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Cohort Profile
Cohort profile: the Taiwan Initiative for Geriatric Epidemiological Research - a prospective cohort study on cognition
Pei-Iun Hsieh, Te-Hsuan Huang, Jeng-Min Chiou, Jen-Hau Chen, Yen-Ching Chen
Epidemiol Health. 2024;46:e2024057.   Published online June 25, 2024
DOI: https://doi.org/10.4178/epih.e2024057
  • 2,571 View
  • 333 Download
AbstractAbstract AbstractSummary PDF
Abstract
The Taiwan Initiative for Geriatric Epidemiological Research (TIGER) was founded in 2011 to elucidate the interrelationships among various predictors of global and domain-specific cognitive impairment, with the aim of identifying older adults with an increased risk of dementia in the preclinical phase. TIGER, a population-based prospective cohort, recruited 605 and 629 (total of 1,234) older adults (aged 65 and above) at baseline (2011-2013 and 2019-2022) of phase I and II, respectively. Participants have undergone structured questionnaires, global and domain-specific cognitive assessments, physical exams, and biological specimen collections at baseline and biennial follow-ups to date. By 2022, TIGER I has included 4 biennial follow-ups, with the participants comprising 53.9% female and having a mean age of 73.2 years at baseline. After an 8-year follow-up, the annual attrition rate was 6.1%, reflecting a combination of 9.9% of participants who passed away and 36.2% who dropped out. TIGER has published novel and multidisciplinary research on cognitive-related outcomes in older adults, including environmental exposures (indoor and ambient air pollution), multimorbidity, sarcopenia, frailty, biomarkers (brain and retinal images, renal and inflammatory markers), and diet. TIGER’s meticulous design, multidisciplinary data, and novel findings elucidate the complex etiology of cognitive impairment and frailty, offering valuable insights into factors that can be used to predict and prevent dementia in the preclinical phase.
Summary
Key Message
1. The Taiwan Initiative for Geriatric Epidemiological Research (TIGER), established in 2001, aims to fill the knowledge gap regarding the longitudinal associations between environmental exposure, clinical factors, and performance in global and cognitive domains. 2. TIGER has made significant findings in various aspects, including the effects of exposure to low-level air pollutants, indoor air quality, clinical factors (brain and retinal images, dental health), nutrition, and biomarkers on cognition over time. 3. TIGER's multidisciplinary data and advanced analysis elucidate the predictors of cognitive impairment, identifying older adults at increased risk of dementia in the preclinical phase for early prevention and intervention.
Original Articles
Age-specific findings on lifestyle and trajectories of cognitive function from the Korean Longitudinal Study of Aging
Seungju lim, Eunyoung Yoo, Ickpyo Hong, Ji-Hyuk Park
Epidemiol Health. 2023;45:e2023098.   Published online November 2, 2023
DOI: https://doi.org/10.4178/epih.e2023098
  • 3,776 View
  • 156 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Few longitudinal studies have explored age-related differences in the relationship between lifestyle factors and cognitive decline. This study investigated lifestyle factors at baseline that slow the longitudinal rate of cognitive decline in young-old (55-64 years), middle-old (65-74 years), and old-old (75+ years) individuals.
METHODS
We conducted an 11-year follow-up that included 6,189 older adults from the Korean Longitudinal Study of Aging, which is a cohort study of community-dwelling older Koreans. Lifestyle factors, including physical activity, social activity (SA), smoking, and alcohol consumption were assessed at baseline. Cognitive function was measured at 2-year intervals over 11 years. Latent growth modeling and multi-group analysis were performed.
RESULTS
The influence of lifestyle factors on the rate of cognitive decline differed by age. Smoking at baseline (-0.05; 95% confidence interval [CI], -0.11 to -0.00, per study wave) accelerated cognitive decline in young-old individuals, whereas frequent participation in SA at baseline (0.02; 95% CI, 0.01 to 0.03, per study wave) decelerated cognitive decline in middle-old individuals. None of the lifestyle factors in this study decelerated cognitive decline in old-old individuals.
CONCLUSIONS
Cognitive strategies based on modifiable lifestyle factors such as smoking cessation in young-old individuals and frequent SA participation in middle-old age individuals may have great potential for preventing cognitive decline. Because the influence of lifestyle factors varied by age group, age-specific approaches are recommended to promote cognitive health.
Summary
Korean summary
본 연구는 국내 노인인구를 연령대별로 구분하여 연소노인(55-64세), 중고령노인(65-74세), 고령노인(75세+)의 인지저하 기울기를 가속 혹은 감속시키는 라이프스타일 요인을 파악하였다. '흡연'은 연소노인의 인지저하를 가속, '사회활동 참여 빈도'는 중고령노인의 인지저하를 감속시키는 것으로 나타났으며, 고령노인의 경우 유의미한 변수가 나타나지 않았다. 본 결과는 노인의 인지건강에 있어 연령대별 차별화된 라이프스타일 전략이 필요할 것을 시사한다.
Key Message
This study aimed to identify lifestyle factors that accelerate or decelerate the cognitive decline slope in the older population in South Korea, categorized by age groups: young-old adults (55-64), middle-old adults (65-74), and old-old adults (75+). The findings indicated that 'smoking' accelerates cognitive decline in young-old adults, while 'frequency of social activity participation' decelerates cognitive decline in middle-old adults. However, no significant lifestyle variables were identified for old-old adults. These results suggest the necessity of differentiated lifestyle strategies based on age groups for promoting cognitive health in the older population.

