Business & Economics Collected Works - Research Publications
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ItemNo Preview AvailableBrain structure in subjective cognitive decline: A replication study(Wiley, 2021-12)Background Alzheimer’s disease (AD) is an incurable neurodegenerative disorder, which disproportionately affects women (Erol et al., 2015). Given that the current treatments for AD aim to prevent symptom progression, the primary objective of emerging research is to identify pre‐clinical biological markers. Investigating such biomarkers would be appropriate in those experiencing subjective cognitive decline (SCD). Individuals with SCD are thought to be the earliest along the cognitive continuum between healthy aging and AD, as their reported change in cognition is not yet measurable using standard neuropsychological assessment measures. Previous research has found differences to exist in brain function, but not structure between healthy controls and those with SCD (Parker et al., 2020). The current study represents a preliminary analysis of structural brain images in healthy women compared to women with SCD; no structural differences between groups were hypothesized. Method The 3T T1 anatomical magnetic resonance images (MRI) used in this analysis was a subset of participants obtained from the Women’s Healthy Ageing Project collected in 2012 (N = 170). This subset included 30 healthy women (mean age = 71.4; SD = 3.12) and 30 women with SCD (mean age = 70.5; SD = 2.23). Voxel‐based morphometry (VBM) analyses were conducted using FMRIB’s Software Library to examine cross sectional differences between healthy women and women with SCD. Result Whole brain VBM analyses did not reveal any significant differences in grey matter tissue density between healthy women and women with SCD at p < 0.05 level with threshold free cluster enhancement (corrected for multiple comparisons). Conclusion Although the current findings did not reveal differences in grey matter between healthy women and women with SCD, this result replicates our previous findings and other reports in the literature that structural differences may not be detectable between healthy individuals and those with SCD. Follow‐up work will include investigation of differences in functional connectivity between these two groups using resting‐state functional MRI with the total sample collected in 2012 (N = 170). Identifying changes in brain function prior to structural atrophy and measurable decline on neuropsychological measures would represent a major advance in AD biomarker research.
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ItemNo Preview AvailableThe Women’s Healthy Ageing Project: A pattern of cognitive decline after brain injury(Wiley, 2021-12)Abstract Background It is well recognised that damage sustained by traumatic brain injury (TBI) initiate injury mechanisms that continue to develop long after insult. Increasing evidence suggests TBI may lead to chronic cognitive decline and the development of dementia later in life. However, due to the low rate of TBI in the general community, there is a paucity of data on the impact of cognitive decline in community TBI. We examined longitudinal cognitive changes over a 12‐year period to determine if there was any relationship with community reported TBI. Method The Women’s Healthy Aging Project is an ongoing longitudinal cohort study of community‐dwelling Australian women. Assessments included an extensive range of measures, including neuropsychological testing of multiple cognitive domains and questions relating to head injury. In total, 110 women had complete neuropsychological testing at all three time points; from 2002, 2012 and 2014. Of these women, nine (aged 56‐65 in 2002) had a history of moderate to severe TBI. Composite cognitive scores were compared to 18 healthy controls randomly selected from the complete dataset individually matched for age, education, and APO4‐genotype. Analyses were conducted in five datasets drawn from the complete dataset and results were averaged. Result Median scores for executive function were similar for both the TBI group and healthy controls in 2002, lower in the TBI group by 2012 and this difference increased further in 2014. Median scores for verbal episodic memory were slightly lower in the TBI group than controls in 2002 and 2012, and this difference increased in 2014. Although this initial pilot study with small samples in mid‐aged healthy women did not show statistically significant results, the observed relationships were constant over the five datasets, warranting further exploration. Conclusion In our small pilot study, we observed greater rate of decline of both executive function and verbal episodic memory in women with a history of TBI. Findings warrant a need for larger studies to explore this relationship as it indicates that community‐based reported TBI may impact cognitive performance even in early ageing. Further work will continue to explore cognitive trajectories in women with a mean age 80 at next follow‐up.
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ItemPromoting clinical best practice in a user-centred design study of an upper limb rehabilitation robot(Taylor & Francis, 2021-01-01)Purpose: Despite their promise to increase therapy intensity in neurorehabilitation, robotic devices have not yet seen mainstream adoption. Whilst there are a number of contributing factors, it is obvious that the treating clinician should have a clear understanding of the objectives and limitations of robotic device use. This study sought to explore how devices can be developed to support a clinician in providing clinical best practice. Methods and Materials: A user-centred design study of a robotic device was conducted, involving build-then-use iterations, where successive iterations are built based on feedback from the use cycle. This work reports results of an analysis of qualitative and quantitative data describing the use of the robotic device in the clinical sessions, and from a focus group with the treating clinicians. Results and Conclusions: The data indicated that use of the device did not result in patient goal-setting and may have resulted in poor movement quality. Therapists expected a higher level of autonomy from the robotic device, and this may have contributed to the above problems. These problems can and should be addressed through modification of both the study design and device to provide more explicit instructions to promote clinical best practice. Implications for Rehabilitation: • Encouraging clinical best practice when using evaluating prototype devices within a clinical setting is important to ensure that best practice is maintained - and can be achieved through both study and device design • Support from device developers can significantly improve the confidence of therapists during the use of that device in rehabilitation, particularly with new or prototype devices • End effector-based robotic devices for rehabilitation show potential for a wide variety of patient presentations and capabilities.
