Abstract
BackgroundComorbid medical diseases are highly prevalent in the geriatric population, imposing hardship on healthcare services for demented individuals. Dementia also complicates clinical care for other co-existing medical conditions. This study investigated the comorbidities associated with dementia in the elderly population aged 65 years and over in Taiwan.MethodsWe conducted a nationwide, population-based, cross-sectional survey; participants were selected by computerized random sampling from all 19 Taiwan counties between December 2011 and March 2013. After exclusion of incomplete or erroneous data, 8,456 subjects were enrolled. Of them, 6,183 were cognitively normal (control group), 1,576 had mild cognitive impairment (MCI), and 697 had dementia. We collected information about types of comorbidities (i.e., vascular risk factors, lung diseases, liver diseases, gastrointestinal diseases, and cancers), Charlson comorbidity index score, and demographic variables to compare subjects with normal cognition, MCI, and dementia.ResultsRegardless of the cognitive condition, over 60% of the individuals in each group had at least one comorbid disease. The proportion of subjects possessing at least three comorbidities was higher in those with cognitive impairment (MCI 20.9%, dementia 27.3%) than in control group (15%). Hypertension and diabetes mellitus were the most common comorbidities. The mean number of comorbidities and Charlson comorbidity index score were greater in MCI and dementia groups than in control group. Logistic regression demonstrated that the comorbidities significantly associated with MCI and dementia were cerebrovascular disease (OR 3.35, CI 2.62–4.28), cirrhosis (OR 3.29, CI 1.29–8.41), asthma (OR 1.56, CI 1.07–2.27), and diabetes mellitus (OR 1.24, CI 1.07–1.44).ConclusionMultiple medical comorbid diseases are common in older adults, especially in those with cognitive impairment. Cerebrovascular disease, cirrhosis, asthma, and diabetes mellitus are important contributors to cognitive deterioration in the elderly. Efforts to lower cumulative medical burden in the geriatric population may benefit cognitive function.
Highlights
The incidence of dementia increases with age and puts a profound socioeconomic burden on care-givers and healthcare systems in Taiwan [1,2]
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
We report evidence that cerebrovascular disease, cirrhosis, asthma, and diabetes mellitus (DM) increase the odds for cognitive impairment
Summary
The incidence of dementia increases with age and puts a profound socioeconomic burden on care-givers and healthcare systems in Taiwan [1,2]. The number of people with dementia in Taiwan is estimated to increase substantially, doubling every 20 years, and is expected to reach 0.32 million by 2030 and to exceed 0.6 million by 2050 [4]. Previous studies have highlighted that a number of non-modifiable risk factors, such as age and apolipoprotein E genotype, were strongly associated with dementia [5]. Emphasis should be placed on understanding which potentially modifiable lifestyle and medical factors might alter the risk of dementia. Improved knowledge of the comorbidities of highly prevalent chronic health problems in patients with dementia would facilitate the development of preventive strategies aimed at slowing or avoiding rapid clinical and functional deterioration. This study investigated the comorbidities associated with dementia in the elderly population aged 65 years and over in Taiwan
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