Publications by authors named "Lisa L Barnes"

206 Publications

Higher circulating α-carotene was associated with better cognitive function: an evaluation among the MIND trial participants.

J Nutr Sci 2021 16;10:e64. Epub 2021 Aug 16.

Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.

There is emerging evidence linking fruit and vegetable consumption and cognitive function. However, studies focusing on the nutrients underlying this relationship are lacking. We aim to examine the association between plasma nutrients and cognition in a population at risk for cognitive decline with a suboptimal diet. The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) trial is a randomized controlled intervention that examines the effects of the MIND diet to prevent cognitive decline. The primary outcome is global cognition. A multivariate linear model was used to investigate the association between blood nutrients and global and/or domain-specific cognition. The model was adjusted for age, sex, education, study site, smoking status, cognitive activities and physical activities. High plasma α-carotene was associated with better global cognition. Participants in the highest tertile of plasma α-carotene had a higher global cognition score of 0⋅17 when compared with individuals in the lowest tertile ( 0⋅002). Circulating α-carotene levels were also associated with higher semantic memory scores ( for trend 0⋅007). Lutein and zeaxanthin (combined) was positively associated with higher semantic memory scores ( for trend 0⋅009). Our study demonstrated that higher α-carotene levels in blood were associated with higher global cognition scores in a US population at risk for cognitive decline. The higher α-carotene levels in blood reflected greater intakes of fruits, other types of vegetables and lesser intakes of butter and margarine and meat. The higher circulating levels of lutein plus zeaxanthin reflected a dietary pattern with high intakes of fruits, green leafy, other vegetables and cheese, and low consumption of fried foods. Objective nutrient markers in the blood can better characterize dietary intake, which may facilitate the implementation of a tailored dietary intervention for the prevention of cognitive decline.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/jns.2021.56DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411267PMC
August 2021

Stroke Belt Birth State and Late-life Cognition in The Study of Healthy Aging in African Americans (STAR).

Ann Epidemiol 2021 Sep 9. Epub 2021 Sep 9.

Department of Neurology, University of California Davis School of Medicine, 4860 Y St, Suite 3700, Sacramento, CA, USA 95817; Department of Public Health Sciences, University of California Davis School of Medicine, Medical Science 1-C, One Shields Ave, Davis, CA, USA 95616.

Purpose: We examined the association of Stroke Belt birth state with late-life cognition in The Study of Healthy Aging in African Americans (STAR).

Methods: STAR enrolled 764 Black Americans ages 50+ who were long-term Kaiser Permanente Northern California members. Participants completed Multiphasic Health Check-ups (MHC;1964-1985) where early-life overweight/obesity, hypertension, diabetes, and hyperlipidemia were measured. At STAR (2018), birth state, self-reported early-life socioeconomic status (SES), and executive function, verbal episodic memory, and semantic memory scores were collected. We used linear regression to examine the association between Stroke Belt birth and late-life cognition adjusting for birth year, gender, and parental education. We evaluated early-life SES and cardiovascular risk factors (CVRF) as potential mechanisms.

Results: Twenty-seven percent of participants were born in the Stroke Belt with a mean age of 69(SD=9) at STAR. Stroke Belt birth was associated with worse late-life executive function (β(95% CI):-0.18(-0.33,-0.02)) and semantic memory (-0.37(-0.53, -0.21)), but not verbal episodic memory (-0.04(-0.20, 0.12)). Adjustment for SES and CVRF attenuated associations of Stroke Belt birth with cognition (executive function (-0.05(-0.25, 0.14)); semantic memory (-0.28(-0.49, -0.07))).

Conclusion: Black Americans born in the Stroke Belt had worse late-life cognition than those born elsewhere, underscoring the importance of early-life exposures on brain health.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.annepidem.2021.09.001DOI Listing
September 2021

Racial Differences in the Effect of HIV Status on Motor and Pulmonary Function and Mobility Disability in Older Adults.

J Racial Ethn Health Disparities 2021 Aug 17. Epub 2021 Aug 17.

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.

Background: Older Black adults face a disproportionate burden of HIV prevalence, but less is known about racial disparities in age-related outcomes in HIV. We assessed the effect of HIV status and race on motor and pulmonary function, as well as how they contribute to mobility disability.

Setting: Community-based study; Chicago, IL METHODS: Participants were 363 community-dwelling adults age ≥ 50 years, 48% living with HIV, and 68% Black. Participants with HIV were recruited from a specialty HIV clinic, and participants without HIV (comparable on key demographic, lifestyle, and behavioral characteristics) were recruited from the community. Measures included motor function summarized by 10 motor performance measures, pulmonary function summarized by 3 measures assessed using handheld spirometry, and self-reported mobility disability.

Results: In fully adjusted linear models, HIV was associated with better motor (β = 9.35, p < 0.001) and pulmonary function (β = 16.34, p < 0.001). For pulmonary function, the effect of HIV status was moderated by race (interaction between Black race and HIV status: β =  - 11.66, p = 0.02), indicating that better pulmonary function among participants with HIV was less evident among Black participants. In fully adjusted models, odds of mobility disability did not differ by race, HIV status, or pulmonary function; better motor function was associated with lower odds of mobility disability (OR = 0.91 per 1-point higher, 95% CI 0.88-0.93).

Conclusion: Better motor and pulmonary function exhibited by participants with HIV could reflect access to medical care. Racial differences in lung function among participants with HIV indicate potential disparities in prevention or treatment of pulmonary disease or underlying risk factors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40615-021-01126-0DOI Listing
August 2021

Impact of Cardiovascular Risk Factors in Adolescence, Young Adulthood, and Midlife on Late-Life Cognition: Study of Healthy Aging in African Americans.

J Gerontol A Biol Sci Med Sci 2021 Aug;76(9):1692-1698

Department of Neurology, University of California Davis School of Medicine, Sacramento, USA.

Background: Midlife cardiovascular risk factors (CVRFs) increase risk of dementia. Black Americans experience an elevated prevalence of CVRFs and dementia. However, little is known of how CVRFs prior to midlife affect late-life cognition. We examined CVRFs in adolescence, young adulthood, and midlife with late-life cognition in the Study of Healthy Aging in African Americans (STAR).

