Palliative care (PC) is becoming more widely available and its benefits, including improved quali... more Palliative care (PC) is becoming more widely available and its benefits, including improved quality of life for patients, have been demonstrated. Studies on patient-level barriers to PC access focus on knowledge and misperceptions. This study aimed to explore, among a community sample, whether more approach-focused coping styles may be associated with more positive attitudes towards PC and whether more avoidant coping styles are associated with more negative attitudes towards PC. Two linear regression analyses (an approach model and an avoidance model) were conducted to determine predictors of attitudes towards PC, controlling for potential confounds. The sample consisted of 87 community-dwelling adults ages 65+ (mean age=72.72 (5.88); 56.32% = women; 86.21% = White). In both models, more knowledge of PC was associated with more positive attitudes towards PC (β = .71, p<.01). Coping by engaging more social support was significantly associated with more positive attitudes towards PC (β = .54, p<.05). Results demonstrated a significant interaction (β = -1.24, p<.01) such that women who endorsed high levels of disengaged coping reported more favorable attitudes towards PC than men who endorsed high levels of disengaged coping. Results indicate the need for a tailored approach to PC education for patients and families. Men who often cope with a stressor via distraction, self-blame, denial, or giving up may be less receptive to acceptance of PC. Future research on educational interventions tailored for individuals with distinct coping styles may be beneficial, particularly for men who frequently rely on disengaged coping styles.
Background:Mitochondrial DNA (mtDNA) may play a role in Alzheimer’s disease (AD) and cognitive de... more Background:Mitochondrial DNA (mtDNA) may play a role in Alzheimer’s disease (AD) and cognitive decline. A particular haplogroup of mtDNA, haplogroup J, has been observed more commonly in patients with AD than in cognitively normal controls.Objective:We used two mtDNA haplogroups, H and J, to predict change in cognitive performance over five years. We hypothesized that haplogroup J carriers would show less cognitive resilience.Methods:We analyzed data from 140 cognitively normal older adults who participated in the University of Kansas Alzheimer’s Disease Research Center clinical cohort between 2011 and 2020. We used factor analysis to create three composite scores (verbal memory, attention, and executive function) from 11 individual cognitive tests. We performed latent growth curve modeling to describe trajectories of cognitive performance and change adjusting for age, sex, years of education, and APOE ε4 allele carrier status. We compared haplogroup H, the most common group, to haplogroup J, the potential risk group.Results:Haplogroup J carriers had significantly lower baseline performance and slower rates of improvement on tests of verbal memory compared to haplogroup H carriers. We did not observe differences in executive function or attention.Conclusion:Our results reinforce the role of mtDNA in changes to cognitive function in a domain associated with risk for dementia, verbal memory, but not with other cognitive domains. Future research should investigate the distinct mechanisms by which mtDNA might affect performance on verbal memory as compared to other cognitive domains across haplogroups.
Lifestyle behaviors are important determinants of healthy brain aging. Research has not fully exp... more Lifestyle behaviors are important determinants of healthy brain aging. Research has not fully explored how sleep quality and physical activity may differentially influence specific domains of cognitive function. The present study aimed to estimate the relative influence of sleep quality and physical activity on cognitive performance in three domains in a sample of older adults. Older adults (ages 60-89, M = 74.74) without cognitive impairment (N= 160) wore an accelerometer for 7 days in a free-living environment. We used average vector magnitude counts per minute to measure total physical activity (TPA), and average wake after sleep onset (WASO) to measure sleep quality. We created cognitive composite scores (executive function, attention, and verbal memory) from neuropsychological data using confirmatory factor analysis. We regressed cognitive scores onto TPA and WASO with age and education entered as covariates. Higher amounts of physical activity and better sleep quality were associated with better executive function (R2 = 20.3%, F (4, 155) = 11.12, p &amp;amp;lt; .001). Neither physical activity nor sleep quality was associated with verbal memory or attention. Results suggest that more physical activity and improved ability to stay asleep may benefit executive function, but not other cognitive domains. Future studies should clarify the interaction and mechanisms of action between health behaviors and cognitive performance in older adults.
Journal for the measurement of physical behaviour, Jun 1, 2018
Time spent being sedentary is associated with poorer cognitive function and risk of developing Al... more Time spent being sedentary is associated with poorer cognitive function and risk of developing Alzheimer’s disease (AD). The present study aimed to compare patterns of sitting in a free-living environment among older adults with and without early stage AD who were similar in physical limitations, body mass, and cardiorespiratory capacity. We also compared estimates of sitting patterns between two different monitors (postural and non-postural) with different body placements (thigh-worn vs. hip-worn). Comparing older adults without cognitive impairment to those with early AD, we found that although there was no difference in the total amount of daily sitting time (p = .52), the AD group tended to have longer durations of sitting than those without AD. Inclinometry data from the hip-worn ActiGraph GT3X+ consistently underestimated time spent sitting compared to the thigh worn monitor activPAL™ (hours per day, proportion of waking hours, number of sitting bouts greater than 30 minutes, and duration of sitting bouts). Our results have implications for prevention strategies to reduce sedentary time, which is predominantly sitting, in persons with cognitive impairment and highlight the importance of monitor selection and placement for the accurate assessment of sitting patterns in this population.
