Abstract
Cognitive decline with normal aging varies widely among individuals. This study aimed to investigate predictors of longitudinal changes in cognitive function in community-dwelling Korean adults aged 65 years and older. Data from 727 older adults who participated in the Korean Longitudinal Study of Aging (KLoSA) survey from 2006 (baseline) until 2018 (seventh wave) were used. Cognitive performance was assessed with the Korean Mini-Mental State Examination. The participants were retrospectively classified into normal cognition, mild cognitive impairment, and moderate/severe cognitive impairment. Education, income, religion, living area, alcohol intake, smoking, physical activity, handgrip strength, functional dependency, depression, comorbidity, medications, fall experience, and unintentional weight loss were included as covariates. A linear mixed regression analysis showed that a steeper decline in cognitive function over time was significantly associated with parameters of poor socio-economic status, health conditions, and unhealthy behaviors. Individuals with mild cognitive impairment or moderate/severe cognitive impairment were likely to have steeper cognitive declines compared with individuals with normal cognition. The current findings of the study showed that age-related cognitive decline was multifactorial in older Korean adults.
Highlights
Population aging is an inevitable and global trend due to lower fertility and reduced mortality, especially in developed and developing countries [1]
By analyzing data extracted from previous national statistics and nationwide studies conducted in South Korea, Park et al [8] reported that the dementia-related burden of disease was estimated to be 528 per 100,000 people, which was highest in the elderly Korean population and is expected to increase sharply with population aging
Cognitive function was significantly related to age (r = −0.193, p < 0.001), sex (r = −0.136, p < 0.001), existence of spouse (r = −0.085, p < 0.001), residence area (r = −0.107, p < 0.001), education (r = 0.234, p < 0.001), income (r = 0.152, p < 0.001), smoking (r = 0.071, p < 0.001), heavy drinking (r = 0.063, p < 0.001), physical activity (r = 0.069, p < 0.001), handgrip strength (r = 0.185, p < 0.001), CES-D score (r = −0.114, p < 0.001), experience of falls (r = −0.029, p = 0.006), number of comorbidities (r = −0.091, p < 0.001), number of medications (r = −0.046, p < 0.001), and unintentional weight loss (UWL) (r = 0.033, p = 0.002)
Summary
Population aging is an inevitable and global trend due to lower fertility and reduced mortality, especially in developed and developing countries [1]. From a Korean public health perspective, such a rapidly growing proportion of older adults implies a substantial burden and cost to individuals and society due to the various health conditions associated with aging [3,4]. A systematic review and meta-analysis of 11 previous studies involving Korean adults aged 65 years and older showed that the prevalence of dementia was 9.2%, higher than those observed in Western and other Asian populations [7]. By analyzing data extracted from previous national statistics and nationwide studies conducted in South Korea, Park et al [8] reported that the dementia-related burden of disease was estimated to be 528 per 100,000 people, which was highest in the elderly Korean population and is expected to increase sharply with population aging
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