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

Medicina ◽  
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.

scholarly journals Apolipoprotein E Genotype, Meat, Fish, and Egg Intake in Relation to Mortality Among Older Adults: A Longitudinal Analysis in China

2021 ◽  
Vol 8 ◽  
Author(s):  
Xurui Jin ◽  
Shangzhi Xiong ◽  
Changzheng Yuan ◽  
Enying Gong ◽  
Xian Zhang ◽  
...  
Keyword(s):  
Older Adults ◽  
Apolipoprotein E ◽  
Cox Regression ◽  
Population Based ◽  
Fish Intake ◽  
Chinese Older Adults ◽  
Healthy Longevity ◽  
All Cause Mortality ◽  
Diet Pattern ◽  
Interactive Relationship

Introduction: The interactions between apolipoprotein E (APOE) genotype and diet pattern changes were found significant in several trials, implying that APOE gene may modify the effect of animal protein-rich food on health outcomes. We aim to study the interaction of APOE genotype with the effect of meat, fish and egg intake on mortality.Methods: This population-based study enrolled 8,506 older adults (mean age: 81.7 years, 52.3% female) from the Chinese Longitudinal Healthy Longevity Study. The intake frequency of meat, fish and egg was assessed by 3-point questions at baseline. Cox regression was conducted to calculate the hazard ratios for all-cause mortality of intake levels of meat, fish and egg. The analyses were stratified by APOE genotype and sex. The analyses were performed in 2020.Results: In the multivariable-adjusted models, meat and fish intake was associated with all-cause mortality (high vs. low intake: meat: HR: 1.14, 95% CI: 1.01, 1.28; fish: HR: 0.83, 95% CI: 0.73, 0.95). APOE genotype have significant interactions with meat and fish intake (Ps &lt; 0.05). Compared with low fish intake, high fish intake was associated with lower risk of mortality (HR: 0.74, 95% CI: 0.56–0.98) only among the APOE ε4 carriers. High meat intake was significantly associated with higher risks of mortality (HR: 1.13, 95% CI: 1.04–1.25) only among the APOE ε4 non-carriers. The interactive relationship was restricted among the male. No significant findings were observed between egg and mortality among carriers or non-carriers.Conclusions: Among Chinese older adults, the significance of associations of mortality with reported meat or fish intake depended on APOE-E4 carriage status. If validated by other studies, our findings provide evidence for gene-based “precision” lifestyle recommendations.

scholarly journals Inequalities in Cognitive Impairment Among Older Adults in China and the Associated Social Determinants: A Decomposition Approach

2020 ◽  
Author(s):  
Qingwen Deng ◽  
Wenbin Liu
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Emotional Support ◽  
Financial Support ◽  
Concentration Index ◽  
Economic Status ◽  
Living Arrangement ◽  
Education Level ◽  
Socioeconomic Inequalities ◽  
Chinese Older Adults

Abstract BackgroundDespite there is growing evidence focusing on health inequalities in China, socioeconomic inequalities in cognitive impairment among older adults have received little attention. This study aims to measure socioeconomic inequalities in cognitive impairment among Chinese older adults, and determine the contributing social factors to the inequalities.MethodsA cross-sectional analysis was performed using data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), a total of 10556 older adults aged 65 and over were included in the study. The prevalence of cognitive impairment was measured by using the Chinese version of the Mini-Mental State Examination. The socioeconomic inequalities in cognitive impairment were illustrated and quantified by the concentration curve and normalized concentration index. Multivariate logistic regression was conducted to identify the associated factors of cognitive impairment. And decomposition analysis was further applied to decompose the contribution of each determinant to the observed inequalities in cognitive impairment.ResultsThe study indicated that the prevalence of cognitive impairment among Chinese older adults was 18.95%. The overall concentration index for cognitive impairment was − 0.046, which suggested a higher concentration of cognitive impairment among socioeconomically disadvantaged older adults. The results showed the prevalence of cognitive impairment was associated with sex, age, marital status, education level, occupation, economic status, emotional support, financial support, living arrangement, and participation in informal activities. Decomposition results further revealed the contributions of the determinants to the inequalities in cognitive impairment. Specifically, age (131.61%), marital status (85.68%), emotional support (84.85%), education level (39.73%), occupation (21.24%), sex (17.25%), financial support (− 4.19%), economic status (1.02%), living arrangement (0.88%), and informal activities (0.30%) have varying degrees of contributions to the inequality in cognitive impairment.ConclusionThis study sheds light on the pro-rich inequality in cognitive impairment among older adults in China. It suggests that policymakers should pay more attention to older adults who are female, old-old, widowed, illiterate, economically disadvantaged, have no social support, and are less socially involved. Also, more targeted interventions should be undertaken to improve the socioeconomic conditions of these vulnerable individuals and their ability to cope with the risk of cognitive impairment.

