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No abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55888/1/21016_ftp.pd

Prevalence of Dementia in Older Latinos: The Influence of Type 2 Diabetes Mellitus, Stroke and Genetic Factors

To estimate dementia prevalence in older Mexican Americans, determine the distribution of dementia by etiology, and evaluate the contribution of type 2 diabetes mellitus, stroke, and apolipoprotein E (ApoE) genotype to dementia. DESIGN: Analysis of baseline data from an epidemiological cohort study. SETTING: Sacramento Valley, California. PARTICIPANTS: One thousand seven hundred eighty-nine Latinos aged 60 and older residing in targeted census tracts during 1998–99. MEASUREMENTS: Each subject was interviewed and screened for dementia and cardiovascular risk factors and diseases. Fasting blood samples were drawn for glucose, insulin, and lipids. Buccal cells were obtained for genetic analysis of ApoE. A three-stage process of screening was used to diagnose dementia, including cognitive testing, a clinical examination, and imaging to determine etiology. Presence of dementia was established according to National Institute of Neurological Disorders and Stroke/Alzheimers and Related Disorders Association criteria and California Alzheimer's Disease Diagnostic and Treatment Criteria. RESULTS: Overall dementia prevalence was 4.8%. Prevalence in those aged 85 and older was 31%. Education and Anglo cultural orientation was negatively associated with dementia risk. Risk of dementia was nearly eight times higher in those with both type 2 diabetes mellitus and stroke. Forty-three percent of dementia was attributable to type 2 diabetes mellitus, stroke, or a combination of the two. ApoE allele frequency was E2 5.9%, E3 90.1%, and E4 4%. Those with any E4 and 4–4 combinations had a higher risk for dementia than those with the E3–3 combination. CONCLUSIONS: Dementia prevalence in this ethnic group is similar to that reported in Canadian and European studies but lower than in Caribbean-Hispanics residing in the United States. The etiological fraction of dementia attributable to type 2 diabetes mellitus and stroke is substantial and points toward the need for intervention research and treatment with the goal of reducing neurological sequelae in groups with high prevalence of type 2 diabetes mellitus. The allele frequency of ApoE was similar to that in other published studies on Mexican Americans. The low frequency of the E4 allele may contribute to the difference in etiology of dementia in older Mexican Americans and older people of European background. Dementia in this ethnic group may be related to preventable causes, with a smaller genetic component than in Europeans.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66237/1/j.1532-5415.2003.51054.x.pd

Cognitively Stimulating Activities: Effects on Cognition across Four Studies with up to 21 Years of Longitudinal Data

Engagement in cognitively stimulating activities has been considered to maintain or strengthen cognitive skills, thereby minimizing age-related cognitive decline. While the idea that there may be a modifiable behavior that could lower risk for cognitive decline is appealing and potentially empowering for older adults, research findings have not consistently supported the beneficial effects of engaging in cognitively stimulating tasks. Using observational studies of naturalistic cognitive activities, we report a series of mixed effects models that include baseline and change in cognitive activity predicting cognitive outcomes over up to 21 years in four longitudinal studies of aging. Consistent evidence was found for cross-sectional relationships between level of cognitive activity and cognitive test performance. Baseline activity at an earlier age did not, however, predict rate of decline later in life, thus not supporting the concept that engaging in cognitive activity at an earlier point in time increases one's ability to mitigate future age-related cognitive decline. In contrast, change in activity was associated with relative change in cognitive performance. Results therefore suggest that change in cognitive activity from one's previous level has at least a transitory association with cognitive performance measured at the same point in time

Homocysteine, B vitamins, and the incidence of dementia and cognitive impairment: results from the Sacramento Area Latino Study on Aging

http://deepblue.lib.umich.edu/bitstream/2027.42/55438/1/Haan M, Homocysteine, b vitamins, and the incidence of dementia, 2007.pd

Are adverse childhood experiences associated with late-life cognitive performance across racial/ethnic groups: results from the Kaiser Healthy Aging and Diverse Life Experiences study baseline

Objectives Evidence on adverse childhood experiences (ACEs) and late-life cognitive outcomes is inconsistent, with little research among diverse racial/ethnic groups. We investigated whether ACE exposures were associated with worse late-life cognition for all racial/ethnic groups and at different ages of exposure.Design Covariate-adjusted mixed-effects linear regression models estimated associations of: (1) total number of ACEs experienced, (2) earliest age when ACE occurred and (3) type of ACE with overall cognition.Setting Kaiser Permanente Northern California members aged 65 years and older, living in Northern California.Participants Kaiser Healthy Aging and Diverse Life Experiences study baseline participants, aged 65 years and older (n=1661; including 403 Asian-American, 338 Latino, 427 Black and 493 white participants).Results Most respondents (69%) reported one or more ACE, most frequently family illness (36%), domestic violence (23%) and parental divorce (22%). ACE count was not adversely associated with cognition overall (β=0.01; 95% CI −0.01 to 0.03), in any racial/ethnic group or for any age category of exposure. Pooling across all race/ethnicities, parent’s remarriage (β=−0.11; 95% CI −0.20 to −0.03), mother’s death (β=−0.18; 95% CI −0.30 to −0.07) and father’s death (β=−0.11; 95% CI −0.20 to −0.01) were associated with worse cognition.Conclusion Adverse childhood exposures overall were not associated with worse cognition in older adults in a diverse sample, although three ACEs were associated with worse cognitive outcomes

