TY - JOUR T1 - Trajectories of self-reported hearing and their associations with cognition: evidence from the United Kingdom and United States of America. JF - Age Ageing Y1 - 2023 A1 - Matthews, Katey A1 - Dawes, Piers A1 - Elliot, Rebecca A1 - Pendleton, Neil A1 - Tampubolon, Gindo A1 - Maharani, Asri KW - Cognition KW - hearing KW - Humans KW - Longitudinal Studies KW - Memory, Episodic KW - Self Report KW - United Kingdom KW - United States AB -

OBJECTIVE: This study aimed to investigate the relationships between trajectories of change in self-reported hearing over eight years with subsequent effects on cognition, measured using episodic memory.

METHODS: Data were drawn from 5 waves (2008-2016) of the English Longitudinal Study of England (ELSA) and the Health and Retirement Study (HRS), involving 4,875 individuals aged 50+ at the baseline in ELSA and 6,365 in HRS. The latent growth curve modelling was used to identify trajectories of hearing over eight years, and linear regression models were performed to investigate the relationship between hearing trajectory memberships and episodic memory scores, controlling for confounding factors.

RESULTS: Five trajectories of hearing (stable very good, stable fair, poor to fair/good, good to fair, and very good to good) were retained in each study. Individuals whose hearing remains suboptimal and those whose hearing deteriorates within suboptimal levels throughout eight years have significantly poorer episodic memory scores at follow-up than those with stable very good hearing. Conversely, individuals whose hearing declines but is within an optimal category at baseline do not see significantly poorer episodic memory scores than those with consistently optimal hearing. There was no significant relationship between individuals whose hearing improved from suboptimal baseline levels to optimal by follow-up and memory in ELSA. However, analysis using HRS data shows a significant improvement for this trajectory group (-1.260, P < 0.001).

CONCLUSIONS: Either stable fair or deterioration in hearing is associated with worse cognitive function, both stable good or improving hearing is associated with better cognitive function specifically episodic memory.

VL - 52 IS - 2 ER - TY - JOUR T1 - Associations between self-reported sensory impairment and risk of cognitive decline and impairment in the Health and Retirement Study (HRS) cohort. JF - Journals of Gerontology, Series B: Psychological Sciences & Social Sciences Y1 - 2020 A1 - Maharani, Asri A1 - Dawes, Piers A1 - James Nazroo A1 - Tampubolon, Gindo A1 - Pendleton, Neil KW - Cognition & Reasoning KW - Hearing loss KW - Risk Factors KW - Self Report AB -

OBJECTIVES: We aimed to determine whether self-assessed single (hearing or visual) and dual sensory (hearing and visual) impairments are associated with cognitive decline and incident possible Cognitive Impairment, No Dementia (CIND) and probable dementia.

METHOD: Data were drawn from the 1996-2014 surveys of the Health and Retirement Study (HRS), involving 19,618 respondents who had no probable dementia and who were aged 50 years or older at the baseline. We used linear mixed models to test the association between self-assessed sensory impairment and cognitive decline followed by a Cox proportional hazard model to estimate the relative risk of incident possible CIND and probable dementia associated with the presence of sensory impairment.

RESULTS: Respondents with self-assessed single and dual sensory impairment performed worse in cognitive tests than those without sensory impairment. The fully adjusted incidence of developing possible CIND was 17% higher for respondents with hearing impairment than those without hearing impairment. Respondents with visual impairment had 35% and 25% higher risk for developing possible CIND and probable dementia, respectively, than those without visual impairment. Respondents with dual sensory impairment at baseline were 38% and 26% more likely to develop possible CIND and probable dementia, respectively, than those with no sensory impairment.

DISCUSSION: Self-assessed sensory impairment is independently associated with cognitive decline and incident possible CIND and probable dementia. Further studies are needed to identify the mechanism underlying this association and to determine whether treatment of sensory impairment could ameliorate cognitive decline and delay the onset of dementia among older adults.

