Cognitive Functioning Trajectories and Their Association With Mental Health in Older Adults With Hypertension: Secondary Analysis of the Chinese Longitudinal Healthy Longevity Survey Data.

IF 4.8 Q1 GERIATRICS & GERONTOLOGY
JMIR Aging Pub Date : 2025-08-21 DOI:10.2196/74916
Peiyun Wu, Cheng Lin, Jing Yang, Zhizhuo Wang
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引用次数: 0

Abstract

Background: There is a lack of research on the trajectories of cognitive functioning in older people with hypertension, as well as possible contributing factors and correlations between cognitive functioning and mental health.

Objective: This study aimed to conduct a secondary longitudinal analysis to examine cognitive functioning trajectories and their associated factors in older people with hypertension.

Methods: The data used in our study were retrieved from the Chinese Longitudinal Healthy Longevity Survey. The Chinese version of the Mini-Mental State Examination was used to assess cognitive functioning. The trajectories of cognitive functioning of older individuals with hypertension were determined by using group-based trajectory modeling. The binary logistic regression analyses were performed to examine how participant factors affected the trajectories of cognitive functioning in older individuals with hypertension. The relationships between cognitive functioning and mental health were investigated using multivariable linear regression models. Data were analyzed using SPSS (version 20.0; SPSS Inc) and Stata (version 16.0; StataCorp LLC).

Results: A total of 642 older people with hypertension were included. Cognitive functioning was categorized into 2 trajectories according to group-based trajectory modeling: "rapid decline" (48/642, 7.9%) and "slow decline" (594/642, 92.1%). Binary logistic regression results showed that older adults with hypertension aged equal to or greater than 80 years had an elevated risk of rapid decline in cognitive functioning (odds ratio 5.484, 95% CI 2.365-12.719), and higher score in mental health was the protector of rapid decline in cognitive functioning during the following 13 years (odds ratio 0.918, 95% CI 0.852-0.988). In the unadjusted model, mental health was positively associated with cognitive functioning (β=.246, 95% CI 0.125-0.234, P<.001), and this association was maintained after partial or complete adjustment for covariates (β=.159, 95% CI 0.059-0.174, P<.001; β=.138, 95% CI 0.043-0.158, P=.001). Subgroup analyses by age showed that this positive correlation was only seen in the 60-69 years age group (β=.183, 95% CI 0.036-0.193, P=.004), while subgroup analyses by sex revealed that the association between these 2 indicators was no longer presented among males in the fully adjusted model (β=.082, 95% CI -0.024 to 0.119, P=.19), and BMI fully stratification demonstrated this association persisted in the healthy weight group (β=.125, 95% CI 0.039-0.210, P=.004).

Conclusions: Our research showed that the decline in cognitive functioning is associated with lower mental health and occurs more rapidly in older adults with hypertension who are older than 80 years.

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老年高血压患者的认知功能轨迹及其与心理健康的关系:中国健康长寿纵向调查数据的二次分析
背景:目前缺乏对老年高血压患者认知功能发展轨迹、认知功能与心理健康之间可能的影响因素和相关性的研究。目的:本研究旨在对老年高血压患者的认知功能轨迹及其相关因素进行二次纵向分析。方法:本研究使用的数据来源于中国健康长寿纵向调查。使用中文版的简易精神状态测验来评估认知功能。采用基于群体的轨迹模型确定老年高血压患者的认知功能轨迹。采用二元logistic回归分析来检验参与者因素如何影响老年高血压患者的认知功能轨迹。采用多变量线性回归模型研究认知功能与心理健康之间的关系。数据分析使用SPSS(20.0版本;SPSS Inc)和Stata(16.0版本;StataCorp LLC)。结果:共纳入642例老年高血压患者。根据基于群体的轨迹模型,认知功能分为“快速下降”(48/642,7.9%)和“缓慢下降”(594/642,92.1%)两种轨迹。二元logistic回归结果显示,年龄≥80岁的老年高血压患者认知功能快速下降的风险增加(优势比5.484,95% CI 2.365 ~ 12.719),较高的心理健康评分是随后13年认知功能快速下降的保护因子(优势比0.918,95% CI 0.852 ~ 0.988)。在未调整的模型中,心理健康与认知功能呈正相关(β= 0.246, 95% CI 0.125-0.234, p)。结论:我们的研究表明,认知功能的下降与较低的心理健康有关,并且在80岁以上的老年高血压患者中发生得更快。
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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来源期刊
JMIR Aging
JMIR Aging Social Sciences-Health (social science)
CiteScore
6.50
自引率
4.10%
发文量
71
审稿时长
12 weeks
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