Correlates of cognitive function in middle-aged adults

James R. Cerhan, Aaron R. Folsom, James A. Mortimer, Eval Shahar, David S. Knopman, Paul G. McGovern, Melissa A. Hays, Larry D. Crum, Gerardo Heiss

Research output: Contribution to journalArticlepeer-review

232 Scopus citations


The Atherosclerosis Risk in Communities Study administered cognitive function tests to more than 14,000 middle-aged adults in 1990-1992. The battery included the Delayed Word Recall test, the Digit Symbol Subtest of the Wechsler Adult Intelligence Scale-Revised, and the Controlled Oral Word Association (Word Fluency) test. Test performance was correlated positively with education level, negatively with age, was better in women than in men, and better in managers/professionals compared with other occupations. After controlling for these factors, race and community, the findings most consistent for both sexes were that Delayed Word Recall was negatively associated with depressive symptoms, diabetes, and fibrinogen level; the Digit Symbol Subtest was associated with marital status, negatively associated with depressive symptoms, smoking status, fibrinogen level, and carotid intima-media thickness, and positively associated with alcohol drinking and FEV1; and the Word Fluency test was positively associated with marital status, alcohol drinking, sports participation, and FEV1. Most of these cross-sectional results were in the predicted direction and have biologic plausibility, but mean differences between extreme categories were small (generally on the order of 0.1 to 0.2 of a standard deviation). Longitudinal study is warranted to evaluate whether small differences in middle-age lead to larger, clinically meaningful deficits with aging.

Original languageEnglish (US)
Pages (from-to)95-105
Number of pages11
Issue number2
StatePublished - 1998

Bibliographical note

Funding Information:
From the 1Copenhagen Centre for Prospective Population Studies (Copenhagen County Centre of Preventive Medicine, Copenhagen Male Study, and Copenhagen City Heart Study), Danish Epidemiology Science Centre at the Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen; and the 2Department of Gastroenterology, Division of Medical Gastroenterology, and Alcohol Unit, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark. Received May 16, 2001; accepted December 28, 2001. Supported by the Danish National Board of Health. The Copenhagen Centre for Prospective Population Studies is funded by The Danish National Research Council, and the Danish Epidemiology Science Centre is funded by the Danish National Research Foundation. Address reprint requests to: Ulrik Becker, M.D., Alcohol Unit 161, Hvidovre Hospital, DK 2650 Hvidovre, Denmark. E-mail:; fax: (45) 36-32-37-90. Copyright © 2002 by the American Association for the Study of Liver Diseases. 0270-9139/02/3504-0017$35.00/0 doi:10.1053/jhep.2002.32101


  • Cognition
  • Cognitive disorders
  • Dementia
  • Risk factors


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