title: Risk factors for cognitive decline in elderly people: findings from the two-year follow-up study in a Shanghai urban community.
abstract: BACKGROUND
  The prevalence of cognitive impairment (CI) and its associated risk factors among elderly peoples in China has been investigated. However, dynamic studies revealing the risk factors associated with cognitive decline from follow-up observations in China are rarely performed.
  
  
  OBJECTIVE
  The present study aimed to identify factors predicting late-life cognitive decline in China.
  
  
  METHODS
  Participants were 223 community-dwelling residents (≥65 years old) from the urban community of Shanghai with no CI upon comprehensive assessments at baseline. Cognitive decline at 2-year follow-up was defined as a drop of two or more points from baseline score in the Mini-Mental State Examination (MMSE). Associations with baseline demographic, lifestyle, health, and medical factors were then determined within the population.
  
  
  RESULTS
  After 2 years, cognitive decline and incident CI developed in 75 (33.6%) and 25 (11.2%) participants, respectively. Across all participants, risk factors for cognitive decline included low education, high body mass index, and diabetes mellitus. Among participants with cognitive decline, points were predominantly lost in items relating to time orientation and complex commands in the MMSE.
  
  
  CONCLUSIONS
  This study confirms the differences in risk factors between cross-sectional and longitudinal studies for cognitive decline among the elderly population in urban Shanghai. Interventions tailored to potential risk factors associated with cognitive decline may offer further benefits.
authors: Department of Neurology & Neuroscience Institute, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Gang
authors: G
authors: Wang
authors: Department of Neurology & Neuroscience Institute, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Hui-Dong
authors: HD
authors: Tang
authors: Department of Neurology & Neuroscience Institute, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Jun-Peng
authors: JP
authors: Zhuang
authors: Department of Neurology & Neuroscience Institute, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Xu-Hua
authors: XH
authors: Xu
authors: Department of Neurology & Neuroscience Institute, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Li-Hua
authors: LH
authors: Liu
authors: Department of Neurology & Neuroscience Institute, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Bo
authors: B
authors: Li
authors: Department of Neurology & Neuroscience Institute, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Li-Ling
authors: LL
authors: Wang
authors: Department of Neurology & Neuroscience Institute, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Zhi-Min
authors: ZM
authors: Xu
authors: Department of Neurology & Neuroscience Institute, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Epidemiology, Public Health School, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Qi
authors: Q
authors: Cheng
authors: Department of Neurology & Neuroscience Institute, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Sheng-Di
authors: SD
authors: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012111:Residence Characteristics; D012307:Risk Factors; D014505:Urban Population / Q000639:trends*
keywords: Alzheimer's disease; body mass index; cognitive impairment; diabetes mellitus