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  • 1
    Online Resource
    Online Resource
    Does parity matter in women’s risk of dementia? A COSMIC collaboration cohort study
    Springer Science and Business Media LLC ; 2020
    In:  BMC Medicine Vol. 18, No. 1 ( 2020-12)
    Details
    In: BMC Medicine, Springer Science and Business Media LLC, Vol. 18, No. 1 ( 2020-12)
    Abstract: Dementia shows sex difference in its epidemiology. Childbirth, a distinctive experience of women, is associated with the risk for various diseases. However, its association with the risk of dementia in women has rarely been studied. Methods We harmonized and pooled baseline data from 11 population-based cohorts from 11 countries over 3 continents, including 14,792 women aged 60 years or older. We investigated the association between parity and the risk of dementia using logistic regression models that adjusted for age, educational level, hypertension, diabetes mellitus, and cohort, with additional analyses by region and dementia subtype. Results Across all cohorts, grand multiparous (5 or more childbirths) women had a 47% greater risk of dementia than primiparous (1 childbirth) women (odds ratio [OR] = 1.47, 95% confidence interval [CI]  = 1.10–1.94), while nulliparous (no childbirth) women and women with 2 to 4 childbirths showed a comparable dementia risk to primiparous women. However, there were differences associated with region and dementia subtype. Compared to women with 1 to 4 childbirths, grand multiparous women showed a higher risk of dementia in Europe (OR = 2.99, 95% CI = 1.38–6.47) and Latin America (OR = 1.49, 95% CI = 1.04–2.12), while nulliparous women showed a higher dementia risk in Asia (OR = 2.15, 95% CI = 1.33–3.47). Grand multiparity was associated with 6.9-fold higher risk of vascular dementia in Europe (OR = 6.86, 95% CI = 1.81–26.08), whereas nulliparity was associated with a higher risk of Alzheimer disease (OR = 1.91, 95% CI 1.07–3.39) and non-Alzheimer non-vascular dementia (OR = 3.47, 95% CI = 1.44–8.35) in Asia. Conclusion Parity is associated with women’s risk of dementia, though this is not uniform across regions and dementia subtypes.
    Type of Medium: Online Resource
    ISSN: 1741-7015
    URL: Article
    DOI: 10.1186/s12916-020-01671-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2131669-7
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  • 2
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    Comparison of In‐Person and Telephone Administration of the Mini‐Mental State Examination in the University of Alabama at Birmingham Study of Aging
    Wiley ; 2014
    In:  Journal of the American Geriatrics Society Vol. 62, No. 10 ( 2014-10), p. 1928-1932
    Details
    In: Journal of the American Geriatrics Society, Wiley, Vol. 62, No. 10 ( 2014-10), p. 1928-1932
    Abstract: To validate the Mini‐Mental State Examination ( MMSE ) Telephone ( MMSET ) against the MMSE . Design Cross‐sectional. Setting Homes of community‐dwelling older adults. Participants African‐American and non‐Hispanic white adults aged 75 and older participating in the University of Alabama at Birmingham Study of Aging II , a longitudinal epidemiological study across the state of Alabama ( N  = 419). Measurements Cognition, measured using the MMSE , MMSET , and Six‐Item Screener ( SIS ), and function, based on self‐reported difficulty performing instrumental activities of daily living ( IADL s). Correlation and agreement coefficients were used to examine concordance of the MMSE and MMSET ; linear and logistic regressions were used to test associations with clinical outcomes of IADL difficulty and verified diagnoses of dementia. Results The MMSET showed good internal consistency (Cronbach α  = 0.845), similar to the full MMSE , and strong correlation with the latter (Spearman ρ  = 0.694, P   〈  .001). The MMSET explained a similar proportion of IADL difficulty as the full MMSE (coefficient of variation = 0.201 and 0.189, respectively). The MMSET was also associated with verified dementia diagnoses (area under the receiver operating characteristic curve = 0.73), which was similar to the full MMSE . Conclusion The MMSET is a brief, valid measure of cognition in older adults with psychometric properties similar to that of the full MMSE . Because it can be administered over the telephone, further use in epidemiological studies is promising.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    URL: Article
    DOI: 10.1111/jgs.2014.62.issue-10
    DOI: 10.1111/jgs.13027
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2040494-3
