@article {11156, title = {Factor structure of the Harmonized Cognitive Assessment Protocol neuropsychological battery in the Health and Retirement Study}, journal = {Neuropsychology}, year = {Forthcoming}, abstract = {Objectives: The Harmonized Cognitive Assessment Protocol (HCAP) describes an assessment battery and a family of population-representative studies measuring neuropsychological performance. We describe the factorial structure of the HCAP battery in the US Health and Retirement Study (HRS).Method: The HCAP battery was compiled from existing measures by a cross-disciplinary and international panel of researchers. The HCAP battery used in the 2016 wave of the HRS. We used factor analysis methods to assess and refine a theoretically-driven single and multiple domain factor structure for tests included in the HCAP battery among 3,347 participants with evaluable performance data. Results: For the eight domains of cognitive functioning identified theoretically (orientation, memory [immediate, delayed, \& recognition], set shifting, attention/speed, language/fluency, andvisuospatial), all single factor models fit reasonably well, although four of these domains had either 2 or 3 indicators where good fit is axiomatic. Multidimensional models suggested the eight-domain model was overly complex. A five-domain model (orientation, memory delayed and recognition, executive functioning, language/fluency, visuospatial) was identified as a reasonable model for summarizing performance in this sample (standardized root mean square residual = 0.05, root mean square error of approximation = 0.05, confirmatory fit index = 0.94). Discussion: The HCAP battery conforms adequately to a multidimensional structure of neuropsychological performance. The derived measurement models can be used as anchors for calibrating cross-national studies of cognitive performance, and to identify persons performing atthe low end as part of an algorithmic classification of probable dementia}, keywords = {Cognitive Ability, Confirmatory Factor Analysis, HCAP, Older Adults}, doi = {10.31234/osf.io/rvmhj}, author = {Richard N Jones and Jennifer J Manly and Kenneth M. Langa and Lindsay H Ryan and Deborah A Levine and Ryan J McCammon and David R Weir} } @article {13526, title = {Harmonization of Later-Life Cognitive Function Across National Contexts: Results from the Harmonized Cognitive Assessment Protocols (HCAPs).}, journal = {medRxiv}, year = {Forthcoming}, abstract = {

BACKGROUND: The Harmonized Cognitive Assessment Protocol (HCAP) is an innovative instrument for cross-national comparisons of later-life cognitive function, yet its suitability across diverse populations is unknown. We aimed to harmonize general and domain-specific cognitive scores from HCAPs across six countries, and evaluate precision and criterion validity of the resulting harmonized scores.

METHODS: We statistically harmonized general and domain-specific cognitive function across the six publicly available HCAP partner studies in the United States, England, India, Mexico, China, and South Africa (N=21,141). We used an item banking approach that leveraged common cognitive test items across studies and tests that were unique to studies, as identified by a multidisciplinary expert panel. We generated harmonized factor scores for general and domain- specific cognitive function using serially estimated graded-response item response theory (IRT) models. We evaluated precision of the factor scores using test information plots and criterion validity using age, gender, and educational attainment.

FINDINGS: IRT models of cognitive function in each country fit well. We compared measurement reliability of the harmonized general cognitive function factor across each cohort using test information plots; marginal reliability was high (r> 0{\textperiodcentered}90) for 93\% of respondents across six countries. In each country, general cognitive function scores were lower with older ages and higher with greater levels of educational attainment.

INTERPRETATION: We statistically harmonized cognitive function measures across six large, population-based studies of cognitive aging in the US, England, India, Mexico, China, and South Africa. Precision of the estimated scores was excellent. This work provides a foundation for international networks of researchers to make stronger inferences and direct comparisons of cross-national associations of risk factors for cognitive outcomes.

FUNDING: National Institute on Aging (R01 AG070953, R01 AG030153, R01 AG051125, U01 AG058499; U24 AG065182; R01AG051158).

}, keywords = {Cognition, Education, harmonization, HCAP}, doi = {10.1101/2023.06.09.23291217}, author = {Gross, Alden L and LI, CHIHUA and Brice{\~n}o, Emily M and Renter{\'\i}a, Miguel Arce and Richard N Jones and Kenneth M. Langa and Jennifer J Manly and Nichols, Emma L and David R Weir and Wong, Rebeca and Berkman, Lisa and Lee, Jinkook and Lindsay C Kobayashi} } @article {12477, title = {A cultural neuropsychological approach to harmonization of cognitive data across culturally and linguistically diverse older adult populations.}, journal = {Neuropsychology}, volume = {37}, year = {2023}, pages = {247-257}, abstract = {

OBJECTIVE: To describe a cultural neuropsychological approach to prestatistical harmonization of cognitive data across the United States (U.S.) and Mexico with the Harmonized Cognitive Assessment Protocol (HCAP).

