Cognitive Impairment In Elderly Population Research Articles

Obstructive sleep apnea and chronic pain as risk factors of cognitive impairment in elderly population: A study from Indonesia.

Obstructive sleep apnea (OSA), one of the most prevalent sleep-related breathing disorders in the elderly, seems to be underdiagnosed. Meanwhile, the resulting complication on cognitive function could impact on patient's quality of life. Association between OSA and cognitive function in the elderly varies highly, depending on study type, setting, and possibly by demographic differences. Therefore, this study sought to determine the risk of OSA among elderly and to assess the association of OSA risk and other plausible factors with cognitive function. In this cross-sectional study, patients aged 60 years and above who visited the outpatient clinic at two main hospitals in Surabaya of Indonesia were examined. A total of 178 participants were interviewed to evaluate the OSA risk using STOP-Bang questionnaire, the cognitive dysfunction using Montreal Cognitive Assessment Indonesian version (MoCA-Ina), depressive symptoms using Geriatric Depression Scale-15 (GDS-15), and sleep disorder using Insomnia Screening Questionnaire (ISQ). The Mann-Whitney and Chi-square tests were used to assess factors associated with cognitive impairment. In addition, logistic regression analyses were performed to evaluate the role of high risk of OSA on cognitive impairment. A total of 120 patients were considered having high risk of OSA (STOP- Bang score ≥3), and 129 had mild cognitive impairment (MCI) (MoCA-Ina <26). Among the elderly who had high risk of OSA, 94 were diagnosed with MCI (78.3%). Multivariate logistic regression analysis showed that high risk of OSA (OR: 2.99; 95%CI: 1.39, 6.46, p=0.005), chronic pain (OR: 5.53; 95%CI: 1.19, 25.64, p=0.029), and low education level (OR: 4.57; 95%CI: 1.79, 11.63) were associated with MCI. In conclusion, our data suggests a high prevalence of MCI among high risk OSA elderly. Screening and comprehensive management might be beneficial to improve or to preserve cognitive function in elderly group.

Correlation between the counts and volume of cerebral microbleeds and cognitive function in patients with cerebral small vessel disease

AbstractBackgroundCerebral small vessel disease(CSVD)is a primary reason of vascular cognitive impairment in elderly population. One of the neuroimaging markers of CSVD is cerebral microbleeds(CMBs). However, little is known about the quantifed volumetry analysis of CMBs and its correlation with cognitve function in these CSVD patients.MethodA total of 207 individuals were recruited, including CMBs with cognitive impairment (CMBs‐CI) (n=73), CMBs without cognitive impairment (CMBs‐non‐CI) (n=68) and normal controls (NC) (n=66). All underwent neuro‐psychological testing and 3.0T MRI Scan. Accubrain IV 1.0 kit was used to investigate the count and the quantifed volumetry analysis of CMBs. Multivariate logistic regression analysis was applied to assess the independent influencing factors of cognitive impairment. Multiple linear regression equation was performed to analyze the independent influencing factors of cognitive score. Finally, we used receiver operating characteristic (ROC) curve to evaluate the predictive value of the CMBs count and volume on cognitive impairment.ResultCompared with CMBs‐non‐CI and NC group, the number and volumes(lg: logarithmic transformation) of CMBs in CMBs‐CI group were significantly increased() Multivariate logistic regression analysis showed that the number and volume of CMBs were independent risk factors for cognitive impairment. (OR= 1.498, 95%CI: 1.282‐1.750, P &lt; 0.001; OR=7.640, 95%CI: 3.982‐11.656, P &lt; 0.001). But there was no significant correlation between the counts of CMBs and cognitive scores (ß = ‐ 0.020, P = 0.383), while the volume of CMBs were negatively correlated with the cognitive ability( ß= ‐ 0.582, P&lt;0.001). ROC curve analysis of the amount of CMBs in predicting cognitive impairment was 0.694(Area under the curve, AUC) (95%CI: 0.611‐0.769, 3(optimal threshold) 47.95%( sensitivity) and 89.71%(specificity); ROC curve analysis of the volume of CMBs in predicting cognitive impairment was 0.886 (Area under the curve, AUC) (95%CI: 0.822‐0.933),14.125mm3(optimal threshold) 75.34% (sensitivity) and 86.76% (specificity) correspondingly. The difference between the two areas under the ROC curves was 0.192 (95% CI:0.090‐0.294, P = 0.001).ConclusionIn CSVD patients, there is a significant correlation between CMBs and poor cognitive performance. Our results suggested that compared with the count of CMBs, the volume of CMBs was hope to be a more liable predictor to the progress of cognitve impairment.

