School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100871, China.
Center for Statistical Science, Peking University, No.5 Summer Palace Road, Beijing, 100871, China.
BMC Geriatr. 2022 Nov 7;22(1):838. doi: 10.1186/s12877-022-03529-y.
The oldest-old (aged 80 or older) are the most rapidly growing age group, and they are more likely to suffer from cognitive impairment, leading to severe medical and economic burdens. The influence of intergenerational relationships on cognition among Chinese oldest-old adults is not clear. We aim to examine the association of intergenerational relationships with cognitive impairment among Chinese adults aged 80 or older.
This was a prospective cohort study, and data were obtained from the Chinese Longitudinal Healthy Longevity Survey, 14,180 participants aged 80 or older with at least one follow-up survey from 1998 to 2018. Cognitive impairment was assessed by the Chinese version of Mini Mental State Examination, and intergenerational relationships were assessed by getting main financial support from children, living with children or often being visited by children, and doing housework or childcare. We used time-varying Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of associations between intergenerational relationships and cognitive impairment.
We identified 5443 incident cognitive impairments in the 24-cut-off MMSE cohort and 4778 in the 18-cut-off MMSE cohort between 1998 and 2018. After adjusting for a wide range of confounders, the HR was 2.50 (95% CI: 2.31, 2.72) in the old who received main financial support from children, compared with those who did not. The HR was 0.89 (95% CI: 0.83, 0.95) in the oldest-old who did housework or childcare, compared with those who did not. However, there were no significant associations between older adults' cognitive impairments and whether they were living with or often visited by their children. Our findings were consistent in two different MMSE cut-off values (24 vs. 18) for cognitive impairment.
Sharing housework or childcare for children showed a protective effect on older adults' cognitive function, whereas having children provide primary financial support could increase the risk for cognitive impairments. Our findings suggest that governments and children should pay more attention to older adults whose main financial sources from their children. Children can arrange some easy tasks for adults 80 years of age or older to prevent cognitive impairments.
最年长的老年人（80 岁或以上）是增长最快的年龄群体，他们更有可能遭受认知障碍，导致严重的医疗和经济负担。代际关系对中国最年长老年人认知的影响尚不清楚。我们旨在研究代际关系与 80 岁及以上中国成年人认知障碍之间的关联。
这是一项前瞻性队列研究，数据来自中国纵向健康长寿调查，共有 1998 年至 2018 年期间至少有一次随访调查的 14180 名 80 岁或以上的参与者。认知障碍通过中文版简易精神状态检查进行评估，代际关系通过从子女处获得主要经济支持、与子女同住或经常被子女探望以及做家务或照顾子女来评估。我们使用时变 Cox 比例风险模型来估计代际关系与认知障碍之间关联的风险比 (HR) 和 95%置信区间 (CI)。
我们在 24 分 MMSE 队列中确定了 5443 例新发生的认知障碍，在 18 分 MMSE 队列中确定了 4778 例新发生的认知障碍，发生在 1998 年至 2018 年之间。在调整了广泛的混杂因素后，与没有从子女处获得主要经济支持的老年人相比，从子女处获得主要经济支持的老年人的 HR 为 2.50（95%CI：2.31，2.72）。与没有做家务或照顾子女的老年人相比，做家务或照顾子女的最年长老年人的 HR 为 0.89（95%CI：0.83，0.95）。然而，老年人是否与子女同住或经常被子女探望与认知障碍之间没有显著关联。我们的发现与认知障碍的两个不同 MMSE 截断值（24 与 18）一致。
为子女分担家务或照顾子女对老年人的认知功能有保护作用，而让子女提供主要经济支持可能会增加认知障碍的风险。我们的研究结果表明，政府和子女应该更加关注那些主要经济来源来自子女的老年人。子女可以为 80 岁及以上的成年人安排一些简单的任务，以防止认知障碍。
