Neuropsychology and cognitive health in healthy older adults: a brief overview for psychiatric nurses

This article contains a brief synopsis on nonpathological aspects of the neuropsychology of aging and cognitive health. In nonpathological aging, normal subtle decline occurs in a number of cognitive domains such as executive functioning, speed of processing, memory, language, and psychomotor ability; however, some domains of cognitive functioning appear to increase with age, such as vocabulary and crystallized intelligence. In the neuropsychology and the cognitive aging literatures, several hypotheses for such age-related declines are proposed, including the diminished speed-of-processing hypothesis, the common cause hypothesis, and the frontal aging hypothesis. As these age-related changes diminish cognitive reserve, the decline in the related cognitive domains emerges. Ways to protect and improve cognitive health are suggested to encourage positive neuroplasticity and discourage negative neuroplasticity. Implications for nursing practice are provided.     

Predictors of falling in older Maryland drivers: a structural-equation model

Falls can impair health and reduce quality of life among older adults. Although many factors are related to falling, few analyses examine causal models of this behavior. In this study, factors associated with falling were explored simultaneously using structural-equation modeling. A variety of cognitive, physical-performance, and health measures were administered to 694 older adult drivers from the state of Maryland. The observed and latent variables of age, cognitive ability, physical functioning, health, and falling behavior were used to create a causal model. The model revealed that being older was associated with declines in cognition, and such cognitive declines predicted increased falling. Similarly, poorer health was related to poorer physical functioning, which, in turn, also predicted increased falling. This model indicates that in addition to existing fall-prevention interventions aimed at improving physical functioning, interventions to improve cognition and health might also be effective. It is speculated that fear of falling, which often results in reduced mobility among older adults, might account for the lack of a direct relationship between age and falling. This hypothesis should be examined in further research.     

Parental Depression in the Context of Divorce and the Impact on Children

The impact of divorce on children has been well documented over the past 30 years. Divorcing parents who are also experiencing clinical depression often have a compromised ability to parent well and to give the children needed support. Children are then impacted both by the divorce itself and the effects of parental depression. They are at higher risk of numerous problems including poorer physical health, deficits in academic performance not attributable to intellectual limitations, poor social functioning, conduct disorder and other disruptive behavior problems, phobias, and other anxiety disorders. Because children of depressed parents are at higher risk for depression themselves, they should be monitored for depressive symptoms. If there are concerns, the child should be assessed by a mental health professional.     

Gambling Participation and Social Support Among Older Adults: A Longitudinal Community Study

The purpose of this preliminary study was to examine associations between leaving home to engage in bingo or gambling activity and indices of physical and mental health and social support among a representative community cohort of 1016 elderly people. Cross-sectional and longitudinal data gathered from a prospective epidemiological study in a rural, low socio-economic status, area of Pennsylvania was employed. The cohort had a mean age of 78.8 (SD = 5.1) (range 71–97) and participated in three consecutive biennial waves of data collection. Nearly half (47.7) of the cohort reported gambling. To predict gambling, the independent variables included age, sex, education, employment, social support, depressive symptoms, self-rated health, alcohol use, cigarette use, and cognitive functioning. In cross-sectional, univariate analyses, gambling was associated with younger age, sex (male), fewer years of education, greater social support, lower depression scores, better self-rated health, alcohol use in the past year, and higher cognitive functioning. In a cross-sectional multiple regression model, younger age, greater social support, and alcohol use in the past year remain strongly and independently associated with gambling activity. Longitudinally, age, sex, social support, alcohol use, and gambling are predictive of future gambling activity. The results revealed that gambling may offer a forum of social support to older adults who are often isolated as they age.     

