Adverse life event and risk of cognitive impairment: a 5-year prospective longitudinal study in Chongqing, China

Background and purpose: Current knowledge of factors that increase or decrease the risk of cognitive impairment in elderly people is limited. Recently adverse life events appeared to be associated with the increased risk of cognitive impairment in elderly people. However, this is less studied. We conducted a 5-year prospective study to evaluate the association between adverse life events and the risk of cognitive impairment in Chinese elderly people. Methods: Of 9167 community residents aged 55 years and over, 5262 were enrolled into the study and followed up annually for 5 years. At baseline demographic data, smoking and drinking status, medical history, adverse life events, clinical, functional and cognitive status, depressive symptom, and complementary data were collected. The cognitive status was assessed using a structured battery of neuropsychological tests. Subjects were followed-up annually to assess the cognitive function during follow-up. Results: Over the follow-up period of 5 years, cognitive impairment developed in 569 subjects. Among the adverse life events, the death of the spouse and a financial crisis were associated with the increased risk of cognitive impairment. These associations persisted after adjusting for the subjects with possible baseline pre-clinical cognitive impairment, depressive symptom, stroke and vascular risk factors respectively. Conclusions: Adverse life events, such as the death of a spouse and a financial crisis, are associated with a higher risk of cognitive impairment. Further in-depth longitudinal and intervention studies are needed to confirm the causal relationship between adverse life events and risk of cognitive impairment in the future.