Mid-life and late life activities and their relationship with MRI measures of brain structure and functional connectivity in the UK Biobank cohort

Anatürk, Melis; Suri, Sana; Smith, Stephen M.; Ebmeier, Klaus P.; Sexton, Claire E.

doi:10.1101/2020.04.10.035451

Cited by 3 publications

(6 citation statements)

References 40 publications

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“…One study found a moderation effect for midlife leisure activities, but in line with our findings, they did not find evidence of either a moderation or independent effect for later-life leisure activities [124]. Future research is warranted to clarify which specific leisure activities should be included in measures for this proxy given that only a few activities have been associated with cognition in mid-/old-age samples, albeit without adjusting for brain structure [116,125]. However, our results do not support the use of later-life leisure activities as a proxy measure of CR in crosssectional studies of cognitively healthy older adults.…”

Section: Occupational Complexity Leisure Activities and Physical Activity Did Not Show Robust Effects On Cognitionsupporting

confidence: 74%

“…Quality of education can differ greatly among individuals with the same quantity of education due to various socioeconomic and systemic factors [113], such as class size [114], and also due to individual-level factors such as intrinsic learning motivation and academic self-efficacy [115]. Secondly, measures of verbal intelligence may reflect wider lifetime educational and cognitive experiences as compared to years of education which is generally restricted to early-life formal education [79][80][81][82] and typically neglects to consider later-life education which has been positively associated with cognitive function [116,117]. In this sense, verbal intelligence could be considered a dynamic CR proxy which can change over time [118,119], as it may increase from young to mid-adulthood before decreasing in older adulthood [120].…”

Section: Verbal Intelligence Had Larger and More Robust Effects On Cognition Than Educational Attainmentmentioning

confidence: 99%

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Verbal intelligence is a more robust cross-sectional measure of cognitive reserve than level of education in healthy older adults

et al. 2021

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Background Cognitive reserve is most commonly measured using socio-behavioural proxy variables. These variables are easy to collect, have a straightforward interpretation, and are widely associated with reduced risk of dementia and cognitive decline in epidemiological studies. However, the specific proxies vary across studies and have rarely been assessed in complete models of cognitive reserve (i.e. alongside both a measure of cognitive outcome and a measure of brain structure). Complete models can test independent associations between proxies and cognitive function in addition to the moderation effect of proxies on the brain-cognition relationship. Consequently, there is insufficient empirical evidence guiding the choice of proxy measures of cognitive reserve and poor comparability across studies. Method In a cross-sectional study, we assessed the validity of 5 common proxies (education, occupational complexity, verbal intelligence, leisure activities, and exercise) and all possible combinations of these proxies in 2 separate community-dwelling older adult cohorts: The Irish Longitudinal Study on Ageing (TILDA; N = 313, mean age = 68.9 years, range = 54–88) and the Cognitive Reserve/Reference Ability Neural Network Study (CR/RANN; N = 234, mean age = 64.49 years, range = 50–80). Fifteen models were created with 3 brain structure variables (grey matter volume, hippocampal volume, and mean cortical thickness) and 5 cognitive variables (verbal fluency, processing speed, executive function, episodic memory, and global cognition). Results No moderation effects were observed. There were robust positive associations with cognitive function, independent of brain structure, for 2 individual proxies (verbal intelligence and education) and 16 composites (i.e. combinations of proxies). Verbal intelligence was statistically significant in all models. Education was significant only in models with executive function as the cognitive outcome variable. Three robust composites were observed in more than two-thirds of brain-cognition models: the composites of (1) occupational complexity and verbal intelligence, (2) education and verbal intelligence, and (3) education, occupational complexity, and verbal intelligence. However, no composite had larger average effects nor was more robust than verbal intelligence alone. Conclusion These results support the use of verbal intelligence as a proxy measure of CR in cross-sectional studies of cognitively healthy older adults.

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Section: Occupational Complexity Leisure Activities and Physical Activity Did Not Show Robust Effects On Cognitionsupporting

confidence: 74%

Section: Verbal Intelligence Had Larger and More Robust Effects On Cognition Than Educational Attainmentmentioning

confidence: 99%

Verbal intelligence is a more robust cross-sectional measure of cognitive reserve than level of education in healthy older adults

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Future research is warranted to clarify which speci c leisure activities should be included in measures for this proxy given that only a few activities have been associated with cognition in mid-/old-age samples, albeit without adjusting for brain structure (115,124). Considering our results, we suggest that later life leisure activities should not be used as an individual CR proxy.…”

Section: Discussionmentioning

confidence: 90%

“…Secondly, measures of verbal intelligence may re ect wider lifetime educational and cognitive experiences as compared to years of education which is generally restricted to early-life formal education (54,104,113,114) and typically neglects to consider later-life education which has been positively associated with cognitive function (115,116). In this sense, verbal intelligence could be considered a dynamic CR proxy which can change over time (117)(118)(119) whereas years of education may be considered a static CR proxy (30).…”

