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Self-reported measures of limitation in physical function in late midlife are associated with incident Alzheimer’s disease and related dementias

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Abstract

Background

Even small improvements in modifiable Alzheimer’s disease and related dementias (ADRD) risk factors could lead to a substantial reduction of dementia cases.

Aims

To determine if self-reported functional limitation associates with ADRD symptoms 4–18 years later.

Methods

We conducted a prospective longitudinal study using the Health and Retirement Study of adults aged 51–59 years in 1998 without symptoms of ADRD by 2002 and followed them to 2016. Main exposure variables were difficulty with activities of daily living, mobility, large muscle strength, gross motor and upper limb activities. The outcome was incident ADRD identified by the Lange-Weir algorithm, death, or alive without ADRD. We fit two GEE multinomial models for each measure: (1) baseline measure of function and (2) change in function over time.

Results

In the model with baseline only and outcome, only difficulty with mobility associated with future ADRD across levels of difficulty with near dose–response effect (risk ratios (RR) difficulty with 1–5 functions respectively, compared with no difficulty: 1.82; 2.70; 1.73 2.81; 4.03). Mobility also significantly associated with ADRD when allowing for change over time among those with 3, 4 or 5 versus no mobility limitations (RR 1.76; 2.36; 2.37).

Discussion

The results infer that an adult in midlife reporting difficulty with mobility as well as those with no mobility limitations in midlife but who later report severe limitations may be at increased risk of incident ADRD.

Conclusions

Self-reported measures of mobility limitation may be early indicators of ADRD and may be useful for public health planning.

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Funding

This research was supported, in part, by NIH R03AG070668-01. Data from the Health and Retirement Survey were collected by the University of Michigan through funding from the National Institute on Aging (NIA U01AG009740) and the Social Security Administration. BHB, LR, EJ, and SG designed the study and edited the manuscript, BHB conducted the analyses, drafted the manuscript, and obtained funding for the project.

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Authors and Affiliations

  1. Department of Health Services, Policy, and Practice, Brown University School of Public Health, 121 S. Main Street Box G-S121-6, Providence, RI, 02912, USA

    Barbara H. Bardenheier, Linda Resnik, Eric Jutkowitz & Stefan Gravenstein

  2. Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA

    Barbara H. Bardenheier

  3. Center of Innovation in Long-Term Services and Supports, Providence, RI, USA

    Linda Resnik

  4. Veterans Affairs Medical Center, Providence, RI, USA

    Linda Resnik, Eric Jutkowitz & Stefan Gravenstein

  5. Center for Neurorestoration and Neurotechnology, Providence Veterans Affairs Medical Center, Providence, RI, USA

    Linda Resnik

  6. Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA

    Stefan Gravenstein

Authors
  1. Barbara H. Bardenheier
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  2. Linda Resnik
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  3. Eric Jutkowitz
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  4. Stefan Gravenstein
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Corresponding author

Correspondence to Barbara H. Bardenheier.

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Statement of human and animal rights

This article does not contain any experimental study with humans or animals performed by the authors.

Informed consent

Data from the Health and Retirement Study are publicly available, so informed consent was not applicable for the authors. Data were collected by the University of Michigan who obtained informed consent from study participants, per the University of Michigan’s IRB.

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Bardenheier, B.H., Resnik, L., Jutkowitz, E. et al. Self-reported measures of limitation in physical function in late midlife are associated with incident Alzheimer’s disease and related dementias. Aging Clin Exp Res 34, 1845–1854 (2022). https://doi.org/10.1007/s40520-022-02132-w

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  • DOI: https://doi.org/10.1007/s40520-022-02132-w

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