Older Adults with Multiple Chronic Conditions at Increased Risk for Mild Cognitive Impairment
Monday, September 14, 2015
A new study published in the Journal of the American Geriatrics Society reveals that older adults who have two or more chronic conditions are at increased risk for developing mild cognitive impairment (MCI). The team of researchers studied data from 2,176 older adults who were classified as “cognitively normal” and who were enrolled in the Mayo Clinic Study of Aging.
The participants ranged in age from 70- to 89-years-old when they enrolled in the study. About 50% of the participants were male and about 87% had two or more chronic health conditions. These conditions included high cholesterol, high blood pressure, depression, diabetes, arthritis, cancer, heart disease, asthma, substance abuse disorders, arthritis, chronic kidney disease, and other chronic illnesses.
At the beginning of the study, all participants took psychological tests to assess how well they functioned in several key areas, including memory abilities, decision-making, and skills related to language and visual perception (such as being able to recognize or draw specific shapes). A physician also reviewed their mental and physical health and gave them complete neurological examinations. Participants were classified as “cognitively normal” if they did not meet the criteria for MCI or dementia. MCI refers to problems with memory, language, thinking, and judgment that are greater than age-related changes but that usually don’t interfere with normal daily function.
Researchers followed and retested the participants for up to roughly seven years. Across this time period, 583 people—or 27%—developed MCI or dementia. Interestingly, those who had four or more chronic conditions had a significantly higher risk for developing cognitive problems.
The researchers noted that the most frequently occurring pairs of chronic conditions were:
- high blood pressure and high cholesterol
- high blood pressure and arthritis
- high cholesterol and arthritis
- coronary artery disease and high cholesterol
- high blood pressure and coronary artery disease
People with these most common combinations were at a higher risk for MCI no matter what other chronic illnesses they also had. According to the researchers, three possible reasons could explain their findings:
- Heart disease—including high blood pressure, high cholesterol, and coronary artery disease—can increase a person’s risk for MCI.
- Aging itself also raises the risk for MCI. The risk was more than three-times higher in people 80-years-old and older who had multiple chronic diseases than it was in those 70- to 79-year olds.
- Potentially, two or more chronic illnesses could promote, contribute to, or accelerate cognitive decline.
“Preventing chronic diseases may be beneficial in delaying or preventing MCI and dementia,” concluded the researchers.
This summary is from “Multimorbidity and Increased Risk of Mild Cognitive Impairment" in the September 2015 issue of the Journal of the American Geriatrics Society. The study authors are Maria Vassilaki, MD, MPH, PhD; Jeremiah A. Aakre, MPH; Ruth H. Cha, MS; Walter K. Kremers, PhD; Jennifer L. St. Sauver, PhD, MPH; Michelle M. Mielke, PhD; Yonas E. Geda, MD, MSc; Mary M. Machulda, PhD, LP; David S. Knopman, MD; Ronald C. Petersen, MD, PhD; and Rosebud O. Roberts, MD, ChB, MS.