The mediational role of physical activity, social contact and stroke on the association between age, education, employment and dementia in an Asian older adult population

• Published in: BMC psychiatry Vol. 17; no. 1; p. 98
• Main Authors: Abdin, Edimansyah, Chong, Siow Ann, Peh, Chao Xu, Vaingankar, Janhavi Ajit, Chua, Boon Yiang, Verma, Swapna, Jeyagurunathan, Anitha, Shafie, Saleha, Subramaniam, Mythily
• Format: Journal Article
• Language: English
• Published: England BioMed Central 20.03.2017
• Subjects: Adults; Age; Aged; Aged, 80 and over; Aggression; Aging; Alzheimer Disease - diagnosis; Alzheimer Disease - epidemiology; Alzheimer Disease - ethnology; Alzheimer Disease - psychology; Alzheimer's disease; Asian Continental Ancestry Group - psychology; Asian Continental Ancestry Group - statistics & numerical data; Atrophy; Body mass; Body mass index; Brain research; Cardiovascular diseases; Cognitive ability; Data processing; Dementia; Dementia disorders; Diabetes; Diabetes mellitus; Education; Educational Status; Employment; Ethics; Ethnicity; Exercise; Female; Health risk assessment; Health Surveys; Humans; Hypertension; Interpersonal Relations; Lifestyles; Loneliness; Longevity; Male; Mental depression; Mental disorders; Middle Aged; Minority & ethnic groups; Neurodegenerative diseases; Older people; Physical activity; Physical fitness; Physical training; Population; Population studies; Psychiatry; Public health; Risk Factors; Singapore; Social interactions; Social organization; Sociodemographics; Statistics as Topic; Stroke; Stroke - diagnosis; Stroke - epidemiology; Stroke - psychology; Transient ischemic attack; Singapore; Moderator; Population-based; Stroke; Exercise; Social contact; Elderly; Mediation; Dementia
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-017-1272-8

Our study aimed to investigate the pathways by which socio-demographic factors, modifiable health and lifestyle risk factors influence each other, and subsequently, lead to dementia. We used data from the Well-being of the Singapore Elderly study, a nationally representative survey of the older adult population aged 60 years and above in Singapore. Dementia diagnosis was established using 10/66 dementia criteria. Structural equation modelling (SEM) without latent variable was applied to confirm the hypothesized model. The results of SEM supported the hypothesized model (χ = 14.999, df = 10, p = 0.132). The final model showed that those aged 75-84 years and 85 years and over (vs. 60-74 years), having no formal education, who had completed primary or secondary education (vs. completed tertiary), who were homemakers and retired (vs. paid work), and with a history of stroke were directly associated with higher odds of having dementia, while those who had more frequent contact with friends and neighbors as well as being physically active were directly associated with lower odds of having dementia diagnosis. The study also found that physical activity, more frequent contact with friends and stroke played a significant role as mediators in these relationships. The overall pathways model explained 57.7% of the variance in dementia. Our results suggest that physical activity, social contact and stroke were potential mediators in the relationship between age, education, employment and dementia. Intervention programmes focusing on physical activity such as exercise and social contact may be useful in reducing the risk of dementia among older adults.