Neighborhood physical activity facilities predict risk of incident mixed and vascular dementia: The Cardiovascular Health Cognition Study.

Introduction: Neighborhood environments may promote neurocognitive health in part by providing amenities that encourage physical activity. We examined associations between quantity of walkable facilities, including specifically physical activity facilities (e.g.

Longitudinal Changes in Peak Expiratory Flow Predict Risk for Incident Dementia.

Background: Impaired respiratory function, measured via peak expiratory flow (PEF), has been associated with increased dementia risk. However, much of the current literature uses cross-sectional measures of PEF, whereas longitudinal relationships between changes in respiratory function and dementia risk are underexplored.

Methods: Using 10 years of data (2011-2021) from 2 439 adults ages 65 and older in the National Health and Aging Trends Study, we examined whether 5-year changes in PEF (2011-2016) were associated with risk for incident dementia over the subsequent 5-year period (2017-2021).

Population reference equations for handheld peak expiratory flow in older U.S. adults.

Background: Peak expiratory flow (PEF) is a simple, inexpensive measure of respiratory effort and is a valuable predictor of health outcomes in older adults. Yet, there is a lack of epidemiological data validating PEF prediction equations among older adult populations, especially those ≥80 years. The National Health and Aging Trends Study (NHATS) is a large, nationally representative sample of U.

Neighborhood Walkability Is Associated With Global Positioning System-Derived Community Mobility of Older Adults.

Background: Neighborhood walkability may encourage greater out-of-home travel (ie, community mobility) to support independent functioning in later life. We examined associations between a novel walkability audit index and Global Positioning System (GPS)-derived community mobility in community-dwelling older adults. We compared associations with the validated Environmental Protection Agency (EPA) National Walkability Index and further examined moderation by clinical walking speed.

Identification of complier and noncomplier average causal effects in the presence of latent missing-at-random (LMAR) outcomes: a unifying view and choices of assumptions.

The study of treatment effects is often complicated by noncompliance and missing data. In the one-sided noncompliance setting where of interest are the complier and noncomplier average causal effects, we address outcome missingness of the latent missing at random type (LMAR, also known as latent ignorability). That is, conditional on covariates and treatment assigned, the missingness may depend on compliance type.

Global Positioning System Indicators of Community Mobility and Future Health Outcomes Among Older Adults.

Background: We examined the relationship between global positioning system (GPS) indicators of community mobility and incident hospitalizations, emergency department (ED) visits, and falls over 1-year in community-dwelling older adults.

Methods: We performed a secondary analysis of a randomized trial investigating a physical therapy intervention to improve mobility in older adults. One hundred and forty-eight participants (mean age: 76.

CogDrisk, ANU-ADRI, CAIDE, and LIBRA Risk Scores for Estimating Dementia Risk.

Importance: While the Australian National University-Alzheimer Disease Risk Index (ANU-ADRI), Cardiovascular Risk Factors, Aging, and Dementia (CAIDE), and Lifestyle for Brain Health (LIBRA) dementia risk tools have been widely used, a large body of new evidence has emerged since their publication. Recently, Cognitive Health and Dementia Risk Index (CogDrisk) and CogDrisk for Alzheimer disease (CogDrisk-AD) risk tools have been developed for the assessment of dementia and AD risk, respectively, using contemporary evidence; comparison of the relative performance of these risk tools is limited.

Objective: To evaluate the performance of CogDrisk, ANU-ADRI, CAIDE, LIBRA, and modified LIBRA (LIBRA with age and sex estimates from ANU-ADRI) in estimating dementia and AD risks (with CogDrisk-AD and ANU-ADRI).

Association of Postoperative Delirium With Incident Dementia and Graft Outcomes Among Kidney Transplant Recipients.

Background: Kidney transplant (KT) recipients have numerous risk factors for delirium, including those shared with the general surgical population (eg, age and major surgery) and transplant-specific factors (eg, neurotoxic immunosuppression medications). Evidence has linked delirium to long-term dementia risk in older adults undergoing major surgery. We sought to characterize dementia risk associated with post-KT delirium.

Association of Gait Quality With Daily-Life Mobility: An Actigraphy and Global Positioning System Based Analysis in Older Adults.

Objective: Walking is a key component of daily-life mobility. We examined associations between laboratory-measured gait quality and daily-life mobility through Actigraphy and Global Positioning System (GPS). We also assessed the relationship between two modalities of daily-life mobility i.

Hearing Impairment and Allostatic Load in Older Adults.

Importance: Allostatic load, the cumulative strain that results from the chronic stress response, is associated with poor health outcomes. Increased cognitive load and impaired communication associated with hearing loss could potentially be associated with higher allostatic load, but few studies to date have quantified this association.

Objective: To investigate if audiometric hearing loss is associated with allostatic load and evaluate if the association varies by demographic factors.

Examining the Causal Mediating Role of Cardiovascular Disease on the Effect of Subclinical Cardiovascular Disease on Cognitive Impairment via Separable Effects.

Background: An important epidemiological question is understanding how vascular risk factors contribute to cognitive impairment. Using data from the Cardiovascular Health Cognition Study, we investigated how subclinical cardiovascular disease (sCVD) relates to cognitive impairment risk and the extent to which the hypothesized risk is mediated by the incidence of clinically manifested cardiovascular disease (CVD), both overall and within apolipoprotein E-4 (APOE-4) subgroups.

Methods: We adopted a novel "separable effects" causal mediation framework that assumes that sCVD has separably intervenable atherosclerosis-related components.

OLDER ADULTS' SUBJECTIVE WELL-BEING EXPERIENCING THE EXERGAME "I AM DOLPHIN".

