Association between Stroke and Cognitive Decline in Community Dwelling Older and Oldest People: The SONIC Study

Abstract Background Increasing in the older people and a decline in mortality after stroke, the rate of post-stroke cognitive decline has increased. The relationship between risk factors and post-stroke cognitive decline in dwelling old and oldest people who living in the community especially with asymptomatic stroke have to be elucidated. Therefore, the aim of this study is to investigate the association between stroke and cognitive decline during three years in community dwelling older and oldest people.Methods This study was longitudinal study with a 3-year follow-up in urban and rural areas of Japan. The participants were 1,333 community dwelling older and oldest people (70 years old = 675, 80 years old = 589, and 90 years old = 69). Data collected included basic data (age, sex, and history of stroke), vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, and current smoking), and social factors (educational level, frequency of going outdoors, and long-term care (LTC) service used). The Japanese version of the Montreal Cognitive Assessment (MoCA-J) was used for cognitive assessment, and a decline of ≥ 2 points was defined as cognitive decline. Multiple logistic regression analysis was used to investigate the association between stroke and other risk factors with cognitive decline during a 3-year follow-up.Results Rates of cognitive decline increased in advanced ages, equaling 33.3, 39.4, and 66.7% in those aged 70, 80, and 90 years old, respectively. The fit of the hypothesized model by multiple logistic regression showed that a history of stroke, advanced age, and greater MoCA-J score at the baseline were important risk factors, while the presence of dyslipidemia and a higher educational level were protective factors that were significantly correlated with cognitive decline during the 3-year follow-up.Conclusions The cognitive decline after the 3-year follow-up was influenced by the history of stroke, advanced age, and greater MoCA-J score at the baseline, but protective factors were the presence of dyslipidemia and a higher educational level. Therefore, these factors are considered important and should be taken into consideration when searching for creative solutions to prevent cognitive decline after stroke in community dwelling older and oldest people.

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The Importance of Stroke as a Risk Factor of Cognitive Decline in Community Dwelling Older and Oldest peoples : The SONIC Study

10.21203/rs.2.15994/v3 ◽

2020 ◽

Author(s):

Werayuth Srithum ◽

Mai Kabayama ◽

Yasuyuki Gondo ◽

Yukie Masui ◽

Yuya Akagi ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Risk Factor ◽

Protective Factors ◽

Cognitive Decline ◽

Educational Level ◽

Community Dwelling ◽

Multiple Logistic Regression ◽

History Of

Abstract Background: Cognitive impairment is a major health concern among older and oldest people.Moreover, stroke is a relevant contributor for cognitive decline and development of dementia. The study of cognitive decline focused on stroke as the important risk factor by recruiting older and oldest is still lagging behind. Therefore, the aim of this study was to investigate the importance of stroke as a risk factor of cognitive decline during three years in community dwelling older and oldest people. Methods: This study was longitudinal study with a 3-year follow-up in Japan. The participants were 1,333community dwelling older and oldest people (70 years old = 675, 80 years old = 589, and 90 years old = 69). Data collected included basic data (age, sex, and history of stroke), vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, and current smoking), and social factors (educational level, frequency of going outdoors, long-term care (LTC) service used, and residential area). The Japanese version of the Montreal Cognitive Assessment (MoCA-J) was decline of ≥ 2 points was defined as cognitive decline. Multiple logistic regression analysis was used to investigate the association between stroke and other risk factors with cognitive decline during a 3-year follow-up. Results: The fit of the hypothesized model by multiple logistic regression showed that a history of stroke, advanced age, and greater MoCA-J score at the baseline were important risk factors, while the presence of dyslipidemia and a higher educational level were protective factors that were significantly correlated with cognitive decline during the 3-year follow-up. Conclusions: The cognitive decline after the 3-year follow-up was influenced by the history of stroke and advanced age, while greater MoCA-J score at the baseline was positively associated with subsequent 3 years cognitive decline. The protective factors were the presence of dyslipidemia and a higher educational level. Therefore, these factors are considered important and should be taken into consideration when searching for creative solutions to prevent cognitive decline after stroke in community dwelling older and oldest people.

