The Mex-Cog cognitive assessment battery: discriminant analysis of the cognitive performance profile in older adults.

OBJECTIVE: To analyze the cognitive profile of a clinical sample using the Mex-Cog cognitive battery and establish which cognitive measures and domains contribute most to group separation. MATERIALS AND METHODS: A group of 145 older adults previously diagnosed with dementia (n= 47), mild cognitive impairment MCI (n= 47), or as cognitively normal (n= 51) were assessed with the Mex-Cog cognitive battery. Six linear discriminant analyses (LDA) were estimated to compare dementia vs. cognitively normal, MCI vs. cognitively normal, and MCI vs. dementia, using ten individual measures and six cognitive domains. We used a leave-one-out cross-validation procedure to evaluate the predictive capacity of LDA models. RESULTS: Discriminant functions using individual measures and domains distinguished correctly 100% of dementia and cognitively normal groups showing a memory and executive function profile. The predictive group membership for MCI versus cognitively normal varied between 82 and 85%, with a cognitive profile associated with attention-executive function followed by memory. Group separation between MCI and dementia was between 80 and 87%, characterized by orientation, memory, and visuospatial abilities. CONCLUSIONS: The Mex-Cog cognitive battery is useful for identifying cognitive impairment in older adults.

Effect of Demographic and Health Dynamics on Cognitive Status in Mexico between 2001 and 2015: Evidence from the Mexican Health and Aging Study.

Sources of health disparities such as educational attainment, cardiovascular risk factors, and access to health care affect cognitive impairment among older adults. To examine the extent to which these counteracting changes affect cognitive aging over time among Mexican older adults, we examine how sociodemographic factors, cardiovascular diseases, and their treatment relate to changes in cognitive function of Mexican adults aged 60 and older between 2001 and 2015. Self and proxy respondents were classified as dementia, cognitive impairment no dementia (CIND), and normal cognition. We use logistic regression models to examine the trends in dementia and CIND for men and women aged 60 years or older using pooled national samples of 6822 individuals in 2001 and 10,219 in 2015, and sociodemographic and health variables as covariates. We found higher likelihood of dementia and a lower risk of CIND in 2015 compared to 2001. These results remain after adjusting for sociodemographic factors, cardiovascular diseases, and their treatment. The improvements in educational attainment, treatment of diabetes and hypertension, and better access to health care in 2015 compared to 2001 may not have been enough to counteract the combined effects of aging, rural residence disadvantage, and higher risks of cardiovascular disease among older Mexican adults.

Socioeconomic Disparities and Gender Inequalities in Dementia: a Community-Dwelling Population Study from a Middle-Income Country.

The proportion of the world's older adults and of its dementia cases is increasing in low and middle-income countries. This is particularly true in Colombia. There, the number of individuals with dementia may increase five-fold by 2050. Yet research is lacking on dementia in such settings. This work estimates the prevalence of dementia in a community-dwelling population in Colombia. It also assesses how gender-based differences in cardiovascular conditions and socioeconomic disparities affect dementia. This work analyzes data on 2000 respondents at least 60 years of age in the Health, Well-Being, And Aging (SABE) study in Bogota. Respondents with dementia are those who have cognitive impairment and at least two limitations in instrumental activities of daily living. The SABE study finds 8.4% of respondents have dementia. Age, cardiovascular risks, and socioeconomic disparities contributed to higher odds of dementia. The contributors to dementia can differ for men and women. For example, socioeconomic disparities were a larger contributor to dementia for women than men. The findings support the cognitive reserve hypothesis on dementia. This holds that pre-existing cognitive processes and compensatory mechanisms influence dementia. Women in Latin America are more likely to suffer from socioeconomic disparities that limit their cognitive reserve. This research points to several policy implications that can help offset these disparities and reduce the prevalence of dementia.

[Factors associated with functional dependence in older adults: a secondary analysis of the National Study on Health and Aging, Mexico, 2001]. / Factores asociados con la dependencia funcional en los adultos mayores: un análisis secundario del Estudio Nacional sobre Salud y Envejecimiento en México, 2001.

