Lifestyle and cognition: Separating the effects of average lifestyle and lifestyle changes based on the LIBRA score.

IF 4.3 Q2 BUSINESS

The Journal of Prevention of Alzheimer's Disease Pub Date : 2025-04-08 DOI:10.1016/j.tjpad.2025.100159

Kej Wesenhagen, K Deckers, Hsj Picavet, M L Rietman, Aal Kok, S Köhler, M A Ikram, F J Wolters, M Huisman, Wmm Verschuren

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引用次数: 0

Abstract

Background: The LIfestyle for BRAin Health (LIBRA) score, consisting of twelve factors, highlights individuals' potential for dementia risk reduction through lifestyle. The LIBRA score includes modifiable protective factors such as low to moderate alcohol consumption, and risk factors such as hypertension.

Objective: We studied whether LIBRA scores are longitudinally associated with cognition, and to what extent this is due to between-person differences or within-person changes in LIBRA scores.

Methods: Individuals were included from four Dutch community-based cohorts: Doetinchem Cohort Study (DCS; n = 4770), Maastricht Aging Study (MAAS; n = 1295), Longitudinal Aging Study Amsterdam (LASA; n = 2391) and the Rotterdam Study (RS; n = 5205). The number of available LIBRA components (range 7-11) and timepoints (range 3-9) differed per cohort. Outcomes were standardized processing speed (LDST), memory (15-word delayed recall of the verbal learning test (VLT)) and verbal fluency. Hybrid mixed models were fit for the association of 1) mean LIBRA score and 2) change in LIBRA between subsequent timepoints. Models were adjusted for age, sex, education and learning effects. Interactions of the mean LIBRA score with age, and change in LIBRA score with age were tested in two separate models.

Results: Higher (i.e., unhealthier) mean LIBRA scores were associated with worse cognitive speed (lower LDST z-score per 1-point higher LIBRA, range between cohorts: 0.039 - 0.0587), memory (VLT, 0.026 - 0.035), and fluency (0.020 - 0.033). Associations of mean LIBRA scores with cognitive function were stronger with older age (LDST: significant age-interaction, 2 out of 4 cohorts; VLT and fluency: 1 out of 4 cohorts). Relative to 65-year-old individuals with a mean LIBRA score at the 50th percentile, individuals at the 90th percentile of the LIBRA score showed an estimated 1.9-3.2 years more advanced cognitive ageing for LDST, 1.9 - 5.3 years for VLT and 1.4 - 1.7 years for fluency. Within-person change in LIBRA showed no consistent associations with cognitive decline.

Conclusions: An individual's mean LIBRA score, but not their change in LIBRA score over time, was longitudinally associated with cognitive functioning. In the general population, the investigated version of the LIBRA score is possibly not suitable to capture how cognition (as a proxy for dementia risk) changes with improvements in lifestyle.

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生活方式和认知：根据天秤座评分分离平均生活方式和生活方式改变的影响。

背景：大脑健康生活方式（LIBRA）评分由12个因素组成，突出了个体通过生活方式降低痴呆风险的潜力。LIBRA评分包括可修改的保护因素，如低至中度饮酒，以及高血压等危险因素。目的：我们研究了LIBRA分数是否与认知有纵向关联，以及这在多大程度上是由于LIBRA分数的人与人之间的差异或人与人之间的变化。方法：个体被纳入四个荷兰社区队列：Doetinchem队列研究（DCS）；n = 4770), Maastricht Aging Study (MAAS；n = 1295)，阿姆斯特丹纵向老龄化研究(LASA；n = 2391)和鹿特丹研究(RS；N = 5205)。每个队列可用的LIBRA成分（范围7-11）和时间点（范围3-9）的数量不同。结果包括标准化处理速度（LDST）、记忆（15字延迟回忆言语学习测试（VLT））和言语流畅性。混合混合模型拟合1)平均LIBRA评分和2)随后时间点之间LIBRA变化的关联。模型根据年龄、性别、教育程度和学习效果进行了调整。在两个独立的模型中测试了LIBRA平均评分与年龄的相互作用，以及LIBRA评分与年龄的变化。结果：较高（即不健康）的平均LIBRA分数与较差的认知速度（每高1分的LIBRA较低的LDST z-score，队列之间的范围：0.039 - 0.0587），记忆（VLT, 0.026 - 0.035）和流畅性（0.020 - 0.033）相关。随着年龄的增长，平均LIBRA评分与认知功能的关联更强(LDST：显著的年龄相互作用，4个队列中有2个；VLT和流利度：1 / 4队列)。相对于平均天秤座分数在50百分位的65岁个体，天秤座分数在90百分位的个体在LDST、VLT和流利度方面的认知老化程度分别要提前1.9-3.2年、1.9- 5.3年和1.4 - 1.7年。天秤座的个人变化与认知能力下降没有一致的联系。结论：个体的平均天秤座评分与认知功能有纵向关系，而不是他们的天秤座评分随时间的变化。在一般人群中，调查版本的LIBRA评分可能不适合捕捉认知（作为痴呆风险的代理）如何随着生活方式的改善而变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

The Journal of Prevention of Alzheimer's Disease Medicine-Psychiatry and Mental Health

CiteScore

9.20

自引率

0.00%

发文量

期刊介绍： The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.