Showing papers by "Lisa L. Barnes published in 2006"

Memory complaints are related to Alzheimer disease pathology in older persons

Abstract: Objective: To study the relationship between Alzheimer disease (AD) pathology and memory complaints proximate to death. Methods: A group of 90 older persons underwent detailed clinical evaluations and brain autopsy at death. The evaluations included administration of questions on subjective memory complaints and clinical classification of dementia and AD. On postmortem examination, neuritic plaques, diffuse plaques, and neurofibrillary tangles in tissue samples from five cortical regions were counted, and a summary measure of overall AD pathology was derived. In addition, amyloid load and tau tangles were quantified in eight regions. Results: In multiple linear regression models adjusted for age, sex, and education, memory complaints were associated with AD pathology, including both amyloid and tau tangles. Subsequent analyses demonstrated that the relationship between memory complaints and AD pathology was present in those with and without dementia, and could not be explained by the potentially confounding effects of depressive symptoms or coexisting common chronic health problems. Conclusion: Memory complaints in older persons may indicate self awareness of a degenerative process.

Childhood adversity and psychosocial adjustment in old age.

Abstract: Objective The objective of this study was to test the hypothesis that higher level of childhood adversity is associated with lower level of psychosocial adjustment in old age. Method Participants are 253 older persons (mean age: 79.8, standard deviation: 2.1; 73.9% women) from the Rush Memory and Aging Project, a clinicopathologic study of common chronic conditions of old age. Childhood adversity was assessed with a 16-item measure based on portions of the Childhood Trauma Questionnaire and other inventories. Psychosocial adjustment was assessed with multiple measures of neuroticism (i.e., proneness to negative emotions) and social engagement. Results Based in part on a factor analysis, composite measures of total adversity, emotional neglect, parental intimidation, parental violence, family turmoil, and financial need were developed. In a series of linear regression models adjusted for age, sex, own education, and parental education, the composite measure of childhood adversity was associated with all facets of neuroticism and accounted for more than 13% of the variance in the composite neuroticism measure. Emotional neglect and parental intimidation had the strongest associations with neuroticism. Childhood adversity was not related to frequency of participation in social activities, but more adversity was associated with having a smaller network (accounting for 3% of the variance) and feeling more emotionally isolated (accounting for 7% of the variance). Conclusion Childhood adversity is associated with less adaptive psychosocial functioning in old age.

Cognitive decline and survival in Alzheimer's disease.

Abstract: Objective To test the association of rate of cognitive decline, an indicator of the severity of the underlying disease process, with risk of death in Alzheimer's disease (AD). Methods A total of 472 persons with clinically diagnosed AD were recruited from a memory disorders clinic and day care centers in the Chicago area. They completed a uniform clinical evaluation at baseline and a battery of nine cognitive tests at six-month intervals for a mean of about three years. A previously established measure of global cognition was derived from the nine tests. Results During follow-up, 168 persons (36%) died. In a proportional hazards model that controlled for age, sex, race, education, and baseline level of cognition, individual rate of global cognitive decline, estimated with least squares regression, was linearly related to mortality risk. Thus, a person declining minimally (increase of 0.04 unit per year, 90th percentile) was 2.7 times less likely to die during the study period than a person declining rapidly (decrease of 0.76 unit per year, 10th percentile). Controlling for baseline disability did not substantially affect results. The association of cognitive decline with mortality was substantially stronger for white persons compared to African Americans and in those with less compared to more education. Conclusion The results indicate that the rate at which cognition declines in AD is robustly related to survival. Copyright © 2006 John Wiley & Sons, Ltd.

Change in Cognitive Function in Alzheimer’s Disease in African-American and White Persons

Abstract: Few studies have examined the association of race with change in cognitive function in Alzheimer’s disease (AD). We studied the rate of decline in global and specific measures of cognitive function in

The relation of lifetime cognitive activity and lifetime access to resources to late-life cognitive function in older African Americans.

Abstract: Research in older Caucasians has demonstrated that cognitive activity is related to cognitive function in late adulthood. Knowledge of this association is limited in older minority populations. We examined the relation of cognitive activity and access to cognitive resources, with cognitive function in a group of 108 older African Americans. We constructed two scales to measure the frequency of cognitive activity and the presence of resources that promote cognitive activity during early and late life. Both measures had high internal consistency and the cognitive activity scale had adequate temporal stability over a 4-week interval. In analyses that controlled for age and education, more frequent lifetime cognitive activity was related to current cognitive function, but lifetime cognitive resources only approached significance. The results suggest that both measures are psychometrically sound in a minority population and that lifetime cognitive activity may contribute to current cognitive function in African Americans.