The objective of this study was to understand older adults' perceptions of the connections between an exergame intervention, "I Am Dolphin," and their subjective well-being. Researchers conducted three focus groups with 14 older adults who participated in the exergame feasibility study. The semi-structured focus groups were transcribed, coded, and analysed using deductive and inductive techniques.

Older Adults and Three-Dimensional Exergaming: Motivators and Barriers to Participation and Retention.

Cognitive and physical activity are important for daily functioning. However, limited research exists on the motivators and barriers associated with older adults participating and adhering to exergame studies that promote physical and cognitive activity. Our objective was to examine older adults' motivators and barriers to joining and completing a three-dimensional exergame study.

Body Mass Index and Cognition: Associations Across Mid- to Late Life and Gender Differences.

Background: Higher mid-life body mass index (BMI) is associated with lower late-life cognition. Associations between later-life BMI and cognition are less consistent; evidence suggests reverse causation may play a role. We aimed to characterize associations between BMI and cognition across a wide age range during mid- to late life (55-85 years) and examine whether associations vary by gender.

Neighborhood greenspace and cognition: The cardiovascular health study.

Objectives: We examined whether greenspace measures (overall percent greenspace and forest, and number of greenspace types) were associated with clinically adjudicated dementia status.

Methods: In a sample of non-demented older adults (n = 2141, average age = 75.3 years) from the Cardiovascular Health and Cognition Study, Cox proportional hazard and logistic regression analyses were used to estimate associations of baseline greenspace with risks of incident dementia and MCI, respectively, while adjusting for demographics, co-morbidities, and other neighborhood factors.

Peak Expiratory Flow Predicts Incident Dementia in a Representative Sample of U.S. Older Adults: The National Health and Aging Trends Study (NHATS).

Background: Dementia is an increasingly important public health problem with various risk factors. Respiratory function, measured via peak expiratory flow (PEF), may be a modifiable dementia risk factor.

Methods: We investigated the association between PEF and incident dementia in 5 935 older adults from the National Health and Aging Trends Study (NHATS) from 2011 to 2014.

Using GPS Technologies to Examine Community Mobility in Older Adults.

Background: Objective measures of community mobility are advantageous for capturing movement outside the home. Compared with subjective, self-reported techniques, global positioning system (GPS) technologies leverage passive, real-time location data to reduce recall bias and increase measurement precision. We developed methods to quantify community mobility among community-dwelling older adults and assessed how GPS-derived indicators relate to clinical measures of physical and cognitive performance.

Exploring the Relationship Between Engagement in Enriching Early-Life Activities During Adolescence and Cognition in Later-Life: Results From the Health and Retirement Study.

The cognitive benefits associated with mid- to late-life engagement have been demonstrated in several studies. However, the link between engagement in enriching early-life activities (EELAs) during adolescence and later-life cognition has been relatively unexplored in major epidemiological studies. We examined the EELA-cognition relationship in a nationally representative sample of adults aged 50+.

The relationship between older adults' technology use, in-person engagement, and pandemic-related mental health.

Objective: The objectives of this study are to 1) describe changes in in-person communication/activity and changes in older adult technology use during the COVID-19 pandemic and 2) examine whether less in-person communication/activity mediates the relationship between pandemic-related mental health and technology use.

Method: Linear regressions (stratified by age and financial strain) and structural equation modeling were employed using a nationally representative, cross-sectional survey of 3,188 older adults from the 2020 National Health and Aging Trends Study's COVID-19 Questionairre.

Results: Older adults engaged in more technology-based activity (b = 0.

Assessment of hearing and vision impairment in cohort studies collecting cognitive data in older adults.

Introduction: There are no standard practices for considering sensory impairment in studies measuring cognitive function among older adults. Exclusion of participants with impairments may inaccurately estimate the prevalence of cognitive impairment and dementia.

Methods: We surveyed prospective cohort studies measuring cognitive function in older adults, determined the proportion that excluded participants based on sensory impairment and the proportion that assessed each type of sensory impairment, and described the methods of sensory assessment.

Life-space Mobility in Older Men: The Role of Perceived Physical and Mental Fatigability.

Background: Physical performance and fatigue can limit mobility within the larger environment (life-space mobility). It is unknown whether perceived fatigability, self-reported fatigue anchored to activity intensity and duration, is independently associated with life-space.

Methods: We assessed this cross-sectionally in Visit 4 (2014-2016) of the Osteoporotic Fractures in Men Study (MrOS; N = 1 672, Age: Mean = 84.

Productive Social Engagement as a Vehicle to Promote Activity and Neuro-Cognitive Health in Later Adulthood.

Objective: We have witnessed two key findings that shift our understanding of human brain aging in new directions. First, we learned that the adult brain remains plastic beyond childhood development, generating new neurons in response to activity and new experiences, particularly in regions that integrate memories in social contexts. The second emerging finding is the importance of physical activity and social engagement to cognitive aging.

Traits and treadmills: Association between personality and perceived fatigability in well-functioning community-dwelling older adults.

Physical fatigability, or susceptibility to physical fatigue, is strongly associated with aging, disease, and disability. Over the lifecourse, personality traits are also connected to numerous age-related vulnerabilities and resistance-yet, their longitudinal association with fatigability remains unknown. Well-functioning community-dwelling volunteers aged ≥50 (N = 995) from the Baltimore Longitudinal Study of Aging (BLSA) were assessed over an average of 2 years on personality traits (NEO-PI-R; openness, conscientiousness, extraversion, agreeableness, and neuroticism) and perceived fatigability [Borg Rating of Perceived Exertion (RPE) after a 5-min slow treadmill walk; 6 (low) to 20 (high) exertion].