Top

BMC Geriatrics

Published in:

Open Access 01-12-2018 | Research article

Age dependency of risk factors for cognitive decline

Authors: N. Legdeur, M. W. Heymans, H. C. Comijs, M. Huisman, A. B. Maier, P. J. Visser

Published in: BMC Geriatrics | Issue 1/2018

Abstract

Background

Risk factors for cognitive decline might depend on chronological age. The aim of the study was to explore the age dependency of risk factors for cognitive decline in cognitively healthy subjects aged 55–85 years at baseline.

Methods

We included 2527 cognitively healthy subjects from the Longitudinal Aging Study Amsterdam (LASA). Median follow-up was 9.1 (IQR: 3.2–19.0) years. The association of genetic and cardiovascular risk factors, depressive symptoms, inflammation markers and lifestyle risk factors with decline in MMSE and memory function was tested using spline regression analyses.

Results

Subjects were on average 70.1 (SD 8.8) years old at baseline. Based on a spline regression model, we divided our sample in three age groups: ≤70 years (young-old), > 70–80 years (old) and > 80 years (oldest-old). The association of LDL cholesterol, homocysteine, hypertension, history of stroke, depressive symptoms, interleukin-6, a1-antichymotrypsin, alcohol use and smoking with cognitive decline significantly differed between the age groups. In general, the presence of these risk factors was associated with less cognitive decline in the oldest-old group compared to the young-old and old group.

Conclusions

The negative effect of various risk factors on cognitive decline decreases with higher age. A combination of epidemiological factors, such as the selection towards healthier subjects during follow-up, but also risk factor specific features, for example ensuring the cerebral blood flow in case of hypertension, explain this diminished association at higher age. It is important to take these age differences into account when applying preventive strategies to avert cognitive decline.

Available only for authorised users

World Health Organization and Alzheimer’s Disease International. Dementia - A public health priority. 2012.

Kramer AF, Colcombe SJ, McAuley E, Scalf PE, Erickson KI. Fitness, aging and neurocognitive function. Neurobiol Aging. 2005;26:124–7. https://doi.org/10.1016/j.neurobiolaging.2005.09.009.CrossRefPubMed

Baumgart M, Snyder HM, Carrillo MC, Fazio S, Kim H, Johns H. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: a population-based perspective. Alzheimers Dement. 2015;11:1–9. https://doi.org/10.1016/j.jalz.2015.05.016.CrossRef

Smith RG, Todd S, Passmore PA. Chronic medical disease and cognitive aging: toward a healthy body and brain. Inflammation and Cognitive Decline. Edited by Kristine Yaffe. Can Geriatr J. 2013;16(3):143–44.

Bretsky P, Guralnik JM, Launer L, Albert M, Seeman TE. The role of APOE-epsilon4 in longitudinal cognitive decline: MacArthur studies of successful aging. Neurology. 2003;60:1077–81. https://doi.org/10.1212/01.WNL.0000055875.26908.24.CrossRefPubMed

Cheng G, Huang C, Deng H, Wang H. Diabetes as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies. Intern Med J. 2012;42:484–91. https://doi.org/10.1111/j.1445-5994.2012.02758.x.CrossRefPubMed

Van Den Kommer TN, Comijs HC, Aartsen MJ, Huisman M, Deeg DJH, Beekman ATF. Depression and cognition: how do they interrelate in old age? Am J Geriatr Psychiatry. 2013;21:398–410. https://doi.org/10.1016/j.jagp.2012.12.015.CrossRefPubMed

Anstey KJ, Mack HA, Cherbuin N. Alcohol consumption as a risk factor for dementia and cognitive decline: Meta-analysis of prospective studies. Am J Geriatr Psychiatry. 2009;17:542–55. https://doi.org/10.1097/JGP.0b013e3181a2fd07.CrossRefPubMed

Anstey KJ, Lipnicki DM, Low L-F. Cholesterol as a risk factor for dementia and cognitive decline: a systematic review of prospective studies with Meta-analysis. Am J Geriatr Psychiatry. 2008;16:343–54. https://doi.org/10.1097/01.JGP.0000310778.20870.ae.CrossRefPubMed

10.

