Changes in Cognitive Function and Risk Factors for Cognitive Impairment of the Elderly in China: 2005–2014
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Settings
2.2. Measurement
2.2.1. Cognitive Function
2.2.2. Cognitive Impairment
2.2.3. Socio-Demographic and Health Related Characteristics
2.3. Statistical Analysis
3. Results
3.1. Changes and Demographic Differences in Cognitive Function of Chinese Elderly
3.1.1. Changes in the Cognitive Function of the Chinese Elderly: 2005–2014
3.1.2. Demographic Differences of the Cognitive Function of Chinese Elderly: 2005–2014
3.2. Risk Factors for Cognitive Impairment of the Chinese Elderly
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
AD | Alzheimer’s disease |
ADL | Activities of daily living |
CLHLS | Chinese Longitudinal Healthy Longevity Survey |
CVD | Cerebrovascular diseases |
MMSE | Mini-mental state examination |
PWB | Psychological well-being |
References
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Domain | Question | Score (Total = 30) |
---|---|---|
Orientation | What time of day is it right now (morning, afternoon, evening)? | 1 |
What is the animal year of this year? | 1 | |
What is the date (day and month) of the mid-autumn festival? | 1 | |
What is the season right now? | 1 | |
What is the name of this county or district? | 1 | |
Naming foods | Please name as many kinds of food as possible in 1 minute (1 point for each food and 7 points for those who name 7 or more foods). | 7 |
Registration | Table, apple, cloth. Please repeat these 3 objects. | 3 |
Attention and calculation | I will ask you to spend $3 from $20, then you must spend $3 from the number you arrived at and continue to spend $3 until you are asked to stop. | 5 |
Copy a figure | The individual is asked to draw a figure of overlapping pentagons. | 1 |
Recall | Name the 3 objects learned earlier (table, apple, and cloth). | 3 |
Language | Naming pen and watch. | 2 |
Repeating the following sentence: “What you plant is what you will get.” | 1 | |
The individual is asked to follow the interviewer’s instruction: “Take the paper using your right hand, fold it in the middle using both hands, and place the paper on the floor.” | 3 |
Variables | Measurement | 2005 (%) | 2008 (%) | 2011 (%) | 2014 (%) | p-Value |
---|---|---|---|---|---|---|
Gender | Male = 0 | 47.06% | 47.06% | 47.06% | 47.06% | <0.001 |
female = 1 | 52.94% | 52.94% | 52.94% | 52.94% | ||
Age | 64 to 75 = 1 | 60.85% | 46.75% | 30.46% | 13.17% | <0.001 |
76 to 85 = 2 | 26.77% | 34.69% | 44.41% | 51.71% | ||
86 and over = 3 | 12.37% | 18.55% | 25.12% | 35.11% | ||
Education (years) | No formal education = 1 | 50.71% | 50.71% | 50.71% | 50.71% | <0.001 |
1 to 6 = 2 | 35.69% | 35.69% | 35.69% | 35.69% | ||
7 or more = 3 | 13.60% | 13.60% | 13.60% | 13.60% | ||
