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Haldar P, Tripathi M, Prasad K, Kant S, Dwivedi SN, Vibha D, Pandit AK, Srivastava AK, Kumar A, Ikram MA, Henning T. Association of obstructive sleep apnea and sleep quality with cognitive function: a study of middle-aged and elderly persons in India. Sleep Breath 2024; 28:975-987. [PMID: 38055152 DOI: 10.1007/s11325-023-02953-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/28/2023] [Accepted: 11/20/2023] [Indexed: 12/07/2023]
Abstract
INTRODUCTION Symptoms of obstructive sleep apnea (OSA) and poor sleep quality affect around one in ten people in India. We aimed to determine if OSA symptoms and poor sleep quality are independently associated with cognition in middle-aged and elderly urban Indian populations. METHODS We studied the cross-sectional association between OSA symptoms (by Berlin Questionnaire), poor sleep quality (by Pittsburgh Sleep Quality Index), and cognitive function in adults ≥ 50 years. Using a standard neuropsychological battery for cognitive function, a G-factor was derived as the first rotated principal component assessing domains of information processing, memory, and executive function. The associations of exposures with cognitive measures were modeled using linear regression, adjusted for metabolic risk factors, lifestyle factors, and psychosocial problems, followed by stratified analysis by decadal age group. RESULTS A total of 7505 adults were enrolled. Excluding those with MMSE < 26 (n 710), of 6795 individuals (49.2% women), mean (SD) age 64.2 (9.0) years, 38.3% had high risk of OSA symptoms, and 15.9% had poor sleep quality. OSA symptoms were negatively associated with cognitive domains of information processing (adjusted beta coefficient of z-score - 0.02, p-value 0.006), memory (- 0.03, 0.014), and G-factor (- 0.11, 0.014) in full-model. Stratified analysis by age group showed significant adverse effects of OSA symptoms on cognition for middle-aged people (50-60 years) (- 0.26, 0.001), but not in later age groups. Poor sleep quality was also associated with lower cognitive scores for G-factor (- 0.48, < 0.001), memory (- 0.08, 0.005), and executive domains (- 0.12, < 0.001), but not with information domain. CONCLUSION The findings suggest that both symptoms of OSA and poor sleep quality have a direct adverse impact on cognition in an Indian setting. A modest effect of age on the relationship of OSA and cognition was also observed.
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Affiliation(s)
- Partha Haldar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Kameshwar Prasad
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India.
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sada Nand Dwivedi
- Formerly at: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Awadh Kishor Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Amit Kumar
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India
| | - MArfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Tiemeier Henning
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Alkhawaldeh A, Alsaraireh M, ALBashtawy M, Rayan A, Khatatbeh M, Alshloul M, Aljezawi M, ALBashtawy S, Musa A, Abdalrahim A, Khraisat O, AL-Bashaireh A, ALBashtawy Z, Alhroub N. Assessment of Cognitive Impairment and Related Factors Among Elderly People in Jordan. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2024; 29:120-124. [PMID: 38333338 PMCID: PMC10849287 DOI: 10.4103/ijnmr.ijnmr_169_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/08/2023] [Accepted: 10/06/2023] [Indexed: 02/10/2024]
Abstract
Background With an increase in elderly people, it is essential to address the issue of cognitive impairment and support healthy aging. This study aimed to assess cognitive impairment and factors associated with it among older adults. Materials and Methods A cross-sectional study was carried out in different catchment areas within the Jerash governorate in the north of Jordan. The Elderly Cognitive Assessment Questionnaire (ECAQ) and a household face-to-face interview were used to collect data from 220 older adult participants aged 60 years and more. Descriptive statistics were conducted to describe the study variables. Correlation tests were applied to find associations between them. Logistic regression analysis was applied, with a minimum significance level (p < 0.05). Results About 9.10% of the older adults had cognitive impairment. Cognitive impairment was correlated with age, self-perceived health, hypertension, stroke, and mental illness. The primary predictors of cognitive impairment were age [odds ratio (OR) =1.07 (1.01-1.14), p = 0.001] and stroke [OR = 10.92 (1.44-82.85), p = 0.001]. Conclusions While many factors were correlated with cognitive impairment, the strongest predictors of cognitive impairment were age and stroke.
