scholarly journals Association between anemia and cognitive decline among Chinese middle-aged and elderly: evidence from the China health and retirement longitudinal study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Tingting Qin ◽  
Mingming Yan ◽  
Zhen Fu ◽  
Yating Song ◽  
Wanrong Lu ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Cognitive Functions ◽  
Hemoglobin Concentration ◽  
Cognitive Test ◽  
Middle Aged ◽  
Cross Sectional ◽  
Global Cognitive Function

Abstract Background Our objective was to characterize the relationship of anemia and hemoglobin concentrations with cross-sectional cognitive functions and changes in cognitive functions over 2 years in a large sample of Chinese middle aged and elderly. Methods Ten thousand nine hundred eighteen adults aged 45 years or older participating in the China Health and Retirement Longitudinal Study (CHARLS) were used for cross-sectional analyses and 9324 were used for longitudinal analysis. Cognitive functions were assessed by memory recall (episodic memory), mental status (TICS), and global cognitive function at baseline survey (Visit 1) and first follow-up survey (Visit 2). The lower the cognitive test score, the worse the cognitive function. Anemia was defined as hemoglobin concentrations lower than 13 g/dl for men and lower than 12 g/dl for women. Adjusted multivariate regression analyses were used to explore the relationships of different cognitive domains with anemia and hemoglobin concentration. Results Overall, the prevalence of anemia was 12.86% and the mean hemoglobin concentration was 14.37 ± 2.20 g/dl. After adjusting for socio-demographic and health-related covariates, the cross-sectional association between anemia and global cognitive function [β (95%CI) = − 0.49(− 0.69~ − 0.29)], episodic memory [β (95%CI) = − 0.14(− 0.23~ − 0.05)], and TICS [β (95%CI) = − 0.23(− 0.38~ − 0.08)] were significant and did not differ by gender. The hemoglobin concentration was also associated with global cognitive function among the whole sample (P < 0.05 for all). The longitudinal analyses showed global cognitive function and episodic memory were associated with anemia independent of covariates (P < 0.05 for all). Sensitivity analyses further provided significant results showing the association between anemia and cognition decline (P < 0.05). Conclusion There was a cross-sectional and longitudinal association between anemia and accelerated decline in cognitive functions in Chinese middle-aged and elderly. This suggests that anemia and low hemoglobin concentrations are independent risk factors of cognitive decline.

scholarly journals Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study

2021 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Social Isolation ◽  
Mental Status ◽  
Chinese Older Adults ◽  
Confounding Variables

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.

scholarly journals Impact of secondhand smoke exposure on cognitive function among middle-aged and older women in China: findings from three waves of the China Health and Retirement Longitudinal Study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039824
Author(s):  
Anying Bai ◽  
Yinzi Jin ◽  
Yangmu Huang
Keyword(s):  
Longitudinal Study ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Secondhand Smoke ◽  
Chinese Women ◽  
Memory Function ◽  
Pooled Analysis ◽  
Visuospatial Ability ◽  
Global Cognitive Function ◽  
Normal Cognitive Function

ObjectivesTo examine the association between secondhand smoke (SSH) and women’s global cognitive function and cognitive subdomains.DesignCohort study.ParticipantsData for this study were obtained from the China Health and Retirement Longitudinal Study (2011-2013-2015), and pooled analysis was applied to wave 1 and wave 2 (2011–2013), wave 2 and wave 3 (2013–2015) and wave 1 and wave 3 (2011–2015). Data from a total of 6875 Chinese women with normal cognitive function at baseline were selected for analysis, including 2981 who were interviewed in 2011, 2471 in 2013, and 1894 in 2015.Main outcome measures and methodsSHS was classified based on the number of exposed years (<25 years, ≥25 years to <30 years, ≥30 years to <40 years, ≥40 years). Global cognitive function, visuospatial ability, orientation and attention, and episodic memory function were used as measures of cognitive function. Three waves of data were pooled using a dummy variable to differentiate between 2-year and 4-year groups. LDV models were used to examine independent associations between SHS and cognitive function. Demographic factors, socioeconomic factors, baseline cognitive functioning and health conditions were controlled for in our models.ResultsSSH was found to be inversely and significantly associated with cognitive function. Compared with those who had not been exposed to household SSH, women who had lived with a smoking husband had a significantly faster cognition decline, especially in global cognitive function (β=−0.33, 95% CI=−0.66 to −0.01, p<0.01), visuospatial ability (β=−0.04, 95% CI=−0.08 to −0.01, p<0.05) and episodic memory function (β=−0.16, 95% CI=−0.31 to −0.01, p=0.031).ConclusionsHousehold SSH exposure for more than 40 years was associated with a more significant decline in global cognitive function, visuospatial ability and episodic memory function, but not in orientation and attention function among older Chinese women.

