Chronic Physical Conditions, Multimorbidity, and Mild Cognitive Impairment in Low‐ and Middle‐Income Countries

Koyanagi, Ai; Lara, Elvira; Stubbs, Brendon; Carvalho, André F.; Oh, Hans; Stickley, Andrew; Veronese, Nicola; Vancampfort, Davy

doi:10.1111/jgs.15288

Cited by 99 publications

(113 citation statements)

References 48 publications

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“…Adjustment for country was done by including dummy variables for each country in the model as in previous SAGE publications [33,34]. All variables were included in the models as categorical variables with the exception of age and number of chronic conditions (continuous variables).…”

Section: Discussionmentioning

confidence: 99%

Fruit and Vegetable Consumption and Sarcopenia among Older Adults in Low- and Middle-Income Countries

et al. 2020

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Fruit and vegetable consumption may protect against sarcopenia but there are no studies on this topic from low- and middle-income countries (LMICs). Thus, we assessed this association among older adults from six LMICs. Community-based cross-sectional data of the Study on Global Aging and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. Quintiles of vegetable and fruit consumption were created based on the number of servings consumed on a typical day. Multivariable logistic regression analysis was conducted. The sample consisted of 14,585 individuals aged ≥65 years (mean (SD) age 72.6 (11.4) years; 55% females). Adjusted analyses showed that overall, compared to the lowest quintile (Q1), the highest quintile (Q5) of fruit consumption was associated with a 40% lower odds for sarcopenia (OR = 0.60; 95% CI = 0.42−0.84) but this association was largely driven by the strong association among females (e.g., Q5 vs. Q1 OR = 0.42; 95% CI = 0.24−0.73), with no significant associations found among males. Vegetable consumption was not significantly associated with sarcopenia. Future studies of longitudinal design may shed light on whether increasing fruit consumption among older females in LMICs may reduce risk for sarcopenia.

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Section: Discussionmentioning

confidence: 99%

Fruit and Vegetable Consumption and Sarcopenia among Older Adults in Low- and Middle-Income Countries

et al. 2020

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“…There are some studies that have showed that the presence of particular aspects, or some diseases, in hypertensive population confers a greater risk of cognitive impairment. This is the case of hypertensive patients with depression (49,50), or hypertensive population with a worse economic situation (51). In general population, many others factors such as depression, educational level, socioeconomic status (rural areas, low income, less social participation), physical inactivity or unhealthy diet have also been related to the development of cognitive impairment (3,(52)(53)(54)(55).…”

Section: Other Factors Related To High Bp and Risk Of Developing Cognmentioning

confidence: 99%

Hypertension and the Risk of Dementia

Sierra

2020

Front. Cardiovasc. Med.

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Hypertension, particularly midlife high blood pressure, has been related to a higher risk of cognitive decline and dementia, including Alzheimer disease. However, these associations are complex and not fully elucidated. Cerebral small vessel disease emerges as one of the most important causes. Several observational studies have shown the potential beneficial role of antihypertensive treatment in preventing cognitive decline. However, randomized clinical trials (RCTs) have shown controversial results without proving nor disproving the association. On the other hand, in very elderly or frail people some studies have observed a relationship between low blood pressure and worse cognitive function. The optimal systolic and diastolic blood pressure values for protecting cognitive function, especially in elderly people, are not known.

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“…24 We applied the identical algorithms used in previous SAGE publications to identify cases of MCI. [25][26][27] Briefly, individuals fulfilling all of the following conditions were considered to have MCI:…”

Section: Mild Cognitive Impairment (Outcome)mentioning

confidence: 99%

“…41 Nonetheless, a recent study with a longer follow-up period assessed 708 adults at six time points over a 20-year period and concluded that the strength and stability of the connections between handgrip strength and cognition indicate bidirectionality and/or third-factor causality. 42 With regard to thirdfactor causality, both lower muscle strength and cognitive impairment occur in concert with a higher risk for chronic diseases 43 and low physical activity participation 44,45 which are on their turn risk factors for further cognitive decline. However, the association between weak handgrip strength and MCI remained significant in our study even after controlling for chronic conditions, depression, and physical inactivity indicating that the relationship is likely to be explained by underlying biological mechanisms, which were not assessed in the current study.…”

Section: General Findingsmentioning

confidence: 99%

Associations between handgrip strength and mild cognitive impairment in middle‐aged and older adults in six low‐ and middle‐income countries

Vancampfort

Stubbs

Firth

et al. 2019

Int J Geriat Psychiatry

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Objectives A number of small‐scale, single‐country studies have suggested that muscular weakness may be a biomarker for cognitive health, mild cognitive impairment (MCI), and dementia. However, multinational, representative studies are lacking, particularly from low‐ and middle‐income countries (LMICs). Thus, we assessed the association between muscular strength (measured by maximal handgrip) and MCI in six LMICs (China, Ghana, India, Mexico, Russia, and South Africa), using nationally representative data. Methods Cross‐sectional, community‐based data on individuals aged 50 years or older from the World Health Organization's Study on Global Ageing and Adult Health were analyzed. MCI was defined according to the National Institute on Aging‐Alzheimer's Association criteria. Weak handgrip strength was defined as less than 30 kg for men and less than 20 kg for women using the average value of two handgrip measurements of the dominant hand. Multivariable logistic regression analysis was conducted to assess the association between muscular strength and MCI. Results A total of 32 715 participants were included (mean age 62 ± SD 15.6 y and 51.7% female). The prevalence of MCI and weak handgrip strength was 15.3% (95% CI, 14.4%‐16.3%) and 46.5% (95% CI, 43.6%‐49.5%), respectively. After adjustment for potential confounders, weak handgrip strength was associated with 1.41 (95% CI, 1.23‐1.61) times higher odds for MCI. The corresponding figures for those aged 50 to 64 years and 65 years or older were 1.35 (95% CI, 1.14‐1.60) and 1.54 (95% CI, 1.27‐1.86), respectively. Conclusions Muscular weakness may provide a clinically useful indicator of MCI risk. Increasing our understanding of the connection between muscular and cognitive function could ultimately lead to the development and broader implementation of resistance training interventions targeting both physical and cognitive health.

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Chronic Physical Conditions, Multimorbidity, and Mild Cognitive Impairment in Low‐ and Middle‐Income Countries

Abstract: These results highlight the need to investigate the underlying mechanisms linking chronic conditions and MCI and whether prevention or treatment of chronic conditions or multimorbidity can reduce the onset of cognitive decline and subsequent dementia, especially in LMICs.

Cited by 99 publications

References 48 publications

Fruit and Vegetable Consumption and Sarcopenia among Older Adults in Low- and Middle-Income Countries

Fruit and Vegetable Consumption and Sarcopenia among Older Adults in Low- and Middle-Income Countries

Hypertension and the Risk of Dementia

Associations between handgrip strength and mild cognitive impairment in middle‐aged and older adults in six low‐ and middle‐income countries

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