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The Importance of Stroke as a Risk Factor of Cognitive Decline in Community Dwelling Older and Oldest peoples : The SONIC Study

10.21203/rs.2.15994/v2 ◽

2020 ◽

Author(s):

Werayuth Srithum ◽

Mai Kabayama ◽

Yasuyuki Gondo ◽

Yukie Masui ◽

Yuya Akagi ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Risk Factor ◽

Protective Factors ◽

Cognitive Decline ◽

Educational Level ◽

Community Dwelling ◽

Multiple Logistic Regression ◽

History Of

Abstract Background: Increasing older people make a cognitive impairment is a major health concerns among older and oldest people. Moreover, the stroke is a relevant contribution for cognitive decline and development of dementia.The study of cognitive decline focused on stroke as the important risk factor by recruiting older and oldest still lagging behind. Therefore, the aim of this study was to investigate the importance of stroke as a risk factor of cognitive decline during three years in community dwelling older and oldest people. Methods: This study was longitudinal study with a 3-year follow-up in Japan.The participants were1,333community dwelling older and oldest people (70 years old = 675, 80 years old = 589, and 90 years old = 69). Data collected included basic data (age, sex, and history of stroke), vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, and current smoking), and social factors (educational level, frequency of going outdoors, long-term care (LTC) service used, and residential area). The Japanese version of the Montreal Cognitive Assessment (MoCA-J) was decline of ≥ 2 points was defined as cognitive decline. Multiple logistic regression analysis was used to investigate the association between stroke and other risk factors with cognitive decline during a 3-year follow-up. Results: The fit of the hypothesized model by multiple logistic regression showed that a history of stroke, advanced age, and greater MoCA-J score at the baseline were important risk factors, while the presence of dyslipidemia and a higher educational level were protective factors that were significantly correlated with cognitive decline during the 3-year follow-up. Conclusions: The cognitive decline after the 3-year follow-up was influenced by the history of stroke and advanced age, while greater MoCA-J score at the baseline was associated with decline of the score after 3-year, but it was not supposed to be risk.The protective factors were the presence of dyslipidemia and a higher educational level. Therefore, these factors are considered important and should be taken into consideration when searching for creative solutions to prevent cognitive decline after stroke in community dwelling older and oldest people.

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Predictors of Cognitive Decline in 85-Year-Old Patients Without Cognitive Impairment at Baseline

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/1533317512475021 ◽

2013 ◽

Vol 28 (2) ◽

pp. 147-153 ◽

Cited By ~ 10

Author(s):

Francesc Formiga ◽

Assumpta Ferrer ◽

David Chivite ◽

Jesus Alburquerque ◽

Claudia Olmedo ◽

...

Keyword(s):

Cognitive Decline ◽

Mini Mental State Examination ◽

Oldest Old ◽

Multiple Logistic Regression Analysis ◽

Community Dwelling ◽

Multiple Logistic Regression ◽

Community Based ◽

Old Patients ◽

State Examination

Background/Rationale: To determine how many 85-year-old community-dwelling patients with good cognitive performance at baseline maintain this level at 2-year follow-up. Methods: We realized a longitudinal community-based study including 169 inhabitants. Patients who maintained scores >23 on the Spanish version of the Mini-Mental State Examination (MEC) were compared with the rest. Results: A total of 144 individuals (85.2%) were found maintaining a MEC score >23. Under the combined criteria 110 (65%) presented no new cognitive decline. Multiple logistic regression analysis showed that maintaining a MEC score >23 was significantly associated with having a higher MEC score at baseline ( P < .001, odds ratio 1.280, 95% confidence interval 1.104-1.484). Conclusion: Most oldest-old patients with good cognitive function at baseline maintain this level at 2-year follow-up.