scholarly journals Food Insecurity and Cognitive Function in Middle to Older Adulthood: A Systematic Review

2019 ◽  
Vol 11 (3) ◽  
pp. 667-676 ◽  
Author(s):  
Muzi Na ◽  
Nan Dou ◽  
Naiwen Ji ◽  
Dixin Xie ◽  
Jie Huang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Function ◽  
Food Insecurity ◽  
Cognitive Functions ◽  
Data Extraction ◽  
Controlled Trial ◽  
Later Life ◽  
Cross Sectional ◽  
Older Adulthood ◽  
Global Cognitive Function

ABSTRACT Food insecurity (FI) may limit cognitive functioning during aging. The goal of this systematic review was to summarize existing evidence linking FI and general or specific cognitive functions in middle and older adulthood. A systematic search of human studies published between 1 January 2000 and 30 April 2018 was conducted in PubMed, PsycINFO, and CAB Direct. Four independent reviewers assessed the eligibility of identified articles and conducted data extraction and data quality assessment. Ten studies were included in the review, including 1 cluster-randomized controlled trial, 2 longitudinal studies, and 7 cross-sectional studies. Three studies reported the association between early-life FI experience and a global cognitive function measure. Nine studies reported later-life FI experience in relation to global or specific cognitive functions. The results suggest an adverse association between FI experienced in early or later life and global cognitive function; and between later-life FI and executive function and memory. Findings from the review are preliminary because of sparse data, heterogeneity across study populations, exposure and outcome assessments, and potential risk of bias across studies. Future studies are recommended to better understand the role of FI in cognitive function, with the goal of identifying possible critical windows for correction of FI in vulnerable subpopulations to prevent neurocognitive deficit in adulthood.

scholarly journals Positive Psychosocial Factors and Cognitive Decline in Ethnically Diverse Older Adults

2020 ◽  
pp. 1-10
Author(s):  
Laura B. Zahodne ◽  
Neika Sharifian ◽  
Ann Zarina Kraal ◽  
Ketlyne Sol ◽  
Afsara B. Zaheed ◽  
...  
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Ethnic Groups ◽  
Psychosocial Factors ◽  
Disease Risk ◽  
Late Life ◽  
Cross Sectional ◽  
Standard Deviation Increase

Abstract Objectives: Previous cross-sectional studies have documented associations between positive psychosocial factors, such as self-efficacy and emotional support, and late-life cognition. Further, the magnitudes of concurrent associations may differ across racial and ethnic groups that differ in Alzheimer’s disease risk. The goals of this longitudinal study were to characterize prospective associations between positive psychosocial factors and cognitive decline and explicitly test for differential impact across race and ethnicity. Methods: 578 older adults (42% non-Hispanic Black, 31% non-Hispanic White, and 28% Hispanic) in the Washington Heights-Inwood Columbia Aging Project completed cognitive and psychosocial measures from the NIH Toolbox and standard neuropsychological tests over 2.4 years. Latent difference scores were used to model associations between positive psychosocial factors and cognitive decline controlling for baseline cognition, sociodemographics, depressive symptoms, physical health, and other positive psychosocial factors. Multiple-group modeling was used to test interactions between the positive psychosocial factors and race/ethnicity. Results: Higher NIH Toolbox Friendship scores predicted less episodic memory decline. One standard deviation increase in friendship corresponded to 6 fewer years of memory aging. This association did not significantly differ across racial/ethnic groups. Conclusions: This longitudinal study provides support for the potential importance of friendships for subsequent episodic memory trajectories among older adults from three ethnic groups. Further study into culturally informed interventions is needed to investigate whether and how friend networks may be targeted to promote cognitive health in late life.

scholarly journals The cross-sectional association between mean corpuscular volume level and cognitive function in Chinese over 45 years old: Evidence from the China Health and Retirement Longitudinal Study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243227
Author(s):  
Yao Chen ◽  
Chen’Xi’ Nan Ma ◽  
Lan Luo ◽  
Jieyun Yin ◽  
Zhan Gao ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Mental Status ◽  
Mean Corpuscular Volume ◽  
Corpuscular Volume ◽  
Cross Sectional ◽  
Global Cognitive Function ◽  
Male Subjects

