Older Mexican Adults Research Articles

Dietary Patterns and Geriatric Syndromes in older Mexican adults: Analysis of the 2018-19 National Health and Nutrition Survey

BackgroundThe study of dietary patterns in older adults (OA) and their association with geriatric syndromes (GS) is scarce in Latin America. ObjectiveTo describe the association of dietary patterns with GS in the Mexican older adult population, using data from the 2018-19 National Health and Nutrition Survey. MethodsDietary data were collected from 3,511 adults (≥60 years of age, both sexes) using a semi-quantitative food frequency questionnaire. Dietary patterns were derived by principal component analysis based on the consumption of 162 foods from 24 food groups. The GS studied were: frailty, depressive symptoms (DS), low appendicular skeletal muscle mass (ASMM), and inflammation. Logistic regression models were used. ResultsFour major dietary patterns were identified: a) “Western”, b) “Prudent”, c) “Soups”, and d) “Traditional”. The middle and higher tertiles of the “Prudent” pattern were associated with lower odds of DS (OR 0.71, p = 0.04; and OR 0.61, p = 0.008), respectively. The second tertile of the “Soups” pattern was associated with lower odds of low ASMM (OR 0.68, p = 0031) and inflammation (OR 0.58, p = 0.022). The highest tertile of the “Traditional” pattern was associated with low ASMM (OR 1.55, p = 0.008) and lower odds of inflammation (OR 0.69, p = 0.044). No association was found between the “Western” dietary pattern and GS. ConclusionsThree of four major dietary patterns were associated with GS in older Mexican adults. Further studies are needed to address strategies to improve diet quality in this age group and its association with health and functional outcomes.

Disentangling the relationship between biological age and frailty in community-dwelling older Mexican adults.

Older adults have heterogeneous aging rates. Here, we explored the impact of biological age (BA) and accelerated aging on frailty in community-dwelling older adults. We assessed 735 community-dwelling older adults from the Coyocan Cohort. BA was measured using AnthropoAge, accelerated aging with AnthropoAgeAccel, and frailty using both Fried's phenotype and the frailty index. We explored the association of BA and accelerated aging (AnthropoAgeAccel ≥0) with frailty at baseline and characterized the impact of both on body composition and physical function. We also explored accelerated aging as a risk factor for frailty progression after 3-years of follow-up. Older adults with accelerated aging have higher frailty prevalence and indices, lower handgrip strength and gait speed. AnthropoAgeAccel was associated with higher frailty indices (β=0.0053, 95%CI 0.0027-0.0079), and increased odds of frailty at baseline (OR 1.16, 95%CI 1.09-1.25). We observed a sexual dimorphism in body composition and physical function linked to accelerated aging in non-frail participants; however, this dimorphism was absent in pre-frail/frail participants. Accelerated aging at baseline was associated with higher risk of frailty progression over time (OR 1.74, 95%CI 1.11-2.75). Despite being intertwined, biological accelerated aging is largely independent of frailty in community-dwelling older adults.

Cardiovascular Risk Factors as Predictors of Nutritional Status in Older Mexican Adults.

Aging is commonly accompanied by increased cardiovascular risk and diet plays a crucial role in health condition. The aim of this study was to determine cardiovascular risk factors as predictors of nutritional risk in Mexican older adults. A cross-sectional study on Mexican patients aged ≥60 years with cardiovascular risk factors affiliated with a medical unit in Northeast Mexico was performed from July to December 2021. The nutritional risk evaluations were performed using the Mini Nutritional Assessment (MNA) questionnaire. After a multivariate analysis, the cardiovascular risk factors identified as independent predictors of risk of malnutrition were hypertriglyceridemia (adjusted OR (AOR): 1.8; 95% CI: 1.03-3.14; p = 0.04) and systolic hypertension I (AOR: 2.28; 95% CI: 1.04-5.02; p = 0.041); age over 80 years (AOR: 5.17; 95% CI: 1.83-14.65, p = 0.002) and elementary school education (AOR: 2.34; 95% CI: 1.20-4.55; p = 0.013) were also related. The cross-sectional design and single-center approach of this study limits the generalizability of the results; however, conducting timely evaluations of blood pressure, triglyceride levels, and risk of malnutrition using the MNA tool for patients aged ≥60 years could prevent illness and reduce mortality within this population group.

