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Article ; Online: Multimorbidity, Social Engagement, and Age-Related Cognitive Decline in Older Adults from the Rancho Bernardo Study of Healthy Aging.

Posis, Alexander Ivan B / Shadyab, Aladdin H / Parada, Humberto / Alcaraz, John E / Kremen, William S / McEvoy, Linda K

2024 Volume 97, Issue 4, Page(s) 1689–1702

Abstract: Background: Multimorbidity is associated with increased rate of cognitive decline with age. It is unknown whether social engagement, which is associated with reduced risk of dementia, modifies associations between multimorbidity and cognitive decline.!## ...

Abstract	Background: Multimorbidity is associated with increased rate of cognitive decline with age. It is unknown whether social engagement, which is associated with reduced risk of dementia, modifies associations between multimorbidity and cognitive decline. Objective: To examine the associations of multimorbidity with longitudinal cognitive test performance among community-dwelling older adults, and to determine whether associations differed by levels of social engagement. Methods: We used data from the Rancho Bernardo Study of Healthy Aging, a community-based prospective cohort study. Starting in 1992-1996, participants completed a battery of cognitive function tests at up to 6 study visits over 23.7 (mean = 7.2) years. Multimorbidity was defined as≥2 of 14 chronic diseases. Social engagement was assessed using items based on the Berkman-Syme Social Network Index. Multivariable linear mixed-effects models were used to test associations of multimorbidity and cognitive performance trajectories. Effect measure modification by social engagement was evaluated. Results: Among 1,381 participants (mean age = 74.5 years; 60.8% women; 98.8% non-Hispanic White), 37.1% had multimorbidity and 35.1% had low social engagement. Multimorbidity was associated with faster declines in Mini-Mental State Examination (MMSE; β= -0.20; 95% CI -0.35, -0.04), Trail-Making Test Part B (β= 10.02; 95% CI 5.77, 14.27), and Category Fluency (β= -0.42; 95% CI -0.72, -0.13) after adjustment for socio-demographic and health-related characteristics. Multimorbidity was associated with faster declines in MMSE among those with low compared to medium and high social engagement (p-interaction < 0.01). Conclusions: Multimorbidity was associated with faster declines in cognition among community-dwelling older adults. Higher social engagement may mitigate multimorbidity-associated cognitive decline.
MeSH term(s)	Humans ; Female ; Aged ; Male ; Multimorbidity ; Prospective Studies ; Social Participation ; Healthy Aging ; Cognitive Dysfunction/psychology ; Cognition ; Longitudinal Studies
Language	English
Publishing date	2024-02-02
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1440127-7
ISSN	1875-8908 ; 1387-2877
ISSN (online)	1875-8908
ISSN	1387-2877
DOI	10.3233/JAD-230809
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Article ; Online: Psychometric Analysis of the Modified Differential Emotions Scale and the Six-Item Life Orientation Test-Revised in a Cohort of Older Women from the Women's Health Initiative.

Posis, Alexander Ivan B / Yarish, Natalie M / Ryu, Rita H / Tindle, Hilary A / Michael, Yvonne L / Wactawski-Wende, Jean / Bellettiere, John

Journal of women's health (2002)

2023 Volume 32, Issue 9, Page(s) 992–1005

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Humans ; Female ; Aged ; Psychometrics ; Reproducibility of Results ; Emotions ; Women's Health ; Surveys and Questionnaires
Language	English
Publishing date	2023-07-17
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	1139774-3
ISSN	1931-843X ; 1059-7115 ; 1540-9996
ISSN (online)	1931-843X
ISSN	1059-7115 ; 1540-9996
DOI	10.1089/jwh.2023.0056
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Article ; Online: The association of leukocyte telomere length with exceptional longevity among older women.

Thai, Nhat Quang N / LaCroix, Andrea Z / Haring, Bernhard / Wactawski-Wende, Jean / Manson, JoAnn E / Posis, Alexander Ivan B / Shadyab, Aladdin H

GeroScience

2023 Volume 46, Issue 2, Page(s) 2083–2092

Abstract: The association of leukocyte telomere length (LTL) with survival to late life with intact mobility has not been adequately studied. This prospective cohort study consisted of 1451 postmenopausal women from a Women's Health Initiative ancillary study, who ...

