Risk Factors For Mild Cognitive Impairment Research Articles

The Impact of Loneliness In Older Adults Presenting With Memory Impairment: A Single-Center Experience

Background: Memory impairment may be the first sign of an amnestic mild cognitive impairment (MCI) or geriatric depression. Loneliness hurts consciousness and mood in the elderly population. This study aimed to investigate the impact of loneliness on possible MCI and depressive symptoms in older adults with memory impairment. Method: The data of this cross-sectional study was collected from a single center in Sakarya. Standardized Mini Mental Test (SMMT), geriatric depression, and loneliness scales were applied to 120 older adults who met the inclusion criteria. SPSS 22.0 was used for statistical analysis. Logistic regression analysis were used to determine possible risk factors of MCI and depression. p

Does periodontitis have any association with mild cognitive impairment?

This study aimed at determining the association between periodontitis and mild cognitive impairment. For this, different electronic databases, including PubMed, Scopus, Embase and Web of Science, were searched for finding the relevant literature. In addition, hand searching of relevant journals was also done to find gray literature. The systematic review included observational studies only. Accordingly, case-control, cohort and cross-sectional studies were searched. The search strategy was based on PECO framework, wherein the studies which included patients with/without periodontitis and patients with/without mild cognitive impairment (MCI)were included. A total of 7 studies were included and the data from these studies and the data including bibliographic details, demographic data, data about periodontitis, presence of MCI etc. was extracted from the included articles. The extracted data, was then assessed for heterogeneity using clinical parameters and I2 statistical test. Owing to low heterogeneity, fixed-effects model was used for meta-analysis. Meta-analysis was done to determine the association between periodontitis and MCI and significantly higher incidence of MCI was found in patients with periodontitis OR = OR, 1.70 (95% CI: 1.24-2.32, p < 0.001). A subgroup analysis was done by including the studies comparing incidence of MCI in patients with severe periodontitis, which resulted in even stronger association with an OR of 2.09 (95% CI: 1.49-2.92, p < 0.001). Lastly, periodontal parameters, including CAL, PPD, and PI were compared amongst patients with/without MCI. Significant differences were observed for both CAL and PI, with worsening of values in patients with MCI. Observed mean difference for CAL and PI were 0.44 (95% CI: 0.12-0.75) and 0.72 (95% CI:0.50-0.93), respectively. NS differences were observed for PPD values with a mean difference of 0.21 and 95% CI as -0.08 to 0.49. Strong association between periodontitis and MCI was observed, indicating periodontitis to be a risk factor for MCI.

Cholinergic hyperintensity pathways are associated with cognitive performance in patients with asymptomatic carotid artery stenosis

ObjectivesWe aimed to determine whether asymptomatic carotid artery stenosis (ACS) induced cognitive impairments were related to the cholinergic hyperintensity pathway. MethodsThis cross-sectional study included patients with moderate-to-severe ACS, who were categorized into mild cognitive impairment (MCI) and normal cognition groups on the basis of Montreal Cognitive Assessment (MoCA) scores. The cholinergic pathway hyperintensity scale (CHIPS), Fazekas, and medial temporal atrophy (MTA) scores were assessed. SPSS software was used for statistical analyses. ResultsA total of 117 ACS patients (70.89 ± 8.81 years) and 105 controls (67.87 ± 9.49 years) were evaluated (t = 2.46, p = 0.015). The ACS group showed a worse median Mini-Mental Status Examination (MMSE) score (z = −2.41, p = 0.016) and MoCA score (z = −3.51, p < 0.001), and a significantly higher median total CHIPS score (z = 4.88, p < 0.001) and mean Fazekas score (t = 2.39, p = 0.018). In the correlation analysis, the MoCA score showed a significant negative correlation with the CHIPS score (ρ = −0.41, p < 0.001) and Fazekas score (ρ = −0.31, p < 0.001) in ACS group. Logistic regression analyses suggested that CHIPS scores were risk factors for MCI in patients with ACS (odds ratio [OR] = 1.07, 95% Confidence Interval [CI]1.01–1.13 and controls (OR = 1.09, 95%CI 1.01–1.17), while the MTA and Fazekas scores showed no predictive power. The receiver operating characteristic curve showed that the area under the curve of the CHIPS score for predicting MCI was 0.71 in ACS group, but was only 0.57 in controls. ConclusionsPatients with ACS showed poorer cognitive performance and higher CHIPS and Fazekas scores. CHIPS, but not Fazekas, scores were risk factors for cognitive impairment and were a valuable factor to predict MCI in patients with ACS.

