Cadar, D; (2013) The role of lifestyle behaviours on cognitive functioning and on cognitive decline. Doctoral thesis , UCL (University College London).

Abstract

Cognitive decline is the first outward sign of dementia and has a major public health impact on individuals and governments around the world. There is a well-established relationship between specific lifestyle behaviours and cognitive decline, but extremely limited research on the role of combined behaviours. The aim of this thesis was to examine the role of lifestyle behaviours (alcohol, smoking, physical activity and dietary choice) separately and in combination on cognitive functioning in midlife (age 43) and on 20-year cognitive decline from mid to later life using data from the MRC National Survey of Health and Development. Key findings were that high quality dietary choices made in midlife were associated with slower memory decline as compared to low quality dietary choices, and active levels of physical activity were associated with slower visual search speed decline compared to those who were inactive. Smoking was marginally associated with faster decline in visual search speed compared to non-smokers, but not with memory decline. Associations for these behaviours were independent of each other, as well as of a range of covariates. Cluster patterns of two and three healthy lifestyle behaviours showed a stronger positive association with verbal memory decline compared to no healthy lifestyle behaviours adopted in early midlife. These results provide further evidence of the effectiveness of healthy lifestyle behaviours adopted in early midlife. Public health interventions based on modifiable lifestyle behaviours represent high level priorities and should be regarded as an important line of defence against cognitive decline and dementia.

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