METHOD: We performed a comprehensive review of the administration, scoring, and coding procedures for each cognitive test item administered across the English and Spanish versions of the HCAP in the Health and Retirement Study (HRS) in the U.S. and the Ancillary Study on Cognitive Aging in Mexico (Mex-Cog). For items that were potentially equivalent across studies, we compared each cognitive test item for linguistic and cultural equivalence and classified items as confident or tentative linking items, based on the degree of confidence in their comparability across cohorts and language groups. We evaluated these classifications using differential item functioning techniques.

RESULTS: We evaluated 132 test items among 21 cognitive instruments in the HCAP across the HRS and Mex-Cog. We identified 72 confident linking items, 46 tentative linking items, and 14 items that were not comparable across cohorts. Measurement invariance analysis revealed that 64\% of the confident linking items and 83\% of the tentative linking items showed statistical evidence of measurement differences across cohorts.

CONCLUSIONS: Prestatistical harmonization of cognitive data, performed by a multidisciplinary and multilingual team including cultural neuropsychologists, can identify differences in cognitive construct measurement across languages and cultures that may not be identified by statistical procedures alone. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

}, keywords = {cognitive data, HCAP, Mex-Cog, neuropsychology}, issn = {1931-1559}, doi = {10.1037/neu0000816}, author = {Brice{\~n}o, Emily M and Arce Renter{\'\i}a, Miguel and Gross, Alden L and Richard N Jones and Gonzalez, Christopher and Wong, Rebeca and David R Weir and Kenneth M. Langa and Jennifer J Manly} } @article {12760, title = {1 in 10 Americans over 65 have dementia, study finds}, year = {2022}, publisher = {CNN}, keywords = {Cognition, Dementia, HCAP}, url = {https://www.cnn.com/2022/10/24/health/dementia-cognitive-decline-wellness/index.html?utm_content=2022-10-24T15\%3A48\%3A07\&utm_term=link\&utm_source=twCNN\&utm_medium=social}, author = {LaMotte, Sandee} } @article {12666, title = {Cross-national harmonization of cognitive measures across HRS HCAP (USA) and LASI-DAD (India).}, journal = {PLoS One}, volume = {17}, year = {2022}, pages = {e0264166}, abstract = {

BACKGROUND: As global populations age, cross-national comparisons of cognitive health and dementia risk are increasingly valuable. It remains unclear, however, whether country-level differences in cognitive function are attributable to population differences or bias due to incommensurate measurement. To demonstrate an effective method for cross-national comparison studies, we aimed to statistically harmonize measures of episodic memory and language function across two population-based cohorts of older adults in the United States (HRS HCAP) and India (LASI-DAD).

METHODS: Data for 3,496 HRS HCAP (>=65 years) and 3,152 LASI-DAD (>=60 years) participants were statistically harmonized for episodic memory and language performance using confirmatory factor analysis (CFA) methods. Episodic memory and language factor variables were investigated for differential item functioning (DIF) and precision.

RESULTS: CFA models estimating episodic memory and language domains based on a priori adjudication of comparable items fit the data well. DIF analyses revealed that four out of ten episodic memory items and five out of twelve language items measured the underlying construct comparably across samples. DIF-modified episodic memory and language factor scores showed comparable patterns of precision across the range of the latent trait for each sample.

CONCLUSIONS: Harmonization of cognitive measures will facilitate future investigation of cross-national differences in cognitive performance and differential effects of risk factors, policies, and treatments, reducing study-level measurement and administrative influences. As international aging studies become more widely available, advanced statistical methods such as those described in this study will become increasingly central to making universal generalizations and drawing valid conclusions about cognitive aging of the global population.