Method: STAR assesses cognitive aging among 764 Black Americans aged ≥50 (mean age = 69; SD = 9; range = 53-95). Participants' body mass index, blood pressure, glucose, and total cholesterol were collected during Multiphasic Health Checkups (MHC; 1964-1985). At STAR baseline (2018-2019), executive function, verbal episodic memory, and semantic memory were measured using the Spanish and English Neuropsychological Assessment Scales. Linear regression models examined associations between CVRFs and cognition adjusting for demographics and years since MHC.

Results: At MHC, 36% of participants had 1 CVRF and 26% had ≥2. Twenty-two percent of participants were adolescents (age 12-20), 62% young adults (age 21-34), and 16% midlife adults (age 35-56). Overweight/obesity was not associated with cognition. Hypertension was associated with worse executive function (β [95% CI]: -0.14 [-0.28, -0.0003]) and verbal episodic memory (β [95% CI]: -0.22 [-0.37, -0.07]) compared to normotension. Diabetes was associated with worse executive function (β [95% CI]: -0.43 [-0.83, -0.03]). Having ≥2 CVRFs (vs 0) was associated with worse executive function (β [95% CI]: -0.19 [-0.34, -0.03]) and verbal episodic memory (β [95% CI]: -0.25 [-0.41, -0.08]). Adolescents with hypertension had lower late-life executive function compared to normotensive adolescents (β [95% CI]: -0.39 [-0.67, -0.11]). Young adulthood hypertension (β [95% CI]: -0.29 [-0.49, -0.09]) and midlife hyperlipidemia (β [95% CI]: -0.386 [-0.70, -0.02]) were associated with lower verbal episodic memory.

Conclusions: Among Black Americans, life-course CVRFs were associated with poorer executive function and verbal episodic memory emphasizing the importance of cardiovascular health on the aging brain.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/gerona/glab143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361347PMC
August 2021

MIND Diet, Common Brain Pathologies, and Cognition in Community-Dwelling Older Adults.

J Alzheimers Dis 2021 ;83(2):683-692

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.

Background: MIND diet, a hybrid of the Mediterranean diet and the Dietary Approaches to Stop Hypertension diet, is associated with a slower cognitive decline and lower risk of Alzheimer's disease (AD) dementia in older adults.

Objective: We aim to examine whether the association of the MIND diet with cognition is independent of common brain pathologies.

Methods: Utilizing data from the Rush Memory and Aging Project (MAP), a longitudinal clinical-pathologic study, we studied 569 decedents with valid dietary data, cognitive testing proximate to death, and complete autopsy data at the time of these analyses. A series of regression analyses were used to examine associations of the MIND diet, dementia-related brain pathologies, and global cognition proximate to death adjusting for age, sex, education, APOEɛ4, late-life cognitive activities, and total energy intake.

Results: A higher MIND diet score was associated with better global cognitive functioning proximate to death (β= 0.119, SE = 0.040, p = 0.003), and neither the strength nor the significance of association changed substantially when AD pathology and other brain pathologies were included in the model. The β-estimate after controlling for global AD pathology was 0.111 (SE = 0.037, p = 0.003). The MIND diet-cognition relationship remained significant when we restricted our analysis to individuals without mild cognitive impairment at the baseline (β= 0.121, SE = 0.042, p = 0.005) or in people diagnosed with postmortem diagnosis of AD based on NIA-Reagan consensus recommendations (β= 0.114, SE = 0.050, p = 0.023).

Conclusion: MIND diet is associated with better cognitive functioning independently of common brain pathology, suggesting that the MIND diet may contribute to cognitive resilience in the elderly.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3233/JAD-210107DOI Listing
January 2021

ARTS: A novel In-vivo classifier of arteriolosclerosis for the older adult brain.

Neuroimage Clin 2021 24;31:102768. Epub 2021 Jul 24.

Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Dept. of Diagnostic Radiology & Nuc Med, Rush University Medical Center, Chicago, IL, USA. Electronic address:

Brain arteriolosclerosis, one of the main pathologies of cerebral small vessel disease, is common in older adults and has been linked to lower cognitive and motor function and higher odds of dementia. In spite of its frequency and associated morbidity, arteriolosclerosis can only be diagnosed at autopsy. Therefore, the purpose of this work was to develop an in-vivo classifier of arteriolosclerosis based on brain MRI. First, an ex-vivo classifier of arteriolosclerosis was developed based on features related to white matter hyperintensities, diffusion anisotropy and demographics by applying machine learning to ex-vivo MRI and pathology data from 119 participants of the Rush Memory and Aging Project (MAP) and Religious Orders Study (ROS), two longitudinal cohort studies of aging that recruit non-demented older adults. The ex-vivo classifier showed good performance in predicting the presence of arteriolosclerosis, with an average area under the receiver operating characteristic curve AUC = 0.78. The ex-vivo classifier was then translated to in-vivo based on available in-vivo and ex-vivo MRI data on the same participants. The in-vivo classifier was named ARTS (short for ARTerioloSclerosis), is fully automated, and provides a score linked to the likelihood a person suffers from arteriolosclerosis. The performance of ARTS in predicting the presence of arteriolosclerosis in-vivo was tested in a separate, 91% dementia-free group of 79 MAP/ROS participants and exhibited an AUC = 0.79 in persons with antemortem intervals shorter than 2.4 years. This level of performance in mostly non-demented older adults is notable considering that arteriolosclerosis can only be diagnosed at autopsy. The scan-rescan reproducibility of the ARTS score was excellent, with an intraclass correlation of 0.99, suggesting that application of ARTS in longitudinal studies may show high sensitivity in detecting small changes. Finally, higher ARTS scores in non-demented older adults were associated with greater decline in cognition two years after baseline MRI, especially in perceptual speed which has been linked to arteriolosclerosis and small vessel disease. This finding was shown in a separate group of 369 non-demented MAP/ROS participants and was validated in 72 non-demented Black participants of the Minority Aging Research Study (MARS) and also in 244 non-demented participants of the Alzheimer's Disease Neuroimaging Initiative 2 and 3. The results of this work suggest that ARTS may have broad implications in the advancement of diagnosis, prevention and treatment of arteriolosclerosis. ARTS is publicly available at https://www.nitrc.org/projects/arts/.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.nicl.2021.102768DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8329541PMC
September 2021

Susceptibility to Scams in Older Black and White Adults.

Front Psychol 2021 12;12:685258. Epub 2021 Jul 12.

Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States.

