A Cognitive Reserve and Social Support-Focused Latent Class Analysis to Predict Self-Reported Confusion or Memory Loss among Middle-Aged World Trade Center Health Registry Enrollees

Bibliographic Data

ID15466272
AuthorsKacie Seil (0000-0001-9359-2794, New York City Department of Health and Mental Hygiene, corresponding author), Shengchao Yu (0000-0002-4555-0220, New York City Department of Health and Mental Hygiene), Howard Alper (0000-0003-4402-0145, New York City Department of Health and Mental Hygiene)
Year2019
Volume16
Issue8
Pages1401-1401
Publication date2019-04-18
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph16081401
PMID31003460
OpenAlexW2936203144
LanguageEN
Citations received3
References cited45

The World Trade Center Health Registry includes 9/11 survivors who have been surveyed about their health conditions over time. The prevalence of posttraumatic stress disorder (PTSD) remains high among the cohort and is a risk factor for cognitive impairment or dementia. We thus sought to examine the degree to which confusion or memory loss (CML)-potential symptoms of cognitive decline-are occurring among enrollees aged 35-64 years. Cognitive reserve theory suggests that higher levels of education and engaging in cognitively challenging activities can create stronger neural connections, offering protection against cognitive decline. We hypothesized that enrollees with less cognitive reserve would be more likely to report CML. In this study, we: (1) estimated the incidence of CML in our study sample; (2) identified indicators of cognitive reserve (e.g., indicators of educational attainment, social support); and (3) determined whether CML is associated with cognitive reserve level, stratified by PSTD status. First, we described demographics of the study sample ( n = 14,574) and probable PTSD status, also stratifying by CML. Next, we conducted a latent class analysis on two groups: those with probable PTSD and those without probable PTSD, creating classes with varying cognitive reserve levels. Finally, using adjusted log binomial models, we predicted risk of CML based on cognitive reserve level. The probable PTSD group ( n = 1213) and not probable PTSD group ( n = 13,252) each had four latent classes: low, medium-low, medium-high, and high cognitive reserve. In the probable PTSD model, compared to the high cognitive reserve class, those with medium-low cognitive reserve were 35% more likely to report CML (relative risk (RR) = 1.4, 95% confidence interval (CI): 1.1, 1.7). Among the not probable PTSD group, those with low and medium levels of cognitive reserve were significantly more likely to report CML (RR = 1.8 and 1.4, respectively). Overall, those with less cognitive reserve were more likely to report CML regardless of PTSD status

Cognition · Cognitive decline · Cognitive impairment · Cognitive reserve · Cognitive test · Cohort · Dementia · Effects of sleep deprivation on cognitive performance · Latent class model · Psychiatry · Clinical Psychology · Demography · Medicine · Occupational Health and Performance · Posttraumatic Stress Disorder Research · Psychology · Traumatic Brain Injury Research · Gerontology · Internal Medicine

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