). There was a significant interaction between the PHD score and the APOE ε4 allele (P-interaction = 0.042). Each one-SD increment in the PHD score was significantly associated with lower risk of poor cognitive function (OR: 0.89; 95% CI: 0.83, 0.96) in non-carriers of APOE ε4 allele, but not in APOE ε4 allele carriers (OR: 1.04, 95% CI: 0.89, 1.23). ConclusionsMidlife adherence to the PHD was associated with reduced risk of poor cognitive function in later life. However, this was not observed in carriers of APOE ε4 allele who had higher risk of poor cognitive function.

66 Omega-3 Fatty Acids, Cognition, and Brain Volume in Healthy Elderly Adults

Objective:One common concern amongst the aging population is that of worsening memory. Speed of processing and executive functions are also areas of age-related decline that affect daily living. Lifestyle modifications such as diet, exercise, and sleep have garnered intense interest as potential methods to prevent or delay cognitive decline. Among dietary factors, omega-3 fatty acids (FAs) have been documented as containing a myriad of health benefits, including neuroprotective effects. The aim of this study is to examine the associations between omega-3 FAs, cognitive function, and neuroanatomical regions of interest in a healthy aging population.Participants and Methods:Adults aged 65 and older (n=40, 48.9% Female) were recruited for the Loma Linda University Adventist Health Study-2 Cognitive and Neuroimaging Substudy. Participants had a mean age of 76.25 years (SD=8.29), 16.78 years of education (SD=2.53), and were predominantly White (85.0%). Participants received a two-hour neurocognitive battery, including measures of immediate and delayed memory (Rey Auditory Verbal Learning Test, RAVLT; WMS-IV Logical Memory, LM), processing speed (Stroop), and executive functions (Stroop Color/Word). Participants underwent brain imaging on a 3T Siemens MRI, including a 3D T1-weighted MPRAGE sequence. Cortical reconstruction and volumetric segmentation were performed using FreeSurfer software. Blood samples were collected for fatty acid analysis. Individual FAs were expressed as a percent of total FAs. An omega-3 index was constructed as the sum of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) FAs. Correlational analyses, controlling for age, sex, and education, investigated relationships between omega-3 levels (individual and index) and (a) cognitive function (immediate and delayed memory, processing speed, executive functions), and (b) brain volumes in specific regions of interest (hippocampus, entorhinal cortex, frontal pole, white matter).Results:EPA was significantly positively correlated with Stroop Color (r=.34, p=.048). Although not statistically significant, trends were observed between the omega-3 index and Stroop Color (r=.30, p=.08), and between both DHA and the omega-3 index with RAVLT – delayed recall (r=.29, p=.095; r=.30, p=.08, respectively). With regards to regional brain volumes, EPA and the omega-3 index were both significantly positively correlated with the entorhinal cortex (r=.34, p=.041; r=.41, p=.01, respectively) and white matter volume (r=.36, p=.028; r=.34, p=.038, respectively). DHA was significantly positively correlated with white matter volume (r=.34, p=.044).Conclusions:Blood levels of EPA were positively correlated with a measure of processing speed, and trends were observed between DHA, the omega-3 index and[GN1] verbal memory, and between the omega-3 index and processing speed. We also found that omega-3 FA values were associated with greater brain volume in the entorhinal cortex and white matter in our sample of healthy older adults. Atrophy of the entorhinal cortex has been associated with pathological processes. Additionally, white matter is known to effect processing speed. These findings may offer support for the idea that omega-3 FAs exert their neuroprotective effects by fortifying areas of the brain, specifically the entorhinal cortex and white matter, that promote maintenance of cognitive function in late life.

