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Stickel AM, Mendoza A, Tarraf W, Kuwayama S, Kaur S, Morlett Paredes A, Daviglus ML, Testai FD, Zeng D, Isasi CR, Baiduc RR, Dinces E, Lee DJ, González HM. Hearing Loss and Associated 7-Year Cognitive Outcomes Among Hispanic and Latino Adults. JAMA Otolaryngol Head Neck Surg 2024:2816120. [PMID: 38512278 PMCID: PMC10958383 DOI: 10.1001/jamaoto.2024.0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/29/2024] [Indexed: 03/22/2024]
Abstract
Importance Hearing loss appears to have adverse effects on cognition and increases risk for cognitive impairment. These associations have not been thoroughly investigated in the Hispanic and Latino population, which faces hearing health disparities. Objective To examine associations between hearing loss with 7-year cognitive change and mild cognitive impairment (MCI) prevalence among a diverse cohort of Hispanic/Latino adults. Design, Setting, and Participants This cohort study used data from a large community health survey of Hispanic Latino adults in 4 major US cities. Eligible participants were aged 50 years or older at their second visit to study field centers. Cognitive data were collected at visit 1 and visit 2, an average of 7 years later. Data were last analyzed between September 2023 and January 2024. Exposure Hearing loss at visit 1 was defined as a pure-tone average (500, 1000, 2000, and 4000 Hz) greater than 25 dB hearing loss in the better ear. Main outcomes and measures Cognitive data were collected at visit 1 and visit 2, an average of 7 years later and included measures of episodic learning and memory (the Brief-Spanish English Verbal Learning Test Sum of Trials and Delayed Recall), verbal fluency (word fluency-phonemic fluency), executive functioning (Trails Making Test-Trail B), and processing speed (Digit-Symbol Substitution, Trails Making Test-Trail A). MCI at visit 2 was defined using the National Institute on Aging-Alzheimer Association criteria. Results A total of 6113 Hispanic Latino adults were included (mean [SD] age, 56.4 [8.1] years; 3919 women [64.1%]). Hearing loss at visit 1 was associated with worse cognitive performance at 7-year follow-up (global cognition: β = -0.11 [95% CI, -0.18 to -0.05]), equivalent to 4.6 years of aging and greater adverse change (slowing) in processing speed (β = -0.12 [95% CI, -0.23 to -0.003]) equivalent to 5.4 years of cognitive change due to aging. There were no associations with MCI. Conclusions and relevance The findings of this cohort study suggest that hearing loss decreases cognitive performance and increases rate of adverse change in processing speed. These findings underscore the need to prevent, assess, and treat hearing loss in the Hispanic and Latino community.
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Affiliation(s)
- Ariana M. Stickel
- Department of Psychology, San Diego State University, San Diego, California
| | - Alonzo Mendoza
- Department of Neurosciences, University of California, San Diego, La Jolla
| | - Wassim Tarraf
- Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, Michigan
| | - Sayaka Kuwayama
- Department of Neurosciences, University of California, San Diego, La Jolla
| | - Sonya Kaur
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida
| | | | - Martha L. Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago
| | - Fernando D. Testai
- Department of Neurology & Rehabilitation, College of Medicine, University of Illinois at Chicago, Chicago
| | - Donglin Zeng
- Department of Biostatistics, University of North Carolina, Chapel Hill
| | - Carmen R. Isasi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Rachael R. Baiduc
- Speech, Language, and Hearing Sciences, University of Colorado Boulder, Boulder
| | - Elizabeth Dinces
- Department of Otorhinolaryngology, Albert Einstein College of Medicine, Bronx, New York
| | - David J. Lee
- Department of Epidemiology & Public Health, University of Miami, Miami, Florida
| | - Hector M. González
- Department of Neurosciences, University of California, San Diego, La Jolla
