Life's Simple 7 and Global- and Domain-Specific Cognitive Function in an Older Adult Population
| dc.contributor.author | Lopez, Kyra Elise | en |
| dc.contributor.committeechair | Davy, Kevin P. | en |
| dc.contributor.committeemember | Davy, Brenda M. | en |
| dc.contributor.committeemember | Katz, Benjamin D. | en |
| dc.contributor.department | Human Nutrition, Foods and Exercise | en |
| dc.date.accessioned | 2023-01-15T07:00:21Z | en |
| dc.date.available | 2023-01-15T07:00:21Z | en |
| dc.date.issued | 2021-07-23 | en |
| dc.description.abstract | The American Heart Association Life's Simple 7 (LS7), a metric that classifies cardiovascular health using modifiable risk factors, has been reported to be associated with cognitive function. However, the assessment of cognitive function in prior studies has been limited to relatively crude global measures. We hypothesized that greater LS7 scores at baseline are associated with less cognitive decline and lower incidence of dementia and Alzheimer's. Using data from the core Health and Retirement Study survey (2012-2018), 2013 Health Care and Nutrition Questionnaire and enhanced face-to-face interviews we will evaluate cognitive scores in relation to LS7. The participants included in this analysis (n = 2,753) are greater than 50 years of age without dementia. A global cognitive score was calculated using the combination scores on multiple cognitive tests that include measurements of semantic memory, quantitative reasoning, episodic memory, and executive functioning. Changes in cognitive scores are evaluated based on marginal effects after adjustments for confounding variables. Baseline LS7 scores (0-14) were calculated using information on smoking habits, body mass index, habitual diet, blood pressure, non, physical activity, and hemoglobin a1c. Results were analyzed using linear mixed models fit with random intercepts and the use of Huber-White variance estimates to analyze the results. Knots were introduced to explain non-linear change in respondents. Global cognitive scores in all respondents decreased more between baseline to year two and year two to year four than year four to year six (ΔB-2: -2.796, Δ2-4: -3.362 v. Δ4-6: -1.191). A one unit increase in LS7 score presented a protective effect and slowed the rate of decline by 0.11 unit in global cognitive scores between baseline and year two. The protective effect was lower between year two and four (0.07 units) and non-significant between year four and six. Black respondents did not respond similarly in models than white respondents. A one unit increase in LS7 score increased the rate of decline from baseline to year two and year two to year 4 in black respondents (p<0.001, p<0.05). LS7 scores had no significant interaction with global cognitive scores between year 2 and 6. Serial 7 scores did not significantly change over time in any of the racial categories. A unit increase in LS7 scores showed a marginal protective effect on memory scores from year two to four in all respondents (r=0.03, p<0.001). In white respondents, higher LS7 scores had a protective effect on memory scores (r=0.01, p<0.05). The probability of developing dementia or Alzheimer's over the study period was the highest for males (P = 3.6%) than females (P = 3.3%) and lowest for white, females (P=13%) and highest for black, males (P=15%). Having higher LS7 scores at baseline is associated lower cognitive decline over a 6-year period in white, older adults. LS7 scores at baseline delayed word recall/memory scores over time but not serial 7/executive functioning scores. LS7 scores at baseline are not associated with lower incidence of cognitive impairment and dementia. Findings suggest better habits formed earlier in life have a better protective effect than late-life habits | en |
| dc.description.abstractgeneral | The United States is dealing with a rapidly aging population. By the year 2035, there is expected to be more adults over the age of 65 than children. As the number of older adults increases as will the number of new and existing cases of Alzheimer's and other dementias. The burden of older adults with Alzheimer's and dementia strains the U.S. healthcare system therefore new research is emerging on interventions used to slow the onset of this life-altering disease before critical and expensive care is required. One method that has been effective is modifying lifestyle behaviors. In 2010 the American Heart Association classified the Life's Simple 7 (LS7) metrics which involved both behavioral and biological measures for cardiovascular risk assessment in Americans. The LS7 metrics include smoking behaviors, physical activity, diet, body mass index, blood pressure, cholesterol, and fasting blood glucose. The American Heart Association's LS7 metric adherence during early and mid-life has been shown to decrease risk for Alzheimer's and dementia, however, research of adherence in late-life is limited. Preventing late-life onset of dementia is vital to older adults therefore this study aims to observe late-life adherence LS7 and change in cognitive functioning over a 6-year period (2012-2018). Participants included in this study are from the Health and Retirement Study (HRS) that are 50 years and older without diagnoses of dementia or Alzheimer's at the time of baseline measurement in 2012. Late-life adherence to Life's Simple 7 metrics are associated with slower rates of cognitive decline in white respondents. The Life's Simple 7 metric is not significantly associated lower cases of dementia and is associated slower rates of decline in memory but not executive functioning. This study aimed to expand evidence for racial differences on global cognitive changes and domain-specific cognitive measurements and the effect Life's Simple Seven scores have on that relationship. | en |
| dc.description.degree | Master of Science | en |
| dc.format.medium | ETD | en |
| dc.identifier.other | vt_gsexam:31919 | en |
| dc.identifier.uri | http://hdl.handle.net/10919/113180 | en |
| dc.publisher | Virginia Tech | en |
| dc.rights | In Copyright | en |
| dc.rights.uri | http://rightsstatements.org/vocab/InC/1.0/ | en |
| dc.subject | Alzheimer's Disease | en |
| dc.subject | Dementia | en |
| dc.subject | cognitive functioning | en |
| dc.subject | Life's Simple 7 | en |
| dc.subject | cardiovascular disease | en |
| dc.subject | cognitive impairment | en |
| dc.title | Life's Simple 7 and Global- and Domain-Specific Cognitive Function in an Older Adult Population | en |
| dc.type | Thesis | en |
| thesis.degree.discipline | Human Nutrition, Foods, and Exercise | en |
| thesis.degree.grantor | Virginia Polytechnic Institute and State University | en |
| thesis.degree.level | masters | en |
| thesis.degree.name | Master of Science | en |
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