Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University.
Melbourne School of Psychological Sciences, University of Melbourne.
Neuropsychology. 2023 Jul;37(5):582-594. doi: 10.1037/neu0000900. Epub 2023 Mar 16.
Studies of modifiable dementia risk factors (MDRFs) generally consider MDRFs individually, despite strong evidence that they co-occur in adult populations. In a large sample of middle-aged adults, this study aimed to determine the frequency and co-occurrence of MDRFs, spanning five domains (mood symptomatology, risky lifestyle behaviors, cardiovascular conditions, cognitive/social engagement, sleep disorders/symptomatology). The relationship between number of domains in which MDRFs were reported with cognitive performance and subjective cognitive concerns was then determined.
Middle-aged adults ( = 1,610) enrolled in the Healthy Brain Project and completed self-report surveys about their health and lifestyle. Participants also completed the Cogstate Brief Battery and the Cognitive Function Instrument, a measure of subjective ratings of cognition. Participants were classified according to number of domains (mood symptomatology, risky lifestyle behaviors, cardiovascular conditions, cognitive/social engagement, sleep disorders/symptomatology) in which they reported at least one MDRF (0-5). Age, sex, education, and ethnicity were adjusted for in analyses.
Most individuals (66.5%) reported MDRFs in two or more domains. Compared with individuals displaying no MDRFs, individuals with MDRFs in 3-5 domains showed worse learning/working memory performance and greater subjective cognitive concerns, with the magnitude of these differences moderate-to-large ( = 0.30-0.93). Individuals displaying MDRFs in five domains also showed worse attention/psychomotor function ( = 0.58) compared to those displaying no MDRFs.
These findings may suggest that multidomain MDRFs are highly frequent in middle-aged adults and are related to poorer cognition. This supports that modifiable dementia risk is multidimensional and raises the possibility that multidomain behavioral intervention trials in middle-aged adults may be useful to delay or prevent cognitive impairment or decline. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
尽管有大量证据表明，可改变的痴呆风险因素（MDRFs）在成年人群中共同存在，但对其进行的研究通常仍将 MDRFs 单独考虑。在一项针对中年成年人的大型样本研究中，本研究旨在确定跨越五个领域（情绪症状、危险生活方式行为、心血管状况、认知/社会参与、睡眠障碍/症状）的 MDRFs 的发生频率和共同发生情况。然后，确定报告 MDRFs 的领域数量与认知表现和主观认知关注之间的关系。
参加“健康大脑计划”的中年成年人（n=1610）完成了关于他们健康和生活方式的自我报告调查。参与者还完成了 Cogstate 简短电池和认知功能仪器的测试，该测试用于测量主观认知评估。根据报告至少存在一个 MDRF（0-5）的领域数量（情绪症状、危险生活方式行为、心血管状况、认知/社会参与、睡眠障碍/症状）对参与者进行分类。在分析中调整了年龄、性别、教育程度和种族等因素。
大多数人（66.5%）报告存在两个或更多领域的 MDRFs。与没有 MDRFs 的个体相比，存在 3-5 个领域 MDRFs 的个体在学习/工作记忆表现和更大的主观认知关注方面表现更差，这些差异的幅度为中等到较大（=0.30-0.93）。与没有 MDRFs 的个体相比，存在五个领域 MDRFs 的个体在注意力/心理运动功能方面的表现也更差（=0.58）。
这些发现可能表明，中年成年人中多领域 MDRFs 非常普遍，且与认知能力下降有关。这支持了可改变的痴呆风险是多维度的，并提出了在中年成年人中进行多领域行为干预试验可能有助于延缓或预防认知障碍或衰退的可能性。
