Cognitive decline begins earlier than previously thought

Cognitive Decline May Begin As Early As Age 45
Cognitive Decline May Begin As Early As Age 45

HealthDay News -- Cognitive functioning, including memory, reasoning and comprehension skills may start to deteriorate as early as 45 years of age and may decline even faster among adults older than 65 years, according to a large prospective study published online in BMJ.

Archana Singh-Manoux, PhD, of the University College London, and colleagues observed more than 10,000 British civil servants who participated in the Whitehall II study. This included 5,198 men and 2,192 women who were aged 45 to 70 years when cognitive testing began in 1997 to 1999. Memory, reasoning, vocabulary and phonemic and semantic fluency were assessed three times during the study period.

On all of these measures except vocabulary, which typically remains unaffected with age, linear trends were observed in decline, with greater changes seen in those who were older at baseline. In men, mental reasoning declined 3.6% among those aged 45 to 49 years at baseline, and 9.6% in those aged 65 to 70 years. In women, the corresponding declines were 3.6% and 7.4%, respectively.

These findings have important clinical implications as evidence increases supporting the importance of lifestyle  and cardiovascular risk factors during middle age, including hypertension, obesity and dyslipidemia, on later life cognitive function.

"There is emerging consensus that 'what is good for our hearts is also good for our heads,' making aggressive control of behavioral and cardiovascular risk factors as early as possible key targets for clinical practice and public health," Singh-Manoux and colleagues wrote.

The researchers called for more studies to identify specific modifiable risk factors that could be targeted at younger ages. "Determining the age window at which potential interventions are likely to be most beneficial is also a crucial next step," they wrote.

Singh-Manoux A et al. BMJ. 2011; doi: 10.1136/bmj.d7622.
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