Gerontology & Geriatric Research

Abstract

Role of Co-existence of Multiple Chronic Conditions on the Longitudinal Decline in Cognitive Performance among Older Adults in the US

Rashmita Basu, John E Zeber, Laurel A Copeland and Alan B. Stevens

Background: The primary goal of this study was to examine the influence of the co-existence of multiple chronic conditions on the longitudinal decline in cognitive performance among elderly individuals of the nationally representative Aging Demographic and Memory Study. Methods: Retrospective longitudinal cohort study of individuals aged 70 years or above. Random effect ordinal logistic regression analysis was performed to assess the impact of co-existing chronic conditions on the longitudinal decline in cognitive function (transitioning from normal functioning to cognitive impairment (no dementia (CIND) to dementia) among older adults. Principal component factor analysis was conducted to identify the clusters of chronic health conditions. Results: About 35% of respondents had at least one of four cardiovascular risk factors (diabetes, hypertension, high cholesterol or heart problems). The odds of remaining in normal cognitive status (compared to CIND and dementia) were 56% lower for those who experienced an incidence of stroke at baseline compared to those who did not experience a stroke incidence. Cardiovascular risk factors were not associated with cognitive decline. Conclusions: The lack of significant impact of cardiovascular (CVD) risk factors on cognitive decline may be attributable to indirect but important pathways through which CVD factors are associated with a stroke incidence. The importance of this topic remains as the prevalence of dementia and other cognitive impairments is increasing worldwide, and our limited findings underscore the imperative need for longitudinal studies with a larger group of geriatric patients and wider use of brief assessments of cognitive status. Due to the complexity of managing chronic cardiovascular disease, establishment of a care coordination manager as a bridge between patients and other medical specialists may improve clinical outcomes and prevent cognitive decline.