Association between Apoϵ4 allele and cardiometabolic and social risk factors with cognitive impairment in elderly population from Bogota.

ABSTRACTBeing an ϵ4 carrier in the Apoϵ gene has been suggested as a modifying factor for the interaction between cardio-metabolic, social risk factors, and the development of cognitive impairment.Objective:The main objective of this study was to assess the existence of such interaction in a sample of Bogota’s elderly population.Methods:A cross-sectional study was conducted with 1,263 subjects older than 50 years. Each participant was diagnosed by consensus, after neuropsychological and neuropsychiatric evaluations, under a diagnosis of normal cognition, mild cognitive impairment (MCI) according to Petersen’s criteria, or dementia according to DSM-IV criteria. Apoϵ was typified and an analysis of MoCA test was performed in each group carrying or not ϵ4 allele.Results:Our study showed that 75% were women with a median age of 68 years (interquartile range 62–74 years) and a median schooling for 6 years (interquartile range 4–12 years). Dementia was related to low education level of ≤5 years OR=11.20 (95%CI 4.99–25.12), high blood pressure (HBP) OR=1.45 (95%CI 1.03–2.05), and age over 70 years OR=7.68 (95%CI 3.49–16.90), independently of being or not an ϵ4 allele carrier. Diabetic subjects with dementia carrying ϵ4 allele showed a tendency to exhibit lower scores on the MoCA test, when compared with noncarriers’ diabetic subjects with dementia.Conclusions:The presence of ϵ4 allele does not modify the relationship between cognitive impairment and the different cardio-metabolic and social risk factors, except in diabetic subjects ϵ4 carriers with dementia who showed a tendency to exhibit lower scores of the MoCA test, when compared with noncarriers’ diabetic subjects with dementia.

Combined Factors for Predicting Cognitive Impairment in Elderly Population Aged 75 Years and Older: From a Behavioral Perspective.

To unravel the combined effect of risk and protective factors that may contribute to preserve or impair cognitive status, this prospective cohort study systematically investigated a cluster of factors in elders aged 75 years and older from Guangxi Longitudinal Cohort (GLC) dataset. GLC has tracked 630 oldest-elders for two times within 2 years and will continue to follow two times in the next 4 years. At baseline geriatric assessment, sociodemographic information (e.g., education, Mandarin, marriage, and income), physical status [body mass index (BMI), chronic disease/medicine], lifestyle factors (smoking, alcohol, and exercise), and self-rated mental health (self-care, well-being, anxiety) were recorded by online interview. With 2 years’ follow-up, Mini-Mental State Examination (MMSE) and memory test were performed through person-to-person interview. The performance of MMSE was applied to represent the responder’s cognitive status which classified into cognitive impairment and normal group based on a cutoff point of 20. An age-related cognitive declining trend of 15 stratified factors was observed, though with a small effect size (R-square: 0.001–0.15). The odds of exposure or non-exposure on factors (memory, self-care, exercise, income, education, and literacy) had a significantly different effect on cognitive impairment through multivariate analysis after adjusting other confounding variables. Through stepwise multiple logistic regression analysis, the following 12 factors/index would be integrated to predict cognitive impairment: gender, physical health factors (BMI, chronic disease), socioeconomic and lifestyle factors (education, literacy, Mandarin, marriage, income, and exercise), and psychological health factors (memory, self-care cognition, and anxiety). Related clinical and nursing applications were also discussed.

Prevalence of cognitive impairment in elderly population residing in an urban area of Belagavi.

