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1.
BMC Geriatr ; 24(1): 551, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38918697

RESUMO

BACKGROUND: Although a growing body of literature documents the importance of neighborhood effects on late-life cognition, little is known about the relative strength of objective and subjective neighborhood measures on late-life cognitive changes. This study examined effects of objective and subjective neighborhood measures in three neighborhood domains (neighborhood safety, physical disorder, food environments) on longitudinal changes in processing speed, an early marker of cognitive aging and impairment. METHODS: The analysis sample included 306 community-dwelling older adults enrolled in the Einstein Aging Study (mean age = 77, age range = 70 to 91; female = 67.7%; non-Hispanic White: 45.1%, non-Hispanic Black: 40.9%). Objective and subjective measures of neighborhood included three neighborhood domains (i.e., neighborhood safety, physical disorder, food environments). Processing speed was assessed using a brief Symbol Match task (unit: second), administered on a smartphone device six times a day for 16 days and repeated annually for up to five years. Years from baseline was used as the within-person time index. RESULTS: Results from mixed effects models showed that subjective neighborhood safety (ß= -0.028) and subjective availability of healthy foods (ß= -0.028) were significantly associated with less cognitive slowing over time. When objective and subjective neighborhood measures were simultaneously examined, subjective availability of healthy foods remained significant (ß= -0.028) after controlling for objective availability of healthy foods. Associations of objective neighborhood crime and physical disorder with processing speed seemed to be confounded by individual-level race and socioeconomic status; after controlling for these confounders, none of objective neighborhood measures showed significant associations with processing speed. CONCLUSION: Subjective neighborhood safety and subjective availability of healthy foods, rather than objective measures, were associated with less cognitive slowing over time over a five-year period. Perception of one's neighborhood may be a more proximal predictor of cognitive health outcomes as it may reflect one's experiences in the environment. It would be important to improve our understanding of both objective and subjective neighborhood factors to improve cognitive health among older adults.


Assuntos
Características de Residência , Segurança , População Urbana , Humanos , Idoso , Masculino , Feminino , Idoso de 80 Anos ou mais , Estudos Longitudinais , Características da Vizinhança , Cognição/fisiologia , Vida Independente/psicologia , Velocidade de Processamento
2.
BMC Geriatr ; 23(1): 302, 2023 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-37198552

RESUMO

BACKGROUND: . Although prior studies have examined the associations between neighborhood characteristics and cognitive health, little is known about whether local food environments, which are critical for individuals' daily living, are associated with late-life cognition. Further, little is known about how local environments may shape individuals' health-related behaviors and impact cognitive health. The aim of this study is to examine whether objective and subjective measures of healthy food availability are associated with ambulatory cognitive performance and whether behavioral and cardiovascular factors mediate these associations among urban older adults. METHODS: . The sample consisted of systematically recruited, community-dwelling older adults (N = 315, mean age = 77.5, range = 70-91) from the Einstein Aging Study. Objective availability of healthy foods was defined as density of healthy food stores. Subjective availability of healthy foods and fruit/vegetable consumption were assessed using self-reported questionnaires. Cognitive performance was assessed using smartphone-administered cognitive tasks that measured processing speed, short-term memory binding, and spatial working memory performance 6 times a day for 14 days. RESULTS: . Results from multilevel models showed that subjective availability of healthy foods, but not objective food environments, was associated with better processing speed (estimate= -0.176, p = .003) and more accurate memory binding performance (estimate = 0.042, p = .012). Further, 14~16% of the effects of subjective availability of healthy foods on cognition were mediated through fruit and vegetable consumption. CONCLUSIONS: . Local food environments seem to be important for individuals' dietary behavior and cognitive health. Specifically, subjective measures of food environments may better reflect individuals' experiences regarding their local food environments not captured by objective measures. Future policy and intervention strategies will need to include both objective and subjective food environment measures in identifying impactful target for intervention and evaluating effectiveness of policy changes.


