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Risk and protective factors against cognitive decline in older adults from a nationally representative sample in India: Results from the LASI-DAD

Gross, A. L.; Nichols, E.; Arce Renteria, M.; Khobragade, P. Y.; Meijer, E.; Petrosyan, S.; Varghese, M.; Weerman, A.; Hu, P.; Banerjee, J.; Chien, S.; Angrisani, M.; Dhankhar, A.; Vishwakarrma, H.; Ali, I.; Zhou, Z.; Aravindakshan, R.; Chakrabarti, S. S.; Das, M. P.; De, K.; Dhar, M.; Dewangan, G. C.; Gupta, M.; Khan, U. H.; Jain, V.; John, J. P.; Kirti, R.; Kokane, A.; Lehl, S. S.; Mohanty, R. R.; Pandit, V.; Rajguru, C.; Sahoo, D. P.; Sankhe, L.; Sukumar, M.; Talukdar, A.; Gunasekaran, V.; Sekher, T. V.; Bloom, D. E.; Langa, K. M.; Sivakumar, P. T.; Ganguli, M.; Crimmins, E. M.; Dey, S.; De

2025-07-10 epidemiology
10.1101/2025.07.07.25331027 medRxiv
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INTRODUCTIONWe characterized modifiable risk and protective factors for cognitive decline in India. METHODSUsing the first nationally representative population-based longitudinal sample of N=6,168 older adults in India, we evaluated associations of risk factors (demographic characteristics, self-reported and objective health characteristics, health behaviors, and sensory function) for late-life cognitive decline with up to 6.4 years of follow-up (range: 2.8 to 6.4 years). RESULTSThe mean rate of general cognitive decline was -0.029 SD per year, and was progressively steeper with age. Most risk factors, particularly demographic and cardiovascular characteristics, were associated with steeper cognitive decline in expected directions: associations of history of high cholesterol or heart attack on rate of cognitive decline, for example, were comparable to being 11-12 years older. DISCUSSIONMost risk factors were associated with change in expected directions, highlighting the potential generalizability to India of previously identified risk factors for dementia.

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