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P3‐086: Unravelling earliest neuropathology of memory impairment during normal senescence and Alzheimer's disease
Author(s) -
Daulatzai Mak Adam
Publication year - 2010
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.2010.05.1580
Subject(s) - neuroscience , basal forebrain , hypoglossal nucleus , hippocampus , entorhinal cortex , brainstem , cholinergic , psychology
Background: Constriction of life space, the extent of spatial movement through the environment covered during daily functioning, is common for many older adults and associated with adverse health outcomes. Little is known about the relationship between life space and Alzheimer’s disease (AD). We tested the hypothesis that a constricted life space is associated with an increased risk of incident Alzheimer’s disease (AD), incident mild cognitive impairment (MCI), and more rapid cognitive decline in older adults. Methods: Participants included 1,294 community-dwelling elders without baseline clinical dementia. Self-report life space (ranging from the bedroom to outside of town) was measured at baseline, and a detailed clinical evaluation administered annually and used to diagnose incident AD and MCI. Results: During an average follow-up of 4 years, 180 (13.9%) persons developed AD. In a proportional hazards model which controlled for age, sex, race, and education, a more constricted life space was associated with an increased risk of AD (HR 1⁄4 1.21, 95% CI 1.08, 1.36, p < 0.001), such that a person with a life space constricted to their immediate home environment (score1⁄4 3) was almost twice as likely to develop AD than a person with the largest life space (score 1⁄4 0, out of town). The association did not vary along demographic lines and persisted after the addition of terms for performance-based physical function, disability, depressive symptoms, social network size, vascular disease burden, and vascular risk factors. The association persisted after excluding persons with the lowest levels of cognitive function. A constricted life space was also associated with an increased risk of MCI (HR 1⁄4 1.17, 95% CI 1.06, 1.28, p 1⁄4 0.001), and a more rapid rate of cognitive decline (life space * time estimate: -0.012 (S.E., 0.003), p < 0.001). Conclusions: A constricted life space is associated with an increased risk of AD, MCI, and cognitive decline among community-dwelling older persons.