Changes in cognitive function and influencing factors in older men

In this study, we investigated the changes and influencing factors of cognitive function in older Korean males. Despite significant investigation into the decline of cognitive function in older adults, this particular population of patients has received insufficient research attention due to their unique socio-economic context. In this study, we utilized data from 1543 elderly men aged 65 and over, drawing from the 1st to 8th rounds of the Korean Longitudinal Study of Aging (KLoSA) conducted between 2006 and 2020. A latent growth model was employed to estimate changes in their cognitive function. Specifically, we used an unconditional model to evaluate the pattern of cognitive changes in elderly men and a conditional model to identify the factors influencing these functional changes. Analysis showed that the cognitive function of elderly men showed an increasing rate of decline over time, thus indicating a progressively sharp reduction in the level of cognitive function. Secondly, we identified a range of factors influencing cognitive function in elderly men, including age, education, employment status and depression. In addition, we found that no independent variable influenced the linear rate of change or the quadratic rate of change rate of cognitive function in elderly men. Despite certain limitations, such as the inability to control for external impacts such as the COVID-19 pandemic and a high sample attrition rate, this study paves the way for future investigations aimed at gaining a better understanding of the dynamics of cognitive function in older Korean males and designing effective interventions.

Cognitive function; Older adults; Depression; Public health; CES-D (Center for Epidemiologic Studies Depression Scale)

[1] Britton A, Shipley M, Singh‐Manoux A, Marmot MG. Successful aging: the contribution of early‐life and midlife risk factors. Journal of the American Geriatrics Society. 2008; 56: 1098–1105.

[2] Kim JW, Kim SK, Lee KY, Shin HR, Kim YS. Relationship between cognitive function and depression in elderly women: focusing on the parameter effect of mobility constraint. Korean Journal of Gerontological Social Welfare. 2019; 37–60. (In Korean)

[3] Kim SM, Lee YJ, Kim HJ. Effect of resistance training on joint flexibility and muscle strength of upper extremities of elderly with impaired cognition. Journal of the Korean Gerontological Society. 2009; 29: 987–1000. (In Korean)

[4] Kim YO, Shim MS. Cognitive functions, instrumental activities of daily living, depression and quality of life in the elderly with mild cognitive impairment. Journal of Korean Public Health Nursing. 2015; 29: 219–230. (In Korean)

[5] Kim SH, Jung JH. The correlation between cognitive function and basic activities of daily living of the elderly people with dementia in the residential care facilities. Society of Occupational Therapy for the Aged and Dementia. 2013; 57–67. (In Korean)

[6] Choi YI. Relationships among cognitive functions, activities of daily living, participation and quality of life in community-dwelling elderly. Journal of Therapeutic Science for Rehabilitation. 2020; 9: 45–54. (In Korean)

[7] Podcasy JL, Epperson CN. Considering sex and gender in Alzheimer disease and other dementias. Dialogues in Clinical Neuroscience. 2016; 18: 437–446.

[8] Ministry of Health and Welfare, Seoul National University Hospital. Prevalence of dementia in the elderly. Ministry of Health and Welfare: Seoul. 2009.

[9] Ministry of Health and Welfare. Ministry of Health and Welfare Dementia Status by City and County. 2022. Available at: https://www.data.go.kr/data/15073342/fileData.do.

[10] Lee JS, Kang MJ, Choi MJ, Yoon HW, Lee OJ, Jo HH, et al. Dementia Status in South Korea 2022. Central Dementia Center: Seoul. 2023.

[11] Halpern DF. Sex differences in cognitive abilities. 3rd edn. Psychology Press: NY. 2000.

[12] Van Hooren SAH, Valentijn AM, Bosma H, Ponds RWHM, van Boxtel MPJ, Jolles J. Cognitive functioning in healthy older adults aged 64–81: a cohort study into the effect of age, sex, and education. Aging, Neurosychology, and Cognition. 2007; 14: 40–54.

[13] Ratigan A, Kritz-Silverstein D, Barrett-Connor E. Sex differences in the association of physical function and cognitive function with life satisfaction in older age: the Tancho Bernardo study. Maturitas. 2016; 89: 29–35.

[14] Lee H, Kim JS. Secondary data analysis on the factors associated with cognitive function decline according to gender in Korean elderly. Korea Gerontological Society. 2021; 41: 1073–1095.

[15] Ministry of Health and Welfaere. Korea Dementia Observatory 2022. National Institute of Dementia: Seoul. 2023.

[16] Rowe JW, Kahn RL. Successful aging. The Gerontologist. 1997; 37: 433–440.