Marriage status | Without spouse = 0 | 44.30% | 49.56% | 54.43% | 59.26% | <0.001 |
Have spouse = 1 | 55.70% | 50.44% | 45.57% | 40.74% | ||
Income (yuan) | Continuous measurements | 2374 (1.03) | 2412 (1.15) | 2253 (1.30) | 2347 (1.31) | <0.001 |
Place of residence | City =1 | 17.13% | 16.98% | 20.28% | 21.21% | <0.001 |
Town = 2 | 18.86% | 23.01% | 35.42% | 38.80% | ||
Rural = 3 | 64.00% | 60.01% | 44.30% | 39.99% | ||
Coresidence | Living with family = 1 | 86.05% | 83.17% | 82.20% | 81.26% | <0.001 |
Living alone = 2 | 12.87% | 15.44% | 16.07% | 16.55% | ||
Living in nursing home = 3 | 1.08% | 1.38% | 1.73% | 2.19% | ||
PWB | Continuous measurements | 26.38(4.04) | 25.97(3.79) | 27.02(4.06) | 26.50(4.15) | <0.001 |
Fresh fruit intake | Rarely or never = 1 | 23.67% | 20.28% | 28.04% | 29.55% | <0.001 |
Sometimes = 2 | 40.57% | 39.99% | 34.96% | 34.05% | ||
Often = 3 | 24.74% | 26.93% | 21.69% | 21.88% | ||
Almost every day = 4 | 11.03% | 12.79% | 15.31% | 15.52% | ||
Fresh vegetable intake | Rarely or never = 1 | 1.58% | 1.38% | 2.50% | 3.97% | <0.001 |
Sometimes = 2 | 8.91% | 7.07% | 6.11% | 7.12% | ||
Often = 3 | 33.38% | 23.74% | 25.74% | 26.53% | ||
Almost every day = 4 | 56.13% | 67.81% | 65.66% | 62.38% | ||
Smoking | Past and present = 1 | 22.65% | 18.42% | 18.05% | 15.12% | <0.001 |
Past or present = 2 | 16.49% | 20.76% | 20.28% | 23.11% | ||
Rarely or never = 3 | 60.86% | 60.82% | 61.66% | 61.77% | ||
rinking | Past and present = 1 | 32.65% | 25.38% | 26.30% | 22.27% | <0.001 |
Past or present = 2 | 13.35% | 18.54% | 17.87% | 18.94% | ||
Rarely or never = 3 | 54.00% | 56.08% | 55.84% | 58.79% | ||
Exercising | Past and present = 1 | 22.69% | 18.92% | 19.45% | 16.03% | <0.001 |
Past or present = 2 | 24.62% | 36.19% | 40.49% | 36.90% | ||
Rarely or never = 3 | 52.69% | 44.88% | 40.06% | 47.07% | ||
Outdoor activity | Rarely or never = 1 | 19.98% | 23.43% | 26.05% | 35.08% | <0.001 |
Sometimes = 2 | 6.65% | 5.03% | 5.57% | 4.28% | ||
Monthly = 3 | 4.88% | 4.30% | 2.23% | 2.58% | ||
Weekly = 4 | 12.45% | 12.29% | 11.37% | 9.98% | ||
Daily = 5 | 56.05% | 54.94% | 54.78% | 48.07% | ||
Playing Cards or Mahjong | Rarely or never = 1 | 73.88% | 76.87% | 79.42% | 81.07% | <0.001 |
Sometimes = 2 | 5.53% | 4.61% | 3.92% | 3.43% | ||
Monthly = 3 | 3.76% | 2.96% | 2.00% | 2.35% | ||
Weekly = 4 | 8.28% | 5.65% | 5.62% | 5.36% | ||
Daily = 5 | 8.57% | 9.91% | 9.04% | 7.79% | ||
Social activities | Rarely or never = 1 | 79.63% | 82.64% | 79.18% | 81.18% | <0.001 |
Sometimes = 2 | 10.26% | 6.99% | 10.62% | 9.53% | ||
Monthly = 3 | 3.11% | 4.23% | 2.89% | 2.82% | ||
Weekly = 4 | 2.81% | 2.38% | 2.96% | 2.35% | ||
Daily = 5 | 4.19% | 3.76% | 4.35% | 4.13% | ||
ADL | Continuous measurements | 17.91 (0.63) | 17.88 (0.80) | 17.58 (1.42) | 17.03 (2.43) | <0.001 |
