MRC Unit of Lifelong Health and Ageing at UCL, London, United Kingdom.
Centre for Dementia Prevention, University of Edinburgh, Edinburgh, United Kingdom.
Neuroepidemiology. 2017;49(3-4):121-128. doi: 10.1159/000481136. Epub 2017 Nov 16.
Cognitive capabilities change in later life, although their onset and rate of decline, and how they are shaped by lifetime socioeconomic position, childhood cognition and adult health status are all unclear.
From the Medical Research Council National Survey of Health and Development, we analysed 3,192 participants undergoing one or more cognitive assessments at ages 43, 53, 60-64 and 69. Linear mixed models described cognitive trajectories, adjusting for factors across the life course.
For both search speed and verbal memory, better performance at age 43 (the intercept) was associated with higher paternal and own education, childhood cognition, and adult occupational class. For search speed, the trajectory was best described as a quadratic function (decline of 45.6 letters/5-years + 4.6 letters). Verbal memory showed a linear decline of 0.20 words/5-years between ages 43 and 60 and a steeper linear decline of 0.95 words/5-years between ages 60 and 69. Decline in verbal memory in the latter period was steeper in those with higher educational achievements at age 26 (additional 0.28 words/5-years for highest attainment).
Decline in verbal memory and search speed across midlife is evident, though with different non-linear trajectories. By implication, pathways to cognitive impairment and dementia in older age may have their origins in this period.
认知能力在晚年发生变化,但其发病和下降速度,以及其如何受到终身社会经济地位、儿童认知和成年健康状况的影响尚不清楚。
我们对参加医学研究委员会国民健康与发展调查的 3192 名参与者进行了分析,这些参与者在 43 岁、53 岁、60-64 岁和 69 岁时接受了一次或多次认知评估。线性混合模型描述了认知轨迹,调整了整个生命周期的因素。
对于搜索速度和言语记忆,43 岁时的表现越好(截距)与父亲和自己的教育程度较高、儿童认知和成年职业阶层较高有关。对于搜索速度,轨迹最好用二次函数来描述(每 5 年下降 45.6 个字母+4.6 个字母)。言语记忆在 43 岁至 60 岁之间呈线性下降,每 5 年下降 0.20 个单词,在 60 岁至 69 岁之间呈更陡峭的线性下降,每 5 年下降 0.95 个单词。在这一后期,在 26 岁时教育程度较高的人言语记忆下降速度更快(最高程度的额外 0.28 个单词/5 年)。
中年时期言语记忆和搜索速度的下降是明显的,尽管其轨迹是非线性的。这意味着,老年认知障碍和痴呆的途径可能起源于这一时期。