Caitlin N. Pope

Background Hearing loss is a leading modifiable risk factor for dementia, yet its cognitive consequences may depend on broader social and structural conditions. Methods Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (n = 2,397; M mean age = 73.6 years; 75.9% women), we examined whether self-reported hearing loss predicted 10-year domain-specific cognitive trajectories and whether social determinants of health (SDoH) moderated these associations. Hearing status was categorized as no hearing loss, uncorrected hearing loss, and hearing loss with hearing aid use. Linear mixed-effects models adjusted for age, sex, race, education, depressive symptoms, physical morbidity, and intervention effects. Results Hearing loss was associated with lower memory scores and steeper memory decline. However, these associations were conditioned by SDoH. Access to healthcare significantly moderated memory trajectories among participants with uncorrected hearing loss (β = .03, SE=.012, p=.029). Individuals with uncorrected hearing loss use showed greater memory decline when healthcare access was low (-1 SD: β = − .02, SE = .006, p < .001) and average (β=-.01, SE=.004, p=.010), but not when access was high (+ 1 SD: ps>.50). Access to healthcare also moderated reasoning trajectories (β = .06, SE=.017, p<.001). Participants with uncorrected hearing loss declined more in reasoning at low access (β=-.02, SE=.008, p=.030), showed no difference at average access (p=.970), and demonstrated better reasoning trajectories at high access (β = .04, SE=.012, p=.010). Neighborhood and built environment resources similarly moderated reasoning decline (β = .08, SE=.018, p<.001), with greater decline at low resources (β=-.03, SE=.008, p<.001) and improved trajectories at high resources (β = .06, SE=.013, p<.001). No significant SDoH moderation effects were observed among participants with hearing loss using hearing aids. Conclusion These findings indicate that the cognitive impact of hearing loss depends on structural resources, highlighting the need to integrate sensory health and social context in dementia prevention efforts.

Dump truck safety recommendations have been implemented by companies, but a comprehensive study of risk factors associated with dump truck injuries and fatalities has not been performed. Published research specifically focusing on dump truck injuries is limited. The purpose of this descriptive study was to characterize risk factors associated with dump truck-related inspection cases reported by the OSHA in the United States. Dump truck inspections during 2016–2020 were obtained from the online OSHA IMIS database. Pearson’s chi-square test and logistic regression were performed. An intraclass correlation coefficient (ICC) using PROC MIXED and a generalized linear mixed model was calculated on 122 closed dump truck-related inspection cases. One half of dump truck worker fatalities resulted in a serious OSHA violation, whereas three quarters of nonfatal dump truck worker injuries resulted in an ‘other’ or no OSHA violation; 22% of fatalities involved the dump truck backing up. A nonfatal injury narrative often involved the words ‘finger’, ‘tailgate’, and ‘bed’, whereas the words ‘trailer’, ‘asphalt’, ‘load’, and ‘loader’ were mentioned more often in fatalities. A fatal dump truck injury was three times more likely to be associated with a serious OSHA violation compared to a nonfatal dump truck injury. Industries should provide initial and refresher worker safety training to dump truck drivers and other employees who work within the dump truck hazard zone, particularly employees who utilize dump trucks for working with asphalt or around power lines, and employees who repair dump trucks.

Nearly 40% of people with HIV (PWH) experience HIV-associated Neurocognitive Disorder (HAND). In this 3-group efficacy study, 216 PWH 40 + years with HAND or borderline HAND were randomized to either: (1) 10 h of SOP training (n = 70); (2) 20 h of SOP training (n = 73), or (3) 10 h of Internet navigation training (n = 73; contact control group). Participants were administered a measure of SOP [i.e., the Useful Field of View Test (UFOV®)] at baseline, at posttest immediately after training, and at year 1 and year 2 follow up. Intent-to-treat linear mixed-effect models with subject-specific intercept and slope were fitted to estimate between-group mean differences at the follow-up time-points. At the post-intervention time-point, small beneficial SOP training effects were observed for the 10-h group in UFOV® total (d = 0.28, p = 0.002). Effects were of larger magnitude for the 20-h group in these same outcomes [UFOV® total (d = 0.43, p < 0.001)]. These results indicated better benefit with more training. No intervention effect was observed at year 1. At year 2, beneficial effects of small magnitude were observed again in the 10-h group [UFOV® total (d = 0.22, p = 0.253)] with larger small-to-moderate magnitude in the 20-h group [UFOV® total (d = 0.32, p = 0.104)]. This study suggests that SOP training can improve a key indicator of this cognitive performance and that treatment gains are small-to-moderate over a two-year period. Prior literature suggests slower SOP is predictive of impairment in everyday functioning in older PWH; such an approach could potentially improve everyday functioning in PWH.

Speed of processing (SOP) cognitive training may improve indicators of the quality of life (QoL) in people living with HIV. In this 2-year, longitudinal, randomized, controlled trial, 216 participants ages 40 years and older with HIV-associated neurocognitive disorder or borderline HIV-associated neurocognitive disorder were assigned to one of three groups: (a) 10 hr of SOP training ( n = 70); (b) 20 hr of SOP training ( n = 73), or (c) 10 hr of internet navigation control training (a contact control group; n = 73). Participants completed several QoL measures at baseline, posttest, and Year 1 and Year 2 follow-ups. Using linear mixed-effect models, no strong pattern of training effects across QoL outcomes was apparent, with small-magnitude, nonsignificant, between-group differences in depression, locus of control, and Medical Outcomes Study-HIV scales. In conclusion, despite prior work showing some transfer of SOP cognitive training improving QoL, that was not observed. Implications for research and practice are posited.

Objectives: Processing speed is essential to functional independence in later life, such as driving a vehicle. Few studies have examined processing speed and driving mobility in the context of racial differences and social determinants of health (SDoH). This study characterized the longitudinal association between processing speed and driving mobility, and how it varied by race and SDoH. Methods: Using data from the control arm of the Advanced Cognitive Training in Vital Elderly study ( n = 581, 24.5% Black), multilevel models examined longitudinal associations between processing speed and driving mobility outcomes (driving space, exposure, and difficulty). Race and SDoH moderations were explored. Results: Decline in processing speed measures was associated with increased self-reported driving difficulty, but only for older adults with below-average to average scores for neighborhood and built environments and social community context SDoH domains. Discussion: Findings emphasize the influence of physical and social environmental characteristics on processing speed and driving mobility.