Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
Arch Gerontol Geriatr. 2019 May-Jun;82:81-87. doi: 10.1016/j.archger.2019.01.018. Epub 2019 Jan 29.
This study aims to identify distinctive cognitive trajectories jointly with mortality probabilities and to explore factors related to the particular trajectories of cognitive ageing in China.
6842 individuals aged 80 years and above from 7 waves of the Chinese Longitudinal Healthy Longevity Survey were assessed with the Mini-Mental State Examination for up to 16 years. A group-based trajectory model was used to jointly estimate cognitive ageing and mortality trajectories; and to explore the factors related to membership of the trajectory groups.
A four-group model best fit the data. For all groups, the cognitive function declined with age according to different rates. Group 4, 3, 2, and 1 showed slow (prevalence 52.8%), moderate (31.1%), progressive (12.6%) and rapid (3.5%) cognitive decline, respectively. Mortality probability trajectories followed a hierarchy in consistence with cognitive trajectories approximately. Females, illiteracy, and those born in rural areas were less likely to belong to the most favorable trajectory group.
The heterogeneity of cognitive ageing was identified among Chinese oldest-old. Childhood socioeconomic status, especially education, was associated with the rate of cognitive decline.
本研究旨在识别独特的认知轨迹，同时确定死亡率概率，并探讨与中国认知老化特定轨迹相关的因素。
对来自中国纵向健康长寿调查的 7 波共 6842 名 80 岁及以上的个体进行了长达 16 年的 Mini-Mental State Examination 评估。采用基于群组的轨迹模型联合估计认知老化和死亡率轨迹；并探讨与轨迹组归属相关的因素。
四项群组模型最符合数据。对于所有群组，认知功能均随年龄以不同的速率下降。第 4、3、2 和 1 组分别表现出缓慢（患病率为 52.8%）、中度（31.1%）、渐进（12.6%）和快速（3.5%）认知下降。死亡率概率轨迹与认知轨迹大致呈层次结构一致。女性、文盲和农村地区出生的人不太可能属于最有利的轨迹组。
本研究在中国高龄老人中确定了认知老化的异质性。儿童期社会经济地位，特别是教育程度，与认知下降的速度有关。