Frailty Was Associated With Atmospheric NO2 Levels: A Geospatial Approach.

Recent evidence has linked air pollution with frailty, yet little is known about the role of NO2 in this association. Our aim was to assess the association between frailty and NO2 air concentrations in Mexican older adults. We used georeferenced data from the population-based Nutrition and Health Survey in Mexico (NHNS) 2021, representative of national and subnational regions, to measure a frailty index based on 31 health deficits in adults aged 50 and older. Air pollution due to NO2 concentrations was estimated from satellite images validated with data from surface-level stations. Maps were produced using Jensen's Natural break method. The association of frailty and NO2 concentrations was measured using the frailty index (multivariate fractional response logit regression) and a frailty binary variable (frailty index [FI] ≥0.36, multivariate logit regression). There was a positive and significant association of the frailty index with the NO2 concentrations, adjusting for age, sex, urban and rural area, years of education, socioeconomic status, living arrangement, particulate matter smaller than 2.5 microns, and indoor pollution. For each standard deviation increase in NO2 concentrations measured 10 years before the survey, the odds of being frail were 15% higher, and the frailty index was 14.5% higher. The fraction of frailty attributable to NO2 exposure ranged from 1.8% to 23.5% according to different scenarios. Frailty was positively associated with exposure to NO2 concentrations. Mapping frailty and its associated factors like NO2 air concentrations can contribute to the design of targeted pro-healthy aging policies.

Geriatric Syndromes and Their Relationship with Mortality in a Population of Mexican Older Adults Aged 65 and Over, Admitted to the Emergency Department of a Second-Level Care Hospital.

The main objective of this study was to analyze the relationship between Geriatric Syndromes (GSs) and in-hospital mortality in adults aged 65 and older admitted to the Emergency Department (ED). The study included 202 Older Adults (OAs) who met the inclusion criteria. We conducted a Comprehensive Geriatric Assessment and collected clinical and demographic data. A univariate analysis was carried out for each of the GSs analyzed. Those variables with p < 0.05 were entered into a multiple logistic regression using the backward stepwise entry method to analyze the independent predictor variables. The average number of GSs per individual was 4.65 (±2.76). Frailty syndrome was the most prevalent (70.2% of patients). Our study found an association between mortality and some GSs, such as frailty (p = 0.042), risk of falls (p = 0.010), delirium, cognitive impairment, dependence, and risk of ulcers (p < 0.001). We found that cognitive impairment (adjusted OR, 6.88; 95% CI, 1.41-33.5; p = 0.017) and dependence (adjusted OR, 7.52; 95% CI, 1.95-29.98; p = 0.003) were independent predictors associated with mortality in our population. It is necessary to develop new care strategies in the ED that respond to the needs of aging societies, including the use of new technologies and personnel with experience in gerontology.

Effect of Self-transcendence, Self-distancing, and Family Functionality on Self-care Agency in Older Adults.

To determine the effect of self-distancing, self-transcendence, and family functioning on self-care agency in Mexican older adults. Correlational-explanatory design, with a sample of 253 elderly, collecting data through a simple random sampling. A personal data questionnaire was applied, the scale of: self-transcendence, the self-distancing subscale, the family APGAR and the ability to self-care in Mexican population from different demographic groups. Descriptive and inferential statistics were applied (Mann-Whitney U and a structural equation model) and the study was approved by a registered ethics committee. The study had participation from 253 elderly, with a mean age of 68.02 years, with prevalence of the female sex (60.1%); the level of education was primary school or lower (51.4%). It was observed that the group of chronic diseases had lower self-distancing (U = 4.449.5, p = 0.038) and greater self-transcendence (U = 4177.0, p = 0.008), and selfcare (U = 4365.5, p = 0.024) than the group without chronic diseases. It was also found that self-transcendence, self-distancing, and family functionality produce a positive effect of 37% on selfcare. Self-distancing, self-transcendence, and family functionality explain an important proportion of selfcare in the elderly. Said knowledge permits understanding the care behavior of the elderly and, thus, propose future educational interventions by nursing to prevent or avoid functional, cognitive loss and social effects.