}, keywords = {Cognition, cognitive aging, Episodic, HCAP, India, Language, LASI-DAD, Memory, Neuropsychological tests}, issn = {1932-6203}, doi = {10.1371/journal.pone.0264166}, author = {Vonk, Jet M J and Gross, Alden L and Zammit, Andrea R and Bertola, Laiss and Avila, Justina F and Jutten, Roos J and Gaynor, Leslie S and Suemoto, Claudia K and Lindsay C Kobayashi and O{\textquoteright}Connell, Megan E and Elugbadebo, Olufisayo and Amofa, Priscilla A and Staffaroni, Adam M and Arce Renter{\'\i}a, Miguel and Turney, Indira C and Richard N Jones and Jennifer J Manly and Lee, Jinkook and Zahodne, Laura B} } @article {12222, title = {Crosswalk between the Mini-Mental State Examination and the Telephone Interview for Cognitive Status (TICS-27/30/40).}, journal = {Alzheimer{\textquoteright}s \& Dementia}, year = {2022}, abstract = {

BACKGROUND: We develop a crosswalk between the Mini-Mental State Examination (MMSE) and Telephone Interview for Cognitive Status (TICS)-27, TICS-30, and TICS-40 for adults 65 years and older.

METHODS: We examined the scores of 1809 participants, with and without cognitive impairment, who completed the MMSE and the TICS assessment in the 2016 Health and Retirement Study and the 2016 Harmonized Cognitive Assessment Protocol study. Crosswalks between MMSE and TICS-27/30/40 were developed via equipercentile equating.

RESULTS: We present crosswalks for MMSE and TICS-27/30/40 for the 65+ population representative of the US elderly. While monotonic, the pattern of the TICS-30 to MMSE crosswalk differs from the other two crosswalks (MMSE to TICS-27/40).

CONCLUSION: Our analysis offers an empirical crosswalk between two commonly used cognitive measures-the MMSE and TICS. Our findings suggest the need for validated and robust measures that allow for the comparison of scores on different cognitive scales.

}, keywords = {Alzheimer, crosswalk, Dementia, HCAP, Mini-Mental State Examination, Telephone Interview for Cognitive Status}, issn = {1552-5279}, doi = {10.1002/alz.12569}, author = {Hl{\'a}vka, Jakub P and Yu, Jeffrey C and Darius Lakdawalla} } @article {12498, title = {DNA methylation "GrimAge" acceleration mediates sex/gender differences in verbal memory and processing speed: Findings from the Health and Retirement Study.}, journal = {The Journals of Gerontology, Series A}, year = {2022}, abstract = {

Whether sex/gender differences in rates of biological aging mediate sex/gender differences in cognition in older adults has not been fully examined. The aim of the current study was to investigate this association. Data from up to 1,928 participants (mean age = 75, SD = 7.04, female = 57\%) who took part in the 2016 Harmonized Cognitive Assessment Protocol and Venous Blood Study; sub-studies of the Health and Retirement Study were included in the current study. The residuals from four age-adjusted epigenetic clocks (Horvath, Hannum, PhenoAge, and GrimAge) were used to measure biological age acceleration. Sex/gender differences in cognition were tested using a series of ANCOVAs. Mediation analyses tested whether the measures of age acceleration accounted for these sex/gender differences, controlling for age, education, smoking status, and white blood cell count. Women outperformed men on measures of verbal learning, verbal memory, visual scanning, and processing speed. No other significant sex/gender differences were identified. Results from mediation analyses revealed that women{\textquoteright}s slower rates of GrimAge fully accounted for their faster processing speeds and partially accounted for their better performances on verbal learning, verbal memory, and visual scanning measures. None of the other measures of age acceleration were significant mediators. Accounting for sex/gender differences in biological aging may differentiate between cognitive sex/gender differences that are driven by universal (i.e., age-related) versus sex-specific mechanisms. More broadly, these findings support the growing evidence that the GrimAge clock outperforms other clocks in predicting cognitive outcomes.

