Effect of Demographic and Health Dynamics on Cognitive Status in Mexico between 2001 and 2015: Evidence from the Mexican Health and Aging Study.

Silvia Mejia-Arango,Rebeca Wong,Alejandra Michaels-Obregon,Marc A Garcia,Joseph L Saenz,Brian Downer,Rafael Samper-Ternent,Jaqueline Avila

doi:10.3390/geriatrics6030063

Abstract

Sources of health disparities such as educational attainment, cardiovascular risk factors, and access to health care affect cognitive impairment among older adults. To examine the extent to which these counteracting changes affect cognitive aging over time among Mexican older adults, we examine how sociodemographic factors, cardiovascular diseases, and their treatment relate to changes in cognitive function of Mexican adults aged 60 and older between 2001 and 2015. Self and proxy respondents were classified as dementia, cognitive impairment no dementia (CIND), and normal cognition. We use logistic regression models to examine the trends in dementia and CIND for men and women aged 60 years or older using pooled national samples of 6822 individuals in 2001 and 10,219 in 2015, and sociodemographic and health variables as covariates. We found higher likelihood of dementia and a lower risk of CIND in 2015 compared to 2001. These results remain after adjusting for sociodemographic factors, cardiovascular diseases, and their treatment. The improvements in educational attainment, treatment of diabetes and hypertension, and better access to health care in 2015 compared to 2001 may not have been enough to counteract the combined effects of aging, rural residence disadvantage, and higher risks of cardiovascular disease among older Mexican adults.

Highlights

Over the past 15 years, research on cognitive impairment and dementia in low- and middle-income countries has increased as the potential for a significant increase in dementia burden in faster-aging populations occurs [1]
Gender-specific associations have shown that the availability of health insurance is more likely to increase medical service utilization in women than in men [14]
Because education is a critical covariate of cognitive aging, and there are important gender differences in educational achievement in Mexico, we present the multivariate results for the total analytical sample and results stratified by sex

Summary

Introduction

Over the past 15 years, research on cognitive impairment and dementia in low- and middle-income countries has increased as the potential for a significant increase in dementia burden in faster-aging populations occurs [1]. Prevalent chronic diseases among Mexican adults, such as hypertension, stroke, and diabetes, are associated with cognitive impairment [4,5]. As a group, the more recent cohorts have a higher prevalence of obesity, diabetes, hypertension, and physical disability [7,8]. This combination of change in key socioeconomic factors and health risks of the older adult population is quite evident by comparing cohorts who are only ten years apart, for example, those 60 and older in 2001 and 2012 [9,10,11]. Gender-specific associations have shown that the availability of health insurance is more likely to increase medical service utilization in women than in men [14]

Methods

Results

Discussion

Conclusion