DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20205196

A cross-sectional study on prevalence of cognitive impairment and its associated factors among the elderly in an urban area of Chennai, India

Rajesh J., Ramasubramanian R., Santhanam R. S.

Abstract


Background: Elderly people often experience cognitive decline with aging. Existing longitudinal studies report that older adults with mild cognitive impairment (MCI) have a 10-15% annual risk of converting to probable Alzheimer’s disease (AD). Objectives were to determine the prevalence of cognitive impairment among the elderly in an urban area of Chennai and to assess the factors associated with cognitive impairment among the elderly.

Methods: This Community based Cross sectional study was conducted between July and October 2019 among 77 individuals aged 60 years and above from an urban area in Chennai, Pudupet. After the institutional ethics committee approval, subjects were interviewed with a pre-designed semi-structured questionnaire followed by administration of standardized mini mental state examination (SMMSE) tool and scoring. Data was analysed using relevant descriptive and inferential statistics with trial version of SPSS.v.25. and OpenEpi software.

Results: The overall prevalence (95% CI) of cognitive impairment was 35.06 % (25.35%, 46.20%). Its prevalence among males and females were 26.08 % (12.55%, 46.47%) and 38.88 (27.04%, 52.21%) respectively. The mean age (95% CI) of study subjects with cognitive impairment was 66.37 years (64.58, 68.16). Those subjects who led a solitary life, had less than 10 years of schooling, used kerosene as cooking fuel and consumed bore well water had significant association with cognitive impairment.

Conclusions: Usage of cooking fuel like LPG and consumption of filtered and purified water could minimize cognitive impairment. Early detection of cognitive impairment would improve the health care and quality of life of the elderly.


Keywords


Cognitive impairment, Dementia, SMMSE, Elderly mental health

Full Text:

PDF

References


Consensus writing group of experts on diagnosis and treatment of cognitive impairment in the elderly, Geriatric neurology group of geriatric medicine branch of Chinese medical association. Expert advice on the diagnosis and treatment process of cognitive impairment in the elderly in China. Chin J Geriatr. 2014;33:817-25.

CDC. Cognitive Impairment: A call for action, now! U.S. Department of Health and Human Services. Centers for disease control and prevention. Atlanta, Georgia. 2011.

Knopman DS, Petersen RC. Mild Cognitive Impairment and Mild Dementia: A Clinical Perspective. Mayo Clin Proc. 2014;89(10):1452-9.

Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med. 2004;256(3):183-94.

Gauthier S, Reisberg B, Zaudig M, Petersen RC, Ritchie K, Broich K et al. Mild cognitive impairment. Lancet. 2006;367:1262-70.

Kluger A, Gianutsos JG, Golomb J, Wagner Jr A, Wagner D, Scheurich S. Clinical features of MCI: motor changes. Int. Psychogeriatr. 2008;20:32-9.

Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Arch. Neurol. 1999;56:303-8.

De Carli C. Mild cognitive impairment: prevalence, prognosis, aetiology, and treatment. Lancet Neurol. 2003;2:15-21.

Saxton J, Morrow L, Eschman A, Archer G, Luther J, Zuccolotto A. Computer assessment of mild cognitive impairment. Postgrad Med. 2009;121(2):177-85.

Manly JJ, Tang MX, Schupf N, Stern Y, Vonsattel JP, Mayeux R. Frequency and course of mild cognitive impairment in a multiethnic community. Ann. Neurol. 2008;63(4):494-506.

Petersen RC, Roberts RO, Knopman DS, Boeve BF, Geda YE, Ivnik RJ, et al. Mild cognitive impairment: ten years later. Arch. Neurol. 2009;66(12):1447-55.

Minhas S, Khanum A, Riaz F, Khan S, Alvi A. Predicting Progression from Mild Cognitive Impairment to Alzheimer's Disease using Autoregressive Modelling of Longitudinal and Multimodal Biomarkers. 2017;22(3):1-1.

Spasov S, Passamonti L, Duggento A, Lio P, Toschi N. A parameter-efficient deep learning approach to predict conversion from mild cognitive impairment to Alzheimer's disease within three years. Neuro Image. 2019;189:276-87.

Ashford WJ, Borson S, O’Hara R, Dash P, Frank L, et al. Should older adults be screened for dementia? Alzheimers and dementia. 2006;2:76-85.

Zamboni G, Wilcock G. Lack of awareness of symptoms in people with dementia: the structural and functional basis. Int J Geriatr Psychiatry. 2011;26(8):783-92.

Johnson E, Torres I. Unawareness of deficits in Alzheimer’s disease and other dementias: operational definitions and empirical findings. Neuropsychol Rev. 2005;15(3):147-66.

Aalten P, Valen VE, Clare L, Kenny G, Verhey F. Awareness in dementia: a review of clinical correlates. Aging Ment Health. 2005;9(5):414-22.

Silva MR, Moser D, Pflüger M, Pusswald G, Stögmann E, Dal-Bianco P et al. Self-reported and informant-reported memory functioning and awareness in patients with mild cognitive impairment and Alzheimer´s disease. neuropsychiatrie. 2016;30(2):103-12.