Abstract	The association of leukocyte telomere length (LTL) with survival to late life with intact mobility has not been adequately studied. This prospective cohort study consisted of 1451 postmenopausal women from a Women's Health Initiative ancillary study, who were eligible, because of birth year, to survive to age 90 as of March 6, 2021. LTL was measured by Southern blot at baseline (1993-1998). Associations between LTL and survival to age 90 were evaluated using logistic regression models adjusted for socio-demographic characteristics, health factors, and lifestyle factors. Multinominal logistic regression was utilized to examine associations of LTL with survival to age 90 with or without intact mobility. Mediation analysis examined the extent to which incident coronary heart disease and stroke-mediated the association between LTL and longevity. Overall, 76.7% of women were White, and 23.3% were Black; average age at baseline was 70.4±3.5 years. Relative to death before age 90, the odds of survival to age 90 were 60% higher (OR, 1.60; 95% CI, 1.28-2.01), the odds of survival to age 90 with mobility limitation were 72% higher (OR, 1.72; 95% CI, 1.33-2.21), and the odds of survival to age 90 with intact mobility were 44% higher (OR, 1.44; 95% CI, 1.06-1.95) for every one kilobase longer LTL. Absence of CHD, stroke, or CHD/stroke mediated the association of LTL with survival to age 90 by 11.1%, 37.4%, and 31.3%, respectively; however, these findings were not significant. Longer LTL was associated with higher odds of survival to age 90 among older women.
MeSH term(s)	Humans ; Female ; Aged ; Aged, 80 and over ; Longevity/genetics ; Prospective Studies ; Telomere ; Leukocytes ; Stroke/epidemiology ; Stroke/genetics
Language	English
Publishing date	2023-10-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2886586-8
ISSN	2509-2723 ; 2509-2715
ISSN (online)	2509-2723
ISSN	2509-2715
DOI	10.1007/s11357-023-00964-6
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Article ; Online: Loneliness, social isolation, and cardiovascular disease among nonveteran and veteran women.

Yarish, Natalie M / Posis, Alexander Ivan B / Nguyen, Steve / Weitlauf, Julie / Bellettiere, John / Saquib, Nazmus / Richey, Phyllis A / Allison, Matthew / Kroenke, Candyce / Goveas, Joseph S / Coday, Mace / LaCroix, Andrea Z

Journal of women & aging

2024 , Page(s) 1–12

Abstract: We examined the prospective associations of social isolation and loneliness with incident cardiovascular disease (CVD) among aging nonveteran and veteran women, and effect modification by veteran status. Participants with no history of myocardial ... ...

Abstract	We examined the prospective associations of social isolation and loneliness with incident cardiovascular disease (CVD) among aging nonveteran and veteran women, and effect modification by veteran status. Participants with no history of myocardial infarction (MI), stroke, coronary heart disease (CHD), or coronary heart failure from the Women's Health Initiative Extension Study II self-reported social isolation, loneliness, health behaviors, health status, and veteran status. CVD and CVD subevents were physician adjudicated. Hazard ratios (HR) and 95% confidence intervals (CI) for the Interquartile Range (IQR) in social isolation (IQR = 1) and loneliness (IQR=.33) were calculated using Cox proportional hazard models adjusting for sociodemographic, health behavior, and health status characteristics. Veteran status was tested as an effect modifier. Among 52,442 women (Mean age = 79 ± 6.1; veterans
Language	English
Publishing date	2024-04-24
Publishing country	England
Document type	Journal Article
ZDB-ID	1045930-3
ISSN	1540-7322 ; 0895-2841
ISSN (online)	1540-7322
ISSN	0895-2841
DOI	10.1080/08952841.2024.2336655
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Article ; Online: Associations of Accelerometer-Measured Physical Activity and Sedentary Time With All-Cause Mortality by Genetic Predisposition for Longevity.

Posis, Alexander Ivan B / Bellettiere, John / Salem, Rany M / LaMonte, Michael J / Manson, JoAnn E / Casanova, Ramon / LaCroix, Andrea Z / Shadyab, Aladdin H

Journal of aging and physical activity

2022 Volume 31, Issue 2, Page(s) 265–275

Abstract: The goal of this study was to examine associations between accelerometer-measured physical activity (PA) and sedentary time (ST) with mortality by a genetic risk score (GRS) for longevity. Among 5,446 women, (mean [SD]: age, 78.2 [6.6] years), 1,022 ... ...

