Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada.
Int J Geriatr Psychiatry. 2018 Jul;33(7):926-933. doi: 10.1002/gps.4873. Epub 2018 Mar 7.
Despite a steady increase in life expectancy, a few studies have investigated cross-sectional correlates and longitudinal predictors of cognitive function, a core domain of the successful aging, among socio-clinico-demographic factors in the oldest-old exclusively.
The aims of this study were to examine socio-clinico-demographic characteristics associated with global cognition and its changes in the oldest-old.
We reanalyzed a dataset of cognitively preserved community-dwelling subjects aged 85 years and older in the Tokyo Oldest Old Survey on Total Health, a 6-year longitudinal observational study. This study consisted of (1) baseline cross-sectional analyses examining correlates of global cognition (n = 248) among socio-clinico-demographic factors and (2) longitudinal analyses examining baseline predictors for changes of global cognition in 3-year follow-up (n = 195). The Mini-Mental State Examination was used as a screening test to assess global cognition.
At baseline, higher weights were related to higher cognitive function in the oldest-old. The baseline predictors of global cognitive decline in 3-year follow-up were higher global cognition, shorter education period, and lower sociocultural activities and lower instrumental activity of daily living, in this order.
The present study suggests that it is crucial to attain higher education during early life and avoid leanness or obesity, participate in sociocultural cognitive activities during late life, and maintain instrumental activity of daily living to preserve optimal cognitive function in the oldest-old, which will facilitate developing prevention strategies for cognitive decline and promoting successful aging in this increasing population.
尽管预期寿命稳步延长,但仅有少数研究专门针对最年长人群,调查了与认知功能(成功老龄化的核心领域)相关的社会临床人口统计学因素的横断面相关性和纵向预测因素。
本研究旨在探讨与最年长人群的整体认知及其变化相关的社会临床人口统计学特征。
我们重新分析了东京全健康老年研究中认知正常的社区居住 85 岁及以上老年人的数据集,这是一项为期 6 年的纵向观察研究。该研究包括:(1)基线横断面分析,研究社会临床人口统计学因素与整体认知相关的因素(n=248);(2)纵向分析,研究 3 年随访期间整体认知变化的基线预测因素(n=195)。采用简易精神状态检查作为筛查测试来评估整体认知。
在基线时,较高的体重与最年长人群较高的认知功能相关。在 3 年随访期间,整体认知下降的基线预测因素依次为较高的整体认知、较短的受教育年限、较少的社会文化认知活动和较低的日常生活工具性活动。
本研究表明,在生命早期获得更高的教育水平、避免消瘦或肥胖、在晚年参与社会文化认知活动以及维持日常生活的工具性活动对于保持最年长人群的最佳认知功能至关重要,这将有助于制定针对认知能力下降的预防策略,并促进该人群的成功老龄化。