The Cognitive Change Among Successful Aging And Correlative Factors

Objective: To explore the difference of cognitive aging among successful aging, usual aging and mild cognitive impairment elderly, and its biological and psychological base.Methods: (1) 421 community elderly who aged 65 years or over were interviewed at baseline, among which there were 230 in successful aging (SA) group, 137 in usual aging (UA) group, 54 in mild cognitive impairment (MCI) group. 156 testees were interviewed in follow-up phase, among which there were 73 in SA group, 57 in UA group, 26 in MCI group. (2) All were assessed by Neuropsychological Test Battery for Elderly (NTBE). Using polymerase chain reaction (PCR)-based technique, polymorphism of Apolipoprotein E (ApoE) and Angiotensin-converting enzyme (ACE) were determined in them. (3) One-way analysis and multiple variable analysis were employed according to the characteristics of the distribution of data. The statistical software used throughout the analysis were SPSS 11.5 and SAS 6.12.Results: 1. Baseline: (1) Controlling age and educational level, there existed some significant difference in most neuropsychological sub-tests, and the SA group was significant better than the UA group in several sub-tests. The learning efficiency indexes have no significant difference among three groups. (2) Group without ApoE e4 allele outperformed the group with e4 on some sub-test, the difference were significant. The same did between the group without ACE D allele and the group with D. 2. Follow-up phase: (1) The ratio of completing some neuropsychological sub-tests in MCI group was less than SA and UA group. (2) The number of sub-tests in which there exist significant differences in this phase was less than baseline. The SA group was better in delayed recall probability and retrieval from long-term memory than UA group. 3. Change from baseline to follow-up phase: (1) Among SA group, the decline in the immediate recall, delayed recall probability and retrieval from long-term memory were little and the decline in perceptive speed and executive function was distinct. The decline in work memory and executive fuction was distinct among UA group. The item number in which decline significantly was very little in MCI. Amost items declined steeper in 71～75 aged people. (2) Physical activity, self-efficacy and mental status correlates to the change of some neuropsychological items, especially on executive function. (3) The executive function was worse in the group with ApoEe4 allele and the group with ACE D allele.Conclusions: (1) The high cognitive level of SA is correlative with integrated ability of brain and effective compensation, building effective compensation strategy should be an important means of intervention for successful aging. (2) Executive function may be an impressionable field while cognitive aging, and it may be an important medium of the effect on cognitive function for biological and psychological factor. (3) 71～75 may be the susceptive phase of cognitive aging. (4) The cognitive of UA and MCI still have somewhat plasticity, successful aging interventions have realistic significance.