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. 2013 Jun 14;8(6):e65841.
doi: 10.1371/journal.pone.0065841. Print 2013.

Risk factors for late-life cognitive decline and variation with age and sex in the Sydney Memory and Ageing Study

Darren M Lipnicki  1 , Perminder S Sachdev, John Crawford, Simone Reppermund, Nicole A Kochan, Julian N Trollor, Brian Draper, Melissa J Slavin, Kristan Kang, Ora Lux, Karen A Mather, Henry Brodaty
Affiliations

Risk factors for late-life cognitive decline and variation with age and sex in the Sydney Memory and Ageing Study

Darren M Lipnicki et al. PLoS One. .

Abstract

Introduction: An aging population brings increasing burdens and costs to individuals and society arising from late-life cognitive decline, the causes of which are unclear. We aimed to identify factors predicting late-life cognitive decline.

Methods: Participants were 889 community-dwelling 70-90-year-olds from the Sydney Memory and Ageing Study with comprehensive neuropsychological assessments at baseline and a 2-year follow-up and initially without dementia. Cognitive decline was considered as incident mild cognitive impairment (MCI) or dementia, as well as decreases in attention/processing speed, executive function, memory, and global cognition. Associations with baseline demographic, lifestyle, health and medical factors were determined.

Results: All cognitive measures showed decline and 14% of participants developed incident MCI or dementia. Across all participants, risk factors for decline included older age and poorer smelling ability most prominently, but also more education, history of depression, being male, higher homocysteine, coronary artery disease, arthritis, low health status, and stroke. Protective factors included marriage, kidney disease, and antidepressant use. For some of these factors the association varied with age or differed between men and women. Additional risk and protective factors that were strictly age- and/or sex-dependent were also identified. We found salient population attributable risks (8.7-49.5%) for older age, being male or unmarried, poor smelling ability, coronary artery disease, arthritis, stroke, and high homocysteine.

Discussion: Preventing or treating conditions typically associated with aging might reduce population-wide late-life cognitive decline. Interventions tailored to particular age and sex groups may offer further benefits.

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Conflict of interest statement

Competing Interests: Perminder Sachdev has received payment for lectures by Eli Lilly and Pfizer. Henry Brodaty has received payment for lectures by Pfizer, Janssen, and Novartis, is on the Alzheimer’s Advisory Boards of these companies and Lunbeck, consults for Wyeth, and has received institutional grants for an Alzheimer’s drug trial from Sanofi and Medivation. All other authors have declared that no competing interests exist. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Factors associated with cognitive decline.
Interventions modifying factors with a significant population attributable risk might greatly reduce population-wide cognitive decline. Age and sex interactions suggest further benefits by tailoring interventions to particular demographic groups.
See this image and copyright information in PMC

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