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Association of Multi-Domain Factors with Cognition in the UK Biobank Study

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The Journal of Prevention of Alzheimer's Disease Aims and scope Submit manuscript

Abstract

Background

Dementia is a multifactorial syndrome attributable to a combination of vascular risk factors, lifestyle factors and neurodegeneration. However, little is known about the relative contribution of all these factors and their combined effects on cognition among the older population.

Objective

To examine the association of four domains of risk factors (sociodemographic, vascular risk factors, neuroimaging markers, lifestyle and psychosocial factors) with cognition in older adults.

Design

A cross-sectional study.

Setting

Data was obtained from a large-scale population-based study, UK Biobank study, at the first imaging visit assessment.

Participants

Participants are citizen or permanent residents of UK, aged 60 years old and above.

Measures

Cognitive function was assessed using the general cognitive ability score (g-factor score) derived from principal components analysis estimates of six cognitive tests. Associations with cognition were examined using multivariable linear regression for each domain and in combination.

Results

The study included 19,773 participants (mean age 68.5 ± 5.3 years SD, 9,726 (49%) male). Participants with lower cognitive scores (poorer cognition) were older, female, non-whites individuals, less educated and more socially deprived than participants with better cognitive scores. Participants with lower cognitive scores also tended to have higher vascular risk factors, lower brain volumes and more adverse lifestyle behaviours. The multivariable analysis found associations between adverse lifestyle and psychosocial factors with poorer cognition, i.e., being obese by measure of body fat percentage, having diabetes, higher white matter hyperintensity volume, increased sedentary screen time watching TV, being socially isolated and having depression were independently associated with poorer cognition. While larger hippocampal volume, having optimal sleep duration, adherence to a heathy diet, current and former alcohol drinking, increased wine consumption and sedentary screen time using a computer were associated with better cognition.

Conclusion

A combination of adverse lifestyle and psychosocial factors were independently associated with poorer cognition in older adults. Findings in this study can potentially support public health communications to promote cognitive function and independence among older adults. This research has been conducted using the UK Biobank Resource under Application Number 71022.

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Abbreviations

AD:

Alzheimer’s disease

ApoE ε4:

Apolipoprotein ε4

BMI:

Body mass index

DSST:

Digit symbol substitution test

g factor score:

General cognitive ability score

MATRIX:

Matrix pattern completion

MCI:

Mild cognitive impairment

MRI:

Magnetic resonance imaging

NAWM:

Normal appearing white matter volume

BFP:

Body fat percentage

TOWER:

Tower rearranging

TMT-B:

Trail making test, alphanumeric trail

VNR:

Verbal numeric reasoning

WHR:

Waist to hip ratio

WMH:

White Matter hyperintensities

PCA:

Principal component analysis.

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Acknowledgements

This research has been conducted using the UK Biobank resource (application number 71022). The authors express their gratitude to all UK Biobank participants and staff involved in the data collection and management of this study.

Funding

Fundings: This work was supported by NUS start-up grant (R-608-000-257-133), National Medical Research Council Singapore, Transition Award (R-608-000-342-213), Ministry of Education, Academic Research Fund Tier 1 (A-0006106-00-00) and Absence Leave Grant (A-8000336-00-00). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript.

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Authors and Affiliations

  1. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore

    W. Y. Tan &  Saima Hilal

  2. Institute of Data Sciences, National University of Singapore, Singapore, Singapore

    W. Y. Tan

  3. Office of the President, National University of Singapore, Singapore, Singapore

    C. A. Hargreaves

  4. Dementia Research Centre, Lee Kong Chian School of Medicine, Singapore, Singapore

    N. Kandiah

  5. Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Saima Hilal

  6. Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-03T, Singapore, 117549, Singapore

    Saima Hilal

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  1. W. Y. Tan
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Corresponding author

Correspondence to Saima Hilal.

Ethics declarations

Conflict of Interest Disclosures: All authors declare no conflict of interest.

Ethical standards: The UK Biobank study was approved by National Health Service National Research Ethics Service (17 June 2011, Ref: 11/NW/0382).

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Tan, W.Y., Hargreaves, C.A., Kandiah, N. et al. Association of Multi-Domain Factors with Cognition in the UK Biobank Study. J Prev Alzheimers Dis 11, 13–21 (2024). https://doi.org/10.14283/jpad.2024.3

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  • DOI: https://doi.org/10.14283/jpad.2024.3

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