Prevalence, Incidence, and Progression of Cognitive Impairment, No Dementia Among Rural-Dwelling Chinese Older Adults

2021 ◽  
pp. 1-10
Author(s):  
Yifei Ren ◽  
Yi Dong ◽  
Tingting Hou ◽  
Xiaolei Han ◽  
Rui Liu ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Multinomial Logistic Regression ◽  
Chinese Older Adults ◽  
Multinomial Logistic Regression Analysis ◽  
Incident Dementia ◽  
Increased Risk ◽  
Cognitive Impairment No Dementia

Background: Few studies have examined occurrence and progression of cognitive impairment, no dementia (CIND) in rural China. Objective: To determine the prevalence and incidence of CIND in rural-dwelling Chinese older adults, and to examine risk and protective factors associated with progression to CIND and dementia. Methods: This population-based study included 2,781 dementia-free participants (age≥65 years) who were examined at baseline (2014) and followed in 2018. Demographic, epidemiological, clinical, and neuropsychological data were collected following a structured questionnaire. We defined CIND according to subjective cognitive complaints and the age- and education-specific Mini-Mental State Examination (MMSE) score. Data were analyzed with the multinomial logistic regression models. Results: The overall prevalence of CIND was 10.54% and the incidence was 28.26 per 1,000 person-years. CIND at baseline was associated with the multi-adjusted odds ratio (OR) of 2.06 (95% confidence interval = 1.23–3.47) for incident dementia. Multinomial logistic regression analysis suggested that compared with no CIND, the multi-adjusted OR of incident CIND was 2.21 (1.51–3.23) for women and 0.62 (0.38–0.99) for high social support, whereas the multi-adjusted OR of incident dementia was 1.14 (1.09–1.18) for older age, 0.29 (0.16–0.53) for high education, and 2.91 (1.47–5.74) for having a stroke history. Conclusion: CIND affects over one-tenth of older adults living in rural communities of western Shandong province. People with CIND are twice as likely to progress to dementia as people without CIND. Female sex, low education, stroke history, and low social support are associated with an increased risk of progression from normal cognition to CIND or dementia.

scholarly journals PSYCHOLOGICAL WELL-BEING AND THE ONSET OF COGNITIVE IMPAIRMENT AMONG CHINESE OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S114-S115
Author(s):  
Jiaan Zhang
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Multinomial Logistic Regression ◽  
Well Being ◽  
Functional Health ◽  
Survey Study ◽  
Psychological Well Being ◽  
Chinese Older Adults ◽  
Study Results ◽  
Over Time

Abstract Previous research has shown the beneficial effects of positive psychological assets on health, but more research is needed to confirm the prospective effects on cognitive function. The purpose of this study is to examine the relationship between psychological well-being and the earliest onset of cognitive impairment among Chinese older adults. Data came from 2000 to 2014 waves of the Chinese Longitudinal Healthy Longevity Survey. Study sample consisted of 6,225 older adults who were free from cognitive impairment in 2000. Psychological well-being was measured based on seven items that assessed optimism, conscientiousness, self-determination, happiness, self-esteem, pessimism, and loneliness, with responses ranging from “always (1)” to never (5)”. Negative feelings items were reverse coded. Higher score indicated more positive psychological well-being. Cognitive impairment was measured by a Chinese version of the Mini-Mental State Examination. Respondents scored at or above 24 were regarded as having no cognitive impairment. A multi-category time-varying variable was used to capture four potential outcomes: (1) persistently free of cognitive impairment between waves, (2) onset of cognitive impairment, (3) death between waves, and (4) attrition. Socio-demographics, chronical diseases conditions, functional health status were served as controls. Multilevel multinomial logistic regression models that account for clustering of observations within a subject over time were employed for the study. Results show that more positive psychological well-being is significantly associated with reduced risk of cognitive impairment onset and death over time. Results suggest that developing more psychological resilience-based intervention programs among older adults may help them delay the onset of cognitive impairment.

