Generic placeholder image

Current Psychiatry Research and Reviews

Editor-in-Chief

ISSN (Print): 2666-0822
ISSN (Online): 2666-0830

Research Article

Biopsychosocial Predictors of Cognitive Impairment in the Elderly: A Case-control Study

Author(s): Zahra Roshani, Ahmad-Ali Akbari Kamrani and Yadollah Abolfathi Momtaz*

Volume 16, Issue 2, 2020

Page: [119 - 126] Pages: 8

DOI: 10.2174/2666082216666200705234912

Price: $65

Abstract

Background: Cognitive impairment is one of the most common diseases in the elderly. Several studies have already been conducted to identify related factors, but few have explored all the factors involved in the development of cognitive problems.

Objective: The present study aimed to identify significant biopsychosocial predictors of cognitive impairment.

Methods: This case-control study was conducted on 535 elderly people referred to Shafa Clinic in the city of Tehran in 2017. The biological factors including serum cholesterol, fasting blood sugar, systolic and diastolic blood pressure, vitamin D, vitamin B12, serum folate, serum homocysteine, height, and weight were measured. The psychological variable in this study was a history of depression that was extracted from the medical records. Social network and social support were measured by LSNS-6 and MOS-SSS questionnaires. The SPSS version 25 was used to analyze the data.

Results: The mean age of the control group was 68.4 years (SD = 5.89) and of the case group was 71.5 years (SD = 7.37). The results of multiple logistic regression analysis showed age (AOR=1.05; CI:1.089-1.016, p≤0.05,), Secondary education (AOR=0.51; CI:0.266-0.990, p<0.05,), Tertiary education (AOR=0.41; CI:0.212-0.810, p<0.01,), hypertension (AOR=2.16; CI:3.671-1.266, p<0.01) homocysteine level (AOR=1.09; CI:1.147-1.045, p<0.001,), Hypothyroidism (AOR=0.43; CI: 0.226 0.820, p<0.001,), and depression (AOR=4.5; CI:7.163-2.822, p<0.001) to be significant predictors of cognitive impairment.

Conclusion: Results of this study showed that low education level, high blood pressure, high level of homocysteine and depression likely increase the risk of cognitive impairment; also, it was implied that timely screening can identify people at risk. The novelty of the present study is that it used a combination of the biopsychosocial factors to predict unique predictors of cognitive impairment.

Keywords: Age, biopsychosocial factors, cognitive impairment, dementia, depression, older adults.

