Added: Hanan Jowett - Date: 30.12.2021 01:55 - Views: 15451 - Clicks: 8286
Social relations are important for health, particularly at older ages. We examined the salience of frequency of social contacts and marital status for cognitive ageing trajectories over 21 years, from midlife to early old age. Data are from the Whitehall II cohort study, including men and women aged 35—55 years at baseline — Frequency of social contacts and marital status were measured in —88 and — Assessment of cognitive function on five occasions —94, —99, —04, —09 and —13 included the following tests: short-term memory, inductive reasoning, verbal fluency phonemic and semantic and a combined global score.
Cognitive trajectories over the study period were analysed using longitudinal latent growth class analyses, and the associations of these latent classes trajectory memberships with social relations were analysed using multinominal logistic regression.
More frequent social contacts [relative risk RRR 0. These associations persisted after adjustment for covariates. Of the sub-tests, social relations variables had the strongest association with phonemic fluency RRR 0.
More frequent social contacts and having a spouse were associated with more favourable cognitive ageing trajectories. Further studies are needed to examine whether interventions deed to improve social connections affect cognitive ageing. Key Messages Baseline cognitive performance was not strongly associated with subsequent rate of cognitive decline. Frequent social contacts and being married were associated with better cognitive performance trajectory over time. The associations between social relations and cognitive performance trajectories were independent of age, gender, socioeconomic position, behavioural risks and cardiometabolic factors.
People with dense, good and supportive social relations are healthier and they live longer than those without such relations. Although there are a of studies that have examined the association between social support functional aspects of social relations and cognitive performance using cross-sectional 8—10 and longitudinal des, 8 only two time points of cognitive performance measures have typically been used.
This is a limitation due to the fluctuation in cognitive performance, which could be especially marked at older age. Moreover, most longitudinal studies have used linear mixed-effects models, 1112 which models correlated repeated measures with random effects, to allow individuals differences in both cognitive scores at baseline and rates of cognitive decline.
However, this strategy does not take into the possibility that certain groups of individuals may have different developmental trajectories. An alternative Any younger women into older guys 47 whitehall 47, namely latent class modelling a semi-parametric specification of mixed modelling 13 allows the underlying, unobserved characteristics of groups of individuals to be taken intowith identification of homogeneous subgroups within the study population.
To address these limitations, the aim of the current study was to examine, using latent class modelling, the association between structural aspects of social relations, i. We used five assessments of cognitive performance spanning 21 years, and examined the associations with specific cognitive abilities. Participants were from the ongoing Whitehall II Study, 1415 which originally included 10 London-based civil servants from 20 civil service departments, who were 35—55 years of age at study baseline phase 1: data collection took place between and Data from phase 1 baseline, —88phase 2 —90 and five follow-up phases 3 —945 —997 —049 —09 and 11 —13 were used in this study.
Ethical approval for the Whitehall II Study was obtained from the University College London Medical School Committee on the ethics of human research, and informed consent was obtained from all study participants. Short-term verbal memory was assessed with a word free recall test. There were two tests of verbal fluency. First, the raw scores from each test were standardized to a z-score based on the phase 5 mean value and SD, and then these z scores were averaged to obtain the global cognitive performance scores.
Similar procedure has been used in studies. Age, sex, ethnicity White, non-White and socioeconomic status, measured as occupational position low, intermediate, high were reported at the study baseline and were used as covariates in all analyses. Occupational position has been shown to be a broad marker of socioeconomic status in the Whitehall II study, as it has been associated with salary, educational level and the level of responsibility at work.
All of these factors have been associated with cognitive function or cognitive decline ly. Trajectories of cognitive performance were defined using group-based trajectory models GBTM that identify classes of individuals trajectory groups with a similar trajectory over time a special case of latent class analyses. GBTM is increasingly being applied to clinical research to map the developmental course of disease and to identify theshape and size of different latent trajectory groups in the data. We hypothesized a priori that there would be two to three latent trajectories, as suggested by research.
The latent class modelling is a semi-parametric specification of mixed modelling, which approximates the underlying continuous distribution with a discrete distribution. Each individual was classified as being a member of a given trajectory group based on a posterior classification index for each individual, i. The method includes participants with data from any of the data collection phases. The estimates were adjusted for i age and sex, ii additionally for socioeconomic status and iii additionally for cardiometabolic risk factors including CRP and health behaviours.
In addition, individuals who were included into the study sample had a higher frequency of social contacts 10 vs 9.
