Associations between asthma and cognitive functioning among older adults. Does the age of asthma diagnosis matter? Results from the RAND IFLS-5 study.

OBJECTIVE: To assess the associations of asthma status or age at asthma diagnosis with cognition using the Telephone Survey of Cognitive Status from a large population-based sample. Further, we investigated the possibility that asthma treatment mediates these associations. METHODS: This is a cross-sectional study from the Indonesian Family Life Survey Fifth Wave (IFLS-5) collected in 2014-2015. A weighted linear regression model was used to examine the associations between asthma and cognitive functioning scores in adults aged 50 years or older. Of the 6660 total samples included in this study, 176 participants had asthma (2.6%). We controlled for age, sex, and urbanicity with further adjustments for adult covariates or childhood covariates, as appropriate. RESULTS: There was no association between overall asthma status and cognitive functioning scores. However, asthma diagnosed at 0-19 years was associated with significantly higher cognitive functioning scores (Beta coefficient = 2.24, 95% CI: 0.62 - 0.87), compared to those without asthma. In the analysis involving current treatment status (restricted analysis), the significant association disappeared among those under current asthma treatment status, indicating that asthma treatment may mediate the association. CONCLUSION: Asthma might not be a risk factor for cognitive impairment. Observations of a significant association of pediatric asthma with higher cognitive scores need further investigation. Understanding cognitive functioning among older adults with asthma may improve the surveillance of cognitive decline inthis age group.

Emotional valence perception in music and subjective arousal: Experimental validation of stimuli.

Musical stimuli are widely used in emotion research and intervention studies. However, reviews have repeatedly noted that a lack of pre-evaluated musical stimuli is stalling progress in our understanding of specific effects of varying music. Musical stimuli vary along a plethora of dimensions. Of particular interest are emotional valence and tempo. Thus, we aimed to evaluate the emotional valence of a set of slow and fast musical stimuli. N = 102 (mean age: 39.95, SD: 13.60, 61% female) participants rated the perceived emotional valence in 20 fast (>110 beats per minute [bmp]) and 20 slow (<90 bpm) stimuli. Moreover, we collected reports on subjective arousal for each stimulus to explore arousal's association with tempo and valence. Finally, participants completed questionnaires on demographics, mood (profile of mood states), personality (10-item personality index), musical sophistication (Gold-music sophistication index), and sound preferences and hearing habits (sound preference and hearing habits questionnaire). Using mixed-effect model estimates, we identified 19 stimuli that participants rated to have positive valence and 16 stimuli that they rated to have negative valence. Higher age predicted more positive valence ratings across stimuli. Higher tempo and more extreme valence ratings were each associated with higher arousal. Higher educational attainment was also associated with higher arousal reports. Pre-evaluated stimuli can be used in future musical research.

How is the usability of commercial activity monitors perceived by older adults and by researchers? A cross-sectional evaluation of community-living individuals.

OBJECTIVES: Using commercial activity monitors may advance research with older adults. However, usability for the older population is not sufficiently established. This study aims at evaluating the usability of three wrist-worn monitors for older adults. In addition, we report on usability (including data management) for research. DESIGN: Data were collected cross-sectionally. Between-person of three activity monitor type (Apple Watch 3, Fitbit Charge 4, Polar A370) were made. SETTING: The activity monitors were worn in normal daily life in an urban community in Germany. The period of wear was 2 weeks. PARTICIPANTS: Using convenience sampling, we recruited N=27 healthy older adults (≥60 years old) who were not already habitual users of activity monitors. OUTCOMES: To evaluate usability from the participant perspective, we used the System Usability Scale (SUS) as well as a study-specific qualitative checklist. Assessment further comprised age, highest academic degree, computer proficiency and affinity for technology interaction. Usability from the researchers' perspective was assessed using quantitative data management markers and a study-specific qualitative check-list. RESULTS: There was no significant difference between monitors in the SUS. Female gender was associated with higher SUS usability ratings. Qualitative participant-usability reports revealed distinctive shortcomings, for example, in terms of battery life and display readability. Usability for researchers came with problems in data management, such as completeness of the data download. CONCLUSION: The usability of the monitors compared in this work differed qualitatively. Yet, the overall usability ratings by participants were comparable. Conversely, from the researchers' perspective, there were crucial differences in data management and usability that should be considered when making monitor choices for future studies.

