Doctoral Dissertation Research: Dynamic Analyses of Cognition and Mortality in the Oldest Old

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Evidence is accumulating that cognitive abilities are inversely associated with mortality, and this association seems to be present irrespective of study population, cohort, and the cognitive tests used. Cognitive abilities are not traditionally considered in epidemiology, however, and their additional value to the prediction of mortality is not clear. On the other hand, cognitive decline is viewed as one of the multifaceted aspects of the aging process, but few studies have related characteristics in the changing process of cognition to mortality. The examination of these problems largely has been impeded by methodological difficulties. This project will examine several novel methods to investigate the relations of cognition (in particular, episodic memory and verbal ability) and mortality using longitudinal data in a national sample of U.S. adults aged 70 years and older. These methods will be employed in a progressive order and will include latent curve models, mixed-effects change point models, joint growth and survival models, traditional survival analysis, and recursive partitioning techniques (survival trees and random forests). The project will examine cognitive change in the oldest population cohort and relate it to mortality. The increasing proportion of this group in the population is impacting many social and economic issues. The substantive results from this project may be especially informative for policy makers in considering hospice care plans. Methodologically, this project will compare alternative approaches to analyzing longitudinal and survival data and will employ exploratory data mining in survival analysis. The methodological finding may have broad applications for many fields in the behavioral and health sciences. As a Doctoral Dissertation Research Improvement award, support is provided to enable a promising student to establish a strong, independent research career.