title: Age, vascular risk, and cognitive decline in an older, British, African-Caribbean population.
abstract: OBJECTIVE
  To investigate associations between baseline factors and subsequent cognitive decline in an older African-Caribbean population.
  
  
  METHODS
  Three-year follow-up of a community sample.
  
  
  METHODS
  Registration lists for seven primary care services in south London, United Kingdom.
  
  
  METHODS
  Of 290 Caribbean-born people aged 55 to 75 recruited at baseline, 216 (75%) were reinterviewed after a 3-year period. Sufficient data for analysis were present for 207.
  
  
  METHODS
  Tests of verbal memory (immediate and delayed), orientation, and attention were administered at baseline and at 3 years. A composite measure of cognitive change was derived through factor analysis. Participants in the lowest quintile were defined as having cognitive decline and were compared with the rest of the sample with respect to baseline characteristics.
  
  
  RESULTS
  Cognitive decline was strongly associated with increased age, but not with sex, education, or occupation. It was also not directly associated with hypertension, diabetes mellitus, or exercise, but the age-decline association was significantly stronger in people with diabetes mellitus and was lower in those reporting vigorous physical exercise at baseline. When cognitive decline was investigated separately for individual tests, both these patterns of association were particularly strong for decline in delayed verbal recall.
  
  
  CONCLUSIONS
  The association between increased age and cognitive decline, particularly decline in verbal recall, was stronger in people with diabetes mellitus (but not hypertension) and weaker in people who were more physically active.
authors.affiliation: Section of Epidemiology, Institute of Psychiatry, London, United Kingdom. r.stewart@iop.kcl.ac.uk
authors.forename: Robert
authors.initials: R
authors.lastname: Stewart
authors.forename: Martin
authors.initials: M
authors.lastname: Prince
authors.forename: Anthony
authors.initials: A
authors.lastname: Mann
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D044383:Black People; D017691:Caribbean Region / Q000208:ethnology; D003072:Cognition Disorders / Q000175:diagnosis / Q000208:ethnology*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000208:ethnology*; D008131:London; D008297:Male; D008875:Middle Aged