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Prospective Evaluation of the Association Between Arthritis and Cognitive Functions in Middle-Aged and Elderly Chinese

ABSTRACT: Background: Assessing the relation between arthritis and cognitive impairment could expand the understanding of health consequences of arthritis. The aim was to prospectively examine the association between arthritis and cognitive functions among middle-aged and elderly Chinese. Methods: Our analyses were based on data from the nationwide China Health and Retirement Longitudinal Study (2011–2016). Arthritis was ascertained by self-reported doctor diagnosis during the baseline survey. Cognitive functions were evaluated in three domains including episodic memory, mental status, and global cognition. Linear mixed models were employed to assess the association between baseline arthritis and cognition functions. Results: Of 7,529 Chinese adults, 49.79% were men, and mean age was 57.53 years. During a follow-up of 4 years, participants with baseline arthritis showed lower scores of episodic memory [β = −0.08; 95% confidence interval (CI): −0.14, −0.03], mental status (β = −0.14; 95% CI: −0.22, −0.05), and global cognition (β = −0.22; 95% CI: −0.34, −0.11), compared to those without arthritis. In addition, participants with arthritis showed increased rates of decline in mental status and global cognition by 0.04 (95% CI: 0.01, 0.08) and 0.05 (95% CI: 0.01, 0.09) units per year, respectively. Conclusion: Arthritis was associated with subsequent risk of poorer cognitive functions and slightly faster declines in cognitive functions among Chinese middle-aged and elderly adults. Our findings should be confirmed in future large prospective studies in Chinese and other populations.

SUBMITTER: Liu W

PROVIDER: S-EPMC8579809 | biostudies-literature |

REPOSITORIES: biostudies-literature

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A Prospective Study on the Association Between Grip Strength and Cognitive Function Among Middle-Aged and Elderly Chinese Participants.

Project description:Objective:To study the efficacy of grip strength (GS) as a predictor of cognitive function in a large, nationwide sample of Chinese participants aged 45 years and above. Methods:We used data from three waves (W1, W2, and W3) fielded by the China Health and Retirement Longitudinal Study (CHARLS). Cognitive function was tested biennially and calculated using two categories: episodic memory and mental intactness. Demographics, health behaviors, and medical conditions were considered potential confounders. Using multivariate linear regression models (MLRMs), we examined the association between baseline GS (measure in W1) and cognitive function in W3. Using a generalized estimating equation (GEE), we examined baseline GS as a predictor of cognitive function change. Results:Total 9,333 individuals (53.2% women), with a mean baseline episodic memory score of 6.5, mean baseline mental intactness score of 7.2, and aged over 45 years (mean age = 58.6), were selected. The mean follow-up time was 4.0 years (range: 3.3-5.0 years). Using MLRMs and comparing the lowest GS score with the highest baseline GS score, we observed a significant correlation with a higher global cognitive function in both women (? = 1.061, p < 0.001) and men (? = 1.233, p < 0.001). After adjusting baseline global cognition, the highest GS level was still statistically significant in both women (? = 0.543, p < 0.05) and men (? = 0.742, p < 0.001). GEE suggested that the participants in the highest GS quartile had better cognitive performance over time in both women (? = 0.116, p = 0.030) and men (? = 0.143, p = 0.008) than those in the lowest quartile. Conclusion:Higher baseline level of GS was significantly related to better cognitive function and slowed the rate of its decline. Thus, it is an independent predictor of better cognitive status in middle-aged and elderly Chinese.

| S-EPMC6747049 | biostudies-literature

Patterns of cognitive function in middle-aged and elderly Chinese adults-findings from the EMCOA study.

Project description:BackgroundThe principal aim of this study was to demonstrate the gender-specific cognitive patterns among middle-aged and elderly Chinese adults, investigate the risk factors on global and domain-specific cognitive performance in men and women, respectively, and report demographically adjusted norms for cognitive tests.MethodsThe Effects and Mechanism of Cholesterol and Oxysterol on Alzheimer's disease (EMCOA) study enrolled 4573 participants aged 50-70 years in three Chinese cities. All participants underwent an extensive neuropsychological test battery. Composite scores for specific domains were derived from principal component analysis (PCA). Multivariate linear regression models were used to determine gender-specific risk factors and demographically adjusted normative data.ResultsThree cognitive domains of verbal memory, attention/processing speed/executive function, and cognitive flexibility were extracted. A female advantage in verbal memory was observed regardless of age, whereas men tended to outperform women in global cognition and attention/processing speed/executive function. The effects of education on women were more substantial than men for general cognition and attention/processing speed/executive function. For all the cognitive tests, regression-based and demographically adjusted normative data were calculated.ConclusionsThere is a need for gender-specific intervention strategies for operationalizing cognitive impairment.Trial registrationEMCOA, ChiCTR-OOC-17011882 . Retrospectively registered on 5 July 2017.

| S-EPMC6138914 | biostudies-literature

Nephrolithiasis Among Middle Aged and Elderly Urban Chinese: A Report from Prospective Cohort Studies in Shanghai.

