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Potentially modifiable lifestyle factors, cognitive reserve, and cognitive function in later life: A cross-sectional study.
PLoS Med 2017; 14(3):e1002259PM

Abstract

BACKGROUND

Potentially modifiable lifestyle factors may influence cognitive health in later life and offer potential to reduce the risk of cognitive decline and dementia. The concept of cognitive reserve has been proposed as a mechanism to explain individual differences in rates of cognitive decline, but its potential role as a mediating pathway has seldom been explored using data from large epidemiological studies. We explored the mediating effect of cognitive reserve on the cross-sectional association between lifestyle factors and cognitive function in later life using data from a population-based cohort of healthy older people.

METHODS AND FINDINGS

We analysed data from 2,315 cognitively healthy participants aged 65 y and over in the Cognitive Function and Ageing Study Wales (CFAS-Wales) cohort collected in 2011-2013. Linear regression modelling was used to investigate the overall associations between five lifestyle factors-cognitive and social activity, physical activity, diet, alcohol consumption, and smoking-and cognition, adjusting for demographic factors and chronic conditions. Mediation analysis tested for indirect effects of the lifestyle factors on cognition via cognitive reserve. After controlling for age, gender, and the presence of chronic conditions, cognitive and social activity, physical activity, healthy diet, and light-to-moderate alcohol consumption were positively associated with cognitive function, together accounting for 20% (95% CI 17%-23%) of variance in cognitive test scores. Cognitive reserve was an important mediator of this association, with indirect effects via cognitive reserve contributing 21% (95% CI 15%-27%) of the overall effect on cognition. The main limitations of the study derive from the cross-sectional nature of the data and the challenges of accurately measuring the latent construct of cognitive reserve.

CONCLUSIONS

Cross-sectional associations support the view that enhancing cognitive reserve may benefit cognition, and maintenance of cognitive health may be supported by a healthy and active lifestyle, in later life.

Authors+Show Affiliations

Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, United Kingdom. PenCLAHRC, Institute of Health Research, University of Exeter Medical School, Exeter, United Kingdom. Centre for Research Excellence in Promoting Cognitive Health, Australian National University, Canberra, Australia.Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, United Kingdom. PenCLAHRC, Institute of Health Research, University of Exeter Medical School, Exeter, United Kingdom.Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, United Kingdom. PenCLAHRC, Institute of Health Research, University of Exeter Medical School, Exeter, United Kingdom.Dementia Services Development Centre Wales, School of Healthcare Sciences, Bangor University, Bangor, United Kingdom.Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, United Kingdom. MRC Biostatistics Unit, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.Dementia Services Development Centre Wales, School of Healthcare Sciences, Bangor University, Bangor, United Kingdom.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

28323829

Citation

Clare, Linda, et al. "Potentially Modifiable Lifestyle Factors, Cognitive Reserve, and Cognitive Function in Later Life: a Cross-sectional Study." PLoS Medicine, vol. 14, no. 3, 2017, pp. e1002259.
Clare L, Wu YT, Teale JC, et al. Potentially modifiable lifestyle factors, cognitive reserve, and cognitive function in later life: A cross-sectional study. PLoS Med. 2017;14(3):e1002259.
Clare, L., Wu, Y. T., Teale, J. C., MacLeod, C., Matthews, F., Brayne, C., & Woods, B. (2017). Potentially modifiable lifestyle factors, cognitive reserve, and cognitive function in later life: A cross-sectional study. PLoS Medicine, 14(3), pp. e1002259. doi:10.1371/journal.pmed.1002259.
Clare L, et al. Potentially Modifiable Lifestyle Factors, Cognitive Reserve, and Cognitive Function in Later Life: a Cross-sectional Study. PLoS Med. 2017;14(3):e1002259. PubMed PMID: 28323829.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Potentially modifiable lifestyle factors, cognitive reserve, and cognitive function in later life: A cross-sectional study. AU - Clare,Linda, AU - Wu,Yu-Tzu, AU - Teale,Julia C, AU - MacLeod,Catherine, AU - Matthews,Fiona, AU - Brayne,Carol, AU - Woods,Bob, AU - ,, Y1 - 2017/03/21/ PY - 2016/09/15/received PY - 2017/02/10/accepted PY - 2017/3/22/entrez PY - 2017/3/23/pubmed PY - 2017/6/13/medline SP - e1002259 EP - e1002259 JF - PLoS medicine JO - PLoS Med. VL - 14 IS - 3 N2 - BACKGROUND: Potentially modifiable lifestyle factors may influence cognitive health in later life and offer potential to reduce the risk of cognitive decline and dementia. The concept of cognitive reserve has been proposed as a mechanism to explain individual differences in rates of cognitive decline, but its potential role as a mediating pathway has seldom been explored using data from large epidemiological studies. We explored the mediating effect of cognitive reserve on the cross-sectional association between lifestyle factors and cognitive function in later life using data from a population-based cohort of healthy older people. METHODS AND FINDINGS: We analysed data from 2,315 cognitively healthy participants aged 65 y and over in the Cognitive Function and Ageing Study Wales (CFAS-Wales) cohort collected in 2011-2013. Linear regression modelling was used to investigate the overall associations between five lifestyle factors-cognitive and social activity, physical activity, diet, alcohol consumption, and smoking-and cognition, adjusting for demographic factors and chronic conditions. Mediation analysis tested for indirect effects of the lifestyle factors on cognition via cognitive reserve. After controlling for age, gender, and the presence of chronic conditions, cognitive and social activity, physical activity, healthy diet, and light-to-moderate alcohol consumption were positively associated with cognitive function, together accounting for 20% (95% CI 17%-23%) of variance in cognitive test scores. Cognitive reserve was an important mediator of this association, with indirect effects via cognitive reserve contributing 21% (95% CI 15%-27%) of the overall effect on cognition. The main limitations of the study derive from the cross-sectional nature of the data and the challenges of accurately measuring the latent construct of cognitive reserve. CONCLUSIONS: Cross-sectional associations support the view that enhancing cognitive reserve may benefit cognition, and maintenance of cognitive health may be supported by a healthy and active lifestyle, in later life. SN - 1549-1676 UR - https://www.unboundmedicine.com/medline/citation/28323829/Potentially_modifiable_lifestyle_factors_cognitive_reserve_and_cognitive_function_in_later_life:_A_cross_sectional_study_ L2 - http://dx.plos.org/10.1371/journal.pmed.1002259 DB - PRIME DP - Unbound Medicine ER -