Cognitive Impairment among the Elderly Population of Rural Haryana, India and its Association with Smoking, Alcohol Intake and Impairments in Vision, Hearing and Activities of Daily Living
DOI:
https://doi.org/10.31584/jhsmr.2022900Keywords:
activities of daily living, cognitive impairment, elderly, mini-cog, smokingAbstract
Objective: The study aimed to estimate the prevalence of cognitive impairment among elderly people in rural Haryana, India and determine its association with smoking, alcohol consumption and impairments.
Material and Methods: This was a community-based cross-sectional study carried out among 575 elderly people aged 60 years and above in the rural field practice area of a medical college in the Haryana state of India. Cognitive impairment was evaluated by the Mini-Cog test. To determine factors associated with cognitive impairment, unadjusted odds ratios with a 95% confidence interval were obtained and binary logistic regression analysis was carried out to calculate adjusted odds ratios.
Results: Cognitive impairment was found in 4.5% of the elderly subjects. Those aged 75 years and more, currently not married, illiterate, elderly living alone, current smokers, currently consuming alcohol and elderly with visual, hearing or activities of daily living (ADL) impairments had significantly higher cognitive impairment. Binary logistic regression analysis revealed that illiteracy (adjusted OR=3.173, p-value=0.033), living alone (adjusted OR=6.299, p-value=0.015), current tobacco smoking (adjusted OR=5.393, p-value=0.029), current alcohol drinking (adjusted OR=7.360, p-value=0.001) and ADL impairment (adjusted OR=6.427, p-value=0.001) were independently associated with cognitive impairment.
Conclusion: Tobacco smoking, alcohol consumption and ADL impairment were independently associated with cognitive impairment in the elderly people of Haryana state of India. Early screening and timely intervention for signs of cognitive decline may help in improving their quality of life.
References
Howieson DB, Loring DW, Hannay HJ. Neurobehavioural variables and diagnostic issues. In: Lezak MD, editor. Neuropsychological assessment. 4th ed. New York: Oxford University Press; 2004;p.286-336.
Ritchie K, Lovestone S. The dementias. Lancet 2002;360:1759– 66.
Singh P, Govil D, Kumar V, Kumar J. Cognitive impairment and quality of life among elderly in India. Applied Research in Quality of Life 2017:12:963–79.
United Nations. Department of Economic and Social Affairs, Population Division. World population ageing 2020 highlights: living arrangements of older persons [monograph on the Internet]. New York: United Nations; 2020 [cited 2021 Jun 2]. Available from: https://www.un.org/development/desa/ pd/sites/www.un.org.development.desa.pd/files/undesa_pd 2020_world_population_ageing_highlights.pdf
Dening T, Barapatre C. Mental health and the ageing population. J Br Menopause Soc 2004;10:49-53.
van der Flier WM, Scheltens P. Use of laboratory and imaging investigations in dementia. J Neurol Neurosurg Psychiatry 2005;76(Suppl 5):v45-52.
Maroof M, Ahmad A, Khalique N, Ansari MA, Shah MS, Eram U. Prevalence and determinants of cognitive impairment among rural elderly population of Aligarh. Ntl J Community Med 2016;7:189-92.
Wade DT, Collin C. The Barthel ADL Index: a standard measure of physical disability? Int Disabil Stud 1988;10:64-7.
Woodford HJ, George J. Cognitive assessment in the elderly: a review of clinical methods. QJM 2007;100:469-84.
Sharma D, Mazta SR, Parashar A. Prevalence of cognitive impairment and related factors among elderly: a population-based study. J Dr NTR Univ Health Sci 2013;2:171-6.
Poddar K, Kant S, Singh A, Sing TB. An epidemiological study of dementia among the habitants of Eastern Uttar Pradesh, India. Ann Indian Acad Neurol 2011;14:164-8.