Torres AH, Strauss VE, Viitanen M, Winblad B, Fratiglioni L. Institutionalization in the elderly: the role of chronic diseases and dementia. Cross-sectional and longitudinal data from a population-based study. J Clin Epidemiol. 2001;54(8):795-801.

Yang L, Jin X, Yan J, Jin Y, Xu S, Xu Y et al. Comparison of prevalence and associated risk factors of cognitive function status among elderly between nursing homes and common communities of China: A strobe-compliant observational study. Med. 2019;98:49(e18248).

The Dementia India Report 2010. Prevalence, impact, costs and services for dementia. Alzheimer’s and Related Disorders Society of India, New Delhi. 2010:13-15.

IHPA. Standardised Mini-Mental State Examination (SMMSE) Guidelines for administration and scoring instructions. Independent Hospital Pricing authority. Australia. 2014. Available at: https://www.ihpa.gov.au/what-we-do/standardised-mini-mental-state-examination-smmse. Accessed 10 June 2019.

Ren L, Zheng Y, Wu L, Gu Y, He Y, Jiang B et al. Investigation of the prevalence of Cognitive Impairment and its risk factors within the elderly population in Shanghai, China. Scientific Reports. 2018;8:3575.

Liu H, Zhang Y, Burgard SA, Needham BL. Marital status and cognitive impairment in the United States: evidence from the National Health and Aging Trends Study. Annals Epidemiol. 2019;38:28-34.

Cheng ST, Lam LC, Chow PK. Under-recognition of dementia in long-term care homes in Hong Kong. Aging Ment Health. 2012;16:516-20.

Shadlen MF, Siscovick D, Fitzpatrick AL, Dulberg C, Kuller LH, Jackson S. Education, cognitive test scores, and black‐white differences in dementia risk. J Ame Geriatr Soci. 2006;54(6):898-905.

Krishnamoorthy Y, Sarveswaran G, Sivaranjini K, Sakthivel M, Majella MG, and Ganesh Kumar SG. Association between Indoor Air Pollution and Cognitive Impairment among Adults in Rural Puducherry, South India. J Neurosci Rural Pract. 2018; 9(4):529-34.

Rondeau V, Commenges D, Jacqmin-Gadda H, Dartigues JF. Relation between aluminum concentrations in drinking water and Alzheimer’s disease: an 8-year follow-up study. Am J Epidemiol. 2000;152:59-66.

Guyonnet SG, Andrieu S, Nourhashemi F, Guéronnière VDL, Grandjean H, Vellas B. Cognitive impairment and composition of drinking water in women: findings of the EPIDOS Study. Am J Clin Nutr. 2005;81:897-902.

Kessing LV, Gerds TA, Knudsen NN, Jorgensen LF, Kristiansen SM, Voutchkova D, et al. Association of Lithium in Drinking Water with the Incidence of Dementia. JAMA Psychiatry. 2017;74(10):1005-10.

Sabia S, Fayosse A, Dumurgier J, Dugravot A, Akbaraly T, Britton A, et al. Alcohol consumption and risk of dementia: 23 year follow-up of Whitehall II cohort study. BMJ. 2018;362:k2927.

Rusanen M, Kivipelto M, Quesenberry CP, Zhou J, Whitmer RA. Heavy smoking in midlife and long-term risk of Alzheimer disease and vascular dementia. Archive Intern Med. 2011;171(4):333-9.

Srinivasan V, Braidy N, Chan EK, Xu YH, Chan DK. Genetic and environmental factors in vascular dementia: an update of blood brain barrier dysfunction. Clin Exp Pharmacol Physiol. 2016;43(5):515-21.

Hou Q, Guan Y, Yu W, Liu X, Wu L, Xiao M et al. Associations between obesity and cognitive impairment in the Chinese elderly: an observational study. Clinical Interventions in Aging. 2019;14:367-73.

Xue M, Xu W, Ou YN, Cao XP, Tan MS, Tan L et al. Diabetes mellitus and risks of cognitive impairment and dementia: A systematic review and meta-analysis of 144 prospective studies. Ageing Res Reviews. 2019;55:1-9.

Ebady SA, Arami MA, Shafigh MH. Investigation on the relationship between diabetes mellitus type 2 and cognitive impairment. Dia Res Clin Pract. 2008;82:305-9.

Zhou Y, Fang R, Liu LH, Chen SD, Tang HD. Clinical Characteristics for the Relationship between Type-2 Diabetes Mellitus and Cognitive Impairment: A Cross-Sectional Study. Aging and Disease. 2015;6(4):236-44.

Obisesan TO. Hypertension and Cognitive Function. Clin Geriatr Med. 2009;25:259-88.

Cherubini A, Lowenthal DT, Paran E, Mecocci P, Williams LS, Senin U. Hypertension and cognitive function in the elderly. Dis Mon. 2010;56:106-47.

De Carli C. Blood pressure control and cognitive performance: something to think about with aging. JAMA. 2015;313:1963-4.