Age-associated cognitive changes in community dwelling adults

最近的研究表明，咖啡因的摄入与抑郁症和认知能力下降的风险较低有关。然而，没有研究已经检查的关系，在非洲裔美国人相比，一个白色，社会经济多样化的代表性城市样本。研究人员使用了来自生命周期多样性社区健康老龄化（HANDLS）研究的数据，以确定1，724名参与者样本中咖啡因使用与抑郁症和认知的相关性。美国农业部的自动多次通过方法由受过训练的采访者使用，以收集两个人的24小时饮食回忆。抑郁症状和整体认知分别使用流行病学研究中心抑郁量表（CES-D）和简易精神状态检查（MMSE）进行评估。咖啡因的摄入量是基于两次回忆。资料以t检验、卡方检定、相关分析及有序逻辑回归分析。结果：非裔美国人摄入的咖啡因明显少于白人（分别为89.0-3.2和244.0-8.7 mg）。咖啡因摄入量与抑郁症或整体认知无关。年龄、5年级以下文化程度和高中以下教育程度与抑郁症状和认知功能显著相关。吸烟者患抑郁症的风险高出43%，但患认知障碍的风险仅高出3%。HANDLS研究参与者中低水平的饮食咖啡因摄入量与吸烟相结合可能影响了与抑郁症或整体认知缺乏关联。在这个样本中，文化程度低和受教育程度低与抑郁症状和认知功能的相关性比咖啡因摄入量高。 在第二项研究中，我们检查了种族和贫困（收入<联邦贫困线的125%）是否会改变糖尿病与城市居民样本中认知之间的关联。使用横断面数据2066参与者（平均年龄= 47.6岁，56.8%的女性，56.2%的非洲裔美国人，38.6%低于贫困）从第一波的健康老龄化社区的多样性在整个寿命研究，糖尿病，种族和贫困状态之间的相互作用与11个测试测量认知功能进行了评估多元回归分析。糖尿病、种族和贫困状况之间存在显著的相互作用。在贫困的非裔美国人中，糖尿病患者在加州语言学习测试自由回忆短延迟中的表现低于非糖尿病患者（z = -0.444 0.123 vs z = -0.137 0.045）和长延迟（z = -0.299 0.123 vs z = -0.130 0.045），数字跨度向后（z = -0.347 0.109对z = -0.072 0.041），以及注意力的简短测试（z = -0.452 -0.099 vs. z = -0.099 0.047），类别流畅性更高（z = 0.114 0. 117 vs. z = -0.118 0.044）。在非裔美国人和白色贫困以上的参与者中，糖尿病和非糖尿病个体之间没有一致的差异。糖尿病与生活在贫困中的非裔美国人的言语记忆、工作记忆和注意力较差有关。糖尿病非裔美国人在贫困以下可能会增加年轻时认知缺陷的风险。改善健康素养、医患沟通和针对贫困人群的多学科医疗护理可能会减少差异。需要进一步的研究来澄清这些关联的机制。 在第三项研究中，我们检查了饮食抗氧化剂是否可以抑制伴随神经变性的反应，从而防止认知障碍。我们描述了饮食中的抗氧化剂与认知功能在一个大的birabolic人口的协会，同时测试适度的性别，种族和年龄和抑郁症状的调解。这是一个横断面分析的1274名成年人（541名男性和733名女性）年龄在30至64岁的基线（平均标准差= 47.5 ± 9.3）在健康老龄化的多样性社区的寿命研究，巴尔的摩市，MD。评估了记忆、语言/言语、注意力、空间、心理速度、执行功能和整体精神状态等领域的认知表现。20项流行病学研究中心抑郁量表被用来衡量抑郁症状。通过两次24小时回忆来评估饮食摄入量，估计每1000千卡的总类胡萝卜素和维生素A、C和E的每日消耗量。在关键发现中，1个标准差（约2.02 mg/1000 kcal）高维生素E与言语记忆、即时回忆（beta = +0.64 0.19，p = .001）和更好的语言/言语流畅性表现（beta = +0.53 0.16，p = .001）得分较高相关，特别是在年轻年龄组中。维生素E摄入量较高的女性（β =+0.680.21，p = 0.001）在心理速度测试中表现更好。维生素E-文字记忆关联部分由抑郁症状介导（比例介导= 13%-16%）。总之，未来的队列研究和饮食干预应侧重于饮食维生素E与认知能力下降的关联，特别是在言语记忆、言语流畅性和心理速度方面。

Recent research has linked caffeine consumption with a lower risk for depression and cognitive decline. However, no studies have examined the relationship in an African American compared to a white, socioeconomically diverse representative urban sample. Data from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used to determine the associations of caffeine use with depressive symptomatology and cognition in a sample of 1,724 participants. The United States Department of Agriculture's Automated Multiple Pass Method was used by trained interviewers to collect two, in-person 24-hour dietary recalls. Depressive symptoms and global cognition were assessed using two well-validated measures: the Center for Epidemiologic Studies Depressive Scale (CES-D) and Mini Mental State Examination (MMSE), respectively. Usual caffeine intake was based on both recalls. Data were analyzed with t- and chi-square tests, correlation analysis, and ordinal logistic regression. Results: African Americans consumed significantly less caffeine than did whites (89.0-3.2 and 244.0-8.7 mg respectively). Caffeine consumption was not associated with depressive symptomatology or global cognition. Age, less than 5th grade literacy, and less than high school education were significantly associated with both depressive symptoms and cognitive function. Smokers had a 43% greater risk for depression but only a 3% higher risk for cognitive impairment. The low level of dietary caffeine intake in combination with smoking among HANDLS study participants may have influenced the lack of association with depressive symptomatology or global cognition. For this sample, low literacy and education appear more highly associated with depressive symptoms and