Cognitive Impairment and Social Determinants of Health Among Indigenous Women.

BACKGROUND AND OBJECTIVES: Cognitive impairment and Alzheimer's disease and related dementias (ADRD) pose significant challenges for Indigenous populations, necessitating urgent research. Limited evidence suggests that high rates of ADRD among Indigenous peoples are associated with social determinants of health (SDOH), such as education, income, health literacy, religion, and social engagement. RESEARCH DESIGN AND METHODS: Collaborating with a Northern Plains tribe, participants were recruited 123 self-identified Indigenous women aged 40-70 through a comprehensive recruitment strategy. Employing the SDOH framework, the research assessed cognitive impairment and Alzheimer's disease knowledge (ADK), utilizing the Ascertain Dementia 8 and Alzheimer's disease knowledge scales (ADK-30). The investigation examined the relationships between selected SDOH variables and cognitive impairment status. RESULTS: More than half of the participants showed signs of cognitive impairment, which correlated with lower income and education levels. Increased knowledge about Alzheimer's disease, particularly in terms of treatment management and its life impact subscales, was associated with lower odds of cognitive impairment. Conversely, higher levels of depressive symptoms and participation in religious activities were linked to increased odds of cognitive impairment. DISCUSSION AND IMPLICATIONS: The findings underscore the importance of culturally grounded tools and SDOH frameworks tailored to Indigenous contexts in addressing ADRD disparities. Future research should integrate historical and cultural factors to advance health equity within Indigenous communities, ultimately mitigating the impact of ADRD and promoting overall well-being.

Differences in Life Space Activity Patterns Between Older Adults With Mild Cognitive Impairment Living Alone or as a Couple: Cohort Study Using Passive Activity Sensing.

BACKGROUND: Measuring function with passive in-home sensors has the advantages of real-world, objective, continuous, and unobtrusive measurement. However, previous studies have focused on 1-person homes only, which limits their generalizability. OBJECTIVE: This study aimed to compare the life space activity patterns of participants living alone with those of participants living as a couple and to compare people with mild cognitive impairment (MCI) with cognitively normal participants in both 1- and 2-person homes. METHODS: Passive infrared motion sensors and door contact sensors were installed in 1- and 2-person homes with cognitively normal residents or residents with MCI. A home was classified as an MCI home if at least 1 person in the home had MCI. Time out of home (TOOH), independent life space activity (ILSA), and use of the living room, kitchen, bathroom, and bedroom were calculated. Data were analyzed using the following methods: (1) daily averages over 4 weeks, (2) hourly averages (time of day) over 4 weeks, or (3) longitudinal day-to-day changes. RESULTS: In total, 129 homes with people living alone (n=27, 20.9%, MCI and n=102, 79.1%, no-MCI homes) and 52 homes with people living as a couple (n=24, 46.2%, MCI and n=28, 53.8%, no-MCI homes) were included with a mean follow-up of 719 (SD 308) days. Using all 3 analysis methods, we found that 2-person homes showed a shorter TOOH, a longer ILSA, and shorter living room and kitchen use. In MCI homes, ILSA was higher in 2-person homes but lower in 1-person homes. The effects of MCI status on other outcomes were only found when using the hourly averages or longitudinal day-to-day changes over time, and they depended on the household type (alone vs residing as a couple). CONCLUSIONS: This study shows that in-home behavior is different when a participant is living alone compared to when they are living as a couple, meaning that the household type should be considered when studying in-home behavior. The effects of MCI status can be detected with in-home sensors, even in 2-person homes, but data should be analyzed on an hour-to-hour basis or longitudinally.

Depressive symptoms in older adult couples: Associations with dyadic physical health, social engagement, and close friends.

Objective: The objective of this study was to examine associations between level of depressive symptoms in older adult spouse/partner couples and their physical health and social factors (social activity and number of close friends). Methods: Using data from 116 community-dwelling couples (age 76.2 ± 8.5), we simultaneously analyzed associations between depressive symptoms (Geriatric Depression Scale, range 0-11) and dyadic physical health, engagement in social activities, and connectedness with close friends. Results: Greater engagement in social activities was associated with fewer depressive symptoms in men, whereas more close friendships were associated with fewer depressive symptoms in women, controlling for partner effects, age, education, and cognitive function, with good model fit. Additionally, more disparate physical health within the couple (latent incongruence score) was associated with greater depressive symptoms in men. Discussion: Less social activity and fewer close friends were associated with depressive symptoms in older adult couples, but may be distinctly influential depending on gender and in the context of the older adult couple's physical health.

