Wenyuan Li, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China Tel: +86-19186432600, E-mail:
J Prev Alzheimers Dis. 2024;11(5):1410-1417. doi: 10.14283/jpad.2024.96.
To identify cognitive decline trajectories in a Chinese elderly population, explore the associations between these trajectories and mortality, and further identify risk factors related to certain trajectories of cognitive decline.
Prospective cohort study.
The group-based trajectory modeling and Cox proportional hazards models were conducted to explore the association between cognitive trajectory groups and mortality, while multinomial logistic regression models were constructed to estimate potential risk factors.
We included 7082 participants aged 65 years or above in three consecutive but non-overlapping cohorts of the Chinese Longitudinal Healthy Longevity Survey with the Chinese version of the Mini-Mental State Examination up to 6 years. Participants were subsequently followed for a median (IQR) of 2.89 (1.38-3.12) years to obtain their survival status and date of death.
Chinese version of the Mini-Mental State Examination was used to measure participants' cognitive function.
Through use of group-based trajectory modeling, we determined three cognitive trajectory groups. Then, after adjusting for confounding factors, we found a monotonic and positive association between cognitive decline and mortality risk. Meanwhile, the association varied among elderly populations in different age groups and BMI categories, but did not differ by sex, smoking, drinking and exercising. Older seniors, females and those with poorer baseline cognitive function and less social participation tended to be more likely to be in the unfavorable trajectory groups.
We found that the faster the cognitive decline, the higher the mortality, especially among those aged 65-79 years and those overweight. Our findings suggested the importance of implement better monitoring of the cognitive function of the elderly population.
本研究旨在识别中国老年人群的认知衰退轨迹，探讨这些轨迹与死亡率之间的关联，并进一步确定与认知衰退特定轨迹相关的风险因素。
前瞻性队列研究。
采用基于群组的轨迹建模和 Cox 比例风险模型来探讨认知轨迹组与死亡率之间的关联，同时构建多项逻辑回归模型来估计潜在的风险因素。
我们纳入了来自中国长寿纵向研究的三个连续但无重叠队列的 7082 名年龄在 65 岁及以上的参与者，这些参与者在基线时接受了 6 年的中文版简易精神状态检查。随后，对参与者进行了中位数（IQR）为 2.89（1.38-3.12）年的随访，以获取其生存状态和死亡日期。
使用中文版简易精神状态检查来测量参与者的认知功能。
通过基于群组的轨迹建模，我们确定了三个认知轨迹组。然后，在调整了混杂因素后，我们发现认知衰退与死亡率风险之间存在单调正相关。同时，这种关联在不同年龄组和 BMI 类别的老年人群中存在差异，但与性别、吸烟、饮酒和运动无关。年龄较大的老年人、女性以及基线认知功能较差和社会参与度较低的老年人更有可能处于不利的轨迹组。
我们发现认知衰退越快，死亡率越高，尤其是在 65-79 岁和超重的人群中。我们的研究结果表明，实施更好的老年人认知功能监测的重要性。
