Division of Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, Texas.
Department of Sociology, University of Nebraska, Lincoln, Lincoln, Nebraska.
Am J Epidemiol. 2019 Jan 1;188(1):119-129. doi: 10.1093/aje/kwy196.
Research suggests that the prevalence and incidence of cognitive impairment among older adults is decreasing. This analysis used data from 9 waves (1993-2016) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly to assess cognitive status and cognitive decline for 2 cohorts of Mexican-Americans aged ≥75 years in 1993-1994 versus 2004-2005. Logistic regression, joint longitudinal survival models, and illness-death models for interval-censored data were used to examine cohort differences in the odds of prevalent cognitive impairment, trajectories of cognitive decline, and the risk of 10-year incident cognitive impairment, respectively. Results indicated that compared with the 1993-1994 cohort, the 2004-2005 cohort had higher odds for prevalent cognitive impairment (odds ratio = 2.51, 95% confidence interval (CI): 1.92, 3.29), particularly among participants with <4 years of education (odds ratio = 2.99, 95% CI: 2.14, 4.18). Conversely, the 2004-2005 cohort exhibited significantly slower rates of cognitive decline (βˆ = 0.50, 95% CI: 0.39, 0.62) and had a significantly lower risk of incident cognitive impairment (hazard ratio = 0.75, 95% CI: 0.62, 0.91) compared with the 1993-1994 cohort. This analysis provides mixed results for cohort trends in the cognitive health of older Mexican-Americans. Continued research is needed to identify risk factors that contribute to these population-level trends.
研究表明，老年人认知障碍的患病率和发生率正在下降。本分析使用了来自西班牙裔老年人流行病学研究的 9 个波次（1993-2016 年）的数据，评估了 1993-1994 年和 2004-2005 年 2 个队列中≥75 岁的墨西哥裔美国人的认知状况和认知衰退。使用逻辑回归、联合纵向生存模型和间隔censored 数据的疾病死亡模型，分别检查了队列间在现患认知障碍的可能性、认知衰退的轨迹以及 10 年新发认知障碍的风险方面的差异。结果表明，与 1993-1994 年队列相比，2004-2005 年队列现患认知障碍的可能性更高（优势比=2.51，95%置信区间[CI]：1.92，3.29），特别是在受教育程度<4 年的参与者中（优势比=2.99，95% CI：2.14，4.18）。相反，与 1993-1994 年队列相比，2004-2005 年队列的认知衰退速度明显较慢（βˆ=0.50，95% CI：0.39，0.62），新发认知障碍的风险明显较低（风险比=0.75，95% CI：0.62，0.91）。本分析为老年墨西哥裔美国人认知健康的队列趋势提供了混合结果。需要进一步研究以确定导致这些人群水平趋势的风险因素。
