Acute Effects of Cadence-Controlled Walking on Cognition and Vascular Function in Physically Inactive Older Adults: A Randomized Crossover Study.

BACKGROUND: Cadence-controlled walking may be a desirable approach for older adults to self-monitor exercise intensity and achieve physical activity guidelines. We examined the acute effects of cadence-controlled walking on cognition and vascular function in physically inactive older adults. METHODS: In a randomized crossover design, 26 participants (65% females, 67.8 ± 11.3 years) underwent 30-min acute exercise (walking at 100 steps/min) and control (sitting) conditions. We measured cognition, central blood pressure (BP), and arterial stiffness before, and immediately, after each condition. RESULTS: We observed significant Time × Condition interactions in the Flanker Inhibitory Control and Attention (Flanker) test and Dimensional Change Card Sort (DCCS) test scores, and in central systolic BP, central pulse pressure, and carotid to femoral pulse wave velocity (p < .05). The Flanker and DCCS scores significantly increased after walking (d = 0.4 and 0.5, respectively), but not after sitting. Central systolic BP, central pulse pressure, and carotid to femoral pulse wave velocity significantly increased after sitting but remained unchanged after acute walking (d = 0.4-0.2), with p-values < .05. After walking, significant correlations were observed between DCCS and diastolic BP and central pulse pressure change scores and change scores in central pulse wave velocity, Flanker, and DCCS (rs = -0.45 to -0.52). CONCLUSION: These findings suggest that a single bout of cadence-controlled walking elicited an immediate improvement in cognition and might have mitigated increases in arterial stiffness and central BP observed in the seated control condition. Further research is needed to examine the association between cognition and vascular function following acute exercise compared to control conditions. SIGNIFICANCE: Our findings may have practical implications for developing daily physical activity recommendations for improving the cognitive health for successful aging.

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.

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.

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.

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.

Using transcranial direct current stimulation (tDCS) on the dorsolateral prefrontal cortex to promote long-term foreign language vocabulary learning.

Transcranial direct current stimulation (tDCS) on the dorsolateral prefrontal cortex (DLPFC) was used to improve foreign-langue learning while using mental imagery. Participants underwent two sessions of 1 mA, 1.5 mA, or sham stimulation prior to learning Swahili-English word pairs two consecutive days. During learning, participants were encouraged to create a mental image of the associated English word. Twenty-four hours after learning and one week later, participants received a cued recall test. A linear dose-response effect of stimulation was found across both tests that occurred long after the immediate effects of stimulation. Follow-up comparisons revealed that only the 1.5 mA condition differed from the sham group. Exploratory moderating effects revealed interactions with sleep quality and handedness. Those with poorer sleep and who were left-handed showed greater recall after 1.5 mA of stimulation than those with better sleep and right-handers. A follow-up behavioral study probing strategy usage indicated that mental imagery strategy use did not strongly impact learning but point to other possible mechanisms including the importance of attending to multimodal perceptual details and memory consolidation. This preliminary evidence supports the role of the DLPFC or connected regions in foreign language vocabulary learning and verbal memory encoding.

The association between the number of chronic health conditions and advance care planning varies by race/ethnicity.

Objectives: Although a national consensus exists on the need to increase the rates of advance care planning (ACP) for all adults, racial/ethnic differences in ACP have been consistently observed. This study investigated the intersection of racial/ethnic differences and the number of chronic health conditions on ACP among middle-aged and older adults in the United States.Method: Responses from 8,926 adults from the 2014 wave of the Health and Retirement Study were entered into multilevel hierarchical logistic regression analyses with generalized linear mixed models to predict ACP focused on assigning a durable power of attorney for healthcare (DPOAHC) and having a written living will after adjusting for covariates.Results: We found a significant positive relationship between the number of chronic health conditions and ACP. Non-Hispanic Blacks/African Americans and Hispanics were less likely to engage in ACP than non-Hispanic Whites/Caucasians. Racial/ethnic disparities were even starker for completing a living will. The number of chronic health conditions had a greater effect for Hispanics than non-Hispanic Whites/Caucasians on ACP through assigning a DPOAHC and having a living will. The initial disparity in ACP among Hispanics with no chronic health conditions decreased as the number of chronic health conditions increased.Conclusion: Our findings suggest that more chronic health conditions increase the likelihood that Hispanics will complete ACP documents. These ACP differences should be highlighted to researchers, policymakers, and healthcare professionals to reduce stark racial/ethnic disparities in ACP. A comprehensive and culturally caring decision-making approach should be considered when individuals and families engage in ACP.

Refining the metamemory in adulthood questionnaire: a 20-item version of change and capacity designed for research and clinical settings.

