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S5‐04–05: Cognitive rehabilitation
Author(s) -
Loewenstein David
Publication year - 2008
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2008.05.583
Subject(s) - cognition , cognitive rehabilitation therapy , cognitive training , physical medicine and rehabilitation , rehabilitation , intervention (counseling) , psychology , psychological intervention , cognitive psychology , medicine , neuroscience , psychiatry
Participants are over 6,000 non-Hispanic African Americans (61%) and non-Hispanic Whites (39%), aged 65 years and older, from the Chicago Health and Aging Project (CHAP), and over 1300 non-Hispanic African Americans (29%) and non-Hispanic Whites (71%) from the Minority Aging Research Study (MARS) and the Memory and Aging Project, respectively. During 12 years of follow-up in CHAP, participants underwent up to four interviews that included the administration of four cognitive tests, from which a global measure of cognition was derived. A stratified, random sample underwent uniform, structured clinical evaluations for Alzheimer’s disease (AD). During a 3-year period, MARS and MAP participants underwent annual clinical evaluations that included detailed cognitive function testing from which global and specific measures of cognition were derived. Psychosocial risk factors in three domains including, social resources, negative emotional states, and chronic psychosocial stressors were assessed at baseline. Results: We found that negative emotional states, including depressive symptoms, hostility, and neuroticism, and chronic psychosocial stressors such as perceived discrimination, were related to lower baseline cognition, faster rates of decline, or increased risk of AD. In contrast, social resources were related to slower rates of decline. Although most risk factors operated the same in African Americans and Whites, social engagement was protective against cognitive decline and neuroticism increased the risk of AD for Whites only. Perceived discrimination was more strongly associated with lower cognition in African Americans. Conclusions: Although many psychosocial risk factors have the same effect on cognition among African Americans and Whites, the relationships between social engagement, neuroticism, and cognition may differ. Cultural implications related to the measurement of psychosocial factors in diverse populations are discussed.