This study explores cognitive impairment and its correlation to early- life adverse experiences in non-patient population between the ages of 50 to 65. This developmental approach and observational study design explores cognition in pre-clinical Alzheimer’s disease (AD). Using a standardized neuropsychological instrument, the Montreal Cognitive Assessment (MoCA) and clinically administered questionnaire, the ACE (Adverse Childhood Experiences), I hypothesized that participants with high ACE scores will inversely have low MoCA scores.
My goal was to use a multiple linear regression model with 3 covariates and 1 predictor of interest (ACEs). At 80% power, a sample size of 40 was calculated as needed. This would mean that the results would have 80 % chance of declaring statistical significance. This corresponds to an R-squared value (percentage of variation in MoCA score explained by the predictor) of 17.2%. The desired sample size was not attained successfully due to several barriers in receiving sample data from the collaborating site and the 2017 Hurricane Irma causing a drop in participation rate. Overall 13 participants had successfully participated. The analysis of the results is demonstrated in a line graph indicating a relationship between ACE and MoCA scores. The accuracy of the descriptive statistics could be argued against due to the low sample size. The analysis of the ethnographic interviews brings out some trends in the participant responses. The focus here has been to discuss these responses as to how they advocate for the entanglement theory of aging. In other words, how the exposure to social and environmental factors at various stages of an individual’s lifecourse can interact with one’s physiology, resulting in exposure- specific health conditions at later life stages. Among the period of exposure, my focus through this study is specifically on the early exposures in the lifecourse. This is facilitated by the use of the ACE questionnaire regarding exposures to adverse experiences such as sexual/ physical abuse, familial mental health issues, alcohol/ drug abuse in the family and loss or separation from parents. The entanglement theory further allows for race or culture specific exposures to adversity that raises the question of varying health consequences among cultural or racial groups and the need for a more critical approach in providing access to healthcare and healthcare policy development. Trends in ethnographic results obtained have allowed for the critical discourse in the transgenerational effects of social adversity, effects of resilience- building from adversity and the need for care- giver mental health services.
The study brought out critiques on how the ACE module could be made more inclusive of experiences specific to diverse cultures and regions, as well as the need to address the severity of individual experiences. We conclude by discussing how effects of social or environmental experiences can be used toward AD and aging research and what supporting literature and initiatives currently exist. The discussion is also inspired by the existing political discourse around the medicalization of AD and how that influences the reductionist methods in AD research. This new direction of applied and holistic approach derives its perspective from neuroanthropology and applied medical anthropology. The overall aim of this study is to ask questions challenging existing research methods with the ultimate hope to newly influence the allocation of AD research and risk reduction toward interdisciplinary focus and funding, involving early-life lived experiences and life course perspectives.
| Identifer | oai:union.ndltd.org:USF/oai:scholarcommons.usf.edu:etd-8216 |
| Date | 08 November 2017 |
| Creators | Dutt, Mohini D. |
| Publisher | Scholar Commons |
| Source Sets | University of South Flordia |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Graduate Theses and Dissertations |
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