scholarly journals Trends in the prevalence of cognitive impairment in Chinese older adults: based on the Chinese Longitudinal Healthy Longevity Survey cohorts from 1998 to 2014

2020 ◽  
Vol 12 (5) ◽  
pp. 378-387
Author(s):  
Weihong Kuang ◽  
Mingyue Gao ◽  
Liantian Tian ◽  
Yang Wan ◽  
Peiyuan Qiu

Abstract In the context of a rapidly ageing Chinese population, this study aims to examine trends in the prevalence of cognitive impairment among people ≥65 y of age in China. Our sample is 72 821 adults aged 65–105 y from the seven waves of the Chinese Longitudinal Healthy Longevity Survey, a national mixed longitudinal cohort. The Chinese version of the Mini-Mental State Examination was used to measure CI. Risk factor-adjusted prevalence trend was examined using multilevel regression models. Age-standardized prevalence of cognitive impairment increased from 11.00% in 1998 to 11.84% in 2008 and decreased to 8.88% in 2014. Older age, female gender, less education, rural residence, not married, lack of physical and cognitive activities, suffering from stroke, vision and hearing impairment, and activities of daily living disability were negatively associated with cognitive impairment. Our study suggests a decreasing trend of cognitive impairment prevalence in China. However, whether decreasing prevalence will contribute to a reduced burden of cognitive impairment given the ageing of the population is unknown.

2021 ◽  
Vol 13 ◽  
Author(s):  
Yun Zhang ◽  
Shihui Fu ◽  
Ding Ding ◽  
Michael W. Lutz ◽  
Yi Zeng ◽  
...  

Background: Both leisure activities and the ε4 allele of the apolipoprotein E (APOE ε4) have been shown to affect cognitive health. We aimed to determine whether engagement in leisure activities protects against APOE ε4-related cognitive decline.Methods: We used the cohort data from the Chinese Longitudinal Healthy Longevity Survey. A total of 3,017 participants (mean age of 77.0 years, SD = 9.0; 49.3% female) from 23 provinces of China were recruited in 2008 and were reinterviewed in 2014. We assessed cognitive function using the Mini-Mental State Examination (MMSE). We calculated cognitive decline using subtraction of the MMSE score of each participant in 2008 and 2014. We genotyped a number of APOE ε4 alleles for each participant at baseline and determined the Index of Leisure Activities (ILAs) by summing up the frequency of nine types of typical activities in productive, social, and physical domains. We used ordinal logistic regression models to estimate the effects of leisure activities, APOE ε4, and their interaction on cognitive decline, statistically adjusted for a range of potential confounders.Results: There were significant associations between APOE ε4 and faster cognitive decline, independent of potential confounders, and between leisure activities and mitigated cognitive decline. The odds ratios were 1.25 (95% CI: 1.03, 1.53) and 0.93 (95% CI: 0.89, 0.97), respectively. We found significant interactions of APOE ε4 with leisure activities with a P-value of 0.018. We also observed interactive effects of subtypes of leisure activities: participants who regularly engaged in productive activities were more likely to reduce the risk of APOE ε4-related cognitive decline.Conclusion: Our findings provide support for the indication that participating in leisure activities reduces the risk of APOE ε4-related cognitive decline.


Author(s):  
Hai-Lian Yang ◽  
Fu-Rong Li ◽  
Pei-Liang Chen ◽  
Xin Cheng ◽  
Chen Mao ◽  
...  

