Cognitive Function Trajectories and Factors among Chinese Older Adults with Subjective Memory Decline: CHARLS Longitudinal Study Results (2011–2018)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Cognitive Assessment
2.2.1. Subjective Memory Decline
2.2.2. Cognitive Function
2.3. Covariates
2.3.1. Demographic and Health-Related Variables
2.3.2. Instrumental Activities of Daily Living (IADL)
2.3.3. Depression
2.4. Statistical Analysis
3. Results
3.1. Descriptive Statistics
3.2. Univariate LGCM of Cognitive Function
3.3. Conditional LGCM
3.4. Unconditional Parallel Process LGCM
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Baseline (n = 1465) | n/mean | %/SD | n/mean | %/SD | ||||
Age | 65.47 | 4.56 | Male | 884 | 60.34% | |||
Education | Female | 581 | 39.66% | |||||
Illiterate | 165 | 11.26% | Smoking (Yes) | 706 | 48.19% | |||
Primary school or below | 863 | 58.91% | Smoking (No) | 759 | 51.81% | |||
Middle school | 289 | 19.73% | Drinking (Yes) | 432 | 37.75% | |||
High school or above | 148 | 10.10% | Drinking (No) | 912 | 62.25% | |||
Four Waves | 2011 | 2013 | 2015 | 2018 | ||||
n/mean | %/SD | n/mean | %/SD | n/mean | %/SD | n/mean | %/SD | |
Married with spouse present | 1243 | 84.85% | 1224 | 83.55% | 1184 | 80.82% | 1109 | 75.70% |
Chronic diseases | ||||||||
Hypertension | 459 | 31.46% | 521 | 35.59% | 587 | 40.65% | 747 | 50.99% |
Dyslipidemia | 200 | 13.91% | 253 | 17.29% | 267 | 18.53% | 400 | 27.30% |
Diabetes | 116 | 7.98% | 153 | 10.45% | 166 | 11.40 | 245 | 16.72% |
Heart disease | 250 | 17.16% | 282 | 19.26% | 329 | 22.55% | 430 | 29.35% |
Stroke | 34 | 2.32% | 44 | 3.00% | 45 | 3.09% | 151 | 10.31% |
Memory-related disease | 27 | 1.85% | 28 | 1.91% | 44 | 3.01% | 93 | 6.35% |
Sleeping time | ||||||||
Night sleeping time (hours) | 6.17 | 1.79 | 6.04 | 1.72 | 6.18 | 1.90 | 6.08 | 2.05 |
Napping time (minutes) | 36.25 | 43.17 | 43.29 | 46.59 | 41.82 | 44.76 | 47.35 | 54.86 |
Cognitive functions | ||||||||
Global cognition | 15.59 | 4.22 | 15.56 | 4.53 | 14.66 | 4.60 | 13.97 | 5.64 |
Orientation | 4.09 | 1.09 | 4.09 | 1.17 | 4.04 | 1.16 | 3.84 | 1.16 |
Episodic memory | 7.24 | 2.95 | 7.23 | 3.10 | 6.65 | 3.18 | 6.65 | 4.01 |
Calculation | 3.50 | 1.74 | 3.50 | 1.72 | 3.26 | 1.80 | 2.87 | 1.89 |
Constructability | 0.76 | 0.43 | 0.75 | 0.43 | 0.71 | 0.45 | 0.61 | 0.49 |
IADL | 5.55 | 1.51 | 5.53 | 1.57 | 5.68 | 1.83 | 6.01 | 2.28 |
Depression | 8.52 | 6.13 | 7.69 | 5.42 | 7.74 | 6.21 | 8.45 | 6.32 |
Depression symptoms | 424 | 28.94% | 307 | 20.96% | 352 | 24.03% | 418 | 28.59% |