}, keywords = {Biological age, Cognition, DNA Methylation, GrimAge, HCAP, sex/gender differences}, issn = {1758-535X}, doi = {10.1093/gerona/glac133}, author = {O{\textquoteright}Shea, Deirdre M and Maynard, Taylor and Tremont, Geoffrey} } @article {10.1001/jamaneurol.2022.3543, title = {Estimating the Prevalence of Dementia and Mild Cognitive Impairment in the US: The 2016 Health and Retirement Study Harmonized Cognitive Assessment Protocol Project}, journal = {JAMA Neurology}, volume = {79}, year = {2022}, pages = {1242-1249}, abstract = {Nationally representative data are critical for understanding the causes, costs, and outcomes associated with dementia and mild cognitive impairment (MCI) in the US and can inform policies aimed at reducing the impact of these conditions on patients, families, and public programs. The nationally representative Health and Retirement Study (HRS) is an essential resource for such data, but the HRS substudy providing dementia diagnostic information was fielded more than 20 years ago and more recent data are needed.The Harmonized Cognitive Assessment Protocol (HCAP) was developed to update national estimates of the prevalence of MCI and dementia in the US and examine differences by age, race, ethnicity, and sex.HRS is an ongoing longitudinal nationally representative study of people 51 years and older with staggered entry dates from 1992 to 2022 and follow-up ranging from 4 to 30 years. HCAP is a cross-sectional random sample of individuals in HRS who were 65 years or older in 2016. Of 9972 age-eligible HRS participants, 4425 were randomly selected for HCAP, and 3496 completed a comprehensive neuropsychological test battery and informant interview, none of whom were excluded. Dementia and MCI were classified using an algorithm based on standard diagnostic criteria and comparing test performance to a robust normative sample.Groups were stratified by age, sex, education, race, and ethnicity.National prevalence estimates using population weights.The mean (SD) age of the study population sample (N = 3496) was 76.4 (7.6) years, and 2095 participants (60\%) were female. There were 551 participants who self-identified as Black and not Hispanic (16\%), 382 who self-identified as Hispanic regardless of race (16\%), 2483 who self-identified as White and not Hispanic (71\%), and 80 who self-identified as another race (2\%), including American Indian or Alaska Native, Asian, Native Hawaiian or Pacific Islander, or another self-described race. A total of 393 individuals (10\%; 95\% CI, 9-11) were classified as having dementia and 804 (22\%; 95\% CI, 20-24) as having MCI. Every 5-year increase in age was associated with higher risk of dementia (weighted odds ratio [OR], 1.95 per 5-year age difference; 95\%, CI, 1.77-2.14) and MCI (OR, 1.17 per 5-year age difference, 95\% CI, 1.09-1.26). Each additional year of education was associated with a decrease in risk of dementia (OR, 0.93 per year of school, 95\% CI, 0.89-0.97) and MCI (OR, 0.94, 95\% CI, 0.91-0.97). Dementia was more common among non-Hispanic Black individuals (OR, 1.81; 95\% CI, 1.20-2.75) and MCI in Hispanic individuals (OR, 1.42; 95\% CI, 1.03-1.96) compared with non-Hispanic White individuals. Other group comparisons by race and ethnicity were not possible owing to small numbers. No differences in prevalence were found between female individuals and male individuals.Using a comprehensive neuropsychological test battery and large sample, the national prevalence of dementia and MCI in 2016 found in this cross-sectional study was similar to that of other US-based studies, indicating a disproportionate burden of dementia and MCI among older Black and Hispanic adults and those with lower education.}, keywords = {Dementia, HCAP, mild cognitive impairment}, issn = {2168-6149}, doi = {10.1001/jamaneurol.2022.3543}, author = {Jennifer J Manly and Richard N Jones and Kenneth M. Langa and Ryan, Lindsay H. and Levine, Deborah A. and McCammon, Ryan and Heeringa, Steven G. and David R Weir} } @article {12299, title = {Future Directions for the HRS Harmonized Cognitive Assessment Protocol.}, journal = {Forum for Health Economics and Policy}, year = {2022}, abstract = {

In the absence of effective pharmacological treatment to halt or reverse the course of Alzheimer{\textquoteright}s disease and related dementias (ADRDs), population-level research on the modifiable determinants of dementia risk and outcomes for those living with ADRD is critical. The Harmonized Cognitive Assessment Protocol (HCAP), fielded in 2016 as part of the U.S. Health and Retirement Study (HRS) and multiple international counterparts, has the potential to play an important role in such efforts. The stated goals of the HCAP are to improve our ability to understand the determinants, prevalence, costs, and consequences of cognitive impairment and dementia in the U.S. and to support cross-national comparisons. The first wave of the HCAP demonstrated the feasibility and value of the more detailed cognitive assessments in the HCAP compared to the brief cognitive assessments in the core HRS interviews. To achieve its full potential, we provide eight recommendations for improving future iterations of the HCAP. Our highest priority recommendation is to increase the representation of historically marginalized racial/ethnic groups disproportionately affected by ADRDs. Additional recommendations relate to the timing of the HCAP assessments; clinical and biomarker validation data, including to improve cross-national comparisons; dropping lower performing items; enhanced documentation; and the addition of measures related to caregiver impact. We believe that the capacity of the HCAP to achieve its stated goals will be greatly enhanced by considering these changes and additions.

