Time Trend in Persistent Cognitive Decline: Results from the Longitudinal Aging Study Amsterdam

Tessa N. Van Den Kommer, Dorly J.H. Deeg, Wiesje M. Van Der Flier, Hannie C. Comijs

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Objective To study time trends in the incidence of persistent cognitive decline (PCD), and whether an increase or decrease is explained by changes in well-known risk factors of dementia. Method Data from the Longitudinal Aging Study Amsterdam over a period of 20 years were used. Subsamples of 65-88 year-olds were selected at 7 waves, with numbers ranging from 1,800 to 1,165. Within-person change in cognitive functioning was used to determine PCD. In logistic generalized estimating equations (GEE), time (0, 3, 6, 9, 13, and 16 years) was the main predictor of 3-year PCD incidence. Explanatory variables were lagged one wave before incident PCD and included in separate models. Results PCD incidence was 2.5% at first, and 3.4% at last follow-up. GEE showed a positive time trend for PCD incidence [Exp(B) time = 1.042; p <.001]. None of the explanatory variables significantly changed the strength of the regression coefficient of linear time. Higher age, lower education, diabetes mellitus, smoking, lower body-mass index, and lower level of physical activity were associated with higher incidence of PCD. Conclusion An increase in PCD incidence over time was found. Although well-known risk factors were associated with incidence per se, they did not explain the increase in incidence of PCD.

Original languageEnglish
Pages (from-to)S57-S64
JournalJournals of Gerontology - Series B Psychological Sciences and Social Sciences
Publication statusPublished - 16 Apr 2018


  • Dementia
  • Incidence
  • Older adults
  • Risk factors

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