Huntley J, Corbett A, Wesnes K, Brooker H, Stenton R, Hampshire A, Ballard C
Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK.
University of Exeter, Exeter, UK.
Int J Geriatr Psychiatry. 2018 Feb;33(2):e286-e293. doi: 10.1002/gps.4790. Epub 2017 Sep 27.
Several potentially modifiable risk factors for cognitive decline and dementia have been identified, including low educational attainment, smoking, diabetes, physical inactivity, hypertension, midlife obesity, depression, and perceived social isolation. Managing these risk factors in late midlife and older age may help reduce the risk of dementia; however, it is unclear whether these factors also relate to cognitive performance in older individuals without dementia.
Data from 14 201 non-demented individuals aged >50 years who enrolled in the online PROTECT study were used to examine the relationship between cognitive function and known modifiable risk factors for dementia. Multivariate regression analyses were conducted on 4 cognitive outcomes assessing verbal and spatial working memory, visual episodic memory, and verbal reasoning.
Increasing age was associated with reduced performance across all tasks. Higher educational achievement, the presence of a close confiding relationship, and moderate alcohol intake were associated with benefits across all 4 cognitive tasks, and exercise was associated with better performance on verbal reasoning and verbal working memory tasks. A diagnosis of depression was negatively associated with performance on visual episodic memory and working memory tasks, whereas being underweight negatively affected performance on all tasks apart from verbal working memory. A history of stroke was negatively associated with verbal reasoning and working memory performance.
Known modifiable risk factors for dementia are associated with cognitive performance in non-demented individuals in late midlife and older age. This provides further support for public health interventions that seek to manage these risk factors across the lifespan.
已确定了几种可能导致认知能力下降和痴呆的可改变风险因素,包括低教育程度、吸烟、糖尿病、缺乏体育锻炼、高血压、中年肥胖、抑郁症和感知到的社会孤立感。在中年后期和老年期管理这些风险因素可能有助于降低患痴呆症的风险;然而,尚不清楚这些因素是否也与无痴呆症老年人的认知表现有关。
来自14201名年龄超过50岁的非痴呆个体的数据(这些个体参与了在线PROTECT研究)被用于检验认知功能与已知的可改变痴呆风险因素之间的关系。对评估言语和空间工作记忆、视觉情景记忆以及言语推理的4项认知结果进行了多变量回归分析。
年龄增长与所有任务的表现下降相关。更高的教育成就、存在亲密的倾诉关系以及适度饮酒与所有4项认知任务的良好表现相关,而锻炼与言语推理和言语工作记忆任务的更好表现相关。抑郁症诊断与视觉情景记忆和工作记忆任务的表现呈负相关,而体重过轻对除言语工作记忆外的所有任务表现均有负面影响。中风病史与言语推理和工作记忆表现呈负相关。
已知的可改变痴呆风险因素与中年后期和老年非痴呆个体的认知表现相关。这为旨在终生管理这些风险因素的公共卫生干预措施提供了进一步支持。