The Distribution Characteristics Of Mild Cognitive Impairment Among Older Adults And Its Association With Mortality In Urban And Rural Areas Of Beijing

Objective: The aim of this study was to clarify the distribution characteristics of mild cognitive impairment(MCI)and its its influencing factors among older adults in urban and rural areas of Beijing,and to investigate the association between MCI and mortality in old adults,so as to provide basic data for the early prevention and treatment of MCI.Methods: Data were obtained from the Beijing Comprehensive Health Cohort Study of the Elderly,a multi-stage randomized whole-group sampling design with a baseline survey of elderly people in urban Haidian District and Miyun district communities in Beijing from 2009 to 2014,with follow-up until March 2021.The Chinese version of MMSE(CMMSE)was used to assess the cognitive function of old adults and to classify MCI.Factors influencing CMMSE scores were analyzed using linear regression models,and MCI influences were analyzed using multifactorial logistic regression.Using the Kaplan-Meier method to plot survival curves and to compare survival rates,five models were designed with stepwise correction covariates to quantify the effect of association between MCI and mortality by the Cox proportional risk model and to assess the hazard ratio(HR)and 95% CI for reporting MCI and death.covariates included demographic characteristics,lifestyle,and diseases.Results: 1.The baseline prevalence of MCI in the elderly in urban and rural communities in Beijing was 22.2%,and showed a trend of increasing with age.The prevalence of MCI was significantly higher in female elderly than in male(P<0.05),and the prevalence of MCI was significantly higher in rural areas than in urban areas(P<0.05).Meanwhile,advanced age,rural area,female,stroke,dyslipidemia,family history of hypertension,SBP,higher BMI and TC were potential risk factors for MCI,and higher education level,exercise time ≥5h per week,higher HC and higher LDL-C were potential protective factors for MCI.2.A total of 667(14.8%)deaths occurred in 4,499 older adults during the follow-up period.In the fully adjusted model,MCI patients had a 1.441-fold increased risk of all-cause mortality [HR=1.441,(95%CI: 1.196,1.737)] and a 1.646-fold increased risk of death from CVD [HR=1.646,(95% CI: 1.246,2.173)] compared to elderly with normal cognitive function.After similar multivariate adjustment,each SD increase in standardized MMSE score was associated with a 15.3% reduction in all-cause mortality [HR=0.847,(95%CI:0.769,0.933)] and a 28.8% reduction in the risk of CVD death [HR=0.712,(95%CI:0.621,0.817)]Conclusion: This study found that the prevalence of MCI was high in the elderly in this region and that multiple traditional factors influenced MCI prevalence.MCI has shown significant value as a predictor of all-cause mortality and CVD mortality risk independent of traditional mortality risk.The results suggest that regular assessment of cognitive function and screening for MCI in the elderly population should be strengthened,and more targeted measures should be developed to reduce the risk of MCI and mortality.