Age- and Sex-Specific Prevalence and Modifiable Risk Factors of Mild Cognitive Impairment Among Older Adults in China: A Population-Based Observational Study

Jingzhu Fu; Qian Liu; Yue Du; Yun Zhu; Changqing Sun; Hongyan Lin; Mengdi Jin; Fei Ma; Wen Li; Huan Liu; Xumei Zhang; Yongjie Chen; Zhuoyu Sun; Guangshun Wang; Guowei Huang

doi:10.3389/fnagi.2020.578742

Age- and Sex-Specific Prevalence and Modifiable Risk Factors of Mild Cognitive Impairment Among Older Adults in China: A Population-Based Observational Study

Front Aging Neurosci. 2020 Oct 30:12:578742. doi: 10.3389/fnagi.2020.578742. eCollection 2020.

Authors

Jingzhu Fu^{1

2}, Qian Liu^{1

2}, Yue Du^{2

3}, Yun Zhu^{2

4}, Changqing Sun⁵, Hongyan Lin^{1

2}, Mengdi Jin^{1

2}, Fei Ma^{1

2}, Wen Li^{1

2}, Huan Liu^{1

2}, Xumei Zhang^{1

2}, Yongjie Chen^{2

4}, Zhuoyu Sun^{2

4}, Guangshun Wang⁶, Guowei Huang^{1

2}

Affiliations

¹ Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.
² Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
³ Department of Social Medicine and Health Management, School of Public Health, Tianjin Medical University, Tianjin, China.
⁴ Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
⁵ Neurosurgical Department of Baodi Clinical College of Tianjin Medical University, Tianjin, China.
⁶ Department of Tumor, Baodi Clinical College of Tianjin Medical University, Tianjin, China.

Abstract

Background: Minimal data are available on the prevalence of mild cognitive impairment (MCI) in older Chinese adults. Moreover, the current information on MCI shows important geographical variations.

Objective: We aimed to assess the prevalence and risk factors for MCI by age and sex among older adults in a North Chinese population.

Methods: In this population-based cross-sectional study, we enrolled a random sample of 4,943 adults aged ≥ 60 years between March 2018 and June 2019 in Tianjin, China. Of these, 312 individuals were excluded due to a lack of data (e.g., fasting blood test). As a result, 4,631 subjects were assessed. Individuals with MCI were identified using neuropsychological assessments, including the Mini-Mental State Examination and Activities of Daily Living scale, based on a modified version of the Petersen's criteria.

Results: The mean (SD) age of the 4,631 participants was 67.6 (4.89) years, and 2,579 (55.7%) were female. The overall age- and sex-standardized prevalence of MCI in our study population was 10.7%. There were significant associations of MCI with age [65-69 vs. 60-64 years, OR = 0.74; 95% confidence interval (CI): 0.58, 0.96], physical activity (≥23.0 vs. <23.0 MET-hours/week, OR = 0.79; 95% CI: 0.64, 0.96), body mass index (BMI) (OR = 0.92; 95% CI: 0.89, 0.95), grip strength (OR = 0.50; 95% CI: 0.38, 0.67), hypertension (yes vs. no, OR = 1.44; 95% CI: 1.18, 1.77), higher levels of sleepiness (OR = 1.80; 95% CI: 1.36, 2.37), and longer sleep duration (OR = 1.40; 95% CI: 1.14, 1.72). The inverse association between BMI and MCI was stronger in older age groups (P for heterogeneity = 0.003). Moreover, the magnitude of association between triglycerides and MCI was different between the sexes (P for heterogeneity = 0.029).

Conclusion: The age- and sex-standardized prevalence of MCI was 10.7% in the study sample. Physical activity, BMI, grip strength, sleepiness, sleep duration, and hypertension were associated with the prevalence of MCI. Additionally, triglycerides and BMI might be differently associated with the presence of MCI for different sexes and age stages, respectively.

Keywords: age differences; mild cognitive impairment; older adults; prevalence; risk factors; sex differences.