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Gerontologist. 2019 May 22. pii: gnz066. doi: 10.1093/geront/gnz066. [Epub ahead of print]

Development of a Combined Sensory-Cognitive Measure Based on the Common Cause Hypothesis: Heterogeneous Trajectories and Associated Risk Factors.

Author information

1
Department of Psychiatry, Universidad Autónoma de Madrid, Spain.
2
Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain.
3
Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
4
Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK.
5
Parc Sanitari Sant Joan de Déu, Barcelona, Spain.
6
Department of Preventive Medicine, Public Health, and Microbiology, Universidad Autónoma de Madrid, Spain.
7
CIBER of Epidemiology and Public Health, Madrid, Spain.

Abstract

BACKGROUND AND OBJECTIVES:

There is a link between sensory and cognitive functioning across old age. However, there are no integrative measures for assessing common determinants of sensory-cognitive functioning. This study aims to develop a combined measure of sensory-cognitive functioning, and to identify heterogeneous trajectories and associated risk factors.

RESEARCH DESIGN AND METHODS:

Two thousand two hundred and fifty-five individuals aged 60 years and over selected from the first six waves (2002-2012) of the English Longitudinal Study of Ageing completed a set of five self-reported visual and hearing functioning items and four cognitive items. Several health-related outcomes were also collected.

RESULTS:

The common cause model presented longitudinal factorial invariance (Tucker-Lewis index [TLI] = 0.989; Comparative Fit Index [CFI] = 0.991; Root Mean Square Error of Approximation [RMSEA] = 0.026). A common factor explained 32%, 36%, and 26% of the visual, hearing, and cognitive difficulties, respectively. The developed sensory-cognitive measure predicted incident dementia over 10 years (area under the curve = .80; 95% confidence interval [CI] = .75, .86). A three-trajectory model was proved to fit better, according to growth mixture modeling. Low levels of education and household wealth, disability, diabetes, high blood pressure, depressive symptoms, and low levels of physical activity were risk factors associated with the classes showing trajectories with a steeper increase of sensory-cognitive difficulties.

DISCUSSION AND IMPLICATIONS:

A time-invariant factor explains both sensory and cognitive functioning over 8 years. The sensory-cognitive measure derived from this factor showed a good performance for predicting dementia 10 years later. Several easily identifiable socioeconomic and health-related risk factors could be used as early markers of subsequent sensory-cognitive decline. Therefore, the proposed latent measure could be useful as a cost-effective indicator of sensory-cognitive functioning.

KEYWORDS:

Sensory functioning; Cognitive functioning; Latent classes; Structural equation modeling

PMID:
31115438
DOI:
10.1093/geront/gnz066

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