Assuntos
Frutas , Verduras , Humanos , Idoso , Acesso a Alimentos Saudáveis , Cognição , Comportamentos Relacionados com a Saúde
3.
Alzheimers Dement ; 19(7): 3171-3185, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37074203

RESUMO

INTRODUCTION: The projected growth of Alzheimer's disease (AD) and AD-related dementia (ADRD) cases by midcentury has expanded the research field and impelled new lines of inquiry into structural and social determinants of health (S/SDOH) as fundamental drivers of disparities in AD/ADRD. METHODS: In this review, we employ Bronfenbrenner's ecological systems theory as a framework to posit how S/SDOH impact AD/ADRD risk and outcomes. RESULTS: Bronfenbrenner defined the "macrosystem" as the realm of power (structural) systems that drive S/SDOH and that are the root cause of health disparities. These root causes have been discussed little to date in relation to AD/ADRD, and thus, macrosystem influences, such as racism, classism, sexism, and homophobia, are the emphasis in this paper. DISCUSSION: Under Bronfenbrenner's macrosystem framework, we highlight key quantitative and qualitative studies linking S/SDOH with AD/ADRD, identify scientific gaps in the literature, and propose guidance for future research. HIGHLIGHTS: Ecological systems theory links structural/social determinants to AD/ADRD. Structural/social determinants accrue and interact over the life course to impact AD/ADRD. Macrosystem is made up of societal norms, beliefs, values, and practices (e.g., laws). Most macro-level determinants have been understudied in the AD/ADRD literature.


Assuntos
Doença de Alzheimer , Demência , Humanos , Determinantes Sociais da Saúde
4.
J Leis Res ; 53(2): 211-228, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36210884

RESUMO

This study examined the effects of participation in enjoyable activities and the experience of uplifting events on individuals' momentary positive affect (PA) and tested for age differences in these effects. 176 adults (ages 25-66) completed ecological momentary assessments (EMAs) 5 times per day for 14 days. We found that individuals reported higher levels of PA at times when an uplifting event had occurred compared to times when an uplifting event had not occurred (p < 0.05), and this association was amplified among those who participated less frequently in enjoyable activities (p < 0.05). The moderating effect of participation in enjoyable activities was invariant across the sample's age range. The findings demonstrated that individuals who habitually participated in enjoyable activities experienced higher levels of PA in everyday life. In contrast, individuals who infrequently or never engaged in enjoyable activities depended upon recent uplifting events to experience higher levels of PA.

5.
Aging Ment Health ; 22(5): 611-618, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-28351162

RESUMO

OBJECTIVES: Given that the association between work stress and negative affect can exacerbate negative health and workplace outcomes, it is important to identify the protective and risk factors that moderate this association. Socioemotional aging and cognitive abilities might influence how people utilize emotion regulation skills and engage in practical problem solving to manage their work stress. The aim of this study is to examine whether age and cognitive abilities independently and interactively moderate the association between work-related stress and negative affect. METHOD: A diverse working adult sample (N = 139, age 25-65, 69% of females) completed a cross-sectional survey that assessed chronic work stress, negative affect, and fluid and crystallized cognitive abilities. RESULTS: Results from regression analyses suggested that both fluid and crystallized cognitive abilities, but not age, moderated the association between work stress and negative affect. Further, we found that crystallized cognition had a stronger attenuating effect on the work stress-negative affect association for older compared to younger workers. The moderating effect of fluid cognition was invariant across age. CONCLUSION: Our findings demonstrate that cognitive abilities are an important personal resource that might protect individuals against the negative impacts of work stress and negative affect. Although the role that fluid cognition plays in work stress-negative affect association is comparably important for both younger and older workers, crystallized cognition might play a more valuable role for older than younger workers.


