Risk factors of attempted suicide in the elderly: The role of cognitive impairment

As the number of older people is growing rapidly worldwide and the fact that elderly people are also apparently living longer, dementia, the most common cause of cognitive impairment is getting to be a greater public health problem. Nutrition plays a role in the ageing process, but there is still a lack of knowledge about nutrition-related risk factors in cognitive impairment. Research in this area has been intensive during the last decade, and results indicate that subclinical deficiency in essential nutrients (antioxidants such as vitamins C, E and β-carotene, vitamin B12, vitamin B6, folate) and nutrition-related disorders, as hypercholesterolaemia, hypertriacylglycerolaemia, hypertension, and diabetes could be some of the nutrition-related risk factors, which can be present for a long time before cognitive impairment becomes evident. Large-scale clinical trials in high-risk populations are needed to determine whether lowering blood homocysteine levels reduces the risk of cognitive impairment and may delay the clinical onset of dementia and perhaps of Alzheimer's disease. A curative treatment of cognitive impairment, especially Alzheimer's disease, is currently impossible. Actual drug therapy, if started early enough, may slow down the progression of the disease. Longitudinal studies are required in order to establish the possible link of nutrient intake – nutritional status with cognitive impairment, and if it is possible, in fact, to inhibit or delay the onset of dementia.

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Prevalence of Cognitive Impairment among Peritoneal Dialysis Patients, Impact on Peritonitis and Role of Assisted Dialysis

Peritoneal Dialysis International ◽

10.3747/pdi.2014.00247 ◽

2016 ◽

Vol 36 (3) ◽

pp. 284-290 ◽

Cited By ~ 12

Author(s):

Yat Fung Shea ◽

Man Fai Lam ◽

Mi Suen Connie Lee ◽

Ming Yee Maggie Mok ◽

Sing-leung Lui ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Peritoneal Dialysis ◽

Cognitive Assessment ◽

Self Care ◽

Blood Parameters ◽

Montreal Cognitive Assessment ◽

Dialysis Adequacy ◽

Significant Independent Risk Factor

Background Chronic renal failure and aging are suggested as risk factors for cognitive impairment (CI). We studied the prevalence of CI among peritoneal dialysis (PD) patients using Montreal Cognitive Assessment (MoCA), its impact on PD-related peritonitis in the first year, and the potential role of assisted PD. Methods One hundred fourteen patients were newly started on PD between February 2011 and July 2013. Montreal Cognitive Assessment was performed in the absence of acute illness. Data on patient characteristics including demographics, comorbidities, blood parameters, dialysis adequacy, presence of helpers, medications, and the number PD-related infections were collected. Results The age of studied patients was 59±15.0 years, and 47% were female. The prevalence of CI was 28.9%. Patients older than 65 years old (odds ratio [OR] 4.88, confidence interval [CI] 1.79 – 13.28 p = 0.002) and with an education of primary level or below (OR 4.08, CI 1.30 – 12.81, p = 0.016) were independent risk factors for CI in multivariate analysis. Patients with PD-related peritonitis were significantly older ( p < 0.001) and more likely to have CI as defined by MoCA ( p = 0.035). After adjustment for age, however, CI was not a significant independent risk factor for PD-related peritonitis among self-care PD patients (OR 2.20, CI 0.65 – 7.44, p = 0.20). When we compared patients with MoCA-defined CI receiving self-care and assisted PD, there were no statistically significant differences between the 2 groups in terms of age, MoCA scores, or comorbidities. There were also no statistically significant differences in 1-year outcome of PD-related peritonitis rates or exit-site infections. Conclusion Cognitive impairment is common among local PD patients. Even with CI, peritonitis rate in self-care PD with adequate training is similar to CI patients on assisted PD.

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Depression and mild cognitive impairment – Comorbidity and/or continuum?

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.430 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S190-S191

Author(s):

G. Sobreira ◽

M.A. Aleixo ◽

C. Moreia ◽

J. Oliveira

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Late Life ◽

The Elderly ◽

Late Life Depression ◽

Pubmed Database ◽

Competing Interest ◽

The Relationship

IntroductionDepression and mild cognitive impairment are common among the elderly. Half the patients with late-life depression also present some degree of cognitive decline, making the distinction between these conditions difficult.ObjectivesTo conduct a database review in order to understand the relationship between these entities, and treatment approaches.AimsTo create and implement clinical guidelines at our institution, to evaluate and treat elderly patients presenting with depression and mild cognitive impairment.MethodsA PubMed database search using as keywords “late life depression”, “depression”; “cognitive impairment”; “mild cognitive impairment” and “dementia” between the year 2008 and 2015.ResultsLate-life depression and cognitive impairment are frequent among the elderly (10–20%). Depression is also common in the early stages of dementia decreasing as the cognitive decline progresses. The causal relationship between these entities is not well understood and some authors advocate a multifactorial model (genetic risk factors; neuroendocrine changes; vascular risk factors) and the cognitive impairment of said changes is dependent on the individual's cognitive reserve. Regarding treatment of depression in patients with cognitive impairment, most authors advocate a stepped approach with watchful waiting and then, if symptoms persist, the introduction of pharmacotherapy and psychosocial intervention.ConclusionsThe relationship between cognitive impairment and depression is still not clear and probably multifactorial. The diagnosis of depressive symptoms in patients with severe cognitive impairment can be difficult and most forms of pharmacological treatment in this population are not beneficial, making it important to carefully evaluate the benefits of introducing new medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Pulse-wave velocity is associated with cognitive impairment in haemodialysis patients

