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Bilingualism delays the onset of dementia symptoms and contributes to cognitive reserve. However, the neural basis of this mechanism remains elusive. The few studies that have investigated neural mechanisms of cognitive reserve and bilingualism have focused on Alzheimer’s disease. This study investigated the neural basis of cognitive reserve among persons with frontotemporal dementia (FTD) using regional brain volumes. Sixty-eight persons with FTD (42 bilinguals and 26 monolinguals) were included. After propensity score matching for age, sex, education, FTD subtype and clinical severity, there were 26 bilinguals and 26 monolinguals. The results showed that bilinguals had reduced thalamic volume compared to monolinguals despite having similar cognitive performance. The results indicate that bilinguals were able to tolerate more severe atrophy compared to monolinguals while maintaining comparable cognitive abilities. Our study therefore suggests that bilingualism contributes to cognitive reserve in persons with FTD.
This study aimed to refine the content of a new patient-reported outcome (PRO) measure via cognitive interviewing techniques to assess the unique presentation of depressive symptoms in older adults with cancer (OACs).
Methods
OACs (≥ 70years) with a history of a depressive disorder were administered a draft measure of the Older Adults with Cancer – Depression (OAC-D) Scale, then participated in a semi-structured cognitive interview to provide feedback on the appropriateness, comprehensibility, and overall acceptability of measure. Interviews were audio-recorded and transcribed, and qualitative methods guided revision of scale content and structure.
Results
OACs (N = 10) with a range of cancer diagnoses completed cognitive interviews. Participants felt that the draft measure took a reasonable amount of time to answer and was easily understandable. They favored having item prompts and response anchors repeated with each item for ease of completion, and they helped identify phrasing and wording of key terms consistent with the authors’ intended constructs. From this feedback, a revised version of the OAC-D was created.
Significance of results
The OAC-D Scale is the first PRO developed specifically for use with OACs. The use of expert and patient input and rigorous cognitive interviewing methods provides a conceptually accurate means of assessing the unique symptom experience of OACs with depression.
We conducted a detailed linguistic analysis of Oral Proficiency Interviews (OPIs) from older Spanish-English bilinguals (n = 28) to determine which cognitive, linguistic, and demographic factors predict proficiency. In the dominant language, older age was associated with lower proficiency scores, but aging effects were not significant after accounting for cognitive functioning scores. In the nondominant language, bilinguals with larger vocabulary scores, fewer speech errors, and higher education levels obtained higher proficiency scores. Multiple linguistic submeasures from the OPIs were highly correlated across languages (e.g., fast speakers spoke fast in both languages), but these same measures exhibited significant language dominance effects (e.g., bilinguals spoke faster in the dominant than in the nondominant language). These results suggest it is critical to control for cognitive functioning when examining aging effects on language production, reveal powerful individual differences that affect how people talk regardless of language, and validate the use of the OPI to measure bilingual proficiency.
Elder abuse (EA) often remains hidden, and many victims do not interact with formal systems. Concerned persons (CPs) are family, friends, and neighbours who play an essential role in supporting EA victims.
Objective
The aim of this study was to understand CPs’ role and help-seeking experiences.
Methods
Nineteen self-identified CPs shared their experience of being involved in an EA case via an interview and/or survey, with responses analysed qualitatively.
Findings
CPs were primarily the victims’ female relatives, often related to the perpetrator, and had sought help from a wide range of formal and informal sources, facing many barriers in protecting victims from harm. Challenges commonly related to formal services and EA perpetrators. Through knowing about the abuse and/or seeking help, participants experienced negative impacts, particularly psychological ones.
Discussion
Findings suggest that CPs can play a key role in supporting EA victims but require further support and recognition from services to fulfil this role.
Home care aims to reduce harmful effects of poor health and increase well-being.
Objective
We studied whether receiving formal or informal home care was associated with changes in satisfaction with life (SwL).
Methods
The study includes people aged 70+ who participated in the Canadian Longitudinal Study on Aging (CLSA) at baseline and three-year follow-up. Linear regression models adjusted for individual factors were used to examine the relationship between home care and changes in SwL at two time points.
Results
Receiving home care was associated with declining SwL. The association was different for formal and informal care, and to some extent, for men and women. Changes in health mainly explained the association of SwL with formal but not informal care.
Discussion
The connection between home care and declining SwL suggests that some people’s needs are not met, especially by informal care, which negatively affects life satisfaction. This finding deserves more attention when planning home-based care.