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  • 3
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    ACTIVE Cognitive Training and Rates of Incident Dementia
    Cambridge University Press (CUP) ; 2012
    In:  Journal of the International Neuropsychological Society Vol. 18, No. 4 ( 2012-07), p. 669-677
    Details
    In: Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 18, No. 4 ( 2012-07), p. 669-677
    Abstract: Systematic cognitive training produces long-term improvement in cognitive function and less difficulty in performing activities of daily living. We examined whether cognitive training was associated with reduced rate of incident dementia. Participants were from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study ( n = 2,802). Incident dementia was defined using a combination of interview- and performance-based methods. Survival analysis was used to determine if ACTIVE treatment affected the rate of incident dementia during 5 years of follow-up. A total of 189 participants met criteria for incident dementia. Baseline factors predictive of incident dementia were older age, male gender, African American race, fewer years of education, relationship other than married, no alcohol use, worse MMSE, worse SF-36 physical functioning, higher depressive symptomatology, diabetes, and stroke (all p 〈 .05). A multivariable model with significant predictors of incident dementia and training group revealed that cognitive training was not associated with a lower rate of incident dementia. Cognitive training did not affect rates of incident dementia after 5 years of follow-up. Longer follow-up or enhanced training may be needed to fully explore the preventive capacity of cognitive training in forestalling onset of dementia. ( JINS , 2012, 18 , 1–9)
    Type of Medium: Online Resource
    ISSN: 1355-6177 , 1469-7661
    URL: Article
    DOI: 10.1017/S1355617711001470
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2012
    detail.hit.zdb_id: 2000018-2
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  • 4
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    Online Resource
    GEOGRAPHIC DISPARITIES IN COUNTY-LEVEL PREVALENCE OF ALZHEIMER’S DISEASE ACROSS THE UNITED STATES
    Oxford University Press (OUP) ; 2019
    In:  Innovation in Aging Vol. 3, No. Supplement_1 ( 2019-11-08), p. S782-S782
    Details
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 3, No. Supplement_1 ( 2019-11-08), p. S782-S782
    Abstract: Small-area geographic disparities in health care delivery have been observed across multiple disorders, but remain poorly studied for Alzheimer’s disease (AD) and other dementias. While national and state estimates of the prevalence and incidence of AD are available, estimates across finer geographic regions offer an opportunity to tailor programs to the needs of the local population. We estimated prevalence of AD at the county level across the continental United States. We used prevalence rates of AD by age category and race among Medicare fee-for-service beneficiaries published by the Centers for Disease Control (CDC). These prevalence rates were projected onto bridged-race county-level population data for 2017 from the National Center for Health Statistics, with empirical Bayes spatial smoothing to reduce variability in rates due to small population sizes. Estimated prevalence of AD varied more than threefold across counties, from a low of 51.8 per 1,000 persons in Loving County, Texas to a high of 169.6 per 1,000 persons in Kalawao County, Hawaii. Higher prevalence of AD was seen in the Southeastern and Midwestern United States. However, we observed specific counties with low prevalence of AD within regions with high prevalence of AD, and vice versa. These small-area geographic variations may provide vital information about social and environmental influences on dementia care, yet little data have been available to date. Understanding geographic disparities in prevalence will be critical for addressing practice variation in the prevention and diagnosis of dementia.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    URL: Article
    DOI: 10.1093/geroni/igz038.2878
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2905697-4
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  • 5
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    Online Resource
    Life-Space in a National Cohort of U.S. Older Adults: Normative Data for the UAB Life-Space Assessment
    Oxford University Press (OUP) ; 2020
    In:  Innovation in Aging Vol. 4, No. Supplement_1 ( 2020-12-16), p. 289-289
    Details
