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Background: Evidence suggests that a combination of biological and social factors influence risk of dementia differently for women and men. In healthy older women, several factors may contribute to changes in cognition. Objective: Describe the characteristics associated with variation in cognition in a sample of cognitively healthy older Panamanian women. Methods: The study includes cross-sectional analyses of cognitive domains at baseline (n = 357) and 17-month (SD = 2.0) follow-up (n = 200) for women aged 60 years and older enrolled in the Panama Aging Research Initiative-Health Disparities (PARI-HD) study. Instruments included clinical questionnaires, physiological measures, and a neuropsychological test battery assessing global cognition and seven cognitive domains. Multiple regression analyses examined the associations between demographic and clinical characteristics and cognition at baseline. Repeated measures analyses were used to investigate changes in cognition from baseline to follow-up. Results: On average, participants were 68.6 years of age (SD = 5.9) with 16.1 years of education (SD = 4.7). Age, income, and education showed robust associations with baseline cognition. Subjective cognitive impairment was associated with lower performance in global cognition, verbal learning, and memory domains. Only performance in the attention domain decreased at follow-up, and subjective health state and depressive symptoms significantly predicted the change in attention. Discussion: Our study findings contribute to the investigation of cognitive health in older Hispanic women and to the understanding of sociodemographic and health-related factors associated with cognitive decline and the progression to cognitive impairment and dementia.
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Background: A growing body of evidence points to potential risks associated with polypharmacy (using ≥5 medications) in older adults, but most evidence is derived from studies where racial and ethnic minorities remain underrepresented among research participants. Objective: Investigate the association between polypharmacy and cognitive function, subjective health state, frailty, and falls in Hispanic older adults. Methods: Panama Aging Research Initiative-Health Disparities (PARI-HD) is a community-based cohort study of older adults free of dementia at baseline. Cognitive function was measured with a neuropsychological test battery. Frailty assessment was based on the Fried criteria. Subjective health state and falls were self-reported. Linear and multinomial logistic regression analyses were used to examine association. Results: Baseline evaluations of 468 individuals with a mean age of 69.9 years (SDâ=â6.8) were included. The median number of medications was 2 (IQR: 1-4); the rate of polypharmacy was 19.7% (95% confidence interval [CI]â=â16.1-23.3). Polypharmacy was inversely associated with self-rated overall health (bâ=-5.89, pâ<â0.01). Polypharmacy users had 2.3 times higher odds of reporting two or more falls in the previous 12 months (odds ratio [OR]â=â2.31, 95% CIâ=â1.06-5.04). Polypharmacy was independently associated with Fried's criteria for pre-frailty (ORâ=â2.90, 95% CIâ=â1.36-5.96) and frailty (ORâ=â5.14, 95% CIâ=â1.83-14.42). Polypharmacy was not associated with cognitive impairment. Conclusions: These findings illustrate the potential risks associated with polypharmacy among older adults in Panama and may inform interventions to improve health outcomes in this population.
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Fragilidade , Humanos , Idoso , Fragilidade/epidemiologia , Estudos de Coortes , Polimedicação , Gerociência , Avaliação de Resultados em Cuidados de Saúde , Idoso FragilizadoRESUMO
The Panama Aging Research Initiative is a cohort study of 423 adults aged ≥65 years recruited from an outpatient geriatric department of Panama's largest public hospital, the Social Security Fund's Dr Arnulfo Arias Madrid Hospital Complex (Complejo Hospitalario Dr Arnulfo Arias Madrid de la Caja de Seguro Social). The study provides the first reports of modifiable and non-modifiable risk factors of cognitive impairment and dementia, as well as various health conditions common among older adults in Panama, including chronic illnesses, polypharmacy and rates of comorbidity. The initial study, conducted September 2012-May 2016, included a clinical interview; physical assessments of body mass index and handgrip strength; and cognitive testing, plus non-fasting blood draws for measurements of genetic (Apolipoprotein E genotype) and blood-based biological markers. Information was collected regarding limitations in activities of daily living, symptoms of depression and fall incidents. A subsample of participants provided cerebrospinal fluid to measure proteins related to Alzheimer's disease; another subsample underwent ultrasonography and electroencephalography. This report describes the general study design and highlights lessons learned and future directions. In particular, drawing on lessons learned from this clinical research, a community-based prospective cohort study is currently under way among older adults in Panama to validate a blood-based biomarker profile for detecting mild cognitive impairment and Alzheimer's disease, as well as risk factors for cognitive decline. KEYWORDS: Dementia, biomarkers, Latin America, aging, cognition, chronic disease, Panama.