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Affiliation(s)
- Abdullah Alkhawaldeh
- Department of Community and Mental Health Nursing, Princess Salma Faculty of Nursing, Al Al-Bayt University, Mafraq, Jordan
| | - Mahmoud Alsaraireh
- Department of Nursing, Princess Aisha Bint Al Hussein College of Nursing and Health Sciences, Al-Hussain Bin Talal University, Ma’an, Jordan
| | - Mohammed ALBashtawy
- Department of Community and Mental Health Nursing, Princess Salma Faculty of Nursing, Al Al-Bayt University, Mafraq, Jordan
| | - Ahmad Rayan
- Department of Nursing, Faculty of Nursing, Zarqa University, Zarqa, Jordan
| | - Moawiah Khatatbeh
- Al-Balqa Applied University, Prince Al Hussein Bin Abdullah II Academy for Civil Protection, Amman, Jordan
| | | | - Ma’en Aljezawi
- Department of Community and Mental Health Nursing, Princess Salma Faculty of Nursing, Al Al-Bayt University, Mafraq, Jordan
| | - Sa’d ALBashtawy
- Department of Nursing, Princess Salma Faculty of Nursing, Al Al-Bayt University, Mafraq, Jordan
| | - Ahmad Musa
- Faculty of Nursing, Al-Ahliyya Amman University, Amman, Jordan
| | - Asem Abdalrahim
- Department of Community and Mental Health Nursing, Princess Salma Faculty of Nursing, Al Al-Bayt University, Mafraq, Jordan
| | - Omar Khraisat
- Faculty of Health Sciences, Higher College of Technology, Abu Dhabi, United Arab Emirates
| | - Ahmad AL-Bashaireh
- Department of Public Health, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Zaid ALBashtawy
- Al-Balqa Applied University, Prince Al Hussein Bin Abdullah II Academy for Civil Protection, Amman, Jordan
| | - Nisser Alhroub
- Department of Nursing, Faculty of Nursing, Jerash University, Jerash, Jordan
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Anaika G, Regalla SS, Reddy BM, Ganguly E, Sharma PK. Association of Obesity with Cognitive Impairment and Depression among Oldest Old Population having Frailty syndrome. J Frailty Sarcopenia Falls 2022; 7:207-221. [PMID: 36531515 PMCID: PMC9729753 DOI: 10.22540/jfsf-07-207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2022] [Indexed: 06/26/2024] Open
Abstract
Objectives The objectives were to estimate prevalence of obesity among frail individuals aged ≥80 years and examine the association of obesity with cognitive impairment and depression among frail individuals aged ≥80 years. Methods Two-hundred community-dwelling participants aged ≥80 years, were enrolled; 166 frail participants were further analyzed. Obesity and adiposity were determined by Body Mass Index (BMI), Waist Circumference (WC) and Body Fat Percentage (BF%). Cognitive impairment and Depression were assessed using Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15). Frailty was assessed by Fried criteria. Chi-Square, t-test, trend-analysis and Logistic Regression (LR) were done. Results Obesity among Frail individuals aged ≥80 years was 40% using BMI and 73.2% using WC. Obesity was inversely associated with cognitive impairment and depression among frail individuals. Severity of cognitive impairment and depression was lower among obese frail than non-obese frail. Trend-analysis showed decreasing cognitive impairment and depression with increasing BF%. On LR, obesity among frail individuals had inverse association with cognitive impairment and depression. Conclusion Obesity among frail individuals aged ≥80 years was associated with lower odds of cognitive impairment and depression in our population. Positive effects of weight gain in oldest old frail individuals and development of cognitive impairment and dementia should be explored in further researches.
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Affiliation(s)
| | | | | | - Enakshi Ganguly
- Epidemiology, Department of Community Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Hyderabad, India
- SHARE INDIA, Fogarty International, NIH (USA) and Department of Epidemiology, University of Pittsburgh, USA
| | - Pawan Kumar Sharma
- Epidemiology, Department of Community Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Hyderabad, India
- SHARE INDIA, Fogarty International, NIH (USA) and Department of Epidemiology, University of Pittsburgh, USA
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Fekadu B, Tareke M, Tadesse M, Anbesaw T. Neurocognitive Impairment and Associated Factors Among Elderly in the Bahir Dar City Administration, Northwest Ethiopia. Front Aging Neurosci 2022; 14:888704. [PMID: 35912086 PMCID: PMC9328744 DOI: 10.3389/fnagi.2022.888704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background Neurocognitive impairment is a widely common problem in the elderly. It encompasses mild and major cognitive impairment, which will lead to disability and increase the risk of death. It also compromises the quality of life of the patient and poses a burden on the family and society as a whole. However, there is a paucity of information concerning neurocognitive impairment among the elderly in Ethiopia. This study aimed to assess the prevalence of neurocognitive impairment and associated factors among the elderly in Bahir Dar city, Ethiopia 2020. Methods A community-based cross-sectional study was conducted among 423 respondents using a simple random sampling technique from 1 June to 30 June 2020. Neurocognitive impairment was measured using the Mini-Mental State Exam adjusted cutoff point (presence or absence) by the level of education of the participants. Data were entered into EpiData version 4.62 and exported to SPSS version 23 for analysis: descriptive statistics were used for summarization and presentation and binary logistic regression for a measure of association between exposures and outcome variable. Results The prevalence of neurocognitive impairment was 42.1%. Factors such as having no spouse [AOR = 1.76, 95% confidence interval (CI): 1.08-2.86], having depression (AOR = 3.04, 95% CI: 1.80-5.14), lifetime alcohol use (AOR = 2.90, 95% CI: 1.19-7.07), and having low family support (AOR = 3.07, 95% CI: 1.35-6.96) and moderate family support (AOR = 1.83; 95% CI: 1.10-3.06) were significantly associated with neurocognitive impairment. Conclusion and Recommendation The prevalence of neurocognitive impairment was high in Bahir Dar city administration. Neurocognitive impairment has shown significant association with no spouse, depression, alcohol use, and low and moderate family social support. It is important to pay attention to old age with comorbid mental illness and also to strengthen social support systems to prevent and manage neurocognitive impairment.