Graphical Abstract

[1]
Zanjari N, Sadeghi R, Delbari A. Analysis of gender differences in time use among Iranian older adults. Salmand Iran J Ageing 2019; 13(5): 588-603.
[http://dx.doi.org/10.32598/SIJA.13.Special-Issue.588]
[2]
Mirzaie M, Darabi S. Population aging in Iran and rising health care costs. Salmand Iran J Ageing 2017; 12(2): 156-69.
[http://dx.doi.org/10.21859/sija-1202156]
[3]
Eshaghi SR, Farajzadegan Z, Babak A. Healty lifestyle assessment questionnaire in elderly: translation, reliability and validity. Payesh 2010; 9(1): 91-9.
[4]
Eshkoor SA, Hamid TA, Mun CY, Ng CK. Mild cognitive impairment and its management in older people. Clin Interv Aging 2015; 10: 687-93.
[http://dx.doi.org/10.2147/CIA.S73922] [PMID: 25914527]
[5]
Bordet R, Ihl R, Korczyn AD, et al. Towards the concept of disease-modifier in post-stroke or vascular cognitive impairment: a consensus report. BMC Med 2017; 15(1): 107.
[http://dx.doi.org/10.1186/s12916-017-0869-6] [PMID: 28539119]
[6]
Pennisi M, Lanza G, Cantone M, et al. Acetyl-L-Carnitine in dementia and other cognitive disorders: a critical update. Nutrients 2020; 12(5): 1389.
[http://dx.doi.org/10.3390/nu12051389] [PMID: 32408706]
[7]
Cantone M, Catalano MA, Lanza G, et al. Motor and perceptual recovery in adult patients with mild intellectual disability. Neural Plast 2018; 20183273246
[http://dx.doi.org/10.1155/2018/3273246] [PMID: 29849555]
[8]
Lanza G, Casabona JA, Bellomo M, et al. Update on intensive motor training in spinocerebellar ataxia: time to move a step forward? J Int Med Res 2019.
[http://dx.doi.org/10.1177/0300060519854626]
[9]
Lanza G, Centonze SS, Destro G, et al. Shiatsu as an adjuvant therapy for depression in patients with Alzheimer’s disease: a pilot study. Complement Ther Med 2018; 38: 74-8.
[http://dx.doi.org/10.1016/j.ctim.2018.04.013] [PMID: 29857884]
[10]
Fisicaro F, Lanza G. Repetitive transcranial magnetic stimulation in stroke rehabilitation: review of the current evidence and pitfalls 2019; 12 1756286419878317.
[http://dx.doi.org/10.1177/1756286419878317]
[11]
Fisicaro F, Lanza G, Bella R, Pennisi M. “Self-Neuroenhancement”: the last frontier of noninvasive brain stimulation? J Clin Neurol 2020; 16(1): 158-9.
[http://dx.doi.org/10.3988/jcn.2020.16.1.158] [PMID: 31942774]
[12]
World Health Organization Dementia 2020 [cited 2019 June 17]. Available from: . https://www.who.int/news-room/fact-sheets/detail/dementia
[13]
Prince M, Guerchet M, Prina M. Alzheimer’s Disease International Policy Brief for Heads of Government: The Global Impact of Dementia 2013-2050. Alzheimer’s Disease International London 2013.
[14]
Sharifi F, Fakhrzadeh H, Varmaghani M, et al. Prevalence of dementia and associated factors among older adults in Iran: National Elderly Health Survey (NEHS). Arch Iran Med 2016; 19(12): 838-44.
[PMID: 27998158]
[15]
Russ TC, Gatz M, Pedersen NL, et al. Geographical variation in dementia: examining the role of environmental factors in Sweden and Scotland. Epidemiology 2015; 26(2): 263-70.
[http://dx.doi.org/10.1097/EDE.0000000000000230] [PMID: 25575031]
[16]
McGuire LC, Ford ES, Ajani UA. Cognitive functioning as a predictor of functional disability in later life. Am J Geriatr Psychiatry 2006; 14(1): 36-42.
[http://dx.doi.org/10.1097/01.JGP.0000192502.10692.d6] [PMID: 16407580]
[17]
Mohammadzadeh J, Sayehmiri K. Standardization of social support scale (MOS) of adults who have chronic diseases in Ilam, 2015. Sci J Ilam Uni Med Sci 2016; 23(7): 69-77.
[18]
Hamid TA, Momtaz YA, Ibrahim R. Predictors and prevalence of successful aging among older Malaysians. Gerontology 2012; 58(4): 366-70.
