Abstract
Objectives
To examine (1) the clustering of reduced falls-efficacy, social withdrawal, and physical
activity withdrawal in Irish adults aged 50 years and older, and (2) the concurrent
and prospective associations of these clustered behaviors with cognitive decline.
Design
Longitudinal cohort study.
Setting and Participants
Data were from 4571 participants (mean age 64.5 ± 8.6, 54.9% women) in The Irish Longitudinal
Study on Ageing, a population-based study.
Methods
Changes in social and physical activity and falls-efficacy from 2012/2013 to 2014/2015
were used to define the behaviors of social withdrawal, physical activity withdrawal,
and reduced falls-efficacy. Patterns of behaviors were associated with concurrent
(2012/2013–2014/2015) and prospective (2014/2015–2016/2017) changes in immediate recall,
delayed recall, and verbal fluency using random effects mixed models.
Results
Eighty-six percent of participants had social withdrawal, physical activity withdrawal,
or reduced falls-efficacy, and 15% had all 3 behaviors. Participants with all 3 behaviors
showed the greatest declines in immediate recall (concurrent: B = −0.51, confidence
interval [CI] = −0.77 to −0.25; prospective: B = −0.51, CI = −0.78 to −0.25), delayed
recall (concurrent: B = −0.40, CI = −0.61 to −0.18; prospective: B = −0.47, CI = −0.69
to −0.25) and verbal fluency (concurrent: B = −1.05, CI = −1.58 to −0.52; prospective:
B = −1.29, CI = −1.83 to −0.74).
Conclusions and Implications
The clustering of social withdrawal, physical activity withdrawal, and reduced falls-efficacy
is common. Presence of multiple behaviors was associated with greater cognitive declines,
suggesting a cumulative association of these behaviors with cognitive decline. These
findings guide (1) identification of vulnerable groups, (2) intervention design, and
(3) care planning for people presenting with 1 or more of these changes in behavior.
Keywords
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Article info
Publication history
Published online: July 25, 2020
Footnotes
The authors declare no conflicts of interest.
This work was supported by a Global Brain Health Institute fellowship (GP). The Irish Longitudinal Study on Ageing is funded by the Irish Government, the Atlantic Philanthropies and Irish Life PLC. RRO is funded by Science Foundation Ireland (grant 18/FRL/6188).
Identification
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