Harmonisation and Between-Country Differences of the Lifetime of Experiences Questionnaire in Older Adults.

Valentin Ourry,Denis Vivien,Karine Goldet,Tim Whitfield,Natalie L Marchant,Lena Sannemann,Dix Meiberth,Frank Jessen,Vincent De La Sayette,Romain Bachelet,Julie Gonneaud,Maëlle Botton,Robin De Flores,Leslie Reyrolle,Miranka Wirth,Julie Lebahar,Gaël Chételat,Géraldine Rauchs,Ann‐Katrin Schild ,Olga Klimecki ,Michael Valenzuela ,Nina Coll-Padrós ,Harriet Demnitz‐King ,José Luís Molinuevo ,Pierre Krolak‐Salmon ,Eider M Arenaza‐Urquijo

doi:10.3389/fnagi.2021.740005

Abstract

Background: The Lifetime of Experiences Questionnaire (LEQ) assesses complex mental activity across the life-course and has been associated with brain and cognitive health. The different education systems and occupation classifications across countries represent a challenge for international comparisons. The objectives of this study were four-fold: to adapt and harmonise the LEQ across four European countries, assess its validity across countries, explore its association with brain and cognition and begin to investigate between-country differences in life-course mental activities.Method: The LEQ was administered to 359 cognitively unimpaired older adults (mean age and education: 71.2, 13.2 years) from IMAP and EU-funded Medit-Ageing projects. Education systems, classification of occupations and scoring guidelines were adapted to allow comparisons between France, Germany, Spain and United Kingdom. We assessed the LEQ's (i) concurrent validity with a similar instrument (cognitive activities questionnaire - CAQ) and its structural validity by testing the factors' structure across countries, (ii) we investigated its association with cognition and neuroimaging, and (iii) compared its scores between countries.Results: The LEQ showed moderate to strong positive associations with the CAQ and revealed a stable multidimensional structure across countries that was similar to the original LEQ. The LEQ was positively associated with global cognition. Between-country differences were observed in leisure activities across the life-course.Conclusions: The LEQ is a promising tool for assessing the multidimensional construct of cognitive reserve and can be used to measure socio-behavioural determinants of cognitive reserve in older adults across countries. Longitudinal studies are warranted to test further its clinical utility.

Highlights

Cognitive Reserve (CR) refers to “the adaptability of cognitive processes that helps to explain differential susceptibility of cognitive abilities or day-to-day function to brain ageing, pathology, or insult” (Stern et al, 2018)
The total Lifetime of Experiences Questionnaire (LEQ) was not associated with age (p = 0.56) and was positively associated with education (p < 0.001)
Similar results were observed at the country-level: total LEQ was not associated with age and was positively associated with education (p (UK) = 0.009; all other p < 0.001)

Summary

Introduction

Cognitive Reserve (CR) refers to “the adaptability (i.e., efficiency, capacity, flexibility) of cognitive processes that helps to explain differential susceptibility of cognitive abilities or day-to-day function to brain ageing, pathology, or insult” (Stern et al, 2018). Cognitive reserve is determined by environmental and genetic factors (Valenzuela, 2019), nurtured throughout the life-course by exposure to mentally stimulatory activities. These include, but are not limited to, education (Stern et al, 1992), occupation complexity (Stern et al, 1995) and leisure activities (Scarmeas et al, 2001), sometimes referred to as “CR proxies.”. The objectives of this study were four-fold: to adapt and harmonise the LEQ across four European countries, assess its validity across countries, explore its association with brain and cognition and begin to investigate between-country differences in life-course mental activities

Objectives

Methods

Results

Conclusion