Geriatrics Commons^™

Developing A Community-Based Rehabilitation Programs In Elderly Nursing Home: A Brief Descriptive Analysis, Melinda Harini, Dosmaria Dosmaria, Herry Herry, Lisa Emilda, Listyani Herman, Nelfidayani Nelfidayani, Putu K. Mahardini, Shynta D. Hantogo, Widya Meiliana, Ikhsan Johnson, Peggy Peggy, Wanarani Aries, Widjajalaksmi Kusumaningsih, Luh K. Wahyuni

ASEAN Journal of Community Engagement

The need for rehabilitation services in nursing homes (NH) for the elderly is increasing each year, and this need is fulfilled both with ordinary clinical rehabilitation center visits, as well as community-based rehabilitation (CBR) inside the facility. However, a proper situation analysis is needed to establish a well-delivered CBR program in the NH, a niche to be fulfilled in this study. This study used a descriptive measurement and cross-sectional design to target the elderly who are living in the NHs. Consecutive sampling was done in the largest NH in Jakarta, in Cipayung District. Participants who were dependently ambulated were assessed …

Caring For Older Adults In The Hallway Of A Crowded Emergency Department, Rebecca Weeks, Kathy Sawasky, Michael Malone

Journal of Geriatric Emergency Medicine

This paper describes strategies for emergency department providers to address the needs of older adults when facilities are overcrowded and care extends into the hallway.

The Role Of Physical Activity In Older Adults And Practical Intervention, Se Won Lee, Rebecca Patel, Bryan Werner, Ji Won Yoo, Timothy Tiu

HCA Healthcare Journal of Medicine

Physical inactivity (PI), defined as not meeting guidelines for physical activity beyond baseline daily living activities, is common among older adults (age 65 and older) and contributes to increased morbidity, increased mortality and increased health care spending. Understanding the clinical impact of PI on common medical conditions among older adults will help primary care physicians (PCPs) to educate these patients successfully. Physical activity and exercise are effective in the primary and secondary prevention of chronic diseases that can lead to physical impairments, disability and/or premature death. Physical activity and exercise have been shown to improve cognitive dysfunction and painful musculoskeletal …

Late-Life Exercise Mitigates Skeletal Muscle Epigenetic Aging, Kevin A. Murach, Andrea L. Dimet-Wiley, Yuan Wen, Camille R. Brightwell, Christine M. Latham, Cory M. Dungan, Christopher S. Fry, Stanley J. Watowich

Center for Muscle Biology Faculty Publications

There are functional benefits to exercise in muscle, even when performed late in life, but the contributions of epigenetic factors to late-life exercise adaptation are poorly defined. Using reduced representation bisulfite sequencing (RRBS), ribosomal DNA (rDNA) and mitochondrial-specific examination of methylation, targeted high-resolution methylation analysis, and DNAge™ epigenetic aging clock analysis with a translatable model of voluntary murine endurance/resistance exercise training (progressive weighted wheel running, PoWeR), we provide evidence that exercise may mitigate epigenetic aging in skeletal muscle. Late-life PoWeR from 22–24 months of age modestly but significantly attenuates an age-associated shift toward promoter hypermethylation. The epigenetic age of muscle …

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …

Persistent Polypharmacy And Fall Injury Risk: The Health, Aging And Body Composition Study, Lingshu Xue, Robert M. Boudreau, Julie M. Donohue, Janice C. Zgibor, Zachary A. Marcum, Tina Costacou, Anne B. Newman, Teresa M. Waters, Elsa S. Strotmeyer

Health Management and Policy Faculty Publications

Background

Older adults receive treatment for fall injuries in both inpatient and outpatient settings. The effect of persistent polypharmacy (i.e. using multiple medications over a long period) on fall injuries is understudied, particularly for outpatient injuries. We examined the association between persistent polypharmacy and treated fall injury risk from inpatient and outpatient settings in community-dwelling older adults.

