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2.
BMJ Open ; 10(3): e036607, 2020 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-32193278

RESUMO

INTRODUCTION: Numerous studies have found associations between characteristics of urban environments and risk factors for dementia and cognitive decline, such as physical inactivity and obesity. However, the contribution of urban environments to brain and cognitive health has been seldom examined directly. This cohort study investigates the extent to which and how a wide range of characteristics of urban environments influence brain and cognitive health via lifestyle behaviours in mid-aged and older adults in three cities across three continents. METHODS AND ANALYSIS: Participants aged 50-79 years and living in preselected areas stratified by walkability, air pollution and socioeconomic status are being recruited in Melbourne (Australia), Barcelona (Spain) and Hong Kong (China) (n=1800 total; 600 per site). Two assessments taken 24 months apart will capture changes in brain and cognitive health. Cognitive function is gauged with a battery of eight standardised tests. Brain health is assessed using MRI scans in a subset of participants. Information on participants' visited locations is collected via an interactive web-based mapping application and smartphone geolocation data. Environmental characteristics of visited locations, including the built and natural environments and their by-products (e.g., air pollution), are assessed using geographical information systems, online environmental audits and self-reports. Data on travel and lifestyle behaviours (e.g., physical and social activities) and participants' characteristics (e.g., sociodemographics) are collected using objective and/or self-report measures. ETHICS AND DISSEMINATION: The study has been approved by the Human Research Ethics Committee of the Australian Catholic University, the Institutional Review Board of the University of Hong Kong and the Parc de Salut Mar Clinical Research Ethics Committee of the Government of Catalonia. Results will be communicated through standard scientific channels. Methods will be made freely available via a study-dedicated website. TRIAL REGISTRATION NUMBER: ACTRN12619000817145.

3.
J Appl Gerontol ; : 733464820902943, 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32003281

RESUMO

Background: Despite expectations of deterioration in memory function with age, some older adults demonstrate superior memory performance and have been defined as SuperAgers. Method: SuperAgers were identified in a population-based prospective cohort in Australia (n = 1,679; 49.4% female; mean age = 70.6 ±1.5 years) as participants who, over a 12-year period, consistently scored at or above the median of participants 40 years younger on recall tasks. Chi-square and t tests and logistic regression models measured associations between risk factors and being a SuperAger. Results: The prevalence of SuperAgers was higher in women (8.6%) than men (5.3%). Education was associated with being a SuperAger for women (adjusted odds ratio [OR] =1.13, 95% confidence interval [CI] = [1.01, 1.26]) and men (adjusted OR = 1.22, 95% CI = [1.05, 1.40]). Other associated factors were investigative activities and alcohol consumption for women and social activities and depressive symptoms for men. Conclusion: Adults over 60 can sustain superior memory recall; however, associated factors may vary between genders.

4.
Sports Med ; 50(2): 403-413, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31529300

RESUMO

BACKGROUND: Besides physical activity as a target for dementia prevention, sedentary behaviour is hypothesized to be a potential target in its own right. The rising number of persons with dementia and lack of any effective treatment highlight the urgency to better understand these modifiable risk factors. Therefore, we aimed to investigate whether higher levels of sedentary behaviour are associated with reduced global cognitive functioning and slower cognitive decline in older persons without dementia. METHODS: We used five population cohorts from Greece, Australia, USA, Japan, and Singapore (HELIAD, PATH, SALSA, SGS, and SLAS2) from the Cohort Studies of Memory in an International Consortium. In a coordinated analysis, we assessed the relationship between sedentary behaviour and global cognitive function with the use of linear mixed growth model analysis (mean follow-up range of 2.0-8.1 years). RESULTS: Baseline datasets combined 10,450 older adults without dementia with a mean age range between cohorts of 66.7-75.1 years. After adjusting for multiple covariates, no cross-sectional association between sedentary behaviour and cognition was found in four studies. One association was detected where more sedentary behaviour was cross-sectionally linked to higher cognition levels (SLAS2, B = 0.118 (0.075; 0.160), P < 0.001). Longitudinally, there were no associations between baseline sedentary behaviour and cognitive decline (P > 0.05). CONCLUSIONS: Overall, these results do not suggest an association between total sedentary time and lower global cognition in older persons without dementia at baseline or over time. We hypothesize that specific types of sedentary behaviour may differentially influence cognition which should be investigated further. For now, it is, however, too early to establish undifferentiated sedentary time as a potential effective target for minimizing cognitive decline in older adults without dementia.

