{"title":"Using the Cox Multi-State Models to Examine Cognitive Transitions Among Older Adults: Findings From a Longitudinal Study (2008-2018).","authors":"Yen-Han Lee, Cai Xu","doi":"10.1177/01640275261461683","DOIUrl":null,"url":null,"abstract":"<p><p>This study assessed sociodemographic and health behavior-related factors associated with better cognitive transition in Chinese older adults. We analyzed four waves of the Chinese Longitudinal Healthy Longevity Survey (2008-2018), including 22,392 participants aged ≥65 years with 32,348 person-wave observations, to examine transitions in cognitive states using sequentially adjusted multistate Cox models. Approximately 68.44%, 19.45%, and 12.11% reported normal cognitive function, moderate, and severe cognitive impairment, respectively. Sociodemographic advantages, including education, marital status, income, and urban residence, were associated with more favorable MMSE-defined cognitive transitions. Physical activity and higher life satisfaction were also associated with more favorable MMSE transitions, but smoking and alcohol consumption demonstrated no consistent associations. Interventions targeting modifiable factors, such as physical activity and wellbeing, may enhance cognitive impairment and help maintain good cognitive function among older adults.</p>","PeriodicalId":47983,"journal":{"name":"Research on Aging","volume":" ","pages":"1640275261461683"},"PeriodicalIF":2.2000,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Research on Aging","FirstCategoryId":"90","ListUrlMain":"https://doi.org/10.1177/01640275261461683","RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
This study assessed sociodemographic and health behavior-related factors associated with better cognitive transition in Chinese older adults. We analyzed four waves of the Chinese Longitudinal Healthy Longevity Survey (2008-2018), including 22,392 participants aged ≥65 years with 32,348 person-wave observations, to examine transitions in cognitive states using sequentially adjusted multistate Cox models. Approximately 68.44%, 19.45%, and 12.11% reported normal cognitive function, moderate, and severe cognitive impairment, respectively. Sociodemographic advantages, including education, marital status, income, and urban residence, were associated with more favorable MMSE-defined cognitive transitions. Physical activity and higher life satisfaction were also associated with more favorable MMSE transitions, but smoking and alcohol consumption demonstrated no consistent associations. Interventions targeting modifiable factors, such as physical activity and wellbeing, may enhance cognitive impairment and help maintain good cognitive function among older adults.
期刊介绍：
Research on Aging is an interdisciplinary journal designed to reflect the expanding role of research in the field of social gerontology. Research on Aging exists to provide for publication of research in the broad range of disciplines concerned with aging. Scholars from the disciplines of sociology, geriatrics, history, psychology, anthropology, public health, economics, political science, criminal justice, and social work are encouraged to contribute articles to the journal. Emphasis will be on materials of broad scope and cross-disciplinary interest. Assessment of the current state of knowledge is as important as provision of an outlet for new knowledge, so critical and review articles are welcomed. Systematic attention to particular topics will also be featured.
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