Risk Factors of Subjective Cognitive Decline among Older People with Low Socioeconomic Status
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Issue
Vol. 18 No. 2 (2023)
Accepted
31 July 2023
Published
31 July 2023
Keywords:
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cognitive impairment, depressive symptoms, socioeconomic status, subjective cognitive decline, older adults
Abstract
The aim of the study is to investigate the predictors associated with Subjective Cognitive Decline (SCD)especially among older people with low socioeconomic status. This was a cross- sectional study involving older people with low socioeconomic status in Kelantan, which is one of the poorest states in Malaysia. Data of anthropometry, body composition, cognitive function, sarcopenia, depressive symptoms, medical history, blood pressure and polypharmacy were obtained via face-to-face interview. SCD was determined by a single item in the Geriatric Depression Scale (GDS). Variables were analysed using the binary logistic regression model for identification of risk factors. A total of 293 older people with mean age of 69.1 years old was recruited. The SCD proportion in this study was 24.6%. One unit increase in Geriatric Depression Scale (GDS) score increases risk of subjective cognitive decline by odds of 1.814 (OR=0.595: 95% CI:1.441–2.283; p<0.001). Meanwhile, those with diabetes have a tendency of 2.972 to have SCD as compared to non-diabetics (OR=1.089: 95% CI:1.062–8.315; p<0.038). The prevalence of SCD in this study is high and may contribute to cognitive impairment. The predictors of SCD were larger waist circumference, having diabetes, and increasing score in GDS. SCD must be screened earlier and healthy lifestyle must be emphasized. Routine screening and monitoring of non-communicable disease risk factors are important for the prevention of SCD.
References
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Hill NL, Mogle J. 2018. Alzheimer's disease risk factors as mediators of subjective memory impairment and objective memory decline: Protocol for a construct-level replication analysis. BMC Geriatr 18(1):1−8. https://doi.org/10.1186/s12877-018-0954-5
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Kan KC, Subramaniam P, Shahrizaila N, Kamaruzzaman SB, Razali R, Ghazali SE. 2019. Validation of the Malay version of addenbrooke's cognitive examination III in detecting mild cognitive impairment and dementia. Dement Geriatr Cogn Disord Extra 9(1):66−76. https://doi.org/10.1159/000495107
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Liew TM. 2019. Depression, subjective cognitive decline, and the risk of neurocognitive disorders. Alzheimer's Res Ther 11(1):1−8. https://doi.org/10.1186/s13195-019-0527-7
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Marseglia A, Fratiglioni L, Kalpouzos G, Wang R, Bäckman L, Xu W. 2019. Prediabetes and diabetes accelerate cognitive decline and predict microvascular lesions: A population-based cohort study. Alzheimer's Dement 15(1):25−33. https://doi.org/10.1016/j.jalz.2018.06.3060
Miley-Akerstedt A, Jelic V, Marklund K, Walles H, Åkerstedt T, Hagman G, Andersson C. 2019. Lifestyle factors are important contributors to subjective memory complaints among patients without objective memory impairment or positive neurochemical biomarkers for Alzheimer's disease. Dement Geriatr Cogn Disord Extra 8(3):439−452. https://doi.org/10.1159/000493749
Nazri NS, Vanoh D, Leng SK. 2021. Malnutrition, low diet quality and its risk factors among older adults with low socio-economic status: A scoping review. Nutr Res Reviews 34(1):107−116. https://doi.org/10.1017/S0954422420000189