}, keywords = {Alzheimer, Dementia, HCAP, Measurement}, issn = {1558-9544}, doi = {10.1515/fhep-2021-0064}, author = {Torres, Jacqueline M and M. Maria Glymour} } @article {12665, title = {Linear linking for related traits (LLRT): A novel method for the harmonization of cognitive domains with no or few common items.}, journal = {Methods}, volume = {204}, year = {2022}, pages = {179-188}, abstract = {

Harmonization means to make data comparable. Recent efforts to generate comparable data on cognitive performance of older adults from many different countries around the world have presented challenges for direct comparison. Neuropsychological instruments vary in many respects, including language, administration techniques and cultural differences, which all present important obstacles to assumptions regarding the presence of linking items. Item response theory (IRT) methods have been previously used to harmonize cross-national data on cognition, but these methods rely on linking items to establish the shared metric. We introduce an alternative approach for linking cognitive performance across two (or more) groups when the fielded assessments contain no items that can be reasonably considered linking items: Linear Linking for Related Traits (LLRT). We demonstrate this methodological approach in a sample from a single United States study split by educational attainment, and in two sets of cross-national comparisons (United States to England, and United States to India). All data were collected as part of the Harmonized Cognitive Assessment Protocol (HCAP) and are publicly available. Our method relies upon strong assumptions, and we offer suggestions for how the method can be extended to relax those assumptions in future work.

}, keywords = {Cognition, HCAP, Research Design}, issn = {1095-9130}, doi = {10.1016/j.ymeth.2021.11.011}, author = {Nichols, Emma L and Cadar, Dorina and Lee, Jinkook and Richard N Jones and Gross, Alden L} } @article {12798, title = {One in 10 older Americans has dementia}, year = {2022}, publisher = {Michigan News, University of Michigan}, keywords = {Dementia, HCAP}, url = {https://news.umich.edu/one-in-10-older-americans-has-dementia/}, author = {Sherburne, Morgan} } @article {11497, title = {Racial and ethnic differences in cognitive health appraisals: a comparison of non-Hispanic White, non-Hispanic Black, and Hispanic older adults.}, journal = {Aging \& Mental Health}, volume = {26}, year = {2022}, pages = {519-525}, abstract = {

OBJECTIVES: To investigate the relationship between cognitive performance and cognitive health appraisals across non-Hispanic White, non-Hispanic Black, and Hispanic older adults in the United States and to explore within-group variations by examining interactions between cognitive performance and background and health variables.

METHOD: The sample ( = 3,099) included 2,260 non-Hispanic White, 498 non-Hispanic Black, and 341 Hispanic adults aged 65 or older, from the 2016-2017 Harmonized Cognitive Assessment Protocol. Regression models of cognitive health appraisals, indicated by self-rated cognitive health, were examined in the entire sample and in racial and ethnic subgroups to test direct and interactive effects of cognitive performance, indicated by the Mini-Mental State Examination (MMSE).

RESULTS: The regression model for the entire sample showed direct effects of cognitive performance and race/ethnicity on cognitive health appraisals, as well as a significant interaction between cognitive performance and being non-Hispanic Black. Cognitive performance and cognitive health appraisals were positively associated in non-Hispanic Whites but not significantly associated in non-Hispanic Blacks. Our subsequent analysis within each racial/ethnic group showed that the effect of cognitive performance in non-Hispanic Blacks and Hispanics became either reversed or nonsignificant when background and health variables were considered. Modification by age or chronic medical conditions in each racial and ethnic group was also observed.

CONCLUSION: Overall, these findings suggest that perceptions and appraisals of cognitive health vary by race and ethnicity and hold implications for how these differences should be considered in research and practice with diverse groups of older adults.

