Long-term Ozone Exposure and Cognitive Impairment among Chinese Older Adults: Analysis of the Chinese Longitudinal Healthy Longevity Survey

Abstract Background Evidence regarding the associations of tooth loss and denture use with incident cognitive impairment is inconclusive in older adults, and few prospective studies have examined the potential interaction between tooth loss and denture use in these specific populations. Methods Data were assessed from 17 079 cognitively normal older adults aged ≥65 years, participating in the Chinese Longitudinal Healthy Longevity Survey. The outcome of interest was cognitive impairment (assessed by the Chinese version of Mini-Mental State Examination). The number of natural teeth and status of denture use were collected by a structural questionnaire. Results A total of 6456 cases of cognitive impairment were recorded during 88 627 person-years of follow-up. We found that compared with participants with 20+ teeth, those with 10–19, 1–9, and 0 teeth had increased risks of incident cognitive impairment (p-trend < .001). Participants without dentures also had a higher risk of incident cognitive impairment, compared with those who wore dentures. Effect modification by denture use was observed (p-interaction = .010). Specifically, among those without dentures, the adjusted hazard ratio (95% confidence interval) for participants with 10–19, 1–9, and 0 teeth were 1.19 (1.08, 1.30), 1.28 (1.17, 1.39), and 1.28 (1.16, 1.41), respectively, as compared to those with 20+ teeth. In contrary, among denture users, detrimental effect was only observed among those with 0 teeth (hazard ratio 1.14, 95% confidence interval: 1.16, 1.41). Conclusions In Chinese older adults, maintaining 20+ teeth is important for cognitive health; denture use would attenuate the detrimental effects of tooth loss, especially for partial tooth loss, on cognitive impairment.

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Hypothetical Interventions on Risk Factors for Cognitive Impairment among Chinese Older Adults: An Application of the Parametric G-Formula

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17031021 ◽

2020 ◽

Vol 17 (3) ◽

pp. 1021

Author(s):

Zi Zhou ◽

Lun Cai ◽

Jian Fu ◽

Yaofeng Han ◽

Ya Fang

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Dietary Intake ◽

Psychosocial Factors ◽

Social Engagement ◽

Vegetable Intake ◽

Well Being ◽

Dietary Interventions ◽

Chinese Older Adults ◽

Healthy Longevity

The effects of psychosocial and dietary interventions on risk of cognitive impairment is not known. The aim of this study was to estimate the 10-year risks of cognitive impairment under hypothetical interventions of psychosocial factors and dietary intake among Chinese older adults. A sample of 7377 respondents aged 65 and over was drawn from the last four waves of the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2011/2012. The parametric g-formula was used to estimate the risk of cognitive impairment under independent hypothetical interventions of social engagement, psychological well-being (PWB), dietary intake, and the joint interventions of their different combination. The observed risk of cognitive impairment was 20.08% (95% confidence interval (CI): 18.81, 21.07). The risk ratios (RR) of cognitive impairment under the hypothetical interventions on higher social engagement, eating fruits at least sometimes, eating vegetables at least sometimes, positive PWB were 0.72 (95% CI: 0.65, 0.82), 0.93 (95% CI: 0.89, 0.95), 0.98 (95% CI: 0.89, 1.00) and 0.99 (95% CI: 0.98, 0.99), respectively. The RR of joint intervention was 0.64 (95% CI: 0.58, 0.73). Hypothetical interventions on psychosocial factors such as social engagement and PWB, as well as fruits and vegetable intake, were beneficial to protect older adults from cognitive impairment.

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Transition of Living Arrangement and Cognitive Impairment Status among Chinese Older Adults: Are They Associated?