Citations

Citations to this article as recorded by  
  • Social activities in multidomain dementia prevention interventions: insights from practice and a blueprint for the future
    Jeroen Bruinsma, Leonie N. C. Visser, Alara Abaci, Anna Rosenberg, Ana Diaz, Sten Hanke, Rik Crutzen, Francesca Mangialasche, Miia Kivipelto, Charlotta Thunborg
    Frontiers in Psychiatry.2024;[Epub]     CrossRef
  • Association between dietary quality and accelerated aging: a cross-sectional study of two cohorts
    Yue Chen, Xin Zheng, Yiming Wang, Chenan Liu, Jinyu Shi, Tong Liu, Shiqi Lin, Hailun Xie, Heyang Zhang, Xiaoyue Liu, Zhaoting Bu, Li Deng, Shouling Wu, Hanping Shi
    Food & Function.2024; 15(15): 7837.     CrossRef
The Relationship between Height and Cognitive Function among Community-dwelling Elderly: Hallym Aging Study
Shan Ai Quan, Jin-Young Jeong, Dong-Hyun Kim
Epidemiol Health. 2013;35:e2013002.   Published online April 30, 2013
DOI: https://doi.org/10.4178/epih/e2013002
  • 17,613 View
  • 94 Download
  • 7 Crossref
AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>Height is known as an index that reflects the environment of the fetal, childhood, and adolescent periods, which affect adult health. This study was conducted to elucidate whether height is associated with cognitive impairment in community-dwelling elders in Korea.</p></sec><sec><title>METHODS</title><p>The study subjects were recruited among community dwelling elderly individuals aged 65 or over who participated in the 2004 Hallym Aging Study. They were invited to a general hospital and were evaluated for socioeconomic status, smoking history, and various clinical measures. Cognitive function measurement was performed using the Korean-Mini Mental State Examination. Logistic regression was used to evaluate the association between height and cognitive function.</p></sec><sec><title>RESULTS</title><p>After adjusting for potential covariates such as age and education, the smallest group was associated with higher risk of cognitive impairment compared with the tallest group among elderly men (odds ratio [OR], 4.20; 95% confidence interval [CI], 1.02-17.36), but not among elderly women (OR,1.65; 95% CI, 0.62-4.40).</p></sec><sec><title>CONCLUSIONS</title><p>The reason for this difference according to sex may be explained by the differential effects of education on cognitive function by sex. A larger population-based prospective cohort study is needed to examine the association between height and cognitive function according to sex.</p></sec>
Summary

Citations

Citations to this article as recorded by  
  • Taller adult height is associated with better performance of cognitive trajectories in Chinese over 45 years old: Evidence from the China Health and Retirement Longitudinal Study
    Lan Luo, Fangfei Xie, Yun Wang, Li‐Qiang Qin, Jie‐Yun Yin, Zhongxiao Wan
    Geriatrics & Gerontology International.2021; 21(8): 732.     CrossRef
  • Sex-related associations between body height and cognitive impairment among low-income elderly adults in rural China: a population-based cross-sectional study
    Dongwang Qi, Chanhong Shi, Rongyan Mao, Xuewei Yang, Jinhui Song, Yanjia Wang, Jun Tu, Jinghua Wang, Xianjia Ning, Yi Wu
    Biology of Sex Differences.2021;[Epub]     CrossRef
  • Book-Oriented Environment in Childhood and Current Cognitive Performance among Old-Aged Europeans
    Galit Weinstein, Ella Cohn-Schwartz, Noam Damri
    Dementia and Geriatric Cognitive Disorders.2021; 50(3): 274.     CrossRef
  • Host and disease factors are associated with cognitive function in European HIV‐infected adults prior to initiation of antiretroviral therapy
    A Winston, W Stöhr, A Antinori, A Arenas‐Pinto, JM Llibre, H Amieva, A Cabié, I Williams, G Di Perri, MJ Tellez, J Rockstroh, A Babiker, A Pozniak, F Raffi, L Richert
    HIV Medicine.2016; 17(6): 471.     CrossRef
  • Adult Body Height Is a Good Predictor of Different Dimensions of Cognitive Function in Aged Individuals: A Cross-Sectional Study
    Vitor H. Pereira, Patrício S. Costa, Nadine C. Santos, Pedro G. Cunha, Margarida Correia-Neves, Joana A. Palha, Nuno Sousa
    Frontiers in Aging Neuroscience.2016;[Epub]     CrossRef
  • Associations among height, body mass index and intelligence from age 11 to age 78 years
    Mathew A. Harris, Caroline E. Brett, Ian J. Deary, John M. Starr
    BMC Geriatrics.2016;[Epub]     CrossRef
  • Body Mass Index, Height and Socioeconomic Position in Adolescence, Their Trajectories into Adulthood, and Cognitive Function in Midlife
    Irit Cohen-Manheim, Glen M. Doniger, Ronit Sinnreich, Ely S. Simon, Havi Murad, Ronit Pinchas-Mizrachi, Jeremy D. Kark
    Journal of Alzheimer's Disease.2016; 55(3): 1207.     CrossRef
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