Secular Changes in Cognitive Predictors of Dementia and Mortality in 70-year-olds

Overview

Journal Neurology

Specialty Neurology

Date 2010 Sep 1

PMID 20805523

Citations 22

Authors

S Sacuiu

D Gustafson

M Sjogren

X Guo

S Ostling

B Johansson

I Skoog

Affiliations

Soon will be listed here.

Abstract

Background: Successive elderly birth cohorts improved in cognitive performance during the 20th century. It is not clear whether this influences cognitive predictors of dementia and mortality.

Objective: In 2 longitudinal population studies, representing 2 cohorts of 70-year-olds examined 30 years apart, we investigated the relation between baseline cognitive function and 5-year occurrence of dementia and mortality.

Methods: Two representative cohorts of 70-year-olds initially free from dementia born in 1901-1902 (cohort 1901-1902: n = 381) and 1930 (cohort 1930: n = 551) from Gothenburg, Sweden, were examined in 1971-1972 and 2000-2001 and after 5 years for the outcome of dementia and death. Recent memory was evaluated during psychiatric examinations, and nonmemory domains using psychometric tests.

Results: At age 70, cohort 1930 performed better on psychometric tests, and had fewer recent memory problems compared to cohort 1901-1902. During 5-year follow-up, 5.0% in cohort 1901-1902 and 4.4% in cohort 1930 (p = 0.742) developed dementia, and 15.7% in cohort 1901-1902 and 4.4% in cohort 1930 died (p < 0.001). Recent memory was associated with incident dementia in both cohorts. Low scores in nonmemory tests were associated with incident dementia in cohort 1901-1902, but not in cohort 1930. Recent memory problems and lower scores in nonmemory tests were associated with 5-year mortality in cohort 1901-1902, but not in cohort 1930.

Conclusions: Secular changes in cognitive performance may influence cognitive predictors of dementia and mortality, despite similar incidence of dementia. The findings should be taken cautiously due to differences between cohorts in refusal rates, quality of education, and dementia recognition in medical records.

Citing Articles

Attrition in the Gothenburg H70 birth cohort studies, an 18-year follow-up of the 1930 cohort.

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Better cognitive function in younger generations - Insights from two cohort studies of middle-aged to older adults in Wisconsin.

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Hu X, Gu S, Zhen X, Sun X, Gu Y, Dong H Front Public Health. 2021; 9:753671.

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References

Backman L, Jonsson Laukka E, Wahlin A, Small B, Fratiglioni L . Influences of preclinical dementia and impending death on the magnitude of age-related cognitive deficits. Psychol Aging. 2002; 17(3):435-42. DOI: 10.1037//0882-7974.17.3.435. View

Guo X, Waern M, Sjogren K, Lissner L, Bengtsson C, Bjorkelund C . Midlife respiratory function and Incidence of Alzheimer's disease: a 29-year longitudinal study in women. Neurobiol Aging. 2006; 28(3):343-50. DOI: 10.1016/j.neurobiolaging.2006.01.008. View

Johansson B, Berg S . The robustness of the terminal decline phenomenon: longitudinal data from the Digit-Span Memory Test. J Gerontol. 1989; 44(6):P184-6. DOI: 10.1093/geronj/44.6.p184. View

Laukka E, MacDonald S, Backman L . Terminal-decline effects for select cognitive tasks after controlling for preclinical dementia. Am J Geriatr Psychiatry. 2008; 16(5):355-65. DOI: 10.1097/JGP.0b013e318160f312. View

Steen G, Berg S, Steen B . Cognitive function in 70-year-old men and women. A 16-year cohort difference population study. Aging (Milano). 1998; 10(2):120-6. DOI: 10.1007/BF03339646. View

Fischer P, Jungwirth S, Zehetmayer S, Weissgram S, Hoenigschnabl S, Gelpi E . Conversion from subtypes of mild cognitive impairment to Alzheimer dementia. Neurology. 2007; 68(4):288-91. DOI: 10.1212/01.wnl.0000252358.03285.9d. View