Nyunt MSZ, Fones C, Niti M, Ng TP. 2009. Criterion-based validity and reliability of the geriatric depression screening scale (GDS-15) in a large validation sample of community-living Asian older adults. Aging Ment Health 13(3):376−382. https://doi.org/10.1080/13607860902861027
Papunen S, Mustakallio-Könönen A, Auvinen J, Timonen M, Keinänen-Kiukaanniemi S, Sebert S. 2020. The association between diabetes and cognitive changes during aging. Scand J Prim Health Care 38(3):281−290. https://doi.org/10.1080/02813432.2020.1802140
Roh M, Dan H, Kim O. 2021. Influencing factors of subjective cognitive impairment in middle-aged and older adults. Int J Environ Res Public Health 18(21):11488. https://doi.org/10.3390/ijerph182111488
Röhr S, Pabst A, Riedel-Heller SG, Jessen F, Turana Y, Handajani YS, Brayne C, Matthews FE, Stephan BC, Lipton RB et al. 2020. Estimating prevalence of subjective cognitive decline in and across international cohort studies of aging: A COSMIC study. Alzheimer's Res Ther 12(1):1−14. https://doi.org/10.1186/s13195-020-00734-y
Rosli R, Goodson M, Tan MO, Mohan D, Reidpath D, Allotey O, Kamaruzzaman S, Chin AV, Robinson L. 2021. Challenges and research priorities for dementia car in Malaysia from the perspective of health and allied health professionals. Int J Environ Res Public Health 18(21):11010. https://doi.org/10.3390/ijerph182111010
Schwarz C, Lange C, Benson GS, Horn N, Wurdack K, Lukas M, Buchert R, Wirth M, Flöel A. 2021. Severity of subjective cognitive complaints and worries in older adults are associated with cerebral amyloid-β load. Front Aging Neurosci 13:675583. https://doi.org/10.3389/fnagi.2021.675583
Shahar S, Vanoh D, Ludin AFM, Singh DKA, Hamid TA. 2019. Factors associated with poor socioeconomic status among Malaysian older adults: An analysis according to urban and rural settings. BMC Public Health 19(4):1−12. https://doi.org/10.1186/s12889-019-6866-2
Tadai ME, Straughan PT, Cheong G, Yi RNW, Er TY. 2023. The effects of SES, socialsupport, and resilience on older adults' wellbeing during COVID-19: Evidence from Singapore. Urban Governance 3(1):14−21.https://doi.org/10.1016/j.ugj.2023.02.002
Taylor CA, Bouldin ED, Greenlund KJ, McGuire LC. 2020. Comorbid chronic conditions among older adults with subjective cognitive decline, United States, 2015−2017. Innov Aging 4(1):igz045. https://doi.org/10.1093/geroni/igz045
Vanoh D, Suzana S, Yahya HM, Hamid TA. 2016. Prevalence and determinants of depressive disorders among community-dwelling older adults: Findings from the towards useful aging study. Int J Gerontol 10(2):81−85. https://doi.org/10.1016/j.ijge.2016.02.001
Vlachos GS, Cosentino S, Kosmidis MH, Anastasiou CA, Yannakoulia M, Dardiotis E, Hadjigeorgiou, G, Sakka P, Ntanasi E, Scarmeas N. 2019. Prevalence and determinants of subjective cognitive decline in a representative Greek elderly population. Int J Geriatr Psychiatry 34(6):846−854. https://doi.org/10.1002/gps.5073
Wang X, Wang M, Wang X, Zhou F, Jiang J,Liu H, Han Y. 2022. Subjective cognitive decline-related worries modulate the relationship between global amyloid load and gray matter volume in preclinical Alzheimer's disease. Brain Imaging Behav 16(3):1088−1097. https://doi.org/10.1007/s11682-021-00558-w
Wei YC, Huang LY, Chen CK, Lin C, Shyu YC, Chen YL, Huang WY, Lin CP. 2019. Subjective cognitive decline in the community is affected at multiple aspects of mental health and life quality: a cross-sectional study of the community medicine of Keelung Chang Gung Memorial Hospital. Dement Geriatr Cogn Disord Extra 9(1):152−162. https://doi.org/10.1159/000497222