5.
Alzheimers Dement ; 16(2): 345-353, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31786126

RESUMO

INTRODUCTION: Observational studies have suggested that light-to-moderate alcohol consumption decreases the risk of Alzheimer's disease, but it is unclear if this association is causal. METHODS: Two-sample Mendelian randomization (MR) analysis was used to examine whether alcohol consumption, alcohol dependence, or Alcohol Use Disorder Identification Test (AUDIT) scores were causally associated with the risk of Late-Onset Alzheimer's disease (LOAD) or Alzheimer's disease age of onset survival (AAOS). Additionally, γ-glutamyltransferase levels were included as a positive control. RESULTS: There was no evidence of a causal association between alcohol consumption, alcohol dependence, or AUDIT, and LOAD. Alcohol consumption was associated with an earlier AAOS and increased γ-glutamyltransferase blood concentrations. Alcohol dependence was associated with a delayed AAOS. DISCUSSION: MR found robust evidence of a causal association between alcohol consumption and an earlier AAOS, but not alcohol intake and LOAD risk. The protective effect of alcohol dependence is potentially due to survivor bias.

6.
Ther Adv Chronic Dis ; 10: 2040622319880392, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31662837

RESUMO

Noncommunicable disease now contributes to the World Health Organization top 10 causes of death in low-, middle- and high-income countries. Particular examples include stroke, coronary heart disease, dementia and certain cancers. Research linking clinical and lifestyle risk factors to increased risk of noncommunicable disease is now well established with examples of confirmed risk factors, including smoking, physical inactivity, obesity and hypertension. However, despite a need to target our resources to achieve risk reduction, relatively little work has examined the overlap between the risk factors for these main noncommunicable diseases. Our high-level review draws together the evidence in this area. Using a systematic overview of reviews, we demonstrate the likely commonality of established risk factors having an impact on multiple noncommunicable disease outcomes. For example, systematic reviews of the evidence on physical inactivity and poor diet found each to be associated with increased risk of cancers, coronary heart disease, stroke, diabetes mellitus and dementia. We highlight the potential for targeted risk reduction to simultaneously impact multiple noncommunicable disease areas. These relationships now need to be further quantified to allow the most effective development of public health interventions in this area.

7.
Br J Psychiatry ; : 1-13, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31368428

RESUMO

BACKGROUND: The global ageing population and the long prodromal period for the development of cognitive decline and dementia brings a need to understand the antecedents of both successful and impaired cognitive ageing. It is increasingly apparent that the trajectory of risk-factor change, as well as the level of the risk factor, may be associated with an increased or decreased risk of cognitive decline or dementia.AimsOur aim was to summarise the published evidence and to generate hypotheses related to risk-factor trajectories and risk of incident cognitive decline or dementia. METHOD: We collated data from longitudinal observational studies relating to trajectory of blood pressure, obesity and cholesterol and later cognitive decline or dementia using standard systematic review methodology. The databases MEDLINE, Embase and PsycINFO were searched from inception to 26 April 2018. RESULTS: Thirteen articles were retained for inclusion. Analytical methods varied. Our summary of the current evidence base suggests that first body mass index and then blood pressure rises and then falls more steeply in those who go on to develop dementia. The evidence for cholesterol was less consistent. CONCLUSION: Based on our review we present the hypothesis that weight falls around 10 years and blood pressure around 5 years before diagnosis. Confirmatory work is required. However, characterisation of risk according to combinations and patterns of risk factors may ultimately be integrated into the assessments used to identify those at risk of receiving a diagnosis of cognitive decline or dementia in late life.Declaration of interestNone.

