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Moreno-Noguez M, Castillo-Cruz J, García-Cortés LR, Gómez-Hernández HR. [Risk factors associated with cognitive impairment in aged: Cross-sectional study]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:S395-S406. [PMID: 37934797 PMCID: PMC10732693 DOI: 10.5281/zenodo.8319815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 02/15/2023] [Indexed: 11/09/2023]
Abstract
Background With the increase in life expectancy, conditions related to older age have increased in incidence, one of these pathologies is Cognitive Impairment (CI), which has a prevalence of up to 28%, conditions that increase the presence of CI are known. However, there is controversy about the factors that increase the risk of CI. Objective To determine the factors associated with cognitive impairment in older adults. Material and methods We conducted a cross-sectional, analytical, observational, retroprolective study that included adults ≥65 years of age, with no history of cerebral vascular event, cranioencephalic trauma. Demographic factors were analyzed, CI was assessed with the Mini Mental State Examination test. For statistical analysis we used Odds Ratio (OR) and 95% confidence interval (95% CI) for each factor and multiple logistic regression as multivariate analysis. Results 420 older adults were included, 61% were women, 32.6% with age >75 years, 84.5% with schooling <9 years, in the multiple logistic regression the following were independent factors for the presence of mild CI: dependence on basic activities of daily living (ADLs) with OR 5.88, absence of cognitive stimulation RM 4.50, age >75 years OR 2.92, polypharmacy OR 2.16, uncontrolled blood pressure OR 1.92. Conclusion ADLs dependence, absence of cognitive stimulation, age >75 years, polypharmacy and uncontrolled blood pressure are risk factors associated with CI in older adults.
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Affiliation(s)
- Moises Moreno-Noguez
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 55, Departamento de Enseñanza. Zumpango, Estado de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Juan Castillo-Cruz
- Instituto Politécnico Nacional, Facultad de Medicina, Unidad de Posgrado. Ciudad de México, MéxicoInstituto Politécnico NacionalMéxico
| | - Luis Rey García-Cortés
- Instituto Mexicano del Seguro Social, Órgano de Operación Administrativa Desconcentrada Regional Estado de México Oriente, Jefatura de Prestaciones Médicas. Naucalpan, Estado de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Haynna Raquel Gómez-Hernández
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 52, Consulta Externa. Cuautitlán Izcalli, Estado de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
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Fu X, Eikelboom RH, Tian R, Liu B, Wang S, Jayakody DMP. The Relationship of Age-Related Hearing Loss with Cognitive Decline and Dementia in a Sinitic Language-Speaking Adult Population: A Systematic Review and Meta-Analysis. Innov Aging 2023; 7:igac078. [PMID: 36873915 PMCID: PMC9976757 DOI: 10.1093/geroni/igac078] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Indexed: 12/24/2022] Open
Abstract
Background and Objectives Substantial evidence supports the association between untreated hearing loss, cognitive decline, and dementia in the non-tonal language-speaking population. Whether a similar association between hearing loss and cognitive decline and dementia exists in Sinitic tonal language-speaking people is yet to be elucidated. We aimed to systematically review the current evidence on the association between hearing loss and cognitive impairment/decline, and dementia in older adults who speak a Sinitic tonal language. Research Design and Methods This systematic review considered peer-reviewed articles that employed objective or subjective hearing measurement and cognitive function, cognitive impairment, or diagnosis of dementia. All articles written in English and Chinese and published before March 2022 were included. Databases including Embase, MEDLINE, Web of Science, PsycINFO and Google Scholar, SinoMed, and CBM were utilized using MeSH terms and keywords. Results Thirty-five articles met our inclusion criteria. Of these, 29 unique studies with an estimated 372,154 participants were included in the meta-analyses. Among all included studies, the effect size of cognitive function with hearing loss, the regression coefficient was -0.26 (95% confidence interval [CI], -0.45 to -0.07). Among cross-sectional and cohort studies, a significant association was found between hearing loss and cognitive impairment and dementia, with odds ratios of 1.85 (95% CI, 1.59-2.17) and 1.89 (95% CI, 1.50-2.38), respectively. Discussion and Implications Most of the studies included in this systematic review observed a significant association between hearing loss and cognitive impairment and dementia. There was no significant difference to the findings in non-tonal language populations.
