Matching Items (2)
Description
Identifying modifiable causes of chronic disease is essential to prepare for the needs of an aging population. Cognitive decline is a precursor to the development of Alzheimer's and other dementing diseases, representing some of the most prevalent and least understood sources of morbidity and mortality associated with aging. To contribute to the literature on cognitive aging, this work focuses on the role of vascular and physical health in the development of cognitive trajectories while accounting for the socioeconomic context where health disparities are developed. The Assets and Health Dynamics among the Oldest-Old study provided a nationally-representative sample of non-institutionalized adults age 65 and over in 1998, with biennial follow-up continuing until 2008. Latent growth models with adjustment for non-random missing data were used to assess vascular, physical, and social predictors of cognitive change. A core aim of this project was examining socioeconomic and racial/ethnic variation in vascular predictors of cognitive trajectories. Results indicated that diabetes and heart problems were directly related to an increased rate of memory decline in whites, where these risk factors were only associated with baseline word-recall for blacks when conditioned on gender and household assets. These results support the vascular hypotheses of cognitive aging and attest to the significance of socioeconomic and racial/ethnic variation in vascular influences on cognitive health. The second substantive portion of this dissertation used parallel process latent growth models to examine the co-development of cognitive and functional health. Initial word-recall scores were consistently associated with later functional limitations, but baseline functional limitations were not consistently associated with later word-recall scores. Gender and household income moderated this relationship, and indicators of lifecourse SES were better equipped to explain variation in initial cognitive and functional status than change in these measures over time. Overall, this work suggests that research examining associations between cognitive decline, chronic disease, and disability must account for the social context where individuals and their health develop. Also, these findings advocate that reducing socioeconomic and racial/ethnic disparities in cognitive health among the aging requires interventions early in the lifecourse, as disparities in cognitive trajectories were solidified prior to late old age.
ContributorsBishop, Nicholas Joseph (Author) / Kronenfeld, Jennie J. (Thesis advisor) / Haas, Steven A. (Committee member) / Eggum, Natalie D. (Committee member) / Arizona State University (Publisher)
Created2011
Description
The beginning of the large Baby Boomer cohort's retirement, coupled with the increased divorce rate among older adults, means that there will be more single older adults than ever before beginning to consider living arrangements and long-term care needs as they age. Using a cumulative (dis)advantage framework and logistic regression, this research examines whether marital disruption and social support at Wave 1 increase the odds of having a specific chronic disease at Wave 2, diabetes, heart failure, and hypertension. The sample consists of 2,261 adults age 57-85 who participated in the first two waves of the National Social Life, Health, and Aging Project (NSHAP). Being female and having more positive social support reduced the odds of having diabetes at Wave 2. Being older at Wave 1 increased the odds of having congestive heart failure at Wave 2. Being black and having a happy family life in childhood increased the odds of having hypertension at Wave 2. Suggestions for increasing positive social support are discussed, along with implications for long-term care and health education.
ContributorsPalmer, Doris, Ph.D (Author) / Kronenfeld, Jennie J. (Thesis advisor) / Hayford, Sarah (Committee member) / Ayers, Stephanie (Committee member) / Arizona State University (Publisher)
Created2016