Context:Cognitive impairment (CI) is emerging as an important health problem of the elderly population in India. As the impact of this illness at various levels is not well understood, so situation analysis is the need of the hour.Aims:(1) To know the prevalence of CI in elderly population residing in an urban area. (2) To assess the burden of health care among the care givers.Settings and Design:A cross-sectional study was carried out among 770 elderly aged ≥60 years residing in two Urban Health Centres of Belagavi District.Methods and Material:Socio-demographic profile of the participant was collected using a predesigned and pretested questionnaire by personal interview at the participants’ residence. To assess the CI and burden of healthcare, Mini Mental State Examination and Zarit Caregiver Burden Scale were used, respectively.Statistical Analysis Used:IBM SPSS version 22 was used. Chi square test and Fisher's Exact test were applied.Results:The overall prevalence of CI was 8.4% in our study. The risk factors noted for CI were advancing age, female sex, unmarried or widow/widower, illiterate, not working presently, staying alone, and poverty. Out of 65 caregivers, 67.7% of them had mild or moderate burden of caring for the cognitively impaired elderly.Conclusions:It is important to assess older people for any CI, when planning geriatric health care. Priority must be given to the older age group and female, as they are more vulnerable to CI.

Multi-component Exercise on Mild Cognitive Impairment In Elderly Population

Multi-component Exercise on Mild Cognitive Impairment In Elderly Population

The Relationship Between Plasma DPP4 Activity to BDNF Ratio and Mild Cognitive Impairment in Elderly Population With Normal Glucose Tolerance.

Objective: Since decreased brain-derived neurotrophic factor (BDNF) and increased dipeptidyl peptidase-4 (DPP4) activity have both been implicated in the pathogenesis of mild cognitive impairment (MCI), the aim of our study was to evaluate the association of MCI with plasma DPP4 activity to BDNF ratio (DBR) in an elderly population with normal glucose tolerance.Methods: We cross-sectionally measured C-reactive protein, interleukin-6, nitrotyrosine, 8-iso-PGF2a, DPP4 activity BDNF and calculated the DBR in a total of 1,066 elderly participants in China. MCI was determined by the Montreal Cognitive Assessment and finally confirmed by neurologists.Results: An inverse correlation was found between DPP4 activity and BDNF (r = -0.456, P < 0.001) and this inverse correlation was partly mediated by nitrotyrosine and 8-iso-PGF2a. Across rising quartiles of DBR, nitrotyrosine, 8-iso-PGF2a, C-reactive protein and interleukin-6 progressively increased, whereas the Montreal Cognitive Assessment score progressively decreased. Subjects in the lowest quartile of BDNF and highest quartiles of DBR and DPP4 activity, had higher MCI risk compared with subjects in the highest quartile of the BDNF and lowest quartiles of DBR and DPP4 activity, respectively (all P < 0.05). The odds ratio for MCI became more pronounced with decreased BDNF and increased DPP4.Conclusion: In conclusion, a negative correlation was found between DPP4 activity and BDNF, and this negative correlation was partly mediated by oxidative stress, not inflammation. The DBR was positively associated with MCI and thus may be used as a novel risk biomarker for MCI in an elderly population with normal glucose tolerance.

Nutritional status and cognitive impairment in elderly population in a rural area of Thrissur district, Kerala

Background: The past decade has witnessed a marked increase in elderly population of India. This rapid ageing will substantially increase the number of elderly individuals, who are affected by cognitive impairment. Recent studies suggest the association between malnutrition and cognitive impairment in elderly. This study aims to describe the nutritional status and cognitive impairment in elderly population in a rural area of Thrissur district, Kerala.Methods: A community based cross-sectional study was conducted in 100 elderly residents of Adat Panchayat, Thrissur, from January to April 2016. Data was collected using a pre-tested structured questionnaire, which included socio-demographic variables, self-reported physical morbidities, mini mental state examination (MMSE) scale and mini nutritional assessment (MNA) scale.Results: The prevalence of cognitive impairment and malnutrition in elderly was noted to be 55% and 12% respectively. Factors showing significant association with MMSE score included older age groups, female gender, elderly belonging to BPL families, financial dependence, single/widowed status and sleep difficulties. The association between cognitive impairment and nutritional status was found to be statistically significant with a p value of &lt;0.001. A moderate to strong correlation was observed between MNA score and MMSE score (r=0.623).Conclusions: There is an association between cognitive impairment and nutritional deficit. Therefore it is essential to screen elderly for nutritional status while assessing cognitive impairment.