Project description:IntroductionKidney stone risk factors are understudied among Asians. Our study objective was to investigate associations of obesity and other chronic diseases with incident kidney stones among the urban Chinese.Patients and methodsIncluded in this study are two prospective cohorts: the Shanghai Women's Health Study (N?=?69,166) and Shanghai Men's Health Study (N?=?58,054). Incident kidney stones were determined by self-report in 2004 and 2008. Cox regression models were used to evaluate the associations of study variables with stone risk with adjustment of demographics, medical history, and dietary intakes.ResultsThere were 2653 incident stones over 1,007,958 person-years of follow-up. Overall incidence rates (per 1000 person-years, 95% confidence interval [CI]) were 2.10 (1.99, 2.21) among women and 3.80 (3.59, 4.02) among men. Higher body mass index (BMI) was associated with risk (BMI ?25 vs 18.5-24.9?kg/m2, women: hazard ratio [HR]?=?1.14 [95% CI 1.01, 1.28]; men: HR?=?1.17 [1.03, 1.32]). High waist-hip ratio (?0.80 and ?0.90 for women and men, respectively) was associated with risk (HR 1.13, 95% CI 1.01, 1.27 for women; HR 1.19, 95% CI 1.05, 1.35 for men). Coronary heart disease or stroke history was associated with risk in women only (HR 1.31, 95% CI 1.10, 1.56). Hypertension history was associated with risk in men only (HR 1.27, 95% CI 1.11, 1.45). No significant association with diabetes mellitus was observed.ConclusionsAmong the Chinese, kidney stone incidence in men is almost twice that of women. Obesity is a shared risk factor. Hypertension history is associated with risk in men, whereas history of coronary heart disease or stroke is associated with risk in women.

| S-EPMC5734141 | biostudies-literature

Association between cognitive function and ambient particulate matters in middle-aged and elderly Chinese adults: Evidence from the China Health and Retirement Longitudinal Study (CHARLS).

Project description:Increasing studies have discussed how ambient air pollution affects cognitive function, however, the results are inconsistent, and such studies are limited in developing countries. To fill the gap, in this study, we aimed to explore the effect of ambient particulate matters (PM1, PM2.5, PM10) on cognitive function of middle-aged and elderly Chinese adults. A total of 7928 participants older than 45 were included from CHARLS collected in 2011, 2013, and 2015. Cognitive function was evaluated with two dimensions, the first one was episodic memory and the second dimension was mental status. The total score of cognitive function was the sum of above two dimensions (0-31 points). Participants' exposure to ambient particulate matters was estimated by using a satellite-based spatiotemporal model. Linear mixed models were applied to analyze the impact of PM1, PM2.5, and PM10 on cognition function. Further interaction analyses were applied to examine the potential effect modifications on the association. After adjusting for confounding factors, we found an IQR increase in all three ambient particulate matters was significantly associated with a decrease in cognitive function score, with the greatest effect in the 90-day exposure window for PM1 (β = -0.227, 95%CI: -0.376, -0.078) and PM2.5 (β = -0.220, 95%CI: -0.341, -0.099). For ambient PM10, the most significant exposure window was 60-day (β = -0.158, 95%CI: -0.274, -0.042). Interaction analyses showed that the PM-cognitive function association could be modified by gender, region, alcohol consumption, smoking, education level, chronic diseases, and depressive symptoms. In conclusion, exposure to ambient particulate matter for a certain period would significantly decrease cognitive function among middle-aged and elderly Chinese. Furthermore, individuals who were female, or lived in the midland of China were more susceptible to the adverse effect of particulate matters.

| S-EPMC9112163 | biostudies-literature

Association Between Childhood Neighborhood Quality and the Risk of Cognitive Dysfunction in Chinese Middle-Aged and Elderly Population: The Moderation Effect of Body Mass Index.

