scholarly journals The Paradoxical Effect of Living Alone on Cognitive Reserve and Mild Cognitive Impairment among Women Aged 60+ in Mexico City

Author(s):  
Antonio R. Villa ◽  
Elsa Guerrero ◽  
Ana M. Villa ◽  
Rosalinda Sánchez-Arenas ◽  
María Araceli Ortiz-Rodríguez ◽  
...  

An elderly person who lives alone must often be autonomous and self-sufficient in daily living activities. We explored if living alone and marital status were associated with mild cognitive impairment and low cognitive reserve in a sample of Mexican women aged 60+ attending continuing education courses using a cross-sectional design. Objective cognitive functions were assessed using the MMSE and Blessed Dementia Scale. We administered the Cognitive Reserve Questionnaire. Independence skills were assessed with the Katz index and Lawton index. Multivariate logistic regression analysis was used. We recruited 269 participants (x¯ = 69.0 ± 5.8 years). Single, widowed, separated, and divorced women comprised 73% of the participants. A third lived alone and 84% had completed high school. Mild cognitive deficit was observed among 24.5–29.0%; the upper range for cognitive reserve was 61.7%. Living alone versus living with someone was associated with cognitive impairment (OR = 0.51, p = 0.04) and with low to medium cognitive reserve (OR = 0.51, p = 0.02) after adjusting for confounding variables. Living alone was an independent factor associated with a lower probability of displaying mild cognitive impairment and a higher probability of displaying high cognitive reserve. Women living alone in this study had a more robust cognitive framework and had built their own support networks.

2021 ◽  
Vol 55 (5) ◽  
pp. 407-415
Author(s):  
Mulalibieke Heizhati ◽  
Nanfang Li ◽  
Lin Wang ◽  
Jing Hong ◽  
Mei Li ◽  
...  

<b><i>Background:</i></b> Relationship between hypertension and mild cognitive impairment (MCI) remains undetermined in population from less-developed regions. We aimed to explore whether hypertension is associated with MCI in this specific population. <b><i>Methods:</i></b> In this cross-sectional study, we enrolled subjects aged ≥18 years using multistage random sampling from Emin, China, in 2019. Participants underwent questionnaires and data collection including mini-mental state examination (MMSE) and blood pressure measurement. <b><i>Results:</i></b> Finally, 31,329 subjects were included, with 11,270 hypertensives. Compared with normotensive subjects, hypertensives were characterized by significantly older age (55.19 ± 12.25 vs. 43.26 ± 12.71), more men (52.5% vs. 42.9%), low education attainment (≤primary education: 42.4% vs. 26.3%), more abdominal obesity (39.7% vs. 19.1%), poor sleep quality (39.1% vs. 28.7%), and chronic kidney disease (6.6% vs. 3.4%, <i>p</i> for all &#x3c;0.001). Prevalence of MCI in hypertensives was significantly higher than that of normotensive subjects (24.3% vs. 15.6%, <i>p</i> &#x3c; 0.001). Multivariate logistic regression analysis showed in a fully adjusted model that the odds for MCI were significantly increased in hypertensives than in normotensive population (OR = 1.19, 95% CI: 1.09, 1.30, <i>p</i> &#x3c; 0.001) and independent of all the parameters studied including age, education level, and stroke. In the age-stratified regression model, presence of hypertension significantly increased the odds of MCI by 1.17-fold (95% CI: 1.03, 1.33, <i>p</i> = 0.020) and by 1.22-fold (95% CI: 1.04, 1.44, <i>p</i> = 0.016) in middle-aged and elderly population. Sensitivity analysis of excluding those with stroke history showed that hypertension was still a risk factor for MCI in total, middle-aged, and elderly population. <b><i>Conclusion:</i></b> Hypertension is in independent negative association with MCI in middle-aged and elderly population from underdeveloped regions.


2020 ◽  
Vol 18 (3) ◽  
pp. 2017
Author(s):  
Klejda Harasani ◽  
Delina Xhafaj ◽  
Anxhela Begolli ◽  
Maria C. Olvera-Porcel

