Stressors in Midlife and Risk of Dementia: The Role of Race and Education.
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ABSTRACT:
SUBMITTER: Gilsanz P
PROVIDER: S-EPMC6710152 | biostudies-literature | 2019 Jul-Sep
REPOSITORIES: biostudies-literature
Publications
Stressors in Midlife and Risk of Dementia: The Role of Race and Education.
Gilsanz Paola P Quesenberry Charles P CP Mayeda Elizabeth Rose ER Glymour M Maria MM Farias Sarah T ST Whitmer Rachel A RA
Alzheimer disease and associated disorders 20190701 3
<h4>Background</h4>Posttraumatic stress disorder is associated with increased dementia risk but less is known about stress because of everyday problems in diverse populations.<h4>Methods</h4>A total of 9605 health care plan members who provided information regarding midlife stressors in 1972 to 1973 (ages, 40 to 55 y) were followed for dementia diagnosis between 1996 and 2017. Cox proportional hazard models evaluated associations between midlife stressors and dementia adjusting for demographics ...[more]
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Project description:ObjectivesAnxiety is an increasingly recognised predictor of cognitive deterioration in older adults and in those with mild cognitive impairment. Often believed to be a prodromal feature of neurodegenerative disease, anxiety may also be an independent risk factor for dementia, operationally defined here as preceding dementia diagnosis by ?10 years.DesignA systematic review of the literature on anxiety diagnosis and long-term risk for dementia was performed following published guidelines.Setting and participantsMedline, PsycINFO and Embase were searched for peer-reviewed journals until 8 March 2017. Publications reporting HR/OR for all-cause dementia based on clinical criteria from prospective cohort or case-control studies were selected. Included studies measured clinically significant anxiety in isolation or after controlling for symptoms of depression, and reported a mean interval between anxiety assessment and dementia diagnosis of at least 10 years. Methodological quality assessments were performed using the Newcastle-Ottawa Scale.Outcome measureHR/OR for all-cause dementia.ResultsSearches yielded 3510 articles, of which 4 (0.02%) were eligible. The studies had a combined sample size of 29 819, and all studies found a positive association between clinically significant anxiety and future dementia. Due to the heterogeneity between studies, a meta-analysis was not conducted.ConclusionsClinically significant anxiety in midlife was associated with an increased risk of dementia over an interval of at least 10 years. These findings indicate that anxiety may be a risk factor for late-life dementia, excluding anxiety that is related to prodromal cognitive decline. With increasing focus on identifying modifiable risk factors for dementia, more high-quality prospective studies are required to clarify whether clinical anxiety is a risk factor for dementia, separate from a prodromal symptom.
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Project description:IntroductionThe interplay between midlife vascular risk factors and midlife cognitive function with later life mild cognitive impairment (MCI) and dementia (DEM) is not well understood.MethodsIn the Atherosclerosis Risk in Communities Study, cardiovascular risk factors and cognition were assessed in midlife, ages 45-64 years. In 2011-2013, 20-25 years later, all consenting Atherosclerosis Risk in Communities participants underwent a cognitive and neurological evaluation and were given adjudicated diagnoses of cognitively normal, MCI, or DEM.ResultsIn 5995 participants with complete covariate data, midlife diabetes, hypertension, obesity, and hypercholesterolemia were associated with late-life MCI and DEM. Low midlife cognition function was also associated with greater likelihood of late-life MCI or DEM. Both midlife vascular risk factors and midlife cognitive function remained associated with later life MCI or DEM when both were in the model.DiscussionLater life MCI and DEM were independently associated with midlife vascular risk factors and midlife cognition.
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