THE COGNITIVE IMPPAIRMENT AND ITS RELATED FACTORS AMONG FACTORS AMONG ELDERLY HYPERTENSIVE IN TWO RURAL DISTRICTS AREAS, MALAYSIA
Keywords:screening, cognitive impairment, associated factors, elderly hypertensive
As cognition declines with age, cognitive impairment rates are expected to increase ranging from 100% to 300% in this region. It could be higher among elderly who had any chronic diseases. The aim of the present work was to determine the prevalence and associated factors of cognitive impairment among elderly with hypertension. A clinic-based, cross-sectional study was conducted at several community clinics in Sabak Bernam and Hilir Perak districts from July to December 2015. A total of 480 patients were recruited. The prevalence of cognitive impairment was 13.13% (95%CI: 13.11, 13.15). Factors associated with cognitive impairment among elderly hypertensive were no formal educational level [OR: 3.95 (95%CI: 1.80, 8.67)]; history of high cholesterol [OR: 3.24 (95%CI: 1.15, 9.16)]; underweight [adj. OR: 4.88 (95%CI: 1.34, 17.67)]; and increasing age [OR: 1.03 (95%CI: 1.01, 1.06)]. Public health policy makers and geriatric practitioners should emphasise on early cognitive function assessment among elderlies who are hypertensive, unemployed, poor educational background, males, high cholesterol level and underweight to enhance the quality of geriatric services. Earlier establishment of diagnosis may prevent from greater rate of decline in cognitive functioning among this vulnerable group.
2. Mafauzy M. The Problems and Challenges of the Aging Population of Malaysia. The Malaysian Journal of Medical Sciences 2000;7(1):1-3.
3. Kalaria RN, Maestre GE, Arizaga R, Friedland RP, Galasko D, Hall K, Luchsinger JA, Ogunniyi A, Perry EK, Potocnik F, Prince M, Stewart R, Wimo A, Zhang ZX, Antuono P, World Federation of Nuerology Dementia Research Group. Alzheimer's Disease and Vascular Dementia in Developing Countries: Prevalence, Management, and Risk Factors. The Lancet Neurology 2008;7(9): 812-826.
4. Rashid AK, Azizah AM, Rohana S. Cognitive Impairment Among The Elderly Malays Living In Rural Malaysia. Med J Malaysia 2012;67(2):187-189
5. Enzer N, Simonson E, Blankstein SS. Fatigue of Patients with Circulatory Insufficiency, Investigated by Means of the Fusion Frequency of Flicker. Ann Intern Med 1942;16:702-707.
6. Simonson E, Enzer N. State of Motor Centers in Circulatory Insufficiency. Archives of Internal Medicine 1941;68(3):498-512.
7. Jalavisto E. On the Interdependence of Circulatory-Respiratory and Neural-Mental Variables. Gerontology 1964;10(1):31-37.
8. King HE. (1956). Comparison of Fine Psychomotor Movement by Hypertensive and Hypotensive Subjects. Perceptual and Motor Skills 1956;6:199-204.
9. Pentz CA III, Elias MF, Wood WG, Schultz NA, Dineen J. Relationship of Age and Hypertension to Neuropsychological Test Performance. Experimental Aging Research 1979;5(4):351-372.
10. Schultz NR Jr, Dineen JT, Elias MF, Pentz CA III, Wood WG. WAIS Performance for Different Age Groups of Hypertensive and Control Subjects During the Administration of a Diuretic. Journal of Gerontology 1979;34(2):246-253.
11. Shapiro AP, Miller RE, King HE, Ginchereau EH, Fitzgibbon K. Behavioral Consequences of Mild Hypertension. Hypertension 1982;4(3):355-360.
12. Hertzog C, Schaie KW, Gribbin K. Cardiovascular Disease and Changes in Intellectual Functioning from Middle to Old Age. Journal of Gerontology 1978;33(6):872-883.
13. Wilkie F, Eisdorfer C. Intelligence and Blood Pressure in the Aged. Science 1971 172(3986):959-962.
14. Schultz Jr NR, Elias MF, Robbins MA, Streeten DH, Blakeman N. A Longitudinal Study of the Performance of Hypertensive and Normotensive Subjects on the Wechsler Adult Intelligence Scale. Psychology and Aging 1989;4(4):496-499.
15. Schultz NR, Elias MF, Robbins MA, Streeten DH, Blakeman N (1986). A longitudinal Comparison of Hypertensives and Normotensives on the Wechsler Adult Intelligence Scale: Initial Findings. Journal of Gerontology 1986;41(2):169-175.
