"Instrumental activities of daily living trajectories and risk of mild cognitive impairment among Chinese older adults: results of the Chinese longitudinal healthy longevity survey, 2002-2018"

作者全名："Yang, Jialu; Zhang, Yangchang; Shen, Shisi; Yu, Han; Yang, Luran; Zhao, Yao; Xiong, Yang; Su, Jiayi; Wang, Lianlian; Lei, Xun"

作者地址："[Yang, Jialu; Zhang, Yangchang; Lei, Xun] Chongqing Med Univ, Sch Publ Hlth & Management, Chongqing, Peoples R China; [Yang, Jialu; Zhang, Yangchang; Lei, Xun] Chongqing Med Univ, Res Ctr Med & Social Dev, Chongqing, Peoples R China; [Yang, Jialu; Zhang, Yangchang; Lei, Xun] Chongqing Med Univ, Innovat Ctr Social Risk Governance Hlth, Chongqing, Peoples R China; [Zhang, Yangchang; Lei, Xun] Chongqing Med Univ, Res Ctr Publ Hlth Secur, Chongqing, Peoples R China; [Shen, Shisi; Yang, Luran] Chongqing Med Univ, Sch Clin Med 1, Chongqing, Peoples R China; [Yu, Han] Chongqing Med Univ, Sch Clin Med 2, Chongqing, Peoples R China; [Zhao, Yao] Chongqing Med Univ, Affiliated Hosp 2, Chongqing, Peoples R China; [Xiong, Yang] Sichuan Univ, West China Hosp, Chengdu, Peoples R China; [Su, Jiayi] Jiang Jin Cent Hosp Chongqing, Chongqing, Peoples R China; [Wang, Lianlian] Chongqing Med Univ, Affiliated Hosp 1, Dept Reprod Ctr, Chongqing, Peoples R China; [Wang, Lianlian] Chongqing Med Univ, State Key Lab Maternal & Fetal Med Chongqing Munic, Chongqing, Peoples R China"

通信作者："Lei, X (通讯作者)，Chongqing Med Univ, Sch Publ Hlth & Management, Chongqing, Peoples R China.; Lei, X (通讯作者)，Chongqing Med Univ, Res Ctr Med & Social Dev, Chongqing, Peoples R China.; Lei, X (通讯作者)，Chongqing Med Univ, Innovat Ctr Social Risk Governance Hlth, Chongqing, Peoples R China.; Lei, X (通讯作者)，Chongqing Med Univ, Res Ctr Publ Hlth Secur, Chongqing, Peoples R China.; Wang, LL (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Reprod Ctr, Chongqing, Peoples R China.; Wang, LL (通讯作者)，Chongqing Med Univ, State Key Lab Maternal & Fetal Med Chongqing Munic, Chongqing, Peoples R China."

来源：FRONTIERS IN PUBLIC HEALTH

ESI学科分类：SOCIAL SCIENCES, GENERAL

WOS号：WOS:000988397900001

JCR分区：Q2

影响因子：3

年份：2023

卷号：11

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：CLHLS; GBTM; IADL; MCI; Chinese older adults

摘要："BackgroundThe association between the instrumental activities of daily living (IADL) score and the risk of initial cognitive function impairment is inconclusive. We aimed to identify distinctive IADL trajectories and examine their relationship with the onset of mild cognitive impairment (MCI) among Chinese older people. MethodsThe study used six-wave longitudinal data from the Chinese Longitudinal Healthy Longevity Survey conducted between 2002 and 2018. It included a total of 11,044 Chinese people aged 65 years or older. A group-based trajectory model was used to identify distinctive trajectories of the IADL score, and the Cox proportional hazards model was used to explore the hazard ratio of various trajectories at the onset of MCI. Interaction analysis was used to analyze individual modification between the IADL trajectories and the onset of MCI. Finally, we adopted four types of sensitivity analysis to verify the robustness of the results. ResultsDuring a median follow-up of 16 years, the incidence of MCI was 6.29 cases per 1,000 person-years (95% confidence interval [CI] 5.92-6.68). Three distinct IADL trajectory groups were identified: a low-risk IADL group (41.4%), an IADL group with increasing risk (28.5%), and a high-risk IADL group (30.4%). Using the Cox proportional hazards model after adjusting for covariates, we found that compared with the low risk IADL group, the hazard ratio of the IADL group with increasing risk was 4.49 (95% CI = 3.82-5.28), whereas that of the high-risk IADL group was 2.52 (95% CI 2.08-3.05). Treating the IADL group with increasing risk as the reference, the hazard ratio for the high-risk IADL group was 0.56 (95% CI 0.48-0.66). Interaction analyses showed that age and residence were significant moderators (P for interaction <0.05). ConclusionA group-based trajectory model was developed to classify older people into three distinct trajectory groups of the IADL score. The IADL group with increasing risk had a greater risk of MCI than the high-risk IADL group. In the IADL group with increasing risk, city residents of >= 80 years were the most likely to develop MCI."

基金机构：National Natural Science Foundation of China [72174033]; Science and Technology Research Project of Chongqing Education Commission [KJQN202100432]

基金资助正文：The present study was supported by the National Natural Science Foundation of China (Grant No. 72174033) and the Science and Technology Research Project of Chongqing Education Commission (Grant No. KJQN202100432).