Table 1.
Baseline participant characteristics as stratified by outcome caseness (n = 371)
| Measures | Cognitive Decline (CD)a | Incident dementia: Alzheimer's Disease (AD)b | Incident dementia: Vascular and other dementias (VoD)c | Depressive symptomatologyd | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Controls (n = 168) | Cases (n = 203) | Adjusted Pe | Controls (n = 264) | Cases (n = 76) | Adjusted Pe | Controls (n = 264) | Cases (n = 31) | Adjusted Pe | Controls (n = 109) | Cases (n = 262) | Adjusted Pe | |
| Sociodemographic characteristics | ||||||||||||
| Age (years) | 75 (4.1) | 76 (4.5) | 0.85 | 75 (4.3) | 77 (4.1) | 0.008 ** | 75 (4.3) | 77 (4.7) | 0.19 | 76 (4.3) | 76 (4.4) | 0.72 |
| Sex; female | 109 (65) | 136 (67) | 0.48 | 163 (62) | 58 (76) | 0.20 | 163 (62) | 24 (80) | 0.19 | 176 (67) | 70 (63) | 0.66 |
| Education ≥ secondary schoolf | 53 (32) | 60 (30) | 0.69 | 81 (31) | 21 (28) | 0.97 | 81 (31) | 11 (37) | 0.59 | 190 (73) | 71 (64) | 0.054 q |
| Health indicators | ||||||||||||
| BMI (kg m−2) | 26.3 (3.72) | 26.8 (4.41) | 0.50 | 26.7 (4.14) | 26.2 (4.72) | 0.51 | 26.7 (4.12) | 26.5 (2.91) | 0.84 | 26.4 (4.13) | 26.4 (3.81) | 0.81 |
| Plasma total cholesterol (mmol L −1 ) | 5.19 (1.15) | 5.38 (1.45) | 0.15 | 5.80 (0.95) | 5.93 (0.99) | 0.26 | 5.80 (0.95) | 5.78 (0.86) | 0.004 ** | 5.8 (1.0) | 5.9 (0.9) | 0.59 |
| Plasma LDL cholesterol (mmol L −1 ) | 5.78 (0.91) | 5.85 (0.98) | 0.11 | 3.60 (0.83) | 3.77 (0.88) | 0.22 | 3.60 (0.83) | 3.65 (0.76) | 0.003 ** | 3.6 (0.8) | 3.7 (0.8) | 0.83 |
| Plasma HDL cholesterol (mmol L −1 ) | 3.59 (0.80) | 3.68 (0.86) | 0.49 | 1.60 (0.39) | 1.50 (0.36) | 0.35 | 1.60 (0.39) | 1.68 (0.37) | 0.002 ** | 1.6 (0.4) | 1.6 (0.4) | 0.77 |
| Plasma triglycerides (mmol L−1) | 1.60 (0.38) | 1.57 (0.39) | 0.97 | 1.32 (0.77) | 1.29 (0.68) | 0.75 | 1.32 (0.77) | 1.40 (0.57) | 0.90 | 1.3 (0.7) | 1.4 (0.7) | 0.21 |
| Plasma glucose (mmol L −1 ) | 1.28 (0.66) | 1.36 (0.79) | 0.27 | 5.26 (1.21) | 5.34 (1.75) | 0.89 | 5.26 (1.21) | 5.45 (1.11) | 0.004 ** | 5.2 (1.1) | 5.5 (1.7) | 0.048 * |
| Genetic risk factors | ||||||||||||
| ApoE-ε4 carrier g | 19 (11) | 52 (26) | <0.001 *** | 44 (17) | 21 (28) | 0.03 * | 44 (17) | 5 (17) | 0.33 | 50 (19) | 22 (20) | 0.55 |
| Medical factors | ||||||||||||
| Hypertensionh | 124 (74) | 160 (79) | 0.86 | 198 (75) | 57 (75) | 0.49 | 198 (75) | 28 (93) | 0.11 | 202 (77) | 83 (75) | 0.58 |
| Diabetes i | 10 (6) | 26 (13) | 0.03 * | 20 (8) | 9 (12) | 0.54 | 20 (8) | 7 (25) | 0.02 * | 10 (26) | 11 (10) | 0.54 |
| Hypercholesterolemia j | 101 (60) | 122 (60) | 0.45 | 147 (56) | 49 (64) | 0.61 | 147 (56) | 25 (83) | 0.01 * | 152 (58) | 73 (66) | 0.15 |
| Antecedents of CVDk | 44 (26) | 68 (33) | 0.81 | 75 (29) | 23 (30) | 0.43 | 75 (29) | 14 (47) | 0.12 | 86 (33) | 28 (25) | 0.09 |
| Medication | ||||||||||||
|
Antihypertensive medication
use l |
87 (52) | 129 (64) | 0.02 * | 151 (57) | 44 (58) | 0.36 | 151 (57) | 21 (70) | 0.02 * | 149 (57) | 69 (62) | 0.21 |
| Diabetic medication use m | 13 (8) | 14 (7) | 0.66 | 19 (7) | 3 (4) | 0.29 | 19 (7) | 5 (17) | 0.056 q | 17 (7) | 10 (9) | 0.44 |
| Lipid lowering medication usen | 52 (31) | 78 (38) | 0.11 | 88 (34) | 32 (42) | 0.46 | 88 (34) | 10 (33) | 0.23 | 88 (34) | 39 (35) | 0.53 |
| Psychotropics and antidepressants use o | 41 (24) | 68 (33) | 0.19 | 68 (26) | 27 (36) | 0.09 q | 68 (26) | 13 (43) | 0.03 * | 75 (29) | 36 (32) | 0.68 |
