Business & Economics Collected Works - Research Publications
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ItemAccounting for retest effects in cognitive testing with the Bayesian double exponential model via intensive measurement burst designs.(Frontiers Media SA, 2022)Monitoring early changes in cognitive performance is useful for studying cognitive aging as well as for detecting early markers of neurodegenerative diseases. Repeated evaluation of cognition via a measurement burst design can accomplish this goal. In such design participants complete brief evaluations of cognition, multiple times per day for several days, and ideally, repeat the process once or twice a year. However, long-term cognitive change in such repeated assessments can be masked by short-term within-person variability and retest learning (practice) effects. In this paper, we show how a Bayesian double exponential model can account for retest gains across measurement bursts, as well as warm-up effects within a burst, while quantifying change across bursts in peak performance. We also highlight how this approach allows for the inclusion of person-level predictors and draw intuitive inferences on cognitive change with Bayesian posterior probabilities. We use older adults' performance on cognitive tasks of processing speed and spatial working memory to demonstrate how individual differences in peak performance and change can be related to predictors of aging such as biological age and mild cognitive impairment status.
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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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ItemA highly feasible, reliable, and fully remote protocol for mobile app-based cognitive assessment in cognitively healthy older adults.(Wiley, 2022)INTRODUCTION: The early detection of cognitive impairment is one of the most important challenges in Alzheimer's disease (AD) research. The use of brief, short-term repeated test sessions via mobile app has demonstrated similar or better reliability and validity compared to standard in-clinic assessments in adult samples. The present study examined adherence, acceptability, and reliability for a remote, app-based cognitive screening protocol in healthy older adults. METHODS: Cognitively unimpaired older adults (N = 52, ages 60-80) completed three brief cognitive testing sessions per day within morning, afternoon, and evening time windows, for 8 consecutive days using a mobile app-based cognitive testing platform. Cognitive tasks assessed visual working memory, processing speed, and episodic memory. RESULTS: Participants completed an average of 93% (M = 22.3 sessions, standard deviation = 10.2) of the 24 assigned sessions within 8 to 9 days. Average daily adherence ranged from 95% of sessions completed on day 2 to 88% of sessions completed on day 8. There was a statistically significant effect of session time on adherence between the morning and afternoon sessions only F (1, 51) = 9.15, P = .004, η p 2 = 0.152, with fewer afternoon sessions completed on average. The within-person reliabilities of average scores, aggregated across all 24 sessions, were exceptionally high, ranging from 0.89 to 0.97. Performance on the episodic memory task was positively and significantly associated with total score and word list recall score on the Telephone Interview for Cognitive Status. In an exit survey, 65% of participants reported that they "definitely" would complete the sessions again. DISCUSSION: These findings suggests that remote, mobile app-based cognitive testing in short bursts is both highly feasible and reliable in a motivated sample of cognitively normal older adults. Limitations include the limited diversity and generalizability of the sample; this was a largely White, highly educated, and motivated sample self-selected for AD research.
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ItemThe where and when of COVID-19: Using ecological and Twitter-based assessments to examine impacts in a temporal and community context.(Public Library of Science (PLoS), 2022)In March 2020, residents of the Bronx, New York experienced one of the first significant community COVID-19 outbreaks in the United States. Focusing on intensive longitudinal data from 78 Bronx-based older adults, we used a multi-method approach to (1) examine 2019 to early pandemic (February-June 2020) changes in momentary psychological well-being of Einstein Aging Study (EAS) participants and (2) to contextualize these changes with community distress scores collected from public Twitter posts posted in Bronx County. We found increases in mean loneliness from 2019 to 2020; and participants that were higher in neuroticism had greater increases in thought unpleasantness and feeling depressed. Twitter-based Bronx community scores of anxiety, depressivity, and negatively-valenced affect showed elevated levels in 2020 weeks relative to 2019. Integration of EAS participant data and community data showed week-to-week fluctuations across 2019 and 2020. Results highlight how community-level data can characterize a rapidly changing environment to supplement individual-level data at no additional burden to individual participants.
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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.
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ItemThe Support Person's Preferences and Perspectives of Physical Activity Programs for Older Adults With Cognitive Impairment(FRONTIERS MEDIA SA, 2021-09-23)Objectives: Physical activity (PA) is beneficial for older adults' cognition. There is limited research investigating perspectives of support persons (SPs) of next-of-kins (NOKs) with cognitive impairment. This exploratory study aimed to investigate perspectives of SPs of older adults with Alzheimer's Dementia (AD) or Mild Cognitive Impairment (MCI). Methods: A telephone survey of 213 SPs of NOKs from the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing (AIBL) was undertaken to quantitatively assess SPs' beliefs and knowledge about PA benefits, current PA level of their NOK, and PA program preferences. The contribution of age, gender, diagnosis and mental health symptoms was assessed using multiple logistic regression analyses. Results: Many SPs were aware of PA benefits for memory (64%) and believed it would help their NOK (72%). Older SP age was associated with less awareness of benefits (p = 0.016). SPs caring for male NOKs were more likely to believe that PA would be helpful than those caring for female NOKs (p = 0.049). NOK AD diagnosis (rather than MCI) (p = 0.014), older age (p = 0.005) and female gender (p = 0.043) were associated with lower PA levels. SPs were mixed regarding preference for their NOKs to participate in individual (45%) or group (54%) PA. Many SPs wanted to participate in PA with their NOK (63%). Conclusions: The results highlight that SPs have high levels of awareness of the cognitive benefits of PA, and describe their preferences regarding PA programs. The findings provide new information to inform targeted public health messaging, PA prescribers and providers, and future research directions.