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 4, No. Supplement_1 ( 2020-12-16), p. 289-289
    Abstract: The University of Alabama at Birmingham Life-Space Assessment (LSA) is a self-reported measure for assessing community mobility. Restricted mobility is correlated with a number of adverse health outcomes, including mortality, frailty, cognitive decline, and nursing home admissions. Thus, it is important for providers to understand how the LSA score of a patient compares to the general population. To facilitate such comparisons, we developed demographically adjusted norms for the LSA and its correlation with other functional measures. Norms were based on 15,390 participants age 45 and older in the National Institutes of Health-funded REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national, population-based, longitudinal study investigating the causes of excess stroke mortality among African Americans and individuals living in the Southeastern US stroke belt region. LSA scores declined from a median of 100 in the 45-54 age range to a median of 59.7 in the 85 and older age range, with higher median scores in males. LSA scores showed modest but significant positive correlations with SF-12 Physical Component and Mental Component, Center for Epidemiologic Studies Depression Scale, and Six Item Screener cognitive scores, as well as modest but significant negative correlations with AD8 Dementia Screening, Katz Activities of Daily Living, and Timed Walk scores. The LSA is a brief, easily administered measure that offers a valid method of assessing community mobility in the older adult population.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    URL: Article
    DOI: 10.1093/geroni/igaa057.926
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2905697-4
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  • 6
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    Online Resource
    The Wechsler Test of Adult Reading as a Measure of Premorbid Intelligence Following Traumatic Brain Injury
    Oxford University Press (OUP) ; 2016
    In:  Archives of Clinical Neuropsychology
    Details
    In: Archives of Clinical Neuropsychology, Oxford University Press (OUP)
    Type of Medium: Online Resource
    ISSN: 0887-6177 , 1873-5843
    URL: Article
    DOI: 10.1093/arclin/acw081
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2016
    detail.hit.zdb_id: 2003528-7
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  • 7
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    Neuropsychological Correlates of Anosognosia for Objective Functional Difficulties in Older Adults on the Mild Cognitive Impairment Spectrum
    Oxford University Press (OUP) ; 2020
    In:  Archives of Clinical Neuropsychology Vol. 35, No. 4 ( 2020-05-22), p. 365-376
    Details
    In: Archives of Clinical Neuropsychology, Oxford University Press (OUP), Vol. 35, No. 4 ( 2020-05-22), p. 365-376
    Abstract: To examine the neuropsychological correlates of anosognosia for instrumental activities of daily living (IADLs) in older adults with mild cognitive impairment (MCI) and mild dementia. Method Participants (n = 103; age range = 54–88, 52% female) with MCI and mild dementia were recruited from neurology and geriatrics clinics for cross-sectional analysis. They completed neuropsychological tests along with subjective and performance-based assessments of six IADLs: financial management, driving, grocery shopping, nutrition evaluation, telephone use, and medication management. For each IADL, participants were classified as having anosognosia when there was objective difficulty but no subjective complaints. Results Depending on functional domain, 13–39% of the sample had objective IADL difficulty, and of those, 65–93% lacked insight into these deficits. Binomial logistic regression models controlling for demographic variables revealed that measures of global cognition, executive function, visual attention, and verbal memory predicted classification of anosognosia, and these relationships varied across IADLs. In contrast, basic auditory attention, working memory, depressive symptoms, nor cognitive reserve were significantly related to anosognosia for any IADL. Conclusion Results support the Conscious Awareness Model, which theorizes that accurate metacognitive output is reliant on attentional, memory, and executive functioning systems. Findings from this study suggest that anosognosia for different IADLs may arise from breakdowns at varying points in this model, explaining both inter- and intra-patient variability in self-awareness of functional deficits.