Objective: Subjective memory concerns (SMCs) might be an early indicator of future cognitive decline and conversion to dementia. However, a rich history of mixed findings, moderating factors, and heterogenous methods preclude the usefulness of SMCs in both research and clinical settings. The present study aimed to review some of the factors that might cause mixed results and propose a revised version the Metamemory in Adulthood (MIA) Questionnaire that can be easily implemented to more consistently derive estimates of SMCs.Method: We used factor analysis and regression to investigate the utility of a revised 20-item version of the MIA Change and Capacity subscales.Results: Based on two samples of older adults (N = 382 and N = 221), the revised scale showed strong internal reliability and a two-factor structure. Regression analyses supported the incremental validity of the MIA-Revised Change scale in predicting performance on the Rivermead Behavioural Memory Test.Conclusions: By establishing a revised version of a well-known and previously validated questionnaire to assess SMCs, research and clinics can better implement a psychometrically sound measure quickly and easily. Moreover, the revised Change and Capacity subscales provide sufficient divergence to be sensitive to different facets of SMCs in a community dwelling older adult sample.

Do older adults with Alzheimer's disease engage in estate planning and advance care planning preparation?

OBJECTIVES: This study investigated the estate planning and advance care planning (ACP) of older adults diagnosed with Alzheimer's disease (AD) for the presence of (1) a valid will, (2) a durable power of attorney for health care, and (3) a living will. METHOD: We analyzed 10,273 adults aged 65 and older from the 2012 Health and Retirement Study (HRS) using multilevel logistic regression. RESULTS: We found that a diagnosis of AD was significantly associated with the ACP variables. Older adults with AD were more likely to assign a durable power of attorney for health care and have a written living will than older adults without an AD diagnosis. However, we found no significant association between a diagnosis of AD and having a valid will. These findings were robust when adjusting for demographic and socioeconomic variables. Other factors decreased engagement in estate planning and ACP, including lower socioeconomic status, being male, and being a minority. CONCLUSION: Our findings suggest that a diagnosis of AD is associated with more engagement in ACP for individuals and their families, but important barriers exist for people with fewer resources.

Biological markers of aging and mental health: A seed and soil model of neurocognitive disorders.

As the population of the world gets older, cognitive and mental health decline in older adults has become one of the most pressing scientific problems of the 21st century. It has been well-established that multiple pathways exist that can lead to future cognitive decline and the development of age-related mental health conditions. Making matters more complicated is the fact that aging is not a homogenous or simple process; rather, each person brings a diverse set of circumstances to the table, leading to differences in biologically aging. Research is needed to identify how the intersection of environmental and biological factors may protect older adults or put them at future risk for cognitive decline and the development of age-related mental health conditions. Furthermore, each potential factor may impact different domains of cognition and mental health or may impact individuals differentially based on genetic, environmental, social, emotional, and behavioral factors. Neuroimaging is one key tool that can be used to discover and assess markers of cognitive and mental health. The goal of this special issue is to expand the science on how biological markers can aid the understanding of aging and mental health through the lens of the individual from an international perspective, representing Germany, Taiwan, Thailand, the United Kingdom, and the United States. Common themes from these articles are used to support the new Seed and Soil Model of Neurocognitive Disorders.

Memory training for adults with probable mild cognitive impairment: a pilot study.

Background & Objectives: This pilot study aimed to evaluate the efficacy of memory training and health training intervention over a 24-month period in people with probable mild cognitive impairment (MCI). Research Design & Methods: Based on the accepted criteria, and the neuropsychiatric measures used in the trial, MCI was defined as a subjective change in cognition, impairment in episodic memory, preservation of independence of functional abilities, and no dementia. Without a neurological assessment, laboratory tests, and psychometric evaluation combined, some of our participants may have had dementia that we were unable to detect through neuropsychological testing. Of the 263 total participants, 39 met criteria for a diagnosis of MCI. There were 19 adults in the memory and 20 in health training conditions. Both groups received twenty hours of classroom content that included eight hours of booster sessions at three months post intervention. Hierarchical linear models (HLM) and standardized regression-based (SBR) analyses were used to test the efficacy of the intervention on immediate recall, delayed recall, subjective memory complaints, and memory self-efficacy. Age, education, depression, racial group, ethnic group, MMSE score, and baseline performance were included as covariates. Results: Over 24 months, the MCI group in the memory training condition showed better objective and subjective memory outcomes compared with the MCI group in the health training condition. Conclusions: Senior WISE Memory training delivered to individuals with MCI was able to forestall the participants' declining cognitive ability and sustain the benefit over two years in both subjective and objective memory function.

A Review on the Trajectory of Attentional Mechanisms in Aging and the Alzheimer's Disease Continuum through the Attention Network Test.