24 Associations Between Positive Psychological Factors and Neurocognitive Functioning in Older Adults

Objective:Psychological wellness and strong cognitive skills are both important to successful aging. Although there are well-established relationships between psychiatric illness (e.g., depression, anxiety, PTSD) and cognitive dysfunction, few studies have focused on the relationships between positive psychological factors and neurocognitive function in older adults. Our goal was to explore associations between these two sets of measures in older adults.Participants and Methods:Participants (n=111) were part of a longitudinal study of biopsychosocial functioning in independently living older adult residents of a Continuing Care Senior Housing Community. Participants were administered a cognitive screening test (Montreal Cognitive Assessment; MoCA), a comprehensive neuropsychological battery, and a set of published self-report scales measuring positive emotional and psychological function. Neuropsychological scores were appropriately normed, and composite scores were calculated for the following domains: language (Boston Naming Test, Delis-Kaplan Executive Function System [D-KEFS] Verbal Fluency), attention/working memory (Wechsler Adult Intelligence Scale-IV [WAIS-IV] Digit Span, DKEFS Visual Scanning), learning and delayed recall (Brief Visuospatial Memory Test-Revised, Hopkins Verbal Learning Test-Revised), processing speed (WAIS-IV Coding, D-KEFS Trails Number and Letter Sequencing, D-KEFS Color-Word Interference Test Color and Word Naming), and executive function (D-KEFS Color-Word Inhibition and Inhibition/Switching, DKEFS Letter/Number Switching). Self-Report scales included the Perceived Stress Scale, Center for Epidemiological Studies in Depression Scale, Emotional Support Scale, Connor-Davidson Resilience Scale, Coping Humor and Self-Efficacy Scales, Personal Mastery Scale, Meaning in Life Scale, Self-Rated Successful Aging, Satisfaction with Life, Cognitive Failures Questionnaire, and Lifetime Orientation Test-Revised. Due to the large number of psychological functioning measures, dimension reduction was undertaken via principal component analysis, resulting in a two-factor solution. Bivariate Pearson correlations were then computed between the two factor scores and each neurocognitive variable.Results:Factor 1 consisted of variables reflecting Positive Subjective Functioning. A higher score on Factor 1 (indicating higher self-rating of successful aging, fewer perceived cognitive failures, fewer reported depressive symptoms, less perceived stress/anxiety, more perceived emotional support, more satisfaction with life, more meaningfulness in life, and more search for meaning in life) was associated with better attention/working memory (r=0.226, p=0.049) and executive function (r=0.242, p=0.035). Factor 2 consisted of variables that reflected Positive Coping Skills. A higher score on Factor 2 (indicating more happiness, higher optimism, greater resilience, higher sense of personal mastery, more use of humor as a coping strategy, and greater coping self-efficacy) was associated with better performance on tests of language (r=0.325, p=0.004), learning (r=0.313, p=0.006) and delayed recall (r=0.241, p=0.035) of visual and verbal information, and better MoCA performance (r=0.440, p<0.001). Neither factor was associated with processing speed.Conclusions:Higher levels of subjective functioning and positive outlook/coping skills were associated with better neuropsychological performance. Given that late life is a time of risk for cognitive decline, future research should consider the influence of positive psychological functioning on neurocognitive outcomes and vice versa, as these relationships may have neurobiological and therapeutic implications for overall function in later life.

Race, everyday discrimination, and cognitive function in later life.

Discrimination is pernicious in many ways, but there are inconsistent findings regarding whether it is harmful to cognitive function in later life. To address the inconsistency, we use two closely related concepts of everyday discrimination to predict cognitive trajectories in a diverse sample. Using data from the Health and Retirement Study (HRS), we examine whether the frequency of discrimination, measured at baseline with six questions, is related to poorer cognitive function and change in function over time (2008-2016). Age at baseline ranged from 53 to 100. Growth curve models of initial cognitive function and change in function were estimated. Everyday global discrimination was associated with poorer initial cognition and slower declines over time, and these relationships were not moderated by race and ethnicity. By contrast, the relationship between everyday racial discrimination and cognition was moderated by race: more frequent everyday racial discrimination was associated with better initial cognitive function among Black adults but not among Hispanic and White adults. Discrimination is a multifaceted concept, and specific types of discrimination manifest lower or higher cognitive function during later life for White, Black, and Hispanic adults.

Association between Loneliness and Memory Function through White Matter Hyperintensities in Older Adults: The Moderating Role of Gender.

