Department of Social Sciences, University of Luxembourg. Belval Campus,11, Porte des Sciences, L-4366, Esch-sur-Alzette, Luxembourg.
Department of Social Sciences, University of Luxembourg. Belval Campus,11, Porte des Sciences, L-4366, Esch-sur-Alzette, Luxembourg.
Arch Gerontol Geriatr. 2024 Dec;127:105555. doi: 10.1016/j.archger.2024.105555. Epub 2024 Jun 27.
Patterns of cognitive change and modifiable factors for cognitive decline versus stable cognitive trajectories have rarely been described in lower-educated older adults.
We aimed to identify long-term trajectories of cognitive functioning and possible factors associated with cognitive decline.
We used data from 1,042 adults aged ≥ 60 participating in the Health, Welfare and Aging Study (SABE), São Paulo, Brazil, without cognitive impairment at baseline. Data were collected across four waves (2000-2015). Group-based trajectory modelling was used to identify cognitive trajectories. Associations with socioeconomic variables, childhood background, lifestyle, and cardiovascular risk factors were explored using weighted multinomial logistic regressions.
The abbreviated Mini-Mental State Examination was used to measure cognition.
Three cognitive trajectories were identified: stable (n= 754, 68.6%), mild-decline (n= 183, 20.8%), and strong-decline (n= 105, 10.7%). At baseline, respondents in the strong-decline group were more likely to be older than those with stable and mild-decline trajectories. Furthermore, participants in both the mild and strong-decline groups were more likely to have no schooling, be divorced/separated, receive less than 4 monthly wages, and be underweight (BMI < 18.5) compared to the stable group. Finally, the mild-decline group was more likely to have lived in rural areas during childhood than participants located in a stable trajectory.
Our findings suggest that interventions to reduce cognitive decline for low-educated older adults might include strategies addressing inequalities and improving modifiable risk factor burden.
认知变化模式以及导致认知能力下降与认知轨迹稳定的可改变因素在受教育程度较低的老年人中很少被描述。
我们旨在确定认知功能的长期轨迹以及与认知能力下降相关的可能因素。
我们使用了来自巴西圣保罗健康、福利和老龄化研究（SABE）的 1042 名年龄≥60 岁且基线时无认知障碍的成年人的数据。数据收集跨越了四个波次（2000-2015 年）。使用基于群组的轨迹建模来识别认知轨迹。使用加权多项逻辑回归探讨了与社会经济变量、儿童期背景、生活方式和心血管危险因素的关联。
使用简短的简易精神状态检查来测量认知。
确定了三种认知轨迹：稳定（n=754，68.6%）、轻度下降（n=183，20.8%）和重度下降（n=105，10.7%）。在基线时，处于重度下降轨迹的受访者比处于稳定和轻度下降轨迹的受访者更有可能年龄较大。此外，与稳定轨迹相比，轻度和重度下降轨迹组的参与者更有可能没有接受过学校教育、离婚/分居、收入低于 4 个月工资和体重不足（BMI<18.5）。最后，与处于稳定轨迹的参与者相比，轻度下降轨迹组的参与者在童年时更有可能居住在农村地区。
我们的研究结果表明，针对受教育程度较低的老年人的认知能力下降的干预措施可能包括解决不平等问题和改善可改变的危险因素负担的策略。