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Stickel AM, Tarraf W, Kuwayama S, Wu B, Sundermann EE, Gallo LC, Lamar M, Daviglus M, Zeng D, Thyagarajan B, Isasi CR, Lipton RB, Cordero C, Perreira KM, Gonzalez HM, Banks SJ. Connections between reproductive health and cognitive aging among women enrolled in the HCHS/SOL and SOL-INCA. Alzheimers Dement 2024; 20:1944-1957. [PMID: 38160447 PMCID: PMC10947951 DOI: 10.1002/alz.13575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 11/01/2023] [Accepted: 11/13/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Reproductive health history may contribute to cognitive aging and risk for Alzheimer's disease, but this is understudied among Hispanic/Latina women. METHODS Participants included 2126 Hispanic/Latina postmenopausal women (44 to 75 years) from the Study of Latinos-Investigation of Neurocognitive Aging. Survey linear regressions separately modeled the associations between reproductive health measures (age at menarche, history of oral contraceptive use, number of pregnancies, number of live births, age at menopause, female hormone use at Visit 1, and reproductive span) with cognitive outcomes at Visit 2 (performance, 7-year change, and mild cognitive impairment [MCI] prevalence). RESULTS Younger age at menarche, oral contraceptive use, lower pregnancies, lower live births, and older age at menopause were associated with better cognitive performance. Older age at menarche was protective against cognitive change. Hormone use was linked to lower MCI prevalence. DISCUSSION Several aspects of reproductive health appear to impact cognitive aging among Hispanic/Latina women.
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Affiliation(s)
- Ariana M. Stickel
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Wassim Tarraf
- Institute of Gerontology & Department of Healthcare SciencesWayne State UniversityDetroitMichiganUSA
| | - Sayaka Kuwayama
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Benson Wu
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Erin E. Sundermann
- Department of PsychiatryUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Linda C. Gallo
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Melissa Lamar
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoCollege of MedicineChicagoIllinoisUSA
- Rush Alzheimer's Disease Research Center and the Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Martha Daviglus
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoCollege of MedicineChicagoIllinoisUSA
| | - Donglin Zeng
- Department of BiostatisticsUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and PathologyUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Carmen R. Isasi
- Department of Epidemiology & Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Richard B. Lipton
- Department of Epidemiology & Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
| | | | - Krista M. Perreira
- Department of Social MedicineUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Hector M. Gonzalez
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Sarah J. Banks
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCaliforniaUSA
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Estrella ML, Tarraf W, Kuwayama S, Gallo LC, Wu B, Marquine MJ, Perreira KM, Vasquez PM, Isasi CR, Lipton RB, Mattei J, González HM, Daviglus ML, Lamar M. Psychosocial factors associated with 7-year change in cognition among middle-aged and older Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) and Sociocultural ancillary studies. Alzheimers Dement 2024; 20:1137-1148. [PMID: 37897802 PMCID: PMC10916974 DOI: 10.1002/alz.13527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/02/2023] [Accepted: 10/06/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION Few studies have examined the associations of psychosocial factors with cognitive change in Hispanics/Latinos. METHODS Data from the Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (HCHS/SOL INCA) and Sociocultural studies were used (n = 2,155; ages ≥45 years). Psychosocial exposures included intrapersonal (ethnic identity, optimism, purpose in life), interpersonal (family cohesion, familism, social networks, social support), and social factors (ethnic discrimination, loneliness, subjective social status). Survey-linear regression models examined associations between psychosocial exposures and 7-year cognitive change (global cognition [GC], verbal learning, memory, word fluency [WF], and digit symbol substitution [DSS]). RESULTS Familism predicted decline in GC, verbal learning, and memory; family cohesion predicted DSS decline; and loneliness predicted memory decline. Ethnic identity was protective against decline in GC and memory, optimism and social support were protective against decline in memory, and purpose in life was protective against WF decline. DISCUSSION Psychosocial factors are differentially related to cognitive changes. Culturally relevant factors should be explored in Hispanic/Latino cognitive aging research. HIGHLIGHTS Psychosocial factors are differentially related to cognitive changes in Latinos. Role of culturally relevant factors on cognition should be further explored. Familism predicted decline in global cognition, verbal learning, and memory. Ethnic identity predicted increase in global cognition and memory.