Long-term inequalities in health among older Mexican adults: An outcome-wide analysis

The relationship between socioeconomic level and health outcomes in older people has been widely studied, but less information about health inequalities associated with gender and place of residence exists. Also, there is scarce evidence of longitudinal inequalities, particularly in countries from the global south. This study aimed to describe the longitudinal patterns of health inequalities associated with wealth, gender, and residence area among older Mexican adults. We used data from two longitudinal studies in Mexico: The Study on Global AGEing and Adult Health (SAGE) and the Mexican Health and Aging Study (MHAS). Three domains to characterize health inequities were used: wealth, gender, and rurality. We conducted an outcome-wide analysis with nine health indicators assessing older adults' physical and cognitive function. The Slope Index of Inequality and the Relative Index of Inequality were used as inequality measurements. Our results indicate that the greatest inequalities are observed in relation to wealth and gender. Older adults with lower socioeconomic status demonstrated higher rates of depression, sarcopenia, falls, and limitations in both basic and instrumental activities of daily living compared to their wealthier counterparts, with increasing trends in physical functionality over time. Furthermore, women experienced higher rates of depression, sarcopenia, frailty, and physical limitations compared to men. The only significant difference related to rurality was a lower rate of frailty among rural older adults. Longitudinal trajectories revealed an increase in the gap of inequality for various health indicators, especially in terms of wealth and gender. Health inequalities in old age are one of the greatest challenges facing health systems globally. Actions like universal coverage of health services for older people and the empowerment of individuals and their communities to have control over their lives and circumstances must be guaranteed.

Cognitive function in Mexican older adults 6-months after recovering from SARS-CoV-2 infection

BackgroundSARS-CoV-2 infection has been associated with multiple short- and long-term complications including depression, and cognitive impairment (CI). However, older adults with CI after COVID-19 have not been fully documented. ObjectiveTo evaluate cognitive function in Mexican adults post-recovery from SARS-CoV-2 infection. MethodsIn this prospective observational cohort study, we assess cognitive function (CF) by the Montreal Cognitive Assessment (MOCA) test with a cut-off less than 26 points, and functional status via telemedicine. Eligible patients with a history of moderate–severe COVID-19 aged ≥60 years, cognitively healthy (evaluated by Everyday Cognition Scale) and required admission to an intensive care unit (ICU) were included. Patients with history of dementia, stroke, and delirium during the cognitive evaluation were excluded. The association between CI and COVID-19 was assessed with a Cox regression model. ResultsFrom the 634 patients admitted to the ICU, 415 survived, afterward 308 were excluded and 107 were analyzed. Mean age was 70 years, 58% were female, and 53% had severe COVID.The mean MoCA score was 21±5 points, CI was present in 61 patients (57%). Infection severity (RR 1.87; 95% CI: 1.11–3.15, p<0.05), lower education (RR 0.92; 95% CI: 0.87–0.97, p<0.01), and activity daily living disability (RR 1.87; 95% CI: 1.07–3.26, p<0.05) were the main factors associated with CI (unadjusted model by age and sex). The delayed recall, orientation, and language (83.2, 77.6 and 72.9% respectively) domains were the most affected in patients with CI. ConclusionsFifty-seven percent of patients analyzed developed CI six months post-ICU discharge due to SARS-CoV-2, and COVID severity was the main factor associated to its outcome.

Association between sociodemographic factors and metabolic syndrome in Mexican older adults

Association between sociodemographic factors and metabolic syndrome in Mexican older adults

A virtually supervised exercise program improved fitness and mental wellness in healthy and comorbidity older adult individuals during the COVID-19 pandemic.

