P2‐114: Predictors of successful cognitive aging: Findings from the cache county memory study
Year: 2009
Type: article
Study design: Observational Study
Abstract: Identifying predictors of “successful cognitive aging” to late old age (85+) without dementia has important implications for models of Alzheimer's disease (AD) pathogenesis and dementia-free survival. The Cache County Memory Study (CCMS) offers an ideal opportunity to explore predictors of both conditions within late old age. We examined groups of factors in relation to successfully aging to 85 without dementia: 1) factors that are immutable (APOE genotype, family history of AD, gender), 2) early life experiences (education), 3) psychosocial factors in later life (marital status, religious involvement, social support), and 4) self-rated health and lifestyle factors (tobacco and alcohol use, drinking, exercise, and self-rated health). The CCMS cohort represents a population-based sample aged 65 and older in 1995 (n=5,092), examined in three triennial waves with dementia diagnosis assigned via comprehensive clinical evaluation, ending in expert consensus. Successful cognitive aging was defined as survival to age 85 without dementia. After removal of prevalent dementia cases, we examined the contributions of the specified factors on incident dementia hazard rate using Cox proportional hazard modeling, censoring everyone at age 85. We then determined likelihood of successful cognitive aging, sequentially adding each risk factor group. Those who had sedentary lifestyle (p=.035), were not current (p=.014) or prior (p=.026) drinker, had e4 allele (p<.001), or positive family history (p=.004) were significantly less likely to successfully age, with a trend for past smokers (p=.072) being non-married (p=.075), and being male (p=.066) also associated with reduced likelihood. Compared to those with none of the deleterious risk factors, those with all such risk factors were 99.7% less likely to successfully age. Those with only deleterious immutable risk factors were 69% less likely to successfully age. Although APOE genotype and a positive family history have a strong negative impact on successful cognitive aging, a number of modifiable psychosocial and physical health factors in later life appear to be beneficial. Continuing work explores the relative effect of these positive factors across the lifespan and their interaction with APOE genotype and family history.
Source: Alzheimer s & Dementia
Authors: Kathleen A. Welsh‐Bohmer, Maria C. Norton, Kathleen M. Hayden, Truls østbye, Carl F. Pieper, Christopher Corcoran, John C.S. Breitner, Cache County Investigators
Institutions: Duke University, Utah State University, University of Washington
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2090122333