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Influence of ApoE Genotype and Clock T3111C Interaction with Cardiovascular Risk Factors on the Progression to Alzheimer’s Disease in Subjective Cognitive Decline and Mild Cognitive Impairment Patients

Journal of Personalized Medicine ◽

10.3390/jpm10020045 ◽

2020 ◽

Vol 10 (2) ◽

pp. 45 ◽

Cited By ~ 3

Author(s):

Valentina Bessi ◽

Juri Balestrini ◽

Silvia Bagnoli ◽

Salvatore Mazzeo ◽

Giulia Giacomucci ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Cardiovascular Risk ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Cardiovascular Risk Factors ◽

Subjective Cognitive Decline ◽

Apoe Ε4 ◽

History Of

Background: Some genes could interact with cardiovascular risk factors in the development of Alzheimer’s disease. We aimed to evaluate the interaction between ApoE ε4 status, Clock T3111C and Per2 C111G polymorphisms with cardiovascular profile in Subjective Cognitive Decline (SCD) and Mild Cognitive Impairment (MCI). Methods: We included 68 patients who underwent clinical evaluation; neuropsychological assessment; ApoE, Clock and Per2 genotyping at baseline; and neuropsychological follow-up every 12–24 months for a mean of 13 years. We considered subjects who developed AD and non-converters. Results: Clock T3111C was detected in 47% of cases, Per2 C111G in 19% of cases. ApoE ε4 carriers presented higher risk of heart disease; Clock C-carriers were more frequently smokers than non C-carriers. During the follow-up, 17 patients progressed to AD. Age at baseline, ApoE ε 4 and dyslipidemia increased the risk of conversion to AD. ApoE ε4 carriers with history of dyslipidemia showed higher risk to convert to AD compared to ApoE ε4− groups and ApoE ε4+ without dyslipidemia patients. Clock C-carriers with history of blood hypertension had a higher risk of conversion to AD. Conclusions: ApoE and Clock T3111C seem to interact with cardiovascular risk factors in SCD and MCI patients influencing the progression to AD.

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Biological, Social, and Economic Risk Factors of Child Tuberculosis in Surakarta Central Java: A Multiple Logistic Regression

Childhood Stunting, Wasting, and Obesity, as the Critical Global Health Issues: Forging Cross-Sectoral Solutions ◽

10.26911/the7thicph.01.45 ◽

2020 ◽

Author(s):

Dyah Ayu Saputri ◽

◽

Yulia Lanti Retno Dewi ◽

Bhisma Murti ◽

◽

...

Keyword(s):

Public Health ◽

Risk Factors ◽

Logistic Regression ◽

Nutritional Status ◽

Exclusive Breastfeeding ◽

Family Income ◽

Smoke Exposure ◽

Multiple Logistic Regression ◽

Central Java ◽

History Of

ABSTRACT Background: Tuberculosis (TB) disease in children under 15 years (pediatric TB) is a public health problem of special significance because it is a marker for recent transmission of TB. This study aimed to analyze biological, social, and economic risk factors of child TB. Subjects and Method: A case control study was carried out at 25 villages in Surakarta, from August to September 2019. A sample of 200 chilren aged 0-18 years was selected by fixed disease sampling. The dependent variable was TB. The independent variables were birthweight, BCG immunization, exclusive breastfeeding, nutritional status, family income, smoke exposure, family history of TB. Data on TB cases were obtained from medical record. The other variables were collected by questionnaire. The data were analyzed by a multiple logistic regression. Results: The risk of TB increased with poor house sanitation (OR= 4.50; 95% CI= 1.18 to 17.12; p= 0.027), smoke exposure (OR= 4.13; 95% CI= 1.05 to 16.22; p= 0.042), and had history of TB (OR= 5.54; 95% CI= 1.49 to 20.61; p= 0.011). The risk of TB decreased with normal birthweight ≥2,500 g (OR= 0.18; 95% CI= 0.05 to 0.57; p= 0.003), BCG immunization (OR= 0.18; 95% CI= 0.06 to 0.58 p= 0.004), exclusive breastfeeding (OR= 0.11; 95% CI= 0.02 to 0.55; p= 0.006), good nutritional status (OR= 0.10; 95% CI= 0.02 to 0.48; p= 0.004), and family income ≥Rp1,802,700 (OR= 0.09; 95% CI= 0.02 to 0.36; p= 0.001). Conclusion: The risk of TB increases with poor house sanitation, smoke exposure, and had history of TB. The risk of TB decreases with normal birthweight ≥2,500 g, BCG immunization, exclusive breastfeeding, good nutritional status, and high family income. Keywords: Tuberkulosis, biological, sosial dan ekonomi. Correspondence: Dyah Ayu Saputri. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile: 081353236388. DOI: https://doi.org/10.26911/the7thicph.01.45

