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1.
Health Psychol Behav Med ; 12(1): 2390939, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39157430

RESUMEN

Objective: To examine associations between sleep disturbance, social support, and social comparison among midlife and older adults, including the moderating role of gender. Methods: Adults ages ≥40 years (N = 557, MAge = 57, 53% men) completed a cross-sectional survey including validated measures of sleep disturbance, perceptions of social support, and social comparison orientation. Results: Sleep disturbance was negatively associated with social support (rs = -0.42 to - 0.33, ps = 0.001) and associations were stronger for men than women - particularly perceived support from friends (η 2 = 0.01). Sleep disturbance was also associated with upward comparison orientation (r = 0.12, p = 0.003), more strongly for women than men (η 2 = 0.01). Discussion: Findings indicate that perceived support from friends (for men) and upward comparison (for women) may have particular influence on sleep among midlife and older adults. Additional work is needed to clarify the nature of these associations and their mechanism(s) of action, to inform potential treatment adaptations for this population.

2.
Psychol Aging ; 2024 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-39133611

RESUMEN

Although perceived control is a well-established predictor of cognitive aging, less is known about how and under what developmental circumstances these beliefs about personal influence may protect against cognitive declines. Our study examined light physical activity (LPA) as an unexplored mechanism that may link changes in two facets of perceived control (personal mastery, perceived constraints) to longitudinal trajectories of cognitive functioning. We also examined whether mediated pathways were moderated by age (i.e., differed across the adult lifespan). We analyzed two-wave, 9-year data from the national Midlife in the United States Study (n = 2,456; Mage = 56 years, range = 30-84; 56% female) using autoregressive mediation and moderated mediation models. Mediation models showed that changes in personal mastery and perceived constraints predicted episodic memory and executive functioning via self-reported change in LPA. Only the mediated effects of constraints remained significant in a model that included both mastery and constraints as predictors. Moderated mediation models showed that, for episodic memory, the mediated pathways were strongest in old age and emerged only for constraints: For older but not younger adults, declines in constraints were associated with less decline in episodic memory, as mediated by increases in LPA. Results were consistent in sensitivity analyses that controlled for levels and change in moderate-to-vigorous physical activity. Findings inform lifespan theories of control and provide initial evidence that change in a largely overlooked health behavior (LPA) may underlie the link between perceived constraints and cognitive functioning, with this pathway becoming more pronounced in late life. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

3.
Innov Aging ; 8(6): igae038, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38854852

RESUMEN

Background and Objectives: Although prior research has shown that social relationships and daily stress are strongly associated with cognitive function, few studies have explored the link between the quality of daily social encounters and subjective cognitive decline (SCD). The present study explores whether the quality of older adults' daily social encounters is associated with SCD through daily stress. Research Design and Methods: This study used data from 254 adults aged 70 or older (M age  = 76.5 years, SD = 4.4; 67.7% women) who completed the Einstein Aging Study, a 2-week experience sampling study. Multilevel mediation analyses were conducted to account for daily measurements nested within individuals. We tested the indirect effect of the quality of daily social encounters on SCD through daily stress levels. Results: There was a significant positive association between ambivalent and neutral social encounters and daily stress levels at both the within- and between-person levels. Between-person daily stress was, in turn, associated with greater SCD. Specifically, there was a significant indirect path from ambivalent social encounters to SCD through daily stress. Discussion and Implications: This study contributes to a more detailed understanding of how the quality of daily social encounters can influence cognition via increased exposure to daily stress. The findings suggest that emotional support may be crucial to preserving perceptions of older adults' cognitive functioning.

