Abstract
With the aging of the U.S. population, the number of cognitively disabled persons is expected to substantially increase in coming decades, underscoring the urgent need for effective interventions. Here, we review the current evidence linking psychosocial factors to late-life cognitive loss and consider the study design needed to illuminate the biologic bases of the associations. We then examine an ongoing study that includes several of the key design elements, the Rush Memory and Aging Project. In this longitudinal clinical-pathological cohort study, indicators of personality, social connectedness, and psychological well-being were shown to predict late-life cognitive outcomes. Participants who died underwent a uniform neuropathologic examination to quantify common dementia-related pathologies. Some psychosocial indicators were associated with cerebral infarction; some indicators modified the association of neurodegenerative pathologies with cognitive loss; and the association of some indicators with cognitive outcomes appears to be independent of the pathologies traditionally associated with late-life dementia. These findings suggest that psychosocial behavior influences late-life cognitive health through multiple neurobiologic mechanisms. A better understanding of these mechanisms may lead to novel strategies for preserving cognitive health in old age.
Highlights
The age of the population of the United States and much of the rest of the world is projected to increase in the coming decades
The ideal study would enroll participants early in life; collect longitudinal data on risk factors, cognition, and biomarkers until death; and conduct a uniform postmortem examination of the brain to quantify pathologies traditionally associated with dementia and putative markers of neural reserve
The Rush Memory and Aging Project includes all of the design and operational features that are standard for an analytic epidemiologic cohort study of incident disease, and nested within the study is organ donation
Summary
The age of the population of the United States and much of the rest of the world is projected to increase in the coming decades. Among persons aged 85 years or older, the fastest growing age group in the population, approximately 40% are estimated to meet dementia criteria [3] Because of this demographic shift, the number of people with dementia in the United States is expected to double or triple by mid-century [3], representing a substantial challenge to our health care system, even if the overall prevalence of late-life dementia is slightly decreasing, as suggested by some epidemiologic data from the United States [4,5] and Europe [6]. Project [21,22]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
