Determinants of cognitive performance and decline in 20 diverse ethno-regional groups: A COSMIC collaboration cohort study

Abstract

Background With no effective treatments for cognitive decline or dementia, improving the evidence base for modifiable risk factors is a research priority. This study investigated associations between risk factors and late-life cognitive decline on a global scale, including comparisons between ethno-regional groups. Methods and findings We harmonized longitudinal data from 20 population-based cohorts from 15 countries over 5 continents, including 48,522 individuals (58.4% women) aged 54-105 (mean = 72.7) years and without dementia at baseline. Studies had 2-15 years of follow-up. The risk factors investigated were age, sex, education, alcohol consumption, anxiety, apolipoprotein E ε4 allele (APOE*4) status, atrial fibrillation, blood pressure and pulse pressure, body mass index, cardiovascular disease, depression, diabetes, self-rated health, high cholesterol, hypertension, peripheral vascular disease, physical activity, smoking, and history of stroke. Associations with risk factors were determined for a global cognitive composite outcome (memory, language, processing speed, and executive functioning tests) and Mini-Mental State Examination score. Individual participant data meta-analyses of multivariable linear mixed model results pooled across cohorts revealed that for at least 1 cognitive outcome, age (B = −0.1, SE = 0.01), APOE*4 carriage (B = −0.31, SE = 0.11), depression (B = −0.11, SE = 0.06), diabetes (B = −0.23, SE = 0.10), current smoking (B = −0.20, SE = 0.08), and history of stroke (B = −0.22, SE = 0.09) were independently associated with poorer cognitive Determinants of cognition in diverse ethno-regional groups

Trajectories of cognitive function and their determinants in older people: 12 years of follow-up in the Chinese Longitudinal Healthy Longevity Survey

“…Another aim was to investigate the baseline characteristics of the identified heterogeneous classes of cognitive trajectories and the potential baseline predictors of trajectory membership. Potential predictors of cognitive decline were selected from the literature (Baumgart et al, 2015;Lipnicki et al, 2019;Olaya et al, 2017;Zaninotto et al, 2018) to cover several categories: sociodemographic characteristics, physical activity, leisure activities, and health status.…”

Mild Cognitive Impairment in the Migrant Population Living in Europe: An Epidemiological Estimation of the Phenomenon

“…In addition, a relevant variability of MCI prevalence across different immigrant groups was observed [18]. Such heterogeneity can be attributed to various determinants (e.g., vascular risk factors, educational level, lifestyles, physical activity, social interactions [19][20][21]) that have robustly been associated with the risk of cognitive disturbances and that were unavailable for the present analysis. The decision to base our analysis on the data produced by the COSMIC collaboration [14] (and not on other MCI prevalence data available in the literature) stems from the aim of providing different estimates of the phenomenon of interest according to alternative operationalizations of MCI that are widely adopted in the routine practice.…”

Socio-demographic characteristics and cognitive performance in oldest old subjects asking for driving license renewal

“…Contrary to hypothesis 1.c, in our sample we found that sex is a significant predictor of the total test score, with females having a higher mean total score in both tests [ 54 ]. As compared to males, females in general may have lower levels of age-associated cognitive decline, possibly because of biological mechanisms such as the effects of estrogen or sex-specific cognitive reserve, but also due to sociocultural factors, as emerged for Whites – including a cohort in the neiborhood of Milan - in an updated pooled analysis of individual-level longitudinal data from 20 population-based cohorts (2–15 years of follow-up) from 15 countries over 5 continents, including 48,522 individuals (58.4% women) aged 54–105 (mean = 72.7) years and without dementia at baseline [ 55 ].…”