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Determinants of cognitive performance and decline in 20 diverse ethno-regional groups: A COSMIC collaboration cohort study

PLoS Medicine Aug 07, 2019

Lipnicki DM, Makkar SR, Crawford JD, et al. – In this study, researchers assessed the link between risk factors and late-life cognitive decline on a global scale, including comparisons between ethno-regional groups. They harmonized longitudinal data from 20 population-based cohorts from 15 countries over 5 continents (n = 48,522; 58.4%; aged 54–105 years and dementia-free at baseline). Studies had 2–15 years of follow-up. The risk factors assessed included age, sex, education, alcohol consumption, anxiety, apolipoprotein E ε4 allele (APOE*4) status, atrial fibrillation, blood pressure and pulse pressure, BMI, cardiovascular disease, depression, diabetes, self-rated health, high cholesterol, hypertension, peripheral vascular disease, physical activity, smoking, and history of stroke. Associations with risk factors were determined for a global cognitive composite outcome and Mini-Mental State Examination score. According to findings, education, smoking, physical activity, diabetes, and stroke are all modifiable factors linked to cognitive decline. The investigators noted that, if these factors are found to be causal, controlling them could abate global levels of cognitive decline. However, any global prevention strategy may need to consider ethno-regional differences.

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