Stability and Change in Cognitive Status Classification of Black Older Adults

Abstract

OBJECTIVES:The purpose of this study was to determine whether stability and change in cognitive status are associated with sociodemographic characteristics and health function. DESIGN: Secondary analysis of data. SETTING: Baltimore Study of Black Aging-Patterns of Cognitive Aging. PARTICIPANTS: Community-dwelling black adults (N = 407; mean age 68.6 AE 9.1). MEASUREMENTS: Baseline (n = 602) and 33-month follow-up (n = 450) assessments of cognition, health, and psychosocial function. RESULTS: For the present analyses, participants were grouped as being cognitively normal (n = 249), having stable mild cognitive impairment (MCI) (n = 32), or being MCI converters (n = 72; normal at baseline, MCI at follow-up) or reverters (n = 54; MCI at baseline, normal at follow-up). Multivariate analysis of variance showed that the groups differed significantly in education and lung function (P < .010). Post hoc analyses indicated that converters had fewer years of education than the other groups, whereas those who were cognitively normal had better lung function than converters and reverters (P < .050). CONCLUSION: These results suggest that education and lung health are associated with patterns of cognitive status change and stability. Future research should account for sociodemographic and health factors when examining stability of cognitive status classifications. J Am Geriatr Soc 66:179-183, 2018.Key words: cognition; mild cognitive impairment; MCI reversion rates; black R esearch has described mild cognitive impairment (MCI) as a precursor to Alzheimer's disease (AD) and other dementias.1 Although first described as a focal memory impairment with intact functional abilities, MCI's conceptualization as a clinical entity has evolved, with many different operational definitions and criteria that include cognitive impairments beyond memory.2 The various MCI conceptualizations and diagnostic criteria affect not only incidence rates of MCI, but also observed rates of progression to dementia. 2,3Substantial evidence has suggested that MCI is not always a stable condition, with all cases progressing to AD. Instead, some cases spontaneously revert to normal cognitive status, and researchers have suggested that more attention be given to MCI reversion rates. 4 It has been proposed that the concept of MCI be redefined as a condition that potentially leads to positive cognitive outcomes. 4 One pattern of findings showed that a small number of individuals with MCI worsen to dementia status, whereas more individuals remained stable or reverted to normal status.2 These findings also demonstrated that MCI conceptualizations identifying a focal memory impairment had more predictive value regarding progression to dementia than definitions based on nonmemory impairment.2 In contrast, another study found that individuals with multiple-domain MCI were more more likely to decline, with focal memory impairment unassociated with greater rates of progression.5 Such inconsistencies in the literature make MCI of great interest to researchers and indi...

Factors for predicting reversion from mild cognitive impairment to normal cognition: A meta‐analysis

“…A total of 1610 articles in English were screened, of which 17 were selected and included according to the established search strategy (Table S1). The total number of subjects was 6829, of which 1883 were reverted, amounting to an overall reversion rate of 27.57%.…”

“…An increasing body of evidence suggests that being an APOE ε4 carrier is a risk factor for AD and the progression of MCI to AD . APOE is closely related to the status and stability of MCI .…”

Sources of nonreplicability in aging ethnoracial health disparities research.

“…Research using such screeners demonstrated that measures of executive functioning, immediate, and delayed recall had adequate sensitivity and specificity to provide useful information to healthcare providers (Cameron et al, 2016). Overall, when researchers control for group differences in health, differences in performance between ethnoracial minorities and non-Hispanic Whites can be attenuated (Aiken-Morgan et al, 2018; Jones, 2003). Another way to minimize group differences is to estimate mean performance by freely estimating the intercepts for different ethnoracial groups (Avila et al, 2020).…”

Associations between pulmonary function and cognitive decline in the middle-aged and older adults: evidence from the China Health and Retirement Longitudinal Study

“…Based on previous studies [6,11,[26][27][28], demographic characteristics included age (years), residence (urban/ rural), marital status (married/divorced/single), education (illiterate/primary school/middle school and above) and health insurance status (yes/no). Lifestyle behaviors including smoking status (current/former/never), alcohol use (current/former/never) and social activity (none/inactive/active) were also taken into consideration.…”