}, keywords = {cognitive aging, HCAP, Hispanics; depressive symptoms, non-Hispanic Blacks, older racial/ethnic minorities, self-rated cognitive health}, issn = {1364-6915}, doi = {10.1080/13607863.2021.1899132}, author = {Yuri Jang and Choi, E Y and Franco, Y and Park, N S and Chiriboga, D A and Kim, M T} } @article {12797, title = {Study estimates the burden of dementia among older adults in the U.S.}, year = {2022}, publisher = {News-Medical.Net}, keywords = {cognitive impairment, Dementia, HCAP}, url = {https://www.news-medical.net/news/20221024/Study-estimates-the-burden-of-dementia-among-older-adults-in-the-US.aspx}, author = {Henderson, Emily} } @article {12199, title = {Future Directions for the HRS Harmonized Cognitive Assessment Protocol}, year = {2021}, publisher = {National Institute on Aging}, address = {Bethesda, MD}, abstract = {In the absence of effective pharmacological treatment to halt or reverse the course of Alzheimer{\textquoteright}s disease and related dementias (ADRDs), population-level research on the modifiable determinants of dementia risk and outcomes for those living with ADRD is critical. The Harmonized Cognitive Assessment Protocol (HCAP), fielded in 2016 as part of the U.S. Health and Retirement Study (HRS) and multiple international counterparts, has the potential to play an important role in such efforts. The stated goals of the HCAP are to improve both our ability to understand the determinants, prevalence, costs, and consequences of cognitive impairment and dementia in the U.S. and to support cross-national comparisons. The first wave of HCAP demonstrated feasibility and value of the more detailed cognitive assessments. To achieve its full potential, we recommend that the HCAP: 1) increase the representation of racial/ethnic minority participants disproportionately affected by ADRDs, 2) administer the HCAP repeatedly and with greater frequency to facilitate longitudinal analyses, cross-national harmonization, and precise characterization of practice and period effects, 3) field a clinical dementia assessment for at least a subset of HCAP participants, 4) phase-in a baseline assessment for people under age 60 in order to facilitate research on the earlier stages of cognitive impairment and midlife dementia prevention, 5) consider dropping lower performing items from the HCAP to increase feasibility of scaling the assessment to more participants at more frequent intervals, 6) enhance the documentation, multi-lingual options, training activities, and randomized sub-studies of language effects or other tools to promote the use of the HCAP and cross-national comparisons, 7) incorporate blood-based AD biomarkers, and 8) improve the capacity of the HCAP to understand the consequences of dementia, including for caregivers and for policy-relevant outcomes such as use of home and community-based services. We believe that the capacity of the HCAP to achieve its stated goals will be greatly enhanced by considering these changes and additions.}, keywords = {Alzheimer, Dementia, HCAP}, author = {Torres, W. Jackeline and M. Maria Glymour} } @article {10999, title = {Subjective age and informant-rated cognition and function: A prospective study.}, journal = {Psychology and Aging}, volume = {36}, year = {2021}, pages = {338-343}, abstract = {

The present study examined whether subjective age is related to informant-rated cognition. Participants were adults ( = 2,337, mean age = 69.84 years, = 7.45) from the Health and Retirement Study who provided subjective age and demographic factors in 2008/2010 and informant-rated cognition in 2016 as part of the Harmonized Cognitive Assessment Protocol. An older subjective age was associated with informant reports of steeper cognitive decline, worse cognitive function, lower ability, and loss of ability to do everyday activities. The present study indicates that subjective age predicts cognitive function in everyday life as observed by knowledgeable informants. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

}, keywords = {Cognition, HCAP, Subjective age}, issn = {1939-1498}, doi = {10.1037/pag0000566}, author = {Yannick Stephan and Angelina R Sutin and Martina Luchetti and Antonio Terracciano} } @article {11640, title = {Subjective age, depressive symptoms, and cognitive functioning across five domains.}, journal = {Journal of Clinical and Experimental Neuropsychology}, volume = {43}, year = {2021}, pages = {310-323}, abstract = {

: Younger subjective age predicts better episodic memory and executive functioning performance independent of chronological age. This study examined whether subjective age is associated with performance in five cognitive domains, quantified the extent to which these relationships are mediated by depressive symptoms, and tested whether these associations are moderated by chronological age. Participants in this cross-sectional study included 993 adults aged 65 and older from the Health and Retirement Study{\textquoteright}s 2016 Harmonized Cognitive Assessment Protocol. Moderated mediation models estimated direct and indirect effects of subjective age on factor scores representing episodic memory, executive functioning, language, visuoconstruction, and speed through depressive symptoms and tested whether associations differed according to chronological age. Depressive symptoms explained 21-32\% of the associations between subjective age and language, speed, episodic memory, and executive functioning. Chronological age moderated the indirect effect involving language, such that depressive symptoms were more strongly related to worse language performance at older chronological ages. After accounting for indirect effects, direct effects of younger subjective age remained for language and speed domains. This study extends research on the cognitive correlates of subjective age and demonstrates that depressive symptoms partly mediate these relationships. Subjective age may bemost strongly associated with language among individuals at older chronological ages not because they are more sensitive to the negative mental health impact of feeling older than they are but because they may be particularly vulnerable to the negative effects of depressive symptoms on language ability. Additional longitudinal research is needed to determine whether links between subjective age and cognition are causal versus predictive.