Bullain SS, Corrada MM. Dementia in the oldest old. Continuum (Minneap Minn). 2013;19:457–69. https://doi.org/10.1212/01.CON.0000429172.27815.3f.CrossRef

11.

Farrer LA, Cupples LA, Haines JL, Hyman B, Kukull WA, Mayeux R, et al. Effects of age, sex, and ethnicity on the association between apolipoprotein E genotype and Alzheimer disease. A meta-analysis. APOE and Alzheimer disease Meta analysis consortium. JAMA. 1997;278:1349–56. https://doi.org/10.1001/jama.1997.03550160069041.CrossRefPubMed

12.

Qiu C, Winblad B, Fratiglioni L. The age-dependent relation of blood pressure to cognitive function and dementia. Lancet Neurol. 2005;4:487–99. https://doi.org/10.1016/S1474-4422(05)70141-1.CrossRefPubMed

13.

Harrison SL, Stephan BCM, Siervo M, Granic A, Davies K, Wesnes KA, et al. Is there an association between metabolic syndrome and cognitive function in very old adults? The Newcastle 85+ study. J Am Geriatr Soc. 2015;63:667–75. https://doi.org/10.1111/jgs.13358.CrossRefPubMed

14.

van den Berg E, Biessels GJ, de Craen a J, Gussekloo J, RGJ W. The metabolic syndrome is associated with decelerated cognitive decline in the oldest old. Neurology. 2007;69:979–85. https://doi.org/10.1212/01.wnl.0000271381.30143.75.CrossRefPubMed

15.

Huisman M, Poppelaars J, van der Horst M, Beekman ATF, Brug J, van Tilburg TG, et al. Cohort profile: the longitudinal aging study Amsterdam. Int J Epidemiol. 2011;40:868–76. https://doi.org/10.1093/ije/dyq219.CrossRefPubMed

16.

Reijs BLR, Ramakers IHGB, Elias-Sonnenschein L, Teunissen CE, Koel-Simmelink M, Tsolaki M, et al. Relation of odor identification with Alzheimer’s disease markers in cerebrospinal fluid and cognition. J Alzheimers Dis. 2017;60:1025–34. https://doi.org/10.3233/JAD-170564.CrossRefPubMed

17.

Havekes LM, De Knijff P, Beisiegel U. A rapid micromethod for apolipoprotein E phenotyping directly in serum. J Lipid Res. 1987;28:455–63.PubMed

18.

Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.PubMed

19.

Kriegsman DM, Penninx BW, van Eijk JT, Boeke AJ, Deeg DJ. Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients’ self-reports and on determinants of inaccuracy. J Clin Epidemiol. 1996;49:1407–17. https://doi.org/10.1016/S0895-4356(96)00274-0.CrossRefPubMed

20.

Radloff LS, Teri L. Use of the Center for Epidemiological Studies-Depression Scale with older adults. Clin Gerontol. 1986;5:119–36. https://doi.org/10.1007/BF01537606.CrossRef

21.

Stel VS, Smit JH, Pluijm SMF, Visser M, Deeg DJH, Lips P. Comparison of the LASA physical activity questionnaire with a 7-day diary and pedometer. J Clin Epidemiol. 2004;57:252–8. https://doi.org/10.1016/j.jclinepi.2003.07.008.CrossRefPubMed

22.

Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98. https://doi.org/10.1016/0022-3956(75)90026-6.CrossRefPubMed

23.

Rey A. L’examen clinique en psychologie. Paris: Presses Universitaires de France; 1964.

24.

Verhaeghen P, Salthouse TA. Meta-analyses of age-cognition relations in adulthood: estimates of linear and nonlinear age effects and structural models. Psychol Bull. 1997;122:231–49. https://doi.org/10.1037//0033-2909.122.3.231.CrossRefPubMed

25.

