Cognitive Aging in Black and White Americans: Cognition, Cognitive Decline, and Incidence of Alzheimer Disease Dementia.

Background: US-based studies have reported that older blacks perform worse than older whites on cognitive tests and have higher risk of Alzheimer disease dementia (AD). It is unclear whether these findings reflect differences in cognitive decline.

Methods: The Chicago Health and Aging Project followed individuals, 65+ years old (64% black, 36% white), for up to 18 years.

Rate of Cognitive Decline Before and After the Onset of Functional Limitations in Older Persons.

Background: Loss in physical function is indicative of deterioration in physiological health that may also be associated with deterioration in neurological health. The objective of this study was to examine whether the onset of functional limitations and their severity is associated with increases in cognitive decline among older adults.

Methods: The study sample consists of 3825 (65% African Americans and 53% females) participants over the age of 65 with no functional limitations.

Deaths in the United States among persons with Alzheimer's disease (2010-2050).

Background: Alzheimer's disease (AD) profoundly affects the end-of-life experience. Yet, counts of deaths attributable to AD understate this burden of AD in the population. Therefore, we estimated the annual number of deaths in the United States among older adults with AD from 2010 to 2050.

Contribution of Alzheimer disease to mortality in the United States.

Objective: To assess the burden of mortality attributable to Alzheimer disease (AD) dementia in the United States.

Methods: Data came from 2,566 persons aged 65 years and older (mean 78.1 years) without dementia at baseline from 2 cohort studies of aging with identical annual diagnostic assessments of dementia.

Cognitive aging and rate of hospitalization in an urban population of older people.

Background: The association of age-related cognitive change with hospitalization is not well understood.

Methods: At 3-year intervals for a mean of 8.7 years, 2,273 older residents of a geographically defined urban community underwent cognitive testing from which a global measure was derived.

Alzheimer disease in the United States (2010-2050) estimated using the 2010 census.

Objectives: To provide updated estimates of Alzheimer disease (AD) dementia prevalence in the United States from 2010 through 2050.

Methods: Probabilities of AD dementia incidence were calculated from a longitudinal, population-based study including substantial numbers of both black and white participants. Incidence probabilities for single year of age, race, and level of education were calculated using weighted logistic regression and AD dementia diagnosis from 2,577 detailed clinical evaluations of 1,913 people obtained from stratified random samples of previously disease-free individuals in a population of 10,800.

Disability in basic and instrumental activities of daily living is associated with faster rate of decline in cognitive function of older adults.

Background: The purpose of this study is to examine whether physical disability is associated with faster rate of decline in cognitive function.

Methods: A longitudinal population-based cohort of 6,678 initially nondisabled older adults from a biracial urban community was interviewed at 3-year intervals from 1993 to 2012. Cognitive function was assessed using a standardized global cognitive score, and physical disabilities using activities of daily living (ADL) and instrumental activities of daily living (IADL).

Do Community and Caregiver Factors Influence Hospice Use at the End of Life Among Older Adults With Alzheimer Disease?

Hospice is an underused service among people with Alzheimer disease. This study used the Hospice Use Model to examine community, care recipient, and caregiver characteristics associated with hospice use before death among 145 community-dwelling care recipients with Alzheimer disease and their caregivers. Secondary analysis using logistic regression modeling indicated that older age, male gender, black race, and better functional health of care recipients with Alzheimer disease were associated with a decreased likelihood of using hospice (model = 23.

Cognitive and physical functions as determinants of delayed age at onset and progression of disability.

Background: This study examined the association of cognitive and physical functions with age-related transition and progression of activities of daily living (ADL) disability in a population-based longitudinal cohort of nondisabled older adults.

Methods: A longitudinal population-based cohort study of 5,317 initially nondisabled older adults with an average age of 73.6 years of an urban Chicago community were interviewed annually for up to 8 years from 2000 through 2008.

A prospective population-based study of differences in elder self-neglect and mortality between black and white older adults.

Background: Self-neglect is the behavior of an elderly person that threatens his or her own health and safety, and it is associated with increased morbidity and mortality. Although report of self-neglect is more common among black older adults, the racial/ethnic differences in mortality remain unclear.

Methods: The Chicago Healthy Aging Project is a population-based cohort study conducted from 1993 to 2005.

Trends in the incidence and prevalence of Alzheimer's disease, dementia, and cognitive impairment in the United States.

