Cognitive ageing trajectories and mortality of Chinese oldest-old.

OBJECTIVE: This study aims to identify distinctive cognitive trajectories jointly with mortality probabilities and to explore factors related to the particular trajectories of cognitive ageing in China.

METHOD: 6842 individuals aged 80 years and above from 7 waves of the Chinese Longitudinal Healthy Longevity Survey were assessed with the Mini-Mental State Examination for up to 16 years. A group-based trajectory model was used to jointly estimate cognitive ageing and mortality trajectories; and to explore the factors related to membership of the trajectory groups.

RESULTS: A four-group model best fit the data. For all groups, the cognitive function declined with age according to different rates. Group 4, 3, 2, and 1 showed slow (prevalence 52.8%), moderate (31.1%), progressive (12.6%) and rapid (3.5%) cognitive decline, respectively. Mortality probability trajectories followed a hierarchy in consistence with cognitive trajectories approximately. Females, illiteracy, and those born in rural areas were less likely to belong to the most favorable trajectory group.

CONCLUSIONS: The heterogeneity of cognitive ageing was identified among Chinese oldest-old. Childhood socioeconomic status, especially education, was associated with the rate of cognitive decline.