Abstract Background Evidence regarding the associations of tooth loss and denture use with incident cognitive impairment is inconclusive in older adults, and few prospective studies have examined the potential interaction between tooth loss and denture use in these specific populations. Methods Data were assessed from 17 079 cognitively normal older adults aged ≥65 years, participating in the Chinese Longitudinal Healthy Longevity Survey. The outcome of interest was cognitive impairment (assessed by the Chinese version of Mini-Mental State Examination). The number of natural teeth and status of denture use were collected by a structural questionnaire. Results A total of 6456 cases of cognitive impairment were recorded during 88 627 person-years of follow-up. We found that compared with participants with 20+ teeth, those with 10–19, 1–9, and 0 teeth had increased risks of incident cognitive impairment (p-trend < .001). Participants without dentures also had a higher risk of incident cognitive impairment, compared with those who wore dentures. Effect modification by denture use was observed (p-interaction = .010). Specifically, among those without dentures, the adjusted hazard ratio (95% confidence interval) for participants with 10–19, 1–9, and 0 teeth were 1.19 (1.08, 1.30), 1.28 (1.17, 1.39), and 1.28 (1.16, 1.41), respectively, as compared to those with 20+ teeth. In contrary, among denture users, detrimental effect was only observed among those with 0 teeth (hazard ratio 1.14, 95% confidence interval: 1.16, 1.41). Conclusions In Chinese older adults, maintaining 20+ teeth is important for cognitive health; denture use would attenuate the detrimental effects of tooth loss, especially for partial tooth loss, on cognitive impairment.


2020 ◽  
Vol 7 (1) ◽  
pp. 23
Author(s):  
Ika Suswanti ◽  
Meiwita Paulina Budiharsana ◽  
Yuda Turana ◽  
Yvonne Suzy Handajani

ABSTRAK Gangguan kognitif merupakan bagian dari proses neurodegeneratif, saat ini belum ada  perawatan atau pengobatan untuk mencegah progresifitas. Tujuan penelitian ini adalah untuk mengetahui faktor risiko gangguan kognitif dalam studi prospektif. Penelitian dengan desain studi kohort prospektif pada 110 subjek dengan pengambilan sampel  dilakukan secara purposive sampling berdasarkan kriteria memiliki kognitif normal, pendidikan lebih dari 9 tahun dan berusia di atas 60 tahun yang berasal dari wilayah binaan Atma Jaya Active Aging Research yaitu Penjaringan, Cideng dan Cengkareng pada tahun 2014-2015 sebagai baseline studi. Fungsi kognitif diperiksa ulang setelah follow-up 2,5 tahun. Subjek diidentifikasi gangguan kognitif jika memiliki skor Mini Mental State Examination kurang dari 24. Penelitian kami menemukan bahwa 16,4% subjek mengalami gangguan kognitif dengan rerata usia  68,6 ± 6,3 tahun, dan 63 perempuan (57,3%). Skor Instrumental Activity Daily Living yang lebih rendah di awal studi memprediksi penurunan kognitif setelah 2,5 tahun follow up secara independen (13,9 ± 2,6 vs 15,3 ± 1,4; p-value= 0,001). Analisis multivariat menggunakan regresi logistik menunjukkan bahwa skor Instrumental Activity Daily Living yang lebih rendah memprediksi 1,47 kali untuk mengalami gangguan kognitif pada lanjut usia dengan pendidikan diatas 9 tahun setelah 2,5 tahun follow up. Nilai Instrumental Activity Daily Living yang lebih rendah ditemukan sebagai prediktor gangguan kognitif pada lansia setelah 2,5 tahun follow up. Kata-kata kunci: Neurodegeneratif, penilaian, fungsional, klinis, kohor  ABSTRACT Cognitive impairment is a part of neurodegenerative process, currently there was no treatment or medication to prevent the progressivity. The aims of the study was to investigate the risk factors of cognitive impairment in prospective study. The study was a prospective cohort study design on 110 subjects with sampling conducted by purposive sampling based on the criteria of having normal cognitive, education more than 9 years and aged over 60 years. The study based from the Atma Jaya Active Aging Research in Penjaringan, Cideng dan Cengkareng in 2014-2015 as the study baseline. The cognitive function was re-examined after a follow up 2.5-year. Subjects identified cognitive impairment if had Mini Mental State Examination score less than 24. Our study found that 16.4% subjects was cognitive impairment with mean of age 68.6±6.3 years, and 63 (57.3%) female. Lower Instrumental Activity of Daily Living score at baseline predicted cognitive impairment at the present (13.9±2.6vs15.3±1.4; p-value= 0.001). Multivariat analyses using regression logistic showed that lower Instrumental Activity Daily Living score predicting 1.47 more likely to progress cognitive impairment in elderly after follow up 2.5 years. Lower of Instrumental Activity Daily Living score found as a risk factor of worse cognitive funtion in elderly after 2.5-year prospective study.   Keywords: Neurodegenerative, functional, assessment, clinical, follow up  


2021 ◽  
pp. 174749302098455
Author(s):  
Nick A Weaver ◽  
Angelina K Kancheva ◽  
Jae-Sung Lim ◽  
J Matthijs Biesbroek ◽  
Irene MC Huenges Wajer ◽  
...  

