The Association between Subjective Cognitive Decline and Trajectories of Objective Cognitive Decline: Do Social Relationships Matter?

Objectives : We examine the association between subjective cognitive decline (SCD) and the trajectories of objective cognitive decline (OCD); and the extent to which this association is moderated by social relationships. Methods : Data come from waves 10 (2010) through 14 (2018) of the Health and Retirement Study, a nationally representative panel survey of individuals aged 50 and above in the United States. OCD is measured using episodic memory, and overall cognition. SCD is assessed using a baseline measure of self-rated memory. Social relationships are measured by social network size and perceived positive and negative social support. Growth curve models estimate the longitudinal link between SCD and subsequent OCD trajectories and the interactions between SCD and social relationship variables on OCD. Results : SCD is associated with subsequent OCD. A wider social network and lower perceived negative support are linked to slower decline in memory, and overall cognition. None of the social relationship variables, however, moderate the link between SCD and future OCD. Conclusion : Knowing that SCD is linked to subsequent OCD is useful because at SCD stage, deficits are more manageable relative to those at subsequent stages of OCD. Future work on SCD and OCD should consider additional dimensions of social relationships

Bidirectional association between depressive symptoms and mild cognitive impairment over 20 years: Evidence from the health and retirement study in the United States

BACKGROUND: Research examining the association between depressive symptoms and mild cognitive impairment (MCI) has yielded conflicting results. This study aimed to examine the bidirectional association between depressive symptoms and MCI, and the extent to which this bidirectional association is moderated by gender and education. METHODS: Data come from the US Health and Retirement Study over a 20-year period (older adults aged ≥50 years). Competing-risks regression is employed to examine the association between baseline high-risk depressive symptoms and subsequent MCI (N = 9317), and baseline MCI and subsequent high-risk depressive symptoms (N = 9428). Interactions of baseline exposures with gender and education are tested. RESULTS: After full adjustment, baseline high-risk depressive symptoms were significantly associated with subsequent MCI (SHR = 1.20, 95%CI 1.08–1.34). Participants with baseline MCI are more likely to develop subsequent high-risk depressive symptoms than those without baseline MCI (SHR = 1.16, 95%CI 1.01–1.33). Although gender and education are risk factors for subsequent depression and MCI, neither moderates the bidirectional association. LIMITATIONS: Items used to construct the composite cognitive measure are limited; selection bias due to missing data; and residual confounding. CONCLUSIONS: Our study found a bidirectional association between depressive symptoms and MCI. High-risk depressive symptoms are related to a higher risk of subsequent MCI; and MCI predicts subsequent high-risk depression. Though neither gender nor education moderated the bidirectional association, public health interventions crafted to reduce the risk of depression and MCI should pivot attention to older women and those with less formal education

Gender differences in the association between cardiovascular diseases and major depressive disorder among older adults in India

Background: Despite the global disease burden associated with the co-occurrence of cardiovascular diseases (CVDs) and depression, depression remains underdiagnosed and undertreated in the CVD population, especially among older adults in India. As such, this study examines (1) the association between single and multiple CVDs and major depres- sive disorder among older Indians; (2) whether this association is mediated by older adults' self-rated health and func- tional limitations; and (3) whether these associations vary for older men and women. Methods: Data come from the 2017–18 wave 1 of the Longitudinal Ageing Study in India. Multivariable logistic regres- sion is used to explore the association between CVDs and major depressive disorder among older men and women. The Karlson–Holm–Breen (KHB) method is used to examine the mediation effects of self-rated health and functional diffi- culties in the observed associations. Results: Overall, 5.08% of the older adults had multiple CVDs. Older women (9.71%) had a higher prevalence of major depressive disorder compared to men (7.50%). Multiple CVDs were associated with greater odds of major depressive disorder after adjusting the potential covariates (adjusted odds ratio [AOR]: 1.49; 95% confidence interval [CI]: 1.10–2.00). Older men with multiple CVDs had a greater risk of major depressive disorder (AOR: 1.64; 95% CI: 1.05–2.57) relative to women with CVDs (AOR: 1.39; 95% CI: 0.93–2.08). The association between multiple CVDs and depression was mediated by self-rated health (34.03% for men vs. 34.55% for women), ADL difficulty (22.25% vs. 15.42%), and IADL difficulty (22.90% vs. 19.10%). Conclusions: One in five older Indians with multiple CVDs reports major depressive disorder, which is three times more common than the prevalence of depressive disorder in older adults without CVDs. This association is attenuated by self-rated health and functional limitations. Moreover, these associations are more pronounced in older men relative to older women. These findings depart from prior inferences that men with CVDs are less psychologically distressed than their female counterparts. Moreover, the findings underscore the importance of gender-specific approaches to in- terventions and therapeutics for CVD-related mental health

