Gender and Educational Differences in the Association between Lifestyle and Cognitive Decline over 10 Years: The Doetinchem Cohort Study
Gender and Educational Differences in the Association between Lifestyle and Cognitive Decline over 10 Years: The Doetinchem Cohort Study
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DOI：
10.3233/jad-180492
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发表时间：
2019-01-01
影响因子：
4
通讯作者：
Kohler, Sebastian
中科院分区：
文献类型：
--
作者：
Deckers, Kay;Nooyens, Astrid;Kohler, Sebastian
背景资料：认知功能下降的几个可改变的危险因素已被确定，但是否存在性别和教育水平的差异尚不清楚objective：本研究旨在通过前瞻性调查健康和生活方式因素与认知功能之间的关系来澄清这一点，在不同的亚组中定义性别和教育水平。对来自杜廷赫姆队列研究的2，347名认知健康个体（平均年龄= 54.8岁，SD = 6.8，范围：41-71岁; 51.8%为女性; 26.2%为低教育程度）进行了基线、5年和10年随访时的认知功能检查。健康和生活方式因素被标记为“生活方式对大脑健康”（LIBRA）的多环境风险评分捕获。该评分由认知能力下降和痴呆的12个可改变的风险和保护因素组成，评分越高表示风险越大（范围：-2.7至+12.7）。LIBRA和言语记忆，认知灵活性和心理速度下降之间的异质性关联进行了评估，男性和女性之间的个人与不同教育水平的线性混合models.Results：总体而言，较高的LIBRA分数预测更快的言语记忆，认知灵活性下降，心理速度超过10年。更高的LIBRA评分进一步与认知障碍事件风险增加相关（LIBRA增加1分：HR =1.09，1.04-1.14，p = 0.001）。在一般情况下，这些影响是相似的跨性别和教育level.Conclusion：一个复合风险评分，包括不健康的生活方式和相对较差的健康状况在中年显着相关的认知过程中，10年后。这些关联在很大程度上与性别或教育差异无关。
Background: Several modifiable risk factors for cognitive decline have been identified, but whether differences by gender and educational level exist is unclear.Objective: The present study aims to clarify this by prospectively investigating the relationship between health and lifestyle factors and cognitive functioning in different subgroups defined by gender and educational level.Methods: 2,347 cognitive healthy individuals (mean age = 54.8, SD = 6.8, range: 41-71; 51.8% female; 26.2% low education) from the Doetinchem Cohort Study were examined for cognitive function at baseline, and at 5- and 10-year follow-up. Health-and lifestyle factors were captured by a poly-environmental risk score labelled 'Lifestyle for BRAin Health' (LIBRA). This score consists of 12 modifiable risk and protective factors for cognitive decline and dementia, with higher scores indicating greater risk (range: -2.7 to +12.7). Heterogeneity in associations between LIBRA and decline in verbal memory, cognitive flexibility, and mental speed between males and females and individuals with different levels of education were assessed in linear mixed models.Results: Overall, higher LIBRA scores predicted faster decline in verbal memory, cognitive flexibility, and mental speed over 10 years. Higher LIBRA scores were further associated with increased risk for incident cognitive impairment (one-point increase in LIBRA: HR =1.09, 1.04-1.14, p = 0.001). In general, these effects were similar across gender and educational level.Conclusion: A composite risk score comprising unhealthy lifestyle and relatively poor health in midlife is significantly associated with a worse course of cognition 10 years later. These associations were for the most part unrelated to gender or educational differences.