Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study

Jia, Longfei; Du, Yifeng; Chu, Lan; Zhang, Zhanjun; Li, Fangyu; Lyu, Diyang; Li, Yan; Zhu, Min; Jiao, Haishan; Yang, Song; Shi, Yuqing; Zhang, Heng; Gong, Min; Wei, Cuibai; Tang, Yi; Fang, Boyan; Guo, Dongmei; Wang, Fen; Zhou, Aihong; Chu, Changbiao; Zuo, Xianbo; Yu, Yueyi; Yuan, Quan; Wang, Wei; Li, Fang; Shi, Shengnan; Yang, Heyun; Zhou, Chunkui; Liao, Zuwei; Lv, Yan; Li, Yang; Kan, Min-chen; Zhao, Huiying; Wang, Shan; Yang, Shanshan; Li, Hao; Liu, Zhongling; Wang, Qi; Qin, Wei; Jia, Jianping; Quan, Meina; Wang, Yan; Li, Wenwen; Cao, Shuman; Xu, Lingzhi; Han, Yue; Liang, Junhua; Qiao, Yuchen; Qin, Qi; Qiu, Qiongqiong

doi:10.1016/s2468-2667(20)30185-7

Cited by 904 publications

(730 citation statements)

References 34 publications

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“…Female, those of older age, people with lower education, those widowed, farmers, those who suffered hearing loss, and those who had stroke history were linked with an increased risk for cognitive impairment, while regular physical exercise, socializing with neighbors, and reading newspapers were all protective factors. The findings were consistent with the conclusions made in other studies [ 3 , 4 , 8 , 12 ]. Nevertheless, we found no significant associations between cognitive impairment and living area, smoking, alcohol drinking, living with family, BMI, hypertension, or coronary heart disease.…”

Section: Discussionsupporting

confidence: 93%

“…Health-related variables involved body mass index (BMI), hypertension, diabetes, coronary heart disease (CHD), stroke, and hearing loss. These factors were collected for their possible association with cognitive function [ 3 , 4 , 8 , 12 ].…”

Section: Methodsmentioning

confidence: 99%

“…A systematic review in 2018 showed an 14.7% prevalence of MCI in China [ 3 ]. A recent national survey conducted in China from 2015 to 2018 reported that dementia affects 6% of adults aged 60 years and above, and MCI affects 15.5% [ 4 ]. A meta-analysis of 41 robust inception cohort studies summarized that less than half of individuals with MCI tend to progress to dementia in 3–10 years [ 5 ], and the annual progression rate is 5–15% [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…A most recent review and meta-analysis reported low social contact and depression were two of the risk factors of dementia [ 8 ]. A study in China showed similar risk factors of dementia and MCI, including rural residence, less education, unmarried, smoking, hypertension, hyperlipidaemia, diabetes, heart disease, and cerebrovascular disease [ 4 ]. However, most of these factors are less likely to be modified.…”

Section: Introductionmentioning

confidence: 99%

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Mobile Phone Use and Cognitive Impairment among Elderly Chinese: A National Cross-Sectional Survey Study

Sun

Yin

et al. 2021

IJERPH

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The study aimed to investigate the relationship between mobile phone use and cognitive impairment using the data of the Prevention and Intervention on Neurodegenerative Disease for Elderly in China (PINDEC) survey. A total of 21,732 participants aged 60 years and above in China were recruited using a stratified, multi-stage cluster sampling method, providing information on demographics, lifestyle and health-related characteristics, mobile phone use, and cognitive impairment through face-to-face interviews by trained staff according to a standard protocol. All estimates of rates were weighted by sex, age, and living area (rural or urban) in the elderly Chinese population. The rate of mobile phone usage was 65.5% (14.3% for smartphone use). The prevalence of cognitive impairment in non-users of mobile phone, dumbphone users, and smartphone users were 17.8%, 5.0%, and 1.4%, respectively. The odds of having cognitive impairment in users of dumbphone and smartphone were lower than non-users after adjusting for demographics, lifestyle, and health-related factors (adjusted odds ratio (AOR), 0.39, 95% CI 0.35 to 0.45; p < 0.001; AOR, 0.16, 95% CI 0.11 to 0.25; p < 0.001, respectively). Smartphone use in Chinese elderly people was quite low. A strong correlation was found between mobile phone use and better cognitive function; yet longitudinal studies are warranted to explore the causal relationship. Future design of mobile phone-based interventions should consider the feasibility among those in need.

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Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mobile Phone Use and Cognitive Impairment among Elderly Chinese: A National Cross-Sectional Survey Study

Sun

Yin

et al. 2021

IJERPH

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“…Alzheimer’s disease (AD) is a common neurodegenerative disease characterized by progressive dementia and results in an enormous emotional and financial burden in the patients and society worldwide ( Jia et al, 2020 ). Under normal conditions, microtubule-associated protein tau functions to regulate microtubules assembly and stability.…”

Section: Introductionmentioning

confidence: 99%

Cornel Iridoid Glycoside Protects Against STAT1-Dependent Synapse and Memory Deficits by Increasing N-Methyl-D-aspartate Receptor Expression in a Tau Transgenic Mice

Huang

Guo

et al. 2021

Front. Aging Neurosci.

