Muñoz, E., & Choi, J. Contextualizing the effects of stress on cognitive health in U.S. Latinx adults. In Aging in the Americas (6th ed.) . Springer Nature.
Choi, J., Han, S. H., Ng, Y. T., & Muñoz, E. Neighborhood cohesion across the life course and effects on cognitive aging. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences , 78 (10), 1765–1774. Publisher's Version
Hyun, J., Katz, M., Derby, C. A., Roque, N., Muñoz,, Sliwinski, M.J.,, Lovasi, G. S., et al. Availability of healthy foods, fruit and vegetable consumption, and cognition among urban older adults. BMC Geriatrics , 23 (302). Publisher's Version
Muñoz, E., Yan, W., Tse, H. W., Zavala, D., Lopez, B. G., & Kim, S. Y. Prospective effects of discrimination, depressive symptoms, and cognitive control among Mexican-origin women. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences. Publisher's Version
Cuevas, H., Muñoz, E., Nagireddy, D., Kim, J., Woods, S., Ganucheau, G., & Alolmoush, F. The association of glucose variability and dementia incidence in Latinx adults with type 2 diabetes: A retrospective study. Clinical Nursing Research , 32 (2), 249-255. Publisher's Version
Muñoz, E., Sutin, G., & Robins, R. Perceived ethnic discrimination and cognitive function: A 12-year longitudinal study of Mexican-origin adults. Social Science & Medicine. Publisher's VersionAbstract


Hispanic/Latinx adults are at increased risk for cognitive impairment, and it is critically important to identify modifiable risk factors for cognitive impairment in this population. We addressed two key questions: (1) How does perceived discrimination change across middle adulthood? And, (2) how are discrimination and the trajectory of discrimination associated with cognitive function?


We used data from 1,110 Mexican-origin adults between 26 and 62 years old (63% female; 85% born in Mexico). Participants completed a perceived ethnic discrimination scale five times across 12 years and completed cognitive assessments in the last wave, which were composited into a measure of overall cognitive function. We used latent growth curve models to estimate the longitudinal trajectory of perceived ethnic discrimination and growth mixture models to identify sub-groups of change trajectories. We evaluated whether patterns of perceived discrimination trajectories, baseline, intermediary, and concurrent discrimination predicted cognitive function at the last wave.


Perceived ethnic discrimination decreased over time on average. Significant individual differences in within-person change revealed two change trajectory classes: Stable Low and High Declining. The Stable Low class had better cognitive performance compared to the High Declining class, but this effect was not robust to educational attainment. Perceived discrimination at the last wave was associated with worse cognitive function, and this effect remained after accounting for covariates.


This study is among the first to evaluate changes in perceived ethnic discrimination in a sample of Mexican-origin adults and their associations with cognitive function. The results highlight the need for more research to better understand the role of discrimination and other social stressors on cognitive health outcomes.

Phillips, D., Finkel, D., Petkus, A. J., Muñoz, E., Pahlen, S., Johnson, W., Reynolds, C. R., et al. Longitudinal analyses indicate bidirectional associations between loneliness and health. Aging & Mental Health , 1-9. Publisher's VersionAbstract

Objectives To evaluate temporal dynamics between loneliness and both objective and subjective health (i.e. functional impairment and self-rated health) in mid- to late-adulthood.

Method We applied bivariate dual-change-score models to longitudinal data from 3 Swedish twin studies (N = 1,939) to explore dynamic associations between loneliness and health across 3 age ranges (50–69, 70–81, and 82+ years) to investigate whether associations between loneliness and health change with age due to increasing incidence of chronic health conditions and bereavement.

Results Results showed bidirectional associations between loneliness and both objective and subjective health, with adverse impacts of loneliness observed on subsequent subjective and objective health beginning at age 70. Associations between health and subsequent loneliness were observed after age 82 and varied for subjective and objective health, with subjective health associated with less loneliness and objective health associated with greater loneliness.

Conclusions Our results indicate dynamic associations between loneliness and health with age in mid- to late-adulthood, with earlier impacts of loneliness on health and later impacts of health on loneliness that vary for objective and subjective measures of health. These findings suggest impacts of health on loneliness may arise later in life when worsening health or mobility interfere with social interaction.

