Determinants of cognitive health in the elderly: a comprehensive analysis of demographics, health status, and lifestyle factors from NHANES.

This study analyzes data from the National Health and Nutrition Examination Survey (NHANES) to identify factors influencing cognitive performance among the elderly, as measured by the Digit Symbol Substitution Test (DSST). Employing multivariable linear regression, we evaluated the impact of demographic, lifestyle, and health-related factors on cognitive function in U.S. adults aged 60 and older. Our findings indicate that advanced age, particularly in those aged 70-79 and 80 + years, is associated with lower DSST scores. Male gender is linked with reduced cognitive performance, while higher educational attainment appears protective. Lifestyle factors, including current smoking and higher alcohol consumption, negatively impact cognitive outcomes, and excessive sleep duration (over 9 h) is also detrimental. Among health conditions, diabetes, chronic heart failure, and a history of stroke were associated with cognitive declines. Furthermore, increasing severity of depression correlates with lower cognitive function. These results underline the need for comprehensive public health strategies that integrate lifestyle modifications and chronic disease management to maintain cognitive health in older adults.