Japan is shrinking. Current projections indicate a population decrease of around one quarter by mid-century. Depopulation is potentially good news, providing opportunities for reconfiguring living conditions and alleviating human-environmental pressures. Nevertheless, ageing and depopulation have outcomes that require adjustment. One of these is spatial inequalities, which have been accelerating since the 1990s. Japan is the Asia-Pacific’s pioneer ageing and shrinking society. In East Asia both China and South Korea are ageing and expected to begin shrinking soon. Even high immigration Anglophone countries such as New Zealand are experiencing post-growth demographic processes at subnational level. Japan’s significance is in how adaptive responses there inform prospects for others as they experience their own post-growth pathways. This article presents case studies of Sado Island in Japan and New Zealand’s South Island in a comparative qualitative analysis of rural agency under population decline. Overall, I contend there is potential for benefitting from demographic shrinkage - what I term a ‘depopulation dividend’ - and for rural regions in the Asia-Pacific to progress towards a sustainable post-growth economy and society.
The ability to understand and speak more than one language (i.e., bilingualism) may provide benefits to preserving social cognition against normal age-related deteriorations. This study examined how variations in bilingual language experience influence theory-of-mind (ToM) understanding in late adulthood. One hundred and five cognitively healthy older adults (Mage = 66.23 years, range = 56–79) and 80 young adults (Mage = 22.03 years, range = 19–30), who were bilingual speakers, completed a ToM task battery, a self-report questionnaire on their language background, and a battery of general cognition assessments. We found an overall age-related decline in ToM, where older adults made more errors in inferring others’ mental states compared with young adults. Importantly, an earlier L2 age of acquisition (L2AoA) predicted better ToM performance among older adults, over and above the effects of age, education, and general cognition. The results suggest that early bilingual acquisition may enhance social cognitive processes during development and contribute to intact ToM abilities in older adult bilinguals.
Cumulative exposure to anticholinergic and sedative medications has been associated with worsening physical function in older adults. We evaluated the feasibility of measuring physical function using wearable devices and explored the impact of reducing the anticholinergic and sedative medication burden in a pilot study of community-dwelling adults aged 60 years and older. Evaluations included the 10-meter walk test (10MWT), the Short Physical Performance Battery (SPPB), and the mini-BESTest. Two participants/month were recruited in one clinic in 2022. The five participants had a median age of 67, a median DBI of 1.7, and four were female. The feasibility analysis showed that the 10MWT and SPPB tests were completed on 12/12, and the mini-BESTest on 11/12. An exploratory analysis showed clinically meaningful improvements in gait speed (mean +0.18 m/s) and SPPB (mean +2.2 points). We showed the feasibility of measuring physical function by wearable devices during deprescribing of anticholinergic and sedative medications.
Independence in everyday functioning has been associated with successful aging and declines in functioning may be indicative of pathological cognitive decline. Social determinants of health, like economic status and access to health care, a]lso play a role in everyday functioning. Understanding these factors are of particular importance for older Black adults who have had long-standing disparate access to care, education, and treatments. The current study aimed to evaluate social determinants of health, more specifically social engagement, as moderators of the association between cognition and everyday functioning.
Method:
A sample of 930 older Black adults from Rush University: The Memory and Aging Project, African American Clinical Core, and Minority Adult Research Study were used. Participants completed a battery of neuropsychological testing as well as questionnaires about their everyday functioning and social behaviors. Hierarchical linear regressions were utilized to determine to what extent social factors moderated the relationship between cognition and everyday functioning.
Results:
Late life social activity reduced the effect of global cognition on everyday functioning and was independently associated with everyday functioning. Social network size was associated with increased impairment.
Conclusion:
Results from the current study provide novel information regarding the role of social interaction on cognition in an older Black adult sample. Future interventions may benefit from an emphasis on increasing social engagement.
Fully updated and revised, Cognitive and Social Neuroscience of Aging, 2nd Edition provides an accessible introduction to aging and the brain. Now with full color throughout, it includes over fifty figures illustrating key research findings and anatomical diagrams. Adopting an integrative perspective across domains of psychological function, this edition features expanded coverage of multivariate methods, moral judgments, cognitive reserve, prospective memory, event boundaries, and individual differences related to aging, including sex, race, and culture. Although many declines occur with age, cognitive neuroscience research reveals plasticity and adaptation in the brain as a normal function of aging. With this perspective in mind, the book emphasizes the ways in which neuroscience methods have enriched and changed thinking about aging.