Marquine, M. J., Gallo, L. C., Tarraf, W., Wu, B., Moore, A.A.,, Vásquez, P. M., Talavera, G., et al. The association of stress, metabolic syndrome and systemic inflammation with neurocognitive function in the Hispanic Community Health Study/Study of Latinos and its Sociocultural Ancillary Study. The Journals of Gerontology: Series B , 77 (5), 860-871. Publisher's VersionAbstract
Identifying sociocultural correlates of neurocognitive dysfunction among Hispanics/Latinos, and their underlying biological pathways, is crucial for understanding disparities in Alzheimer’s disease and related dementias. We examined cross-sectional associations between stress and neurocognition, and the role that metabolic syndrome (MetS) and systemic inflammation might play in these associations.Participants included 3,045 adults aged 45–75 (56% female, education 0–20+ years, 86% Spanish-speaking, 23% U.S.-born), enrolled in the Hispanic Community Health Study/Study of Latinos and its Sociocultural Ancillary Study. Global neurocognition was the primary outcome and operationalized as the average of the z scores of measures of learning and memory, word fluency, and processing speed. Stress measures included self-report assessments of stress appraisal (perceived and acculturative stress) and exposure to chronic and traumatic stressors. MetS was defined via established criteria including waist circumference, high blood pressure, elevated triglycerides, fasting plasma glucose, and high levels of high-density lipoprotein cholesterol. Systemic inflammation was represented by high-sensitivity C-reactive protein (hs-CRP).Separate survey multivariable linear regression models adjusting for covariates showed that higher perceived (b = −0.004, SE = 0.002, p < .05) and acculturative stress (b = −0.004, SE = 0.001, p < .0001) were significantly associated with worse global neurocognition, while lifetime exposure to traumatic stressors was associated with better global neurocognition (b = 0.034, SE = 0.009, p < .001). Neither MetS nor hs-CRP were notable pathways in the association between stress and neurocognition; rather, they were both independently associated with worse neurocognition in models including stress measures (ps < .05).These cross-sectional analyses suggest that stress appraisal, MetS, and systemic inflammation may be targets to reduce neurocognitive dysfunction among Hispanics/Latinos.
Muñoz, E. Challenges and opportunities during a “new normal” of psychological aging research. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences , 76 (9), e122–e128. Publisher's Version
Muñoz, E., Gallo, L. C., Hua, S., Sliwinski, M. J., Kaplan, R., Lipton, R. B., González, H. M., et al. Stress is associated with neurocognitive function in Hispanic/Latino adults: results from HCHS/SOL Socio-Cultural Ancillary Study. Journal of Gerontology: Psychological Sciences , 76 (4), e122-e128. Publisher's VersionAbstract

Objectives: The purpose of this study was to evaluate the hypothesis that chronic and acculturative stress would be negatively associated with neurocognitive function among middle aged to older Hispanics/Latinos.

Method: Our analytic sample consisted of 3,265 participants (mean age = 56.7 (+/-0.24)) from the Hispanic Community Health Study/Study of Latinos who participated in its Sociocultural Ancillary Study. During the baseline phase of this project, participants were assessed on multiple domains of neurocognitive function, and completed self-report measures of chronic and acculturative stress.

Results: Each standard deviation increase in chronic stress was associated with lower performance in a verbal learning task (B = -.17, 95% CI [-.32, -.01]); this association was no longer significant after adjusting for mental and physical health symptoms, including depression and anxiety symptoms, and cardiovascular health. A standard deviation increase in acculturative stress was associated with poorer performance in all cognitive measures (Bs range = -.13 to -1.03). Associations of acculturation stress with psychomotor speed, verbal learning, and word fluency remained significant after adjusting for mental and physical health symptoms.

Discussion: Our results suggest that mental and physical health may help explain some cross-sectional associations between stress and cognition and highlight the need to examine culture-specific psychosocial stressors to better understand the context of psychosocial risk factors for neurocognitive performance.