Prediction model for mild cognitive impairment in patients with type 2 diabetes using the autonomic function test.

Type 2 diabetes mellitus (T2DM) is a risk factor for cognitive impairment, and reduced heart rate variability (HRV) has been correlated with cognitive impairment in elderly individuals. This study investigated risk factors and validated a predictive model for mild cognitive impairment (MCI) in patients with T2DM using an autonomic function test. Patients with T2DM, 50-85years of age, who attended the diabetes clinic at Gyeongsang National University Hospital between March 2018 and December 2019, were included. A total of 201 patients had been screened; we enrolled 124 patients according to the inclusion and exclusion criteria in this study. Cognitive function was assessed using the Montreal Cognitive Assessment-Korean version (MOCA-K); MCI was defined as a total MOCA-K score ≤ 23. Risk factors for MCI in patients with T2DM, including demographic- and diabetes-related factors, and autonomic function test results, were analyzed. Based on multivariate logistic regression, a nomogram was developed as a prediction model for MCI. Thirty-nine of 124 patients were diagnosed with MCI. Age, education, and decreased cardiovagal function were associated with a high risk for MCI, with cardiovagal function exerting the greatest influence. However, diabetes-related factors, such as glycemic control, duration of diabetes, or medications, were not associated with the risk for MCI. The nomogram demonstrated excellent discrimination (area under the curve, 0.832) and was well calibrated. Approximately one-third of patients had MCI; as such, carefully evaluating cognitive function in elderly T2DM patients with reduced HRV is important to prevent progression to dementia.

Identifying mild cognitive impairment and its predictors among normal middle adulthood in Pune, Maharashtra: A community-based cross-sectional survey

BackgroundCognitive health is still an undermined, hidden issue in India. Cognitive decline like forgetfulness, inattention, slowness affects one's daily living. Mild cognitive impairment (MCI) is an intermediate stage between dementia & normal cognition. Study suggests this decline begins around mid20s with average memory decline detected by mid30s.Thus, the study explore the dearth in literature regarding the prevalence and risk factors of MCI in middle adulthood in India. MethodsA community-based, cross-sectional analytical study conducted on 605 adults aged 40–60years in Pune, India after an ethical clearance. Pre-diagnosed cases of psychological & neurological problems were excluded. Cognition, physical activity and lifestyle were assessed using Addenbrookes cognitive examination-III test, International physical activity questionnaire-SF and Simple lifestyle indicator questionnaire respectively. Also preset questions for socio-demographic data and risk factors was interviewed. ResultsData was analyzed by chi square and multivariate logistic regression. Prevalence of MCI among adult was 27.77 % with 95 % CI (24.35–31.47). The risk of MCI significantly increases in higher age groups, in females, higher in lower educational status, one with severe stress level and with low physical activity (p < 0.001). The other covariates like marital status, family type, diet, BMI, sleep and lifestyle were not significantly associated with the MCI (p > 0.05). ConclusionThus, the prevalence of MCI (27.77 %) in adults aged 40–60 years might be an alarming issue of early onset of dementia. Therefore, it is advised to include early cognitive assessment, to intervene quickly and decrease the burden of diseases.

Impact of insulin resistance on mild cognitive impairment in type 2 diabetes mellitus patients with non-alcoholic fatty liver disease

