Measuring cognitive performance in way that incorporates the concept of active and healthy ageing (AHA)

Influence of biopsychosocial factors on a functionally delayed ageing process

PURPOSE

Increasing life expectancy and rising populations create new challenges for science, economy, politics, society and each individual. The bio-functional status (BFS) as a theoretical model incorporates the International Classification of Functioning (ICF) and the concept of active and healthy ageing (AHA). This study addresses the question of which the strengths and resources have the greatest positive impact on bio-functional age (BFA) and might be influencable.

METHODS

A monocenter, cross-sectional, observational, non-interventional trial was performed from 2012 to 2014 at Inselspital Bern to evaluate the BFS, a complex, generic, non-invasive, sex- and age-validated assessment tool. A standardized battery of assessments was performed on 464 females and 166 males, aged 18 to 65 years (n = 630). We aimed to statistically identify BFS items that might be influenceable to support healthy ageing and vitality.

RESULTS

341 participants of the original cohort were included. After carrying out regression analysis, 10 parameters (T = 8.992; p < 0.001) remained as possible variables that can be influenced (R2 = 0.758). Of those identified parameters, one can be assigned to subcategory I of BFS (pulse performance index), two to II (tapping frequency part I and II), two to III (strategy building and verbal reaction time) and three to IV [sense of coherence, social potency, complaint questionnaire (BFB total)]. Age and sex, nevertheless, have an influence on the BFA and the BFA-Index.

CONCLUSION

The most promising approach to support vitality, is to support low social stress, high social integration, a good sense of coherence and maintaining a good mental and cognitive status.

Measuring Quality of Life: Incorporating Objectively Measurable Parameters within the Cross-Sectional Bern Cohort Study 2014 (BeCS-14)

Up until now, the measurement of Quality of Life (QoL) was based on validated subjective rating tools rather than objective measurement. To become more independent of the self-assessment of probands, a way to objectively measure QoL should be found. A monocenter, cross-sectional, observational, non-interventional trial was performed from 2012 to 2014 at Inselspital Bern to evaluate the bio-functional status (BFS), a complex, generic, non-invasive, sex- and age-validated assessment tool, in a wide range of areas. A standardized battery of assessments was performed on 464 females and 166 males, ages 18 to 65 (n = 630). In addition to the survey of the BFS, participants replied-among others-to the validated questionnaire SF-36 for health-related QoL (n = 447, subgroup 1). Since the accepted cut-off value for BFA calculation is age ≥ 35 years, subgroup 2 included 227 subjects (all participants aged ≥ 35 years out of subgroup 1). In order to be able to compare the eight SF-36 subscales to BFS parameters, a comparable score set of single BFS items had to be constructed. Subsequently, we aimed to statistically identify BFS item combinations that best represented each SF-36 subscale. All eight SF-36 subscales were significantly represented by various different combinations of BFS items. A total of 24 single BFS items significantly correlated with SF-36 subscales, of which 15 were objective and nine were subjective. All eight SF-36 subscales were significantly represented by various different combinations of BFS items leading to stronger correlations (range five to nine BFS items), and overall, sex and age did not affect these associations, but in the SF-36 subscales 'bodily pain' (sex) and 'role limitations due to physical health problems' (age in men). To our knowledge, we are the first to correlate a validated set of 34 objective and 9 subjective parameters with subjectively evaluated SF-36 subscales. This first study on the objectifiability of the SF-36 questionnaire demonstrated that questions on quality of life can be answered independently of a subjective assessment by subjects in future scientific studies.

Impact of chronic stress exposure on cognitive performance incorporating the active and healthy aging (AHA) concept within the cross-sectional Bern Cohort Study 2014 (BeCS-14)

Purpose

This study aims to verify that the mental-cognitive domain of the validated generic bio-functional status (BFS)/bio-functional age (BFA) assessment tool, incorporating the concept of Active and Healthy Ageing (AHA), reflects cognitive performance. In addition, the effects of chronic stress exposure on the mental-cognitive BFS/BFA should be investigated.

Methods

The study was carried out as a monocenter, cross-sectional, observational, non-interventional trial (Bern Cohort Study 2014, BeCS-14) with the participation of 147 non-pediatric, non-geriatric subjects. All participants followed a standardized battery of biopsychosocial assessments consisting of BFS/BFA, a validated cognitive performance test battery (Inventar zur Gedächtnisdiagnostik; IGD) and a validated questionnaire for the assessment of chronic stress (Trier Inventory for the assessment of Chronic Stress; TICS), respectively.

Results

Mean cognitive performance was average and higher in younger or better educated individuals. The BFA of the participants was 7.8 ± 7.8 year-equivalents below their chronological age. The mental-cognitive BFS/BFA assessment correlated well with the validated questionnaire for cognition assessment, the IGD. Further, three TICS subdomains (work overload (r =  − 0.246, p = 0.003), work discontent (r =  − 0.299, p = 0.006) and pressure to succeed (r =  − 0.274, p < 0.001)), reflecting mainly work-related stress, showed a significant negative correlation with the mental-cognitive BFS/BFA.

Conclusions

Our study shows that the BFS/BFA assessment tool follows European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) requirements. Further, we could demonstrate that higher levels of chronic work-related stress may be associated with poorer mental-cognitive performance and a pro-aging state indicating that cognitive impairments can be reduced by stress management interventions.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00404-021-06289-z.