Midlife Hearing, Vision, Olfactory, and Motor Function Improve the Long‐Term Prediction of Cognitive Decline and Onset of Cognitive Impairment
Year: 2023
Type: article
Study design: Observational Study
Abstract: Background Dementia has a long preclinical phase with pathological changes starting decades before clinical symptoms. Early detection of high‐risk individuals in midlife has great potential for future targeted treatments and prevention but we currently lack non‐invasive, low‐cost screening tools. Sensory (hearing, vision, olfaction) and motor changes are common in aging adults and have been associated with cognitive impairment and dementia. We aimed to assess whether midlife sensory and motor function can improve risk prediction models of 10‐year cognitive decline and impairment in comparison to risk predictions using the CAIDE and Framingham Risk Score (FRS). Method This longitudinal study is based on N = 1529 (54% women, mean age 49 years, range = 22‐84) Beaver Dam Offspring Study participants with data from baseline, 5‐year, and 10‐year follow‐up that have undergone a neurocognitive review. We assessed hearing, vision, olfactory, motor, cardiovascular health, and health history, and calculated the CAIDE and FRS at baseline. We determined 10‐year cognitive decline (Trail‐Making Test B time;10% most decline) and cognitive impairment (neurocognitive case review by clinical expert panel). We tested whether including baseline sensory (hearing, vision, olfactory) impairment and motor function improves CAIDE or FRS risk prediction models of 10‐year incidence of cognitive decline or cognitive impairment. We used logistic regression models to calculate the area under the receiver operating characteristics curve (AUROC) for models using only CAIDE or FRS and for CAIDE‐sensory‐motor / FRS‐sensory‐motor models. Results Overall, 139 participants experienced cognitive decline and 240 developed a cognitive impairment. Adding sensory and motor measures improved AUROCs for cognitive decline models from 0.72[95% confidence interval 0.68–0.76] in CAIDE‐only to 0.77[0.73–0.81] in CAIDE‐sensory‐motor (p<.001) and from 0.71[0.67–0.76] in FRS‐only to 0.78[0.74–0.82] in FRS‐sensory‐motor (p<.001). Cognitive impairment AUROCs improved 0.59[0.55–0.63] to 0.65[0.61–0.68] (CAIDE;p<.001) and 0.59[0.55–0.63] to 0.65[0.61–0.69] (FRS;p<.01), after adding sensory and motor measures. Conclusion Including midlife hearing, vision, olfactory, and motor function improved risk prediction of long‐term cognitive decline and impairment in middle‐aged to older adults. Sensory and motor assessments could potentially become relevant cost‐effective and non‐invasive screening tools to identify those at high risk for neurodegeneration and cognitive decline early to target future prevention and intervention strategies.
Source: Alzheimer s & Dementia
DOI: 10.1002/alz.071813
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4390199187