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The role of cognitive reserve on terminal decline: a cross-cohort analysis from two European studies: OCTO-Twin, Sweden, and Newcastle 85+, UK.
Int J Geriatr Psychiatry 2016; 31(6):601-10IJ

Abstract

OBJECTIVE

Cognitive performance shows a marked deterioration in close proximity to death, as postulated by the terminal decline hypothesis. The effect of education on the rate of terminal decline in the oldest people (i.e. persons 85+ years) has been controversial and not entirely understood. In the current study, we investigated the rate of decline prior to death with a special focus on the role of education and socioeconomic position, in two European longitudinal studies of ageing: the Origins of Variance in the Old-Old: Octogenarian Twins (OCTO-Twin) and the Newcastle 85+ study.

METHODS

A process-based approach was used in which individuals' cognitive scores were aligned according to distance to death. In a coordinated analysis, multilevel models were employed to examine associations between different markers of cognitive reserve (education and socioeconomic position) and terminal decline using the mini-mental state examination (MMSE), controlling for age at baseline, sex, dementia incidence and time to death from the study entry to the time of death within each cohort.

RESULTS

The current findings suggest that education was positively associated with higher MMSE scores prior to death in the OCTO-Twin, but not in the Newcastle 85+ study, independent of socioeconomic position and other factors such as baseline age, sex and time to death from the study entry. However, education was not associated with the rate of terminal decline in both of these studies.

CONCLUSIONS

Our results offer only partial support to the cognitive reserve hypothesis and cognitive performance prior to death.

Authors+Show Affiliations

MRC Unit for Lifelong Health and Ageing at University College London, London, UK.Institute of Health and Society, Newcastle University, Newcastle, UK.Institute of Health and Society, Newcastle University, Newcastle, UK.Department of Psychology, University of Gothenburg, Gothenburg, Sweden.Department of Psychology, University of Victoria, Victoria, Canada.Department of Psychology, University of Victoria, Victoria, Canada.MRC Unit for Lifelong Health and Ageing at University College London, London, UK.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Twin Study

Language

eng

PubMed ID

26471722

Citation

Cadar, Dorina, et al. "The Role of Cognitive Reserve On Terminal Decline: a Cross-cohort Analysis From Two European Studies: OCTO-Twin, Sweden, and Newcastle 85+, UK." International Journal of Geriatric Psychiatry, vol. 31, no. 6, 2016, pp. 601-10.
Cadar D, Stephan BC, Jagger C, et al. The role of cognitive reserve on terminal decline: a cross-cohort analysis from two European studies: OCTO-Twin, Sweden, and Newcastle 85+, UK. Int J Geriatr Psychiatry. 2016;31(6):601-10.
Cadar, D., Stephan, B. C., Jagger, C., Johansson, B., Hofer, S. M., Piccinin, A. M., & Muniz-Terrera, G. (2016). The role of cognitive reserve on terminal decline: a cross-cohort analysis from two European studies: OCTO-Twin, Sweden, and Newcastle 85+, UK. International Journal of Geriatric Psychiatry, 31(6), pp. 601-10. doi:10.1002/gps.4366.
Cadar D, et al. The Role of Cognitive Reserve On Terminal Decline: a Cross-cohort Analysis From Two European Studies: OCTO-Twin, Sweden, and Newcastle 85+, UK. Int J Geriatr Psychiatry. 2016;31(6):601-10. PubMed PMID: 26471722.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of cognitive reserve on terminal decline: a cross-cohort analysis from two European studies: OCTO-Twin, Sweden, and Newcastle 85+, UK. AU - Cadar,Dorina, AU - Stephan,Blossom C M, AU - Jagger,Carol, AU - Johansson,Boo, AU - Hofer,Scott M, AU - Piccinin,Andrea M, AU - Muniz-Terrera,Graciela, Y1 - 2015/10/15/ PY - 2015/01/17/received PY - 2015/08/26/revised PY - 2015/09/10/accepted PY - 2015/10/17/entrez PY - 2015/10/17/pubmed PY - 2017/1/14/medline KW - MMSE KW - cognition KW - cognitive reserve KW - death KW - dementia KW - education KW - longitudinal study KW - mixed multilevel KW - terminal decline SP - 601 EP - 10 JF - International journal of geriatric psychiatry JO - Int J Geriatr Psychiatry VL - 31 IS - 6 N2 - OBJECTIVE: Cognitive performance shows a marked deterioration in close proximity to death, as postulated by the terminal decline hypothesis. The effect of education on the rate of terminal decline in the oldest people (i.e. persons 85+ years) has been controversial and not entirely understood. In the current study, we investigated the rate of decline prior to death with a special focus on the role of education and socioeconomic position, in two European longitudinal studies of ageing: the Origins of Variance in the Old-Old: Octogenarian Twins (OCTO-Twin) and the Newcastle 85+ study. METHODS: A process-based approach was used in which individuals' cognitive scores were aligned according to distance to death. In a coordinated analysis, multilevel models were employed to examine associations between different markers of cognitive reserve (education and socioeconomic position) and terminal decline using the mini-mental state examination (MMSE), controlling for age at baseline, sex, dementia incidence and time to death from the study entry to the time of death within each cohort. RESULTS: The current findings suggest that education was positively associated with higher MMSE scores prior to death in the OCTO-Twin, but not in the Newcastle 85+ study, independent of socioeconomic position and other factors such as baseline age, sex and time to death from the study entry. However, education was not associated with the rate of terminal decline in both of these studies. CONCLUSIONS: Our results offer only partial support to the cognitive reserve hypothesis and cognitive performance prior to death. SN - 1099-1166 UR - https://www.unboundmedicine.com/medline/citation/26471722/The_role_of_cognitive_reserve_on_terminal_decline:_a_cross_cohort_analysis_from_two_European_studies:_OCTO_Twin_Sweden_and_Newcastle_85+_UK_ L2 - https://doi.org/10.1002/gps.4366 DB - PRIME DP - Unbound Medicine ER -