Association between dietary diversity and cognitive function among the elderly based on group-based trajectory model
DONG Chunling1,2, WANG Chong3, GUAN Tianyuan2, LIU Yue2, LI Xueying2, ZHANG Yuhai2
1. School of Public Health, Shaanxi University of Chinese Medicine, Xianyang, Shannxi 712046, China; 2. Department of Military Health Statistics, Faculty of Military Preventive Medicine, Air Force Medical University, Key Laboratory of Hazard Assessment and Control in Special Operational Environment, Ministry of Education, Xi'an, Shannxi 710032, China; 3. Medical Research Experimental Center, Shaanxi University of Chinese Medicine, Xianyang, Shannxi 712046, China
Abstract:Objective To analyze the association between dietary diversity and cognitive function among the elderly using group-based trajectory model, so as to provide the basis for formulating dietary intervention strategies to prevent cognitive impairment. Methods Based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) project, demographic information, lifestyle behaviors, psychological well-being, and activities of daily living of elderly individuals aged ≥65 years from 2008 to 2018 were collected. Dietary diversity was assessed using a food frequency questionnaire, with a score of <7 points defined as low dietary diversity. Cognitive function was evaluated using the Chinese version of the Mini-Mental State Examination (MMSE). A group-based trajectory model was established based on cognitive function scores from 2008 to 2018 to analyze the trajectories of cognitive function change. The association between dietary diversity and cognitive function was analyzed using a multinomial logistic regression model. Results A total of 1 613 individuals were collected, with a median age was 72.00 (interquartile range, 10.00) years. There were 810 males (50.22%) and 803 females (49.78%). The group-based trajectory model analysis categorized the participants into three groups: the low-level normal group, the high-level normal group, and the slow-then-rapid decline group, comprising 796 (49.35%), 585 (36.27%), and 232 (14.38%) individuals, respectively. Among these groups, the numbers of individuals with low dietary diversity were 497 (62.44%), 311 (53.16%), and 166 (71.55%), respectively, with a statistically significant difference (P<0.05). Multinomial logistic regression analysis showed that after adjusting for demographic information, lifestyle behaviors, psychological well-being, and activities of daily living, compared with the high-level normal group, low dietary diversity was statistically associated with cognitive function in the slow-then-rapid decline group (OR=1.622, 95%CI: 1.103-2.384). Conclusion Low dietary diversity may increase the risk of cognitive impairment among the elderly.
董春玲, 王冲, 关添元, 刘玥, 李雪莹, 张玉海. 基于组轨迹模型的老年人膳食多样性与认知功能研究[J]. 预防医学, 2025, 37(9): 865-869.
DONG Chunling, WANG Chong, GUAN Tianyuan, LIU Yue, LI Xueying, ZHANG Yuhai. Association between dietary diversity and cognitive function among the elderly based on group-based trajectory model. Preventive Medicine, 2025, 37(9): 865-869.
[1] ZHU C G,WALSH C,ZHOU L L,et al.Latent classification analysis of leisure activities and their impact on ADL,IADL and cognitive ability of older adults based on CLHLS(2008-2018)[J/OL].Int J Environ Res Public Health,2023,20(2)[2025-08-03].https://doi.org/10.3390/ijerph20021546. [2] 黄文,李金,陈奇峰.老年人认知功能损害的影响因素分析[J].预防医学,2020,32(11):1130-1133. HUANG W,LI J,CHEN Q F.Influencing factors for cognitive impairment among the elderly[J].China Prev Med J,2020,32(11):1130-1133.(in Chinese) [3] MA T P,LIAO J Q,YE Y G,et al.Social support and cognitive activity and their associations with incident cognitive impairment in cognitively normal older adults[J/OL].BMC Geriatr,2024,24(1)[2025-08-03].https://doi.org/10.1186/s12877-024-04655-5. [4] ZHANG C,TANG D S,WANG Y,et al.Community support and promoting cognitive function for the elderly[J/OL].Front Psychol,2022,13[2025-08-03].https://doi.org/10.3389/fpsyg.2022.942474. [5] NAUREEN Z,DHULI K,MEDORI M C,et al.Dietary supplements in neurological diseases and brain aging[J].J Prev Med Hyg,2022,63(2 Suppl.3):174-188. [6] AN R,LIU G G.Cognitive impairment and mortality among the oldest-old Chinese[J].Int J Geriatr Psychiatry,2016,31(12):1345-1353. [7] WANG X Y,LI S H,ZHANG Z N,et al.Association between widowhood and cognitive function among Chinese older adults with hearing impairment:the moderating effect of social support and participation[J/OL].BMC Geriatr,2024,24(1)[2025-08-03].https://doi.org/10.1186/s12877-024-05358-7. [8] ZHU A N,CHEN H,SHEN J,et al.Interaction between plant-based dietary pattern and air pollution on cognitive function:a prospective cohort analysis of Chinese older adults[J/OL].Lancet Reg Health West Pac,2022,20[2025-08-03].https://doi.org/10.1016/j.lanwpc.2021.100372. [9] SHEN X Y,CHEN X H,CHEN X H,et al.Association of vision and hearing impairment and dietary diversity among the oldest old in China:findings from the Chinese longitudinal healthy longevity survey[J/OL].BMC Public Health,2024,24(1)[2025-08-03].https://doi.org/10.1186/s12889-024-19482-x. [10] 彭星,李逸晗,陈振霆,等.基于组轨迹模型的中老年人群衰弱与认知功能关联研究[J].预防医学,2025,37(5):449-454. PENG X,LI Y H,CHEN Z T,et al.Association between frailty and cognitive function among middle-aged and elderly populations based on group-based trajectory model[J].China Prev Med J,2025,37(5):449-454.(in Chinese) [11] MOSCONI L,MURRAY J,TSUI W H,et al.Mediterranean diet and magnetic resonance imaging-assessed brain atrophy in cognitively normal individuals at risk for Alzheimer's disease[J].J Prev Alzheimers Dis,2014,1(1):23-32. [12] JIN Y Z,LIANG J,HONG C L,et al.Cardiometabolic multimorbidity,lifestyle behaviours,and cognitive function:a multicohort study[J].Lancet Healthy Longev,2023,4(6):265-273. [13] 应旭华,李松涛,翟羽佳,等.老年人脉压差与认知功能的关系研究[J].预防医学,2016,28(11):1119-1122. YING X H,LI S T,ZHAI Y J,et al.A study on the association between pulse blood pressure and cognitive function among the elders in Yuhuan County of Zhejiang Province[J].China Prev Med J,2016,28(11):1119-1122.(in Chinese) [14] ZHONG W F,SONG W Q,WANG X M,et al.Dietary diversity changes and cognitive frailty in Chinese older adults:a prospective community-based cohort study[J/OL].Nutrients,2023,15(17)[2025-08-03].https://doi.org/10.3390/nu15173784.