Muñoz, E., Scott, S. B., Corley, R., Wadsworth, S. J., Sliwinski, M. J., & Reynolds, C. A. The role of perceived neighborhood stressors on cognitive function: a coordinated analysis. Health & Place , 66, e102442. Publisher's VersionAbstract
The objective of this study was to evaluate the association between perceived neighborhood stressors, encompassing negative perceived neighborhood characteristics, and specific cognitive abilities in adulthood. We conducted a coordinated analysis across three studies of adults in the United States and found that perceived neighborhood stressors were consistently associated with poorer performance on attention-demanding cognitive tasks. We specifically found that perceived neighborhood stressors were associated with lower performance in spatial abilities, working memory, and executive function but not perceptual speed, and that the effect was most consistent for lower perceived neighborhood safety followed by lower perceived aesthetic quality, greater perceived neighborhood crime, and lower perceived neighborhood cohesion. These results highlight the importance of the psychosocial neighborhood context for cognitive health in adulthood.
Johnson, K. E., Sol, K., Sprague, B. N., Cadet, T., Muñoz, E., & Webster, N. J. The impact of region and urbanicity on the discrimination-cognitive health link among older Blacks. Research in Human Development. , 17 (1), 4-19. Publisher's Version
Munoz, E., Stawski, R. S., Sliwinski, M. J., Smyth, J. M., & MacDonald, S. W. S. The ups and downs of cognitive function: neuroticism and negative affect drive performance inconsistency. The Journals of Gerontology: Series B , 75 (2), 263–273. Publisher's VersionAbstract


Response time inconsistency (RTI)—or trial-to-trial variability in speeded performance—is increasingly recognized as an indicator of transient lapses of attention, cognitive health status, and central nervous system integrity, as well as a potential early indicator of normal and pathological cognitive aging. Comparatively, little research has examined personality predictors of RTI across adulthood.


We evaluated the association between the personality trait neuroticism and RTI in a community-dwelling sample of 317 adults between the ages of 19–83 and tested for two indirect pathways through negative affect (NA) and cognitive interference (CI).


The personality trait neuroticism predicted greater RTI independent of mean response time performance and demographic covariates; the results were age-invariant. Furthermore, NA (but not CI) accounted for this association and moderated mediation model results indicated that older adults were more vulnerable to the adverse effects of NA.


Neuroticism predicts greater RTI irrespective of mean performance and this effect is driven largely by heightened negative emotionality that may be particularly detrimental for older adults.

Reynolds, C. A., Tan, Q., Munoz, E., Jylhävä, J., Hjelmborg, J., Christiansen, L., Hägg, S., et al. A decade of epigenetic change in aging twins: genetic and environmental contributions to longitudinal DNA methylation. Aging Cell , 19 (8), e13197. Publisher's VersionAbstract


Epigenetic changes may result from the interplay of environmental exposures and genetic influences and contribute to differences in age‐related disease, disability, and mortality risk. However, the etiologies contributing to stability and change in DNA methylation have rarely been examined longitudinally.


We considered DNA methylation in whole blood leukocyte DNA across a 10‐year span in two samples of same‐sex aging twins: (a) Swedish Adoption Twin Study of Aging (SATSA; N = 53 pairs, 53% female; 62.9 and 72.5 years, SD = 7.2 years); (b) Longitudinal Study of Aging Danish Twins (LSADT; N = 43 pairs, 72% female, 76.2 and 86.1 years, SD=1.8 years). Joint biometrical analyses were conducted on 358,836 methylation probes in common. Bivariate twin models were fitted, adjusting for age, sex, and country.


Overall, results suggest genetic contributions to DNA methylation across 358,836 sites tended to be small and lessen across 10 years (broad heritability M = 23.8% and 18.0%) but contributed to stability across time while person‐specific factors explained emergent influences across the decade. Aging‐specific sites identified from prior EWAS and methylation age clocks were more heritable than background sites. The 5037 sites that showed the greatest heritable/familial–environmental influences (< 1E−07) were enriched for immune and inflammation pathways while 2020 low stability sites showed enrichment in stress‐related pathways.


Across time, stability in methylation is primarily due to genetic contributions, while novel experiences and exposures contribute to methylation differences. Elevated genetic contributions at age‐related methylation sites suggest that adaptions to aging and senescence may be differentially impacted by genetic background.

