Modifiable risk factors for mild cognitive impairment: Insights from a 7‐year follow‐up cohort study among Shanghai community‐dwelling older adults
Xinyi Qian, Yuanyuan Liu, Bo Hong, Ning Su, Yehao Jiang, Wei Li, Feng Yan, Xiaochen Hu, Xia Li, Ling Yue, Shifu XiaoAbstract
INTRODUCTION
We aimed to identify key modifiable risk factors (MRFs) for mild cognitive impairment (MCI) among community‐dwelling older adults in Shanghai by incorporating potential China‐specific factors into established MRF frameworks at an earlier stage of Alzheimer's disease.
METHODS
Baseline cognitively normal participants from the Shanghai Brain Aging Study ( N = 2464) were selected and followed for a maximum of 7 years, with demographic, lifestyle, and clinical data and comprehensive neuropsychological assessments. Cox regression and population attributable fraction (PAF) were used to quantify the contribution of MRFs to incident MCI. Sex stratification analyses were used for exploratory purposes.
RESULTS
At follow‐up, 26.7% of individuals had developed MCI. Six MRFs were included in the PAF analysis. Somatic comorbidity (diabetes or cerebral infarction, hazard ratio [HR] = 1.84), manual labor (HR = 1.47), short sleep duration (HR = 1.45), and lack of soy products (HR = 1.36) were the principal contributors. Divorced or widowed status and persistent depressive mood contributed weakly and non‐significantly. Together, these six MRFs accounted for a PAF of 19.22% after adjustment for age and education. The overall PAF was higher in females (22.94%) than in males (13.10%), with a broader range of contributing factors in females.
DISCUSSION
Six MRFs accounted for nearly 20% of MCI at the population level in this 7‐year follow‐up Shanghai community population, extending the modifiable‐risk framework from dementia to its earlier prodromal stage and providing novel insights for early dementia prevention.