Music-based interventions for community-dwelling people with dementia: A systematic review.

The majority of people with dementia (PwD) live in the community. Compared to institutionalised PwD, their access to formalised music therapy is limited. Initial works suggest that non-therapist-led music-based interventions (MBIs) may be an accessible and effective alternative. The aim of this review was, therefore, to synthesise evidence on MBIs for community-dwelling PwD. We systematically searched electronic databases (PubMed, PsycInfo, Web of Science) for records reporting on controlled studies of MBIs delivered to community-dwelling PwD. Two reviewers independently screened records according to inclusion/exclusion criteria. A total of 15 relevant publications reporting on 14 studies were initially identified and assessed using the Cochrane risk-of-bias tool for randomised trials (RoB 2) and the risk of bias. In non-randomised studies of interventions (ROBINS-I) tool. A total of 11 records of 10 studies, with a total of n = 327 PwD, were included in the synthesis. MBIs consisted either of singing or music listening interventions and were variable in duration. MBIs had immediate positive effects on cognition. Short-term MBIs (lasting 1-4 months) benefited cognition, anxiety and pain. Evidence on depressive symptoms was conflicting. The benefits of longer term MBIs (lasting 6+ months) were less apparent. According to GRADE criteria, the overall quality of evidence was moderate to low. The inconsistency in designs, procedures and measures prevents specific conclusions at this stage. Still, the diversity observed in existing studies suggests that there are multiple interesting avenues for researchers to pursue, including the involvement of informal caregivers in MBI delivery. Future studies need to ensure adequate reporting to facilitate continued development. The protocol of this review was pre-registered with the Prospective Register of Systematic Reviews (PROSPERO, Registration Number: CRD42020191606).

Coping strategies for memory problems in everyday life of people with cognitive impairment and older adults: A systematic review.

OBJECTIVES: Dealing with memory loss is a major challenge for older people. Coping strategies for memory problems could enable cognitively impaired people to live independently for longer. We conducted a systematic review to summarize evidence on coping strategies for older people and people with cognitive impairment to stabilize everyday life functioning. METHODS: We systematically searched the databases PubMed, PsychInfo, Scopus and WebofScience using a well-defined search string. Studies were included if they were published between January 1990 and February 2021 and written in English, German, Spanish, French, or Swedish language. Two blind researchers independently checked the studies for inclusion and exclusion criteria and evaluated the quality of the studies using Critical Appraisal Skills Programme-checklists. Evidence was summarized in a narrative synthesis. RESULTS: A total of 16 relevant studies with adequate quality were identified. These studies reported on three categories of strategies: external, internal, and behavioral coping strategies. External strategies included reminder systems and integrated features in the environment and were used by people with and without cognitive impairments. Internal strategies such as visualization, verbalization, active remembering, and systematic thinking were reported less often by people with cognitive impairment than those without cognitive impairment. Behavioral strategies such as reducing expectations and acceptance of support was most frequently reported by people with cognitive impairment. CONCLUSIONS: The findings of our systematic review show a great number of coping strategies, which seem to depend on cognitive status. Appropriate training tools incorporating these strategies should be developed.

Validation of a social deprivation index and association with cognitive function and decline in older adults.

