Hope messages influence health behavior intentions more than fear messages: An experimental study during COVID-19.

BACKGROUND: Fear tactics were used in the pandemic of Coronavirus Disease 2019. PURPOSE: We tested how messaging style, fear vs. hope, and differences in age and political affiliation related to intentions to engage in preventive behaviors during Coronavirus Disease 2019. METHODS: Participants (N = 606) aged 18 to 94 were randomly assigned to receive health messages that emphasized the dangers of the virus (fear messages) or the ability of health behaviors to mitigate the impact of the virus (hope messages). The primary outcome was health behavior intentions. DISCUSSION: Hope messaging rather than fear messaging promoted health behavior intentions with no moderation by age or political affiliation. Older and Democratic-identified adults had higher health behavior intentions. Health behaviors were mediated by death anxiety and perceived credibility of the messages. CONCLUSION: Tailored hope messaging may improve health behaviors by increasing the credibility of messages.

The Drug Burden Index Is Associated With Measures of Cognitive Function Among Older Adults in the Health, Aging, and Body Composition Study.

BACKGROUND: Anticholinergic and sedative medications affect cognition among older adults. The Drug Burden Index (DBI) is a validated measure of exposure to these medications, with higher DBI scores indicating higher drug burden. This ancillary analysis investigated the association between DBI and cognition assessed by the Modified Mini-Mental State Examination (3MS) and the Digit Symbol Substitution Test (DSST). METHODS: The Health, Aging, and Body Composition Study was a prospective study of community-dwelling adults aged 70-79 years at enrollment. Using data from years 1, 5, and 10, DBI was calculated using medication data per participant. Linear mixed modeling was used to assess cross-sectional and longitudinal effects of DBI on 3MS and DSST. Adjusted models included biological sex, race, education level, APOE status, and death. Sensitivity analyses included testing the strength of the associations for each year and testing attrition due to death as a possible confounding factor via Cox-Proportional Hazard models. RESULTS: After adjustment, DBI was inversely associated with 3MS and DSST scores. These associations became stronger in each subsequent year. Neither DBI at year 1 nor within-person change in DBI were predictive of longitudinal declines in either cognitive measure. Sensitivity analyses indicated that DBI, 3MS, and DSST were associated with a greater risk of attrition due to death. CONCLUSIONS: Results suggest that in years when older adults had a higher DBI scores, they had significantly lower global cognition and slower processing speed. These findings further substantiate the DBI as a useful pharmacological tool for assessing the effect of medication exposure.

Does Consumer Credit Precede or Follow Health Among Older Adults? An Investigation in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Trial.

Background and Objectives: Consumer credit has shown increasing relevance to the health of older adults; however, studies have not been able to assess the extent to which creditworthiness influences future health or health influences future creditworthiness. We assessed the relationships between 4-year pre and postmorbid consumer credit history and self-rated physical and mental health outcomes among older adults. Research Design and Methods: Generalized estimating equations models assessed pre and postmorbid credit history (credit scores, derogatory accounts, and unpaid accounts in collections) and the onset of poor self-rated health (SF-36 score <50) among 1,740 participants aged 65+ in the Advanced Cognitive Training for Independent and Vital Elderly study from 2001 to 2017, linked to TransUnion consumer credit data. Results: In any given year, up to 1/4 of participants had a major derogatory, unpaid, or collections account, and up to 13% of the sample had poor health. Each 50-point increase in credit score trended toward a 5% lower odds of poor health in the next 1 year, a 6% lower odds in the next 2 years, and a statistically significant finding of 13% lower odds by 3 years. A drop in credit score was associated with a 10% greater odds of poor health in the next year, and having a major derogatory account was associated with an 86% greater odds of poor health in the next 3 years. After poor health onset, credit scores continued to see significant losses up to the 3 years, with larger decrements over time. Discussion and Implications: Having a major derogatory account or a sudden loss in credit may be a time to monitor older adults for changes in health. After a downturn in health, supporting older adults to manage their debt may help stabilize their credit.