Previous reports on racial differences in scam susceptibility have yielded mixed findings, and few studies have examined reasons for any observed race differences. Older Black and White participants without dementia ( = 592) from the Minority Aging Research Study and the Rush Memory and Aging Project who completed a susceptibility to scam questionnaire and other measures were matched according to age, education, sex, and global cognition using Mahalanobis distance. In adjusted models, older Black adults were less susceptible to scams than older White adults (Beta = -0.2496, SE = 0.0649, = 0.0001). Contextual factors did not mediate and affective factors did not moderate this association. Analyses of specific items revealed Black adults had greater knowledge of scam targeting of older adults and were less likely to pick up the phone for unidentified callers. Older Black adults are less susceptible to scams than demographically-matched older White adults, although the reasons remain unknown.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpsyg.2021.685258DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311557PMC
July 2021

Genetic risk, adherence to a healthy lifestyle, and cognitive decline in African Americans and European Americans.

Alzheimers Dement 2021 Jul 26. Epub 2021 Jul 26.

Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.

Introduction: We investigated the role of genetic risk and adherence to lifestyle factors on cognitive decline in African Americans and European Americans.

Methods: Using data from the Chicago Health and Aging Project (1993-2012; n = 3874), we defined the genetic risk based on presence of apolipoprotein E (APOE) allele and determined a healthy lifestyle using a scoring of five factors: non-smoking, exercising, being cognitively active, having a high-quality diet, and limiting alcohol use. We used linear mixed-effects models to estimate cognitive decline by genetic risk and lifestyle score.

Results: APOE  allele was associated with faster cognitive decline in both races. However, within APOE  carriers, adherence to a healthy lifestyle (eg., 4 to 5 healthy factors) was associated with a slower cognitive decline by 0.023 (95% confidence interval [CI] 0.004, 0.042) units/year in African Americans and 0.044 (95% CI 0.008, 0.080) units/year in European Americans.

Discussion: A healthy lifestyle was associated with a slower cognitive decline in African and European Americans.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/alz.12435DOI Listing
July 2021

Inflammatory markers and tract-based structural connectomics in older adults with a preliminary exploration of associations by race.

Brain Imaging Behav 2021 Jul 16. Epub 2021 Jul 16.

Department of Psychology, University of Illinois at Chicago, Chicago, IL, 60607, USA.

Peripheral inflammation has been implicated in cognitive dysfunction and dementia. While studies outline the relationship between elevated inflammation and individual gray or white matter alterations, less work has examined inflammation as related to connectivity between gray and white matter or variability in these associations by race. We examined the relationship between peripheral inflammation and tract-based structural connectomics in 74 non-demented participants (age = 69.19 ± 6.80 years; 53% female; 45% Black) who underwent fasting venipuncture and MRI. Serum was assayed for C-reactive protein, interleukin-6, and interleukin-1β. Graph theory analysis integrated T1-derived gray matter volumes and DTI-derived white matter tractography into connectivity matrices analyzed for local measures of nodal strength and efficiency in a priori regions of interest associated with cardiovascular disease risk factors and dementia. Linear regressions adjusting for relevant covariates showed associations between inflammatory markers and nodal strength in the isthmus, posterior and caudal anterior cingulate (p's ≤ .042). Adding an inflammatory marker*race term showed race-modified associations between C-reactive protein and efficiency in the thalamus and amygdala, and nodal strength in the putamen (p's ≤ .048), between interleukin-6 and efficiency in the pars triangularis and amygdala (p's ≤ .024), and between interleukin-1β and nodal strength in the pars opercularis (p = .048). Higher levels of inflammation associated with lower efficiency and higher strength for White participants but higher efficiency and lower strength for Black participants. Results suggest inflammation is associated with tract-based structural connectomics in an older diverse cohort and that differential relationships may exist by race within prefrontal and limbic brain regions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11682-021-00483-yDOI Listing
July 2021

Latent Profile Analysis of Cognition in a Non-Demented Diverse Cohort: A Focus on Modifiable Cardiovascular and Lifestyle Factors.

J Alzheimers Dis 2021 ;82(4):1833-1846

Rowan University School of Osteopathic Medicine, New Jersey Institute for Successful Aging Departments of Geriatrics and Gerontology and Psychology, Stratford, NJ, USA.

Background: Cognitively-defined subgroups are well-documented within neurodegeneration.

Objective: We examined such profiles in diverse non-demented older adults and considered how resulting subgroups relate to modifiable factors associated with neurodegeneration.

Methods: 121 non-demented (MMSE = 28.62) diverse (46%non-Latino Black, 40%non-Latino White, 15%Latino) community-dwelling adults (age = 67.7 years) completed cognitive, cardiovascular, physical activity, and diet evaluations. Latent profile analyses (LPA) employed six cognitive scores (letter fluency, letter-number sequencing, confrontational naming, 'animal' fluency, list-learning delayed recall, and recognition discriminability) to characterize cognitively-defined subgroups. Differences between resulting subgroups on cardiovascular (composite scores of overall health; specific health components including fasting blood levels) and lifestyle (sedentary behavior; moderate-to-vigorous physical activity; Mediterranean diet consumption) factors were examined using ANCOVAs adjusting for relevant confounders.

Results: Based on sample means across cognitive scores, LPA resulted in the following cognitive subgroups: 1) high-average cognition, 55%non-Latino White and 64%female participants; 2) average cognition, 58%non-Latino Black and 68%male participants; 3) lower memory, 58%non-Latino Black participants; and 4) lower executive functioning, 70%Latinos. The high-average subgroup reported significantly higher Mediterranean diet consumption than the average subgroup (p = 0.001). The lower executive functioning group had higher fasting glucose and hemoglobin A1c than all other subgroups (p-values<0.001).

Conclusion: LPA revealed two average subgroups reflecting level differences in cognition previously reported between non-Latino White and Black adults, and two lower cognition subgroups in domains similar to those documented in neurodegeneration. These subgroups, and their differences, suggest the importance of considering social determinants of health in cognitive aging and modifiable risk.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3233/JAD-210110DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8384683PMC
January 2021

Purpose in Life May Delay Adverse Health Outcomes in Old Age.

Am J Geriatr Psychiatry 2021 May 21. Epub 2021 May 21.

Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL.

Objective: Test the hypothesis that a higher level of purpose in life is associated with an older age of Alzheimer's dementia onset and later mortality.

Design: Prospective cohort studies of aging and Alzheimer's dementia.

Setting: Community-based.

Participants: Two thousand five hundred fifty-eight older adults initially free of dementia underwent assessments of purpose in life and detailed annual clinical evaluations to document incident Alzheimer's dementia and mortality. General accelerated failure time models examined the relation of baseline purpose in life with age at Alzheimer's dementia diagnosis and mortality.

