Correlation between trajectories of cognitive functions and disability among the elderly
Objective To investigate the trajectories of cognitive functions and the risk of disability among the elderly in China,so as to provide the evidence for reducing the burden of disability and promoting healthy aging among the elderly.Methods Six waves of longitudinal data were collected from the Chinese Longitudinal Healthy Longevity Survey(CLHLS),and the elderly at ages of 65 years and older were selected as study subjects.The cognitive function was evaluated using the Mini-mental State Examination(MMSE)scale,and the disability was assessed with the Activities of Daily Living(ADL)scale.The trajectories of cognitive functions were classi-fied with the growth mixture modeling(GMM),and the risk of disability was analyzed among the elderly with different trajectories of cognitive functions.Results A total of 3 359 elderly individuals were enrolled,and two trajectories of cognitive functions were identi-fied,including normal cognitive functions and cognitive decline.There were 3 141 elderly individuals with complete disability variables,with a median cognitive score of 27.00 points and a disability percentage of 20.53％.Logistic regression analysis showed that the risk of disability was 6.14 times(95％CI:4.86～7.76,P＜0.01)higher among the elderly with cognitive decline trajectories than among those with normal cognitive functions,and advanced age(75 to 84 years,OR=2.61;85 years and older,OR=6.61),living in urban ar-eas(OR=1.47)and depression(OR=1.26)were risk factors of disability and males(OR=0.79)and an educational level of prima-ry school(OR=0.77)were protective factors of disability(all P values＜0.05).Conclusions There are two trajectories of cognitive functions among the elderly in China,and there is a higher risk of disability among the elderly with cognitive decline trajectories.
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