Interactive effects of age and inflammation on change in ecologically-assessed cognitive functioning

Abstract Inflammation has been implicated as a precursor to steeper declines in age-associated cognitive decline. Here we investigated biomarkers of peripheral inflammation [basal cytokines, stimulated cytokines (ex vivo), C-reactive protein (CRP)] as moderators of age-related changes in cognitive functioning. As part of the Effects of Stress on Cognitive Aging, Physiology, and Emotion (ESCAPE) study, participants (N = 233; 65% female; 63% Black, 25% Hispanic; 25-65 years of age) completed up to four instances of ambulatory cognitive testing per day across two weeks, over three waves of annual assessments. After each 2-week ecological momentary assessment (EMA) burst, blood was collected and assayed for inflammatory biomarkers. Performance on spatial working memory (mean Euclidean distance errors), processing speed (mean symbol search reaction time), and working memory (n-back test accuracy) tasks were averaged across all instances within an EMA burst. CRP and age interactively predicted change in spatial working memory (B = 0.003, [0.000, 0.005], t(133.60) = 2.350, p = 0.020) such that higher CRP at older ages (~60 years) was associated with a loss of the expected practice effects across waves; at younger ages, CRP did not relate to change in spatial working memory. In a similar fashion, basal (B = -0.002, [-0.004, -0.000], t(103.26) = -2.399, p = 0.018) and stimulated cytokine levels (B = -0.002, [-0.004, -0.000], t(126.65) = -2.183, p = 0.031) interacted with age to predict change in processing speed across waves. These results indicate that inflammation may be critically associated with changes in cognitive functioning in older mid-life adults.

2. University of Nebraska at Omaha, University of Nebraska at Omaha,Nebraska,United States,3. University of Nebraska Medical Center,Omaha,Nebraska,United States Walking and talking on the phone are common highcognitive-load-situations (HCLS; e.g.dual-tasks), requiring extra attentional allocation and increasing perceived stress.We explored whether two load types, 1) single-task (ST) walking or talking on a phone and 2) HCLS walking while talking on a phone, influenced walking and/or cognitive performance among young (n=7; age=23.00±2.08yrs),middle-aged (n=14; age=44.79±7.42yrs),and older (n=15; age=74.47±3.91yrs)adults while controlling for perceived stress.Participants completed 3-minute trials of singletask walking (ST-W), single-task phone conversations with common (e.g., weather; ST-C) and uncommon topics (e.g., life experience; ST-U), and walking while talking on a phone (HCLS-C and HCLS-U).Walking speed was analyzed with 3(ST-W;HCLS-C;HCLS-U) x 3(Age) ANCOVA.HCLS resulted in slower walking speed (p<.001).Older adults exhibited slower speed across conditions compared to young (p=.015).Cognitive complexity (i.e., conversational tone and words greater than six letters (SIXLTR)) on the Linguistic Inquiry and Word Count (LIWC) were analyzed with 2(Cvs.U) x 2(STvs.HCLS) x 3(Age) ANCOVAs.Older age was associated with less cognitive complexity; positive tone (p=.014) and SIXLTR (p=.016), respectively in conversations.Uncommon topics reduced positive tone (p=.022) and SIXLTR (p=.003).Effects of HCLS on tone (p=.040) and SIXLTR (p=.005) varied with age.HCLS with different conversation topics resulted in reduced walking and cognitive complexity while controlling for perceived stress.The analysis of cognitive complexity using common/uncommon conversation topics is a novel method to assess the impact of HCLS.This research will disrupt the transformation of aging leading to a better understanding of attentional allocation and its effects on function.

INTERACTIVE EFFECTS OF AGE AND INFLAMMA-TION ON CHANGE IN ECOLOGICALLY-ASSESSED COGNITIVE FUNCTIONING
Christopher Engeland, 1 Erik Knight, 2 Martin Sliwinski, 3 and Jennifer Graham-Engeland, Inflammation has been implicated as a precursor to steeper declines in age-associated cognitive decline.Here we investigated biomarkers of peripheral inflammation [basal cytokines, stimulated cytokines (ex vivo), C-reactive protein (CRP)] as moderators of age-related changes in cognitive functioning.As part of the Effects of Stress on Cognitive Aging, Physiology, and Emotion (ESCAPE) study, participants (N = 233; 65% female; 63% Black, 25% Hispanic; 25-65 years of age) completed up to four instances of ambulatory cognitive testing per day across two weeks, over three waves of annual assessments.After each 2-week ecological momentary assessment (EMA) burst, blood was collected and assayed for inflammatory biomarkers.Performance on spatial working memory (mean Euclidean distance errors), processing speed (mean symbol search reaction time), and working memory (n-back test accuracy) tasks were averaged across all instances within an EMA burst.CRP and age interactively predicted change in spatial working memory (B = 0.003, [0.000, 0.005], t(133.60)= 2.350, p = 0.020) such that higher CRP at older ages (~60 years) was associated with a loss of the expected practice effects across waves; at younger ages, CRP did not relate to change in spatial working memory.In a similar fashion, basal (B = -0.002,[-0.004, -0.000], t(103.26)= -2.399,p = 0.018) and stimulated cytokine levels (B = -0.002,[-0.004, -0.000], t(126.65)= -2.183,p = 0.031) interacted with age to predict change in processing speed across waves.These results indicate that inflammation may be critically associated with changes in cognitive functioning in older mid-life adults.