Wancata J, Borjesson-Hanson A, Ostling S, Sjogren K, Skoog I . Diagnostic criteria influence dementia prevalence. Am J Geriatr Psychiatry. 2007; 15(12):1034-45. DOI: 10.1097/JGP.0b013e31813c6b6c. View

Linn R, Wolf P, Bachman D, Knoefel J, Cobb J, Belanger A . The 'preclinical phase' of probable Alzheimer's disease. A 13-year prospective study of the Framingham cohort. Arch Neurol. 1995; 52(5):485-90. DOI: 10.1001/archneur.1995.00540290075020. View

Zelinski E, Kennison R . The Long Beach Longitudinal Study: evaluation of longitudinal effects of aging on memory and cognition. Home Health Care Serv Q. 2001; 19(3):45-55. DOI: 10.1300/J027v19n03_04. View

10.

Stern Y, Gurland B, Tatemichi T, Tang M, Wilder D, Mayeux R . Influence of education and occupation on the incidence of Alzheimer's disease. JAMA. 1994; 271(13):1004-10. View

11.

Schaie K, Willis S, Pennak S . An Historical Framework for Cohort Differences in Intelligence. Res Hum Dev. 2006; 2(1-2):43-67. PMC: 1513180. DOI: 10.1080/15427609.2005.9683344. View

12.

Sacuiu S, Gustafson D, Johansson B, Thorvaldsson V, Berg S, Sjogren M . The pattern of cognitive symptoms predicts time to dementia onset. Alzheimers Dement. 2009; 5(3):199-206. DOI: 10.1016/j.jalz.2008.10.007. View

13.

Hall K, Gao S, Baiyewu O, Lane K, Gureje O, Shen J . Prevalence rates for dementia and Alzheimer's disease in African Americans: 1992 versus 2001. Alzheimers Dement. 2009; 5(3):227-33. PMC: 2718566. DOI: 10.1016/j.jalz.2009.01.026. View

14.

Rogers M, Plassman B, Kabeto M, Fisher G, McArdle J, Llewellyn D . Parental education and late-life dementia in the United States. J Geriatr Psychiatry Neurol. 2008; 22(1):71-80. PMC: 2670459. DOI: 10.1177/0891988708328220. View

15.

La Rue A, Jarvik L . Cognitive function and prediction of dementia in old age. Int J Aging Hum Dev. 1987; 25(2):79-89. DOI: 10.2190/DV3R-PBJQ-E0FT-7W2B. View

16.

Stern Y, Albert S, Tang M, Tsai W . Rate of memory decline in AD is related to education and occupation: cognitive reserve?. Neurology. 1999; 53(9):1942-7. DOI: 10.1212/wnl.53.9.1942. View

17.

Tschanz J, Welsh-Bohmer K, Lyketsos C, Corcoran C, Green R, Hayden K . Conversion to dementia from mild cognitive disorder: the Cache County Study. Neurology. 2006; 67(2):229-34. DOI: 10.1212/01.wnl.0000224748.48011.84. View

18.

Tierney M, Yao C, Kiss A, McDowell I . Neuropsychological tests accurately predict incident Alzheimer disease after 5 and 10 years. Neurology. 2005; 64(11):1853-9. DOI: 10.1212/01.WNL.0000163773.21794.0B. View

19.

Kay D, Roth M, Beamish P . OLD AGE MENTAL DISORDERS IN NEWCASTLE UPON TYNE. II. A STUDY OF POSSIBLE SOCIAL AND MEDICAL CAUSES. Br J Psychiatry. 1964; 110:668-82. DOI: 10.1192/bjp.110.468.668. View

20.

Berg S . Psychological functioning in 70- and 75-year-old people. A study in an industrialized city. Acta Psychiatr Scand Suppl. 1980; 288:1-47. View