scholarly journals Association Between Body Mass Index, Its Change And Cognitive Impairment Among Chinese Older Adults: A Community-Based, 9-Year Prospective Cohort Study

2021 ◽  
Author(s):  
Shanshan Wu ◽  
Xiaozhen Lv ◽  
Jie Shen ◽  
Hui Chen ◽  
Yuan Ma ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Weight Loss ◽  
Cohort Study ◽  
Cognitive Impairment ◽  
Prospective Cohort ◽  
Community Based ◽  
Chinese Older Adults ◽  
Large Weight Loss ◽  
Increased Risk

Abstract Objective To examine the association of baseline body mass index (BMI) and BMI change with cognitive impairment among older adults in China. Methods The study included data from the Chinese Longitudinal Healthy Longevity Study, a national community-based prospective cohort study from 2002-2018. Baseline BMI and BMI change measurements were available for 12,027 adults aged older than 65 years. Cognitive impairment was defined as Chinese version of the Mini Mental State Examination score less than 18. Multivariable Cox proportional hazard model was used.Results Among 12027 participants (mean age was 81.23 years old and 47.48% were male), the proportion of underweight, normal, overweight and obese at baseline was 33.87%, 51.39%, 11.39% and 3.34%, respectively. During an average of 5.9 years’ follow-up, 3086 participants (4.35 per 100 person-years) with incident cognitive impairment were identified. Compared with normal weight group, adjusted hazard ratio (AHR) for cognitive impairment was 0.86 (95% CI 0.75-0.99) among overweight group, whereas corresponding AHR was 1.02 (95% CI 0.94-1.10) in underweight and 1.01 (95% CI 0.80-1.28) in obese. Large weight loss (<-10%) was significantly associated with an increased risk of cognitive impairment (AHR, 1.42, 95% CI 1.29-1.56), compared to stable weight status group (-5%~5%). In the restricted cubic spline models, BMI change showed a L-shaped association with cognitive impairment. Conclusions BMI-defined overweight is associated with a reduced risk of cognitive impairment among Chinese older adults, while large weight loss is associated with increased risk. More attention should be paid to older adults with significant weight loss.

scholarly journals Self-reported sleep disturbances are associated with poorer cognitive performance in older adults with hypertension: a multi-parameter risk factor investigation

2019 ◽  
Vol 32 (7) ◽  
pp. 815-825 ◽  
Author(s):  
Jordan N. Kohn ◽  
Emily Troyer ◽  
Robert N. Guay-Ross ◽  
Kathleen Wilson ◽  
Amanda Walker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Sleep Disturbances ◽  
Depressive Symptomatology ◽  
Cognitive Outcomes ◽  
Cognitive Domain ◽  
Increased Risk

ABSTRACTObjectives:Given the evidence of multi-parameter risk factors in shaping cognitive outcomes in aging, including sleep, inflammation, cardiometabolism, and mood disorders, multidimensional investigations of their impact on cognition are warranted. We sought to determine the extent to which self-reported sleep disturbances, metabolic syndrome (MetS) factors, cellular inflammation, depressive symptomatology, and diminished physical mobility were associated with cognitive impairment and poorer cognitive performance.Design:This is a cross-sectional study.Setting:Participants with elevated, well-controlled blood pressure were recruited from the local community for a Tai Chi and healthy-aging intervention study.Participants:One hundred forty-five older adults (72.7 ± 7.9 years old; 66% female), 54 (37%) with evidence of cognitive impairment (CI) based on Montreal Cognitive Assessment (MoCA) score ≤24, underwent medical, psychological, and mood assessments.Measurements:CI and cognitive domain performance were assessed using the MoCA. Univariate correlations were computed to determine relationships between risk factors and cognitive outcomes. Bootstrapped logistic regression was used to determine significant predictors of CI risk and linear regression to explore cognitive domains affected by risk factors.Results:The CI group were slower on the mobility task, satisfied more MetS criteria, and reported poorer sleep than normocognitive individuals (all p < 0.05). Multivariate logistic regression indicated that sleep disturbances, but no other risk factors, predicted increased risk of evidence of CI (OR = 2.00, 95% CI: 1.26–4.87, 99% CI: 1.08–7.48). Further examination of MoCA cognitive subdomains revealed that sleep disturbances predicted poorer executive function (β = –0.26, 95% CI: –0.51 to –0.06, 99% CI: –0.61 to –0.02), with lesser effects on visuospatial performance (β = –0.20, 95% CI: –0.35 to –0.02, 99% CI: –0.39 to 0.03), and memory (β = –0.29, 95% CI: –0.66 to –0.01, 99% CI: –0.76 to 0.08).Conclusions:Our results indicate that the deleterious impact of self-reported sleep disturbances on cognitive performance was prominent over other risk factors and illustrate the importance of clinician evaluation of sleep in patients with or at risk of diminished cognitive performance. Future, longitudinal studies implementing a comprehensive neuropsychological battery and objective sleep measurement are warranted to further explore these associations.

