scholarly journals Association of Cognitive Impairment With Migrant Status Among Older Adults in India: A Cross-Sectional Study

Author(s):  
Shobhit Srivast ◽  
Ruchi Singh ◽  
Prem Shankar Mishra ◽  
Alok Aditya

Abstract Introduction Among various health implications for older adult, cognitive impairment and related dementias are significant public health concern in many low and middle income countries, including India and lack due attention in policy arena. Socio-economic and health vulnerability are associated with cognitive impairment among older adults. Therefore the present study explores the prevalence and determinants of cognitive impairment among older adults in India with special reference to migrant status of older adults. MethodsData for this study was utilized from recent release of Longitudinal Ageing Study in India (LASI) wave 1 2017-19. The LASI is a nationally representative survey over 72000 older adults age 45 and above across all states and union territories of India. The present study is conducted on the eligible respondent’s age 60 years and above. The total sample size for the present study is 31,464 older adults aged 60 years and above (Male-15,068; Female-16,366). Descriptive and logistic regression analysis carried to fulfil the objective of the study. ResultsOverall, the prevalence of cognitive impairment among male older adults was 6.4% and female older adults 19.8%. Non-migrant status (6.8%) was more likely to face cognitive impairment than migrant status (5.7%) among older adults. The high prevalence of cognitive impairment were found with increasing socio-economic, demographic and multi-morbidities among older adults. Older adults (male 6.7% vs. female 20.2%) with no social participation were more likely to be face cognitive impairment. The result of logistic regression of our study is supported the bivariate analysis. Older adults with migrant status were more likely to be suffered from the cognitive impairment with unadjusted [UOR; 1.57, CI: 1.45-1.70] & after adjusting with covariates [AOR; 1.14, CI: 1.03-1.26] as compared to non-migrant status. Among the individual factors, odds of impairment was very high for the oldest-older adults age group [AOR: 2.95, CI: 2.59-3.36] as compared to young-older adults and further, female older adults were more likelihood to be cognitive impairment [AOR: 1.99, CI: 1.77-2.24] than their counterparts. Similar findings were also found with socio-economic and health vulnerability among older adults.Conclusion The study demonstrates that female older adults need more care and support from community and government as they face higher cognitive impairment. Further, the results significantly varied across different socio-economically, demographically, regionally in cognitive impairment and those who were suffering with co-morbidities. Comprehensive primary health care with community health approach may improve the health status of older adults in later period of life.

2019 ◽  
Vol 32 (6) ◽  
pp. 697-703
Author(s):  
Marina Maria Biella ◽  
Alaise Silva Santos de Siqueira ◽  
Marcus Kiiti Borges ◽  
Elyse Soares Ribeiro ◽  
Regina Miksian Magaldi ◽  
...  

ABSTRACTObjective:Decision-making (DM) is a component of executive functioning. DM is essential to make proper decisions regarding important life and health issues. DM can be impaired in cognitive disorders among older adults, but current literature is scarce. The aim of this study was to evaluate the DM profile in participants with and without cognitive impairment.Design:Cross-sectional analysis of a cohort study on cognitive aging.Participants:143 older adults.Setting:University-based memory clinic.Methods:Patients comprised three groups after inclusion and exclusion criteria: healthy controls (n=29), mild cognitive impairment (n=81) and dementia (n=33). Participants were evaluated using an extensive neuropsychological protocol. DM profile was evaluated by the Melbourne Decision Making Questionnaire. Multinomial logistic regression was used to evaluate associations between age, sex, educational level, estimated intelligence quotient (IQ), cognitive disorders, depressive or anxiety symptoms, and the DM profiles.Results:The most prevalent DM profile was the vigilant type, having a prevalence of 64.3%. The vigilant profile also predominated in all three groups. The multinomial logistic regression showed that the avoidance profile (i.e. buck-passing) was associated with a greater presence of dementia (p=0.046) and depressive symptoms (p=0.024), but with less anxious symptoms (p=0.047). The procrastination profile was also associated with depressive symptoms (p=0.048). Finally, the hypervigilant profile was associated with a lower pre-morbid IQ (p=0.007).Conclusion:Older adults with cognitive impairment tended to make more unfavorable choices and have a more dysfunctional DM profile compared to healthy elders.


