CFAS Wales

Cognitive Function And Ageing Studies

A Longitudinal Cohort Study (CFAS Wales)

This longitudinal study will establish and follow a new cohort of older people to address key questions regarding later life and ageing in the 21st century that currently cannot be answered by other sources. By evaluating function at individual, social and macro levels it provides data of international significance that advance scientific theory and inform policy and planning for the ageing population in an era where by 2025 one in five of the population in the UK will be over 65 and 5.5% over 80 (UN, 2006).

The sampling and evaluation of the cohort links with and follows the methodology developed in the Cognitive Function and Ageing Study (MRC-CFAS) By using shared methodology and data management, this proposal provides a cost- effective approach, able to draw on data from previous assessment waves in the study area, whilst addressing important questions that cannot be addressed with the current CFAS-2 study. The addition of 2 sites in Wales adds to the diversity of locations included, in terms of rurality, healthy life expectancy, bilingualism and the context of policy and services.

Over the last 15 years there have been lifestyle changes, including exercise and activities, and health for new cohorts of older people, as well as in their expectations of ageing, services and families. In this project we will: a) identify the nature of any differences in social networks between the new cohort and the original CFAS cohort. b) estimate whether prevalence and incidence rates of cognitive impairment have changed in Wales 15 years after the first CFAS cohort was established quantifying differences seen between 1994 and 2009/11, adding comparative data on any differences for a rural area in relation to the study being undertaken in 3 areas of England (CFAS-II).

Cross-sectional studies have confirmed the role of psychological resources such as resilience in mediating and/or moderating the effects of adversity in later life on well-being. In this longitudinal study we will examine the dynamic interplay between the antecedents, associations and outcomes of resilience, and test the extent to which resilience ameliorates the impact of cognitive impairment

Variables such as education, cognitive activity and bilingualism have been reported to add to cognitive brain reserve and potentially to have protective effects, along with social and biochemical factors. This study will examine the interplay between biochemical, cultural and life style factors in particular evaluating the influence of bilingualism, social networks, nutritional status and activity on changes in overall cognition (and in discrete cognitive domains), function and well-being. Specifically: a) we will test the hypothesis that older people who have a greater cognitive reserve will show a lower incidence of the development of cognitive impairment b) we will test the hypothesis that larger social networks may be protective in relation to the development of cognitive impairment c) we will investigate how longitudinal changes in measures of B12 deficiency and folate status impact on changes in cognition and upon discrete cognitive domains and examine how levels of these biochemical measures are related to cultural and lifestyle factors.

The effects of clear cut dementia on day-to-day function are well established, but the impact of milder levels of cognitive change on broader social and civic participation have not been evaluated, although these areas of function are increasingly valued by older people and encouraged by government policy. Using operational definitions of Mild Cognitive Impairment (MCI) developed from the CFAS studies, in this study we will test whether older people with MCI show lower levels of participation in such activities.