Background: Potentially inappropriate prescribing is clearly associated with adverse health consequences among older people. Nevertheless, scarce evidence exists regarding the prevalence of potentially inappropriate prescriptions (PIP) in Albania, a Western Balkans country. Objective: The aim of this study was to assess the prevalence of PIP among older Albanian patients in primary care and to determine the associated sociodemographic and medical factors, including the presence of mild cognitive impairment (MCI). Methods: Cross-sectional study in two primary healthcare centers located in two different cities of Albania, a middle-income country in the Western Balkans. The Montreal Cognitive Assessment (MoCA) tool was applied to evaluate MCI. PIPs were assessed by two trained pharmacists using the Beers criteria 2019 update. Multivariate logistic regression analysis was conducted for possible risk factors predicting PIP in the study population. Results: At least one PIP was identified among 40.23 % of the participants (174 older patients) and 10.35 % had more than one PIP. MCI was detected among 79.31 % of the patients. The most commonly represented drug groups in PIP were diuretics (24.71 %), benzodiazepines in the presence of MCI and antidepressants (both 8.62 %). The lack of electrolytes monitoring was the most common reason for PIP. According to the multivariate analysis, the only statistically significant association observed was between PIP and number of drugs prescribed [three to four drugs (OR 3.34; 95% CI 1.65:6.76), five or more than five drugs (OR 4.08; 95% CI 1.42:11.69)]. Conclusions: About four out of 10 older Albanian patients experience PIP in primary care. Further studies are needed for a comprehensive estimation of the prevalence and factors associated with PIP, particularly among elderly with mild cognitive impairment.


2020 ◽  
Vol 28 (4) ◽  
pp. 386-390
Author(s):  
Robert Haussmann ◽  
Amrei F E von Lieres und Wilkau ◽  
Cathrin Sauer ◽  
Fabienne Nilles ◽  
Markus Donix

Objective: Cognitive reserve influences age of onset, speed of progression, and clinical manifestations of Alzheimer’s disease. We investigated whether cognitive reserve interacts with clinical and neuropsychological parameters in mild cognitive impairment (MCI). Methods: In this cross-sectional study, we recruited 273 people (70.6 ± 10.1 years, 54.6% women) suffering from subjective memory complaints ( n = 65), MCI ( n = 121), or dementia ( n = 87). Patients underwent neuropsychological evaluation, laboratory testing, and brain imaging. Additionally, we obtained information on years of education and help-seeking motivation. Results: MCI patients with a university degree were significantly older than those without (71.6 ± 9.6 vs. 66.9 ± 10.3, p = 0.02). University-educated MCI patients demonstrated superior performance in verbal fluency. Intrinsic help-seeking motivation (self-referral) was associated with higher cognitive reserve. Female MCI patients presented with greater intrinsic motivation. Conclusion: Cognitive reserve modulates clinical and neuropsychological measures in patients with MCI.


2021 ◽  
Author(s):  
Elizabeth Jimenez-Puig ◽  
Ana Cristina Baute-Abreu ◽  
Daniela Liz Valdes-Perez ◽  
Yeisel Santana-Dominguez ◽  
Marina Jesus Anon-Villegas ◽  
...  

Introduction: Aging is a natural process that occurs in all individuals. Due to the increase in aging figures worldwide, the diagnosis of mild cognitive impairment and other dementia syndromes has increased. An element of essential relevance in protecting against the risk of suffering from dementia is the cognitive reserve. Objective: To indicate the levels of cognitive reserve in a sample of Cuban older adults with Mild Cognitive Impairment. Methods: An exploratory study was carried out using questionnaires, with a cross-sectional, quantitative design. The sampling was non-probabilistic and intentional, obtaining a sample of 51 older adults with mild cognitive impairment. The information collection was carried out from the Cognitive Reserve Scale (CRS). Quantitative data was analyzed through frequency analysis. Results: Most of the participants showed higher levels of cognitive reserve for carrying out activities of daily life and for relating to other people. The dimensions most affected were Formation / Information and Hobbies. Conclusions: The research allowed a preliminary approach to the cognitive reserve of older adults. It would be interesting to conduct investigations of this nature in larger samples, including groups of healthy controls, which would allow comparison of results. In addition, it would be relevant to investigate the impact of institutionalization. Keywords: older adult, cognitive reserve, Mild Cognitive Impairment.


2020 ◽  
Vol 17 (6) ◽  
pp. 556-565
Author(s):  
Yujie Guo ◽  
Pengfei Li ◽  
Xiaojun Ma ◽  
Xiaochen Huang ◽  
Zhuoheng Liu ◽  
...  

Background: The present study was designed to examine the association of circulating cholesterol with cognitive function in non-demented community aging adults. Methods: This was a cross-sectional study including 1754 Chinese adults aged 55-80 years. The association between serum cholesterol levels and cognitive function was examined. Participants were categorized into four groups according to the quartile of circulating TC (total cholesterol), High Density Lipoprotein Cholesterol (HDL-c), Low Density Lipoprotein Cholesterol (LDL-c) levels and HDLc/ LDL-c ratio. The difference in cognitive performance among the groups was compared. Logistic regression model was used to determine the association of circulating cholesterol level with the risk of Mild Cognitive Impairment (MCI). Results: Mild increase of serum LDL-c level correlated with better visual and executive, language, memory and delayed recall abilities. Higher circulating TC and HDL-c levels were found to be associated with poorer cognitive function, especially in aging female subjects. Higher circulating TC, HDL-c and HDL/LDL ratio indicated an increased risk of MCI, especially in female subjects. Conclusion: Slight increase in circulating LDL-c level might benefit cognitive function in aging adults. However, higher circulating TC and HDL-c levels might indicate a decline of cognitive function, especially in aging female subjects.


