Johnsen Bente, Strand Bjørn Heine, Martinaityte Ieva, Mathiesen Ellisiv B, Schirmer Henrik
Department of Clinical Medicine (BJ, IM, EBM, HS), UiT The Arctic University of Norway; Department of Medicine (BJ, IM), University Hospital of North Norway, Tromsø; Norwegian Institute of Public Health (BHS), Oslo; Department of Neurology (EBM), University Hospital of North Norway, Tromsø; Department of Cardiology (HS), Akershus University Hospital, Lørenskog; and Institute of Clinical Medicine (HS), University of Oslo, Norway.
Neurol Clin Pract. 2021 Dec;11(6):e856-e866. doi: 10.1212/CPJ.0000000000001115.
Physical capacity and cardiovascular risk profiles seem to be improving in the population. Cognition has been improving due to a birth cohort effect, but evidence is conflicting on whether this improvement remains in the latest decades and what is causing the changes in our population older than 60 years. We aimed to investigate birth cohort differences in cognition.
The study comprised 9,514 participants from the Tromsø Study, an ongoing longitudinal cohort study. Participants were aged 60-87 years, born between 1914 and 1956. They did 4 cognitive tests in 3 waves during 2001-2016. Linear regression was applied and adjusted for age, education, blood pressure, smoking, hypercholesterolemia, stroke, heart attack, depression, diabetes, physical activity, alcohol use, BMI, and height.
Cognitive test scores were better in later-born birth cohorts for all age groups, and in both sexes, compared with earlier-born cohorts. Increased education, physical activity, alcohol intake, decreasing smoking prevalence, and increasing height were associated with one-third of this improvement across birth cohorts in women and one-half of the improvement in men.
Cognitive results were better in more recent-born birth cohorts compared with earlier born, assessed at the same age. The improvement was present in all cognitive domains, suggesting an overall improvement in cognitive performance. The 80-year-olds assessed in 2015-2016 performed like 60-year-olds assessed in 2001. The improved scores were associated with increased education level, increase in modest drinking frequency, increased physical activity, and, for men, smoking cessation and increased height.
人群的身体机能和心血管风险状况似乎正在改善。由于出生队列效应，认知能力一直在提高，但关于这种改善在最近几十年是否依然存在以及是什么导致60岁以上人群发生这些变化，证据存在冲突。我们旨在研究出生队列在认知方面的差异。
本研究纳入了来自特罗姆瑟研究的9514名参与者，这是一项正在进行的纵向队列研究。参与者年龄在60 - 87岁之间，出生于1914年至1956年。他们在2001年至2016年期间分3个阶段进行了4项认知测试。应用线性回归，并对年龄、教育程度、血压、吸烟、高胆固醇血症、中风、心脏病发作、抑郁症、糖尿病、身体活动、饮酒、体重指数和身高进行了调整。
与早出生队列相比，所有年龄组和男女两性中，晚出生队列的认知测试得分更高。教育程度提高、身体活动增加、饮酒量增加、吸烟率下降以及身高增加，与女性出生队列中这一改善的三分之一以及男性改善的二分之一相关。
在相同年龄评估时，与早出生队列相比，晚出生队列的认知结果更好。这种改善存在于所有认知领域，表明认知表现总体有所提高。2015 - 2016年评估的80岁老人的表现与2001年评估的60岁老人相当。得分提高与教育水平提高、适度饮酒频率增加、身体活动增加有关，对男性而言，还与戒烟和身高增加有关。