Methods

The Health, Aging and Body Composition Study included 1764 community-dwelling adults (age 73.6 ± 2.9 years; 52% women; 38% black) with Medicare Fee-For-Service (FFS) claims at or within 6 months after 1998/99 clinic visit. Incident fall injuries (N = 545 in …

Deletion Of Sa Β-Gal+ Cells Using Senolytics Improves Muscle Regeneration In Old Mice, Cory M. Dungan, Kevin A. Murach, Christopher J. Zdunek, Zuo Jian Tang, Georgia L. Vonlehmden, Camille R. Brightwell, Zachary Hettinger, Davis A. Englund, Zheng Liu, Christopher S. Fry, Antonio Filareto, Michael Franti, Charlotte A. Peterson

Physical Therapy Faculty Publications

Systemic deletion of senescent cells leads to robust improvements in cognitive, cardiovascular, and whole-body metabolism, but their role in tissue reparative processes is incompletely understood. We hypothesized that senolytic drugs would enhance regeneration in aged skeletal muscle. Young (3 months) and old (20 months) male C57Bl/6J mice were administered the senolytics dasatinib (5 mg/kg) and quercetin (50 mg/kg) or vehicle bi-weekly for 4 months. Tibialis anterior (TA) was then injected with 1.2% BaCl₂ or PBS 7- or 28 days prior to euthanization. Senescence-associated β-Galactosidase positive (SA β-Gal+) cell abundance was low in muscle from both young and old mice …

A Survey Of Delirium Self-Reported Knowledge And Practices Among Emergency Physicians In The United States, Anita N. Chary, Adriane Lesser, Sharon K. Inouye, Christopher R. Carpenter Md, Msc, Amy R. Stuck, Maura Kennedy

Journal of Geriatric Emergency Medicine

Objective: This study aimed to evaluate United States emergency physicians’ self-reported knowledge and practices regarding the detection, prevention, and management of delirium, a common and deadly syndrome that disproportionately affects older emergency department (ED) patients. Knowledge and practices of the broader emergency physician community about these priority topics in geriatric emergency medicine are understudied.

Design: Electronic self-administered online survey

Setting: United States

Participants: One-hundred ninety-seven emergency physicians of the American College of Emergency Physicians Emergency Medicine Practice Research Network

Measures: Descriptive statistics were generated from survey responses.

Results: Of 734 physicians in the research network who were sent the …

Dementia Risk Reduction: Why Haven't The Pharmacological Risk Reduction Trials Worked? An In-Depth Exploration Of Seven Established Risk Factors, Ruth Peters, John Breitner, Sarah James, Gregory A. Jicha, Pierre-Francois Meyer, Marcus Richards, A. David Smith, Hussein N. Yassine, Erin L. Abner, Atticus H. Hainsworth, Patrick G. Kehoe, Nigel Beckett, Christopher Weber, Craig Anderson, Kaarin J. Anstey, Hiroko H. Dodge

Neurology Faculty Publications

Identifying the leading health and lifestyle factors for the risk of incident dementia and Alzheimer's disease has yet to translate to risk reduction. To understand why, we examined the discrepancies between observational and clinical trial evidence for seven modifiable risk factors: type 2 diabetes, dyslipidemia, hypertension, estrogens, inflammation, omega-3 fatty acids, and hyperhomocysteinemia. Sample heterogeneity and paucity of intervention details (dose, timing, formulation) were common themes. Epidemiological evidence is more mature for some interventions (eg, non-steroidal anti-inflammatory drugs [NSAIDs]) than others. Trial data are promising for anti-hypertensives and B vitamin supplementation. Taken together, these risk factors highlight a future need …

It Takes Courage To Pause: Rapid Goals-Of-Care Conversations In The Emergency Department, Anita N. Chary, Aanand D. Naik, Kei Ouchi

Journal of Geriatric Emergency Medicine

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Partnering With Hospital Providers To Facilitate Handoff For Persons With Dementia In The Acute Care Setting, Vanessa Jeune

Student Scholarly Projects

Practice Problem: Individuals with Alzheimer's disease and related dementias cannot verbalize their care needs during transitions of care (TOC) and rely on their home caregivers (HCs) for advocacy. The lack of communication between clinicians in one setting and HCs can lead to detrimental health outcomes for the length of stay.