The COVID-19 pandemic affected older adults worldwide. Sedentary older adults experienced more severe adverse health effects due to their shelter-in-place. Physical activity was strongly recommended during periods of social distancing. The present study evaluated the impact of a virtually supervised exercise program on the physical fitness and mental health of Mexican older adults during the pandemic's lockdown. Participants were 44 older adults who were assigned to one of four physical fitness groups: a healthy control group (Ctrl-H, n = 15), a comorbidity control group (Ctrl-COM, n = 9), an exercise group without comorbidities (Exe-H, n = 11), and an exercise group with comorbidities (Exe-COM, n = 9). The participants engaged in a 60-min, virtually-supervised concurrent exercise session three times/week for 12 weeks. Fitness was measured using the online Senior Fitness Tests and the 4-m Gait Speed Test. Mental health was evaluated through virtual interviews using the Hamilton Depression Rating Scale, the Geriatric Depression Scale, and the Connor-Davidson Resilience Scale. Within-subject pre vs. post-intervention comparisons tested for significant differences, between-groups and over time. Significant interactions were found in the scores of the Geriatric Depression Scale (p ≤ 0.0001; ηp2 = 0.35), the Hamilton Depression Scale (p ≤ 0.0001; ηp2 = 0.35), resilience scores (p ≤ 0.0001; ηp2 = 0.46), lower-body strength (p ≤ 0.0001; ηp2 = 0.32), timed up-and-go test (p = 0.018; ηp2 = 0.18), the 6MWT distance scores (p ≤ 0.0001; ηp2 = 0.39), and the 4-m gait speed test scores (p = 0.011; ηp2 = 0.20). A long-term virtually-supervised exercise program conducted during the COVID-19 lockdown period led to marked improvements in both the fitness and mental health of older Mexican adults. Comorbidities did not diminish these benefits. These findings provide empirical support for online exercise programs in the daily routines of older adults to make clinically meaningful improvements in both physical and mental well-being.

Intrinsic capacity trajectories and socioeconomic inequalities in health: the contributions of wealth, education, gender, and ethnicity

BackgroundLife-long health inequalities exert enduring impacts and are governed by social determinants crucial for achieving healthy aging. A fundamental aspect of healthy aging, intrinsic capacity, is the primary focus of this study. Our objective is to evaluate the social inequalities connected with the trajectories of intrinsic capacity, shedding light on the impacts of socioeconomic position, gender, and ethnicity.MethodsOur dynamic cohort study was rooted in three waves (2009, 2014, 2017) of the World Health Organization’s Study on Global AGEing and Adult Health in Mexico. We incorporated a nationally representative sample comprising 2722 older Mexican adults aged 50 years and over. Baseline measurements of socioeconomic position, gender, and ethnicity acted as the exposure variables. We evaluated intrinsic capacity across five domains: cognition, psychological, sensory, vitality, and locomotion. The Relative Index of Inequality and Slope Index of Inequality were used to quantify socioeconomic disparities.ResultsWe discerned three distinct intrinsic capacity trajectories: steep decline, moderate decline, and slight increase. Significant disparities based on wealth, educational level, gender, and ethnicity were observed. Older adults with higher wealth and education typically exhibited a trajectory of moderate decrease or slight increase in intrinsic capacity. In stark contrast, women and indigenous individuals were more likely to experience a steeply declining trajectory.ConclusionsThese findings underscore the pressing need to address social determinants, minimize gender and ethnic discrimination to ensure equal access to resources and opportunities across the lifespan. It is imperative for policies and interventions to prioritize these social determinants in order to promote healthy aging and alleviate health disparities. This approach will ensure that specific demographic groups receive customized support to sustain their intrinsic capacity during their elder years.

Predictors of Frailty Transitions in Mexican Older Adults.

Frailty is a dynamic state in older adults. Current evidence, mostly in high-income countries, found that improving frailty is more likely in mild states (prefrailty). We aimed to determine the probability of frailty transitions and their predictors. Participants were adults aged 50 years or over from the Study on Global Ageing and Adult Health in Mexico during 4 waves (2009, 2014, 2017, and 2021). We defined frailty with the frailty phenotype and we used multinomial logistic models to estimate the probabilities of frailty transitions and determine their predictors. For the 3 analyzed periods (2009-2014, 2014-2017, and 2017-2021), transition probabilities from frail to robust were higher for the younger age group (50-59 years) at 0.20, 0.26, and 0.20, and lower for the older age group (≥80 years), 0.03, 0.08 and 0.04. Transitioning from prefrail to robust had probabilities of 0.38, 0.37, and 0.35, for the younger age group, and 0.09, 0.18, and 0.10, for the older age group. The probabilities of transitioning to frail and to death were lower for the younger age group and for the robust at baseline; but higher for the older age group and for the frail at baseline. We identified age, disability, and diabetes as the most significant predictors of frailty transitions. These findings show that frailty has a dynamic nature and that a significant proportion of prefrail and frail individuals can recover to a robust or prefrail state. They also emphasize that prefrailty should be the focus of interventions.