Evaluation of cognitive impairment in elderly population with hypertension from a low-resource setting: Agreement and bias between screening tools.

IntroductionThe evaluation of cognitive impairment in adulthood merits attention in societies in transition and especially in people with chronic diseases. Screening tools available for clinical practice and epidemiological studies have been designed in high-income but not in resource-constrained settings. The aim of this study was to assess the agreement and bias of three common tools used for screening of cognitive impairment in people with hypertension: the modified Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Leganés Cognitive Test (LCT).MethodsA cross-sectional study enrolling participants with hypertension from a semi-urban area in Peru was performed. The three screening tools for cognitive impairment were applied on three consecutive days. The prevalence of cognitive impairment was calculated for each test. Pearson's correlation coefficients, Bland-Altman plots, and Kappa statistics were used to assess agreement and bias between screening tools.ResultsWe evaluated 139 participants, mean age 76.5 years (SD ± 6.9), 56.1% females. Cognitive impairment was found in 28.1% of individuals using LCT, 63.3% using MMSE, and 100% using MoCA. Correlation coefficients ranged from 0.501 between LCT and MoCA, to 0.698 between MMSE and MoCA. Bland-Altman plots confirmed bias between screening tests. The agreement between MMSE and LCT was 60.4%, between MMSE and MoCA was 63.3%, and between MoCA and LCT was 28.1%.ConclusionsThree of the most commonly used screening tests to evaluate cognitive impairment showed major discrepancies in a resource-constrained setting, signaling towards a sorely need to develop and validate appropriate tools.

Memory, executive functions and cognitive impairment in elderly population

Cognitive functions refer to the superior brain or mental function. These processes are usually first to suffer cognitive impairment associated with ageing. The aim of this study was: to analyse the state of memory and executive functions in a sample of elder population with and without cognitive impairment; and compare the cognitive state between elder who live in a public home for the elderly and elder who live in their homes. Therefore, a screening test was carried out to check the cognitive impairment level (Cognitive Mini Test MEC-35), and after that, the Memory Alteration Test (T@M) and the Ring Test were applied. The participants were 24 subjects, 12 of which belonged to a public home for the elderly and the other 12 lived in their homes. The average age of the participants was 78. The study has allowed us to establish the significant relation between the cognitive deterioration level and the state of the memory and executive functions. Besides, sex was indifferent in memory as a variable, but not in executive functions. Finally, the fact of the people living in a public home show us no significant differences in the state of memory and executive functions compared to people who live in their homes.

Memory, executive functions and cognitive impairment in elderly population

Cognitive functions refer to the superior brain or mental function. These processes are usually first to suffer cognitive impairment associated with ageing. The aim of this study was: to analyse the state of memory and executive functions in a sample of elder population with and without cognitive impairment; and compare the cognitive state between elder who live in a public home for the elderly and elder who live in their homes. Therefore, a screening test was carried out to check the cognitive impairment level (Cognitive Mini Test MEC-35), and after that, the Memory Alteration Test (T@M) and the Ring Test were applied. The participants were 24 subjects, 12 of which belonged to a public home for the elderly and the other 12 lived in their homes. The average age of the participants was 78. The study has allowed us to establish the significant relation between the cognitive deterioration level and the state of the memory and executive functions. Besides, sex was indifferent in memory as a variable, but not in executive functions. Finally, the fact of the people living in a public home show us no significant differences in the state of memory and executive functions compared to people who live in their homes.

Cognitive impairment in chronic kidney disease: keep vascular disease in mind

Cognitive impairment is a major cause of morbidity in people with chronic kidney disease (CKD) and is associated with lower quality of life, more difficulty adhering to medications, and worse survival. Prior data suggest a relationship between vascular disease and cognitive impairment in individuals with CKD, although overall risk factors remain poorly understood. Critically, clinicians should be aware of the high rates of cognitive impairment that occur in all stages of CKD, which, although sometimes subtle, may impact comprehension and decision making in these individuals and may herald future, more debilitating impairment.