Exposures: Purpose in life was assessed at baseline.

Main Outcomes: Alzheimer's dementia diagnosis was documented annually based on detailed clinical evaluations and mortality was documented via regular contacts and annual evaluations.

Results: During a mean of 6.89 years of follow-up, 520 individuals were diagnosed with incident Alzheimer's dementia at a mean age of 88 (SD = 6.7; range: 64.1-106.5). They had a mean baseline level of purpose in life of 3.7 (SD = 0.47; range: 1-5). A higher level of purpose in life was associated with a considerably later age of dementia onset (estimate = 0.044; 95% CI: 0.023, 0.065); specifically, individuals with high purpose (90th percentile) developed Alzheimer's dementia at a mean age of about 95 compared to a mean age of about 89 for individuals with low purpose (10th percentile). Further, the estimated mean age of death was about 89 for individuals with high purpose compared to 85 for those with low purpose. Results persisted after controlling for sex and education.

Conclusion And Relevance: Purpose in life delays dementia onset and mortality by several years. Interventions to increase purpose in life among older persons may increase healthspan and offer considerable public health benefit.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jagp.2021.05.007DOI Listing
May 2021

The link between social and emotional isolation and dementia in older black and white Brazilians.

Int Psychogeriatr 2021 Jun 15:1-7. Epub 2021 Jun 15.

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.

Objective: To examine the link between social and emotional isolation and likelihood of dementia among older black and white Brazilians.

Design: Cross-sectional clinical-pathological cohort study.

Setting: Medical center in Sao Paulo, Brazil.

Participants: As part of the Pathology, Alzheimer's and Related Dementias Study, we conducted uniform structured interviews with knowledgeable informants (72% children) of 1,493 older (age > 65) Brazilian decedents.

Measurements: The interview included measures of social isolation (number of family and friends in at least monthly contact with decedent), emotional isolation (short form of UCLA Loneliness Scale), and major depression plus the informant portion of the Clinical Dementia Rating Scale to diagnose dementia and its precursor, mild cognitive impairment (MCI).

Results: Decedents had a median social network size of 8.0 (interquartile range = 9.0) and a median loneliness score of 0.0 (interquartile range = 1.0). On the Clinical Dementia Rating Scale, 947 persons had no cognitive impairment, 122 had MCI, and 424 had dementia. In a logistic regression model adjusted for age, education, sex, and race, both smaller network size (odds ratio [OR] = 0.975; 95% confidence interval [CI]: 0.962, 0.989) and higher loneliness (OR = 1.145; 95% CI: 1.060, 1.237) were associated with higher likelihood of dementia. These associations persisted after controlling for depression (present in 10.4%) and did not vary by race. After controlling for depression, neither network size nor loneliness was related to MCI.

Conclusion: Social and emotional isolation are associated with higher likelihood of dementia in older black and white Brazilians.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1041610221000673DOI Listing
June 2021

Vitamin D Intake and Brain Cortical Thickness in Community-Dwelling Overweight Older Adults: A Cross-Sectional Study.

J Nutr 2021 Sep;151(9):2760-2767

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.

Background: Vitamin D is critical to brain health and a promising candidate to prevent cognitive decline and onset of Alzheimer disease (AD), although the underlying brain mechanisms are unclear.

Objectives: This study aimed to determine the association between vitamin D intake and brain cortical thickness in older adults.

Methods: This was a cross-sectional investigation of 263 cognitively unimpaired participants, aged 65 y and older, participating in the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) trial (an ongoing study testing the effects of a 3-y diet intervention on cognitive decline). Vitamin D intake, from diet and supplements, was ascertained from an FFQ. Linear regression analysis, adjusted for age, sex, race, education, income, cognitive and physical activities, and cardiovascular disease risk factors, was used to determine the association between vitamin D intake and cortical thickness of the whole brain, lobes, and AD signature.

Results: Total vitamin D intake was associated with cortical thickness of the temporal lobe and AD signature. Compared with individuals in the lowest quartile of total vitamin D intake [median: 140 international units (IU)/d], those in the highest quartile (median: 1439 IU/d) had a 0.038-mm (95% CI: 0.006, 0.069 mm) thicker temporal lobe and 0.041-mm (95% CI: 0.012, 0.070 mm) thicker AD signature. Most vitamin D intake was from supplements, and supplemental intake was also associated with cortical thickness. Compared with those who used no supplement, individuals taking 800-1000 IU/d and >1000 IU/d of supplemental vitamin D had a 0.039-mm (95% CI: 0.013, 0.066 mm) and 0.047-mm (95% CI: 0.013, 0.081 mm) thicker temporal lobe and a 0.037-mm (95% CI: 0.013, 0.061 mm) and 0.046-mm (95% CI: 0.015, 0.077 mm) thicker AD signature, respectively. Dietary vitamin D was not related to brain cortical thickness in our sample.

Conclusions: In cognitively unimpaired older adults, total and supplemental vitamin D intakes were associated with cortical thickness in regions vulnerable to AD.This trial was registered at clinicaltrials.gov as NCT02817074.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/jn/nxab168DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8417916PMC
September 2021

Association of Lewy Bodies With Age-Related Clinical Characteristics in Black and White Decedents.

Neurology 2021 08 4;97(8):e825-e835. Epub 2021 Jun 4.

From the Departments of Pathology (Neuropathology) (S.N., J.A.S.), Neurological Sciences (L.L.B., L.Y., A.S.B., D.A.B., J.A.S., R.S.W.), and Psychiatry and Behavioral Sciences (L.L.B., R.S.W.), Rush Alzheimer Disease Center and Rush University Medical Center, Chicago, IL.

Objective: The associations of Lewy bodies (LBs) with olfactory dysfunction, parkinsonism, and higher odds of dementia were assessed in Black and White community-dwelling elders and racial differences in these associations were tested.

Methods: Black decedents (n = 81) were matched 2-to-1 by age, sex, years of education, and follow-up time in the study with White decedents (n = 154) from 4 longitudinal studies of dementia and aging. Participants underwent uniform clinical examination and cognitive, motor, and olfactory testing. LBs were detected in 7 brain regions by α-synuclein immunohistochemistry and racial differences in their association with olfaction, parkinsonism, and odds of dementia were determined using regression analyses.