scholarly journals Long‐Term Blood Pressure Variability and Risk of Cognitive Decline and Dementia Among Older Adults

2021 ◽  
Author(s):  
Michael E. Ernst ◽  
Joanne Ryan ◽  
Enayet K. Chowdhury ◽  
Karen L. Margolis ◽  
Lawrence J. Beilin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Blood Pressure Variability ◽  
Link Type ◽  
Incident Dementia ◽  
Increased Risk ◽  
The Impact

Background Blood pressure variability (BPV) in midlife increases risk of late‐life dementia, but the impact of BPV on the cognition of adults who have already reached older ages free of major cognitive deficits is unknown. We examined the risk of incident dementia and cognitive decline associated with long‐term, visit‐to‐visit BPV in a post hoc analysis of the ASPREE (Aspirin in Reducing Events in the Elderly) trial. Methods and Results ASPREE participants (N=19 114) were free of dementia and significant cognitive impairment at enrollment. Measurement of BP and administration of a standardized cognitive battery evaluating global cognition, delayed episodic memory, verbal fluency, and processing speed and attention occurred at baseline and follow‐up visits. Time‐to‐event analysis using Cox proportional hazards regression models were used to calculate hazard ratios (HR) and corresponding 95% CI for incident dementia and cognitive decline, according to tertile of SD of systolic BPV. Individuals in the highest BPV tertile compared with the lowest had an increased risk of incident dementia and cognitive decline, independent of average BP and use of antihypertensive drugs. There was evidence that sex modified the association with incident dementia (interaction P =0.02), with increased risk in men (HR, 1.68; 95% CI, 1.19–2.39) but not women (HR, 1.01; 95% CI, 0.72–1.42). For cognitive decline, similar increased risks were observed for men and women (interaction P =0.15; men: HR, 1.36; 95% CI, 1.16–1.59; women: HR, 1.14; 95% CI, 0.98–1.32). Conclusions High BPV in older adults without major cognitive impairment, particularly men, is associated with increased risks of dementia and cognitive decline. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01038583; isrctn.com . Identifier: ISRCTN83772183.

Decision-making profile in older adults: the influence of cognitive impairment, premorbid intelligence and depressive symptoms

2019 ◽  
Vol 32 (6) ◽  
pp. 697-703
Author(s):  
Marina Maria Biella ◽  
Alaise Silva Santos de Siqueira ◽  
Marcus Kiiti Borges ◽  
Elyse Soares Ribeiro ◽  
Regina Miksian Magaldi ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Cognitive Aging ◽  
Multinomial Logistic Regression ◽  
Cognitive Disorders ◽  
Cross Sectional ◽  
Premorbid Intelligence