Assuntos
Afeto/fisiologia , Envelhecimento/fisiologia , Cognição/fisiologia , Inteligência/fisiologia , Estresse Ocupacional/fisiopatologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
6.
Psychol Sport Exerc ; 70: 102561, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37951452

RESUMO

OBJECTIVE: This study investigated the association between morning pleasant anticipation (i.e., how pleasant will the day be?) and daily positive incidental affect (PIA, e.g., feeling enjoyable, energetic) on daily steps as measured by ecological momentary assessment (EMA) and accelerometry. METHODS: A total of 152 adults in Taiwan (female = 67.1 %, age range = 18-59, M = 24.97) completed smartphone-based surveys upon waking and at three quasi-random times during the day for seven days during the COVID-19 outbreak (February-July 2022). They also wore accelerometers for the same seven days to measure physical activity (daily steps). The morning survey asked participants to self-report pleasant anticipation throughout the day, and the three quasi-random time surveys assessed current PIA. Multilevel modeling was used to examine day-level associations between morning pleasant anticipation, PIA, and daily steps. A list of key covariates (i.e., age, sex, educational attainment, marital status, living arrangement, chronic disease, body mass index [BMI], smoking, drinking, wellbeing, daily sleep quality, daily sleep hours, and accelerometer wear time) were included in the models to adjust for the covariates' potential effects on the study outcomes. RESULTS: The study sample consisted of 989 morning observations and 2714 quasi-random time observations (EMA response rate = 87.01 %). Findings suggest that higher-than-usual levels of pleasant anticipation in the morning were significantly associated with more same-day daily steps (b = 0.03, SD = 0.01, p = .03) after adjusting for covariates. In addition, daily PIA was a significant moderator between morning pleasant anticipation and daily steps (b = 0.02, SD = 0.01, p < .01), such that higher levels of daily PIA were associated with greater increases in daily steps in response to higher levels of morning pleasant anticipation. CONCLUSION: On days when participants had higher levels of pleasant anticipation in the morning, they took more steps per day. In addition, the association between morning pleasant anticipation and steps per day was stronger on days when participants had higher levels of PIA. These findings have practical implications for future EMA studies investigating the "anticipatory" affective processes on movement behaviors with the goal of promoting physical activity in daily life.


Assuntos
Avaliação Momentânea Ecológica , Emoções , Adulto , Feminino , Humanos , Exercício Físico/fisiologia , Autorrelato , Inquéritos e Questionários , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Masculino
7.
Soc Sci Med ; 348: 116807, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38569283

RESUMO

OBJECTIVE: Exposure to neighborhood violence may have negative implications for adults' cognitive functioning, but the ecological sensitivity of these effects has yet to be determined. We first evaluated the link between exposure to neighborhood violence and two latent constructs of cognitive function that incorporated laboratory-based and ambulatory, smartphone-based, cognitive assessments. Second, we examined whether the effect of exposure to violence was stronger for ambulatory assessments compared to in-lab assessments. METHODS: We used data from 256 urban-dwelling adults between 25 and 65 years old (M = 46.26, SD = 11.07); 63.18% non-Hispanic Black, 9.21% non-Hispanic White, 18.41% Hispanic White, 5.02% Hispanic Black, and 4.18% other. Participants completed baseline surveys on neighborhood exposures, cognitive assessments in a laboratory/research office, and ambulatory smartphone-based cognitive assessments five-times a day for 14 days. RESULTS: Exposure to neighborhood violence was associated with poorer performance in a latent working memory construct that incorporated in-lab and ambulatory assessments, but was not associated with the perceptual speed construct. The effect of exposure to neighborhood violence on the working memory construct was explained by its effect on the ambulatory working memory task and not by the in-lab cognitive assessments. CONCLUSION: This study shows the negative effect that exposure to neighborhood violence may have on everyday working memory performance in urban-dwelling adults in midlife. Results highlight the need for more research to determine the sensitivity of ambulatory assessments to quantify the effects of neighborhood violence on cognitive function.