Background Post-stroke cognitive impairment can occur after damage to various brain regions, and cognitive deficits depend on infarct location. The Mini-Mental State Examination (MMSE) is still widely used to assess post-stroke cognition, but it has been criticized for capturing only certain cognitive deficits. Along these lines, it might be hypothesized that cognitive deficits as measured with the MMSE primarily involve certain infarct locations. Aims This comprehensive lesion-symptom mapping study aimed to determine which acute infarct locations are associated with post-stroke cognitive impairment on the MMSE. Methods We examined associations between impairment on the MMSE (<5th percentile; normative data) and infarct location in 1198 patients (age 67 ± 12 years, 43% female) with acute ischemic stroke using voxel-based lesion-symptom mapping. As a frame of reference, infarct patterns associated with impairments in individual cognitive domains were determined, based on a more detailed neuropsychological assessment. Results Impairment on the MMSE was present in 420 patients (35%). Large voxel clusters in the left middle cerebral artery territory and thalamus were significantly (p < 0.01) associated with cognitive impairment on the MMSE, with highest odds ratios (>15) in the thalamus and superior temporal gyrus. In comparison, domain-specific impairments were related to various infarct patterns across both hemispheres including the left medial temporal lobe (verbal memory) and right parietal lobe (visuospatial functioning). Conclusions Our findings indicate that post-stroke cognitive impairment on the MMSE primarily relates to infarct locations in the left middle cerebral artery territory. The MMSE is apparently less sensitive to cognitive deficits that specifically relate to other locations.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fatima Nari ◽  
Bich Na Jang ◽  
Hin Moi Youn ◽  
Wonjeong Jeong ◽  
Sung-In Jang ◽  
...  

AbstractFrailty is considered a multidimensional geriatric syndrome, manifested by the accumulation of age-associated deficits. The consequences of frailty transitions are still understudied. This study evaluated the influence of frailty transitions on cognitive function in the older adult population. We used data derived from the Korean Longitudinal Study of Aging (KLoSA) (2008–2018) on older adults aged ≥ 65 years. Frailty was assessed using a validated Korean frailty measure known as the frailty instrument (FI), and cognitive function was measured using the Korean version of the Mini-Mental State Examination (K-MMSE). Transitions in frailty and their relationship with cognitive function were investigated using lagged generalized estimating equations (GEE), t-tests, and ANOVA. Respondents who experienced frailty transitions (those with ameliorating frailty), those who developed frailty, and whose frailty remained constant, were more likely to have a lower cognitive function than those who were consistently non-frail. Older age, activities of daily living (ADL) disability, and instrumental ADL disability were more negatively associated with declining cognitive function, especially in the “frail → frail” group. Changes in all individual components of the frailty instrument were significantly associated with impaired cognitive function. The results suggest an association between frailty transitions and cognitive impairment. Over a 2-year span, the remaining frail individuals had the highest rate of cognitive decline in men, while the change from non-frail to frail state in women was significantly associated with the lowest cognitive function values. We recommend early interventions and prevention strategies in older adults to help ameliorate or slow down both frailty and cognitive function decline.


2021 ◽  
Vol 2021 (7) ◽  
Author(s):  
Ingrid Arevalo-Rodriguez ◽  
Nadja Smailagic ◽  
Marta Roqué-Figuls ◽  
Agustín Ciapponi ◽  
Erick Sanchez-Perez ◽  
...  