AimsInsulin resistance (IR) is a pivotal factor in the pathogenesis of type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). Nevertheless, the impact of IR on cognitive dysfunction in T2DM patients with NAFLD remains inadequately understood. We aim to investigate the effect of IR on mild cognitive impairment (MCI) in T2DM individuals with NAFLD.Materials and methods143 T2DM individuals were categorized into Non-MCI and MCI groups, as well as Non-NAFLD and NAFLD groups. Clinical parameters and cognitive preference test outcomes were compared. Correlation and regression analyses were executed to explore the interconnections between IR and cognitive details across all T2DM patients, as well as within the subgroup of individuals with NAFLD.ResultsIn comparison to the Non-MCI group, the MCI group displayed elevated HOMA-IR levels. Similarly, the NAFLD group exhibited higher HOMA-IR levels compared to the Non-NAFLD group. Additionally, a higher prevalence of MCI was observed in the NAFLD group as opposed to the Non-NAFLD group. Notably, HOMA-IR levels were correlated with Verbal Fluency Test (VFT) and Trail Making Test-B (TMTB) scores, both related to executive functions. Elevated HOMA-IR emerged as a risk factor for MCI in the all patients. Intriguingly, increased HOMA-IR not only correlated with TMTB scores but also demonstrated an influence on TMTA scores, reflecting information processing speed function in patients with NAFLD.ConclusionIR emerges as a contributory factor to cognitive dysfunction in T2DM patients. Furthermore, it appears to underlie impaired executive function and information processing speed function in T2DM individuals with NAFLD.

Exosomal miR-let-7c-5p is involved in the cognitive function of type 2 diabetes mellitus patients by interleukin 10: A cross-sectional study.

Interleukin (IL)-10 plays a notable role in the inflammatory-associated mild cognitive impairment (MCI). We aimed to investigate whether IL-10 and its upstream factors exert an impact on MCI in type 2 diabetes mellitus (T2DM) patients. A total of 117 T2DM patients were recruited and divided into Control group and MCI group based on the presence or absence of MCI. Clinical parameters were collected. The Montreal Cognitive Assessment (MoCA) was conducted for global cognitive function. Digit Span Test (DST), Verbal Fluency Test (VFT), and Trail Making Test-B (TMTB) were used to evaluate the executive functions of the diabetic patients. Trail Making Test-A (TMTA) was performed to examine the information processing speed function. Patients' scene memory was examined by Logical Memory Test (LMT). After the baseline data were compared, correlation and regression analyses were performed to explore the relationship amongIL-10, miR-let-7c-5p and cognitive function. Compared to 80 patients in the control group, 37 patients in the MCI group exhibited lower IL-10 in plasma and higher miR-let-7c-5p levels in exosomes from plasma. The IL-10 level was negatively associated with MoCA. Likewise, miR-let-7c-5p levels were negatively correlated with IL-10 levels and MoCA. Elevated miR-let-7c-5p levels and decreased IL-10 levels are risk factors for MCI in T2DM patients. Increased miR-let-7c-5p and downregulated IL-10 may influence VFT and TMTB, respectively, associated with executive function. We demonstrated that IL-10 is correlated to the executive function of T2DM patients. Decreased IL-10 may result from the regulation of miR-let-7c-5p in exosomes.

Influencing factors of mild cognitive impairment among the Chinese elderly: a meta-analysis

Objective: To conduct a meta-analysis on the influencing factors of mild cognitive impairment (MCI) in the Chinese elderly. Methods: The literature related to the influencing factors of MCI in Chinese elderly population was retrieved through CNKI, Wanfang, VIP, PubMed, Embase and Web of Science databases up to March 13, 2022. Stata17.0 software was used to calculate the combined risk ratio (RR) with the 95% confidence interval (CI), test the heterogeneity, and assess the publication bias. Results: A total of 2 450 articles were retrieved, and 49 articles met the inclusion criteria, including 5 cohort studies and 44 case-control studies. Meta-analysis results showed that male (RR=0.778, 95%CI: 0.696-0.870, I2=73.1), education>6years (RR=0.428, 95%CI: 0.374-0.490, I2=86.9) and regular exercise (RR=0.496, 95%CI: 0.421-0.585, I2=81.5) were protective factors for MCI, while age≥70 years (RR=2.431, 95%CI: 2.086-2.833, I2=79.3), family history of dementia (RR=3.228, 95%CI: 2.140-4.867, I2=0.0), smoking (RR=1.214, 95%CI: 1.098-1.342, I2=78.8), alcohol consumption (RR=1.165, 95%CI: 1.047-1.297, I2=68.2), solitary living (RR=2.816, 95%CI: 2.123-3.736, I2=42.0), insomnia (RR=1.402, 95%CI: 1.093-1.799, I2=41.3), overweight/obesity (RR=1.431, 95%CI: 1.207-1.696, I2=75.9), hypertension (RR=1.731, 95%CI: 1.589-1.886, I2=67.1), hyperlipidemia (RR=1.722, 95%CI: 1.541-1.924, I2=63.9), diabetes mellitus (RR=1.495, 95%CI: 1.341-1.666, I2=71.6), cardiovascular diseases (RR=1.671, 95%CI: 1.446-1.932, I2=74.6) and cerebrovascular diseases (RR=2.309, 95%CI: 2.040-2.613, I2=76.3) were risk factors of MCI. Conclusion: The present study indicates that male, junior high school education or above and regular exercise are protective factors of MCI, while age≥70 years, family history of dementia, smoking, alcohol consumption, living alone, insomnia, overweight/obesity, hypertension, hyperlipidemia, diabetes, cardiovascular diseases and cerebrovascular diseases are risk factors of MCI.

