Protective factors associated with normal cognition in persons age 80 years and older. (31st December 2021)

• Record Type: Journal Article
• Authors: Trammell, Antoine R; Hajjar, Ihab; Goldstein, Felicia C; Parker, Monica W
• Is Part Of: Alzheimer's & dementia. Volume 17(2021)Supplement 10
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-12-31
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.056710
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: Identifying cognitive protective factors with aging is critical to addressing the development and progression of Alzheimer's Disease and Related Dementias (ADRD). Despite evidence of cognitive resilience in African Americans (AA), older AA are at increased risk for ADRD. Studies exploring cognitive resilience have been conducted in predominantly white samples. Using a biracial sample, this study explores for factors related to normal cognition in persons over age 80. Method: Data from the NACC through the November 2020 data freeze was requested. White and AA persons over age 80 with normal cognition (NC) and mild cognitive impairment (MCI) were analyzed. Demographics, functioning, medical and vascular factors, and medications were evaluated. Comparisons of white vs. AA and NC vs. MCI using ANOVA or chi‐square were performed. Multinomial logistic regression further evaluated race‐cognitive groups and potential factors related to normal cognition. Result: Data from 20, 088 subjects was reviewed. Mean age of the same was 85.7 years, 15.3 years of education, and MoCA score of 23.7. It was 85.9% white, 57.8% female, and 36.2% had NC. AA/NC had higher BMI than AA/MCI ( 27.2vs.26.6, p=0.3 ). Most AA/NC were female ( 80.6%vs.74.4%, p<0.0001 ). AA/NC were non‐diabetic ( 61.4%vs.58.3%, p<0.0001 ) and lacked heart disease ( 7.4%vs.3.62%, p<0.0001 ). AA/NC lived independently ( 8.25%vs.3.01%, p<0.0001 ), were married ( 4.95%vs.1.97%, p<0.0001 ), and had intact problem‐solving ( 7.31%vs.1.95%, p<0.0001 ). Most white/NC were female ( 60.1%vs.47.3%, p<0.0001 ). White/NC were non‐diabetic ( 59.5%vs.31.3%, p<0.0001 ) and had no stroke ( 59.4% vs. 29.3%, p<0.0001 ). White/NC lived independently ( 55.3%vs.21.4%, p<0.0001 ), were married ( 28.9%vs.11.5%, p<0.0001 ), and had intact problem‐solving ( 55.7%vs.15.3%, p<0.0001 ). AA over age 80 were more likely to have NC if they lacked diabetes ( OR:5.1, 95%CI:1.38‐18.7 ), depression ( OR:5.3, 95%CI:1.33‐21.1 ), had intact problem solving ( OR:4.26, 95%CI:1.29‐14 ), and didn't take ACEI ( OR:3.59, 95%CI1.58‐8.13 ) or diuretics ( OR:3.51, 95%CI1.71‐7.22 ). Whites over age 80 were more likely to have NC if they were female ( OR:1.72, 9%CI:1.41‐2.11 ), had no depression (OR 2.93, 2.06‐1.14 95% CI), intact problem solving ( OR:10.8, 95%CI:6.43‐18.2 ), live with a spouse ( OR:11.9, 95%CI:1.46‐95.1 ), and not take antidepressants ( OR:1.73, 95%CI:1.35‐2.23 ). Conclusion: Differences in demographic and vascular factors, medications, and functioning are associated with normal cognition in advancing age. The factors can vary with race. Studies of prospective studies are needed to further study these differences.