Association between mid-life marital status and cognitive function in later life: population based cohort study

Håkansson, Krister; Rovio, Suvi; Helkala, Eeva‐Liisa; Vilska, Anna-Riitta; Winblad, Bengt; Soininen, Hilkka; Nissinen, Aulikki; Mohammed, Abdul K.; Kivipelto, Miia

doi:10.1136/bmj.b2462

Cited by 256 publications

(232 citation statements)

References 51 publications

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“…Social class was included as a 6-category variable: professional, managerial, skilled nonmanual, skilled manual, semiskilled manual, and unskilled manual. As Håkansson et al 26 suggested that cohabitation was associated with reduced risk of cognitive impairment and AD in later life, partnership status was included as a binary (married or partnership versus single) covariate in the analyses. Smoking was assessed according to participants' number of cigarettes smoked per day.…”

Section: Covariatesmentioning

confidence: 99%

Does the Influence of Stroke on Dementia Vary by Different Levels of Prestroke Cognitive Functioning?

Dregan

Wolfe

Gulliford

2013

Stroke

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Background and Purpose-The association between stroke and subsequent dementia or Alzheimer disease is well established. What is less understood is the extent to which this association is dependent on prestroke cognitive functioning. The study estimated the occurrence in poststroke dementia as a function of prestroke cognitive status and incident stroke. Methods-Study data were derived from the English Longitudinal Study of Ageing, a 10-year long prospective cohort study of older adults living in England. Baseline data (2002/2003) were used to group participants into tertiles of cognitive, memory, and executive functioning before an incident stroke. Data from 4 follow-up surveys were used to identify new stroke and poststroke dementia events. Results-The analyses were based on 10 809 participants aged ≥50 years at baseline. High prestroke executive functioning was associated with lower relative risk (RR) of dementia (RR, 0.24; 95% confidence interval, 0.13-0.45; P<0.001). Stroke was associated with increased RR of poststroke dementia (RR, 2.63; 95% confidence interval, 1.80-3.84; P<0.001). The association of stroke with poststroke dementia was greater for participants with higher prestroke executive functioning (interaction term RR, 4.4; 95% confidence interval, 1.35-14.63; P=0.014). For participants with higher executive functioning, the probability of dementia was 0.3% without stroke and 3.1% after stroke, compared with 1.9% and 5.2% for lower executive functioning. Conclusions-Stroke and prestroke cognition were independently associated with increased probability of poststroke dementia. Stroke results in disproportionate increase in the risk of dementia when premorbid cognitive functioning is high. (Stroke. 2013;44:3445-3451.)

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Section: Covariatesmentioning

confidence: 99%

Does the Influence of Stroke on Dementia Vary by Different Levels of Prestroke Cognitive Functioning?

Dregan

Wolfe

Gulliford

2013

Stroke

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“…Social Isolation: Those widowed or divorced in midlife and still so at follow-up were at higher risk of showing cognitive impairment compared with persons married or cohabiting. 24 5. Metabolic Syndrome and Adiposity: Metabolic syndrome prospectively predicted risk of developing cognitive impairment in older women 25 ; higher levels of all adiposity measures were prospectively associated with worsening cognitive function in men 26 ; and in midlife, there was an increased risk of dementia for obese persons, but the risk estimates were reversed in assessments of late-life body mass index.…”

Section: Table 2 Key Results About Other Cardiovascular Risk Factorsmentioning

confidence: 99%

“…Эти дополнительные данные представлены в таблице 2 [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34].…”

Section: церебральная амилоидная ангиопатия сосудистая дисфункция и unclassified

“…Изоляция от общества: У лиц, овдовевших или разведенных в зрелом возрасте и оставшихся в этом статусе в течение периода наблюдений, был повышен риск развития когнитивных нарушений по сравнению с лицами, вступившими в брак или состоящими в супружеских отношениях [24].…”

Section: нейровизуализация гистопатология и генетика: в центре внимаunclassified

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Advances in Vascular Cognitive Impairment

Gorelick

Bowler

2010

Stroke

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A dvances in our understanding of vascular cognitive impairment (VCI) have springboarded from further elucidation of the role of vascular risk factors, surgical procedures, medications, and neuroimaging studies that are related to this condition. The main focus of this VCI review will highlight the relation of diabetes mellitus and hippocampal dysfunction in VCI; coronary artery bypass surgery and cognitive decline; the role of cerebral amyloid angiopathy (CAA) in vascular dysfunction; and a discussion of other cardiovascular risk factors, treatment, and neuroimaging findings related to disease progression; and histopathologic and genetic correlates. Diabetes Mellitus, Hippocampal Function, Cerebral Blood Volume, Glucose, and InfarctsDiabetes increases the risk of both VCI and Alzheimer disease and may do so by the effects of insulin resistance, hyperglycemia-related increases in advanced glycation end products, and via oxidative stress, inflammation, and macrovascular or microvascular injury. 1 Insulin is transported into the central nervous system through the blood-brain barrier by a saturable receptor-mediated process, and insulin receptors are located in astrocytes and neuronal synapses and are highly concentrated in the olfactory bulb, cerebral cortex, hippocampus, hypothalamus, amygdala, and septum. 1 Of these structures, the hippocampus has been a focus of interest in relation to metabolic dysfunction and cognitive impairment in persons with diabetes.Wu et al 2 have shown that in community-based, nondemented elderly who underwent magnetic resonance imaging (MRI) and high-resolution functional mapping of the hippocampus, both diabetes and brain infarcts were associated with hippocampal dysfunction but with separate hippocampal subregions suggestive of distinct underlying mechanisms. Specifically, blood glucose levels were inversely and selectively correlated with dentate gyrus cerebral blood volume, and blood glucose levels were selectively and inversely correlated with total recall on the Selective Reminding Test, whereas CA1 dysfunction was linked to the occurrence of cerebral infarcts, an area known to be differentially vulnerable to transient hypoperfusion. Therefore, these findings clarify how blood glucose levels and brain infarcts in later life may differentially target hippocampal formation and suggest possible mechanisms for prevention of late-life memory decline.Diabetes is nonetheless associated with a variety of types of cerebral damage. In the SMART study of MRI segmentation data in 1043 individuals, of whom 151 had type 2 diabetes, diabetes mellitus was associated with global atrophy, subcortical atrophy, leukoaraiosis, and lacunar infarcts (but not large infarcts) after correction for other common vascular risk factors. 3 In the Adult Changes in Thought Study, a longitudinal, population-based study of aging and cognitive decline, 2 different patterns of cerebral injury at brain necropsy were noted in patients with dementia: Individuals without diabetes had a greater amyloid-B peptide load an...

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“…Håkansson and associates (27) from Sweden and Finland studied 2000 persons in 1972 to 1987 (midlife visit) and 1449 during a reexamination in 1998, an average of 21 years later (later life visit). Data on several vascular-and lifestyle-related factors were collected at both times.…”

Section: Midlife Marital Status and Later Life Cognitive Functionmentioning

confidence: 99%

Facts and Ideas from Anywhere

Roberts¹

2010

Baylor University Medical Center Proceedings

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Association between mid-life marital status and cognitive function in later life: population based cohort study

Abstract: Objectives To evaluate whether mid-life marital status is related to cognitive function in later life.

Cited by 256 publications

References 51 publications

Does the Influence of Stroke on Dementia Vary by Different Levels of Prestroke Cognitive Functioning?

Does the Influence of Stroke on Dementia Vary by Different Levels of Prestroke Cognitive Functioning?

Advances in Vascular Cognitive Impairment

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