Gail E. Bond

Alcohol and cognitive performance: a longitudinal study of older Japanese Americans. The Kame Project

BACKGROUND Recent data demonstrate that moderate consumption of alcohol (13-52 grams of ethanol per day) may be beneficial to cognitive functioning among older adults. METHODS Longitudinal growth curve analyses controlling for baseline age, body mass index (BMI), education/income, migrant status, smoking, history of diagnosed stroke, hypertension, coronary heart disease (CHD), depression, diabetes and stroke (time-varying) were used to examine the relationship between alcohol consumption, gender and cognitive performance over an 8-year follow-up period. The sample included 1624 Japanese American community-dwelling adults aged 65 and older who were cognitively intact at baseline and participated in at least one follow-up examination. Cognitive performance was measured using the Cognitive Abilities Screening Instrument (CASI; 0-100 point scale), a global test of cognitive function. RESULTS Current consumers (n = 480) scored significantly (p < 0.05) higher on CASI (mean rate of change-1.22 CASI units) over the 8-year follow-up period than past consumers or abstainers (n = 1144; mean rate of change-3.77 CASI units). There was no significant main effect for gender, or an alcohol and gender interaction. CONCLUSIONS This study provides further support regarding the beneficial effects of moderate alcohol consumption on cognitive performance over time. Observed benefits were not modified by gender. Future studies need to determine whether alcohol preserves cognition directly or whether other factors such as physiology or cultural drinking practices are driving the observed association.

Older Adults and Functional Decline: A Cross-Cultural Comparison

BACKGROUND The study was conducted to examine the relationships between functional decline, health risk factors, lifestyle practices, and demographic variables in two culturally diverse, community-based samples of White and Japanese American older adults. DESIGN The study was an analysis of data from two ongoing studies of aging and dementia in King County, Washington. Functional status at baseline was evaluated, and factors associated with functional decline over a 4-year follow-up period were identified. The sample included 1,083 Japanese American and 1,011 White cognitively intact, community-dwelling adults aged 65 and older, who had no functional limitations at baseline and participated in at least one follow-up examination. RESULTS In 4 years of follow-up, 70% of the subjects reported no increase in functional limitation, and fewer than 5% of subjects declined in five or more activities. Risk factors associated with functional decline included increased age, female gender, medical comorbidity (particularly cerebrovascular disease, arthritis, and hypertension), elevated body mass index, poorer self-perceived health, and smoking. Depression and diabetes were also significant for persons with the greatest functional decline over the 4-year follow-up. Japanese speakers were significantly less likely to decline over the follow-up period than White or English-speaking Japanese American subjects. However, Japanese speakers were more likely to discontinue participation during the follow-up period, and may also have been more likely to underreport symptoms of functional decline. CONCLUSIONS The present study provides further support that healthy lifestyle practices and prevention of chronic disease are important for maintaining functional independence in older adults. Japanese-speaking subjects were less likely to decline over time, although this could be due in part to differential dropout and reporting bias. These findings have important implications for the design and interpretation of longitudinal studies of older adults. Researchers interested in the effects of ethnicity on health and aging should be cognizant of differences in recruitment and enrollment strategies among studies, and the ways in which these affect study findings. This study also demonstrates the importance of devoting adequate resources to minimize dropouts, and of including measures of health and functioning that are culturally equivalent and less reliant on self-report data.

Alcohol, Gender, and Cognitive Performance: A Longitudinal Study Comparing Older Japanese and Non-Hispanic White Americans

Background: Recent data demonstrate that moderate consumption of alcohol may be beneficial to cognition. Design: Longitudinal growth curve analyses controlling for variables related to cognition were used to examine the relationship between alcohol consumption, ethnic differences, gender, and cognition over a 4-year-follow-up period. Sample: The sample included 1,836 Japanese American and 2,581 Non-Hispanic White American community-dwelling adults age 65 and older who were cognitively intact at baseline and participated in at least one follow-up examination. Measurement: Cognitive performance was measured using the Cognitive Abilities Screening Instrument (CASI) and reaction time. Results: Current drinkers scored significantly higher on CASI over time than past drinkers or abstainers. The same association between alcohol and CASI was observed in both genders and both ethnic groups. Conclusion: This study provides support regarding the potential beneficial outcomes associated with alcohol consumption and cognition and that these benefits were not modified by gender or ethnicity.

Computer-Aided Cognitive Training of the Aged: A Pilot Study

Abstract Research indicates that individuals above the age of 65 can improve their cognitive abilities and memories. Use of computers with elders has shown promise in maintaining cognitive function. The purpose of this study was to compare the effects of a computer intervention on selected cognitive abilities of 14 elders in a long-term care setting who used a computer program versus 15 who did not. Controlling for initial level of cognitive function, multivariate analysis of variance (MANOVA) showed significant improvement with the computer users compared to the nonusers on five cognitive outcomes. Future studies are needed to examine larger samples and explore gender differences.

Alcohol, aging, and cognitive performance: a cross-cultural comparison.

Objectives: This study investigated the relationship between alcohol consumption and cognitive performance in two culturally diverse community-based populations. Methods: A cross-sectional analysis was used including Japanese Americans (n = 1,836) and Caucasians (n = 2,581) aged 65 and older. Cognitive performance was measured using the Cognitive Abilities Screening Instrument (CASI) (0 to 100 point scale) and reaction time. Results: Multivariate analysis revealed significant cultural and gender differences with cognitive performance. Compared to abstainers, Caucasian drinkers scored higher than Japanese American drinkers on the CASI (adjusted means = 93.4 versus 91.6). In contrast, Japanese American drinkers scored faster than Caucasian drinkers on choice reaction time (adjusted means = 505 versus 579 milli-seconds). Discussion: Results showed that current drinking was associated with better cognition in both the Caucasian and Japanese American groups. Longitudinal studies are needed to support the possible protective effects of alcohol on cognition and explore whether culture may modify this apparent benefit.

Lifestyle Practices and Occupational Stressors as Predictors of Health Outcomes in Urban Firefighters

This study developed lifestyle risk factor profiles for firefighters and tested the influence of lifestyle along with other individual and organizational risk and protective factors on emotional and physical health outcomes. A sample of 441 male firefighters was recruited from 2 urban fire departments in a Pacific Northwest state. Self-reported questionnaire data were collected and analyzed by descriptive and multivariate statistics. In this sample of firefighters, 13% met criteria for lifestyle strengths, 53% met criteria for lifestyle concerns, and 33% met criteria for lifestyle risks. After controlling for the influence of demographic factors, job stressors, and job satisfaction, the lifestyle risk composite variable (based on exercise, alcohol consumption, and smoking), accounted for a significant increase in the variance predicting health outcomes. It was concluded that lifestyle behaviors deserve increased attention from occupational health researchers.

The visibility of organizational culture in a long-term care facility.

Our findings suggest that the perceptions of the staff members and families are not easily discernible by administrators or outsiders such as family members. This inability to judge important changes in the culture of an organization has important consequences for management. If administrators cannot tell which groups perform in the desired direction, they are not in a position to reward and reinforce desired behaviors. If cultural changes are necessary prerequisites to ensure organizational survival, how will an organization be able to create and maintain changes in the culture if there is no prevailing culture that is visible or public to others? More importantly, how will an organization be able to create a visible culture to others if management does not agree on what constitutes successful change? Nursing leaders who understand organizational culture concepts will be in a better position to influence the successful outcome of organizational change.