Abstract
Evidence suggests that cognitive decline in older adults is influenced by cardiovascular health (CVH), with metabolic and vascular mechanisms hypothesized to underlie the etiology of cognitive impairment. Research in high-income nations suggests that improved CVH is linked with decreased cognitive impairment risk, but it is unclear if this pattern is evident in low-income countries. Nationally-representative data collected in China were drawn from the World Health Organization's Study on global AGing and adult health Wave 1 (2007–2010; n = 11,295). Seven CVH factors were classified as “ideal” or “not ideal”: smoking and drinking frequency, body mass index, physical activity level, blood pressure, diet, and self-reported anxiety. Additionally, scores from five cognitive performance tests (immediate and delayed verbal recall, forward and backward digit span, verbal fluency) were used to create a composite cognitive function variable. Linear regression analyses tested whether ideal CVH measures were associated with higher composite cognitive performance, controlling for sociodemographic factors. As hypothesized, ideal CVH was generally associated with higher cognitive performance. Low anxiety levels and reliable access to sufficient food (including produce) were particularly associated with higher cognitive function. These results suggest early detection and controlling modifiable CVH risks may protect aging individuals in China from cognitive decline.
Highlights
The global population is currently experiencing a rapid aging transition, largely due to increased life expectancies and decreased fertility in many countries; global aging and health patterns are not uniform
Several factors that impair vascular and metabolic health have been linked with increased dementia risk in older adults: smokers experience a significantly more pronounced decline in cognitive function, flexibility, and speed [9]; high alcohol consumption has been associated with poorer neurological function [10]; and, overweight and obese adults display significantly lower cognitive function compared to healthy weight individuals [8, 11]
Cognitive test scores varied based on test type, from the wide range of scores evident on the verbal fluency test to the lower scores recorded on the backward digit span test
Summary
The global population is currently experiencing a rapid aging transition, largely due to increased life expectancies and decreased fertility in many countries; global aging and health patterns are not uniform. At the start of the Twenty-first century, the number of Chinese adults aged 60 years and older reached an estimated 130 million, roughly 10% of the total Chinese population and 21% of the world’s older population [1, 2] This trend is expected to continue such that the population of older adults in China will nearly triple and comprise 25% of the national population by Cardiovascular and Cognitive Health. Over the last three decades, the prevalence of both Alzheimer’s disease and vascular dementia has significantly increased, and it appears previous work has underestimated the burden and growth of dementia in China [4] This increased disease burden will challenge healthcare systems to reform as they seek to meet the demands of patients and their caregivers in the coming years. Several factors that impair vascular and metabolic health have been linked with increased dementia risk in older adults: smokers experience a significantly more pronounced decline in cognitive function, flexibility, and speed [9]; high alcohol consumption has been associated with poorer neurological function [10]; and, overweight and obese adults display significantly lower cognitive function compared to healthy weight individuals [8, 11]
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