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  • 1
    In: Digital Biomarkers, S. Karger AG, Vol. 4, No. Suppl. 1 ( 2020-11-26), p. 100-118
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Future digital health research hinges on methodologies to conduct remote clinical assessments and in-home monitoring. The Collaborative Aging Research Using Technology (CART) initiative was introduced to establish a digital technology research platform that could widely assess activity in the homes of diverse cohorts of older adults and detect meaningful change longitudinally. This paper reports on the built end-to-end design of the CART platform, its functionality, and the resulting research capabilities. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 CART platform development followed a principled design process aiming for scalability, use case flexibility, longevity, and data privacy protection while allowing sharability. The platform, comprising ambient technology, wearables, and other sensors, was deployed in participants’ homes to provide continuous, long-term (months to years), and ecologically valid data. Data gathered from CART homes were sent securely to a research server for analysis and future data sharing. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The CART system was created, iteratively tested, and deployed to 232 homes representing four diverse cohorts (African American, Latinx, low-income, and predominantly rural-residing veterans) of older adults ( 〈 i 〉 n 〈 /i 〉 = 301) across the USA. Multiple measurements of wellness such as cognition (e.g., mean daily computer use time = 160–169 min), physical mobility (e.g., mean daily transitions between rooms = 96–155), sleep (e.g., mean nightly sleep duration = 6.3–7.4 h), and level of social engagement (e.g., reports of overnight visitors = 15–45%) were collected across cohorts. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The CART initiative resulted in a minimally obtrusive digital health-enabled system that met the design principles while allowing for data capture over extended periods and can be widely used by the research community. The ability to monitor and manage health digitally within the homes of older adults is an important alternative to in-person assessments in many research contexts. Further advances will come with wider, shared use of the CART system in additional settings, within different disease contexts, and by diverse research teams.
    Type of Medium: Online Resource
    ISSN: 2504-110X
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 2906645-1
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  • 2
    In: Gerontology, S. Karger AG, Vol. 63, No. 3 ( 2017), p. 253-262
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The human immunodeficiency virus (HIV) is associated with cognitive impairment, and loneliness is associated with cognitive decline in old age. Older Black adults with HIV may be at particular risk of loneliness due to stigma and lack of social resources. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 We tested the hypotheses that (1) older Black adults with HIV would show greater loneliness than older White adults with HIV, and (2) greater loneliness among older Black adults with HIV would be associated with poorer cognitive function. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 370 participants (177 with HIV, 193 without HIV; mean age 58.8 years, standard deviation 6.2 years; mean education 13.4 years, standard deviation 2.9 years; 73.9% male, 68.9% Black) in a community-based cross-sectional study of the Rush Center of Excellence on Disparities in HIV and Aging (CEDHA) completed a 5-item self-report scale used to measure emotional loneliness and a battery of cognitive measures. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Contrary to our expectations, older Black adults indicated less overall loneliness than White adults (β = -0.3893, SE = 0.1466, 〈 i 〉 p 〈 /i 〉 = 0.0087) in models controlling for the effects of age, education, sex, global cognition, and income. However, in models with cognitive function as the outcome, an interaction between race and loneliness was observed, such that older Black adults who indicated greater loneliness showed poorer cognitive function relative to White adults (β = -0.2736, SE = 0.1138, 〈 i 〉 p 〈 /i 〉 = 0.0174). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Older Black adults with HIV reported less loneliness than older White adults; however, the inverse association between loneliness and cognitive function was stronger in Black than White older adults. Additional work is needed to elucidate the mechanisms underlying this interaction.
    Type of Medium: Online Resource
    ISSN: 0304-324X , 1423-0003
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 1482689-6
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  • 3
    In: Neuroepidemiology, S. Karger AG, Vol. 26, No. 1 ( 2006), p. 16-22
    Abstract: Few studies have examined the association of race with change in cognitive function in Alzheimer’s disease (AD). We studied the rate of decline in global and specific measures of cognitive function in a cohort of 410 older African-Americans and whites with clinically diagnosed AD. Persons were examined annually for an average of 3.5 years, and follow-up participation among survivors exceeded 90%. In mixed-effects models that controlled for age, gender, education, and premorbid reading activity, African-Americans scored lower than whites at baseline on a composite measure of global cognition and on specific measures of visuoconstruction and naming. However, they experienced less rapid decline in episodic memory (p 〈 0.01), with similar but not quite significant effects for global cognition (p = 0.06), perceptual speed (p = 0.07) and naming (p = 0.08). The results suggest that the rate of cognitive decline in AD is slower in African-Americans compared with whites, particularly for episodic memory.
    Type of Medium: Online Resource
    ISSN: 0251-5350 , 1423-0208
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2006
    detail.hit.zdb_id: 1483032-2
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  • 4
    In: Gerontology, S. Karger AG, Vol. 67, No. 6 ( 2021), p. 729-739
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Evidence suggests that older Black adults are frequent victims of financial fraud and exploitation. This study aims to identify the factors associated with scam susceptibility in older Black adults. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Participants were 383 older Black adults living in the Chicago metropolitan area (mean age = 78 years and 82% female). A scam susceptibility measure assessed perceptions and behaviors that predispose older adults to fraud and scams. Categories of age-associated factors, including cognition, physical health, psychosocial factors, personality, and behavioral economics, were measured using uniform systematic assessments. For each category separately, measures associated with scam susceptibility were identified via stepwise variable selection. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Older age was associated with greater scam susceptibility. Further, the analysis revealed a robust association of cognitive health with scam susceptibility, particularly the domains of semantic and working memory. Psychological well-being was associated with susceptibility, as was neuroticism. Behavioral economic measures including financial and health literacy and financial and health decision-making ability were also implicated. In a final model that included all the measures initially retained by variable selection, semantic memory, psychological well-being, and financial and health literacy were independently associated with scam susceptibility. Moreover, the association of age was attenuated and no longer significant after adjusting for these correlates. 〈 b 〉 〈 i 〉 Discussion: 〈 /i 〉 〈 /b 〉 Age-associated vulnerabilities, rather than age itself, predispose older Black adults to financial fraud and scams. The correlates of scam susceptibility in community-living older Black adults primarily involve cognitive health, psychological, and behavioral economic factors.
    Type of Medium: Online Resource
    ISSN: 0304-324X , 1423-0003
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 1482689-6
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  • 5
    In: Neuroepidemiology, S. Karger AG, Vol. 54, No. 5 ( 2020), p. 404-418
    Abstract: The Rush Alzheimer’s Disease Center (RADC) conducts 5 harmonized prospective clinical-pathologic cohort studies of aging – with 1 study, the Latino Core, focused exclusively on Latinxs, 2 studies consisting of mostly non-Latinx whites, and 2 studies of mostly non-Latinx blacks. This paper contextualizes the Latino Core within the other 4 harmonized RADC cohort studies. The overall aim of the paper is to provide information from the RADC, so that researchers can learn from our participants and procedures to better advance the science of Alzheimer’s disease and related dementias in Latinxs. We describe an annual clinical evaluation that assesses risk factors for Alzheimer’s dementia among older adults without known dementia at enrollment. As all RADC cohort studies offer brain donation as a part of research participation, we discuss our approach to brain donation and subsequent participant decision-making among older Latinxs. We also summarize baseline characteristics of older Latinxs across the 5 RADC cohort studies in relation to the baseline characteristics of non-Latinx blacks and non-Latinx whites. Finally, we outline challenges and considerations as well as potential next steps in cognitive aging research with older Latinxs.
    Type of Medium: Online Resource
    ISSN: 0251-5350 , 1423-0208
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1483032-2
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