Abstract
Objectives
Grip strength and cognitive function reflect upper body muscle strength and mental capacities. Cross-sectional research has suggested that in old age these two processes are ...moderately to highly associated, and that an underlying common cause drives this association. Our aim was to synthesize and evaluate longitudinal research addressing whether changes in grip strength are associated with changes in cognitive function in healthy older adults.
Methods
We systematically reviewed English-language research investigating the longitudinal association between repeated measures of grip strength and of cognitive function in community-dwelling older adults to evaluate the extent to which the two indices decline concurrently. We used four search engines: Embase, PsychINFO, PubMed, and Web of Science.
Results
Of 459 unique citations, 6 met our full criteria: 4 studies reported a longitudinal association between rates of change in grip strength and cognitive function in older adults, 2 of which reported the magnitudes of these associations as ranging from low to moderate; 2 studies reported significant cross-sectional but not longitudinal associations among rates of change. All studies concluded that cognitive function and grip strength declined, on average, with increasing age, although with little to no evidence for longitudinal associations among rates of change.
Conclusions
Future research is urged to expand the study of physical and cognitive associations in old age using a within-person and multi-study integrative approach to evaluate the reliability of longitudinal results with greater emphasis on the magnitude of this association.
Systematic review registration number
CRD42016038544.
Confirmatory factor analysis (CFA) has been frequently applied to executive function measurement since first used to identify a three-factor model of inhibition, updating, and shifting; however, ...subsequent CFAs have supported inconsistent models across the life span, ranging from unidimensional to nested-factor models (i.e., bifactor without inhibition). This systematic review summarized CFAs on performance-based tests of executive functions and reanalyzed summary data to identify best-fitting models. Eligible CFAs involved 46 samples (N = 9,756). The most frequently accepted models varied by age (i.e., preschool = one/two-factor; school-age = three-factor; adolescent/adult = three/nested-factor; older adult = two/three-factor), and most often included updating/working memory, inhibition, and shifting factors. A bootstrap reanalysis simulated 5,000 samples from 21 correlation matrices (11 child/adolescent; 10 adult) from studies including the three most common factors, fitting seven competing models. Model results were summarized as the mean percent accepted (i.e., average rate at which models converged and met fit thresholds: CFI ≥ .90/RMSEA ≤ .08) and mean percent selected (i.e., average rate at which a model showed superior fit to other models: ΔCFI ≥ .005/.010/ΔRMSEA ≤ −.010/−.015). No model consistently converged and met fit criteria in all samples. Among adult samples, the nested-factor was accepted (41-42%) and selected (8-30%) most often. Among child/adolescent samples, the unidimensional model was accepted (32-36%) and selected (21-53%) most often, with some support for two-factor models without a differentiated shifting factor. Results show some evidence for greater unidimensionality of executive function among child/adolescent samples and both unity and diversity among adult samples. However, low rates of model acceptance/selection suggest possible bias toward the publication of well-fitting but potentially nonreplicable models with underpowered samples.
Public Significance Statement
Previous research has explored whether executive functions are best described as a single self-regulatory ability (i.e., unity) or a diverse set of abilities related to control over thoughts and behaviors (i.e., diversity). This systematic review identified three abilities most frequently evaluated in psychological research (i.e., inhibition, shifting, and updating/working memory), and a reanalysis of previous studies identified greater unity of executive functions during childhood and greater diversity arising from adolescence into adulthood.
Replication of research findings across independent longitudinal studies is essential for a cumulative and innovative developmental science. Meta-analysis of longitudinal studies is often limited by ...the amount of published information on particular research questions, the complexity of longitudinal designs and the sophistication of analyses, and practical limits on full reporting of results. In many cases, cross-study differences in sample composition and measurements impede or lessen the utility of pooled data analysis. A collaborative, coordinated analysis approach can provide a broad foundation for cumulating scientific knowledge by facilitating efficient analysis of multiple studies in ways that maximize comparability of results and permit evaluation of study differences. The goal of such an approach is to maximize opportunities for replication and extension of findings across longitudinal studies through open access to analysis scripts and output for published results, permitting modification, evaluation, and extension of alternative statistical models and application to additional data sets. Drawing on the cognitive aging literature as an example, the authors articulate some of the challenges of meta-analytic and pooled-data approaches and introduce a coordinated analysis approach as an important avenue for maximizing the comparability, replication, and extension of results from longitudinal studies.
We investigated the power to detect variances and covariances in rates of change in the context of existing longitudinal studies using linear bivariate growth curve models. Power was estimated by ...means of Monte Carlo simulations. Our findings show that typical longitudinal study designs have substantial power to detect both variances and covariances among rates of change in a variety of cognitive, physical functioning, and mental health outcomes. We performed simulations to investigate the interplay among number and spacing of occasions, total duration of the study, effect size, and error variance on power and required sample size. The relation between growth rate reliability (GRR) and effect size to the sample size required to detect power greater than or equal to .80 was nonlinear, with rapidly decreasing sample sizes needed as GRR increases. The results presented here stand in contrast to previous simulation results and recommendations (Hertzog, Lindenberger, Ghisletta, & von Oertzen, 2006; Hertzog, von Oertzen, Ghisletta, & Lindenberger, 2008; von Oertzen, Ghisletta, & Lindenberger, 2010), which are limited due to confounds between study length and number of waves, error variance with growth curve reliability, and parameter values that are largely out of bounds of actual study values. Power to detect change is generally low in the early phases (i.e., first years) of longitudinal studies but can substantially increase if the design is optimized. We recommend additional assessments, including embedded intensive measurement designs, to improve power in the early phases of long-term longitudinal studies.