Association of Qi-stagnation constitution and subjective sleep characteristics with mild cognitive impairment among elderly in community: A cross-sectional study

Depression and sleep disturbance are commonly reported in patients with mild cognitive impairment (MCI). However, it remains unclear whether Qi-stagnation constitution is still a risk factor for MCI before the older adults suffer from depression. Subjects from 34 community elderly day care centers in China. Intensive face-to-face interviews were conducted using tools such as Montreal cognitive function assessment, AD8 dementia screening questionnaire, Pittsburgh Sleep Quality Index(PSQI), and Traditional Chinese medicine constitution assessment scale. Multi-factor logistical regression was employed to analyze the association among subjective sleep quality, TCM constitution, and MCI. A total of 1,071 cases were analyzed in this study, including 314 patients with MCI. The probability of Qi-deficiency and Qi-stagnation suffering from MCI was 1.559 times and 1.706 times higher than that of the older adults without Qi-deficiency and Qi-stagnation, respectively (P<0.05). In the PSQI scale, individuals with MCI had poorer subjective sleep quality, longer sleep latency, shorter sleep duration, and aggravated daytime dysfunction (P<0.05) compared with those without MCI. The results of multi-factor logistical regression showed that sleep latency (OR=1.168), daytime dysfunction (OR=1.261), and Qi-stagnation (OR=1.449) were the risk factors for MCI; the OR of suffering from MCI in elder with sleep disturbance and Qi-stagnation was 2.581. (all P<0.05). MCI patients have a higher prevalence of sleep disorders and Qi-stagnation, and may show specific changes in their daytime and nighttime sleep characteristics, with the specific manifestations such as difficulty in falling asleep, easily waking up at night/ early morning, and daytime dysfunction, among others. Chinese Clinical Trial Registry ChiCTR2000039411

Association of stressful life events with cognitive impairment in patients with type 2 diabetes mellitus

This study was carried out to investigate the relationship of stressful life events (SLEs) with the risk of cognitive impairment in patients with type 2 diabetes mellitus. A total of 316 patients with type 2 diabetes mellitus aged >45 years were recruited in this study, and data on demographics, medical history, lifestyle characteristics and SLEs were collected. The cognitive status of patients was evaluated with a battery of cognitive function scales. Logistic regression analyses were carried out to evaluate the risk and protective factors for mild cognitive impairment (MCI). Participants, including 217 type 2 diabetes mellitus patients with MCI and 99 patients without MCI, were enrolled in the current study. Among the SLEs, the death of an offspring or parent (odds ratio [OR] 1.994, 95% confidence interval [CI] 1.017-3.908) was a risk factor for MCI after adjustment for age and education level. In the subgroup of participants aged <60 years, the death of an offspring or parent (OR 2.731, 95% CI 1.119-6.665) and financial difficulty (OR 22.205, 95% CI 4.365-112.966) were risk factors for the development of MCI, whereas high working pressure (OR 0.154, 95% CI 0.048-0.495) and career changes (OR 0.324, 95% CI 0.124-0.847) were protective factors for MCI. These data suggested that SLEs were associated with cognitive function in patients with type 2 diabetes mellitus. Adverse life events, such as the death of an offspring or parent, were risk factors for cognitive impairment, whereas high work pressure in middle-aged people was a protective factor against cognitive impairment.

Association between Cognitive Impairment and Malnutrition in Hemodialysis Patients: Two Sides of the Same Coin.