PICOT: The PICOT question that guided this project was: With the assistance of family nurse consultants (P), how does the implementation of standardized care needs communication tool for support persons of persons with dementia (I) vs. no standardized process (C) enhance the ability for the support person to …

Exploring Treatment Targets To Mitigate Fear Of Falling Activity Avoidance Behavior In Parkinson's Disease And Older Adults, John Vincent Rider

UNLV Theses, Dissertations, Professional Papers, and Capstones

Fear of falling (FOF) is a significant concern among individuals with Parkinson’s disease (PD) and older adults in general. This FOF can lead to avoidance behavior resulting in activity restriction. Some level of fear of falling avoidance behavior (FFAB) may be protective (adaptive) and decrease the likelihood of falls, especially among individuals with physical limitations and high fall risk. However, excessive (maladaptive) avoidance behavior may lead to downstream consequences such as further physical and psychological decline and an increased likelihood of falls, especially when there is a disparity between the FFAB and physiological fall risk. While poor physical functioning, disease …

Mitochondrial Aberrations During The Progression Of Disuse Atrophy Differentially Affect Male And Female Mice, Megan E. Rosa-Caldwell, Seongkyun Lim, Wesley S. Haynie, Jacob L. Brown, David E. Lee, Kirsten R. Dunlap, Lisa T. Jansen, Tyrone A. Washington, Michael P. Wiggs, Nicholas P. Greene

Health, Human Performance and Recreation Faculty Publications and Presentations

Background

Disuse decreases muscle size and is predictive of mortality across multiple pathologies. Detriments to mitochondrial function are hypothesized to underlie disuse-induced muscle atrophy. Little data exist on early mechanisms contributing to onset of these pathologies, nor is it known how they differ between sexes. The purpose of this study was to examine differential and conserved responses to mitochondrial quality control in male and female mice during the development and progression of disuse-induced atrophy.

Methods

One hundred C57BL/6J mice (50 male and 50 female) were hindlimb unloaded to induce disuse atrophy for 0 (con), 24, 48, 72, or 168 h. …

Aberrant Crosstalk Between Insulin Signaling And Mtor In Young Down Syndrome Individuals Revealed By Neuronal-Derived Extracellular Vesicles, Marzia Perluigi, Anna Picca, Elita Montanari, Riccardo Calvani, Federico Marini, Roberto Matassa, Antonella Tramutola, Alberto Villani, Giuseppe Familiari, Fabio Di Domenico, D. Allan Butterfield, Kenneth J. Oh, Emanuele Marzetti, Diletta Valentini, Eugenio Barone

Chemistry Faculty Publications

INTRODUCTION: Intellectual disability, accelerated aging, and early-onset Alzheimer-like neurodegeneration are key brain pathological features of Down syndrome (DS). Although growing research aims at the identification of molecular pathways underlying the aging trajectory of DS population, data on infants and adolescents with DS are missing.

METHODS: Neuronal-derived extracellular vesicles (nEVs) were isolated form healthy donors (HDs, n = 17) and DS children (n = 18) from 2 to 17 years of age and nEV content was interrogated for markers of insulin/mTOR pathways.

RESULTS: nEVs isolated from DS children were characterized by a significant increase in pIRS1^Ser636, a marker of …

Overcoming The Covid-19 Pandemic For Dementia Research: Engaging Rural, Older, Racially And Ethnically Diverse Church Attendees In Remote Recruitment, Intervention And Assessment, Lisa Kirk Wiese, Ishan C. Williams, Nancy E. Schoenberg, James E. Galvin, Jennifer Lingler

Behavioral Science Faculty Publications

Background: Access to cognitive screening in rural underserved communities is limited and was further diminished during the COVID-19 pandemic. We examined whether a telephone-based cognitive screening intervention would be effective in increasing ADRD knowledge, detecting the need for further cognitive evaluation, and making and tracking the results of referrals.

Method: Using a dependent t-test design, older, largely African American and Afro-Caribbean participants completed a brief educational intervention, pre/post AD knowledge measure, and cognitive screening.

Results: Sixty of 85 eligible individuals consented. Seventy-percent of the sample self-reported as African American, Haitian Creole, or Hispanic, and 75% were female, with an average …

Polypharmacy And High-Risk Medications In Older Veterans Presenting For Emergency Care, Paige Morizio, Vinita Mistry, Ashley Mcknight, Marc Pepin, William Bryan, Ryan Owenby, Laura Previll, Luna Ragsdale

Journal of Geriatric Emergency Medicine

Background: Guidelines suggest screening for polypharmacy and documentation of high-risk medications in the geriatric Emergency Department (ED) setting. The purpose of this quality improvement initiative was to describe high-risk medications and polypharmacy in older Veterans presenting to the ED in order to inform the workflow of a Geriatric ED pharmacist.