Project description:Background: Identification of early modifiable factors is crucial to delay or prevent the development of cognitive impairment and reduce the social and economic burden. Objective: This study aimed to examine the longitudinal associations of childhood neighborhood quality (CNQ) with the risk of later-life cognitive dysfunction and the role of body mass index (BMI) in this association. Methods: A total of 8,289 community-dwelling middle-aged and elderly population from wave 2011, wave 2013, and wave 2015 of the China Health and Retirement Longitudinal Study (CHARLS) were included. Cognitive function and CNQ were measured by standardized questionnaires. Multilevel linear regression models were used to estimate the associations of CNQ and cognitive function. The interactions of BMI with CNQ in the progress of cognitive function were also estimated. Results: The participants with higher CNQ had a significantly low risk of cognitive impairment than those with lower CNQ score (β = 0.067, 95% CI: 0.031, 0.103), and the results remained similar (β = 0.039, 95% CI: 0.004, 0.075) after controlling other confounding variables. Furthermore, there was an interaction between BMI with CNQ score (P < 0.001) for the risk of cognitive impairment. In BMI-stratified analysis, we found that the association of CNQ and cognitive function was not statistically significant in overweight or obese population (β = 0.019, 95% CI: -0.032, 0.070), but was statistically significant in people with lower BMI (β = 0.059, 95% CI: 0.010, 0.107). Conclusions: Higher CNQ score is significantly associated with the lower risk of cognitive dysfunction in adulthood. BMI may moderate the associations of CNQ with the risk of cognitive function.

| S-EPMC8155274 | biostudies-literature

Association of Vascular Aging With Cardiovascular Disease in Middle-Aged Chinese People: A Prospective Cohort Study.

Project description:BackgroundWhether middle-aged individuals with a greater difference between chronological age and vascular age show a lower cardiovascular disease risk remains to be clarified.ObjectivesThis study sought to examine whether individuals with supernormal vascular aging (VA) have a lower cardiovascular disease risk than do individuals with normal VA.MethodsThis prospective cohort study included 20,917 middle-aged (40-60 years) participants from the Kailuan Study. VA was defined as the predicted age in a multivariate regression model, including classic cardiovascular risk factors and pulsed wave velocity. The chronological age minus the VA was defined as the Δ-age, and the 10th and 90th percentiles of the Δ-age were used as cutoffs to define early VA and supernormal VA, respectively. The outcome was a composite of myocardial infarction, hospital admission for heart failure, and stroke. The study used Cox proportional hazards regression to examine the association between the VA categories and the incident cardiovascular outcome.ResultsDuring the median 4.6-year follow-up period, 584 endpoint events were observed. After adjusting for potential variables, when compared with the normal VA group, the supernormal VA group had a decreased rate of cardiovascular events (HR: 0.47; 95% CI: 0.35-0.64), and the early VA group had an increased rate (HR: 1.90; 95% CI: 1.22-2.95) of cardiovascular events.ConclusionsIndividuals with supernormal VA are at a lower risk of cardiovascular events, and individuals with early VA are at a higher risk of cardiovascular events than individuals with normal VA. Further characterization may provide novel insight into future preventive strategies against cardiovascular disease.

| S-EPMC10751638 | biostudies-literature

Association of serum fatty acid and estimated desaturase activity with hypertension in middle-aged and elderly Chinese population.

Project description:We aimed to investigate the cross-sectional associations of serum fatty acid (FA) and related ?-desaturase with hypertension among 2,447 community-dwellers aged 35-79 years living in Zhejiang Province, China. Individual FA was determined in serum, ?(5)-desaturase (D5D) and ?(6)-desaturase (D6D) activities were indirectly estimated by FA product/precursor ratios. Participants in the highest quartile of D5D component scores (20:4n-6, 20:5n-3, 22:6n-3 and D5D) have significantly lower odds of hypertension compared with individuals in the lowest (multivariate-adjusted odds ratio (OR)?=?0.68, 95%?CI: 0.46-0.98). When further stratified by gender, high D5D component scores were significantly associated with lower odds of hypertension in women (OR?=?0.53, 95%?CI: 0.35-0.80), but not in men (OR?=?0.78, 95%?CI: 0.52-1.18). Multivariate-adjusted prevalent OR for an interquartile increment of individual FA and estimated desaturase was 1.27 (95%?CI: 1.08-1.50) for 16:0, 1.15 (95%?CI: 1.01-1.30) for 16:1n-7, 0.89 (95%?CI: 0.80-0.99) for 22:6n-3, 1.32 (95%?CI: 1.01-1.72) for D6D (18:3n-6/18:2n-6), and 0.74 (95%?CI: 0.56, 0.98) for D5D (20:4n-6/20:3n-6). Present findings suggested that high serum 22:6n-3 and D5D as well as low 16:0, 16:1n-7 and D6D were associated with a low prevalence of hypertension in this Chinese population.

| S-EPMC4804219 | biostudies-literature

Higher visit-to-visit total cholesterol variability is associated with lower cognitive function among middle-aged and elderly Chinese men.

