Department of Neurology, the First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
Department of Geriatric Medicine, the First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
Medicine (Baltimore). 2022 Nov 25;101(47):e31817. doi: 10.1097/MD.0000000000031817.
Currently, studies exploring factors associated with the cognition at some time point and no study identifying the trajectories of cognitive changes and factors might associate with the trajectories of cognitive changes in people. This study was to identify factors associated with the trend of cognitive decline in middle-aged and older people. In this cohort study, the data of 6954 subjects were collected from China Health and Retirement Longitudinal Survey database. Group-based trajectory modeling was applied for identifying three different trajectories of cognitive function change [high initial level and slow decline group (n = 1024), moderate initial level and moderate decline group (n = 2673) and low initial level and rapid decline (LRD) group (n = 3277)]. Univariate and multivariate logistic regression analysis was conducted to identify variables influencing factors of the trajectories of cognitive function in middle-aged and older people. The follow-up interval was 2 years from 2011 to 2015, and 3 years from 2015 to 2018 via face-to-face interview. High initial level and slow decline group versus LRD group, age (OR = 2.591, 95% CI: 1.962-3.421), gender (OR = 1.398, 95% CI: 1.133-1.725), education (OR = 0.051, 95% CI: 0.039-0.068), place of residence (OR = 2.768, 95% CI: 1.663-4.606), disabled (OR = 1.557, 95% CI: 1.189-2.039), family annual income (OR = 0.757, 95% CI: 0.618-0.929), sleep duration (OR = 1.266, 95% CI: 1.023-1.567), instrumental activity of daily living impairment (OR = 2.513, 95% CI: 1.947-3.245), community activities participation (OR = 0.611, 95% CI: 0.500-0.748), depression (OR = 1.471, 95% CI: 1.185-1.828), and systolic blood pressure (OR = 1.005, 95% CI: 1.001-1.009) were factors influencing the trajectories of cognitive function. Comparing moderate initial level and moderate decline group and LRD group, age (OR = 1.245, 95% CI: 1.052-1.474), gender (OR = 1.244, 95% CI: 1.062-1.458), education (OR = 0.244, 95% CI: 0.190-0.314), marital status (OR = 1.291, 95% CI: 1.079-1.546), place of residence (OR = 1.677, 95% CI: 1.358-2.071), disability (OR = 1.396, 95% CI: 1.180-1.652), smoking (OR = 1.249, 95% CI: 1.071-1.457), family annual income (OR = 0.863, 95% CI: 0.768-0.970), sleep duration (OR = 1.215, 95% CI: 0.973-1.541), instrumental activity of daily living impairment (OR = 1.309, 95% CI: 1.098-1.560), community activities participation (OR = 0.804, 95% CI: 0.718-0.900) and depression (OR = 1.383, 95% CI: 1.217-1.571) were factors associated with the trajectories of cognitive function changes. Middle-aged and older adults who had characteristics associated with increased risk of cognitive decline might be provided with timely interventions.
目前，有研究探讨了与某个时间点认知相关的因素，但没有研究确定认知变化的轨迹以及可能与认知变化轨迹相关的因素。本研究旨在确定与中老年人认知下降趋势相关的因素。在这项队列研究中，我们从中国健康与退休纵向研究数据库中收集了 6954 名受试者的数据。采用基于群组的轨迹建模方法识别认知功能变化的三种不同轨迹[高初始水平和缓慢下降组（n=1024）、中初始水平和中度下降组（n=2673）和低初始水平和快速下降（LRD）组（n=3277）]。采用单变量和多变量逻辑回归分析确定影响中老年人认知功能轨迹的变量。随访间隔为 2011 年至 2015 年的 2 年，以及 2015 年至 2018 年的 3 年，通过面对面访谈进行。高初始水平和缓慢下降组与 LRD 组相比，年龄（OR=2.591，95%CI：1.962-3.421）、性别（OR=1.398，95%CI：1.133-1.725）、教育（OR=0.051，95%CI：0.039-0.068）、居住地（OR=2.768，95%CI：1.663-4.606）、残疾（OR=1.557，95%CI：1.189-2.039）、家庭年收入（OR=0.757，95%CI：0.618-0.929）、睡眠时间（OR=1.266，95%CI：1.023-1.567）、日常生活活动障碍（OR=2.513，95%CI：1.947-3.245）、社区活动参与（OR=0.611，95%CI：0.500-0.748）、抑郁（OR=1.471，95%CI：1.185-1.828）和收缩压（OR=1.005，95%CI：1.001-1.009）是影响认知功能轨迹的因素。与中初始水平和中度下降组与 LRD 组相比，年龄（OR=1.245，95%CI：1.052-1.474）、性别（OR=1.244，95%CI：1.062-1.458）、教育（OR=0.244，95%CI：0.190-0.314）、婚姻状况（OR=1.291，95%CI：1.079-1.546）、居住地（OR=1.677，95%CI：1.358-2.071）、残疾（OR=1.396，95%CI：1.180-1.652）、吸烟（OR=1.249，95%CI：1.071-1.457）、家庭年收入（OR=0.863，95%CI：0.768-0.970）、睡眠时间（OR=1.215，95%CI：0.973-1.541）、日常生活活动障碍（OR=1.309，95%CI：1.098-1.560）、社区活动参与（OR=0.804，95%CI：0.718-0.900）和抑郁（OR=1.383，95%CI：1.217-1.571）是与认知功能变化轨迹相关的因素。具有认知下降风险增加特征的中老年人可能需要及时干预。