Fewer studies have focused on the independent association between mean corpuscular volume (MCV) and cognitive performance. This study was designed to characterize the cross-sectional association between MCV and cognitive performance in a large sample of Chinese residents (age≥45 years) from the China Health and Retirement Longitudinal Study (CHARLS). A total of 4023 male and 4173 female adults with MCV ≥ 80 fl were included for analysis. By multivariable linear regression analysis, for the total subjects, MCV level was significantly negatively associated with global cognitive function and episodic memory. When adjusted by sex, only in male subjects, higher MCV level was associated with reduced scores for global cognitive function, episodic memory and mental status. Via binary logistic regression analysis, the higher MCV level (MCV>100 fl) was associated with poor global cognitive function (OR = 1.601; 95% CI = 1.198–2.139; p = 0.001), episodic memory (OR = 1.679; 95% CI = 1.281–2.201; p<0.001), and mental status (OR = 1.422; 95% CI = 1.032–1.959; p = 0.031) for the whole participants. When testing this association by sex, the significant relationship between higher MCV level with worse episodic memory was observed both in male (OR = 1.690; 95% CI = 1.211–2.358; p = 0.002) and female (OR = 1.729; 95% CI = 1.079–2.770; p = 0.023) subjects; while the association between higher MCV level and poor global cognitive function (OR = 1.885; 95% CI = 1.329, 2.675; p<0.001) and mental status (OR = 1.544; 95% CI = 1.034, 2.306; p = 0.034) only existed in male subjects. Further studies are warranted to clarify the association between MCV level and cognitive performance by considering sex into consideration both cross-sectionally and longitudinally.

Plasma concentrations of vitamin B12 and folate and global cognitive function in an older population: cross-sectional findings from The Irish Longitudinal Study on Ageing (TILDA)

2020 ◽  
Vol 124 (6) ◽  
pp. 602-610 ◽  
Author(s):  
Deirdre M. A. O’Connor ◽  
Eamon J. Laird ◽  
Daniel Carey ◽  
Aisling M. O’Halloran ◽  
Robert Clarke ◽  
...  
Keyword(s):  
Older Adults ◽  
Folic Acid ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Cognitive Performance ◽  
Vitamin B ◽  
Plasma Vitamin ◽  
Cross Sectional ◽  
Folate Status ◽  
Global Cognitive Function

AbstractThe uncertainty surrounding high intakes of folic acid and associations with cognitive decline in older adults with low vitamin B12 status has been an obstacle to mandatory folic acid fortification for many years. We estimated the prevalence of combinations of low/normal/high vitamin B12 and folate status and compared associations with global cognitive function using two approaches, of individuals in a population-based study of those aged ≥50 years in the Republic of Ireland. Cross-sectional data from 3781 men and women from Wave 1 of The Irish Longitudinal Study on Ageing were analysed. Global cognitive function was assessed by the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Prevalence estimates for combinations of vitamin B12 (plasma vitamin B12 < or ≥258 pmol/l) and folate (plasma folate ≤ or >45·3 nmol/l) concentrations were generated. Negative binomial regression models were used to investigate the associations of vitamin B12 and folate status with global cognitive function. Of the participants, 1·5 % (n 51) had low vitamin B12 (<258 pmol/l) and high folate (>45·3 nmol/l) status. Global cognitive performance was not significantly reduced in these individuals when compared with those with normal status for both B-vitamins (n 2433). Those with normal vitamin B12/high folate status (7·6 %) had better cognitive performance (MMSE: incidence rate ratio (IRR) 0·82, 95 % CI 0·68, 0·99; P = 0·043, MoCA: IRR 0·89, 95 % CI 0·80, 0·99; P = 0·025). We demonstrated that high folate status was not associated with lower cognitive scores in older adults with low vitamin B12 status. These findings provide important safety information that could guide fortification policy recommendations in Europe.

scholarly journals Cognitive decline associated with anticholinergics, benzodiazepines, and Z-drugs: findings from The Irish Longitudinal Study on Ageing (TILDA)

2020 ◽  
Author(s):  
Frank Moriarty ◽  
George M Savva ◽  
Carlota M Grossi ◽  
Kathleen Bennett ◽  
Chris Fox ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Medication Use ◽  
Community Dwelling ◽  
Word Recall ◽  
Middle Aged ◽  
Anticholinergic Medications ◽  
Pharmacy Claims ◽  
Burden Scale

Aim To estimate the association between patterns of anticholinergic, benzodiazepine, and Z-drug medication use and change in cognitive function in middle-aged and older adults. Method This prospective cohort study used data from the first three waves of The Irish Longitudinal Study on Ageing (TILDA), including community-dwelling adults aged ≥50 years followed for up to four years (n=7,027). Cognitive function was assessed using the Mini Mental State Examination, animal naming test, and word recall tests. Regular medication use was self-reported at baseline and follow-up interviews at two and four years. Pharmacy dispensing claims for a subset (n=2,905) allowed assessment of medication use between interviews and cumulative dosage. Medication use at consecutive waves of TILDA was analysed in relation to change in cognitive function between waves. Results Strongly anticholinergic medications (Anticholinergic Cognitive Burden scale 3), benzodiazepines, and Z-drugs were reported by 7.3%, 5.8% and 5.1% of participants respectively at any time during the study. Adjusting for potential confounders, new anticholinergic use between interviews was associated with change in recall score (-1.09, 95% confidence interval -1.64, -0.53) over 2 years compared to non-use, but not with MMSE (0.07; 95%CI -0.21, 0.34) or animal naming (-0.70; -1.43, 0.03). The pharmacy claims analysis was consistent with this finding. Other hypothesised associations were not supported. Discussion Except for new use of anticholinergic medications, no other findings supported a risk of cognitive decline over 2-year periods in this middle-aged and older cohort. Patients and prescribers should weigh this potential risk against potential benefits of commencing anticholinergic medications.