Clinical Science ◽

10.1042/cs20170973 ◽

2017 ◽

Vol 131 (13) ◽

pp. 1495-1498 ◽

Cited By ~ 3

Author(s):

Eve Miller-Hodges ◽

Neeraj Dhaun

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Arterial Stiffness ◽

Pulse Wave ◽

The Elderly ◽

Dialysis Patients ◽

Maintenance Haemodialysis ◽

Dementia Risk ◽

Independent Association ◽

Recent Demonstration

Chronic kidney disease (CKD) is common, its prevalence increasing with age. Cognitive impairment is common in the elderly, in CKD and in those on maintenance haemodialysis. As cognitive impairment is the precursor to dementia, the identification of reversible risk factors for cognitive decline is the key to reducing dementia risk. Arterial stiffness is one such potential risk factor. It is independently associated with cardiovascular outcome in dialysis patients. Importantly, the recent demonstration of an independent association between arterial stiffness and cognitive impairment in these patients suggests that vascular stiffness might be potentially causative in the development of cognitive impairment and also be an opportune target for interventions. Whether unstiffening of blood vessels in patients on maintenance haemodialysis can reduce the incidence of cognitive impairment or indeed slow its progression to dementia, remain unanswered questions. In this issue of the Clinical Science, Angermann and colleagues present thought-provoking data related to cognitive impairment in haemodialysis patients.

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Role of cardiovascular risk factors (CRF) in the patients with mild cognitive impairment (MCI)

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2011.04.025 ◽

2012 ◽

Vol 54 (2) ◽

pp. 330-332 ◽

Cited By ~ 17

Author(s):

E. Ettorre ◽

E. Cerra ◽

B. Marigliano ◽

M. Vigliotta ◽

A. Vulcano ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Cardiovascular Risk ◽

Mild Cognitive Impairment ◽

Cardiovascular Risk Factors

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Risk Factors Associated with Mild Cognitive Impairment аmong Apparently Healthy People and the Role of MicroRNAs

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.834 ◽

2019 ◽

Vol 7 (19) ◽

pp. 3253-3261 ◽

Cited By ~ 3

Author(s):

Iman I. Salama ◽

Somia I. Salama ◽

Dalia M. Elmosalami ◽

Rehan M. Saleh ◽

Hanaa Rasmy ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Sensitivity And Specificity ◽

Cross Sectional Study ◽

Cross Sectional ◽

Logistic Analysis ◽

Modifiable Factors ◽

Low Sensitivity

BACKGROUND: Mild cognitive impairment (MCI) is a stage between the expected cognitive decline of normal ageing and the serious decline of dementia. AIM: To identify risk factors and role of miRNAs associated with mild cognitive impairment (MCI) among employees. SUBJECTS AND METHOD: A cross-sectional study was carried out on 186 employees aged between 40 and 65 years. Cognitive function was evaluated using ACEIII, MoCA, and Quick cognitive tests. Medical history and lifestyle were assessed. Family 132 & 134 miRNA expressions were assessed by real-time PCR. RESULTS: MCI was detected among 14 / 186 (7.5%). miRNA 132 expression was the only significant miRNAs to detect MCI with low sensitivity and specificity (70%). The logistic analysis revealed that higher miRNA132 expressions, low monthly intake of; vegetables, unroasted nuts, low education and higher ALT levels were predicting factors for MCI with AOR 1.1 (1.01-3.3), 1.2 (1.04-1.43), 0.8 (0.8-0.98), 2.7 (1.9-7.4) and 1.6 (1.1-2.3) respectively. CONCLUSION: MiRNAs expression showed low sensitivity and specificity in detecting MCI; only miRNA 132 might be used. Several modifiable factors seem to reduce the risk of MCI.

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Metabolic Syndrome, Cognitive Impairment and the Role of Diet: A Narrative Review

Nutrients ◽

10.3390/nu14020333 ◽

2022 ◽

Vol 14 (2) ◽

pp. 333

Author(s):

Matina Kouvari ◽

Nathan M. D’Cunha ◽

Nikolaj Travica ◽

Domenico Sergi ◽

Manja Zec ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Cognitive Impairment ◽

Cognitive Decline ◽

Clinical Manifestations ◽

Narrative Review ◽

Cognitive Outcomes ◽

Food Groups ◽

Cardiometabolic Disorders

Background: This narrative review presents the association between metabolic syndrome (MetS), along with its components, and cognition-related disorders, as well as the potential reversal role of diet against cognitive impairment by modulating MetS. Methods: An electronic research in Medline (Pubmed) and Scopus was conducted. Results: MetS and cognitive decline share common cardiometabolic pathways as MetS components can trigger cognitive impairment. On the other side, the risk factors for both MetS and cognitive impairment can be reduced by optimizing the nutritional intake. Clinical manifestations such as dyslipidemia, hypertension, diabetes and increased central body adiposity are nutrition-related risk factors present during the prodromal period before cognitive impairment. The Mediterranean dietary pattern stands among the most discussed predominantly plant-based diets in relation to cardiometabolic disorders that may prevent dementia, Alzheimer’s disease and other cognition-related disorders. In addition, accumulating evidence suggests that the consumption of specific dietary food groups as a part of the overall diet can improve cognitive outcomes, maybe due to their involvement in cardiometabolic paths. Conclusions: Early MetS detection may be helpful to prevent or delay cognitive decline. Moreover, this review highlights the importance of healthy nutritional habits to reverse such conditions and the urgency of early lifestyle interventions.

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