Social Support and Cognition: Early Childhood Versus Older Adulthood

Distinct domains of childhood disadvantage and cognitive performance among older Brazilians: Evidence from ELSI-Brazil

Objective

To investigate the relationship between of distinct domains of childhood disadvantage and cognitive performance among older adults within the context of a middle-income country.

Methods

This study used baseline data (2015/2016) from the Brazilian Longitudinal Study of Aging (ELSI), a nationally representative cohort of 9412 adults aged 50 and over. Nine childhood exposure variables were grouped into three domains (family SES, childhood health, and cultural capital), for which scores were created. Survey-weighted Ordinary Least Squares (OLS) regressions estimated the association childhood disadvantage with cognitive performance as measured by immediate memory, late memory and semantic verbal fluency. Mediation analysis assessed whether adulthood socioeconomic status (SES) mediated this relationship of interest.

Results

Important disparities in cognitive performance were observed, particularly in terms of age, education, income, occupational status. Before controlling for adulthood SES in the multivariable analysis, all domains of childhood disadvantage were found to be associated with lower cognitive performance across all three measures. After inclusion of adulthood SES variables, the observed associations only remained for semantic verbal fluency. Formal mediation analysis indicated that adulthood SES mediates 47.9% (95% CI: 34.3%-78.6%) of the association between later-life verbal fluency and poor childhood health, and 49.9% (95% CI: 43.6%-57.8%) of the association between later-life verbal fluency and low childhood cultural capital.

Conclusions

We found that childhood disadvantage is associated with low performance in memory tests and semantic verbal fluency tests among older Brazilians. Adulthood SES fully mediated the association between all domains of childhood disadvantage and memory performance and only partially mediated its association with verbal fluency. Our findings support policy efforts to enhance early childhood development and improve adulthood SES, and guide additional research to better the mechanisms driving these relationships.

Association of intergenerational relationships with cognitive impairment among Chinese adults 80 years of age or older: prospective cohort study

Background

The oldest-old (aged 80 or older) are the most rapidly growing age group, and they are more likely to suffer from cognitive impairment, leading to severe medical and economic burdens. The influence of intergenerational relationships on cognition among Chinese oldest-old adults is not clear. We aim to examine the association of intergenerational relationships with cognitive impairment among Chinese adults aged 80 or older.

Methods

This was a prospective cohort study, and data were obtained from the Chinese Longitudinal Healthy Longevity Survey, 14,180 participants aged 80 or older with at least one follow-up survey from 1998 to 2018. Cognitive impairment was assessed by the Chinese version of Mini Mental State Examination, and intergenerational relationships were assessed by getting main financial support from children, living with children or often being visited by children, and doing housework or childcare. We used time-varying Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of associations between intergenerational relationships and cognitive impairment.

Results

We identified 5443 incident cognitive impairments in the 24-cut-off MMSE cohort and 4778 in the 18-cut-off MMSE cohort between 1998 and 2018. After adjusting for a wide range of confounders, the HR was 2.50 (95% CI: 2.31, 2.72) in the old who received main financial support from children, compared with those who did not. The HR was 0.89 (95% CI: 0.83, 0.95) in the oldest-old who did housework or childcare, compared with those who did not. However, there were no significant associations between older adults’ cognitive impairments and whether they were living with or often visited by their children. Our findings were consistent in two different MMSE cut-off values (24 vs. 18) for cognitive impairment.

Conclusions

Sharing housework or childcare for children showed a protective effect on older adults’ cognitive function, whereas having children provide primary financial support could increase the risk for cognitive impairments. Our findings suggest that governments and children should pay more attention to older adults whose main financial sources from their children. Children can arrange some easy tasks for adults 80 years of age or older to prevent cognitive impairments.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03529-y.

Associations of conflict and migration on childhood cognitive development in Ethiopia: Evidence from a longitudinal study

BACKGROUND

Migration has substantial consequences on the wellness of affected households, thereby exposing children to circumstances that are detrimental for healthy cognitive development. This study evaluates the relationship between conflict and migration during conception or early childhood and childhood cognitive development outcomes among families in Ethiopia. We hypothesized that migration is associated with worse cognitive development outcomes among children and that this association is mediated by educational disparities and caregiver psychological distress.

METHODS

The study used longitudinal data of children enrolled in the Young Lives Study (YLS) conducted in Ethiopia during 2002 (age 1), 2006-2007 (age 5), and 2009-2010 (age 8). We used multivariate linear and logistic regression to analyze the association between migration on cognitive development during middle childhood. Household migration and caregiver psychological distress were measured during round 1, type of education was measured at round 2, and cognitive development was measured at round 3.

