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American Journal of Epidemiology Advance Access originally published online on July 2, 2009
American Journal of Epidemiology 2009 170(4):428-437; doi:10.1093/aje/kwp161
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Health Behaviors From Early to Late Midlife as Predictors of Cognitive Function

The Whitehall II Study

Séverine Sabia, Hermann Nabi, Mika Kivimaki, Martin J. Shipley, Michael G. Marmot and Archana Singh-Manoux

Correspondence to Séverine Sabia, INSERM U687-IFR69, Hopital Paul Brousse, 16 Avenue Paul Vaillant Couturier, Bâtiment 15/16, 94807 Villejuif Cedex, France (e-mail: severine.sabia{at}inserm.fr).

Received for publication March 2, 2009. Accepted for publication May 11, 2009.

The authors examined associations of health behaviors over a 17-year period, separately and in combination, with cognition in late midlife in 5,123 men and women from the Whitehall II study (United Kingdom). Health behaviors were assessed in early midlife (mean age = 44 years; phase 1, 1985–1988), in midlife (mean age = 56 years; phase 5, 1997–1999), and in late midlife (mean age = 61 years; phase 7, 2002–2004). A score of the number of unhealthy behaviors (smoking, alcohol abstinence, low physical activity, and low fruit and vegetable consumption) was defined as ranging from 0 to 4. Poor (defined as scores in the worst sex-specific quintile) executive function and memory in late midlife (phase 7) were analyzed as outcomes. Compared with those with no unhealthy behaviors, those with 3–4 unhealthy behaviors at phase 1 (odds ratio (OR) = 1.84, 95% confidence interval (CI): 1.27, 2.65), phase 5 (OR = 2.38, 95% CI: 1.76, 3.22), and phase 7 (OR = 2.76, 95% CI: 2.04, 3.73) were more likely to have poor executive function. A similar association was observed for memory. The odds of poor executive function and memory were the greater the more times the participant reported unhealthy behaviors over the 3 phases. This study suggests that both the number of unhealthy behaviors and their duration are associated with subsequent cognitive function in later life.

cognition; health behavior; longitudinal studies; middle aged

Abbreviations: CI, confidence interval; OR, odds ratio; SD, standard deviation


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