4.
Artículo en Inglés | MEDLINE | ID: mdl-38785210

RESUMEN

Women age 40-60 are disproportionately affected by health problems that increase their risk for cardiovascular disease (CVD; e.g. hypertension). Social comparisons (i.e. self-evaluations relative to others) are known to influence health in this and other groups, but their nature and consequences in daily life are poorly understood. We conducted an ecological momentary assessment study over 10 days (5x/day) with 75 women ages 40-60 who had ≥1 CVD risk conditions (MAge = 51.6 years, MBMI = 34.0 kg/m2). Using a mix of frequentist and Bayesian analytic approaches, we examined characteristics of women's naturally occurring comparisons and tested predictions from the Identification/Contrast Model within-person (e.g. identifying with an upward target results in positive affect, whereas contrasting results in negative affect). Comparisons occurred at 21% of moments, with considerable within-person variability in response. In line with predictions from the Identification/Contrast Model, women were more likely to experience positive affect after upward identification or downward contrast and more likely to experience negative affect after upward contrast or downward identification, though observed nuances warrant additional consideration. Overall, findings support the Identification/Contrast Model to describe women's comparison experiences as they occur in daily life. Future work should determine pathways between the immediate consequences of comparisons and longer-term health outcomes.

5.
Alzheimer Dis Assoc Disord ; 38(2): 168-177, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38651790

RESUMEN

BACKGROUND: Persons living with Alzheimer disease and related dementia (ADRD) in nursing homes (NH) are often excluded from conversations about their health/safety. These omissions impinge on personhood and the rights to have care preferences heard and honored. While persons with ADRD maintain the ability to communicate their preferences long after their decision-making abilities are affected, little is known about how persons with ADRD understand the risks associated with their preferences. METHODS: As part of a larger focused ethnography, in-depth interviews and an adapted risk propensity questionnaire explored the risk perceptions of NH residents with ADRD (N=7) associated with their preferences for care and activities of daily living. RESULTS: Residents generally self-identified as risk avoiders ( M =3.2±1.84) on the risk propensity scale and were able to rate risk associated with preferences described within 5 thematic categories: 1) participation in decision-making, 2) risk awareness, 3) paying attention to safety, 4) reliance on nursing home staff and family, and 5) impacts on quality of life and quality of care. DISCUSSION: Results suggest NH residents with ADRD can express risk surrounding their preferences and should be encouraged to participate in discussions about their health and safety.


Asunto(s)
Toma de Decisiones , Demencia , Casas de Salud , Humanos , Masculino , Femenino , Demencia/psicología , Anciano de 80 o más Años , Anciano , Encuestas y Cuestionarios , Actividades Cotidianas/psicología , Calidad de Vida/psicología , Prioridad del Paciente/psicología
6.
J Behav Med ; 47(4): 622-634, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38429599

RESUMEN

Although it is well established that moderate-to-vigorous physical activity (MVPA) buffers against declines in cognitive health, less is known about the benefits of light physical activity (LPA). Research on the role of LPA is crucial to advancing behavioral interventions to improve late life health outcomes, including cognitive functioning, because this form of physical activity remains more feasible and amenable to change in old age. Our study examined the extent to which increases in LPA frequency protected against longitudinal declines in cognitive functioning and whether such a relationship becomes pronounced in old age when opportunities for MVPA are typically reduced. We analyzed 9-year data from the national Midlife in the United States Study (n = 2,229; Mage = 56 years, range = 33-83; 56% female) using autoregressive models that assessed whether change in LPA frequency predicted corresponding changes in episodic memory and executive functioning in middle and later adulthood. Increases in LPA frequency predicted less decline in episodic memory (ß = 0.06, p = .004) and executive functioning (ß = 0.14, p < .001) over the 9-year follow-up period, even when controlling for moderate and vigorous physical activity. Effect sizes for moderate and vigorous physical activity were less than half that observed for LPA. Moderation models showed that, for episodic memory, the benefits of increases in LPA frequency were more pronounced at older ages. Findings suggest that increases in LPA over extended periods of time may help slow age-related cognitive declines, particularly in later life when opportunities for MVPA are often diminished.