The Remote Assessment and Dynamic Response Program: Development of an In-Home Dementia-Related Care Needs Assessment to Improve Well-Being.

Background and Objectives: The Remote Assessment and Dynamic Response (READyR) Program was developed in order to address the current lack of early-stage dementia care planning programs that assess the care needs of persons with dementia. The goal was to create a program informed by care values and ongoing ecologically valid data. The objectives of this study are to describe the development and design process of the READyR Program, and to evaluate the utility of the READyR Program for identifying dementia-related care needs. Research Design and Methods: A prototype of the web-based READyR Program tool was first created using digital activity data that were collected by previous studies using a platform of multimodal sensors installed in the homes of older adult couples with and without dementia. Digital activity data were then mapped onto potential care values (e.g., safety & autonomy) to create a values-based needs assessment that is tailored to the individual care dyad. Next, evaluation of the READyR Program by 11 professional dementia care coordinators and case managers (across 3 semistructured focus groups) was used to explore the utility of READyR for assessing dementia-related needs. Qualitative description using conventional content analysis was used to iteratively code focus group data and to describe prevalent themes. Results: Prevalent focus groups themes included barriers to (e.g., family relationship strain) and facilitators of (e.g., tailored assessments) the optimal process for assessing dementia-related care needs by care coordinators, as well as advantages to (e.g., providing new objective insights into function, and routines) and disadvantages of (e.g., bringing up new questions about care) incorporating the remote monitoring data into a values-based needs assessment. Discussion and Implications: READyR has the potential to help family members, as well as care coordinators and providers, gain insight into the values-based care needs of persons with early-stage dementia. Clinical Trials Registration Number: NCT04542109.

Binge drinking and family history of alcoholism are associated with an altered developmental trajectory of impulsive choice across adolescence.

AIMS: To test whether binge drinking, the density of familial alcoholism (FHD) and their interaction are associated with an altered developmental trajectory of impulsive choice across adolescence, and whether more life-time drinks are associated with a greater change in impulsive choice across age. DESIGN: Alcohol-naive adolescents, with varying degrees of FHD, were recruited as part of an ongoing longitudinal study on adolescent development, and were grouped based on whether they remained non-drinkers (n = 83) or initiated binge drinking (n = 33) during follow-up. During all visits, adolescents completed a monetary delay discounting task to measure impulsive choice. The effects of binge-drinking status, FHD and their interaction on impulsive choice across adolescence were tested. SETTING: Developmental Brain Imaging Laboratory, Oregon Health & Science University, Portland, Oregon, USA. PARTICIPANTS: A total of 116 healthy male and female adolescents (ages 10-17 years at baseline) completed two to four visits between July 2008 and May 2016. MEASUREMENTS: Discounting rates were obtained based on adolescents' preference for immediate or delayed rewards. FHD was based on parent-reported prevalence of alcohol use disorder in the participant's first- and second-degree relatives. Binge-drinking status was determined based on the number of recent binge-drinking episodes. FINDINGS: There was a significant interaction effect of binge-drinking status and FHD on impulsive choice across age (b = 1.090, P < 0.05, ß = 0.298). In adolescents who remained alcohol-naive, greater FHD was associated with a steeper decrease in discounting rates across adolescence (b = -0.633, P < 0.05, ß = -0.173); however, this effect was not present in binge-drinkers. Furthermore, total life-time drinks predicted escalated impulsive choice (b = 0.002, P < 0.05, ß = 0.295) in binge-drinking adolescents. CONCLUSIONS: A greater degree of familial alcoholism is associated with a steeper decline in impulsive choice across adolescence, but only in those who remain alcohol-naive. Meanwhile, more life-time drinks during adolescence is associated with increases in impulsive choice across age.

How suspect race affects police use of force in an interaction over time.

Although studies often find racial disparities in policing outcomes, less is known about how suspect race biases police interactions as they unfold. This study examines what is differentially occurring during police-suspect interactions for White, Black, and Latino suspects across time. It is hypothesized that racial bias may be more evident earlier in interactions, when less information about the situation is available. One hundred thirty-nine (62 White, 42 Black, and 35 Latino) use-of-force case files and associated written narratives from a medium to large size urban police department in the United States were analyzed. Trained coders broke down the interaction narratives into discrete "sequences," or dyadic action-reaction steps involving a suspect action (level of resistance) and an officer response (level of force). A linear mixed-effects model was run on amount of police use of force by suspect race and time, with suspect resistance and suspect actions toward third-party/self as controls. Results demonstrated that Black and Latino suspects receive more force in the beginning stages of the interaction, whereas Whites escalated in level of force faster after initial levels. By breaking down police-suspect interactions into discrete sequences, the current study reveals a better understanding of when bias originates in police use of force and informs how to focus policing interventions. (PsycINFO Database Record

Can student engagement serve as a motivational resource for academic coping, persistence, and learning during late elementary and early middle school?