RESULTS

Results of the multivariate regression analysis showed that migrant children achieved lower scores on a test of verbal intelligence after controlling for sex, ethnicity, religion, and caregiver distress (β: -8.09; 95% CI: -15.33, -0.85). Results of the mediation analysis show that the type of schooling that children attended, but not caregiver psychological distress, mediated the association between migration and cognitive development. Migrant children were more likely to attend private schools, which buffered the association between migration and lower cognitive development.

CONCLUSIONS

This study suggests that migration is a key determinant of childhood cognitive development among migrated populations. More research is needed to build the evidence base to support interventions for this growing, underserved population.

Revealing the Role of Social Support on Cognitive Deficits in Fibromyalgia Syndrome

Despite the relevance of cognitive deficits in fibromyalgia syndrome (FMS) and the attempts to elucidate the influence of the disorder symptoms in the cognitive decline reported by patients, no studies have explored the specific role of social support on cognition in FMS. Social support has been shown to be an essential modulator factor on cognitive performance in other diseases. Sixty-four women with FMS and 32 healthy women participated in the study and completed questionnaires pertaining to anxiety, depression, fatigue, insomnia, clinical pain, and social support, along with a neuropsychological battery assessing verbal memory, organization, strategic and planning abilities, self-regulation, processing speed, attention, and cognitive flexibility. Results showed that FMS patients exhibited lower values in all social support dimensions in comparison with healthy individuals, especially in the socializing dimension. Despite the lower social support observed in FMS, all social support dimensions showed a positive impact on verbal memory, organization and planning abilities, strategic planning, self-regulation, processing speed, attention, and cognitive flexibility in these patients. In fact, social support was associated with greater correct responses and processing speed and minor number of errors in all the neuropsychological battery tests. Socializing was the main predictor of organization and planning abilities, strategic planning, and self-regulation. In sum, results suggest that social support may be a key factor in buffering the cognitive decline observed in FMS. Designing psychoeducation programs and intervention programs directed not only to FMS patients but also relatives, health care workers, and the general population might be essential to improve the social support of FMS patients and positively impact on patient's cognitive status.

The Impact of Informal Social Support on Older Health: Evidence from China

Objectives: To explore the impact of informal social support (ISS) on older health. Methods: Multiple regression was used as the baseline regression, grouping regression was used to examine whether there were health effect differences among groups based on age and household registration, and insurance was selected to explore moderating effects of formal social support (FSS). Results: First, economic support, accompanied support, and number of intimate contacts had significantly positive effects on older health except for care support’s negative effects. Second, ISS had different health effects for different groups based on age and household registration. Third, FSS was a significant moderating for ISS. Conclusions: The government should emphasize and strengthen the supplementary role of ISS to FSS and promote the effective combination of the two, especially for the older who are high-age and rural, and further improve the role of care support.

Cognitive differences associated with HIV serostatus and antiretroviral therapy use in a population-based sample of older adults in South Africa

Previous clinical studies have reported adverse cognitive outcomes for people living with HIV (PLWH), but there are no population-based studies comparing cognitive function between older PLWH and comparators without HIV in sub-Saharan Africa. We analyzed baseline data of 40 + years-old participants in "Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa" (HAALSI) cohort. We measured cognition using a battery of conventional instruments assessing orientation, immediate- and delayed-recall, and numeracy (N = 4560), and the Oxford Cognitive Screen [OCS]-Plus, a novel instrument for low-literacy populations, assessing memory, language, visual-spatial ability, and executive functioning (N = 1997). Linear regression models comparing cognitive scores between participants with and without HIV were adjusted for sex, education, age, country of birth, father's occupation, ever-consumed alcohol, and asset index. PLWH scored on average 0.06 (95% CI 0.01-0.12) standard deviation (SD) units higher on the conventional cognitive function measure and 0.02 (95% CI - 0.07 to 0.04) SD units lower on the OCS-Plus measure than HIV-negative participants. We found higher cognitive function scores for PLWH compared to people without HIV when using a conventional measure of cognitive function but not when using a novel instrument for low-literacy settings.

