Challenges and healthy ageing:
the role of resilience across the life
course
Biological resilience
and cognitive function
in the over 65s
Definitions

Resilience
–

Disease risk exposure
–

Buffer in disease risk exposure brought about by
high health assets (Harrison et al 2004)
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
–

Low levels of B12 lead to
–

MMA, homocysteine.
MMA, Folate trapped as methyl-THF
Raised MMA
–
Associated with cognitive performance (Garcia
2004; Lewerin 2005; Lewis 2005)
The data

Cognition
–
–

From serum
–

MMSE
CAMCOG – language comprehension, language
expression, remote memory, recent memory,
constructional praxis, ideational praxis, total
praxis, abstraction, perception
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
Education
MMSE
CAMCOG
78
9
26
89
69 – 93
7 – 21
18 – 30
56 – 103
Descriptive data
B12
HoloTC
Folate
146
59
10.9
Creatinine 98
MMA
0.44
11-486
9-163
2.7-45
17 (20%)
22 (26%)
4 (5%)
49-154
15 (18%)
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
Perception
Recent memory
Remote memory
Constructional praxis
Ideational praxis
Total praxis
Language expression
Lang comprehension
Age
Age
Age
Age
Ed
Folate
Folate
Folate MMA
Folate MMA
MMA
MMA
Challenges and healthy ageing:
the role of resilience across the life
course
Cognitive function,
social activity and
spousal bereavement
Definitions

Resilience
–

Disease risk exposure
–

Buffer in disease risk exposure brought about by
high health assets (Harrison et al 2004)
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
Pr. ASSESSMENT
N=2640
PREVALENCE SCREEN
N=13004
FOLLOW UP
N=920
INCIDENCE SCREEN
N=7175
Inc.
ASSESSMENT
N=1463
SCREEN AND
ASSESSMENT
N=1651
FOLLOW UP
N=920
SCREEN AND ASSESSMENT N=1743
SCREEN
AND
ASSESSMENT
N~5000
SCREEN
AND
ASSESSMENT
N=
Respondent’s characteristics
Married
Age at t1
72.4 yrs
Female
40%
MMSE t1
27.5
MMSE t2
26.9
Change MMSE -0.6
Satis.social activ.75%
Newly widowed
74.5 yrs
65%
26.9
26.1
-0.8
70%
Age
Social Activity
t1
Social Activity
t2
Gender
MMSE t1
MMSE t2
Age
Social Activity
t1
Social Activity
t2
Gender
MMSE t1
MMSE t2
=
NW .21
M .41
NW-.17
= M-.12
Gender
Social Activity
t2
Social Activity
t1
Age
=
=
=
MMSE t1
NW -.01 (ns)
M .013
=
=
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