How children and youth deal with academic challenges and setbacks can make a material difference to their learning and school success. Hence, it is important to investigate the factors that allow students to cope constructively. A process model focused on students' motivational resources was used to frame a study examining whether engagement in the classroom shapes students' academic coping, and whether coping in turn contributes to subsequent persistence on challenging tasks and learning, which then feed back into ongoing engagement. In fall and spring of the same school year, 880 children in 4th through 6th grades and their teachers completed measures of students' engagement and disaffection in the classroom, and of their re-engagement in the face of obstacles and difficulties; students also reported on 5 adaptive and 6 maladaptive ways of academic coping; and information on a subset of students' classroom grades was collected. Structural analyses, incorporating student-reports, teacher-reports, and their combination, indicated that the model of motivational processes was a good fit for time-ordered data from fall to spring. Multiple regressions examining each step in the process model also indicated that it was the profile of coping responses, rather than any specific individual way of coping, that was most centrally connected to changes in engagement and persistence. Taken together, findings suggest that these internal dynamics may form self-perpetuating cycles that could cement or augment the development of children's motivational resilience and vulnerability across time. (PsycINFO Database Record

Do sensitive parents foster kind children, or vice versa? Bidirectional influences between children's prosocial behavior and parental sensitivity.

Bidirectional theories of social development have been around for over 40 years (Bell, 1968), yet they have been applied primarily to the study of antisocial development. In the present study, the reciprocal relationship between parenting behavior and children's socially competent behaviors were examined. Using the National Institute of Child Health and Development Study of Early Child Care data set (NICHD Early Child Care Research Network, 2005), bidirectional relationships between parental sensitivity and children's prosocial behavior were modeled using latent variables in structural equation modeling for mothers and fathers, separately. Children and their parents engaged in structured interactions when children were 54-month-olds, 3rd graders, and 5th graders, and these interactions were coded for parental sensitivity. At 3rd, 5th, and 6th grades, teachers and parents reported on children's prosocial behavior. Parental education and child gender were entered as covariates in the models. The results provide support for a bidirectional relationship between children's prosocial behavior and maternal sensitivity (but not paternal sensitivity) in middle childhood. The importance of using a bidirectional approach to examine the development of social competence is emphasized.

An idiographic approach to estimating models of dyadic interactions with differential equations.

We present an idiographic approach to modeling dyadic interactions using differential equations. Using data representing daily affect ratings from romantic relationships, we examined several models conceptualizing different types of dyadic interactions. We fitted each model to each of the dyads and the resulting AICc values were used to classify the most likely configuration of interaction for each dyad. Additionally, the AICc from the different models were used in parameter averaging across models. Averaged parameters were used in models involving predictors of relationship dynamics, as indexed by these parameters, as well as models wherein the parameters predicted distal outcomes of the dyads such as relationship satisfaction and status. Results indicated that, within our sample, the most likely interaction style was that of independence, without evidence of emotional interrelations between the two individuals in the couple. Attachment-related avoidance and anxiety showed significant relations with model parameters, such that ideal levels of affect for males were negatively influenced by higher levels of avoidance from their partner while their own levels of anxiety had positive effects on their levels of dyadic coregulation. For females coregulation was negatively influenced by both time in the relationship and their partner's level of avoidance. Analysis involving distal outcomes showed modest influences from the individual's level of ideal affect.

White matter maturation supports the development of reasoning ability through its influence on processing speed.

The structure of the human brain changes in several ways throughout childhood and adolescence. Perhaps the most salient of these changes is the strengthening of white matter tracts that enable distal brain regions to communicate with one another more quickly and efficiently. Here, we sought to understand whether and how white matter changes contribute to improved reasoning ability over development. In particular, we sought to understand whether previously reported relationships between white matter microstructure and reasoning are mediated by processing speed. To this end, we analyzed diffusion tensor imaging data as well as data from standard psychometric tests of cognitive abilities from 103 individuals between the ages of 6 and 18. We used structural equation modeling to investigate the network of relationships between brain and behavior variables. Our analyses provide support for the hypothesis that white matter maturation (as indexed either by microstructural organization or volume) supports improved processing speed, which, in turn, supports improved reasoning ability.

