Marioni Riccardo E, Proust-Lima Cecile, Amieva Helene, Brayne Carol, Matthews Fiona E, Dartigues Jean-Francois, Jacqmin-Gadda Helene
Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB2 0SR, UK.
Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, UK.
BMC Public Health. 2015 Oct 24;15:1089. doi: 10.1186/s12889-015-2426-6.
Identifying modifiable lifestyle correlates of cognitive decline and risk of dementia is complex, particularly as few population-based longitudinal studies jointly model these interlinked processes. Recent methodological developments allow us to examine statistically defined sub-populations with separate cognitive trajectories and dementia risks.
Engagement in social, physical, or intellectual pursuits, social network size, self-perception of feeling well understood, and degree of satisfaction with social relationships were assessed in 2854 participants from the Paquid cohort (mean baseline age 77 years) and related to incident dementia and cognitive change over 20-years of follow-up. Multivariate repeated cognitive information was exploited by defining the global cognitive functioning as the latent common factor underlying the tests. In addition, three latent homogeneous sub-populations of cognitive change and dementia were identified and contrasted according to social environment variables.
In the whole population, we found associations between increased engagement in social, physical, or intellectual pursuits and increased cognitive ability (but not decline) and decreased risk of incident dementia, and between feeling understood and slower cognitive decline. There was evidence for three sub-populations of cognitive aging: fast, medium, and no cognitive decline. The social-environment measures at baseline did not help explain the heterogeneity of cognitive decline and incident dementia diagnosis between these sub-populations.
We observed a complex series of relationships between social-environment variables and cognitive decline and dementia. In the whole population, factors such as increased engagement in social, physical, or intellectual pursuits were related to a decreased risk of dementia. However, in a sub-population analysis, the social-environment variables were not linked to the heterogeneous patterns of cognitive decline and dementia risk that defined the sub-groups.
确定认知衰退和痴呆风险的可改变生活方式关联因素很复杂，尤其是因为很少有基于人群的纵向研究对这些相互关联的过程进行联合建模。最近的方法学进展使我们能够研究具有不同认知轨迹和痴呆风险的统计学定义亚人群。
对来自Paquid队列的2854名参与者（平均基线年龄77岁）的社交、身体或智力活动参与情况、社交网络规模、被理解的自我认知以及对社会关系的满意度进行评估，并将其与20年随访期间的新发痴呆症和认知变化相关联。通过将全球认知功能定义为测试背后的潜在共同因素，利用多变量重复认知信息。此外，根据社会环境变量识别并对比了认知变化和痴呆症的三个潜在同质亚人群。
在整个人口中，我们发现社交、身体或智力活动参与度增加与认知能力提高（而非衰退）以及新发痴呆症风险降低之间存在关联，并且被理解的感觉与认知衰退减缓之间也存在关联。有证据表明存在认知衰老的三个亚人群：快速、中等和无认知衰退。基线时的社会环境测量指标无助于解释这些亚人群之间认知衰退和痴呆症诊断的异质性。
我们观察到社会环境变量与认知衰退和痴呆症之间存在一系列复杂的关系。在整个人口中，社交、身体或智力活动参与度增加等因素与痴呆症风险降低有关。然而，在亚人群分析中，社会环境变量与定义亚组的认知衰退和痴呆症风险的异质性模式无关。
