TY - JOUR T1 - Estimating the Prevalence of Serious Mental Illness and Dementia Diagnoses Among Medicare Beneficiaries in the Health and Retirement Study JF - Research on Aging Y1 - 2018 A1 - Maria T. Brown A1 - Douglas A. Wolf KW - Cognitive Ability KW - Dementia KW - Depressive symptoms KW - Medicare linkage KW - Mental Health AB - Methods: This study utilizes HRS-linked Medicare claims data sets and inverse probability weighting to estimate overall and age-specific cumulative prevalence rates of dementia and serious mental illnesses among 18,740 Medicare beneficiaries. Two-way tabulations determine conditional probabilities of dementia diagnoses among beneficiaries diagnosed with specific mental illnesses, and binary logistic regressions determine conditional probabilities of dementia diagnoses among beneficiaries diagnosed with specific mental illnesses, controlling for covariates. Results: Weighted prevalence estimates for dementia, schizophrenia (SZP), bipolar disorder (BPD), and major depressive disorder (MDD) are similar to previous studies. Odds of dementia diagnosis are significantly greater for beneficiaries diagnosed with SZP, BPD, or MDD. Conclusions: Co-occurring mental disabilities require further investigation, as in the near future increasing numbers of mentally ill older adults will need appropriate and affordable community-based services and supports. VL - 40 UR - http://journals.sagepub.com/doi/10.1177/0164027517728554 IS - 7 JO - Res Aging ER - TY - JOUR T1 - Veteran Status and Men s Later-Life Cognitive Trajectories: Evidence from the Health and Retirement Study JF - Journal of Aging and Health Y1 - 2014 A1 - Maria T. Brown A1 - Janet M Wilmoth A1 - Andrew S London KW - Demographics KW - Event History/Life Cycle KW - Health Conditions and Status AB - Objective: The aim of this study is to determine the extent to which men s later-life cognitive trajectories vary by veteran status. Method: We use Health and Retirement Study (HRS) data to estimate growth curve models examining men s later-life cognitive trajectories by veteran status, war service status, and period of service. Analyses control for early-life characteristics that influence selection into military service and later-life cognition, and mid- to late-life characteristics that potentially mediate the relationship between military service and later-life cognition. Results: Veterans have higher cognition scores relative to nonveterans around retirement age, but their cognition scores decline more rapidly with increasing age, such that cognition scores are similar in both groups among the oldest old. Veterans who served during the Korean War have lower cognition scores around retirement age, but less steep age-related declines, than veterans who served during World War II. Discussion: Findings are discussed in relation to the extant literature, future research, potential service needs, and study limitations. UR - http://jah.sagepub.com/content/early/2014/05/23/0898264314534893.abstract U4 - cognitive trajectories/veterans/life course/Military service ER - TY - JOUR T1 - Early-life characteristics, psychiatric history, and cognition trajectories in later life. JF - Gerontologist Y1 - 2010 A1 - Maria T. Brown KW - Aged KW - Aged, 80 and over KW - Aging KW - Cognition KW - Cognition Disorders KW - Cohort Studies KW - Female KW - Health Status KW - Humans KW - Male KW - Mental Disorders KW - Middle Aged KW - Psychiatric Status Rating Scales KW - Social Environment KW - Socioeconomic factors KW - Time Factors AB -

PURPOSE OF THE STUDY: Although considerable attention has been paid to the relationship between later-life depression and cognitive function, the relationship between a history of psychiatric problems and cognitive function is not very well documented. Few studies of relationships between childhood health, childhood disadvantage, and cognitive function in later life consider both childhood health and disadvantage, include measures for psychiatric history, or use nationally representative longitudinal data.

DESIGN AND METHODS: This study uses growth curve models to analyze the relationships between childhood health and disadvantage, psychiatric history, and cognitive function using 6 waves of the Health and Retirement Study, controlling for demographics, health behavior, and health status.

RESULTS: A history of psychiatric problems is associated with lower cognitive function and steeper declines in cognitive function with age. The influence of childhood health is mediated by later-life health status and behaviors. A combined history of childhood disadvantage and psychiatric problems more strongly affects cognitive function, but cognitive declines remain consistent with those associated with psychiatric history. These effects are partially mediated by later-life demographic, socioeconomic, or health characteristics.

IMPLICATIONS: These findings demonstrate that cumulative disadvantage and a history of psychiatric problems shape later-life cognition and cognitive decline. This evidence can enhance public understanding of the trajectories of cognitive decline experienced by groups living with disadvantage and can enable policy makers and human services providers to better design and implement preventative interventions and support services for affected populations.

PB - 50 VL - 50 IS - 5 N1 - Using Smart Source Parsing pp. Oct Gerontological Society of America, Washington DC U1 - http://www.ncbi.nlm.nih.gov/pubmed/20566836?dopt=Abstract U3 - 20566836 U4 - cognitive Function/Cognitive decline/psychiatric history/Health outcomes/Childhood/Health Behavior/Public Policy/socioeconomic Status/demographics ER - TY - THES T1 - Psychiatric history and cognition trajectories in later life: Variation by sex, race and ethnicity, and childhood disadvantage Y1 - 2010 A1 - Maria T. Brown KW - Adult children KW - Demographics KW - Health Conditions and Status AB - Advocates of the life course perspective suggest that cumulative inequality affects later-life cognitive function, and that a history of psychiatric problems may be detrimental to cognition among individuals at risk of experiencing cumulative disadvantage. Psychiatric conditions are more prevalent among disadvantaged groups, who may also be at risk of experiencing cognitive decline in later life. Therefore, it is important to explore the relationships between sex, race/ethnicity, childhood disadvantage, psychiatric history, and cognitive function. This study addresses the following research questions: (1) Do individuals with a history of psychiatric problems have lower initial cognitive functioning and/or a unique trajectory of cognitive function with age? (2) Does the relationship between psychiatric history and cognitive function in later life change when controlling for ascribed, early-life, and later-life characteristics? (3) Do ascribed characteristics interact with psychiatric history to affect cognitive function in later life? This study applies growth curve models to analyze six waves of Health and Retirement Study data, examining influences on total cognitive function and three components of cognitive function, while controlling for demographic and health variables. The psychiatric history variable includes psychiatric, emotional, and nervous problems. Findings indicate that psychiatric history is related to lower cognition and steeper rates of decline, and that race/ethnicity and childhood disadvantage are also related to cognition. These findings also demonstrate that cumulative disadvantage and psychiatric history shape later-life cognition and decline and can enhance our understanding of trajectories of cognitive decline experienced by disadvantaged groups. PB - Syracuse University CY - Syracuse, NY VL - Ph.D. N1 - ISBN 9781124288253 U4 - socioeconomic Factors JO - Psychiatric history and cognition trajectories in later life: Variation by sex, race and ethnicity, and childhood disadvantage ER -