scholarly journals Cognitive function trajectories and their determinants in older people: 8 years of follow-up in the English Longitudinal Study of Ageing

2018 ◽  
Vol 72 (8) ◽  
pp. 685-694 ◽  
Author(s):  
Paola Zaninotto ◽  
G David Batty ◽  
Michael Allerhand ◽  
Ian J Deary
Keyword(s):  
Executive Function ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Older People ◽  
Cognitive Decline ◽  
Physical Function ◽  
Global Cognitive Function ◽  
Growth Curve Modelling ◽  
Randomised Controlled ◽  
English Longitudinal Study

BackgroundMaintaining cognitive function is an important aspect of healthy ageing. In this study, we examined age trajectories of cognitive decline in a large nationally representative sample of older people in England. We explored the factors that influence such decline and whether these differed by gender.MethodsLatent growth curve modelling was used to explore age-specific changes, and influences on them, in an 8-year period in memory, executive function, processing speed and global cognitive function among 10 626 participants in the English Longitudinal Study of Ageing. We run gender-specific models with the following exposures: age, education, wealth, childhood socioeconomic status, cardiovascular disease, diabetes, physical function, body mass index, physical activity, alcohol, smoking, depression and dementia.ResultsAfter adjustment, women had significantly less decline than men in memory (0.011, SE 0.006), executive function (0.012, SE 0.006) and global cognitive function (0.016, SE 0.004). Increasing age and dementia predicted faster rates of decline in all cognitive function domains. Depression and alcohol consumption predicted decline in some cognitive function domains in men only. Poor physical function, physical inactivity and smoking were associated with faster rates of decline in specific cognitive domains in both men and women. For example, relative to study members who were physically active, the sedentary experienced greater declines in memory (women −0.018, SE 0.009) and global cognitive function (men −0.015, SE 0.007 and women −0.016, SE 0.007).ConclusionsThe potential determinants of cognitive decline identified in this study, in particular modifiable risk factors, should be tested in the context of randomised controlled trials.

scholarly journals Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study

2020 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Social Isolation ◽  
Mental Status ◽  
Chinese Older Adults ◽  
Confounding Variables

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study (CHARLS) and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.

scholarly journals Consistency and applicability of different brief screen instrument of cognitive function in elderly population

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lixia Lu ◽  
Lin Chen ◽  
Weiwen Wu ◽  
Yang Wang ◽  
Zhenbao Liu ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Functions ◽  
Test Scores ◽  
Correlation Coefficients ◽  
Cross Sectional Study ◽  
Screening Tools ◽  
Cognitive Test ◽  
Cross Sectional ◽  
Education Levels ◽  
Screen Instrument

Abstract Background Screening for cognitive impairment (CI) is often hampered by lack of consensus as to which screening instrument to use. The aim is to assess the consistence and applicability of different CI screening tools. Method In a cross-sectional study from October 2017 to September 2018 in 7 communities in Shanghai, China, elder (≧60) residential volunteers with no history of major cardiovascular diseases, cancers and other comorbidities known to affect cognitive functions were recruited. The participants underwent tests with 7 cognitive function screening instruments. Multivariate linear regressions were performed to test correlations between demographic characteristics, including gender, age, education, and marital status, with cognitive test scores. Mini-Mental State Examination (MMSE) score adjusted according to the correlation coefficients was used to detect CI with a cutoff of 24. Other cognitive function scores were compared between participants with and without CI. In addition, Pearson’s correlation test was used to detect association between different test scores. Results 172 participants with relatively low education levels were included. Age and education showed significant association with cognitive test scores. Using adjusted MMSE, 39.6% of participants were identified with CI, while the percentage was 87.2% when adjusted Montreal Cognitive Assessment (MoCA) with cutoff of 26 was used. Analysis of “abnormal” test scores showed that MMSE had the highest percentage of valid data (98.8%). MoCA and Isaacs test of Verbal Fluency (VF) score had correlation with most the other scores, while MMSE only significantly associated with VF and MoCA. Conclusions MMSE may still present the most applicable tools for quick screen of cognitive functions, especially when environmental conditions may interfere with participants’ attention.

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