Results: The mean scores of the odor test, global parkinsonism signs, and global cognition were lower in Black than White decedents; the frequency of dementia was similar in both groups. The frequency of LBs was similar in Black and White decedents (∼25%), as was the frequency of LBs in individual brain regions, while the mean LB counts/mm were similar in all regions except the cingulate cortex, which showed higher mean LB counts in Black decedents. In regression analyses, LBs were associated with impaired olfaction (-2.23, 95% confidence interval [CI] -3.45 to -1.01) and higher odds of dementia (odds ratio 3.0, 95% CI 1.10-8.17) in both racial groups; an association with parkinsonism was stronger in Black than White decedents.

Conclusions: The frequency, distribution, and clinical manifestations of LBs are similar in Black and White elders.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1212/WNL.0000000000012324DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397586PMC
August 2021

Neighborhood Socioeconomic Resources and Crime-Related Psychosocial Hazards, Stroke Risk, and Cognition in Older Adults.

Int J Environ Res Public Health 2021 05 12;18(10). Epub 2021 May 12.

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.

Living in neighborhoods with lower incomes, lower education/occupational levels, and/or higher crime increases one's risk of developing chronic health problems including cardiovascular disease risk factors and stroke. These cardiovascular health problems are known to contribute to cognitive decline and dementia. The purpose of this study was to determine the association of neighborhood socioeconomic resources and crime-related psychosocial hazards on stroke risk and cognition, hypothesizing that cardiovascular health would mediate any relationship between the neighborhood-level environment and cognition. The study evaluated 121 non-demented Chicago-area adults (~67 years; 40% non-Latino White) for cardiovascular health problems using the Framingham Stroke Risk Profile 10-year risk of stroke (FSRP-10). The cognitive domains that were tested included memory, executive functioning, and attention/information processing. Neighborhood socioeconomic resources were quantified at the census tract level (income, education, and occupation); crime-related psychosocial hazards were quantified at the point level. Structural equation modeling (SEM) did not show that the FSRP-10 mediated the relationship between neighborhood characteristics and domain-specific cognition. The SEM results did suggest that higher crime rates were associated with a higher FSRP-10 ((105) = 2.38, = 0.03) and that higher FSRP-10 is associated with reduced attention/information processing performance ((105) = -0.04, = 0.02) after accounting for neighborhood socioeconomic resources. Clinicians may wish to query not only individual but also neighborhood-level health when considering cognition.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph18105122DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8151671PMC
May 2021

Bootstrap approach for meta-synthesis of MRI findings from multiple scanners.

J Neurosci Methods 2021 08 27;360:109229. Epub 2021 May 27.

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, United States; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, 60612, United States; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612, United States.

Background: Neuroimaging data from large epidemiologic cohort studies often come from multiple scanners. The variations of MRI measurements due to differences in magnetic field strength, image acquisition protocols, and scanner vendors can influence the interpretation of aggregated data. The purpose of the present study was to compare methods that meta-analyze findings from a small number of different MRI scanners.

Methods: We proposed a bootstrap resampling method using individual participant data and compared it with two common random effects meta-analysis methods, DerSimonian-Laird and Hartung-Knapp, and a conventional pooling method that combines MRI data from different scanners. We first performed simulations to compare the power and coverage probabilities of the four methods in the absence and presence of scanner effects on measurements. We then examined the association of age with white matter hyperintensity (WMH) volumes from 787 participants.

Results: In simulations, the bootstrap approach performed better than the other three methods in terms of coverage probability and power when scanner differences were present. However, the bootstrap approach was consistent with pooling, the optimal approach, when scanner differences were absent. In the association of age with WMH volume, we observed that age was significantly associated with WMH volumes using the bootstrap approach, pooling, and the DerSimonian-Laird method, but not using the Hartung-Knapp method (p < 0.0001 for the bootstrap approach, DerSimonian-Laird, and pooling but p = 0.1439 for the Hartung-Knapp approach).

Conclusion: The bootstrap approach using individual participant data is suitable for integrating outcomes from multiple MRI scanners regardless of absence or presence of scanner effects on measurements.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jneumeth.2021.109229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324567PMC
August 2021

Population estimate of people with clinical Alzheimer's disease and mild cognitive impairment in the United States (2020-2060).

Alzheimers Dement 2021 May 27. Epub 2021 May 27.

Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.

Introduction: The estimate of people with clinical Alzheimer's disease (AD) and mild cognitive impairment provides an understanding of the disease burden.

Methods: We estimated people with cognitive impairment using a quasibinomial regression model in 10,342 participants with cognitive test scores.

Results: The 2020 US Census-adjusted prevalence of clinical AD was 11.3% (95% confidence interval [CI] = 10.7-11.9): 10.0% among non-Hispanic Whites, 14.0% among Hispanics, and 18.6% among non-Hispanic Blacks. We estimate that in 2020, 6.07 (95% CI = 5.75-6.38) million people were living with clinical AD, which increases to 13.85 (95% CI = 12.98-14.74) million in 2060, 423% higher among Hispanics, 192% higher among Blacks, and 63% higher among Whites. However, there are predicted to be more significant increases in later years among those over 85 and women compared to men.

Discussion: The number of people with clinical AD will increase as the "baby boom" generation reaches older ages, exerting a strong upward influence on disease burden.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/alz.12362DOI Listing
May 2021

Impact of Early Life Socioeconomic Status on Decision Making in Older Adults Without Dementia.

Arch Gerontol Geriatr 2021 Jul-Aug;95:104432. Epub 2021 May 9.

Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 West Harrison St. Suite 1000, Chicago, IL 60612; Department of Psychiatry and Behavioral Sciences.

Objectives: A growing body of evidence points to the negative impact of early life socioeconomic status (SES) on health and cognitive outcomes in later life. However, the effect of early life SES on decision making in old age is not well understood. This study investigated the association of early life SES with decision making in a large community-based cohort of older adults without dementia from the Rush Memory and Aging Project.

Materials And Methods: Cross-sectional data from the Rush Alzheimer's Disease Center Memory and Aging Project was analyzed. Participants were 1044 community-dwelling older adults without dementia (M age = 81.15, SD = 7.49; 75.8% female; 5.4% non-White). Measures of financial and healthcare decision making and early life SES were collected, along with demographics, global cognition, and financial and health literacy.

Results: Early life SES was positively associated with decision making (estimate = 0.218, p = 0.027), after adjustments for demographic covariates and global cognition, such that a one-unit increase in early life SES was equivalent to the effect of being four years younger in age as it pertains to decision making. A subsequent model demonstrated that the relationship was strongest in those with low literacy, and weakest for those with high literacy (estimate = -0.013, p = 0.029).

