Subjective Memory Complaints Predict Decline in Memory, Instrumental Activities of Daily Living, and Social Participation in Older Adults: A Fixed-Effects Model

Subjective Memory Problems and Social Determinants of Health on Timed Instrumental Activities of Daily Living With Older Adults in the ACTIVE Study

ObjectiveThis study examines the longitudinal relationship between subjective memory problems (SMPs) and timed instrumental activity of daily living (IADL) performance while considering the effects of depressive symptoms and the moderating role of the social determinants of health (SDHs).MethodsData from 2622 older adults in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized control trial were analyzed longitudinally, spanning up to 10 years. SMPs and timed IADL performance were assessed at each wave. The SDHs were captured using validated factors incorporating US Census data and person-level data from the ACTIVE Study. Multilevel mixed models examined associations, adjusting for demographics and the effects of depressive symptoms.ResultsMore SMPs at baseline were associated with slower timed IADL performance which rapidly became slower over time. Those older adults who experienced SMPs as they aged also experienced declines in timed IADL. These associations were influenced by socially determined health outcomes such as neighborhood and built environment, healthcare access and quality, and social and community context. Living in a better neighborhood and built environment and having access to quality healthcare weakened relationships over time between baseline SMPs and slower timed IADL performance. Better healthcare access and quality weakened the association of increases in SMPs with the slowing of timed IADL. Contrary to our prediction, living in a better social and community context, which fostered social engagement and decreased social isolation, strengthened relationships over time between baseline SMPs and slower timed IADL performance as well as the association of increases in SMPs with slower timed IADL performance over time.DiscussionMore SMPs at baseline were significantly related to slower rates of timed IADL performance over time, especially in older adults living in worse neighborhoods and built environments as well as areas with better social and community contexts. Increases in SMPs as one aged were also related to the slowing of timed IADL performance, especially in older adults living in areas with worse healthcare access and quality. Finally, our study found that higher scores on SMPs were related to slower timed IADL performance-independent of major confounds such as depressive symptoms.

The African American Dementia and Aging Project: an Oregon-based longitudinal study

Introduction

The vast majority of studies on aging, cognition, and dementia focus on non-Hispanic white subjects. This paper adds to the extant literature by providing insight into the African American aging experience. Here we describe the study design and baseline characteristics of the African American Dementia and Aging Project (AADAPt) study, which is exploring aging and cognition in African American older adults in Oregon.

Methods

African American older adults (n = 177) participated in AADAPt, a longitudinal study that collected data on cognitive, physical, and social functioning in annual visits since 2000.

Results

AADAPt participants had risk factors for developing dementia in future, such as hypertension and hyperlipidemia, but also reported protective factors such as high social engagement.

Discussion

The AADAPt project offers new insights into aging in older African Americans that includes data on cognition, social engagement, and physical health, which are crucial for understanding the experience of under-represented groups and making future studies more inclusive.

The African American Dementia and Aging Project (AADAPt): An Oregon-based Longitudinal Study

Objectives

The vast majority of studies on aging, cognition, and dementia focus on non-Hispanic white subjects. This paper adds to the extant literature by providing insight into the African American aging experience. Here we describe the study design and baseline characteristics of the African American Dementia and Aging Project (AADAPt) study, which is exploring aging and cognition in African American older adults in Oregon.

Methods

African American older adults (n=177) participated in AADAPt, a longitudinal study that collected data on cognitive, physical, and social functioning in annual visits since 2000.

Results

AADAPt participants had risk factors for developing dementia in future, such as hypertension and hyperlipidemia, but also reported protective factors such as high social engagement.

Conclusions

The AADAPt project offers new insights into aging in older African Americans that includes data on cognition, social engagement, and physical health, which are crucial for understanding the experience of under-represented groups and making future studies more inclusive. These findings reflect a window of time for a geographically-focused cohort, and the lessons learned from this study likely have broader implications for shaping the health of these older African American adults. Keywords: African American, Dementia, Observational Study.

Subjective Cognitive Decline in Community-Dwelling Older Adults With Objectively Normal Cognition: Mediation by Depression and Instrumental Activities of Daily Living

OBJECTIVE

Subjective cognitive decline (SCD) refers to self-reported memory loss despite normal cognitive function and is considered a preclinical stage of Alzheimer's disease. This study aimed to examine the mediating effects of depression and Instrumental Activities of Daily Living (IADL) on the association between the scoring of Clinical Dementia Rating Scale-Sum of Boxes (CDR-SB) and Subjective Cognitive Decline Questionnaire (SCD-Q).

METHODS

A sample of 139 community-dwelling older adults aged 65-79 with normal cognitive function completed the SCD-Q, a comprehensive neuropsychological battery, and functional/psychiatric scales. We conducted 1) a correlation analysis between SCD-Q scores and other variables and 2) a path analysis to examine the mediating effects of depression and IADL on the relationship between CDR-SB and SCD-Q.

RESULTS

CDR-SB was found to be indirectly associated with SCD-Q, with depressive symptoms mediating this relationship. However, no direct association was observed between SCD-Q and CDR-SB. Additionally, IADL was not associated with SCD-Q and did not mediate the relationship between CDR-SB and SCD-Q. The model fit was acceptable (minimum discrepancy function by degrees of freedom divided [CMIN/DF]=1.585, root mean square error of approximation [RMSEA]=0.065, comparative fit index [CFI]=0.955, Tucker-Lewis index [TLI]=0.939).

CONCLUSION

Our results suggest that SCD-Q is influenced by depressive symptoms, but not by IADL. The role of depressive symptoms as a mediator between CDR-SB and SCD-Q indicates that psychological factors may contribute to the perception of SCD. Therefore, interventions targeting depression may mitigate the concerns associated with SCD and reduce feelings of worse performance compared to others of the same age group.

Association of mobile device proficiency and subjective cognitive complaints with financial management ability among community-dwelling older adults: a population-based cross-sectional study

BACKGROUND

Mobile devices have been used by many older adults and have the potential to assist individuals with subjective cognitive complaints (SCCs) in daily living tasks. Financial management is one of the most complex daily activity for older adults, as it is easily impaired in the prodromal stage of dementia and cognitive impairment.

AIM

To investigate financial management ability among older adults from SCCs and mobile device proficiency.

METHODS

A self-administered questionnaire was sent to 529 participants who were ≥ 65 years and regularly use mobile devices. Participants were divided into four groups based on SCC prevalence and scores of the Mobile Device Proficiency Questionnaire (MDPQ-16). Financial management abilities were compared between groups using the Process Analysis of Daily Activities for Dementia subscale. Regression model and crosstabulation table were used to investigate associations in detail.

RESULTS

A significant difference in financial management ability was observed among the four groups (p < 0.001), with the dual impairment group showed significantly lower than the robust and SCC groups (p < 0.001). Educational history, sex, and MDPQ-16 score were significantly associated with participants' financial management ability (p ≤ 0.01). The proportion of participants who could use ATMs and electronic money independently was significantly lower among those with low proficiency in mobile devices (LPM), regardless of SCC (p < 0.05).

CONCLUSION

The LPM group showed an impaired ability to manage their finances, particularly in situations where they would use information devices. Therefore, healthcare professionals should assess not only the SCC but also their proficiency with mobile devices to predict their impairment in activities of daily living.