[http://dx.doi.org/10.1159/000334671] [PMID: 22179496]
[19]
Park T, Reilly-Spong M, Gross CR. Mindfulness: a systematic review of instruments to measure an emergent patient-reported outcome (PRO). Qual Life Res 2013; 22(10): 2639-59.
[http://dx.doi.org/10.1007/s11136-013-0395-8] [PMID: 23539467]
[20]
Alzheimer’s Association. 2019 Alzheimer’s disease facts and figures. Alzheimer’s Association 2019; 15(3): 321-87.
[http://dx.doi.org/10.1016/j.jalz.2019.01.010]
[21]
Li M, Gao Y, Cui J, et al. Cognitive impairment and risk factors in elderly people living in fluorosis areas in China. Biol Trace Elem Res 2016; 172(1): 53-60.
[http://dx.doi.org/10.1007/s12011-015-0568-0] [PMID: 26606914]
[22]
Sampedro-Piquero P, Begega A. Environmental enrichment as a positive behavioral intervention across the lifespan. Curr Neuropharmacol 2017; 15(4): 459-70.
[http://dx.doi.org/10.2174/1570159X14666160325115909] [PMID: 27012955]
[23]
Victor CR, Scambler SJ, Bowling A, Bond J. The prevalence of, and risk factors for, loneliness in later life: a survey of older people in Great Britain. Ageing Soc 2005; 25(6): 357-75.
[http://dx.doi.org/10.1017/S0144686X04003332]
[24]
Bhattathiry M. A Case-control study to identify the risk factors of dementia among clinically diagnosed patients in Kerala. Int Neuropsychiatr Dis J 2017; 9(1): 1-8.
[http://dx.doi.org/10.9734/INDJ/2017/31691]
[25]
Ruitenberg A, Hofman A, Stricker BH, Breteler MM. Antihypertensive drugs and incidence of dementia: the Rotterdam study. Neurobiol Aging 2001; 22(3): 407-12.
[http://dx.doi.org/10.1016/S0197-4580(00)00241-4] [PMID: 11378246]
[26]
Reitz C, Luchsinger JA. Hypertension, cognitive impairment and dementia: an epidemiological perspective. Curr Hypertens Rev 2007; 3(3): 166-76.
[http://dx.doi.org/10.2174/157340207781386747] [PMID: 22545032]
[27]
Reitz C, Tang M-X, Manly J, Mayeux R, Luchsinger JA. Hypertension and the risk of mild cognitive impairment. Arch Neurol 2007; 64(12): 1734-40.
[http://dx.doi.org/10.1001/archneur.64.12.1734] [PMID: 18071036]
[28]
Obisesan TO. Hypertension and cognitive function. Clin Geriatr Med 2009; 25(2): 259-88.
[http://dx.doi.org/10.1016/j.cger.2009.03.002] [PMID: 19555872]
[29]
Cito A, Porcelli B, Coppola MG, Mangiavacchi P, Cortelazzo A, Terzuoli L. WITHDRAWN: Analysis of serum levels of homocysteine and oxidative stress markers in patients with Alzheimer disease. Elsevier 2010.
[30]
Van Dam F, Van Gool WA. Hyperhomocysteinemia and Alzheimer’s disease: a systematic review. Arch Gerontol Geriatr 2009; 48(3): 425-30.
[http://dx.doi.org/10.1016/j.archger.2008.03.009] [PMID: 18479766]
[31]
Aisen PS, Schneider LS, Sano M, et al. Alzheimer disease cooperative study. High-dose B vitamin supplementation and cognitive decline in Alzheimer disease: a randomized controlled trial. JAMA 2008; 300(15): 1774-83.
[http://dx.doi.org/10.1001/jama.300.15.1774] [PMID: 18854539]
[32]
Bagheri-Dizaj M, Alavi Naeini A, Yekaninejadi MS, Mirzaei K. The relationship between dietary patterns and mild cognitive impairment in retired elderly women in Tehran. Med J Mashhad Uni Med Sci 2016; 58(10): 590-602.
[33]
Baldini IM, Vita A, Mauri MC, et al. Psychopathological and cognitive features in subclinical hypothyroidism. Prog Neuropsychopharmacol Biol Psychiatry 1997; 21(6): 925-35.
[http://dx.doi.org/10.1016/S0278-5846(97)00089-4] [PMID: 9380789]
[34]
Resta F, Triggiani V, Barile G, et al. Subclinical hypothyroidism and cognitive dysfunction in the elderly. Endocr Metab Immune 2012; 12(3): 260-7.
[http://dx.doi.org/10.2174/187153012802002875]
[35]
