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Alcohol exposure and cognitive development: an example of why we need a contextualized, dynamic life course approach to cognitive ageing--a mini-review.

Abstract

BACKGROUND

A substantial literature exists that demonstrates associations between putative risk factors and cognitive decline in late life. However, there is a need to integrate this broad literature within a framework that incorporates the interaction of behavioral and ecological influences with cognitive development. Such a framework is required for developing a range of personal and environmental interventions to optimize cognitive development in the population, and to reduce the risk of cognitive impairment in late life.

OBJECTIVE

This review aims to identify the key considerations for developing a life course model of the various factors that influence cognitive development and cognitive decline. A contextualized, dynamic approach to life course epidemiology is proposed.

METHODS

A theoretical evaluation of key methodological and interpretational issues relating to how risk factors influence cognitive development and cognitive impairment was conducted. This focused on the example of alcohol consumption as a risk factor for cognitive decline and dementia.

RESULTS

This review identified dimensions that need to be accounted for in life course theories of cognitive development and cognitive impairment. These include: (a) intergenerational influences; (b) methodological and interpretational issues; (c) individual differences (personal factors); (d) contextual factors (environmental or ecological factors), and (e) cognitive ability as determinant. The methodological and interpretational factors included measurement of exposure and outcome variables; the important distinction between level of ability versus change over time; nonlinear relationships among exposures and outcomes, and outcomes and age; the distinction between association and cause, and between short-term effects and long-term change.

CONCLUSION

A contextualized, dynamic approach to life course epidemiology accounts for the complex range of influences over the life course that interact to determine normal and pathological cognitive ageing. This approach provides a framework for the development of interventions to maximize cognitive gains in early life, and minimize cognitive loss in late life.

Links

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  • Authors+Show Affiliations

    Ageing Research Unit, Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia. kaarin.anstey@anu.edu.au

    Source

    Gerontology 54:5 2008 pg 283-91

    MeSH

    Aging
    Alcohol Drinking
    Chronic Disease
    Cognition Disorders
    Dementia
    Humans
    Models, Theoretical
    Risk Factors
    Social Environment

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    18841026

    Citation

    Anstey, Kaarin J.. "Alcohol Exposure and Cognitive Development: an Example of Why We Need a Contextualized, Dynamic Life Course Approach to Cognitive Ageing--a Mini-review." Gerontology, vol. 54, no. 5, 2008, pp. 283-91.
    Anstey KJ. Alcohol exposure and cognitive development: an example of why we need a contextualized, dynamic life course approach to cognitive ageing--a mini-review. Gerontology. 2008;54(5):283-91.
    Anstey, K. J. (2008). Alcohol exposure and cognitive development: an example of why we need a contextualized, dynamic life course approach to cognitive ageing--a mini-review. Gerontology, 54(5), pp. 283-91. doi:10.1159/000161735.
    Anstey KJ. Alcohol Exposure and Cognitive Development: an Example of Why We Need a Contextualized, Dynamic Life Course Approach to Cognitive Ageing--a Mini-review. Gerontology. 2008;54(5):283-91. PubMed PMID: 18841026.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Alcohol exposure and cognitive development: an example of why we need a contextualized, dynamic life course approach to cognitive ageing--a mini-review. A1 - Anstey,Kaarin J, Y1 - 2008/10/08/ PY - 2008/04/08/received PY - 2008/08/18/accepted PY - 2008/10/9/pubmed PY - 2008/12/17/medline PY - 2008/10/9/entrez SP - 283 EP - 91 JF - Gerontology JO - Gerontology VL - 54 IS - 5 N2 - BACKGROUND: A substantial literature exists that demonstrates associations between putative risk factors and cognitive decline in late life. However, there is a need to integrate this broad literature within a framework that incorporates the interaction of behavioral and ecological influences with cognitive development. Such a framework is required for developing a range of personal and environmental interventions to optimize cognitive development in the population, and to reduce the risk of cognitive impairment in late life. OBJECTIVE: This review aims to identify the key considerations for developing a life course model of the various factors that influence cognitive development and cognitive decline. A contextualized, dynamic approach to life course epidemiology is proposed. METHODS: A theoretical evaluation of key methodological and interpretational issues relating to how risk factors influence cognitive development and cognitive impairment was conducted. This focused on the example of alcohol consumption as a risk factor for cognitive decline and dementia. RESULTS: This review identified dimensions that need to be accounted for in life course theories of cognitive development and cognitive impairment. These include: (a) intergenerational influences; (b) methodological and interpretational issues; (c) individual differences (personal factors); (d) contextual factors (environmental or ecological factors), and (e) cognitive ability as determinant. The methodological and interpretational factors included measurement of exposure and outcome variables; the important distinction between level of ability versus change over time; nonlinear relationships among exposures and outcomes, and outcomes and age; the distinction between association and cause, and between short-term effects and long-term change. CONCLUSION: A contextualized, dynamic approach to life course epidemiology accounts for the complex range of influences over the life course that interact to determine normal and pathological cognitive ageing. This approach provides a framework for the development of interventions to maximize cognitive gains in early life, and minimize cognitive loss in late life. SN - 1423-0003 UR - https://www.unboundmedicine.com/medline/citation/18841026/Alcohol_exposure_and_cognitive_development:_an_example_of_why_we_need_a_contextualized_dynamic_life_course_approach_to_cognitive_ageing__a_mini_review_ L2 - https://www.karger.com?DOI=10.1159/000161735 DB - PRIME DP - Unbound Medicine ER -