Predictors of cognitive stability or decline during aging: A longitudinal study in primary care.
Appl Neuropsychol Adult
; 27(1): 22-34, 2020.
Article
em En
| MEDLINE
| ID: mdl-30183358
ABSTRACT
We aimed to identify the early predictors of cognitive decline, and primary care physicians' (PCP) ability to diagnose cognitively impaired subjects, in a cohort of individuals recruited in primary care centers. Independent adults, aged ≥50 years at inception, with an overall low level of education, undertook a prospective clinical and cognitive evaluation targeting memory, attention and executive functions. At follow-up subjects were classified as cognitively normal (CN) or impaired (CI). Of 275 subjects (70.4 ± 8.3 years old, 176 females, 7.5 ± 4.4 education, 162 with MRI), 31 (11.2%) presented CI 4.9 years later, the majority (64.5%) presenting subjective cognitive complaints. PCP could correctly identify 40% of CI individuals, particularly if they presented current cognitive complaints. Male sex (OR = 3.117; CI95% 1.007-9.645), age (OR = 1.063; CI95% 1.004-1.126) and baseline scores on TMT-B (OR = 0.225; CI95% 0.073-0.688) and Vocabulary (OR = 0.940; 95% CI 0.894-0.986) predicted CI. This study shows that measures indicating poor cognitive reserve and low executive performance (as shown by low vocabulary and executive test scores, respectively) can be early indicators of the risk of decline, stressing the role of cognitive assessment as part of prevention/early intervention programs. The results also underline the need to help PCP to improve the detection of subjects with cognitive decline.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Envelhecimento
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Função Executiva
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Reserva Cognitiva
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Disfunção Cognitiva
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article