Modifiable risk factors of dementia in Successful Aging: an ELSI‐Brazil study
Bibliographic record
Abstract
BACKGROUND: High Performing Older Adults (HPOA) are older individuals with above-average cognitive abilities, indicating resilience to age-related pathological processes. Here, we compare HPOA with typical agers, regarding modifiable risk factors of dementia. METHOD: Older adults were selected from the ELSI-Brazil dataset (first wave, 2015-2016). Cognitive and demographic data was collected for this study. A global cognitive composite z-score was calculated using orientation (spatial and temporal), memory (immediate and delayed-recall) and semantic fluency scores. Each score was z-transformed according to the sample's mean and standard deviation (SD). HPOA was defined as individuals with cognitive z-scores above 1.5 SD. Typical older adults (TOA) were within -1.5 and +1.5 SD from the mean. Thirteen modifiable risk factors were retrieved according to the Lancet Commission: lower levels of education, hearing impairment, high blood pressure, smoking, obesity, depression, high LDL cholesterol, physical inactivity, diabetes, excessive alcohol consumption, air pollution, social isolation, and visual impairment. RESULT: Among 9412 individuals from the cohort, 5432 (57.7%) were classified as TOA and 497 were classified as HPOA (Tab. 1). Regarding demographic characteristics, HPOA had a higher educational level (Tab. 1, p < 0.001). HPOA showed significantly lower prevalence of lower education, hearing loss, physical inactivity and visual loss (Tab. 2, p < 0.001). Contrarily, HPOA had a higher prevalence than typical agers of alcohol abuse and hypertension (Tab. 2, p <0.001). There were no significant differences in depression, smoking, diabetes, obesity, and high LDL cholesterol between the groups. Logistic regression models identified that risk factors such as low education (beta = -1.8, p <0.001), physical inactivity (beta = -0.6, p < 0.001), and visual loss (beta = -0.4, p = 0.002) were negatively associated with HPOA. Obesity was positively associated with HPOA (beta = 0.31, p = 0.03). CONCLUSION: Low education, physical inactivity and visual loss were inversely associated with HPOA. Contrary to expected, the absence of modifiable risk factors of dementia was not proven to be associated with high cognitive abilities. Studying the influence of protective factors in successful aging is essential to underscore their importance in high cognitive performance.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".