Self-Reported Chronic Stress Is Unique Across Lifetime Periods: A Test of Competing Structural Equation Models.

BACKGROUND AND OBJECTIVES: Chronic stress can have deleterious effects on physical and mental health. However, self-report measures of chronic stress typically only assess stress recently, ignoring ongoing or repeated stress throughout the life span. The present study tested whether retrospective judgments of stress across different lifetime periods offer unique information that cannot be ascertained by measures of recent chronic stress. RESEARCH DESIGN AND METHODS: A survey was given to 271 adults aged 46-81 using Amazon's Mechanical Turk. The questions assessed self-reported stress across multiple domains (e.g., general stress, financial stress, interpersonal stress) from well-known and validated surveys. Also, items were added to assess different lifetime periods of self-reported stress, including one's childhood, 20s/30s, and 50s/60s. Using structural equation modeling, we tested competing models for how lifetime periods and stress domains might relate to one another. RESULTS: The best fitting model revealed that different domains of stress (discrimination, loneliness, personal, and general stress) were highly correlated with one another within a given lifetime period but that the different lifetime periods (childhood, 20s/30s, 50s/60s, and current) were relatively independent. DISCUSSION AND IMPLICATIONS: Current measures assessing the frequency or strength of "chronic stress" are misleading because they do not capture ongoing or repeated stress throughout the life span. Past experiences convey unique information about one's chronic stress, offering a new perspective on the meaning of "chronic stress" from a life-course perspective, consistent with previous stress accumulation models.

Associations Between Body Mass Index and Cognitive Change in the ACTIVE Study: Variations by Race and Social Determinants of Health.

Objectives: The current study examines relationships between Body Mass Index (BMI) and cognitive performance and change in processing speed, memory, and reasoning, while accounting for variations by race and the influence of social determinants of health. Methods: Secondary data analysis of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, which included participants who self-identified as African American or Black (n = 728) and White (n = 2028). Latent growth curve modeling was used to assess study aims. Results: Increases in BMI were associated with less cognitive decline over 10 years across each cognition domain. Race moderation effects were noted for speed and memory. Relationships between BMI and cognitive trajectories were mediated by economic stability for speed and reasoning. Discussion: Overall, these findings are consistent with the "obesity paradox." Further research is needed to elucidate patterns of results by race.

Does Consumer Credit Precede or Follow Changes in Cognitive Impairment Among Older Adults? An Investigation in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Trial.

OBJECTIVES: We assessed the relationships between pre- and post-morbid consumer credit history (credit scores, debts unpaid, or in collections) and classification of mild (or greater) cognitive impairment (MCI). METHODS: Generalized Estimating Equation models assessed pre-and post-morbid credit history and MCI risk among 1740 participants aged 65+ in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, linked to TransUnion consumer credit data. RESULTS: Each 50-point increase in credit score was associated with up to 8% lower odds of MCI in the next 3 years. In contrast, new unpaid collections over doubled the odds of having MCI in the next 3 years. MCI was associated with subsequent credit score declines and a 47%-71% greater risk of having a new unpaid collection in the next 4 years. DISCUSSION: Credit declines may signal risk for future MCI. MCI may lead to financial challenges that warrant credit monitoring interventions for older adults.

Aging alone and financial insecurity predict depression: a path analysis of objective and subjective indices.

OBJECTIVES: This study draws on conservation of resources theory and transactional stress theory to guide our understanding of how social isolation, financial insecurity, and social support serve as a balance of both risk and protection for late-life depression. METHODS: Data were from the Leave-Behind Questionnaire in the 2016 (N = 4293) and 2018 (N = 4714) waves of the Health and Retirement Study. We conducted a cross-sectional path analysis via structural equation modeling, including objective and subjective perspectives. The same model was tested in both samples. RESULTS: Both social isolation and financial insecurity were associated with depression. We found several mediating risks and protective factors of these relationships. Objective financial status affected depression through both perceived financial insecurity and perceived social isolation, whereas objective isolation affected depression through perceived social support. This mediation model was -significant after adjusting for confounders. CONCLUSION: This study underscores the importance of investigating the balance between risk and protection for depression, in the rising number of older adults aging alone in society. Findings suggest that objective and perceived measures offer unique windows into psychological constructs. Considering both objective and subjective perspectives may provide alternative targets for subsequent interventions to improve mental health in later life.