2019 ◽  
Vol 2 (1) ◽  
pp. 27-33
Author(s):  
Megawati Sinambela ◽  
Evi Erianty Hasibuan

Antenatal care is a service provided to pregnant women to monitor, support maternal health and detect mothers whether normal or problematic pregnant women. According to the WHO, globally more than 70% of maternal deaths are caused by complications of pregnancy and childbirth such as hemorrhage, hypertension, sepsis, and abortion. Based on data obtained from the profile of the North Sumatra provincial health office in 2017, in the city of Padangsidimpuan in 2017 the coverage of ANC visits reached (76.58%) and had not reached the target in accordance with the 2017 Provincial Health Office strategy plan (95%). This type of research was an observational analytic study with a cross sectional design. The population in this study were independent practice midwives who were in the Padangsidimpuan, the sample in this study amounted to 102 respondents. The technique of collecting data used questionnaires and data analysis used univariate, bivariate and multivariate analysis with logistic regression analysis. Based on bivariate analysis showed that there was a relationship between facilities, knowledge and attitudes of independent midwives with compliance with the standards of antenatal care services with a value of p <0.05. The results of the study with multivariate logistic regression analysis showed that the factors associated with the compliance of independent midwives in carrying out antenatal care service standards were attitudes with values (p = 0.026).


Author(s):  
Tran Dai Tri Han ◽  
Keiko Nakamura ◽  
Kaoruko Seino ◽  
Vo Nu Hong Duc ◽  
Thang Van Vo

This study examined the prevalence of cognitive impairment among older adults in central Vietnam and the roles of communication (with or without communication devices) in the association between cognitive impairment and hearing loss. This cross-sectional study was performed on 725 randomly selected community-dwelling older adults aged ≥60 years from Thua Thien Hue province, Vietnam. Participants attended a face-to-face survey. Sociodemographic characteristics, social interaction with or without communication devices, health status and cognitive function using the Mini-Mental State Examination were reported. Ordinal logistic regression analysis was performed to quantify the association between hearing loss and cognitive function by frequency of communication with and without devices. Mild and severe cognitive impairment had prevalence rates of 23.6% and 19.3%, respectively. Cognitive impairment was more prevalent among older adults with hearing-loss, vision loss and difficulties with instrumental activities of daily living (IADL). The association between hearing loss and cognitive impairment was not significant when older adults had frequent communication with others using devices. This study presented the relatively high prevalence of cognitive impairment in community-dwelling older adults in Vietnam. Frequent communication using devices attenuated the association between hearing loss and cognitive impairment.


Author(s):  
Diego Urrunaga-Pastor ◽  
Diego Chambergo-Michilot ◽  
Fernando M. Runzer-Colmenares ◽  
Josmel Pacheco-Mendoza ◽  
Vicente A. Benites-Zapata

<b><i>Introduction:</i></b> Dementia is a chronic disease with a variable prevalence throughout the world; however, this could be higher at high-altitude populations. We aimed to summarize the prevalence of cognitive impairment and dementia in older adults living at high altitude. <b><i>Methods:</i></b> We searched in PubMed, Medline, Scopus, Web of Science, and Embase and included the studies published from inception to July 20, 2020, with no language restriction, which reported the frequency of cognitive impairment or dementia in older adults living at high-altitude populations. Random-effects meta-analyses were performed to calculate the overall prevalence and 95% confidence intervals (95% CI) of cognitive impairment and dementia. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. <b><i>Results:</i></b> Six studies were included (3,724 participants), and 5 of the 6 included studies were carried out in Latin America. The altitude ranged from 1,783 to 3,847 m, the proportion of women included varied from 38.7 to 65.6%, and the proportion of participants with elementary or illiterate educational level ranged from 71.7 to 97.6%. The overall prevalence of cognitive impairment was 22.0% (95% CI: 8–40, <i>I</i><sup>2</sup>: 99%), and the overall prevalence of dementia was 11.0% (95% CI: 6–17, <i>I</i><sup>2</sup>: 92%). In a subgroup analysis according to the instrument used to evaluate cognitive impairment, the prevalence of cognitive impairment was 21.0% (95% CI: 5–42, <i>I</i><sup>2</sup>: 99%) in the MMSE group while the prevalence was 29.0% (95% CI: 0–78) in the non-MMSE group. <b><i>Conclusions:</i></b> The prevalence of cognitive impairment and dementia in older adults living at high altitude is almost twice the number reported in some world regions.