Project description:To examine the prospective associations between total cholesterol (TC) variability and cognitive function in a large sample of Chinese participants aged 45 years and above. A total of 6,377 people who participated in the China Health and Retirement Longitudinal Study (CHARLS) were included. TC variability was defined as the intra-individual standard deviation over two blood tests in CHARLS 2011 and 2015 (Wave 1 and Wave 3). Cognitive function was assessed by a global cognition score, which included three tests: episodic memory, figure drawing and Telephone Interview of Cognitive Status (TICS). Multivariate linear regression models (MRLMs) and generalized estimating equation (GEE) were used to investigate associations between TC variability and cognitive scores. After adjusting for potential confounders, male participants with higher visit-to-visit TC variability showed lower global cognition scores (??=?- 0.71, P?<?0.001). After further adjustment for baseline cognition, the association remained statistically significant (??=?- 0.68, P?<?0.001). The domains with declines were focused on episodic memory (??=?- 0.22, P?=?0.026) and TICS (??=?- 0.44, P?=?0.004). However, these associations were not found in women (??=?- 0.10, P?=?0.623). For men, the rates of decline in global cognition increased by 0.14 (??=?- 0.14, P?=?0.009) units per year while TC variability increased by 1 mmol/L. For males, higher visit-to-visit TC variability correlated with lower cognitive function and an increased rate of decreases in memory. More attention should be paid to cognitive decline in males with high TC variability, and particularly, on decreases in memory, calculation, attention and orientation.

| S-EPMC7511393 | biostudies-literature

Sex-specific associations between lipids and cognitive decline in the middle-aged and elderly: a cohort study of Chinese adults.

Project description:Background: Studies regarding the lipid-cognition relationship have increasingly gained popularity but have generated much mixed results. To date, few studies have focused on the difference between sexes.Methods: This study included 6792 Chinese adults aged over 45?years (women, 48.56%; mean age, 57.28?years), who were free of severe conditions known to affect cognitive function at the baseline (2011). Blood concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and triglycerides (TG) were assessed at baseline, and both continuous and categorical values were used in final analyses. Global cognitive functions were assessed by the word recall test and the mental status test in 2011, 2013, and 2015, respectively. We graded participants into three groups according to the cognitive change slopes: no decline (??0), moderate decline (median to 0), and severe decline (< median). Sex-specific associations between blood lipids and cognitive decline were analyzed using ordinal logistic models, adjusting for sociodemographic information, lifestyle behaviors, and health status.Results: Higher baseline TC and LDL-C concentrations exhibited no significant association with 5-year cognitive decline in men but were significantly associated with greater 5-year cognitive decline in women [odds ratio (OR) 1.026, 95% confidence interval (CI) 1.003, 1.050; OR 1.026, CI 1.002, 1.051, respectively]. For higher serum HDL-c levels, a significantly protective effect on cognition was observed in men, but a slightly adverse effect was found in women (not significant after Bonferroni correction). TG presented almost no effect on later cognition in either sex.Conclusion: Different associations between sexes were observed for the lipid-cognition relationship, and maintaining serum cholesterol levels at an appropriate range may have a positive effect on cognitive health.

| S-EPMC7722300 | biostudies-literature

Association between social participation and cognitive function among middle- and old-aged Chinese: A fixed-effects analysis.

Project description:BackgroundSocial Participation (SP) is known to benefit cognitive function. However, whether the positive relationship holds across different types of SP and dimensions of cognitive function, and whether the statement stays true in middle- and old-aged Chinese have not been investigated. The present study aimed to understand the current patterns of SP and cognitive function in China's context, and therefore, explore the associations between cognitive function and SP at different levels from various aspects.MethodsA total of 7973 community residents aged 45 years and older were selected from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2015). A fixed-effects analysis was used to explore the association between changes in SP (diversity, frequency, and type) and that in cognitive function (memory and mental status) over a four-year period.ResultsChanging from no SP to more variety (β = 0.377, 95% confidence interval (CI) = 0.192-0.562 for 1 type, β = 0.703, 95% CI = 0.470-0.937 for ≥2 types) or higher frequency (β = 0.235, 95% CI = 0.007-0.462 for not regularly, β = 0.604, 95% CI = 0.411-0.798) of SP was associated with improvements in cognitive function. Playing mah-jong and using Internet were associated with improved memory but not with mental status. Sports and volunteering were associated with improved mental status but not with memory. The same pattern was observed in men and in women.ConclusionsThe study confirmed that more diversity and higher frequency of SP was associated with improved cognitive function, whereas reminded policymakers to consider cultural context when developing target strategies to improve cognitive function.

| S-EPMC7568928 | biostudies-literature

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