Methods: This was a retrospective, quality improvement project that included patients age 65 years or older who presented to the ED between 10/1/2017 and 9/30/2019. The endpoints included the number of patients with at least one high-risk medication and the mean number of medications on the outpatient medication list. The …

Intermediate Care Technicians-A Novel Workforce For Veterans Affairs Geriatric Emergency Departments, Kristina T. Snell, Thomas Edes, Colleen M. Mcquown

Journal of Geriatric Emergency Medicine

No abstract provided.

Geriatric Emergency Medicine Fellowship Journal Club: Frailty, Sarah Keene, Rebecca Fisher, Lauren Cameron-Comasco

Journal of Geriatric Emergency Medicine

No abstract provided.

Ten Clinical Tips In The Assessment Of Genitourinary Emergencies Of An Older Adult, Nicole Soria, Danya Khoujah

Journal of Geriatric Emergency Medicine

Editorial For The Genetics Of Alzheimer’S Disease Special Issue: October 2021, Laura Ibanez, Justin B. Miller

Sanders-Brown Center on Aging Faculty Publications

No abstract provided.

Ultrafiltration Rate And Incident Atrial Fibrillation Among Older Individuals Initiating Hemodialysis, Jennifer E Flythe, Sai Liu, Maria E Montez-Rath, Wolfgang C Winkelmayer, Tara I Chang

Faculty, Staff and Students Publications

BACKGROUND: Higher ultrafiltration (UF) rates are associated with numerous adverse cardiovascular outcomes among individuals receiving maintenance hemodialysis. We undertook this study to investigate the association of UF rate and incident atrial fibrillation in a large, nationally representative US cohort of incident, older hemodialysis patients.

METHODS: We used the US Renal Data System linked to the records of a large dialysis provider to identify individuals ≥67 years of age initiating hemodialysis between January 2006 and December 2011. We applied an extended Cox model as a function of a time-varying exposure to compute adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) …

Feasibility Of A Sensor-Controlled Digital Game For Heart Failure Self-Management: Randomized Controlled Trial, Kavita Radhakrishnan, Christine Julien, Tom Baranowski, Matthew O'Hair, Grace Lee, Atami Sagna De Main, Catherine Allen, Bindu Viswanathan, Edison Thomaz, Miyong Kim

Faculty, Staff and Students Publications

BACKGROUND: Poor self-management of heart failure (HF) contributes to devastating health consequences. Our innovative sensor-controlled digital game (SCDG) integrates data from sensors to trigger game rewards, progress, and feedback based on the real-time behaviors of individuals with HF.

OBJECTIVE: The aim of this study is to compare daily weight monitoring and physical activity behavior adherence by older adults using an SCDG intervention versus a sensors-only intervention in a feasibility randomized controlled trial.

METHODS: English-speaking adults with HF aged 55 years or older who owned a smartphone and could walk unassisted were recruited from Texas and Oklahoma from November 2019 to …

Prediction Of Fall Risk Among Community-Dwelling Older Adults Using A Wearable System, Thurmon Lockhart, Rahul Soangra, Hyunsoo Yoon, Teresa Wu, Christopher W. Frames, Raven Weaver, Karen A. Roberto

Physical Therapy Faculty Articles and Research

Falls are among the most common cause of decreased mobility and independence in older adults and rank as one of the most severe public health problems with frequent fatal consequences. In the present study, gait characteristics from 171 community-dwelling older adults were evaluated to determine their predictive ability for future falls using a wearable system. Participants wore a wearable sensor (inertial measurement unit, IMU) affixed to the sternum and performed a 10-m walking test. Measures of gait variability, complexity, and smoothness were extracted from each participant, and prospective fall incidence was evaluated over the following 6-months. Gait parameters were refined …

