Journal
JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES
Volume 66, Issue -, Pages 17-25Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/geronb/gbr018
Keywords
Alzheimer's disease; Cardiovascular disease; Cognition; Epidemiology; Health
Funding
- Clinical Science Research and Development Service, U.S. Department of Veterans Affairs
- National Institute on Aging [R01-AG014345, R01-AG018436]
- Center for Healthcare Evaluation at VA Palo Alto Healthcare System, Menlo Park, CA
- Center for Advanced Study in the Behavioral Sciences, Stanford, CA
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Objectives. We argue that age is a descriptive, and not explanatory, variable and consequently cannot account for the cognitive changes that often occur with aging. Once age is removed from consideration, other truly causal explanations for cognitive aging must be identified. We argue that health and disease represent an important class of explanatory variables for age-related cognitive changes. Methods/Results. We make this argument first by reviewing the prevalence of risk factors, disability, and subclinical and frank disease in the elderly population. We emphasize that the complexity of health effects rivals that of age on cognition while noting that most studies of cognitive aging rarely consider this complexity fully. We then consider in more detail the vascular hypothesis, which proposes that vascular diseases (e.g., stroke, heart disease) and their risk factors (e.g., hypertension) can explain aspects of cognitive decline in aging through their impact on circulatory and brain functions. Clinical implications of this hypothesis suggest that treatment of vascular risk factors might well reduce the incidence or severity of dementia syndromes. Discussion. We conclude with a brief summary of approaches to further integrate aspects of health and disease into the study of cognitive aging.
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