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Predictors of healthy brain aging
M Gonzales Mc Neal1, S Zareparsi, R Camicioli
1Departments of Molecular and Medical Genetics, Oregon Health Sciences University, Portland 97201, USA.
Summary
Superior health in old age does not prevent cognitive impairment (CI) or Alzheimer's disease (AD). While risks are similar to the general population, factors like male gender and absence of apolipoprotein E-epsilon4 may delay cognitive decline onset.
Area of Science:
- Gerontology
- Neuroscience
- Epidemiology
Background:
- Optimal health in advanced age is often associated with better cognitive function.
- However, the protective effect of superior health against cognitive impairment (CI) and Alzheimer's disease (AD) in the oldest-old remains unclear.
Purpose of the Study:
- To investigate whether exceptional health in individuals aged 85 and older protects against the development of CI and AD.
- To identify factors associated with delayed onset of cognitive decline in this population.
Main Methods:
- Prospective study of 100 optimally healthy oldest-old individuals (>=85 years).
- Follow-up period of 5.6 +/- 0.3 years.
- Assessment of cognitive status, CI, and AD development, with analysis of factors including apolipoprotein E-epsilon4, gender, estrogen use, and education.
Main Results:
- During follow-up, 34% developed CI and 23% progressed to AD.
- By age 100, the probability of CI was 65% and AD was 49%.
- Median onset age for CI was 97 and for AD was 100. Absence of apolipoprotein E-epsilon4 and male gender were linked to later onset.
Conclusions:
- Superior health in old age does not guarantee protection against cognitive decline or Alzheimer's disease.
- While lifetime risks appear similar to the general population, factors delaying onset are crucial for cognitive health in the elderly.
- Targeting factors that delay cognitive decline onset may be a key strategy for improving cognitive health outcomes in aging populations.