Assuntos
Cognição , Exposição à Violência , Características de Residência , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Características de Residência/estatística & dados numéricos , Exposição à Violência/psicologia , Exposição à Violência/estatística & dados numéricos , Idoso , Análise e Desempenho de Tarefas , População Urbana/estatística & dados numéricos , Violência/psicologia , Violência/estatística & dados numéricos , Memória de Curto Prazo
8.
Leis Sci ; 44(7): 995-1012, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-37033273

RESUMO

Leisure engagement is believed to offer emotional benefits. However, relatively few studies have examined how leisure engagement influences emotional well-being in the context of individuals' everyday lives. The current study examined the associations between leisure engagement and daily emotional well-being, as measured by participants' mean levels of positive affect (PA), PA variability, and PA reactivity to stressors. Using smartphones, participants (n = 176) completed ecological momentary assessments (EMAs) 5 times per day for 14 consecutive days. The Pearson correlations indicated that the participants who engaged in leisure more frequently experienced higher mean levels of PA and lower PA variability in daily life compared to those with less frequent leisure engagement. However, multilevel models indicated that individuals' differences in frequency of leisure engagement did not influence their emotional reactivity in response to daily stressors. The findings extend the importance of leisure engagement to consider the dynamics of daily emotional well-being.

9.
J Pain ; 23(4): 616-624, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34780992

RESUMO

An individual's pain experiences vary substantially over time. Though variability in pain may be an important metric which usually predicts health consequences, research on the measurement of pain variability estimates is lacking among older adults. We aimed to examine the reliabilities of both intra-individual mean (IIM) and intra-individual variability (IIV) of pain assessed using ecological momentary assessments (EMA) among racially diverse, systematically recruited community dwelling cohort of older adults. Participants (N = 311, age = 70-91) completed a 14-day EMA protocol which included self-reports of pain intensity, pain interference with activities, and pain interference with concentration multiple times a day. Over a 2-week period, we found excellent reliabilities for both pain IIM (.99), and pain IIV (≥.90). We also found that we need 5 to 6 days to achieve good reliability (.8) for pain IIV, suggesting that a shorter protocol may be used to reduce participants' burden among the current sample, although caution is required when using this result to determine EMA study designs among different samples. Future studies are required to examine the associations of various EMA pain metrics with different health outcomes among older adults to facilitate the detection of underlying mechanisms linking pain to health as a prelude to interventions. PERSPECTIVE: Mean levels and variability in pain intensity, pain interference with activities, and pain interference with concentration can be reliably measured to be linked with various health outcomes in older adults. Future studies including these pain metrics will assess the natural history, the consequences, and effects of intervention of pain.


Assuntos
Envelhecimento , Avaliação Momentânea Ecológica , Idoso , Idoso de 80 Anos ou mais , Humanos , Dor , Reprodutibilidade dos Testes , Autorrelato
10.
J Alzheimers Dis ; 85(1): 179-196, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34776437

RESUMO

BACKGROUND: Education and occupational complexity are main sources of mental engagement during early life and adulthood respectively, but research findings are not conclusive regarding protective effects of these factors against late-life dementia. OBJECTIVE: This project aimed to examine the unique contributions of education and occupational complexity to incident dementia, and to assess the mediating effects of occupational complexity on the association between education and dementia across diverse cohorts. METHOD: We used data from 10,195 participants (median baseline age = 74.1, range = 58∼103), representing 9 international datasets from 6 countries over 4 continents. Using a coordinated analysis approach, the accelerated failure time model was applied to each dataset, followed by meta-analysis. In addition, causal mediation analyses were performed. RESULT: The meta-analytic results indicated that both education and occupational complexity were independently associated with increased dementia-free survival time, with 28%of the effect of education mediated by occupational complexity. There was evidence of threshold effects for education, with increased dementia-free survival time associated with 'high school completion' or 'above high school' compared to 'middle school completion or below'. CONCLUSION: Using datasets from a wide range of geographical regions, we found that both early life education and adulthood occupational complexity were independently predictive of dementia. Education and occupational experiences occur during early life and adulthood respectively, and dementia prevention efforts could thus be made at different stages of the life course.


