Project description:Large population-based studies on the associations of childhood factors with late-life cognition are lacking in many low and middle income countries including India. In this study, we assessed the prevalence of late-life cognitive impairment and examined the associations of childhood socioeconomic status (SES) and health conditions with cognitive impairment among older adults in India. Data for this study were derived from the Longitudinal Ageing Study in India conducted in 2017-18. The effective sample size was 31,464 older adults aged 60 years and above. Cognitive functioning was measured through five global domains (memory, orientation, arithmetic function, executive function, and object naming). The overall score ranged between 0 and 43, and the score was reversed indicating cognitive impairment. Descriptive statistics along with mean scores of cognitive impairment were presented. Additionally, moderated multivariable linear regression models were employed to examine the association between explanatory variables, including childhood SES and health conditions and late-life cognitive impairment. The mean score of cognitive functioning among the study participants was 21.72 (CI 2.64-21.80). About 15% of older adults had poor health conditions, and 44% had lower financial status during their childhood. Older adults who had a fair health during their childhood were more likely to suffer from cognitive impairment in comparison to older adults who had good health during their childhood (Coef: 0.60; CI 0.39, 0.81). In comparison to older adults who had good childhood financial status, those who had poor childhood financial status were more likely to suffer from cognitive impairment (Coef: 0.81; CI 0.56, 1.07). Older adults who had fair childhood health status and poor childhood financial status were more likely to suffer from cognitive impairment in comparison to older adults who had good childhood health and good financial status (Coef: 1.26; CI 0.86, 1.66). Social policies such as improving educational and financial resources in disadvantaged communities and socioeconomically poor children and their families, would help to enhance a better cognitive ageing and a healthy and dignified life in old age.
Project description:ObjectiveTo determine whether alcohol consumption is causally associated with cognitive impairment in older men as predicted by mendelian randomization.MethodsRetrospective analysis of a cohort study of 3,542 community-dwelling men aged 65 to 83 years followed for 6 years. Cognitive impairment was established by a Mini-Mental State Examination score of 23 or less. Participants provided detailed information about their use of alcohol during the preceding year and were classified as abstainers, occasional drinkers, and regular drinkers: mild (<15 drinks/wk), moderate (15-27 drinks/wk), heavy (28-34 drinks/wk), and abusers (≥35 drinks/wk). We genotyped the rs1229984 G→A variant of the alcohol dehydrogenase 1B (ADH1B) gene, which is associated with lower prevalence of alcohol abuse and dependence. Other measures included age, education, marital status, smoking and physical activity, body mass index, diabetes, hypertension, and cardiovascular diseases.ResultsAt study entry, rs1229984 G→A polymorphism was associated with lower prevalence of regular use of alcohol and decreased consumption among regular users. Six years later, 502 men (14.2%) showed evidence of cognitive impairment. Abstainers and irregular drinkers had higher odds of cognitive impairment than regular drinkers (odds ratio [OR] = 1.23, 95% confidence interval [CI] = 1.00-1.51, after adjustment for other measured factors). The rs1229984 G→A polymorphism did not decrease the odds of cognitive impairment (AA/GG OR = 1.35, 95% CI = 0.29-6.27; GA/GG OR = 1.05, 95% CI = 0.71-1.55).ConclusionsAlcohol consumption, including heavy regular drinking and abuse, is not a direct cause of cognitive impairment in later life. Our results are consistent with the possibility, but do not prove, that regular moderate drinking decreases the risk of cognitive impairment in older men.
Project description:Genome wide DNA methylation assays was conducted using the Illumina Infinium MethylationEPIC BeadArray technology (Methyl850K chip) that allows genome-wide DNA methylation analysis of 866,836 CpG sites. We included baseline and 2-year follow-up samples from 25 persons with mild cognitive impairment (cases) and 20 persons with cognitively normal (controls). Sample was balanced by age and sex.