cognitive function than caffeine intake. In a second study, we examined whether race and poverty (income <125% of the federal poverty limit), modifies associations between diabetes and cognition in a biracial, urban-dwelling sample.: Using cross-sectional data for 2066 participants (mean age = 47.6 years, 56.8% women, 56.2% African American, 38.6% below poverty) from the first wave of the Healthy Aging in Neighborhoods of Diversity across the Life Span study, interactions among diabetes, race, and poverty status with eleven tests measured cognitive function were assessed in multiple regression analyses. Significant interactions among diabetes, race, and poverty status were observed. Among African Americans below poverty, diabetic individuals performed lower than non-diabetic individuals on California Verbal Learning Test Free Recall Short Delay (z = -0.444 0.123 versus z = -0.137 0.045) and Long Delay (z = -0.299 0.123 versus z = -0.130 0.045), Digit Span Backward (z = -0.347 0.109 versus z = -0.072 0.041), and the Brief Test of Attention (z = -0.452 -0.099 versus z = -0.099 0.047), and higher on Category Fluency (z = 0.114 0.117 versus z = -0.118 0.044). No consistent differences between diabetic and non-diabetic individuals were found for African American and white participants above poverty. Diabetes was associated with poorer verbal memory, working memory, and attention among African Americans living in poverty. Diabetic African Americans below poverty may have increased risk of cognitive deficit at a younger age. Improving health literacy, doctor-patient communication, and multidisciplinary medical care for impoverished individuals may reduce differences. Additional research is needed to clarify mechanisms underlying these associations. In a third study, we examined whether dietary antioxidants can inhibit reactions accompanying neurodegeneration and thus prevent cognitive impairment. We describe associations of dietary antioxidants with cognitive function in a large biracial population, while testing moderation by sex, race, and age and mediation by depressive symptoms. This was a cross-sectional analysis of 1274 adults (541 men and 733 women) aged 30 to 64 years at baseline (mean standard deviation = 47.5 9.3) in the Healthy Aging in Neighborhoods of Diversity Across the Lifespan Study, Baltimore city, MD. Cognitive performance in the domains of memory, language/verbal, attention, spatial, psychomotor speed, executive function, and global mental status were assessed. The 20-item Center for Epidemiologic Studies Depression Scale was used to measure depressive symptoms. Dietary intake was assessed with two 24-hour recalls, estimating daily consumption of total carotenoids and vitamins A, C, and E per 1000 kcal. Among key findings, 1 standard deviation ( approximately 2.02 mg/1000 kcal) higher vitamin E was associated with a higher score on verbal memory, immediate recall (beta = +0.64 0.19, p = .001), and better language/verbal fluency performance (beta = +0.53 0.16, p = .001), particularly among the younger age group. Women with higher vitamin E intake (beta = +0.68 0.21, p = .001) had better performance on a psychomotor speed test. The vitamin E-verbal memory association was partially mediated by depressive symptoms (proportion mediated = 13%-16%). In sum, future cohort studies and dietary interventions should focus on associations of dietary vitamin E with cognitive decline, specifically for domains of verbal memory, verbal fluency, and psychomotor speed.