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Gender and Educational Differences in the Association between Lifestyle and Cognitive Decline over 10 Years: The Doetinchem Cohort Study.
J Alzheimers Dis. 2019; 70(s1):S31-S41.JA

Abstract

BACKGROUND

Several modifiable risk factors for cognitive decline have been identified, but whether differences by gender and educational level exist is unclear.

OBJECTIVE

The present study aims to clarify this by prospectively investigating the relationship between health and lifestyle factors and cognitive functioning in different subgroups defined by gender and educational level.

METHODS

2,347 cognitive healthy individuals (mean age = 54.8, SD = 6.8, range: 41-71; 51.8% female; 26.2% low education) from the Doetinchem Cohort Study were examined for cognitive function at baseline, and at 5- and 10-year follow-up. Health- and lifestyle factors were captured by a poly-environmental risk score labelled 'LIfestyle for BRAin Health' (LIBRA). This score consists of 12 modifiable risk and protective factors for cognitive decline and dementia, with higher scores indicating greater risk (range: -2.7 to +12.7). Heterogeneity in associations between LIBRA and decline in verbal memory, cognitive flexibility, and mental speed between males and females and individuals with different levels of education were assessed in linear mixed models.

RESULTS

Overall, higher LIBRA scores predicted faster decline in verbal memory, cognitive flexibility, and mental speed over 10 years. Higher LIBRA scores were further associated with increased risk for incident cognitive impairment (one-point increase in LIBRA: HR = 1.09, 1.04-1.14, p = 0.001). In general, these effects were similar across gender and educational level.

CONCLUSION

A composite risk score comprising unhealthy lifestyle and relatively poor health in midlife is significantly associated with a worse course of cognition 10 years later. These associations were for the most part unrelated to gender or educational differences.

Authors+Show Affiliations

Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands.Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.

Pub Type(s)

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

Language

eng

PubMed ID

30507570

Citation

Deckers, Kay, et al. "Gender and Educational Differences in the Association Between Lifestyle and Cognitive Decline Over 10 Years: the Doetinchem Cohort Study." Journal of Alzheimer's Disease : JAD, vol. 70, no. s1, 2019, pp. S31-S41.
Deckers K, Nooyens A, van Boxtel M, et al. Gender and Educational Differences in the Association between Lifestyle and Cognitive Decline over 10 Years: The Doetinchem Cohort Study. J Alzheimers Dis. 2019;70(s1):S31-S41.
Deckers, K., Nooyens, A., van Boxtel, M., Verhey, F., Verschuren, M., & Köhler, S. (2019). Gender and Educational Differences in the Association between Lifestyle and Cognitive Decline over 10 Years: The Doetinchem Cohort Study. Journal of Alzheimer's Disease : JAD, 70(s1), S31-S41. https://doi.org/10.3233/JAD-180492
Deckers K, et al. Gender and Educational Differences in the Association Between Lifestyle and Cognitive Decline Over 10 Years: the Doetinchem Cohort Study. J Alzheimers Dis. 2019;70(s1):S31-S41. PubMed PMID: 30507570.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gender and Educational Differences in the Association between Lifestyle and Cognitive Decline over 10 Years: The Doetinchem Cohort Study. AU - Deckers,Kay, AU - Nooyens,Astrid, AU - van Boxtel,Martin, AU - Verhey,Frans, AU - Verschuren,Monique, AU - Köhler,Sebastian, PY - 2018/12/7/pubmed PY - 2020/10/21/medline PY - 2018/12/4/entrez KW - Aging KW - cognition KW - dementia KW - education KW - gender KW - lifestyle KW - modifiable risk factors KW - prevention SP - S31 EP - S41 JF - Journal of Alzheimer's disease : JAD JO - J Alzheimers Dis VL - 70 IS - s1 N2 - BACKGROUND: Several modifiable risk factors for cognitive decline have been identified, but whether differences by gender and educational level exist is unclear. OBJECTIVE: The present study aims to clarify this by prospectively investigating the relationship between health and lifestyle factors and cognitive functioning in different subgroups defined by gender and educational level. METHODS: 2,347 cognitive healthy individuals (mean age = 54.8, SD = 6.8, range: 41-71; 51.8% female; 26.2% low education) from the Doetinchem Cohort Study were examined for cognitive function at baseline, and at 5- and 10-year follow-up. Health- and lifestyle factors were captured by a poly-environmental risk score labelled 'LIfestyle for BRAin Health' (LIBRA). This score consists of 12 modifiable risk and protective factors for cognitive decline and dementia, with higher scores indicating greater risk (range: -2.7 to +12.7). Heterogeneity in associations between LIBRA and decline in verbal memory, cognitive flexibility, and mental speed between males and females and individuals with different levels of education were assessed in linear mixed models. RESULTS: Overall, higher LIBRA scores predicted faster decline in verbal memory, cognitive flexibility, and mental speed over 10 years. Higher LIBRA scores were further associated with increased risk for incident cognitive impairment (one-point increase in LIBRA: HR = 1.09, 1.04-1.14, p = 0.001). In general, these effects were similar across gender and educational level. CONCLUSION: A composite risk score comprising unhealthy lifestyle and relatively poor health in midlife is significantly associated with a worse course of cognition 10 years later. These associations were for the most part unrelated to gender or educational differences. SN - 1875-8908 UR - https://www.unboundmedicine.com/medline/citation/30507570/Gender_and_Educational_Differences_in_the_Association_between_Lifestyle_and_Cognitive_Decline_over_10_Years:_The_Doetinchem_Cohort_Study_ L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/JAD-180492 DB - PRIME DP - Unbound Medicine ER -