A. Univariate LGCM | |||||||||||
Mean | Variance | Fit Indexes | |||||||||
n = 1465 | Intercept | Slope | Intercept | Slope | Correlation | χ2 | df | CFI | TLI | RMSEA | SRMR |
Global cognition | 15.759 *** | −0.251 *** | 7.778 *** | 0.094 ** | 0.413 *** | 26.412 *** | 5 | 0.988 | 0.985 | 0.054 | 0.025 |
Orientation | 4.134 *** | −0.038 *** | 0.507 *** | 0.008 ** | −0.011 | 25.549 *** | 5 | 0.980 | 0.976 | 0.053 | 0.030 |
Episodic memory | 7.264 *** | −0.104 *** | 2.714 *** | 0.038 * | 0.161 ** | 20.759 *** | 5 | 0.984 | 0.980 | 0.046 | 0.022 |
Calculation | 3.591 *** | −0.095 *** | 0.839 *** | 0.007 | 0.007 | 20.226 ** | 5 | 0.975 | 0.971 | 0.046 | 0.030 |
Constructability | 0.779 *** | −0.022 *** | 0.048 *** | <0.001 | <0.001 | 15.365 ** | 5 | 0.977 | 0.972 | 0.038 | 0.021 |
B. Conditional LGCM | |||||||||||
Global Cognition a | Orientation a | Episodic Memory a | Calculation a | Constructability a | |||||||
n = 1426 | β | SE | β | SE | β | SE | β | SE | β | SE | |
Intercept | 5.824 *** | 0.267 | 5.835 *** | 0.287 | 4.500 *** | 0.295 | 3.829 *** | 0.281 | 3.394 *** | 0.285 | |
Intercept variance | 0.677 *** | 0.037 | 0.706 *** | 0.041 | 0.779 *** | 0.043 | 0.774 *** | 0.120 | 0.513 *** | 0.099 | |
Slope | −1.142 ** | 0.260 | −0.265 | 0.207 | −0.972 ** | 0.291 | −1.215 ** | 0.462 | −0.389 | 3.382 | |
Slope variance | 0.766 *** | 0.084 | 0.955 *** | 0.037 | 0.659 *** | 0.133 | 0.836 *** | 0.120 | 0.895 ** | 0.282 | |
Correlation | 0.255 | 0.183 | −0.257 *** | 0.093 | 0.198 | 0.256 | −0.063 | 0.224 | 0.075 | 0.378 | |
Intercept on Baseline | |||||||||||
Age | −0.157 *** | 0.034 | 0.008 | 0.035 | −0.219 *** | 0.041 | −0.080 | 0.042 | −0.048 | 0.042 | |
Gender | 0.010 | 0.045 | −0.024 | 0.046 | 0.123 * | 0.055 | −0.122 * | 0.056 | −0.097 | 0.056 | |
≤Primary school | −0.105 *** | 0.035 | −0.036 | 0.037 | −0.133 ** | 0.044 | −0.037 | 0.045 | 0.008 | 0.045 | |
Middle school | 0.248 *** | 0.037 | 0.239 *** | 0.038 | 0.148 ** | 0.045 | 0.189 *** | 0.047 | 0.349 *** | 0.048 | |
≥High school | 0.368 *** | 0.039 | 0.315 *** | 0.041 | 0.308 *** | 0.049 | 0.229 *** | 0.050 | 0.328 *** | 0.052 | |
Smoking status | 0.028 | 0.041 | 0.007 | 0.043 | 0.008 | 0.051 | 0.065 | 0.052 | 0.040 | 0.052 | |
Drinking status | −0.038 | 0.036 | −0.027 | 0.038 | −0.053 | 0.045 | 0.010 | 0.046 | 0.032 | 0.046 | |
Marriage | −0.030 | 0.680 | 0.010 | 0.072 | −0.058 | 0.089 | 0.047 | 0.089 | 0.026 | 0.095 | |
Night sleeping time | 0.054 | 0.053 | −0.016 | 0.055 | 0.017 | 0.068 | 0.097 | 0.067 | 0.154 * | 0.103 | |
