The Association Of Residential Living Status With Cognitive Performance In Two Cognitively Normal Elderly Samples

Objectives: Age-related cognitive changes, which are common among the elderly, can affect daily life and lead to dementia. The present study compared the cognitive status of cognitively normal older adults living in the community or nursing homes.Methods: This cross-sectional study was conducted in four communities and a nursing home (NH) in Hangzhou, China. The eligibility criteria were being 65 years old or older and having normal cognitive functioning. Cognitive functioning was evaluated using the Mini-Mental State Exam (MMSE).Results: In total, 924 community-dwelling elderly and 301 NH residents participated in the study. Their median total MMSE score was 27.87 +/- 2.66, and 103 (8.4%) had an MMSE score =23. The NH group performed significantly worse than the community group on the overall MMSE and its individual items. The best performance was observed for naming common objects. The three items with the poorest performance in the entire sample and the community sample were episodic recall, repeating a sentence and attention and calculation. The NH sample also performed poorly on the copy a design task. Bivariate correlations showed that the total MMSE score of the community group was significantly lower for participants who were women, older, unemployed and less educated. The total MMSE score was significantly related only to age and education in the NH group.Conclusions: The results indicate that cognitive decline is common in elderly populations; fluid abilities are impaired more severely than crystallised abilities are. Compared with the community population, the cognitive function of the NH population decreased more significantly. Education and employment may have protective effects against cognitive decline.Clinical implications: Although cognitive decline does not inevitably lead to dementia, screening for cognitive ability in elderly populations is important, especially in the NH population. The findings also highlight the importance of increased education and lifestyle changes to reduce the risk of cognitive decline.