Research On Cognitive Impairment Of The Elderly And Its Influencing Factors

Objectives:This study used cohort study design to understand the prevalence of cognitive impairment in the elderly,and explore its influencing factors from the perspectives of demographic characteristics,behavioral lifestyles,physical health status,mental health status and social participation status,in order to provide a reference for relevant departments to formulate more detailed prevention and control strategies and measures for cognitive impairment,and provide scientific basis for the prevention and control of the occurrence and development of cognitive impairment in the elderly.Methods:In this study,the data of four follow-up surveys of the Chinese Longitudinal Healthy Longevity Survey(CLHLS)waves from 2008 to 2009,2011 to 2012,2014 and 2017 to 2018 were used.6770 elderly people with sound cognition in the 2008 survey were taken as the research subjects.SPSS 24.0 and R 4.2.1 were used for data screening and statistical analysis.Descriptive analysis was used to describe the basic conditions of the study subjects.Considering the competitive risk of death among the elderly,the cumulative risk model was used for univariate analysis to estimate the cumulative incidence of cognitive impairment in the elderly,and Gray test was used for inter-group comparison.In multivariate analysis,the sub-distribution hazard model was used to explore the factors affecting the cognitive impairment of the elderly.Results:1.The cumulative incidence of cognitive impairment and death over a 10-year follow-up period was 27.4% and 42.3%,respectively.2.The results of univariate analysis showed the subjects with different gender,age,marital status,education level,living arrangement,self-rated economic status,dietary diversity,smoking status,drinking status,physical exercise status,sleep duration,BMI status,IADL status,hearing status,vision status,chewing ability status,loneliness status,self-uselessness status,social intercourse participation status,recreational social participation status and organized social activities participation status,there were statistically significant differences in the cumulative incidence of cognitive impairment among the elderly(P < 0.05).3.During the follow-up period,the cumulative incidence of cognitive impairment of women increased and was always higher than that of men.The cumulative incidence of cognitive impairment of people with no spouse and illiteracy was higher than that people with spouse and non-illiteracy.The cumulative incidence of cognitive impairment of people living alone was always higher than that of people living with their families,and the cumulative incidence of cognitive impairment of people with poor self-rated economy was always higher.With the increase of follow-up time,the cumulative incidence of cognitive impairment in people with poor dietary diversity increases and was always higher than that in people with good dietary diversity.The cumulative incidence of cognitive impairment in people who smoke,drink and exercise at each time point were lower than that in people who don’t smoke,drink or exercise.And the cumulative incidence of cognitive impairment in people with thin BMI was higher at each time point.The cumulative incidence of cognitive impairment in patients with IADL disorder increased at all time points and was always higher than that in those without IADL disorder.With the increase of follow-up time,the cumulative incidence of cognitive impairment increased in the people with hearing impairment,visual impairment and poor chewing ability at each time point and was always higher than that in the persons with no hearing impairment,no visual impairment and good chewing ability.The cumulative incidence of cognitive impairment in those who often or always feel lonely or useless is always higher than that in those who never feel lonely or useless.The cumulative incidence of cognitive impairment at each time point in the people with social intercourse participation or organized social activities participation was lower than that in the people without social intercourse participation or organized social activities participation.4.The results of the sub-distribution hazard model showed that after considering the competitive risk of death,gender,age,educational level,self-rated economic status,dietary diversity,IADL status,and chewing ability were the influencing factors of cognitive impairment in the elderly.Increased cumulative incidence of cognitive impairment in women compared with men(HR = 1.585,95% CI =(1.410,1.780)).The cumulative incidence of cognitive impairment of people greater than or equal to80 years old was greater than people from 65 to 79 years old(HR = 1.452,95% CI =(1.281,1.640)).The cumulative incidence of cognitive impairment was higher in the illiterate than in the non-illiterate(HR = 1.396,95% CI =(1.250,1.560)).Compared with those who rated themselves as having good economic conditions,the cumulative incidence of cognitive impairment increased among those who rated themselves as having poor economic conditions(HR = 1.216,95% CI =(1.019,1.450)).The cumulative incidence of cognitive impairment increased in people with poor dietary diversity(HR = 1.120,95% CI =(1.016,1.240)).The cumulative incidence of cognitive impairment in IADL patients increased(HR = 1.182,95% CI =(1.052,1.330)).Increased cumulative incidence of cognitive impairment in people with poor chewing ability(HR = 1.134,95% CI =(1.025,1.250)).Conclusions:1.The cumulative incidence of cognitive impairment was 27.4% during the10-year follow-up from 2008 to 2018.It is very important to prevent and control cognitive impairment in the elderly.2.During the 10-year follow-up,the cumulative incidence of cognitive impairment in the elderly at different time points in different groups increased year by year with the increase of follow-up time.3.During the 10-year follow-up,the cumulative incidence of cognitive impairment in the elderly was higher among people who were women,≥ 80 years old,or having no spouse,poor self-rated economic status,poor dietary diversity,no exercise,thin BMI,IADL disorder,hearing impairment,visual impairment,poor chewing ability,loneliness or self-uselessness.However,the cumulative incidence of cognitive impairment among the group of smoking,drinking,social intercourse participation or organized social activities participation was relatively low.4.In this study,the competitive risk of death among the elderly was considered,and the sub-distribution hazard model was used to conclude that female,aged ≥ 80 years old,illiteracy,poor self-rated economic status,poor dietary diversity,IADL disorder and poor chewing ability were the risk factors for cognitive impairment in the elderly.