Loneliness has an important impact on memory function in late life. However, the neural mechanism by which loneliness detrimentally influences memory function remains elusive. Furthermore, it remains unclear whether the association between loneliness and memory function varies by gender. The current study aimed to investigate the neural mechanism underlying the association between loneliness and episodic memory function and explore whether it varies with gender among cognitively normal older adults. A total of 173 community-dwelling adults aged 60 years or older from the Korean Social Life, Health, and Aging Project (KSHAP) study (mean age = 71.87) underwent an assessment of loneliness, neuropsychological testing, and structural magnetic resonance imaging. The association between loneliness and episodic memory function was mediated by the volume of white matter hyperintensities (WMHs), but not by hippocampal or gray matter volumes. In addition, the association between loneliness and memory function through WMHs was significantly moderated by gender; specifically, the indirect effect was significant among men but not among women. The study suggests that WMHs may be a potential neurological mechanism that causes late-life memory dysfunction associated with loneliness in older men. The findings underscore the need for gender-specific interventions to mitigate memory impairment associated with late-life loneliness, with significant public health implications.

Economic insecurity exposure and cognitive function in late life

ObjectivesThis study took the State-owned Enterprises (SOE) reform from 1996 to 2002 in China as a natural experiment to explore the consequences of economic insecurity exposure during early-adulthood and mid-adulthood...

Male minipuberty in human and non-human primates: planting the seeds of future fertility.

Minipuberty is a transient activity period of the hypothalamic-pituitary-gonadal axis in the postnatal and infant period including surging serum concentrations of reproductive hormones. Increasing evidence points to an important role of this period for maturation of the testes and thereby for male reproductive function. Minipuberty is a transient activity period of the hypothalamic-pituitary-gonadal (HPG) axis in the postnatal and infant period in humans and non-human primates. Hallmarks of this period are surging serum concentrations of reproductive hormones. While in females, the role of minipuberty seems to be dispensable for future fertility, in males, it is significantly associated with reproductive function in later life. In males, this activity period promotes further masculinization, including testicular and penile growth, as well as completion of testicular descent if not already achieved at birth. At the testicular level, both, somatic and germ cells undergo proliferation and partial maturation during this period. Minipuberty is thought to prime male gonadal tissue for subsequent growth and maturation. Notably, perturbed or absent minipuberty is associated with reduced male reproductive function in adulthood. While the sustained HPG axis activity during adulthood is known to control reproductive function, minipuberty appears to be a prerequisite for obtaining full male reproductive function in later life, thereby determining future fertility potential, i.e. the ability to father a child. This review maps the role of male minipuberty for reproductive function and presents suitable animal models to study minipuberty. Also, it describes the development and maturation of testicular cell types, discusses short- and long-term effects of minipuberty and highlights future research perspectives.

Switching it up: Activity diversity and cognitive functioning in later life.

Participating in a broad and balanced range of daily activities (i.e., activity diversity) has been associated with better cognitive functioning in later life. One possible explanation for this finding is that high levels of activity diversity are merely a proxy for being more physically active, a factor robustly linked to cognitive health. The present study examined whether activity diversity has a unique association with cognitive functioning beyond physical movement. Community-dwelling older adults (N = 252, Mage = 73.55 years, SD = 6.39) completed a cognitive battery and then responded to ecological momentary assessments of their participation in 10 common activity types (e.g., reading, chores, social visits) every 3 hr for 5-6 days. They also wore accelerometers to track daily physical movement. Multiple regression models revealed that greater diversity in daily activities was related to higher cognitive functioning even after adjusting for physical movement and other covariates such as education level. This study further clarifies the unique relationship of activity diversity, beyond physical movement, with cognition. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Negative wealth shocks in later life and subsequent cognitive function in older adults in China, England, Mexico, and the USA, 2012–18: a population-based, cross-nationally harmonised, longitudinal study