Wen C, Hu H, Ou YN, Bi YL, Ma YH, Tan L, Yu JT. 2021. Risk factors for subjective cognitive decline: The CABLE study. Transl Psychiatry 11(1):576. https://doi.org/10.1038/s41398-021-01711-1
West NA, Lirette ST, Cannon VA, Turner ST, Mosley Jr TH, Windham BG. 2017. Adiposity, change in adiposity, and cognitive decline in mid-and late life. J Am Geriatr Soc 65(6):1282−1288. https://doi.org/10.1111/jgs.14786
West RK, Ravona-Springer R, Heymann A, Schmeidler J, Leroith D, Koifman K, D’Arcy RC, Song X, Guerrero-Berroa, E, Preiss R et al. 2016. Waist circumference is correlated with poorer cognition in elderly type 2 diabetes women. Alzheimer's Dement 12(8):925−929. https://doi.org/10.1016/j.jalz.2016.03.017
Yasuda T, Fukumura K, Nakajima T. 2017. Short physical performance battery for middleaged and older adult cardiovascular disease patients: Implication for strength tests and lower extremity morphological evaluation. J Phys Ther Sci 29(4):748−753. https://doi.org/10.1589/jpts.29.748
Brown MJ, Hill NL, Haider MR. 2022. Age and gender disparities in depression and subjective cognitive declinerelated outcomes. Aging Ment Health 26(1):48−55. https://doi.org/10.1080/13607863.2020.1861214
Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, Jang HC, Kang L, Kim M, Kim S et al. 2020. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc 21(3):300−307. https://doi.org/10.1016/j.jamda.2019.12.012
Chen R, Cai G, Xu S, Sun Q, Luo J, Wang Y, Li M, Lin H, Liu J. 2022. Body mass index related to executive function and hippocampal subregion volume in subjective cognitive decline. Front Aging Neurosci 14:905035. https://doi.org/10.3389/fnagi.2022.905035
Dainy NC, Kusharto CM, Madanijah S, Nasrun MWS, Turana Y. 2018. Nutritional status, physical activity, oxidative stress, and cognitive function in pre-elderly and elderly. J Gizi Pangan 13(3):117−122. https://doi.org/10.25182/jgp.2018.13.3.117-122
Dove A, Shang Y, Xu W, Grande G, Laukka EJ, Fratiglioni L, Marseglia A. 2021. The impact of diabetes on cognitive impairment and its progression to dementia. Alzheimer's Dement 17(11):1769−1778. https://doi.org/10.1002/alz.12482
Foong HF, Haron SA, Koris R, Hamid TA, Ibrahim R. 2021. Relationship between financial well-being, life satisfaction, and cognitive function among low-income community- dwelling older adults: the moderating role of sex. Psychogeriatrics 21(4):586−595. https://doi.org/10.1111/psyg.12709
Fung FY, Koh YLE, Malhotra R, Ostbye T, Lee PY, Shariff Ghazali S, Tan NC. 2019. Prevalence of and factors associated with sarcopenia among multi-ethnic ambulatory older Asians with type 2 diabetes mellitus in a primary care setting. BMC Geriatr 19:1−10. https://doi.org/10.1186/s12877-019-1137-8
Hill NL, Mogle J, Wion R, Munoz E, DePasquale N, Yevchak AM, Parisi JM. 2016. Subjective cognitive impairment and affective symptoms: A systematic review. The Gerontologist 56(6):109−127. https://doi.org/10.1093/geront/gnw091
Hill NL, Mogle J. 2018. Alzheimer's disease risk factors as mediators of subjective memory impairment and objective memory decline: Protocol for a construct-level replication analysis. BMC Geriatr 18(1):1−8. https://doi.org/10.1186/s12877-018-0954-5
Hou Q, Guan Y, Yu W, Liu X, Wu L, Xiao M, Lü Y. 2019. Associations between obesity and cognitive impairment in the Chinese elderly: An observational study. Clin Interv Aging 2019:367−373. https://doi.org/10.2147/CIA.S192050
