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Hostility and Change in Cognitive Function Over Time in Older Blacks and Whites

From the Rush Alzheimer’s Disease Center (L.L.B., R.S.W.) and Rush Institute for Healthy Aging (C.F.M.d.L., J.L.B., D.A.E.) and Departments of Neurological Sciences (L.L.B., R.S.W., D.A.E.), Internal Medicine (J.L.B., D.A.E.), Preventive Medicine (C.F.M.d.L., J.L.B.), and Behavioral Sciences (L.L.B., R.S.W.), Rush University Medical Center, Chicago, Illinois, and Department of Medicine and Program in Health Disparities Research (S.A.E-R.), University of Minnesota, Minneapolis, Minnesota.

Address correspondence and reprint requests to Lisa L. Barnes, PhD, Rush Alzheimer’s Disease Center, Rush University Medical Center, Armour Academic Facility, 600 S. Paulina, Suite 1038, Chicago, IL 60612. E-mail: lbarnes1{at}rush.edu

Objective: To test whether the level of hostility predicted the rate of cognitive decline in a community of older blacks and whites and whether the association varied as a function of race.

Methods: Over 4800 persons from a defined community in Chicago completed up to three structured interviews at approximately 3 year intervals over a period of up to 8.8 years (mean = 4.4 years). At the baseline interview, hostility was assessed with 8-items from the Cook-Medley Hostility Scale. Cognitive function was assessed at each interview with four cognitive function tests from which a composite measure of cognition was formed. Mixed effects models were used to assess change in cognition and its relation to hostility, controlling for age, sex, education, and race.

Results: The average score on the hostility scale at baseline was 3.0 (SD = 2.1). Higher levels of hostility were associated with lower cognitive scores (estimate = –0.028, SE = 0.004, p < .001). Cognition declined at a rate of 0.051 U per year on average, but hostility was not related to the rate of decline. Results were unchanged after controlling for depressive symptoms, chronic health, neuroticism, and social and cognitive activity patterns, or when persons with cognitive impairment at baseline were excluded. The association was similar in blacks and whites.

Conclusion: The results suggest that hostility is associated with level of cognitive function in older persons but not related to cognitive decline.

Key Words: cognitive decline • hostility • race • longitudinal

Abbreviations: SES = socioeconomic status; MMSE = mini-mental state examination; SD = standard deviation; SE = standard error.