Asunto(s)
Función Ejecutiva , Ejercicio Físico , Humanos , Femenino , Ejercicio Físico/psicología , Masculino , Anciano , Persona de Mediana Edad , Anciano de 80 o más Años , Función Ejecutiva/fisiología , Adulto , Memoria Episódica , Estudios Longitudinales , Envejecimiento/psicología , Envejecimiento/fisiología , Disfunción Cognitiva/prevención & control , Disfunción Cognitiva/psicología , Estados Unidos , Cognición
7.
Innov Aging ; 8(3): igae018, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38511204

RESUMEN

Background and Objectives: Purpose in life is associated with healthier cognitive outcomes in older adulthood. This research examines within-person dynamics between momentary purpose and cognitive function to provide proof of concept that increases in purpose are associated with better cognitive performance. Research Design and Methods: Participants (N = 303; 54% female; Mage = 51.71, SD = 7.32) completed smartphone-based momentary assessments of purpose and short cognitive tasks 3 times a day for 8 days. Results: In moments when participants felt more purpose driven than their average, they had faster processing speed (b = -1.240, SE = 0.194; p < .001), independent of person, temporal, and contextual factors and practice effects. Momentary purpose was unrelated to visual working memory performance (b = -0.001, SE = 0.001; p = .475). In contrast to purpose, momentary hedonic affect (e.g., happiness) was unrelated to momentary cognition. Discussion and Implications: Feeling more momentary purpose may support faster processing speed in daily life. Such evidence provides stage 0 support for a purpose-based intervention for healthier cognition, which may be particularly useful in middle adulthood and the transition to older adulthood before the onset of cognitive impairment.

8.
J Alzheimers Dis ; 98(1): 319-332, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38393900

RESUMEN

Background: The Cognitive Change Index (CCI) is a widely-used measure of self-perceived cognitive ability and change. Unfortunately, it is unclear if the CCI predicts future cognitive and clinical decline. Objective: We evaluated baseline CCI to predict transition from normal cognition to cognitive impairment in nondemented older adults and in predementia groups including, subjective cognitive decline, motoric cognitive risk syndrome, and mild cognitive impairment. Different versions of the CCI were assessed to uncover any differential risk sensitivity. We also examined the effect of ethnicity/race on CCI. Methods: Einstein Aging Study participants (N = 322, Mage = 77.57±4.96, % female=67.1, Meducation = 15.06±3.54, % non-Hispanic white = 46.3) completed an expanded 40-item CCI version (CCI-40) and neuropsychological evaluation (including Clinical Dementia Rating Scale [CDR], Montreal Cognitive Assessment, and Craft Story) at baseline and annual follow-up (Mfollow - up=3.4 years). CCI-40 includes the original 20 items (CCI-20) and the first 12 memory items (CCI-12). Linear mixed effects models (LME) and generalized LME assessed the association of CCI total scores at baseline with rate of decline in neuropsychological tests and CDR. Results: In the overall sample and across predementia groups, the CCI was associated with rate of change in log odds on CDR, with higher CCI at baseline predicting faster increase in the odds of being impaired on CDR. The predictive validity of the CCI broadly held across versions (CCI-12, 20, 40) and ethnic/racial groups (non-Hispanic black and white). Conclusions: Self-perception of cognitive change on the CCI is a useful marker of dementia risk in demographically/clinically diverse nondemented samples. All CCI versions successfully predicted decline.


Asunto(s)
Trastornos del Conocimiento , Disfunción Cognitiva , Humanos , Femenino , Anciano , Masculino , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/psicología , Pruebas Neuropsicológicas , Cognición , Envejecimiento
9.
J Fam Psychol ; 38(3): 502-509, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38330322

