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Abstract
Objectives
Both cognitive reserve and modifiable-risk-factor profiles play a role in dementia incidence. We investigated whether cognitive reserve moderates the risk of dementia attributable to the modifiable-risk-factor profile.
Method
We followed 2102 older individuals aged 65+ years recruited from the population-based longitudinal cohort CFAS Wales study, begun in 2011, and the follow-up wave completed in early 2016. Cognitive reserve was measured by combining educational level, occupation complexity, and engagement in social and cognitive activities in later life. Modifiable-risk-factor profile scores were based on depression, diabetes, smoking, physical activity, healthy diet, and drinking. The interactions between cognitive reserve indicators and modifiable-risk-factor profiles were assessed on multiplicative and additive scales.
Results
There is an additive interaction between the composite effect of cognitive reserve indicator and modifiable-risk-factor profile on dementia. In those with low cognitive reserve, the risk of dementia in participants with a favorable profile was significantly lower than in those with an unfavorable one (OR = 0.08, 95% CI = 0.02–0.27).
Conclusion
Cognitive reserve significantly moderates the association between modifiable-risk-factor profiles and dementia.
Acknowledgements
The sponsors played no role in study design, methods, subject recruitment, data collection, analysis or preparation of the paper.
Disclosure statement
The authors have no conflict of interest to declare.
Author contributions
Feifei Jia and Fenglin Cao contributed the central idea, analyzed most of the data, and worte the initial draft of the paper. The remaining authors contributed to refining the ideas, carrying out additional analyses and finalizing this paper.