Prospective changes in anemia are associated with the incidence and persistence of sarcopenia among older Mexican adults.

Low hemoglobin levels are a significant biomarker in the prognosis of sarcopenia. Anemia and sarcopenia are frequent and disabling conditions in the older adult population, but little is known about the role of anemia in the onset and progression of sarcopenia. This study aimed to determine whether prospective changes in anemia are associated with the incidence and persistence of sarcopenia. Data come from the second and third waves (2014, 2017) of the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) in Mexico. SAGE-Mexico is a dynamic cohort with national representativeness, including a follow-up sample and new enrollments. For this study, 1,500 older adults (aged 50 or above) with measurements in both waves were included. Sarcopenia was defined as having low muscle quantity and either/both slow gait speed and weak handgrip strength. Anemia was defined according to hemoglobin concentrations, adjusted for altitude, as recommended by the WHO, <120 g/L for women and <130 g/L for men. Multinomial logistic regression was used to estimate the association between anemia and prospective changes in sarcopenia. The baseline prevalence of anemia was 17.4%, and that of sarcopenia was 12.1%. The incidence and persistence of anemia were 10.6% (95% CI: 7.3-15.0%) and 6.9% (95% CI: 4.7-9.8%), respectively, and for sarcopenia, they were 5.3% (95% CI: 3.7-7.7%) and 9.2% (95% CI: 6.4-13.0%), respectively. Incident anemia was associated with incident (RRR = 3.64, 95% CI: 1.18-11.19) but not with persistent (RRR = 0.75, 95% CI: 0.18-3.20) sarcopenia. Persistent anemia was significantly associated with persistent (RRR = 3.59, 95% CI: 1.14-11.27) but not incident (RRR = 1.17, 95% CI: 0.30-4.54) sarcopenia. Changes in anemia are significantly associated with incident and persistent sarcopenia. Primary actions to promote a healthy diet rich in antioxidants, high-quality proteins, and micronutrients, as well as moderate physical activity and maintaining a healthy weight, are crucial for the aging population to delay the deleterious effects of anemia and sarcopenia.

MULTIMORBIDITY PATTERNS AND COGNITIVE CHANGE AMONG MEXICAN OLDER ADULTS IN THE MEXICAN HEALTH AND AGING STUDY

Abstract Multimorbidity (≥ 2 chronic conditions) increases the risk of non-normative cognitive decline. Among Mexican older adults, little is known about 1) the prevalence of multimorbidity, 2) patterns of multimorbidity, and 3) the relationship between multimorbidity patterns and cognitive decline. We used representative data from the Mexican Health and Aging Study to estimate prevalence of multimorbidity, identify common multimorbidity patterns, and examine associations between multimorbidity patterns and cognitive change from 2012–2015 in Mexican adults aged ≥ 65 (n=5,079; mean age: 72.2 (SD=6.1)). Chronic conditions including hypertension, diabetes, cancer, lung disease, heart attack, stroke, and arthritis were measured in 2012, and cognitive function was assessed in 2012 and 2015 using the Cross Cultural Cognitive Examination (CCCE; range:3–96). We used descriptive analyses to estimate multimorbidity prevalence and identify disease patterns, then used weighted linear regression (adjusted for age, sex, martial/partnership status, education, literacy, and household income and wealth) to estimate associations between multimorbidity patterns and cognitive change (modeled as CCCE-2015 regressed on CCCE-2012). In 2012, 50.7% of respondents reported multimorbidity and average CCCE score was 46.6 (SD=17.2). From 2012–2015, CCCE decreased on average 2.7 units (SD=13.1). Disease patterns with ≥ 2% prevalence included hypertension+depression (6.0%), hypertension+arthritis (5.9%), hypertension+diabetes (5.8%), hypertension+arthritis+depression (5.4%), hypertension+diabetes+depression (2.8%), hypertension+diabetes+arthritis (2.7%), and arthritis+depression (2.1%). Compared to those reporting no conditions, respondents reporting arthritis+depression (b=-3.88, CI=-6.11:-1.66), hypertension+diabetes (b=-3.72, CI=-5.33:-2.11), or hypertension+diabetes+depression (b=-3.41, CI=-5.32:-1.21) experienced greater cognitive decline. Our results suggest diabetes and depression are common elements of multimorbidity associated with cognitive decline in Mexican older adults.

