Wu Xueqin, Tang Yufu, He Yushan, Wang Qiwei, Wang Yinhui, Qin Xiujun
School of Public Health, Shanxi Medical University, Taiyuan, China.
Shanxi Provincial Key Laboratory of Drug Toxicology and Radiation Damage Drugs, Department of Radiology and Environmental Medicine, China Institute for Radiation Protection, Taiyuan, China.
Front Public Health. 2024 Dec 24;12:1500172. doi: 10.3389/fpubh.2024.1500172. eCollection 2024.
Cognitive impairment is a major public health concern in aging societies. This study aimed to investigate the prevalence of cognitive impairment and its associated factors among Chinese adults aged 60 years and older using data from the 2018 China Health and Retirement Longitudinal Study (CHARLS).
Utilizing data from the 2018 wave of CHARLS, we assessed participants' cognitive status using the Mini-Mental State Examination (MMSE), and the influencing factors related to cognitive impairment were analyzed by using the chi-square test and multifactor logistic regression. The prevalence of cognitive impairment was stratified by gender, education level, residence, marital status, daytime napping, and nighttime sleep duration, and the trend of cognitive impairment prevalence with age was observed.
9,804 participants were finally included in the study and the overall prevalence of cognitive impairment was 44.04% (95%CI, 43.02-45.06%). The prevalence was significantly higher in females (50.8%) than males (37.1%), and increased with age, from 41.5% in those aged 60-64 years to 57.7% in those aged ≥75 years. Lower educational level, rural residence, and being divorced/ widowed/unmarried were associated with a higher prevalence of cognitive impairment (all < 0.001). Multifactor logistic regression indicated that older age (OR = 1.51, 95%CI, 1.33-1.73 for ≥75 vs. 60-64 years), female gender (OR = 1.54, 95%CI, 1.35-1.77), higher education (OR = 0.46, 95%CI, 0.42-0.51 for primary school and below vs. illiteracy), rural areas (OR = 2.35, 95%CI, 2.07-2.65 for village vs. the center of city/town), divorced/ widowed/unmarried status (OR = 1.40, 95%CI, 1.25-1.57) and participation in physical activity (OR = 0.80, 95%CI, 0.73-0.87) were significantly associated with cognitive impairment.
Cognitive impairment is highly prevalent among older adults in China with substantial demographic disparities. Targeted interventions and public health strategies are needed to promote cognitive health in this rapidly aging population.
认知障碍是老龄化社会中的一个主要公共卫生问题。本研究旨在利用2018年中国健康与养老追踪调查（CHARLS）的数据，调查60岁及以上中国成年人认知障碍的患病率及其相关因素。
利用CHARLS 2018年调查的数据，我们使用简易精神状态检查表（MMSE）评估参与者的认知状况，并通过卡方检验和多因素逻辑回归分析与认知障碍相关的影响因素。认知障碍的患病率按性别、教育水平、居住地、婚姻状况、白天小睡和夜间睡眠时间进行分层，并观察认知障碍患病率随年龄的变化趋势。
最终9804名参与者纳入本研究，认知障碍的总体患病率为44.04%（95%CI，43.02 - 45.06%）。女性患病率（50.8%）显著高于男性（37.1%），且随年龄增长而增加，从60 - 64岁人群中的41.5%增至75岁及以上人群中的57.7%。较低的教育水平、农村居住以及离婚/丧偶/未婚与较高的认知障碍患病率相关（均P < 0.001）。多因素逻辑回归表明，高龄（≥75岁与60 - 64岁相比，OR = 1.51，95%CI，1.33 - 1.73）、女性（OR = 1.54，95%CI，1.35 - 1.77）、较高教育水平（小学及以下与文盲相比，OR = 0.46，95%CI，0.42 - 0.51）、农村地区（农村与城市/城镇中心相比，OR = 2.35，95%CI，2.07 - 2.65）、离婚/丧偶/未婚状态（OR = 1.40，95%CI，1.25 - 1.57）以及参与体育活动（OR = 0.80，95%CI，0.73 - 0.87）与认知障碍显著相关。
中国老年人中认知障碍非常普遍，且存在显著的人口统计学差异。需要有针对性的干预措施和公共卫生策略来促进这一快速老龄化人群的认知健康。