VL - 75 IS - 6 ER - TY - JOUR T1 - Frailty Index associates with GRIN2B in two representative samples from the United States and the United Kingdom. JF - PLoS One Y1 - 2018 A1 - Mekli, Krisztina A1 - Stevens, Adam A1 - Alan Marshall A1 - Thalida E. Arpawong A1 - Drystan F. Phillips A1 - Tampubolon, Gindo A1 - Lee, Jinkook A1 - Carol A Prescott A1 - James Nazroo A1 - Pendleton, Neil KW - ELSA KW - Frailty KW - Gene Ontology KW - Genome-Wide Association Study KW - Phenotype AB -

The concept of frailty has been used in the clinical and research field for more than two decades. It is usually described as a clinical state of heightened vulnerability to poor resolution of homeostasis after a stressor event, which thereby increases the risk of adverse outcomes, including falls, delirium, disability and mortality. Here we report the results of the first genome-wide association scan and comparative gene ontology analyses where we aimed to identify genes and pathways associated with the deficit model of frailty. We used a discovery-replication design with two independent, nationally representative samples of older adults. The square-root transformed Frailty Index (FI) was the outcome variable, and age and sex were included as covariates. We report one hit exceeding genome-wide significance: the rs6765037 A allele was significantly associated with a decrease in the square-root transformed FI score in the Discovery sample (beta = -0.01958, p = 2.14E-08), without confirmation in the Replication sample. We also report a nominal replication: the rs7134291 A allele was significantly associated with a decrease in the square-root transformed FI score (Discovery sample: beta = -0.01021, p = 1.85E-06, Replication sample: beta = -0.005013, p = 0.03433). These hits represent the KBTBD12 and the GRIN2B genes, respectively. Comparative gene ontology analysis identified the pathways 'Neuropathic pain signalling in dorsal horn neurons' and the 'GPCR-Mediated Nutrient Sensing in Enteroendocrine Cells', exceeding the p = 0.01 significance in both samples, although this result does not survive correction for multiple testing. Considering the crucial role of GRIN2B in brain development, synaptic plasticity and cognition, this gene appears to be a potential candidate to play a role in frailty. In conclusion, we conducted genome-wide association scan and pathway analyses and have identified genes and pathways with potential roles in frailty. However, frailty is a complex condition. Therefore, further research is required to confirm our results and more thoroughly identify relevant biological mechanisms.

VL - 13 IS - 11 ER - TY - JOUR T1 - Genome-wide scan of depressive symptomatology in two representative cohorts in the United States and the United Kingdom. JF - Journal of Psychiatric Research Y1 - 2018 A1 - Mekli, Krisztina A1 - Drystan F. Phillips A1 - Thalida E. Arpawong A1 - Vanhoutte, Bram A1 - Tampubolon, Gindo A1 - James Nazroo A1 - Lee, Jinkook A1 - Carol A Prescott A1 - Stevens, Adam A1 - Pendleton, Neil KW - depression KW - ELSA KW - Genome-Wide Association Study AB -

Unlike the diagnosed Major Depressive Disorder, depressive symptomatology in the general population has received less attention in genome-wide association scan (GWAS) studies. Here we report a GWAS study on depressive symptomatology using a discovery-replication design and the following approaches: To improve the robustness of the phenotypic measure, we used longitudinal data and calculated mean scores for at least 3 observations for each individual. To maximize replicability, we used nearly identical genotyping platforms and identically constructed phenotypic measures in both the Discovery and Replication samples. We report one genome-wide significant hit; rs58682566 in the EPG5 gene was associated (p = 3.25E-08) with the mean of the depression symptom in the Discovery sample, without confirmation in the Replication sample. We also report 4 hits exceeding the genome-wide suggestive significance level with nominal replications. Rs11774887, rs4147527 and rs1379328, close to the SAMD12 gene, were associated with the mean depression symptom score (P-values in Discovery sample: 4.58E-06, 7.65E-06 and 7.66E-06; Replication sample: 0.049, 0.029 and 0.030, respectively). Rs13250896, located in an intergenic region, was associated with the mean score of the three somatic items of the depression symptoms score (p = 3.31E-07 and 0.042 for the Discovery and Replication samples). These results were not supported by evidence in the literature. We conclude that despite the strengths of our approach, using robust phenotypic measures and samples that maximize replicability potential, this study does not provide compelling evidence of a single genetic variant's significant role in depressive symptomatology.