Wadsworth, S. J., Corley, R. P., Munoz, E., Trubenstein, B. P., Knaap, E., DeFries, J. C., Plomin, R., et al. CATSLife: A study of lifespan behavioral development and cognitive functioning. Twin Research and Human Genetics , 1–12. Publisher's VersionAbstract
The purpose of this update is to provide the most current information about both the Colorado Adoption Project (CAP) and the Longitudinal Twin Study (LTS) and to introduce the Colorado Adoption/Twin Study of Lifespan behavioral development and cognitive aging (CATSLife), a product of their merger and a unique study of lifespan behavioral development and cognitive aging. The primary objective of CATSLife is to assess the unique saliency of early childhood genetic and environmental factors to adult cognitive maintenance and change, as well as proximal influences and innovations that emerge across development. CATSLife is currently assessing up to 1600 individuals on the cusp of middle age, targeting those between 30 and 40 years of age. The ongoing CATSLife data collection is described as well as the longitudinal data available from the earlier CAP and LTS assessments. We illustrate CATSLife via current projects and publications, highlighting the measurement of genetic, biochemical, social, sociodemographic and environmental indices, including geospatial features, and their impact on cognitive maintenance in middle adulthood. CATSLife provides an unparalleled opportunity to assess prospectively the etiologies of cognitive change and test the saliency of early childhood versus proximal influences on the genesis of cognitive decline.
Stawski, R. S., MacDonald, S. W. S., Brewster, P. W. H., Munoz, E., Cerino, E. S., & Halliday, D. W. R. A comprehensive comparison of quantifications of intraindividual variability in response times: a measurement burst approach. The Journals of Gerontology: Series B , 74 (3), 397–408. Publisher's VersionAbstract


To formally identify and contrast the most commonly-employed quantifications of response time inconsistency (RTI) and elucidate their utility for understanding within-person (WP) and between-person (BP) variation in cognitive function with increasing age.


Using two measurement burst studies of cognitive aging, we systematically identified and computed five RTI quantifications from select disciplines to examine: (a) correlations among RTI quantifications; (b) the distribution of BP and WP variation in RTI; and (c) the comparability of RTI quantifications for predicting attention switching.


Comparable patterns were observed across studies. There was significant variation in RTI BP as well as WP across sessions and bursts. Correlations among RTI quantifications were generally strong and positive both WP and BP, except for the coefficient of variation. Independent prediction models indicated that slower mean response time (RT) and greater RTI were associated with slower attention switching both WP and BP. For selecting simultaneous prediction models, collinearity resulted in inflated standard errors and unstable model estimates.


RTI reflects a novel dimension of performance that is a robust and theoretically informative predictor of BP and WP variation in cognitive function. Among the plenitude of RTI quantifications, not all are interchangeable, nor of comparable predictive utility.

Mogle, J., Muñoz, E., Hill, N. L., Smyth, J. M., & Sliwinski, M. J. Daily memory lapses in adults: characterization and influence on affect. The Journals of Gerontology: Series B , 74 (1), 59–68. Publisher's VersionAbstract

Objective: The current analyses examined the impact of daily memory lapses on daily affect and whether this impact varied across age.

Method: One hundred sixty-six adults (ages 20-79) completed assessments of memory lapses and affect each day for 7 consecutive days. Assessments included retrospective and prospective memory lapses as well as the impact of these lapses (how irritating, interfering, and consequential). Affect was assessed using ratings of daily positive and negative affect.

Results: Participants reported memory lapses on 33.3% of days. Prospective lapses were consistently rated as more consequential. Regardless of age, participants had significantly lower in positive affect and significantly higher in negative affect on days with a prospective lapse. Effects of retrospective lapses depended on age: compared to older adults, younger adults reported lower positive affect on days with a retrospective lapse.

Discussion: Previous work on daily memory lapses has focused on prospective lapses. Although retrospective lapses occurred more frequently in this sample, prospective lapses appeared to have a greater impact on daily experiences regardless of age. By measuring daily memory lapses and affect over consecutive days, we can begin to understand how the experience of forgetting impacts individuals at a micro-level.

