title: Impact of offspring death on cognitive health in late life: the Cache County study.
abstract: OBJECTIVE
  Experiencing the death of a child is associated with negative short-term mental health consequences, but less is known about cognitive outcomes and whether such associations extend to late life. We tested the hypothesis that experiencing an offspring death (OD) is associated with an increased rate of cognitive decline in late life.
  
  
  METHODS
  This population-based longitudinal study observed four cognitive statuses spaced 3-4 years apart, linked to an extensive database containing objective genealogic and vital statistics data. Home visits were conducted with 3,174 residents of a rural county in northern Utah, initially without dementia, aged 65-105. Cognitive status was measured with the Modified Mini-Mental State Exam at baseline and at 3-, 7-, and 10-year follow-ups. OD was obtained from the Utah Population Database, which contains statewide birth and death records.
  
  
  RESULTS
  In linear mixed models, controlling for age, gender, education, and apolipoprotein E status, subjects who experienced OD while younger than age 31 years experienced a significantly faster rate of cognitive decline in late life, but only if they had an ε4 allele. Reclassifying all OD (regardless of age) according to subsequent birth of another child, OD was only related to faster cognitive decline when there were no subsequent births.
  
  
  CONCLUSIONS
  Experiencing OD in early adulthood has a long-term association with cognitive functioning in late life, with a gene-environment interaction at the apolipoprotein E locus. Subsequent birth of another child attenuates this association.
authors: Department of Family Consumer and Human Development, Utah State University, Logan, UT.
authors: Daylee
authors: D
authors: Greene
authors: Department of Psychology, Center for Epidemiologic Studies, Utah State University, Logan, UT.
authors: JoAnn T
authors: JT
authors: Tschanz
authors: Department of Family and Consumer Studies, Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT.
authors: Ken R
authors: KR
authors: Smith
authors: Duke Global Health Institute, Duke University, Durham, NC; Duke-NUS Graduate Medical School, Singapore.
authors: Truls
authors: T
authors: Ostbye
authors: Department of Mathematics and Statistics, Center for Epidemiologic Studies, Utah State University, Logan, UT.
authors: Chris
authors: C
authors: Corcoran
authors: The Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Duke University, Durham, NC.
authors: Kathleen A
authors: KA
authors: Welsh-Bohmer
authors: Department of Family Consumer and Human Development, Utah State University, Logan, UT; Department of Psychology, Center for Epidemiologic Studies, Utah State University, Logan, UT. Electronic address: maria.norton@usu.edu.
authors: Maria C
authors: MC
authors: Norton
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D053327:Apolipoprotein E4 / Q000235:genetics; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D005260:Female; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations; D012307:Risk Factors; D012737:Sex Factors; D014589:Utah / Q000453:epidemiology; D055815:Young Adult
chemical_list: D053327:Apolipoprotein E4
keywords: Cognitive decline; apoE; psychosocial stress
references: J Neurosci. 2006 Aug 30;26(35):9047-56
references: 16943563
references: Fam Relat. 2010 Jul 1;59(3):269-282
references: 20676393
references: Neurology. 2004 Mar 9;62(5):726-9
references: 15007121
references: Epidemiology. 2001 Jul;12(4):383-9
references: 11416775
references: Br J Psychiatry. 1997 May;170:453-5
references: 9307696
references: Nat Neurosci. 2009 Mar;12(3):342-8
references: 19234457
references: Neurobiol Aging. 2002 Sep-Oct;23(5):921-39
references: 12392796
references: Am J Geriatr Psychiatry. 2011 Sep;19(9):814-24
references: 21873837
references: J Neurosci. 2010 May 12;30(19):6726-31
references: 20463234
references: J Psychiatr Res. 1975 Nov;12(3):189-98
references: 1202204
references: Neuropsychiatry Neuropsychol Behav Neurol. 2002 Mar;15(1):28-38
references: 11877549
references: J Epidemiol Community Health. 2012 Oct;66(10):927-33
references: 22045850
references: J Palliat Med. 2010 Nov;13(11):1321-6
references: 20954828
references: Diabet Med. 2005 Oct;22(10):1338-42
references: 16176193
references: Psychol Aging. 1996 Mar;11(1):127-39
references: 8726378
references: Neurobiol Aging. 2005 Mar;26(3):325-34
references: 15639310
references: Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2010 May;17(3):257-69
references: 19634026
references: Age Ageing. 2009 May;38(3):340-3
references: 19276094
references: Neurology. 2000 Jan 25;54(2):415-20
references: 10668705
references: Lancet. 2003 Feb 1;361(9355):363-7
references: 12573371
references: Circulation. 2002 Sep 24;106(13):1634-9
references: 12270855
references: Arch Psychiatr Nurs. 2005 Dec;19(6):245-55
references: 16308124
references: Neurology. 1999 Jul 22;53(2):321-31
references: 10430421
references: J Clin Psychol. 2008 Oct;64(10):1145-63
references: 18698614
references: Pediatrics. 2008 Apr;121 Suppl 4:S290-310
references: 18381495
references: J Clin Psychiatry. 1987 Aug;48(8):314-8
references: 3611032
references: Nat Neurosci. 1998 May;1(1):69-73
references: 10195112
references: Biol Psychiatry. 2007 Sep 1;62(5):472-8
references: 17544378
references: Neurology. 1993 Aug;43(8):1467-72
references: 8350998
references: FASEB J. 2011 Oct;25(10):3306-11
references: 21680892
references: Endocr Rev. 1986 Aug;7(3):284-301
references: 3527687
references: Lancet. 2007 Dec 8;370(9603):1960-73
references: 18068517
references: Aust N Z J Psychiatry. 1998 Apr;32(2):235-41
references: 9588303