Cognitive impairment and malnutrition are prevalent in patients on hemodialysis (HD), and they negatively affect the outcomes of HD patients. Evidence suggests that cognitive impairment and malnutrition may be associated, but clinical studies to assess this association in HD patients are lacking. The aim of this study was to evaluate the association between cognitive impairment evaluated by the Montreal Cognitive Assessment (MoCA) score and nutritional status evaluated by the malnutrition inflammation score (MIS) in HD patients. We enrolled 84 HD patients (44 males and 40 females; age: 75.8 years (63.5-82.7); HD vintage: 46.0 months (22.1-66.9)). The MISs identified 34 patients (40%) as malnourished; the MoCa scores identified 67 patients (80%) with mild cognitive impairment (MCI). Malnourished patients had a higher prevalence of MCI compared to well-nourished patients (85% vs. 70%; p = 0.014). MoCa score and MIS were negatively correlated (rho:-0.317; p < 0.01). Our data showed a high prevalence of MCI and malnutrition in HD patients. Low MoCA scores characterized patients with high MISs, and malnutrition was a risk factor for MCI. In conclusion, it is plausible that MCI and malnutrition are linked by common sociodemographic, clinical, and biochemical risk factors rather than by a pathophysiological mechanism.

Association of body mass index and dietary intake with mild cognitive impairment and dementia: a retrospective cohort study

BackgroundThe prevalence of cognitive impairment in older adults is gradually increasing, and this is leading to many adverse outcomes. Common causes of cognitive impairment in advancing age are mild cognitive impairment (MCI) and dementia. However, how the nutritional status and nutrient intake are related to MCI and dementia is controversial. Therefore, we aimed to evaluate the association of body mass index (BMI) and dietary intake with the risk of MCI and dementia.MethodsThis retrospective cohort study involved 821 participants aged ≥ 50 years from a previous population-based cohort study: the Electricity Generating Authority of Thailand (EGAT) study in 2013–2014 (baseline) and 2018–2019 (follow-up). Dietary intake was recorded using a 12-month self-reported food frequency questionnaire. MCI and dementia were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria using the Montreal Cognitive Assessment with ADL and the Kessler Psychological Distress Scale (K10) at study entry and at the 5-year follow-up.ResultsAmong the 821 participants, the mean age was 60.0 ± 4.3 years, and the incidence rate of MCI and dementia was 42.5 and 11.2 per 1,000 person-years, respectively. The rate of MCI and dementia was higher in participants aged ≥ 60 years and with an education level of < 7 years. The rate of MCI was also higher in those with a BMI of ≥ 25 kg/m2 and type 2 diabetes. Compared to BMI 18.5–22.9 kg/m2, BMI of ≥ 25 kg/m2 (odds ratio 1.91 [95% confidence interval, 1.12–3.26], p < 0.001) was associated with an increased risk of MCI after adjusted for age, education level, and type 2 diabetes. Regarding dietary intake, fresh red meat consumption was inversely associated with the risk of MCI (p = 0.037) and dementia (p = 0.011) after adjusting for age, education level, type 2 diabetes, and BMI.ConclusionObesity was associated with a greater risk of MCI. Moreover, low consumption of fresh red meat could be a risk factor for MCI and dementia. Further studies are required to confirm and explain these findings.

Dietary choline metabolite TMAO impairs cognitive function and induces hippocampal synaptic plasticity declining through the mTOR/P70S6K/4EBP1 pathway.