The impact of unsupervised regular walking on health: a sample of Turkish middle-aged and older adults

Regular walking is one of the most recommended and popular physical activity worldwide. This study (1) detected the effects of unsupervised regular walking on physical and cognitive functioning, emotional status, and quality of life in middle-aged and older adults and (2) compared the results with inactive controls. Forty middle-aged and older adults with a mean age of 56.30 ± 4.85 years (range 40–70) walking for at least 1 year, at least three times a week, and at least 45 min a day and 40 inactive participants with a mean age of 55.15 ± 5.64 years (range 40–70) participated. Before testing, sociodemographics of the participants were recorded. Body mass index and waist–hip ratio were calculated. The two groups were evaluated and compared in terms of physical functioning (handgrip strength, balance performance, cardio-vascular endurance, flexibility, muscular endurance and coordination), cognitive functioning (Mini Mental Test), emotional status (Beck Depression Inventory), and health related quality of life (CDC HRQOL- 4). The results obtained from this study showed that there were significant differences in terms of all outcome measurements between the groups (p < 0.05). The regular walking group had better scores in most parameters than the inactive controls. The results indicate that unsupervised regular walking improves health and is also a safe, cheap, and can easily be adapted into daily life. Therefore, it can be recommended to improve physical and cognitive functioning, emotional status, and quality of life of middle-aged and older adults.     

Successful aging: how does physical activity influence engagement with life?

With the increasing number of individuals over the age of 65?years worldwide, it is critical for society to recognize the importance of helping seniors maintain their health, physical, and cognitive functioning as well as their engagement with life. These three dimensions provide the foundation for successful aging (SA). The positive role of engagement with life has been understated to date in the literature. This review highlights the components of SA with particular emphasis on engagement and how physical activity positively impacts engagement which in turn positively influences health and physical function.     

GENDER AND THE HEALTH BENEFITS OF EDUCATION

Does education improve health more for one sex than the other? We develop a theory of resource substitution which implies that education improves health more for women than men. Data from a 1995 survey of U.S. adults with follow‐ups in 1998 and 2001 support the hypothesis. Physical impairment decreases more for women than for men as the level of education increases. The gender gap in impairment essentially disappears among people with a college degree. Latent growth SEM vectors also show that among the college educated, men's and women's life course patterns of physical impairment do not differ significantly.     

Aging and inactivity—capitalizing on the protective effect of planned physical activity in old age

The paper discusses two parallel biocultural trends—aging and inactivity. The principle of economy in movement in modern society versus the dependency of human beings on movement for their development and health is described. The results of inactivity are sometimes mistakenly considered irreversible losses caused by aging, but in actual fact, inactivity accelerates the irreversible losses caused by the aging process. The paper then describes the contribution of physical activity in terms of increasing positive aspects or decreasing risks: increasing life expectancy or decreasing risk of mortality, increasing cardiovascular fitness or decreasing risk of cardiovascular disease, increasing muscle mass or decreasing falls and instability, improving cognitive performance or reducing cognitive decline and neurological disorders, and improving well-being or reducing depression. The optimal dose of physical activity is then described, followed by recommendations for further research on mechanisms determining physical activity behavior.     

Medical care, living conditions, and children's well-being

We examine the effect of medical care and living conditions on children's physical and psychological well-being. We develop a causal model in which living conditions (including the socioeconomic status of the family and the social-psychological aspects of family functioning) may affect well-being both directly, and indirectly through medical care. We find that families in the higher social classes and families that function well tend to go to large prepaid groups where they receive good medical care. High quality technical care of illness, in turn, improves physical health. The quality of psychotherapeutic care, on the other hand, has no effect on psychological well-being. For this aspect of health, the effect of living conditions is largely direct, rather than indirect by way of medical care. Families characterized by high levels of functioning have children who are psychologically healthy. In addition, physical health affects psychological well-being, but not vice versa.     

Housing Dissatisfaction and Cognitive Decline in Older Adults

Analysis of a nationally representative, longitudinal survey of community-dwelling Americans older than 50 years of age indicated that rating the physical condition of one's dwelling unit as “poor” predicted significantly more rapid cognitive decline in subsequent years. This relationship persisted after controlling for a variety of factors such as wealth, income, education, health, family status, neighborhood safety, depression, and initial cognitive ability. Dissatisfaction with the physical conditions of one's housing may have a direct effect on the rate of cognitive decline in older adults. Addressing housing inadequacy for older adults may thus produce a wider range of societal benefits than previously realized.     

Cognitive differentiation in consumer product judgments

The investigations reported in this article examined some of the individual and situational determinants of the level of cognitive product differentiation in consumer products judgements, Subjects consisted of four large samples of male and female consumers in two large metropolitan areas in the USA. These four independent studies found empirical support for the following hypothesis: consumers tend to have more differentiated judgments of negatively valenced products than positively valenced products. These findings were discussed in the context of the “vigilance”. “justification” and “Pollyanna” hypotheses. Finally, as a promising direction for future research. the need for an interactionist approach to cognitive functioning was emphasized.     