8.
Gerontologist ; 2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31350849

RESUMO

BACKGROUND AND OBJECTIVES: This systematic review aimed to synthesize and quantify the associations of awareness of age-related change (AARC) with emotional well-being, physical well-being, and cognitive functioning. RESEARCH DESIGN AND METHODS: We conducted a systematic review with a correlational random effects meta-analysis. We included quantitative studies, published from January 1, 2009 to October 3, 2018, exploring associations between AARC and one or more of the following outcomes: emotional well-being, physical well-being, and cognitive functioning. We assessed heterogeneity (I2) and publication bias. RESULTS: We included 12 studies in the review, 9 exploring the association between AARC and emotional well-being and 11 exploring the association between AARC and physical well-being. No study explored the association between AARC and cognitive functioning. Six articles were included in the meta-analysis. We found a moderate association between a higher level of AARC gains and better emotional well-being (r = .33; 95% CI 0.18, 0.47; p <.001; I2 = 76.01) and between a higher level of AARC losses and poorer emotional (r = -.31; 95% CI -0.38, -0.24; p < .001; I2 = 0.00) and physical well-being (r = -.38; 95% CI -0.51, -0.24; p < .001; I2 = 83.48). We found a negligible association between AARC gains and physical well-being (r = .08; 95% CI 0.02, 0.14; p < .122; I2 = 0.00). Studies were of medium to high methodological quality. DISCUSSION AND IMPLICATIONS: There is some indication that AARC gains and losses can play a role in emotional well-being and that AARC losses are associated with physical well-being. However, the number of included studies is limited and there was some indication of heterogeneity. PROSPERO REGISTRATION: CRD42018111472.

10.
PLoS Med ; 16(7): e1002853, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31335910

RESUMO

BACKGROUND: With no effective treatments for cognitive decline or dementia, improving the evidence base for modifiable risk factors is a research priority. This study investigated associations between risk factors and late-life cognitive decline on a global scale, including comparisons between ethno-regional groups. METHODS AND FINDINGS: We harmonized longitudinal data from 20 population-based cohorts from 15 countries over 5 continents, including 48,522 individuals (58.4% women) aged 54-105 (mean = 72.7) years and without dementia at baseline. Studies had 2-15 years of follow-up. The risk factors investigated were age, sex, education, alcohol consumption, anxiety, apolipoprotein E ε4 allele (APOE*4) status, atrial fibrillation, blood pressure and pulse pressure, body mass index, cardiovascular disease, depression, diabetes, self-rated health, high cholesterol, hypertension, peripheral vascular disease, physical activity, smoking, and history of stroke. Associations with risk factors were determined for a global cognitive composite outcome (memory, language, processing speed, and executive functioning tests) and Mini-Mental State Examination score. Individual participant data meta-analyses of multivariable linear mixed model results pooled across cohorts revealed that for at least 1 cognitive outcome, age (B = -0.1, SE = 0.01), APOE*4 carriage (B = -0.31, SE = 0.11), depression (B = -0.11, SE = 0.06), diabetes (B = -0.23, SE = 0.10), current smoking (B = -0.20, SE = 0.08), and history of stroke (B = -0.22, SE = 0.09) were independently associated with poorer cognitive performance (p < 0.05 for all), and higher levels of education (B = 0.12, SE = 0.02) and vigorous physical activity (B = 0.17, SE = 0.06) were associated with better performance (p < 0.01 for both). Age (B = -0.07, SE = 0.01), APOE*4 carriage (B = -0.41, SE = 0.18), and diabetes (B = -0.18, SE = 0.10) were independently associated with faster cognitive decline (p < 0.05 for all). Different effects between Asian people and white people included stronger associations for Asian people between ever smoking and poorer cognition (group by risk factor interaction: B = -0.24, SE = 0.12), and between diabetes and cognitive decline (B = -0.66, SE = 0.27; p < 0.05 for both). Limitations of our study include a loss or distortion of risk factor data with harmonization, and not investigating factors at midlife. CONCLUSIONS: These results suggest that education, smoking, physical activity, diabetes, and stroke are all modifiable factors associated with cognitive decline. If these factors are determined to be causal, controlling them could minimize worldwide levels of cognitive decline. However, any global prevention strategy may need to consider ethno-regional differences.


