Tang Fengyan, Yin Qingqing, Da Wendi, Jin Guoping, Jiang Yanping
School of Social Work, University of Pittsburgh. 2318 Cathedral of Learning, Pittsburgh, PA 15260, United States.
Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States.
J Nutr Health Aging. 2025 Apr;29(4):100511. doi: 10.1016/j.jnha.2025.100511. Epub 2025 Feb 14.
To examine patterns of physical frailty changes, their sociocultural correlates, and associations with initial cognitive functioning and cognitive decline over an eight-year observation period among community-dwelling older Chinese immigrants.
An 8-year follow-up longitudinal study.
2,835 community-dwelling adults aged 60 and above living in Chicago, who self-identified as Chinese, with a mean age of 72.5 years at baseline.
Frailty was assessed using five indicators across the five waves, and patterns of change were identified through repeated measures latent class analysis (RMLCA). Cognitive functioning was assessed using the Chinese Mini-Mental State Examination (C-MMSE). The associations between frailty patterns and cognitive change trajectories were evaluated using latent growth curve modeling (LGCM), adjusted for sociodemographic, health, and immigration covariates.
Four distinct frailty patterns were identified: least frail (53%), decreased frailty (21%), increased frailty (15%), and constantly frail (11%), with differential sociodemographic and immigration profiles. Compared to the least frail class, respondents in the increased frailty class (intercept: B = -0.108, p < .05; slope: B = -0.073, p < .001) and the constantly frail class (intercept: B = -0.150, p < .01; slope: B = -0.043, p < .001) showed poorer initial cognitive functioning and faster rates of cognitive decline after controlling for covariates. No significant differences in cognitive outcomes were observed between the least frail and the decreased frailty classes. Compared to Cantonese speakers, Mandarin speakers experienced a slower rate of cognitive decline (B = 0.033, p < .001).
These findings demonstrate that physical frailty is associated with cognitive decline, particularly among older Chinese immigrants who remain constantly frail or experience increasing frailty over time. Clinical interventions should prioritize addressing both physical frailty and cognitive decline, with special attention to vulnerable subgroups within this population.
研究社区居住的老年华裔移民在八年观察期内身体虚弱变化模式、其社会文化相关因素以及与初始认知功能和认知衰退的关联。
一项为期8年的随访纵向研究。
2835名居住在芝加哥的60岁及以上社区成年人，他们自我认定为华裔，基线时平均年龄为72.5岁。
在五个时间点使用五个指标评估虚弱状况，并通过重复测量潜在类别分析（RMLCA）确定变化模式。使用中文版简易精神状态检查表（C-MMSE）评估认知功能。使用潜在增长曲线模型（LGCM）评估虚弱模式与认知变化轨迹之间的关联，并对社会人口统计学、健康和移民协变量进行调整。
确定了四种不同的虚弱模式：最不虚弱（53%）、虚弱程度降低（21%）、虚弱程度增加（15%）和持续虚弱（11%），各模式在社会人口统计学和移民特征方面存在差异。与最不虚弱类别相比，在控制协变量后，虚弱程度增加类别（截距：B = -0.108，p <.05；斜率：B = -0.073，p <.001）和持续虚弱类别（截距：B = -0.150，p <.01；斜率：B = -0.043，p <.001）的受访者初始认知功能较差，认知衰退速度较快。最不虚弱类别和虚弱程度降低类别在认知结果上未观察到显著差异。与说粤语者相比，说普通话者的认知衰退速度较慢（B = 0.033，p <.001）。
这些发现表明，身体虚弱与认知衰退相关，特别是在那些持续虚弱或随着时间推移虚弱程度增加的老年华裔移民中。临床干预应优先解决身体虚弱和认知衰退问题，特别关注该人群中的脆弱亚组。
