Turning Point of Cognitive Decline for Chinese Older Adults from a Longitudinal Analysis: Protective Factors and Risk Factors

Abstract

Objectives: To explore the turning point of cognitive decline in Chinese older adults and to explore the influencing factors including covariates. Participants: Aged 65 and older whose cognitive function was normal at their first test. Methods: a secondary analysis that identified participants from the database of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Cohort-sequential design was used to categorize the data by age (rather than study wave), including the follow-up data of Chinese older adults aged 65–79 years and spanning 14 years. Cognitive function in 1278 participants was assessed using the Chinese Mini-Mental State Examination (CMMSE) in five waves over 14 years. Piecewise latent growth curve modeling was used to analyze the data. Results: (1) The turning point of cognitive decline in Chinese older adults occurs between the ages of 68 and 70. (2) There are statistically significant individual differences in the initial level of cognitive function and the growth rate of cognitive function before and after the transition stage. (3) Factors influencing cognitive function include residence, education level, smoking, drinking, exercise, leisure activities, social activities, Activities of Daily Living (ADL), and Instrumental Activities for Daily Living (IADL). (4) Exercise and ADL are the main protective factors, while smoking and drinking are the main risk factors. Conclusions: There is a transition stage (68–70) in the decline of cognitive function in Chinese older adults and four main factors (such as smoking, drinking, exercise and ADL) have impacts on the cognitive decline. We should strengthen these protective factors (exercise and ADL) for the cognitive decline of older adults and avoid these risk factors (smoking, drinking). To prevent the decline of the cognitive function of older adults, the government should build more places conducive to activities for older adults and actively encourage older adults to improve their physical activity level. Given our findings, public health interventions centered on alcohol and tobacco cessation in older adults should be governmentally endorsed.

Can the Frailty of Older Adults in China Change? Evidence from a Random-Intercept Latent Transition Profile Analysis

“…Data were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) [ 1 ], which is a large national representative database focusing on older adults in China, covering 631 county-level administrative regions in 23 provinces, autonomous regions, and municipalities in China. Participants included a large, random sample of Chinese elders involved in the CLHLS [ 27 ].…”

“…The aging of the population and the care of older adults pose major challenges to the global health care system. In 2020, the number of people aged 60 and over around the world surpassed the number of children under 5 years old for the first time in history [ 1 ]. China’s aging problem is also very severe.…”

Reading Holy Quran Associated With Better Cognitive Function in Older Adults: A Systematic Review

“…Additionally, promoting social participation has been recognized as an important strategy for preventing a decline in the cognitive function of older adults, especially those living in rural areas ( Yang et al, 2021 ). Furthermore, identifying protective factors and risk factors through longitudinal analysis can inform the development of interventions aimed at preventing the decline of cognitive function in older adults ( G. Li & Li, 2022 ). Moreover, the interaction of diet and history of stroke with the risk of cognitive decline underscores the importance of lifestyle and medical history in interventions targeting cognitive health in older adults ( Xu et al, 2022 ).…”

Latent transition analysis of instrumental activities of daily living in Chinese elderly: based on the 2014–2018 wave of the Chinese Longitudinal Healthy Longevity Survey

“…Residential status also influences IADL, with studies showing that rural residents and those who live alone are more likely to experience IADL impairment [ 15 , 16 ]. Unhealthy habits such as smoking and alcohol consumption have detrimental effects on IADL [ 17 , 18 ], contributing to the development of chronic diseases, impaired cognitive function, and weakening physical capabilities. Encouraging elderly individuals to engage in social and leisure activities has been suggested as a way to delay the onset of impaired IADL, regardless of the specific type of activity [ 19 ].…”