Prevalence of Cognitive Impairment and Associated Factors among Elderly Hong Kong Chinese Aged 70 Years and Over

Woo, Jean; Ho, Suzanne C.; Lau, Susan; Lau, Joseph T. F.; Yuen, Kwok‐Yung

doi:10.1159/000110358

Cited by 57 publications

(43 citation statements)

References 23 publications

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“…Demographic and clinical variables between the participants and patients who were excluded from the study were compared by 2 and Mann-Whitney U tests. To investigate the clinical determinants of PSDE, a univariate logistic regression was first performed to identify possible risk factors.…”

Section: Discussionmentioning

confidence: 99%

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Frequency and Determinants of Poststroke Dementia in Chinese

Tang

Chan

Chiu

et al. 2004

Stroke

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Background and Purpose-Both dementia and stroke are major health problems in Chinese societies. Stroke is a frequent cause of dementia. Only a few studies have been published on poststroke dementia (PSDE), none of which has investigated a consecutive stroke cohort in Asian patient populations. The objective of this study was to examine the prevalence and clinical correlates of PSDE in Chinese stroke patients in Hong Kong. Methods-Two hundred eighty stroke patients consecutively admitted to the medical wards of a university-affiliated regional hospital were interviewed by a psychiatrist 3 months after stroke. The presence of dementia and vascular dementia was diagnosed according to the Diagnostic and Statistical Manual, 4th edition. In addition, a wide range of demographic and clinical variables were examined. Results-Fifty-five participants (20%) had PSDE. Univariate analysis found that PSDE was associated with age; level of education; prestroke Rankin Scale score; prestroke Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) score; National Institutes of Health Stroke Scale (NIHSS) best language score, dysarthria score, and total score; urinary incontinence; cortical infarct; leukoaraiosis; bilateral lesions; number of lesions; involvement of middle cerebral artery circulation; and cerebral atrophy index. Multivariate logistic regression suggested that prestroke IQCODE score, NIHSS total score, leukoaraiosis, involvement of middle cerebral artery territory, and cerebral atrophy index were independent risk factors of PSDE. After removal of 22 patients with prestroke dementia, which was defined as a prestroke IQCODE score Ն4.0, the frequency of PSDE dropped to 15.5%. Furthermore, involvement of the middle cerebral artery territory and cerebral atrophy index were replaced by level of education and bilateral lesions as independent predictors in the final logistic model. Conclusions-PSDE is common among Chinese stroke patients in Hong Kong. Its frequency is comparable to that in white populations. The clinical determinants of PSDE, after the exclusion of patients with prestroke dementia, include premorbid level of cognitive function, severity of stroke, leukoaraiosis, level of education, and bilateral lesions.

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Section: Discussionmentioning

confidence: 99%

“…1 Stroke significantly contributes to the development of cognitive impairment in stroke sufferers. 2 Stroke is clearly related to vascular dementia, the secondmost-common type of dementia. 3 Stroke increases the risk of dementia up to 12 times.…”

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confidence: 99%

Frequency and Determinants of Poststroke Dementia in Chinese

Tang

Chan

Chiu

et al. 2004

Stroke

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“…Previous studies have suggested that low education might be a risk factor per se for poststroke dementia [4,6], Alzheimer's disease [5,7], and all types of dementia [3,8,9,10]. However, these proposals are difficult to verify, since a low educational level is associated with impaired performance in cognitive tests [39][40][41][42][43], and with the usual diagnostic criteria, dementia may be detected earlier in subjects with a lower premorbid cognitive level. The results from this study point to another possibility, namely that an increased cardiovascular risk amongst lower-educated persons may contribute to cognitive impairment of vascular origin.…”

Section: Discussionmentioning

confidence: 99%

Cognitive function, vascular risk factors and education. A cross‐sectional study based on a cohort of 70‐year‐old men

Kilander

Nyman

Boberg

et al. 1997

Journal of Internal Medicine

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Objectives.A low level of education is associated with an increased risk of developing a dementia disorder, as well as with a higher risk of cardiovascular disease. The aim of this study was to investigate the association between education and cardiovascular risk factors, and to study the relation between these factors and cognitive function in elderly men. Design. Cross-sectional population-based study. Setting. Uppsala, Sweden. Subjects. 504 men aged 69-74 years, participants in a longitudinal health survey concerning cardiovascular risk factors. Main outcome measure. Cognitive function as measured by a composite score of 13 standard psychometric tests. Results.A low level of education was associated with poorer cognitive performance, as well as with obesity, smoking, diabetes, high concentrations of serum triglycerides and plasma fibrinogen. In the entire cohort, subjects with obesity, smoking, diabetes or hypertriglyceridaemia showed impaired cognitive test results, independent of socio-economic factors. When stroke cases were excluded, obesity and smoking were still related to impaired cognitive function. Conclusions. Smoking and obesity with associated metabolic disturbances are inversely related both to educational level and to cognitive function. Cognitive decline of vascular origin is potentially preventable by treatment of risk factors. The question of whether the increased vascular risk contributes to the higher prevalence of cognitive disorders in individuals with low socio-economic status, needs to be further evaluated in longitudinal population-based studies.

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“…The overall response rate was 60%. Details of the sampling method and of the baseline cohort have been reported elsewhere [13][14][15][16].…”

Section: Methodsmentioning

confidence: 99%

Lifestyle Factors and Health Outcomes in Elderly Hong Kong Chinese Aged 70 Years and Over

Woo

Ho²,

2002

Gerontology

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Background: Although increasing emphasis is being placed on strategies for successful aging, few studies have examined the relationship between lifestyle factors and mortality and other health outcomes in the old-old population. Objective: To examine the impact of physical activity, dietary habits, smoking, and alcohol consumption on 3-year mortality and other health outcomes. Methods: 2,032 Chinese subjects aged 70 years and older (mean age 80 years) were recruited territorywide by proportional random sampling and followed for 3 years. Baseline information was obtained by interview on level of physical activity, dietary habits (frequency of consumption per week of major food groups), alcohol consumption, and smoking habits. Outcome measures include mortality, self-perceived health status, frequency of hospitalization, geriatric depression score, and development of new diseases (stroke, heart disease, hypertension, diabetes mellitus, fractures). Logistic regression was used to examine the effects of lifestyle factors on each health outcome, with and without adjustment for age and baseline health status. Results: The mortality risk is reduced with increasing physical activity, daily fish intake and moderate alcohol consumption, and avoidance of smoking; hospitalization is inversely associated with increasing activity; better self-perceived health is associated with moderate alcohol consumption and a non-smoking status, and there is an inverse relationship between depressive symptoms and increasing activity and moderate alcohol consumption. After adjustment for age and baseline health status, higher levels of physical activity are associated with decreased mortality and hospitalization; non-smokers have reduced mortality and a better self-perceived health, and moderate alcohol consumption is also associated with better self-perceived health. Conclusion: Lifestyle factors may influence health outcomes even in the old-old population.

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Prevalence of Cognitive Impairment and Associated Factors among Elderly Hong Kong Chinese Aged 70 Years and Over

Cited by 57 publications

References 23 publications

Frequency and Determinants of Poststroke Dementia in Chinese

Frequency and Determinants of Poststroke Dementia in Chinese

Cognitive function, vascular risk factors and education. A cross‐sectional study based on a cohort of 70‐year‐old men

Lifestyle Factors and Health Outcomes in Elderly Hong Kong Chinese Aged 70 Years and Over

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