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
– Failing cognitive function
High health assets
– High levels of vitamin B12
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
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)
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
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
Descriptive data
Age 78 69 – 93
Education 9 7 – 21
MMSE 26 18 – 30
CAMCOG 89 56 – 103
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%)
Results - MMSE and CAMCOG
MMSE
– Age [-0.12(0.05)]
– MMA [-2.42(1.02)]
CAMCOG
– Age [-0.63(0.18)]
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
Challenges and healthy ageing:
the role of resilience across the life
course
Cognitive function,
social activity and
spousal bereavement
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
The study
To explore whether spousal loss influences
both cognitive function and social activity and
whether their relationship is changed as a
consequence?
Literature
Bereavement and social activity
– Burton 2006; Bennett 2005; Utz 2002;
Bereavement and cognitive function
– Xavier 2002; Grimby 1995;
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
MRC CFAS study design
PREVALENCE SCREEN Pr. ASSESSMENT
N=13004 N=2640
FOLLOW UP
N=920
Inc. SCREEN AND
INCIDENCE SCREEN ASSESSMENT ASSESSMENT
N=7175 N=1463 N=1651
FOLLOW UP
N=920
SCREEN AND ASSESSMENT N=1743
SCREEN AND ASSESSMENT N~5000
SCREEN AND ASSESSMENT N=
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%
Social Activity Social Activity
Age
t1 t2
Gender MMSE t1 MMSE t2
Social Activity Social Activity
Age
t1 t2
Gender MMSE t1 MMSE t2
=
NW .21
M .41
Social Activity Social Activity
Age
t1 t2
= NW -.01 (ns)
NW-.17 = M .013
= M-.12 =
Gender MMSE t1 MMSE t2
= =
Relationships unaffected by marital
status
Age predicts MMSEt2, SAt1, SAt2
(independent of SAt1)
Gender predicts MMSEt1, SAt1
MMSEt1 predicts MMSEt2
SAt1 predicts MMSEt2
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.
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.
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