VL - 100 ER - TY - JOUR T1 - Longitudinal Relationship Between Hearing Aid Use and Cognitive Function in Older Americans JF - Journal of the American Geriatrics Society Y1 - 2018 A1 - Maharani, Asri A1 - Dawes, Piers A1 - James Nazroo A1 - Tampubolon, Gindo A1 - Pendleton, Neil KW - Cognitive Ability KW - Hearing aids KW - Hearing loss KW - Longitudinal data AB - Objectives: To test whether hearing aid use alters cognitive trajectories in older adults. Design: US population-based longitudinal cohort study Setting: Data were drawn from the Health and Retirement Study (HRS), which measured cognitive performance repeatedly every 2 years over 18 years (1996-2014). Participants: Adults aged 50 and older who who took part in a minimum of 3 waves of the HRS and used hearing aids for the first time between Waves 4 and 11 (N=2,040). Measurements: Cognitive outcomes were based on episodic memory scores determined according to the sum of immediate and delayed recall of 10 words. Results: Hearing aid use was positively associated with episodic memory scores (β=1.53, p<.001). Decline in episodic memory scores was slower after (β=-0.02, p<.001) than before using hearing aids (β=-0.1, p<.001). These results were robust to adjustment for multiple confounders and to attrition, as accounted for using a joint model. Conclusions: Hearing aids may have a mitigating effect on trajectories of cognitive decline in later life. Providing hearing aids or other rehabilitative services for hearing impairment much earlier in the course of hearing impairment may stem the worldwide rise of dementia. VL - 66 UR - http://doi.wiley.com/10.1111/jgs.15363http://onlinelibrary.wiley.com/wol1/doi/10.1111/jgs.15363/fullpdfhttps://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fjgs.15363 IS - 6 JO - J Am Geriatr Soc ER - TY - JOUR T1 - Trajectories of allostatic load among older Americans and Britons: Longitudinal cohort studies. JF - BMC Geriatrics Y1 - 2018 A1 - Tampubolon, Gindo A1 - Maharani, Asri KW - Cross-National KW - Depressive symptoms KW - Gender Differences AB -

BACKGROUND: Difference in life expectancy between males and females has been suggested to rest on sex difference in physiological dysregulation. But allostatic load, a physiological index, has not been carefully examined for an extended period beyond middle age. We aim to draw longitudinal trajectories of allostatic load in a national sample of older Americans and Britons; also to examine sex-based trajectories and factors behind their differences.

METHODS: We studied men and women aged ≥50 years participating in the Health and Retirement Study Waves 8-11, 2006-2012 (N = 15,583 person-years) and the English Longitudinal Study of Ageing Waves 2, 4 and 6, 2004-2012 (N = 14,765 person-years). Because of the difference in provenance, we included different number of biomarkers to calculate allostatic load in HRS and ELSA. In HRS we used 8 biomarkers (systolic and diastolic blood pressure, haemoglobin A1c, high-density lipoprotein, total cholesterol, waist circumference, cystatin C, and C-reactive protein), while ELSA allostatic load was constructed from 10 biomarkers (systolic and diastolic blood pressure, haemoglobin A1c, high-density lipoprotein, total cholesterol, waist circumference, BMI, triglyceride, fibrinogen and C-reactive protein). A growth curve model was fitted to repeated observations of allostatic load, demographic characteristics, socioeconomic position, comorbidities and health behaviours (smoking, drinking, and physical exercise). To account for attrition, a joint model was applied.

RESULTS: The analysis showed that allostatic load increases linearly with age in the U.S. However, there are different levels for males and females. In England allostatic load follows such different paths that their trajectories cross in later life.