2021 ◽  
pp. 1-10
Author(s):  
Yosuke Yamada ◽  
Hiroyuki Umegaki ◽  
Fumie Kinoshita ◽  
Chi Hsien Huang ◽  
Taiki Sugimoto ◽  
...  

Background: Homocysteine is a common risk factor for cognitive impairment and sarcopenia. However, very few studies have shown an association between sarcopenia and serum homocysteine levels after adjustment for cognitive function. Objective: The purpose of this study was to investigate the relationship between homocysteine and sarcopenia in memory clinic patients. Methods: This cross-sectional study investigated outpatients in a memory clinic. We enrolled 1,774 participants (≥65 years old) with measured skeletal muscle mass index (SMI), hand grip strength (HGS), and homocysteine. All participants had undergone cognitive assessments and were diagnosed with dementia, mild cognitive impairment, or normal cognition. Patient characteristics were compared according to sarcopenia presence, SMI level, or HGS. Multivariate logistic regression analysis was performed to determine the association of homocysteine with sarcopenia, low SMI, or low HGS. Next, linear regression analysis was performed using HGS as a continuous variable. Results: Logistic regression analysis showed that low HGS was significantly associated with homocysteine levels (p = 0.002), but sarcopenia and low SMI were not. In linear regression analysis, HGS was negatively associated with homocysteine levels after adjustment for Mini-Mental State Examination score (β= –2.790, p <  0.001) or clinical diagnosis of dementia (β= –3.145, p <  0.001). These results were similar for men and women. Conclusion: Our results showed a negative association between homocysteine and HGS after adjustment for cognitive function. Our findings strengthen the assumed association between homocysteine and HGS. Further research is needed to determine whether lower homocysteine levels lead to prevent muscle weakness.


Author(s):  
Yoshihiro Kugimiya ◽  
Masanori Iwasaki ◽  
Yuki Ohara ◽  
Keiko Motokawa ◽  
Ayako Edahiro ◽  
...  

Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and sarcopenia in community-dwelling older adults. We included 878 adults (268 men and 610 women, mean age 76.5 ± 8.3 years). Tongue coating index, oral moisture, occlusal force, oral diadochokinesis (/pa/,/ta/,/ka/), tongue pressure, mas-ticatory function, and swallowing function were evaluated as indicators of oral hypofunction. Grip strength, gait speed, and skeletal muscle mass index were measured as diagnostic sarcopenia parameters. The association between oral hypofunction and sarcopenia was examined via logistic regression using sarcopenia as the dependent variable. Oral hypofunction prevalence was 50.5% overall, 40.3% in men, and 54.9% in women. The prevalence of sarcopenia was 18.6% overall, 9.7% in men, and 22.5% in women. A logistic regression showed oral hypofunction, age, body mass index, higher-level functional capacity, and serum albumin level were significantly associated with sarcopenia. Sarcopenia occurred at an increased frequency in patients diagnosed with oral hypofunction (odds ratio: 1.59, 95% confidence interval: 1.02–2.47); accordingly, oral hypofunction appears to be significantly associated with sarcopenia.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049926
Author(s):  
Sandra Angelika Mümken ◽  
Paul Gellert ◽  
Malte Stollwerck ◽  
Julie Lorraine O'Sullivan ◽  
Joern Kiselev