ABSTRACTObjective:Decision-making (DM) is a component of executive functioning. DM is essential to make proper decisions regarding important life and health issues. DM can be impaired in cognitive disorders among older adults, but current literature is scarce. The aim of this study was to evaluate the DM profile in participants with and without cognitive impairment.Design:Cross-sectional analysis of a cohort study on cognitive aging.Participants:143 older adults.Setting:University-based memory clinic.Methods:Patients comprised three groups after inclusion and exclusion criteria: healthy controls (n=29), mild cognitive impairment (n=81) and dementia (n=33). Participants were evaluated using an extensive neuropsychological protocol. DM profile was evaluated by the Melbourne Decision Making Questionnaire. Multinomial logistic regression was used to evaluate associations between age, sex, educational level, estimated intelligence quotient (IQ), cognitive disorders, depressive or anxiety symptoms, and the DM profiles.Results:The most prevalent DM profile was the vigilant type, having a prevalence of 64.3%. The vigilant profile also predominated in all three groups. The multinomial logistic regression showed that the avoidance profile (i.e. buck-passing) was associated with a greater presence of dementia (p=0.046) and depressive symptoms (p=0.024), but with less anxious symptoms (p=0.047). The procrastination profile was also associated with depressive symptoms (p=0.048). Finally, the hypervigilant profile was associated with a lower pre-morbid IQ (p=0.007).Conclusion:Older adults with cognitive impairment tended to make more unfavorable choices and have a more dysfunctional DM profile compared to healthy elders.

The Association Between Cognitive Impairment and Patterns of Activity Engagement Among Older Adults

2017 ◽  
Vol 40 (7) ◽  
pp. 645-667 ◽  
Author(s):  
Takashi Amano ◽  
Sojung Park ◽  
Nancy Morrow-Howell
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Cognitive Impairment ◽  
High Activity ◽  
Logistic Regression Analysis ◽  
Multinomial Logistic Regression ◽  
Activity Engagement ◽  
Multinomial Logistic Regression Analysis ◽  
Activity Group ◽  
Low Activity

This study aims to assess the association between cognitive impairment and activity engagement patterns. Data from the 2012 Health and Retirement Study were used. A total of 3,943 participants aged 65 or older were included in analyses. Latent class analysis and multinomial logistic regression analysis were used. Four activity engagement profiles were identified: high activity (31.2%), active leisure (18.9%), passive leisure (28.2%), and low activity (21.7%). People in the high activity group engaged in all activities more than people in any other group, whereas people in the low activity group did not actively engage in most activities. Multinomial logistic regression analysis showed that cognitive impairment had an independent effect on the probability of being assigned to the low activity group compared to other groups. Cognitive impairment was associated with inactivity in a variety of activities. Future studies should examine supportive factors, which facilitate active patterns among people with cognitive impairment.

scholarly journals The COVID-19 pandemic and changes in the level of contact between older parents and their non-coresident children: A European study

2021 ◽  
Author(s):  
Jorik Vergauwen ◽  
Katrijn Delaruelle ◽  
Pearl A. Dykstra ◽  
Piet Bracke ◽  
Dimitri Mortelmans
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Empirical Evidence ◽  
Multinomial Logistic Regression ◽  
Older Men ◽  
Positive Outcome ◽  
European Study ◽  
Older Parents ◽  
Multinomial Logistic Regression Analysis

Objective: The present study aims to investigate changes in the frequency of parent-child contact among Europeans aged 65 years and over within the context of the COVID-19 pandemic, while recognizing heterogeneity within the group of older adults. Background: Physical distancing measures have been implemented worldwide to curb the spread of the COVID-19 pandemic. Although this policy has proven to be effective in flattening the curve, it undoubtedly posed a serious challenge to intergenerational relations. Experts hinted that physical distancing measures may have reduced older adults’ level of contact with their non-coresident children. However, empirical evidence is lacking. Method: Data from the SHARE COVID-19 questionnaire and previous SHARE waves for 26,077 individuals from 26 European countries and Israel were used and analyzed using multilevel multinomial logistic regression analysis. Results: The analysis revealed that older adults’ level of intergenerational contact remained stable or even increased – rather than decreased – during the COVID-19 pandemic. Despite the overall positive outcome, some subgroups (i.e., older men, residents of nursing homes, less educated older adults and older adults living in countries with less stringent COVID-19 measures) were more likely to report reduced intergenerational contact. Conclusion: Although variation was observed among older adults, the pandemic generally did not pose a threat to their level of intergenerational contact with non-coresident children.

