Dynamic relations between longitudinal morphological, behavioral, and emotional indicators and cognitive impairment: evidence from the Chinese Longitudinal Healthy Longevity Survey

Abstract Background We aimed to assess the effects of body mass index (BMI), activities of daily living (ADL), and subjective well-being (SWB) on cognitive impairment and propose dynamic risk prediction models for aging cognitive decline. Methods We leveraged the Chinese Longitudinal Healthy Longevi...

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Main Authors: Jianle Sun, Luojia Deng, Qianwen Li, Jie Zhou, Yue Zhang
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-024-21072-w
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author Jianle Sun
Luojia Deng
Qianwen Li
Jie Zhou
Yue Zhang
author_facet Jianle Sun
Luojia Deng
Qianwen Li
Jie Zhou
Yue Zhang
author_sort Jianle Sun
collection DOAJ
description Abstract Background We aimed to assess the effects of body mass index (BMI), activities of daily living (ADL), and subjective well-being (SWB) on cognitive impairment and propose dynamic risk prediction models for aging cognitive decline. Methods We leveraged the Chinese Longitudinal Healthy Longevity Survey from 1998 to 2018. Cognitive status was measured using the Chinese Mini-Mental State Examination. We employed repeated measures correlation to assess associations, linear mixed-effect models to characterize the longitudinal changes, and Cox proportional hazard regression to model survival time. Dynamic predictive models were established based on the Bayesian joint model and deep learning approach named dynamic-DeepHit. Marginal structural Cox models were adopted to control for time-varying confounding factors and assess effect sizes. Results ADL, SWB, and BMI showed protective effects on cognitive impairment after controlling observed confounding factors, with respective direct hazard ratios of 0.756 (0.741, 0.771), 0.912 (0.902, 0.921), and 0.919 (0.909, 0.929). Dynamic risk predictive models manifested high accuracy (best AUC = 0.89). ADL was endowed with the best predictive capability, although the combination of BMI, ADL, and SWB showed the most remarkable performance. Conclusions BMI, ADL, and SWB are protective factors for cognitive impairment. A dynamic prediction model using these indicators can efficiently identify vulnerable individuals with high accuracy.
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spelling doaj-art-c2718f77ae2645349e9febf73be994d62025-08-20T01:57:14ZengBMCBMC Public Health1471-24582024-12-0124111210.1186/s12889-024-21072-wDynamic relations between longitudinal morphological, behavioral, and emotional indicators and cognitive impairment: evidence from the Chinese Longitudinal Healthy Longevity SurveyJianle Sun0Luojia Deng1Qianwen Li2Jie Zhou3Yue Zhang4Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong UniversityDepartment of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong UniversityDepartment of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong UniversityDepartment of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong UniversityDepartment of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong UniversityAbstract Background We aimed to assess the effects of body mass index (BMI), activities of daily living (ADL), and subjective well-being (SWB) on cognitive impairment and propose dynamic risk prediction models for aging cognitive decline. Methods We leveraged the Chinese Longitudinal Healthy Longevity Survey from 1998 to 2018. Cognitive status was measured using the Chinese Mini-Mental State Examination. We employed repeated measures correlation to assess associations, linear mixed-effect models to characterize the longitudinal changes, and Cox proportional hazard regression to model survival time. Dynamic predictive models were established based on the Bayesian joint model and deep learning approach named dynamic-DeepHit. Marginal structural Cox models were adopted to control for time-varying confounding factors and assess effect sizes. Results ADL, SWB, and BMI showed protective effects on cognitive impairment after controlling observed confounding factors, with respective direct hazard ratios of 0.756 (0.741, 0.771), 0.912 (0.902, 0.921), and 0.919 (0.909, 0.929). Dynamic risk predictive models manifested high accuracy (best AUC = 0.89). ADL was endowed with the best predictive capability, although the combination of BMI, ADL, and SWB showed the most remarkable performance. Conclusions BMI, ADL, and SWB are protective factors for cognitive impairment. A dynamic prediction model using these indicators can efficiently identify vulnerable individuals with high accuracy.https://doi.org/10.1186/s12889-024-21072-wAging cognitive impairmentDynamic risk predictionBayesian joint modelDeep survival modelLongitudinal causal inferenceBody mass index
spellingShingle Jianle Sun
Luojia Deng
Qianwen Li
Jie Zhou
Yue Zhang
Dynamic relations between longitudinal morphological, behavioral, and emotional indicators and cognitive impairment: evidence from the Chinese Longitudinal Healthy Longevity Survey
BMC Public Health
Aging cognitive impairment
Dynamic risk prediction
Bayesian joint model
Deep survival model
Longitudinal causal inference
Body mass index
title Dynamic relations between longitudinal morphological, behavioral, and emotional indicators and cognitive impairment: evidence from the Chinese Longitudinal Healthy Longevity Survey
title_full Dynamic relations between longitudinal morphological, behavioral, and emotional indicators and cognitive impairment: evidence from the Chinese Longitudinal Healthy Longevity Survey
title_fullStr Dynamic relations between longitudinal morphological, behavioral, and emotional indicators and cognitive impairment: evidence from the Chinese Longitudinal Healthy Longevity Survey
title_full_unstemmed Dynamic relations between longitudinal morphological, behavioral, and emotional indicators and cognitive impairment: evidence from the Chinese Longitudinal Healthy Longevity Survey
title_short Dynamic relations between longitudinal morphological, behavioral, and emotional indicators and cognitive impairment: evidence from the Chinese Longitudinal Healthy Longevity Survey
title_sort dynamic relations between longitudinal morphological behavioral and emotional indicators and cognitive impairment evidence from the chinese longitudinal healthy longevity survey
topic Aging cognitive impairment
Dynamic risk prediction
Bayesian joint model
Deep survival model
Longitudinal causal inference
Body mass index
url https://doi.org/10.1186/s12889-024-21072-w
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