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Lower mental health related quality of life precedes dementia diagnosis: findings from the EPIC-Norfolk prospective population-based study.

Published version
Peer-reviewed

Repository DOI


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Authors

Chintapalli, Renuka  ORCID logo  https://orcid.org/0000-0001-9388-0323
Myint, Phyo K 
Brayne, Carol 
Hayat, Shabina 
Keevil, Victoria L 

Abstract

Lower Health Related Quality of Life (HRQoL) precedes dementia in older adults in the USA. We explore prospective associations between HRQoL and dementia in British adults in mid and late-life, when interventions to optimise cognitive ageing may provide benefit. 7,452 community-dwelling participants (57% women; mean age 69.3 ± 8.3 years) attended the European Prospective Investigation of Cancer-Norfolk study's third health check (3HC) and reported their HRQoL using Short-Form 36 (SF-36). Cox Proportional Hazard regression models explored associations between standard deviation differences in baseline Physical Component (PCS) and Mental Component Summary (MCS) scores, as well as eight SF-36 sub-scales (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health), and incident dementia over ten years. Logistic regression models explored cross-sectional relationships at the 3HC between HRQoL and objective global cognitive function (n = 4435; poor cognition = lowest performance decile). The cohort was examined as a whole and by age-group (50-69, ≥ 70), considering socio-demographics and co-morbidity. Higher MCS scores were associated with lower chance of incident dementia (Hazard Ratio [HR] = 0.74, 95% CI 0.68-0.81) and lower odds of poor cognition (Odds Ratio [OR] = 0.82, 0.76-0.89), with findings similar by age-group. Higher PCS scores were not associated with dementia in the whole cohort (HR = 0.93, 0.84-1.04) or considering age-groups; and were only associated with poor cognition in younger participants (OR = 0.81, 0.72-0.92). Similarly, associations between higher scores on subscales pertaining to mental, but not physical, HRQoL and lower dementia incidence were observed. Lower mental HRQoL precedes dementia diagnosis in middle-aged and older British adults.

Description

Keywords

Cognitive decline, Dementia, Health-related quality of life, Mental health, SF-36, Middle Aged, Humans, Female, Aged, Male, Quality of Life, Mental Health, Comorbidity, Logistic Models, Dementia, Surveys and Questionnaires

Journal Title

Eur J Epidemiol

Conference Name

Journal ISSN

0393-2990
1573-7284

Volume Title

39

Publisher

Springer Science and Business Media LLC
Sponsorship
MRC (MR/T023902/1)
Medical Research Council (MC_UU_12015/1)
Medical Research Council (MR/N003284/1)
MRC (MC_UU_00006/1)