Medicina ◽

10.3390/medicina57090961 ◽

2021 ◽

Vol 57 (9) ◽

pp. 961

Author(s):

Yen-Han Lee ◽

Chia-Hung Lin ◽

Jia-Ren Chang ◽

Ching-Ti Liu ◽

Mack Shelley ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Cognitive Function ◽

Filial Piety ◽

Cox Regression ◽

Living Arrangement ◽

Living Alone ◽

Chinese Older Adults ◽

Healthy Longevity ◽

Household Members

Background and Objectives: Living arrangement is a crucial factor for older adults’ health. It is even more critical for Chinese older adults due to the tradition of filial piety. With the aging of China’s population, the prevalence of cognitive impairment among older adults has increased. This study examines the association between living arrangement transition and cognitive function among Chinese older adults. Materials and Methods: Using three waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS; 2008–2009, 2011–2012, and 2014), we analyzed data for older adults (age ≥ 65) who lived with other household members and reported good cognitive function or mild cognitive impairment when they participated in the survey. Multistate Cox regression was employed to study changes in cognitive function. Results: Older adults who transitioned to living alone had lower risk of cognitive impairment (hazard ratio (HR) = 0.66, 95% CI: 0.52, 0.83; p < 0.01), compared with those who continued to live with other household members. Moving into an institution was also not associated with cognitive impairment. Conclusions: With older adults’ transition to living alone, public health practitioners or social workers might educate them on the benefits of such a living arrangement for cognitive function.

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Alcohol consumption and cognitive impairment among Chinese older adults: 8‐year follow‐up of Chinese Longitudinal Healthy Longevity Study

Alzheimer s & Dementia ◽

10.1002/alz.057651 ◽

2021 ◽

Vol 17 (S10) ◽

Author(s):

Ziyi Zhao ◽

Bingyu Li ◽

Chang Wei ◽

Feng Sha

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Alcohol Consumption ◽

Chinese Older Adults ◽

Healthy Longevity

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Five-Year Change in Body Mass Index Predicts Conversion to Mild Cognitive Impairment or Dementia Only in APOE ɛ4 Allele Carriers

Journal of Alzheimer s Disease ◽

10.3233/jad-201360 ◽

2021 ◽

pp. 1-11

Author(s):

Kylie R. Kadey ◽

John L. Woodard ◽

Allison C. Moll ◽

Kristy A. Nielson ◽

J. Carson Smith ◽

...

Keyword(s):

Older Adults ◽

Body Mass Index ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Body Mass ◽

Carrier Status ◽

Healthy Older Adults ◽

E4 Allele ◽

Lifestyle Risk

Background: Body mass index (BMI) has been identified as an important modifiable lifestyle risk factor for dementia, but less is known about how BMI might interact with Apolipoprotein E ɛ4 (APOE ɛ4) carrier status to predict conversion to mild cognitive impairment (MCI) and dementia. Objective: The aim of this study was to investigate the interaction between APOE ɛ4 status and baseline (bBMI) and five-year BMI change (ΔBMI) on conversion to MCI or dementia in initially cognitively healthy older adults. Methods: The associations between bBMI, ΔBMI, APOE ɛ4 status, and conversion to MCI or dementia were investigated among 1,289 cognitively healthy elders from the National Alzheimer’s Coordinating Center (NACC) database. Results: After five years, significantly more carriers (30.6%) converted to MCI or dementia than noncarriers (17.6%), p < 0.001, OR = 2.06. Neither bBMI (OR = 0.99, 95%CI = 0.96–1.02) nor the bBMI by APOE interaction (OR = 1.02, 95%CI = 0.96–1.08) predicted conversion. Although ΔBMI also did not significantly predict conversion (OR = 0.90, 95%CI = 0.78–1.04), the interaction between ΔBMI and carrier status was significant (OR = 0.72, 95%CI = 0.53–0.98). For carriers only, each one-unit decline in BMI over five years was associated with a 27%increase in the odds of conversion (OR = 0.73, 95%CI = 0.57–0.94). Conclusion: A decline in BMI over five years, but not bBMI, was strongly associated with conversion to MCI or dementia only for APOE ɛ4 carriers. Interventions and behaviors aimed at maintaining body mass may be important for long term cognitive health in older adults at genetic risk for AD.

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