Multiple domains of cognition are known to decline in both normal aging and in the trajectory towards Alzheimer's disease (AD). While declines in episodic memory are most well-known in both normal aging and AD, some of these memory differences might stem from early deteriorations in attention that have consequences for later memory. Further complicating the matter is that attention is a multifaceted construct that might be differentially affected in normal aging and AD. According to cognitive neuroscience models of attention, three types of attention networks exist: alerting, orienting, and executive. Efficiency of these three networks can be captured using the Attention Network Test (ANT). We reviewed the literature investigating differences in attention networks using the ANT as a function of normal aging and the AD trajectory, which included people at risk for AD, preclinical stages of AD, mild cognitive impairment, and those diagnosed with AD. We found that normal aging and the AD trajectory evidenced different patterns of attentional declines. Whereas normal aging was most consistently associated with impairments in alerting, early phases of the AD trajectory were most consistently associated with impairments in executive attention, and later phases of the AD trajectory were mixed. The mixed results with AD are largely attributed to small sample sizes and confounding effects of general slowing. These findings highlight key gaps in the literature linking different phases of AD while also highlighting the usefulness of the ANT to distinguish normal aging from the AD trajectory, especially in the earliest phases of the disease process.

Memory's aging echo: age-related decline in neural reactivation of perceptual details during recollection.

Episodic memory decline is a hallmark of normal cognitive aging. Here, we report the first event-related fMRI study to directly investigate age differences in the neural reactivation of qualitatively rich perceptual details during recollection. Younger and older adults studied pictures of complex scenes at different presentation durations along with descriptive verbal labels, and these labels subsequently were used during fMRI scanning to cue picture recollections of varying perceptual detail. As expected from prior behavioral work, the two age groups subjectively rated their recollections as containing similar amounts of perceptual detail, despite objectively measured recollection impairment in older adults. In both age groups, comparisons of retrieval trials that varied in recollected detail revealed robust activity in brain regions previously linked to recollection, including hippocampus and both medial and lateral regions of the prefrontal and posterior parietal cortex. Critically, this analysis also revealed recollection-related activity in visual processing regions that were active in an independent picture-perception task, and these regions showed age-related reductions in activity during recollection that cannot be attributed to age differences in response criteria. These fMRI findings provide new evidence that aging reduces the absolute quantity of perceptual details that are reactivated from memory, and they help to explain why aging reduces the reliability of subjective memory judgments.

Age-related differences in prefrontal cortex activity during retrieval monitoring: testing the compensation and dysfunction accounts.

Current theories of cognitive aging emphasize that the prefrontal cortex might not only be a major source of dysfunction but also a source of compensation. We evaluated neural activity associated with retrieval monitoring--or the selection and evaluation of recollected information during memory retrieval--for evidence of dysfunction or compensation. Younger and older adults studied pictures and words and were subsequently given criterial recollection tests during event-related functional magnetic resonance imaging. Although memory accuracy was greater on the picture test than the word test in both groups, activity in right dorsolateral prefrontal cortex (DLPFC) was associated with greater retrieval monitoring demands (word test > picture test) only in younger adults. Similarly, DLPFC activity was consistently associated with greater item difficulty (studied > nonstudied) only in younger adults. Older adults instead exhibited high levels of DLPFC activity for all of these conditions, and activity was greater than younger adults even when test performance was naturally matched across the groups (picture test). Correlations also differed between DLPFC activity and test performance across the groups. Collectively, these findings are more consistent with accounts of DLPFC dysfunction than compensation, suggesting that aging disrupts the otherwise beneficial coupling between DLPFC recruitment and retrieval monitoring demands.

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.

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.

False memory and importance: can we prioritize encoding without consequence?

Given the large amount of information that we encounter, we often must prioritize what information we attempt to remember. Although critical for everyday functioning, relatively little research has focused on how people prioritize the encoding of information. Recent research has shown that people can and do selectively remember information assigned with higher, relative to lower, importance. However, the mechanisms underlying this prioritization process and the consequences of these processes are still not well understood. In the present study, we sought to better understand these prioritization processes and whether implementing these processes comes at the cost of memory accuracy, by increasing false memories. We used a modified form of the Deese/Roediger-McDermott (DRM) paradigm, in which participants studied DRM lists, with each list paired with low, medium, or high point values. In Experiment 1, encoding higher values led to more false memories than did encoding lower values, possibly because prioritizing information enhanced relational processing among high-value words. In Experiment 2, disrupting relational processing selectively reduced false memories for high-value words. Finally, in Experiment 3, facilitating relational processing selectively increased false memories for low-value words. These findings suggest that while prioritizing information can enhance true memory, this process concomitantly increases false memories. Furthermore, the mechanism underlying these prioritization processes depends on the ability to successfully engage in relational processing. Thus, how we prioritize the encoding of incoming information can come at a cost in terms of accurate memory.

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.

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.