Age-related cognitive decline and associations with sex, education and apolipoprotein E genotype across ethnocultural groups and geographic regions: a collaborative cohort study - Université de Montpellier
Article Dans Une Revue PLoS Medicine Année : 2017

Age-related cognitive decline and associations with sex, education and apolipoprotein E genotype across ethnocultural groups and geographic regions: a collaborative cohort study

Darren Lipnicki
  • Fonction : Auteur
  • PersonId : 948379
Nicole Kochan
  • Fonction : Auteur
  • PersonId : 948380
Carol Brayne
  • Fonction : Auteur
  • PersonId : 948386
Blossom Stephan
Mindy Katz
  • Fonction : Auteur
  • PersonId : 948390
Efthimios Dardiotis
  • Fonction : Auteur
  • PersonId : 912211
Linda Lam
  • Fonction : Auteur
  • PersonId : 948394
Candy Wong
  • Fonction : Auteur
  • PersonId : 948395
Ada Fung
  • Fonction : Auteur
  • PersonId : 948396
Antonio Guaita
  • Fonction : Auteur
Roberta Vaccaro
  • Fonction : Auteur
Annalisa Davin
  • Fonction : Auteur
Ji Won Han
Tae Hui Kim
  • Fonction : Auteur
Kaarin J Anstey
  • Fonction : Auteur
  • PersonId : 948406
Nicolas Cherbuin
  • Fonction : Auteur
  • PersonId : 948407
Shuzo Kumagai
  • Fonction : Auteur
Simone Reppermund
  • Fonction : Auteur
  • PersonId : 948410
Henry Brodaty
  • Fonction : Auteur
  • PersonId : 948411

Résumé

BACKGROUND: The prevalence of dementia varies around the world, potentially contributed to by international differences in rates of age-related cognitive decline. Our primary goal was to investigate how rates of age-related decline in cognitive test performance varied among international cohort studies of cognitive aging. We also determined the extent to which sex, educational attainment, and apolipoprotein E ε4 allele (APOE*4) carrier status were associated with decline. METHODS AND FINDINGS: We harmonized longitudinal data for 14 cohorts from 12 countries (Australia, Brazil, France, Greece, Hong Kong, Italy, Japan, Singapore, Spain, South Korea, United Kingdom, United States), for a total of 42,170 individuals aged 54-105 y (42% male), including 3.3% with dementia at baseline. The studies began between 1989 and 2011, with all but three ongoing, and each had 2-16 assessment waves (median = 3) and a follow-up duration of 2-15 y. We analyzed standardized Mini-Mental State Examination (MMSE) and memory, processing speed, language, and executive functioning test scores using linear mixed models, adjusted for sex and education, and meta-analytic techniques. Performance on all cognitive measures declined with age, with the most rapid rate of change pooled across cohorts a moderate -0.26 standard deviations per decade (SD/decade) (95% confidence interval [CI] [-0.35, -0.16], p < 0.001) for processing speed. Rates of decline accelerated slightly with age, with executive functioning showing the largest additional rate of decline with every further decade of age (-0.07 SD/decade, 95% CI [-0.10, -0.03], p = 0.002). There was a considerable degree of heterogeneity in the associations across cohorts, including a slightly faster decline (p = 0.021) on the MMSE for Asians (-0.20 SD/decade, 95% CI [-0.28, -0.12], p < 0.001) than for whites (-0.09 SD/decade, 95% CI [-0.16, -0.02], p = 0.009). Males declined on the MMSE at a slightly slower rate than females (difference = 0.023 SD/decade, 95% CI [0.011, 0.035], p < 0.001), and every additional year of education was associated with a rate of decline slightly slower for the MMSE (0.004 SD/decade less, 95% CI [0.002, 0.006], p = 0.001), but slightly faster for language (-0.007 SD/decade more, 95% CI [-0.011, -0.003], p = 0.001). APOE*4 carriers declined slightly more rapidly than non-carriers on most cognitive measures, with processing speed showing the greatest difference (-0.08 SD/decade, 95% CI [-0.15, -0.01], p = 0.019). The same overall pattern of results was found when analyses were repeated with baseline dementia cases excluded. We used only one test to represent cognitive domains, and though a prototypical one, we nevertheless urge caution in generalizing the results to domains rather than viewing them as test-specific associations. This study lacked cohorts from Africa, India, and mainland China. CONCLUSIONS: Cognitive performance declined with age, and more rapidly with increasing age, across samples from diverse ethnocultural groups and geographical regions. Associations varied across cohorts, suggesting that different rates of cognitive decline might contribute to the global variation in dementia prevalence. However, the many similarities and consistent associations with education and APOE genotype indicate a need to explore how international differences in associations with other risk factors such as genetics, cardiovascular health, and lifestyle are involved. Future studies should attempt to use multiple tests for each cognitive domain and feature populations from ethnocultural groups and geographical regions for which we lacked data.
Fichier principal
Vignette du fichier
Ancelin_13.pdf (1.4 Mo) Télécharger le fichier
Origine Fichiers éditeurs autorisés sur une archive ouverte
Loading...

Dates et versions

hal-02399392 , version 1 (09-12-2019)

Licence

Identifiants

Citer

Darren Lipnicki, John D. Crawford, Rajib Dutta, Anbupalam Thalamuthu, Nicole Kochan, et al.. Age-related cognitive decline and associations with sex, education and apolipoprotein E genotype across ethnocultural groups and geographic regions: a collaborative cohort study. PLoS Medicine, 2017, 14 (3), pp.e1002261. ⟨10.1371/journal.pmed.1002261⟩. ⟨hal-02399392⟩
64 Consultations
74 Téléchargements

Altmetric

Partager

More