RESUMEN

Cognitive behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD; Monson & Fredman, 2012) is associated with improvements in patients' and partners' mental health and relationship satisfaction. Some pretreatment relationship characteristics have predicted CBCT for PTSD outcomes for patients, but findings were limited to a single community sample consisting primarily of female patients with male partners. A better understanding of whether pretreatment relationship characteristics predict outcomes in other patient populations and whether there are partners who may be particularly responsive to couple therapy for PTSD could optimize treatment matching. This study investigated whether pretreatment partner accommodation and relationship satisfaction predicted patient and partner treatment outcomes from an uncontrolled trial of an abbreviated, intensive, multicouple group version of CBCT for PTSD conducted with 24 active-duty military or veteran couples (96% male patients/female partners). In general, changes in patients' PTSD and comorbid symptoms and relationship satisfaction did not vary by pretreatment partner accommodation or patients' own pretreatment relationship satisfaction. In contrast, pretreatment relationship characteristics predicted partner outcomes. Partners who engaged in higher levels of accommodation pretreatment and partners who reported lower levels of pretreatment relationship satisfaction experienced greater declines in psychological distress following treatment. Also, partners who began the study relationally distressed exhibited significant increases in relationship satisfaction following treatment, whereas those who were not relationally distressed did not. Findings suggest that improvements generally do not vary by pretreatment relationship characteristics for patients, whereas partners who begin treatment with elevated relationship risk factors may be especially likely to experience improvement across outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Terapia Cognitivo-Conductual , Terapia de Parejas , Trastornos por Estrés Postraumático , Humanos , Femenino , Masculino , Trastornos por Estrés Postraumático/terapia , Emociones , Salud Mental
10.
Artículo en Inglés | MEDLINE | ID: mdl-38334405

RESUMEN

OBJECTIVES: Theoretical perspectives on aging suggest that when people experience declines in later life, they often selectively focus on maintaining aspects of their lives that are most meaningful and important to them. The social domain is one of these selected areas. The current study examines people's reports of control over their daily stressors over 10 years, predicting that the declines in control that are often observed in later life will not be observed for stressors involving interpersonal conflict and tensions with social partners. METHODS: Adults ranging from 35 to 86 years old at baseline (N = 1,940), from the National Study of Daily Experiences, reported control over interpersonal and noninterpersonal daily stressors across 8 consecutive days at 2 time points, about 10 years apart. RESULTS: Findings from multilevel models indicate that for noninterpersonal stressors, perceived control decreased over time. In contrast, perceived control over interpersonal conflicts and tensions remained robust over time. No cross-sectional baseline age differences were found for levels of interpersonal and noninterpersonal stressor control. DISCUSSION: Results are consistent with socioemotional selectivity and underscore the importance of interpersonal relationships in later adulthood. Understanding how people select and preserve certain aspects of control in their daily life can help guide efforts toward maximizing gains and minimizing losses in domains that matter most to people as they grow older.


Asunto(s)
Relaciones Interpersonales , Estrés Psicológico , Humanos , Adulto , Anciano , Anciano de 80 o más Años , Estrés Psicológico/psicología , Envejecimiento/psicología , Conflicto Psicológico , Análisis Multinivel
11.
Am J Physiol Heart Circ Physiol ; 326(3): H648-H654, 2024 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-38214903

RESUMEN

The prevalence of major depressive disorder (MDD) is highest in young adults and contributes to an increased risk of developing future cardiovascular disease (CVD). However, the underlying mechanisms remain unclear. The studies examining cardiac autonomic function that have included young unmedicated adults with MDD report equivocal findings, and few have considered the potential influence of disease severity or duration. We hypothesized that heart rate variability (HRV) and cardiac baroreflex sensitivity (BRS) would be reduced in young unmedicated adults with MDD (18-30 yr old) compared with healthy nondepressed young adults (HA). We further hypothesized that greater symptom severity would be related to poorer cardiac autonomic function in young adults with MDD. Heart rate and beat-to-beat blood pressure were continuously recorded during 10 min of supine rest to assess HRV and cardiac BRS in 28 HA (17 female, 22 ± 3 yr old) and 37 adults with MDD experiencing current symptoms of mild-to-moderate severity (unmedicated; 28 female, 20 ± 3 yr old). Neither HRV [root mean square of successive differences between normal heartbeats (RMSSD): 63 ± 34 HA vs. 79 ± 36 ms MDD; P = 0.14] nor cardiac BRS (overall gain, 21 ± 10 HA vs. 23 ± 7 ms/mmHg MDD; P = 0.59) were different between groups. In young adults with MDD, there was no association between current depressive symptom severity and either HRV (RMSSD, R2 = 0.004, P = 0.73) or cardiac BRS (overall gain, R2 = 0.02, P = 0.85). Taken together, these data suggest that cardiac autonomic dysfunction may not contribute to elevated cardiovascular risk factor profiles in young unmedicated adults with MDD of mild-to-moderate severity.NEW & NOTEWORTHY This study investigated cardiac autonomic function in young unmedicated adults with major depressive disorder (MDD). The results demonstrated that both heart rate variability and cardiac baroreflex sensitivity were preserved in young unmedicated adults with MDD compared with healthy nondepressed young adults. Furthermore, in young adults with MDD, current depressive symptom severity was not associated with any indices of cardiac autonomic function.