Social housing enhances acquisition of task set independently of environmental enrichment: A longitudinal study in the Barnes maze

Human studies suggest that healthy social relationships benefit cognition, yet little is known about the underlying neural mechanisms of this protective effect. In rodents, studies on acute isolation and environmental enrichment (EE) confirm the importance of social exposure. Despite the widely recognized importance of sociality, however, rodent models have yet to explore the independent contributions of social housing divorced of other forms of enrichment. This study dissociates the effects of social and physical enrichment on spatial learning and memory from adulthood to old age. Rats were placed in either single or group housing, provided with ample enrichment, and tested at three time points on several phases/versions of the Barnes maze (BM) (standard, retention probes, variable location, and reversal). We found that sustained social housing enhanced cognitive flexibility, as evidenced by superior acquisition of task set (standard BM), adaptability to a new task set (variable BM), and improved reversal learning (reversal BM). Long-term retention (BM retention probes) of spatial memory was unaffected by housing conditions. Recent studies from our lab, including this report, are the first to show that social housing confers cognitive benefits beyond those of physical enrichment. Importantly, our experimental design is ideal for exploring the neural underpinnings of this socially induced cognitive protection. Understanding how sociality influences cognition will be invaluable to translational models of aging, neuropsychiatric disease, and neurological injury.

Aerobic Fitness Level Moderates the Association Between Cannabis Use and Executive Functioning and Psychomotor Speed Following Abstinence in Adolescents and Young Adults

OBJECTIVES

The high rate of cannabis (CAN) use in emerging adults is concerning given prior research suggesting neurocognitive deficits associated with CAN use in youth. Regular CAN use downregulates endocannabinoid activity, while aerobic exercise upregulates cannabinoid receptor 1 activity and releases endocannabinoids. Here we investigate the influence of regular CAN use on neuropsychological performance, and whether aerobic fitness moderates these effects.

METHODS

Seventy-nine young adults (37 CAN users) aged 16-26 participated. Groups were balanced for aerobic fitness level. Exclusion criteria included: left-handedness, past-year independent Axis-I disorders, major medical/neurologic disorders, prenatal issues, or prenatal alcohol/illicit drug exposure. After 3 weeks of abstinence, participants completed a neuropsychological battery and a maximal oxygen consumption test (VO2 max). Multiple regressions tested whether past-year CAN use, VO2 max, and CAN*VO2 max interaction predicted neuropsychological performance, controlling for past-year alcohol use, cotinine, gender, and depression symptoms.

RESULTS

Increased CAN use was associated with decreased performance on working memory and psychomotor tasks. High aerobic fitness level was related to better performance on visual memory, verbal fluency, and sequencing ability. CAN*VO2 max predicted performance of psychomotor speed, visual memory, and sequencing ability.

CONCLUSIONS

Following monitored abstinence, increased CAN use was associated with poorer performance in working memory and psychomotor speed. Higher aerobic fitness level moderated the impact of CAN on visual memory, executive function and psychomotor speed, as more aerobically fit CAN users demonstrated better performance relative to low-fit users. Therefore, aerobic fitness may present an affordable and efficacious method to improve cognitive functioning in CAN users. (JINS, 2019, 25, 134-145).

Identifying Cognitive Impairment in Hospitalized Older Adults to Prevent Readmission: Two Case Studies

OBJECTIVE

To describe two patient outcomes post-discharge from an acute hospital admission. Both patients underwent cognitive testing during hospitalization.

METHODS

A battery of cognitive tests was administered to two hospitalized older adult patients. Both patients were evaluated in their homes within 72 hours of discharge and again at 14- and 30-days by a nurse practitioner.

RESULTS

One of the patients was readmitted within 30 days of hospital discharge due to complications from an amputation. This patient did not perform well on cognitive measures which may have been related to his pain levels and/or his medication regimen.

CONCLUSIONS

Not all readmissions are avoidable; however, if readmissions are related to cognitive impairment, implementing strategies tailored to this population may reduce readmission rates.

CLINICAL IMPLICATIONS

Risk factors for readmission should be identified so the discharge team can develop a tailored plan of care. Including both the patient and an informal caregiver may reduce the chance of a hospital readmission in older adults with cognitive impairment regardless of the etiology.

Effect of Life Events, Social Supports, and Personality on Mental Status in Later Life

The goal of this study was to explore the influences of proximal and distal life events on mental status in later life. Additionally, life events were categorized into positive and negative experiences. Data from 208 older adults over 80 years of age from the Georgia Centenarian Study were included in this study. Results from a series of blockwise regression analyses indicated that the number of distal negative life events that older adults had experienced was a predictor of older adults' better mental status. Oldest-old adults' age, education, social supports, and social provision were also associated with their cognition. Cumulative negative life events may protect people in cognitive function as implicated by our results.