The influence of the tasks characteristics in physical performance and psychosocial aspects of workers

The work and life conditions have influence on the health and life quality of workers. Physically active persons can demonstrate a life style that are and affect the physical performance, psychosocial aspects and work capacity. The purpose of this study was to investigate the physical activity level and work capacity in different tasks characteristics, one with more physical exertion and other with more cognitive exertion. A total of 193 workers from an institution of higher education and 457 workers from a metallurgical industry participated in the current study. All participants completed the International Physical Activity Questionnaire (IPAQ-short) and Work Ability Index (WAI). The results indicated that both groups were classified as having high level of physical activity while only few of them were considered sedentary (less than 27%). However, the group of metallurgical workers had greater indices (82%) than the workers from higher education institution (74%). Overall, the workers reported their work ability as moderate to excellent, suggesting that overall they are satisfied with their working and health conditions. It can be concluded that even though workers performed tasks with different demands (cognitive versus physical), they demonstrated similar level of physical activity as well as work ability.     

The urban neighborhood and cognitive functioning in late middle age

This study examines the association of cognitive functioning with urban neighborhood socioeconomic disadvantage and racial/ethnic segregation for a U.S. national sample of persons in late middle age, a time in the life course when cognitive deficits begin to emerge. The key hypothesis is that effects of neighborhood on cognitive functioning are not uniform but are most pronounced among subgroups of the population defined by socioeconomic status and race/ethnicity. Data are from the third wave of the Health and Retirement Survey for the birth cohort of 1931 to 1941, which was 55 to 65 years of age in 1996 (analytic N = 4,525), and the 1990 U.S. Census. Neighborhood socioeconomic disadvantage has an especially large negative impact on cognitive functioning among persons who are themselves poor, an instance of compound disadvantage. These findings have policy implications supporting "upstream" interventions to enhance cognitive functioning, especially among those most adversely affected by neighborhood socioeconomic disadvantage.     

Self-rated health and mortality: does the relationship extend to a low income setting?

Although a relationship between poor self-reported health status and excess mortality risk has been well-established for industrialized countries, almost no research considers developing countries. We use data from Indonesia to show that in a low-income setting, as in more advantaged parts of the world, individuals who perceive their health to be poor are significantly more likely to die in subsequent follow-up periods than their counterparts who view their health as good. This result characterizes both men and women, holds for multiple time periods, and remains after inclusion of measures of nutritional status, physical functioning, symptoms of poor physical health and depression, and hypertension. We also consider the correlates of self-rated health. Symptoms and physical functioning are strong predictors of reporting poor rather than good health, but neither these indicators nor other covariates we consider distinguish between reports of excellent rather than good health.     

Physical activity and cognitive-health content in top-circulating magazines, 2006-2008

Physical activity may promote cognitive health in older adults. Popular media play an important role in preventive health communication. This study examined articles discussing associations between physical activity and cognitive health in top-circulating magazines targeting older adults. 42,753 pages of magazines published from 2006 to 2008 were reviewed; 26 articles met inclusion criteria. Explanations regarding the link between physical activity and cognitive health were provided in 57.7% of articles. These explanations were generally consistent with empirical evidence; however, few articles included empirical evidence. Physical activity recommendations were presented in 80.8% of articles; a wide range was recommended (90-300 min of physical activity per wk). Socioeconomic status and education level were not mentioned in the text. Results suggest an opportunity for greater coverage regarding the role of physical activity in promoting cognitive health in popular media. Magazine content would benefit from including more empirical evidence, culturally sensitive content, and physical activity recommendations that are consistent with U.S. guidelines.     

Psychosocial Consequences of Agricultural Transformation: The Farm Crisis and Depression1

Abstract The recent farm financial crisis has resulted in a rapid and dramatic economic decline for many farmers. Although researchers have long observed that economic crisis and vulnerability contribute to social-psychological depression, few studies have examined the links between farm restructuring and the depression process. We address this issue using a sample of 503 Ohio farmers from 1987. We hypothesize 1) that sociodemographic and farm structural characteristics are related to economic vulnerability, 2) that economic vulnerability is related to feelings of economic hardship and perceived stress, and 3) that these, in turn, are related to depression. The findings generally support the hypotheses and help clarify the depression process: beyond economic vulnerability, a negative cognitive appraisal of one's situation and ineffective coping mechanisms are related to more severe depression.     