Chen H, Zhao B, Cao G, Proges EC, O’Shea A, Woods AJ, et al. Statistical approaches for the study of cognitive and brain aging. Front Aging Neurosci. 2016;8:1–10. https://doi.org/10.3389/fnagi.2016.00176.CrossRef

26.

Corrada MM, Paganini-Hill A, Berlau DJ, Kawas CH. Apolipoprotein e genotype, dementia, and mortality in the oldest old: the 90+ study. Alzheimers Dement. 2013;9:12–8. https://doi.org/10.1016/j.jalz.2011.12.004.CrossRefPubMed

27.

Elias-Sonnenschein LS, Viechtbauer W, Ramakers IHGB, Verhey FRJ, Visser PJ. Predictive value of APOE-ε4 allele for progression from MCI to AD-type dementia: a meta-analysis. J Neurol Neurosurg Psychiatry. 2011;82:1149–56. https://doi.org/10.1136/jnnp.2010.231555.CrossRefPubMed

28.

Mielke MM, Zandi PP, Sjögren M, Gustafson D, Ostling S, Steen B, et al. High total cholesterol levels in late life associated with a reduced risk of dementia. Neurology. 2005;64:1689–95. https://doi.org/10.1212/01.WNL.0000161870.78572.A5.CrossRefPubMed

29.

Weverling-Rijnsburger AW, Blauw GJ, Lagaay AM, Knook DL, Meinders AE, Westendorp RG. Total cholesterol and risk of mortality in the oldest old. Lancet (London, England). 1997;350:1119–23. https://doi.org/10.1016/S0140-6736(97)04430-9.CrossRef

30.

van den Kommer TN, Dik MG, Comijs HC, Lutjohann D, Lips P, Jonker C, et al. The role of extracerebral cholesterol homeostasis and ApoE e4 in cognitive decline. Neurobiol Aging. 2012;33:622.e17–28. https://doi.org/10.1016/j.neurobiolaging.2011.02.019.CrossRef

31.

Corrada MM, Hayden KM, Paganini-Hill A, Bullain SS, DeMoss J, Aguirre C, et al. Age of onset of hypertension and risk of dementia in the oldest-old: the 90+ study. Alzheimers Dement. 2017;13:103–10. https://doi.org/10.1016/j.jalz.2016.09.007.CrossRefPubMedPubMedCentral

32.

Kennelly SP, Lawlor BA, Kenny RA. Blood pressure and the risk for dementia-a double edged sword. Ageing Res Rev. 2009;8:61–70. https://doi.org/10.1016/j.arr.2008.11.001.CrossRefPubMed

33.

Ruitenberg A, Skoog I, Ott A, Aevarsson O. Blood pressure and risk of dementia: results from the Rotterdam study and the Gothenburg H-70 study. Blood Press. 2001:33–9. https://doi.org/10.1159/000051233.

34.

Skoog I, Lernfelt B, Landahl S, Palmertz B, Andreasson LA, Nilsson L, et al. 15-year longitudinal study of blood pressure and dementia. Lancet (London, England). 1996;347:1141–5. https://doi.org/10.1016/S0140-6736(96)90608-X.CrossRef

35.

Spira AP, Rebok GW, Stone KL, Kramer JH, Yaffe K. Depressive symptoms in oldest-old women: risk of mild cognitive impairment and dementia. Am J Geriatr Psychiatry. 2011;19:S56–7.CrossRef

36.

Berkman LF, Berkman CS, Kasl S, Freeman DHJ, Leo L, Ostfeld AM, et al. Depressive symptoms in relation to physical health and functioning in the elderly. Am J Epidemiol. 1986;124:372–88. https://doi.org/10.1093/oxfordjournals.aje.a114408.CrossRefPubMed

37.

