Modifiable Risk Factors for Cognitive Decline in Community-Dwelling Older Adults Differ by Sex and APOE4
Emilie T Reas1, Humberto Parada2,3, Jaclyn Bergstrom4
1Department of Neurosciences, University of California San Diego, La Jolla, California, USA.
Summary
Lifestyle factors significantly impact cognitive aging. Managing cardiometabolic health and engaging in physical, cognitive, and social activities can preserve cognitive health span by up to a decade.
Area of Science:
- Gerontology and Cognitive Neuroscience
- Public Health and Epidemiology
Background:
- The influence of lifestyle on cognitive aging trajectories is not fully understood.
- Identifying key factors for mitigating age-related cognitive decline is crucial.
Purpose of the Study:
- To investigate how lifestyle shapes cognitive aging.
- To identify factors that best predict and potentially mitigate cognitive decline.
Main Methods:
- Longitudinal analysis of 1,489 participants (Rancho Bernardo Study) over 27 years.
- Factor analysis of 24 baseline risk variables into 9 composite factors.
- Mixed effects models assessing cognitive change prediction by baseline factors, stratified by sex and APOE4 status.
Main Results:
- Hyperlipidemia, obesity, depression, and low physical activity were linked to faster cognitive decline.
- Distinct risk profiles emerged for men vs. women and APOE4 carriers vs. non-carriers.
- Low-risk profiles could preserve cognitive health span by 7-9.5 years compared to high-risk profiles.
Conclusions:
- Multifactorial, life-course strategies focusing on cardiometabolic health and engagement are vital for mitigating cognitive decline.
- Personalized, multidomain approaches are essential, considering sex and APOE4-related differences in risk and potential interventions.
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