Palliative care (PC) is becoming more widely available and its benefits, including improved quali... more Palliative care (PC) is becoming more widely available and its benefits, including improved quality of life for patients, have been demonstrated. Studies on patient-level barriers to PC access focus on knowledge and misperceptions. This study aimed to explore, among a community sample, whether more approach-focused coping styles may be associated with more positive attitudes towards PC and whether more avoidant coping styles are associated with more negative attitudes towards PC. Two linear regression analyses (an approach model and an avoidance model) were conducted to determine predictors of attitudes towards PC, controlling for potential confounds. The sample consisted of 87 community-dwelling adults ages 65+ (mean age=72.72 (5.88); 56.32% = women; 86.21% = White). In both models, more knowledge of PC was associated with more positive attitudes towards PC (β = .71, p<.01). Coping by engaging more social support was significantly associated with more positive attitudes towards PC (β = .54, p<.05). Results demonstrated a significant interaction (β = -1.24, p<.01) such that women who endorsed high levels of disengaged coping reported more favorable attitudes towards PC than men who endorsed high levels of disengaged coping. Results indicate the need for a tailored approach to PC education for patients and families. Men who often cope with a stressor via distraction, self-blame, denial, or giving up may be less receptive to acceptance of PC. Future research on educational interventions tailored for individuals with distinct coping styles may be beneficial, particularly for men who frequently rely on disengaged coping styles.
Background:Mitochondrial DNA (mtDNA) may play a role in Alzheimer’s disease (AD) and cognitive de... more Background:Mitochondrial DNA (mtDNA) may play a role in Alzheimer’s disease (AD) and cognitive decline. A particular haplogroup of mtDNA, haplogroup J, has been observed more commonly in patients with AD than in cognitively normal controls.Objective:We used two mtDNA haplogroups, H and J, to predict change in cognitive performance over five years. We hypothesized that haplogroup J carriers would show less cognitive resilience.Methods:We analyzed data from 140 cognitively normal older adults who participated in the University of Kansas Alzheimer’s Disease Research Center clinical cohort between 2011 and 2020. We used factor analysis to create three composite scores (verbal memory, attention, and executive function) from 11 individual cognitive tests. We performed latent growth curve modeling to describe trajectories of cognitive performance and change adjusting for age, sex, years of education, and APOE ε4 allele carrier status. We compared haplogroup H, the most common group, to haplogroup J, the potential risk group.Results:Haplogroup J carriers had significantly lower baseline performance and slower rates of improvement on tests of verbal memory compared to haplogroup H carriers. We did not observe differences in executive function or attention.Conclusion:Our results reinforce the role of mtDNA in changes to cognitive function in a domain associated with risk for dementia, verbal memory, but not with other cognitive domains. Future research should investigate the distinct mechanisms by which mtDNA might affect performance on verbal memory as compared to other cognitive domains across haplogroups.
Lifestyle behaviors are important determinants of healthy brain aging. Research has not fully exp... more Lifestyle behaviors are important determinants of healthy brain aging. Research has not fully explored how sleep quality and physical activity may differentially influence specific domains of cognitive function. The present study aimed to estimate the relative influence of sleep quality and physical activity on cognitive performance in three domains in a sample of older adults. Older adults (ages 60-89, M = 74.74) without cognitive impairment (N= 160) wore an accelerometer for 7 days in a free-living environment. We used average vector magnitude counts per minute to measure total physical activity (TPA), and average wake after sleep onset (WASO) to measure sleep quality. We created cognitive composite scores (executive function, attention, and verbal memory) from neuropsychological data using confirmatory factor analysis. We regressed cognitive scores onto TPA and WASO with age and education entered as covariates. Higher amounts of physical activity and better sleep quality were associated with better executive function (R2 = 20.3%, F (4, 155) = 11.12, p &amp;amp;lt; .001). Neither physical activity nor sleep quality was associated with verbal memory or attention. Results suggest that more physical activity and improved ability to stay asleep may benefit executive function, but not other cognitive domains. Future studies should clarify the interaction and mechanisms of action between health behaviors and cognitive performance in older adults.
Journal for the measurement of physical behaviour, Jun 1, 2018
Time spent being sedentary is associated with poorer cognitive function and risk of developing Al... more Time spent being sedentary is associated with poorer cognitive function and risk of developing Alzheimer’s disease (AD). The present study aimed to compare patterns of sitting in a free-living environment among older adults with and without early stage AD who were similar in physical limitations, body mass, and cardiorespiratory capacity. We also compared estimates of sitting patterns between two different monitors (postural and non-postural) with different body placements (thigh-worn vs. hip-worn). Comparing older adults without cognitive impairment to those with early AD, we found that although there was no difference in the total amount of daily sitting time (p = .52), the AD group tended to have longer durations of sitting than those without AD. Inclinometry data from the hip-worn ActiGraph GT3X+ consistently underestimated time spent sitting compared to the thigh worn monitor activPAL™ (hours per day, proportion of waking hours, number of sitting bouts greater than 30 minutes, and duration of sitting bouts). Our results have implications for prevention strategies to reduce sedentary time, which is predominantly sitting, in persons with cognitive impairment and highlight the importance of monitor selection and placement for the accurate assessment of sitting patterns in this population.
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Papers by Amber Watts