1 Rush University Medical Center, Chicago, IL, USA.
2 University of Southern California, Los Angeles, CA, USA.
J Aging Health. 2018 Oct;30(9):1389-1405. doi: 10.1177/0898264317716361. Epub 2017 Jun 23.
To quantify longitudinal change in financial and health literacy and examine the associations of declining literacy with incident Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI).
Data came from 799 participants of an ongoing cohort study. Literacy was measured using a battery of 32 questions. Clinical diagnoses were made annually following uniform structured procedures. The associations of declining literacy with incident AD dementia and MCI were tested using a joint model for longitudinal and time-to-event data.
We observed an overall decline in total literacy score over up to 6 years of follow-up ( p < .001). Faster decline in literacy was associated with higher risks for incident AD dementia (hazard ratio = 4.526, 95% confidence interval = [2.993, 6.843], p < .001) and incident MCI (hazard ratio = 2.971, 95% confidence interval = [1.509, 5.849], p = .002).
Declining literacy among community-dwelling older persons predicts adverse cognitive outcomes and serves as an early indicator of impending dementia.
量化金融和健康素养的纵向变化，并研究阅读能力下降与阿尔茨海默病（AD）痴呆和轻度认知障碍（MCI）发病的相关性。
数据来自一项正在进行的队列研究的 799 名参与者。使用 32 个问题的测试题来测量读写能力。每年通过统一的结构化程序进行临床诊断。使用纵向和事件时间数据的联合模型来检验阅读能力下降与 AD 痴呆和 MCI 发病的相关性。
我们观察到在长达 6 年的随访中，总体的读写能力得分呈下降趋势（p<0.001）。读写能力下降越快，AD 痴呆发病风险越高（风险比=4.526，95%置信区间=[2.993,6.843]，p<0.001），MCI 发病风险也越高（风险比=2.971，95%置信区间=[1.509,5.849]，p=0.002）。
社区居住的老年人的读写能力下降预示着不良的认知结果，是痴呆的早期指标。