Asunto(s)
Enfermedades del Sistema Nervioso Autónomo , Trastorno Depresivo Mayor , Cardiopatías , Humanos , Femenino , Adulto Joven , Trastorno Depresivo Mayor/diagnóstico , Sistema Nervioso Autónomo , Corazón , Presión Sanguínea/fisiología , Barorreflejo/fisiología , Frecuencia Cardíaca/fisiología
12.
Fam Process ; 63(1): 428-442, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36806013

RESUMEN

The coronavirus disease (COVID-19) pandemic has necessitated the use of health-protective behaviors (HPB), such as social distancing, staying at home, frequent handwashing, and wearing facemasks to mitigate the transmission of disease. An investigation of interpersonal costs associated with the use of HPB can help inform strategies to promote their sustained implementation. This study examined the daily associations between the implementation of HPB and family functioning and assessed moderation by coparenting quality, economic strain, and the number of days that state-level stay-at-home policies had been in effect, during the early days of the pandemic. Mothers and fathers from 155 families with children who were 9 years old, on average, completed daily reports of HPB, parental stress, and family relationship quality over eight consecutive days in April or May of 2020. Hierarchal linear models showed that HPB was associated with increased levels of parental stress and interparental conflict. Negative coparenting relations exacerbated the next-day association between HPB and interparental conflict. HPB was also associated with increased levels of parent-child and interparental closeness, but these linkages dissipated for families who had spent more days under state-level stay-at-home policies. Although crucial for public health, the implementation of HPB may have detrimental short-term effects on daily family life. Family support and interventions are necessary to minimize the psychosocial burden of these important public health measures and increase their sustained adherence.


Asunto(s)
COVID-19 , Pandemias , Femenino , Humanos , Niño , Pandemias/prevención & control , COVID-19/prevención & control , Relaciones Familiares , Madres/psicología , Conflicto Familiar/psicología , Padres/psicología
13.
Artículo en Inglés | MEDLINE | ID: mdl-37899644

RESUMEN

DNA methylation-derived epigenetic clocks offer the opportunity to examine aspects of age acceleration (ie, the difference between an individual's biological age and chronological age), which vary among individuals and may better account for age-related changes in cognitive function than chronological age. Leveraging existing ambulatory cognitive assessments in daily life from a genetically diverse sample of 142 adults in midlife, we examined associations between 5 measures of epigenetic age acceleration and performance on tasks of processing speed and working memory. Covarying for chronological age, we used multilevel models to examine associations of epigenetic age acceleration (Horvath 1, Horvath 2, Hannum, PhenoAge, and GrimAge clocks) with both average level and variability of cognitive performance. Positive age acceleration (ie, epigenetic age greater than chronological age) was associated with poorer mean processing speed (Horvath 1 and 2) and working memory (GrimAge). Higher chronological age was also associated with poorer mean processing speed and working memory performance. Further, positive age acceleration was generally associated with greater intraindividual variability in working memory and processing speed tasks, whereas being chronologically older was associated with less intraindividual variability. Although further work is needed, our results indicate age acceleration effects have comparable or greater size as those for chronological age differences, suggesting that epigenetic age acceleration may account for additional risk and interindividual variation in cognitive performance above chronological age.