This research aimed to comprehensively explore the impact of diverse challenges encountered by older adults on the development of post-traumatic stress disorder (PTSD). It delved into how these effects vary depending on individuals’ levels of trust in authority and medical professionals, providing a nuanced understanding of the interplay between external challenges, personal trust, and mental health outcomes in the older population.
Background:
The COVID-19 pandemic has imposed significant hardships, particularly on the ageing population, with potential psychological repercussions such as PTSD. Notably, there is a dearth of research exploring this association within the context of Chinese older adults, a group that may experience unique impacts due to cultural differences in the face of global crises.
Methods:
Data were collected from a representative sample of 1,211 participants aged 60 years and above in Shenzhen. Logistic and hierarchical linear regression methods were utilized to investigate the relationship between the challenges posed by COVID-19, public trust, and the manifestation of PTSD symptoms.
Findings:
Higher levels of challenges related to ‘supplies, services access and safety’, ‘abuse and conflicts’, and ‘anger and fear’ were associated with PTSD. Furthermore, a lower level of challenges related to ‘disease management and information’ was associated with PTSD. Trust in authority or medical professionals was the moderator between the challenges brought about by COVID-19 and PTSD, which helped to lower the impact of challenges. Despite the challenges brought by COVID-19 to people, nurturing a stronger sense of trust in authority and medical professionals would ease older adults’ psychological stress and concerns.
Research examining (MCI) criteria in diverse and/or health-disparate populations is limited. There is a critical need to investigate the predictive validity for incident dementia of widely used MCI definitions in diverse populations.
Method:
Eligible participants were non-Hispanic White or Black Bronx community residents, free of dementia at enrollment, with at least one annual follow-up visit after baseline. Participants completed annual neurological and neuropsychological evaluations to determine cognitive status. Dementia was defined based on DSM-IV criteria using case conferences. Cox proportional hazard models assessed predictive validity for incident dementia of four specific MCI definitions (Petersen, Jak/Bondi, number of impaired tests, Global Clinical Ratings) at baseline, controlling for age, sex, education, and race/ethnicity. Time-dependent sensitivity and specificity at 2–7 years for each definition, and Youden’s index were calculated as accuracy measures.
Results:
Participants (N = 1073) ranged in age from 70 to 100 (mean = 78.4 ± 5.3) years at baseline. The sample was 62.5% female, and educational achievement averaged 13.9 ± 3.5 years. Most participants identified as White (70.0%), though Black participants were well-represented (30.0%). In general, MCI definitions differed in sensitivity and specificity for incident dementia. However, there were no significant differences in Youden’s index for any definition, across all years of follow-up.
Conclusions:
This work provides an important step toward improving the generalizability of the MCI diagnosis to underrepresented/health-disparate populations. While our findings suggest the studied MCI classifications are comparable, researchers and clinicians may choose to consider one method over another depending on the rationale for evaluation or question of interest.
Older age significantly increases risk for cognitive decline. A growing number of older adults (≥ 65 years) experience cognitive decline that compromises immediate and/or long-term health. Interventions to mitigate cognitive decline are greatly needed. Intermittent fasting aligned with innate circadian rhythms is associated with health benefits and improved circadian rhythms; here, we explore impacts on cognition and cardiometabolic outcomes.
Methods:
We conducted a single-group, pre-/post-pilot study to explore an 8-week prolonged nightly fasting intervention (14 h fasting/night) among adults 65+ years with self-reported memory decline. We explored changes in cognitive function, insomnia, and cardiometabolic risk factors. Intervention engagement/adherence were assessed. The intervention was delivered fully remotely; participants completed their fasting protocol at home and were not required to come into the lab.
Results:
In total, 20 individuals signed consent and 18 participants completed the study. Participants were mean age 69.7 years, non-Hispanic White (89%), predominantly female (95%), married (50%), and employed (65%). Paired t-tests indicated an increase in cognitive function (Memory and Attention Phone Screener) (p = 0.02) with a medium effect size (Cohen’s d = 0.58) and a decrease in insomnia (Insomnia Severity Index) (p = 0.04) with a medium effect size (Cohen’s d = 0.52). Changes in BMI or diet quality were not observed. Engagement (66%–77%) and adherence (70%–100%) were high.
