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Challenges and healthy ageing: the role of resilience across the life course

Challenges and healthy ageing: the role of resilience across the life course. Biological resilience and cognitive function in the over 65s . Definitions. Resilience Buffer in disease risk exposure brought about by high health assets (Harrison et al 2004) Disease risk exposure

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Challenges and healthy ageing: the role of resilience across the life course

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  1. Challenges and healthy ageing: the role of resilience across the life course Biological resilience and cognitive function in the over 65s

  2. Definitions Resilience Buffer in disease risk exposure brought about by high health assets (Harrison et al 2004) Disease risk exposure Failing cognitive function High health assets High levels of vitamin B12

  3. The study To explore the association between vitamin B12 and cognition In a sample from Gwynedd CFAS cohort 84 community dwelling non demented people aged 65 and over

  4. Background Vitamin B12 is the coenzyme for the conversion of MMA, homocysteine. Low levels of B12 lead to MMA, Folate trapped as methyl-THF Raised MMA Associated with cognitive performance (Garcia 2004; Lewerin 2005; Lewis 2005)

  5. The data Cognition MMSE CAMCOG – language comprehension, language expression, remote memory, recent memory, constructional praxis, ideational praxis, total praxis, abstraction, perception From serum vitamin B12, HoloTC, creatinine, folate, MMA Age, sex, education

  6. Method • Model variability in • MMSE score • CAMCOG score • scores on cognitive domains • Using age, sex, education, creatinine, folate and in turn • Vitamin B12, holoTC or MMA

  7. Descriptive data Age 78 69 – 93 Education 9 7 – 21 MMSE 26 18 – 30 CAMCOG 89 56 – 103

  8. Descriptive data B12 146 11-486 17 (20%) HoloTC 59 9-163 22 (26%) Folate 10.9 2.7-45 4 (5%) Creatinine 98 49-154 15 (18%) MMA 0.44 0.08-1.85 42 (50%)

  9. Results - MMSE and CAMCOG • MMSE • Age [-0.12(0.05)] • MMA [-2.42(1.02)] • CAMCOG • Age [-0.63(0.18)]

  10. Results - Cognitive domains Abstraction Age Perception Age Recent memory Age Remote memory Age Ed Folate Constructional praxis Folate Ideational praxis Folate MMA Total praxis Folate MMA Language expression MMA Lang comprehension MMA

  11. Cognitive function, social activity and spousal bereavement Challenges and healthy ageing: the role of resilience across the life course

  12. Definitions • Resilience • Buffer in disease risk exposure brought about by high health assets (Harrison et al 2004) • Disease risk exposure • Failing cognitive function in the face of spousal bereavement • High health assets • High levels of social activity

  13. The study To explore whether spousal loss influences both cognitive function and social activity and whether their relationship is changed as a consequence?

  14. Literature • Bereavement and social activity • Burton 2006; Bennett 2005; Utz 2002; • Bereavement and cognitive function • Xavier 2002; Grimby 1995;

  15. The data • Taken from 5 centres of MRC CFAS • Two groups at time 2 • still married (n=3481) and newly widowed (n=257) • Variables • Age, gender, social activity T1 and T2, MMSE T1 and T2

  16. PREVALENCE SCREEN N=13004 Pr. ASSESSMENT N=2640 Inc. ASSESSMENT N=1463 SCREEN ANDASSESSMENT N=1651 FOLLOW UP N=920 FOLLOW UP N=920 INCIDENCE SCREEN N=7175 SCREEN AND ASSESSMENT N=1743 SCREEN AND ASSESSMENT N= MRC CFAS study design SCREEN AND ASSESSMENT N~5000

  17. Respondent’s characteristics Married Newly widowed Age at t1 72.4 yrs 74.5 yrs Female 40% 65% MMSE t1 27.5 26.9 MMSE t2 26.9 26.1 Change MMSE -0.6 -0.8 Satis.social activ. 75% 70%

  18. Age Social Activity t1 Social Activity t2 Gender MMSE t1 MMSE t2

  19. Age Social Activity t2 Social Activity t1 Gender MMSE t1 MMSE t2

  20. = NW .21 M .41 Age Social Activity t2 Social Activity t1 NW -.01 (ns) M .013 = = NW-.17 M-.12 = = Gender MMSE t1 MMSE t2 = =

  21. Relationships unaffected by marital status • Age predicts MMSEt2, SAt1, SAt2 (independent of SAt1) • Gender predicts MMSEt1, SAt1 • MMSEt1 predicts MMSEt2 • SAt1 predicts MMSEt2

  22. Relationships affected by marital status • SAt1 predicts SAt2 - satisfaction with social activities remains the same but is more likely to do so if married. • Age predicts MMSEt1 - older people have lower cognitive function especially if newly widowed. • MMSEt1 predicts SAt2 – cognitive function weakly predicts satisfaction with social activity if married but not if newly widowed.

  23. Conclusions • Spousal bereavement • Modifies satisfaction with social activities • Intensifies the effect of age on cognitive function • and the impact is during the transition phase not post-widowhood.

  24. Overall In the face of assaults to good cognitive function in the over 65s resilient individuals • Have high levels of vitamin B12 • Are satisfied with their level of social activity

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