title: Predictors of Optimal Cognitive Aging in 80+ Women: The Women's Health Initiative Memory Study.
abstract: BACKGROUND
  Independent predictors of preserved cognitive functioning and factors associated with maintaining high preserved cognitive function in women ≥ 80 years remain elusive.
  
  
  METHODS
  Two thousand two hundred twenty-eight women with a mean age of 85 years who participated in the Women's Health Initiative Memory Study were classified as cognitively normal (n = 1,905, 85.5%), mild cognitive impairment (n = 88, 3.9%), dementia (n = 121, 5.4%) or other cognitive impairment (n = 114, n = 5.1%) by central adjudication. Global cognitive functioning was assessed using telephone interview for cognitive status-modified in those women who did not meet cognitive impairment criteria. Differences between women grouped by cognitive status with respect to each potential risk factor were assessed using chi-squared tests and t-tests. Backward stepwise logistic regression was used to select factors that were independently associated with cognitive status.
  
  
  RESULTS
  Factors associated with preserved cognitive functioning were younger age, higher education, and family incomes, being non-Hispanic white, better emotional wellbeing, fewer depressive symptoms, more insomnia complaints, being free of diabetes, and not carrying the apolipoprotein E-epsilon 4 allele. Cognitively normal women who demonstrated sustained high preserved cognition were younger, more educated, and endorsed better self-reported general health, emotional wellbeing, and higher physical functioning.
  
  
  CONCLUSIONS
  Addressing sociodemographic disparities such as income inequality, and targeting interventions to improve depressive symptoms and vascular risk factors, including diabetes, may play an important role in preserving cognition among women who survive to 80 years of age. Person-centered approaches that combine interventions to improve physical, cognitive, and psychosocial functioning may promote maintenance of high preserved cognitive health in the oldest-old.
authors: Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. jgoveas@mcw.edu.
authors: Joseph S
authors: JS
authors: Goveas
authors: Department of Psychiatry and Behavioral Medicine and.
authors: Stephen R
authors: SR
authors: Rapp
authors: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors: Patricia E
authors: PE
authors: Hogan
authors: Department of Psychology, University of Wisconsin at Milwaukee.
authors: Ira
authors: I
authors: Driscoll
authors: Division of Internal Medicine, University of Pittsburgh, Pennsylvania.
authors: Hilary A
authors: HA
authors: Tindle
authors: Department of Kinesiology, University of Maryland, College Park.
authors: J Carson
authors: JC
authors: Smith
authors: Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, California.
authors: Shelli R
authors: SR
authors: Kesler
authors: Department of Nursing, Faculty of Health Science and Social Welfare, University of Haifa, Israel.
authors: Oleg
authors: O
authors: Zaslavsky
authors: HealthPartners Insitute for Education and Research, Minneapolis, Minnesota.
authors: Rebecca C
authors: RC
authors: Rossom
authors: Department of Medicine, University of Massachusetts Medical School, Worcester.
authors: Judith K
authors: JK
authors: Ockene
authors: Department of Psychiatry, Neurology and Epidemiology, University of California, San Francisco.
authors: Kristine
authors: K
authors: Yaffe
authors: Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors: JoAnn E
authors: JE
authors: Manson
authors: Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, Maryland.
authors: Susan M
authors: SM
authors: Resnick
authors: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors: Mark A
authors: MA
authors: Espeland
mesh_terms: D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000453:epidemiology / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D011788:Quality of Life; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D016387:Women's Health
keywords: Cognition; Cognitive aging; Successful aging