Napping time | −0.052 | 0.051 | −0.032 | 0.053 | −0.106 | 0.066 | 0.023 | 0.066 | 0.020 | 0.071 | |
CCVD | −0.002 | 0.075 | 0.113 | 0.077 | −0.131 | 0.097 | 0.051 | 0.098 | 0.154 | 0.103 | |
IADL | −0.118 * | 0.051 | −0.128 * | 0.054 | −0.122 | 0.067 | −0.018 | 0.067 | −0.047 | 0.072 | |
Depression | −0.108 | 0.056 | −0.129 * | 0.058 | −0.038 | 0.074 | −0.058 | 0.073 | −0.045 | 0.079 | |
Slope on Baseline | |||||||||||
Age | −0.158 ** | 0.061 | −0.073 | 0.057 | −0.130 | 0.070 | −0.155 | 0.094 | −0.085 | 0.102 | |
Gender | 0.073 | 0.078 | −0.050 | 0.075 | 0.143 | 0.092 | −0.114 | 0.118 | 0.015 | 0.130 | |
≤Primary school | −0.023 | 0.062 | 0.011 | 0.059 | −0.046 | 0.071 | −0.004 | 0.090 | −0.062 | 0.105 | |
Middle school | 0.226 ** | 0.068 | 0.061 | 0.061 | 0.243 ** | 0.080 | 0.159 | 0.102 | −0.123 | 0.113 | |
≥High school | 0.189 ** | 0.071 | −0.012 | 0.066 | 0.271 ** | 0.087 | −0.011 | 0.111 | 0.101 | 0.119 | |
Smoking status | −0.092 | 0.072 | −0.118 | 0.069 | 0.055 | 0.082 | −0.136 | 0.108 | 0.051 | 0.120 | |
Drinking status | 0.001 | 0.063 | 0.003 | 0.060 | 0.026 | 0.072 | −0.048 | 0.093 | −0.023 | 0.105 | |
Marriage | 0.083 | 0.105 | −0.033 | 0.082 | 0.105 | 0.122 | 0.059 | 0.158 | −0.054 | 0.179 | |
Night sleeping time | −0.103 | 0.087 | −0.033 | 0.081 | −0.003 | 0.101 | −0.261 | 0.139 | −0.211 | 0.159 | |
Napping time | 0.058 | 0.086 | 0.006 | 0.081 | 0.137 | 0.101 | −0.055 | 0.127 | −0.017 | 0.145 | |
CCVD | 0.157 | 0.117 | 0.111 | 0.113 | 0.226 | 0.135 | −0.049 | 0.175 | −0.072 | 0.200 | |
IADL | 0.136 | 0.087 | 0.068 | 0.083 | 0.130 | 0.102 | 0.062 | 0.129 | 0.196 | 0.159 | |
Depression | −0.013 | 0.096 | 0.053 | 0.091 | −0.116 | 0.111 | 0.089 | 0.142 | −0.138 | 0.166 | |
TVCs → Cognitive Functions | |||||||||||
T1(Marriage) → T1 | 0.021 | 0.042 | 0.005 | 0.043 | 0.027 | 0.047 | −0.025 | 0.046 | 0.018 | 0.047 | |
T2(Marriage) → T2 | 0.073 * | 0.028 | 0.031 | 0.030 | 0.063 * | 0.032 | 0.028 | 0.034 | 0.027 | 0.033 | |
T3(Marriage) → T3 | 0.054 * | 0.021 | 0.044 | 0.023 | 0.030 | 0.024 | 0.035 | 0.024 | 0.015 | 0.024 | |
T4(Marriage) → T4 | 0.078 ** | 0.025 | 0.011 | 0.028 | 0.088 ** | 0.027 | 0.042 | 0.030 | −0.058 | 0.030 | |
T1(Night sleeping time) → T1 | −0.033 | 0.037 | 0.009 | 0.038 | −0.031 | 0.041 | −0.017 | 0.046 | −0.077 | 0.042 | |
T2(Night sleeping time) → T2 | −0.038 | 0.023 | −0.042 | 0.025 | −0.026 | 0.026 | −0.019 | 0.027 | −0.030 | 0.027 | |
T3(Night sleeping time) → T3 | 0.006 | 0.020 | 0.020 | 0.022 | 0.001 | 0.023 | −0.008 | 0.025 | −0.007 | 0.024 | |
