Cognitive impairment among older persons with chronic illness attending primary care and its association with cardiovascular risk using the Framingham risk score.

IF 3.4 2区 医学 Q2 GERIATRICS & GERONTOLOGY
Nimelesh Balanthiren, Mohd Fairuz Ali, Aznida Firzah Abdul Aziz
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Abstract

Background: Dementia is a major public health burden, particularly among the older persons with significant implications for individuals, caregivers, and society. Identifying mild cognitive impairment early can facilitate timely intervention and care.This cross-sectional study aims to investigate the association between Framingham risk score (FRS), a widely used tool for cardiovascular disease (CVD) risk prediction, and cognitive impairment among older persons with chronic illness in Malaysia.

Methods: A total of 289 participants aged 60 years and above with chronic illness were recruited from Klinik Primer Hospital Tuanku Chanselor Muhriz via simple random sampling via computer generator. The Montreal Cognitive Assessment Bahasa Malaysia version (MoCA-BM) was used to assess cognitive function and the FRS was calculated on the basis of CVD risk factors.

Results: The prevalence of cognitive impairment among the participants was found to be 19.7%. Multiple Logistic Regression revealed that age (AOR 1.101, 95% CI = 1.041,1.163, p < 0.001), systolic blood pressure (AOR 1.048, 95%CI = 1.024, 1.072, p < 0.001) diabetes (AOR 2.655, 95% CI = 1.194, 5.906, p = 0.017) increased the odds of having cognitive impairment among older persons with chronic illness whereas secondary education ( AOR 0.087, 95% CI = 0.008, 0.963, p = 0.047) and higher education ( AOR 0.037, 95% CI = 0.002, 0.833, p = 0.038) reduced the likelihood of having cognitive impairment. Individuals with higher FRS were more likely to have cognitive impairment (AOR 1.099, 95% CI = 1.049, 1.172, p < 0.001). The optimal cutoff point for the FRS to determine cognitive impairment is 30 for males with a sensitivity and specificity of 84.4% and 51.2% while the optimal cut off point for females is 18.5 with a sensitivity and specificity of 76% and 63.1% respectively.

Conclusions: These findings suggest that the FRS which was originally designed for CVD risk assessment may also serve as a valuable predictive tool for cognitive impairment among older persons with chronic illness. Integrating FRS into routine primary care assessments could enhance the early identification of individuals at risk and enable appropriate cognitive screenings and interventions. Further research such as a longitudinal cohort study in a larger and more diverse population is warranted to validate the association of CVD risks with the development of dementia.

接受初级保健的慢性病老年人的认知障碍及其与使用弗雷明汉风险评分的心血管风险的关系。
背景:痴呆症是一项重大的公共卫生负担,尤其是在老年人中,对个人、照顾者和社会都有重大影响。这项横断面研究旨在调查马来西亚患有慢性疾病的老年人中,弗雷明汉风险评分(FRS)与认知障碍之间的关系:通过计算机生成器进行简单随机抽样,从Klinik Primer医院(Tuanku Chanselor Muhriz)招募了289名60岁及以上的慢性病患者。评估认知功能时使用了蒙特利尔认知评估马来语版(MoCA-BM),并根据心血管疾病风险因素计算了FRS:结果:参与者中认知功能障碍的发生率为 19.7%。多重逻辑回归显示,年龄(AOR 1.101,95% CI = 1.041,1.163,P 结论:这些结果表明,FRS(心血管疾病危险因素)是评估认知功能的重要指标:这些研究结果表明,最初设计用于心血管疾病风险评估的 FRS 也可以作为预测患有慢性疾病的老年人认知功能障碍的重要工具。将 FRS 纳入常规初级保健评估可加强对高危人群的早期识别,并进行适当的认知筛查和干预。为了验证心血管疾病风险与痴呆症发展之间的联系,有必要开展进一步的研究,如在更大范围和更多样化的人群中开展纵向队列研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Geriatrics
BMC Geriatrics GERIATRICS & GERONTOLOGY-
CiteScore
5.70
自引率
7.30%
发文量
873
审稿时长
20 weeks
期刊介绍: BMC Geriatrics is an open access journal publishing original peer-reviewed research articles in all aspects of the health and healthcare of older people, including the effects of healthcare systems and policies. The journal also welcomes research focused on the aging process, including cellular, genetic, and physiological processes and cognitive modifications.
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