Maternal perceptions of the infant: Relationship to maternal self-efficacy during the first six weeks' postpartum.

Mothers' perceptions of their infants and their own levels of self-efficacy contribute to developing maternal-infant attunement. The purpose of this investigation was to examine the associations between maternal perceptions of their own infants relative to other infants and maternal self-efficacy in a group of ethnically diverse, low-income, first-time mothers during the first six weeks postpartum. By employing a structural equation model approach, we explored relationships between the predictor (maternal neonatal perceptions) and dependent variable (maternal self-efficacy). Changes in maternal perceptions of their own infants significantly contributed to self-reported levels of self-efficacy while controlling for concurrent self-esteem. Maternal perceptions of her infant as less difficult than the average infant at six weeks postpartum predicted increased levels of maternal self-reported self-efficacy. The present study supports further exploration of the first six weeks postpartum as a sensitive period for targeting intervention and support, particularly for mothers and infants at highest risk.

Latent Differential Equation Modeling of Self-Regulatory and Coregulatory Affective Processes.

We examine emotion self-regulation and coregulation in romantic couples using daily self-reports of positive and negative affect. We fit these data using a damped linear oscillator model specified as a latent differential equation to investigate affect dynamics at the individual level and coupled influences for the 2 partners in each couple. Results indicate an absence of damping of relationship-specific affect within individuals in the sample. When both positive and negative affect are modeled at the individual level, the influence of positive affect is greater than that of negative affect. At the dyad level, the findings indicate coupled influences in both positive and negative affect between partners. With regard to positive affect, females are sensitive to their partners' overall displacement from average as well as their rate of change; males are sensitive only to their partners' displacement from average. For negative affect both partners are sensitive to each other's displacement from average, yet there are no coupled influences for rates of change in this dimension. We interpret the influence of the parameters on the system by examining the expected behavior of the system as a function of varying parameter values.

Response to Oud & Folmer: Randomness and Residuals.

This article presents our response to Oud and Folmer's "Modeling Oscillation, Approximately or Exactly?" (2011), which criticizes aspects of our article, "Latent Differential Equation Modeling of Self-Regulatory and Coregulatory Affective Processes" (2011). In this response, we present a conceptual explanation of the derivative-based estimation that we implemented in our original article, as well as the exact discrete model promoted by Oud & Folmer. We describe relevant differences between each of the two methods, highlight some of their benefits and limitations, and offer justifications for our choice.

Early behavioral associations of achievement trajectories.

Duncan et al. (2007) examined associations between early behavioral and cognitive skills with later achievement. These associations were examined in 6 different data sets and results converged to suggest that early behavioral competences or problems had little, if any, prediction to later achievement and that attentional competences had small positive relations with later achievement. In contrast, cognitive abilities were by far the strongest predictors of achievement. We provide and investigate potential reasons why Duncan et al. found little to no association between behavior and later achievement in a reanalysis of data from 3 studies previously analyzed by Duncan et al. Potential reasons include the validity of the behavioral measures, treatment of the behavioral measures as continuous as opposed to categorical, and the choice of data analytic method. In this article, we discuss these issues at greater length and address them in our reanalysis. We also bring into question the nature of the relationship between behavior and achievement. Generally, our reanalysis supports the idea that attention measures are more predictive than behavioral measures; however, certain behavior measures showed small to moderate associations to concurrent levels of academic achievement and changes in academic achievement through elementary school.

Fine motor skills and early comprehension of the world: two new school readiness indicators.

Duncan et al. (2007) presented a new methodology for identifying kindergarten readiness factors and quantifying their importance by determining which of children's developing skills measured around kindergarten entrance would predict later reading and math achievement. This article extends Duncan et al.'s work to identify kindergarten readiness factors with 6 longitudinal data sets. Their results identified kindergarten math and reading readiness and attention as the primary long-term predictors but found no effects from social skills or internalizing and externalizing behavior. We incorporated motor skills measures from 3 of the data sets and found that fine motor skills are an additional strong predictor of later achievement. Using one of the data sets, we also predicted later science scores and incorporated an additional early test of general knowledge of the social and physical world as a predictor. We found that the test of general knowledge was by far the strongest predictor of science and reading and also contributed significantly to predicting later math, making the content of this test another important kindergarten readiness indicator. Together, attention, fine motor skills, and general knowledge are much stronger overall predictors of later math, reading, and science scores than early math and reading scores alone.