Exploring the Association between Multimorbidity and Cognitive Impairment in Older Adults Living in the Community: A Review of the Literature

Abstract

Two-thirds of older adults have multimorbidity (MM), or co-occurrence of two or more medical conditions. Mild cognitive impairment (CI) is found in almost 20% of older adults and can lead to further cognitive decline and increased mortality. Older adults with MM are the primary users of home health care services and are at high risk for CI development; however, there is no validated cognitive screening tool used to assess the level of CI in home health users. Given the prevalence of MM and CI in the home health setting, we conducted a review of the literature to understand this association. Due to the absence of literature on CI in home health users, the review focused on the association of MM and CI in community-dwelling older adults. Search terms included home health, older adults, cognitive impairment, and multimorbidity and were applied to the databases PubMed, CINAHL, and PsychInfo leading to eight studies eligible for review. Results show CI is associated with MM in older adults of increasing age, among minorities, and in older adults with lower levels of education. Heart disease was the most prevalent disease associated with increased CI. Sleep disorders, hypertension, arthritis, and hyperlipidemia were also significantly associated with increased CI. The presence of MM and CI was associated with increased risk for death among older adults. Further research and attention are needed regarding the use and development of a validated cognitive assessment tool for home health users to decrease adverse outcomes in the older adult population.

Association of Psychological distress and Physical Health with Subjective and Objective Memory in Older Adults

“…It has been documented that older adults with multimorbidity tended to have more SM complaints (Aarts et al, 2011a, 2011b; Franco et al, 2022; Ghose & Abdoul Razak, 2017; Jacob et al, 2019; Pedro et al, 2016). Similarly, our finding that multimorbidity was associated with worse performance on an OM task is consistent with previous studies (Aarts et al, 2011b; Bendayan et al, 2021; Wei et al, 2020; for reviews, see Wittenberg et al, 2022). Our study contributes to this literature by simultaneously assessing subjective and objective memory, while considering important co-occurring psychological and physical health conditions.…”

“…The relationship between PHY and cognitive function is widely documented in middle-age and older adults. Systemic conditions, such as multimorbidity and obesity, are the norm rather than the exception among middle-age and older adults and have been previously shown to impact cognitive function in this population (Prickett et al, 2015;Wittenberg et al, 2022). Multimorbidity (i.e., two or more co-occurring chronic diseases) is highly prevalent, with ∼72% of adults ages 50-64 and up to 90% of those over the age of 65 having been diagnosed with at least two chronic diseases (Buttorff et al, 2017;Calderón-Larrañaga et al, 2017;King et al, 2018).…”

Multimorbidity and depressive symptoms in older adults and the role of social support: Evidence using Canadian Longitudinal Study on Aging (CLSA) data

“…The prevalence of multimorbidity is increasing due to longer life expectancy and the growing number of people who live with chronic conditions [2]. Multimorbidity is associated with negative consequences including higher disability, functional decline, cognitive impairment, decrease in quality of life, high health care costs and increased risk of death [3][4][5][6][7][8][9]. The relationship between multimorbidity and mental health has also been examined [10][11][12].…”

Asociación entre la diabetes mellitus y la hipertensión arterial con el deterioro cognitivo en una población del norte del Perú

“…Asimismo, existen medicamentos que pueden limitar la absorción de ciertas vitaminas implicadas en la función cognitiva, como lo es el caso de la metformina y la deficiencia de vitamina B12, llevando a consecuencias similares a las ya descritas. Ahora, en lo que a la definición de multimorbilidad respecta, si bien estudios anteriores han abordado la asociación entre multimorbilidad con DC, su definición de multimorbilidad ha diferido de la nuestra respecto al número de comorbilidades y combinaciones de otras patologías (16,50,51). En un estudio de Vassilaki et al (50) se contemplaron 19 enfermedades crónicas asociadas al DC, y se definió multimorbilidad cómo la presencia de 2 o más condiciones.…”

“…A pesar de ello, hay evidencia que sugiere que tanto la DM cómo la HTA son factores de riesgo que pueden agravar el DC, así como favorecer su progresión a demencia (18)(19)(20)(21)55,56,60). Además, se ha demostrado que la presencia de multimorbilidad en general, incluso en personas asintomáticas, está asociada a mayor progresión de DC (16,50,51). No obstante, los hallazgos de nuestro estudio no son suficientes para sugerir el tamizaje de DC en individuos con multimorbilidad por ambas enfermedades.…”