Abstract
Background
Hispanics/Latinos are at increased risk for Alzheimer’s disease and related dementias (ADRD). Impairments in both cognition and daily functioning are required to meet clinical criteria for ADRD. Poorer cognition and female sex have been associated with greater declines in daily functioning with age. However, predictors of daily functioning among older Hispanics/Latinos are seldom investigated.
Method
Participants included 6292 cognitively healthy adults from the Study of Latinos ‐ Investigation of Neurocognitive Aging (SOL‐INCA), an ancillary study of a subset of participants 50+ years old in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Cognitive data (learning and memory, executive functioning, processing speed) were collected at Visit 1 (HCHS/SOL). Daily functioning was assessed using the self‐rated version of the Instrumental Activities of Daily Living (IADL) questionnaire at Visit 2 (SOL‐INCA), an average of 7 years later. We used survey two‐part models (mixture of logit and generalized linear model with Gaussian distribution) and ordered logistic regression to examine whether cognitive performance (on individual tests and a cognitive composite z‐score) was associated with later functioning (risk of any impairment and degree of impairment) and tested for modifications by age (50‐59/60‐69/70+ years: Unweighted ns =2,659, 2,576, 1,057) and sex (male/female: Unweighted ns = 2239, 4053).
Result
After covariates adjustment, higher Visit 1 global cognitive (z‐score units) performance (OR= 0.56; 95% CI=[0.47;0.67]; p<0.001), as well as higher domain specific cognitive function, were associated with lower risk of any IADL dysfunction at Visit 2. Associations were stronger for the oldest group (70+ years) relative to the youngest group (50‐59 years), and this was consistent for all measures, except word fluency. Sex did not modify any associations between cognition and later functioning. Across the full sample, higher scores on learning, memory, and the cognitive composite were also associated with lower degree of IADL impairment.
Conclusion
Our findings confirm that cognitive health is an important predictor of everyday functioning among Hispanics/Latinos 7‐years later, especially in older adulthood. Additionally, IADL functioning among female Hispanics/Latinas was no more or less impacted by cognition as compared to their male counterparts.