# Cognitive function in normotensive elderly adults: a population-based cross-sectional study in rural China

**Authors:** Changqing Zhan, Qiao Wang, Yingnian Chen, Na Pan, Wenyu Wang, Xueping Lu, Xinling Xie

PMC · DOI: 10.3389/fmed.2026.1756221 · Frontiers in Medicine · 2026-03-09

## TL;DR

This study found that older age, being female, and lower BMI are linked to worse cognitive function in elderly adults without high blood pressure in rural China.

## Contribution

The study identifies specific risk factors for cognitive dysfunction in normotensive elderly individuals in a rural Chinese population.

## Key findings

- Women scored significantly lower on cognitive tests than men.
- Older age and lower BMI were associated with lower cognitive scores.
- BMI showed a positive correlation with cognitive scores in men.

## Abstract

Worldwide, the number of people with cognitive disorders is rapidly increasing. The risk factors for cognitive dysfunction in normotensive elderly individuals remain unclear. This study explored cognitive function and related risk factors in a rural elderly population in Tianjin, China.

Participants were recruited from the Tianjin Brain Research Institute. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Multivariate logistic and linear regression analyses were performed using SPSS (version 27.0), with statistical significance set at P < 0.05.

A total of 386 participants (191 males, 195 females; mean age 65.88 years) were included. Multivariate analysis revealed that gender, age, and body mass index (BMI) were significantly associated with MMSE scores. Women scored 2.40 points lower than men (95%CI: −3.78, −1.02, P < 0.001). Individuals aged ≥75 scored 3.18 points lower than those aged 60–64 (95%CI: −4.88, −1.49, P < 0.001). BMI was positively correlated with MMSE scores, increasing by 0.18 points per unit increase in BMI (95%CI: 0.03, 0.33, P = 0.019). Subgroup analysis exploratory results suggested that age may be associated with cognitive impairment in women, while BMI may show a positive correlation with MMSE scores in men. Among participants aged ≥75 years, alcohol status may benefit cognition; triglycerides generally exhibited a risk trend but may show an inverse association in the 70–74 age group. Blood glucose levels showed no significant effect on cognition (P > 0.05).

Older age, female gender, and lower BMI are associated with lower MMSE scores in normotensive elderly individuals. Strengthening community screening and education for older women and men with low BMI is essential.

## Full-text entities

- **Diseases:** cognitive disorders (MESH:D003072)
- **Chemicals:** Blood glucose (MESH:D001786), alcohol (MESH:D000438), triglycerides (MESH:D014280)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

56 references — full list in the complete paper: https://tomesphere.com/paper/PMC13006621/full.md

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Source: https://tomesphere.com/paper/PMC13006621