Measuring Cognition: The Chicago Cognitive Function Measure in the National Social Life, Health and Aging Project, Wave 2

Sunkara, Priya; Kotwal, Ashwin; Kern, David W.; Henning, Sara L; McClintock, Martha K.; Schumm, L. Philip; Waite, Linda J.; Dale, William

doi:10.1093/geronb/gbu106

Cited by 62 publications

(58 citation statements)

References 24 publications

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“…First, we do not have full neuropsychological testing for our large sample, and thus cannot provide formal diagnoses of MCI or dementia. However, we used a well-tested survey adaptation of a screening tool, the MoCA-SA, 28,39 as well as appropriate cutoffs for a community sample. [42][43][44] A sensitivity analysis utilizing both a continuous cognitive measure and multiple different cutoffs yielded similar associations with social variables (data available on request).…”

Section: Discussionmentioning

confidence: 99%

“…38 Following extensive testing, an 18-item survey adaptation of the Montreal Cognitive Assessment (MoCA-SA) was included in NSHAP-W2. 28 The MoCA-SA was designed for administration by nonmedical personnel and to reduce respondent burden within the context of a large, time-limited national survey, while preserving the MoCA's sensitivity to a range of cognitive abilities. MoCA-SA scores are highly correlated with the MoCA and scores can be accurately converted into MoCA scores.…”

Section: Methodsmentioning

confidence: 99%

“…Cognitive assessments have relied on dementia diagnoses or have used screening tools, such as the Short Portable Mental Status Questionnaire (SPMSQ), 21,23,24 or the MiniMental Status Exam (MMSE), 8,10,25 which are relatively insensitive to early impairment. [26][27][28] Clinicians would benefit from understanding whether early stages of impairment are associated with altered social relationships.…”

Section: Introductionmentioning

confidence: 99%

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Social Function and Cognitive Status: Results from a US Nationally Representative Survey of Older Adults

et al. 2016

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BACKGROUND: An early sign of cognitive decline in older adults is often a disruption in social function, but our understanding of this association is limited. OBJECTIVE: We aimed to determine whether those screening positive for early stages of cognitive impairment have differences across multiple dimensions of social function and whether associations differ by gender. DESIGN: United States nationally representative cohort (2010), the National Social life, Health, and Aging Project (NSHAP). PARTICIPANTS: Community-dwelling adults aged 62-90 years (N = 3,310) with a response rate of 76.9 %. MAIN MEASURES: Cognition was measured using a survey adaptation of the Montreal Cognitive Assessment categorized into three groups: normal, mild cognitive impairment (MCI), and dementia. We measured three domains of social relationships, each comprised of two scales: network structure (size and density), social resources (social support and social strain), and social engagement (community involvement and socializing). We used multiple linear regression to characterize the relationship of each social relationship measure to cognition. KEY RESULTS: Individuals screened as at risk for MCI and early dementia had smaller network sizes by 0.3 and 0.6 individuals (p < 0.001), and a 10 % and 25 % increase in network density (p < 0.001), respectively. For social resources, individuals at risk for MCI and dementia had 4 % and 14 % less social strain (p = 0.01), but only women had 3 % and 6 % less perceived social support (p = 0.013), respectively. For social engagement, individuals screened positive for MCI and dementia had 8 % and 19 % less community involvement (p = 0.01), but only men had 8 % and 13 % increased social involvement with neighbors and family members (p < 0.001), respectively. CONCLUSION: Changes in social functioning provide an early indication to screen for cognitive loss. Recognition that early cognitive loss is associated with differences in social function can guide counseling efforts and help identify social vulnerabilities to ease the transition to overt dementia for both patients and caregivers.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Social Function and Cognitive Status: Results from a US Nationally Representative Survey of Older Adults

et al. 2016

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“…The NESARC-III sample is nationally representative [46], large enough to conduct factor analysis in random sample halves, covers a broader age range than previous general population samples with cognition measures [31–35], and includes measures for a range of substances. The two self-reported scales, which offer the advantages of fast, efficient cognitive data collection [44], were supported by discriminant and construct validation.…”

Section: Discussionmentioning

confidence: 99%

“…Extant surveys with measures of substance use and cognitive functioning included only middle-aged or older U.S. adults [30–35], omitting late adolescent and early adult participants, when prevalence of alcohol and drug use and related disorders is highest [36–38]. Thus, in large, national samples with participants at the peak ages of risk, information is lacking on the relationship of cognitive functioning to substance use, an increasing health problem with high morbidity and mortality among adults [36,37,39].…”