OBJECTIVES: Previous work using a US sample has shown that an index of social deprivation (SoDep Index) is associated with cognitive functioning and decline in older adults. This study aimed to replicate these findings using a European sample (Survey of Health, Ageing and Retirement in Europe, SHARE). DESIGN: We analyzed data of 51,630 respondents aged 50 years and older (M: 63.5 years, standard deviation [SD]: 9.1) with at least two cognitive assessments (follow-up M: 6.06 years, SD: 3.86). Cognitive scores were transformed to Z-scores. Multiple growth curve modeling was used to model cognitive status and decline as predicted by the SoDep Index. In a sensitivity analysis, we constructed a new SoDep Index (SoDep Indexnew) including further social deprivation domains. RESULTS: Adjusting for covariates, a unit increase in SoDep Index was associated with a cognitive score of 0.037 SDs smaller (p < .001) and a decline 0.003 SDs per year faster (p < .001). Of the covariates, depressive symptoms, chronic disease burden, male gender, and widowhood were also associated with poorer cognition. Being divorced was associated with better cognition. Sensitivity analysis confirmed findings. Compared to the SoDep Index, the SoDep Indexnew showed a more pronounced association with both cognition and cognitive decline. CONCLUSIONS: We were able to replicate results showing an association between SoDep Index and cognitive function and decline. The sensitivity analysis further emphasizes the relevance of financial security. This strengthens the implication that preventing social deprivation can contribute to reducing the dementia burden by raising cognitive functioning in the older population. The findings are relevant to policy-makers and health care practitioners.

The role of education and income for cognitive functioning in old age: A cross-country comparison.

OBJECTIVES: Previous studies have shown that higher education promotes cognitive health. This effect, however, is embedded in the living conditions of a particular country. Since it is not clear to what extent the country and its specific living standards are necessary preconditions for the observed effect, we investigated whether the impact of education and income on cognitive functioning differs between countries. METHODS: Analyses were based on harmonized data from the World Health Organization's multi-country Study on global AGEing and adult health, the Health and Retirement Study, and the Survey of Health, Ageing and Retirement in Europe of over 85,000 individuals aged 50 years and older. Analyses were conducted via multivariate regression analyses and structural equation modeling adjusted for age, gender, marital status, health status, and depression. RESULTS: The effect of education was twice as large as the effect of income on cognitive functioning and indirectly moderated the effect of income on cognitive functioning. The effect sizes varied strongly between countries. The country's gross domestic product per capita seems to influence cognitive functioning. CONCLUSIONS: Our findings indicate that education has a dominant effect on cognitive functioning in people aged 50 years and older, which might even offset the adverse implications of living with low income on cognitive health. Therefore, expanding efforts to achieve universal education are essential to mitigate health disparities due to low income and early life disadvantages, including chances for good cognitive functioning over the life-span.

Association of social deprivation with cognitive status and decline in older adults.

OBJECTIVES: Social deprivation, i.e. the relative deprivation in socioeconomic domains, is known to exacerbate disease risk. Less is known about its role in cognitive functioning and decline in older adults. This study aimed to investigate the association between social deprivation and cognitive status as well as rate of decline. METHODS: We analysed data from the nationally representative Health and Retirement study (HRS) of individuals aged 50 and older. The analysis sample contained 11,101 respondents (mean age at baseline: 69.4, SD: 8.6%, 55% female) with at least two cognitive assessments (mean follow up: 11.2, SD: 5.4). To quantify social deprivation we constructed a social deprivation index (SDI) with structural equation modelling. Multiple growth curve modelling was used to model cognitive status and decline as predicted by SDI. RESULTS: After adjusting for covariates, greater social deprivation was associated with poorer cognitive status (ß = -0.910, p < 0.001; 95% CI: -0.998-0.823) and faster cognitive decline (ß = -0.005, p = 0.002; 95% CI:-0.009-0.002). Of the covariates, depressive symptoms, chronic disease burden, belonging to a racial or ethnical minority, and male gender were also associated with poorer cognitive status. Marriage statuses other than being married or partnered had a positive association with cognitive status. CONCLUSIONS: Our findings indicate that greater social deprivation was associated with significantly poorer cognitive status implying that preventing social deprivation can contribute to raising cognitive functioning in the older population and help reduce the incidence of dementia. Policy that facilitates early intervention in social deprivation will be key.