Skip to main content
    • Aa
    • Aa

The association of cognitive performance with mental health and physical functioning strengthens with age: the Whitehall II cohort study

  • M. Jokela (a1) (a2), A. Singh-Manoux (a1) (a3), J. E. Ferrie (a1), D. Gimeno (a1) (a4), T. N. Akbaraly (a1) (a5), M. J. Shipley (a1), J. Head (a1), M. Elovainio (a1) (a6), M. G. Marmot (a1) and M. Kivimäki (a1) (a7)...

Cognitive performance has been associated with mental and physical health, but it is unknown whether the strength of these associations changes with ageing and with age-related social transitions, such as retirement. We examined whether cognitive performance predicted mental and physical health from midlife to early old age.


Participants were 5414 men and 2278 women from the Whitehall II cohort study followed for 15 years between 1991 and 2006. The age range included over the follow-up was from 40 to 75 years. Mental health and physical functioning were measured six times using SF-36 subscales. Cognitive performance was assessed three times using five cognitive tests assessing verbal and numerical reasoning, verbal memory, and phonemic and semantic fluency. Socio-economic status (SES) and retirement were included as covariates.


High cognitive performance was associated with better mental health and physical functioning. Mental health differences associated with cognitive performance widened with age from 39 to 76 years of age, whereas physical functioning differences widened only between 39 and 60 years and not after 60 years of age. SES explained part of the widening differences in mental health and physical functioning before age 60. Cognitive performance was more strongly associated with mental health in retired than non-retired participants, which contributed to the widening differences after 60 years of age.


The strength of cognitive performance in predicting mental and physical health may increase from midlife to early old age, and these changes may be related to SES and age-related transitions, such as retirement.

Corresponding author
*Address for correspondence: Dr M. Jokela, Department of Psychology, University of Helsinki, PO Box 9, FIN-00014, Finland. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

GD Batty , IJ Deary , LS Gottfredson (2007 a). Premorbid (early life) IQ and later mortality risk: systematic review. Annals of Epidemiology 17, 278288.

GD Batty , IJ Deary , I Schoon , CR Gale (2007 c). Mental ability across childhood in relation to risk factors for premature mortality in adult life: the 1970 British Cohort Study. Journal of Epidemiology and Community Health 61, 997–1003.

GD Batty , MJ Shipley , LH Mortensen , SH Boyle , J Barefoot , M Grønbaek , CR Gale , IJ Deary (2008). IQ in late adolescence/early adulthood, risk factors in middle age and later all-cause mortality in men: the Vietnam Experience Study. Journal of Epidemiology and Community Health 62, 522531.

T Chandola , J Ferrie , A Sacker , M Marmot (2007). Social inequalities in self reported health in early old age: follow-up of prospective cohort study. British Medical Journal 334, 990.

J Chodosh , DM Kado , TE Seeman , AS Karlamangla (2007). Depressive symptoms as a predictor of cognitive decline: MacArthur Studies of Successful Aging. American Journal of Geriatric Psychiatry 15, 406415.

IJ Deary , GD Batty (2007). Cognitive epidemiology. Journal of Epidemiology and Community Health 61, 378384.

VM Dotson , SM Resnick , AB Zonderman (2008). Differential association of concurrent, baseline, and average depressive symptoms with cognitive decline in older adults. American Journal of Geriatric Psychiatry 16, 318330.

LS Gottfredson (2004). Intelligence: is it the epidemiologists' elusive ‘fundamental cause’ of social class inequalities in health? Journal of Personality and Social Psychology 86, 174199.

LS Gottfredson , IJ Deary (2004). Intelligence predicts health and longevity, but why? Current Directions in Psychological Science 13, 14.

CL Hart , MD Taylor , G Davey Smith , LJ Whalley , JM Starr , DJ Hole , V Wilson , IJ Deary (2003). Childhood IQ, social class, deprivation, and their relationships with mortality and morbidity risk in later life: prospective observational study linking the Scottish Mental Survey 1932 and the Midspan studies. Psychosomatic Medicine 65, 877883.

