Prevalence of functional cognitive impairment and associated factors in Brazilian community-dwelling older adults
Andréa Silva Gondim; João Macedo Coelho Filho; Alexandre de Andrade Cavalcanti; Jarbas de Sá Roriz Filho; Charlys Barbosa Nogueira; Arnaldo Aires Peixoto Junior; José Wellington de Oliveira Lima
keywords: aging, epidemiology, prevalence, elderly, dementia.
The identification of the prevalence of cognitive impairment and associated factors among older adults is important in countries facing rapid demographic transition, given the significant implications for public policy and health planning.
OBJECTIVE: To determine the prevalence of functional cognitive impairment (FCI) and associated factors in Brazilian community-dwelling older adults.
METHODS: A cross-sectional study involving 461 elderly subjects residing in Fortaleza city, Ceará was conducted. Cognitive assessment was performed using three tests: the MMSE (Mini-Mental State Examination), VF (Verbal Fluency) and CT (Clock Test). The functional capacity evaluation was based on a survey of 21 basic and instrumental activities of daily living (ADLs). Cognitive impairment was defined by MMSE cut-off points adjusted for literacy. Functional impairment was defined as dependency to carry out more than four ADLs.
RESULTS: The prevalence of FCI was 13.64% (95% CI: 10.33 to 16.64%). FCI was proportionally associated with age with OR=2.24 (95% CI: 1.04 to 4.79) for individuals aged 70 to 79 years and OR=8.27 (95 % CI: 4.27 to 16.4) for those aged 80 to 100 years. FCI was associated with self-reported diseases including hypertension OR=2.06 (95% CI: 1.17 to 3.65), stroke OR=2.88 (95% CI: 1.66 to 5.00) and acute myocardial infarction OR=2.94 (95% CI: 1.59 to 5.42). The occurrence of FCI was proportionally correlated with the number of drugs used.
CONCLUSION: Functional cognitive impairment is a prevalent condition in Brazilian community-dwelling older adults and its occurrence is associated with age, number of drugs used, and vascular morbidities.