On average, older people remember less and walk more slowly than do younger persons. Some researchers argue that this is due in part to a common biologic process underlying age-related declines in ...both physical and cognitive functioning. Only recently have longitudinal data become available for analyzing this claim. We conducted a systematic review of English-language research published between 2000 and 2011 to evaluate the relations between rates of change in physical and cognitive functioning in older cohorts. Physical functioning was assessed using objective measures: walking speed, grip strength, chair rise time, flamingo stand time, and summary measures of physical functioning. Cognition was measured using mental state examinations, fluid cognition, and diagnosis of impairment. Results depended on measurement type: Change in grip strength was more strongly correlated with mental state, while change in walking speed was more strongly correlated with change in fluid cognition. Examining physical and cognitive functioning can help clinicians and researchers to better identify individuals and groups that are aging differently and at different rates. In future research, investigators should consider the importance of identifying different patterns and rates of decline, examine relations between more diverse types of measures, and analyze the order in which age-related declines occur.
The Positive and Negative Affect Schedule (PANAS) is a widely used measure of emotional experience. The factor structure of the PANAS has been examined predominantly with cross-sectional designs, ...which fails to disaggregate within-person variation from between-person differences. There is still uncertainty as to the factor structure of positive and negative affect and whether they constitute 2 distinct independent factors. The present study examined the within-person and between-person factor structure of the PANAS in 2 independent samples that reported daily affect over 7 and 14 occasions, respectively. Results from multilevel confirmatory factor analyses revealed that a 2-factor structure at both the within-person and between-person levels, with correlated specific factors for overlapping items, provided good model fit. The best-fitting solution was one where within-person factors of positive and negative affect were inversely correlated, but between-person factors were independent. The structure was further validated through multilevel structural equation modeling examining the effects of cognitive interference, daily stress, physical symptoms, and physical activity on positive and negative affect factors.
Alzheimer's disease and related dementias (ADRDs) are a global crisis facing the aging population and society as a whole. With the numbers of people with ADRDs predicted to rise dramatically across ...the world, the scientific community can no longer neglect the need for research focusing on ADRDs among underrepresented ethnoracial diverse groups. The Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment (ISTAART; alz.org/ISTAART) comprises a number of professional interest areas (PIAs), each focusing on a major scientific area associated with ADRDs. We leverage the expertise of the existing international cadre of ISTAART scientists and experts to synthesize a cross-PIA white paper that provides both a concise “state-of-the-science” report of ethnoracial factors across PIA foci and updated recommendations to address immediate needs to advance ADRD science across ethnoracial populations.
•Neuroticism is associated with higher risk of mortality.•Extraversion, agreeableness, conscientiousness are associated with lower mortality.•Smoking has a small mediating effect on the ...neuroticism-mortality association.•These effects are consistent across 15 long term longitudinal studies.•Baseline age and country-of-origin partially explain heterogeneity in effects.
This study examined the Big Five personality traits as predictors of mortality risk, and smoking as a mediator of that association. Replication was built into the fabric of our design: we used a Coordinated Analysis with 15 international datasets, representing 44,094 participants. We found that high neuroticism and low conscientiousness, extraversion, and agreeableness were consistent predictors of mortality across studies. Smoking had a small mediating effect for neuroticism. Country and baseline age explained variation in effects: studies with older baseline age showed a pattern of protective effects (HR<1.00) for openness, and U.S. studies showed a pattern of protective effects for extraversion. This study demonstrated coordinated analysis as a powerful approach to enhance replicability and reproducibility, especially for aging-related longitudinal research.
Older adults who ultimately develop dementia experience accelerated cognitive decline long before diagnosis. A similar acceleration in cognitive decline occurs in the years before death as well. To ...evaluate preclinical and terminal cognitive decline, past researchers have incorporated change points in their analyses of longitudinal data, identifying point estimates of how many years prior to diagnosis or death that decline begins to accelerate. The current systematic review aimed to summarize the published literature on preclinical and terminal change points in relation to mild cognitive impairment (MCI), dementia, and death, identifying the order in which cognitive and neurological outcomes decline and factors that modify the onset and rate of decline. A systematic search protocol yielded 35 studies, describing 16 longitudinal cohorts, modeling change points for cognitive and neurological outcomes preceding MCI, dementia, or death. Change points for cognitive abilities ranged from 3-7 years prior to MCI diagnosis, 1-11 years prior to dementia diagnosis, and 3-15 years before death. No sequence of decline was observed preceding MCI or death, but the following sequence was tentatively accepted for Alzheimer's disease: verbal memory, visuospatial ability, executive functions and fluency, and last, verbal IQ. Some of the modifiers of the onset and rate of decline examined by previous researchers included gender, education, genetics, neuropathology, and personality. Change point analyses evidence accelerated decline preceding MCI, dementia, and death, but moderators of the onset and rate of decline remain ambiguous due to between-study modeling differences, and coordinated analyses may improve comparability across future studies.
Intensive repeated measurement designs are frequently used to investigate within-person variation over relatively brief intervals of time. The majority of research utilizing these designs relies on ...unit-weighted scale scores, which assume that the constructs are measured without error. An alternative approach makes use of multilevel structural equation models (MSEM), which permit the specification of latent variables at both within-person and between-person levels. These models disaggregate measurement error from systematic variance, which should result in less biased within-person estimates and larger effect sizes. Differences in power, precision, and bias between multilevel unit-weighted models and MSEMs were compared through a series of Monte Carlo simulations. Results based on simulated data revealed that precision was consistently poorer in the MSEMs than the unit-weighted models, particularly when reliability was low. However, the degree of bias was considerably greater in the unit-weighted model than the latent variable model. Although the unit-weighted model consistently underestimated the effect of a covariate, it generally had similar power relative to the MSEM model due to the greater precision. Considerations for scale development and the impact of within-person reliability are highlighted.
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