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Affiliation(s)
- Betelhem Fekadu
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Minale Tareke
- Department of Psychiatry, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Meseret Tadesse
- Department of Psychiatry, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tamrat Anbesaw
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Kumari R, Langer B, Gupta RK, Bahl R, Akhtar N, Nazir H. Prevalence and Determinants of Cognitive Impairment and Depression among the Elderly Population in a Rural Area of North India. Indian J Community Med 2021; 46:236-240. [PMID: 34321733 PMCID: PMC8281830 DOI: 10.4103/ijcm.ijcm_475_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 01/20/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Demographic transition has resulted in population aging, which has led to advancement in multiple geriatric problems including cognitive impairment (CI) and depression. Objectives: The objective was to find the prevalence and determinants of CI and depression in the rural elderly population. Materials and Methods: This was a community-based cross-sectional study conducted in a rural area. The prevalence of CI was measured using the Mini-Mental State Examination scale and depression was assessed using the Geriatric Depression Scale. The data so collected were analyzed using PSPP software. Results: The mean age of the study participants was 67.47 ± 6.43 years. The prevalence of CI and geriatric depression was found to be 36% (153/425) and 29.1% (124/425), respectively. Variables which were found to have independent significant association on multivariate analysis with CI were literacy, memory complaints, and depression. For geriatric depression, an independent association was seen with literacy, socioeconomic status, memory complaints, stress in the family, and presence of CI. CI and geriatric depression were found to be strongly correlated with each other (r = −0.252, P < 0.001). Conclusions: Almost one-third of the geriatric population is suffering from depression (29.1%) and CI (36%). This necessitates for accurate and timely diagnosis, so as to ensure proper care and support to the elderly population with emphasis on geriatric mental health care.
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Affiliation(s)
| | | | | | - Rakesh Bahl
- Department of Community Medicine, GMC, Jammu, India
| | - Najma Akhtar
- Department of Community Medicine, GMC, Jammu, India
| | - Heena Nazir
- Department of Community Medicine, GMC, Jammu, India
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Muhammad T, Srivastava S, Sekher TV. Association of self-perceived income sufficiency with cognitive impairment among older adults: a population-based study in India. BMC Psychiatry 2021; 21:256. [PMID: 34001051 PMCID: PMC8130352 DOI: 10.1186/s12888-021-03257-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 05/03/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Greater cognitive performance has been shown to be associated with better mental and physical health and lower mortality. The present study contributes to the existing literature on the linkages of self-perceived income sufficiency and cognitive impairment. Study also provides additional insights on other socioeconomic and health-related variables that are associated with cognitive impairment in older ages. METHODS Data for this study is derived from the 'Building Knowledge Base on Population Ageing in India'. The final sample size for the analysis after removing missing cases was 9176 older adults. Descriptive along with bivariate analyses were presented to show the plausible associations of cognitive impairment with potential risk factors using the chi-square test. Also, binary logistic regression analysis was performed to provide the relationship between cognitive impairment and risk factors. The software used was STATA 14. RESULTS About 43% of older adults reported that they had no source of income and 7.2% had income but not sufficient to fulfil their basic needs. Older adults with income but partially sufficient to fulfil their basic needs had 39% significantly higher likelihood to suffer from cognitive impairment than older adults who had sufficient income [OR: 1.39; OR: 1.21-1.59]. Likelihood of cognitive impairment was low among older adults with asset ownership than older adults with no asset ownership [OR: 0.83; CI: 0.72-0.95]. Again, older adults who work by compulsion (73.3%) or felt mental or physical stress due to work (57.6%) had highest percentage of cognitive impairment. Moreover, older adults with poor self-rated health, low instrumental activities of daily living, low activities of daily living, low subjective well-being and low psychological health were at increased risk for cognitive impairment. CONCLUSION The study highlights the pressing need for care and support and especially financial incentives in the old age to preserve cognitive health. Further, while planning geriatric health care for older adults in India, priority must be given to financially backward, with no asset ownership, with poor health status, older-older, widowed, and illiterate older individuals, as they are more vulnerable to cognitive impairment.
