Background Cognitive decline may be an early indicator of major health issues in older adults, though research using population-based data is lacking. Researchers objective was to assess the relationships between distinct cognitive trajectories and subsequent health outcomes, including health status, depressive symptoms, and mortality, using a nationally representative cohort. Methods Data were drawn from the National Health and Aging Trends Study. Global cognition was assessed annually between 2011 and 2018. The health status of 4 413 people, depressive symptoms in 4 342 individuals, and deaths among 5 955 living respondents were measured in 2019. Distinct cognitive trajectory groups were identified using an innovative Bayesian group-based trajectory model. Ordinal logistic, Poisson, and logistic regression models were used to examine the associations between cognitive trajectories and subsequent health outcomes. Results Researchers identified five cognitive trajectory groups with distinct baseline values and subsequent changes in cognitive function. Compared with the group with stably high cognitive function, worse cognitive trajectories (ie, lower baseline values and sharper declines) were associated with higher risks of poor health status, depressive symptoms, and mortality, even after adjusting for relevant covariates. Conclusions Among older adults, worse cognitive trajectories are strongly associated with subsequent poor health status, high depressive symptoms, and high mortality risks. Regular screening of cognitive function may help to facilitate early identification and interventions for older adults susceptible to adverse health outcomes.

中文翻译：

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美国老年人认知轨迹与随后的健康状况、抑郁症状和死亡率之间的关联：一项具有全国代表性的研究结果


背景 认知能力下降可能是老年人主要健康问题的早期指标，尽管缺乏使用基于人群的数据的研究。研究人员的目标是使用具有全国代表性的队列来评估不同的认知轨迹与随后的健康结果之间的关系，包括健康状况、抑郁症状和死亡率。方法 数据来自国家健康和老龄化趋势研究。在 2011 年至 2018 年期间，每年评估一次整体认知能力。2019 年测量了 4 413 人的健康状况、4 342 人的抑郁症状和 5 955 名在世受访者的死亡情况。使用创新的基于贝叶斯群的轨迹模型确定不同的认知轨迹组。使用顺序 logistic、Poisson 和 logistic 回归模型来检查认知轨迹与后续健康结果之间的关联。结果 研究人员确定了 5 个具有不同基线值和随后认知功能变化的认知轨迹组。与认知功能稳定较高的组相比，较差的认知轨迹 （即较低的基线值和更急剧的下降） 与较高的健康状况不佳、抑郁症状和死亡率风险相关，即使在调整了相关协变量后也是如此。结论 在老年人中，较差的认知轨迹与随后的健康状况不佳、抑郁症状高、死亡风险高密切相关。定期筛查认知功能可能有助于促进对易受不良健康结果影响的老年人的早期识别和干预。