The effect of lifestyle on late-life cognitive change under different socioeconomic status.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Attention/*physiology ; Cognition/*physiology ; Cognition Disorders/*epidemiology ; Dementia/*epidemiology; Aged ; Aged, 80 and over ; Cognition Disorders/pathology ; Dementia/physiopathology ; Female ; Humans ; Male ; Menopause/physiology ; Neuropsychological Tests ; Social Class ; Socioeconomic Factors ; Taiwan/epidemiology

This study aimed to identify lifestyle factors associated with cognitive change and to explore whether the effect of lifestyle varies by socioeconomic status (SES). Participants aged 65 years and older were recruited from elderly health checkup programs from 2011 to 2013 in Taiwan. Neuropsychological tests, including tests of global cognition, logical memory, executive function, verbal fluency and attention, were administered at baseline (N = 603) and 2 years later (N = 509). After literature review, 9 lifestyle factors and 3 SES indicators were chosen and their effects on cognitive change were evaluated using linear regression adjusting for age, sex, education, APOE ε4 status, and baseline cognitive score. Five lifestyle factors (high vegetable and fish intake, regular exercise, not smoking, and light to moderate alcohol consumption) and 3 SES indicators [annual household income (> 33,333 USD vs. less), occupational complexity (high vs. low mental demanding job), and years of education (> 12 years vs. less)] were found to be protective against cognitive decline (P < 0.1 in any cognitive domains, ß ranging from 0.06 to 0.38). After further adjusting for all the lifestyle and SES factors, fish intake, higher income and occupational complexity remained protective. Significant interactions were found between a healthful lifestyle (defined as having ≥ 3 healthful lifestyle factors) and income on changes of global cognition and verbal fluency (Pinteraction = 0.02 and 0.04). The protective effect of a healthful lifestyle was observed only among participants with lower income in global cognition and logical memory [ß = 0.17, 95% confidence interval (CI) = 0.07-0.26; ß = 0.30, 95% CI = 0.14-0.46]. To the best of our knowledge, this study for the first time explored how the interactions of lifestyle and SES affect cognitive change. Our findings will aid in developing dementia prevention programs and reduce health inequalities.

The authors have declared that no competing interests exist.

J Am Geriatr Soc. 2017 Jun;65(6):1159-1167. (PMID: 28092399)
PLoS One. 2015 Mar 12;10(3):e0118333. (PMID: 25763939)
J Intern Med. 2011 Jan;269(1):107-17. (PMID: 20831630)
J Am Geriatr Soc. 2012 Oct;60(10):1847-53. (PMID: 23013064)
J Nutr. 2013 Nov;143(11):1767-73. (PMID: 23986363)
Dement Geriatr Cogn Disord. 2016;41(3-4):137-45. (PMID: 26910258)
JAMA. 2006 Oct 18;296(15):1885-99. (PMID: 17047219)
Einstein (Sao Paulo). 2014 Apr;12(2):149-53. (PMID: 25003917)
Neurology. 1996 May;46(5):1484-5. (PMID: 8628509)
Medicine (Baltimore). 2016 May;95(22):e3809. (PMID: 27258519)
Soc Sci Med. 2006 Jan;62(2):467-78. (PMID: 16039026)
Clin Nutr. 2017 Jun;36(3):730-736. (PMID: 27288328)
JAMA. 2002 Jun 26;287(24):3223-9. (PMID: 12076218)
Clinics (Sao Paulo). 2011;66(4):623-7. (PMID: 21655757)
J Health Soc Behav. 2004 Sep;45(3):306-21. (PMID: 15595509)
Soc Sci Med. 2000 Jul;51(2):307-17. (PMID: 10832576)
J Nutr Health Aging. 2012 Jul;16(7):626-30. (PMID: 22836704)
J Epidemiol. 2012;22(1):2-6. (PMID: 22156290)
Curr Clin Pharmacol. 2015;10(3):204-12. (PMID: 26338173)
Neurosci Biobehav Rev. 2015 Jan;48:1-9. (PMID: 25446949)
Lancet. 2015 Jun 6;385(9984):2255-63. (PMID: 25771249)
Ageing Res Rev. 2015 Sep;23(Pt B):167-82. (PMID: 26144974)
Int Psychogeriatr. 2016 Nov;28(11):1791-1806. (PMID: 27502691)
Neurology. 2014 Dec 9;83(24):2285-91. (PMID: 25411439)
Dement Geriatr Cogn Disord. 2010;29(6):523-9. (PMID: 20606433)
Int J Geriatr Psychiatry. 2005 May;20(5):465-70. (PMID: 15852439)
Stroke. 2006 Feb;37(2):345-50. (PMID: 16397184)
Am J Clin Nutr. 2014 Dec;100(6):1520-31. (PMID: 25411287)
Alzheimers Dement. 2011 May;7(3):270-9. (PMID: 21514249)
Med Sci Sports Exerc. 2008 Feb;40(2):303-7. (PMID: 18202571)
Biomed Res Int. 2017;2017:9016924. (PMID: 28271072)
JAMA. 2015 Aug 25;314(8):781-90. (PMID: 26305648)
Ageing Res Rev. 2015 Jul;22:39-57. (PMID: 25956016)
Int Health. 2014 Dec;6(4):322-30. (PMID: 25052530)
Am J Public Health. 2003 Aug;93(8):1302-9. (PMID: 12893619)
JAMA. 1994 Apr 6;271(13):1004-10. (PMID: 8139057)
Mol Neurobiol. 2016 Jul;53(5):3113-3123. (PMID: 25983035)
Aging Ment Health. 2017 Jul 13;:1-12. (PMID: 28703027)
J Formos Med Assoc. 2015 Dec;114(12 ):1216-24. (PMID: 25457293)
J Psychosom Res. 2002 Oct;53(4):891-5. (PMID: 12377299)
Asia Pac J Clin Nutr. 2006;15(2):161-9. (PMID: 16672199)
Int J Geriatr Psychiatry. 2015 Mar;30(3):234-46. (PMID: 25504093)
J Int Neuropsychol Soc. 2000 May;6(4):469-79. (PMID: 10902416)
J Gerontol B Psychol Sci Soc Sci. 2015 Jul;70(4):661-71. (PMID: 25161216)
BMJ. 2008 Mar 1;336(7642):496-501. (PMID: 18310004)
Ann N Y Acad Sci. 2010 Feb;1186:223-39. (PMID: 20201875)

Date Created: 20180614 Date Completed: 20181211 Latest Revision: 20181211

20250114

PMC5999076

10.1371/journal.pone.0197676

29897986