Latent Class Analysis and Influence Factors Study of Cognitive Function among Older People with Chronic Diseases in Community

Abstract

Background Older people with chronic diseases in the community have a higher risk of impaired cognitive function, which seriously threatens their quality of life. Improving cognitive function is crucial for enhancing their quality of life. However, there is heterogeneity in the forms of individual cognitive impairment, and how to effectively improve their cognitive function needs to be further explored. Objective To explore the Latent class of cognitive function among older people with chronic diseases in the community, and analyze the influence factors of different categories, to provide a reference for formulating targeted cognitive function improvement strategies for older people with chronic diseases in the community. Methods Convenience sampling was used to recruit 502 older people with chronic diseases in the community who visited the Tianjin University of Traditional Chinese Medicine Affiliated Baokang Hospital from September to December 2022, using the General Information Questionnaire, Mini-mental State Examination (MMSE), Activity of Daily Living Scale (ADLS), Social Support Rating Scale (SSRS), and Cognitive Reserve Questionnaire (CR). Mplus 8.3 was used to conduct a latent class analysis of cognitive function among older people with chronic diseases in the community and establish a subgroup model. Univariate analysis and unordered multiple Logistic regression were used to analyze the influence factors of cognitive function among older people with chronic diseases in different categories. Results In this study, a total of 526 questionnaires were distributed and 502 valid questionnaires were recovered, with an effective response rate of 95.44%. The cognitive function among 502 older people with chronic diseases in the community was classified into three categories: high cognition with memory impairment group (n=253), moderate cognition with attention impairment group (n=158), and low cognition with overall impairment group (n=91). Unordered multivariate Logistic regression analysis showed that the high cognition with memory impairment group compared to the low cognition with overall impairment group, older people aged 60-74 years (OR=2.315, 95%CI=1.163-4.608, P=0.017), with two chronic diseases (OR=4.105, 95%CI=1.807-9.327, P=0.001), normal blood pressure (OR=2.763, 95%CI=1.414-5.400, P=0.003), normal blood lipids (OR=2.016, 95%CI=1.014-4.008, P=0.046), higher CR scores (OR=1.031, 95%CI=1.005-1.057, P=0.018), and higher SSRS scores (OR=1.055, 95%CI=1.007-1.105, P=0.023) were more likely to belong to the high cognition with memory impairment group, while those with higher ADLS scores (OR=0.920, 95%CI=0.885-0.957, P<0.001) were more likely to belong to the low cognition with overall impairment group. Similarly, in the moderate cognition with attention impairment group compared to the low cognition with overall impairment group, older people with chronic diseases in the community with two chronic diseases (OR=2.862, 95%CI=1.254-6.529, P=0.012), normal blood pressure (OR=2.655, 95%CI=1.350-5.225, P=0.005), normal blood lipids (OR=2.310, 95%CI=1.147-4.652, P=0.019), and higher SSRS scores (OR=1.077, 95%CI=1.027-1.129, P=0.002) were more likely to belong to the moderate cognition with attention impairment group, while those with higher ADLS scores (OR=0.948, 95%CI=0.913-0.984, P=0.005) were more likely to belong to the low cognition with overall impairment group. Conclusion There are significant differences in the classification characteristics of cognitive function among older people with chronic diseases in the community. Age, number of chronic diseases, blood pressure, blood lipids, cognitive reserve, social support, and activities of daily living are the influencing factors of the latent classes of cognitive function. Medical staff should actively identify the cognitive function characteristics of different categories of older people with chronic diseases in the community, and provide timely and effective intervention measures to improve the cognitive function level of older people with chronic diseases in the community.

Keywords

• chronic disease|cognition|community|aged|latent class analysis|root cause analysis