Mild cognitive impairment (MCI) is an intermediate state between "healthy" and "dementia", which affects memory and cognitive function. Timely intervention and treatment of MCI can effectively prevent it from developing into an incurable neurodegenerative disease. Lifestyle factors, such as dietary habits, were highlighted as risk factors for MCI. The effect of a high-choline diet on cognitive function is contentious. In this study, we focus our attention on the choline metabolite trimethylamine-oxide (TMAO), an acknowledged pathogenic molecule of cardiovascular disease (CVD). With recent studies indicating that TMAO also plays a potential role in the central nervous system (CNS), we aim to explore the effect of TMAO on synaptic plasticity in the hippocampus, the basic structure of studying and memory. Using various hippocampal-dependent spatial references or working memory-related behavioral texts, we found that TMAO treatment caused both long-term memory (LTM) and short-term memory (STM) deficits in vivo. Simultaneously, the plasm and whole brain levels of choline and TMAO were measured by employing liquid phase mass spectrometry (LC/MS). Furthermore, the effects of TMAO on the hippocampus were further explored by applying Nissl staining and transmission electron microscopy (TEM). Moreover, the expression of synaptic plasticity-related proteins, including synaptophysin (SYN), postsynaptic density protein95 (PSD95), and N-methyl-aspartate receptor (NMDAR), was examined by western blotting and immunohistochemical (IHC). The results showed that TMAO treatment contributes to neuron loss, synapse ultrastructure alteration, and synaptic plasticity impairments. In mechanism, the mammalian target of rapamycin (mTOR) regulates synaptic function, and the activation of the mTOR signaling pathway was observed in TMAO groups. In conclusion, this study confirmed that the choline metabolite TMAO can induce hippocampal-dependent learning and memory ability impairment with synaptic plasticity deficits by activating the mTOR signaling pathway. The effects of choline metabolites on cognitive function may provide a theoretical basis for establishing the daily reference intakes (DRIs) of choline.

Association Between the Ratios of Selenium to Several Elements and Mild Cognitive Impairment in the Elderly.

To investigate the relationship between the correlation ratios of selenium (Se) and other elements and mild cognitive impairment (MCI) among older adults. A total of 1000 individuals participated in our research analysis. The concentrations of elements in whole blood were determined using inductively coupled plasma mass spectrometry to reflect their exposure levels. Participants' cognitive function was assessed using the Mini-Mental State Examination. Logistic regression analysis was used to evaluate the relationship between elemental ratios and MCI. Se concentration was positively correlated with red blood cell count (r = 0.219, p < 0.001), haemoglobin level (r = 0.355, p < 0.001), haematocrit (r = 0.215, p < 0.001), mean corpuscular haemoglobin (r = 0.294, p < 0.001) and mean corpuscular haemoglobin concentration (r = 0.428, p < 0.001) and negatively correlated with red cell volume distribution width-standard deviation (r = -0.232, p < 0.001) and platelet distribution width (r = -0.382, p < 0.001). Compared with the normal group, the ratios of Se/vanadium (V), Se/lead (Pb) and Se/cadmium (Cd) in the whole blood of the MCI group were significantly lower (all p < 0.001), while the ratios of manganese (Mn)/Se and iron (Fe)/Se were higher (all p < 0.001). The increase in the ratios of Se/V, Se/Pb and Se/Cd is related to a decreased risk of MCI among older adults; contrarily, an increase in the ratios of Mn/Se and Fe/Se may be a risk factor for MCI.

A systematic review and meta-analysis of the prevalence and correlation of mild cognitive impairment in sarcopenia.

Sarcopenia is a progressive skeletal muscle disorder involving the loss of muscle mass and function, associated with an increased risk of disability and frailty. Though its prevalence in dementia has been studied, its occurrence in mild cognitive impairment (MCI) has not been well established. As MCI is often a prelude to dementia, our study aims to investigate the prevalence of MCI among individuals with sarcopenia and to also ascertain whether sarcopenia is independently associated with MCI. The Cochrane Library, PubMed, Ovid, Embase and Web of Science were systematically searched for articles on MCI and/or sarcopenia published from inception to 1 February 2022. We reviewed the available literature on the number of individuals with MCI and/or sarcopenia and calculated odds ratios (ORs) of sarcopenia in MCI and MCI in sarcopenia, respectively. Statistical analyses were performed using the meta package in Stata, Version 12.0. A total of 13 studies and 27428 patients were included in our analysis. The pooled prevalence of MCI in participants with sarcopenia was 20.5% (95% confidence interval [CI]: 0.140-0.269) in a total sample of 2923 cases with a high level of heterogeneity (P<0.001; I2 =95.4%). The overall prevalence of sarcopenia with MCI was 9.1% (95% CI: 0.047-0.134, P<0.001; I2 =93.0%). For overall ORs, there were 23364 subjects with a mean age of 73years; the overall adjusted OR between MCI and sarcopenia was 1.46 (95% CI: 1.31-1.62). Slight heterogeneity in both adjusted ORs (P=0.46; I2 =0%) was noted across the studies. The prevalence of MCI is relatively high in patients with sarcopenia, and sarcopenia may be a risk factor for MCI.

