Identifying the lifetime cognitive and socioeconomic antecedents of cognitive state: seven decades of follow-up in a British birth cohort study

ObjectivesThe life course determinants of midlife and later life cognitive function have been studied using longitudinal population-based cohort data, but far less is known about whether the pattern of these pathways is similar or distinct for clinically relevant cognitive state. We investigated thi...

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Bibliographic Details
Published in:BMJ open 2019-04, Vol.9 (4), p.e024404-e024404
Main Authors: Richards, M, James, Sarah-Naomi, Sizer, Alison, Sharma, Nikhil, Rawle, Mark, Davis, Daniel H J, Kuh, Diana
Format: Article
Language:English
Subjects:
Adolescent
Adult
Adults
Age
Aged
Aging
Apolipoprotein E4 - metabolism
Apolipoproteins
Child
Child Development
Cognition
Cognition & reasoning
Cognition Disorders - epidemiology
Cognition Disorders - etiology
Cognition Disorders - metabolism
Cognitive ability
Cohort analysis
Cohort Studies
Dementia
Dementia - epidemiology
Dementia - etiology
Dementia - metabolism
Disease
Education
Educational attainment
Educational Status
England
Epidemiology
Female
Follow-Up Studies
Genotype & phenotype
Health risk assessment
Health Surveys
Humans
Language Arts
Longitudinal Studies
Male
Market entry
Medical research
Memory
Meta-analysis
Middle Aged
Occupations
Older people
Polymorphism
Scotland
Social Class
Socioeconomic factors
Systematic review
Wales
Wechsler Scales
Whites
Young Adult
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Summary:ObjectivesThe life course determinants of midlife and later life cognitive function have been studied using longitudinal population-based cohort data, but far less is known about whether the pattern of these pathways is similar or distinct for clinically relevant cognitive state. We investigated this for Addenbrooke’s Cognitive Examination third edition (ACE-III), used in clinical settings to screen for cognitive impairment and dementia.DesignLongitudinal birth cohort study.SettingResidential addresses in England, Wales and Scotland.Participants1762 community-dwelling men and women of European heritage, enrolled since birth in the Medical Research Council (MRC) National Survey of Health and Development (the British 1946 birth cohort).Primary outcomeACE-III.ResultsPath modelling estimated direct and indirect associations between apolipoprotein E (APOE) status, father’s social class, childhood cognition, education, midlife occupational complexity, midlife verbal ability (National Adult Reading Test; NART), and the total ACE-III score. Controlling for sex, there was a direct negative association between APOE ε4 and the ACE-III score (β=−0.04 [–0.08 to –0.002], p=0.04), but not between APOE ε4 and childhood cognition (β=0.03 [–0.006 to 0.069], p=0.10) or the NART (β=0.0005 [–0.03 to 0.03], p=0.97). The strongest influences on the ACE-III were from childhood cognition (β=0.20 [0.14 to 0.26], p
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2018-024404