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Trajectories of cognitive function and their determinants in older people: 12 years of follow-up in the Chinese Longitudinal Healthy Longevity Survey

Published online by Cambridge University Press:  27 April 2020

Lihui Tu ,
Xiaozhen Lv ,
Changzheng Yuan ,
Ming Zhang ,
Zili Fan ,
Xiaolin Xu ,
Yi Zeng ,
Xin Yu  and
Huali Wang Open the ORCID record for Huali Wang [Opens in a new window]
Lihui Tu
Affiliation:
Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
Xiaozhen Lv
Affiliation:
Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
Changzheng Yuan
Affiliation:
School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Ming Zhang
Affiliation:
Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Zili Fan
Affiliation:
Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
Xiaolin Xu
Affiliation:
School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China Center for Longitudinal and Lifecourse Epidemiology, School of Public Health, The University of Queensland, Brisbane, QLD, Australia
Yi Zeng
Affiliation:
Center for the Study of Aging and Human Development, Medical School of Duke University, Durham, NC, USA Center for Healthy Aging and Development Studies, National School of Development, Raissun Institute for Advanced Studies, Peking University, Beijing, China
Xin Yu*
Affiliation:
Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
Huali Wang*
Affiliation:
Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
*
*Correspondence should be addressed to: Dr. Huali Wang, Dementia Care and Research Center, Peking University Institute of Mental Health, No. 51 Huayuanbei Road, Haidian District, Beijing100191, China. Phone: +86-10-82801983. Fax: +86-10-62011769. Email: huali_wang@bjmu.edu.cn or Dr. Xin Yu, Beijing Dementia Key Lab, Peking University Institute of Mental Health, Beijing, China. Phone: +86-10-82801999. Fax: +86-10-62026310. Email: yuxin@bjmu.edu.cn.
*Correspondence should be addressed to: Dr. Huali Wang, Dementia Care and Research Center, Peking University Institute of Mental Health, No. 51 Huayuanbei Road, Haidian District, Beijing100191, China. Phone: +86-10-82801983. Fax: +86-10-62011769. Email: huali_wang@bjmu.edu.cn or Dr. Xin Yu, Beijing Dementia Key Lab, Peking University Institute of Mental Health, Beijing, China. Phone: +86-10-82801999. Fax: +86-10-62026310. Email: yuxin@bjmu.edu.cn.
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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.

Keywords

cognitive functiongroup-based trajectory modellongitudinalChinese Longitudinal Healthy Longevity Surveyrisk factors
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 6: Issue Theme: Interaction of Depression and Cognition in Older Age , June 2020 , pp. 765 - 775
Copyright
© International Psychogeriatric Association 2020

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Footnotes

#

These authors have contributed equally to this work.

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