Figure 1 shows that each trajectory had a slightly declining shape over time. Trajectories of cognitive performance subscales are presented in Supplementary Figures 1—4available as Supplementary data at IJE online. There were clear differences in the level intercept of the cognitive performance trajectories. Similar pattern was found in all performance subscales; the biggest decline was found in the low-performance group. Description of the study sample according to global cognitive performance trajectory membership is shown in Table 1.
There were clear differences in cognitive function trajectory memberships between various demographichealth behaviour and most cardiometabolic risk factors. These associations were robust to adjustments for health behaviours, CRP and cardiometabolic factors. The corresponding analysis, in which individual cognitive function trajectory memberships were tested as outcomes, are presented in Table 3. Both social relations variables seemed to have a stronger association with fluency measures than with inductive reasoning.
The trajectory of short-term memory performance was not associated either of the social relations measures. Table 2 Multinomial logistic regression analysis for the associations of social relations dimensions at phase 2 with trajectories of global cognitive performance from phase 3 until phase Multinomial logistic regression analysis for the associations of social relations dimensions at phase 2 with trajectories of global cognitive performance from phase 3 until phase Multinomial logistic regression analysis for the associations of social relations dimensions at phase 2 with trajectories of individual cognitive performance tests from phase 3 until phase We additionally tested the associations using mixed models with frequency of social contacts and marital status as predictors separate analyses and overall cognitive performance over all study phases as an outcome in analyses adjusted for age and sex.
Three trajectory groups of global cognitive function were identified among middle-aged men and women, with up to five repeated measurements of cognitive performance over a maximum follow-up of 21 years. There were clear differences in intercepts of cognitive performance between trajectory groups, but relatively small differences in the steepness or shape of the slopes. Thus, the baseline level of cognitive performance did not have a very strong association with the rate of cognitive decline.
Similar trajectories have also been ly identified. The associations were independent of demographic, behavioural and cardiometabolic factors.
Of the individual cognitive performance trajectories, all but short-term memory performance were better in people with more frequent social contacts and among those who were married. Taken together, the findings suggest that less social contacts and living without a partner predict poorer cognitive performance between midlife and old age. Particularly availability of other people, as indicated by frequent social contacts or living with a partner, seems to be a factor associated with cognitive decline.
Current findings are in line with studies where structural aspects of social relations have been associated with better average levels of cognitive performance and slower cognitive decline. We did find a stronger association between structural aspects of social relations and verbal ability. Married people have been shown to have more frequent contact with their social networks, 30 and this engagement may directly strengthen cognitive ability through repeated practice and refinement of communication, which could explain this finding.
Our study adds new insight by using a relatively large dataset and repeat measures of cognitive performance, starting in midlife. Our approach to modelling risk factors for cognitive function, using long-term trajectory modelling of cognitive performance using the GBTM, is new.
In studies, cognitive performance has been often examined using cross-sectional data, shorter follow-up time or analysing cognitive decline with mixed modelling 1112 that models correlated repeated measures with random effects, to allow individuals differences in both cognitive scores at baseline and rates of cognitive decline. This strategy does not take into the possibility that certain of individuals may have different developmental trajectories. GBTM, a semi-parametric specification of mixed modelling, 13 allows the underlying, unobserved characteristics of groups of individuals to be taken intowith identification of homogeneous subgroups within the study population.
The large sample size, long follow-up period and multiple waves of cognitive assessment strengthen confidence in the. Several known confounding factors were included in the analysis. Combining four tests into a single measure of global cognition reduces measurement error. All participants were from a sample of basically white-collar employees, and that restricts the generalizability of our.
However, the cohort covers a wide socioeconomic range, with a large difference in full-time salary between the highest and lowest occupational grade. As the effect appeared to be of a similar magnitude in all trajectories, this was unlikely to have affected our. Subjective perceptions of the social environment, derived from a well-validated questionnaire, are relevant indictors of social relationships and have been shown to associate with various health outcomes.
However, as this study was an observational study, further studies are needed to examine whether interventions deed to improve possibilities for social connections would affect cognition favourably. To form a comprehensive picture of the role of social relations in cognitive performance, future studies also should examine the roles of both structural and functional aspects of social relations.
We studied only the associations between midlife social relationships and subsequent cognitive performance development, to reduce the risk of reverse causality affecting our. In future, the impact of social relationship changes during the time from middle age to old age on cognitive performance should be investigated. Our emphasize the importance of structural aspects of social relations in relation to cognitive function. Supplementary data are available at IJE online.
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Alcohol consumption and cognitive function in the Whitehall II Study.Any younger women into older guys 47 whitehall 47
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