Pairwise Correlation Analysis Of The Alzheimer’S Disease Neuroimaging Initiative (Adni) Dataset Reveals Significant Feature Correlation, Erik D. Huckvale, Matthew W. Hodgman, Brianna B. Greenwood, Devorah O. Stucki, Katrisa M. Ward, Mark T. W. Ebbert, John S. K. Kauwe, The Alzheimer’S Disease Neuroimaging Initiative, The Alzheimer’S Disease Metabolomics Consortium, Justin B. Miller

Sanders-Brown Center on Aging Faculty Publications

The Alzheimer’s Disease Neuroimaging Initiative (ADNI) contains extensive patient measurements (e.g., magnetic resonance imaging [MRI], biometrics, RNA expression, etc.) from Alzheimer’s disease (AD) cases and controls that have recently been used by machine learning algorithms to evaluate AD onset and progression. While using a variety of biomarkers is essential to AD research, highly correlated input features can significantly decrease machine learning model generalizability and performance. Additionally, redundant features unnecessarily increase computational time and resources necessary to train predictive models. Therefore, we used 49,288 biomarkers and 793,600 extracted MRI features to assess feature correlation within the ADNI dataset to determine the …

Expanding The Horizon Of Research Into The Pathogenesis Of The White Matter Diseases Proceedings Of The 2021 Annual Workshop Of The Albert Research Institute For White Matter And Cognition, Shawn N. Whitehead, Askiel Bruno, Jeffrey M. Burns, S. Thomas Carmichael, Anna Csiszar, Jodi D. Edwards, Fanny Elahi, Giuseppe Faraco, Douglas B. Goulding, Deborah R. Gustafson, Vladimir Hachinski, Gary A. Rosenberg, Farzaneh A. Sorond, Andy Y. Shih, Kai Hei Tse, Zoltan Ungvari, Donna M. Wilcock, Kristen L. Zuloaga, Frank C. Barone

Sanders-Brown Center on Aging Faculty Publications

White matter pathologies are critically involved in the etiology of vascular cognitive impairment–dementia (VCID), Alzheimer’s disease (AD), and Alzheimer’s disease and related diseases (ADRD), and therefore need to be considered a treatable target (Roseborough A, Hachinski V, Whitehead S. White matter degeneration - a treatable target? Roseborough et al. JAMA Neurol [Internet]. 2020 Apr 27;77(7):793–4, [1]. To help address this often-missed area of research, several workshops have been sponsored by the Leo and Anne Albert Charitable Trust since 2015, resulting in the incorporation of “The Albert Research Institute for White Matter and Cognition” in 2020. The first annual “Institute” meeting …

Diversity In Alzheimer's Disease Drug Trials: The Importance Of Eligibility Criteria, Sanne Franzen, Jade Emily Smith, Esther Van Den Berg, Monica Rivera Mindt, Rozemarijn L. Van Bruchem-Visser, Erin L. Abner, Lon S. Schneider, Niels D. Prins, Ganesh M. Babulal, Janne M. Papma

Sanders-Brown Center on Aging Faculty Publications

INTRODUCTION: To generalize safety and efficacy findings, it is essential that diverse populations are well represented in Alzheimer's disease (AD) drug trials. In this review, we aimed to investigate participant diversity in disease-modifying AD trials over time, and the frequencies of participant eligibility criteria.

METHODS: A systematic review was performed using Medline, Embase, the Cochrane Library, and Clinicaltrials.gov, identifying 2247 records.

RESULTS: In the 101 included AD trials, participants were predominantly White (median percentage: 94.7%, interquartile range: 81.0-96.7%); and this percentage showed no significant increase or decrease over time (2001-2019). Eligibility criteria such as exclusion of persons with psychiatric illness …

Committee On High-Quality Alzheimer’S Disease Studies (Chads) Consensus Report, Gregory A. Jicha, Erin L. Abner, Steven E. Arnold, Maria C. Carrillo, Hiroko H. Dodge, Steven D. Edland, Keith N. Fargo, Howard H. Feldman, Larry B. Goldstein, James A. Hendrix, Ruth Peters, Julie M. Robillard, Lon S. Schneider, Jodi R. Titiner, Christopher J. Weber

Sanders-Brown Center on Aging Faculty Publications

Background: Consensus guidance for the development and identification of high-quality Alzheimer's disease clinical trials is needed for protocol development and conduct of clinical trials.