Jessen F, Amariglio RE, Buckley RF, van der Flier WM, Han Y, Molinuevo JL, Rabin L, Rentz DM, Rodriguez-Gomez O, Saykin AJ et al. 2020. The characterisation of subjective cognitive decline. Lancet Neurol 19(3):271−278. https://doi.org/10.1016/S1474-4422(19)30368-0
Kan KC, Subramaniam P, Shahrizaila N, Kamaruzzaman SB, Razali R, Ghazali SE. 2019. Validation of the Malay version of addenbrooke's cognitive examination III in detecting mild cognitive impairment and dementia. Dement Geriatr Cogn Disord Extra 9(1):66−76. https://doi.org/10.1159/000495107
Künzi M, Joly-Burra E, Zuber S, Haas M, Tinello D, Da Silva Coelho C, Hering A, Ihle A, Laera G, Mikneviciute G et al. 2021. The relationship between life course socioeconomic conditions and objective and subjective memory in older age. Brain Sci 11(1):61. https://doi.org/10.3390/brainsci11010061
Liew TM. 2019. Depression, subjective cognitive decline, and the risk of neurocognitive disorders. Alzheimer's Res Ther 11(1):1−8. https://doi.org/10.1186/s13195-019-0527-7
Lin LH, Wang SB, Xu WQ, Hu Q, Zhang P, Ke Y, Huang JH, Ding KR, Li XL, Hou CL et al. 2022. Subjective cognitive decline symptoms and its association with socio-demographic characteristics and common chronic diseases in the southern Chinese older adults. BMC Public Health 22(1):1−9. https://doi.org/10.1186/s12889-022-12522-4
Marseglia A, Fratiglioni L, Kalpouzos G, Wang R, Bäckman L, Xu W. 2019. Prediabetes and diabetes accelerate cognitive decline and predict microvascular lesions: A population-based cohort study. Alzheimer's Dement 15(1):25−33. https://doi.org/10.1016/j.jalz.2018.06.3060
Miley-Akerstedt A, Jelic V, Marklund K, Walles H, Åkerstedt T, Hagman G, Andersson C. 2019. Lifestyle factors are important contributors to subjective memory complaints among patients without objective memory impairment or positive neurochemical biomarkers for Alzheimer's disease. Dement Geriatr Cogn Disord Extra 8(3):439−452. https://doi.org/10.1159/000493749
Nazri NS, Vanoh D, Leng SK. 2021. Malnutrition, low diet quality and its risk factors among older adults with low socio-economic status: A scoping review. Nutr Res Reviews 34(1):107−116. https://doi.org/10.1017/S0954422420000189
Nyunt MSZ, Fones C, Niti M, Ng TP. 2009. Criterion-based validity and reliability of the geriatric depression screening scale (GDS-15) in a large validation sample of community-living Asian older adults. Aging Ment Health 13(3):376−382. https://doi.org/10.1080/13607860902861027
Papunen S, Mustakallio-Könönen A, Auvinen J, Timonen M, Keinänen-Kiukaanniemi S, Sebert S. 2020. The association between diabetes and cognitive changes during aging. Scand J Prim Health Care 38(3):281−290. https://doi.org/10.1080/02813432.2020.1802140
Roh M, Dan H, Kim O. 2021. Influencing factors of subjective cognitive impairment in middle-aged and older adults. Int J Environ Res Public Health 18(21):11488. https://doi.org/10.3390/ijerph182111488
Röhr S, Pabst A, Riedel-Heller SG, Jessen F, Turana Y, Handajani YS, Brayne C, Matthews FE, Stephan BC, Lipton RB et al. 2020. Estimating prevalence of subjective cognitive decline in and across international cohort studies of aging: A COSMIC study. Alzheimer's Res Ther 12(1):1−14. https://doi.org/10.1186/s13195-020-00734-y
Rosli R, Goodson M, Tan MO, Mohan D, Reidpath D, Allotey O, Kamaruzzaman S, Chin AV, Robinson L. 2021. Challenges and research priorities for dementia car in Malaysia from the perspective of health and allied health professionals. Int J Environ Res Public Health 18(21):11010. https://doi.org/10.3390/ijerph182111010
