Risk and protective factors of neurocognitive disorders in older adults in Central and Eastern Europe: A systematic review of population-based studies

Abstract

Background A wide range of potentially modifiable risk factors, indicating that the onset of neurocognitive disorders can be delayed or prevented, have been identified. The region of Central and Eastern Europe has cultural, political and economic specifics that may influence the occurrence of risk factors and their link to the cognitive health of the population. Objective We aimed to systematically review population-based studies from Central and Eastern Europe to gather evidence on risk and protective factors for neurocognitive disorders. Methods We searched the electronic databases PubMed, Cochrane Database of Systematic Reviews, PsycINFO, Web of Science, and Embase. The search was performed on 26th of February 2020 and repeated at the end of the review process on 20th May 2021. Results We included 25 papers in a narrative synthesis of the evidence describing cardiovascular risk factors (n = 7), social factors (n = 5), oxidative stress (n = 2), vitamins (n = 2), genetic factors (n = 2) and other areas (n = 7). We found that there was a good body of evidence on the association between neurocognitive disorders and the history of cardiovascular disease while there were gaps in research of genetic and social risk factors. Conclusion We conclude that the epidemiological evidence from this region is insufficient and population-based prospectively followed cohorts should be established to allow the development of preventive strategies at national levels.

Association of Trimethylamine N-Oxide with Normal Aging and Neurocognitive Disorders: A Narrative Review

“…Although age increases risk, there are marked individual differences in the vulnerability for older adults in terms of NCD. Indeed, the onset of these disorders could be prevented or delayed, given that a wide range of predictive features, such as bio-behavioral factors, psychosocial characteristics, and cardiovascular diseases, are potentially modifiable [ 5 , 6 ]. Among them, gut microbiota and their metabolic products, including trimethylamine-N-oxide (TMAO), have recently emerged as a promising disease modifier and might play a putative role in aging and the development and progression of NCD [ 7 , 8 , 9 ].…”

Life-course Factors and Later Life Health in Eastern and Western Europe

“…Comparative analyses indicate that Eastern European countries do not differ from Western European countries in cognition, especially in verbal fl uency, though they fare somewhat worse in recall (Ahrenfeldt et al 2019;Formanek et al 2019). General associations with cognition have been similar to other European countries, including the relevance of education (Horvat et al 2014;Wolfova et al 2021). Like other spheres, educational systems went through various transitions in Eastern European countries during the 20 th century.…”

“…Education is one of the most important factors in cognition: The higher the education received, the better cognition outcomes in later life, especially regarding memory (Everson-Rose et al 2003;Zhang et al 2008;Horvat et al 2014;Schneeweis et al 2014;Lee/Schafer 2021;Wolfova et al 2021). Among its several benefi ts, one may be that education enables a better sense of control, therefore extending the pathway into late-life cognition advantages (Lee/Schafer 2021).…”