Declines in heart disease and stroke mortality rates are conventionally attributed to reductions in cigarette smoking, recognition and treatment of hypertension and diabetes, effective medications to improve serum lipid levels and to reduce clot formation, and general lifestyle improvements. Recent evidence implicates these and other cerebrovascular factors in the development of a substantial proportion of dementia cases. Analyses were undertaken to determine whether corresponding declines in age-specific prevalence and incidence rates for dementia and cognitive impairment have occurred in recent years.

Sources of variability in estimates of the prevalence of Alzheimer's disease in the United States.

Background: The prevalence of Alzheimer's disease (AD) in the United States was estimated at 2.3 million in 2002 by the Aging, Demographics, and Memory Study (ADAMS), which is almost 50% less than the estimate of 4.5 million in 2000 derived from the Chicago Health and Aging Project.

National estimates of the prevalence of Alzheimer's disease in the United States.

Several methods of estimating prevalence of dementia are presented in this article. For both Brookmeyer and the Chicago Health and Aging project (CHAP), the estimates of prevalence are derived statistically, forward calculating from incidence and survival figures. The choice of incidence rates on which to build the estimates may be critical.

Upper and lower extremity motor performance and functional impairment in Alzheimer's disease.

This report examines the relation of upper and lower extremity motor performance to functional impairment among 371 persons with probable Alzheimer's disease (AD). Cognitive and motor performance tests were administered at 6-month intervals for up to 4 years. Motor performance was assessed using 3 lower extremity tests and 2 upper extremity tests.

Elder self-neglect and abuse and mortality risk in a community-dwelling population.

Context: Both elder self-neglect and abuse have become increasingly prominent public health issues. The association of either elder self-neglect or abuse with mortality remains unclear.

Objective: To examine the relationship of elder self-neglect or abuse reported to social services agencies with all-cause mortality among a community-dwelling elderly population.

Change in direct measures of physical performance among persons with Alzheimer's disease.

Objectives: Measures of physical performance were used in intact and community populations. We examined upper and lower extremity physical performance tests among people with Alzheimer's disease.

Method: A total of 367 persons with probable Alzheimer's disease, recruited from an Alzheimer's disease diagnostic center, were given three tests of lower extremity function and two tests of upper extremity function at 6 month intervals for up to 4 years.

The effect of adult day care services on time to nursing home placement in older adults with Alzheimer's disease.

Purpose: This longitudinal study examined whether the use of adult day care services delayed time to nursing home placement in persons with Alzheimer's disease.

Design And Methods: Two hundred and eighteen adult day care clients with Alzheimer's disease were recruited from 16 adult day programs in a large metropolitan area. Two hundred and ninety eight persons with Alzheimer's disease but not using adult day care were recruited from a federally funded Alzheimer's diagnostic center and frequency matched to adult day care users on age, gender, race, and level of cognitive impairment.

Dietary folate and vitamin B12 intake and cognitive decline among community-dwelling older persons.

Background: Deficiencies in folate and vitamin B12 have been associated with neurodegenerative disease.

Objective: To examine the association between rates of age-related cognitive change and dietary intakes of folate and vitamin B12.

Design: Prospective study performed from 1993 to 2002.

Predictors of beginning and ending caregiving during a 3-year period in a biracial community population of older adults.

Objectives: We sought to identify predictors of beginning and ending caregiving.

Methods: At baseline and 3-year follow-up, we interviewed 4245 community residents (61.4% Black, 38.

Alzheimer disease in the US population: prevalence estimates using the 2000 census.

Context: Current and future estimates of Alzheimer disease (AD) are essential for public health planning.

Objective: To provide prevalence estimates of AD for the US population from 2000 through 2050.

Design: Alzheimer disease incidence estimates from a population-based, biracial, urban study, using a stratified random sampling design, were converted to prevalence estimates and applied to US Census Bureau estimates of US population growth.

Incidence of Alzheimer disease in a biracial urban community: relation to apolipoprotein E allele status.

Context: Few studies compare Alzheimer disease (AD) incidence among black and white subjects.

Objective: To estimate incidence and the effect of the apolipoprotein E (APOE) epsilon4 allele in these races.

Design: Population-based study of disease incidence using a random, stratified sample.

Association between blood pressure and cognitive function in a biracial community population of older persons.

We examined whether or not blood pressure is related to cognitive function in a cross-sectional study of a biracial community of 5,816 persons aged 65 years and older. Blood pressure had a curvilinear association with cognitive performance in linear regression models adjusted for age, sex, race and education. Scores were lower by 2-5 percentiles at 100 mm Hg systolic pressure compared to scores at the mean of 140 mm Hg and lower by <1 percentile at 180 mm Hg.