Journals of Gerontology Series B-Psychological Sciences and Social Sciences最新文献

Objective: This study classified preclinical Alzheimer's disease (AD) using cognitive screening, neighborhood deprivation via the area deprivation index (ADI), and sociodemographic and genetic risk factors. Additionally, it compared the predictive accuracy of multiple machine learning algorithms and examined model performance with two bootstrapping procedures.

Methods: Data were drawn from a longitudinal cohort that required participants to be age 65 or older, cognitively normal at baseline, and active drivers, defined as taking at least one trip a week. Naturalistic driving data were collected using a commercial datalogger. Biomarker positivity was determined via amyloid pathology using cerebrospinal fluid and positron emission tomography imaging. ADI was captured based on geocoding latitude and longitude to derive a national ranking for the specific location (home or unique destination). Machine learning algorithms classified preclinical AD. Each individual model's predictive ability was confirmed in a 20% testing dataset with 100 rounds of resampling with and without replacement.

Results: Among 292 participants (n = 2,792 observations), including ADI of trip destinations, participants' home ADI, and frequency of trips to the same ADI led to a slight but notable improvement in predicting preclinical AD. The ensemble model demonstrated superior predictive performance, highlighting the potential of integrating multiple models for early AD detection.

Discussion: Our findings underscore the importance of incorporating socioeconomic and environmental variables, such as neighborhood deprivation, in predicting preclinical AD. Addressing socioeconomic disparities through public health strategies is crucial for mitigating AD risk and enhancing the quality of life for older adults.

Objectives: Confronted with shrinking social networks, older adults exhibit individual differences in social adaptability, reflected as socially resilient versus socially vulnerable. The purpose of this study was to examine key features that reflect this social asymmetry in later life.

Methods: Three data sets were analyzed, with the training set (N = 424) included older adults from China, whereas 2 test sets (N1 = 2877, N2 = 2343) were from the United States. Social asymmetry was assessed using residuals from a regression of social network on loneliness, with individuals with positive residuals categorized as socially vulnerable and those with negative residuals as socially resilient. Feature selection was performed with the Boruta algorithm, model building with the gradient boosting machine (GBM) algorithm, and model interpretation with the local interpretable model-agnostic explanations (LIME) algorithm.

Results: Socially resilient older adults were more prevalent than socially vulnerable ones across datasets from various cultural backgrounds. Five key features-depression, anxiety, stress, sleep disturbance, and personality-were found to predict social asymmetry, with area under the curve (AUC) values ranging from 0.76 to 0.86 across data sets. Older adults with lower levels of depression, anxiety, stress, and sleep disturbance, and typical A or B (vs intermediate) personality, were more likely to be socially resilient.

Discussion: The prevalence of socially resilient older adults indicates a relatively positive trend, and most of the key features are plastic and amenable, such as negative emotions and sleep behavior. Developing emotional regulation strategies and providing sleep hygiene education could improve the social adaptability of older adults.

Objectives: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) midlife and older adults are known to face elevated risks of subjective cognitive impairment (SCI). This study examines the relationships between multifaceted aspects of social connectedness and SCI among LGBTQ midlife and older adults, taking into consideration racial and ethnic differences.

Methods: We used biennial longitudinal data from the Aging with Pride: National Health, Aging, and Sexuality/Gender Study of LGBTQ adults aged 50 and older, with repeated measures of SCI from 2014 to 2020. We employed hierarchical linear mixed models to estimate the overall level of and changes in SCI, their associations with social connectedness properties, and racial and ethnic heterogeneity in the associations.

Results: The time-only model revealed a significant linear increase in SCI over time, but this time effect disappeared after controlling for background characteristics and social connectedness properties. Results of interaction effects of time and social connectedness revealed that a steeper increase in SCI is observed for those with low network diversity, diminished network size, and reduced LGBTQ community engagement. When compared to non-Hispanic Whites, Hispanics, Blacks, and individuals of other races showed a higher SCI. The interaction effects of time and social connectedness on SCI were pronounced among Hispanics.

Discussion: Social isolation is a major concern among LGBTQ midlife and older adults. This study suggests that promoting social connectedness may help alleviate the increase in SCI. Addressing racial and ethnic differences is imperative in developing public health policies and interventions for this underserved and demographically diverse at-risk population.

Objectives: Living in a complex food environment, humans face numerous decisions and choices every day. These decisions necessitate cognitive resources and the ability to balance metabolic needs with gratification. This study sought to examine whether aging enhances responses to food stimuli due to reduced inhibitory control or reduces such responses due to a decline in the motivational system.

Methods: 50 young adults, aged 20-30 years, and 55 older adults, aged 65-91 years, without obesity, were recruited. Participants were asked to rate explicitly liking, wanting, and healthiness of both high- and low-calorie foods on a Likert scale. Additionally, they completed an affective priming task measuring affective reactions toward foods and a food go/no-go task to assess inhibitory control.

Results: Older adults exhibit reduced food liking and wanting compared to young adults, but did not show increased impulsivity or implicit preference for high- and/or low-calorie foods. No significant relationship between perceived healthiness and reward responsiveness was observed in the older adult group.

Discussion: Our findings suggest that healthy aging is characterized by a diminished response to food due to low reward responsiveness. This is noteworthy, as the hedonic properties of foods are commonly believed to guide dietary choices. Understanding the relationship between age and food-related behavior is crucial for developing targeted dietary interventions for older adults, which could enhance their overall health and quality of life.

Objectives: Alzheimer's disease and related dementias significantly affect older adults' quality of life. The clock-drawing test (CDT) is a widely used dementia screening tool due to its ease of administration and effectiveness. However, manual CDT-coding in large-scale studies can be time-intensive and prone to coding errors and is typically limited to ordinal responses. In this study, we developed a continuous CDT score using a deep learning neural network (DLNN) and evaluated its ability to classify participants as having dementia or not.

Methods: Using a nationally representative sample of older adults from the National Health and Aging Trends Study (NHATS), we trained deep learning models on CDT images to generate both ordinal and continuous scores. Using a modified NHATS dementia classification algorithm as a benchmark, we computed the area under the receiver operating characteristic curve for each scoring approach. Thresholds were determined by balancing sensitivity and specificity, and demographic-specific thresholds were compared to a uniform threshold for classification accuracy.

Results: Continuous CDT scores provided more granular thresholds than ordinal scores for dementia classification, which vary by demographic characteristics. Lower thresholds were identified for Black individuals, those with lower education, and those ages 90 or older. Compared to ordinal scores, continuous scores also allowed for a more balanced sensitivity and specificity.

Discussion: This study demonstrates the potential of continuous CDT generated by DLNN to enhance dementia classification. By identifying demographic-specific thresholds, it offers a more inclusive and adaptive approach, which could lead to improved guidelines for using CDT in dementia screening.

Objectives: Both the level and distribution of neighborhood-level socioeconomic resources are associated with cognitive health in later life. This study examined psychological mechanisms underlying these associations for Black and White older adults.

Methods: Data from 591 (50% Black, 43% White) older adults from the Michigan Cognitive Aging Project were linked to census tract-level information on neighborhood disadvantage, affluence, and racial income inequality from the National Neighborhood Data Archive. Global cognition was a z-score composite of 5 domains from a comprehensive neuropsychological battery. Psychological mediators were external perceived control and depressive symptoms measured with self-report questionnaires. Simultaneous mediation models accounting for neighborhood clustering examined associations between neighborhood factors and cognition through external perceived control and depressive symptoms.

Results: External perceived control, but not depressive symptoms, mediated the negative association between neighborhood disadvantage and cognition in the whole sample. Moderated mediation models showed a stronger neighborhood disadvantage-cognition association independent of the psychological mediators among Black participants and stronger associations between affluence and both psychological mediators among White participants.

Discussion: Psychosocial stress may be one pathway linking neighborhood disadvantage to dementia risk among diverse older adults. Future studies should characterize additional modifiable pathways, particularly for Black older adults, who also live in neighborhoods with greater disadvantage than White older adults, on average. Future studies should also investigate why neighborhood affluence may have stronger positive psychological and cognitive effects among White older adults than Black older adults, which could involve discrimination and racially patterned barriers to accessing neighborhood resources.

Objectives: Depression is a significant public health concern among middle-aged and older adults in China. While formal education's protective role against depression is well-established, the association of adult education with depression remains understudied. Adult education refers to organized learning activities for adults who have completed or left formal schooling. This nationwide longitudinal cohort study examined the association between adult education and depressive symptoms among Chinese adults aged 45 and older.

Methods: Using data from the China Health and Retirement Longitudinal Study (2011-2018), we analyzed 37,325 observations from 11,453 participants. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale, while adult education was measured by participation, duration, and attainment.