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ItemDaily Cognitive Difficulties and Social Experiences Among Older Adults(Oxford University Press (OUP), 2021-12-17)Abstract Self-reported cognitive difficulties are common in older adults and may be an early indicator of future cognitive decline or dementia. In past retrospective reports, cognitive difficulties have been linked with differences in social engagement or social relationships among older adults. However, little is known about how self-reported cognitive difficulties in daily life, such as memory lapses, relate to older adults’ daily social experiences. This study examined how self-reported cognitive difficulties were related to older adults’ daily social interactions and loneliness. Data were drawn from 312 community-dwelling older adults (aged 70 to 90 years) who reported their social interactions and loneliness throughout the day (five times) as well as cognitive difficulties (e.g., memory lapses, problems with attention) at the end of each day for 14 days. Multilevel models revealed that participants reported fewer memory lapses on days when they reported more frequent interactions with family members (p=.041). Higher levels of disruptions to daily activities caused by cognitive difficulties, in turn, predicted higher levels of loneliness the next day (p=.006), but not changes in social interactions the next day. At the between-person level, more memory lapses in daily life were associated with less frequent social interactions with friends, but more frequent unpleasant social interactions and higher levels of loneliness on average. These results suggest that older adults’ self-reported cognitive difficulties were dynamically associated with their social interactions and loneliness at the daily level and played an important role in older adults’ social life and well-being.
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ItemVolunteering and Chronic Inflammation in Later Life: Is Sustained Volunteering Beneficial for Health?(Oxford University Press (OUP), 2021-12-17)Abstract Although research on the health benefits of volunteering has proliferated in recent decades, most studies have focused on whether or not a person volunteers or the monthly frequency of volunteering. This study examines whether sustained volunteering has health benefits above and beyond occasional or short-lived volunteering. To investigate the salubrious effects of volunteering, the present study considers sustained volunteering engagement in terms of both formal and informal volunteering. Using four waves of data from the Health and Retirement Study, we assess the influence of sustained volunteering on chronic inflammation, measured by C-reactive protein (CRP). Results reveal that sustained engagement in formal and informal volunteering is related to lower CRP concentration, but this association is partly mediated by adult health and socioeconomic factors. Although sustained volunteering is associated with lower levels of chronic inflammation, older adults who maintain their volunteering over time are a select category of adults, characterized by higher education and wealth and better health.
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ItemHow Is Daily Social Interaction Related to Loneliness in Older Adults? The Roles of Trait Loneliness and Personality.(Oxford University Press (OUP), 2021-12-17)Abstract Loneliness is prevalent among older adults and is associated with increased risks for morbidity and mortality. This study examined what types of social interactions could reduce loneliness for older adults and who would benefit the most from social interactions. We used data from 312 community-dwelling older adults (aged 70 to 90 years) who completed ecological momentary assessments (EMA) five times a day for 16 consecutive days using smartphones (n=20,507 reports), as part of the ongoing Einstein Aging Study (EAS). At each EMA, participants reported their social interactions in the past 3 to 4 hours and their current feelings of loneliness. Results from multilevel models revealed that older adults reported lower levels of loneliness on occasions when they had pleasant social interactions (p<.000) or interactions with family (p=.001) in the past few hours, compared with occasions when they had no social interaction. In contrast, they reported higher levels of loneliness if they had unpleasant social interactions in the past few hours (p=.004). These within-person (WP) effects of social interactions on momentary loneliness were significantly moderated by participants’ trait levels of loneliness and neuroticism; and were significantly stronger among those with higher (vs. lower) trait loneliness (ps <.001) or neuroticism (ps <.042). Other personality traits (Extraversion, Openness, Conscientiousness, Agreeableness) did not moderate any WP association. These results highlight the importance of having pleasant social interactions and frequent interactions with family for reducing older adults’ loneliness in daily life, especially for those higher in trait loneliness and neuroticism.
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ItemLike A Dew Drop On A Lotus Leaf: Perceptions Of Aging Well In South Asian American Older Adults(Oxford University Press (OUP), 2021-12-17)Abstract Past research has underscored four key themes prevalent in popular and scientific discourse on successful aging in North America – the emphasis on individual agency and control; continuing productive activity into old age; the value of independence in late life; and an ideal construction of permanent personhood, wherein the realities of mortality and decline are inadequately addressed (Lamb, 2014). Yet, the meanings attached to successful aging differ across cultures and are not very well-understood. The Perceptions of Aging Well in Diverse Populations study aims to acquire a holistic understanding of the attitudes and beliefs around aging well across cultures and to identify the similarities and differences in these perceptions within diverse racial and ethnic groups. This presentation highlights preliminary findings from in-depth, semi-structured qualitative interviews with South Asian Americans 50 years and older (n=19; 9 men, 10 women). Participants shared that a sense of inevitability and aging with “grace”, “dignity”, and “wisdom” were key components of successful aging. Maintaining good health, keeping a positive attitude, and remaining independent in later life appeared motivated primarily by a desire to remain connected to, but not necessarily “burden” adult children with caregiving responsibilities. Religious faith and spiritual well-being, availability of support systems, and a sense of community were key facilitators. Limited English proficiency and loneliness posed challenges to aging well, particularly in late-life immigrants. These findings provide unique insights into subjective perceptions of successful aging and may help inform programs and policies that support the health and well-being of older South Asian Americans.
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ItemOlder Adults Performed Worse on Cognitive Assessment at Lonelier Moments: Using Ambulatory Assessment Approach(Oxford University Press (OUP), 2021-12-17)Abstract This study focused on investigating the short-term effect of loneliness on older adults’ cognitive performances in daily life. Loneliness is suggested as a risk factor for cognitive health, but results in previous studies are inconsistent due to the lack of valid measures and limited research design. The attention-depletion hypothesis highlights that acute stress could immediately compromise cognitive ability by consuming attentional resources. Accordingly, this study examined whether loneliness, as one of the stressors related to one’s social relationship, was immediately associated with worse daily cognitive performances in older adults. Using an ecological momentary assessment approach, 311 community-dwelling older adults (Mage=77.5 (range=70-90), 67% female, 45% white) reported their level of loneliness as well as performed cognitive assessment five times a day for 16 days. Multilevel modeling showed that on occasion when participants reported a higher level of loneliness than normal, they performed worse in the processing speed test (p<.01) and the short-term memory binding test (p<.01) during those moments, controlling for age, gender, education, ethnicity, IADL, and retest-practice effect. Moreover, those momentary associations between loneliness and cognitive performances remained significant after controlling for the momentary level of feeling depressed. Unlike the concurrent effect, there was no lagged effect of loneliness on daily cognitive performances. These results suggest that transient but intense feelings of loneliness can function as acute stress and thus, compromise daily cognitive functioning short-term. Results will be discussed in terms of the potential benefit of momentary real-time interventions to lessen feelings of loneliness to maintain older adults’ cognitive functioning.
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ItemSegmenting communities as public health strategy: A view from the social sciences and humanities(F1000Research, 2020-01-01)On the 5th of May 2020, a group of modellers, epidemiologists and biomedical scientists from the University of Edinburgh proposed a 'segmenting and shielding' approach to easing the lockdown in the UK over the coming months. Their proposal, which has been submitted to the government and since been discussed in the media, offers what appears to be a pragmatic solution out of the current lockdown. The approach identifies segments of the population as at-risk groups and outlines ways in which these remain shielded, while 'healthy' segments would be allowed to return to some kind of normality, gradually, over several weeks. This proposal highlights how narrowly conceived scientific responses may result in unintended consequences and repeat harmful public health practices. As an interdisciplinary group of researchers from the humanities and social sciences at the University of Edinburgh, we respond to this proposal and highlight how ethics, history, medical sociology and anthropology - as well as disability studies and decolonial approaches - offer critical engagement with such responses, and call for more creative and inclusive responses to public health crises.
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ItemThe Association Between Loneliness and Inflammation: Findings From an Older Adult Sample.(Frontiers Media SA, 2021)Loneliness has been linked to poor mental and physical health outcomes. Past research suggests that inflammation is a potential pathway linking loneliness and health, but little is known about how loneliness assessed in daily life links with inflammation, or about linkages between loneliness and inflammation among older adults specifically. As part of a larger investigation, we examined the cross-sectional associations between loneliness and a panel of both basal and LPS-stimulated inflammatory markers. Participants were 222 socioeconomically and racially diverse older adults (aged 70-90 years; 38% Black; 13% Hispanic) systematically recruited from the Bronx, NY. Loneliness was measured in two ways, with a retrospective trait measure (the UCLA Three Item Loneliness Scale) and an aggregated momentary measure assessed via ecological momentary assessment (EMA) across 14 days. Inflammatory markers included both basal levels of C-reactive protein (CRP) and cytokines (IL-1β, IL-4, IL-6, IL-8, IL-10, TNF-α) and LPS-stimulated levels of the same cytokines. Multiple regression analyses controlled for age, body-mass index, race, and depressive symptoms. Moderation by gender and race were also explored. Both higher trait loneliness and aggregated momentary measures of loneliness were associated with higher levels of CRP (β = 0.16, p = 0.02; β = 0.15, p = 0.03, respectively). There were no significant associations between loneliness and basal or stimulated cytokines and neither gender nor race were significant moderators. Results extend prior research linking loneliness with systemic inflammation in several ways, including by examining this connection among a sample of older adults and using a measure of aggregated momentary loneliness.