scholarly journals Social Networks, Community Engagement, and Cognitive Impairment among Community-Dwelling Chinese Older Adults

2019 ◽  
Vol 9 (3) ◽  
pp. 330-337
Author(s):  
Jinlei Li ◽  
Zijuan Wang ◽  
Zhiwei Lian ◽  
Zhikai Zhu ◽  
Yuanli Liu
Keyword(s):  
Older Adults ◽  
Social Networks ◽  
Cognitive Impairment ◽  
Social Network ◽  
Cognitive Function ◽  
Community Engagement ◽  
Community Dwelling ◽  
Chinese Older Adults ◽  
Network Characteristics ◽  
Community Activities

Aims: To examine the association of social networks and community engagement with cognitive impairment among community-dwelling Chinese older adults. Methods: From November 2017 to May 2018, we selected 1,115 elderly individuals from 3 Chinese communities (Beijing, Hefei, and Lanzhou) using a random-cluster sampling method, and recorded data on demographics, social network characteristics, community activities, and cognitive function. The odds ratios (ORs) of these associations were adjusted for potential confounders in logistic regression models. Results: The prevalence of cognitive impairment was 25.7% (n = 287). An adequate social network (OR 0.55; 95% confidence interval [CI] 0.33–0.91) and enough social support from friends (OR 0.43; 95% CI 0.29–0.62) were negatively associated with cognitive impairment. Family support was not significantly associated with cognitive impairment (OR 0.64; 95% CI 0.34–1.21). Taking part in elderly group travel, communication with others using WeChat, and community activities such as Tai Chi and walking together were negatively associated with cognitive impairment. Conclusion: Social network characteristics and community engagement were found to be related to cognitive function among community-dwelling Chinese elderly adults.

Is Social Network a Protective Factor for Cognitive Impairment in US Chinese Older Adults? Findings from the PINE Study

Gerontology ◽  
2017 ◽  
Vol 64 (3) ◽  
pp. 246-256 ◽  
Author(s):  
Mengting Li ◽  
Xinqi Dong
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Cognitive Impairment ◽  
Social Network ◽  
Cognitive Function ◽  
Protective Factor ◽  
Network Size ◽  
Chinese Older Adults ◽  
Cognitive Domains ◽  
Global Cognition

Background: Social network has been identified as a protective factor for cognitive impairment. However, the relationship between social network and global and subdomains of cognitive function remains unclear. Objective: This study aims to provide an analytic framework to examine quantity, composition, and quality of social network and investigate the association between social network, global cognition, and cognitive domains among US Chinese older adults. Methods: Data were derived from the Population Study of Chinese Elderly (PINE), a community-engaged, population-based epidemiological study of US Chinese older adults aged 60 and above in the greater Chicago area, with a sample size of 3,157. Social network was assessed by network size, volume of contact, proportion kin, proportion female, proportion co-resident, and emotional closeness. Cognitive function was evaluated by global cognition, episodic memory, executive function, working memory, and Chinese Mini-Mental State Examination (C-MMSE). Linear regression and quantile regression were performed. Results: Every 1-point increase in network size (b = 0.048, p < 0.001) and volume of contact (b = 0.049, p < 0.01) and every 1-point decrease in proportion kin (b = -0.240, p < 0.01) and proportion co-resident (b = -0.099, p < 0.05) were associated with higher level of global cognition. Similar trends were observed in specific cognitive domains, including episodic memory, working memory, executive function, and C-MMSE. However, emotional closeness was only significantly associated with C-MMSE (b = 0.076, p < 0.01). Social network has differential effects on female versus male older adults. Conclusion: This study found that social network dimensions have different relationships with global and domains of cognitive function. Quantitative and structural aspects of social network were essential to maintain an optimal level of cognitive function. Qualitative aspects of social network were protective factors for C-MMSE. It is necessary for public health practitioners to consider interventions that enhance different aspects of older adults' social network.