Masters or pawns? Examining injury and chronic disease in male Masters Athletes and chess players compared to population norms from the Canadian Community Health Survey

Background

Identifying the optimal type and amount of activity for the maintenance of function in older adults has proved challenging. On the one hand, Masters Athletes have been proposed as the ideal model of successful aging but most of this research has focused on physical functioning. On the other hand, the importance of cognitive engagement has been emphasized, which may be more strongly related to activities such as playing chess. The current study aimed to compare physical health outcomes (i.e., prevalence of physical injury and chronic disease) among older athletes and chess players. Masters Athletes and chess players were recruited from track and field and chess competitions within the province of Ontario. In addition to these primary groups, moderately active and inactive older adults from Canadian Community Health Survey were also included for comparison.

Results

Masters Athletes had significantly higher rates of injury with the lowest rates of chronic disease, compared to all other activity groups. In contrast, chess players reported lower rates of injury compared to Masters Athletes as well as lower prevalence of chronic diseases compared to the moderately active and inactive groups. The normative groups reported the lowest rate of injury, but increased prevalence of chronic diseases compared to Masters Athletes and chess players.

Conclusions

Findings from this study indicate that both athletic and cognitive engagement may be positively related to the physical health of older adults, since Masters Athletes and chess players reported a lower prevalence of chronic disease. Importantly, the results expand our current understanding of health by providing evidence for physical health outcomes associated with an activity that is primarily associated with cognitive health.

     

How does language affect decision-making in social interactions and decision biases?

This paper investigates how communication in a particular language affects decision-making in social interactions and risk preferences. We test two competing hypotheses: the cognitive accessibility hypothesis, and the expectation-based hypothesis. The cognitive accessibility hypothesis argues that communication in a particular language will activate the underlying cultural frame and affect behavior. The expectation-based hypothesis argues that different languages will induce different expectations regarding the choices of others and affect behavior. We test these two hypotheses using an extensive range of behaviors in a set of incentivized experiments with bilingual subjects in Chinese and English. We find that the subjects are more prosocial in strategic interaction games (trust games) when the experiments are conducted in Chinese. However, no treatment effects are observed in the individual choice games on social preference. The results are more in line with the expectation-based hypothesis.     

An examination of the mechanisms underlying the effects of physical activity on brain and cognition

Physical activity positively influences brain health and cognitive functioning in older adults. Several physiological and psychological mechanisms have been identified to underlie such a relationship. Cardiovascular fitness is accompanied with changes in mechanisms such as cerebral blood flow, neurotrophic factors, neurotransmitter systems and neural architecture that have themselves been associated with cognitive performance. Factors associated with exercise such as arousal, mood and self-perception of competence seem also to influence cognitive performance. Other explanation for the benefits of exercise in cognition, results from the fact that the performance of motor skills involve an important cognitive component (e.g., executive functions and information processing speed). Evidence of brain plasticity and behavior has been provided from studies where animals are exposed to enriched or complex environments. Exposure to such paradigms in which physical activity plays an important role has been found to influence various aspects of brain function and structure. Studies using neuroimaging techniques have established a link between the acquisition of different motor skills and the occurrence of neuroplasticity in human adults. This literature review indicates that the type of exercise and its specific perceptual and cognitive characteristics may influence cognitive performance. However, most of the research has been focused on self-paced movements or automatized skills and few intervention studies have examined the results of merging exercise and cognitive training in a single program. An important scientific challenge for the coming years is to design exercise programs capable of mobilizing several type of mechanisms underlying the effects of physical activity on brain and cognition.     

Exercises for mental wellness. Couldn't we all benefit?

For most of us, our cognitive functioning could be improved in many ways. Many of us struggle with our thinking skills at times, especially during times of stress and information overload. Some of the research that supports the use of prescribed cognitive exercises to slow cognitive decline in older adults may ultimately prove to be beneficial for all of us. Mental health nurses should encourage regular daily mental workouts, along with aerobic physical exercises, for everyone, not just older adults. Personal fitness training should focus not only on physical fitness, but also on mental fitness.