Objectives Racial disparities exist for multiple health outcomes and cognitive domains across the lifespan. Many physical health disparities appear less prominent in late life, which is likely due to higher mortality rates for African Americans. This study examined whether this attenuation of racial disparities at older ages observed for physical health outcomes can be extended to cognitive outcomes in mid-life and late-life samples. Evidence of selective survival with respect to cognition would imply that conventional risk factor patterns for dementia may be distorted among older African Americans, and clinical predictions based on less selected white peers will be inaccurate. Design Cross-sectional associations between race and cognitive functioning were examined as a function of age. Setting The National Survey of Midlife Development in the United States (MIDUS) and the Washington Heights-Inwood Columbia Aging Project (WHICAP). Participants 3,857 MIDUS participants (10.5% African American); 2,729 WHICAP participants (53.8% African American). Measurements Composite scores of executive functioning and episodic memory. Results Independent of main effects of age, birth cohort, sex, education and chronic health conditions, significant age by race interactions indicated that racial disparities in episodic memory and executive functioning were larger at younger ages than older ages in both samples. Conclusion Attenuation of racial inequalities at older ages can be extended to cognitive outcomes, which likely reflects selective survival. Research on cognitive disparities or on race-specific causes of cognitive outcomes in old age must incorporate corrections for selective survival if the goal is to identify causal predictors of cognitive outcomes, rather than merely statistical predictors.
To our knowledge, this was the first study to examine metacognition in relation to cortical thickness. Both global and local metamemory functions appear to rely on the integrity of right sided midline regions, known to be important for processing self-referential information. Findings are conceptualized with regard to the Default Mode Network, and also considered in relation to recent findings pointing to the right insula as a region critical for self-awareness. (PsycINFO Database Record
Background: The utility of subjective cognitive decline (SCD) as an indicator of preclinical AD is overshadowed by its inconsistent association with objective cognition. Objective: This study examines if manipulations of SCD measurement affect its association with early cognitive dysfunction characteristic of preclinical AD. Methods: Cognitively healthy older adults (n = 110) completed SCD questionnaires that elicited complaints in general, compared to 5 years ago (retrospective SCD) and compared to their peers (age-anchored SCD) in binary and Likert scales. Outcome cognitive tasks included an associative memory task (Face-Name Test), a visual short-term memory binding task (STMB test), and a clinical neuropsychological list learning test (Selective Reminder Test). Results: SCD complaints, when compared to age-matched peers (age-anchored SCD) was endorsed less frequently than complaints compared to 5 years ago (retrospective SCD) (p < 0.01). In demographically adjusted regressions, age-anchored ordinal-rated SCD was associated with short term memory binding (β= –0.22, p = 0.040, CI = –0.45, –0.01), associative memory (β= –0.26, p = 0.018, CI = –0.45, –0.06), and list learning (β= –0.31, p = 0.002, CI = –0.51, –0.12). Retrospective and general ordinal-rated SCD was associated with associative memory (β= –0.25, p = 0.012, CI = –0.44, –0.06; β= –0.29, p = 0.003, CI = –0.47, –0.10) and list learning only (β= –0.25, p = 0.014, CI = –0.45, –0.05; β= –0.28, p = 0.004, CI = –0.48, –0.09). Conclusion: Ordinal age-anchored SCD appears better suited than other SCD measurements to detect early cognitive dysfunction characteristic of preclinical AD.
INTRODUCTION The Predictors study was designed to predict the length of time to major disease outcomes in Alzheimer’s disease (AD) patients. Here we describe the development of a new, Predictors 3, cohort. METHODS Patients with prevalent or incident AD, and individuals at-risk for developing AD were selected from the North Manhattan community, and followed annually with instruments comparable to those used in the original two Predictors cohorts. RESULTS The original Predictors cohorts were clinic-based and racially/ethnically homogenous (94% white, 6% black; 3% Hispanic). In contrast the 274 elders in this cohort are community–based and ethnically diverse (39% white, 40% black, 21% other; 78% Hispanic). Confirming previous observations, psychotic features were associated with poorer function and mental status, and extrapyramidal signs with poorer function. DISCUSSION This new cohort will allow us to test observations made in our original clinic-based cohorts in patients that may be more representative of the general community.
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