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Cardiovascular burden, cognition, and depression as predictors of daily function in a sample of multiethnic JEANNINE SKINNER RESEARCH ASSOCIATE MEHARRY-VANDERBILT.

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Presentation on theme: "Cardiovascular burden, cognition, and depression as predictors of daily function in a sample of multiethnic JEANNINE SKINNER RESEARCH ASSOCIATE MEHARRY-VANDERBILT."— Presentation transcript:

1 Cardiovascular burden, cognition, and depression as predictors of daily function in a sample of multiethnic JEANNINE SKINNER RESEARCH ASSOCIATE MEHARRY-VANDERBILT ALLIANCE

2 Data Description Washington Heights-Inwood Columbia Aging Project (WHICAP) Longitudinal study of aging and dementia in community-dwelling adults aged 65+yrs Race/ethnically diverse sample Data from cohort 2- study entry in 1999 Follow/up data every 18-30 months Average follow-up time 7.6 years Sub-sample of interest includes n=2141

3 Specific Aims & Hypothesis Aims Examine the contributions of cardiovascular diseases and risk factors (CVDRFs), cognitive function, and depressed mood on trajectories of daily function Hypothesis A higher burden of CVDRFs will be associated with poorer functional abilities and steeper rates of functional decline Poorer cognitive function and more severe depressive symptomatology will be associated with poorer daily function and steeper rates of functional decline

4 Primary variables of interests VariableDescription Cardiovascular diseases & risk factors (CVDRFs) Summary factory score based on presence of DM, HTN, heart disease, stroke, smoking (current), and central obesity. Each condition was assigned a value of 1 if present and 0 if absent Depression (CES-D)10-item scale reporting frequency of depressed feelings, higher scores indicated more depressive symptomatology Executive function (EF)Composite score based on 6 cognitive test of executive function General cognitive performance (GCP)Composite score based on 6 EF test + 4 tests of learning and memory Daily Functional Status39 self-reported and informant-reported indicators of ADLs, IADLs, & social functioning *Each factor was scaled to have a mean of 50 and SD of 10, higher scores indicated better cognitive performance * Factors were calibrated to an external standard using data from the Aging, Demographics, and Memory Study (ADAMs), a sub-study of the Health and Retirement study

5 Statistical Analysis- Completed Functional ability indicators (ADLs, IADLs, social functioning) were subjected parallel analysis to examine dimensionality Factor analysis to derive summary score of daily functional ability Random effect growth models to determine contributions of demographics, CVDRFs, cognition, and depressive sxs to change in daily function

6 Baseline Characteristics

7 Table 2: Random effect growth model for level and change in daily function: general cognition Regression of baseline on the predictor Regression of slope on the predictor Estimate (Beta)95%CI Estimate (Beta) 95%CI Model 1 GCP CVDRF Model 2 CVDRF X GCP Model 3 CES-D Model 4 CVDRF X CES-D -0.14* 1.08* -0.01 1.45* 0.00 (-0.16, -0.12) (0.90, 1.25) (-0.03, 0.01) (1.29, 1.61) (-0.18, 0.18) -0.00 0.04* -0.00 -0.02* -0.01 (0.00, 0.00) (0.02, 0.06) (0.00, 0.00) (-0.04, -0.02) (-0.03, 0.01)

8 Table 3: Random effect growth model: executive function Regression of baseline on the predictorRegression of slope on the predictor Estimate (Beta)95%CIEstimate (Beta)95%CI Model 1 EF CVDRF Model 2 CVDRF X EF Model 3 CES-D Model 4 CVDRF X CES-D -0.19* 1.07* -0.03* 1.46* 0.00 (-0.21, -0.17) (0.89, 1.25) (-0.05, -0.01) (1.30, 1.62) (-0.18, 0.18) -0.00 0.04* -0.00 -0.01 -0.01 (0.00, 0.00) (0.02, 0.06) (0.00, 0.00) (-0.03, 0.01) (-0.03, 0.01)

9 Biostat needs In response to the results showing a) a NS relationship between executive function and CVDRFs and change in function and b) a NS relationship between general cognition and CVDRFS and change in function 1- Show the above findings graphically 2- Analysis of the data to determine whether the results differ by age groups (younger vs. older by medial age split) Assistance with interpretation


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