Caregiver Psychosocial Factors & Stroke Survivor Cognitive Outcomes: A REGARDS-CARES Cohort Study.

Objectives: Caring for an individual with cognitive impairment carries a physical, mental, and emotional toll. This manuscript examines the relationship between caregiver psychosocial measures and longitudinal cognitive outcomes of stroke survivors, as well as analyzing the psychosocial factors as moderators of stroke severity and cognition.

Methods: This analysis was conducted on caregiver and stroke survivor dyads (n = 157) that participated in the Caring for Adults Recovering from the Effects of Stroke (CARES) project, an ancillary study of the REasons for Geographic and Racial Differences in Stroke (REGARDS) national cohort study.

The Independent and Interactive Effects of Economic Stability and Healthcare Access on 10-Year Cognitive Trajectories of Black/African American and White Older Adults from the ACTIVE Study.

Objectives: Social and structural determinants of health (SSDoH) have been linked to racial disparities in Alzheimer's disease and related dementias (ADRD). Research has established that living in an environment with greater economic stability (ES) or healthcare access (HCA) is associated with better baseline cognition, but the interactive effects between these distinct SSDoH on cognition over time have not been studied. Therefore, the present study examined the independent and interactive effects of ES and HCA on 10-year change in cognitive functioning within a large sample of racially diverse community-dwelling older adults.

The Driving Profile of Autistic Drivers and Their Driving Experiences: A Systematic Review.

A developmental milestone that both contributes to and facilitates a successful transition into adulthood is the ability to drive. Yet only one in three autistic adolescents successfully obtain a driver's license by age 21 compared to over three-fourths of non-autistic adolescents. Of those who receive their license, there is inconsistency in driving attitudes, experiences and skills.

Stroke Severity, Caregiver Feedback, and Cognition in the REGARDS-CARES Study.

Background: Cognitive impairment after stroke is common and is present in up to 60% of survivors. Stroke severity, indicated by both volume and location, is the most consequential predictor of cognitive impairment, with severe strokes predicting higher chances of cognitive impairment. The current investigation examines the associations of 2 stroke severity ratings and a caregiver-report of poststroke functioning with longitudinal cognitive outcomes.

Baseline levels and longitudinal changes in plasma Aβ42/40 among Black and white individuals.

Blood-based biomarkers of Alzheimer disease (AD) may facilitate testing of historically under-represented groups. The Study of Race to Understand Alzheimer Biomarkers (SORTOUT-AB) is a multi-center longitudinal study to compare AD biomarkers in participants who identify their race as either Black or white. Plasma samples from 324 Black and 1,547 white participants underwent analysis with CN Diagnostics' PrecivityAD test for Aβ42 and Aβ40.

Does Consumer Credit Precede or Follow Health Among Older Adults? An Investigation in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Trial.

Background And Objectives: Consumer credit has shown increasing relevance to the health of older adults; however, studies have not been able to assess the extent to which creditworthiness influences future health or health influences future creditworthiness. We assessed the relationships between 4-year pre and postmorbid consumer credit history and self-rated physical and mental health outcomes among older adults.

Research Design And Methods: Generalized estimating equations models assessed pre and postmorbid credit history (credit scores, derogatory accounts, and unpaid accounts in collections) and the onset of poor self-rated health (SF-36 score <50) among 1,740 participants aged 65+ in the Advanced Cognitive Training for Independent and Vital Elderly study from 2001 to 2017, linked to TransUnion consumer credit data.

Analyzing Multiple Social Determinants of Health Using Different Clustering Methods.

Social determinants of health (SDoH) have become an increasingly important area to acknowledge and address in healthcare; however, dealing with these measures in outcomes research can be challenging due to the inherent collinearity of these factors. Here we discuss our experience utilizing three statistical methods-exploratory factor analysis (FA), hierarchical clustering, and latent class analysis (LCA)-to analyze data collected using an electronic medical record social risk screener called Protocol for Responding to and Assessing Patient Assets, Risks, and Experience (PRAPARE). The PRAPARE tool is a standardized instrument designed to collect patient-reported data on SDoH factors, such as income, education, housing, and access to care.

Baseline levels and longitudinal rates of change in plasma Aβ42/40 among self-identified Black/African American and White individuals.

Objective: The use of blood-based biomarkers of Alzheimer disease (AD) may facilitate access to biomarker testing of groups that have been historically under-represented in research. We evaluated whether plasma Aβ42/40 has similar or different baseline levels and longitudinal rates of change in participants racialized as Black or White.

Methods: The Study of Race to Understand Alzheimer Biomarkers (SORTOUT-AB) is a multi-center longitudinal study to evaluate for potential differences in AD biomarkers between individuals racialized as Black or White.

Social Support Networks Among Black Caregivers of Persons With Memory Problems.

Positive social support can predict health outcomes in populations that experience significant burdens, such as minority caregivers. The purpose of the current study was to detail the social network (SN) of 36 Black family caregivers (FCGs) for persons with memory problems (PWMP) and examine differences in SN support depending on FCG gender and relationship to the care recipient. Participants were recruited from the Alzheimer's family program at the University of Alabama at Birmingham and the local community.

The ACTIVE Study: Association of Race and Social Determinants of Health (SDoH) with Long-Term Outcomes and Cognitive Training Effects.