}, keywords = {Cognition, cognitive aging, Depressive symptoms, HCAP, Subjective age}, issn = {1744-411X}, doi = {10.1080/13803395.2021.1926436}, author = {Morris, Emily P and Afsara B. Zaheed and Sharifian, Neika and Sol, Ketlyne and A Zarina Kraal and Laura B Zahodne} } @article {11008, title = {Cognitive Function and Cardiometabolic-Inflammatory Risk Factors Among Older Indians and Americans.}, journal = {Journal of the American Geriatrics Society}, volume = {68 }, year = {2020}, pages = {S36-S44}, abstract = {

OBJECTIVES: To investigate how cardiometabolic-inflammatory risk factors are related to cognition among older adults in India and the United States.

DESIGN: The Longitudinal Aging Study in India-Diagnostic Assessment of Dementia (LASI-DAD) and the Harmonized Cognitive Assessment Protocol of the Health and Retirement Study (HRS-HCAP) in the United States conducted an in-depth assessment of cognition, using protocols designed for international comparison.

SETTING: Cognitive tests were conducted in hospital or household settings in India and in household settings in the United States.

PARTICIPANTS: Respondents aged 60 years and older from LASI-DAD (N = 1,865) and respondents aged 65 years and older from HRS-HCAP (N = 2,111) who provided venous blood specimen.

MEASUREMENTS: We used total composite scores from the common cognitive tests administered. Cardiovascular risk was indicated by systolic and diastolic blood pressure, pulse rate, pro-B-type natriuretic peptide (proBNP), and homocysteine. Metabolic risk was measured by body mass index, glycosylated hemoglobin (HbA1c), high-density lipoprotein cholesterol, and lipoprotein (a) (only in India). Inflammatory risk was indicted by white blood cell count, C-reactive protein, albumin, and uric acid (only in India).

RESULTS: The distribution of both total cognition scores and of cardiometabolic risk factors differed significantly between India and the United States. In both countries, lower cognition was associated with older age, lower education, elevated homocysteine, elevated proBNP, and lower albumin levels. The associations between HbA1c levels and cognitive measures were statistically significant in both countries, but in the opposite direction, with a coefficient of 1.5 (P < .001) in India and -2.4 (P < .001) in the United States for one percentage increase in absolute HbA1c value.

CONCLUSION: Cardiometabolic-inflammatory biomarkers are associated with cognitive functional levels in each country, but the relationships may vary across countries. J Am Geriatr Soc 68:S36-S44, 2020.

}, keywords = {cardiometabolic risk, Cognition, HCAP, LASI-DAD}, issn = {1532-5415}, doi = {10.1111/jgs.16734}, author = {Hu, Peifeng and Jinkook Lee and Beaumaster, Sidney and Jung K Kim and Dey, Sharmistha and David R Weir and Eileen M. Crimmins} } @article {10970, title = {Everyday discrimination and subsequent cognitive abilities across five domains.}, journal = {Neuropsychology}, year = {2020}, abstract = {

OBJECTIVE: Previous research suggests that everyday discrimination is associated with worse concomitant performance in several cognitive domains, as well as faster subsequent declines in episodic memory. This study aimed to extend knowledge on the specificity, durability, and mechanisms of associations between everyday discrimination and cognition by using a comprehensive neuropsychological battery and a longitudinal mediation design.

METHOD: Participants included 3,304 older adults in the Health and Retirement Study Harmonized Cognitive Assessment Protocol. Discrimination was assessed using the Everyday Discrimination Scale. Depressive symptoms were assessed with the 8-item Center for Epidemiological Studies Depression Scale. Vascular diseases were quantified as the self-reported presence of hypertension, diabetes, and heart disease. Confirmatory factor analysis was used to estimate episodic memory, executive functioning, processing speed, language, and visuoconstruction across a battery of 13 neuropsychological tests. Structural equation models controlled for sociodemographics and baseline cognition ascertained 2 to 4 years prior.