16. Kleinman KM, Goldman H, Snow MY, Korol B. Relationship Between Essential Hypertension and Cognitive Functioning II: Effects of Biofeedback Training Generalize to Non?Laboratory Environment. Psychophysiology 1977;14(2):192-197.
17. Starr JM, Whalley LJ, Inch S, Shering P. Blood Pressure and Cognitive Function in Healthy Old People. Journal of the American Geriatrics Society 1993:41(7):753-756.
18. Gelber RP, Ross GW, Petrovitch H, Masaki KH, Launer LJ, White LR. Antihypertensive Medication Use and Risk of Cognitive Impairment: the Honolulu-Asia Aging Study. Neurology 2013;81(10):888-895.
19. Peters R, Beckett N, Fagard R, Thijs L, Wang JG, Forette F, Pereira L, Fletcher A, Bulpitt C. Increased Pulse Pressure Linked to Dementia: Further Results from the Hypertension in the Very Elderly Trial - HYVET. J Hypertens 2013;31(9):1868-1875.
20. Qiu C, Winblad B, Fratiglioni L. The Age-Dependent Relation of Blood Pressure to Cognitive Function and Dementia. The Lancet Neurology 2005;4(8):487-499.
21. Ko K, Jung M, Hong S. Prevalence of Cognitive Impairment and Related Factors Among the Elderly in Rural Communities of Jeju Province. Journal of Korean Academy of Nursing, 2003;33(4):503-509.
22. Kua E, Ko S. A Questionnaire to Screen for Cognitive Impairment among Elderly People in Developing Countries. Acta Psychiatrica Scandinavica 1992;85(2):119-122.
23. Feldman H, Levy A, Hsiung GY, Peters K, Donald A, Black S, Bouchard RW, Gauthier SG, Guzman DA, Hogan DB, Kertesz A, Rockwood K. (2003). A Canadian Cohort Study of Cognitive Impairment and Related Dementias (ACCORD): Study Methods and Baseline Results. Neuroepidemiology 2003;22(5):265-274.
24. Liu Z, Albanese E, Li S, Huang Y, Ferri C, Yan F, Sousa R, Dang W, Prince M. Chronic Disease Prevalence and Care among the Elderly in Urban and Rural Beijing, China - A 10/66 Dementia Research Group Cross-sectional survey. BMC Public Health, 2009;9:394.
25. Sharma D, Mazta S, Parashar A. Prevalence of Cognitive Impairment and Related Factors among Elderly: A population-based Study. Journal of Dr. NTR University of Health Sciences 2013;2(3):171-176.
26. Kumar N, Sudhakar T. Prevalence of Cognitive Impairment and Depression among Elderly Patients Attending the Medicine Outpatient of a Tertiary Care Hospital in South India. International Journal of Research in Medical Sciences 2013;1(4):359-364.
27. Laks J, Batista EMR, Guilherme ERL, Contino ALB, Faria MEV, Rodrigues CS, Engelhardt E. Prevalence of Cognitive and Functional Impairment in Community-Dwelling Elderly: Importance of Evaluating Activities of Daily Living. Arquivos de Neuro-psiquiatria, 2005;63(2-A):207-212.
28. Krishnaswamy S. Psychiatric Problems Among the Elderly in Malaysia. Medical Journal of Malaysia 1997;52(3):222-225.
29. Paúl C, Ribeiro O, Santos P. Cognitive Impairment in Old People Living in the Community. Archives of Gerontology and Geriatrics 2010;51(2):121-124.
30. Sato M. Education, Ethnicity and Economics: Higher Education Reforms in Malaysia 1957-2003. NUCB Journal of Language Culture and Communication 2005;7(1):3-88.
31. Duron E, Hanon O. Vascular Risk Factors, Cognitve Decline, and Dementia. Vascular Health and Risk Management 2008;4(2):363-381.
32. Kloppenborg RP, van den Berg E, Kappelle LJ, Biessels GJ. Diabetes and Other Vascular Risk Factors for Dementia: Which Factor Matters Most? A Systematic Review. European Journal of Pharmacology 2008;585(1):97-108.
33. Laurin D, Verreault R, Lindsay J, MacPherson K, Rockwood K. Physical Activity and Risk of Cognitive Impairment and Dementia in Elderly Persons. Archives of Neurology 2001;58(3):498-504.
34. Yaffe K, Barrett-Connor E, Lin F, Grady D. Serum Lipoprotein Levels, Statin Use, and Cognitive Function in Older Women. Archives of Neurology 2002;59(3):378-384
35. Folstein MF, Folstein SE, McHugh PR. “Mini-Mental State”: A Practical Method for Grading the Cognitive State of Patients for the Clinician. Journal of Psychiatric Research, 1975;12(3):189-198.