Conclusion:
These pilot findings suggest that prolonged nightly fasting, targeted to align food intake with circadian rhythms, may improve cognitive function and sleep among older adults. Fully powered, randomized controlled trials to test the efficacy of this non-pharmacological, low cost-to-burden ratio intervention are needed.
The present study examines whether age of second language acquisition, duration of exposure to that language, and chronological age determine vocabulary knowledge in 214 Russian–Hebrew bilinguals (ages 19–80, immigration ages 1–46, and exposure duration 7–63 years). Participants reported their language background and completed a multiple-choice vocabulary test in Hebrew, alongside other objective tests of Russian and Hebrew proficiency. While vocabulary scores were below age-matched norms for native Hebrew speakers, they were similar to those of younger native speakers matching in exposure duration. Raw vocabulary scores were similar whether participants immigrated up to age 15 or after that age, although results indicated a negative association between age of immigration and vocabulary scores. A positive association emerged between exposure duration and vocabulary scores, and when analyzing all measures together, age of immigration did not predict vocabulary scores, whereas exposure duration was its main determinant. We suggest that bilingualism itself does not cause a vocabulary gap, and that bilinguals’ vocabulary knowledge in their second language improves with exposure, as it does in native speakers throughout adulthood. The study emphasizes that learning a foreign language requires extensive exposure and that vocabulary learning is a lifelong process.
The COVID-19 pandemic challenged older adults’ health behaviours, making it even more difficult to engage in healthy diets and physical activity than it had been prepandemic. A resource to promote these could be social support. This study uses data from 136 older adults (Mage = 71.39 years, SD = 5.15, range: 63–87) who reported their daily fruit and vegetable consumption, steps, and health-behaviour-specific support from a close other every evening for up to 10 consecutive days. Findings show that on days when participants reported more emotional support than usual, fruit and vegetable consumption and step counts were higher. Daily instrumental support was positively associated with step counts, only. Participants receiving more overall emotional support across the study period consumed more fruit and vegetables; no parallel person-level association was found for overall steps. There were no significant interactions between dyad type and support links for our outcomes.
Accurate appraisal of one’s own abilities (i.e., insight) is necessary for appropriate compensatory behaviors and sustained independence during aging. Although insight is often purported to be related to executive functioning (EF), nuanced understanding of the cognitive correlates of insight for functional abilities among nondemented older adults is lacking. Because insight shares neuroanatomic underpinnings with time-based prospective memory (PM), the present study examined the contributions of time-based PM, beyond event-based PM and other potential cognitive confounds (i.e., episodic memory, time estimation, and EF), in predicting insight into one’s own performance on instrumental activities of daily living (IADLs) among community-dwelling older adults.
Method:
A group of 88 nondemented, community-dwelling older adults completed performance-based measures of time- and event-based PM, episodic memory, time estimation, and EF, as well as IADL tasks followed by self-appraisals of their own IADL performance as indices of insight.
Results:
Time-based PM was moderately-to-strongly associated with insight, beyond event-based PM, time estimation, and episodic memory [F(1,83) = 11.58, p = .001, ηp2 = .122], as well as beyond EF and demographic covariates [F(1,79) = 10.72, p = .002, ηp2 = .119].Specifically, older adults who performed more poorly on a time-based PM task overestimated the efficiency of their own IADL performance to a greater extent.
Conclusions:
Findings suggest that nondemented older adults with poorer time-based PM may be more prone to inaccurately appraising their functional abilities and that this vulnerability may not be adequately captured by traditional EF measures.
Developing effective, sustainable strategies that promote social inclusion, reduce isolation, and support older adults’ wellbeing continues to be important to aging communities in Canada. One strategy that targets community-living older adults involves identifying naturally occurring retirement communities (NORCs) and supporting them through supportive service programs (NORC-SSPs). This qualitative descriptive study utilized semi-structured interviews to explore how older adults living in a NORC supported by an SSP, sought to build, and maintain, a sense of community during the COVID-19 pandemic. Analysis revealed how changes in context prompted changes in the program and community, and how despite lack of in-person opportunities participants continued to be together and do occupations together in creative ways that supported their sense of community. NORC-SSPs, like Oasis, play an important role in supporting older adults’ capacity to build strong, resilient communities that support wellbeing, during a global pandemic and in non-pandemic times.
Objectives: To evaluate the relationship between Willis-Ekbom Disease/Restless Legs Syndrome and iron deficiency anemia in older people with dementia.