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Risk Factors for Revisiting After Emergency Department Discharge: a Longitudinal Retrospective Chart Review

10.21203/rs.3.rs-62406/v1 ◽

2020 ◽

Author(s):

Chie Teramoto ◽

Satoko Nagata ◽

Takashi Naruse ◽

Susumu Nakajima ◽

Shinichiroh Yokota ◽

...

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Logistic Regression ◽

Chart Review ◽

Multiple Logistic Regression Analysis ◽

Retrospective Chart Review ◽

Multiple Logistic Regression ◽

Enabling Factors ◽

History Of ◽

Hospital Use

Abstract Background: Emergency department (ED) patients are often discharged after treatment for minor illnesses. However, many of these patients revisit the ED. This study aimed to describe ED revisit rate and investigate the risk factors for 3-day/30-day ED revisit. Methods: A longitudinal retrospective chart review was used to extract data regarding predisposing factors (e.g. gender, age), enabling factors (e.g. economic status, ambulance use) and need factors (e.g. diagnosis at ED discharge, history of diseases), from the medical charts of patients discharged from an ED in Tokyo, Japan, from February to December 2013. Multiple logistic regression analyses were used to predict 3-day/30-day ED revisit based on initial visit information. Results: During the studied period, 8,754 patients were discharged from the ED, of whom 48.8% were men, and the mean age was 39.7 years. Of these, 338 (3.9%) revisited the ED within three days and 682 (7.8%) revisited the ED within 30 days of discharge. In the multiple logistic regression analysis, risk factors for 3-day ED revisits were: having a history of same hospital use, arriving by ambulance, having a common problem (e.g. fever), and history of asthma. Risk factors for 30-day ED revisits were using health care services and having a history of same hospital use. Conclusions: In this study, the rate of ED revisit was less than that reported by other studies, which might be because most patients included in this study usually visited the hospital. Our results show that the predictive factors for 3-day/30-day ED revisit in Japan were similar to those in other countries. Patients with the abovementioned factors should be carefully screened on their initial ED visit, and some follow-up care in clinical and community settings should be arranged.

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History of Falls, Dementia, Lower Education Levels, Mobility Limitations, and Aging Are Risk Factors for Falls among the Community-Dwelling Elderly: A Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18179356 ◽

2021 ◽

Vol 18 (17) ◽

pp. 9356

Author(s):

Yan-Yuh Lee ◽

Chien-Liang Chen ◽

I-Chen Lee ◽

I-Ching Lee ◽

Nai-Ching Chen

Keyword(s):

