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. 2021;81(1):123-135.
doi: 10.3233/JAD-210030.

The Relationship Between Cognitive Performance Using Tests Assessing a Range of Cognitive Domains and Future Dementia Diagnosis in a British Cohort: A Ten-Year Prospective Study

Shabina A Hayat  1 , Robert Luben  1 , Kay-Tee Khaw  1 , Carol Brayne  1
Affiliations

The Relationship Between Cognitive Performance Using Tests Assessing a Range of Cognitive Domains and Future Dementia Diagnosis in a British Cohort: A Ten-Year Prospective Study

Shabina A Hayat et al. J Alzheimers Dis. 2021.

Abstract

Background: Exploring the domains of cognitive function which are most strongly associated with future dementia may help with understanding risk factors for, and the natural history of dementia.

Objective: To examine the association of performance on a range of cognitive tests (both global and domain specific) with subsequent diagnosis of dementia through health services in a population of relatively healthy men and women and risk of future dementia.

Methods: We examined the association between performance on different cognitive tests as well as a global score and future dementia risk ascertained through health record linkage in a cohort of 8,581 individuals (aged 48-92 years) between 2004-2019 with almost 15 years follow-up (average of 10 years) before and after adjustment for socio-demographic, lifestyle, and health characteristics.

Results: Those with poor performance for global cognition (bottom 10%) were almost four times as likely to receive a dementia diagnosis from health services over the next 15 years than those who performed well HR = 3.51 (95% CI 2.61, 4.71 p < 0.001) after adjustment for socioeconomic, lifestyle, and biological factors and also prevalent disease. Poor cognition performance in multiple tests was associated with 10-fold increased risk compared to those not performing poorly in any test HR = 10.82 (95% CI 6.85, 17.10 p < 0.001).

Conclusion: Deficits across multiple cognitive domains substantially increase risk of future dementia over and above neuropsychological test scores ten years prior to a clinical diagnosis. These findings may help further understanding of the natural history of dementia and how such measures could contribute to strengthening future models of dementia.

Keywords: Cognition; dementia; epidemiology; risk.

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Conflict of interest statement

Authors’ disclosures available online (https://www.j-alz.com/manuscript-disclosures/21-0030r1).

Figures

Fig. 1
Fig. 1
Selection of study participants in the EPIC-Norfolk third health check (including pilot phase 2004–2006) for all-cause ‘definite’ dementia, followed until 31 March 2019.
Fig. 2
Fig. 2
Distribution of poor performance across the eight measures in the EPIC-Norfolk cohort.
Fig. 3
Fig. 3
Diagrammatic representation of association of level of cognitive impairment and dementia controlling for each of the cognitive test.
See this image and copyright information in PMC

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