{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:16:24Z","timestamp":1785392184394,"version":"3.55.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To develop clinically actionable, education-stratified normative reference ranges for the two-step cognitive self-assessment (TCSA) tool, addressing China\u2019s urgent need for scalable cognitive screening in its rapidly aging population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using generalised additive models for location, scale and shape (GAMLSS) on a cohort of 40\u2009588 community-dwelling adults (50\u2013100\u00a0years), we developed reference curves for core cognition (primary tasks), multi-cognition domains (secondary tasks) and processing speed (TCSA-Response Time, TCSA-RT). Individuals with self-reported dementia or functional dependence assessed via activities of daily living scale were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Smoothed percentile curves were established. A health equity gap manifested through 89% greater cognitive decline variability in low-education groups (\u03c3 intercept\u2009=\u2009\u22120.089 vs. \u22120.168). Education reduced annual decline by 8.7% (\u22120.042 vs. \u22120.046 points\/year) while elevating baseline cognition (\u03bc\u00a0=\u20091.99).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>As the first large-scale normative framework in China\u2019s diverse aging population, it enables precision public health through education-specific screening thresholds for the digital TCSA tool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afag131","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T11:23:38Z","timestamp":1780313018000},"source":"Crossref","is-referenced-by-count":1,"title":["A GAMLSS approach to digital dementia screening and profiling using a two-step cognitive self-assessment tool in China"],"prefix":"10.1093","volume":"55","author":[{"given":"Jing","family":"Nie","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianfeng","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Public Health, Fudan University, Shanghai 200032, Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianxi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianqian","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaowei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of 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