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Lower mental health related quality of life precedes dementia diagnosis: findings from the EPIC-Norfolk prospective population-based study

Chintapalli, Renuka; Myint, Phyo; Brayne, Carol; Keevil, Victoria; (2024) Lower mental health related quality of life precedes dementia diagnosis: findings from the EPIC-Norfolk prospective population-based study. European Journal of Epidemiology , 39 pp. 67-79. 10.1007/s10654-023-01064-7. Green open access

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Abstract

Lower Health Related Quality of Life (HRQoL) precedes dementia in older adults in the USA. We explore prospective associations between HRQoL and dementia in British adults in mid and late-life, when interventions to optimise cognitive ageing may provide benefit. 7,452 community-dwelling participants (57% women; mean age 69.3 ± 8.3 years) attended the European Prospective Investigation of Cancer-Norfolk study’s third health check (3HC) and reported their HRQoL using Short-Form 36 (SF-36). Cox Proportional Hazard regression models explored associations between standard deviation differences in baseline Physical Component (PCS) and Mental Component Summary (MCS) scores, as well as eight SF-36 sub-scales (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health), and incident dementia over ten years. Logistic regression models explored cross-sectional relationships at the 3HC between HRQoL and objective global cognitive function (n = 4435; poor cognition = lowest performance decile). The cohort was examined as a whole and by age-group (50–69, ≥ 70), considering socio-demographics and co-morbidity. Higher MCS scores were associated with lower chance of incident dementia (Hazard Ratio [HR] = 0.74, 95% CI 0.68–0.81) and lower odds of poor cognition (Odds Ratio [OR] = 0.82, 0.76–0.89), with findings similar by age-group. Higher PCS scores were not associated with dementia in the whole cohort (HR = 0.93, 0.84–1.04) or considering age-groups; and were only associated with poor cognition in younger participants (OR = 0.81, 0.72–0.92). Similarly, associations between higher scores on subscales pertaining to mental, but not physical, HRQoL and lower dementia incidence were observed. Lower mental HRQoL precedes dementia diagnosis in middle-aged and older British adults.

Type: Article
Title: Lower mental health related quality of life precedes dementia diagnosis: findings from the EPIC-Norfolk prospective population-based study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s10654-023-01064-7
Publisher version: https://doi.org/10.1007/s10654-023-01064-7
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
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 Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/10179053
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