在美国，老年人的健康相关生活质量 (HRQoL) 较低，先于痴呆症发生。我们探讨了英国中晚年成年人的 HRQoL 与痴呆症之间的前瞻性关联，此时优化认知衰老的干预措施可能会带来益处。 7,452 名社区居民参与者（57% 为女性；平均年龄 69.3±8.3 岁）参加了欧洲癌症前瞻性调查-诺福克研究的第三次健康检查 (3HC)，并使用简表 36 (SF-36) 报告了他们的 HRQoL。 Cox 比例风险回归模型探讨了基线身体成分 (PCS) 和心理成分总结 (MCS) 分数以及八个 SF-36 子量表（身体功能、角色身体、身体疼痛、一般健康状况）的标准差差异之间的关联、活力、社会功能、角色情绪、心理健康）以及十年内发生的痴呆症。逻辑回归模型探讨了 HRQoL 与客观整体认知功能之间 3HC 的横断面关系（n = 4435；不良认知 = 最低表现十分位数）。考虑到社会人口统计学和合并症，对队列进行整体检查并按年龄组（50-69，≥70）进行检查。较高的 MCS 分数与较低的痴呆发生率（风险比 [HR] = 0.74，95% CI 0.68-0.81）和较低的认知不良几率（比值比 [OR] = 0.82，0.76-0.89）相关，研究结果相似按年龄组。在整个队列中（HR = 0.93, 0.84-1.04）或考虑年龄组，较高的 PCS 分数与痴呆无关；并且仅与年轻参与者的认知能力差相关（OR = 0.81, 0.72-0.92）。同样，我们还观察到与精神（而非身体）HRQoL 相关的子量表得分较高与较低的痴呆症发病率之间存在关联。英国中老年成年人的精神 HRQoL 较低，先于痴呆症诊断。© 2023。作者。

Lower Health Related Quality of Life (HRQoL) precedes dementia in older adults in the USA. We explore prospective associations between HRQoL and dementia in British adults in mid and late-life, when interventions to optimise cognitive ageing may provide benefit. 7,452 community-dwelling participants (57% women; mean age 69.3 ± 8.3 years) attended the European Prospective Investigation of Cancer-Norfolk study's third health check (3HC) and reported their HRQoL using Short-Form 36 (SF-36). Cox Proportional Hazard regression models explored associations between standard deviation differences in baseline Physical Component (PCS) and Mental Component Summary (MCS) scores, as well as eight SF-36 sub-scales (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health), and incident dementia over ten years. Logistic regression models explored cross-sectional relationships at the 3HC between HRQoL and objective global cognitive function (n = 4435; poor cognition = lowest performance decile). The cohort was examined as a whole and by age-group (50-69, ≥ 70), considering socio-demographics and co-morbidity. Higher MCS scores were associated with lower chance of incident dementia (Hazard Ratio [HR] = 0.74, 95% CI 0.68-0.81) and lower odds of poor cognition (Odds Ratio [OR] = 0.82, 0.76-0.89), with findings similar by age-group. Higher PCS scores were not associated with dementia in the whole cohort (HR = 0.93, 0.84-1.04) or considering age-groups; and were only associated with poor cognition in younger participants (OR = 0.81, 0.72-0.92). Similarly, associations between higher scores on subscales pertaining to mental, but not physical, HRQoL and lower dementia incidence were observed. Lower mental HRQoL precedes dementia diagnosis in middle-aged and older British adults.© 2023. The Author(s).