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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chengbo Zeng ◽  
Shan Qiao ◽  
Xiaoming Li ◽  
Xueying Yang ◽  
Zhiyong Shen ◽  
...  

Abstract Background Existing literature mostly consider HIV disclosure as a static event and investigate its relationship with stress using a cross-sectional design. It is unclear about the dynamic changes of HIV disclosure levels (defined as the number of disclosure targets) and how stress may influence these changes. This study explored different disclosure levels using a person-centered longitudinal approach, examined whether stress could predict these disclosure levels, and investigated if this relationship differed by gender among people living with HIV (PLWH). Methods Data were derived from a prospective cohort study conducted from November 2016 to January 2018 in Guangxi, China. Four hundred forty-four PLWH were included. Participants were assessed on perceived stress, sociodemographic characteristics, and number of HIV disclosure targets at baseline, 6-month, and 12-month follow-ups. Growth mixture modeling was used to characterize disclosure levels based on the changes of disclosure target number. Multinomial logistic regression was used to predict disclosure levels with baseline stress after adjusting for covariates. The interaction effect of stress by gender was examined. Adjusted odds ratio (AOR) with its 95% confidence interval were reported to show the strength of association.  Results Three levels of disclosure were characterized as “Low levels of disclosure” (Level One), “Increased levels of disclosure” (Level Two), and “High levels of disclosure” (Level Three). Accordingly, 355 (81.2%), 28 (6.4%), and 64 (12.4%) of PLWH were categorized respectively under low, increased, and high levels of disclosure. The interaction of baseline stress by gender was significant in differentiating Level One from Three (AOR = 0.85 [0.74 ~ 0.99]) while it was not significant between Level One and Two (AOR = 0.96 [0.81 ~ 1.15]). Compared to female, male PLWH with higher baseline stress had lower probability to have consistent high disclosure levels over time. PLWH who were married/cohabited had lower probability of being classified into consistent high levels of disclosure than low level (AOR = 0.43 [0.19 ~ 0.94]). Conclusions There was gender difference in the relationship between stress and levels of HIV disclosure. To promote HIV disclosure, gender tailored interventions should be employed to help PLWH cope with stress.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e046879
Author(s):  
Bernhard Grässler ◽  
Fabian Herold ◽  
Milos Dordevic ◽  
Tariq Ali Gujar ◽  
Sabine Darius ◽  
...  

IntroductionThe diagnosis of mild cognitive impairment (MCI), that is, the transitory phase between normal age-related cognitive decline and dementia, remains a challenging task. It was observed that a multimodal approach (simultaneous analysis of several complementary modalities) can improve the classification accuracy. We will combine three noninvasive measurement modalities: functional near-infrared spectroscopy (fNIRS), electroencephalography and heart rate variability via ECG. Our aim is to explore neurophysiological correlates of cognitive performance and whether our multimodal approach can aid in early identification of individuals with MCI.Methods and analysisThis study will be a cross-sectional with patients with MCI and healthy controls (HC). The neurophysiological signals will be measured during rest and while performing cognitive tasks: (1) Stroop, (2) N-back and (3) verbal fluency test (VFT). Main aims of statistical analysis are to (1) determine the differences in neurophysiological responses of HC and MCI, (2) investigate relationships between measures of cognitive performance and neurophysiological responses and (3) investigate whether the classification accuracy can be improved by using our multimodal approach. To meet these targets, statistical analysis will include machine learning approaches.This is, to the best of our knowledge, the first study that applies simultaneously these three modalities in MCI and HC. We hypothesise that the multimodal approach improves the classification accuracy between HC and MCI as compared with a unimodal approach. If our hypothesis is verified, this study paves the way for additional research on multimodal approaches for dementia research and fosters the exploration of new biomarkers for an early detection of nonphysiological age-related cognitive decline.Ethics and disseminationEthics approval was obtained from the local Ethics Committee (reference: 83/19). Data will be shared with the scientific community no more than 1 year following completion of study and data assembly.Trial registration numberClinicalTrials.gov, NCT04427436, registered on 10 June 2020, https://clinicaltrials.gov/ct2/show/study/NCT04427436.


Sign in / Sign up

Export Citation Format

Share Document