Multidomain modifiable dementia risk factors are associated with poorer cognition in midlife

Neuropsychology. 2023 Jul;37(5):582-594. doi: 10.1037/neu0000900. Epub 2023 Mar 16.

Abstract

Objective: Studies of modifiable dementia risk factors (MDRFs) generally consider MDRFs individually, despite strong evidence that they co-occur in adult populations. In a large sample of middle-aged adults, this study aimed to determine the frequency and co-occurrence of MDRFs, spanning five domains (mood symptomatology, risky lifestyle behaviors, cardiovascular conditions, cognitive/social engagement, sleep disorders/symptomatology). The relationship between number of domains in which MDRFs were reported with cognitive performance and subjective cognitive concerns was then determined.

Method: Middle-aged adults (n = 1,610) enrolled in the Healthy Brain Project and completed self-report surveys about their health and lifestyle. Participants also completed the Cogstate Brief Battery and the Cognitive Function Instrument, a measure of subjective ratings of cognition. Participants were classified according to number of domains (mood symptomatology, risky lifestyle behaviors, cardiovascular conditions, cognitive/social engagement, sleep disorders/symptomatology) in which they reported at least one MDRF (0-5). Age, sex, education, and ethnicity were adjusted for in analyses.

Results: Most individuals (66.5%) reported MDRFs in two or more domains. Compared with individuals displaying no MDRFs, individuals with MDRFs in 3-5 domains showed worse learning/working memory performance and greater subjective cognitive concerns, with the magnitude of these differences moderate-to-large (d = 0.30-0.93). Individuals displaying MDRFs in five domains also showed worse attention/psychomotor function (d = 0.58) compared to those displaying no MDRFs.

Conclusions: These findings may suggest that multidomain MDRFs are highly frequent in middle-aged adults and are related to poorer cognition. This supports that modifiable dementia risk is multidimensional and raises the possibility that multidomain behavioral intervention trials in middle-aged adults may be useful to delay or prevent cognitive impairment or decline. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

MeSH terms

  • Affect*
  • Attention
  • Cardiovascular Diseases* / epidemiology
  • Cognition Disorders / epidemiology
  • Cognition Disorders / physiopathology
  • Cognition Disorders / psychology
  • Cognition*
  • Cognitive Dysfunction / epidemiology
  • Cognitive Dysfunction / physiopathology
  • Cognitive Dysfunction / psychology
  • Cohort Studies
  • Dementia* / epidemiology
  • Dementia* / physiopathology
  • Dementia* / psychology
  • Female
  • Humans
  • Learning
  • Life Style*
  • Male
  • Memory, Short-Term
  • Middle Aged
  • Prospective Studies
  • Psychomotor Performance
  • Risk Factors
  • Sleep Wake Disorders* / epidemiology
  • Social Behavior*