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Affiliation(s)
- Mayra L. Estrella
- Department of EpidemiologyHuman Genetics and Environmental SciencesUniversity of Texas Health Sciences Center at Houston (UTHealth Houston) School of Public HealthBrownsvilleTexasUSA
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare SciencesWayne State UniversityDetroitMichiganUSA
| | - Sayaka Kuwayama
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Linda C. Gallo
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Benson Wu
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - María J. Marquine
- Departments of Medicine and PsychiatryDuke Center for the Study of Aging and Human DevelopmentDuke UniversityDurhamNorth CarolinaUSA
| | - Krista M. Perreira
- Department of Social MedicineUniversity of North Carolina School of MedicineChapel HillNorth CarolinaUSA
| | - Priscilla M. Vasquez
- Department of Urban Public HealthCharles R. Drew University of Medicine and ScienceLos AngelesCaliforniaUSA
| | - Carmen R. Isasi
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Richard B. Lipton
- Department of NeurologyAlbert Einstein College of MedicineNew YorkNew YorkUSA
| | - Josiemer Mattei
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Hector M. González
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Martha L. Daviglus
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Melissa Lamar
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Rush Alzheimer's Disease Center and the Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
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Mahanna-Gabrielli E, Kuwayama S, Tarraf W, Kaur S, DeBuc DC, Cai J, Daviglus ML, Joslin CE, Lee DJ, Mendoza-Santiesteban C, Stickel AM, Zheng D, González HM, Ramos AR. The Effect of Self-Reported Visual Impairment and Sleep on Cognitive Decline: Results of the Hispanic Community Health Study/Study of Latinos. J Alzheimers Dis 2023; 92:1257-1267. [PMID: 36872780 PMCID: PMC10792435 DOI: 10.3233/jad-221073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
BACKGROUND Visual impairment could worsen sleep/wake disorders and cognitive decline. OBJECTIVE To examine interrelations among self-reported visual impairment, sleep, and cognitive decline in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Miami-site. METHOD HCHS/SOL Miami-site participants ages 45-74 years (n = 665) at Visit-1, who returned for cognitive test 7-years later (SOL-INCA). Participants completed the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ), validated sleep questionnaires and test for obstructive sleep apnea (OSA) at Visit-1. We obtained verbal episodic learning and memory, verbal fluency, processing speed, and executive functioning at Visit-1 and at SOL-INCA. Processing speed/executive functioning were added to SOL-INCA. We examined global cognition and change using a regression-based reliable change index, adjusting for the time lapse between Visit-1 and SOL-INCA. We used regression models to test whether 1) persons with OSA, self-reported sleep duration, insomnia, and sleepiness have an increased risk for visual impairment, 2a) visual impairment is associated with worse cognitive function and/or decline, and 2b) sleep disorders attenuate these associations. RESULT Sleepiness (β= 0.04; p < 0.01) and insomnia (β= 0.04; p < 0.001) were cross-sectionally associated with visual impairment, adjusting for sociodemographic characteristics, behavioral factors, acculturation, and health conditions. Visual impairment was associated with lower global cognitive function at Visit-1 (β= -0.16; p < 0.001) and on average 7-years later (β= -0.18; p < 0.001). Visual impairment was also associated with a change in verbal fluency (β= -0.17; p < 0.01). OSA, self-reported sleep duration, insomnia, and sleepiness did not attenuate any of the associations. CONCLUSION Self-reported visual impairment was independently associated with worse cognitive function and decline.