Assuntos
Cognição , Disfunção Cognitiva/etnologia , Grupos Étnicos/psicologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Comorbidade , Diabetes Mellitus/etnologia , Exercício , Feminino , Educação em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Fumar/efeitos adversos , Fumar/etnologia , Acidente Vascular Cerebral/etnologia
11.
J Alzheimers Dis ; 70(s1): S165-S186, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31306123

RESUMO

BACKGROUND: The translation of evidence on dementia risk factors into clinical advice requires careful evaluation of the methodology and scope of data from which risk estimates are obtained. OBJECTIVE: To evaluate the quantity, quality, and representativeness of evidence, we conducted a review of reviews of risk factors for Alzheimer's disease (AD), Vascular dementia (VaD), and Any Dementia. METHODS: PubMed, Cochrane library, and the Global Index Medicus were searched to identify meta-analyses of observational studies of risk factors for AD, VaD, and Any Dementia. PROSPERO CRD42017053920. RESULTS: Meta-analysis data were available for 34 risk factors for AD, 26 risk factors for Any Dementia and eight for VaD. Quality of evidence varied greatly in terms of the number of contributing studies, whether data on midlife exposure was available, and consistency of measures. The most evidence was available for cardiovascular risk factors. The most geographically representative evidence (five of six global regions) was available for alcohol, physical activity, diabetes, high midlife BMI, antihypertensives, and motor function. Evidence from Australia/Oceana or Africa was limited. With the exception of diabetes, meta-analysis data were unavailable from Latin America/Caribbean. Midlife specific data were only available for cholesterol and arthritis. CONCLUSION: There is a lack of midlife specific data, limited data on VaD, and a lack of geographical representation for many risk factors for dementia. The quality, quantity, and representativeness of evidence needs to be considered before recommendations are made about the relevance of risk factors in mid- or late-life or for dementia subtypes.

12.
J Alzheimers Dis ; 69(4): 1109-1136, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31156182

RESUMO

The association of Apolipoprotein E (APOE) with late-onset Alzheimer's disease (LOAD) and cognitive endophenotypes of aging has been widely investigated. There is increasing interest in evaluating the association of other LOAD risk loci with cognitive performance and decline. The results of these studies have been inconsistent and inconclusive. We conducted a systematic review of studies investigating the association of non-APOE LOAD risk loci with cognitive performance in older adults. Studies published from January 2009 to April 2018 were identified through a PubMed database search using keywords and by scanning reference lists. Studies were included if they were either cross-sectional or longitudinal in design, included at least one genome-wide significant LOAD risk loci or a genetic risk score, and had one objective measure of cognition. Quality assessment of the studies was conducted using the quality of genetic studies (Q-Genie) tool. Of 2,466 studies reviewed, 49 met inclusion criteria. Fifteen percent of the associations between non-APOE LOAD risk loci and cognition were significant. However, these associations were not replicated across studies, and the majority were rendered non-significant when adjusting for multiple testing. One-third of the studies included genetic risk scores, and these were typically significant only when APOE was included. The findings of this systematic review do not support a consistent association between individual non-APOE LOAD risk and cognitive performance or decline. However, evidence suggests that aggregate LOAD genetic risk exerts deleterious effects on decline in episodic memory and global cognition.

14.
Contemp Clin Trials Commun ; 14: 100351, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30997434

RESUMO

Background: Dementia is considered to be a highly stigmatized condition leading to significant negative effects on the health and well-being of people with dementia and people supporting someone living with dementia. Even though there has been an increasing amount of research on dementia-related stigma over the past two decades, research on effective, evidence-based approaches to reduce dementia-related public stigma is still lacking. Methods: A 2 × 2 factorial randomized controlled trial (RCT) is being conducted to evaluate the feasibility and short-term efficacy of an online intervention program. It compares different approaches to reduce dementia-related public stigma: 1) Education (ED) that is designed to provide written information on dementia; 2) Contact (CT) that is designed to offer indirect virtual contact with people with dementia and/or people supporting someone with dementia; 3) Education plus contact (ED + CT) that is designed to provide both written information on dementia and indirect virtual contact with people with dementia and/or people supporting someone living with dementia; and 4) an active control condition receiving written information on general health. We aim to recruit 500 lay persons aged 40 and over, to complete a questionnaire measuring the level of dementia-related public stigma, assessed with a modified Attribution Questionnaire and dementia knowledge, assessed with the Dementia Knowledge Assessment Scale version 2 at baseline and follow-up assessments (immediately after the intervention and 12 weeks post-intervention). Discussion: Results from this trial will provide evidence on the most effective approach in reducing dementia-related public stigma. The results are also likely to form an evidence base for the feasibility of dementia-related public stigma campaigns to educate the general public.