Household wealth is positively related to cognitive health outcomes in later life. However, the association between negative wealth shocks and cognitive function in later life, and whether this association might differ across countries at different levels of economic development, is unclear. We aimed to investigate whether negative wealth shocks in later life are associated with cognitive function in older adults in China, England, Mexico, and the USA, and whether this association is modified by country income level. For this population-based, cross-nationally harmonised, longitudinal study, data were analysed from core interviews of the population-based US Health and Retirement Study (2012 and 2016) and its partner studies in China (the China Health and Retirement Longitudinal Study; 2015 and 2018), England (the English Longitudinal Study of Ageing; 2012 and 2016), and Mexico (Mexican Health and Aging Study; 2012 and 2015-16), and their respective Harmonized Cognitive Assessment Protocols (HCAPs). Negative wealth shocks over the follow-up periods of the respective cohorts were defined in two ways: an extreme loss of 75% or greater from the baseline amount of wealth, and a decline in within-population wealth quintile rank. The primary outcome was the harmonised general cognitive function (GCF) factor score, which was constructed with factor analysis on the HCAP neuropsychological assessments of memory, orientation, attention, executive function, and verbal fluency performance (mean 0; SD 1). We used sampling-weighted, multivariable-adjusted linear models to examine associations. Data from 9465 participants were included in this analysis: 3796 from China, 1184 from England, 1193 from Mexico, and 3292 from the USA. The mean baseline age of participants was 68·5 (SD 5·4) years in China (49·8% women), 72·0 (7·0) years in England (54·6% women), 70·6 (6·8) years in Mexico (55·1% women), and 72·7 (7·5) years in the USA (60·4% women). A wealth loss of 75% or greater was negatively associated with subsequent cognitive function in the USA (β -0·16 SD units; 95% CI -0·29 to -0·04) and China (-0·14; -0·21 to -0·07), but not in England (-0·01; -0·24 to 0·22) or Mexico (-0·11; -0·24 to 0·03). Similarly, within-population wealth quintile rank declines were negatively associated with subsequent cognitive function in the USA (β -0·07 per quintile rank decline; 95% CI -0·11 to -0·03) and China (β -0·07; -0·09 to -0·04), but not in England (-0·05; -0·11 to 0·01) or Mexico (-0·03; -0·07 to 0·01). The impact of wealth shocks in later life on subsequent lower level of cognitive function of older adults in China, England, Mexico, and the USA differed across macro-level socioeconomic structures. These findings suggest that government policies and social safety nets in countries with different levels of economic development might have a role in protecting older adults from adverse health effects of wealth losses in later life. US National Institute on Aging, US National Institutes of Health.

Wealth shocks and cognitive function in later life

Wealth shocks and cognitive function in later life

Comparing the cognitive functioning of middle-aged and older foreign-origin population in Estonia to host and origin populations.

In migration and health research, the healthy migrant effect has been a common finding, but it usually pertains to specific contexts only. Existing findings are inconsistent and inconclusive regarding the cognitive functioning of the (aging) foreign-origin population relative to the populations of their host and sending countries. Moreover, this comparison is an understudied design setting. We analyze the outcomes and associations of cognitive functioning outcomes of the non-institutionalized middle-aged and older population, comparing the Russian-origin population in Estonia with Estonians in Estonia and Russians in Russia in a cross-sectional design. We aim to estimate the (long-term) effects of migration on cognitive functioning in later life, contextualizing the findings in previous research on the healthy migrant effect. We use data from face-to-face interviews conducted within the SHARE Estonia (2010-2011) and SAGE Russia (2007-2010) surveys. Respondents aged 50+ living in urban areas were grouped by self-identified ethnicity, including 2,365 Estonians, 1,373 Russians in Estonia, and 2,339 Russians in Russia (total N = 6,077). Cognitive functioning was measured using a 25-percentile cut-off threshold for the results of two cognition outcomes - immediate recall and verbal fluency - and the odds of impairment were estimated using binary logistic regression. Russian men and women living in Estonia have significantly higher odds of impairment in immediate recall than Estonian men and women, though they do not differ from Russians in Russia in the final adjusted models. The differences between all groups are non-significant if age at migration is considered. There are no significant differences between the groups in verbal fluency. Contrary to the commonly found healthy migrant effect, the middle-aged and older foreign-origin population in Estonia fares initially worse than the native population in the immediate recall outcome, but does not differ from their sending country population, possibly due to Russia's higher mortality rate and therefore the selective survival of healthier people. Different results depending on the cognitive functioning outcome suggest that migration may affect temporary memory more than crystallized knowledge. However, there are no differences between the groups if defined based on age at migration, which suggests that the age profile differences explain most of the groups' differences in cognitive functioning.