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Affiliation(s)
- T. Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - T. V. Sekher
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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Muhammad T, Govindu M, Srivastava S. Relationship between chewing tobacco, smoking, consuming alcohol and cognitive impairment among older adults in India: a cross-sectional study. BMC Geriatr 2021; 21:85. [PMID: 33514331 PMCID: PMC7847155 DOI: 10.1186/s12877-021-02027-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/13/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Physical aging increases the sensitivity to the effects of substance use, elevating the risk for cognitive impairment among older adults. Since studies on the association of substance use with cognitive ability in later years are scant in India, we aimed to explore the factors associated with cognitive impairment especially, alcohol consumption, smoking, and chewing tobacco later in life. METHODS The present research used nationally representative data from Building a Knowledge Base on Population Aging in India (BKPAI) that was conducted in 2011, across seven states of India (N=9,453). Sample distribution along with percentage distribution was calculated for cognitive impairment over explanatory variables. For finding the association between cognitive impairment over explanatory variables, binary logistic regression models were estimated. RESULTS About 16.5 percent of older adults in rural areas consumed smoked tobacco compared to 11.7 percent in urban areas. Nearly, 23.7 percent of rural older adults consumed smokeless tobacco in comparison to 16 percent in urban areas. Alcohol consumption was high among rural residents (7.9%) than urban counterparts (6.7%). The prevalence of cognitive impairment was 62.8% and 58% among older adults from rural and urban areas respectively. Older adults who smoked tobacco had a 24 percent significantly higher likelihood to have cognitive impairment with reference to older adults who did not smoke [OR: 1.24, CI: 1.02-1.49]. Moreover, older adults who consumed alcohol had a 30 percent significantly higher likelihood to have cognitive impairment [OR: 1.02, 1.65]. It was also found that older adults who had smoked along with consuming alcohol were at risk of worse cognitive outcomes than those who neither smoke nor drink alcohol [OR: 1.56, CI: 1.21-2.00] or consumed either of them unlike consuming smokeless tobacco only. CONCLUSION The encouragement of older people to stop smoking and smokeless tobacco use could be considered as part of a strategy to reduce the incidence of cognitive impairment. Further, appropriate measures should be taken for the detection of early stages of cognitive decline in older individuals and efforts should be made to improve the availability and quality of care for dementing older adults.
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Affiliation(s)
- T. Muhammad
- International Institute for Population Sciences, 400088 Mumbai, Maharashtra India
| | - Manideep Govindu
- International Institute for Population Sciences, 400088 Mumbai, Maharashtra India
| | - Shobhit Srivastava
- International Institute for Population Sciences, 400088 Mumbai, Maharashtra India
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Sharma PK, Reddy BM, Ganguly E. Frailty Syndrome among oldest old Individuals, aged ≥80 years: Prevalence & Correlates. J Frailty Sarcopenia Falls 2020; 5:92-101. [PMID: 33283075 PMCID: PMC7711734 DOI: 10.22540/jfsf-05-092] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Objectives were to study prevalence of frailty among Indian oldest old population, and to detect its correlates. METHODS A cross sectional community based study was done including 200 healthy participants aged ≥80 years, randomly sampled from Hyderabad city in India. They completed an administered questionnaire and physical function tests including SPPB, grip strength. Cognitive function was assessed using MMSE and depression using GDS. Blood pressure, haemoglobin, and fasting blood sugar were measured for all participants. Frailty was defined using Fried phenotype criteria. Logistic regression was done to identify independently associated correlates. RESULTS The prevalence of frailty syndrome was 83.4% in our study population. Frailty among men was 80.3% and among women was 84.7%, and it increased with increasing age. The independent correlates which increased the odds of frailty were poor physical performance (SPPB) (OR: 4.21; 95% CI: 1.12-15.83), depression (OR: 3.35; 95% CI: 1.29-8.73), chronic joint pains (OR: 4.90; 95% CI: 1.97-12.18) and COPD (OR: 3.01; 95% CI: 1.03- 8.78), while hypertension showed inverse association (OR: 0.33;95% CI: 0.11-0.94). CONCLUSION The prevalence of frailty among the oldest old is very high. Geriatric medicine protocols must include routine screening for frailty, while also including early detection of poor physical performance, depression, COPD and osteoarthritis.
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Affiliation(s)
- Pawan Kumar Sharma
- Department of Community Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Hyderabad, India
- Department of Epidemiology, University of Pittsburgh, and SHARE INDIA, Fogarty International, NIH
| | | | - Enakshi Ganguly
- Department of Community Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Hyderabad, India
- Department of Epidemiology, University of Pittsburgh, and SHARE INDIA, Fogarty International, NIH
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