Risk Factors ◽

Community Dwelling ◽

Mobility Limitations ◽

Mild Dementia ◽

Education Levels ◽

History Of ◽

Lower Education ◽

Risk Factors For Falls ◽

Community Dwellers

Background: Falling is a serious issue among elderly community dwellers, often resulting in disability. We aimed to investigate the risk factors for falls among elderly community dwellers. Methods: We recruited 232 participants from multiple community learning and care centers, who provided their information through questionnaires. They were divided into two groups, according to their falling events after a 1-year follow-up. Univariate and multivariate logistic regressions were used for statistical analysis. Results: A total of 64 participants reported a fall at the 1-year follow-up. The falling group comprised older and single people with lower education levels, higher rates of dementia, a history of falls, lower scores on the Mini-Mental State Examination, and more disability functions when compared to the non-falling group (all p < 0.05). The regression model showed that a history of falls (OR: 62.011; p < 0.0001), lower education levels (OR: 4.088; p = 0.039), mild dementia (OR: 20.729; p = 0.028), older age (OR: 1.176; p < 0.0001), walking for 300 m (OR: 4.153; p = 0.030), and running for 30 m (OR: 3.402; p = 0.015) were 1-year risk factors for falls. Conclusion: A history of falling, low education levels, aging, mild dementia, and certain mobility limitations were strong risk factors for future falling accidents in elderly Taiwanese community dwellers.

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A longitudinal study of cognitive decline in rural Tanzania: rates and potentially modifiable risk factors

International Psychogeriatrics ◽

10.1017/s1041610217002861 ◽

2018 ◽

Vol 30 (9) ◽

pp. 1333-1343 ◽

Cited By ~ 7

Author(s):

Jessica Heward ◽

Lydia Stone ◽

Stella-Maria Paddick ◽

Sarah Mkenda ◽

William K. Gray ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Decline ◽

Grip Strength ◽

Functional Disability ◽

Screening Program ◽

Community Dwelling ◽

Sub Saharan Africa ◽

Modifiable Risk Factors ◽

Dementia Risk

ABSTRACTBackground:The number of people living with dementia in sub-Saharan Africa (SSA) is expected to increase rapidly in the coming decades. However, our understanding of how best to reduce dementia risk in the population is very limited. As a first step in developing intervention strategies to manage dementia risk in this setting, we investigated rates of cognitive decline in a rural population in Tanzania and attempted to identify associated factors.Methods:The study was conducted in the rural Hai district of northern Tanzania. In 2014, community-dwelling people aged 65 years and over living in six villages were invited to take part in a cognitive screening program. All participants from four of the six villages were followed-up at two years and cognitive function re-tested. At baseline and follow-up, participants were assessed for functional disability, hypertension, and grip strength (as a measure of frailty). At follow-up, additional assessments of visual acuity, hearing impairment, tobacco and alcohol consumption, and clinical assessment for stroke were completed.Results:Baseline and follow-up data were available for 327 people. Fifty people had significant cognitive decline at two-year follow-up. Having no formal education, low grip strength at baseline, being female and having depression at follow-up were independently associated with cognitive decline.Conclusions:This is one of the first studies of cognitive decline conducted in SSA. Rates of decline at two years were relatively high. Future work should focus on identification of specific modifiable risk factors for cognitive decline with a view to developing culturally appropriate interventions.

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Effects of Digital Device Ownership on Cognitive Decline in a Middle-Aged and Elderly Population: Longitudinal Observational Study

Journal of Medical Internet Research ◽

10.2196/14210 ◽

2019 ◽

Vol 21 (7) ◽

pp. e14210 ◽

Cited By ~ 6

Author(s):

Yinzi Jin ◽

Mingxia Jing ◽

Xiaochen Ma

Keyword(s):

