INS NYC 2024 Program

Poster	Poster Session 08 Program Schedule 02/16/2024 01:45 pm - 03:00 pm Room: Shubert Complex (Posters 1-60) Poster Session 08: Cognition \| Cognitive Reserve Variables Final Abstract #53 Physical Reserve as a Predictor of Cognitive Outcomes Among Older Adults Catherine O'Brien, Ferkauf Graduate School of Psychology of Yeshiva University, Bronx, United States Roee Holtzer, Ferkauf Graduate School of Psychology of Yeshiva University, Bronx, United States Category: Aging Keyword 1: aging (normal) Keyword 2: executive functions Keyword 3: cognitive functioning Objective: As the older adult population grows, there is an increasing need to understand factors that promote successful aging. Physical reserve (PR), which refers to one’s ability to maintain physical functioning despite age, illness, or injury, has recently been shown to predict adverse physical outcomes among older adults. However, the relationship between PR and executive functioning (EF) has not been established. There is evidence to suggest that executive dysfunction occurs earlier and in greater magnitude compared to other age-related cognitive changes, highlighting the importance of examining EF changes in aging. Therefore, the current study examined whether PR was associated with EF scores among healthy older adults. Given decline in EF may be an important and early indicatory of broader cognitive decline, we also examined whether PR predicted EF decline over time. Furthermore, we examined whether PR predicted clinically meaningful declines in key EF measures among healthy older adults over a 4-year period. Participants and Methods: Participants were (n=511) healthy, older adults age 65+ who were enrolled in a longitudinal study. Following a screening interview and consent procedures, participants completed two in-person clinic visits, including a comprehensive interview regarding medical, psychological, and psychosocial history, neuropsychological testing, and gait assessment. Participants were invited for in-person, annual follow-up assessments for up to 4 years, which included repeat neuropsychological assessment. Additionally, participants were contacted bimonthly via phone for a brief interview regarding incidence of falls and changes to health or daily functioning. The residual measurement approach, previously applied to the construct of cognitive reserve, was used to derive PR by extracting standardized residuals from gait speed, while accounting for demographic and clinical/disease variables. Results: Linear regression models revealed that higher PR, as operationalized using standardized residuals, was associated with better baseline (i.e., initial clinic visit) scores on the Digit Symbol Substitution Test (DSST) (R²= .011, F (1, 471) = 5.464, p = .020), Trail Making Test Part A (TMT-A) (R²= .051, F (1, 473) = 25.440, p < .001), and Part B (TMT-B) (R²= .081, F (1, 460) = 40.605, p < .001). All models remained significant when adjusted for covariates. Linear mixed effects models (LMEM) revealed a significant interaction effect, such that the relationship between PR and TMT-B score decreased over time (estimate = -.024, p = .035). Finally, additional Generalized Estimating Equation (GEE) models revealed that baseline PR predicted declines of 1.5 SD or more below the mean over the follow up period for TMT-A (OR=.615 95% CI [.487, .777], p < .001) and TMT-B (OR=.571, 95% CI [.451, .723], p < .001) scores, and these models remained significant when adjusted for covariates. Conclusions: Findings suggest that higher PR is positively associated with EF scores. Furthermore, PR can be useful in predicting meaningful decline in key measures of EF. Executive functioning abilities are necessary to complete instrumental activities of daily living, safely navigate one’s environment, and play an important role in other cognitive processes. Therefore, identifying predictors of executive dysfunction, such as PR, can help identify risk of cognitive decline prior to functional impairment.

Poster

02/16/2024
01:45 pm - 03:00 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 08: Cognition | Cognitive Reserve Variables

Final Abstract #53

Physical Reserve as a Predictor of Cognitive Outcomes Among Older Adults

Catherine O'Brien, Ferkauf Graduate School of Psychology of Yeshiva University, Bronx, United States
Roee Holtzer, Ferkauf Graduate School of Psychology of Yeshiva University, Bronx, United States

Category: Aging

Keyword 1: aging (normal)
Keyword 2: executive functions
Keyword 3: cognitive functioning

Objective:

As the older adult population grows, there is an increasing need to understand factors that promote successful aging. Physical reserve (PR), which refers to one’s ability to maintain physical functioning despite age, illness, or injury, has recently been shown to predict adverse physical outcomes among older adults. However, the relationship between PR and executive functioning (EF) has not been established. There is evidence to suggest that executive dysfunction occurs earlier and in greater magnitude compared to other age-related cognitive changes, highlighting the importance of examining EF changes in aging. Therefore, the current study examined whether PR was associated with EF scores among healthy older adults. Given decline in EF may be an important and early indicatory of broader cognitive decline, we also examined whether PR predicted EF decline over time. Furthermore, we examined whether PR predicted clinically meaningful declines in key EF measures among healthy older adults over a 4-year period.

Participants and Methods:

Participants were (n=511) healthy, older adults age 65+ who were enrolled in a longitudinal study. Following a screening interview and consent procedures, participants completed two in-person clinic visits, including a comprehensive interview regarding medical, psychological, and psychosocial history, neuropsychological testing, and gait assessment. Participants were invited for in-person, annual follow-up assessments for up to 4 years, which included repeat neuropsychological assessment. Additionally, participants were contacted bimonthly via phone for a brief interview regarding incidence of falls and changes to health or daily functioning. The residual measurement approach, previously applied to the construct of cognitive reserve, was used to derive PR by extracting standardized residuals from gait speed, while accounting for demographic and clinical/disease variables.

Results:

Linear regression models revealed that higher PR, as operationalized using standardized residuals, was associated with better baseline (i.e., initial clinic visit) scores on the Digit Symbol Substitution Test (DSST) (R²= .011, F (1, 471) = 5.464, p = .020), Trail Making Test Part A (TMT-A) (R²= .051, F (1, 473) = 25.440, p < .001), and Part B (TMT-B) (R²= .081, F (1, 460) = 40.605, p < .001). All models remained significant when adjusted for covariates. Linear mixed effects models (LMEM) revealed a significant interaction effect, such that the relationship between PR and TMT-B score decreased over time (estimate = -.024, p = .035). Finally, additional Generalized Estimating Equation (GEE) models revealed that baseline PR predicted declines of 1.5 SD or more below the mean over the follow up period for TMT-A (OR=.615 95% CI [.487, .777], p < .001) and TMT-B (OR=.571, 95% CI [.451, .723], p < .001) scores, and these models remained significant when adjusted for covariates.

Conclusions:

Findings suggest that higher PR is positively associated with EF scores. Furthermore, PR can be useful in predicting meaningful decline in key measures of EF. Executive functioning abilities are necessary to complete instrumental activities of daily living, safely navigate one’s environment, and play an important role in other cognitive processes. Therefore, identifying predictors of executive dysfunction, such as PR, can help identify risk of cognitive decline prior to functional impairment.