Understandings of mild cognitive impairment (MCI): a survey study of public and professional perspectives

PurposeThis paper aims to report the findings of a survey study exploring perceptions about cognitive impairment. These findings are relevant to public health campaigns and education programmes.Design/methodology/approachA survey exploring respondents’ views and knowledge about mild cognitive impairment (MCI) was circulated via UK networks. A total of 417 respondents completed the survey, including people living with cognitive impairment (n = 10), care partners (n = 23), older adults (n = 83), younger adults (n = 83), general health-care professionals (n = 96), dementia specialist health-care professionals (n = 48) and dementia specialists (n = 40).FindingsRespondents were more confident in their knowledge about dementia than cognitive impairment but wanted more information about both conditions. Younger adults were uncertain about many aspects of MCI, and were the most likely to view MCI as a normal part of ageing. Diet (45.1%, n = 188) and personal behaviour (63.8%, n = 266) were the least endorsed possible causes of MCI, suggesting a lack of awareness of lifestyle choices as risk factors for MCI.Originality/valueThe results highlight the need to provide education and awareness raising about MCI to enable people to seek help in a timely manner and be able to make informed lifestyle choices that may reduce their risk of MCI and dementia. Implementing education about MCI and dementia in schools is a key target, as younger people were the most uncertain or misinformed about these topics. It is clear that further public health initiatives around MCI are both warranted and welcomed by the general public.

Correlation analysis of lipid level and cognitive function in middle-aged and elderly diabetic population from 2 communities in Beijing in 2017

To investigate the relationship between serum lipid level and cognitive function in middle-aged and elderly patients with type 2 diabetes mellitus(T2 DM). A cross-sectional study was implemented in 2017 to explore the correlation between lipid level and cognitive function in middle-aged and elderly diabetic patients. A random sample of 1526 middle-aged and elderly people were recruited from 2 communities in Beijing. Fasting blood samples were collected for blood lipid level detection, and the cognitive function of the subjects was assessed by the Montreal Cognitive Assessment Scale(MoCA). Logistic regression model was used to analyze the correlation between serum lipid levels and mild cognitive impairment(MCI) in elderly and T2 DM patients and control group. Compared with the control group, there were significant differences in blood lipid levels in T2 DM group. The levels of total cholesterol(TC) and high density lipoprotein cholesterol(HDL-C) in T2 DM group were lower than those in the control group, while triglyceride(TG) and low density lipoprotein cholesterol(LDL-C) were higher than those in the control group. Logistic regression analysis showed that high level of TC was a risk factor for MCI in patients with T2 DM, while high level of LDL-C was a protective factor, but no association was observed in the control population. Phenotype of T2 DM may affect the relationship between lipid level and cognitive function in middle-aged and elderly people.

Exploring the Relationship Between Alzheimer’s Disease and Age-Related Hearing Loss: A Literature Review

Introduction: By 2050, the international prevalence of Alzheimer’s disease (AD) is expected to triple, resulting in immense healthcare costs and personal effect. In recent years, researchers have identified age-related hearing loss (ARHL) as one of the most prevalent causes in older adults to be associated with the predisposition for mild cognitive impairment (MCI) and AD. However, the relationship between the two remains unclear. Several plausible mechanisms explaining this hearing-cognition relationship have been suggested, such as social isolation, auditory activation, and neurobiological factors. This review seeks to investigate the literature examining the relationship between ARHL and dementia, how ARHL as a modifiable risk factor plays a role in the severity of cognitive decline in the AD and MCI population, and advocate for why further research on this topic is essential to help create a cognitively healthier and more informed older adult population. Methods: A comprehensive literature review of fifteen peer-reviewed articles was conducted using a predetermined protocol and inclusion criteria, such as keywords and databases. The search was limited to published articles in the English language from 2010 – present. Results: No associations were found between brain cortical thickness and those with AD and ARHL in comparison to those with SCD where an association was present. A moderate correlation was found between neurobiological factors such as ApoE4 to explain the relationship between AD and ARHL. The use of active hearing aids did not contribute to a cognitive benefit in those with moderate AD and ARHL compared to the use of placebo hearing aids, or after the secondary activation of hearing aids in the placebo group. Discussion: The literature shows inconclusive results about the mechanism linking ARHL and AD. The pattern of findings did not show consistent results between studies supporting a particular domain to explain the mechanism behind this relationship. Conclusion: Through conducting this review, a greater understanding and awareness about the role of ARHL as a risk factor of MCI and AD is provided. Ultimately, this is important in individual lifestyle changes to prevent the onset of ARHL, and subsequently dementia in order to live healthier and with higher quality as they age.