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Avaliação Geriátrica , Acidentes por Quedas/estatística & dados numéricos , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Apolipoproteínas E/sangue , Biomarcadores/sangue , Índice de Massa Corporal , Doença Crônica/epidemiologia , Transtornos Cognitivos/epidemiologia , Comorbidade , Demência/epidemiologia , Depressão/epidemiologia , Feminino , Força da Mão , Humanos , Estudos Longitudinais , Masculino , Panamá/epidemiologia , Polimedicação , Fatores de RiscoRESUMO
BACKGROUND: Falls are common among elderly adults, and are predictors of hospitalization, institutionalization and mortality. OBJECTIVE: The objective of the present study was to examine the relationship between blood-based markers of inflammation and fall events in a sample of elderly Hispanic adults. METHOD: Data were collected from 190 participants enrolled in the Panama Aging Research Initiative study who completed baseline clinical and cognitive assessments. A non-fasting blood sample was obtained. Self-reported falls were classified as no falls, single falls or recurrent (two or more) falls reported in the 12 months prior to baseline evaluations. Serum levels of C Reactive Protein (CRP), T-lymphocyte secreting protein (I-309), interleukin 10 (IL-10), interleukin 6 (IL-6) and interleukin 7 (IL-7) were measured. Global cognition was assessed with the Mini Mental State Examination and depressive symptoms were assessed with the Geriatric Depression Scale (GDS-30). Multinomial logistic regression was used to assess the link between inflammation and fall events. RESULTS: Depressive symptoms, limitations in Instrumental Activities of Daily Living (IADL), IL-7 and I-309 were significantly related to fall events. Elevated levels of IL-7 increased the likelihood of single and recurrent falls, while increased levels of I-309 were associated only with recurrent falls. Greater IADL limitations and depressive symptoms were associated with an increased likelihood of recurrent falls. CONCLUSION: There is a lack of research investigating the relationship between inflammatory biomarkers and fall events. These results provide evidence of risk factors for falls in Hispanic older adults, and could serve to guide public health professionals to establish clinical guidelines to reduce fall risks.
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Acidentes por Quedas , Envelhecimento/sangue , Envelhecimento/psicologia , Depressão/sangue , Mediadores da Inflamação/sangue , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Quimiocina CCL1/sangue , Depressão/complicações , Feminino , Hispânico ou Latino , Humanos , Incidência , Interleucina-10/sangue , Interleucina-6/sangue , Interleucina-7/sangue , Masculino , Panamá/epidemiologia , Fatores de RiscoRESUMO
Individual differences in responses to a novel environment are an important tool to predict predisposition to neuropsychiatric disorders. One way to examine individual differences involves classifying animals based on locomotion in a novel context. In this study we focused on individual and sex differences by categorizing female and male mice as high (HR) or low responders (LR) on the basis of open field locomotion. We then assessed whether groups differed on behavioral measures of spontaneous alternations, anxiety, depression and contextual fear conditioning. In the Y-maze, we observed no differences across HR/LR or sex on spontaneous alternations, but HR displayed more locomotion. HR male mice showed less anxiety-like behavior in the light-dark test but not the elevated plus maze. We observed no differences in the forced swim test across HR/LR, although males exhibited greater depression-like behavior overall. HR mice exhibited less contextual fear memory compared to LR regardless of sex. Principal component analyses suggested sex-specific patterns of behaviors across tests, with female responses within individual tests tending to load together. In females anxiety- and depression-like behaviors explained a large part of the variance observed across tests in our battery, whereas male behavior was primarily explained by variables related to locomotion.