School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Dement Geriatr Cogn Disord. 2021;50(3):274-282. doi: 10.1159/000518129. Epub 2021 Aug 17.
Identifying early-life factors that protect against compromised late-life cognition is of great public health interest. We aimed to explore the associations between book-oriented environment in childhood and late-life cognitive performance in the Survey of Health, Ageing and Retirement in Europe (SHARE).
The sample included 8,239 individuals aged ≥65 years (N = 8,239) free of stroke, Parkinson's disease, or Alzheimer's disease, who participated in both waves 4 (2011) and 5 (2013) of SHARE. Book-oriented environment was assessed by the self-reported home library size during childhood. Cognitive performance was assessed using tests of memory and verbal fluency. Covariates included education and measures of current health, lifestyle, and financial status. Additionally, interactions with age and education were assessed.
After controlling for potential confounders, having large home libraries was related to better performance on the immediate and delayed memory (β = 0.11 ± 0.02, p < 0.001; β = 0.13 ± 0.02, p < 0.001) and the verbal fluency tests (β = 0.14 ± 0.06, p < 0.001) and to a lesser decline in these domains (β = 0.08 ± 0.01, p < 0.001; β = 0.09 ± 0.02, p < 0.001; and β = 0.09 ± 0.06, p < 0.001, respectively). Significant interactions were observed between library size and age such that larger home library was more strongly associated with improved immediate memory (p = 0.016), delayed memory (p < 0.001), and verbal fluency (p = 0.003) and with less cognitive decline (p = 0.013, p < 0.001, and p = 0.095, respectively) among the younger-old (<80 years) compared to the oldest-old (≥80 years) participants. No effect modification by education was observed.
These findings suggest that early-life book-oriented environment may be important in shaping cognitive aging.
识别能预防晚年认知能力受损的早期生活因素具有重要的公共卫生意义。我们旨在探索童年时期以书为导向的环境与欧洲健康、老龄化和退休研究调查(SHARE)中老年人认知表现之间的关联。
该样本包括 8239 名年龄≥65 岁的个体(N=8239),他们在 SHARE 的第 4 波(2011 年)和第 5 波(2013 年)均有参与,且均无中风、帕金森病或阿尔茨海默病病史。童年时期家庭藏书量的自我报告评估了以书为导向的环境。认知表现通过记忆和语言流畅性测试进行评估。协变量包括教育程度以及当前健康、生活方式和财务状况的衡量指标。此外,还评估了与年龄和教育程度的相互作用。
在控制了潜在的混杂因素后,拥有大型家庭图书馆与即时记忆和延迟记忆(β=0.11±0.02,p<0.001;β=0.13±0.02,p<0.001)以及语言流畅性测试(β=0.14±0.06,p<0.001)的表现更好相关,并且这些领域的衰退幅度也更小(β=0.08±0.01,p<0.001;β=0.09±0.02,p<0.001;β=0.09±0.06,p<0.001)。在图书馆规模与年龄之间观察到显著的相互作用,即较大的家庭图书馆与改善即时记忆(p=0.016)、延迟记忆(p<0.001)和语言流畅性(p=0.003)以及认知能力下降幅度较小(p=0.013,p<0.001 和 p=0.095)的相关性在年轻老年人(<80 岁)中比在最老年人(≥80 岁)中更强。未观察到教育程度的调节作用。
这些发现表明,童年时期以书为导向的环境可能对认知衰老的形成具有重要意义。