Brailean A, Aartsen MJ, Muniz-Terrera G, Prince M, Prina AM, Comijs HC, et al. Longitudinal associations between late-life depression dimensions and cognitive functioning: a cross-domain latent growth curve analysis. Psychol Med. 2017;47:690–702. https://doi.org/10.1017/S003329171600297X.CrossRefPubMed

38.

Gorelick PB. Role of inflammation in cognitive impairment: results of observational epidemiological studies and clinical trials. Ann N Y Acad Sci. 2010;1207:155–62. https://doi.org/10.1111/j.1749-6632.2010.05726.x.CrossRefPubMed

39.

Anstey KJ, Windsor TD, Rodgers B, Jorm AF, Christensen H. Lower cognitive test scores observed in alcohol abstainers are associated with demographic, personality, and biological factors: the PATH through life project. Addiction. 2005;100:1291–301. https://doi.org/10.1111/j.1360-0443.2005.01159.x.CrossRefPubMed

40.

Zhong G, Wang Y, Zhang Y, Guo JJ, Zhao Y. Smoking is associated with an increased risk of dementia: a meta-analysis of prospective cohort studies with investigation of potential effect modifiers. PLoS One. 2015;10 https://doi.org/10.1371/journal.pone.0118333.

41.

Chang C-CH, Zhao Y, Lee C-W, Ganguli M. Smoking, death, and Alzheimer’s disease: a case of competing risks. Alzheimer Dis Assoc Disord. 2012;26:300–6. https://doi.org/10.1097/WAD.0b013e3182420b6e.CrossRefPubMedPubMedCentral

42.

Hernán MA, Alonso ALG. Cigarette smoking and dementia: potential selection bias in the elderly. Epidemiol (Cambridge, Mass). 2008;19:242–6. https://doi.org/10.1097/EDE.0b013e31816bbe14.CrossRef

43.

Blondell SJ, Hammersley-Mather R, Veerman J. Does physical activity prevent cognitive decline and dementia?: a systematic review and meta-analysis of longitudinal studies. BMC Public Health. 2014;14:1–12. https://doi.org/10.1186/1471-2458-14-510.CrossRef

44.

Young J, Angevaren M, Rusted J, Tabet N. Aerobic exercise to improve cognitive function in older people without known cognitive impairment (review). Cochrane Database Syst Rev. 2015:1–141. https://doi.org/10.1002/14651858.CD005381.pub4. www.cochranelibrary.com

45.

Jansen WJ, Ossenkoppele R, Tijms BM, Fagan AM, Hansson O, Klunk WE, et al. Association of cerebral amyloid-β aggregation with cognitive functioning in persons without dementia. JAMA Psychiatry. 2018;75:84–95. https://doi.org/10.1001/jamapsychiatry.2017.3391.CrossRefPubMed

46.

Bender R, Lange S. Adjusting for multiple testing - when and how? J Clin Epidemiol. 2001;54:343–9. https://doi.org/10.1016/S0895-4356(00)00314-0.CrossRefPubMed

47.

Perneger TV. What’s wrong with Bonferroni adjustments. BMJ. 1998;316 https://doi.org/10.1136/bmj.316.7139.1236.

Title: Age dependency of risk factors for cognitive decline
Authors: N. Legdeur
M. W. Heymans
H. C. Comijs
M. Huisman
A. B. Maier
P. J. Visser
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Geriatrics / Issue 1/2018
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/s12877-018-0876-2

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Age dependency of risk factors for cognitive decline

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2018

Factors associated with quality of life in patients with Alzheimer’s disease

Cross-sectional study of prevalence of dementia, behavioural symptoms, mobility, pain and other health parameters in nursing homes in Austria and the Czech Republic: results from the DEMDATA project

Personal and behavioral correlates of total and domain-specific sedentary behaviors in older Taiwanese adults

Randomized controlled trial to evaluate a prevention program for frail community-dwelling older adults: a D-SCOPE protocol

Aging perceptions matter for the well-being of elderly Turkish migrants, especially among the chronically ill

Does sarcopenia predict change in mobility after hip fracture? a multicenter observational study with one-year follow-up

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page