Electronic Theses and Dissertations

Date

2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Epidemiology

Committee Chair

Xinhua Yu

Committee Member

Abu Titu

Committee Member

Meredith Ray

Committee Member

satish Kedia

Abstract

Cognitive function decline has been associated with cardiovascular and psychosocial factors. The resulting cognitive impairment and dementia (CID), including Alzheimer’s disease and other related dementia, impose a significant burden among older adults (aged 65 or older), which is expected to increase by 55% or more. CID affected 20% of older adults in the US, and the risk of CID doubles every five years after age 65. This study examined the impact of heart diseases or stroke, depressive symptoms in middle-age, and loneliness on the risk of CID among older adults in the US. We conducted a longitudinal study using the Health and Retirement Study (HRS) data from 1998–2020. HRS participants aged 50 years or older with information regarding heart disease or stroke, depression, and loneliness were included in the study. Fine-Gray competing risk analysis was used to assess the associations. We found that the occurrence and timing of heart disease or stroke were significantly associated with CID, that depressive symptoms in middle-age (especially impairment in executive functions) were associated with a 40% increased risk of CID in later life, and that loneliness (especially social isolation) was also significantly associated with increased risk of CID. Our findings suggest that interventions should target different cardiovascular and psychosocial factors to prevent or reduce the risk of CID.

Comments

Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to ProQuest.

Notes

Open Access

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