Project description:Socioeconomic status differentials in health are well documented. Less is known about the socioeconomic variation in health in older people, and in older women in particular. The aim of the study was to examine the association between socioeconomic status and health in older women in relation to two indicators of socioeconomic status and three measures of health, and further, to investigate whether socioeconomic differences in health increase or decrease with advancing age. Data from a cross-sectional population based health survey inviting all women ≥70 years were analysed; 6,380 women aged 70-103 years participated. Logistic regression was applied to analyse variation in health by socioeconomic status. Disadvantaged socioeconomic status (i.e. lower educational levels and previous manual or never been in paid work) was significantly associated with poorer health outcomes, whether measured as self-assessed health or depression. Limiting long-standing illness was significantly associated with never been in paid work. The associations were not attenuated by simultaneous adjustments for health behavioural factors, social support, and marital status. Additional adjustments for medical conditions did only alter the significant association between employment status and limiting long-standing illness. The analyses revealed that educational inequalities did not decrease with advancing age, whereas the results for employment varied across age groups. Our findings suggest an enduring relation between socioeconomic status and health in later life. The study adds to the understanding of the consistent associations between poorer health and social disadvantages at older age. We are not aware of any previous study showing the persistence of social inequalities in health upon adjustments for medical conditions.
Project description:IntroductionPossible joint effects of subjective cognitive decline (SCD) and apolipoprotein E (APOE) ε4 genotype on incident mild cognitive impairment (MCI) were examined for men and women separately.MethodsCognitively normal participants with and without SCD were included from the first follow-up examination of the population-based Heinz Nixdorf Recall study. Sex-stratified logistic regression models estimated main effects and interactions (additive, multiplicative) of SCD at the first follow-up (yes+/no-) and APOE ε4 (positive+/negative-) groups for MCI 5 years later.ResultsOdds for MCI 5 years later were higher in SCD/APOE ε4 group +/+ than the sum of groups +/- and -/+ in women, with a trend for positive interaction. Odds for incident MCI in men was highest in group +/-, with no interaction effect.DiscussionOur findings indicate that APOE ε4 may play an important role in the association of SCD and incident MCI, especially considering sex. Further studies need to examine these associations with larger sample sizes.
Project description:BackgroundWe observed a lack of population-based longitudinal research examining the association of disadvantaged childhood socioeconomic circumstances (CSC) and disability [activities of daily living (ADL) and instrumental activities of daily living (IADL)] in older age, and whether socioeconomic attainments in adulthood can compensate for a poor socioeconomic start in life.MethodsData on 24 440 persons aged 50-96 in 14 European countries (Survey of Health, Ageing and Retirement in Europe) were used to measure the associations between CSC and limitations with ADL and with IADL, using mixed-effects logistic regression models. Models stratified by gender were adjusted for education during young adulthood, main occupation during middle age, ability to make ends meet during old age and potential confounding and control variables.ResultsRisks of ADL and IADL limitations increased with age and were different between women and men. For women, a gradient across CSC strata was observed, showing that the more disadvantaged the CSC, the higher the risk of ADL and IADL limitations in old age, even after adjustment for adult socioeconomic indicators. For men, the association between CSC and disability was mediated by the main occupation in middle age and the ability to make ends meet at older age.ConclusionWomen who grew up in socioeconomically disadvantaged households were at higher risk of disability in older age and this disadvantage was not attenuated by favourable adult socioeconomic conditions. Men were more likely to make up for a disadvantaged start in adulthood.
Project description:IntroductionIn a geographically diverse sample of women, we asked whether cognitive reserve (CR) is best viewed as a general or cognitive domain-specific construct and whether some cognitive reserve domains but not others exert protective effects on risk of developing mild cognitive impairment (MCI) or dementia.MethodsEstimates of general and domain-specific CR were derived via variance decomposition in 972 cognitively intact women from the Women's Health Initiative Study of Cognitive Aging and Women's Health Memory Study Magnetic Resonance Imaging. Women were then followed up for 13 years.ResultsGeneral CR was the strongest predictor of reduced risk for both MCI and dementia, compared to domain-specific CR measures. Verbal memory, figural memory, and spatial CR were independently protective of MCI, but only verbal memory was independently associated with reduced risk for dementia.DiscussionCognitive reserve is a heterogenous construct with valid quantitative measures identifiable across different neuropsychological processes associated with MCI and dementia.