Relationship between inflammatory markers, compliance to the MIND diet and body composition in older adults without cognitive decline

AbstractBackgroundChronic low‐grade inflammation is one of the main drivers of cognitive decline. The MIND Diet is a dietary pattern that includes foods rich in antioxidants that exert a neuroprotective effect by decreasing oxidative stress (OS) and inflammation. The aim was to evaluate the association between inflammation markers and the intake of foods characteristic of the MIND diet with body composition in older adults.Method Cross‐sectional analysis of 73 older adults (70.6±4.6 years, 63% women) without cognitive decline who are participating in the LatAm Fingers study in Mexico. Basal blood samples were taken to determine C‐reactive protein (CRP) and Lipopolysaccharide (LPS). Subjects were divided into two groups according to CRP levels (≤1.0 mg/L without inflammation; &gt;1.0 mg/L with inflammation). Body composition was measured by multi‐frequency bioelectrical impedance (Inbody 720). Participants were asked to autocomplete a validated food frequency questionnaire (POINTER) to evaluate the dietary intake of the MIND diet foods (leafy green vegetables, other vegetables, olive oil, fish, poultry, nuts, whole grains, legumes, and berries). Low adherence was defined as a total score of &lt;8 out of 15 points. Result74% of women presented elevated CRP levels (&gt;1.0mg/L). Interestingly, subjects from the group without inflammation had lower values of body mass index (BMI) (27.2 ± 2.4 vs. 30.0 ± 3.6 Kg/m²; p = 0.002), total fat percentage (35.5 ± 5.6 vs. 42.9 ± 6.9%; p = 0.0001) and visceral fat area (108.3 ± 20.7 vs. 123.6 ± 24.0 cm²; p = 0.012) and higher levels of total muscle mass (23.9 ± 5.0 vs. 21.6 ± 4.3Kg; p = 0.049). All participants had metabolic endotoxemia (LPS levels 450 ± 211 ng/mL). Compliance with the MIND diet was deficient (score &lt;8 points) in most participants (58.3%).Conclusion High levels of CRP are associated with a negative impact on body composition in older Mexican adults. Additionally, this population is at high risk of cognitive decline as it presents elevated markers of systemic inflammation with a low intake of neuroprotective foods.

Food Insecurity and Executive Function among Older Mexican Adults: Indirect Effects through Depressive Symptoms

AbstractBackgroundRecent work has linked food insecurity with worse cognitive outcomes, with executive function being a domain affected most consistently. The mechanisms underlying this association are largely unknown and few have investigated how changes in food insecurity over time (never food insecure, newly food insecure, formerly food insecure, or chronically food insecure) relate with cognitive outcomes. Food insecurity is also related with worsening depressive symptoms, which may impact executive function. This study evaluates how changes in food insecurity in late‐life relate with executive function, and whether this association is mediated by depressive symptoms among older adults in Mexico.MethodData includes the 2012‐2015 Mexican Health and Aging Study (MHAS) and 2016 Mex‐Cog subsample of the MHAS (n = 1,581 age 55+). Food insecurity was classified as never food insecure (not food insecure in 2012 or 2015), newly food insecure (food insecure in 2015 but not 2012), formerly food insecure (food insecure in 2012 but not 2015), or chronically food insecure (food insecure in 2012 and 2015). Executive function and depressive symptoms (CES‐D) were obtained from the Mex‐Cog. Direct/indirect (through depression) effects of food insecurity were tested using structural equation modeling with bootstrap confidence intervals controlling for demographic and socioeconomic confounders.ResultApproximately half of the sample were never food insecure, 16% were newly food insecure, 15% were chronically food insecure, and 18% were formerly food insecure. SEM results indicated partial mediation. Significant direct effects were observed, with chronic and former food insecurity related with 0.12 and 0.11 standard deviations lower executive function, respectively, compared to the never food insecure. Both chronic and former food insecurity exhibited significant indirect effects via depressive symptoms with indirect effects making up 21% and 15% of the total effects of chronic and former food insecurity on executive function.ConclusionFood insecurity may represent an important modifiable risk factor for poorer executive function outcomes. Although food insecurity had a direct impact on executive function, part of its detrimental effect was through worsening depressive symptoms. This study highlights the importance of considering experiences of food insecurity over time and the co‐existence of both food insecurity and depressive symptoms.