Resilience resources may buffer some middle-aged and older Black Americans from memory decline despite experiencing discrimination.

RATIONALE: Experiences of discrimination have been associated with poorer episodic memory in Black Americans. However, resilience resources at multiple levels (individual, social, and endowed) may act as a buffer to protect future memory decline, especially in the face of discrimination. OBJECTIVE: Using longitudinal data from the 2006-2016 Health and Retirement Study (N = 1862), we tested whether Black Americans aged 50 and older would show different trajectories of episodic memory depending on their reported experiences of discrimination (everyday and major lifetime) and resilience resources. METHODS: Analyses were conducted in three steps: (1) joint latent cluster mixed modeling (JLCMM) to estimate the number of classes, (2) barycentric discriminant analyses (BADA) to model the combined influence of discrimination and resilience resources between each memory class, and (3) multinomial regression analyses to explore interactions between discrimination and resilience resources. RESULTS: JLCMM resulted in three memory classes that differentiated baseline from longitudinal memory performance: "High Decliners," "Low Decliners," and "Low Stable." Two independent patterns described the relationships between the three classes in the context of discrimination and resilience resources. First, compared with High Decliners, the two lower baseline memory classes (Low Decliners and Low Stable) reported more everyday discrimination and lower individual and endowed resilience resources. Second, although the Low Stable class did not report different levels of discrimination, they had more social resilience resources (greater social support and more social contact) than both declining classes. CONCLUSIONS: Black Americans in later life have heterogeneous patterns of memory trajectories as demonstrated by the three memory classes identified. Those with lower baseline memory experienced more everyday discrimination and had fewer resilience resources compared to those with high baseline performance (High Decliners). Greater social resilience resources were associated with maintained episodic memory over time in Black Americans.

Cognitive differences across ethnoracial category, socioeconomic status across the Alzheimer's disease spectrum: Can an ability discrepancy score level the playing field?

An ability discrepancy (crystallized minus fluid abilities) might be a personally relevant cognitive marker of risk for Alzheimer's disease (AD) and might help reduce measurement bias often present in traditional measures of cognition. In a large national sample of adults aged 60-104 years (N = 14,257), we investigated whether the intersectionality of group characteristics previously shown to pose a risk for AD including ethnoracial category, socioeconomic status, and sex (a) differed in ability discrepancy compared to traditional neuropsychological tests and (b) moderated the relationship between an ability discrepancy and AD symptom severity. In cognitively normal older adults, results indicated that across each decade, fluid and memory composite scores generally exhibited large group differences with sex, education, and ethnoracial category. In contrast, the ability discrepancy score showed much smaller group differences, thus removing much of the biases inherent in the tests. Women with higher education differed in discrepancy performance from other groups, suggesting a subgroup in which this score might reduce bias to a lesser extent. Importantly, a greater ability discrepancy was associated with greater AD symptom severity across the AD continuum. Subgroup analyses suggest that this relationship holds for all groups except for some subgroups of Hispanic Americans. These findings suggest that an ability discrepancy measure might be a better indicator of baseline cognition than traditional measures that show more egregious measurement bias across diverse groups of people.

Pet ownership is associated with greater cognitive and brain health in a cross-sectional sample across the adult lifespan.