Project description:Dementia has become a major issue that requires urgent measures. The prevention of dementia may be influenced by dietary factors. We focused on green tea and performed a systematic review of observational studies that examined the association between green tea intake and dementia, Alzheimer's disease, mild cognitive impairment, or cognitive impairment. We searched for articles registered up to 23 August 2018, in the PubMed database and then for references of original articles or reviews that examined tea and cognition. Subsequently, the extracted articles were examined regarding whether they included original data assessing an association of green tea intake and dementia, Alzheimer's disease, mild cognitive impairment, or cognitive impairment. Finally, we included three cohort studies and five cross-sectional studies. One cohort study and three cross-sectional studies supported the positive effects of green tea intake. One cohort study and one cross-sectional study reported partial positive effects. The remaining one cohort study and one cross-sectional study showed no significant association of green tea intake. These results seem to support the hypothesis that green tea intake might reduce the risk for dementia, Alzheimer's disease, mild cognitive impairment, or cognitive impairment. Further results from well-designed and well-conducted cohort studies are required to derive robust evidence.
Project description:BackgroundTo explore the prevalence and inequality of cognitive impairment among older adults in Macau and the contributions of influencing factors to inequality in cognitive impairment.MethodsThe Montreal Cognitive Assessment (MoCA) was used to measure the prevalence of cognitive impairment. Socioeconomic status scores were used to describe economic level of the subjects. The concentration index was applied to measure the inequality of cognitive impairment associated with socioeconomic status (SES) and decomposed into its influencing factors.ResultsThe prevalence of cognitive impairment was 44.35% in Macau. The concentration index of cognitive impairment among the elderly was -0.165 (95% CI: -0.232 to -0.098), indicating that the prevalence of cognitive impairment was concentrated in households with poor SES. Older age, poor SES, long or short sleep duration, other marital status, poor appetite, no tea/coffee drinking, no religious belief, and depression contributed positively to the inequality of cognitive impairment. Among these factors, SES made the largest contribution to inequality, accounting for 76.74%.ConclusionIn Macau, the prevalence of cognitive impairment among people aged 65 years and older is concentrated among those who are in poor economic conditions. Reducing the gap between the rich and the poor at the source, increasing educational level of low SES population and improving their access to healthcare services will help to improve the inequity of cognitive impairment.
Project description:BackgroundTo date much research into nutrition and cognitive function has been at the nutrient or food level, with inconsistent results. There is increasing interest in the dietary pattern approach to assess whole diet quality and its association with cognitive function. This study investigated if diet quality is associated with cognitive function in men and women aged 55 years and over.MethodsAdults aged 55-65 years in the Wellbeing, Eating and Exercise for a Long Life (WELL) study in Victoria, Australia (n = 617) completed a postal survey including a 111-item food frequency questionnaire in 2010 and 2014. Diet quality was assessed via the revised dietary guideline index (DGI-2013) and also by its individual components which assessed key food groups and dietary behaviours from the Australian Dietary Guidelines. The Telephone Interview of Cognitive Status (TICS-m) measured cognitive function in 2014. Associations between past (2010) and recent (2014) diet quality and its components, and cognitive function were assessed by linear regression adjusted for covariates.ResultsAfter adjustment for age, sex, education, urban/rural status and physical activity there were no associations between diet quality in 2010 and cognitive function in 2014. However participants who reported higher dietary variety (B = 0.28, 95% CI 0.03, 0.52) and women who reported "sometimes" adding salt to food after cooking (B = 0.98, 95% CI 0.25, 1.71) in 2010 displayed better cognitive function in 2014. In 2014, usual consumption of higher fibre bread choices in the total sample (B = 1.32, 95% CI 0.42, 2.23), and higher diet quality (B = 0.03, 95% CI 0.00, 0.07) and greater fluid consumption (B = 0.14, 95% CI 0.01, 0.27) in men were all associated with better cognitive function. In addition, men who reported "usually" adding salt to their food during cooking displayed poorer cognitive function (B = -1.37, 95% CI -2.39, - 0.35). There were no other associations between dietary intake and cognitive function observed in the adjusted models.ConclusionAn association between dietary variety and some limited dietary behaviours and cognitive function was observed, with variation by gender. Future research should consider trajectories of dietary change over longer time periods as determinants of health and function in older age.