CONCLUSIONS: Sex-based trajectories of allostatic load showed distinct female advantage and are mostly consistent with female advantage in life expectancy.

VL - 18 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/30352552?dopt=Abstract ER - TY - JOUR T1 - Visual and hearing impairments are associated with cognitive decline in older people. JF - Age and Ageing Y1 - 2018 A1 - Maharani, Asri A1 - Dawes, Piers A1 - James Nazroo A1 - Tampubolon, Gindo A1 - Pendleton, Neil KW - Cognitive Ability KW - Cross-National KW - GWAS KW - Hearing loss KW - Visual function AB -

Introduction: highly prevalagent hearing and vision sensory impairments among older people may contribute to the risk of cognitive decline and pathological impairments including dementia. This study aims to determine whether single and dual sensory impairment (hearing and/or vision) are independently associated with cognitive decline among older adults and to describe cognitive trajectories according to their impairment pattern.

Material and methods: we used data from totals of 13,123, 11,417 and 21,265 respondents aged 50+ at baseline from the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA) and the Survey of Health, Ageing and Retirement in Europe (SHARE), respectively. We performed growth curve analysis to identify cognitive trajectories, and a joint model was used to deal with attrition problems in longitudinal ageing surveys.

Results: respondents with a single sensory impairment had lower episodic memory score than those without sensory impairment in HRS (β = -0.15, P < 0.001), ELSA (β= -0.14, P< 0.001) and SHARE (β= -0.26, P < 0.001). The analysis further shows that older adults with dual sensory impairment in HRS (β= -0.25, P < 0.001), ELSA (β= -0.35, P< 0.001) and SHARE (β= -0.68, P < 0.001) remembered fewer words compared with those with no sensory impairment. The stronger associations between sensory impairment and lower episodic memory levels were found in the joint model which accounted for attrition.

Conclusions: hearing and/or vision impairments are a marker for the risk of cognitive decline that could inform preventative interventions to maximise cognitive health and longevity. Further studies are needed to investigate how sensory markers could inform strategies to improve cognitive ageing.

VL - 47 IS - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/29697748?dopt=Abstract ER - TY - JOUR T1 - When did old age stop being depressing? Depression trajectories of older Americans and Britons 2002–2012 JF - The American Journal of Geriatric Psychiatry Y1 - 2017 A1 - Tampubolon, Gindo A1 - Maharani, Asri KW - Cross-National KW - Depressive symptoms AB - Objective: This study aims to investigate the implications of the heterogeneous cohort composition on depression trajectories of older adults in the United States and England. Methods: Using growth curve models to identify depressive symptom trajectories and data spanning six waves over 10 years (2002-2012) from the U.S. Health Retirement Study and the English Longitudinal Study of Ageing, community-dwelling Americans and Britons aged 50 years and older were studied. Depressive symptoms were measured using the eight-item Center for Epidemiologic Studies Depression Scale. Results: The sample included 11,919 respondents (7,095 women [59.53%]) in the United States and 10,606 respondents (5,802 women [54.7%]) in England aged 50 and older. Older cohorts were shown to have higher depressive symptoms than younger cohorts in the United States and England. The trajectories of depression of older cohorts, particularly those of the prewar cohorts in both countries and the war cohort in England, followed a U-shape. Conversely, the trajectories of depression of the younger cohort, particularly those of the postwar cohorts in both countries and the war cohort in the United States, took an inverted U-shape. Conclusion: The trajectories of depression in later life between cohorts took different shapes. This finding may lead to the development of more cost-effective policies for treating depression in later life. VL - 25 UR - http://linkinghub.elsevier.com/retrieve/pii/S1064748117303500http://api.elsevier.com/content/article/PII:S1064748117303500?httpAccept=text/xmlhttp://api.elsevier.com/content/article/PII:S1064748117303500?httpAccept=text/plain IS - 11 JO - The American Journal of Geriatric Psychiatry ER -