title: The time trends of cognitive impairment incidence among older Chinese people in the community: based on the CLHLS cohorts from 1998 to 2014.
abstract: to examine a 16-year trend in cognitive impairment (CI) incidence and associated factors among older Chinese people.
  
  
  
  aged 60 and above whose cognitive function were normal at their first test.
  
  
  
  a secondary analysis that identified subjects from the database of Chinese Longitudinal Healthy Longevity Survey (CLHLS). The database contained mixed longitudinal cohorts of older Chinese people surveyed in 1998, 2000, 2002, 2005, 2008-09, 2011-12 and 2014. The cognitive function of subjects was tested using the Chinese Mini-Mental State Examination (CMMSE) in each wave. The unique individual code identified a mixed cohort of 17,896 subjects who had multiple CMMSE measures over a 16-year period and available covariates for the analysis. CI was defined as the CMMSE score below 18 points. Crude and age-standardised incidence of CI by gender were calculated by year of survey. Risk factor adjusted time trends in the incidence were examined using multilevel regression models.
  
  
  
  age-standardised CI incidence decreased from 58.77‰ to 10.09‰ (P < 0.001) from 1998 to 2014, and this decrease remained after adjusting for covariates. About 15.8% in the observed decline was explained by higher education, and 7.9% was due to health practice (regular exercise, physical activity and cognitive activity), beyond age and gender effects.
  
  
  
  the CI incidence among older Chinese people decreased from 1998 to 2014. Lower education level and less frequent health practices mentioned above were important risk factors in CI prevention.
authors.affiliation: Department of epidemiology and health statistics, Sichuan University Huaxi Campus, Chengdu, Sichuan, China.
authors.forename: Mingyue
authors.initials: M
authors.lastname: Gao
authors.affiliation: Mental Health Center, Sichuan University Huaxi Campus, Chengdu, Sichuan, China.
authors.forename: Weihong
authors.initials: W
authors.lastname: Kuang
authors.affiliation: Department of epidemiology and health statistics, Sichuan University Huaxi Campus, Chengdu, Sichuan, China.|West China Research Center for Rural Health Development, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Peiyuan
authors.initials: P
authors.lastname: Qiu
authors.affiliation: Dementia Care & Research Center, Peking University Institute of Mental Health,   Beijing, China.|Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, China.
authors.forename: Huali
authors.initials: H
authors.lastname: Wang
authors.affiliation: Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, China.|Dementia Care & Research Center, Peking University Sixth Hospital,   Beijing, China.
authors.forename: Xiaozhen
authors.initials: X
authors.lastname: Lv
authors.affiliation: Department of epidemiology and health statistics, Sichuan University Huaxi Campus, Chengdu, Sichuan, China.|West China Research Center for Rural Health Development, Sichuan University, Chengdu, Sichuan, China.|University of Nottingham School of Medicine, Nottingham, UK.
authors.forename: Min
authors.initials: M
authors.lastname: Yang
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D003071:Cognition; D000066492:Cognitive Aging; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D016208:Databases, Factual; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D006801:Humans; D015994:Incidence; D057187:Independent Living; D008137:Longitudinal Studies; D008297:Male; D000073216:Mental Status and Dementia Tests; D008875:Middle Aged; D015999:Multivariate Analysis; D017678:Sex Distribution; D013997:Time Factors
keywords: cognitive impairment; incidence; older Chinese people; time trend