Abstract
Cumulative evidence suggests that health-related risk factors during midlife and old-age are associated with cognitive impairment. However, studies are needed to clarify the association between early-life risk factors and impaired cognitive functioning to increment existing knowledge. To examine the association between childhood infectious diseases and late-life cognitive functioning in a nationally representative sample of older adults. Eligible respondents were 2994 community-dwelling individuals aged 65-85. Cognitive functioning was assessed using the Mini-Mental State Examination (MMSE). Childhood infectious diseases (i.e. chicken pox, measles, and mumps) were self-reported. The study covariates were age, sex, highest educational level achieved, smoking status, body mass index, and depression. The primary statistical analysis examined the association between the number of childhood infectious diseases and total MMSE scores, accounting for all study covariates. Regression models of progressive complexity were examined for parsimony. The robustness of the primary results was tested in 17 sensitivity analyses. The most parsimonious model was a linear adjusted model (Bayesian Information Criterion = 12646.09). Late-life cognitive functioning significantly improved as the number of childhood infectious diseases increased (β = 0.18; 95% CI = 0.11, 0.26; p < 0.001). This effect was not significantly attenuated in all sensitivity analyses. The current study results are consistent with prior ecological findings indicating that some childhood infectious diseases are associated with better cognitive functioning in old-age. This points to an early-life modifiable risk factor associated with older-life cognitive functioning. Our results may reflect selective mortality and/or beneficial effects via hormetic processes.
Highlights
Impaired cognitive functioning among communitydwelling older adults is estimated to have a prevalence of 18.3% in the UK (Rait et al, 2005), ranging between 8.7% and 22.2% in the United States (Plassman et al, 2008; Langa et al, 2008)
The current study aims to examine the direction of the association between common childhood infectious diseases and late-life cognitive functioning in a nationally representative sample of communitydwelling older adults
The current study examined the association between childhood infectious diseases and old age cognitive functioning, among community-dwelling older adults, using data from a representative national sample
Summary
Impaired cognitive functioning among communitydwelling older adults is estimated to have a prevalence of 18.3% in the UK (Rait et al, 2005), ranging between 8.7% and 22.2% in the United States (Plassman et al, 2008; Langa et al, 2008). Impaired cognitive functioning is associated with increased risks of Alzheimer’s disease (Bäckman et al, 2005) and mortality (Langa et al, 2008). The identification of risk factors and preventative strategies are primary objectives in research on impaired cognitive functioning in older adults (Brayne, 2007; Treichler and Jeste, 2019). Cumulative evidence suggests that health-related risk factors during midlife and old-age are associated with cognitive impairment. Studies are needed to clarify the association between early-life risk factors and impaired cognitive functioning to increment existing knowledge
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