| Vitamin D supplement use | 5 (3) | 10 (5) | 0.96 | 12 (5) | 0 (0) | 0.99 | 12 (5) | 3 (10) | 0.11 | 9 (3) | 6 (5) | 0.15 |
| Lifestyle characteristics | ||||||||||||
| Regular physical exercisep | 55 (37) | 45 (28) | 0.25 | 78 (34) | 16 (29) | 0.62 | 78 (34) | 4 (20) | 0.19 | 65 (25) | 30 (27) | 0.39 |
| Alcohol use (glasses per week) | 15 (18) | 13 (14) | 0.26 | 15 (17) | 10 (11) | 0.22 | 15 (17) | 14 (15) | 0.41 | 14 (17) | 13 (15) | 0.44 |
| Smoking status | 0.43 | 0.42 | 0.82 | 0.30 | ||||||||
| Never | 107 (64) | 139 (68) | – | 167 (63) | 57 (75) | – | 167 (63) | 20 (67) | – | 169 (65) | 77 (69) | – |
| Former | 52 (31) | 54 (27) | – | 83 (32) | 15 (20) | – | 83 (32) | 8 (27) | – | 77 (29) | 31 (28) | – |
| Current | 9 (5) | 10 (5) | – | 13 (5) | 4 (5) | – | 13 (5) | 2 (7) | – | 16 (6) | 3 (3) | – |
Values represent mean (SD) or N (%) of non-missing values. Characteristics (and associated values) in bold are covariates, all of which are controlled for in relevant models. Abbreviations: ApoE-ε4, allele ε4 for the apolipoprotein E gene; HDL, high-density lipoprotein; LDL, low-density lipoprotein; BMI, body mass index; CVD, cardiovascular disease.
aParticipants were classified as either cognitively stable or with accelerated CD based on their average performance in five neuropsychological tests, i.e., the Mini-Mental State Examination, the Benton Visual Retention Test, the Isaac’s Set Test, and the Trail-Making Test parts A and B across five follow-up visits across the 12-year study duration [13].
bAD cases included all diagnoses of probable AD, possible AD, and mixed dementia and was established and validated by an independent committee of neurologists.
c VoD included all diagnoses of vascular dementia, Parkinson dementia, Lewy body dementia, and frontotemporal dementia and was established and validated by an independent committee of neurologists.
d Assessed using the Center for Epidemiological Studies-Depression (CES-D) scale [26, 77]. CES-D scores ≥17 in men and ≥23 in women were used as indicators of a high depressive symptomatology.
e Estimated using logistic regressions controlling for age, sex, and education. FDR correction was applied to control for multiple testing; alpha threshold 0.05; P values represent FDR-corrected P values.
f Education was based on the highest level of attainment and considered dichotomously: either as no or primary level education only or as secondary/high school level and above.
g ApoE genotype was considered dichotomously: presence of at least one ε4 allele.
h Blood pressure ≥ 140/90 mmHg or antihypertensive medication use.
i Glucose ≥7.2 mmol/L or antidiabetic medication use.
j Fasting plasma total cholesterol ≥6.2 mmol/L or lipid-lowering medication use.
k History of cardiovascular or cerebrovascular disease.
l Includes all antihypertensive drugs, calcium channel blockers, diuretics, beta-blockers, and drugs acting on the renin-angiotensin system.
m Includes all antidiabetic drugs except insulin.
n Includes all statins, fibrates, or bile acid sequestrants.
o Includes all psycholeptics and psychoanaleptics—antidepressants, psychostimulants, and nootropics.
p Practice and intensity of physical exercise was assessed using a physical activity questionnaire for older adults [78]. Regular exercise was classified as doing sport regularly or having at least 1h of leisure or household activity per day, as described in detail in [79].
q Also adjusted for in further analyses where relevant.
* P < 0.05.
** P < 0.01.
*** P < 0.001.