Incidence and risk factors for cognitive impairment in rural elderly populations in Costa Rica.

Risk factors for the onset of cognitive impairment in Costa Rica are not well understood, despite a substantial elderly population stemming from a higher than average life expectancy for the western hemisphere. To investigate the risk factors that predict the onset of cognitive impairment in the rural elderly of Costa Rica, a modified version of the Mini Mental State Exam-designed for illiterate populations-was administered to 90 elderly inhabitants of San Carlos, Alajuela, Costa Rica between April and May of 2011. Subsequently, each participant took a structured interview assessing viability of risk factors and behaviors potentially contributing to a diagnosis of cognitive impairment. Results showed strong dependencies between age (p = 0.0001), education level (p = 0.0095), the ability to read (p = 0.0001) and write (p = 0.0153), frequency of reading (p = 0.0011), use of puzzles and mind games (p < 0.0001), vocation (p = 0.0225), area of residence (p < 0.0001), comorbid mental dis- eases (p = 0.0005), history of stroke or brain trauma (p = 0.0104), urinary or renal problems (p = 0.0443), consistent cooking practices (p = 0.0262) and number of living companions (p = 0.0299) in susceptibility for developing cognitive impairment. The study concluded that high intellectual use, or lack thereof, during the lifetime of a person was a predictor for cognitive status later in life. In addition, comorbid mental disorders, including neu- rological trauma due to stroke, impeded normal cognitive function. Future research should examine incidence and risk factors of cognitive impairment in urban, more educated populations.