Raina S, Razdan S, Pandita KK, Raina S. Prevalence of dementia among Kashmiri migrants. Ann Indian Acad Neurol 2008;11:106-8.
Sengupta P, Benjamin AI, Singh Y, Grover A. Prevalence and correlates of cognitive impairment in a north Indian elderly population. WHO South-East Asia J Public Health 2014;3:135- 43.
Jadav PA. Cognition among old age population in a Rural Area. Natl J Community Med 2018;9:240-4
Van Hooren SA, Valentijn AM, Bosma H, Ponds RW, van Boxtel MP, Jolles J. Cognitive functioning in healthy older adults aged 64-81: a cohort study into the effects of age, sex, and education. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2007;14:40–54.
Rashid AK, Azizah AM, Rohana S. Cognitive impairment among the elderly Malays living in rural Malaysia. Med J Malaysia 2012;67;186-9.
Salthouse TA. When does age-related cognitive decline begin? Neurobiol Aging 2009;30:507-14.
Der G, Deary IJ. Reaction time age changes and sex differences in adulthood. Results from a large, population-based study: the UK Health and Lifestyle Survey. Psychol Aging 2006;21:62-73.
Sherina MS, Rampal L, Mustaqim A. Cognitive impairment among the elderly in a rural community in Malaysia. Med J Malaysia 2004;59:252-7.
Roe CM, Xiong C, Miller JP, Morris JC. Education and Alzheimer disease without dementia: support for the cognitive reserve hypothesis. Neurology 2007;68:223–8.
Hakansson K, Rovio S, Helkala EL, Vilska AR, Winblad B, Soininen H, et al. Association between mid-life marital status and cognitive function in later life: population-based cohort study. BMJ 2009;339:b2462.
Sabia S, Elbaz A, Dugravot A, Head J, Shipley M, Hagger Johnson G, et al. Impact of smoking on cognitive decline in early old age: the Whitehall II cohort study. Arch Gen Psychiatry 2012;69:627-35.
Nooyens ACJ, vanGelder BM, Verschuren M. Smoking and cognitive decline among middle-aged men and women: the Doetinchem Cohort Study. Am J Public Health 2008;98:2244- 50.
Ryback RS. The continuum and specificity of the effects of alcohol on memory. A review. Q J Stud Alcohol 1971;32:995- 1016.
Lishman WA. Alcohol and the brain. Br J Psychiatry 1990; 156:635-44.
Wei J, Hu Y, Zhang L, Hao Q, Yang R, Lu H, et al. Hearing Impairment, mild cognitive impairment, and dementia: a meta analysis of cohort studies. Dement Geriatr Cogn Dis Extra 2017;7:440-52.
Lin FR, Yaffe K, Xia J, Xue QL, Harris TB, Purchase-Helzner E, et al. Hearing loss and cognitive decline in older adults. JAMA Intern Med 2013;173:293-9.
Lin MY, Gutierrez PR, Stone KL, Yaffe K, Ensrud KE, Fink HA, et al. Study of osteoporotic fractures research group. Vision impairment and combined vision and hearing impairment predict cognitive and functional decline in older women. J Am Geriatr Soc 2004;52:1996-2002.
Yang L, Yan J, Jin X, Jin Y, Yu W, Xu S, et al. Screening for dementia in older adults: comparison of mini-mental state examination, Mini-Cog, Clock Drawing Test and AD8. PLoS ONE 2016;11:e0168949.
Milian M, Leiherr A, Straten G, Müller S, Leyhe T, Eschweiler G. The Mini-Cog versus the Mini-Mental State Examination and the Clock Drawing Test in daily clinical practice: Screening value in a German Memory Clinic. Int Psychogeriatr 2012;24:766-74.
Tsoi KKF, Chan JYC, Hirai HW, Wong SYS, Kwok TCY. Cognitive tests to detect dementia: a systematic review and meta-analysis. JAMA Intern Med 2015;175:1450-8.
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