Biological expressions of early life trauma in the immune system of older adults.

Poor immune function is associated with increased risk for a number of age-related diseases, however, little is known about the impact of early life trauma on immune function in late-life. Using nationally representative data from the Health and Retirement Study (n = 5,823), we examined the association between experiencing parental/caregiver death or separation before age 16 and four indicators of immune function in late-life: C-reactive Protein (CRP), Interleukin-6 (IL-6), soluble Tumor Necrosis Factor (sTNFR), and Immunoglobulin G (IgG) response to cytomegalovirus (CMV). We also examined racial/ethnic differences. Individuals that identified as racial/ethnic minorities were more likely to experience parental/caregiver loss and parental separation in early life compared to Non-Hispanic Whites, and had poorer immune function in late-life. We found consistent associations between experiencing parental/caregiver loss and separation and poor immune function measured by CMV IgG levels and IL-6 across all racial/ethnic subgroups. For example, among Non-Hispanic Blacks, those that experienced parental/caregiver death before age 16 had a 26% increase in CMV IgG antibodies in late-life (β = 1.26; 95% CI: 1.17, 1.34) compared to a 3% increase in CMV antibodies among Non-Hispanic Whites (β = 1.03; 95% CI: 0.99, 1.07) controlling for age, gender, and parental education. Our results suggest a durable association between experiencing early life trauma and immune health in late-life, and that structural forces may shape the ways in which these relationships unfold over the life course.

The Epidemiology and Societal Impact of Aging-Related Functional Limitations: A Looming Public Health Crisis.

Functional impairment and disability become increasingly common with aging. As more people are reaching old age, the number of people needing care will rise, creating a crisis of need for care. Population studies and clinical trials have demonstrated the importance of the detection of early loss of strength and walking speed in predicting disability and in designing interventions to prevent functional decline. There is a large societal burden linked to age-related disorders. Physical activity is to date the only intervention that has prevented disability in a long-term clinical trial, but is difficult to sustain. Novel interventions are needed to maintain function in late life.

Association of Type 2 Diabetes Mellitus with Cognitive Function in Adults: A Prospective Cohort Study.

The Cognitive role of untreated type 2 diabetes mellitus (T2DM) has been less well substantiated. We sought to explore the prospective association of T2DM and untreated T2DM with cognitive function among middle-aged and older Chinese adults. Data of 7,230 participants without baseline brain damage/mental retardation, or memory-related diseases in China Health and Retirement Longitudinal Study (CHARLS) from 2011- 2012 to 2015, were analyzed. Fasting plasma glucose and self-reported information on T2DM diagnosis and treatment were assessed. Participants were categorized into normoglycemia, impaired fasting glucose (IFG), and T2DM (including untreated and treated T2DM) groups. Episodic memory and executive function were assessed by modified Telephone Interview for Cognitive Status every two years. We used generalized estimating equation model to examine the association of baseline T2DM status with cognitive function in succeedingyears. Compared to those with normoglycemia, T2DM was associated with worse overall cognitive function after controlling for demographic variables, lifestyles, follow-up time, major clinical factors, and baseline cognitive function, although the associations were statistically non-significant (β= -0.19, 95% CI: -0.39, 0.00). However, a significant association was mainly observed for those with untreated T2DM (β= -0.26, 95% CI: -0.47, -0.04), especially in the domain of executive function (β= -0.19, 95% CI: -0.35, -0.03). In general, IFG and treated T2DM individuals had similar levels of cognitive function with normoglycemia participants. Our findings supported a detrimental role of untreated T2DM on cognitive function among middle-aged and older adults. Screening and early treatment for T2DM are warranted for maintaining better cognitive function in later life.

