Late-life cynical hostility is associated with white matter alterations and the risk of Alzheimer's disease

Background Cynical hostility (CH), a specific dimension of hostility that consists of a mistrust of others, has been suggested as a high-risk trait for dementia. However, the influence of CH on the incidence of Alzheimer's disease (AD) remains poorly understood. This study investigated whether late-life CH is associated with AD risk and structural neuroimaging markers of AD. Methods In community-dwelling older adults from the French ESPRIT cohort (n = 1388), incident dementia rate according to CH level was monitored during an 8-year follow-up and analyzed using Cox proportional hazards regression models. Brain magnetic resonance imaging volumes were measured at baseline (n = 508). Using automated segmentation procedures (Freesurfer 6.0), the authors assessed brain grey and white volumes on all magnetic resonance imaging scans. They also measured white matter hyperintensities volumes using semi-automated procedures. Mean volumes according to the level of CH were compared using ANOVA. Results Eighty-four participants developed dementia (32 with AD). After controlling for potential confounders, high CH was predictive of AD (HR 2.74; 95% CI 1.10–6.85; p = 0.030) and all dementia types are taken together (HR 2.30; 95% CI 1.10–4.80; p = 0.027). High CH was associated with white matter alterations, particularly smaller anterior corpus callosum volume (p < 0.01) after False Discovery Rate correction, but not with grey matter volumes. Conclusions High CH in late life is associated with cerebral white matter alterations, designated as early markers of dementia, and higher AD risk. Identifying lifestyle and biological determinants related to CH could provide clues on AD physiopathology and avenues for prevention strategies.

Cynical Hostility and Loneliness in Older Adult Married Couples: An Indirect Effect Through Friendships

Objectives Cynical hostility is a cognitive schema according to which people cannot be trusted, and it has associations with individuals’ loneliness. The present study takes a dyadic approach to examine whether cynical hostility is related to one’s own and their spouse’s loneliness. We further explore whether friendship factors serve as a mediator between individuals’ and spouses’ cynical hostility and loneliness. Method We used 2 waves of the Health and Retirement Study (N = 1,065 couples) and Actor-Partner Interdependence Models (APIMs) with mediation to examine the proposed model. Mediation was tested with the construction of path models and significance levels were reached using bootstrapping. Results For both husbands and wives, cynical hostility was significantly associated with loneliness. Husband’s loneliness was also significantly associated with his wife’s cynical hostility, but wife’s loneliness was not associated with her husband’s cynical hostility. We further found that the association between wife’s own cynical hostility and loneliness was mediated by lower levels of contact with, and support from friends. Friendship factors did not serve as mediators for husbands. Discussion Husbands and wives who have higher levels of cynical hostility may be more vulnerable to loneliness. High levels of cynical hostility in women may be related to deficits in their quantity and quality of friendship, and thus be associated with loneliness. Men who are married to women with a higher level of cynical hostility may experience increased loneliness, but this relationship is not explained by men’s friendships.

Effect of Work Environment on Presenteeism among Aging American Workers: The Moderated Mediating Effect of Cynical Hostility

Cynical hostility in the workplace has been studied. However, there is still no complete study examining how cynical hostility affects work performance. We examined how work environment impacts presenteeism through the mediation of cynical hostility and how chronic work discrimination moderates the relationship between work environment and cynical hostility among ageing workforces. The psychosocial vulnerability model supplies theoretical support for our model. We analyzed data from a sample of 2926 aging workforces from the Health and Retirement Study. Structural equation modeling (SEM) was used to examine the relationships with a moderated mediation model. In the final SEM model, our results showed that work environment was directly negatively associated with presenteeism. Moreover, cynical hostility was significantly inversely correlated with work environment and positively correlated with presenteeism. We found that the significant indirect effect between work environment and presenteeism can be significantly mediated by cynical hostility. In addition, cynical hostility is more likely to be affected by work environment among ageing workforces with lower levels of chronic work discrimination than those with higher levels. Enterprise, government, and employees themselves should be aware of the impact of presenteeism on ageing workforces with high levels of cynical hostility.

Psychosocial Underpinnings of Pain and Sleep Disturbance in Safety-Net Primary Care Patients

Objective. The aim of this study was to uncover possible psychosocial underpinnings of pain and sleep disturbance in a safety-net primary care sample. Methods. Patients (n = 210) awaiting care in a safety-net primary care clinic waiting room completed measures of cynical hostility, social support, mental health, sleep disturbance, and pain. This study was cross-sectional and observational. Results. A structural equation model suggested that higher cynical hostility was associated with lower social support, which in turn was associated with poorer mental health, which then corresponded with higher pain and sleep disturbance. All possible indirect (mediational) effects within this model were statistically significant, suggesting a possible route through which cynical hostility may shape pain and sleep, two common presenting problems in primary care. Conclusions. These findings illustrate the interplay of psychosocial factors with chronic pain and sleep disturbance in a sample of low-income, predominantly African-American patients seeking care at a safety-net primary care clinic. The findings support integrated primary care as a way to target not only behavioral health issues but also the psychosocial factors entangled with physical health.