OBJECTIVES: To identify factors associated with dependence for basic activities of daily living (BADL) and instrumental activities of daily living (IADL) in elderly adults in Mexico. METHODS: A cross-sectional study of data from the first round of Mexico's National Study on Health and Aging, 2001, was undertaken. The sample consisted of 7 171 participants, 60 years of age or older. Multifactorial regression analysis was used to identify associations between BADL and IADL dependence and lifestyle, sociodemographics, family background, and health history, from childhood to present. RESULTS: The mean age of the participants was 69.4 +/- 7.6 years of age, with a range of 60-105 years; females made up 53.4% of the sample. The BADL- and IADL-dependent groups had a higher mean age (P < 0.01), were predominantly female (P < 0.01), had a greater incidence of illiteracy, and reported a significantly higher number of chronic diseases and greater frequency of pain than did the independent participants. Among the 521 (7.3%) BADL-dependent, there was a higher percentage who were single or widowed (P < 0.01), and their self-assessed health was poorer, than that of the independent (P < 0.01). Among the 603 (8.4%) IADL-dependent, significant, independently associated factors were age, cerebrovascular and other chronic diseases, depression, vision issues, excessive pain, and amputation of a limb. Absence of childhood trauma and fewer years of employment were related to a lower incidence of IADL dependence. CONCLUSIONS: Functional dependence in older adults is directly related to aging and has multiple determinants. Awareness of these determinants should help design health programs that can identify individuals who are at high risk of losing their independence, and implement interventions for slowing or reversing the process.

Factores asociados con la dependencia funcional en los adultos mayores: un análisis secundario del Estudio Nacional sobre Salud y Envejecimiento en México, 2001 / Factors associated with functional dependence in older adults: a secondary analysis of the National Study on Health and Aging, Mexico, 2001

OBJETIVO: Identificar los factores asociados con la dependencia funcional de los adultos mayores para realizar actividades básicas de la vida diaria (ABVD) y actividades instrumentales de la vida diaria (AIVD). MÉTODO: Estudio transversal de la información obtenida en la primera vuelta del Estudio Nacional sobre Salud y Envejecimiento en México (ENASEM) en 2001. La muestra estuvo compuesta por 7 171 personas de 60 años o más. Mediante el análisis de regresión logística multifactorial se analizó la asociación de la dependencia funcional para realizar ABVD y AIVD con los hábitos de vida y los antecedentes personales sociales, familiares y de salud desde la infancia de los participantes. RESULTADOS: La edad promedio fue de 69,4 ± 7,6 años (de 60 a 105 años); 53,4 por ciento eran mujeres. Los grupos de dependientes para realizar ABVD y AIVD tenían en promedio mayor edad (P < 0,01), en él predominaban las mujeres (P < 0,01) y había más personas analfabetas y que declararon haber tenido un número significativamente mayor de enfermedades crónicas y haber sufrido dolor con mayor frecuencia en los grupos de personas independientes (P < 0,01). Entre los 521 (7,3 por ciento) dependientes para realizar ABVD se observó una mayor proporción de personas sin pareja (P < 0,01), viudos (P < 0,01) y con una peor percepción de su salud que entre los independientes (P < 0,01). Seiscientos tres (8,4 por ciento) de los entrevistados eran dependientes para realizar AIVD. La mayor edad, padecer de enfermedad cerebrovascular, un mayor número de enfermedades crónicas, síntomas depresivos, deficiencia visual, dolores que limitan sus actividades diarias y tener algún miembro amputado resultaron ser factores significativa e independientemente asociados con la dependencia para realizar AIVD. Un menor número de problemas sociales durante la infancia y menos años de trabajo remunerado estuvieron asociados con una menor dependencia para realizar AIVD. CONCLUSIONES: La...

OBJECTIVES: To identify factors associated with dependence for basic activities of daily living (BADL) and instrumental activities of daily living (IADL) in elderly adults in Mexico. METHODS: A cross-sectional study of data from the first round of MexicoÆs National Study on Health and Aging, 2001, was undertaken. The sample consisted of 7 171 participants, 60 years of age or older. Multifactorial regression analysis was used to identify associations between BADL and IADL dependence and lifestyle, sociodemographics, family background, and health history, from childhood to present. RESULTS: The mean age of the participants was 69.4 ± 7.6 years of age, with a range of 60-105 years; females made up 53.4 percent of the sample. The BADL- and IADL-dependent groups had a higher mean age (P < 0.01), were predominantly female (P < 0.01), had a greater incidence of illiteracy, and reported a significantly higher number of chronic diseases and greater frequency of pain than did the independent participants. Among the 521 (7.3 percent) BADL-dependent, there was a higher percentage who were single or widowed (P < 0.01), and their self-assessed health was poorer, than that of the independent (P < 0.01). Among the 603 (8.4 percent) IADL-dependent, significant, independently associated factors were age, cerebrovascular and other chronic diseases, depression, vision issues, excessive pain, and amputation of a limb. Absence of childhood trauma and fewer years of employment were related to a lower incidence of IADL dependence. CONCLUSIONS: Functional dependence in older adults is directly related to aging and has multiple determinants. Awareness of these determinants should help design health programs that can identify individuals who are at high risk of losing their independence, and implement interventions for slowing or reversing the process.