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[S2‐02‐02]: Life‐course psychosocial factors in relation to dementia in late life
Author(s) -
Fratiglioni Laura,
Wang HuiXin,
Winblad Bengt,
MacDonald Stuart
Publication year - 2005
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2005.06.323
Subject(s) - psychosocial , dementia , confounding , proportional hazards model , gerontology , life course approach , epidemiology , socioeconomic status , population , medicine , psychology , longitudinal study , demography , disease , psychiatry , developmental psychology , environmental health , pathology , sociology
Background: The relevance of psychosocial factors as determinants of dementia has recently emerged from several longitudinal population-based studies. At the same time, a life-course model for dementia risk has received increasing consensus in the epidemiological field (Fratiglioni et al, Lancet Neurology 2004). Objective: The aim of this study was to explore the effect of different psychosocial factors representing different periods in the life course on the risk of Alzheimer’s disease and other dementias. Methods: Data were gathered from the Kungsholmen Project that was carried out in a central area in Stockholm, Sweden, from 1987 to 2000. The population in this study consisted of all non-demented individuals examined at first follow-up (N 712). Incident dementia cases were detected during the following 6 years and diagnosed according to DSM-III criteria (N 146). Psychosocial data were collected at baseline, at least 6 years before dementia diagnosis. The available data permitted exploration of factors acting at three different life periods: early life (education and socioeconomic status); adulthood (work stress and work complexity); and late life (lifestyle including leisure activities and social network). For each period, factor-score weights from a structural equation measurement model were used to calculate composite factor-score predictors for entry in Cox regression analyses. The three composite predictors were examined both as continuous and indicator variables. For all Cox regression analyses, age, gender, health status (disability and vascular diseases), and baseline cognitive performance were entered as potential confounders. Results: When examined as continous variables, the relative risk (95% CI) was 0.8 (0.5-1.2) for the early life factor (higher education and SES); 1.2 (0.9-1.6) for the adulthood factor (more work stress and less work complexity); and 0.8 (0.6-1.0) for the late life factor (frequent social, mental, and physical activities). When examined as categorical quartiles, all three factors showed reliable links without demonstrating any dose-response associations, confirming observed patterns for the previous analyses. Conclusions: Psychosocial factors acting at different life periods are equally relevant for protecting against dementia risk, although late lifestyle activities seem to emerge as the strongest protective factor.