Reynolds, C. A., Smolen, A., Corley, R. P., Munoz, E., Friedman, N. P., Rhee, S. H., Stallings, M. C., et al. APOE effects on cognition from childhood to adolescence. Neurobiology of Aging. Publisher's VersionAbstract
The ε4 allele of APOE is a well-established genetic risk factor for cognitive aging and dementia, but its influence on early life cognition is unknown. Consequently, we assessed associations of APOE genotypes with cognitive performance during 7, 12, and 16 year-assessments in our ongoing Colorado Adoption/Twin Study of Lifespan behavioral development (CATSLife). In general, APOE ε4 was associated with lower Verbal, Performance, and Full Scale IQ scores during childhood and adolescence (e.g., Full Scale IQ was lower by 1.91 points per ε4 allele, d = −0.13), with larger effects in females (e.g., average Full Scale IQ scores were 3.41 points lower in females per each ε4 allele vs. 0.33 points lower in males). Thus, these results suggest that deleterious effects of the APOE ε4 allele are manifested before adulthood, especially in females, and support both early origin theories and differential life-course vulnerabilities for later cognitive impairment.
Munoz, E., Filshtein, T., Bettcher, B. M., McLaren, D., Hedden, T., Tommet, D., Mungas, D., et al. Cognitive function and neuropathological outcomes: a forward-looking approach. Journal of Neurology. Publisher's VersionAbstract
ObjectiveTo evaluate the risk of Alzheimer’s disease-related neuropathology burden at autopsy given older adults’ current cognitive state.MethodParticipants included 1,303 individuals who enrolled in the Religious Orders Study (ROS) and 1,789 who enrolled in the Rush Memory and Aging Project (MAP). Cognitive status was evaluated via standardized assessments of global cognition and episodic memory. At the time of analyses, about 50% of participants were deceased with the remaining numbers right censored. Using multi-state Cox proportional hazard models, we compared the cognitive status of all subjects alive at a given age and estimated future risk of dying with different AD-related neuropathologies. Endpoints considered were Braak Stages (0–2, 3–4, 5–6), CERAD (0, 1, 2, 3), and TDP-43 (0, 1, 2, 3) level.ResultsFor all three pathological groupings (Braak, CERAD, TDP-43), we found that a cognitive test score one standard deviation below average put individuals at up to three times the risk for being diagnosed with late stage AD at autopsy according to pathological designations. The effect remained significant after adjusting for sex, APOE-e4 status, smoking status, education level, and vascular health scores.ConclusionApplying multi-state modeling techniques, we were able to identify those at risk of exhibiting specific levels of neuropathology based on current cognitive test performance. This approach presents new and approachable possibilities in clinical settings for diagnosis and treatment development programs.
Phibbs, S., Stawski, R. S., MacDonald, S. W. S., Munoz, E., Smyth, J. M., & Sliwinski, M. J. The influence of social support and perceived stress on response time inconsistency. Aging & Mental Health , 23 (2), 214–221. Publisher's VersionAbstract

Objectives: Lack of social support and high levels of stress represent potentially modifiable risk factors for cognitive aging. In this study we examined the relationships between these two risk factors and response time inconsistency (RTI), or trial-to-trial variability in choice response time tasks. RTI is an early indicator of declining cognitive health, and examining the influence of modifiable psychosocial risk factors on RTI is important for understanding and promoting cognitive health during adulthood and old age.

Methods: Using data from a community sample study (n = 317; Mage = 49, range = 19-83), we examined the effects of social support, including size of network and satisfaction with support, global perceived stress, and their interactions on RTI.

Results: Neither size of network nor satisfaction with support was associated with RTI independent of perceived stress. Stress was positively associated with increased RTI on all tasks, independent of social support. Perceived stress did not interact with either dimension of social support to predict RTI, and perceived stress effects were invariant across age and sex.

Conclusion: Perceived stress, but not social support, may be a unique and modifiable risk factor for normal and pathological cognitive aging. Discussion focuses on the importance of perceived stress and its impact on RTI in supporting cognitive health in adulthood and old age.