ArticleAlzheimer's research & therapy2015
Cumulative impact of health deficits, social vulnerabilities, and protective factors on cognitive dynamics in late life: a multistate modeling approach.
Article in Alzheimer's research & therapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- The effect of social relationships on cognitive decline in older adults: an updated systematic review and meta-analysis of longitudinal cohort studies.BMC public health · 2022Pooled it
- Combining modifiable risk factors and risk of dementia: a systematic review and meta-analysis.BMJ open · 2019Pooled it
- Individual-level Social Vulnerability and Cognitive Function Among Older Adults in the United States National Health and Nutrition Examination Survey.medRxiv : the preprint server for health sciences · 2026Article
- Mapping Social and Physical Frailty in the Peruvian Amazon: Associated Factors Among Older Adults.Healthcare (Basel, Switzerland) · 2026Article
- Social frailty in community-dwelling older adults: a scoping review.BMC geriatrics · 2025Article
- Frailty is associated with the clinical expression of neuropsychological deficits in older adults.European journal of neurology · 2024Article
- The influence of multiple frailty profiles on institutionalization and all-cause mortality in community-living older adults.Journal of cachexia, sarcopenia and muscle · 2022Article
- The Association between Social Vulnerability and Frailty in Community Dwelling Older People: A Systematic Review.Geriatrics (Basel, Switzerland) · 2022Review
- 10-year frailty trajectory is associated with Alzheimer's dementia after considering neuropathological burden.Aging medicine (Milton (N.S.W)) · 2021Article
- Visualizing risk factors of dementia from scholarly literature using knowledge maps and next-generation data models.Visual computing for industry, biomedicine, and art · 2021Article
- The Foreclosure Crisis, Community Change, and the Cognitive Health of Older Adults.The journals of gerontology. Series B, Psychological sciences and social sciences · 2021Article
- Cumulative health deficits,Journal of neurology, neurosurgery, and psychiatry · 2021Article
- Portals to frailty? Data-driven analyses detect early frailty profiles.Alzheimer's research & therapy · 2021Article
- Motoric Cognitive Risk Syndrome: Symptoms, Pathology, Diagnosis, and Recovery.Frontiers in aging neuroscience · 2021Review
- Social Isolation and Memory Decline in Later-life.The journals of gerontology. Series B, Psychological sciences and social sciences · 2020Article
- Frailty and Risk of Incident Motoric Cognitive Risk Syndrome.Journal of Alzheimer's disease : JAD · 2019Article
- Relationship between frailty and Alzheimer's disease biomarkers: A scoping review.Alzheimer's & dementia (Amsterdam, Netherlands) · 2018Article
- Aging and sex hormones in males.Virulence · 2017Review
- A call for comparative effectiveness research to learn whether routine clinical care decisions can protect from dementia and cognitive decline.Alzheimer's research & therapy · 2016Review
- Changes in Frailty Predict Changes in Cognition in Older Men: The Honolulu-Asia Aging Study.Journal of Alzheimer's disease : JAD · 2016Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMany factors influence late-life cognitive changes, and evaluating their joint impact is challenging. Typical approaches focus on average decline and a small number of factors. We used multistate transition models and index variables to look at changes in cognition in relation to frailty (accumulation of health deficits), social vulnerability, and protective factors in the Honolulu-Asia Aging Study (HAAS).
methodsThe HAAS is a prospective cohort study of 3,845 men of Japanese descent, aged 71 to 93 years at baseline. Cognitive function was measured using the Cognitive Abilities Screening Instrument (CASI). Baseline index variables were constructed of health deficits (frailty), social vulnerabilities, and protective factors. The chances of improvement/stability/decline in cognitive function and death were simultaneously estimated using multistate transition modeling for 3- and 6-year transitions from baseline.
resultsOn average, CASI scores declined by 5.3 points (standard deviation (SD) = 10.0) over 3 years and 9.5 points (SD = 13.9) over 6 years. After adjusting for education and age, baseline frailty was associated with an increased risk of cognitive decline at 3 years (β = 0.18, 95% confidence interval (CI), 0.08 to 0.29) and 6 years (β = 0.40, 95% CI, 0.27 to 0.54). The social vulnerability index was associated with 3-year changes (β = 0.16, 95% CI, 0.09 to 0.23) and 6-year changes (β = 0.14, 95% CI, 0.05 to 0.24) in CASI scores. The protective index was associated with reductions in cognitive decline over the two intervals (3-year: β = -0.16, 95% CI, -0.24 to -0.09; 6-year: β = -0.21, 95% CI, -0.31 to -0.11,).
conclusionsResearch on cognition in late life needs to consider overall health, the accumulation of protective factors, and the dynamics of cognitive change. Index variables and multistate transition models can enhance understanding of the multifactorial nature of late-life changes in cognition.
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Registered trials
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