Hostility and Change in Cognitive Function Over Time in Older Blacks and Whites

Abstract

Objective-To test whether the level of hostility predicted the rate of cognitive decline in a community of older Blacks and Whites and whether the association varied as a function of race.Methods-Over 4800 persons from a defined community in Chicago completed up to three structured interviews at approximately 3 year intervals over a period of up to 8.8 years (mean = 4.4 years). At the baseline interview, hostility was assessed with 8-items from the Cook-Medley Hostility Scale. Cognitive function was assessed at each interview with four cognitive function tests from which a composite measure of cognition was formed. Mixed effects models were used to assess change in cognition and its relation to hostility, controlling for age, sex, education, and race.Results-The average score on the hostility scale at baseline was 3.0 (SD = 2.1). Higher levels of hostility were associated with lower cognitive scores (estimate = −0.028, SE = 0.004, p < .001). Cognition declined at a rate of 0.051 U per year on average, but hostility was not related to the rate of decline. Results were unchanged after controlling for depressive symptoms, chronic health, neuroticism, and social and cognitive activity patterns, or when persons with cognitive impairment at baseline were excluded. The association was similar in Blacks and Whites. Conclusion-The results suggest that hostility is associated with level of cognitive function in older persons but not related to cognitive decline.

Perceived Stress and Change in Cognitive Function Among Adults 65 Years and Older

“…The MMSE measures global cognition and is commonly used as a screening tool for cognitive impairment. As previously reported (27,28), a composite of all four tests was created by converting the raw scores on each test to z scores, using the mean and standard deviation (SD) from the initial assessment in the population, and then averaging the z scores, with higher scores indicating better cognitive function. The composite cognitive score was used in our primary analyses.…”

“…Using data from up to five cycles of data collection (initial interview when perceived stress was measured and up to 4 follow-up cycles), we first ran an unadjusted model (Model 1), which included perceived stress at baseline, time (modeled as a continuous variable in years, months, and days since the initial interview), and the perceived stress × time interaction. Then, on the basis of prior analyses of cognitive decline within the CHAP cohort (27,33), we included the following terms in Model 2: age, sex, education, race, and interactions terms of age × time, education squared (to account for the known quadratic relation of educational attainment with cognitive decline in the CHAP cohort (28)) age × gender, age × education, race × education. Subsequently, a risk factor-adjusted model (Model 3) was estimated in which terms for SBP, BMI and BMI-squared (to account for previously observed non-linear associations of BMI with cognitive decline in the CHAP cohort (29)), smoking status, prevalent chronic conditions, and use of anti-hypertensive medications were added.…”

Associations between aspects of pain and cognitive performance and the contribution of depressive symptoms in mid-life women: A cross-sectional analysis

“…Therefore, we formed a composite measure of cognition by converting raw scores for each of the tests to z scores (using the mean and SD for each), and then averaged the z scores to get the composite score. This approach has been used previously 29 . If fewer than four cognitive test scores were available, available scores were averaged.…”

Neighborhood socioeconomic conditions are associated with psychosocial functioning in older black and white adults

“…Neighborhood conditions have been associated with depression in older age (Bierman, 2009; Kubzansky et al, 2005), but other aspects of psychosocial function have not been considered. For example, hostility has been linked to several health outcomes (Everson-Rose and Lewis, 2005), and although some studies have found that reported hostility declines somewhat with age (Barefoot et al, 1993), it remains significantly related to health and well-being in old age (Barnes et al, 2009). Moreover, although stress and personality factors contribute to psychosocial function and well-being, prior studies of older adults largely have failed to address contextual influences on these psychosocial characteristics.…”