Marseglia, Anna;
Kalpouzos, Grégoria;
Laukka, Erika J;
Maddock, Jane;
Patalay, Praveetha;
Wang, Hui-Xin;
Bäckman, Lars;
... on the behalf of the SHARED Consortium, .; + view all
(2023)
Social health and cognitive change in old age: the role of brain reserve.
Annals of Neurology
10.1002/ana.26591.
(In press).
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Abstract
OBJECTIVE: Individual aspects of social health (SH; e.g. network, engagement, support) have been linked to cognitive health. However, their combined effect, and the role of the structural properties of the brain (brain reserve, BR) remain unclear. We investigated the interplay of SH and BR on cognitive change in older adults. METHODS: Within the Swedish National study on Aging and Care-Kungsholmen, 368 dementia-free adults aged ≥60 years with baseline brain magnetic resonance imaging were followed over 12 years to assess cognitive change. A measure of global cognition was computed at each of the five waves of assessment by averaging domain-specific Z-scores for episodic memory, perceptual speed, semantic memory, letter and category fluency. An SH composite score was computed at baseline by combining leisure activities and social network. BR was proxied by total brain tissue volume (TBTV). Linear mixed models (adjusted for sociodemographic, vascular, and genetic factors) were used to estimate cognitive trajectories in relation to SH, TBTV. Interaction analysis and stratification were used to examine the interplay between SH and TBTV. RESULTS: Moderate-good SH (n=245; vs. poor; β-slope=0.01 [95% CI 0.002, 0.02]; p=0.018) and moderate-to-large TBTV (n=245; vs. small; β-slope=0.03 [95% CI 0.02, 0.04]; p<0.001) were separately associated with slower cognitive decline. In stratified analysis, moderate-good SH was associated with higher cognitive levels (but not change) only in participants with moderate-to-large TBTV (β-intercept=0.21 [95%CI 0.06; 0.37], p<0.01; interaction SH*TBTV p<0.05). INTERPRETATION: Our findings highlight the interplay between social health and brain reserve that likely unfolds throughout the entire life course to shape old-age cognitive outcomes. This article is protected by copyright. All rights reserved.
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