Effects of Sex and Education on Cognitive Change Over a 27-Year Period in Older Adults: The Rancho Bernardo Study

Abstract

Objective This study investigated how cognitive function changes with age and whether rates of decline vary by sex or education in a large, homogenous longitudinal cohort characterized by high participation rates, long-duration of follow-up, and minimal loss to follow-up. Design/Setting/Participants Between 1988–2016, 2,225 community-dwelling participants of the Rancho Bernardo Study, aged 31–99 at their initial cognitive assessment, completed neuropsychological testing approximately every four years, over a maximum 27-year follow-up. Measurements Linear mixed effects regression models defined sex-specific cognitive trajectories, adjusting for education and retest effects. Results Significant decline across all cognitive domains began around age 65 and accelerated after age 80. Patterns of decline were generally similar between sexes, although men declined more rapidly than women on the global function test. Higher education was associated with slower decline on the tests of executive and global functions. After excluding 517 participants with evidence of cognitive impairment, accelerating decline with age remained for all tests, and women declined more rapidly than men on the executive function test. Conclusions Accelerating decline with advancing age occurs across multiple cognitive domains in community-dwelling older adults, with few differences in rates of decline between men and women. Higher education may provide some protection against executive and global function decline with age. These findings better characterize normal cognitive aging, a critical prerequisite for identifying individuals at risk for cognitive impairment, and lay the groundwork for future studies of health and behavioral factors that affect age-related decline in this cohort.

Gambaran Fungsi Kognitif pada Lanjut Usia di Desa Sendangan Kecamatan Remboken

“…Berdasarkan hasil penelitian ini didapatkan responden dengan jenis kelamin perempuan lebih banyak (81,4%). Hal ini ditunjang oleh penelitian yang dilakukan oleh Rasyid et al, 2 Lima et al, 5 dan Reas et al, 6 yang melaporkan bahwa responen perempuan lebih banyak dibandingkan responden laki-laki. Peningkatan jumlah lanjut usia perempuan lebih banyak dibandingkan lanjut usia laki-laki dan perempuan cenderung mengalami penurunan fungsi kognitif yang lebih nyata pada usia yang sudah tua disertai kecepatan psikomotorik yang menurun.…”

“…Peningkatan jumlah lanjut usia perempuan lebih banyak dibandingkan lanjut usia laki-laki dan perempuan cenderung mengalami penurunan fungsi kognitif yang lebih nyata pada usia yang sudah tua disertai kecepatan psikomotorik yang menurun. 2,5,6 Pada pemeriksaan Ina-MoCA dan TMT didapatkan usia 60-70 tahun mengalami penurunan fungsi kognitif, sedangkan pada pemeriksaan CDT pada usia 81 ke atas didapatkan penurunan fungsi kognitif. Hal ini sesuai dengan penelitian yang dilakukan oleh Dale et al dan Lipnicki et al Dikatakan bahwa usia yang lanjut dapat terjadi penurunan fungsi kognitif.…”

“…Hal ini sesuai dengan penelitian yang dilakukan oleh Dale et al dan Lipnicki et al Dikatakan bahwa usia yang lanjut dapat terjadi penurunan fungsi kognitif. [6][7] Hal ini dikaitkan dengan proses penuaan dan penyakit degeneratif yaitu risiko penyakit kardiovaskuler, meningkatnya peripheral artery disease (PAD) yang akan memengaruhi fungsi vaskuler serebral, perfusi, dan tingkat atrofi otak. [8][9] Penurunan fungsi kognitif terbanyak pada pemeriksaan Ina-MoCA ialah pekerja nelayan sedangkan pada pemeriksaan TMT-A, TMT-B dan CDT ialah responden yang tidak bekerja.…”

Elizabeth Barrett-Connor: Instrumental Contributor to the Understanding of Midlife Well-being and Health in Both Women and Men

“…So much of what she pioneered is now so well established in mainstream epidemiologic research that it may be difficult to realize how groundbreaking her approach was at the time. She was one of the earliest researchers to illustrate the scientific value of examining in a population a broad range of physiologic measures and biomarkers such as glucose metabolism, sex hormones, thyroid function, and cytokines; detailed lifestyle factors including diet and physical activity; psychosocial factors such as depression, the role of social status, education, and stress; and new phenotypes including clinical measurements of eyes and bones, as well as functional health (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). She recalls that one of the comments at the time was "Why would you want to study normal people?"…”

The Mediation Effect of Self–Report Physical Activity Patterns in the Relationship between Educational Level and Cognitive Impairment in Elderly: A Cross-Sectional Analysis of Chilean Health National Survey 2016–2017

“…Continuing education has been associated with better cognitive function and lower incidence of dementia [5]. For example, it was found that a higher educational level reduced the possibility of risk of cognitive impairment during aging, protecting against the decline of executive and global function [6].…”