Background: Health-related quality of life (HRQoL) has been shown to predict adverse health outcome in the general population. Objective: We examined the cross-sectional association between HRQoL and cognitive performance at baseline. Next, we explored whether baseline HRQoL predicted 5-year incident cognitive decline and dementia and whether there were gender differences. Methods: 19,106 community-dwelling participants from the ASPirin in Reducing Events in the Elderly (ASPREE) trial, aged 65-98 years, free of major cognitive impairments, and completed the HRQoL 12-item short-form (SF-12) at baseline (2010-2014), were followed until June 2017. The physical (PCS) and mental component scores (MCS) of SF-12 were calculated. The cognitive tests were assessed at baseline, year 1, 3, 5, and 7 or close-out visit. Cognitive decline was defined as > 1.5 SD drop from baseline on any of the cognitive tests. Dementia was adjudicated according to DSM-IV criteria. Linear and Cox proportional-hazards regressions were used to examine the cross-sectional and longitudinal associations respectively. Results: At baseline, higher PCS and MCS were associated with better cognition. Over a median 4.7-year follow-up, higher MCS was associated with a reduced risk of cognitive decline and dementia (12% and 15% respectively, per 10-unit increase) and a 10-unit higher PCS was associated with a 6% decreased risk of cognitive decline. PCS did not predict dementia incidence. Findings were not different by gender. Conclusion: Our study found that higher HRQoL, in particular MCS, predicted a reduced risk of cognitive decline and dementia over time in community-dwelling older people.
Bibliographical noteFunding Information:
The ASPREE trial was mainly supported by grants from the National Institute on Aging and the National Cancer Institute at the National Institutes of Health (grant number U01AG029824); the National Health and Medical Research Council of Australia (grant numbers 334047 and 1127060); Monash University (Australia) and the Victorian Cancer Agency (Australia). Other funding resources and collaborating organizations of the ASPREE study are listed on http://www.aspree.org. AZZP is supported by Monash International Tuition Scholarship (Medicine, Nursing, and Health Sciences) and Monash Graduate Scholarship (30072360). RFP is supported by a National Heart Foundation of Australia Postdoctoral Fellowship (101927). JR is supported by a National Health and Medical Research Council Dementia Research Leader Fellowship (APP 1135727). Funders played no role in the design of the study, in the collection, analysis, and interpretation of data and in the writing of the manuscript.
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