Multi-level factors across the Health Ecological Model are independently associated with subjective cognitive decline among hypertensive patients in rural China
In a cross-sectional study of 860 hypertensive patients in rural Shanxi, China, 80.58% met criteria for subjective cognitive decline (SCD). Factors associated with higher odds of SCD included advanced age (OR=1.042), family history of hypertension (OR=2.352), hypertensive complications (OR=3.049), moderate hypertension risk (OR=1.847), lack of physical exercise (OR=1.611), fairly good or fairly poor sleep quality (OR=1.644 and 1.939), lower household income (OR=3.282), utilization of county-level hospitals (OR=1.697), and mild depression (OR=2.068). Former drinker status was associated with lower odds of SCD (OR=0.294) but may reflect residual confounding.
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Multi-level factors across the Health Ecological Model are independently associated with subjective cognitive decline among hypertensive patients in rural China The current body of evidence comprises 1 study. EvidenceHub rates the overall confidence at 34/100 (low).
The Claim
Multi-level factors across the Health Ecological Model are independently associated with subjective cognitive decline among hypertensive patients in rural China
This conclusion is most relevant to: 860 hypertensive patients from three rural counties in Shanxi Province, China (Daning, Yonghe, Yangqu).
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸A health ecological model study of subjective cognitive decline among hypertensive patients in rural Shanxi, China. (Scientific reports, 2026) —
How It Works
The proposed biological pathway:
- ▸Multi-level factors across HEM layers were assessed
- ▸Logistic regression identified associations with SCD
- ▸Individual, behavioral, and living condition factors showed significant associations
- ▸Policy environment layer showed no significant associations
Who Might Benefit
Evidence fit by population:
- ▸860 hypertensive patients from three rural counties in Shanxi Province, China (Daning, Yonghe, Yangqu)
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Cross-sectional design prevents causal inference
- ▸SCD was self-reported and not clinically confirmed
- ▸Former drinker association may reflect residual confounding and should not be interpreted causally
- ▸Limited generalizability to non-rural or non-Chinese populations
Frequently Asked Questions
What is the prevalence of subjective cognitive decline in this study population?▼
80.58% of the 860 hypertensive patients met the criteria for SCD based on self-reported screening.
Which factors were most strongly associated with SCD?▼
Hypertensive complications (OR=3.049) and lower household income (OR=3.282) showed the strongest associations with higher odds of SCD.
Was sleep quality associated with SCD?▼
Yes, both fairly good sleep quality (OR=1.644) and fairly poor sleep quality (OR=1.939) were associated with higher odds of SCD compared to very good sleep quality.
Can this study establish causality?▼
No, this is a cross-sectional study, so it can only identify associations, not causal relationships. Longitudinal studies are needed to establish predictive value.
References
- 1.Liang R, Liu J, Sun W, Li S, Wang J, Niu Q, Yu H, Qin X, Zhang H, Nie J, Zhang Z, Bai J, Li S, Zhao S. “A health ecological model study of subjective cognitive decline among hypertensive patients in rural Shanxi, China..” Scientific reports, 2026. PMID: 42448799 DOI: 10.1038/s41598-026-62335-3