15.
Am J Epidemiol ; 188(6): 1076-1083, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30865222

RESUMO

The aim of this study was to investigate the within-person associations between the experience of financial hardship and cognitive performance throughout adulthood. Three waves of data provided by 6,343 participants (49% men) were analyzed from a representative community-based sample from Canberra, Australia (2003-2015). The outcome was a composite measure reflecting fluid cognitive abilities. Financial hardship was assessed by markers of scarcity (being unable to heat the home, missing meals, and going without other basic needs) and behavioral responses to hardship (pawning items and seeking help from community welfare organizations). Multivariable-adjusted fixed-effect regression models for panel data with robust standard errors tested time-dependent associations between measures of financial hardship and fluid cognitive abilities. Declines in cognitive performance coincided with the experience of scarcity (ß = -0.07; standard error, 0.018). There was no association between behavioral responses to hardship and cognitive performance, and there was no difference in the associations across age cohorts or by sex. There was no evidence that mastery or mental health attenuated the time-dependent link between hardship and cognition. This study provides new evidence that the onset (shock) of financial hardship is a potent stressor associated with occasion-specific deficits in fluid cognitive abilities.


Assuntos
Cognição , Pobreza/psicologia , Adulto , Fatores Etários , Idoso , Austrália , Feminino , Humanos , Estudos Longitudinais , Masculino , Saúde Mental , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos , Fatores de Tempo
16.
Alzheimers Dement ; 15(4): 581-589, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30826160

RESUMO

INTRODUCTION: Associations between the Mediterranean-DASH diet Intervention for Neurological Delay (MIND) diet and incidence of cognitive impairment have not been evaluated outside the United States. METHODS: We investigated MIND and Mediterranean diet relations with 12-year incidence of Alzheimer's disease/Vascular dementia (National Institute of Neurological Disorders criteria) and mild cognitive impairment (Winbald criteria) in the Personality and Total Health (PATH) Through Life cohort (n = 1220) set in Canberra, Australia: wave-1 2001-2002; wave-2 2005-2006; wave-3 2009-2010; and wave-4 2013-2014. MIND diet and two alternate Mediterranean diet scores were calculated from the baseline food frequency questionnaire responses. Higher dietary scores signified greater adherence. RESULTS: In adjusted logistic regression models, MIND diet (OR = 0.47, 95% CI 0.24, 0.91), but not Mediterranean diet, was associated with reduced odds of 12-year cognitive impairment. DISCUSSION: Preliminary evidence suggests that protective effects of the MIND diet are geographically generalizable. Additional prospective studies are needed in diverse samples to determine the relative effects of the MIND and the Mediterranean diets against cognitive decline.

17.
J Alzheimers Dis ; 70(s1): S145-S163, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30775976

RESUMO

BACKGROUND: Both air pollution and dementia are current and growing global issues. There are plausible links between exposure to specific air pollutants and dementia. OBJECTIVE: To systematically review the evidence base with respect to the relationship between air pollution and later cognitive decline and dementia. METHODS: Medline, Embase, and PsychINFO® were searched from their inception to September 2018, for publications reporting on longitudinal studies of exposure to air pollution and incident dementia or cognitive decline in adults. Studies reporting on exposure to tobacco smoke including passive smoking or on occupational exposure to pollutants were excluded. Using standard Cochrane methodology, two readers identified relevant abstracts, read full text publications, and extracted data into structured tables from relevant papers, as defined by inclusion and exclusion criteria. Papers were also assessed for validity. CRD42018094299Results:From 3,720 records, 13 papers were found to be relevant, with studies from the USA, Canada, Taiwan, Sweden, and the UK. Study follow-up ranged from one to 15 years. Pollutants examined included particulate matter ≤2.5 µ (PM2.5), nitrogen dioxide (NO2), nitrous oxides (NOx), carbon monoxide (CO), and ozone. Studies varied in their methodology, population selection, assessment of exposure to pollution, and method of cognitive testing. Greater exposure to PM2.5, NO2/NOx, and CO were all associated with increased risk of dementia. The evidence for air pollutant exposure and cognitive decline was more equivocal. CONCLUSION: Evidence is emerging that greater exposure to airborne pollutants is associated with increased risk of dementia.