Conclusions: Findings from this study suggest that early life SES is associated with late life decision making and that improving literacy, a modifiable target for intervention, may buffer the negative impact of low early life SES on decision making in older adulthood.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.archger.2021.104432DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8175072PMC
June 2021

Impact of Cardiovascular Risk Factors in Adolescence, Young Adulthood, and Midlife on Late-life Cognition: Study of Healthy Aging in African Americans (STAR).

J Gerontol A Biol Sci Med Sci 2021 May 18. Epub 2021 May 18.

Department of Neurology, University of California Davis School of Medicine, Sacramento, CA, USA.

Background: Midlife cardiovascular risk factors (CVRF) increase risk of dementia. Black Americans experience an elevated prevalence of CVRF and dementia. However, little is known of how CVRF prior to midlife affect late-life cognition. We examined CVRF in adolescence, young adulthood, and midlife with late-life cognition in The Study of Healthy Aging in African Americans (STAR).

Methods: STAR assesses cognitive aging among 764 Black Americans ages ≥50 (mean age=69;SD=9;range 53-95). Participants' body mass index, blood pressure, glucose, and total cholesterol were collected during Multiphasic Health Check-ups (MHC;1964-1985). At STAR baseline (2018-2019), executive function, verbal episodic memory, and semantic memory were measured using the Spanish and English Neuropsychological Assessment Scales. Linear regression models examined associations between CVRF and cognition adjusting for demographics and years since MHC.

Results: At MHC, 36% of participants had 1 CVRF and 26% had ≥2. Twenty-two percent of participants were adolescents (ages:12-20), 62% young adults (ages:21-34), and 16% midlife adults (ages:35-56). Overweight/obesity was not associated with cognition. Hypertension was associated with worse executive function [β(95%CI):-0.14(-0.28,-0.0003)] and verbal episodic memory [β(95%CI):-0.22(-0.37,-0.07)] compared to normotension. Diabetes was associated with worse executive function [β(95%CI):-0.43(-0.83,-0.03)]. Having ≥2 CVRF (versus 0) was associated with worse executive function [β(95%CI):-0.19(-0.34,-0.03)] and verbal episodic memory [β(95%CI):-0.25(-0.41,-0.08)]. Adolescents with hypertension had lower late-life executive function compared to normotensive adolescents [β(95%CI):-0.39(-0.67,-0.11)]. Young adulthood hypertension [β(95%CI):-0.29(-0.49,-0.09)] and midlife hyperlipidemia [β(95%CI):-0.386(-0.70,-0.02)] were associated with lower verbal episodic memory.

Conclusions: Among Black Americans, lifecourse CVRF were associated with poorer executive function and verbal episodic memory emphasizing the importance of cardiovascular health on the aging brain.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/gerona/glab143DOI Listing
May 2021

WITHDRAWN: Informant-Reported Discrimination, Dementia, and Cognitive Impairment in Older Brazilians.

J Alzheimers Dis 2021 Apr 28. Epub 2021 Apr 28.

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.

Ahead of Print article withdrawn by publisher.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3233/JAD-201436DOI Listing
April 2021

Interactive Effects of HLA and GM Alleles on the Development of Alzheimer Disease.

Neurol Genet 2021 Apr 16;7(2):e565. Epub 2021 Feb 16.

Department of Microbiology and Immunology (J.P.P., R.T.K.) and Department of Public Health, Sciences (P.J.N.), Medical University of South Carolina, Charleston; and Rush Alzheimer's Disease Center (L.L.B., D.A.B.), Rush University Medical Center, Chicago, IL.

Objective: We investigated whether particular immunoglobulin GM (γ marker) alleles-individually or epistatically with a known human leukocyte antigen (HLA) risk allele-were associated with the development of Alzheimer disease (AD).

Methods: Using a prospective cohort study design, we genotyped DNA samples from 209 African American (AA) and 638 European American (EA) participants for IgG1 (GM 3 and GM 17), IgG2 (GM 23+ and GM 23-), and rs9271192 (A/C) alleles by TaqMan and rhAMP genotyping assays.

Results: In EA subjects, none of the GM or HLA alleles-individually or epistatically-were associated with time to development of AD. In AA subjects, GM and HLA alleles individually were not associated with time to development of AD. However, there was a significant interaction: In the presence of GM 3 (i.e., GM 3/3 and GM 3/17 subjects), the presence of the HLA-C allele was associated with a 4-fold increase in the likelihood of developing AD compared with its absence (hazard ratio [HR] 4.17, 95% CI, 1.28-13.58). In the absence of GM 3 (GM 17/17 subjects), however, the presence of the HLA-C allele was not associated with time to development of AD (HR 1.10, 95% CI, 0.50-2.41).

Conclusions: These results show that particular GM and HLA alleles epistatically contribute to the development of AD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1212/NXG.0000000000000565DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063623PMC
April 2021

Correlates of Susceptibility to Scams in Community-Dwelling Older Black Adults.

Gerontology 2021 Apr 21:1-11. Epub 2021 Apr 21.

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.

Introduction: 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.

Methods: 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.

Results: 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.

Discussion: 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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000515326DOI Listing
April 2021

Association of Hemoglobin A1C With TDP-43 Pathology in Community-Based Elders.

Neurology 2021 Apr 14. Epub 2021 Apr 14.

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.

Objective: We tested the hypothesis that an inverse association exists between diabetes mellitus (DM) and hemoglobin A1C (A1C) with Transactive response DNA binding protein 43 (TDP-43) levels in older adults.

Methods: We leveraged antemortem and postmortem data of decedents from three community-based clinical-pathological studies. DM status, A1C levels, and medications for DM were documented annually. TDP-43 cytoplasmic inclusions, evaluated in 6 brain regions using immunohistochemistry, were used to obtain a semiquantitative TDP-43 score (0-5) in each region, and scores were averaged across regions to obtain a TDP-43 severity score. We used linear regressions to test the association of DM and A1C with the TDP-43 severity score.

