Education Levels and Poststroke Cognitive Trajectories

JAMA Network Open, Год журнала: 2025, Номер 8(3), С. e252002 - e252002

Опубликована: Март 26, 2025

Importance Acute stroke is associated with accelerated, years-long cognitive decline. Whether education levels are faster decline after unclear. Objective To evaluate the association of level poststroke and to determine whether age at modifies association. Design, Setting, Participants Individual participant data meta-analysis 4 US cohort studies (January 1971 December 2019). Analysis began August 2022 was completed in January 2024. Exposures Education (less than high school, some college, college graduate). Main Outcomes Measures Harmonized outcomes were global cognition (primary outcome), memory, executive function. standardized as t scores (mean [SD], 50 [10]); a 1-point difference represents 0.1-SD cognition, higher score representing better Linear mixed-effect models estimated trajectory incident stroke. Results The analysis included 2019 initially dementia-free survivors (1048 female [51.9%]; median [IQR] stroke, 74.8 [69.0-80.4] years; 339 less school [16.7%]; 613 who [30.4%]; 484 [24.0%]; 583 degree or [28.9%]). Median (IQR) follow-up time 4.1 (1.8-7.2) years. Compared those degree, graduates had initial performance (1.09 points higher; 95% CI, 0.02 2.17 higher), function (1.81 95%CI, 0.38 3.24 memory (0.99 1.96 higher). education, there among (−0.44 points/y faster; −0.69 −0.18 faster) education(−0.30 −0.57 −0.03 faster). not declines memory. Age did modify Conclusions Relevance In this pooled study, varied by domain, suggesting that may have greater reserve but steeper lower level.

Язык: Английский

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Wildfire Smoke Exposure and Incident Dementia

JAMA Neurology, Год журнала: 2024, Номер 82(1), С. 40 - 40

Опубликована: Ноя. 25, 2024

Importance Long-term exposure to total fine particulate matter (PM 2.5 ) is a recognized dementia risk factor, but less known about wildfire-generated PM , an increasingly common source. Objective To assess the association between long-term wildfire and nonwildfire of incident dementia. Design, Setting, Participants This open cohort study was conducted using January 2008 December 2019 electronic health record (EHR) data among members Kaiser Permanente Southern California (KPSC), which serves 4.7 million people across 10 counties. KPSC aged 60 years or older were eligible for inclusion. Members excluded if they did not meet eligibility criteria, had diagnosis before entry, EHR lacked address information. Data analysis from May 2023 2024. Exposures Three-year rolling mean in member census tracts 2006 2019, updated quarterly estimated via monitoring remote-sensing statistical techniques. Main Outcome Measures The primary outcome dementia, identified diagnostic codes EHR. Odds diagnoses associated with 3-year discrete-time approach pooled logistic regression. Models adjusted age, sex, race ethnicity (considered as social construct rather than biological determinant), marital status, smoking calendar year, tract–level poverty population density. Stratified models assessed effect measure modification by ethnicity, poverty. Results Among 1.64 during period, 1 223 107 inclusion this study. consisted 644 766 female (53.0%). In total, 319 521 Hispanic (26.0%), 601 334 non-Hispanic White (49.0%), 80 993 received follow-up (6.6%). models, 1-μg/m 3 increase 18% odds (odds ratio [OR], 1.18; 95% CI, 1.03-1.34). comparison, 1% (OR, 1.01; 1.01-1.02). For exposure, associations stronger 75 old upon racially minoritized subgroups, those living high-poverty vs low-poverty tracts. Conclusions Relevance study, after adjusting measured confounders, over period diagnoses. As climate changes, interventions focused on reducing may reduce related inequities.

Язык: Английский

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Dementia, dementia's risk factors and premorbid brain structure are concentrated in disadvantaged areas: National register and birth‐cohort geographic analyses

Alzheimer s & Dementia, Год журнала: 2024, Номер 20(5), С. 3167 - 3178

Опубликована: Март 14, 2024

Dementia risk may be elevated in socioeconomically disadvantaged neighborhoods. Reasons for this remain unclear, and elevation has yet to shown at a national population level.