Schwarz C, Lange C, Benson GS, Horn N, Wurdack K, Lukas M, Buchert R, Wirth M, Flöel A. 2021. Severity of subjective cognitive complaints and worries in older adults are associated with cerebral amyloid-β load. Front Aging Neurosci 13:675583. https://doi.org/10.3389/fnagi.2021.675583
Shahar S, Vanoh D, Ludin AFM, Singh DKA, Hamid TA. 2019. Factors associated with poor socioeconomic status among Malaysian older adults: An analysis according to urban and rural settings. BMC Public Health 19(4):1−12. https://doi.org/10.1186/s12889-019-6866-2
Tadai ME, Straughan PT, Cheong G, Yi RNW, Er TY. 2023. The effects of SES, socialsupport, and resilience on older adults' wellbeing during COVID-19: Evidence from Singapore. Urban Governance 3(1):14−21.https://doi.org/10.1016/j.ugj.2023.02.002
Taylor CA, Bouldin ED, Greenlund KJ, McGuire LC. 2020. Comorbid chronic conditions among older adults with subjective cognitive decline, United States, 2015−2017. Innov Aging 4(1):igz045. https://doi.org/10.1093/geroni/igz045
Vanoh D, Suzana S, Yahya HM, Hamid TA. 2016. Prevalence and determinants of depressive disorders among community-dwelling older adults: Findings from the towards useful aging study. Int J Gerontol 10(2):81−85. https://doi.org/10.1016/j.ijge.2016.02.001
Vlachos GS, Cosentino S, Kosmidis MH, Anastasiou CA, Yannakoulia M, Dardiotis E, Hadjigeorgiou, G, Sakka P, Ntanasi E, Scarmeas N. 2019. Prevalence and determinants of subjective cognitive decline in a representative Greek elderly population. Int J Geriatr Psychiatry 34(6):846−854. https://doi.org/10.1002/gps.5073
Wang X, Wang M, Wang X, Zhou F, Jiang J,Liu H, Han Y. 2022. Subjective cognitive decline-related worries modulate the relationship between global amyloid load and gray matter volume in preclinical Alzheimer's disease. Brain Imaging Behav 16(3):1088−1097. https://doi.org/10.1007/s11682-021-00558-w
Wei YC, Huang LY, Chen CK, Lin C, Shyu YC, Chen YL, Huang WY, Lin CP. 2019. Subjective cognitive decline in the community is affected at multiple aspects of mental health and life quality: a cross-sectional study of the community medicine of Keelung Chang Gung Memorial Hospital. Dement Geriatr Cogn Disord Extra 9(1):152−162. https://doi.org/10.1159/000497222
Wen C, Hu H, Ou YN, Bi YL, Ma YH, Tan L, Yu JT. 2021. Risk factors for subjective cognitive decline: The CABLE study. Transl Psychiatry 11(1):576. https://doi.org/10.1038/s41398-021-01711-1
West NA, Lirette ST, Cannon VA, Turner ST, Mosley Jr TH, Windham BG. 2017. Adiposity, change in adiposity, and cognitive decline in mid-and late life. J Am Geriatr Soc 65(6):1282−1288. https://doi.org/10.1111/jgs.14786
West RK, Ravona-Springer R, Heymann A, Schmeidler J, Leroith D, Koifman K, D’Arcy RC, Song X, Guerrero-Berroa, E, Preiss R et al. 2016. Waist circumference is correlated with poorer cognition in elderly type 2 diabetes women. Alzheimer's Dement 12(8):925−929. https://doi.org/10.1016/j.jalz.2016.03.017
Yasuda T, Fukumura K, Nakajima T. 2017. Short physical performance battery for middleaged and older adult cardiovascular disease patients: Implication for strength tests and lower extremity morphological evaluation. J Phys Ther Sci 29(4):748−753. https://doi.org/10.1589/jpts.29.748
Authors
Muhamad NazriA. I., VanohD., LengS. K., & BadrasawiM. (2023). Risk Factors of Subjective Cognitive Decline among Older People with Low Socioeconomic Status . Jurnal Gizi Dan Pangan, 18(2), 127-136. https://doi.org/10.25182/jgp.2023.18.2.127-136
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