Assuntos
Cognição , Demência/epidemiologia , Escolaridade , Ocupações , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Internacionalidade , Masculino , Pessoa de Meia-Idade , Fatores de Risco
11.
J Gerontol B Psychol Sci Soc Sci ; 76(4): 671-680, 2021 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-31560775

RESUMO

OBJECTIVES: Engaging in mentally challenging activities is associated with reduced risk for cognitive impairment and dementia; however, its association with rates of cognitive decline has been inconsistent. The aim of this study is to test whether working in mentally challenging occupations is related to rates of cognitive change at later older adulthood. METHOD: The sample consisted of 1,520 individuals (baseline mean age = 78.6 ± 5.1, range = 64-100) from the Einstein Aging Study. Occupation information of each participant was collected retrospectively and linked with the substantive complexity of work score from the Dictionary of Occupational Titles. Cognitive changes in memory, speed, and executive function (EF) domains were represented using two time metrics (i.e., time from retirement, time from study enrollment). RESULTS: Results from mixed models showed that occupational complexity was associated with significantly faster rates of cognitive decline in speed and EF in the "time from retirement" model but not in the "time from baseline" model. Despite faster cognitive loss, the protective effect of occupational complexity persisted for decades after retirement due to higher initial levels of cognition. DISCUSSION: The result suggests that protective factors for cognitive health may be associated with delayed onset but more rapid cognitive decline afterwards at later stages of cognitive aging.


Assuntos
Envelhecimento Cognitivo/psicologia , Disfunção Cognitiva , Reserva Cognitiva , Função Executiva , Inteligência , Ocupações/classificação , Idoso , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/prevenção & controle , Disfunção Cognitiva/psicologia , Progressão da Doença , Feminino , Humanos , Testes de Inteligência , Estudos Longitudinais , Masculino , Competência Mental , Fatores de Proteção , Aposentadoria/psicologia , Aposentadoria/estatística & dados numéricos , Estados Unidos/epidemiologia
12.
Front Digit Health ; 3: 758031, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34927132

RESUMO

Background and Objective: Within-person variability in cognitive performance has emerged as a promising indicator of cognitive health with potential to distinguish normative and pathological cognitive aging. We use a smartphone-based digital health approach with ecological momentary assessments (EMA) to examine differences in variability in performance among older adults with mild cognitive impairment (MCI) and those who were cognitively unimpaired (CU). Method: A sample of 311 systematically recruited, community-dwelling older adults from the Einstein Aging Study (Mean age = 77.46 years, SD = 4.86, Range = 70-90; 67% Female; 45% Non-Hispanic White, 40% Non-Hispanic Black) completed neuropsychological testing, neurological assessments, and self-reported questionnaires. One hundred individuals met Jak/Bondi criteria for MCI. All participants performed mobile cognitive tests of processing speed, visual short-term memory binding, and spatial working memory on a smartphone device up to six times daily for 16 days, yielding up to 96 assessments per person. We employed heterogeneous variance multilevel models using log-linear prediction of residual variance to simultaneously assess cognitive status differences in mean performance, within-day variability, and day-to-day variability. We further tested whether these differences were robust to the influence of environmental contexts under which assessments were performed. Results: Individuals with MCI exhibited greater within-day variability than those who were CU on ambulatory assessments that measure processing speed (p < 0.001) and visual short-term memory binding (p < 0.001) performance but not spatial working memory. Cognitive status differences in day-to-day variability were present only for the measure of processing speed. Associations between cognitive status and within-day variability in performance were robust to adjustment for sociodemographic and contextual variables. Conclusion: Our smartphone-based digital health approach facilitates the ambulatory assessment of cognitive performance in older adults and the capacity to differentiate individuals with MCI from those who were CU. Results suggest variability in mobile cognitive performance is sensitive to MCI and exhibits dissociative patterns by timescale and cognitive domain. Variability in processing speed and visual short-term memory binding performance may provide specific detection of MCI. The 16-day smartphone-based EMA measurement burst offers novel opportunity to leverage digital technology to measure performance variability across frequent assessments for studying cognitive health and identifying early clinical manifestations of cognitive impairment.