Wu T, Flowers JW, Tudiver F, Wilson JL, Punyasavatsut N. Subclinical thyroid disorders and cognitive performance among adolescents in the United States. BMC Pediatr 2006; 6(1): 12.
[http://dx.doi.org/10.1186/1471-2431-6-12] [PMID: 16623938]
[36]
Djurovic M, Pereira AM, Smit JWA, et al. Cognitive functioning and quality of life in patients with Hashimoto thyroiditis on long-term levothyroxine replacement. Endocrine 2018; 62(1): 136-43.
[http://dx.doi.org/10.1007/s12020-018-1649-6] [PMID: 29959689]
[37]
de Jongh RT, Lips P, van Schoor NM, et al. Endogenous subclinical thyroid disorders, physical and cognitive function, depression, and mortality in older individuals. Eur J Endocrinol 2011; 165(4): 545-54.
[http://dx.doi.org/10.1530/EJE-11-0430] [PMID: 21768248]
[38]
Roberts LM, Pattison H, Roalfe A, et al. Is subclinical thyroid dysfunction in the elderly associated with depression or cognitive dysfunction? Ann Intern Med 2006; 145(8): 573-81.
[http://dx.doi.org/10.7326/0003-4819-145-8-200610170-00006] [PMID: 17043339]
[39]
Parsaik AK, Singh B, Roberts RO, et al. Hypothyroidism and risk of mild cognitive impairment in elderly persons: a population-based study. JAMA Neurol 2014; 71(2): 201-7.
[http://dx.doi.org/10.1001/jamaneurol.2013.5402] [PMID: 24378475]
[40]
Samuels MH. Psychiatric and cognitive manifestations of hypothyroidism. Curr Opin Endocrinol Diabetes Obes 2014; 21(5): 377-83.
[http://dx.doi.org/10.1097/MED.0000000000000089] [PMID: 25122491]
[41]
Miller KJ, Parsons TD, Whybrow PC, et al. Memory improvement with treatment of hypothyroidism. Int J Neurosci 2006; 116(8): 895-906.
[http://dx.doi.org/10.1080/00207450600550154] [PMID: 16861154]
[42]
Dugbartey AT. Neurocognitive aspects of hypothyroidism. Arch Intern Med 1998; 158(13): 1413-8.
[http://dx.doi.org/10.1001/archinte.158.13.1413] [PMID: 9665349]
[43]
Leszek J, Trypka E, Koutsouraki E, et al. Late-life depression and alzheimer disease: a potential synergy of the underlying mechanisms. Curr Med Chem 2018; 25(39): 5389-94.
[http://dx.doi.org/10.2174/0929867323666160902152829] [PMID: 27593962]
[44]
Kessing LV, Andersen PK. Does the risk of developing dementia increase with the number of episodes in patients with depressive disorder and in patients with bipolar disorder? J Neurol Neurosurg Psychiatry 2004; 75(12): 1662-6.
[http://dx.doi.org/10.1136/jnnp.2003.031773] [PMID: 15548477]
[45]
Vinciguerra L, Lanza G, Puglisi V, et al. Update on the neurobiology of vascular cognitive impairment: from lab to clinic. Int J Mol Sci 2020; 21(8): 2977.
[http://dx.doi.org/10.3390/ijms21082977] [PMID: 32340195]
[46]
Bella R, Pennisi G, Cantone M, et al. Clinical presentation and outcome of geriatric depression in subcortical ischemic vascular disease. Gerontology 2010; 56(3): 298-302.
[http://dx.doi.org/10.1159/000272003] [PMID: 20051663]
[47]
Green AF, Rebok G, Lyketsos CG. Influence of social network characteristics on cognition and functional status with aging. Int J Geriatr Psychiatry 2008; 23(9): 972-8.
[http://dx.doi.org/10.1002/gps.2023]
[48]
Glei DA, Landau DA, Goldman N, Chuang Y-L, Rodríguez G, Weinstein M. Participating in social activities helps preserve cognitive function: an analysis of a longitudinal, population-based study of the elderly. Int J Epidemiol 2005; 34(4): 864-71.
[http://dx.doi.org/10.1093/ije/dyi049] [PMID: 15764689]
[49]
Paúl C, Ribeiro O, Santos P. Cognitive impairment in old people living in the community. Arch Gerontol Geriatr 2010; 51(2): 121-4.
[http://dx.doi.org/10.1016/j.archger.2009.09.037] [PMID: 19819569]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy