Objectives
To examine the association between cognitive stimulating activities (CSA) in later life (internet/email use, employment, volunteering, evening classes, social club membership and newspaper reading) and risk of cognitive impairment or dementia using marginal structural models to account for time-varying confounding affected by prior exposure.
Methods
Data were used from the English Longitudinal Study of Ageing waves 1 (2002) to 7 (2014), a nationally representative sample of adults in England aged ≥50. Self-reported participation in CSAs were measured as binary exposures from waves 2 (2004) to 6 (2012), with final sample sizes between n = 3937 and n = 2530 for different CSAs. Baseline exposure and covariates were used to create inverse probability of treatment and censoring weights (IPTCW). IPTCW repeated measures Poisson and linear regression were used to estimate each CSAs effect on risk of probable cognitive impairment or dementia at wave 7 (defined as a score of ≤11/27 on a modified telephone interview for cognitive status (TICS-27)). Results were compared to standard regression adjustment.
Results
Internet use at any wave (Risk ratios between 0.62 and 0.69) and volunteering in waves 3 to 6 (RRs between 0.516 and 0.633) were associated with reduced risk of cognitive impairment in IPTCW models. Standard estimates were similar for both internet use and volunteering.
Newspaper reading (RR 95% Confidence interval 0.74–0.99) and social club membership (RR 95% CI 0.54–0.86) at wave 6 were significantly associated with risk of cognitive impairment in standard models, but not in the IPTCW models (RR 95% CI 0.82–1.11 and 0.60–1.08 respectively). Employment and evening classes were not associated with cognitive impairment in either model.
Conclusions
We found that volunteering and internet use were associated with reduced risk of cognitive impairment. Associations between newspaper reading or social club membership and cognitive impairment may be due to time-varying confounding affected by prior exposure.
Background: To see if there is a difference in performance when students switch from traditional paper-and-pencil examinations to computer-based examinations, and to determine whether there are gender differences in student performance in these two examination formats.
Objectives
Recommended cut‐off criteria for testing measurement invariance (MI) using the comparative fit index (CFI) vary between −0.002 and −0.01. We compared CFI results with those obtained using Bayesian approximate MI for cognitive function.
Methods
We used cognitive function data from Waves 1–5 of the English Longitudinal Study of Ageing (ELSA; Wave 1
n
= 11,951), a nationally representative sample of English adults aged ≥50. We tested for longitudinal invariance using CFI and approximate MI (prior for a difference between intercepts/loadings ~N(0,0.01)) in an attention factor (orientation to date, day, week, and month) and a memory factor (immediate and delayed recall, verbal fluency, and a prospective memory task).
Results
Conventional CFI criteria found strong invariance for the attention factor (CFI + 0.002) but either weak or strong invariance for the memory factor (CFI −0.004). The approximate MI results also supported strong MI for attention but found 9/20 intercepts or thresholds were noninvariant for the memory factor. This supports weak rather than strong invariance.
Conclusions
Within ELSA, the attention factor is suitable for longitudinal analysis but not the memory factor. More generally, in situations where the appropriate CFI criteria for invariance are unclear, Bayesian approximate MI could alternatively be used.
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