18.
BMJ Open ; 9(1): e022846, 2019 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-30782689

RESUMO

OBJECTIVE: To systematically review the literature relating to the impact of multiple co-occurring modifiable risk factors for cognitive decline and dementia. DESIGN: A systematic review and meta-analysis of the literature relating to the impact of co-occurring key risk factors for incident cognitive decline and dementia. All abstracts and full text were screened independently by two reviewers and each article assessed for bias using a standard checklist. A fixed effects meta-analysis was undertaken. DATA SOURCES: Databases Medline, Embase and PsycINFO were searched from 1999 to 2017. ELIGIBILITY CRITERIA: For inclusion articles were required to report longitudinal data from participants free of cognitive decline at baseline, with formal assessment of cognitive function or dementia during follow-up, and an aim to examine the impact of additive or clustered comorbid risk factor burden in with two or more core modifiable risk factors. RESULTS: Seventy-nine full-text articles were examined. Twenty-two articles (18 studies) were included reporting data on >40 000 participants. Included studies consistently reported an increased risk associated with greater numbers of intraindividual risk factors or unhealthy behaviours and the opposite for healthy or protective behaviours. A meta-analysis of studies with dementia outcomes resulted in a pooled relative risk for dementia of 1.20 (95% CI 1.04 to 1.39) for one risk factor, 1.65 (95% CI 1.40 to 1.94) for two and 2.21 (95% CI 1.78 to 2.73) for three or more, relative to no risk factors. Limitations include dependence on published results and variations in study outcome, cognitive assessment, length of follow-up and definition of risk factor exposure. CONCLUSIONS: The strength of the reported associations, the consistency across studies and the suggestion of a dose response supports a need to keep modifiable risk factor exposure to a minimum and to avoid exposure to additional modifiable risks. Further research is needed to establish whether particular combinations of risk factors confer greater risk than others. PROSPERO REGISTRATION NUMBER: 42016052914.


Assuntos
Disfunção Cognitiva/epidemiologia , Demência/epidemiologia , Disfunção Cognitiva/prevenção & controle , Demência/prevenção & controle , Humanos , Incidência , Fatores de Risco
19.
Australas J Ageing ; 38(2): 98-106, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30809886

RESUMO

OBJECTIVE: To explore the factors associated with informal care provision by older Australians. METHODS: Longitudinal cohorts of the Personality and Total Health Through Life project (PATH) were used to build a generalised estimating equation model. RESULTS: Older adults who are engaged in volunteer and religious activities are 27.6% and 33.8%, respectively, more likely to provide informal care than their counterparts who are not engaged in these activities. Older adults who formerly provided care are four times more likely to have a continued caregiving role than their counterparts who did not formerly provide care. Those in marriage-type relationships are 50.9% more likely, and those with primary responsibility for household and income tasks are respectively 28.0% and 31.0% more likely, to provide care than their counterparts. CONCLUSION: Personal values for social responsibility and role responsibility are significant predictors of informal care provision by older Australians.


Assuntos
Cuidadores , Assistência ao Paciente , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Responsabilidade Social
20.
Alzheimer Dis Assoc Disord ; 33(2): 95-103, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30681434

RESUMO

PURPOSE: We investigated the association of the Australian National University Alzheimer's Disease Risk Index (ANU-ADRI) and an Alzheimer disease (AD) genetic risk score (GRS) with cognitive performance. METHODS: The ANU-ADRI (composed of 12 risk factors for AD) and GRS (composed of 25 AD risk loci) were computed in 1061 community-dwelling older adults. Participants were assessed on 11 cognitive tests and activities of daily living. Structural equation modeling was used to evaluate the association of the ANU-ADRI and GRS with: (1) general cognitive ability (g), (2) dementia-related variance in cognitive performance (δ), and (3) verbal ability (VA), episodic memory (EM), executive function (EF), and processing speed (PS). RESULTS: A worse ANU-ADRI score was associated with poorer performance in "g" [ß (SE)=-0.40 (0.02), P<0.001], δ [-0.40 (0.04), P<0.001], and each cognitive domain [VA=-0.29 (0.04), P<0.001; EM=-0.34 (0.03), P<0.001; EF=-0.38 (0.03), P<0.001; and PS=-0.40 (0.03), P<0.001]. A worse GRS was associated with poorer performance in δ [-0.08 (0.03), P=0.041] and EM [-0.10 (0.03), P=0.035]. CONCLUSIONS: The ANU-ADRI was broadly associated with worse cognitive performance, including general ability and dementia severity, validating its further use in early dementia risk assessment.

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