Hypertension | No = 0 | 78.67% | 76.26% | 66.52% | 62.18% | 0.703 |
Yes = 1 | 21.33% | 23.74% | 33.48% | 37.82% | ||
Diabetes | No = 0 | 97.33% | 96.66% | 94.82% | 92.77% | 0.741 |
Yes = 1 | 2.67% | 3.34% | 5.18% | 7.23% | ||
Heart disease | No = 0 | 90.59% | 89.73% | 85.46% | 83.45% | 0.020 |
Yes = 1 | 9.41% | 10.27% | 14.54% | 16.55% | ||
Stroke or CVD | No = 0 | 95.32% | 93.92% | 91.42% | 88.66% | <0.001 |
Yes = 1 | 4.68% | 6.08% | 8.58% | 11.34% | ||
Orthopedic disease | No = 0 | 91.87% | 98.12% | 95.29% | 95.68% | <0.001 |
Yes = 1 | 8.13% | 1.88% | 4.71% | 4.32% |
Phase/Year | Deterioration | Unchanged | Improvement | |
---|---|---|---|---|
Phase 1 | 2005–2008 | 1185 (45.52%) | 534 (20.51%) | 884 (33.96%) |
Phase 2 | 2008–2011 | 1154 (44.33%) | 475 (18.25%) | 974 (37.42%) |
Phase 3 | 2011–2014 | 1225 (47.06%) | 512 (19.67%) | 866 (33.27%) |
Overall | 2005–2014 | 1434 (55.09%) | 448 (17.21%) | 721 (27.70%) |
Characteristic Variables | 2005 | 2008 | 2011 | 2014 | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
F | p | F | p | F | p | F | p | |||||
Male | 27.87 a | 92.19 | <0.001 | 27.07 | 64.23 | <0.001 | 26.68 | 87.14 | <0.001 | 25.52 | 87.57 | <0.001 |
3.50 b | 4.91 | 5.22 | 6.87 | |||||||||
(−0.8) c | (−1.19) | (−2.35) | ||||||||||
Female | 26.32 | 25.33 | 24.47 | 22.69 | ||||||||
4.58 | 6.00 | 6.68 | 8.38 | |||||||||
(−0.99) | (−1.85) | (−3.63) | ||||||||||
64 to 75 | 27.91 | 124.95 | <0.001 | 27.59 | 176.25 | <0.001 | 27.49 | 141.76 | <0.001 | 27.32 | 190.42 | <0.001 |
3.13 | 4.01 | 3.54 | 4.09 | |||||||||
(−0.32) | (−0.42) | (−0.59) | ||||||||||
76 to 85 | 26.40 | 26.28 | 25.91 | 25.73 | ||||||||
4.42 | 4.72 | 5.51 | 5.94 | |||||||||
(−0.12) | (−0.49) | (−0.67) | ||||||||||
86 and over | 24.25 | 22.30 | 22.40 | 20.29 | ||||||||
6.19 | 8.12 | 8.15 | 9.71 | |||||||||
(−1.95) | (−1.85) | (−3.96) | ||||||||||
Have spouse | 27.91 | 147.59 | <0.001 | 27.27 | 111.74 | <0.001 | 26.88 | 112.79 | <0.001 | 26.10 | 130.92 | <0.001 |
3.18 | 4.33 | 4.66 | 6.04 | |||||||||
(−0.64) | (−1.03) | (−1.81) | ||||||||||
Without spouse | 25.97 | 25.01 | 24.38 | 22.60 | ||||||||
4.96 | 6.43 | 6.89 | 8.57 | |||||||||
(−0.96) | (−1.59) | (−3.37) | ||||||||||
No formal education | 25.99 | 101.15 | <0.001 | 24.97 | 72.27 | <0.001 | 23.93 | 104.94 | <0.001 | 22.20 | 83.24 | <0.001 |
4.60 | 6.15 | 6.86 | 8.50 | |||||||||
(−1.02) | (−2.06) | (−3.79) | ||||||||||
1 to 6 | 27.85 | 27.00 | 26.76 | 25.61 | ||||||||
3.61 | 4.92 | 5.18 | 6.61 | |||||||||
(−0.85) | (−1.09) | (−2.24) | ||||||||||
7 or more | 28.90 | 28.32 | 28.12 | 26.68 | ||||||||
2.42 | 3.60 | 3.28 | 6.43 | |||||||||
(−0.58) | (−0.77) | (−2.22) | ||||||||||
Urban | 28.05 | 19.97 | <0.001 | 27.12 | 8.15 | <0.001 | 26.02 | 5.01 | 0.006 | 24.15 | 0.45 | 0.636 |
3.01 | 4.94 | 6.37 | 8.20 | |||||||||
(−0.93) | (−2.03) | (−3.9) | ||||||||||