Section: Introductionmentioning

confidence: 99%

Self‐reported cognitive scales in a US National Survey: reliability, validity, and preliminary evidence for associations with alcohol and drug use

et al. 2017

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Aims To evaluate relationships between measures of cognitive functioning and alcohol or drug use among adults (≥18 years) in the U.S. general population. Design Two cognitive scales were created based on dimensionality and reliability of self-reported Executive Function Index items. Relationships between the two scales and validators were evaluated. Associations between the cognitive scales and past-year frequency of alcohol or drug use were estimated with adjusted odds ratios (aOR). Setting USA, using the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, a nationally representative adult sample selected by multistage probability sampling. Participants 36,085 respondents. Measurements Past-year substance use outcome variables categorized binge drinking, marijuana, cocaine, opioid, sedative/tranquilizer, and stimulant use as frequent (at least weekly to daily), infrequent (any to 2–3 times/month), or no use, assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule-V. Key predictors were the two cognitive scales. Construct validators included education and functional impairment. Covariates included age, gender, income, and race/ethnicity. Findings Nine cognitive items fit a two-factor model (Comparative Fit Index=.973): attention (5 items) and executive functioning (4 items). Both scales were positively associated with higher education (ps<.001) and negatively associated with functional impairment (ps<.001), demonstrating construct validity. Poorer attention was associated with frequent and infrequent binge drinking and use of drugs (aOR range=1.07 [binge drinking] to 1.72 [stimulants], ps≤0.01). Poorer executive functioning was associated with frequent binge drinking and use of drugs (aOR range=1.22 [binge drinking] to 2.03 [cocaine], ps<0.001), and infrequent use of all drugs (aOR range=1.19 [marijuana] to 1.63 [cocaine], ps<0.001). Conclusions Impairments in attention and executive functioning are positively correlated with substance use in the U.S. general population.

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Olfactory dysfunction persists after smoking cessation and signals increased cardiovascular risk

Siegel

Wroblewski

McClintock

et al. 2019

Int Forum Allergy Rhinol

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BackgroundOlfaction plays a critical role in health and function in older adults, and impaired sense of smell is a strong predictor of morbidity and mortality. Smoking cigarettes causes olfactory impairment, but the mechanism of damage and ability to recover after cessation are unknown. We investigated the relationship between time since quitting and olfactory dysfunction in order to elucidate the mechanism(s) by which smoking damages the olfactory system and to inform patient counseling.MethodsUsing longitudinal data from the National Social Life Health and Aging Project (n = 3528 older adults, including 1526 former smokers), we analyzed the association between odor identification performance and time since smoking cessation using multivariate ordinal logistic regression, adjusting for cognition and demographic variables. To test whether vascular disease plays a role, we also assessed the relationship between olfactory decline and incidence of heart attack and heart disease.ResultsFormer smokers who quit ≤15 years before testing had significantly impaired olfaction compared to never smokers (p = 0.04), but those who quit >15 years prior did not. Olfactory decline over 5 years showed modest evidence toward predicting increased incidence of heart attack or heart disease (p = 0.08).ConclusionOlfactory impairment in smokers persists 15 years after quitting, which is consistent with a vascular mechanism of impairment. Indeed, olfactory decline is a predictor of the development of cardiovascular disease. Taken together, these data suggest that olfactory loss may be a useful sign of underlying vascular pathology. Further investigation of olfactory loss as an early biomarker for cardiovascular disease is warranted.

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Measuring Cognition: The Chicago Cognitive Function Measure in the National Social Life, Health and Aging Project, Wave 2

Abstract: A survey-based adaptation of the MoCA was successfully integrated into a nationally representative sample of older adults, NSHAP Wave 2.

Cited by 62 publications

References 24 publications

Social Function and Cognitive Status: Results from a US Nationally Representative Survey of Older Adults

Social Function and Cognitive Status: Results from a US Nationally Representative Survey of Older Adults

Self‐reported cognitive scales in a US National Survey: reliability, validity, and preliminary evidence for associations with alcohol and drug use

Olfactory dysfunction persists after smoking cessation and signals increased cardiovascular risk

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