Association of physical-mental comorbidity with cognitive decline in middle-aged and older adults in China, India and Indonesia: a multiple country large scale data cross-sectional comparative study

Abstract

Background: Growing evidence suggests a strong association between multimorbidity and brain health in older adults. However, limited studies have examined the combined impact of physical and mental multimorbidity on cognitive decline.

Objective: This study aims to investigate the relationship between physical-mental multimorbidity and cognitive decline.

Methods: This study utilized three nationally representative survey data from China (China Health and Retirement Longitudinal Study), India (Longitudinal Aging Study in India), and Indonesia (Indonesian Family Life Survey), including a total sample of 73,119 respondentse. Cognitive function was assessed across three domains: time orientation, word recall, and numeracy. Multivariable linear regression model was used to examine the association between physical-mental multimorbidity and cognitive decline, adjusting for sociodemographic and lifestyle factors.

Results: Physical-mental multimorbidity was significantly associated with lower cognitive function scores in China (β= -6.99; 95 % CI: -8.26, -5.71), India (β= -2.76; 95 % CI: -3.41, -2.11), and Indonesia (β= -2.75; 95 % CI: -4.10, -1.41). Stratified analyses revealed stronger associations among women and individuals with higher socioeconomic status compared to men and those with lower socioeconomic status.

Conclusion: Cognitive decline is highly prevalent among individuals with depressive symptoms and physical-mental multimorbidity. Addressing mental health issues in individuals with multimorbidity may help reduce the risk of cognitive impairment and dementia in aging populations.

Keywords

The elderly / Physical-mental multimorbidity / Depression / Cognition performance

Authors' contributions

Conceptualization, Z.S., Y.X. and H.L.; Methodology, Z.S., Y.X. and H.L.; Data curation, Z.Y., K.A., T.M., M.D., Z.S. and Z.T.; Formal analysis, Z.Y., K.A., T.M.; Funding acquisition, not applicable; Project administration, not applicable; Resources, not applicable; Supervision, H.L.; Validation, H.L.; Writing—original draft, Z.S., Z.Y., Z.T.; Writing—review and editing, H.L. All authors have read and agreed to the published version of the manuscript.

Declaration of Competing Interests

Z.Y. is the editorial member of Chinese General Practice Journal, he is not envolved in the editorial review or the decision to publish this article. All authors declare that there are no competing interests.

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