Factors Associated with Cognitive Resilience in Persons Aged 80 and Older

Abstract

AbstractBackgroundAfrican Americans (AA) have increased Alzheimer’s disease (AD) risk. Despite a high prevalence of risk factors for cognitive decline like vascular disease, data indicates that AA have a high degree of cognitive resilience, the ability to maintain normal cognitive functioning with aging. Most knowledge about cognitive resilience and SuperAgers (SA) is based on results from predominantly white samples. In a biracial sample, we investigated factors related to cognitive resilience in persons aged 80 and older.MethodData from the National Alzheimer’s Coordinating Center (NACC) through November 2020 was analyzed. NC was defined per global CDR score = 0 and SA by cognitive performance for episodic memory, executive function, naming, and phonemic fluency within 1 standard deviation of the mean or better. Using ANOVA or chi‐square, we compared demographic, medical, and lifestyle factors by race and cognition [normal cognition (NC) vs. SA]. Logistic regression evaluated factors related to cognitive group by race. The significance level for all tests was p < 0.05.ResultAA SA had more education years (15.3 vs. 13.9, p = .01), no alcohol abuse (11.7 vs. 1.4%, p<.01), and fewer lived alone (5.4 vs. 53.2%, p<.01) compared to NC. White SA had more education years (16.9 vs. 15.4, p<.01) and higher BMI (26.3 vs. 25.7, p = .03) compared to NC. In AA, regression showed that female sex (OR:3.12, 95% CI:1.19‐8.17) and no depression history (OR:7.46, 95% CI: 1.01‐55.1) were more likely to be SA. In whites, female sex (OR: 2.02, 95% CI: 1.56‐2.62) and no heart disease (OR:4.27, 95% CI:2.36‐7.72) were more likely to be SA.ConclusionIn persons of advanced age, factors associated with SA can vary with race. Prospective investigation with a diverse study sample is needed to investigate whether the findings are replicated.