Human-animal interactions that stem from pet ownership have a wide range of benefits for social, emotional, and physical health. These factors also tend to improve cognition. Following this logic, owning a pet could indirectly enhance cognitive and brain health through mechanisms like improvements in well-being, socialization, and decreased stress. In the present study, cross-sectional data were drawn from the Alabama Brain Study on Risk for Dementia in which 95 participants aged 20-74 were recruited. Specifically, 56 adults were pet-owners and 39 adults were not pet-owners. Multivariate analyses revealed that pet ownership was related to higher levels of cognition and larger brain structures, and these effects were largest in dog owners. The most consistent cognitive relationships were found with better processing speed, attentional orienting, and episodic memory for stories, and with dorsal attention, limbic, and default mode networks. Moreover, we show that owning a pet can reduce one's brain age by up to 15 years. Pet ownership was not related to indirect factors including social, emotional, and physical health. We found also that older adults' brain health benefited from owning more than one pet versus owning one or fewer pets. These findings indicate that pet ownership, especially dog ownership, may play a role in enhancing cognitive performance across the adult lifespan, which could in turn influence protection against age-related cognitive decline.

25 years of neurocognitive aging theories: What have we learned?

The past 25 years have provided a rich discovery of at least four fundamental patterns that represent structural and functional brain aging across multiple cognitive domains. Of the many potential patterns of brain aging, few are ever examined simultaneously in a given study, leading one to question their mutual exclusivity. Moreover, more studies are emerging that note failures to replicate some brain aging patterns, thereby questioning the universality and prevalence of these patterns. Although some attempts have been made to create unifying theories incorporating many of these age-related brain patterns, we propose that the field's understanding of the aging brain has been hindered due to a large number of influential models with little crosstalk between them. We briefly review these brain patterns, the influential domain-general theories of neurocognitive aging that attempt to explain them, and provide examples of recent challenges to these theories. Lastly, we elaborate on improvements that can be made to lead the field to more comprehensive and robust models of neurocognitive aging.

Educational quality may be a closer correlate of cardiometabolic health than educational attainment.

Educational quality may be a closer correlate of physical health than more commonly used measures of educational attainment (e.g., years in school). We examined whether a widely-used performance-based measure of educational quality is more closely associated with cardiometabolic health than educational attainment (highest level of education completed), and whether perceived control (smaller sample only), executive functioning (both samples), and health literacy (smaller sample only) link educational quality to cardiometabolic health. In two samples (N = 98 and N = 586) collected from different regions of the US, educational quality was associated with cardiometabolic health above and beyond educational attainment, other demographic factors (age, ethnoracial category, sex), and fluid intelligence. Counter to expectations, neither perceived control, executive function, nor health literacy significantly mediated the association between educational quality and cardiometabolic health. Findings add to the growing literature suggesting that current operationalizations of the construct of education likely underestimate the association between education and multiple forms of health. To the extent that educational programs may have been overlooked based on the apparent size of associations with outcomes, such actions may have been premature.

Impact of stereotype threat on brain activity during memory tasks in older adults.

We report the first neuroimaging experiment to investigate the impact of explicitly activating aging stereotypes (i.e., stereotype threat) on brain activity during cognitive tasks. Cognitively normal older adults read about aging stereotypes or a control passage prior to taking episodic memory, working memory, and a non-demanding control task during fMRI. At the group level, stereotype activation did not impact cognitive performance or measures sensitive to stress and anxiety (physiological or self-report), but like prior work, highly educated and retired adults exhibited greater stereotype effects on episodic memory. At the neural level, stereotype activation did not impact brain activity in executive control or emotional regulation regions previously linked to stereotype threat effects in younger adults, suggesting that stereotype threat operates differently in older adults. Instead, on each task, the stereotype group showed more brain activity than the control group in parietal midline regions (e.g., precuneus, posterior cingulate). Although activity in these regions can arise from many processes, they have previously been associated with self-referential thinking and error-prevention focus, and in our study, brain activity in these regions was associated with slower responses and lower false alarm errors on the episodic memory task. Collectively, these findings are more consistent with the regulatory fit hypothesis than an executive control interference hypothesis of stereotype threat effects in older adults, whereby older adults adopt an error-prevention mindset in response to explicit stereotype threat.