Abstract	The goal of this study was to examine associations between accelerometer-measured physical activity (PA) and sedentary time (ST) with mortality by a genetic risk score (GRS) for longevity. Among 5,446 women, (mean [SD]: age, 78.2 [6.6] years), 1,022 deaths were observed during 33,350 person-years of follow-up. Using multivariable Cox proportional hazards models, higher light PA and moderate to vigorous PA were associated with lower mortality across all GRS for longevity categories (low/medium/high; all ptrend < .001). Higher ST was associated with higher mortality (ptrend across all GRS categories < .001). Interaction tests for PA and ST with the GRS were not statistically significant. Findings support the importance of higher PA and lower ST for reducing mortality risk in older women, regardless of genetic predisposition for longevity.
MeSH term(s)	Humans ; Female ; Aged ; Longevity/genetics ; Sedentary Behavior ; Genetic Predisposition to Disease ; Accelerometry ; Exercise
Language	English
Publishing date	2022-08-24
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ISSN	1543-267X
ISSN (online)	1543-267X
DOI	10.1123/japa.2022-0067
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Article ; Online: Anticholinergic Drug Burden and Neurocognitive Performance in the Study of Latinos-Investigation of Neurocognitive Aging.

Posis, Alexander Ivan B / Tarraf, Wassim / Gonzalez, Kevin A / Soria-Lopez, Jose A / Léger, Gabriel C / Stickel, Ariana M / Daviglus, Martha L / Lamar, Melissa / Zeng, Donglin / González, Hector M

Journal of Alzheimer's disease : JAD

2022 Volume 86, Issue 1, Page(s) 53–65

Abstract: Background: Studies of cumulative anticholinergic drug burden on cognitive function and impairment are emerging, yet few for Hispanics/Latinos.: Objective: To examine associations between anticholinergic use and neurocognitive performance outcomes ... ...

Abstract	Background: Studies of cumulative anticholinergic drug burden on cognitive function and impairment are emerging, yet few for Hispanics/Latinos. Objective: To examine associations between anticholinergic use and neurocognitive performance outcomes among diverse Hispanics/Latinos. Methods: This prospective cohort study included diverse Hispanic/Latino participants, enrolled in the Study of Latinos-Investigation of Neurocognitive, from New York, Chicago, Miami, and San Diego (n = 6,249). Survey linear regression examined associations between anticholinergic use (measured during baseline [Visit 1] and average 7-year follow up [Visit 2]) with global cognition, episodic learning, memory, phonemic fluency, processing speed, executive functioning, and average 7-year change. Results: Anticholinergic use was associated with lower cognitive global cognition (β= -0.21; 95% CI [-0.36; -0.05]), learning (β= -0.27; 95% CI [-0.47; -0.07]), memory (β= -0.22; 95% CI [-0.41; -0.03]), and executive functioning (β= -0.22; 95% CI [-0.40; -0.03]) scores, particularly among those who took anticholinergics at both visits. Anticholinergic use was associated with faster decline in global cognition, learning, and verbal fluency (β: -0.28 [95% CI: -0.55, -0.01]; β: -0.28 [95% CI: -0.55, -0.01]; β: -0.25, [95% CI -0.47, -0.04], respectively). Sex modified associations between anticholinergic use with global cognition, learning, and executive functioning (F3 = 3.59, F3 = 2.84, F3 = 3.88, respectively). Conclusion: Anticholinergic use was associated with lower neurocognitive performance, especially among those who used anticholinergics at both visits, among a study population of diverse Hispanics/Latinos. Findings will support evidence-based decisions regarding anticholinergic prescriptions and efforts to minimize cognitive impact.
MeSH term(s)	Aging/psychology ; Cholinergic Antagonists/adverse effects ; Cognition ; Hispanic or Latino ; Humans ; Neuropsychological Tests ; Prospective Studies
Chemical Substances	Cholinergic Antagonists
Language	English
Publishing date	2022-01-07
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1440127-7
ISSN	1875-8908 ; 1387-2877
ISSN (online)	1875-8908
ISSN	1387-2877
DOI	10.3233/JAD-215247
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Article ; Online: Association of Social Support with Mild Cognitive Impairment and Dementia Among Older Women: The Women's Health Initiative Memory Study.

Posis, Alexander Ivan B / Yarish, Natalie M / McEvoy, Linda K / Jain, Purva / Kroenke, Candyce H / Saquib, Nazmus / Ikramuddin, Farha / Schnatz, Peter F / Bellettiere, John / Rapp, Stephen R / Espeland, Mark A / Shadyab, Aladdin H

Journal of Alzheimer's disease : JAD

2022 Volume 91, Issue 3, Page(s) 1107–1119

Abstract: Background: Social support may be a modifiable risk factor for cognitive impairment. However, few long-term, large prospective studies have examined associations of various forms of social support with incident mild cognitive impairment (MCI) and ... ...

