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Original Article Exploring cognitive trajectories and their association with physical performance: evidence from the China Health and Retirement Longitudinal Study
Jingdong Suo1,2orcid , Xianlei Shen1,2orcid , Jinyu He1,2orcid , Haoran Sun1,2orcid , Yu Shi1,2orcid , Rongxin He1,2orcid , Xiao Zhang1,2orcid , Xijie Wang1,2orcid , Yuandi Xi1,2,3orcid , Wannian Liang1,2orcid
Epidemiol Health 2023;45e2023064-0
DOI: https://doi.org/10.4178/epih.e2023064
Published online: July 9, 2023
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1Vanke School of Public Health, Tsinghua University, Beijing, China
2Institute for Healthy China, Tsinghua University, Beijing, China
3Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, China
Corresponding author:  Xijie Wang,
Email: xijie_wang@126.com
Wannian Liang,
Email: liangwn@tsinghua.edu.cn
Received: 23 March 2023   • Accepted: 13 June 2023
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Abstract

OBJECTIVES
The long-term trends of cognitive function and its associations with physical performance remain unclear, particularly in Asian populations. The study objectives were to determine cognitive trajectories in middle-aged and elderly Chinese individuals, as well as to examine differences in physical performance across cognitive trajectory groups.
METHODS
Data were extracted from the China Health and Retirement Longitudinal Study. A total of 5,701 participants (47.7% male) with a mean age of 57.8 (standard deviation, 8.4) years at enrollment were included. A group-based trajectory model was used to identify cognitive trajectory groups for each sex. Grip strength, repeated chair stand, and standing balance tests were used to evaluate physical performance. An ordered logistic regression model was employed to analyze differences in physical performance across cognitive trajectory groups.
RESULTS
Three cognitive trajectory groups were identified for each sex: low, middle, and high. For both sexes, higher cognitive trajectory groups exhibited smaller declines with age. In the fully adjusted model, relative to the low trajectory group, the odds ratios (ORs) of better physical performance in the middle cognitive group were 1.37 (95% confidence interval [CI], 1.17 to 1.59; p<0.001) during follow-up and 1.40 (95% CI, 1.20 to 1.64; p<0.001) at the endpoint. The ORs in the high trajectory group were 1.94 (95% CI, 1.61 to 2.32; p<0.001) during follow-up and 2.04 (95% CI, 1.69 to 2.45; p<0.001) at the endpoint.
CONCLUSIONS
Cognitive function was better preserved in male participants and individuals with higher baseline cognitive function. A higher cognitive trajectory was associated with better physical performance over time.

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