Results: On average, participants (n=817) were 90 years old at the time of death, three fourth were women, and one fourth had DM. The mean A1C was 6.0% (SD=0.6). TDP-43 was observed in 54% of participants, and the mean TDP-43 score was 0.7 (range 0-4.5). A higher level of A1C was associated with a lower TDP-43 score (estimate=-0.156, S.E.=0.060, =0.009) while DM had a borderline inverse association with the TDP-43 score (estimate=-0.163, S.E.=0.087, =0.060). The association of higher levels of A1C with lower TDP-43 scores persisted after further adjustment by 4, vascular risk factors, stroke, and hypoglycemic medications. Exclusion of the oldest old participants did not change the results.

Conclusion: Overall, the results suggest that a high level of A1C is associated with less TDP-43 proteinopathy in older persons while the relationship of DM with TDP-43 needs further study.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1212/WNL.0000000000012025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205465PMC
April 2021

Late-Life Vascular Risk Score in Association With Postmortem Cerebrovascular Disease Brain Pathologies.

Stroke 2021 Jun 12;52(6):2060-2067. Epub 2021 Apr 12.

Rush Alzheimer's Disease Center (S.O., L.Y., A.C., Z.A., L.L.B., J.A.S., D.A.B., A.S.B.), Rush University Medical Center, Chicago, IL.

Background And Purpose: The general cardiovascular Framingham risk score (FRS) identifies adults at increased risk for stroke. We tested the hypothesis that baseline FRS is associated with the presence of postmortem cerebrovascular disease (CVD) pathologies.

Methods: We studied the brains of 1672 older decedents with baseline FRS and measured CVD pathologies including macroinfarcts, microinfarcts, atherosclerosis, arteriolosclerosis, and cerebral amyloid angiopathy. We employed a series of logistic regressions to examine the association of baseline FRS with each of the 5 CVD pathologies.

Results: Average age at baseline was 80.5±7.0 years and average age at death was 89.2±6.7 years. A higher baseline FRS was associated with higher odds of macroinfarcts (odds ratio, 1.10 [95% CI, 1.07-1.13], <0.001), microinfarcts (odds ratio, 1.04 [95% CI, 1.01-1.07], =0.009), atherosclerosis (odds ratio, 1.07 [95% CI, 1.04-1.11], <0.001), and arteriolosclerosis (odds ratio, 1.04 [95% CI, 1.01-1.07], =0.005). C statistics for these models ranged from 0.537 to 0.595 indicating low accuracy for predicting CVD pathologies. FRS was not associated with the presence of cerebral amyloid angiopathy.

Conclusions: A higher FRS score in older adults is associated with higher odds of some, but not all, CVD pathologies, with low discrimination at the individual level. Further work is needed to develop a more robust risk score to identify adults at risk for accumulating CVD pathologies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1161/STROKEAHA.120.030226DOI Listing
June 2021

Free-living standing activity as assessed by seismic accelerometers and cognitive function in community-dwelling older adults: The MIND trial.

J Gerontol A Biol Sci Med Sci 2021 Apr 9. Epub 2021 Apr 9.

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL.

Background: Few older adults are able to achieve recommended levels of moderate-vigorous physical activity despite known cognitive benefits. Alternatively, less intense activities such as standing can be easily integrated into daily life. No existing study has examined the impact of free-living standing activity during daily life as measured by a device on cognition in older adults. Our purpose was to examine the association between free-living standing activity and cognitive function in cognitively healthy older adults.

Methods: Participants were 98 adult participants aged 65 years or older from the ongoing MIND trial (NCT02817074) without diagnoses or symptoms of mild cognitive impairment or dementia. Linear regression analyses tested cross-sectional associations between standing activity (duration and intensity from the MoveMonitor+ accelerometer/gyroscope) and cognition (4 cognitive domains constructed from 12 cognitive performance tests).

Results: Participants were on average 69.7 years old (SD = 3.7), 69.4% women, and 73.5% had a college degree or higher. Higher mean intensity of standing activity was significantly associated with higher levels of perceptual speed when adjusting for age, gender, and education level. Each log unit increase in standing activity intensity was associated with 0.72 units higher of perceptual speed (p=.023). When we additionally adjusted for cognitive activities and moderate-vigorous physical activity, and then also for body mass index, depressive symptoms, prescription medication use, and device wear time, the positive association remained.

Conclusions: These findings should be further explored in longitudinal analyses and interventions for cognition that incorporate small changes to free-living activity in addition to promoting moderate-vigorous physical activity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/gerona/glab106DOI Listing
April 2021

Trajectories of Multiple Behavioral Risk Factors and Their Associations With Cognitive Function Trajectories Among Older African Americans and White Americans.

J Aging Health 2021 Oct 31;33(9):674-684. Epub 2021 Mar 31.

Alzheimer's Disease Center, 2461Rush University Medical Center, Chicago, IL, USA.

This study examined the joint trajectories of behavioral risk factors (smoking, alcohol drinking, and body mass index) and their associations with cognitive function trajectories among older African Americans and white Americans. Data from the Health and Retirement Study (1998-2014) were used. Group-based mixture modeling and multinomial logistic regression analysis were performed. Three joint trajectories of behavioral risk factors (overweight, smoking and drinking, and drinking and overweight) and three cognitive function trajectories (low, moderate, and high) were identified. A significantly higher percentage of African Americans were in the "overweight," "smoking and drinking," and "low" cognitive functioning groups as measured by the total cognition composite score compared to white Americans. After accounting for covariates, the "drinking and overweight" group was associated with the "moderate" or "high" cognitive functioning group. Future interventions targeting the combinations of behavioral risk factors are needed to promote healthy aging among high-risk populations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/08982643211005905DOI Listing
October 2021

Whitest City in America: A Smaller Black Community's Experience of Gentrification, Displacement, and Aging in Place.

Gerontologist 2021 Mar 27. Epub 2021 Mar 27.

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.

Background And Objectives: The influx of people with higher socioeconomic status into large Black communities is well documented; less is known regarding smaller, aging Black communities. Older Black adults in Portland, Oregon, among America's fastest gentrifying cities with the smallest metropolitan Black population, discussed barriers to healthy aging. Perspectives centered on the experience of gentrification, displacement, and its impact on social microsystems, place security, and aging in place.

Research Design And Methods: One-time focus groups engaged 41 Black adults aged ≥45. A demographic survey included residence area/duration. Discussions were thematically coded. Ecological Systems Theory guided interpretation.

Results: The majority of participants resided within gentrifying historically Black neighborhoods (89.2%), were aged ≥65 (54.6%), and lived in their neighborhood ≥21 years (24.3%). Emergent discussion themes were: Rise and fall of Black ownership; Displacement; Race-related stress; and Financial burden. Gentrification contributed to the dismantling of Black property ownership curated over generations, increased financial burden, and threatened place security. Physical displacement strained social networks, diminishing intergenerational neighborhood ties that supported aging in place. Cultural and physical displacement weakened sense of social cohesion and belonging, and induced race-related stressful interactions with new residents within original and relocation neighborhoods.