13.
J Gerontol A Biol Sci Med Sci ; 76(9): 1661-1667, 2021 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-33099603

RESUMO

BACKGROUND: Given increasing incidence of cognitive impairment and dementia, further understanding of modifiable factors contributing to increased healthspan is crucial. Extensive literature provides evidence that physical activity (PA) delays the onset of cognitive impairment; however, it is unclear whether engaging in PA in older adulthood is sufficient to influence progression through cognitive status categories. METHOD: Applying a coordinated analysis approach, this project independently analyzed 14 longitudinal studies (NTotal = 52 039; mean baseline age across studies = 69.9-81.73) from North America and Europe using multistate survival models to estimate the impact of engaging in PA on cognitive status transitions (nonimpaired, mildly impaired, severely impaired) and death. Multinomial regression models were fit to estimate life expectancy (LE) based on American PA recommendations. Meta-analyses provided the pooled effect sizes for the role of PA on each transition and estimated LEs. RESULTS: Controlling for baseline age, sex, education, and chronic conditions, analyses revealed that more PA is significantly associated with decreased risk of transitioning from nonimpaired to mildly impaired cognitive functioning and death, as well as substantially longer LE. Results also provided evidence for a protective effect of PA after onset of cognitive impairment (eg, decreased risk of transitioning from mild-to-severe cognitive impairment; increased likelihood of transitioning backward from severe-to-mild cognitive impairment), though between-study heterogeneity suggests a less robust association. CONCLUSIONS: These results yield evidence for the importance of engaging in PA in older adulthood for cognitive health, and a rationale for motivating older adults to engage consistently in PA.


Assuntos
Disfunção Cognitiva/prevenção & controle , Exercício Físico , Comportamentos Relacionados com a Saúde , Idoso , Idoso de 80 Anos ou mais , Europa (Continente) , Feminino , Humanos , Estudos Longitudinais , Masculino , América do Norte
14.
J Alzheimers Dis ; 75(4): 1405-1416, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32417772

RESUMO

BACKGROUND: Engaging in mentally challenging activities may protect against dementia in late life. However, little is known whether the association between mentally challenging activities and dementia risk varies with race/ethnicity. OBJECTIVE: The current study investigates whether having jobs with higher mental stimulation is differentially associated with a decreased risk of dementia between African Americans (AAs) and non-Hispanic Whites (nHWs). METHODS: The sample consisted of 1,079 individuals (66% nHWs, 28% AAs; age = 78.6±5.3) from the longitudinal Einstein Aging Study. Occupation information of each participant was collected retrospectively at baseline and was linked to the substantive complexity of work score from the Dictionary of Occupational Titles. Cox proportional hazards models were used to evaluate the associations of occupational complexity with risk of dementia. RESULTS: Individuals whose jobs had moderate-to-high levels of complexity, compared to those with the lowest complexity, were at modestly decreased risk for incident dementia. When stratified by race, moderate-to-high levels of occupational complexity were significantly associated with lower risk of developing dementia for AAs (HR = 0.35). When risk of dementia was evaluated based on the combinations of race×occupational complexity, AAs with lowest occupational complexity showed the highest risk of developing dementia, while other combinations exhibited lower risk of developing dementia (HRs = 0.36~0.43). CONCLUSION: Our results suggest that moderate-to-high levels of complexity at work are associated with a decreased risk of incident dementia in AAs. Understanding the differential effects of mentally challenging occupations across race/ethnicity may suggest important intervention strategies that could mitigate racial disparities in dementia rates.