Association of cognitive impairment with frailty in community-dwelling older adults

2013 ◽  
Vol 26 (1) ◽  
pp. 155-163 ◽  
Author(s):  
Eun Sook Han ◽  
Yunhwan Lee ◽  
Jinhee Kim
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Older People ◽  
Multinomial Logistic Regression ◽  
Community Dwelling ◽  
Men And Women ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Community Dwelling Older Adults

ABSTRACTBackground:Frailty is highly prevalent in older people, but its association with cognitive function is poorly understood. The aim of this study was to examine the association between cognitive function and frailty in community-dwelling older adults.Methods:Data were from the 2008 Living Profiles of Older People Survey, comprising 10,388 nationally representative sample aged 65 years and older living in the community in South Korea. Frailty criteria included unintentional weight loss, exhaustion, weakness, low physical activity, and slow walking speed. Cognitive function was assessed using the Korean version of the Mini-Mental State Examination. Multinomial logistic regression models were constructed with frailty status regressed on cognitive impairment and subdomains of cognitive function, adjusting for covariates.Results:Those who were frail showed a higher percentage of cognitive impairment (55.8% in men, 35.2% in women) than those who were not (22.1% in men, 15.6% in women). Cognitive impairment was associated with an increased risk of frailty in men (odds ratio (OR) = 1.81, 95% confidence interval (CI): 1.25–2.60) and women (OR = 1.69, 95% CI: 1.25–2.30) even after controlling for all covariates. Among the subdomains of cognitive function, time orientation, registration, attention, and judgment were associated with a lower likelihood of frailty in both men and women after adjusting for confounders. Among women higher scores on recall, language components, and visual construction were also significantly associated with lower odds of frailty.Conclusions:Cognitive impairment was associated with a higher likelihood of frailty in community-dwelling older men and women. Total scores and specific subdomains of cognitive function were inversely associated with frailty.

scholarly journals Association between Social Integration and Face Mask Use Behavior during the SARS-CoV-2 Pandemic in Japan: Results from U-CORONA Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4717
Author(s):  
Nobutoshi Nawa ◽  
Yui Yamaoka ◽  
Yuna Koyama ◽  
Hisaaki Nishimura ◽  
Shiro Sonoda ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Social Network ◽  
Social Integration ◽  
Response Bias ◽  
Multinomial Logistic Regression ◽  
Face Mask ◽  
Neighborhood Association ◽  
Multinomial Logistic Regression Analysis ◽  
Use Behavior

Face mask use is a critical behavior to prevent the spread of SARS-CoV-2. We aimed to evaluate the association between social integration and face mask use during the COVID-19 pandemic in a random sample of households in Utsunomiya City, Greater Tokyo, Japan. Data included 645 adults in the Utsunomiya COVID-19 seROprevalence Neighborhood Association (U-CORONA) study, which was conducted after the first wave of the pandemic, between 14 June 2020 and 5 July 2020, in Utsunomiya City. Social integration before the pandemic was assessed by counting the number of social roles, based on the Cohen’s social network index. Face mask use before and during the pandemic was assessed by questionnaire, and participants were categorized into consistent mask users, new users, and current non-users. Multinomial logistic regression analysis was used to examine the association between lower social integration score and face mask use. To account for possible differential non-response bias, non-response weights were used. Of the 645 participants, 172 (26.7%) were consistent mask users and 460 (71.3%) were new users, while 13 (2.0%) were current non-users. Lower social integration level was positively associated with non-users (RRR: 1.76, 95% CI: 1.10, 2.82). Social integration may be important to promote face mask use.

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