Differences in cognitive performance and cognitive decline across European regions: a population-based prospective cohort study

Formánek, Tomáš; Kågström, Anna; Winkler, Petr; Čermáková, Pavla

doi:10.1016/j.eurpsy.2019.03.001

Cited by 33 publications

(27 citation statements)

References 43 publications

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“…To the best of our knowledge, it is the very first study of its kind for a CEE country. These countries have been largely underrepresented in studies on mental disorders [47]; however, existing evidence shows that older adults in CEE have a higher burden of brain disorders compared to their counterparts in Western Europe and Scandinavia [48][49][50]. We believe that the study will prove exceptionally useful in the development of Czech health and social care for dementia and that it will be of great value also to other post-communist CEE countries.…”

Section: Discussionmentioning

confidence: 90%

Hospitalizations and Mortality of Individuals with Dementia: Evidence from Czech National Registers

Broulíková

Arltová

Kuklová

et al. 2020

JAD

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Background: Facing an increasing prevalence of dementia, the Czech Republic is developing a new nationwide strategy for the management and prevention of dementia. Lack of evidence about characteristics of individuals with dementia in the country is a major obstacle. Objective: The study aimed to 1) characterize individuals with dementia, 2) compare their mortality with the general population, and 3) analyze differences in survival between different dementia disorders. Methods: The study capitalizes on two nationwide registers in the Czech Republic, from which information about individuals who were hospitalized with dementia or died from it between 1994 and 2014 was retrieved. Standardized intensity of hospitalizations was calculated for each year, mortality was studied using standardized mortality ratio, life-tables, Kaplan-Mayer curves, and Cox proportional hazard models. Results: Standardized intensity of hospitalizations for dementia increased more than 3 times from 1994 to 2014. Standardized mortality ratio was 3.03 (95% confidence interval 2.97-3.08). One-year survival rate was 45% and five-year survival rate 16%. Vascular dementia was the most common type of dementia disorders and was associated with higher hazard of death than Alzheimer's disease, even after adjusting for sociodemographic and clinical covariates (hazard ratio 1.04; 95% confidence interval 1.02-1.05). Conclusion: The study provides estimates on demographic characteristics and mortality of the Czech hospitalized dementia population, which have not been so far available and which are unique also in the context of the entire region of Central and Eastern Europe.

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Section: Discussionmentioning

confidence: 90%

Hospitalizations and Mortality of Individuals with Dementia: Evidence from Czech National Registers

Broulíková

Arltová

Kuklová

et al. 2020

JAD

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“…Depressive symptoms. Depressive symptoms were assessed in waves 1, 2, 4, 5, 6 and 7, using the EURO-D scale 45 , which is a self-assessment tool to measure symptoms of depression in older adults across Europe and has been used in many previous studies [46][47][48] . The EURO-D scale consists of 12 items (depressed mood, pessimism, wishing death, guilt, sleep, interest, irritability, appetite, fatigue, concentration, enjoyment, and tearfulness), which are scored 0 (symptom not present) or 1 (symptom present), with the reference period being the last month.…”

Section: Discussionmentioning

confidence: 99%

Trajectories of depressive symptoms and associated patterns of cognitive decline

Formánek

Csajbók

Wolfová

et al. 2020

Sci Rep

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The aim was to investigate the pattern and rate of cognitive decline across distinctive trajectories of depressive symptoms in older adults. In this prospective multinational cohort study on 69,066 participants (on average 64 years at baseline, 55% women), assessments of cognitive functions (immediate recall, delayed recall, verbal fluency) and depressive symptoms (EURO-D scale) were conducted at 2-year intervals. The trajectories of depressive symptoms were obtained using latent growth mixture modelling, cognitive decline was assessed using smoothing splines and linear mixed effects models. Four distinct trajectories of depressive symptoms were identified: constantly low (n = 49,660), constantly high (n = 2999), increasing (n = 6828) and decreasing (n = 9579). Individuals with increasing and constantly high depressive symptoms showed linear cognitive decline, while those with constantly low and decreasing depressive symptoms had fluctuating cognition. Participants with increasing depressive symptoms had the fastest decline, while those with decreasing symptoms were spared from decline in cognition. This study suggests that the pattern as well as the rate of cognitive decline co-occurs with specific patterns of changes in depressive symptoms over time. The most pronounced cognitive decline is present in individuals, in whom depressive symptoms increase late in life. Unique mechanisms of cognitive decline may exist for subgroups of the population, and are associated with the trajectory of depressive symptoms.

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“…Covariates. Covariates were identified based on previous evidence on the association of sociodemographic and health-related factors with childhood SEP and cognition 4,55 . Covariate data were derived from the same wave when cognition was measured or, if not available, then from the closest wave.…”

Section: Source Of Data Analysis Is Based On Data From Survey Of Heamentioning

confidence: 99%

Role of sex in the association between childhood socioeconomic position and cognitive ageing in later life

Wolfová

Csajbók

Kågström

et al. 2021

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We aimed to explore sex differences in the association of childhood socioeconomic position (SEP) with the level of cognitive performance and the rate of cognitive decline. We studied 84,059 individuals (55% women; mean age 64 years) from the Survey on Health, Ageing and Retirement in Europe. Sex differences in the association of childhood SEP (household characteristics at age 10) with the level of cognitive performance (verbal fluency, immediate recall, delayed recall) were analysed using multilevel linear regression. Structural equation modelling tested education, depressive symptoms and physical state as mediators. The relationship between childhood socioeconomic advantage and disadvantage and the rate of cognitive decline was assessed using linear mixed-effects models. Higher childhood SEP was associated with a higher level of cognitive performance to a greater extent in women (B = 0.122; 95% CI 0.092–0.151) than in men (B = 0.109; 95% CI 0.084–0.135). The strongest mediator was education. Childhood socioeconomic disadvantage was related to a higher rate of decline in delayed recall in both sexes, with a greater association in women. Strategies to prevent impaired late-life cognitive functioning, such as reducing childhood socioeconomic disadvantages and improving education, might have a greater benefit for women.

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Differences in cognitive performance and cognitive decline across European regions: a population-based prospective cohort study

Cited by 33 publications

References 43 publications

Hospitalizations and Mortality of Individuals with Dementia: Evidence from Czech National Registers

Hospitalizations and Mortality of Individuals with Dementia: Evidence from Czech National Registers

Trajectories of depressive symptoms and associated patterns of cognitive decline

Role of sex in the association between childhood socioeconomic position and cognitive ageing in later life

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