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Cumulative impact of health deficits, social vulnerabilities, and protective factors on cognitive dynamics in late life: a multistate modeling approach

Overview of attention for article published in Alzheimer's Research & Therapy, June 2015
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  • Good Attention Score compared to outputs of the same age (68th percentile)

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Title
Cumulative impact of health deficits, social vulnerabilities, and protective factors on cognitive dynamics in late life: a multistate modeling approach
Published in
Alzheimer's Research & Therapy, June 2015
DOI 10.1186/s13195-015-0120-7
Pubmed ID
Authors

Joshua J Armstrong, Arnold Mitnitski, Melissa K Andrew, Lenore J Launer, Lon R White, Kenneth Rockwood

Abstract

Many factors influence late-life cognitive changes, and evaluating their joint impact is challenging. Typical approaches focus on average decline and a small number of factors. We used multistate transition models and index variables to look at changes in cognition in relation to frailty (accumulation of health deficits), social vulnerability, and protective factors in the Honolulu-Asia Aging Study (HAAS). The HAAS is a prospective cohort study of 3,845 men of Japanese descent, aged 71 to 93 years at baseline. Cognitive function was measured using the Cognitive Abilities Screening Instrument (CASI). Baseline index variables were constructed of health deficits (frailty), social vulnerabilities, and protective factors. The chances of improvement/stability/decline in cognitive function and death were simultaneously estimated using multistate transition modeling for 3- and 6-year transitions from baseline. On average, CASI scores declined by 5.3 points (standard deviation (SD) = 10.0) over 3 years and 9.5 points (SD = 13.9) over 6 years. After adjusting for education and age, baseline frailty was associated with an increased risk of cognitive decline at 3 years (β = 0.18, 95% confidence interval (CI), 0.08 to 0.29) and 6 years (β = 0.40, 95% CI, 0.27 to 0.54). The social vulnerability index was associated with 3-year changes (β = 0.16, 95% CI, 0.09 to 0.23) and 6-year changes (β = 0.14, 95% CI, 0.05 to 0.24) in CASI scores. The protective index was associated with reductions in cognitive decline over the two intervals (3-year: β = -0.16, 95% CI, -0.24 to -0.09; 6-year: β = -0.21, 95% CI, -0.31 to -0.11,). Research on cognition in late life needs to consider overall health, the accumulation of protective factors, and the dynamics of cognitive change. Index variables and multistate transition models can enhance understanding of the multifactorial nature of late-life changes in cognition.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 71 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 1 1%
Unknown 70 99%

Demographic breakdown

Readers by professional status Count As %
Researcher 11 15%
Student > Master 10 14%
Student > Ph. D. Student 8 11%
Student > Doctoral Student 5 7%
Student > Bachelor 5 7%
Other 18 25%
Unknown 14 20%
Readers by discipline Count As %
Medicine and Dentistry 18 25%
Nursing and Health Professions 8 11%
Social Sciences 7 10%
Psychology 6 8%
Environmental Science 4 6%
Other 12 17%
Unknown 16 23%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 January 2018.
All research outputs
#7,789,735
of 25,402,889 outputs
Outputs from Alzheimer's Research & Therapy
#1,253
of 1,469 outputs
Outputs of similar age
#85,573
of 280,851 outputs
Outputs of similar age from Alzheimer's Research & Therapy
#18
of 19 outputs
Altmetric has tracked 25,402,889 research outputs across all sources so far. This one has received more attention than most of these and is in the 69th percentile.
So far Altmetric has tracked 1,469 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 26.6. This one is in the 14th percentile – i.e., 14% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 280,851 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.
We're also able to compare this research output to 19 others from the same source and published within six weeks on either side of this one. This one is in the 10th percentile – i.e., 10% of its contemporaries scored the same or lower than it.