Association between perceived risk of Alzheimer's disease and related dementias and cognitive function among U.S. older adults.
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2023-07
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Abstract
Introduction
The aim of the study was to assess factors associated with the perceived risk of developing Alzheimer's disease and related dementias (ADRD) and how the perceived risk of ADRD was related to cognitive function.Methods
We conducted a retrospective cohort study using 5 waves of data from the Health and Retirement Study (2012-2022) that included adults aged 65 years or older with no previous diagnosis of ADRD at baseline. Cognitive function was measured at baseline and over time using a summary score that included immediate/delayed word recall, serial 7's test, objective naming test, backwards counting, recall of the current date, and naming the president/vice-president (range = 0-35). Perceived risk of developing ADRD was categorized at baseline as "definitely not" (0% probability), "unlikely" (1-49%), "uncertain" (50%), and "more than likely" (>50-100%). Additional baseline measures included participants' sociodemographic background, psychosocial resources, health behaviors, physiological status, and healthcare utilization.Results
Of 1457 respondents (median age 74 [IQR = 69-80] and 59.8% women), individuals who perceived that they were "more than likely" to develop ADRD had more depressive symptoms and were more likely to be hospitalized in the past two years than individuals who indicated that it was "unlikely" they would develop ADRD. Alternatively, respondnets who perceived that they would "definitely not" develop ADRD were more likely to be non-Hispanic Black, less educated, and have lower income than individuals who indicated it was "unlikely" they would develop ADRD. Respondents who reported their risks of developing ADRD as "more than likely" (β = -2.10, P < 0.001) and "definitely not" (β = -1.50, P < 0.001) had the lowest levels of cognitive function; and the associations were explained in part by their socioeconomic, psychosocial, and health status.Conclusions
Perceived risk of developing ADRD is associated with cognitive function. The (dis)concordance between individuals' perceived risk of ADRD and their cognitive function has important implications for increasing public awareness and developing interventions to prevent ADRD.Type
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Publication Info
Wang, Nan, Hanzhang Xu, Jessica S West, Truls Østbye, Bei Wu, Ying Xian and Matthew E Dupre (2023). Association between perceived risk of Alzheimer's disease and related dementias and cognitive function among U.S. older adults. Archives of gerontology and geriatrics, 115. p. 105126. 10.1016/j.archger.2023.105126 Retrieved from https://hdl.handle.net/10161/28646.
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Scholars@Duke

Hanzhang Xu
My research and scholarship center around social determinants of health and disparities in health care and outcomes in diverse older adult populations, with a particular focus on cardiovascular and brain health. My current program of research falls under two themes: (i) the analysis of health disparities in a multinational context, with a particular focus on the cognitive function among older adults; and (ii) the integration of patient-reported social factors in cardiovascular outcome research. I have led several research projects funded by the National Institute of Health (NIH) and American Heart Association (AHA) that leverage the strengths of big data repositories such as electronic health records (EHR), Medicare claims, and national survey data to improve the cardiovascular and brain health of older adults through a lens of equity.
Areas of Expertise:
Global Health; Social Determinants of Health; Cardiovascular Disease; Alzheimer's Disease and Related Dementias; and Population Aging

Jessica Sayles West
Jessica is a medical sociologist who specializes in research on hearing loss, aging, and health disparities over the life course. Jessica’s work has described the “spillover” effects of hearing loss on health outcomes for both individuals and those close to them, as well as sociodemographic disparities in the onset of and life expectancy with hearing loss. Her research, which leverages both population-level data and electronic health record data, has appeared in the Journals of Gerontology, Social Science & Medicine, Ear and Hearing, and other leading journals in medical sociology, hearing, and aging research.
Jessica received a B.A. from the University of Michigan in Social Anthropology (dual Sociology/Anthropology concentration) followed by an M.P.H. in Sociomedical Sciences with a certificate in Public Health Research Methods from Columbia University’s Mailman School of Public Health. She subsequently received an M.A. and Ph.D. in Sociology with a focus in Medical Sociology and Demography at Duke University. She then completed an NIA T32 Postdoctoral Fellowship at the Duke University Aging Center under the mentorship of Matthew E. Dupre, Ph.D. (Population Health Sciences) and Sherri L. Smith, Au.D., Ph.D. (Head and Neck Surgery & Communication Sciences).

Bei Wu
Bei Wu, PhD, is Pauline Gratz Professor of Nursing, Director for International Research at the School of Nursing, and a member of the Global Health Institute. She is also a senior fellow at the Center for the Study of Aging and Human Development. Dr. Wu’s areas of research expertise include aging and global health.
Dr. Wu received her M.S. and Ph.D. in gerontology from the University of Massachusetts, Boston. She is a fellow of the Gerontological Society of America (GSA) and the Association for Gerontology in Higher Education (AGHE). She is an internationally known expert on China’s long-term care policy and system development. She has worked closely with several schools of public health and schools of nursing in China on educational and research initiatives, such as conducting joint research projects, providing lectures, making presentations, and organizing professional conferences/training workshops. As the Principal Investigator, Dr. Wu has led many National Institutes of Health (NIH) and Center for Disease Control and Prevention (CDC) funded projects on aging and health related issues including long-term care, dementia, caregiving, oral health, and health services utilization. She is also the Methods Core Director for the recently NIH-funded center on Adaptive Leadership in Symptom Science.
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