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

Abstract

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.

Prevalence of dementia in Latin America and Caribbean countries: Systematic review and meta-analyses exploring age, sex, rurality, and education as possible determinants

“…Although five articles were classified as unclear regarding the appropriateness of recruited participants ( Brucki and Nitrini, 2014 , Correia et al, 2011 , Lopes et al, 2012 , Pedraza et al, 2017 , Ramos-Cerqueira et al, 2005 ), all articles presented adequate sample size. Further, in 10 studies, it was not clear whether dementia was assessed in a standardised way, i.e., whether those involved in data collection were trained in the use of the instruments ( Albala et al, 1997 ; Eldemire-Shearer et al, 2018 ; Magalhães et al, 2008 ; Martínez Querol et al, 2005 ; Mejia-Arango and Gutierrez, 2011 ; Mejia-Arango et al, 2021 ; Neita et al, 2014 ; Pedraza et al, 2017 ; Sanchez-Arenas et al, 2013 ; Villarreal et al, 2016 ). Finally, Soto-Añari et al (2021) included a non-probabilistic sampling obtained by convenience samples from private and public clinics.…”

“…The diamonds represent the prevalence of all-cause dementia for studies with representative samples, the horizontal bars the 95% confidence intervals. Note: ES: effect size; CI: confidence intervals; * Additional information retrieved from Mejia-Arango et al (2021) .

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“…Two studies included participants aged 50 + years ( Brucki and Nitrini, 2014 , Pedraza et al, 2017 ), one article included participants aged 55 + years ( Molero et al, 2007 ). In contrast, 16 studies included participants aged 60 + years ( Bartoloni et al, 2014 , Bottino et al, 2008 , César et al, 2016 , Gatz et al, 2022 , Gooding et al, 2006 ; Ketzoian et al, 1997a ; Llibre Rodríguez et al, 1999 ; Lopes et al, 2012 ; Magalhães et al, 2008 ; Manrique-Espinoza et al, 2013 , Mejia-Arango and Gutierrez, 2011 , Mejia-Arango et al, 2021 ; Neita et al, 2014 ; Sanchez-Arenas et al, 2013 ; Soto-Añari et al, 2021 ), 11 included participants aged 65 + years ( Albala et al, 1997 ; Correia et al, 2011 , Custodio et al, 2008 , Herrera et al, 2002 , Llibre et al, 2009 ; Llibre Rodriguez et al, 2008 ; Martínez Querol et al, 2005 ; Ramos-Cerqueira et al, 2005 ; Scazufca et al, 2008 ; Villarreal et al, 2016 ), one included participants aged 70 + years ( Davis et al, 2018 ) and one study included participants aged 75 + years ( Caramelli et al, 2011 ). We thus report prevalence estimates by age group (50–59, 60–64, 65–69, 70–74, 75–79, 80 +) in Table 3 .…”

New Trends in Cognitive Aging and Mild Cognitive Impairment

“…Life-course sociodemographic and health-related conditions can change cognitive profiles of old adults participating in these types of studies across different age cohorts. Mejía-Arango et al (2021) [ 2 ] used data from the 2001 and 2015 years of the Mexican Health and Aging Study (MHAS) to study trends in cognitive impairment and dementia for Mexican older adults aged 60 years or older. They found a higher likelihood of dementia and a lower likelihood of cognitive impairment no dementia (CIND) in 2015 compared to 2001.…”

Temporal Dementia and Cognitive Impairment Trends in the Very Old in the 21st Century

“…In recent decades, the incidence of (mild) cognitive impairment has generally been stable [7,8] or decreased [9][10][11]. Three studies of this incidence involved assessment at more than two timepoints; one showed a decreasing incidence of cognitive impairment [Mini-Mental State Examination (MMSE) score < 18] among ≥ 60-year-olds (≥80 years: 77%) in China during 1998-2014 [9], and the other two showed stable trends of the incidence of mild cognitive impairment during 2015-2019 among ≥ 65-year-olds in Germany [7] and during 1993-2016 among ≥ 70-year-olds in the US, with no difference among birth cohorts over the range 1899-1946 [8].…”