Abstract
In the absence of an effective treatment to alter the progressive course of cognitive decline and dementia, identification of modifiable risk factors that could promote healthy cognitive aging has become a public health research priority. This study seeks to comprehensively determine the contemporaneous associations of a broad spectrum of time-varying modifiable lifestyle factors with age-related cognitive decline in a large population-based cohort of older adults. A total of 5,711 subjects aged 50 and older from the WHO Study on global AGEing and adult health (SAGE) in Shanghai were studied. Repeated measures of lifestyle factors and cognitive performance were conducted in 2009–2010 and 2014–2015. Linear random slope models were used to evaluate the contemporaneous associations between time-varying lifestyle factors and cognitive performance. Person-mean centering method was used to disaggregate the between- and within-person effects in the time-varying lifestyle factors in the random slope models. We found that higher vegetable and fruit consumption, as well as higher level of physical activity were positively associated with all cognitive domains. Body mass index (BMI) was negatively associated with all cognitive domains, whereas waist-to-hip ratio (WHR) was negatively associated with verbal fluency score only. Sedentary time was negatively associated with digit span score but positively associated with verbal fluency score. The between-person effects seem to be more dominant than within-person effects. Overall, our findings suggest better management of multiple lifestyle factors may protect against cognitive decline in later life. Higher vegetable and fruit consumption and physical activity are protective, whereas obesity is detrimental to cognitive decline in older adults. This study underpins the development of multi-domain lifestyle recommendations to promote healthy cognitive aging.
Highlights
Aging is accompanied by cognitive decline which is evident from as early as age 45 (Singh-Manoux et al, 2012)
Significant interactions were observed between age and all lifestyle factors: The effects of one unit increase in vegetable and fruit intake (100 g/day), Body mass index (BMI), and physical activity level on digit span score increased by 0.005 (p = 0.046), 0.002 (p = 0.024), and 0.014 (p = 0.013), respectively, when age increased by one unit; the effects of one unit increase in BMI and sedentary time (1 h/day) on delayed verbal recall score changed by 0.001 (p = 0.041) and −0.003 (p = 0.009), when age increased by one unit
This large-scale prospective cohort study has been one of the first attempts to examine the contemporaneous associations of a broad spectrum of time-varying modifiable lifestyle factors with cognitive performance in older Chinese adults
Summary
Aging is accompanied by cognitive decline which is evident from as early as age 45 (Singh-Manoux et al, 2012). Over the past decades, emerging evidence suggests that a “poor” lifestyle such as obesity, physical inactivity, unhealthy diet, smoking, and heavy alcohol consumption are associated with faster cognitive decline in old age (Wajman et al, 2018). Such evidence highlights the potential of promoting healthy lifestyles to preserve cognition in normal aging. To fill the above mentioned gap, this study seeks to explore the contemporaneous associations between a broad spectrum of time-varying modifiable lifestyle factors and cognition, as well as potential interactive effects between different lifestyle factors, in normal aging in a large longitudinal population-based cohort of Chinese adults aged 50 and older
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