Lihui Tu1,2, Xiaozhen Lv1,2, Changzheng Yuan3,4, Ming Zhang1,2,5, Zili Fan1,2, Xiaolin Xu3,6, Yi Zeng7,8, Xin Yu1,2, Huali Wang1,2. 1. Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China. 2. Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China. 3. School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China. 4. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 5. Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 6. Center for Longitudinal and Lifecourse Epidemiology, School of Public Health, The University of Queensland, Brisbane, QLD, Australia. 7. Center for the Study of Aging and Human Development, Medical School of Duke University, Durham, NC, USA. 8. Center for Healthy Aging and Development Studies, National School of Development, Raissun Institute for Advanced Studies, Peking University, Beijing, China.
Abstract
BACKGROUND: Cognitive decline in advanced age is closely related to dementia. The trajectory of cognitive function in older Chinese is yet to be fully investigated. We aimed to investigate the trajectories of cognitive function in a nationally representative sample of older people living in China and to explore the potential determinants of these trajectories. METHODS: This study included 2,038 cognitively healthy persons aged 65-104 years at their first observation in the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2014. Cognitive function was measured using the Chinese version of the Mini-Mental State Examination (MMSE). Group-based trajectory modeling was used to identify potential heterogeneity of longitudinal changes over the 12 years and to investigate associations between baseline predictors of group membership and these trajectories. RESULTS: Three trajectories were identified according to the following types of changes in MMSE scores: slow decline (14.0%), rapid decline (4.5%), and stable function (81.5%). Older age, female gender, having no schooling, a low frequency of leisure activity, and a low baseline MMSE score were associated with the slow decline trajectory. Older age, body mass index (BMI) less than 18.5 kg/m2, and having more than one cardiovascular disease (CVD) were associated with the rapid decline trajectory. CONCLUSION: Three trajectories of cognitive function were identified in the older Chinese population. The identified determinants of these trajectories could be targeted for developing prevention and intervention strategies for dementia.
BACKGROUND:Cognitive decline in advanced age is closely related to dementia. The trajectory of cognitive function in older Chinese is yet to be fully investigated. We aimed to investigate the trajectories of cognitive function in a nationally representative sample of older people living in China and to explore the potential determinants of these trajectories. METHODS: This study included 2,038 cognitively healthy persons aged 65-104 years at their first observation in the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2014. Cognitive function was measured using the Chinese version of the Mini-Mental State Examination (MMSE). Group-based trajectory modeling was used to identify potential heterogeneity of longitudinal changes over the 12 years and to investigate associations between baseline predictors of group membership and these trajectories. RESULTS: Three trajectories were identified according to the following types of changes in MMSE scores: slow decline (14.0%), rapid decline (4.5%), and stable function (81.5%). Older age, female gender, having no schooling, a low frequency of leisure activity, and a low baseline MMSE score were associated with the slow decline trajectory. Older age, body mass index (BMI) less than 18.5 kg/m2, and having more than one cardiovascular disease (CVD) were associated with the rapid decline trajectory. CONCLUSION: Three trajectories of cognitive function were identified in the older Chinese population. The identified determinants of these trajectories could be targeted for developing prevention and intervention strategies for dementia.