Asunto(s)
Envejecimiento , Epigénesis Genética , Humanos , Envejecimiento/genética , Metilación de ADN , Cognición , Aceleración
14.
Dev Psychol ; 60(1): 45-58, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37917487

RESUMEN

Perceived control is an important psychosocial resource for health and well-being across the lifespan. Global control (i.e., overall perceived control) decreases over time in studies following people every few years to upwards of 10 years. Changes across wider intervals of the lifespan, however, have yet to be examined. Further, how perceived control changes for specific aspects of daily life, such as stressors, remains comparatively less clear. Using data from the Midlife in the United States National Study of Daily Experiences (NSDE, N = 1,940, M = 56.25 years, SD = 12.20, 57% female), we examined longitudinal changes in global control across 20 years and daily stressor control across 10 years. Global control was assessed in the first wave of the NSDE (∼1996). In follow-up waves, conducted in ∼2008 and ∼2017, participants again not only reported their global control but also reported their perceived control over stressors they experience across 8 consecutive days. Longitudinal analyses revealed differential change trajectories for global control across 20 years and stressor control across 10 years (ps < .001). Global control declined for younger and older adults but stayed relatively stable for individuals in midlife. The rate of decline in daily stressor control was steeper than the decline in global control and did not vary by age at baseline. In addition, declines were amplified among individuals with higher global control at baseline. Results suggest that daily stressor control is a specific aspect of control beliefs that follows a different rate of change than global control. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Longevidad , Estrés Psicológico , Humanos , Femenino , Estados Unidos , Anciano , Masculino , Estrés Psicológico/psicología
15.
Int J Behav Nutr Phys Act ; 20(1): 137, 2023 Nov 22.
Artículo en Inglés | MEDLINE | ID: mdl-37993862

RESUMEN

BACKGROUND: The beneficial effect of acute physical exercise on cognitive performance has been studied in laboratory settings and in long-term longitudinal studies. Less is known about these associations in everyday environment and on a momentary timeframe. This study investigated momentary and daily associations between physical activity and cognitive functioning in the context of everyday life. METHODS: Middle-aged adults (n = 291, aged 40-70) were asked to wear accelerometers and complete ecological momentary assessments for eight consecutive days. Processing speed and visual memory were assessed three times per day and self-rated evaluations of daily cognition (memory, thinking, and sharpness of mind) were collected each night. The number of minutes spent above the active threshold (active time) and the maximum vector magnitude counts (the highest intensity obtained) before each cognitive test and at a daily level were used as predictors of momentary cognitive performance and nightly subjective cognition. Analyses were done with multilevel linear models. The models were adjusted for temporal and contextual factors, age, sex, education, and race/ethnicity. RESULTS: When participants had a more active time or higher intensity than their average level within the 20 or 60 minutes prior to the cognitive test, they performed better on the processing speed task. On days when participants had more active time than their average day, they rated their memory in the evening better. Physical activity was not associated with visual memory or self-rated thinking and sharpness of mind. CONCLUSIONS: This study provides novel evidence that outside of laboratory settings, even small increases in physical activity boost daily processing speed abilities and self-rated memory. The finding of temporary beneficial effects is consistent with long-term longitudinal research on the cognitive benefits of physical activity.


Asunto(s)
Cognición , Ejercicio Físico , Adulto , Persona de Mediana Edad , Humanos , Ejercicio Físico/psicología , Velocidad de Procesamiento
16.
Innov Aging ; 7(7): igad083, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37841214

RESUMEN

Background and Objectives: Hospitalized persons living with dementia are at risk for functional decline, behavioral symptoms of distress, and delirium, all persisting in the postacute period. In turn, family care partners (FCPs) experience increased anxiety and lack of preparedness for caregiving, compounding existing strain and burden. Family-centered Function-focused Care (Fam-FFC) purposefully engages FCPs in assessment, decision-making, care delivery, and evaluation of function-focused care during and after hospitalization (within 48 hours of discharge, weekly telephone calls for a total of 7 additional weeks, then monthly for 4 months). The objective of this study was to test the efficacy of Fam-FFC. Research Design and Methods: A cluster randomized controlled trial included 455 dyads of persons living with dementia and FCPs in 6 medical units in 3 hospitals. Patient outcomes included return to baseline physical function, behavioral symptoms of distress, depressive symptoms, and delirium severity. Family care partner measures included preparedness for caregiving, anxiety, strain, and burden. Results: Multilevel level modeling demonstrated that the likelihood of returning to baseline function across time for Fam-FFC participants was twice that of the control group by the end of 6 months (OR = 2.4, p = .01, 95% CI 1.2-4.7). Family-centered Function-focused Care was also associated with fewer symptoms of distress (b = -1.1, SE = 0.56, p = .05) but no differences in the amount of moderate physical activity, depressive symptoms, and delirium severity. Preparedness for caregiving increased significantly only from 2 to 6 months (b = 0.89, SE = 0.45, d = 0.21, overall p = .02) in the intervention group, with no group differences in anxiety, strain, and burden. Discussion and Implications: Family-centered Function-focused Care may help prevent some of the postacute functional decline and behavioral symptoms in hospitalized persons living with dementia. Further research is needed to promote sustained improvements in these symptoms with more attention to the postacute needs of the care partner.

