Population aging is an important feature of China’s current social development. As the size of the elderly population aged 60 and above continues to expand, the incidence of cognitive dysfunction among the elderly is also showing a year-on-year upward trend. Cognitive function is the core ability for the elderly to maintain normal life and achieve social participation, covering multiple dimensions such as orientation, memory, attention, and computing power. Its impairment degree directly affects the quality of life of the elderly. Severe cognitive dysfunction (such as dementia) will not only lead to the loss of self-care ability of the elderly, but also impose a heavy care burden on families, while intensifying the pressure on social elderly care services [1].

At present, China’s attention to the cognitive function of the elderly is mostly focused on the stage of clinical diagnosis and treatment, while there is still a lack of early cognitive function screening and risk factor identification at the community level. Most elderly people seek medical attention only after obvious symptoms of cognitive impairment appear, missing the optimal time for early intervention [2]. As an important node city in the Wanjiang City Belt, Ma’anshan City features a prominent aging population. However, there has been no systematic research on the overall status of cognitive function and its related influencing factors among the elderly in its jurisdiction.

The Mini-Mental State Examination (MMSE) has become a commonly used tool for screening cognitive function among community-dwelling older adults due to its simple operation and comprehensive assessment dimensions [3]. This study took permanent residents aged 60 years and above in Ma’anshan City as research subjects to conduct cognitive function assessments. Meanwhile, it comprehensively collected information including general demographics, living habits, mental and psychological status, and disease conditions, and analyzed the main influencing factors of cognitive function in older adults. The purpose is to identify the key populations and critical links for protecting cognitive function among older adults in this region, so as to provide a reference for formulating scientific and feasible community-based cognitive function intervention measures.

This study found that the incidence of abnormal cognitive function in the elderly aged 60 and above in Ma’anshan City was 37%, and the normal cognitive function rate decreased significantly with age, which was consistent with the results of most domestic community-based studies [4]-[6], indicating that cognitive impairment has become an important issue in local community elderly health management, and the elderly over 80 years old are the key protection population.

Age and educational level are the most significant independent risk factors. The risk of abnormal cognitive function in the elderly ≥ 80 years old is 6 times that of the 60 - 69 years old group, which is due to physiological brain atrophy, neuronal reduction and cholinergic system decline with age, and the high incidence of underlying diseases further exacerbates cognitive impairment. The risk of primary school education or below is 6.8 times that of junior college or above, because high education forms a “cognitive reserve” through long-term learning and thinking activities, which can resist brain tissue damage and delay cognitive decline [7][8].

Living status and lifestyle are closely related to cognitive function. Living alone leads to insufficient brain stimulation and increased mental psychological problems, which superimposes cognitive decline. Regular exercise promotes cerebral blood circulation and neuronal metabolism, and abundant social activities maintain cognitive activity; insufficient exercise and social interaction lead to brain function degeneration. Balanced diet provides nutrients such as high-quality protein, B vitamins and folic acid for brain metabolism and neurotransmitter synthesis, which is a protective factor for cognitive function. This study found no significant correlation between smoking, drinking and cognitive function, which may be related to the mild smoking and drinking habits of the sample and the limited sample size, and needs further verification with expanded samples [9][10].

Mental psychological problems are important influencing factors for cognitive function. Insomnia, anxiety and depression lead to insufficient brain rest, impaired neuronal repair and abnormal neurotransmitter secretion, and also reduce the willingness of the elderly to participate in exercise and social activities, forming a vicious cycle of “low mood-reduced activity-cognitive decline” that exacerbates cognitive impairment [11].

Hypertension, diabetes and cerebrovascular disease are important risk factors for abnormal cognitive function. Poor long-term control of hypertension causes chronic cerebral ischemia and hypoxia; diabetes induces microangiopathy and oxidative stress damage to neurons; cerebrovascular disease directly damages brain tissue, and even mild lesions can cause occult cognitive damage, which gradually manifests and triggers cognitive abnormalities [12].

This study has limitations: the sample is only from urban communities of Ma’anshan City with a limited size; the cross-sectional design cannot analyze the dynamic relationship between factors and cognitive function; no stratified analysis of the severity of cognitive dysfunction was conducted. Future research can expand the sample to cover urban and rural areas of Ma’anshan City, conduct prospective cohort studies to explore the long-term mechanism of various factors on cognitive function, and use more refined assessment tools, such as MoCA for stratified analysis to formulate targeted intervention programs.

Based on the research results, multi-dimensional targeted interventions can be formulated for the identified risk factors: first, strengthen cognitive function screening for key populations such as the elderly ≥ 80 years old, those with primary school education or below and living alone; second, guide the elderly to develop healthy living habits through community health education, and organize cultural and sports activities to enrich their social life; third, establish community psychological counseling service stations to provide professional intervention for the elderly with mental psychological problems; fourth, establish chronic disease management files, standardize the diagnosis and treatment of hypertension, diabetes and cerebrovascular disease, and reduce secondary cognitive damage [13].

The incidence of abnormal cognitive function among elderly people aged 60 and above in Ma’anshan City is relatively high, and the rate of normal cognitive function shows a significant downward trend with age. Their cognitive function is jointly affected by multiple factors including age, educational level, living status, living habits, mental psychological status and underlying diseases.

In clinical and community elderly health management, personalized comprehensive intervention measures should be formulated for the above influencing factors: strengthen cognitive function screening for key populations, guide the elderly to form healthy living habits such as regular exercise, balanced diet and abundant social interaction, pay attention to mental psychological health intervention, and standardize the management of hypertension, diabetes and cerebrovascular disease. Through multi-dimensional interventions, the cognitive function of the elderly can be protected, the progression of cognitive impairment can be delayed, and the incidence of dementia can be reduced, thereby improving the quality of life of the elderly and alleviating the care burden of families and society.

This research was conducted by recruiting adult participants voluntarily. All of them agreed to have their real data measured and reported during the study. This research does not involve experimental medical treatment, invasive procedures, or drug intervention. Participants have been informed of the detailed process and purpose of this research, and have agreed to use their anonymized data for research and publication purposes. All records have deleted personal identification information, and participants are only referred to as “Participant 1” (P1) and “Participant 2” (P2)… to maintain their confidentiality and privacy rights. Since this research involves non-invasive research operations and voluntary participation of the participants, the relevant procedures comply with the ethical standards followed by recognized low-risk observational studies.

Project support fund number: WG25067.