Methods: An ad hoc consensus committee was convened in conjunction with the Alzheimer's Association to develop consensus recommendations.

Results: Consensus was readily reached for the need to provide scientific justification, registration of trials, institutional review board oversight, conflict of interest disclosure, funding source disclosure, defined trial population, recruitment resources, definition of the intervention, specification of trial duration, appropriate payment for participant engagement, risk-benefit disclosure as part of the consent process, and the requirement …

Longitudinal Cognitive Performance Of Alzheimer's Disease Neuropathological Subtypes, Madeline Uretsky, Laura E. Gibbons, Shubhabrata Mukherjee, Emily H. Trittschuh, David W. Fardo, Patricia A. Boyle, C. Dirk Keene, Andrew J. Saykin, Paul K. Crane, Julie A. Schneider, Jesse Mez

Sanders-Brown Center on Aging Faculty Publications

Introduction: Alzheimer's disease (AD) neuropathological subtypes (limbic predominant [lpAD], hippocampal sparing [HpSpAD], and typical [tAD]), defined by relative neurofibrillary tangle (NFT) burden in limbic and cortical regions, have not been studied in prospectively characterized epidemiological cohorts with robust cognitive assessments.

Methods: Two hundred ninety-two participants with neuropathologically confirmed AD from the Religious Orders Study and Memory and Aging Project were categorized by neuropathological subtype based on previously specified diagnostic criteria using quantitative regional NFT counts. Rates of cognitive decline were compared across subtypes using linear mixed-effects models that included subtype, time, and a subtype-time interaction as predictors and four cognitive …

Sentinel Paper Review: Exploring Care Transitions From Patient, Caregiver, And Health-Care Provider Perspectives, Kevin T. Fuji, Aaron Malsch, Pamela Martin

Journal of Geriatric Emergency Medicine

No abstract provided.

Associations Between Air Pollution Exposure And Empirically Derived Profiles Of Cognitive Performance In Older Women, Andrew J. Petkus, Diana Younan, Xinhui Wang, Daniel P. Beavers, Mark A. Espeland, Margaret Gatz, Tara Gruenewald, Joel D. Kaufman, Helena C. Chui, Joshua Millstein, Stephen R. Rapp, Joann E. Manson, Susan M. Resnick, Gregory A. Wellenius, Eric A. Whitsel, Keith Widaman, Jiu-Chiuan Chen

Psychology Faculty Articles and Research

Background:Elucidating associations between exposures to ambient air pollutants and profiles of cognitive performance may provide insight into neurotoxic effects on the aging brain. Objective:We examined associations between empirically derived profiles of cognitive performance and residential concentrations of particulate matter of aerodynamic diameter < 2.5 (PM2.5) and nitrogen dioxide (NO2) in older women. Method:Women (N = 2,142) from the Women’s Health Initiative Study of Cognitive Aging completed a neuropsychological assessment measuring attention, visuospatial, language, and episodic memory abilities. Average yearly concentrations of PM2.5 and NO2 were estimated at the participant’s addresses for the 3 years prior to the assessment. Latent profile structural equation models identified subgroups of women exhibiting similar profiles across tests. Multinomial regressions examined associations between exposures and latent profile classification, controlling for covariates. Result:Five latent profiles were identified: low performance across multiple domains (poor multi-domain; n = 282;13%), relatively poor verbal episodic memory (poor memory; n = 216; 10%), average performance across all domains (average multi-domain; n = 974; 45%), superior memory (n = 381; 18%), and superior attention (n = 332; 15%). Using women with average cognitive ability as the referent, higher PM2.5 (per interquartile range [IQR] = 3.64μg/m3) was associated with greater odds of being classified in the poor memory (OR = 1.29; 95% Confidence Interval [CI] = 1.10–1.52) or superior attention (OR = 1.30; 95% CI = 1.10–1.53) profiles. NO2 (per IQR = 9.86 ppb) was associated with higher odds of being classified in the poor memory (OR = 1.38; 95% CI = 1.17–1.63) and lower odds of being classified with superior memory (OR = 0.81; 95% CI = 0.67–0.97). Conclusion:Exposure to PM2.5 and NO2 are associated with patterns of cognitive performance characterized by worse verbal episodic memory relative to performance in other domains.