Episodic memory and executive function in familial longevity
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Successful aging, the ability to resist age-associated illnesses and functional disability, is of increasing importance as the population ages. Studies have shown that exceptionally long-lived individuals fit the successful aging paradigm by compressing disability toward the end of life. This study investigated whether there is evidence of successful cognitive aging in a familial longevity cohort, the Long Life Family Study (LLFS). Part 1 describes the feasibility of conducting a 2.5 hour neuropsychological battery emphasizing episodic memory and executive function, cognitive domains that elicit signs of cognitive dysfunction in relation to normal aging and dementia. The rationale for the selected tests is discussed within the context of minimizing effects from sensory impairments in an aged cohort and optimizing qualitative and quantitative data. In Part 2, the testing of 70 proband generation and 100 offspring generation LLFS participants and 140 generation-matched referent participants without familial longevity is described. Comparison of LLFS proband generation participants with their referent cohort revealed no significant differences in test scores. However, the referent cohort also had more years of education (an important exposure which is discussed in Part 3). LLFS offspring generation participants had borderline significant better performance on a test of executive function (Clock Drawing Test) and attention (Digits Forward) compared with referents. These findings suggest that familial longevity is associated with better cognitive function even at relatively young ages. Continuing to follow these cohorts to older ages may reveal differences in rate of change in cognitive function. Part 3 examines the role of indicators of cognitive reserve. In the proband generation education and participation in mid- and late-life cognitively stimulating activities were found to be higher in the referent cohort. This suggests that people without familial longevity may be more reliant on higher cognitive reserve in order to achieve similar cognitive performance to those from long-lived families. Implications of preserved cognitive function in long-lived families and the effect of cognitive reserve in those without familial longevity are discussed in terms of compression of disability and successful cognitive aging.