The purpose of this article is to introduce a special issue on the ACTIVE project examining the association between race and social determinants of health (SDoH) and long-term participant outcomes and training effectiveness for older Black/African Americans and Whites in the ACTIVE (for Advanced Cognitive Training for Independent and Vital Elderly) Trial on cognitive abilities, everyday functioning, and incidence of dementia. The ACTIVE study is the largest randomized clinical trial ( = 2802) of the efficacy of three types of cognitive training (memory, reasoning, speed of processing) in improving cognitive and everyday functioning in normal older adults, with follow-ups extending through 5 and 10 years post-intervention. We provide background and context for studying the multiple domains of SDoH in understanding long-term participant outcomes in the ACTIVE trial and racial disparities in the efficacy of cognitive training and summarize the 11 articles in this special issue.

Does Consumer Credit Precede or Follow Changes in Cognitive Impairment Among Older Adults? An Investigation in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Trial.

Objectives: We assessed the relationships between pre- and post-morbid consumer credit history (credit scores, debts unpaid, or in collections) and classification of mild (or greater) cognitive impairment (MCI).

Methods: Generalized Estimating Equation models assessed pre-and post-morbid credit history and MCI risk among 1740 participants aged 65+ in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, linked to TransUnion consumer credit data.

Results: Each 50-point increase in credit score was associated with up to 8% lower odds of MCI in the next 3 years.

Effects of Cognitive Training on Alzheimer's Disease and Related Dementias: The Moderating Role of Social Determinants of Health.

We examined whether social determinants of health (SDoH) are associated with Alzheimer's disease and related dementias (ADRD) risk and the effects of cognitive training over a 20-year follow-up period. Data were obtained from 1605 participants in ACTIVE. SDoH measures were created using baseline data at the individual and neighborhood level.

Associations Between Body Mass Index and Cognitive Change in the ACTIVE Study: Variations by Race and Social Determinants of Health.

The current study examines relationships between Body Mass Index (BMI) and cognitive performance and change in processing speed, memory, and reasoning, while accounting for variations by race and the influence of social determinants of health. Secondary data analysis of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, which included participants who self-identified as African American or Black ( = 728) and White ( = 2028). Latent growth curve modeling was used to assess study aims.

Social and Neighborhood Context Moderates the Associations Between Processing Speed and Driving Mobility: A 10-year Analysis of the ACTIVE Study.

Processing speed is essential to functional independence in later life, such as driving a vehicle. Few studies have examined processing speed and driving mobility in the context of racial differences and social determinants of health (SDoH). This study characterized the longitudinal association between processing speed and driving mobility, and how it varied by race and SDoH.

Advances in electrochemical biosensor design for the detection of the stress biomarker cortisol.

The monitoring of stress levels in humans has become increasingly relevant, given the recent incline of stress-related mental health disorders, lifestyle impacts, and chronic physiological diseases. Long-term exposure to stress can induce anxiety and depression, heart disease, and risky behaviors, such as drug and alcohol abuse. Biomarker molecules can be quantified in biological fluids to study human stress.

Stroke Severity, Caregiver Feedback, and Cognition in the REGARDS-CARES Study.

Objective: Cognitive impairment after stroke is common, present up to 60% of survivors. Stroke severity, indicated by both volume and location, is the most consequential predictor of cognitive impairment, with severe strokes predicting higher chances of cognitive impairment. The current investigation examines the associations of two stroke severity ratings and a caregiver-report of post-stroke functioning with longitudinal cognitive outcomes.

Cognitive prescriptions for reducing dementia risk factors among Black/African Americans: feasibility, acceptability, and preliminary efficacy.

Objectives: Black/African Americans (B/AAs) have double the risk of Alzheimer's disease and related dementia than Whites, which is largely driven by health behaviors. This study examined the feasibility, acceptability, and preliminary efficacy of a pilot randomized clinical trial of an individualized multidomain health behavior intervention among middle-aged and older B/AAs (dubbed Cognitive Prescriptions [CogRx]).

Design: Thirty-nine community-dwelling B/AA participants aged 45-65 without significant cognitive impairment were randomized to one of three groups: CogRx, Psychoeducation, or no-contact control.

The role of caregiving in cognitive function and change: The REGARDS study.

Chronic stress is associated with negative health outcomes, including poorer cognition. Some studies found stress from caregiving associated with worse cognitive functioning; however, findings are mixed. The present study examined the relationship between caregiving, caregiving strain, and cognitive functioning.

Variant and Response to Ruxolitinib in an Autoinflammatory Syndrome.

Background: Disabling pansclerotic morphea (DPM) is a rare systemic inflammatory disorder, characterized by poor wound healing, fibrosis, cytopenias, hypogammaglobulinemia, and squamous-cell carcinoma. The cause is unknown, and mortality is high.

Methods: We evaluated four patients from three unrelated families with an autosomal dominant pattern of inheritance of DPM.

The structure of associations: Method insights from analyzing 28 clinical isolates of Cryptococcus neoformans.

Clinical isolates of a fungal pathogen from a single region or country often exhibit structural clonality or phylogenetic clustering at the sequence or MLST level; such population structure can persist also in larger samples. In efforts to improve causal understanding of pathogenesis at the molecular level, genome-wide association screening methods initially designed for other kingdoms have been applied to fungi. The example of a Colombian dataset of 28 clinical Cryptococcus neoformans VNI isolates indicates where the output from standard pipelines may need to be analyzed in new ways in order to efficiently extract hypotheses for experiments from fungal genotype-phenotype data.