Childhood Community Disadvantage and MRI-Derived Structural Brain Integrity After Age 65 Years.

Importance: Prior studies associate late-life community disadvantage with worse brain health. It is relatively unknown if childhood community disadvantage associates with late-life brain health.

Objective: To test associations between childhood residence in an economically disadvantaged community, individual income and education, and late-life cortical brain volumes and white matter integrity.

School-based racial segregation, social support, and late-life cognitive function in the Study of Healthy Aging in African Americans (STAR).

Introduction: School-based social support for Black students may mediate or modify the association between school segregation and late-life cognition.

Methods: Study of Healthy Aging in African Americans participants (n = 574) reported segregated school attendance and school-based social support. Associations of segregated schooling with domain-specific cognitive outcomes and effect modification or mediation by school-based social support were evaluated with linear mixed models.

HbA variability associated with dementia risk in people with type 2 diabetes.

Introduction: Although poor glycemic control is associated with dementia, it is unknown if variability in glycemic control, even in those with optimal glycosylated hemoglobin A (HbA) levels, increases dementia risk.

Methods: Among 171,964 people with type 2 diabetes, we evaluated the hazard of dementia association with long-term HbA variability using five operationalizations, including standard deviation (SD), adjusting for demographics and comorbidities.

Results: The mean baseline age was 61 years (48% women).

Racial and ethnic differences in the association between depressive symptoms and cognitive outcomes in older adults: Findings from KHANDLE and STAR.

Introduction: Depressive symptoms are associated with higher risk of dementia, but how they impact cognition in diverse populations is unclear.

Methods: Asian, Black, Latino, or White participants (n = 2227) in the Kaiser Healthy Aging and Diverse Life Experiences (age 65+) and the Study of Healthy Aging in African Americans (age 50+) underwent up to three waves of cognitive assessments over 4 years. Multilevel models stratified by race/ethnicity were used to examine whether depressive symptoms were associated with cognition or cognitive decline and whether associations differed by race/ethnicity.

Timing and level of educational attainment and late-life cognition in the KHANDLE study.

Introduction: The timing of educational attainment may modify its effects on late-life cognition, yet most studies evaluate education only at a single time point.

Methods: Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study cohort participants (N = 554) reported educational attainment (dichotomized at any college education) at two time points, and we classified them as having low, high, or later-life high educational attainment. Linear mixed-effects models estimated associations between educational attainment change groups and domain-specific cognitive outcomes (z-standardized).

Racial and Ethnic Differences in the Association between Depressive Symptoms and Cognitive Outcomes in Older Adults: Findings from KHANDLE and STAR.

Introduction: Depressive symptoms are associated with higher risk of dementia but how they impact cognition in diverse populations is unclear.

Methods: Asian, Black, LatinX, or White participants (n=2,227) in the Kaiser Healthy Aging and Diverse Life Experiences (age 65+) and the Study of Healthy Aging in African Americans (age 50+) underwent up to three waves of cognitive assessments over four years. Multilevel models stratified by race/ethnicity were used to examine whether depressive symptoms were associated with cognition or cognitive decline and whether associations differed by race/ethnicity.

Pragmatic approaches to handling practice effects in longitudinal cognitive aging research.

Introduction: The challenge of accounting for practice effects (PEs) when modeling cognitive change was amplified by the COVID-19 pandemic, which introduced period and mode effects that may bias the estimation of cognitive trajectory.

Methods: In three Kaiser Permanente Northern California prospective cohorts, we compared predicted cognitive trajectories and the association of grip strength with cognitive decline using three approaches: (1) no acknowledgment of PE, (2) inclusion of a wave indicator, and (3) constraining PE based on a preliminary model (APM) fit using a subset of the data.

Results: APM-based correction for PEs based on balanced, pre-pandemic data, and with current age as the timescale produced the smallest discrepancy between within-person and between-person estimated age effects.

Association of primary lifetime occupational cognitive complexity and cognitive decline in a diverse cohort: Results from the KHANDLE study.

Introduction: Higher occupational complexity has been linked to favorable cognitive outcomes, but rarely examined in racially and ethnically diverse populations.

Methods: In a diverse cohort (n = 1536), linear mixed-effects models estimated associations between main lifetime occupational complexity and domain-specific cognitive decline (z-standardized). Occupational complexity with data, people, and things were classified using the Dictionary of Occupational Titles.

State-Level Indicators of Childhood Educational Quality and Incident Dementia in Older Black and White Adults.

Importance: Higher educational attainment is associated with reduced dementia risk, but the role of educational quality is understudied, presenting a major evidence gap, especially as it may contribute to racial inequities.

Objective: To evaluate the association between state-level educational quality during childhood and dementia risk.

Design, Setting, And Participants: This cohort study analyzed longitudinal data collected from January 1, 1997, through December 31, 2019 (23-year follow-up period).

Rural residence across the life course and late-life cognitive decline in KHANDLE: A causal inference study.

Background: Modifiable risks for dementia are more prevalent in rural populations, yet there is a dearth of research examining life course rural residence on late-life cognitive decline.

Methods: The association of rural residence and socioeconomic status (SES) in childhood and adulthood with late-life cognitive domains (verbal episodic memory, executive function, and semantic memory) and cognitive decline in the Kaiser Healthy Aging and Diverse Life Experiences cohort was estimated using marginal structural models with stabilized inverse probability weights.

Results: After adjusting for time-varying SES, the estimated marginal effect of rural residence in childhood was harmful for both executive function ( = -0.

Eight-Year Depressive Symptom Trajectories and Incident Stroke: A 10-Year Follow-Up of the HRS (Health and Retirement Study).

Background: Evidence suggests a link between depressive symptoms and risk of subsequent stroke. However, most studies assess depressive symptoms at only one timepoint, with few examining this relationship using repeatedly measured depressive symptoms. This study aimed to examine the relationship between depressive symptom trajectories and risk of incident stroke.

Associations Between Marijuana Use and Involuntary Job Loss in the United States: Representative Longitudinal and Cross-Sectional Samples.

Objective: To investigate whether marijuana use is associated with involuntary job loss.

Methods: Multivariable survey logistic analysis of longitudinal (2001 to 2002/2003 to 2004) and cross-sectional data (2012 to 2013) from National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

Results: Marijuana use increased for all user groups with most workers who use marijuana using marijuana monthly (2.

Social Determinants of Health at Older Ages: The Long Arm of Early and Middle Adulthood.

This article discusses the impacts of midlife social exposures on health in later life, especially for women. Of particular interest is the period of early adulthood. Social epidemiology and life course frameworks help reveal how workplace exposures, family dynamics, and public policies related to work and family shape opportunities in midlife that have long-run health consequences.