Risk Factors ◽

Cognitive Function ◽

Protective Factors ◽

Cognitive Decline ◽

Health Condition ◽

Digital Device ◽

Digital Devices ◽

Standard Deviations ◽

At Home

Background Cognitive decline is a major risk factor for disability and death and may serve as a precursor of dementia. Digital devices can provide a platform of cognitively stimulating activities which might help to slow cognitive decline during the process of normal aging. Objective This longitudinal study aimed to examine the independent protective factors of desktop and cellphone ownership against cognitive decline in mid-life and older adulthood and to examine the combined effect of desktop and cellphone ownership on the same outcome. Methods Data was obtained from a China Health and Retirement Longitudinal Studies (CHARLS) cohort made up of 13,457 community-dwelling adults aged 45 years or above in 2011-2012. They were followed for 4 years, with baseline measurements taken as well as 2 two-year follow-up visits. Cognitive function was tested during the baseline test and follow-up visits. A global cognition z-score was calculated based on two domains: word recall and mental intactness. The key independent variables were defined as: whether one had desktops with internet connection at home and whether one had a cellphone. An additional categorical variable of three values was constructed as: 0 (no desktop or cellphone), 1 (desktop or cellphone alone), and 2 (desktop and cellphone both). Mixed-effects regression was adjusted for demographic and health behavior as well as health condition risk factors. Results Adjusted for demographic and health behavior as well as health condition risk factors, desktop and cellphone ownership were independently associated with subsequent decreased cognitive decline over the four-year period. Participants without a desktop at home had an adjusted cognitive decline of –0.16 standard deviations (95% CI –0.18 to –0.15), while participants with a desktop at home had an adjusted cognitive decline of –0.10 standard deviations (95% CI –0.14 to –0.07; difference of –0.06 standard deviations; P=.003). A similar pattern of significantly protective association of 0.06 standard deviations (95% CI 0.03-0.10; P<.001) between cellphone ownership and cognitive function was observed over the four-year period. Additionally, a larger longitudinal protective association on cognitive decline was observed among those with both of the digital devices, although the 95% CIs for the coefficients overlapped with those with a single digital device alone. Conclusions Findings from this study underscored the importance of digital devices as platforms for cognitively stimulating activities to delay cognitive decline. Future studies focusing on use of digital devices are warranted to investigate their longitudinal protective factors against cognitive decline at mid- and later life.

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Incidence and risk factors for late-life depression in the Ibadan Study of Ageing

Psychological Medicine ◽

10.1017/s0033291710002643 ◽

2011 ◽

Vol 41 (9) ◽

pp. 1897-1906 ◽

Cited By ~ 16

Author(s):

O. Gureje ◽

B. Oladeji ◽

T. Abiona

Keyword(s):

Risk Factors ◽

Composite International Diagnostic Interview ◽

Diagnostic Interview ◽

Community Dwelling ◽

World Health ◽

Late Life Depression ◽

History Of ◽

Health Organization ◽

Subsyndromal Symptoms

BackgroundWe present the incidence and risk factors for major depressive disorder (MDD) among community-dwelling elderly Nigerians.MethodA cohort study of persons aged ⩾65 years residing in eight contiguous Yoruba-speaking states in south-west and north-central Nigeria was conducted between November 2003 and December 2007. Of the 2149 baseline sample, 1408 (66%) were successfully followed up after approximately 39 months. Face-to-face in-home assessments were conducted with the World Health Organization (WHO) Composite International Diagnostic Interview, version 3 (CIDI.3) and diagnosis was based on the DSM-IV. Incident MDD was determined in the group with no prior lifetime history of MDD at baseline and who were free of dementia at follow-up (n=892).ResultsDuring the follow-up period, 308 persons had developed incident MDD, representing a rate of 104.3 [95% confidence interval (CI) 93.3–116.6] per 1000 person-years. Compared to males, the age-adjusted hazard for females was 1.63 (95% CI 1.30–2.06). Lifetime or current subsyndromal symptoms of depression at baseline did not increase the risk of incident MDD. Among females, but not males, rural residence and poor social network were risk factors for incident MDD. Physical health status at baseline did not predict new onset of MDD.ConclusionsThe finding of a high incidence of MDD among elderly Nigerians complements earlier reports of a high prevalence of the disorder in this understudied population. Social factors, in particular those relating to social isolation, constitute a risk for incident MDD.

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