Ai Koyanagi1,2, Elvira Lara2,3, Brendon Stubbs4,5,6, Andre F Carvalho7, Hans Oh8, Andrew Stickley9, Nicola Veronese10,11, Davy Vancampfort12,13. 1. Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain. 2. Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain. 3. Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain. 4. Physiotherapy Department, South London and Maudsley National Health Service Foundation Trust, Denmark Hill, London, United Kingdom. 5. Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. 6. Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom. 7. Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil. 8. School of Social Work, University of Southern California, Los Angeles, California. 9. Stockholm Center for Health and Social Change, Södertörn University, Huddinge, Sweden. 10. Geriatrics Unit, Department of Geriatric Care, OrthoGeriatrics and Rehabilitation, E.O. Galliera Hospital, National Relevance and High Specialization Hospital, Genova, Italy. 11. National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy. 12. Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium. 13. University Psychiatric Center, Katholieke Universiteit Leuven, Leuven-Kortenberg, Belgium.
Abstract
OBJECTIVES: To assess the association between chronic physical conditions and multimorbidity and mild cognitive impairment (MCI) in low- and middle-income countries (LMICs). DESIGN: Nationally representative, cross-sectional, community-based study. SETTING: Six countries that participated in the World Health Organization Study on Global Ageing and Adult Health. PARTICIPANTS: Individuals aged 50 and older (N=32,715; mean age 62.1 ± 15.6; 51.7% female). MEASUREMENTS: The definition of MCI was based on the recommendations of the National Institute on Ageing and Alzheimer's Association. Ten chronic conditions were assessed (angina pectoris, arthritis, asthma, cataract, chronic lung disease, diabetes mellitus, edentulism, hearing problems, hypertension, stroke). Multivariable logistic regression analysis was conducted to assess the association between chronic physical conditions, multimorbidity (≥2 chronic conditions), and MCI. RESULTS: The prevalence of multimorbidity was 49.8% (95% confidence interval (CI)=48.1-51.5%) and of MCI was 15.3% (95% CI=14.4-16.3%). After adjustment for potential confounders, edentulism (odds ratio (OR)=1.24), arthritis (OR=1.24), chronic lung disease (OR=1.29), cataract (OR=1.33), stroke (OR=1.94), hearing problems (OR=2.27), and multimorbidity (OR=1.40) were significantly associated with MCI. There was a gradual increase in the likelihood of MCI (1 condition: OR=1.21, 95% CI=1.03-1.42; ≥4 conditions: OR=2.07, 95% CI=1.70-2.52). CONCLUSION: These results highlight the need to investigate the underlying mechanisms linking chronic conditions and MCI and whether prevention or treatment of chronic conditions or multimorbidity can reduce the onset of cognitive decline and subsequent dementia, especially in LMICs.
OBJECTIVES: To assess the association between chronic physical conditions and multimorbidity and mild cognitive impairment (MCI) in low- and middle-income countries (LMICs). DESIGN: Nationally representative, cross-sectional, community-based study. SETTING: Six countries that participated in the World Health Organization Study on Global Ageing and Adult Health. PARTICIPANTS: Individuals aged 50 and older (N=32,715; mean age 62.1 ± 15.6; 51.7% female). MEASUREMENTS: The definition of MCI was based on the recommendations of the National Institute on Ageing and Alzheimer's Association. Ten chronic conditions were assessed (angina pectoris, arthritis, asthma, cataract, chronic lung disease, diabetes mellitus, edentulism, hearing problems, hypertension, stroke). Multivariable logistic regression analysis was conducted to assess the association between chronic physical conditions, multimorbidity (≥2 chronic conditions), and MCI. RESULTS: The prevalence of multimorbidity was 49.8% (95% confidence interval (CI)=48.1-51.5%) and of MCI was 15.3% (95% CI=14.4-16.3%). After adjustment for potential confounders, edentulism (odds ratio (OR)=1.24), arthritis (OR=1.24), chronic lung disease (OR=1.29), cataract (OR=1.33), stroke (OR=1.94), hearing problems (OR=2.27), and multimorbidity (OR=1.40) were significantly associated with MCI. There was a gradual increase in the likelihood of MCI (1 condition: OR=1.21, 95% CI=1.03-1.42; ≥4 conditions: OR=2.07, 95% CI=1.70-2.52). CONCLUSION: These results highlight the need to investigate the underlying mechanisms linking chronic conditions and MCI and whether prevention or treatment of chronic conditions or multimorbidity can reduce the onset of cognitive decline and subsequent dementia, especially in LMICs.
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