OTCohortDisability and rehabilitation2019

The modifying effect of positive emotion on the relationship between cognitive impairment and disability among older Mexican Americans: a cohort study.

Jessica M Jarvis, Brian Downer, Jacques Baillargeon and 3 others

PMID 29378460

WHAT IT FOUND

Positive emotion did not change the link between cognitive impairment and new disability over time in older Mexican Americans.

It did appear to narrow the gap in current disability between impaired and normal cognition.

Key findings

01Baseline positive emotion did not modify baseline cognition's effect on incident ADL disability over time.

02Positive emotion did not modify the relationship between cognition and incident ADL disability at the next observation.

03In cross-sectional analyses, impaired cognition was associated with 2.73 higher odds of ADL disability, and positive emotion modified the cognition-disability relationship.

STILL TO COME

How it was doneWhat they foundWhat it means for OTs

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What it does not show

The study cannot show that positive emotion or cognition caused disability; it observed associations over time. Disability was defined only as needing help with any one of 7 ADLs, which may overstate disability and ignore environment or participation. People with severe cognitive impairment may have reported ADLs inaccurately. Attrition and missing data were substantial; excluded participants were older, more impaired, and had more health problems, and some who dropped out before disability diagnosis were counted as never disabled. Baseline positive emotion was used over a long follow-up, so changes in emotion between 2-3 year interviews may have been missed. Findings apply to community-dwelling Mexican Americans aged 75 years and older, not to all older adults.

Declared interests

The authors declared no conflicts of interest. The article is tagged as supported by NIH extramural and non-U.S. government research support.

The easy way to misread this

Do not conclude that improving positive emotion will prevent disability. The study was observational, and positive emotion did not modify the relationship between baseline cognition and incident disability over time.

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