Systematic Review: Factors Associated With Risk for and Possible Prevention of Cognitive Decline in Later Life

ABSTRACTBackground:An increasing body of evidence suggests that health behaviors may protect against cognitive impairment and dementia. The purpose of this study was to summarize the current evidence on health behavioral factors predicting cognitive health through a systematic review of the published literature.Methods:PubMed, Embase, and PsycINFO databases were searched for studies on community representative samples aged 65 and older, with prospective cohort design and multivariate analysis. The outcome – cognitive health – was defined as a continuum of cognitive function ranging from cognitive decline to impairment and dementia, and health behaviors included physical activity, smoking, alcohol drinking, body mass index, and diet and nutrition.Results:Of 12,105 abstracts identified, 690 relevant full-texts were reviewed. The final yield amounted to 115 articles of which 37 studies were chosen that met the highest standards of quality. Leisure time physical activity, even of moderate level, showed protective effects against dementia, whereas smoking elevated the risk of Alzheimer's disease. Moderate alcohol consumption tended to be protective against cognitive decline and dementia, but nondrinkers and frequent drinkers exhibited a higher risk for dementia and cognitive impairment. Midlife obesity had an adverse effect on cognitive function in later life. Analysis showed vegetable and fish consumption to be of benefit, whereas, persons consuming a diet high in saturated fat had an increased dementia risk.Conclusion:The review demonstrates accumulating evidence supporting health behavioral effects in reducing the risk of cognitive decline and dementia. Results indicate potential benefits of healthy lifestyles in protecting cognitive health in later life.

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Risk Factors Associated with Cognitive Decline after Cardiac Surgery: A Systematic Review

Cardiovascular Psychiatry and Neurology ◽

10.1155/2015/370612 ◽

2015 ◽

Vol 2015 ◽

pp. 1-12 ◽

Cited By ~ 41

Author(s):

Nikil Patel ◽

Jatinder S. Minhas ◽

Emma M. L. Chung

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Cognitive Decline ◽

New Technologies ◽

Perioperative Risk ◽

Factors Associated ◽

Perioperative Risk Factors ◽

Postoperative Cognitive Decline

Modern day cardiac surgery evolved upon the advent of cardiopulmonary bypass machines (CPB) in the 1950s. Following this development, cardiac surgery in recent years has improved significantly. Despite such advances and the introduction of new technologies, neurological sequelae after cardiac surgery still exist. Ischaemic stroke, delirium, and cognitive impairment cause significant morbidity and mortality and unfortunately remain common complications. Postoperative cognitive decline (POCD) is believed to be associated with the presence of new ischaemic lesions originating from emboli entering the cerebral circulation during surgery. Cardiopulmonary bypass was thought to be the reason of POCD, but randomised controlled trials comparing with off-pump surgery show contradictory results. Attention has now turned to the growing evidence that perioperative risk factors, as well as patient-related risk factors, play an important role in early and late POCD. Clearly, identifying the mechanism of POCD is challenging. The purpose of this systematic review is to discuss the literature that has investigated patient and perioperative risk factors to better understand the magnitude of the risk factors associated with POCD after cardiac surgery.

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Social Determinants of Health And The Onset of Dementia in Later Life

Innovation in Aging ◽

10.1093/geroni/igab046.2760 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 749-749

Author(s):

Darren Liu ◽

Takashi Yamashita ◽

Betty Burston ◽

Chetana Guthikonda

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Socioeconomic Status ◽

Food Insecurity ◽

Cognitive Decline ◽

Social Determinants Of Health ◽

Social Determinants ◽

Early Life ◽

Later Life ◽

Determinants Of Health

Abstract Dementia is a debilitating neurodegenerative syndrome characterized by deterioration in memory, cognitive, behavioral, and physical capacity. Recent research has indicated that some early-life social determinants of health (SDH), which vary by race/ethnicity may hold clues to the onset of dementia. Although early life clinical risk factors of dementia have been identified, early-life SDH such as education, sociodemographic and socioeconomic characteristics are yet to be collated. This review study focused on early-life (less than18 years of age) SDH in relation to cognitive decline in later life and differences across racial/ethnic groups in the U.S. A systematic review of articles in and after January of 1999 was conducted using Scoping Reviews - an approach for evidence synthesis to determine the coverage of a body of literature. Studies that report the impact of early-life social determinants on late-life cognitive decline were identified through the searches of CINAHL, Global Health, PsycINFO, PubMed and Scopus databases. Our initial database search resulted in 823 studies, and of those, 102 studies satisfied the inclusion criteria. The systematic review identified the following risk factors: lower education (34%), lower socioeconomic status (25%), Adverse Childhood Experiences (ACEs) (14%), exposure to environmental toxins (11%), food insecurity (6.8%), and rural residence (4%). Although education and socioeconomic status are well-known risk factors of cognitive decline in later life, other understudied factors such as food insecurity and residing in rural areas are yet to be explored. Implications in terms of understanding the link between early life SDH and dementia in later life are discussed.

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Cognitive leisure activities and future risk of cognitive impairment and dementia: systematic review and meta-analysis

International Psychogeriatrics ◽

10.1017/s1041610216001137 ◽

2016 ◽

Vol 28 (11) ◽

pp. 1791-1806 ◽

Cited By ~ 74

Author(s):

Lauren A Yates ◽

Shier Ziser ◽

Aimee Spector ◽

Martin Orrell

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Executive Functioning ◽

Cognitive Decline ◽

Meta Analysis ◽

Leisure Activities ◽

Later Life ◽

Pooled Analysis ◽

Meta Analyses

ABSTRACTBackground:As life expectancies continue to rise, modifiable lifestyle factors that may prevent cognitive decline and dementia in later life become increasingly important in order to maintain quality of life in old age.Methods:Five meta-analyses were conducted on data from papers identified in a systematic review. Studies were grouped according to outcomes (dementia, cognitive impairment including amnestic Mild Cognitive Impairment (aMCI), Mild Cognitive Impairment (MCI), and cognitive decline) and output (risk (RR), odds (OR), or hazard ratios (HR)).Results:Nineteen studies met our inclusion criteria and quality assessments. Four of five meta-analyses showed significant associations between participation in cognitive leisure activities and reduced risk of cognitive impairment (OR = 0.69, 95% CI: 0.56–0.85) and dementia (HR = 0.58, 95% CI: 0.46–0.74; RR = 0.61, 95% CI: 0.42–0.90; OR = 0.78, 95% CI: 0.67–0.90). However, one pooled analysis of cognitive impairment studies did not reach significance (HR = 0.85, 95% CI: 0.71–1.02). Mentally stimulating leisure activities were significantly associated with later life cognition (β = 0.11, p = 0.05), better memory (β = 0.20, 95% CI: 0.11–0.29), speed of processing (β = 0.37, 95% CI: 0.29–0.45), and executive functioning (β = 0.23, 95% CI: 0.15–0.29), and less decline in overall cognition (β = −0.23, p < 0.01), language (β = −0.11, p < 0.05), and executive functioning (β = −0.13, p < 0.05). Activities were also shown to reduce rate of cognitive decline (estimate = 0.03, SE = 0.01, p = 0.00).Conclusions:There is increasing evidence that participation in cognitively stimulating leisure activities may contribute to a reduction of risk of dementia and cognitive impairment in later life. Promoting involvement in such activities across lifespan could be an important focus for primary prevention strategies for governments and health services.

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