Gender and educational differences in the association between lifestyle and cognitive decline over 10 years: the Doetinchem cohort study

Kay Deckers, Astrid Nooyens, Martin van Boxtel, Frans Verhey, Monique Verschuren, Sebastian Köhler

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
Pages (from-to)S31-S41
Number of pages11
JournalJournal of Alzheimer's Disease
Volume70
Early online date28 Nov 2018
DOIs
Publication statusPublished - 2019

Keywords

  • Aging
  • cognition
  • dementia
  • education
  • gender
  • lifestyle
  • modifiable risk factors
  • prevention
  • MODIFIABLE RISK-FACTORS
  • ALZHEIMERS-DISEASE
  • RELATIVE VALIDITY
  • DEMENTIA
  • PREVALENCE
  • PREVENTION
  • HEALTH
  • POPULATION
  • IMPAIRMENT
  • LIBRA

Cite this

@article{11af92da563844fba1f0285ee82a9dae,
title = "Gender and educational differences in the association between lifestyle and cognitive decline over 10 years: the Doetinchem cohort study",
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.",
keywords = "Aging, cognition, dementia, education, gender, lifestyle, modifiable risk factors, prevention, MODIFIABLE RISK-FACTORS, ALZHEIMERS-DISEASE, RELATIVE VALIDITY, DEMENTIA, PREVALENCE, PREVENTION, HEALTH, POPULATION, IMPAIRMENT, LIBRA",
author = "Kay Deckers and Astrid Nooyens and {van Boxtel}, Martin and Frans Verhey and Monique Verschuren and Sebastian K{\"o}hler",
year = "2019",
doi = "10.3233/JAD-180492",
language = "English",
volume = "70",
pages = "S31--S41",
journal = "Journal of Alzheimer's Disease",
issn = "1387-2877",
publisher = "IOS Press",

}

TY - JOUR

T1 - Gender and educational differences in the association between lifestyle and cognitive decline over 10 years

T2 - the Doetinchem cohort study

AU - Deckers, Kay

AU - Nooyens, Astrid

AU - van Boxtel, Martin

AU - Verhey, Frans

AU - Verschuren, Monique

AU - Köhler, Sebastian

PY - 2019

Y1 - 2019

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.

AB - 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.

KW - Aging

KW - cognition

KW - dementia

KW - education

KW - gender

KW - lifestyle

KW - modifiable risk factors

KW - prevention

KW - MODIFIABLE RISK-FACTORS

KW - ALZHEIMERS-DISEASE

KW - RELATIVE VALIDITY

KW - DEMENTIA

KW - PREVALENCE

KW - PREVENTION

KW - HEALTH

KW - POPULATION

KW - IMPAIRMENT

KW - LIBRA

U2 - 10.3233/JAD-180492

DO - 10.3233/JAD-180492

M3 - Article

C2 - 30507570

VL - 70

SP - S31-S41

JO - Journal of Alzheimer's Disease

JF - Journal of Alzheimer's Disease

SN - 1387-2877

ER -