Young Adults with a Parent with Dementia Show Early Abnormalities in Brain Activity and Brain Volume in the Hippocampus: A Matched Case-Control Study.

Having a parent with Alzheimer's disease (AD) and related dementias confers a risk for developing these types of neurocognitive disorders in old age, but the mechanisms underlying this risk are understudied. Although the hippocampus is often one of the earliest brain regions to undergo change in the AD process, we do not know how early in the lifespan such changes might occur or whether they differ early in the lifespan as a function of family history of AD. Using a rare sample, young adults with a parent with late-onset dementia, we investigated whether brain abnormalities could already be detected compared with a matched sample. Moreover, we employed simple yet novel techniques to characterize resting brain activity (mean and standard deviation) and brain volume in the hippocampus. Young adults with a parent with dementia showed greater resting mean activity and smaller volumes in the left hippocampus compared to young adults without a parent with dementia. Having a parent with AD or a related dementia was associated with early aberrations in brain function and structure. This early hippocampal dysfunction may be due to aberrant neural firing, which may increase the risk for a diagnosis of dementia in old age.

Intra-individual cognitive variability in neuropsychological assessment: a sign of neural network dysfunction.

Intra-Individual Cognitive Variability (IICV) predicts progression in neurocognitive disorders . Given important clinical applications, we investigated the association between IICV and multiple brain metrics across 17 networks to better understand the brain mechanisms underlying this performance measure. Sixty-three middle-aged and older adults without dementia underwent a neuropsychological battery, resting-state fMRI, and structural MRI scans. In a linear mixed effect model, higher IICV was associated with lower functional connectivity in control C network relative to medial occipital network (the reference). A multivariate partial least squares analysis revealed that lower mean and higher variability were both associated with lower connectivity in sensorimotor and default mode networks, while higher mean and higher variability were associated with lower volume in default mode and limbic networks. This study suggests that IICV signals widespread network dysfunction across multiple brain networks. These brain abnormalities offer new insights into mechanisms of early cognitive dysfunction. Clinical implications are discussed.

Sources of nonreplicability in aging ethnoracial health disparities research.

The older adult population in the U.S. is becoming increasingly diverse across a constellation of factors including ethnoracial group, socioeconomic status, and immigration status. However, our understanding of the consequences of this diversity for cognitive and mental health is masked by the lack of inclusion of diverse sample characteristics, the use of assessments that might hold a different meaning for different groups of people, and analytical choices that do not probe the impact of diverse characteristics or assume an unwarranted degree of homogeneity within groups. Each of these factors not only hinders our ability to understand various psychological mechanisms that differ as a function of age but also threatens the likelihood of replicability across aging research studies. This article provides our perspective on three key sources of nonreplicability in ethnoracial health disparities research among older adults: (a) what is lost in creating monolithic groups rather than identifying subgroups of minorities, (b) understanding aging from the perspective of intersecting identities, and (c) biases of research materials. We also provide recommendations to increase replicability in aging research with respect to the challenges outlined. Approaching questions on aging from a health disparities lens can both increase the generalizability of research outcomes and improve initiatives of social justice that are long overdue. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Is the Future Bright or Bleak? Assessing Past and Future Outlooks Across the Adult Lifespan.

An individual's outlook on society can change over time and can be related to both their physical and mental health. Here, we developed an instrument to measure outlooks on the past and future in relation to the present in 413 adults ranging in age from 18 to 80 years. Exploratory and confirmatory factor analyses were conducted on independent samples and test-retest reliability was assessed in a subset of participants. Construct validity of the two past and future scales was assessed by relating them to 1) pre-existing scales measuring related constructs, and 2) beliefs and safety behaviors during the COVID-19 pandemic. The final Bright or Bleak Scale (BOBS) consists of a past and future scale, each with two factors measuring societal and personal outlooks. Brighter future societal and personal outlooks were positively associated with longer future time perspectives, while self-reporting a higher likelihood of already having contracted COVID-19 was related to bleaker past societal and personal outlooks.