Developing Topics.

Semantic verbal fluency (SMF) has been identified as an early marker of mild cognitive impairment (MCI). Anemia and some micronutrient deficiencies (MD) have been considered as risk factor for MCI. In Mexico, it has been poorly studied the nutritional drivers associated to MCI. Anemia and MD are frequent in vulnerable Mexican population but controversial exist around the criteria to define such entities in older adults (OA).The aim is to analyse the association between hemoglobin concentration, iron and B12 status, as well as the causes of anemia with SVF in older Mexican adults. 802 OA from 4 urban localities in Campeche and Yucatan -most of them considered themselves as Mayan indigenous- donated a capillary and venous blood sample. Hb (g/dL) was measured in capillary blood using Hemocue. Ferritin, vitamin B12, transferrin receptors (stfr), and other biomarkers were analysed in serum. The causes of anemia were classified as: Iron deficiency (ID), B12 deficiency (B12D), inflammatory, renal, multiple and unexplained. We explored the quartiles (Q) of Hb -sex adjusted-, s-ferritin, and stfr with SVF. Anemia, causes of anemia and MD were modelled separately using multiple linear regression models adjusted by confounders. Anemia, ID and B12D affected to 35.3%, 5% and 10% of OA, respectively. The mean of SVF was 13-5±6.5 words. The Q1 [coef = -1.4, p = 0.025], Q2 [coef = -1.46, p = 0.016] and Q3 [coef = -1.13, p = 0.05] of Hb were negatively associated with SVF in comparison with Q4. No association was observed between the quartiles of s-ferritin, stfr, ID or B12D with SVF. Total anemia (-0.9, p = 0.047), and particularly B12D anemia (-3.5, p = 0.018), were associated to lower SVF vs non-anemics. Higher Hb values (≥13.3 g/dL for women and ≥14.7 g/dL for men) above the cut-off of anemia were positively associated with SVF independent of MD. This finding suggests that normal Hb values in those ranges of Hb might hide a declining in brain function secondary to an inadequate delivery of cerebral oxygen. Those with B12D anemia had the worse SVF performance. It is necessary to identify the main drivers for the optimal Hb range where the OA is functional independent to target early interventions.

Association of sarcopenia with cognitive impairment in older adults in the open population

AbstractBackgroundSarcopenia is a progressive and generalised skeletal muscle condition where there is a loss of muscle mass and function, while cognitive impairment is a clinical syndrome characterised by impairment in different cognitive and neuropsychological domains. Cognitive impairment has been studied as a risk factor for sarcopenia, however, it has not been established whether sarcopenia is a risk factor for cognitive impairment.MethodThis is a secondary analysis of 2,158 adults aged 65 and over assessed within the Dementia Research Group 10/66 protocols. In which grip strength, calf circumference and physical performance were measured to establish a diagnosis of sarcopenia. In addition, they were divided into groups depending on cognitive status.ResultOf all the older adults assessed, those with cognitive impairment or dementia had worse indicators in anthropometric measurements and in sarcopenia‐related measurements.ConclusionIn older Mexican adults, the presence of sarcopenia was not found to be associated with mild cognitive impairment, but was associated with the presence of dementia, even after controlling for other risk factors widely documented in the literature.

Cross‐cultural adaptation, validity and reliability of the Everyday Cognition Scale in Mexico M‐ECog in Older Adults with Subjective Cognitive Decline, Mild Cognitive Impairment and Alzheimer’s Dementia