Abstract	Background: Social support may be a modifiable risk factor for cognitive impairment. However, few long-term, large prospective studies have examined associations of various forms of social support with incident mild cognitive impairment (MCI) and dementia. Objective: To examine associations of perceived social support with incident MCI and dementia among community-dwelling older women. Methods: This prospective cohort study included 6,670 women from the Women's Health Initiative Memory Study who were cognitively unimpaired at enrollment. We used Cox proportional hazards models to assess associations between perceived social support with incident MCI, dementia, or either MCI/dementia during an average 10.7 (SD = 6.1)-year follow-up. Modelling was repeated for emotional/information support, affection support, tangible support, and positive social interaction subscales of social support. Results: Among 6,670 women (average age = 70 years [SD = 3.8]; 97.0% non-Hispanic/Latina; 89.8% White), greater perceived social support was associated with lower risk of MCI/dementia after adjustment for age, ethnicity, race, hormone therapy, education, income, diabetes, hypertension, and body mass index (Tertile [T]3 versus T1: HR = 0.85, 95% CI 0.74-0.99; ptrend = 0.08). Associations were significant for emotional/information support (T3 versus T1: HR = 0.84, 95% CI 0.72-0.97; ptrend = 0.04) and positive social interaction (T3 versus T1: HR = 0.85, 95% CI 0.73-0.99; ptrend = 0.06) subscales. Associations were attenuated and not significant after adjustment for depressive symptom severity. Objective: Perceived social support, emotional/information support, and positive social interaction were associated with incident MCI/dementia among older women. Results were not significant after adjustment for depressive symptom severity. Improving social support may reduce risk of MCI and dementia in older women.
MeSH term(s)	Female ; Humans ; Aged ; Prospective Studies ; Dementia/diagnosis ; Cognitive Dysfunction/diagnosis ; Risk Factors ; Women's Health ; Social Support
Language	English
Publishing date	2022-12-19
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1440127-7
ISSN	1875-8908 ; 1387-2877
ISSN (online)	1875-8908
ISSN	1387-2877
DOI	10.3233/JAD-220967
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Article ; Online: In-Home Cannabis Smoking Among a Cannabis-Using Convenience Sample from the Global Drug Survey: With Weighted Estimates for U.S. Respondents.

Tripathi, Osika / Posis, Alexander Ivan B / Thompson, Caroline A / Ferris, Jason / Anuskiewicz, Blake / Nguyen, Benjamin / Liles, Sandy / Berardi, Vincent / Zhu, Shu-Hong / Winstock, Adam / Bellettiere, John

Cannabis and cannabinoid research

2022 Volume 9, Issue 1, Page(s) 353–362

Abstract: Introduction: ...

Abstract	Introduction:
MeSH term(s)	Male ; Humans ; Female ; Adult ; Adolescent ; Marijuana Smoking/epidemiology ; Tobacco Smoke Pollution/adverse effects ; Cannabis/adverse effects ; Cross-Sectional Studies ; Surveys and Questionnaires ; Hallucinogens
Chemical Substances	Tobacco Smoke Pollution ; Hallucinogens
Language	English
Publishing date	2022-11-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2867624-5
ISSN	2378-8763 ; 2578-5125
ISSN (online)	2378-8763
ISSN	2578-5125
DOI	10.1089/can.2022.0139
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Article ; Online: In-home cannabis smoking more prevalent than in-home tobacco smoking among 2019 Global Drug Survey respondents.

Bellettiere, John / Liles, Sandy / Posis, Alexander Ivan B / Anuskiewicz, Blake / Tripathi, Osika / Nguyen, Benjamin / Chavez, Paul / Zhu, Shu-Hong / Park, Ji-Yeun / Winstock, Adam / Ferris, Jason

Addictive behaviors

2021 Volume 125, Page(s) 107130

Abstract: Purpose of the research: Early evidence from studies of home smoking policies suggests that in-home cannabis smoking is more often allowed than in-home tobacco smoking, but there are not yet data on whether cannabis is more often smoked in the home ... ...