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Affiliation(s)
| | | | | | - Sonya Kaur
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Jianwen Cai
- University of North Carolina, Chapel Hill, NC, USA
| | | | | | - David J Lee
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | | | - Diane Zheng
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Alberto R Ramos
- University of Miami Miller School of Medicine, Miami, FL, USA
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Kuwayama S, González K, Márquez F, González H, Tarraf W. LIFE-COURSE MULTI-DISCIPLINARY PREDICTORS OF DEMENTIA AMONG OLDER ADULTS. Innov Aging 2022. [PMCID: PMC9766777 DOI: 10.1093/geroni/igac059.2802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The incidence of dementia is rapidly increasing. Identifying risk factors for dementia may help improve risk assessment, increase awareness for risk reduction, and identify potential targets for interventions. We use a life-course multi-disciplinary modeling framework to examine leading predictors of incident dementia (ID). We use the Health and Retirement Study (HRS) to measure 57 exposures across 7 different domains: (1) demographic, (2) adverse childhood socioeconomic and psychosocial, (3) adverse adulthood experiences, (4) adult socioeconomic status, (5) health behaviors, (6) social connections, and (7) adult psychological conditions. Our outcome is ID (over 8-years) operationalized using Langa-Weir classification for adults aged 65+ years who meet criteria for cognitively normal at the baseline when all exposures are measured (Nf 1,622 in testing set and Nf1,460 in validation set). We compare standard methods (Logistic regression) with machine learning (ML) approaches (Lasso, Random Forest) in identifying highly predictive exposures across the risk domains of interest. Standard methods identified lower education, childhood financial duress, and pessimism as among the leading factors associated with ID. Psychological factors explained the highest variance for ID, followed by adult socioeconomic and adverse childhood factors. However, ML techniques differed in their identification of (1) predictors and (2) factors predictive importance. The findings emphasize the importance of upstream risk factors and the long-reach of childhood experiences on cognitive health. The ML approaches highlight the importance of life-course multi-disciplinary frameworks for improving dementia risk assessment. Further investigations are needed to identify how complex interactions of life-course risk factors can be addressed through interventions.
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Affiliation(s)
- Sayaka Kuwayama
- University of California San Diego, La Jolla, California, United States
| | - Kevin González
- University of California San Diego, La Jolla, California, United States
| | - Freddie Márquez
- University of California San Diego, La Jolla, California, United States
| | - Hector González
- University of California San Diego, La Jolla, California, United States
| | - Wassim Tarraf
- Wayne State University, Detroit, Michigan, United States
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Mendoza A, Stickel AM, Tarraf W, Kuwayama S, Kaur S, Paredes AM, Daviglus ML, Testai FD, Zeng D, Isasi CR, Baiduc RR, Dinces E, Lee DJ, González HM. Relationships between hearing impairment with 7‐year cognition and cognitive change: Results from the Study of Latinos‐ Investigation of Neurocognitive Aging (SOL‐INCA). Alzheimers Dement 2022. [DOI: 10.1002/alz.064685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | | | - Sonya Kaur
- University of Miami Miller School of Medicine Miami FL USA
| | | | | | - Fenando D Testai
- University of Illinois at Chicago, College of Medicine Chicago IL USA
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Guareña LA, Paredes AM, Tarraf W, Kuwayama S, Zlatar Z, Stickel AM, Gonzalez‐Pardo R, Perreira KM, Wassertheil‐Smoller S, Zeng D, Gallo LC, Daviglus ML, Isasi CR, González HM. Associations between Depression and Subjective Cognitive Decline: Results from the Study of Latinos‐Investigation of Neurocognitive Aging (SOL‐INCA) and HCHS/SOL. Alzheimers Dement 2022. [DOI: 10.1002/alz.069024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Mahanna‐Gabrielli E, Kuwayama S, Tarraf W, DeBuc DC, Cai J, Daviglus ML, Joslin C, Lee DJ, Mendoza‐Santiesteban C, Stickel AM, Zheng D, González HM, Ramos AR. Sleep, self‐reported ocular health, and cognition in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and SOL‐Investigation of Neurocognitive Aging (SOL‐INCA). Alzheimers Dement 2022. [DOI: 10.1002/alz.064694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | | | - Jianwen Cai
- University of North Carolina Chapel Hill NC USA
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Tanimura K, Yoshinaga K, Honda M, Nishigaki M, Kuwayama S, Watanabe T. [A new analysis of the hypertensive vascular change in ocular fundus photographs by using the computer-assisted morphometric analysis]. Nippon Ganka Gakkai Zasshi 1985; 89:1261-6. [PMID: 4091099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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