AbstractBackgroundThe Everyday Cognition (ECog) scale was created to assess the functional abilities of older adults across a wide range of abilities between normal aging and dementia. The original ECog was shown to have convergent and divergent external validity. Developed in 2008 by Farias et al and updated in 2021. This scale screens early cognitive alterations such as Subjective Cognitive Decline (SCD), Mild Cognitive Impairment (MCI) and Alzheimer’s dementia (AD) through the decline of basic activities and instruments of daily life (DLA)To establish validity, reliability, and cross‐cultural adaptation of the ECog in Spanish (M‐ECog) to identify: SCD, MCI, and Alzheimer’s‐type dementia in older Mexican adults.Method200 patients and 200 informants in a memory clinic of a third level hospital in Mexico City. Four groups were formed: 50 cognitively healthy (CH), 50 SQD, 50 MCI and 50 AD. The clinical evaluation included: sociodemographic aspects, cognitive status by the Mini‐Mental State Evaluation (MMSE) and Montreal Cognitive Evaluation Spanish version (MoCA‐E). The informants rated the functional status measured through the KATZ and Lawton &amp; Brody scales, as well as the ECog Spanish version (M‐ECog).ResultThe internal consistency of the overall function of the M‐ECog (Cronbach’s alpha) was 0.881. The intraclass correlation coefficient was 0.877 (95% CI, 0.850‐0.902; p&lt;0.001). M‐ECog was significantly correlated with DLA 0.40 (95% CI, 0.320‐0.471; p&lt;0.001), MMSE 0.68; (95% CI, 0.650‐0.710; p&lt;0.001) and MoCA‐E 0.70 (95% CI, 0.620‐0.892; p&lt;0.001). And it differentiated patients with SCD, MCI and AD from CH (p &lt; 0.002). The area under the curve (AUC) for SQD was 0.70 (95% CI, 0.58‐0.82), p &lt; 0.005 with a cut‐off value of 46 points, (Sensitivity (S) 99%, and Specificity (E) of 96%; the AUC for MCI was 0.94 (95% CI, 0.89‐0.99), p &lt; 0.001 with a cut‐off point of 52 points, (S: 97%, E: 27%); and for the dementia group, the AUC was 0.86 (95% CI, 0.79‐0.92), p &lt;0.001 with a cut‐off value of 85 points, with (S: 97%, E: 51%).ConclusionM‐ECog is a valid, reliable, useful instrument that measures daily skills mediated by cognition in older Mexican adults, self‐applicable (patients and informants) with SCD, MCI and Alzheimer’s Dementia

Prevalence mild cognitive impairment in mexican older adults in a third‐level hospital

AbstractBackgroundMild Cognitive Impairment (MCI) is a common condition among older adults that refers to cognitive deficits that are not derived from daily activities, this condition that can progress to dementia, therefore it deserves special attention since it is prevalent in populations of older adults and It can coexist with geriatric syndromes. we evaluated the epidemiological characteristics in an older population with mild cognitive impairment.MethodA descriptive and cross‐sectional study was carried out, evaluating adults 60 years of age or older, from a dementia clinic at a tertiary level hospital in Mexico. The analytical sample consisted of 700 older adults, from whom patients with Mild Cognitive Impairment were selected, using the Petersen criteria. Epidemiological variables were considered, as well as gait disturbance, geriatric syndromes, among others.ResultThe study found that of the total population of 700 patients, 275 participants were diagnosed with mild cognitive impairment, indicating an estimated overall prevalence of 39.42%. Among those with MCI, 54.1% were in the a‐MCI‐s subtype, 22.5% in the a‐MCI‐md subtype, 18.18% in the na‐MCI‐md subtype, and 5 .09% in the na‐MCI‐s subtype. The prevalence of MCI was higher in women (59.6%) and between 60 and 70 years (55.6%). 46.7% had basic education (&lt;6 years), of which 27.2% belonged to the a‐MCI‐s subtype. in patients with MCI, 28% presented depression, 48.3% gait disturbances. Pre‐frailty was present in 40% of patients. Sensory deprivation was found in 88.3% and polypharmacy in 49.1%. The marital status was predominantly married (61.8%) and 32.3% worked and in terms of comorbidities, a relationship with arterial hypertension (61%) was observed.ConclusionThis study suggests that mild cognitive impairment is common among the elderly population, especially women and people in their 60s and 70s. The a‐MCI‐s subtype was the most common. Mild cognitive impairment was also associated with various comorbidities and geriatric syndromes, including gait disorders, depression, pre‐frailty, sensory deprivation, polypharmacy, and association with arterial hypertension. These findings highlight the importance of identifying and managing mild cognitive impairment and its associated syndromes.