Archief Roodbont

Cognitive performance declines with advancing age. When this decline begins, however, is unclear. In this prospective cohort study, investigators estimated the 10-year decline in cognitive function in London civil servants (age, 45).

At baseline, the 5200 men and 2200 women were divided into five age groups (45–49, 50–54, 55–59, 60–64, and 65–70) and underwent cognitive testing. Cognitive outcomes were tests of memory, reasoning, vocabulary, and phonemic and semantic fluency. Participants were assessed three times during the next 10 years. All cognitive outcomes, except vocabulary, declined significantly in all baseline age groups with evidence for faster decline in older participants. For example, in men who were 45 to 49 at baseline, the 10-year decline in reasoning scores was 3.6%, whereas in men who were 65 to 70, it was 9.6%. (Similar results were obtained for women.)

Comment: In this prospective study, cognitive decline occurred in all age quintiles between 45 and 70 and was faster among older participants. Whether these results can be generalized is unknown, but the results have important public health implications. As the authors note, "research needs to identify the determinants of cognitive decline and assess the extent to which the cognitive trajectories of individuals are modifiable." One issue not addressed by the authors is the distinction between "normal aging" and the cognitive decline that heralds dementia syndromes.

— Paul S. Mueller, MD, MPH, FACP

Published in Journal Watch General Medicine February 9, 2012