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Does lifestyle matter? Individual lifestyle factors and their additive effects associated with cognitive function in older men and women

Authors:
Tianyin Liu at The Hong Kong Polytechnic University
Tianyin Liu
Hao Luo at The University of Hong Kong
Hao Luo
Jennifer YM Tang
Jennifer YM Tang
Jennifer YM Tang
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Gloria HY Wong at University of Reading
Gloria HY Wong
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Objectives: This study investigated the association between healthy lifestyle comprised of multiple domains, gender, and cognitive function in older Chinese people in Hong Kong. Methods: We conducted a cross-sectional analysis with data from 1,831 community-dwellers aged 65 years and above. Participants’ basic demographics, comorbidity, and six lifestyle factors: diet; smoking; alcohol drinking; and physical, mental, and social activities were surveyed. Cognitive function was assessed using the Cantonese Chinese Montreal Cognitive Assessment (CC-MoCA). Linear regressions were performed to examine the associations between lifestyle, gender, and cognitive performance. Results: There were gender differences in lifestyle: men smoked (χ²(1) = 159.4) and drank more (χ²(1) = 85.9) and were more active in mentally stimulating activities (χ²(1) = 14.3, all p<.001); while women were more socially active (χ²(1) = 28.0). Age, gender and education explained the greatest variance in cognition (R²=.32). Being active/healthy in more domains further contributed to better cognitive function, although the effect was small (ΔR²=0.03 in women; ΔR²=0.01 in men, both p<.05). Among the lifestyle domains, physical activity showed the strongest effects on cognitive function (ΔR²=0.004 in men and ΔR²=0.02 in women, both p<.05). Conclusions: Naturalistically, a physically active lifestyle and being active/healthy in more domains is associated with better cognitive function in older people after controlling for non-modifiable and early-life factors. The effects are however small. There are gender differences in lifestyle and the impact of lifestyle on cognitive function. Preventive strategies targeting lifestyle domains for cognitive health in older people may consider these naturalistic associations.
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... A study by Liu et al. (2020) investigated the impact of different areas of lifestyle domains and healthy living on cognitive function. Participants were over 65 years of age with no signs of dementia, although their overall cognitive performance was rather low. ...
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  • BMC Geriatr
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Article
Full-text available
  • Dec 2023
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Article
Full-text available
  • Dec 2023
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Article
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Age-specific findings on lifestyle and trajectories of cognitive function from the Korean Longitudinal Study of Aging
Article
  • Nov 2023
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Article
Full-text available
  • Nov 2023
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“I guess you can interpret it in a number of ways like kind of a milder or the mildest form of dementia?”: Multi-stakeholder perceptions of cognitive impairment
Article
  • Sep 2023
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The influence of healthy lifestyle behaviors on cognitive function among older Chinese adults across age and gender: Evidence from panel data
Article
  • Apr 2023
  • ARCH GERONTOL GERIAT
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Article
Full-text available
  • Dec 2017
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Article
Full-text available
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Articles Effectiveness of a 6-year multidomain vascular care intervention to prevent dementia (preDIVA): a cluster-randomised controlled trial
Article
Full-text available
  • Aug 2016
  • LANCET
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Article
  • Jul 2017
  • LANCET
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Everyday cognitive functioning and global cognitive performance are differentially associated with physical frailty and chronological age in older Chinese men and women
Article
  • May 2017
Objectives: Intact cognition is a key determinant of quality of life. Here, we investigated the relative contribution of age and physical frailty to global and everyday cognition in older adults. Methods: Data came from 1396 community-dwelling, healthy Chinese older adults aged 65 or above. We measured their global cognition using the Cantonese Chinese Montreal Cognitive Assessment, everyday cognition with the short Chinese Lawton Instrumental Activities Daily Living scale, and physical frailty using the Fatigue, Resistance, Ambulation, Illness, and Loss of Weight Scale and grip strength. Multiple regression analysis was used to evaluate the comparative roles of age and physical frailty. Results: In the global cognition model, age explained 12% and physical frailty explained 8% of the unique variance. This pattern was only evident in women, while the reverse (physical frailty explains a greater extent of variance) was evident in men. In the everyday cognition model, physical frailty explained 18% and chronological age explained 9% of the unique variance, with similar results across both genders. Conclusion: Physical frailty is a stronger indicator than age for everyday cognition in both genders and for global cognition in men. Our findings suggest that there are alternative indexes of cognitive aging than chronological age.
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Memory Resilience to Alzheimer's Genetic Risk: Sex Effects in Predictor Profiles
Article
  • Dec 2016
  • J GERONTOL B-PSYCHOL
Objectives: Apolipoprotein E (APOE) ɛ4 and Clusterin (CLU) C alleles are risk factors for Alzheimer's disease (AD) and episodic memory (EM) decline. Memory resilience occurs when genetically at-risk adults perform at high and sustained levels. We investigated whether (a) memory resilience to AD genetic risk is predicted by biological and other risk markers and (b) the prediction profiles vary by sex and AD risk variant. Method: Using a longitudinal sample of nondemented adults (n = 642, aged 53-95) we focused on memory resilience (over 9 years) to 2 AD risk variants (APOE, CLU). Growth mixture models classified resilience. Random forest analysis, stratified by sex, tested the predictive importance of 22 nongenetic risk factors from 5 domains (n = 24-112). Results: For both sexes, younger age, higher education, stronger grip, and everyday novel cognitive activity predicted memory resilience. For women, 9 factors from functional, health, mobility, and lifestyle domains were also predictive. For men, only fewer depressive symptoms was an additional important predictor. The prediction profiles were similar for APOE and CLU. Discussion: Although several factors predicted resilience in both sexes, a greater number applied only to women. Sex-specific mechanisms and intervention targets are implied.
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Montreal Cognitive Assessment (MoCA): Concept and Clinical Review
Chapter
  • Dec 2017
The Montreal Cognitive Assessment (MoCA) is a cognitive screening instrument developed to detect mild cognitive impairment (MCI). It is a simple 10 min paper and pencil test that assesses multiple cognitive domains including memory, language, executive functions, visuospatial skills, calculation, abstraction, attention, concentration, and orientation. Its validity has been established to detect mild cognitive impairment in patients with Alzheimer’s disease and other pathologies in cognitively impaired subjects who scored in the normal range on the MMSE. MoCA’s sensitivity and specificity to detect subjects with MCI due to Alzheimer’s disease and distinguish them from healthy controls are excellent. MoCA is also sensitive to detect cognitive impairment in cerebrovascular disease and Parkinson’s disease, Huntington’s disease, brain tumors, systemic lupus erythematosus, substance use disorders, idiopathic rapid eye movement sleep behavior disorder, obstructive sleep apnea, risk of falling, rehabilitation outcome, epilepsy, chronic obstructive pulmonary disease and human immunodeficiency virus infection. There are several features in MoCA’s design that likely explain its superior sensitivity for detecting MCI. MoCA’s memory testing involves more words, fewer learning trials, and a longer delay before recall than the MMSE. Executive functions, higher-level language abilities, and complex visuospatial processing can also be mildly impaired in MCI participants of various etiologies and are assessed by the MoCA with more numerous and demanding tasks than the MMSE. MoCA was developed in a memory clinic setting and normed in a highly educated population. A new version of the MoCA called MoCA-Basic (MoCA-B) was developed to fulfill the limitation of the MoCA among the low educated and illiterate population. MoCA Memory Index Score is a newly devised score that can help clinicians better predict which patients with MCI are most likely to convert to dementia. The MoCA is freely accessible for clinical and educational purposes (www. mocatest. org), and is available in 56 languages and dialects.
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