The identification of established modifiable mid-life risk factors for cardiovascular disease which contribute to cognitive decline: Korean Longitudinal Study of Aging (KLoSA)

Abstract

Introduction We explored how different chronic diseases, risk factors, and protective factors highly associated with cardiovascular diseases (CVD) are associated with dementia or Mild Cognitive Impairment (MCI) in Korean elders, with a focus on those that manifest in mid-life. Methods A CVD-free cohort (n = 4289) from the Korean Longitudinal Study of Aging was selected to perform Cox mixed-effects proportional hazard regressions. Eighteen control variables with strong associations to CVD were chosen as explanatory variables, and Mini-Mental State Examination (MMSE) score cut-off for dementia and MCI were used as outcome variables. Results The statistically significant (P < 0.05) adverse factors that contribute in developing dementia were age (aHR 1.07, 1.05–1.09), Centre for Epidemiological Studies Depression Scale (CESD-10) (aHR 1.17, 1.12–1.23), diagnosis with cerebrovascular disease (aHR 3.73, 1.81–7.66), living with diabetes (aHR 2.30, 1.22–4.35), and living with high blood pressure (HBP) (aHR 2.05, 1.09–3.87). In contrast, the statistically significant protective factors against developing dementia were current alcohol consumption (aHR 0.67, 0.46–0.99), higher educational attainment (aHR 0.36, 0.26–0.56), and regular exercise (aHR 0.37, 0.26–0.51). The factors with a statistically significant adverse association with progression to MCI were age (aHR 1.02, 1.01–1.03) and CESD-10 (aHR 1.17, 1.14–1.19). In contrast, the statistically significant protective factors against developing MCI were BMI (aHR 0.96, 0.94–0.98), higher educational attainment (aHR 0.33, 0.26–0.43), and regular exercise (aHR 0.83, 0.74–0.92). Conclusion In lieu of the protective factor of MCI and dementia, implementing regular exercise routine well before mid-life and cognitive decline is significant, with adjustments made for those suffering from health conditions, so they can continue exercising despite their morbidity. Further attention in diabetes care and management is needed for patients who already show decline in cognitive ability as it is likely that their MCI impacts their ability to manage their existing chronic conditions, which may adversely affect their cognitive ability furthermore.

Association between Changes in the Regularity of Working Hours and Cognitive Impairment in Middle-Aged and Older Korean Workers: The Korean Longitudinal Study of Aging, 2008–2018

“…Working hours were classified according to whether they worked more than 52 h per week. This classification is based on the Korean Labor Standards Act stipulating that the maximum statutory working hours per week is 52 h. In addition, there have been studies showing that chronic diseases (particularly diabetes, hypertension, and chronic kidney disease) are associated with dementia or mild cognitive impairment in the elderly [ 20 , 21 , 22 ]. Health behaviors, including tobacco and alcohol use, and the presence of other chronic diseases were expressed as health conditions.…”

The Prevalence of Amnestic and Non-Amnestic Mild Cognitive Impairment and Its Association with Different Lifestyle Factors in a South Italian Elderly Population

“…Regarding physical activity, we can speculate that the use of a single item, as in this study, may be insufficiently sensitive in capturing the variability within habits among our study participants. As for other health-related behavior, mixed findings are available; for example, alcohol consumption showed to be a protective factor for dementia, but not for MCI, whilst an opposite pattern can be found for BMI and exercising [ 73 ].…”

The Moderating Effect of Sex on the Association between Education and Cognitive Impairment in Older Koreans: Analysis of Korean Longitudinal Study of Ageing Data

“…First, there is a limitation associated with MMSE itself [28]. Altough a widely used screening measure of cognitive impairment, it has a low sensitivity in people with high educational status and a low specifici-ty in people with low socioeconomic status [29,30]. Second, the present study used a cross-sectional design and therefore precludes drawing the causal relationship between independent variables and cognitive impairment.…”