    Type of Medium: Online Resource
    ISSN: 1873-5843
    URL: Article
    DOI: 10.1093/arclin/acz065
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 8
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    Online Resource
    The relationship of longitudinal cognitive change to self-reported IADL in a general population
    Informa UK Limited ; 2020
    In:  Aging, Neuropsychology, and Cognition Vol. 27, No. 1 ( 2020-01-02), p. 125-139
    Details
    In: Aging, Neuropsychology, and Cognition, Informa UK Limited, Vol. 27, No. 1 ( 2020-01-02), p. 125-139
    Type of Medium: Online Resource
    ISSN: 1382-5585 , 1744-4128
    URL: Article
    DOI: 10.1080/13825585.2019.1597008
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2020
    detail.hit.zdb_id: 1482447-4
    SSG: 5,2
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  • 9
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    Cognitive Processing Speed Is Strongly Related to Driving Skills, Financial Abilities, and Other Instrumental Activities of Daily Living in Persons With Mild Cognitive Impairment and Mild Dementia
    Oxford University Press (OUP) ; 2021
    In:  The Journals of Gerontology: Series A Vol. 76, No. 10 ( 2021-09-13), p. 1829-1838
    Details
    In: The Journals of Gerontology: Series A, Oxford University Press (OUP), Vol. 76, No. 10 ( 2021-09-13), p. 1829-1838
    Abstract: Cognitive processing speed is important for performing everyday activities in persons with mild cognitive impairment (MCI). However, its role in daily function has not been examined while simultaneously accounting for contributions of Alzheimer’s disease (AD) risk biomarkers. We examine the relationships of processing speed and genetic and neuroimaging biomarkers to composites of daily function, mobility, and driving. Method We used baseline data from 103 participants on the MCI/mild dementia spectrum from the Applying Programs to Preserve Skills trial. Linear regression models examined relationships of processing speed, structural magnetic resonance imaging (MRI), and genetic risk alleles for AD to composites of performance-based instrumental activities of daily living (IADLs), community mobility, and on-road driving evaluations. Results In multivariable models, processing speed and the brain MRI neurodegeneration biomarker Spatial Pattern of Abnormality for Recognition of Early Alzheimer’s disease (SPARE-AD) were significantly associated with functional and mobility composite performance. Better processing speed and younger age were associated with on-road driving ratings. Genetic risk markers, left hippocampal atrophy, and white matter lesion volumes were not significant correlates of these abilities. Processing speed had a strong positive association with IADL function (p & lt; .001), mobility (p & lt; .001), and driving (p = .002). Conclusions Cognitive processing speed is strongly and consistently associated with critical daily functions in persons with MCI in models including genetic and neuroimaging biomarkers of AD risk. SPARE-AD scores also significantly correlate with IADL performance and mobility. Results highlight the central role of processing speed in everyday task performance among persons with MCI/mild dementia.
    Type of Medium: Online Resource
    ISSN: 1079-5006 , 1758-535X
    URL: Article
    DOI: 10.1093/gerona/glaa312
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2043927-1
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  • 10
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    Life-Space Mobility: Normative Values From a National Cohort of U.S. Older Adults
    Oxford University Press (OUP) ; 2023
    In:  The Journals of Gerontology: Series A ( 2023-07-22)
    Details
    In: The Journals of Gerontology: Series A, Oxford University Press (OUP), ( 2023-07-22)
    Abstract: Life-space mobility, which measures the distance, frequency, and independence achieved as individuals move through their community, is one of the most important contributors to healthy aging. The University of Alabama at Birmingham Life-Space Assessment (LSA) is the most commonly used measure of life-space mobility in older adults, yet U.S. national norms for LSA have not previously been reported. This study reports such norms based on age and sex among community-dwelling older adults. Methods A cross-sectional analysis using data from the national REasons for Geographic and Racial Disparities in Stroke cohort study. LSA data were available for 10 118 Black and White participants over age 50, which were grouped by age (in 5-year increments) and sex, weighted for the U.S. national population. Correlations were calculated between LSA and measures of functional and cognitive impairment and physical performance. Results The weighted mean LSA ranged from 102.9 for 50–54-year-old males to 69.5 for males aged 85 and older, and from 102.1 for 50–54-year-old females to 60.1 for females aged 85 and older. LSA was strongly correlated with measures of timed walking, activities of daily living, cognition, depressive symptoms, and quality of life (all p & lt; .001). Conclusions We report U.S. national norms for LSA among community-dwelling Black and White older adults. These norms can serve as a reference tool for determining if clinical and research samples have greater or lesser life-space mobility than typical older adults in the United States for their age and sex.
    Type of Medium: Online Resource
    ISSN: 1079-5006 , 1758-535X
    URL: Article
    DOI: 10.1093/gerona/glad176
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2043927-1
    SSG: 12
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