Association between fasting plasma glucose and mild cognitive impairment in Chinese 55 and older population from four provinces

Objective: To analyze the association of fasting plasma glucose (FPG) with mild cognitive impairment (MCI) in the Chinese middle-aged and elderly population from four provinces. Methods: Data were drawn from the baseline data of the Community-based Cohort Study on Nervous System Disease 2018-2019. We selected 3 272 subjects aged 55 and above with completed information on demographics, lifestyle, disease history, cognitive test, psychological assessment, and bio-chemistries measurement, and who were capable of performing basic activities of daily living but without Alzheimer's disease during recruitment. A multivariate logistic regression model was employed to analyze the association between FPG and MCI. Results: Median level of FPG in the study population was 5.5 mmol/L. The prevalence of MCI was 24.8%, and those in groups of the FPG quintile were 19.4%, 22.2%, 29.2%, 26.6%, and 26.1%, respectively, which significantly increased the trend (P=0.002). After adjustment of confounders, multivariate logistic regression analysis found that the MCI risk of subjects in the Q3,Q4 and Q5 groups was 1.641 (95%CI: 1.226-2.131), 1.373 (95%CI: 1.036-1.825), 1.402 (95%CI: 1.054-1.871) times as high as that in the Q1 group, respectively. Conclusion: High FPG level might serve as a risk factor for MCI in the middle-aged and elderly population, suggesting the importance of monitoring and controlling plasma glucose even without diabetes.

Association between physical activity and mild cognitive impairment in community-dwelling older adults: Depression as a mediator.

IntroductionDementia has become a public health priority and is irreversible. Mild cognitive impairment (MCI), an intermediate state between normal cognition and dementia, is the prime time for early diagnosis and intervention. The activities of daily living of dementia patients are usually insufficient. Therefore, continuing to explore the risk factors of MCI, especially the influence of physical activity on MCI and its mechanism can enrich the relevant research fields in China.Materials and methodsFor this cross-sectional study, 2,518 adults aged 60 years or older in Xinzhuang, Minhang District, Shanghai were recruited between July 2019 and April 2019, using a multistage, cluster-sampling method. A binary unconditional logistic regression model was used with MCI status as the dependent variable. Different types of physical activity were separately included in the multifactor model to test their correlations. Sensitivity analysis was performed using BADL as a stratification factor. The mediating effect of depression between physical activity and MCI was examined using the Bootstrap method.ResultsThis research includes 271 (10.8%) MCI. Old age (odds ratio 2.967 [95%CI 2.063∼4.269]), having diabetes (1.816 [1.302∼2.534]), and depression (3.012 [2.209∼4.108]) were possible risk factors for MCI. High education level (0.722 [0.523∼0.999]), medium level of physical activity (0.459 [0.326∼0.645]), and high level of physical activity (0.396 [0.270∼0.580]) were possible protective factors. Medium (0.548 [0.396∼0.757]) and high levels (0.557 [0.366∼0.846]) of physical exercise and medium (0.433 [0.318∼0.590]) and high levels (0.487 [0.296∼0.801]) of household chores are possible protective factors of MCI and their significance remained in the mutually adjusted model. Sensitivity analysis showed that physical activity and household chores were possible protective factors in all strata (P < 0.05). Physical exercise and work-related activities showed a protective effect in fully independent older adults, but the effect disappeared in those who cannot be fully independent. Depression played a partially mediating role with an indirect effect of 6.67%.DiscussionOverall, our results highlight that physical activity is a possible protective factor for MCI. Physical exercise and household chores have strong protective effects and future interventions could be targeted from this perspective. Depression plays a partially mediating role and more attention should be paid to the mental health of older adults.