Assuntos
Demência/etnologia , Ocupações/estatística & dados numéricos , Trabalho/psicologia , Negro ou Afro-Americano/etnologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Masculino , Estudos Retrospectivos , Análise de Sobrevida , População Branca/etnologia
15.
J Alzheimers Dis ; 73(3): 1211-1219, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31884486

RESUMO

BACKGROUND: Amyloid-ß positivity (Aß+) based on PET imaging is part of the enrollment criteria for many of the clinical trials of Alzheimer's disease (AD), particularly in trials for amyloid-targeted therapy. Predicting Aß positivity prior to PET imaging can decrease unnecessary patient burden and costs of running these trials. OBJECTIVE: The aim of this study was to evaluate the performance of a machine learning model in estimating the individual risk of Aß+ based on gold-standard of PET imaging. METHODS: We used data from an amnestic mild cognitive impairment (aMCI) subset of the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort to develop and validate the models. The predictors of Aß status included demographic and ApoE4 status in all models plus a combination of neuropsychological tests (NP), MRI volumetrics, and cerebrospinal fluid (CSF) biomarkers. RESULTS: The models that included NP and MRI measures separately showed an area under the receiver operating characteristics (AUC) of 0.74 and 0.72, respectively. However, using NP and MRI measures jointly in the model did not improve prediction. The models including CSF biomarkers significantly outperformed other models with AUCs between 0.89 to 0.92. CONCLUSIONS: Predictive models can be effectively used to identify persons with aMCI likely to be amyloid positive on a subsequent PET scan.


Assuntos
Peptídeos beta-Amiloides/metabolismo , Encéfalo/metabolismo , Disfunção Cognitiva/metabolismo , Aprendizado de Máquina , Idoso , Alelos , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Apolipoproteína E4/genética , Biomarcadores/líquido cefalorraquidiano , Biomarcadores/metabolismo , Encéfalo/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/genética , Disfunção Cognitiva/psicologia , Feminino , Frequência do Gene , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuroimagem , Testes Neuropsicológicos , Tomografia por Emissão de Pósitrons
16.
J Gerontol B Psychol Sci Soc Sci ; 74(1): 38-46, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-29767767

RESUMO

Objectives: The aim of this study was to examine the association between stress anticipated for the upcoming day and cognitive function later on that day, and how this relationship differed across age. Method: A diverse adult community sample (N = 240, age 25-65 years) completed ecological momentary assessment (EMA) reports for 2 weeks on a smartphone; each day they completed a morning survey upon waking, beeped surveys at five times during a day, and an end-of-day survey. Morning and end-of-day surveys included questions to measure stress anticipation, and each beeped survey included measures of stressful events, followed by a spatial working memory (WM) task. Results: Results from multilevel models indicated that stress anticipation reported upon waking, but not on the previous night, was associated with deficit in WM performance later that day; importantly, this effect was over and above the effect of EMA-reported stress. The detrimental effect of stress anticipation upon waking was invariant across age. Discussion: These findings suggest that anticipatory processes can produce harmful effects on cognitive functioning that are independent of everyday stress experiences. This may identify an important avenue to mitigate everyday cognitive lapses among older adults.


Assuntos
Antecipação Psicológica/fisiologia , Memória de Curto Prazo/fisiologia , Desempenho Psicomotor/fisiologia , Estresse Psicológico/fisiopatologia , Adulto , Avaliação Momentânea Ecológica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Memória Espacial/fisiologia , Fatores de Tempo
17.
Ageing Res Rev ; 52: 32-52, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31002885

RESUMO

Behavioral interventions to improve cognitive function in older adults are widespread and can vary from theater classes to cognitive training programs. However, the effectiveness in maintaining different cognitive domains varies greatly both across and within intervention types. To date, no systematic reviews have synthesized findings across more than a few types of interventions (e.g., cognitive vs. exercise). This systematic review examined 11 types of behavioral interventions and the respective transfer to 19 cognitive domains, as well as transfer to everyday function. Study inclusion criteria were: peer-reviewed articles in English, samples of healthy adults aged 65 and older, and randomized controlled trials of behavioral interventions with reported cognitive outcomes. The 2017 search yielded 75 eligible articles comprising cognitive training, exercise training, combination interventions, cognitively-stimulating activities, and action video games. In general, process- (n = 26) and strategy-based (n = 16) cognitive training improved the trained domains but had weak transfer to non-trained domains. Aerobic training (n = 13) most consistently improved executive function, and strength/resistance (n = 8) and aerobic/resistance combination training (n = 6) most consistently improved cognitive inhibition and visual working memory. Combination interventions (n = 15 nonfactorial, n = 3 factorial) showed promise in improving verbal delayed recall and executive function. Few studies examined cognitively-stimulating activities or action video games, leaving inconclusive results about their effect on cognitive function. Few studies examined everyday function (n = 9), however, process- and strategy-based training demonstrated notable long-term transfer. Recommendations for future research and practice are highlighted.