T4(Night sleeping time) → T4 | 0.005 | 0.020 | −0.028 | 0.022 | 0.010 | 0.022 | 0.034 | 0.024 | −0.017 | 0.024 | |
T1(Napping time) → T1 | 0.036 | 0.035 | 0.0019 | 0.037 | 0.063 | 0.040 | −0.012 | 0.040 | −0.021 | 0.041 | |
T2(Napping time) → T2 | −0.022 | 0.022 | −0.012 | 0.024 | −0.035 | 0.025 | 0.010 | 0.026 | 0.018 | 0.025 | |
T3(Napping time) → T3 | −0.016 | 0.020 | −0.032 | 0.022 | 0.003 | 0.023 | −0.023 | 0.025 | −0.018 | 0.025 | |
T4(Napping time) → T4 | 0.011 | 0.020 | 0.017 | 0.024 | −0.008 | 0.023 | <0.001 | 0.025 | 0.001 | 0.025 | |
T1(CCVD) → T1 | 0.072 | 0.050 | −0.006 | 0.052 | 0.143 * | 0.056 | −0.028 | 0.056 | −0.059 | 0.056 | |
T2(CCVD) → T2 | 0.059 | 0.032 | 0.006 | 0.052 | 0.066 | 0.036 | −0.046 | 0.038 | 0.111 | 0.037 | |
T3(CCVD) → T3 | 0.006 | 0.026 | −0.030 | 0.028 | 0.041 | 0.029 | <0.001 | 0.030 | −0.006 | 0.030 | |
T4(CCVD) → T4 | 0.025 | 0.026 | −0.032 | 0.029 | 0.051 | 0.029 | 0.014 | 0.031 | −0.037 | 0.031 | |
T1(IADL) → T1 | −0.022 | 0.036 | −0.044 | 0.037 | 0.010 | 0.041 | −0.017 | 0.041 | −0.090 * | 0.042 | |
T2(IADL) → T2 | −0.053 * | 0.002 | −0.053 * | 0.024 | −0.034 | 0.025 | −0.024 | 0.027 | −0.052 * | 0.026 | |
T3(IADL) → T3 | −0.040 | 0.021 | −0.055 * | 0.023 | −0.007 | 0.024 | −0.048 * | 0.026 | −0.091 *** | 0.025 | |
T4(IADL) → T4 | −0.071 ** | 0.021 | −0.071 ** | 0.024 | −0.030 | 0.024 | −0.079 ** | 0.026 | −0.094 *** | 0.026 | |
T1(Depression) → T1 | −0.110 ** | 0.039 | −0.006 | 0.041 | −0.160 *** | 0.044 | 0.011 | 0.044 | −0.064 | 0.045 | |
T2(Depression) → T2 | −0.134 *** | 0.024 | −0.123 *** | 0.026 | −0.124 *** | 0.027 | −0.062 * | 0.029 | −0.078 ** | 0.028 | |
T3(Depression) → T3 | −0.100 *** | 0.022 | −0.110 *** | 0.024 | −0.099 *** | 0.025 | −0.004 | 0.027 | −0.048 | 0.026 | |
T4(Depression) → T4 | −0.157 *** | 0.022 | −0.099 *** | 0.025 | −0.158 *** | 0.025 | −0.070 ** | 0.027 | −0.026 | 0.028 | |
Fit Indexes | |||||||||||
χ2 | 98.558 | 126.072 ** | 106.172 * | 75.770 | 75.080 | ||||||
df | 79 | 79 | 79 | 79 | 79 | ||||||
CFI | 0.992 | 0.970 | 0.981 | 1.000 | 1.000 | ||||||
TLI | 0.987 | 0.950 | 0.969 | 1.006 | 1.009 | ||||||
RMSEA | 0.013 | 0.020 | 0.016 | <0.001 | <0.001 | ||||||
SRMR | 0.010 | 0.010 | 0.010 | 0.008 | 0.007 |
C. Unconditional PP-LGCM | |||||
---|---|---|---|---|---|
N = 1462 | β | SE | β | SE | |
Global cognition on IADL a | Orientation on IADL a | ||||
I(IADL) → I(GC) | −0.347 *** | 0.064 | I(IADL) → I(OR) | −0.368 *** | 0.069 |
