Abstract
Background: Dementia secondary to neurodegenerative diseases is prevalent among older adults and leads to social, psychological and economic burden on patients, caregivers and the community as a whole. Cognitive reserve factors such as education, and mental stimulation among others were hypothesized to contribute to the resilience against age-related cognitive impairment. Educational attainment, occupation complexity, physical activity, and leisure activity are explored in the context of protecting the older adults' cognitive function. We investigated the cognitive reserve effect on dementia, cognitive decline and impairment, and global cognitive function.Methods: This study is a secondary analysis of data from a cross-sectional, community-based cohort study that aimed at investigating factors associated with dementia and their prevalence. The sample was of 508 community based older adults in Lebanon, aged 65 years and above in addition to 502 informants designated by these older adults. Older adults and informants answered structured questionnaires administered by interviewers, as well as a physical assessment and a neurological examination. Older adults were diagnosed for dementia. Global cognitive function, depression, and cognitive decline were assessed.Results: Older adults with dementia had lower levels of education, and attained lower occupational complexity. Factors such as high education, complex occupation attainment, and leisure activity, significantly predicted better global cognitive function. An older adult who attained high education levels or high complexity level occupation was 7.1 or 4.6 times more likely to have better global cognitive function than another who attained lower education or complexity level occupation respectively.Conclusion: These results suggest that cognitive reserve factors ought to be taken into consideration clinically during the course of dementia diagnosis and when initiating community-based preventive strategies.
Highlights
Dementia imposes considerable burden on populations throughout the world (Checkoway et al, 2011; Shah et al, 2016). Wimo et al (2013) addressed the socioeconomic impact of dementia in 2010 and indicated that it has become the leading contributor to disability and need for care in aging adults
Around 60% (58.2) of them co-resided with the older adults, 70% were married at the time of the study, 41.8% were employed, and 15.5, 16.5, and 25.3% completed primary, secondary, high school or more respectively
We found that the odds of better global cognitive function increased with high education levels (p < 0.05), increased occupation complexity (p < 0.05) and leisure activity (p < 0.001)
Summary
Dementia imposes considerable burden on populations throughout the world (Checkoway et al, 2011; Shah et al, 2016). Wimo et al (2013) addressed the socioeconomic impact of dementia in 2010 and indicated that it has become the leading contributor to disability and need for care in aging adults. In Lebanon, the crude prevalence of dementia is 7.4% and the age-standardized prevalence of those above 65 years of age is 9.0% Such figures make dementia prevalence in this country rank high within the global range of estimates but comparable to other Middle Eastern countries. Dementia secondary to neurodegenerative diseases is prevalent among older adults and leads to social, psychological and economic burden on patients, caregivers and the community as a whole. Cognitive reserve factors such as education, and mental stimulation among others were hypothesized to contribute to the resilience against age-related cognitive impairment. We investigated the cognitive reserve effect on dementia, cognitive decline and impairment, and global cognitive function
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