Association between self-neglect and incident cognitive impairment among Chinese older adults and its subgroup differences

BACKGROUND: Population aging has led to growing concerns regarding self-neglect and cognitive impairment among older adults. However, research on the association between self-neglect and incident cognitive impairment remains limited. We aimed to investigate the association between self-neglect and incident cognitive impairment and variations in gender and age. METHODS: A longitudinal study was conducted involving 2595 Chinese older adults from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database. Self-neglect was assessed using 17 items from the CLHLS, and cognitive function was evaluated using the Mini-Mental State Examination. Participants with cognitive impairment at baseline were excluded, and incident cognitive impairment during the follow-up period was documented. Cox proportional hazards models, restrictive cubic spline analysis (RCS), and stratified analyses based on gender and age (with 80 as the threshold) were conducted. RESULTS: The study sample comprised 1249 (48.1 %) men and 1346 (51.9 %) women, with an mean age of 79.7 ± 9.8 years. The risk of cognitive impairment was significantly higher for those in the third (Q3) and fourth (Q4) quartiles of self-neglect scores compared to those in the first quartile (Q1). The RCS analysis indicated a significantly linear relationship. The interaction between gender and self-neglect scores was significantly associated with incident cognitive impairment (P for interaction <0.001), suggesting that men are at a higher risk compared to women. CONCLUSION: Self-neglect is identified as a significant risk factor for incident cognitive impairment among older adults, with a particular impact on men, highlighting the critical need to address self-neglect to prevent cognitive decline.