Tooth Loss, Denture Use, and Cognitive Impairment in Chinese Older Adults: A Community Cohort Study

2021 ◽  
Author(s):  
Hai-Lian Yang ◽  
Fu-Rong Li ◽  
Pei-Liang Chen ◽  
Xin Cheng ◽  
Chen Mao ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Confidence Interval ◽  
Tooth Loss ◽  
Potential Interaction ◽  
Hazard Ratio ◽  
Chinese Older Adults ◽  
Healthy Longevity ◽  
Natural Teeth ◽  
State Examination

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 &lt; .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.

A Longitudinal Analysis of the Association Between Living Arrangements and Health Among Older Adults in China

2016 ◽  
Vol 40 (1) ◽  
pp. 72-97 ◽  
Author(s):  
Zi Zhou ◽  
Fanzhen Mao ◽  
Jiaping Ma ◽  
Shichao Hao ◽  
Zhengmin (Min) Qian ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Living Arrangements ◽  
Living Arrangement ◽  
Well Being ◽  
Living Alone ◽  
Psychological Well Being ◽  
Self Rated Health ◽  
Health Differences ◽  
Adl Disability

This article used the nationally representative Chinese Longitudinal Healthy Longevity Survey to explore the associations between living arrangements and health among older adults. Living arrangements were stratified into six categories. Health was measured by self-rated health, activities of daily living (ADL) disability, and cognitive impairment. Random-effects ordered probit regressions were applied. The results indicated that coresidence had a positive effect on self-rated health compared with living alone. After introducing psychological well-being, the health differences observed in living with a spouse and living with both spouse and children were not significant. Participants with each of the living arrangement were more likely to have a higher rate of cognitive impairment and ADL disability than those living alone. Living arrangements were associated with older adults’ health. Psychological well-being was a key factor in this association, which may result from living with a spouse, and could contribute to the self-rated health of older adults.

scholarly journals Physical Work and Exercise Reduce the Risk of Cognitive Impairment in Rural Older Adults: A Population-based Longitudinal Study

2020 ◽  
Author(s):  
Fan He ◽  
Junfen Lin ◽  
Fudong Li ◽  
Yujia Zhai ◽  
Tao Zhang ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Rural Areas ◽  
Tai Chi ◽  
Cox Regression ◽  
Population Based ◽  
Physical Work ◽  
Protective Effects ◽  
Chinese Older Adults

Abstract Background: The effect of physical work on the risk of cognitive impairment in Chinese older adults living in rural areas remains to be elucidated. We investigated whether physical work and exercise can reduce the risk of cognitive impairment. Methods: We collected data from 7,000 individuals without cognitive impairment (age ≥60 years) over a follow-up period of 2 years. The Chinese version of the Mini-Mental State Examination was used to assess cognitive function, and the multivariable Cox regression model was used to identify associations between physical work/exercise and cognitive impairment. Results: Over a median follow-up period of 1.93 years, 1,224 (17.5%) of 7,000 participants developed cognitive impairment, with a total incidence of 97.69 per 1,000 person-years. Participation in physical work (hazard ratio [HR]: 0.66; 95% confidence interval [CI], 0.55-0.78) or exercise (HR: 0.76; 95% CI, 0.62-0.93) was associated with a reduced risk of cognitive impairment. Agricultural work (HR: 0.60; 95% CI, 0.49-0.73) and walking/tai chi (HR: 0.75; 95% CI, 0.60-0.93) exerted significant protective effects against cognitive impairment. Conclusions: Physical work and exercise can reduce the risk of cognitive impairment in older adults. Reasonable types and appropriate intensities of physical activity are recommended to prevent or delay the progression of cognitive impairment.

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