Methods: A cross-sectional study was conducted with 70 older people diagnosed with dementia and restless leg syndrome in a Psychogeriatric outpatient clinic in a city in the interior of São Paulo, Brazil. The older people filled in instruments of sociodemographic characterization, measures to evaluate the Restless Legs Syndrome, neuropsychiatric symptoms, sleep quality, sleepiness and cognition. Blood data were also collected levels of creatinine, ferritin, red blood cells, hemoglobin and hematocrit, the latter collected in the patients’ medical records.
Results: The sample consists mostly of older people with mixed dementia (i.e., Alzheimer’s disease + Vascular Dementia), with 39% of female patients and mean age of 77.80 years (9.36). This study identified a frequency of 15.7% of Restless Legs Syndrome. Patients with the syndrome present more frequency of neuropsychiatric symptoms, worse sleep quality, higher index of body mass and lower levels of ferritin (p < .05).
Conclusions: A frequency of 15.7% was identified for restless leg syndrome among patients with dementia. In addition, patients with the syndrome have ferritin deficiency.
Objectives: Low- and middle-income countries face increasing burden of noncommunicable chronic diseases due to rapid population aging. The Objectives of this study is to estimate the association of co-occurring depression and diabetes with healthcare services utilization in the Brazilian population aged 50 years andolder.
Methods: This is an analysis using baseline data of the ELSI-Brazil study. Measurements used were self-reported previous diagnosis for diabetes and a cut-off point of 4 on the CES-D-8 score for depression. Any medical consultations, specialist consultations and hospitalizations in the previous 12 months were assessed for measuring health services use. Logistic regression was used to estimate the association of having depression, diabetes, or both, compared to having none of the conditions with healthcare services utilization.
Results: In a final sample of 8303 participants, the adjusted odds ratios (95%CI) in the depression only group (27.9%), in the diabetes only group (9.7%), and in the depression and diabetes group (5.8%), for any medical consultations were 1.2 (1.01-1.42), 3.39 (2.4-4.79) and 3.12 (1.82-5.35); for specialist consultations, 1.05 (0.91-1.21), 1.34 (1.07-1.68) and 1.13 (0.86-1.49); and for hospitalizations, 1.42 (1.1-1.84), 1.42 (1.02-1.96) and 3.1 (2.12-4.54), respectively. All models were adjusted for sex, age, education, marital status, insufficient physical activity, current drinking and smoking, obesity and number of other diseases and conditions.
Conclusions: Those with diabetes seemed more likely to have any or specialized medical consultations. However, those with the depression and diabetes comorbidity were more likely than any other group to have been admitted to a hospital in the last year, which is distressing and costly. Screening for depression could be incorporated into diabetes usual care to reduce related complications and hospitalizations.
Funding: This study did not receive any funding. Authors: Ferri and Lima-Costa are recipient of CNPq research productive fellowship.
Higher white matter hyperintensity (WMH) volume is a marker of cardiovascular disease (CVD) risk. CVD risk factors increase risk for Alzheimer’s disease and related dementias (ADRD). Mexican Americans (MA) and individuals of other Hispanic/Latino heritages have higher risk for CVD and ADRD. However, knowledge of associations between WMH volume and cognition in these groups remains limited.
Method:
We conducted a cross-sectional study of associations between WMH volume and neuropsychological performance (attention/executive functioning, memory) in MA (n = 851) and non-Hispanic White (NHW; n = 747) adults in the Health and Aging Brain Study: Health Disparities.
Results:
The MA group (mean age = 63.72 ± 7.90 years; 66.3% female) had higher rates of consensus diagnoses of hypertension and diabetes, whereas the NHW group (mean age = 69.18 ± 8.65 years; 55.2% female) had higher rates of diagnosed CVD (ps < .01). WMH volumes were higher among individuals with CVD risk factors/conditions (ps < .01). There were differential associations between WMH and neuropsychological performance across ethnoracial groups (ps < .001), wherein associations were steeper in the NHW group than in the MA group. Lower educational level was associated with higher WMH volume in the NHW group (p < .001), but no association was seen in the MA group (p > .05).
Conclusions:
Negative effects of pathological changes in the form of WMH on cognition may be less robust or consistent for MA adults than NHW adults. Furthermore, the impact of WMH on cognition in NHW adults may be mitigated by cognitive reserve related to educational attainment.