ObjectivesTo develop a German version of the original University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past 4 weeks and to evaluate its construct validity for urban and rural populations of older adults.DesignCross-sectional validation study.SettingTwo study centres in urban and rural German outpatient hospital settings.ParticipantsIn total, N=83 community-dwelling older adults were recruited (n=40 from urban and n=43 from rural areas; mean age was 78.5 years (SD=5.4); 49.4% men).Primary and secondary outcome measuresThe final version of the translated LSA-D was related to limitations in activities and instrumental activities of daily living (ADL/iADL) as primary outcome measure (primary hypothesis); and with sociodemographic factors, functional mobility, self-rated health, balance confidence and history of falls as secondary outcome measures to obtain construct validity. Further descriptive measurements of health included hand grip strength, screening of cognitive function, comorbidities and use of transportation. To assess construct validity, correlations between LSA-D and the primary and secondary outcome measures were examined for the total sample, and urban and rural subsamples using bivariate regression and multiple adjusted regression models. Descriptive analyses of LSA-D included different scoring methods for each region. All parameters were estimated using non-parametric bootstrapping procedure.ResultsIn the multiple adjusted model for the total sample, number of ADL/iADL limitations (β=−0.26; 95% CI=−0.42 to −0.08), Timed Up and Go Test (β=−0.37; 95% CI=−0.68 to −0.14), shared living arrangements (β=0.22; 95% CI=0.01 to 0.44) and history of falls in the past 6 months (β=−0.22; 95% CI=−0.41 to −0.05) showed significant associations with the LSA-D composite score, while living in urban area (β=−0.19; 95% CI=−0.42 to 0.03) and male gender (β=0.15; 95% CI=−0.04 to 0.35) were not significant.ConclusionThe LSA-D is a valid tool for measuring life-space mobility in German community-dwelling older adults within the past 4 weeks in ambulant urban and rural settings.Trial registration numberDRKS00019023.


2020 ◽  
Author(s):  
GRACIA CASTRO-LUNA ◽  
ANTONIO PÉREZ-RUEDA

Abstract Background: The diagnosis of keratoconus in the early stages of the disease is necessary to initiate an early treatment of keratoconus. Furthermore, to avoid possible refractive surgery that could produce ectasias. This study aims to describe the topographic, pachymetric and aberrometry characteristics in patients with keratoconus, subclinical keratoconus and normal corneas. Additionally to propose a diagnostic model of subclinical keratoconus based in binary logistic regression models Methods: The design was a cross-sectional study. It included 205 eyes from 205 patients distributed in 82 normal corneas, 40 early-stage keratoconus and 83 established keratoconus. The rotary Scheimpflug camera (Pentacam® type) analyzed the topographic, pachymetric and aberrometry variables. It performed a descriptive and bivariate analysis of the recorded data. A diagnostic and predictive model of early-stage keratoconus was calculated with the statistically significant variables Results: Statistically significant differences were observed when comparing normal corneas with early-stage keratoconus/ in variables of the vertical asymmetry to 90º and the central corneal thickness. The binary logistic regression model included the minimal corneal thickness, the anterior coma to 90º and posterior coma to 90º. The model properly diagnosed 92% of cases with a sensitivity of 97.59%, specificity 98.78%, accuracy 98.18% and precision 98.78%Conclusions: The differential diagnosis between normal cases and subclinical keratoconus depends on the mínimum corneal thickness, the anterior coma to 90º and the posterior coma to 90º.


2019 ◽  
Author(s):  
Xueyu Chen ◽  
Hui Xi ◽  
Long Ji ◽  
Weijia Xing ◽  
Haifeng Hou ◽  
...  

Abstract Background Hypertension (HTN) and hyperhomocysteinemia (HHcy) have been reported to be independent predictors of cognitive impairment. However, the conclusions were inconsistent and few studies had reported the combination prediction of HTN and HHcy for cognitive impairment. Our study aimed to evaluate the association between H-type HTN, HTN and HHcy and the risk of cognitive impairment.Methods We used a cross-sectional study- participants aged over 40 years, which were selected from Kailuan communities in China. Cognitive impairment was determined by MMSE scale (MMSE<24). Multivariable logistic regression was used to analyze the association of H-type HTN and cognitive impairment, and we also made stratification analysis by age of participants.Results A total of 3454 participants were included in our study, and ≥65 years old was 16.79%; the gender of male was 56.77%. The prevalence of cognitive impairment in the H-type HTN (HTN+/HHcy+) group (10.74%) was significantly higher than other three groups (2.92%, 6.42%, 5.86%, respectively). The logistic regression results showed that participants with H-type HTN was positively associated with cognitive impairment risk (OR = 2.57, 95% CI: 1.38-4.80). Similar results were observed in participants stratified by age (65 years) (<65 years old: OR =2.01, 95% CI: 0.87- 4.67 ; ≥65 years old: OR=3.63, 95% CI: 1.32-10.01).Conclusion Our finding indicated that H-type HTN was positively associated with the risk of cognitive impairment, especially in ≥ 65 years old. H-type HTN could be the major intervention measures to decrease the incidence of cognitive impairment as well as the stroke in Health Practice Management.


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