Results: Generalized estimating equation models showed that adult education participation was associated with 27.2% lower odds of depressive symptoms (odds ratios = 0.728, 95% CI: 0.620-0.854). Each additional year of adult education was associated with 13.1% lower odds, and those who attained a diploma or degree through adult education showed 61.3% lower odds. Notably, even participation without earning a degree showed 22.1% lower odds. These associations remained consistent across formal education levels, age, gender, and other subgroups. Current smoking, social participation, digital exclusion, and instrumental activities of daily living disability collectively explained 34.0% of the total association.

Discussion: These findings suggest that potential benefits of adult education in addressing depression among China's aging population, with implications for mental health policy and healthy aging initiatives in developing countries.

Objectives: Our study is among the first to analyze the developmental trajectories of cognitive function at the couple level.

Methods: Using longitudinal dyadic data obtained from 2,130 heterosexual couples who participated in the China Health and Retirement Longitudinal Study between 2011 and 2020, we employed the dyadic latent growth curve model to analyze the developmental trajectories of wives' and husbands' cognitive function from 2011 to 2018. We examined the significant predictors of membership of the latent profiles, as well as the extent to which membership of the latent profiles predicted husbands' and wives' depressive symptoms at follow-up (i.e., in 2018 and 2020).

Results: The two identified dyadic profiles reflected distinct developmental trajectories at the couple level: high stable couples with outperforming husbands (Profile 1, 81.6% of couples), and moderate stable wives-moderate rapid decline husbands (Profile 2, 18.4% of couples). Husbands' older age and higher number of functional limitations, and couples' residence in rural areas at baseline predicted a higher likelihood of membership in Profile 2. Husbands reporting more chronic conditions at baseline predicted a lower likelihood of the couple being classified in Profile 2. Couples in Profile 2 exhibited higher levels of depression symptoms than their counterparts in Profile 1 in 2018 and 2020.

Discussion: Our results highlight the utility of a couple approach in analyzing the developmental trajectories of cognitive functioning in later life and advance our understanding of how couple-level changes exert influence on both spouses' mental health.

Objectives: To explore how informal and formal home care was balanced for older adults under the weakening informal caregiving systems due to sociodemographic changes in South Korea, this study examined the relationship between the two types of care and the effects of proximity to family caregivers on them.

Methods: We analyzed adults aged 65 years and older from the 7th wave of the Korean Longitudinal Study of Aging (n = 722) with limitations in activities of daily living or instrumental activities of daily living or dementia. Multinomial logistic regression was adopted to analyze the impact of family structure on the choice of informal caregivers. Two-stage least squares, Heckman, and IV-Heckman models were applied to address endogeneity and sample selection biases.

Results: The results demonstrated that spouses and children close to older parents appeared to be primary caregivers. According to the IV-Heckman model, informal care substitutes for formal home care (b = -0.416, p < .01), and both being married (b = 0.715, p < .01) and proximity to children within 1 hr (b = 0.888, p < .01) appeared to facilitate formal home care use.

Discussion: This study reveals that informal and formal home care are inextricably linked. Spouses and adult children close to parents play a pivotal role in directly providing informal care and indirectly facilitating formal home care. Balancing informal/formal home care should be considered in medium- and long-term plans to improve older adults' well-being and reduce formal care's financial burden.

Objectives: Prominent theories of adult development suggest individuals increasingly prioritize emotional goals and social relationships as they age. Accordingly, older adults are expected to invest more in maintaining their emotional well-being compared with younger adults. Prior work suggests older adults may accomplish this goal by structuring their lives in ways that reduce the need to actively manage unwanted emotion. We tested the hypotheses that (a) older adults regulate their emotions less often in daily life compared with younger adults, and (b) when emotion regulation occurs, older adults are more motivated than younger adults by prohedonic and social concerns.

Method: Using experience sampling (7x/day for 9 days), we assessed emotion regulation frequency and motives in younger adults (n = 75), cognitively normal older adults (n = 93), and older adults with mild cognitive impairment (MCI; n = 63).

Results: Emotion regulation was less frequent for older adults with MCI (16%) and without MCI (18%) compared with younger adults (43%), even when controlling for emotional experience. However, few differences in emotion regulation motives emerged and they were not robust to controlling for age group differences in emotion.

Discussion: These findings extend previous work on emotion regulation in aging, which largely has focused on strategies, by documenting age differences in how often, but not why, people regulate. Future work is needed to explore how age-related differences in life contexts might result in less need for emotion regulation in older adults. Conserving effort directed toward emotion regulation could be particularly beneficial among older adults with more limited cognitive resources.