Institute of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Hebelstraße 29, Freiburg, 79104, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Sci Rep. 2024 Oct 25;14(1):25275. doi: 10.1038/s41598-024-76784-1.
Age-related cognitive decline has become an increasingly relevant public health issue. However, risk and protective factors of cognitive decline have yet to be investigated prospectively taking into account genetic, lifestyle, physical and mental health factors. Population-based data from middle-aged (40 to 59 years; N = 2,764) and older individuals (60 to 80 years; N = 1,254) were drawn from a prospective community cohort study using the Tower of London (TOL) planning task. Assessments were repeated at a 5-year interval to investigate age-related changes in planning performance and to determine the impact of risk and protective factors. Planning performance improved in middle-aged, but declined in older participants over 5 years. SNPs affecting the dopamine system (COMT, DRD2) and APOE polymorphisms differentially predicted cognitive performance in older vs. middle-aged individuals. For older individuals, high alcohol consumption, antidepressant medication and living without a partner had additional negative predictive power on cognition. In contrast, undiagnosed hypertension, no obstructive lung disease, and fewer years of education predicted cognitive decline in the middle-aged group. The results inform screening for individuals particularly vulnerable to cognitive decline and interventions (e.g., focusing on lifestyle factors) to help maintain cognitive performance into old age.
年龄相关的认知能力下降已成为一个日益重要的公共卫生问题。然而，认知能力下降的风险和保护因素尚未得到前瞻性研究，这些研究需要考虑遗传、生活方式、身心健康因素。从中年（40 至 59 岁；N=2764）和老年人群（60 至 80 岁；N=1254）的前瞻性社区队列研究中提取了基于人群的数据，使用伦敦塔（TOL）规划任务进行评估。每 5 年重复评估一次，以调查与年龄相关的规划表现变化，并确定风险和保护因素的影响。在 5 年内，中年参与者的规划表现有所提高，而老年参与者的规划表现则下降。影响多巴胺系统的 SNP（COMT、DRD2）和 APOE 多态性对中年和老年个体的认知表现有不同的预测作用。对于老年个体，高酒精摄入量、抗抑郁药物和没有伴侣会对认知有额外的负面影响。相比之下，未确诊的高血压、无阻塞性肺疾病和受教育年限较少则预示着中年组的认知下降。研究结果为筛选特别容易出现认知能力下降的个体以及干预措施（例如，关注生活方式因素）提供了信息，以帮助保持认知能力进入老年。