RESULTS: Discrimination was associated with more depressive symptoms and vascular diseases. Depressive symptoms mediated negative effects of discrimination on subsequent functioning across all 5 cognitive domains. Vascular diseases additionally mediated negative effects of discrimination on processing speed. After accounting for mediators, direct negative effects of discrimination remained for executive functioning and visuoconstruction.

CONCLUSIONS: This national longitudinal study in the United States provides evidence for broad and enduring effects of everyday discrimination on cognitive aging, which appear to be partially mediated by mental and physical health. Future research should examine additional mechanisms as well as moderators of these associations to better understand points of intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

}, keywords = {Depressive symptoms, Discrimination, HCAP, vascular diseases}, issn = {1931-1559}, doi = {10.1037/neu0000693}, author = {Laura B Zahodne and Morris, Emily P and Sharifian, Neika and Afsara B. Zaheed and A Zarina Kraal and Sol, Ketlyne} } @article {10930, title = {Race/Ethnic Differences in Social Resources as Cognitive Risk and Protective Factors}, journal = {Research in Human Development}, volume = {17}, year = {2020}, pages = {57-77}, abstract = {Overall social network size, often the sum of common lifetime relationships, including children, family, and friends, has been linked to cognitive impairment and Alzheimer?s Disease. However, little research has examined the association between network size composition and cognitive function in middle-aged and older adults in the context of race/ethnicity. We investigated the associations between the number of close children, family, and friends independently with executive function (EF) and memory across a subsample of non-Hispanic Black, Hispanic, and non-Hispanic White participants who completed the Health and Retirement Study Harmonized Cognitive Assessment Protocol (N = 2,395). We found that network size composition was more closely linked to EF than memory and that these associations varied by race/ethnicity. Specifically, the strongest associations existed between EF and quadratic estimates of the number of close children of non-Hispanic Black participants, and number of close family members for Hispanic participants. Among Black participants, a curvilinear relationship indicated that two close children were associated with greater EF, while a smaller or larger number of close children were associated with lower EF. On the other hand, among Hispanic participants, higher EF was associated with fewer (0?1) and greater (4-5+) numbers of family member contacts. Overall, these results indicate that examining children, family, and friends independently may be more useful than the common practice of aggregation of overall network size, especially in the context of race/ethnicity.}, keywords = {Cognition, HCAP, Race/ethnicity, social network}, isbn = {1542-7609}, doi = {10.1080/15427609.2020.1743809}, author = {Katz, Benjamin and Turney, Indira and Ji Hyun Lee and Amini, Reza and Kristine J. Ajrouch and Toni C Antonucci} } @article {9400, title = {House Foreign Affairs Subcommittee on Africa, Global Health, Global Human Rights and International Organizations Hearing}, journal = {House Foreign Affairs Subcommittee on Africa, Global Health, Global Human Rights and International Organizations}, year = {2017}, publisher = {Federal Information \& News Dispatch, Inc.}, address = {Washington, D.C.}, keywords = {Alzheimer{\textquoteright}s disease, Global Health, Government, HCAP, Testimony}, url = {http://proxy.lib.umich.edu/login?url=https://search.proquest.com/docview/1970242679?accountid=14667} } @article {8517, title = {Cognitive Test Selection for the Harmonized Cognitive Assessment Protocol (HCAP)}, year = {2014}, month = {10/2014}, institution = {Institute for Social Research, University of Michigan}, address = {Ann Arbor, Michigan}, abstract = {The goal of this effort, set by the National Institute on Aging (NIA), is to devise a cognitive assessment that meets the following criteria: 1) Can be administered in the home by a survey interviewer in about one hour, 2) Has sufficient overlap with the 2002/03 HRS-ADAMS study that it can be used to establish trends in prevalence of dementia and cognitive impairment without dementia, and 3) Can be administered comparably and lead to comparably valid diagnoses in other developed and developing countries where HRS-type surveys are conducted. This goal is achievable because of substantial investment by the NIA in data collection in population studies focused on dementia. There is thus now an empirical basis for making test selection. Informant reports are a key element of most population-based approaches to assessment to establish the presence or absence of change in cognitive ability and of limitation in activity resulting from change. We intend to include informant reports in our data collection protocol and in the diagnostic algorithm. This document is focused on cognitive testing of the subject.}, keywords = {Cognitive Ability, HCAP, Meta-analyses, Survey Methodology}, author = {David R Weir and Ryan J McCammon and Lindsay H Ryan and Kenneth M. Langa} }