Town | 27.32 | 25.85 | 25.73 | 24.14 | ||||||||
24.14 | 5.45 | 5.87 | 7.55 | |||||||||
(−1.47) | (−1.59) | (−3.18) | ||||||||||
Rural | 26.70 | 25.99 | 25.10 | 23.85 | ||||||||
4.39 | 5.78 | 6.21 | 7.90 | |||||||||
(−0.7) | (−1.6) | (−2.8) | ||||||||||
Whole | 27.05 | 26.15 | 25.51 | 24.03 | ||||||||
4.18 | 5.58 | 6.13 | 7.83 | |||||||||
(−0.9) | (−1.5) | (−3.0) |
Variables | Odds Ratio | SE | z-Values | p-Values | 95%CI |
---|---|---|---|---|---|
Gender | 1.41 | 0.14 | 3.50 | <0.001 | 1.16–1.72 |
Age | 1.07 | 0.01 | 15.52 | <0.001 | 1.06–1.08 |
Education | 0.91 | 0.01 | −6.35 | <0.001 | 0.88–0.94 |
Marriage | 0.72 | 0.06 | −3.58 | <0.001 | 0.61–0.87 |
Income | 0.93 | 0.03 | −2.40 | 0.016 | 0.88–0.99 |
Place of residence | 0.91 | 0.05 | −1.74 | 0.081 | 0.82–1.01 |
Coresidence | 0.94 | 0.09 | −0.68 | 0.495 | 0.78–1.13 |
PWB | 0.93 | 0.01 | −7.51 | <0.001 | 0.91–0.95 |
Fresh fruit intake | 0.81 | 0.03 | −5.03 | <0.001 | 0.75–0.88 |
Fresh vegetable intake | 0.84 | 0.04 | −3.76 | <0.001 | 0.76–0.92 |
Smoking | 1.11 | 0.08 | 1.39 | 0.166 | 0.96–1.28 |
Drinking | 0.92 | 0.06 | −1.21 | 0.228 | 0.81–1.05 |
Exercising | 0.98 | 0.06 | −0.29 | 0.770 | 0.88–1.10 |
Outdoor activities | 0.89 | 0.02 | −5.44 | <0.001 | 0.85–0.93 |
Play cards/mahjong | 0.84 | 0.03 | −4.50 | <0.001 | 0.79–0.91 |
Social activities | 0.81 | 0.04 | −3.68 | <0.001 | 0.73–0.91 |
ADL | 0.77 | 0.02 | −9.05 | <0.001 | 0.72–0.81 |
Hypertension | 1.22 | 0.10 | 2.36 | 0.018 | 1.03–1.44 |
Diabetes | 1.07 | 0.20 | 0.35 | 0.730 | 0.74–1.54 |
Heart disease | 0.77 | 0.09 | −2.10 | 0.036 | 0.61–0.98 |
Stroke or CVD | 1.35 | 0.19 | 2.18 | 0.029 | 1.03–1.77 |
Orthopedic disease | 0.81 | 0.16 | −1.07 | 0.284 | 0.55–1.19 |
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Zhang, Q.; Wu, Y.; Han, T.; Liu, E. Changes in Cognitive Function and Risk Factors for Cognitive Impairment of the Elderly in China: 2005–2014. Int. J. Environ. Res. Public Health 2019, 16, 2847. https://doi.org/10.3390/ijerph16162847
Zhang Q, Wu Y, Han T, Liu E. Changes in Cognitive Function and Risk Factors for Cognitive Impairment of the Elderly in China: 2005–2014. International Journal of Environmental Research and Public Health. 2019; 16(16):2847. https://doi.org/10.3390/ijerph16162847
Chicago/Turabian StyleZhang, Qilin, Yanli Wu, Tiankuo Han, and Erpeng Liu. 2019. "Changes in Cognitive Function and Risk Factors for Cognitive Impairment of the Elderly in China: 2005–2014" International Journal of Environmental Research and Public Health 16, no. 16: 2847. https://doi.org/10.3390/ijerph16162847
APA StyleZhang, Q., Wu, Y., Han, T., & Liu, E. (2019). Changes in Cognitive Function and Risk Factors for Cognitive Impairment of the Elderly in China: 2005–2014. International Journal of Environmental Research and Public Health, 16(16), 2847. https://doi.org/10.3390/ijerph16162847