Risk and protective factors for cognitive impairment in persons aged 85 years and older

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Abstract

Objective: To determine risk and protective factors for mild cognitive impairment (MCI) among persons 85 years and older. Methods: Participants in the population-based prospective Mayo Clinic Study of Aging were comprehensively evaluated at baseline and at 15 monthly intervals to determine incident MCI. At baseline, lifestyle factors in midlife and late life were assessed by self-reported questionnaire; vascular and comorbid conditions were abstracted from participants' medical records. Results: Of 256 participants who were cognitively normal at enrollment (median age 87.3 years, 62% women), 121 developed MCI at a median 4.1 years of follow-up. Predictors of MCI were APOE ε4 allele (hazard ratio [HR] 1.89; p 0.008), current depressive symptoms (HR 1.78; p 0.02), midlife onset of hypertension (HR 2.43; p 0.005), increasing number of vascular diseases (HR 1.13; p 0.02), and chronic conditions from the Charlson Comorbidity Index (HR 1.08; p 0.006). Models were adjusted for sex and education, with age as the time variable. The risk of MCI was reduced for participants who reported engagement in artistic (HR 0.27; p 0.03), craft (HR 0.55; p 0.02), and social (HR 0.45; p 0.005) activities in both midlife and late life, and in the use of a computer in late life (HR 0.47; p 0.008). Conclusions: Chronic disease burden increases risk of MCI, whereas certain lifestyle factors reduce risk in persons 85 years and older. This implies that preventive strategies for MCI may need to begin in midlife and should persist throughout late life.

Original languageEnglish (US)
Pages (from-to)1854-1861
Number of pages8
JournalNeurology
Volume84
Issue number18
DOIs
StatePublished - May 5 2015

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Life Style
Sex Education
Protective Factors
Cognitive Dysfunction
Vascular Diseases
Medical Records
Blood Vessels
Comorbidity
Chronic Disease
Alleles
Depression
Hypertension
Population
Surveys and Questionnaires

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

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title = "Risk and protective factors for cognitive impairment in persons aged 85 years and older",
abstract = "Objective: To determine risk and protective factors for mild cognitive impairment (MCI) among persons 85 years and older. Methods: Participants in the population-based prospective Mayo Clinic Study of Aging were comprehensively evaluated at baseline and at 15 monthly intervals to determine incident MCI. At baseline, lifestyle factors in midlife and late life were assessed by self-reported questionnaire; vascular and comorbid conditions were abstracted from participants' medical records. Results: Of 256 participants who were cognitively normal at enrollment (median age 87.3 years, 62{\%} women), 121 developed MCI at a median 4.1 years of follow-up. Predictors of MCI were APOE ε4 allele (hazard ratio [HR] 1.89; p 0.008), current depressive symptoms (HR 1.78; p 0.02), midlife onset of hypertension (HR 2.43; p 0.005), increasing number of vascular diseases (HR 1.13; p 0.02), and chronic conditions from the Charlson Comorbidity Index (HR 1.08; p 0.006). Models were adjusted for sex and education, with age as the time variable. The risk of MCI was reduced for participants who reported engagement in artistic (HR 0.27; p 0.03), craft (HR 0.55; p 0.02), and social (HR 0.45; p 0.005) activities in both midlife and late life, and in the use of a computer in late life (HR 0.47; p 0.008). Conclusions: Chronic disease burden increases risk of MCI, whereas certain lifestyle factors reduce risk in persons 85 years and older. This implies that preventive strategies for MCI may need to begin in midlife and should persist throughout late life.",
author = "Roberts, {Rosebud O} and Cha, {Ruth H.} and Mielke, {Michelle M} and Geda, {Yonas Endale} and Boeve, {Bradley F} and Machulda, {Mary Margaret} and Knopman, {David S} and Petersen, {Ronald Carl}",
year = "2015",
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TY - JOUR

T1 - Risk and protective factors for cognitive impairment in persons aged 85 years and older

AU - Roberts, Rosebud O

AU - Cha, Ruth H.

AU - Mielke, Michelle M

AU - Geda, Yonas Endale

AU - Boeve, Bradley F

AU - Machulda, Mary Margaret

AU - Knopman, David S

AU - Petersen, Ronald Carl

PY - 2015/5/5

Y1 - 2015/5/5

N2 - Objective: To determine risk and protective factors for mild cognitive impairment (MCI) among persons 85 years and older. Methods: Participants in the population-based prospective Mayo Clinic Study of Aging were comprehensively evaluated at baseline and at 15 monthly intervals to determine incident MCI. At baseline, lifestyle factors in midlife and late life were assessed by self-reported questionnaire; vascular and comorbid conditions were abstracted from participants' medical records. Results: Of 256 participants who were cognitively normal at enrollment (median age 87.3 years, 62% women), 121 developed MCI at a median 4.1 years of follow-up. Predictors of MCI were APOE ε4 allele (hazard ratio [HR] 1.89; p 0.008), current depressive symptoms (HR 1.78; p 0.02), midlife onset of hypertension (HR 2.43; p 0.005), increasing number of vascular diseases (HR 1.13; p 0.02), and chronic conditions from the Charlson Comorbidity Index (HR 1.08; p 0.006). Models were adjusted for sex and education, with age as the time variable. The risk of MCI was reduced for participants who reported engagement in artistic (HR 0.27; p 0.03), craft (HR 0.55; p 0.02), and social (HR 0.45; p 0.005) activities in both midlife and late life, and in the use of a computer in late life (HR 0.47; p 0.008). Conclusions: Chronic disease burden increases risk of MCI, whereas certain lifestyle factors reduce risk in persons 85 years and older. This implies that preventive strategies for MCI may need to begin in midlife and should persist throughout late life.

AB - Objective: To determine risk and protective factors for mild cognitive impairment (MCI) among persons 85 years and older. Methods: Participants in the population-based prospective Mayo Clinic Study of Aging were comprehensively evaluated at baseline and at 15 monthly intervals to determine incident MCI. At baseline, lifestyle factors in midlife and late life were assessed by self-reported questionnaire; vascular and comorbid conditions were abstracted from participants' medical records. Results: Of 256 participants who were cognitively normal at enrollment (median age 87.3 years, 62% women), 121 developed MCI at a median 4.1 years of follow-up. Predictors of MCI were APOE ε4 allele (hazard ratio [HR] 1.89; p 0.008), current depressive symptoms (HR 1.78; p 0.02), midlife onset of hypertension (HR 2.43; p 0.005), increasing number of vascular diseases (HR 1.13; p 0.02), and chronic conditions from the Charlson Comorbidity Index (HR 1.08; p 0.006). Models were adjusted for sex and education, with age as the time variable. The risk of MCI was reduced for participants who reported engagement in artistic (HR 0.27; p 0.03), craft (HR 0.55; p 0.02), and social (HR 0.45; p 0.005) activities in both midlife and late life, and in the use of a computer in late life (HR 0.47; p 0.008). Conclusions: Chronic disease burden increases risk of MCI, whereas certain lifestyle factors reduce risk in persons 85 years and older. This implies that preventive strategies for MCI may need to begin in midlife and should persist throughout late life.

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U2 - 10.1212/WNL.0000000000001537

DO - 10.1212/WNL.0000000000001537

M3 - Article

VL - 84

SP - 1854

EP - 1861

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 18

ER -