INTERGENERATIONAL SOCIOECONOMIC MOBILITY AND COGNITIVE IMPAIRMENT IN CHINESE OLDER ADULTS: DOES GENDER MATTER?
Rong Fu, 1 and Yujun Liu, 2 , 1. Siena College, Loudonville, New York, United States, 2. Northern Illinois University, Naperville, Illinois, United States The prevalence of dementia among older adults in mainland China is projected to increase rapidly in the next few decades.This study aimed to examine the impact of intergenerational socioeconomic mobility on the risk of cognitive impairment in a cohort of Chinese older adults, with a focus on potential gender differences.Data were derived from the 2011 wave of the Chinese Longitudinal Healthy Longevity Survey.Socioeconomic mobility in this study includes three dimensions: occupational mobility, educational mobility, and residential mobility.Cognitive impairment was assessed using the Chinese version of Mini-Mental State Examination.The final sample included 6,233 older adults aged 80 years and above.Logistic regression models were performed to assess the impact of the three dimensions of socioeconomic mobility on the risk of cognitive impairment in older men and women.For men, those with stable high occupational status across generations had the lowest risk of cognitive impairment.For women, those who received no education and lived in rural areas across generations had the highest risk of cognitive impairment.These findings lend support to the cumulative risk theory, which highlights the accumulation of risk factors that places individuals in jeopardy for negative health consequences in later life.The findings have implications for advancing supportive policies and practices related to maximizing the benefits of education and occupation for cognition in later life, especially for women in rural China.

INVOLVEMENT IN DECISION-MAKING FOR DAILY CARE AND COGNITIVE DECLINE AMONG OLDER ADULTS WHO NEED CARE IN JAPAN
Ayane Komatsu, 1 Takeshi Nakagawa, 2 Taiji Noguchi, 2 and Tami Saito, 2 , 1.Department of Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan, 2. National Center for Geriatrics and Gerontology, Obu, Aichi, Japan Effective decision-making regarding daily care for older adults with needs could reduce the risk of dementia by preventing loss of motivation and improving care quality.However, empirical studies are scarce, particularly in non-Western countries with different socio-cultural backgrounds.By using 2-year longitudinal data of older Japanese adults aged 65 years and above who were receiving care at home, as well as of their family caregivers, we examined the association of involvement in decision-making with the onset of cognitive decline among older Japanese adults requiring care.The analysis included 219 cases of individuals with normal cognition and no missing variables at baseline and responded to the follow-up survey.An MMSE score of 23 or lower at follow-up was defined as the onset of cognitive decline.The level of involvement in decision-making was assessed by one item and dichotomized (not involved/involved).The covariates were age, gender, education, MMSE score, eligibility level for long-term care, and others at baseline.At baseline, 67.1% were 75 years or older, 58.9% were female, and 91.8% responded being "involved" in the decision-making.The incidence of cognitive decline at follow-up was 30.6%.The multivariable logistic regression analysis showed that involvement in decision-making (OR=0.298[95% CI: 0.10-0.88],p=0.029) was negatively and significantly associated with the onset of cognitive decline.Our findings show the importance of involvement in the decision-making for daily care to reduce the risk of subsequent cognitive decline in older adults requiring care, even in a culture of familism.

IS SUSCEPTIBILITY TO DEFAULT EFFECTS ASSOCIATED WITH AGE?
Julia Nolte, and Corinna Loeckenhoff, Cornell University, Ithaca, New York, United States Older adults are more likely to avoid making decisions than younger adults are.Because the underlying reasons are poorly understood, the present study investigated the potential role of age differences in susceptibility to default effects.Defaults facilitate decision avoidance because decision makers are more likely to passively accept than to actively reject pre-selected default options.A representative lifespan sample (N = 500, Mage = 49.90,SDage = 19.34,51% female, 67% non-Hispanic White) responded to a pre-registered online study.Participants completed one default effect task comprising two scenarios, one requiring opt-out and one requiring opt-in decisions (i.e., 15 vs. 0 pre-selected features each).Susceptibility to defaults was assessed through the discrepancy between scenarios.In addition, we collected data on known determinants of default effect compliance (i.e., perceived endowment, endorsement, ease, importance of the choice, and experience making similar choices) as well as post-decisional affect.Finally, participants responded to assessments of demographic background, personality, socioemotional and health status, and cognitive ability.Susceptibility to default effects was evident both at the individual and the group level (i.e., across and within scenarios).Unlike hypothesized, older age did not predict greater susceptibility, and older adults were less rather than more likely to endorse determinants of default effect compliance.Of the covariates assessed, only identifying as non-Hispanic White, greater perceived endorsement, and greater perceived ease predicted decision makers' susceptibility to default effects.Thus, results did not support our assumption that age differences in decision avoidance might reflect age-related increments in the acceptance of decision defaults.