Endothelial dysfunction associated with mild cognitive impairment in elderly population

According to the original Petersen criteria, we investigated the association between endothelial dysfunction and mild cognitive impairment (MCI) by flow-mediated dilation (FMD). We aimed to verify if endothelial dysfunction occurs in MCI and whether vascular factors are implicated in the MCI pathogenesis. This is a cross-sectional study performed on 34 subjects with clinical diagnosis of MCI and 37 controls, older than 60years. Patients were enrolled from a geriatric outpatient clinic. All the recognized cardiovascular risk factors and an objective state of cognitive impairment were used as exclusion criteria. Cognitive function was evaluated using a scientific-validated neuropsychological battery, whereas MCI was recognized according to the Petersen criteria. Endothelial function was evaluated according to FMD from the brachial artery. The association between FMD and MCI was evaluated both by using a multivariate analysis and a correlation test. Finally, using the ANOVA analysis of variance, we tested the differences in flow-mediated dilation among MCI subgroups. Brachial FMD was significantly associated with MCI (p<0.01). The multivariate analysis showed that age, years of education and MMSE independently predicted the FMD variation (r (2) =0.73; p<0.0001). In addition, MCI patients with prevalent amnestic multiple domain impairment showed the worst brachial FMD. This finding suggests that vascular dysfunction may play a role in the pathogenesis of cognitive impairment and underlines the lack of therapeutic strategies targeted to such dysfunctions.

Estimate of the prevalence of cognitive impairment in an elderly population of the health center of Senegalese national retirement institution

To assess the prevalence of cognitive impairment in a Senegalese elderly population, of the Sociohealth and university center of Senegalese national retirement institution, Dakar, Senegal. A cross sectional study was conducted in 872 Senegalese elderly population aged 55 years and over utilizing the Sociohealth and university center of IPRES, Dakar, Senegal for health care. Sociodemographic, lifestyles, physical activity, medical history, familial history of dementia data were collected with a structured questionnaire completed with a clinical exam and neuropsychological testing. Cognitive impairment was defined as a score of 28 or less with the test of Senegal. Ninety four subjects (10.8%; 95% CI 8,7-12,9) had cognitive impairment. Mean age was 67.2 years (±7.5 years), 63% were men, 79% were married, and half of them knew how to read and write. Hypertension, arthritis and gastro-intestinal diseases were the main health conditions reported. Prevalence of cognitive impairment varied with age and education. Prevalence of cognitive decline in the Sociohealth and university center of IPRES, Dakar, Senegal, is higher and varied with age and education.

The Death Knoll for the MMSE: Has It Outlived Its Purpose?

The Mini-Mental State Examination (MMSE) is arguably the best-known cognitive screen in the world. Originally designed to assess cognitive impairment in elderly populations, it has become one of the first steps toward a dementia diagnosis. Routinely used in the clinic and in research internationally, the MMSE, despite its flaws, has managed to retain its popularity for more than 30 years. This review explores when and how the test is used, lists its advantages and disadvantages, and ultimately questions its value. The specific issue that is addressed here is whether the test has outlived its original purpose. The conclusion is that although the MMSE may be a useful tool in many circumstances where a cognitive screen is required, practitioners should be wary of using MMSE total scores as a shortcut toward a dementia diagnosis.

Impact of Anesthesia on the Cognitive Functioning of the Elderly

Exposure to general anesthesia has been suggested as a possible cause of long-term cognitive impairment in elderly subjects. The present study reviews the literature in this field in order to describe postoperative cognitive impairment in elderly populations, to determine to what extent this may be attributed to anesthetic agents, and to consider evidence of a causal relationship between anesthesia and onset of senile dementia. A systematic literature search was conducted using five bibliographic databases (PASCAL, Medline, Excerpta Medica, Psychological Abstracts, and Science Citation Index). Significant cognitive dysfunction was found to be common in elderly persons 1 to 3 days after surgery, but reports of longer-term impairment are inconsistent due to the heterogeneity of the procedures used and populations targeted in such studies. Incidence rates vary widely according to type of surgery, suggesting that factors other than anesthesia explain a significant proportion of the observed variance. Anesthesia appears to be associated with longerterm cognitive disorder and the acceleration of senile dementia, but only in a small number of cases, suggesting the existence of other interacting etiological factors.