Discussion And Implications: Gentrification in the Pacific Northwest echoes national trends, uprooting critical close-proximity social networks and deteriorating motivation to engage in neighborhood-based social activity. Smaller, aging Black communities may be particularly vulnerable to these effects which critically impact aging in place. Data inform researchers and policymakers to better understand how gentrification affects smaller, aging Black communities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/geront/gnab041DOI Listing
March 2021

Frequency of Parkinsonism and Parkinson Disease in African Americans in the Chicago Community.

J Gerontol A Biol Sci Med Sci 2021 Jun;76(7):1340-1345

Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA.

Background: There is paucity of data about African American (AA) patients with Parkinson's disease (PD) and parkinsonism which may precede PD in older adults. Prior studies suggest that there are lower rates of PD in the AA population, with more cognitive impairment in AA with PD. This study aimed to investigate differences in PD, parkinsonism, and cognition between White and AA populations in 3 longitudinal epidemiologic cohort studies of aging.

Methods: This study examined parkinsonism, PD frequency, and cognition of community-dwelling older individuals in 3 longitudinal epidemiologic cohort studies. Parkinsonism was based on an exam utilizing the modified Unified Parkinson's Disease Rating Scale performed by a nurse. PD was based on self-report, medications used for treatment of PD, and examination findings. Cognition was assessed using 19 performance-based tests that assess 5 cognitive domains.

Results: AA participants were less likely to have parkinsonism compared to Whites, even with age and gender differences. Frequency of PD was not significant between groups. AA were more likely to have lower cognitive scores as compared to Whites. AA were less likely to have parkinsonism even with controlling for cognitive differences between groups.

Conclusions: Parkinsonian signs are present among AA in the community at lower rates than in White individuals. Cognitive profiles of AA and Whites with parkinsonism may be different, suggesting differing contributions of pathology to cognitive decline and parkinsonism between groups. Additional research is needed to understand the progression of parkinsonism to PD, as well as to understanding the cognitive differences in AA with parkinsonism.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/gerona/glab042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202152PMC
June 2021

Limbic-predominant age-related TDP-43 encephalopathy neuropathologic change and microvascular pathologies in community-dwelling older persons.

Brain Pathol 2021 May 23;31(3):e12939. Epub 2021 Feb 23.

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.

Limbic-predominant age-related transactive response DNA-binding protein 43 (TDP-43) encephalopathy neuropathologic change (LATE-NC) and microvascular pathologies, including microinfarcts, cerebral amyloid angiopathy (CAA), and arteriolosclerosis are common in old age. A relationship between LATE-NC and arteriolosclerosis has been reported in some but not all studies. The objectives of this study were to investigate the frequency of co-occurring LATE-NC and microvascular pathologies and test the hypothesis that arteriolosclerosis, specifically, is related to LATE-NC in brains from community-dwelling older persons. Analyses included 749 deceased participants with completed data on LATE-NC and microvascular pathology from 3 longitudinal clinical pathologic studies of aging. Given the specific interest in arteriolosclerosis, we expanded the examination of arteriolosclerosis to include not only the basal ganglia but also two additional white matter regions from anterior and posterior watershed territories. Ordinal logistic regression models examined the association of microvascular pathology with LATE-NC. LATE-NC was present in 409 (54.6%) decedents, of which 354 (86.5%) had one or multiple microvascular pathologies including 132 (32.3%) with moderate-severe arteriolosclerosis in basal ganglia, 195 (47.6%) in anterior watershed, and 144 (35.2%) in posterior watershed; 170 (41.5%) with moderate-severe CAA, and 150 (36.6%) with microinfarcts. In logistic regression models, only posterior watershed arteriolosclerosis, but not other regions of arteriolosclerosis was associated with a higher odds of more advanced LATE-NC stages (Odds Ratio = 1.12; 95% Confidence Interval = 1.01-1.25) after controlling for demographics, AD, and other age-related pathologies. Capillary CAA, but not the severity of CAA was associated with an increased odds of LATE-NC burden (Odds Ratio = 1.71; 95% Confidence Interval = 1.13-2.58). Findings were unchanged in analyses controlling for APOE ε4, vascular risk factors, or vascular diseases. These findings suggest that LATE-NC with microvascular pathology is a very common mixed pathology and small vessel disease pathology may contribute to LATE-NC in the aging brain.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/bpa.12939DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8363209PMC
May 2021

Impact of the Apolipoprotein E ε4 Allele on the Relationship Between Healthy Lifestyle and Cognitive Decline: A Population-Based Study.

Am J Epidemiol 2021 07;190(7):1225-1233

Adherence to a healthy lifestyle-characterized by abstaining from smoking, being physically and cognitively active, having a high-quality diet, and limiting alcohol use-is associated with slower cognitive decline in older adults, but whether this relationship extends to persons with a genetic predisposition (e.g., carriers of the ε4 allele of the apolipoprotein E gene (APOE*E4)) remains uncertain. Using data from a population-based study, the Chicago Health and Aging Project (Chicago, Illinois), we followed 3,886 individuals who underwent regular clinical and cognitive assessments from 1993 to 2012. Of 3,886 older adults, 1,269 (32.7%) were APOE*E4 carriers. Compared with noncarriers, APOE*E4 carriers had faster cognitive decline (β = -0.027 units/year, 95% confidence interval (CI): -0.032, -0.023). In contrast, persons with 2-3 and 4-5 healthy lifestyle factors had slower cognitive decline (β = 0.008 units/year (95% CI: 0.002, 0.014) and β = 0.019 units/year (95% CI: 0.011, 0.026), respectively) compared with those with 0-1 factor. In analyses stratified by APOE*E4 status, adherence to a healthy lifestyle (e.g., 4-5 factors vs. 0-1 factors) was associated with a slower rate of cognitive decline in both APOE*E4 carriers (β = 0.029, 95% CI: 0.013, 0.045) and noncarriers (β = 0.013, 95% CI: 0.005, 0.022). These results underscore the impact of a healthy lifestyle on cognition, particularly among persons with a genetic predisposition, who are more vulnerable to cognitive decline as they age.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/aje/kwab033DOI Listing
July 2021
-->