MRC Unit for Lifelong Health and Ageing at UCL, UCL, London, UK.
Epidemiology and Public Health, University College London, London, UK.
BMJ Open. 2019 Apr 24;9(4):e024404. doi: 10.1136/bmjopen-2018-024404.
The life course determinants of midlife and later life cognitive function have been studied using longitudinal population-based cohort data, but far less is known about whether the pattern of these pathways is similar or distinct for clinically relevant cognitive state. We investigated this for Addenbrooke's Cognitive Examination third edition (ACE-III), used in clinical settings to screen for cognitive impairment and dementia.
Longitudinal birth cohort study.
Residential addresses in England, Wales and Scotland.
1762 community-dwelling men and women of European heritage, enrolled since birth in the Medical Research Council (MRC) National Survey of Health and Development (the British 1946 birth cohort).
ACE-III.
Path modelling estimated direct and indirect associations between apolipoprotein E () status, father's social class, childhood cognition, education, midlife occupational complexity, midlife verbal ability (National Adult Reading Test; NART), and the total ACE-III score. Controlling for sex, there was a direct negative association between ε4 and the ACE-III score (β=-0.04 [-0.08 to -0.002], p=0.04), but not between ε4 and childhood cognition (β=0.03 [-0.006 to 0.069], p=0.10) or the NART (β=0.0005 [-0.03 to 0.03], p=0.97). The strongest influences on the ACE-III were from childhood cognition (β=0.20 [0.14 to 0.26], p<0.001) and the NART (β=0.35 [0.29 to 0.41], p<0.001); educational attainment and occupational complexity were modestly and independently associated with the ACE-III (β=0.08 [0.03 to 0.14], p=0.002 and β=0.05 [0.01 to 0.10], p=0.02, respectively).
The ACE-III in the general population shows a pattern of life course antecedents that is similar to neuropsychological measures of cognitive function, and may be used to represent normal cognitive ageing as well as a screen for cognitive impairment and dementia.
使用纵向人群队列数据研究中年和晚年认知功能的生命历程决定因素，但对于临床相关认知状态的这些途径模式是否相似或不同知之甚少。我们使用临床中用于筛查认知障碍和痴呆的 Addenbrooke 认知测验第三版（ACE-III）对此进行了研究。
纵向出生队列研究。
英格兰、威尔士和苏格兰的居住地址。
1762 名具有欧洲血统的居住在社区的男性和女性，自出生起就参与了医学研究委员会（MRC）全国健康与发展调查（英国 1946 年出生队列）。
ACE-III。
路径模型估计了载脂蛋白 E () 状态、父亲的社会阶层、儿童认知、教育、中年职业复杂性、中年言语能力（国家成人阅读测验；NART）与 ACE-III 总分之间的直接和间接关联。在控制性别后，ε4 与 ACE-III 评分呈负相关（β=-0.04 [-0.08 至-0.002]，p=0.04），但 ε4 与儿童认知（β=0.03 [-0.006 至 0.069]，p=0.10）或 NART（β=0.0005 [-0.03 至 0.03]，p=0.97）之间没有关联。对 ACE-III 影响最大的是儿童认知（β=0.20 [0.14 至 0.26]，p<0.001）和 NART（β=0.35 [0.29 至 0.41]，p<0.001）；教育程度和职业复杂性与 ACE-III 有适度和独立的关联（β=0.08 [0.03 至 0.14]，p=0.002 和β=0.05 [0.01 至 0.10]，p=0.02）。
一般人群中的 ACE-III 表现出与认知功能的神经心理学测量相似的生命历程前因，可用于代表正常认知衰老以及认知障碍和痴呆的筛查。
