Lifestyle for brain health and cognitive functioning in midlife to early late-life New Zealanders: Utility of the LIBRA index

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY International Journal of Geriatric Psychiatry Pub Date : 2024-04-26 DOI:10.1002/gps.6091

Susanne Röhr, Christine Stephens, Fiona Alpass

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Abstract

Objectives

There is enormous potential to improve brain health and reduce the risk of cognitive decline and dementia based on modifiable risk factors. The Lifestyle for Brain Health (LIBRA) index was developed to quantify modifiable dementia risk or room for brain health improvement. The objective of the study was to investigate the utility of the LIBRA index in relation to cognitive functioning in a midlife to early late-life sample of New Zealanders.

Methods

A subsample (n = 1001) of the longitudinal New Zealand Health, Work and Retirement (NZHWR) study completed face-to-face cognitive assessments using the ‘Kiwi’ Addenbrooke's Cognitive Examination—Revised (ACE-R) in 2010 and again in 2012, in addition to completing biennial NZHWR surveys on socioeconomic, health and wellbeing aspects. The LIBRA index was calculated incorporating information on 8 out of 12 modifiable health and lifestyle factors for dementia. Unadjusted and adjusted regression models and mixed effects models were used to inspect associations of LIBRA with cognitive functioning, cognitive impairment, and cognitive decline.

Results

The analytical sample (n = 881 [88.0%], after considering exclusion criteria and missing data) had a mean age of 63.1 (SD = 6.5) years, 53.3% were female, 26.2% were Māori, and 61.7% were highly educated. Higher LIBRA scores (indicating higher modifiable dementia risk) were associated with lower cognitive functioning (B = −0.33, 95% CI = −0.52;−0.15, p < 0.001) and a higher likelihood of cognitive impairment (OR = 1.22, 95% CI = 1.04; 1.42, p = 0.013), but did not predict cognitive decline over 2 years (B = −0.03, 95% CI = −0.22; 0.16, p = 0.766), adjusted for age, age², gender, education, and ethnicity.

Conclusions

The LIBRA index indicated promising utility for quantifying modifiable dementia risk in midlife and early late-life New Zealanders. For local use, refinement of the LIBRA index should consider cultural differences in health and lifestyle risk factors, and further investigate its utility with a wider range of modifiable factors over a longer observation period.

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新西兰中年至晚年早期人群大脑健康和认知功能的生活方式：LIBRA 指数的实用性

目标基于可改变的风险因素，改善大脑健康、降低认知能力下降和痴呆症风险的潜力巨大。脑健康生活方式（LIBRA）指数旨在量化可改变的痴呆症风险或改善脑健康的空间。本研究的目的是调查 LIBRA 指数在新西兰中年至晚年早期样本中与认知功能相关的实用性。方法新西兰健康、工作和退休（NZHWR）纵向研究的一个子样本（n = 1001）在2010年和2012年使用 "Kiwi "Addenbrooke认知检查-修订版（ACE-R）完成了面对面的认知评估，此外还完成了每两年一次的NZHWR社会经济、健康和福利方面的调查。LIBRA指数的计算包含了12个可改变的痴呆症健康和生活方式因素中8个因素的信息。采用未调整和调整回归模型以及混合效应模型来检验 LIBRA 与认知功能、认知障碍和认知能力下降之间的关联。结果分析样本（n = 881 [88.0%]，已考虑排除标准和缺失数据）的平均年龄为 63.1 (SD = 6.5)岁，53.3%为女性，26.2%为毛利人，61.7%受过高等教育。LIBRA得分越高（表明可改变的痴呆风险越高），认知功能越低（B = -0.33，95% CI = -0.52;-0.15，p <0.001），出现认知障碍的可能性越高（OR = 1.22，95% CI = 1.04; 1.42，p = 0.013），但经年龄、年龄2、性别、教育程度和种族调整后，并不能预测2年内认知能力的下降（B = -0.03，95% CI = -0.22; 0.16，p = 0.766）。结论 LIBRA指数可用于量化中年和晚年新西兰人可改变的痴呆风险。在本地使用时，LIBRA指数的改进应考虑到健康和生活方式风险因素的文化差异，并在更长的观察期内进一步研究其在更广泛的可改变因素中的效用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.