Associations among body mass index, handgrip strength, and cognitive impairment in older men and women in India

Background: This study examined the associations among body mass index (BMI), handgrip strength (HGS) and cognitive impairment among older adults in India. We also assessed whether these associations vary by gender. Methods: We used data from baseline wave of the Longitudinal Aging Study in India (2017–18) with a sample of 31,464 adults age 60 and above. Cognitive impairment was assessed using different domains of cognition, including memory, orientation, arithmetic functioning, and visuospatial and constructional ability. We used multivariable logistic regression and interaction analyses to test the research hypotheses. Results: Older women had 2.25 times the odds of cognitive impairment than older men [AOR: 2.25; CI: 2.01–2.53]. The odds of cognitive impairment were 1.36 times among underweight older adults [AOR: 1.36; CI: 1.23–1.50], 0.72 times among overweight [AOR: 0.72; CI: 0.62–0.83], and 0.66 times among obese older adults [AOR: 0.66; CI: 0.51–0.84] compared to peers with normal BMI. Underweight women had 3.14 times the odds of being cognitively impaired [AOR: 3.14; CI: 2.67–3.68] compared to older men with normal BMI. Further, older men who were underweight and had a weak HGS had higher odds of cognitive impairment than older men with a normal BMI and strong HGS. Conversely, older women who were overweight or obese and had strong HGS reported lower odds of cognitive impairment than older women with normal BMI and strong HGS. Conclusions: That the association between BMI and cognitive impairment differs between men and women and by HGS gives health care providers and practitioners additional information needed to identify groups of older adults most susceptible to cognitive impairment. In particular, gender specific policies and an assessment of HGS may be useful when crafting interventions to minimize the negative consequences of varying body types on later life cognitive function

The association between loneliness and life satisfaction: examining spirituality, religiosity, and religious participation as moderators

Abstract Background Future cohort of older adults may have to rely on non-family sources and forms of support, religion being one of them. This may be especially so, considering the recent longitudinal evidence that individuals are inclined to become more religious with increasing age. Thus, the purpose of the present study was to assess the association between loneliness and life satisfaction among older adults in India, and the extent to which the association between loneliness and life satisfaction is moderated by spirituality, religiosity, and religious participation. Methods Data come from the Longitudinal Ageing Study in India, with a sample of 31,464 individuals aged 60 years and above. Multivariable logistic regression models were employed to examine the independent association of loneliness and life satisfaction. Further, an interaction analysis was conducted to examine the extent to which the association between perceived loneliness and life satisfaction is moderated by spirituality, religiosity and religious participation among older Indians. Results The prevalence of low life satisfaction (LLS) was 30.84%; a total of 37.25% of participants reported feeling lonely, 12.54% reported a lack of spiritual experience, 21.24% reported not being religious, and 19.31% reported not participating in religious activities. Older adults who felt lonely had higher odds of LLS relative to peers who were not lonely. Further, the adverse impact of loneliness on LLS among older Indians is moderated by their spirituality, religiosity, and religious participation. Specifically, the adverse impact of loneliness on LLS was less negatively pronounced among older adults who were spiritual, religious, and engaged in religious activities. Conclusions The study found an independent association between loneliness and lower life satisfaction among older adults in India. It also revealed that religiosity, spirituality and religious participation moderate the association between loneliness and lower life satisfaction. These findings, which underscore the health promoting benefits of religiosity and religious engagement, may be used to build on the interaction between religious and faith-based groups and public health professionals