Multiple chronic conditions: Implications for cognition – Findings from the Wisconsin Registry for Alzheimer's Prevention (WRAP)

Bratzke, Lisa C.; Carlson, Beverly; Moon, Chooza; Brown, Roger; Koscik, Rebecca L.; Johnson, Sterling C.

doi:10.1016/j.apnr.2018.06.004

Cited by 11 publications

(20 citation statements)

References 36 publications

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“…All articles reported data from the analysis of large longitudinal cohort studies. [22][23][24][25][26][27][28][29] Six studies were conducted in the US, 23,[25][26][27][28][29] one study was conducted in the Netherlands 22 and another in Italy. 24 Across the eight studies, sample sizes ranged from 374 24 to 18, 913.…”

Section: Resultsmentioning

confidence: 99%

“…26 Three additional studies investigated the association of multiple chronic conditions and the presence of CI. [23][24][25] Both Vassilaki et al 23 and Bratzke et al 25 assessed the association of co-occurring diseases on cognition. Vassilaki et al 23 reported 131 co-occurring chronic condition pairs (dyads) in older adults.…”

Section: Significant Chronic Conditionsmentioning

confidence: 99%

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

Wittenberg

McKay

O’Connor

2021

Home Health Care Management & Practice

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Significant Chronic Conditionsmentioning

confidence: 99%

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

Wittenberg

McKay

O’Connor

2021

Home Health Care Management & Practice

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“…Although our study is not directly comparable, we find that most patterns with an accelerated decline included high blood pressure as one of the conditions of high prevalence, which is in line with the results found by Olaya et al ( 31 ). Bratzke et al ( 12 ) found no significant decline in memory for those assigned to the depression class (cholesterol, depression, and arthritis) or the cardiovascular class (cholesterol, hypertension, and arthritis). Our study found a significant decline for Class 3 (arthritis and hypertension) in unadjusted models and these differences might be associated differences in the assessment of memory, the methodological approach to capture change over time or the potential higher prevalence of cholesterol in their sample.…”

Section: Discussionmentioning

confidence: 99%

“…When these authors looked at cluster combinations, they found that only the combination of malignancies and movement disorders was significantly related to cognitive decline. Bratzke et al ( 12 ) explored the association between chronic illnesses and MCI finding that those individuals that had sleep disturbances, apnea, and cholesterol were the only ones that showed a significant decline in memory, defined as amnesic MCI, over 8 years follow-up. However, decline was not evident for individuals assigned to the depression class (cholesterol, depression, and arthritis) or the cardiovascular class (cholesterol, hypertension, and arthritis).…”

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confidence: 99%

Multimorbidity Patterns and Memory Trajectories in Older Adults: Evidence From the English Longitudinal Study of Aging

Bendayan

Zhu

Federman

et al. 2021

The Journals of Gerontology: Series A

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Background We aimed to examine the multimorbidity patterns within a representative sample of UK older adults and their association with concurrent and subsequent memory. Methods Our sample consisted of 11,449 respondents (mean age at baseline was 65.02) from the English Longitudinal Study of Ageing (ELSA). We used fourteen health conditions and immediate and delayed recall scores (IMRC and DLRC) over 7 waves (14 years of follow up). Latent class analyses were performed to identify the multimorbidity patterns and linear mixed models were estimated to explore their association with their memory trajectories. Models were adjusted by socio-demographics, BMI and health behaviors. Results Results showed 8 classes: Class 1:Heart Disease/Stroke (26%), Class 2:Asthma/Lung Disease (16%), Class 3:Arthritis/Hypertension (13%), Class 4:Depression/Arthritis (12%), Class 5:Hypertension/Cataracts/Diabetes (10%), Class 6:Psychiatric Problems/Depression (10%), Class 7:Cancer (7%) and Class 8:Arthritis/Cataracts (6%). At baseline, Class 4 was found to have lower IMRC and DLRC scores and Class 5 in DLRC, compared to the no multimorbidity group (n=6380, 55.72% of total cohort). For both tasks, in unadjusted models, we found an accelerated decline in Classes 1, 3 and 8; and, for DLRC, also in Classes 2 and 5. However, it was fully attenuated after adjustments. Conclusions These findings suggest that individuals with certain combinations of health conditions are more likely to have lower levels of memory compared those with no multimorbidity and their memory scores tend to differ between combinations. Socio-demographics and health behaviours have a key role to understand who is more likely to be at risk of an accelerated decline.

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“…As many as 60% of older adults with a chronic physical health condition (hereafter, chronic condition) report some type of cognitive complaint [ 3 ], compared to about 25% of older adults overall [ 4 , 5 ]. Furthermore, many of the most common chronic conditions in older adults are thought to contribute to cognitive decline, and their associated symptoms may mimic the earliest signs of AD [ 6 ]. Characterizing trends in cognitive complaints within and across common chronic conditions is an important step in distinguishing symptoms that are indicative of progressive cognitive decline.…”

Section: Introductionmentioning

confidence: 99%

Cognitive complaints in age-related chronic conditions: A systematic review

et al. 2021

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Introduction Cognitive complaints in older adults may be indicative of progressive cognitive decline including Alzheimer’s disease (AD), but also occur in other age-related chronic conditions, complicating identification of early AD symptoms. To better understand cognitive complaints in aging, we systematically reviewed the evidence to determine their prevalence and characterization among older adults with the most common age-related chronic conditions. Methods This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the review protocol was prospectively registered with PROSPERO (ID: CRD42020153147). Searches were conducted in PubMed, CINAHL, PsycINFO, Web of Science, and ProQuest Dissertations & Theses A&I in June 2020. Two members of the review team independently determined article eligibility for inclusion and conducted quality appraisal. A narrative synthesis of results was used to integrate findings across studies and draw conclusions regarding the strength of the evidence in each chronic condition category. Results Thirty-seven articles met eligibility criteria and were included in the review. Conditions represented were diabetes (n = 20), heart disease (n = 13), hypertension (n = 10), chronic lung disease (n = 5), arthritis (n = 4), heart failure (n = 2), and hyperlipidemia (n = 2). In addition, 16 studies included a measure of multimorbidity. Overall, there was a higher prevalence of cognitive complaints in individuals with higher multimorbidity, including a potential dose-dependent relationship. Findings for specific conditions were inconsistent, but there is evidence to suggest that cross-sectionally, older adults with diabetes, heart disease, chronic lung disease, and arthritis have more cognitive complaints than those without these conditions. Conclusion There is strong evidence demonstrating that cognitive complaints are more common in older adults with higher multimorbidity, but little research examining these associations over time. Improving our understanding of the longitudinal trajectory of cognitive complaints, multimorbidity, and objective cognition in older age is an important area for future research.

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Multiple chronic conditions: Implications for cognition – Findings from the Wisconsin Registry for Alzheimer's Prevention (WRAP)

Abstract: Findings offer evidence of an association between specific MCC groups and the development of cognitive decline. Nurses should monitor and screen for cognitive decline in the presence of MCC in order to better target self-management interventions.

Cited by 11 publications

References 36 publications

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

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

Multimorbidity Patterns and Memory Trajectories in Older Adults: Evidence From the English Longitudinal Study of Aging

Cognitive complaints in age-related chronic conditions: A systematic review

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