Abstract

ObjectivesAge-related cognitive decline is a well-known phenomenon after age 65 but little is known about earlier changes and prior studies are based on relatively small samples. We investigated the impact of age on cognitive decline in the largest population sample to date including young to old adults.MethodBetween 100,352 and 468,534 participants aged 38–73 years from UK Biobank completed at least one of seven self-administered cognitive functioning tests: prospective memory (PM), pairs matching (Pairs), fluid intelligence (FI), reaction time (RT), symbol digit substitution, trail making A and B. Up to 26,005 participants completed at least one of two follow-up assessments of PM, Pairs, FI and RT. Multivariable regression models examined the association between age (<45[reference], 45–49, 50–54, 55–59, 60–64, 65+) and cognition scores at baseline. Mixed models estimated the impact of age on cognitive decline over follow-up (~5.1 years).ResultsFI was higher between ages 50 and 64 and lower at 65+ compared to <45 at baseline. Performance on all other baseline tests was lower with older age: with increasing age category, difference in test scores ranged from 2.5 to 7.8%(P<0.0001). Compared to <45 at baseline, RT and Pairs performance declined faster across all older age cohorts (3.0 and 1.2% change, respectively, with increasing age category, P<0.0001). Cross-sectional results yielded 8 to 12-fold higher differences in RT and Pairs with age compared to longitudinal results.ConclusionsOur findings suggest that declines in cognitive abilities <65 are small. The cross-sectional differences in cognition scores for middle to older adult years may be due in part to age cohort effects.

Highlights

  • Age is a key risk factor for cognitive performance

  • fluid intelligence (FI) was higher between ages 50 and 64 and lower at 65+ compared to

  • Cross-sectional results yielded 8 to 12-fold higher differences in reaction time (RT) and pairs matching (Pairs) with age compared to longitudinal results

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Summary

Introduction

Cognitive decline is common in older ages but recently there has been interest in understanding the age at which significant decline in cognitive abilities begins. Longitudinal studies suggest evidence of cognitive decline in middle age but that age trajectories differ by sex and cognition domain or task [2, 4,5,6,7]. Hughes et al [7] examined cognitive decline among ~2,500 participants aged 25 to 95 years at recruitment in the Midlife in the Unites States (MIDUS) study, and all cognitive domains measured showed significant but small declines over 9 years, with differences in the timing and extent of change. The design of this study allowed for cross-sectional and longitudinal analysis For the former analysis, performance on several tests were progressively lower with older age categories. The cross sectional data considerably overestimated cognitive decline among women but not in men

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