The relationship between optimism, MCI, and dementia among postmenopausal women

Abstract

Objectives

The relationship between optimism and cognitive functioning is not fully understood. We examined the association of optimism with risk of mild cognitive impairment (MCI) and dementia in the Women’s Health Initiative Memory Study (WHIMS).

Methods

Optimism was measured by the Life Orientation Test-Revised (LOT-R) total score, and optimism and pessimism subscales. A panel of experts adjudicated cognitive endpoints based on annual cognitive assessments. We used cox proportional hazard regression models to examine the association of LOT-R total score and optimism and pessimism sub-scores with MCI/dementia. We also examined the relationship between vascular disease, LOT-R total score, optimism and pessimism, and cognition.

Results

Mean age was 70.5 (SD = 3.9) years. The sample (N = 7249) was 87% white, and 29.8% of participants had < 12 years of education. Total LOT-R score (HR = 0.96, 95% CI: 0.94, 0.98, p < 0.001) was associated with lower risk of combined MCI or dementia. More pessimism (HR = 1.08, 95% CI: 1.05, 1.11, p < 0.0001) was associated with higher risk of MCI or dementia after adjustment for ethnicity, education, vascular disease, and depression. No significant relationships emerged from the optimism subscale.

Conclusion

These data suggest that less pessimism, but not more optimism, was associated with a lower risk of MCI and dementia.

Keywords:

• LOT-R
• optimism
• pessimism
• dementia
• MCI

Acknowledgements

The following authors designed and conceptualized the study and drafted the manuscript: Sachs BC, Hayden KM, Gaussoin SA.

Disclosure statement

BCS, GLW, JL, SRR, SAS, GAB, AHS, SAG, RC, JWW, JCC and KMH have no conflicts to declare. Rowan T. Chlebowski is a consultant for Novartis, AstraZeneca, Genentech, Merck, Immunomedics, Puma and received honorarium from Novartis and AstraZeneca.

Data availability statement

The data that support the findings of this study are available upon request from the Women’s Health Initiative and the Women’s Health Initiative Memory Study subject to study policies as well as privacy and ethical restrictions.

Additional information

Funding

The Women’s Health Initiative (WHI) program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C. The Women’s Health Initiative Memory Study (WHIMS) was funded in part by Wyeth Pharmaceuticals, St. Davids, PA. The WHIMS Extension was funded by the National Institute on Aging contract HHSN26820044221C and WHIMS-ECHO is funded by the National Institute on Aging, Contracts HHSN271201100004C, HHSN26820044221C, HHSN271201100004C.

Drs. Hayden, Rapp, Casanova, and Sachs, and Ms. Gaussoin received additional funding from NIA P30 AG049638.

Dr. Rapp has support from the NIH including R01AG058571, HHSN271-2011-00004C, HHSN268201600004C, U10CA 81851, 2R01AG055606-02A1, R01 AG050657-01, 1 P30 AG049638-01A1, R01 HL133684-01A1, R21 CA226960-01A1, R01AG058969, 1U19AG065188-01, and UG1CA189824-S1.

Dr. Chen receives funding from RF1AG054068.

Dr. Wactawski-Wende receives funding from N01WH32122.

Dr. Hayden receive funding from Contract # HHSN271201700002C

ClinicalTrials.gov Identifiers: NCT00017953 (WHIMS-Y); NCT01124773 (WHIMS/WHIMS-ECHO).