Abstract	Purpose of the research: Early evidence from studies of home smoking policies suggests that in-home cannabis smoking is more often allowed than in-home tobacco smoking, but there are not yet data on whether cannabis is more often smoked in the home compared to tobacco, or whether in-home cannabis and tobacco smoking differs by usage status. Using cross-sectional data from over 100,000 sentinel drug users from 17 countries, we compared cannabis and tobacco smoking in the homes of Global Drug Survey 2019 respondents who currently used cannabis only, tobacco only, both tobacco and cannabis, or neither. Principal results: Complete data on cannabis and tobacco use and in-home smoking were available for 107,272 adults (average age = 30 ± 12, 34% women, countries with the three highest response rates; Germany = 32%, USA = 10%, New Zealand = 9%). In total, 53.6% and 50.6% of respondents reported past-year cannabis and tobacco smoking in their home respectively. Stratifying respondents into current cannabis-only users, tobacco-only users, dual users, and non-users, past-year in-home cannabis smoking was more prevalent (78.8%) among cannabis-only users than was in-home tobacco smoking (67.9%) among tobacco-only users. Among dual users, past-year in-home cannabis smoking (82.8%; 95%CI = 80%-86%) was higher than in-home tobacco smoking (75.9%; 95%CI = 69%-81%; p < 0.001). In-home cannabis and tobacco smoking was similar among non-users (20.2% and 20.5%, respectively). Major conclusions: Past-year in-home cannabis smoking was more prevalent than tobacco smoking in the homes of participants who used cannabis and/or tobacco, supporting our speculation that in-home cannabis smoking might be more socially acceptable than in-home tobacco smoking.
MeSH term(s)	Adolescent ; Adult ; Cross-Sectional Studies ; Female ; Humans ; Male ; Marijuana Smoking/epidemiology ; Pharmaceutical Preparations ; Surveys and Questionnaires ; Tobacco Smoking ; Young Adult
Chemical Substances	Pharmaceutical Preparations
Language	English
Publishing date	2021-10-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	197618-7
ISSN	1873-6327 ; 0306-4603
ISSN (online)	1873-6327
ISSN	0306-4603
DOI	10.1016/j.addbeh.2021.107130
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Article ; Online: Waterpipe device cleaning practices and disposal of waste associated with waterpipe tobacco smoking in homes in the USA.

Kassem, Nada Of / Kassem, Noura O / Liles, Sandy / Reilly, Erin / Kas-Petrus, Flora / Posis, Alexander Ivan B / Hovell, Melbourne F

Tobacco control

2019 Volume 29, Issue Suppl 2, Page(s) s123–s130

Abstract: Objectives: To quantify postsmoking waterpipe tobacco (WPT) waste and describe postsmoking waterpipe (WP) device cleaning practices and disposal of associated waste in home settings.: Methods: We analysed data from a US convenience sample of 50 ... ...

Abstract	Objectives: To quantify postsmoking waterpipe tobacco (WPT) waste and describe postsmoking waterpipe (WP) device cleaning practices and disposal of associated waste in home settings. Methods: We analysed data from a US convenience sample of 50 exclusive WPT smokers, mean age 25.3 years. Data were collected at a home visit during which participants smoked one WPT head and completed a self-administered questionnaire on WP cleaning practices and disposal of waste associated with WPT use. Research assistants provided and prepared a WP for participants by weighing and loading 10 g of WPT in the WP head and placing 470 mL of water in the WP bowl. At the completion of the smoking session, research assistants measured the remaining WPT and water. Descriptive analyses were performed. Results: Of the 10 g of fresh WPT used for each smoking session, 70.1% (mean=7.01 g) was discarded postsmoking as waste; for each 470 mL of water used in the WP bowl, 94.3% (mean=443 mL) was discarded. WP device cleaning practices ranged from never cleaning the device to cleaning it after each smoking session. Respondents reported discarding smoked WPT residue in the trash (81.6%) or the kitchen sink (14.3%) and discarding postsmoking charcoal in the trash (57.6%), the kitchen sink (27.3%) or backyard soil (9.1%). Respondents reported discarding smoked WP water in the kitchen sink (76.5%), bathroom sink (14.7%), toilet (2.9%) and backyard soil (5.9%). Conclusions: Interventions and regulations are needed to inform proper WP device cleaning practices and disposal of waste associated with WPT use. Trial registration number: NCT03253653.
Language	English
Publishing date	2019-07-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1146554-2
ISSN	1468-3318 ; 0964-4563
ISSN (online)	1468-3318
ISSN	0964-4563
DOI	10.1136/tobaccocontrol-2019-054959
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