CL Hart , MD Taylor , GD Smith , LJ Whalley , JM Starr , DJ Hole , V Wilson , IJ Deary (2004). Childhood IQ and cardiovascular disease in adulthood: prospective observational study linking the Scottish Mental Survey 1932 and the Midspan studies. Social Science and Medicine 59, 21312138.

M Jokela , GD Batty , IJ Deary , CR Gale , M Kivimäki (2009 a). Childhood IQ and early mortality: assessing the role of childhood and adult risk factors in the 1958 British birth cohort. Pediatrics. Published online 10 August 2009. doi:10.1542/peds.2008-1536.

JE Kim , P Moen (2001). Is retirement good or bad for subjective well-being? Current Directions in Psychological Science 10, 8386.

M Kumari , T Seeman , M Marmot (2004). Biological predictors of change in functioning in the Whitehall II study. Annals of Epidemiology 14, 250257.

MG Marmot , G Davey Smith , S Stansfeld , C Patel , F North , J Head , I White , E Brunner , A Feeney (1991). Health inequalities among British civil servants: the Whitehall II study. Lancet 337, 13871393.

LT Martin , LD Kubzansky , KZ LeWinn , LP Lipsitt , P Satz , SL Buka (2007). Childhood cognitive performance and risk of generalized anxiety disorder. International Journal of Epidemiology 36, 769775.

G Mein , P Martikainen , H Hemingway , S Stansfeld , M Marmot (2003). Is retirement good or bad for mental and physical health functioning? Whitehall II longitudinal study of civil servants. Journal of Epidemiology and Community Health 57, 4649.

EN Naumova , A Must , NM Laird (2001). Tutorial in biostatistics: evaluating the impact of ‘critical periods’ in longitudinal studies of growth using piecewise mixed effects models. International Journal of Epidemiology 30, 13321341.

A Sacker , P Clarke , RD Wiggins , M Bartley (2005). Social dynamics of health inequalities: a growth curve analysis of aging and self assessed health in the British household panel survey 1991–2001. Journal of Epidemiology and Community Health 59, 495501.

J Schnittker (2005). Cognitive abilities and self-rated health: is there a relationship? Is it growing? Does it explain disparities? Social Science Research 34, 821842.

JB Singer , JB Willett (2003). Applied Longitudinal Data Analysis: Modeling Change and Event Occurrence. Oxford University Press: Oxford.

A Singh-Manoux , JE Ferrie , JW Lynch , M Marmot (2005). The role of cognitive ability (intelligence) in explaining the association between socioeconomic position and health: evidence from the Whitehall II prospective cohort study. American Journal of Epidemiology 161, 831839.

A Singh-Manoux , M Marmot (2005). High blood pressure was associated with cognitive function in middle-age in the Whitehall II study. Journal of Clinical Epidemiology 58, 13081315.

T Strenze (2007). Intelligence and socioeconomic success: a meta-analytic review of longitudinal research. Intelligence 35, 401426.

LJ Whalley , IJ Deary (2001). Longitudinal cohort study of childhood IQ and survival up to age 76. British Medical Journal 322, 819.

K Yaffe , T Blackwell , R Gore , L Sands , V Reus , WS Browner (1999). Depressive symptoms and cognitive decline in nondemented elderly women: a prospective study. Archives of General Psychiatry 56, 425430.

S Zammit , P Allebeck , AS David , C Dalman , T Hemmingsson , I Lundberg , G Lewis (2004). A longitudinal study of premorbid IQ score and risk of developing schizophrenia, bipolar disorder, severe depression, and other nonaffective psychoses. Archives of General Psychiatry 61, 354360.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 1
Total number of PDF views: 17 *
Loading metrics...

Abstract views

Total abstract views: 161 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 20th September 2017. This data will be updated every 24 hours.