[17] Wu Y, Prina AM, Brayne C. The association between community environment and cognitive function: a systematic review. Social Psychiatry and Psychiatric Epidemiology. 2015; 50: 351–362.

[18] Engelhardt H, Buber I, Skirbekk V, Prskawetz A. Social involvement, behavioural risks and cognitive functioning among older people. Ageing and Society. 2010; 30: 779–809.

[19] Zelinski EM, Gilewski MJ. Effects of demographic and health variables on Rasch scaled cognitive scores. Journal of Aging and Health. 2003; 15: 435–464.

[20] Shin SJ, Hwang EH. Gender differences in the cognitive function and nutritional status in older age: a representative nationwide data of Korean elders. Journal of the Korean Gerontological Society. 2021; 41: 1073–1095.

[21] Comijs HC, Kriegsman DMW, Dik MG, Deeg DJH, Jonker C, Stalman WAB. Somatic chronic diseases and 6-year change in cognitive functioning among older persons. Archives of Gerontology and Geriatrics. 2009; 48: 191–196.

[22] McDermott LM, Ebmeier KP. A meta-analysis of depression severity and cognitive function. Journal of Affective Disorders. 2009; 119: 1–8.

[23] Wu Y, Prina AM, Brayne C. The association between community environment and cognitive function: a systematic review. Social Psychiatry and Psychiatric Epidemiology. 2015; 50: 351–362.

[24] Kim B. Individual and perceived community environmental factors affecting cognitive function decline in Korean older adults. Journal of the Korean Society for Wellness. 2022; 17: 69–77.

[25] Yang SM, Jeong KH, Choi JS. Effects of social activities on cognitive function by gender difference among older adults: a nine-year longitudinal analysis in south Korea. Korean Journal of Gerontological Social Welfare. 2019; 72: 37–60.

[26] Korea Labor Institute. 2006 Korean longitudinal study of aging user guide. Korea Labor Institute: Sejong. 2007.

[27] Kohout F. J, Berkman L. F, Evans D. A, Cornoni-Huntley J. Two shorter forms of the CES-D depression symptoms index. Journal of Aging and Health. 1993; 5: 179–193.

[28] Kang Y, NA DL, Hahn S. A validity study on the Korean mini-mental state examination (K-MMSE) in dementia patients. Journal of the Korean neurological association, 1997; 15: 300–308.

[29] Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research. 1975; 12: 189–198.

[30] Park SH, Kwon KN. A study on problems and improvement of the public elderly sports project. The Korean Journal of Physical Education. 2020; 59: 43–64.

[31] Park SI, Chang SJ. Influencing factors on the acceptance of serious games for dementia prevention among the elderly at general social welfare centers. Journal of Digital Contents Society. 2023; 24: 1401–1411.

[32] Bonanno G. A. Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist. 2004; 59: 20–28.

[33] Min J, Kim J. 10-year trajectories of cognitive functions among older adults: focus on gender difference and spousal loss. Korea Gerontological Society. 2020; 40: 147–161.

[34] Kim HK. The pattern of change trajectories of cognitive function and their associated factors in Korean older adults: focusing on the cognitive function change from 2006 to 2018. Locality and Globality. 2022; 46: 101–129.

[35] Cerhan JR, Folsom AR, Mortimer JA, Shahar E, Knopman DS, McGovern PG, et al. Correlates of cognitive function in middle-aged adults. Gerontology. 1998; 44: 95–105.

[36] Berkman LF, Glass T, Brissette I, Seeman TE. From social integration to health: Durkheim in the new millennium. Social Science & Medicine. 2000; 51: 843–857.

[37] Lee H. Heterogeneous trajectories of cognitive function in Korean older adults: the effects of cumulative disadvantage and stressors. Journal of Social Science. 2017; 28: 207–228.

[38] Zaninotto P, Batty GD, Allerhand M, Deary IJ. Cognitive function trajectories and their determinants in older people: 8 years of follow-up in the English longitudinal study of ageing. Journal of Epidemiology and Community Health. 2018; 72: 685–694.

[39] Han M. Cognitive function prediction model for the elderly using decision tree analysis: 2020 national survey of the living condition and welfare needs of older Koreans. Journal of the Korea Academia-Industrial Cooperation Society. 2022; 23: 462–475.

[40] Kim MS, Lee WJ. Effects of health promotion behavior on life satisfaction of the elderly—focused on the mediation effect of the cognitive function. The Journal of the Korea Contents Association. 2020; 20: 726–737.