EMPIRICAL ISSUES IN THE STUDY OF COGNITIVE AGING THROUGH POPULATION-BASED STUDIES

Transcription

1 EMPIRICAL ISSUES IN THE STUDY OF COGNITIVE AGING THROUGH POPULATION-BASED STUDIES Silvia Mejía-Arango* and Brian Downer** *El Colegio de la Frontera Norte, Tijuana, Mexico **University of Texas Medical Branch, Galveston, Texas UNIVERSITY OF SOUTHERN CALIFORNIA / LOS ANGELES, CALIFORNIA / SEPTEMBER 20 22, 2017

2 WORK GROUP REBECA WONG (UTMB) RAFAEL SAMPER (UTMB) MARC GARCIA (UTMB) JOSEPH SAENZ (USC) BRIAN DOWNER (UTMB) SILVIA MEJIA (COLEF) INTERNATIONAL CONFERENCE ON AGING IN THE AMERICAS 2

3 OBJECTIVES Present a conceptual framework for the analysis of cognitive aging in population-based studies. Describe the process of operationalization of the concepts into measurable variables. Show the results when applying the conceptual framework and operationalization process in the Mexican Health and Aging Study. Discuss the importance of missing data in the study of cognitive aging in population-based studies. INTERNATIONAL CONFERENCE ON AGING IN THE AMERICAS 3

4 REFERENCES Albert, M. S., DeKosky, S. T., Dickson, D., Dubois, B., Feldman, H. H., Fox, N. C.,... & Snyder, P. J. (2011). The diagnosis of mild cognitive impairment due to Alzheimer s disease: Recommendations from the National Institute on Aging-Alzheimer s Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & dementia, 7(3), Crimmins, E. M., Kim, J. K., Langa, K. M., & Weir, D. R. (2011). Assessment of cognition using surveys and neuropsychological assessment: the Health and Retirement Study and the Aging, Demographics, and Memory Study. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 66(suppl_1), i162-i171. Liverman, C. T., Yaffe, K., & Blazer, D. G. (Eds.). (2015). Cognitive aging: Progress in understanding and opportunities for action. National Academies Press. McKhann, G. M., Knopman, D. S., Chertkow, H., Hyman, B. T., Jack, C. R., Kawas, C. H.,... & Mohs, R. C. (2011). The diagnosis of dementia due to Alzheimer s disease: Recommendations from the National Institute on Aging-Alzheimer s Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & dementia, 7(3), Mejía-Arango, S., Wong, R., & Michaels-Obregón, A. (2015). Normative and standardized data for cognitive measures in the Mexican Healt Stern, Y. (2012). Cognitive reserve in ageing and Alzheimer's disease. The Lancet Neurology, 11(11), h and Aging Study. salud pública de méxico, 57, s90-s96. UNIVERSITY OF SOUTHERN CALIFORNIA, LOS ANGELES, CALIFORNIA, SEPTEMBER 20 22,

5 PROGRESSION FROM NORMAL AGING TO DEMENTIA NORMAL AGING MILD COGNITIVE IMPAIRMENT COGNITIVE DECLINE No Functional Impairment Interference with the ability to function independently DEMENTIA TIME (YEARS)

6 CONCEPTUAL FRAMEWORK 6

7 Macro-social Context Institutional and Public Policy Context Environmental Context OPERATIONALIZATION PROCESS (MHAS) Subjects: proxy and direct interview Life-course Conditions Neurodegenerative Disease Cognitive Impairment Proxy Cognitive IQCODE Direct Cognitive Performance Direct Activities of Daily Living domains 1 IADL Current Conditions BRAIN AND NEURAL CHANGES DURING AGING Functional Impairment Normal Cognition CIND DEMENTIA YES YES YES NO YES Genetic factors Normal Brain Changes Normal Function NORMAL NO NO NO NO YES Brain and Cognitive Reserve 7

8 PRILIMINARY RESULTS MHAS (2015) UNIVERSITY OF SOUTHERN CALIFORNIA, LOS ANGELES, CALIFORNIA, SEPTEMBER 20 22,

9 Age Education Gender Locality

10 MISSING DATA FOR COGNITIVE TASKS

11 Age, n (%) MISSING DATA BY AGE FOR DIRECT RESPONDENTS AGED 60 AND OLDER IN 2015 (N=9,630) Verbal Learning Verbal Recall Visuospatial Learning Cognitive Task Visuospatial Recall Visual Scan Orientation Verbal Fluency Numeracy Missing (0.8) 18 (0.8) 105 (4.9) 114 (5.3) 106 (5.0) 12 (0.6) 18 (0.8) 69 (3.2) 155 (7.3) (0.7) 26 (1.0) 151 (5.5) 173 (6.4) 152 (5.6) 13 ( (0.7) 104 (3.8) 232 (8.5) (0.9) 20 (1.0) 161 (7.9) 183 (9.0) 161 (7.9) 11 (0.7) 16 (0.8) 128 (6.3) 270 (13.3) (1.1) 18 (1.3) 139 (10.1) 158 (11.4) 144 (10.4) 10 (1.2) 13 (0.9) 107 (7.7) 220 (15.9) (1.7) 21 (2.5) 135 (16.1) 153 (18.3) 144 (17.2) 10 (1.2) 14 (1.7) 103 (12.3) 217 (25.9) (1.4) 9 (2.6) 79 (22.8) 91 (26.2) 82 (23.6) 2 (0.6) 5 (1.4) 46 (13.3) 114 (32.9) (4.0) 7 (4.0) 60 (34.7) 65 (37.6) 64 (37.0) 5 (2.9) 7 (4.0) 31 (17.9) 83 (48.0) Total 96 (1.0) 119 (1.2) 830 (8.6) 937 (9.7) 853 (8.9) 63 (0.7) 93 (1.0) 588 (6.1) 1291 (13.4)

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13 SUMMARY MHAS Cognition Work Group is in the process of publishing the conceptual framework Will provide programing codes and variables for cognitive status available to MHAS data users. 68.9% of participants in 2015 classified as cognitively intact 21.9% of participants classified as CIND. 9.2% of participants classified as dementia. Frequency of CIND and dementia increase according to age, lower education, female gender, and rural communities.

14 RECOMMENDATIONS Missing data for cognitive functioning is a concern in the MHAS Imputation of missing data for direct respondents (ongoing) If possible, avoid restricting analyses to only direct respondents who completed all cognitive tasks Include proxies when evaluating cognitive status