Cognitive Decline in Adults Aged 65 and Older in Cumbayá, Quito, Ecuador: Prevalence and Risk Factors

Abstract

ObjectiveTo assess the prevalence of and risk factors for cognitive decline and dementia in individuals greater than 65 years of age in Cumbayá, Quito, Ecuador.MethodsThis is a cross-sectional observational study that was carried out in adults over age 65. The Mini Mental State Examination (MMSE), Ascertain Dementia Eight-Item Informant Questionnaire (AD8), and Mini Nutritional Assessment (MNA) were used to assess the cognitive status and nutritional habits of this population.ResultsA total of 144 patients (mean age 75.3 years, 77.1% female) participated in this study. Forty percent of patients had AD8 and MMSE scores consistent with cognitive impairment and possible dementia. Age (p < 0.01), lower educational level (p < 0.01), history of stroke (p < 0.01), history of intracerebral hemorrhage (p < 0.01), diabetes mellitus (p < 0.01), and malnutrition (p < 0.01) were statistically significant risk factors for cognitive impairment. Exercise was found to be protective against cognitive decline in our study group (p < 0.03). Gender, ethnicity, location, head trauma, Parkinson disease, hypercholesterolemia, myocardial infarction, thyroid disease, depression, anxiety, and family history of dementia were not found to be associated with cognitive decline in this population.ConclusionsThe prevalence of cognitive impairment and possible dementia is 18–21% at age 65 and 54–60% at age 85 in Cumbayá, Quito, Ecuador. The major risk factors for cognitive impairment in this population are age, low educational level, malnutrition, prior stroke, prior intracerebral hemorrhage, and diabetes. Protective factors for cognitive decline include exercise and possibly modest consumption of alcohol.

Elevated plasma levels of exosomal BACE1‑AS combined with the volume and thickness of the right entorhinal cortex may serve as a biomarker for the detection of Alzheimer's disease

“…Results demonstrated a significant decrease in the levels of TG, Tc and Hdl-c, and in the Hb levels in males in the plasma of patients with ad, but these were not significantly correlated with BACE1-AS levels. Previous studies have shown that high Hdl and Tc levels are positively correlated with the risk of ad (52,53), in contrast to the results of the present study. This may be due to differences in the proportions of patients with moderate to severe dementia in the ad group between the two studies; the severity of ad increases the risk of malnutrition, leading to a decrease in plasma cholesterol levels (54,55).…”

Global Cognitive Impairment Prevalence and Incidence in Community Dwelling Older Adults—A Systematic Review

“…Grouping papers according to inclusion age (50–59 years old, 60–69 year old, and ≥70 years old), the reported prevalence ranges from 6.5% to 34% (median = 12%; 25th percentile = 9.6%; 75th percentile = 17.65%) in the first group [ 17 , 19 , 20 , 23 , 24 , 25 , 26 , 41 , 57 , 60 , 61 , 62 , 75 , 81 ], 5.1% to 37.5% (median = 20.1%; 25th percentile = 14.2%; 75th percentile = 24.7%) in the second group [ 11 , 12 , 13 , 14 , 15 , 16 , 21 , 22 , 28 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 42 , 44 , 45 , 46 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 59 , 63 , 64 ,…”

“…When grouping and analyzing the effect of sample size, we divided the studies into four groups based on the number of participants they had (<1001, 1001–2500, 2501–5000 and >5000). The reported prevalence in the first group ranged from 5.3% to 37.5% (median = 22.75%; 25th percentile = 14.9%; 75th percentile = 31.4%) [ 11 , 14 , 20 , 22 , 24 , 30 , 32 , 33 , 40 , 41 , 49 , 53 , 55 , 58 , 64 , 68 , 72 , 75 , 78 , 79 , 80 , 85 , 86 , 87 , 88 , 90 ], from 7.7% to 41% in the second group (median = 15.95%; 25th percentile = 11.60%; 75th percentile = 28.50%) [ 16 , 18 , 19 , 23 , 27 , 28 , 34 , 37 , 38 , 45 , 50 , 51 , 56 , 57 , 59 , 60 , 62 , 63 , 67 , 69 , 77 , 84 , <...>…”

“…When only standardized neurological tests were used (MMSE, MOCA, Short Portable Mental Questionnaire, etc. ), the prevalence of CI ranged from 5.1% to 41% (median = 18.9%; 25th percentile = 12.2%; 75th percentile = 24.7%) [ 11 , 12 , 13 , 14 , 15 , 16 , 18 , 21 , 22 , 23 , 26 , 28 , 30 , 31 , 32 , 33 , 34 , 36 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 55 , 58 , 59 , 60 , 61 , 63 , 64 , 66 , 67 , 69 , 70 , 75 , 76 , 77 , 78 , 79 , 81 …”

“…With regard to the world region where data were collected, in Europe the prevalence of cognitive impairment ranges from 5.1% to 41% (median = 12.1%; 25th percentile = 9.94%; 75th percentile = 23.9%) [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]; in North America, it ranged from 7.1% to 28.3% (median = 20.1%; 25th percentile = 19%; 75th percentile = 24.70%) [ 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]; in South America, it ranged from 24.3% to 37.5% (median = 34%; 25th percentile = 29.15%; 75th percentile = 35.75%) [ 49 , 50 , 51 ]. In Asia the prevalence ranges from 6.5% to 37% (median = 19.44%; 25th percentile = 13.25%; 75th percentile = 25.55%) [ 52 , 53 , 54 , 55 , 56 ,…”