The impact of rural-urban community settings on cognitive decline: results from a nationally-representative sample of seniors in China
Abstract Background Aging and rural-urban disparities are two major social problems in today’s ever-developing China. Much of the existing literature has supported a negative association between adverse community setting with the cognitive functioning of seniors, but very few studies have empiricall...
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| Format: | Article |
| Language: | English |
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BMC
2018-12-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12877-018-1003-0 |
| _version_ | 1818299285981102080 |
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| author | Yuanxi Xiang Hossein Zare Cuiling Guan Darrell Gaskin |
| author_facet | Yuanxi Xiang Hossein Zare Cuiling Guan Darrell Gaskin |
| author_sort | Yuanxi Xiang |
| collection | DOAJ |
| description | Abstract Background Aging and rural-urban disparities are two major social problems in today’s ever-developing China. Much of the existing literature has supported a negative association between adverse community setting with the cognitive functioning of seniors, but very few studies have empirically investigated the impact of rural-urban community settings on cognitive decline in the late life course of the population in developing countries. Methods Data of seniors aged 65 or above (n = 1709) within CHARLS (The China Health and Retirement Longitudinal Study, a sister study of HRS), a nationally representative longitudinal cohort (2011–2015) in China, were analyzed using a multilevel modeling (MLM) of time within individuals, and individual within communities. Cognitive impairment was assessed with an adapted Chinese version of Mini-Mental State Examination. Results Urban community setting showed a significant protective effect (β = − 1.978, p < .000) on cognitive impairment in simple linear regression, and the MLM results showed it also had a significant lower cognitive impairment baseline (β = − 2.278, p < .000). However, the curvature rate of cognitive decline was faster in urban community setting indicated by a positive interaction between the quadratic time term and urban community setting on cognitive impairment (β = 0.320, p < .05). A full model adjusting other individual SES factors was built after model fitness comparison, and the education factor accounted for most of the within and between community setting variance. Conclusions The findings suggest that urban community setting in one’s late-life course has a better initial cognitive status but a potentially faster decline rate in China, and this particular pattern of senior cognitive decline emphasize the importance of more specific preventive measures. Meanwhile, a more holistic perspective should be adopted while construct a risk factor model of community environment on cognitive function, and the influence at society level needs to be further explored in future research. |
| first_indexed | 2024-12-13T04:48:48Z |
| format | Article |
| id | doaj.art-08c3ec1121b44a219a33e658c4b83580 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-13T04:48:48Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-08c3ec1121b44a219a33e658c4b835802022-12-21T23:59:04ZengBMCBMC Geriatrics1471-23182018-12-011811910.1186/s12877-018-1003-0The impact of rural-urban community settings on cognitive decline: results from a nationally-representative sample of seniors in ChinaYuanxi Xiang0Hossein Zare1Cuiling Guan2Darrell Gaskin3School of Management, Hubei University of Chinese MedicineDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public HealthSchool of Management, Hubei University of Chinese MedicineDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public HealthAbstract Background Aging and rural-urban disparities are two major social problems in today’s ever-developing China. Much of the existing literature has supported a negative association between adverse community setting with the cognitive functioning of seniors, but very few studies have empirically investigated the impact of rural-urban community settings on cognitive decline in the late life course of the population in developing countries. Methods Data of seniors aged 65 or above (n = 1709) within CHARLS (The China Health and Retirement Longitudinal Study, a sister study of HRS), a nationally representative longitudinal cohort (2011–2015) in China, were analyzed using a multilevel modeling (MLM) of time within individuals, and individual within communities. Cognitive impairment was assessed with an adapted Chinese version of Mini-Mental State Examination. Results Urban community setting showed a significant protective effect (β = − 1.978, p < .000) on cognitive impairment in simple linear regression, and the MLM results showed it also had a significant lower cognitive impairment baseline (β = − 2.278, p < .000). However, the curvature rate of cognitive decline was faster in urban community setting indicated by a positive interaction between the quadratic time term and urban community setting on cognitive impairment (β = 0.320, p < .05). A full model adjusting other individual SES factors was built after model fitness comparison, and the education factor accounted for most of the within and between community setting variance. Conclusions The findings suggest that urban community setting in one’s late-life course has a better initial cognitive status but a potentially faster decline rate in China, and this particular pattern of senior cognitive decline emphasize the importance of more specific preventive measures. Meanwhile, a more holistic perspective should be adopted while construct a risk factor model of community environment on cognitive function, and the influence at society level needs to be further explored in future research.http://link.springer.com/article/10.1186/s12877-018-1003-0Rural-urbanCommunity settingsCognitive declineMMSEMultilevel modellingChina |
| spellingShingle | Yuanxi Xiang Hossein Zare Cuiling Guan Darrell Gaskin The impact of rural-urban community settings on cognitive decline: results from a nationally-representative sample of seniors in China BMC Geriatrics Rural-urban Community settings Cognitive decline MMSE Multilevel modelling China |
| title | The impact of rural-urban community settings on cognitive decline: results from a nationally-representative sample of seniors in China |
| title_full | The impact of rural-urban community settings on cognitive decline: results from a nationally-representative sample of seniors in China |
| title_fullStr | The impact of rural-urban community settings on cognitive decline: results from a nationally-representative sample of seniors in China |
| title_full_unstemmed | The impact of rural-urban community settings on cognitive decline: results from a nationally-representative sample of seniors in China |
| title_short | The impact of rural-urban community settings on cognitive decline: results from a nationally-representative sample of seniors in China |
| title_sort | impact of rural urban community settings on cognitive decline results from a nationally representative sample of seniors in china |
| topic | Rural-urban Community settings Cognitive decline MMSE Multilevel modelling China |
| url | http://link.springer.com/article/10.1186/s12877-018-1003-0 |
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