17.
BMC Geriatr ; 23(1): 670, 2023 10 17.
Artículo en Inglés | MEDLINE | ID: mdl-37848825

RESUMEN

BACKGROUND: Everyday memory problems are believed to increase with age, leading many researchers to focus on older ages when examining reports of memory lapses. However, real world memory lapses are ubiquitous across the adult lifespan, though less is known about the types of problems and their impacts at younger ages. The current study examined occurrence and impacts of memory lapses using daily diaries in a broad age range and whether characteristics of lapses varied across age, gender, or education level. METHODS: Using an 8-day daily diary protocol, 2,018 individuals (ages 25-91) provided reports of their experiences of two types of daily memory lapses (retrospective and prospective) as well as the impact those lapses had on their emotional and functional well-being that day. Using multilevel modeling, we examined the likelihood of reporting memory lapses and their impacts on daily life and whether these depended on age, gender, or education level. RESULTS: Participants reported lapses on approximately 40% of days; retrospective memory lapses were significantly more likely than prospective lapses. Older ages and higher education level were related to greater likelihood of reporting retrospective lapses. Women (compared to men) were more likely to report prospective memory lapses. Women also tended to report greater impacts of their memory lapses. Lower education levels were related to greater impacts of memory lapses compared to higher education levels. Interestingly, age was not related to impacts of lapses. DISCUSSION: Our results indicate that memory lapses are common across the lifespan and that those individuals more likely to report lapses are not necessarily those that experience the greatest impacts of those lapses on daily life. Additional work is needed to understand the daily experience of memory lapses and how they differentially affect individuals regardless of age, gender, and education. CONCLUSIONS: Memory lapses are an important aspect of daily life across the lifespan and require measurement in an individual's real-world environments. Better measurement of these experiences will allow the development of more sensitive measures of changes in cognitive functioning that may impact an individual's ability to live independently.


Asunto(s)
Individualidad , Longevidad , Masculino , Humanos , Femenino , Estudios Retrospectivos , Trastornos de la Memoria/diagnóstico , Trastornos de la Memoria/epidemiología , Trastornos de la Memoria/psicología , Cognición
18.
J Psychosom Res ; 174: 111489, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37690333

RESUMEN

OBJECTIVE: Limited research has focused on the association between inflammatory markers and features of subjective cognitive functioning among older adults. The present work examined links between inflammation and a specific subjective cognitive report: prospective memory (PM), or our memory for future intentions, such as attending an appointment or taking medication. METHOD: We assessed self-reported PM lapses using a two-week ecological momentary assessment (EMA) diary protocol via smartphone as well as levels of blood-based inflammation among 231 dementia-free older adults (70-90 years, 66% women) enrolled in the Einstein Aging Study. RESULTS: Overall, PM lapses were largely unrelated to inflammatory markers. However, a significant gender difference was observed in the link between basal levels of interleukin (IL)-8 and PM lapses: higher levels of basal IL-8 were associated with more PM lapses among men (estimate = 0.98, 95%CI: [0.43, 1.53], p < .001) but not women (estimate = -0.03, 95%CI: [-0.45, 0.39], p = .826). No other significant relationships between PM lapses and basal or stimulated (ex vivo) cytokine levels (IL-1ß, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor-alpha [TNF-α]) or C-reactive protein (CRP) emerged. CONCLUSION: Elevated levels of IL-8 in older men may possibly be an early indicator of neurodegeneration that relates to PM performance. Future studies should continue to examine PM and inflammation across genders to identify possible mechanisms through which these constructs may indicate neurodegeneration and dementia risk.