The association between MIND diet and cognitive function among Chinese middle aged and older adults: A 9‐year longitudinal study

AbstractBackgroundEvidence on the association of Mediterranean‐DASH Intervention for Neurodegenerative Delay (MIND) diet with cognitive function is limited. This study examined how MIND diet is related to cognitive function among Chinese middle aged and older adults.MethodThis longitudinal study comprised 4066 participants aged ≥55 years from the China Health and Nutrition Survey in 1997. Dietary assessment (using 3‐day 24‐hour dietary recalls) and cognitive tests (using modified Telephone Interview for Cognitive Status) were conducted repeatedly from 1997 to 2006. The study MIND diet score was calculated based on 9 healthy food groups and 3 unhealthy food groups. Linear mixed‐effects models were used to investigate the relation of MIND diet adherence to cognitive function (z‐score).ResultThe median MIND score was 4.5 (range: 0‐12) among overall participants at baseline. During a mean follow‐up of 5.9 years, participants with higher scores of MIND diet had significant better global cognitive function in subsequent years. In the multivariable‐adjusted model, the regression coefficients (95% CI) across the tertiles of MIND score were 0 (ref), 0.01 (‐0.03, 0.06), and 0.07 (0.02, 0.11), respectively. For dietary components, highest consumption (T3 vs T1) of nuts (β = 0.24, 95% CI: 0.09, 0.38), fish (β = 0.11, 95% CI: 0.05, 0.16), poultry (β = 0.09, 95% CI: 0.03, 0.16), red meat (β = 0.09, 95% CI: 0.05, 0.14), tea (β = 0.08, 95% CI: 0.03, 0.13), and green leafy vegetable (β = 0.04, 95% CI: ‐0.00, 0.09) were associated with better global cognitive function, whereas highest intake of fried food (β = ‐0.18, 95% CI: ‐0.26, ‐0.10), pastries and sweets (β = ‐0.07, 95% CI: ‐0.16, 0.02) demonstrated opposite associations. Furthermore, the beneficial association of MIND diet with cognitive function was stronger among residents in rural areas, soutern areas, and among illiterate participants though significant effect modifications were not observed.ConclusionOur findings suggest that higher adherence to MIND diet was associated with better cognitive function in later life. Further research is warranted to confirm the findings and to investigate the underlying mechanisms.

Association of type 2 diabetes mellitus and its management with cognitive function in adults: A prospective cohort study

AbstractBackgroundType 2 Diabetes Mellitus (T2DM) has been associated with lower levels of cognitive function in older adults. However, evidence on the potential role of T2DM management in age‐related cognitive function is limited. To explore the prospective association of T2DM and its management with cognitive function among middle‐aged and older Chinese adults.MethodThis study included 7,230 participants without baseline brain damage, mental retardation, or memory‐related diseases from the China Health and Retirement Longitudinal Study (CHARLS) in 2011‐2012. Fasting plasma glucose and self‐reported information on T2DM diagnosis and treatment was assessed at baseline. Participants were then categorized into normoglycemia, impaired fasting glucose (IFG), and T2DM (including untreated T2DM and treated T2DM) groups. Cognitive function, including episodic memory and executive function, was assessed by the modified Telephone Interview for Cognitive Status (TICS) every two years until 2015. We used the generalized estimating equation (GEE) model to examine the association of baseline T2DM status and cognitive function in succeeding years.ResultCompared to those with normoglycemia, participants with T2DM tended to have lower level of overall cognitive function (β = ‐0.23, 95% CI: ‐0.43, ‐0.02) after controlling for demographic variables, lifestyles, follow‐up time, and major clinical factors. In particular, the strong association was mainly observed for those with untreated T2DM (β = ‐0.31, 95% CI: ‐0.54, ‐0.07), especially in the domain of executive function (β = ‐0.22, 95% CI: ‐0.39, ‐0.06) and among those ≥60 years (β = ‐0.58, 95% CI: ‐0.91, ‐0.23). In general, individuals with IFG and treated T2DM had similar levels of cognitive function with normoglycemia participants.ConclusionOur findings supported the detrimental role of T2DM especially untreated T2DM in cognitive function among middle‐aged and older adults. Screening and early treatment for T2DM are warranted for maintaining better cognitive function in later life.