Education, bilingualism, and cognitive trajectories: Sacramento Area Latino Aging Study (SALSA)

This study examined the influence of education, country where education occurred, and monolingual-bilingual (English/Spanish) language usage on late life cognitive trajectories in the Sacramento Area Latino Study on Aging (SALSA), an epidemiological study of health and cognition in Hispanics, mostly of Mexican origin, age 60 and over (N = 1,499). SALSA followed a large cohort of older Latinos for up to 7 assessment waves from 1998 to 2007. Global cognition was assessed by using the Modified Mini Mental State Examination, and the Spanish English Verbal Learning Test was used to measure episodic memory. Education, country of origin, and language usage patterns were collected at the baseline assessment and used as predictors of longitudinal trajectories of cognition. Parallel process mixed effects models were used to examine effects of education and language variables on baseline cognition and rate of cognitive decline. Mixed effects longitudinal models showed that education had strong effects on baseline global cognition and verbal memory but was not related to decline over up to 9 years of longitudinal follow-up. Differences in education effects between subgroups educated in Mexico and in the United States were minor. Monolingual-bilingual language usage was not related to cognitive decline, and bilinguals did not significantly differ from monolingual English speakers on baseline cognitive scores. Hypotheses that higher education and bilingualism protect against late life cognitive decline were not supported and education effects on late-life cognitive trajectories did not substantially differ across U.S.- and Mexico-educated groups. (PsycINFO Database Recor

Education, bilingualism, and cognitive trajectories: Sacramento Area Latino Aging Study (SALSA).

ObjectiveThis study examined the influence of education, country where education occurred, and monolingual-bilingual (English/Spanish) language usage on late life cognitive trajectories in the Sacramento Area Latino Study on Aging (SALSA), an epidemiological study of health and cognition in Hispanics, mostly of Mexican origin, age 60 and over (N = 1,499).MethodSALSA followed a large cohort of older Latinos for up to 7 assessment waves from 1998 to 2007. Global cognition was assessed by using the Modified Mini Mental State Examination, and the Spanish English Verbal Learning Test was used to measure episodic memory. Education, country of origin, and language usage patterns were collected at the baseline assessment and used as predictors of longitudinal trajectories of cognition. Parallel process mixed effects models were used to examine effects of education and language variables on baseline cognition and rate of cognitive decline.ResultsMixed effects longitudinal models showed that education had strong effects on baseline global cognition and verbal memory but was not related to decline over up to 9 years of longitudinal follow-up. Differences in education effects between subgroups educated in Mexico and in the United States were minor. Monolingual-bilingual language usage was not related to cognitive decline, and bilinguals did not significantly differ from monolingual English speakers on baseline cognitive scores.ConclusionsHypotheses that higher education and bilingualism protect against late life cognitive decline were not supported and education effects on late-life cognitive trajectories did not substantially differ across U.S.- and Mexico-educated groups. (PsycINFO Database Recor

Differences in association of leisure time activities and cognition in a racially/ethnically diverse cohort of older adults: Findings from the KHANDLE study.

IntroductionLeisure time activity is associated with better cognitive function but has not been well studied in racially/ethnically diverse cohorts, who may have different access to activities.MethodsFrequency of participation in 10 leisure time activities (eg, reading, attending cultural events) and cognition (executive function, semantic memory, and verbal episodic memory) were assessed at Wave 1 in the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study, a prospective cohort initiated in 2017. Linear regression models adjusted for sociodemographics and depression estimated cross-sectional associations between leisure time activity variety and frequency and cognitive domains overall and by race/ethnicity. Logistic regression models estimated odds of cognitive impairment among those in the lowest quartiles of activity variety and frequency. All models controlled for age, sex, education, income, retirement status, and depression.ResultsHigher leisure time activity variety was significantly associated with better cognition for all, except for verbal episodic memory among Asians (β = 0.05, 95% confidence interval [CI]: -0.004, 0.11) and semantic memory among Latinos (β = 0.04, 95% CI: -0.01, 0.08). Low activity variety was associated with nearly three-fold increased odds of cognitive impairment (adjusted odds ratio [OR] = 2.87, 95% CI: 1.77, 4.64). Activity frequency was associated with higher executive function only among whites (β = 0.10, 95% CI: 0.02, 0.18). Patterns by race/ethnicity were not explained by education.DiscussionEngaging in a wider variety of leisure time activities may be more important than frequently participating in fewer activities for cognitive aging in racially/ethnically diverse cohorts