S(IADL) → I(GC) | 0.067 | 0.083 | S(IADL) → I(OR) | 0.106 | 0.088 |
I(IADL) → S(GC) | 0.364 * | 0.151 | I(IADL) → S(OR) | 0.252 * | 0.120 |
S(IADL) → S(GC) | −0.637 ** | 0.184 | S(IADL) →S(OR) | −0.417 ** | 0.147 |
Episodic memory on IADL a | Calculation on IADL a | ||||
I(IADL) → I(EM) | −0.260 ** | 0.070 | I(IADL) → I(CA) | −0.223 ** | 0.075 |
S(IADL) → I(EM) | 0.001 | 0.088 | S(IADL) → I(CA) | 0.067 | 0.094 |
I(IADL) → S(EM) | 0.244 | 0.155 | I(IADL) → S(CA) | 0.316 | 0.188 |
S(IADL) → S(EM) | −0.437 * | 0.196 | S(IADL) → S(CA) | −0.592 * | 0.249 |
Constructability on IADL a | Global cognition on Depression a | ||||
I(IADL) → I(CO) | −0.427 *** | 0.090 | I(DP) → I(GC) | −0.408 *** | 0.043 |
S(IADL) → I(CO) | 0.243 * | 0.113 | S(DP) → I(GC) | 0.178 | 0.117 |
I(IADL) → S(CO) | 0.625 | 0.326 | I(DP) → S(GC) | −0.054 | 0.115 |
S(IADL) → S(CO) | −0.891 * | 0.428 | S(DP) → S(GC) | −0.868 ** | 0.286 |
Orientation on Depression a | Episodic memory on Depression a | ||||
I(DE) → I(OR) | −0.349 *** | 0.047 | I(DE) → I(EM) | −0.383 *** | 0.050 |
S(DE) → I(OR) | 0.172 | 0.126 | S(DE) → I(EM) | 0.188 | 0.133 |
I(DE) → S(OR) | 0.037 | 0.093 | I(DE) → S(EM) | −0.102 | 0.129 |
S(DE) → S(OR) | −0.559 * | 0.239 | S(DE) → S(EM) | −0.880 * | 0.339 |
Calculation on Depression a | Constructability on Depression a | ||||
I(DE) → I(CA) | −0.223 *** | 0.049 | I(DE) → I(CO) | −0.358 *** | 0.051 |
S(DE) → I(CA) | 0.074 | 0.123 | S(DE) → I(CO) | 0.088 | 0.130 |
I(DE) → S(CA) | 0.005 | 0.106 | I(DE) → S(CO) | 0.122 | 0.136 |
S(DE) → S(CA) | −0.455 | 0.278 | S(DE) → S(CO) | −0.412 | 0.348 |
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Ma, C.; Li, M.; Wu, C. Cognitive Function Trajectories and Factors among Chinese Older Adults with Subjective Memory Decline: CHARLS Longitudinal Study Results (2011–2018). Int. J. Environ. Res. Public Health 2022, 19, 16707. https://doi.org/10.3390/ijerph192416707
Ma C, Li M, Wu C. Cognitive Function Trajectories and Factors among Chinese Older Adults with Subjective Memory Decline: CHARLS Longitudinal Study Results (2011–2018). International Journal of Environmental Research and Public Health. 2022; 19(24):16707. https://doi.org/10.3390/ijerph192416707
Chicago/Turabian StyleMa, Chifen, Mengyuan Li, and Chao Wu. 2022. "Cognitive Function Trajectories and Factors among Chinese Older Adults with Subjective Memory Decline: CHARLS Longitudinal Study Results (2011–2018)" International Journal of Environmental Research and Public Health 19, no. 24: 16707. https://doi.org/10.3390/ijerph192416707