Daylee Greene1, JoAnn T Tschanz2, Ken R Smith3, Truls Ostbye4, Chris Corcoran5, Kathleen A Welsh-Bohmer6, Maria C Norton7. 1. Department of Family Consumer and Human Development, Utah State University, Logan, UT. 2. Department of Psychology, Center for Epidemiologic Studies, Utah State University, Logan, UT. 3. Department of Family and Consumer Studies, Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT. 4. Duke Global Health Institute, Duke University, Durham, NC; Duke-NUS Graduate Medical School, Singapore. 5. Department of Mathematics and Statistics, Center for Epidemiologic Studies, Utah State University, Logan, UT. 6. The Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Duke University, Durham, NC. 7. 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.
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. CONCLUSION: 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.
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. CONCLUSION: 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: Maria C Norton; Elizabeth Fauth; Christine J Clark; Dan Hatch; Daylee Greene; Roxane Pfister; JoAnn T Tschanz; Ken R Smith Journal: Int J Geriatr Psychiatry Date: 2015-07-01 Impact factor: 3.485