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Mohamed W. Zakaria ◽  
Reem I. El-Korashy ◽  
Mostafa O. Shaheen ◽  
Samah Selim ◽  
Kwashi J. Amum

Abstract Background Cognitive dysfunction in idiopathic interstitial pneumonia (IIP) is an important clinical co-morbidity that is associated with impaired lung function. The aim of the work is to assess cognitive function in major IIP and to find out the relation between cognitive dysfunction and the oxygenation parameters. Results Fifty individuals were involved in the study; 30 patients with major IIP and 20 healthy individuals. Patients with IIP had significantly lower mini mental state examination (MMSE) score compared to the control group (P < 0.001). Wechsler Deterioration Index (WDI) revealed that 33.3% (n = 10) of the patients with IIP had sure cognitive impairment and 26.6% (n = 8) had ongoing cognitive deterioration. Patients with idiopathic pulmonary fibrosis (IPF) had lower cognitive function than other IIP. Conclusion There is an impairment of cognitive function in patients with major IIP, particularly in IPF, as measured by WDI and MMSE. Further large studies are needed to assess the possible predictors of cognitive impairment and their effects on the patients’ outcome.


2021 ◽  
Vol 10 (7) ◽  
pp. 1385
Author(s):  
Hyung Cheol Kim ◽  
Seong Bae An ◽  
Hyeongseok Jeon ◽  
Tae Woo Kim ◽  
Jae Keun Oh ◽  
...  

Cognitive status has been reported to affect the peri-operative and post-operative outcomes of certain surgical procedures. This prospective study investigated the effect of preoperative cognitive impairment on the postoperative course of elderly patients (n = 122, >65 years), following spine surgery for degenerative spinal disease. Data on demographic characteristics, medical history, and blood analysis results were collected. Preoperative cognition was assessed using the mini-mental state examination, and patients were divided into three groups: normal cognition, mild cognitive impairment, and moderate-to-severe cognitive impairment. Discharge destinations (p = 0.014) and postoperative cardiopulmonary complications (p = 0.037) significantly differed based on the cognitive status. Operation time (p = 0.049), white blood cell count (p = 0.022), platelet count (p = 0.013), the mini-mental state examination score (p = 0.033), and the Beck Depression Inventory score (p = 0.041) were significantly associated with the length of hospital stay. Our investigation demonstrated that improved understanding of preoperative cognitive status may be helpful in surgical decision-making and postoperative care of elderly patients with degenerative spinal disease.


2015 ◽  
Vol 21 (6) ◽  
pp. 363-366 ◽  
Author(s):  
Alex J. Mitchell

SummaryThe Mini-Mental State Examination (MMSE) is the most widely used bedside cognitive test. It has previously been shown to be poor as a case-finding tool for both dementia and mild cognitive impairment (MCI). This month's Cochrane Corner review examines whether the MMSE might be used as a risk prediction tool for later dementia in those with established MCI. From 11 studies of modest quality, it appears that the MMSE alone should not be relied on to predict later deterioration in people with MCI. As this is the case, it is likely that only a combination of predictors would be able to accurately predict progression from MCI to dementia.


2000 ◽  
Vol 12 (4) ◽  
pp. 463-471 ◽  
Author(s):  
Michael Dwyer ◽  
Gerard J. A. Byrne

Screaming and other types of disruptive vocalization are commonly observed among nursing home residents. Depressive symptoms are also frequently seen in this group, although the relationship between disruptive vocalization and depressive symptoms is unclear. Accordingly, we sought to examine this relationship in older nursing home residents. We undertook a controlled comparison of 41 vocally disruptive nursing home residents and 43 non-vocally-disruptive nursing home residents. All participants were selected to have Mini-Mental State Examination (MMSE) scores of at least 10. Participants had a mean age of 81.0 years (range 63-97 years) and had a mean MMSE score of 17.8 (range 10-29). Nurse ratings of disruptive vocalization according to a semioperationalized definition were validated against the noisy behavior subscale of the Cohen-Mansfield Agitation Inventory. Subjects were independently rated for depressive symptoms by a psychiatrist using the Dementia Mood Assessment Scale, the Cornell Scale for Depression in Dementia, and the Depressive Signs Scale. Vocally disruptive nursing home residents scored significantly higher than controls on each of these three depresion-in-dementia scales. These differences remained significant when the effects of possible confounding variables of cognitive impairment, age, and sex were removed. We conclude that depressive symptoms are associated with disruptive vocalization and may have an etiological role in the generation of disruptive vocalization behaviors in elderly nursing home residents.


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