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Our results that higher insomnia complaints are associated with preserved cognitive functioning are in contrast to some but not all studies. However, others have found no such relationships Sleep deprivation increases soluble beta-amyloid concentration in the brain; this risk may be higher for those with chronic insomnia 25 , Shorter sleep duration and poorer sleep quality have also been associated with greater beta-amyloid burden in community-dwelling older adults However, others have reported that excessive daytime sleepiness and not nighttime insomnia predicts cognitive decline in those who develop dementia Frequent napping occurs with preclinical cognitive decline.

Changes in the regular patterns of sleep over time, and not increase or decrease in duration, may be associated with poorer cognitive function Furthermore, sleep disordered breathing is associated with AD biomarkers and an increased risk of dementia in the elderly, suggesting a role of hypoxia and not sleep fragmentation as a link between sleep disturbance and incident cognitive decline Our study only evaluated complaints of nocturnal insomnia, and did not assess for chronicity of insomnia complaints, daytime sleepiness, and different etiologies of sleep disturbances or for sleep medication use in our cohort.

Joyce Meyer- Rebellious Wives Who Refuse To Submit

Moreover, while insomnia scores were significantly higher in the preserved cognitive function group than those with cognitive impairment, the severity of insomnia complaints in both groups was below the threshold that signified problematic insomnia A more comprehensive understanding of the bidirectional associations of sleep-wake cycle characteristics with AD neuropathology and cognitive decline may have important therapeutic implications in different stages of preclinical and syndromal dementia states As expected, the predictors of sustained high preserved cognitive function included younger age and greater education 9.

The effects of education further underscore the role of cognitive reserve capacity in maintaining cognitive function even into later years Also, other factors that have been associated with maintenance of preserved cognitive function in prior studies included lack of vascular factors hypertension, diabetes , healthier lifestyle choices lack of smoking, moderate alcohol consumption, and physical exercise , better activities of daily living and social networks.

Discrepancies between our findings and prior studies are most likely due to the differences among studies in the age distributions, duration of follow-up, definition of cognitive groups, and assessment methods. The previous study also did not formally assess for MCI or probable dementia and therefore may have included those with cognitive impairment. The major component that was consistently used in defining successful aging in earlier studies was physical functioning and disability, with self-reported general health and emotional variables included less often However, a greater emphasis is placed on factors associated with health-related quality of life including physical and emotional functioning and less on disability, diseases and demographic characteristics when older adults are asked for their own definitions of successful aging 34 , Maintainers of cognitive function also have lower mortality and incident disability than minor and major decliners among older adults, supporting the view that maintenance of preserved cognitive function is an important component in defining successful aging.

In a previous study that included women aged 65 years and older from the WHI cohort, physical-social functioning and emotional functioning that included self-reported general health and emotional wellbeing measures constituted factors that strongly predicted outcomes related to positive aging phenotype Several demographic, psychosocial, health- and lifestyle-related factors were found to influence distinct trajectories of change in the physical-social and emotional functioning dimensions over time, further suggesting the multidimensional nature of successful aging It is interesting that better emotional wellbeing and lower depressive symptom severity independently predicted better cognition, suggesting that wellbeing captures an important aspect of health that is independent of depression.

In this study of maintenance of cognition into older age, it appears that both are important. It is also interesting that optimism was not associated with maintenance of cognition in this sample of WHIMS participants in adjusted models. This question requires further study. Our findings suggest that HT exposure was not related to cognitive status in the current cohort. These results may therefore indicate a lack of long-term detrimental effects on cognition from hormone use in this oldest-old cohort.

However, prior studies across broader WHIMS cohorts have found differences between the intervention groups to persist for some time even after the HT trial had ceased, both for cognitive function and for brain volumes 39— Specific biomarkers, including genetic, inflammatory, and oxidative stress may influence successful cognitive aging It is plausible that other genetic vulnerabilities and neurobiologic mechanisms and their interactions with medical, psychosocial and behavioral factors may play a role in sustaining high preserved cognitive function in the oldest-old women, and that by excluding women with MCI or dementia from these analyses we may have attenuated relationships.