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P301S transgenic mice are an animal model of tauopathy and Alzheimer’s disease (AD), exhibiting tau pathology and synaptic dysfunction. Cornel iridoid glycoside (CIG) is an active ingredient extracted from Cornus officinalis, a traditional Chinese herb. In the present study, the purpose was to investigate the effects and mechanisms of CIG on tau pathology and synaptic dysfunction using P301S transgenic mice. The results showed that intragastric administration of CIG for 3.5 months improved cognitive impairments and the survival rate of P301S mice. Electrophysiological recordings and transmission electron microscopy study showed that CIG improved synaptic plasticity and increased the ultrastructure and number of synapse. Moreover, CIG increased the expression levels of N-methyl-D-aspartate receptors (NMDAR) subunits GluN1, GluN2A, and GluN2B, and α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (AMPAR) subunit GluA1. We inferred that the major mechanism of CIG involving in the regulation of synaptic dysfunctions was inhibiting the activation of Janus kinase-2 (JAK2)/signal transducer and activator of transcription 1 (STAT1) signaling pathway and alleviating STAT1-induced suppression of NMDAR expressions. Based on our findings, we thought CIG might be a promising candidate for the therapy of tauopathy such as AD.

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Association of Adverse Childhood Experiences and Social Isolation With Later-Life Cognitive Function Among Adults in China

et al. 2022

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ImportanceStudies investigating the association of threat-related and deprivation-related adverse childhood experiences (ACEs) with later-life cognitive decline are lacking.ObjectivesTo evaluate the independent association of threat-related and deprivation-related ACEs with cognitive decline over time among middle-aged and older Chinese adults and to examine the modifying role of social isolation in such associations.Design, Setting, and ParticipantsThis prospective cohort study used cognitive data from the China Health and Retirement Longitudinal Study (CHARLS) baseline survey that was administered between June 1, 2011, and March 31, 2012, and the CHARLS follow-up survey administered between July 1 and September 30, 2015. The life history survey with information of ACEs was additionally administered between June 1 and December 31, 2014. Statistical analysis was performed from March 1 to July 31, 2022. The study population consisted of middle-aged and older adults (age range, 45-97 years) with complete data on ACEs and 2 cognitive assessments and without cognitive impairment at baseline.ExposuresFive threat-related ACEs (ie, physical abuse, household substance abuse, domestic violence, unsafe neighborhood, and bullying) and 5 deprivation-related ACEs (ie, emotional neglect, household mental illness, incarcerated household member, parental separation or divorce, and parental death) before 17 years of age were queried by questionnaires. The cumulative scores of the 2 ACE dimensions were calculated and grouped into 3 categories as 0, 1, and 2 or more in main analyses.Main Outcomes and MeasuresCognitive function was measured by episodic memory and executive function. Global cognition was further calculated as the total score of these 2 dimensions. The raw scores of each cognitive test were standardized to z scores using baseline means and SDs. Linear mixed-effects models were constructed to examine the association between 2 dimensions of ACEs and the rate of annual cognitive decline. The modifying role of baseline social isolation in such associations was assessed with 3-way interaction tests.ResultsOf the 6466 participants included in main analyses, 3301 (51.1%) were men and the mean (SD) age was 57.2 (8.3) years. Compared with no exposures, experience of 1 deprivation-related ACE was associated with faster cognitive decline in global cognition (β = −0.012 [95% CI, −0.022 to −0.002] SD/y) and executive function (β = −0.010 [95% CI, −0.020 to −0.00002] SD/y), whereas individuals with at least 2 childhood deprivations had faster cognitive declines in all cognitive tests (β = −0.035 [95% CI, −0.050 to −0.019] SD/y for global cognition; β = −0.047 [95% CI, −0.068 to −0.025] SD/y for episodic memory; β = −0.019 [95% CI, −0.034 to −0.004] SD/y for executive function). However, such an association was not observed for threat-related ACEs. In addition, baseline social isolation was a significant modifier in the associations between deprivation-related ACEs and cognitive declines in global cognition (β = −0.033 [95% CI, −0.061 to −0.005] SD/y; P = .02 for 3-way interaction) and executive function (β = −0.032 [95% CI, −0.059 to −0.005] SD/y; P = .02 for 3-way interaction).Conclusions and RelevanceDeprivation-related ACEs, but not threat-related ACEs, were associated with faster decline in later-life cognitive function, whereas social isolation could modify such detrimental impact. These findings highlight the potential benefits of promoting social integration in maintaining later-life cognitive function among individuals who have experienced childhood deprivation.

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Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study

Cited by 904 publications

References 34 publications

Mobile Phone Use and Cognitive Impairment among Elderly Chinese: A National Cross-Sectional Survey Study

Mobile Phone Use and Cognitive Impairment among Elderly Chinese: A National Cross-Sectional Survey Study

Cornel Iridoid Glycoside Protects Against STAT1-Dependent Synapse and Memory Deficits by Increasing N-Methyl-D-aspartate Receptor Expression in a Tau Transgenic Mice

Association of Adverse Childhood Experiences and Social Isolation With Later-Life Cognitive Function Among Adults in China

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