Asunto(s)
Interleucina-8 , Memoria Episódica , Humanos , Masculino , Femenino , Anciano , Autoinforme , Envejecimiento/psicología , Trastornos de la Memoria , Inflamación/metabolismo
19.
Drug Alcohol Rev ; 42(7): 1754-1763, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37469227

RESUMEN

INTRODUCTION: Alcohol use has been linked to impairment in both short- and long-term measures of objective memory. However, limited research has investigated the association between alcohol use and subjective memory in everyday life. The study purpose was to investigate within- and between-person associations between daily alcohol use and prospective (i.e., forgetting an intended task) and retrospective (i.e., forgetting something learned in the past) memory lapses among middle-aged and older adults. METHODS: Participants (n = 925; Mage = 55.2) were non-abstaining adults from the Midlife in the United States (MIDUS) study or the MIDUS Refresher who participated in an 8-day telephone diary asking about their daily experiences. RESULTS: Multilevel models revealed that within-individuals, heavier-than-usual alcohol use (i.e., having more drinks than one's daily average number of drinks) was associated with greater odds of reporting any memory lapses (odds ratio [OR] 1.06; 95% confidence interval [CI] 1.01, 1.12), while associations at the between-person level were nonsignificant (OR 1.07; 95% CI 0.99, 1.16). When assessing retrospective and prospective lapses separately, alcohol use was only associated with prospective lapses and only at the between-person level (OR 1.10; 95% CI 1.01, 1.19). Finally, alcohol use was unassociated with reported irritation or interference from memory lapses (p > 0.05). DISCUSSION AND CONCLUSIONS: Heavier-than-usual alcohol use may have acute effects on daily memory functioning. Future studies should assess how alcohol use relates to an individual's ability to meet daily cognitive demands, as these findings may have critical implications for harm reduction efforts targeting daily functioning among older adults.


Asunto(s)
Consumo de Bebidas Alcohólicas , Trastornos de la Memoria , Persona de Mediana Edad , Humanos , Estados Unidos , Anciano , Estudios Retrospectivos , Estudios Prospectivos , Trastornos de la Memoria/psicología , Consumo de Bebidas Alcohólicas/epidemiología
20.
Innov Aging ; 7(6): igad056, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37497342

RESUMEN

Background and Objectives: Subjective cognitive decline (SCD) may be indicative of future objective cognitive decline. However, factors other than objective cognitive performance may influence SCD. This review addresses whether family history or close, nonfamilial exposure to dementia is associated with self-reported SCD. Research Design and Methods: Searches were conducted in PubMed, PsycINFO, Web of Science, and the Dissertations and Theses database. Eligible articles included measures of self-reported cognition for community-dwelling middle-aged or older adults (40+ years) not diagnosed with dementia, and who had either a family history of dementia, a family member, spouse, or close friend with dementia. The quality of evidence was evaluated using the LEGEND Appraisal Tool. Evidence was synthesized narratively. Results: A total of 32 articles were included, with 28 rated as good quality. Across studies, the relationship between dementia exposure and SCD was inconsistent. A significant association between exposure and SCD was found in 6 studies; however, 17 reviewed studies found no evidence of a relationship. The remaining 9 studies found mixed associations. Modifying factors that could potentially influence these associations were exploratorily identified among studies to provide context to our results. These factors included dementia worry, emotional closeness, and measurement sensitivity. Discussion and Implications: Findings of this review suggest that both first-degree relatives and spouses of persons with dementia may have an increased likelihood of reporting SCD, although the current heterogeneity in definitions of exposure to dementia and SCD may influence these findings. In addition to the relationship between dementia exposure and SCD, future research should examine potential modifiers, including meaning attributed to exposure, as identifying how these perceptions affect cognition may promote early intervention.

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