Trends in Memory Function and Memory Impairment Among Older Adults in the United States and Europe, 1996-2018.

Mikko Myrskylä, Jo Mhairi Hale, Daniel C Schneider, Neil K Mehta
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Abstract

Background: Single-country studies document varying time trends in memory function and impairment. Comparative analyses are limited.

Methods: We used self-respondent data on adults aged 50+ years in 13 countries from 3 surveys (United States: Health and Retirement Study, 1998-2018; England: English Longitudinal Study of Ageing, 2002-2018; 11 European countries: Survey of Health, Ageing and Retirement in Europe, 2004-2019). Memory is measured with tests of immediate and delayed word recall. Unweighted age- and gender-adjusted mixed effects regression models as well as models with adjustments for additional sociodemographic characteristics and health behaviors were examined. Heterogeneity in trends by gender, age group, and educational attainment was measured.

Results: The age-adjusted 10-year improvement in average test score is 0.04 standard deviations (SDs) (95% confidence interval [CI]: 0.03, 0.05) in the United States, 0.17 SDs (95% CI: 0.15, 0.19) in England, and 0.24 SDs (95% CI: 0.23, 0.25) in SHARE countries. Trends are largely similar across gender, age groups, and educational attainment. Regional differences in trends remain after adjustment for potential mechanisms. The difference between the United States and other countries is particularly large under 75 years of age compared to 75 years and older.

Conclusions: Pace of improvement in memory function varies strongly across countries. On average, the 11 European countries studied had the fastest improvement, followed by England. The trend in the United States indicates improvement, but at a much slower pace compared to that in England and other European countries. Uncovering the causes for the cross-country heterogeneity in time trends, and in particular the reasons for the comparatively poor performance of the United States, should be both a research and public health priority.

1996-2018 年美国和欧洲老年人记忆功能和记忆障碍的趋势。
背景:单个国家的研究记录了记忆功能和记忆障碍的不同时间趋势。比较分析有限:我们使用了 13 个国家 50 岁以上成年人的自我应答数据,这些数据来自三次调查(美国:HRS,1998-2018 年;英国:ELSA,2002-2018 年;11 个欧洲国家:ELSA,2002-2018 年):ELSA,2002-2018 年;11 个欧洲国家:share,2004-2019 年)。记忆力通过即时和延迟单词回忆测试进行测量。对未加权的年龄和性别调整混合效应回归模型,以及对其他社会人口特征和健康行为进行调整的模型进行了研究。测量了不同性别、年龄组和教育程度的趋势异质性:结果:经年龄调整后,美国的 10 年平均测试分数提高了 0.04 个标准差(95% 置信区间:0.03, 0.05),英国提高了 0.17 个标准差(95% 置信区间:0.15, 0.19),SHARE 国家提高了 0.24 个标准差(95% 置信区间:0.23, 0.25)。不同性别、年龄组和教育程度的趋势基本相似。在对潜在机制进行调整后,地区间的趋势差异依然存在。美国与其他国家之间的差异尤其明显,75 岁以下人群与 75 岁以上人群相比差异更大:各国记忆功能改善的速度差异很大。平均而言,所研究的 11 个欧洲国家的记忆功能改善速度最快,其次是英国。美国的趋势表明记忆功能有所改善,但与英国和其他欧洲国家相比,速度要慢得多。研究和公共卫生领域的当务之急是找出各国时间趋势不同的原因,特别是美国表现相对较差的原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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