LifestyleExercise

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.

Last updated: Jul 17, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. A health ecological model study of subjective cognitive decline among hypertensive patients in rural Shanxi, China.

observational

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 · Scientific reports (2026)

Participants: N/A
Duration: May to August 2024
Intervention: Multi-level factors across five Health Ecological Model layers (individual characteristics, behavior/lifestyle, working/living conditions, policy environment)
Outcome: Subjective cognitive decline (SCD) measured by SCD-Q9 score (≥5 indicating SCD)
Effect Size: OR=1.042 (age), OR=2.352 (family history), OR=3.049 (complications), OR=1.847 (moderate risk), OR=1.611 (no exercise), OR=1.644 (fairly good sleep), OR=1.939 (fairly poor sleep), OR=3.282 (low income), OR=1.697 (county hospital), OR=2.068 (mild depression), OR=0.294 (former drinker)
Population: 860 hypertensive patients from three rural counties in Shanxi Province, China (Daning, Yonghe, Yangqu)

Result:

PubMed: 42448799DOI: 10.1038/s41598-026-62335-3

Mechanism Graph

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

Limitations

  • ⚠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.

Products

Affiliate links coming soon. We only recommend products that match the doses and forms used in the cited research.

References

  1. 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
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.