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. 2024 Apr 23;16(1):87.
doi: 10.1186/s13195-024-01451-6.

Longitudinal validation of cognitive reserve proxy measures: a cohort study in a rural Chinese community

Hao Chen #  1   2 , Jin Hu #  1 , Shiqi Gui  1 , Qiushuo Li  1 , Jing Wang  1 , Xing Yang  3 , Jingyuan Yang  4
Affiliations

Longitudinal validation of cognitive reserve proxy measures: a cohort study in a rural Chinese community

Hao Chen et al. Alzheimers Res Ther. .

Abstract

Background: While evidence supports cognitive reserve (CR) in preserving cognitive function, longitudinal validation of CR proxies, including later-life factors, remains scarce. This study aims to validate CR's stability over time and its relation to cognitive function in rural Chinese older adults.

Methods: Within the project on the health status of rural older adults (HSRO), the survey included baseline assessment (2019) and follow-up assessment (2022). 792 older adults (mean age: 70.23 years) were followed up. The confirmatory factor analysis (CFA) was constructed using cognitive reserve proxies that included years of formal education, social support, hobbies, and exercise. We examined the longitudinal validity of the CR factor using confirmatory factor analyses and measurement invariance and explored the association of CR with cognition using Spearman's correlation and Generalized Estimating Equations (GEE).

Results: The results showed that CR's CFA structure was stable over time (T0, χ2/df: 3.21/2; RMSEA: 0.02, and T1, χ2/df: 7.47/2; RMSEA: 0.05) and that it accepted both configural and metric invariance (Δχ2/df = 2.28/3, P = 0.52). In addition, it was found that CR had a stable positive relationship with cognitive function across time (T0, r = 0.54; T1, r = 0.49). Furthermore, longitudinal CR were associated with MMSE (β = 2.25; 95%CI = 2.01 ~ 2.49).

Conclusions: This study provided valuable evidence on the stability and validity of cognitive reserve proxy measures in rural Chinese older adults. Our findings suggested that cognitive reserve is associated with cognitive function over time and highlighted the importance of accumulating cognitive reserve in later life.

Keywords: Cognition; Cognitive reserve; Confirmatory factor analyses; Measurement invariance.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Correlation of CR with MMSE scores in two waves of study. Note: T0 for baseline, T1 for follow-up
Fig. 2
Fig. 2
Comparison of longitudinal correlation coefficients between CR and MMSE in different cognitive groups. Note: (A) and (B) show the longitudinal comparison of the Z-transformed correlation coefficients of the cognitive maintenance group and the decline group for all subjects; (C), (D) are longitudinal comparisons for the 60–69 age group; (E), (F) are longitudinal comparisons for the 70–79 age group; (G), (H) are longitudinal comparisons for the ≥80 age group. T0 for baseline, T1 for follow-up
See this image and copyright information in PMC

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