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Affiliation(s)
- Xinxing Fu
- Beijing Institute of Otolaryngology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Centre for Ear Sciences, Medical School, The University of Western Australia, Crawley, Western Australia, Australia
| | - Robert H Eikelboom
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa.,Brain and Hearing, Ear Science Institute Australia, Subiaco, Western Australia, Australia
| | - Rong Tian
- Centre for Ear Sciences, Medical School, The University of Western Australia, Crawley, Western Australia, Australia
| | - Bo Liu
- Beijing Institute of Otolaryngology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Shuo Wang
- Beijing Institute of Otolaryngology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Dona M P Jayakody
- Centre for Ear Sciences, Medical School, The University of Western Australia, Crawley, Western Australia, Australia.,Brain and Hearing, Ear Science Institute Australia, Subiaco, Western Australia, Australia
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Lin H, Zhang L, Lin D, Chen W, Zhu Y, Chen C, Chan KC, Liu Y, Chen W. Visual Restoration after Cataract Surgery Promotes Functional and Structural Brain Recovery. EBioMedicine 2018; 30:52-61. [PMID: 29548900 PMCID: PMC5952227 DOI: 10.1016/j.ebiom.2018.03.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/01/2018] [Accepted: 03/04/2018] [Indexed: 01/19/2023] Open
Abstract
Background Visual function and brain function decline concurrently with aging. Notably, cataract patients often present with accelerated age-related decreases in brain function, but the underlying mechanisms are still unclear. Optical structures of the anterior segment of the eyes, such as the lens and cornea, can be readily reconstructed to improve refraction and vision quality. However, the effects of visual restoration on human brain function and structure remain largely unexplored. Methods A prospective, controlled clinical trial was conducted. Twenty-six patients with bilateral age-related cataracts (ARCs) who underwent phacoemulsification and intraocular lens implantation and 26 healthy controls without ARC, matched for age, sex, and education, were recruited. Visual functions (including visual acuity, visual evoke potential, and contrast sensitivity), the Mini-Mental State Examination and functional magnetic resonance imaging (including the fractional amplitude of low-frequency fluctuations and grey matter volume variation) were assessed for all the participants and reexamined for ARC patients after cataract surgery. This trial was registered with ClinicalTrials.gov (NCT02644720). Findings Compared with the healthy controls, the ARC patients presented decreased brain functionality as well as structural alterations in visual and cognitive-related brain areas preoperatively. Three months postoperatively, significant functional improvements were observed in the visual and cognitive-related brain areas of the patients. Six months postoperatively, the patients' grey matter volumes in these areas were significantly increased. Notably, both the function and structure in the visual and cognitive-related brain areas of the patients improved significantly and became comparable to those of the healthy controls 6 months postoperatively. Interpretation We demonstrated that ocular reconstruction can functionally and structurally reverse cataract-induced brain changes. The integrity of the eye is essential for maintaining the structure and function of the brain within and beyond the primary visual pathway. Cataract patients with reduced visual function presented a simultaneous decrease in brain function and grey matter volume. Cataract surgery can reverse cerebral changes in both visual and cognitive-related regions associated with visual decline. The integrity of the eye is essential for maintaining the structure and function of the brain.
The eyes and brain are anatomically and functionally connected. Age related cataract (ARC) is associated with structural and functional impairments of the brain. However, whether these changes are reversible after cataract surgery is largely unknown. We assessed the patients based on subjective cognitive evaluations and objective functional magnetic resonance imaging before and after surgery. Significant improvements in brain function and increases in the grey matter volumes of the visual, cognitive-related, and somatosensory brain areas were observed, demonstrating that the impaired brain function and structure of ARC patients can be reversed after restoration of visual acuity.
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Affiliation(s)
- Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China.
| | - Li Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China; Department of Ophthalmology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, People's Republic of China
| | - Duoru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China
| | - Wan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China
| | - Yi Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China; Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Chuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China; Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Kevin C Chan
- NYU Eye Center, Department of Ophthalmology, NYU School of Medicine, NYU Langone Health, New York University, New York, NY 10016, USA; Department of Radiology, NYU School of Medicine, NYU Langone Health, New York University, New York, NY 10016, USA
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China.
| | - Weirong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China.
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