Cognition and Daily Functioning: Results from the Hispanic Community Health Study/Study of Latinos (SOL) and Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA)

Article type: Research Article

Authors: Stickel, Ariana M.^a | Tarraf, Wassim^b | Wu, Benson^a | Marquine, Maria J.^c | Vásquez, Priscilla M.^d | Daviglus, Martha^e | Estrella, Mayra L.^e | Perreira, Krista M.^f | Gallo, Linda C.^g | Lipton, Richard B.^h | Isasi, Carmen R.^h | Kaplan, Robert^h | Zeng, Donglinⁱ | Schneiderman, Neil^j | González, Hector M.^{a; *}

Affiliations: [a] Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, UC San Diego, La Jolla, CA, USA | [b] Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA | [c] Department of Psychiatry, UC San Diego, La Jolla, CA, USA | [d] Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA | [e] Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA | [f] Department of Social Medicine, UNC School of Medicine, Chapel Hill, NC, USA | [g] Department of Psychology, San Diego State University, San Diego, CA, USA | [h] Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA | [i] Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA | [j] Department of Psychology, University of Miami, Miami, FL, USA

Correspondence: [*] Correspondence to: Hector M. González, PhD, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA, USA. Tel.: +1 858 534 5361; E-mail: mg002@health.ucsd.edu.

Abstract: Background:Among older adults, poorer cognitive functioning has been associated with impairments in instrumental activities of daily living (IADLs). However, IADL impairments among older Hispanics/Latinos is poorly understood. Objective:To characterize the relationships between cognition and risk for IADL impairment among diverse Hispanics/Latinos. Methods:Participants included 6,292 community-dwelling adults from the Study of Latinos - Investigation of Neurocognitive Aging, an ancillary study of 45+ year-olds in the Hispanic Community Health Study/Study of Latinos. Cognitive data (learning, memory, executive functioning, processing speed, and a Global cognitive composite) were collected at Visit 1. IADL functioning was self-reported 7 years later, and treated as a categorical (i.e., risk) and continuous (i.e., degree) measures of impairment. Survey two-part models (mixture of logit and generalized linear model with Gaussian distribution) and ordered logistic regression tested the associations of cognitive performance (individual tests and composite z-score) with IADL impairment. Additionally, we investigated the moderating role of age, sex, and Hispanic/Latino background on the association between cognition and IADL impairment. Results:Across all cognitive measures, poorer performance was associated with higher odds of IADL impairment 7 years later. Associations were generally stronger for the oldest group (70+ years) relative to the youngest group (50–59 years). Sex and Hispanic/Latino background did not modify the associations. Across the full sample, lower scores on learning, memory, and the Global cognitive composite were also associated with higher degree of IADL impairment. Conclusion:Across diverse Hispanics/Latinos, cognitive health is an important predictor of everyday functioning 7 years later, especially in older adulthood.

Keywords: Activities of daily living, aging, cognition, hispanics, latinos, sex

DOI: 10.3233/JAD-200502

Journal: Journal of Alzheimer's Disease, vol. 77, no. 3, pp. 1267-1278, 2020