Facial aging, cognitive impairment, and dementia risk

Table 4 Odds ratio and 95% confidence interval of cognitive impairment according to objective skin variables in the NHAPC study^a

Skin variables		Odds ratio for cognitive impairment
		Q1	Q2	Q3	Q4	P-trend	FDR P-trend
Crow’s feet area	Wrinkle intensity	1 (ref.)	1.26 (0.61, 2.60)	1.90 (0.90, 3.99)	2.09 (0.91, 4.80)	0.04	0.15
	Total number of wrinkles and lines	1 (ref.)	1.43 (0.72, 2.86)	2.07 (1.02, 4.19)	2.48 (1.06, 5.78)	0.02	0.10
	Line wrinkle contrast weighted average	1 (ref.)	1.15 (0.56, 2.38)	2.47 (1.23, 4.97)	2.13 (0.97, 4.68)	0.01	0.10
Cheek area	Wrinkle intensity	1 (ref.)	0.69 (0.34, 1.39)	1.35 (0.65, 2.75)	0.88 (0.41, 1.88)	0.75	0.73
	Total number of wrinkles and lines	1 (ref.)	0.77 (0.39, 1.53)	1.09 (0.54, 2.21)	1.01 (0.47, 2.16)	0.70	0.73
	Line wrinkle contrast weighted average	1 (ref.)	0.82 (0.43, 1.55)	1.09 (0.57, 2.09)	0.70 (0.35, 1.42)	0.53	0.69
Instrumental measurements ^b	TEWL	1 (ref.)	1.23 (0.64, 2.34)	0.91 (0.45, 1.86)	1.75 (0.75, 4.06)	0.39	0.61
	R2	1 (ref.)	1.20 (0.57, 2.56)	1.74 (0.84, 3.58)	1.32 (0.63, 2.77)	0.37	0.61
	R6	1 (ref.)	1.16 (0.59, 2.27)	0.73 (0.37, 1.45)	0.89 (0.43, 1.83)	0.42	0.61
	Skin hydration and skin barrier function	1 (ref.)	0.95 (0.53, 1.70)	0.51 (0.26, 1.00)	0.66 (0.33, 1.32)	0.09	0.22

Abbreviations TEWL = transepidermal water loss, R2: ratio of total reversible recovery, R6: ratio of elastic deformation and inelastic deformation
^a Adjusted for age, sex (men; women), education level (primary school or below; middle school; college or above), current smoker (no; yes), current drinker (no; yes), physical activity (high, moderate, or low), cardiovascular diseases history (no; yes), cancer history (no; yes), hypertension (no; yes), diabetes history (no; yes), body mass index (BMI, < 18.5;18.5–24.0; ≥24.0 kg/m²), C-reactive protein (CRP, quartiles), depressive symptom (no; yes), sun exposure (< 0.5; 0.5-2; 2–4; ≥ 4 h/d), and sun screen (never; occasionally; often)
^b TEWL was measured to assess the rate of water loss through the skin, an indication of barrier function, a lower value indicating better skin health. Skin hydration was the measurement of the outer layer of the epidermis (stratum corneum), a higher value is an indicator of better skin barrier function. Skin elasticity was measured by two parameters, and the ratio of total reversible recovery (R2) and the ratio of elastic deformation and inelastic deformation (R6) were the indicators of gross elasticity, the closer to 1 the more elastic

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