Effects of demographic and lifestyle factors on cognitive speed, attention and executive function measured by the Trail Making Tests A and B in healthy adults

Abstract

Introduction: The Swedish CArdioPulmonarybioImage Study (SCAPIS) implements the use of new imaging technologies, advances in large-scale ‘omics’ and epidemiological analyses to widely characterize a cohort of 30 000 healthy women and men. The collected data are used to improve risk prediction of cardiopulmonary diseases and improve the ability to study disease mechanisms. The study includes data from the Trail Making Test (TMT) A and B, used to evaluate cognitive speed, attention and executive function, i.e. cognitive functions often impaired in patients with vascular cognitive diseases. In addition, the study collects demographic and lifestyle variables such as education, employment, marital status, body mass index (BMI) and smoking status. In this first substudy, we explored how demographic and lifestyle variables affected the cognitive functions measured by TMT-A and B. Methods: In total, there were TMT data for 4821 patients; 2295 men and 2526 women, both with an average age of 57 years. Times to complete TMT-A and TMT-B, as well as the numbers of errors made during the tests, were compared between the participants, when stratified for different demographic and lifestyle variables. Moreover, survival analyses, as a measure of how different variables affected the time to complete the tests, were performed by Kaplan Meier estimation. Results: Women completed the tests faster than men, but there were no differences in number of errors. The average times of finishing both tests were also significantly different between participants stratified for marital status, unemployment and years of education. In the survival analysis, we found that age, sex and BMI affected the completion times for both tests, while education, unemployment and depressive symptoms did not affect time to complete the two tests. Smoking status and hip circumference both affected the time to complete TMT-A, but not TMT-B. Discussion: In this large study of healthy individuals, we found that both demographic and lifestyle variables impacted cognitive speed, attention and executive functions measured by TMT-A and B. In the future, the data will help guide preventive measures to protect these cognitive functions, both in healthy individuals and in persons with increased risks of cardiovascular diseases.