@article {12678, title = {Childhood adversity and cognitive impairment in later life.}, journal = {Frontiers in Psychology}, volume = {13}, year = {2022}, pages = {935254}, abstract = {

Objectives: This study examined the association between childhood adversity and cognitive impairment in later life and explored the potential moderation effect of gender and race.

Methods: The study sample included 15,133 participants of the Health and Retirement Study (1998-2016 surveys) who had complete data on key study measures and were more than 50. The outcome variable is a dichotomous indicator of cognitive impairment as assessed by the Telephone Interview for Cognitive Status for self-respondents and the 16-item Informant Questionnaire on Cognitive Decline in the Elderly for proxies. A total of six childhood adversity indicators included grade retention, parental substance abuse, physical abuse, trouble with the police, moving due to financial hardship, and receipt of help due to financial hardship in early life. The estimation of the association between childhood adversity and cognitive impairment involved Cox proportional hazards regression. Results: Grade retention had the largest effect on incident cognitive impairment (HR = 1.3, 95\% CI = 1.23-1.38, < 0.001), followed by physical abuse by a parent (HR = 1.10, 95\% CI = 1.00-1.20, = 0.001). The impact of grade retention was more detrimental to women than men (interaction term HR = 0.89, 95\% CI = 0.80-1.00, = 0.048, female as the reference). Parental substance abuse was associated with a lower risk of incident cognitive impairment for most racial groups (HR = 0.89, 95\% CI = 0.83-0.95, = 0.001), but this association was reversed in "non-Hispanic other" race, consisting mainly of Asians (HR = 1.54, 95\% CI = 1.05-2.26, = 0.025).

Discussion: Some aspects of childhood adversity continue to harm cognitive functioning in later life, while some events may have the opposite effect, with evidence of heterogeneity across gender and race.

}, keywords = {ACE, Adverse childhood events, Childhood adversity, cognitive impairment, Dementia, life course}, issn = {1664-1078}, doi = {10.3389/fpsyg.2022.935254}, author = {Xiang, Xiaoling and Cho, Joonyoung and Sun, Yihang and Wang, Xiafei} } @article {10676, title = {Associations Between Diagnosis with Type 2 Diabetes and Changes in Physical Activity among Middle-Aged and Older Adults in the United States}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {igz048}, abstract = {BACKGROUND AND OBJECTIVES: Physical activity (PA) is an effective strategy for diabetes self-management and is central to the diabetes regimen. Diagnostic events present an opportunity for health behavior change; however, many older adults with type 2 diabetes (T2D) do not engage in regular PA. The relationships between diagnosis events and subsequent changes in PA are not well understood. Drawing upon life-course theory, this is the first study to examine whether the diagnosis of T2D is followed by a change in PA, whether these changes are sustained, and the sociodemographic characteristics associated with these changes. RESEARCH DESIGN AND METHODS: We examined associations between T2D diagnosis and PA changes among 2,394 adults ages 51+ from the Health and Retirement Study (2004-2014). PA changes were measured using metabolic equivalents of task (METs) estimated values accounting for the vigor and frequency of self-reported PA. Using piecewise mixed models, we examined initial and sustained changes in METs over time and tested whether these changes were modified by race/ethnicity, educational level, gender, and age at diagnosis. RESULTS: Across participants, a significant postdiagnosis increase was observed in self-reported PA following the diagnostic event (β: 0.54, 95\% CI: 0.10, 0.97). The steepness of decline in PA participation over time did not change significantly following T2D diagnosis. Age at diagnosis and race/ethnicity significantly moderated these relationships: participants diagnosed at older ages were less likely to improve PA following diagnosis and non-Hispanic whites experienced relatively steeper rates of decline following diagnosis with T2D. DISCUSSION AND IMPLICATIONS: Modest diagnosis-related increases in PA were observed among participants overall. The usual rate of decline in PA appears unaffected by diagnosis overall. Age at diagnosis and race/ethnicity moderated these relationships. Key implications for future research and clinical practice are discussed.}, keywords = {Age at diagnosis, Chronic disease self-management, Event-oriented model, Life-course perspective, Piecewise regression, Race/ethnicity}, isbn = {2399-5300}, doi = {10.1093/geroni/igz048}, author = {Emily J Nicklett and Chen, Jieling and Xiang, Xiaoling and Leah R. Abrams and Amanda Sonnega and Kimson E Johnson and Cheng, Jianjia and Shervin Assari} }