Язык: Английский

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Medicare Payments and ACOs for Dementia Patients Across Race and Social Vulnerability

American Journal of Geriatric Psychiatry, Год журнала: 2024, Номер 32(12), С. 1433 - 1442

Опубликована: Июль 2, 2024

Язык: Английский

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Telehealth Infrastructure, Accountable Care Organization, and Medicare Payment for Patients with Alzheimer's Disease and Related Dementia Living in Socially Vulnerable Areas

Telemedicine Journal and e-Health, Год журнала: 2024, Номер 30(8), С. 2148 - 2156

Опубликована: Авг. 1, 2024

Structural social determinants of health have an accumulated negative impact on physical and mental health. Evidence is needed to understand whether emerging information technology innovative payment models can help address such structural for patients with complex needs, as Alzheimer's disease related dementias (ADRD).

Язык: Английский

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Consider the Context of Care

Oxford University Press eBooks, Год журнала: 2025, Номер unknown, С. 82 - 85

Опубликована: Янв. 1, 2025

Abstract The needs of the patient must be considered in regard to biopsychosocial context their life.

Язык: Английский

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Factors Associated With Physical Activity in Alzheimer’s Disease: A Cross-Sectional Study of Individuals and Their Caregivers

Journal of Aging and Health, Год журнала: 2025, Номер unknown

Опубликована: Фев. 2, 2025

Introduction Physical activity (PA) is associated with better outcomes in individuals living Alzheimer’s and related dementia (ADRD). We examined environmental, intra-, interpersonal correlates of PA for persons ADRD. Methods (accelerometry), cognitive function, physical sociodemographic factors were collected adults ADRD their caregivers. Spearman’s correlations generalized linear models used to evaluate Results Valid data obtained from 65 pairs (73.6 ± 8.4 years, 39.4% female) caregivers (69.4 9.4 69.2% female, 93.8% spouse). Moderate-to-vigorous (MVPA) light correlated upper lower body strength, aerobic fitness, agility. MVPA sedentary time that caregiver. Conclusion function caregiver may be targets interventions those

Язык: Английский

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Patterns of Factors in the NIA Health Disparities Research Framework Domains and Mild Cognitive Impairment Risk

AJPM Focus, Год журнала: 2025, Номер 4(3), С. 100324 - 100324

Опубликована: Фев. 17, 2025

Язык: Английский

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Cognitive Correlates of Resilience in Adults Experiencing Homelessness

Archives of Clinical Neuropsychology, Год журнала: 2025, Номер unknown

Опубликована: Март 4, 2025

In adults who have experienced homelessness, greater psychological resilience is related to better quality of life, community functioning, and social cognition. Domain-specific cognitive functioning positively associated with in housed populations; however, these relationships yet be explored among experiencing homelessness. The aim this study examine the between domain-specific function One hundred six homelessness were recruited Toronto, Canada, 88 included analyses (51% female, mean age = 43 years). Study measures assessed as well cognition (vocabulary, oral reading, processing speed, episodic memory, executive functioning) using NIH Toolbox Cognition Battery. Additional covariates interest distress, network size, substance misuse, major psychiatric disorders. Hierarchical regression modeling contributions each domain while accounting for established covariates. Oral reading was higher resilience, explaining 12.45% variance controlling age, education, gender, size. Performance on visual memory not found self-reported resilience. results suggest that verbal vocabulary, shaped by accumulation experiences across one's lifetime, may an important contributor Better crystallized abilities reflect more enriched early life are critical coping skills well-being

Язык: Английский

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Association of neighborhood disadvantage with cognitive function and cortical disorganization in an unimpaired cohort: An exploratory study

Alzheimer s & Dementia, Год журнала: 2025, Номер 21(3)

Опубликована: Март 1, 2025

Neighborhood disadvantage has been shown to impact health and cognitive outcomes, while morphological similarity network (MSN) can elucidate structural patterns underlying functions. We hypothesized MSNs could provide cortical linked with neighborhood function, explaining the potential risk of impairment in disadvantaged neighborhoods. For cognitively unimpaired participants from Wisconsin Alzheimer's Disease Research Center or Registry for Prevention (n = 524), Neuroimaging Initiative (ADNI) cohort 100), was obtained using Area Deprivation Index (ADI) its association performance MSN features analyzed linear regression mediation analysis. associated worse on memory, executive processing speed, preclinical tests both datasets. Local organization predominantly frontal temporal regions showed trends ADI. Morphological ADI, in-part, may explain poor functioning a population. Social determinants such as context be studied High related category fluency, implicit learning story recall memory pre-clinical composite. In this exploratory study, brain networks that indicate distribution thickness between regions, we observed centrality marginally status also partially mediated composite test. There is role considering early screening dementia.

Язык: Английский

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