Section: Verbal Intelligence Is a More Robust Proxy Than Educational mentioning

confidence: 99%

“…Differences in these measures or in the speci c activities included in each measure may have contributed to differing effects across both datasets. This may be particularly pertinent for leisure activities as its relationship with cognitive function can vary based on the speci c leisure activities assessed (115). However, this variability across the two datasets re ects the typical variability in the measurement of CR with proxies.…”

Section: Limitationsmentioning

confidence: 99%

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Verbal Intelligence, Not Level of Education, Robustly Assesses Cognitive Reserve

Boyle

Knight

Looze

et al. 2021

Preprint

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Background: Cognitive reserve is most commonly measured using socio-behavioural proxy variables. These variables are easy to collect, have a straightforward interpretation, and are widely associated with reduced risk of dementia and cognitive decline in epidemiological studies. However, the specific proxies vary across studies and have rarely been assessed in complete models of cognitive reserve (i.e., alongside both a measure of cognitive outcome and a measure of brain structure). Complete models can test independent associations between proxies and cognitive function in addition to the moderation effect of proxies on the brain-cognition relationship. Consequently, there is insufficient empirical evidence guiding the choice of proxy measures of cognitive reserve and poor comparability across studies.Method: We assessed the validity of 5 common proxies (education, occupational complexity, verbal intelligence, leisure activities, and exercise) and all possible combinations of these proxies in 2 separate community-dwelling older adult cohorts: The Irish Longitudinal Study on Ageing (TILDA; N = 313, mean age = 68.9 years, range = 54 – 88) and the Cognitive Reserve/Reference Ability Neural Network Study (CR/RANN; N = 234, mean age = 64.49 years, range = 50 – 80). 15 models were created with 3 brain structure variables (grey matter volume, hippocampal volume, and mean cortical thickness) and 5 cognitive variables (verbal fluency, processing speed, executive function, episodic memory, and global cognition).Results: No moderation effects were observed. There were robust positive associations with cognitive function, independent of brain structure, for 2 individual proxies (verbal intelligence and education), and 16 composites (i.e., combinations of proxies). Verbal intelligence was statistically significant in all models. Education was significant only in models with executive function as the cognitive outcome variable. Three robust composites were observed in more than two thirds of brain-cognition models: the composites of 1) occupational complexity and verbal intelligence, 2) education and verbal intelligence, and 3) education, occupational complexity and verbal intelligence. However, no composite had larger average effects nor was more robust than verbal intelligence alone.Conclusion: These results suggest that researchers using proxy variables to measure cognitive reserve should use verbal intelligence where possible.

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A Multidimensional, Person-Centered Framework for Functional Assessment in Dementia: Insights from the ‘What’, ‘How’, ‘To Whom’, and ‘How Much’ Questions

Slachevsky,

Grandi,

Thumala

et al. 2024

Journal of Alzheimer’s Disease

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Dementia is a syndrome characterized by cognitive and neuropsychiatric symptoms associated with progressive functional decline (FD). FD is a core diagnostic criterion for dementia, setting the threshold between its prodromal stages and the full-blown disease. The operationalization of FD continues to generate a great deal of controversy. For instance, the threshold of FD for the diagnosis of dementia varies across diagnostic criteria, supporting the need for standardization of this construct. Moreover, there is a need to reconsider how we are measuring FD to set boundaries between normal aging, mild cognitive impairment, and dementia. In this paper, we propose a multidimensional framework that addresses outstanding issues in the assessment of FD: i) What activities of daily living (ADLs) are necessary to sustain an independent living in aging? ii) How to assess FD in individuals with suspected neurocognitive disorders? iii) To whom is the assessment directed? and iv) How much does FD differentiate healthy aging from mild and major neurocognitive disorders? Importantly, the To Whom Question introduces a person-centered approach that regards patients and caregivers as active agents in the assessment process of FD. Thus, once impaired ADLs have been identified, patients can indicate how significant such impairments are for them in daily life. We envisage that this new framework will guide future strategies to enhance functional assessment and treatment of patients with dementia and their caregivers.

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Mid-life and late life activities and their relationship with MRI measures of brain structure and functional connectivity in the UK Biobank cohort

Cited by 3 publications

References 40 publications

Verbal intelligence is a more robust cross-sectional measure of cognitive reserve than level of education in healthy older adults

Verbal intelligence is a more robust cross-sectional measure of cognitive reserve than level of education in healthy older adults

Verbal Intelligence, Not Level of Education, Robustly Assesses Cognitive Reserve

A Multidimensional, Person-Centered Framework for Functional Assessment in Dementia: Insights from the ‘What’, ‘How’, ‘To Whom’, and ‘How Much’ Questions

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