Assuntos
Envelhecimento , Terapia Comportamental/métodos , Transtornos Cognitivos/prevenção & controle , Cognição , Envelhecimento/fisiologia , Envelhecimento/psicologia , Função Executiva , Humanos , Aprendizagem , Condicionamento Físico Humano/métodos
18.
Assessment ; 25(1): 14-30, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27084835

RESUMO

Mobile technologies are increasingly used to measure cognitive function outside of traditional clinic and laboratory settings. Although ambulatory assessments of cognitive function conducted in people's natural environments offer potential advantages over traditional assessment approaches, the psychometrics of cognitive assessment procedures have been understudied. We evaluated the reliability and construct validity of ambulatory assessments of working memory and perceptual speed administered via smartphones as part of an ecological momentary assessment protocol in a diverse adult sample ( N = 219). Results indicated excellent between-person reliability (≥0.97) for average scores, and evidence of reliable within-person variability across measurement occasions (0.41-0.53). The ambulatory tasks also exhibited construct validity, as evidence by their loadings on working memory and perceptual speed factors defined by the in-lab assessments. Our findings demonstrate that averaging across brief cognitive assessments made in uncontrolled naturalistic settings provide measurements that are comparable in reliability to assessments made in controlled laboratory environments.


Assuntos
Cognição , Memória , Testes Neuropsicológicos/normas , Psicologia Clínica/instrumentação , Adulto , Idoso , Envelhecimento , Ecologia , Feminino , Humanos , Masculino , Rememoração Mental , Pessoa de Meia-Idade , Cidade de Nova Iorque , Estudos Prospectivos , Tempo de Reação , Reprodutibilidade dos Testes , Smartphone , Estresse Psicológico , Análise e Desempenho de Tarefas
19.
J Pers Oriented Res ; 3(2): 86-100, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29868167

RESUMO

BACKGROUND/OBJECTIVES: Invariance of intelligence across age is often assumed but infrequently explicitly tested. Horn and McArdle (1992) tested measurement invariance of intelligence, providing adequate model fit but might not consider all relevant aspects such as sub-test differences. The goal of the current paper is to explore age-related invariance of the WAIS-R using an alternative model that allows direct tests of age on WAIS-R subtests. METHODS: Cross-sectional data on 940 participants aged 16-75 from the WAIS-R normative values were used. Subtests examined were information, comprehension, similarities, vocabulary, picture completion, block design, picture arrangement, and object assembly. The two intelligence factors considered were fluid and crystallized intelligence. Self-reported ages were divided into young (16-22, n = 300), adult (29-39, n = 275), middle (40-60, n = 205), and older (61-75, n = 160) adult groups. RESULTS: Results suggested partial metric invariance holds. Although most of the subtests reflected fluid and crystalized intelligence similarly across different ages, invariance did not hold for block design on fluid intelligence and picture arrangement on crystallized intelligence for older adults. Additionally, there was evidence of a correlated residual between information and vocabulary for the young adults only. This partial metric invariance model yielded acceptable model fit compared to previously-proposed invariance models of Horn and McArdle (1992). CONCLUSION: Almost complete metric invariance holds for a two-factor model of intelligence. Most of the subtests were invariant across age groups, suggesting little evidence for age-related bias in the WAIS-R. However, we did find unique relationships between two subtests and intelligence. Future studies should examine age-related differences in subtests when testing measurement invariance in intelligence.

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