Some limitations may affect the interpretation of our results. Our cohort comprised of only those women who participated in the WHIMS HT trial; therefore, generalizability of our findings needs to be demonstrated. We cannot make causal inferences. Although we included the most contemporaneous values for predictors, some are distributed across a broad timeframe that varied among women. We cannot rule out the possibility of residual confounding bias. In addition, some measures were occasionally missing; therefore, multiple imputations were used in supporting analyses.

Losses to follow-up differentially culled women with chronic diseases, lower education, and lower cognitive function, which may have attenuated some relationships We defined risk factors eg, vascular, lifestyle factors and treatment eg, medication use based on the most recent assessment or last medication inventory prior to the cognitive assessment. Inclusion of data regarding persistence of specific conditions or treatment in the analysis may have served as better predictors of cognitive function; however, because the prior observation periods among women varied, given the study design, it is difficult to address this issue in this study.

Although we used a single validated measure of overall cognitive function to define consistently high performers, it is possible that factors that predict changes in specific cognitive domains over time are different.


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In summary, addressing certain sociodemographic factors such as income inequality and targeting specific treatment interventions to improve depressive symptoms, and vascular risk factors may play an important role in preserving cognitive functioning among women who survive to 80 years of age. Person-centered approaches that combine interventions to improve physical and cognitive functioning and specific psychosocial treatments to address emotional wellbeing may promote maintenance of preserved cognitive aging in the oldest-old.

Such treatments may be crucial to improve quality of life in those women who survive into their later years without pathological cognitive decline. Department of Health and Human Services through contracts N01WH, , —2, —6, —9, —13, , —, , —26, —32, and Wyeth Pharmaceuticals did not participate in the design and conduct of the studies, in the collection, analysis, and interpretation of the data, or in preparation, review or approval of this manuscript. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.

Sign In or Create an Account. Sign In. Advanced Search. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents. Supplementary Material. Oxford Academic. Google Scholar. Stephen R.


  1. .
  2. Solerna;
  3. La Rebelión de Atlas (Spanish Edition);
  4. Yours to Measure Ours to Treasure?
  5. Patricia E. Ira Driscoll. Hilary A. Carson Smith. Shelli R. Oleg Zaslavsky. Rebecca C. Judith K. Kristine Yaffe. JoAnn E. Susan M. Mark A. Article history. Our cohort comprised of only those women who participated in the WHIMS HT trial; therefore, generalizability of our findings needs to be demonstrated. We cannot make causal inferences. Although we included the most contemporaneous values for predictors, some are distributed across a broad timeframe that varied among women. We cannot rule out the possibility of residual confounding bias. In addition, some measures were occasionally missing; therefore, multiple imputations were used in supporting analyses.

    Losses to follow-up differentially culled women with chronic diseases, lower education, and lower cognitive function, which may have attenuated some relationships We defined risk factors eg, vascular, lifestyle factors and treatment eg, medication use based on the most recent assessment or last medication inventory prior to the cognitive assessment. Inclusion of data regarding persistence of specific conditions or treatment in the analysis may have served as better predictors of cognitive function; however, because the prior observation periods among women varied, given the study design, it is difficult to address this issue in this study.

    Although we used a single validated measure of overall cognitive function to define consistently high performers, it is possible that factors that predict changes in specific cognitive domains over time are different. In summary, addressing certain sociodemographic factors such as income inequality and targeting specific treatment interventions to improve depressive symptoms, and vascular risk factors may play an important role in preserving cognitive functioning among women who survive to 80 years of age.

    Person-centered approaches that combine interventions to improve physical and cognitive functioning and specific psychosocial treatments to address emotional wellbeing may promote maintenance of preserved cognitive aging in the oldest-old. Such treatments may be crucial to improve quality of life in those women who survive into their later years without pathological cognitive decline.

    Department of Health and Human Services through contracts N01WH, , —2, —6, —9, —13, , —, , —26, —32, and Wyeth Pharmaceuticals did not participate in the design and conduct of the studies, in the collection, analysis, and interpretation of the data, or in preparation, review or approval of this manuscript.

    Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign In. Advanced Search. Article Navigation.

    Close mobile search navigation Article Navigation. Volume Article Contents. Supplementary Material. Oxford Academic. Google Scholar. Stephen R. Patricia E. Ira Driscoll. Hilary A. Carson Smith. Shelli R. Oleg Zaslavsky.

    Chapter 4: The Muslim Women and Her Husband

    Rebecca C. Judith K. Kristine Yaffe. JoAnn E. Susan M. Mark A. Article history. Cite Citation. Permissions Icon Permissions. Abstract Background. Cognition , Cognitive aging , Successful aging. View large Download slide. Schematic diagram describing the various cognitive subgroups. Table 1. View Large. Table 2. Search ADS.

    The Essence of Femininity

    Mild cognitive impairment, dementia, and their subtypes in oldest old women. Defining successful aging: the importance of including cognitive function over time. Predictors of cognitive change in older persons: MacArthur studies of successful aging. Predictors of maintaining cognitive function in older adults: the Health ABC study. Validation of a cognitive assessment battery administered over the telephone.

    Fast and accurate genotype imputation in genome-wide association studies through pre-phasing. Zeki Al Hazzouri. Long-term cumulative depressive symptom burden and risk of cognitive decline and dementia among very old women. Midlife and late-life obesity and the risk of dementia: cardiovascular health study. Physical activity and risk of cognitive impairment among oldest-old women. Physical and cognitive functioning of people older than 90 years: a comparison of two Danish cohorts born 10 years apart.

    The association of self-reported sleep duration, difficulty sleeping, and snoring with cognitive function in older women. Aging impairs the unfolded protein response to sleep deprivation and leads to proapoptotic signaling. Self-reported sleep and beta-amyloid deposition in community-dwelling older adults. Change in sleep duration and cognitive function: findings from the Whitehall II Study. Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. Definitions and predictors of successful aging: a comprehensive review of larger quantitative studies.

    Correlates of self-rated successful aging among community-dwelling older adults. Address correspondence to Joseph S. Email: jgoveas mcw. Decision Editor: Sally A. Making sure what we say aline with our actions and behaviors. When we lead our self well our spouses will want to follow us. Great post! Caleb — what factors would you look into a potential spouse?

    In other words, how I can be more discerning in finding the right person? Paul, I tell single guys to first focus on becoming the kind of man a godly woman would want to marry and second, look for a woman who strives for the qualities found in Prov Originally that chapter was written as advice for a young man looking for a spouse! Great points. I found when I became more submissive to God, she became submissive to my authority.

    My job is to make sure I listen to and obey His directions and our home will be in proper alignment. Great point Bernard! As husband we can be an example of submission by submitting our will to Christ. These are all pretty huge.


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    The one other thing I would add is to help her have good Christian friends who can be good influences on her. Maybe that means you do couple-dates or you watch the kids to give her some time alone with her friend. What a great post. We can protect her physically and emotionally. I got this wrong in my first marriage. I got it a lot wrong for a long time and I still get things wrong. Thankfully I have a gracious wife. Excellent post. Awesome and encouraging post. Much wisdom, brother. LISTEN: Most men do not want to listen to their wives, when if they would, perhaps they could be saved from making some miserable mistakes.

    The Ideal Muslimah: CHAPTER 4

    Be willing to listen and consider what she has to say. Then pray about it. Perhaps there is a bit of submission toward each other as a whole. Good point Hazel! Sometimes I find it hard to listen too but it is always worth it in the end. Thanks for commenting. My husband stepped in at a young age with the most amazing behavior — he began to prefer me.

    Over and over and over. God really has blessed me.

    The Deepest Mystery

    God bless you and your family! The impression most husbands have is that their wives have been taught the need for obedience before marriage — it might be true in some cases but husbands should know that it a continues processes and they can be involved. Obedience can be facilitated: Obedience is usually easier when a person can identify with a course.

    The Willing obedience is far above all better than the coerced type. In other relationship like business, work place etc it can work. Thank you. Just wanted you to know that I loved it!