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Identifying the lifetime cognitive and socioeconomic antecedents of cognitive state: seven decades of follow-up in a British birth cohort study

Richards, M; Sizer, A; Sharma, N; Rawle, MJ; Davis, D; Kuh, D; James, S-N; (2019) Identifying the lifetime cognitive and socioeconomic antecedents of cognitive state: seven decades of follow-up in a British birth cohort study. BMJ Open , 9 , Article e024404. 10.1136/bmjopen-2018-024404. Green open access

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Abstract

Objectives The life course determinants of midlife and later life cognitive function have been studied using longitudinal population-based cohort data, but far less is known about whether the pattern of these pathways is similar or distinct for clinically-relevant cognitive state. We investigated this for the Addenbrooke’s Cognitive Examination (ACE-III), used in clinical settings to screen for cognitive impairment and dementia. Design Longitudinal birth cohort study. Setting Residential addresses in England, Wales and Scotland. Participants 1762 community-dwelling men and women of European heritage, enrolled since birth in the MRC National Survey of Health and Development (the British 1946 birth cohort). Primary outcome The Addenbrooke’s Cognitive Examination (ACE-III). Results Path modelling estimated direct and indirect associations between APOE status, father’s social class, childhood cognition, education, midlife occupational complexity, midlife verbal ability (National Adult Reading Test; NART), and the total ACE-III score. Controlling for sex, there was a direct negative association between APOE ε4 and the ACE-III score (β=-0.04, [-0.08, -0.002], p=0.04), but not between APOE ε4 and childhood cognition (β=0.03 [-0.006, 0.69, p=0.10] or the NART (β=0.0005 [-0.03, 0.03], p=0.97). The strongest influences on the ACE-III were from childhood cognition (β=0.20 [0.14, 0.26], p<0.001) and the NART (β=0.35 [0.29, 0.41], p<0.001); educational attainment and occupational complexity were modestly and independently associated with the ACE-III (β=0.08 [0.03, 0.14], p=0.002 and β=0.05 [0.01, 0.10], p=0.02, respectively). Conclusions The ACE-III in the general population shows a pattern of life course antecedents that is similar to neuropsychological measures of cognitive function, and may be utilised to represent normal cognitive ageing as well as a screen for cognitive impairment and dementia.

Type: Article
Title: Identifying the lifetime cognitive and socioeconomic antecedents of cognitive state: seven decades of follow-up in a British birth cohort study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjopen-2018-024404
Publisher version: http://doi.org/10.1136/bmjopen-2018-024404
Language: English
Additional information: Copyright © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
UCL > Provost and Vice Provost Offices > UCL SLASH
UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of Arts and Humanities
UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of Arts and Humanities > Dept of Information Studies
URI: https://discovery.ucl.ac.uk/id/eprint/10068534
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