Association Of Chronic Diseases And Comorbidities With Mild Cognitive Impairment In Community Older Adults

Objective: To explore the association of common chronic diseases and their comorbidities with mild cognitive impairment(MCI)in community-dwelling older adults and provide scientific evidence for the prevention and control of MCI in the community.Methods: By cluster random sampling method,all the older adults aged 65 and above who participated in physical examination in Community Health Centre of Wuhan city were selected and all of them received questionnaire survey,physiological index measurement and neuropsychological evaluation from 2019 to 2020.According to the chronic diseases(such as hypertension,diabetes,coronary heart disease and cerebrovascular disease),all the subjects were divided into four groups: Non-disease group,A disease group,B disease group and AB disease group(A and B represent the chronic diseases included in the group).Chi square test was used to compare the differences in the prevalence of MCI among the older adult with different gender,age and chronic diseases.One way ANOVA and chi square test were used to compare the general characteristics among the groups.Multivariate logistic regression was used to analyze the relationship between different chronic diseases and their comorbidities and MCI.Results:(1)The prevalence of MCI was 17.9%(16.5% ～ 19.2%)in 3011 older adults aged 65 and above and which in the four age groups of 65-69,70-74,75-79 and≥ 80 was 12.2%,17.4%,26.0% and 40.6%,respectively,and increased with age(Trend χ2 = 142.82,p < 0.001).(2)The prevalence of MCI in the older adults with chronic diseases(18.9%)was higher than that without chronic diseases(14.6%)(χ2 =6.86,p = 0.009);the prevalence of MCI in the older adults with one,two,three and four chronic diseases was 17.0%,20.2%,24.1% and 34.1%,respectively,and increased with the number of disease(Trend χ2 = 21.95,p < 0.001);the prevalence of MCI in the older adults with hypertension,diabetes and cerebrovascular diseases was20.7%,23.0% and 23.0% respectively,which were higher than those without the disease(p < 0.05).(3)After controlling for the influence of social demographic characteristics,lifestyle and physiological indicators,the risk of MCI in patients with chronic diseases was higher than that without chronic diseases(OR = 1.32,95% CI:1.14-1.63);the risk of MCI in patients with one,two,three and four chronic diseases was higher than that without chronic diseases(OR = 1.19,1.49,1.86,3.03,95% CI:1.08-1.54,1.12-1.97,1.27-2.71,1.57-5.84);The risk of MCI in patients with hypertension,diabetes and cerebrovascular disease was higher than those without the disease(OR = 1.25,1.37,1.41,95% CI: 1.02-1.55,1.08-1.73,1.12-1.76).(4)When grouped by hypertension and diabetes,the groups of hypertension,diabetes and hypertension comorbid diabetes were associated with higher risk of MCI(OR = 1.32,1.53,1.79,95% CI: 1.02-1.54,1.09-2.14,1.23-2.32).(5)When grouped by hypertension and coronary heart disease,each group was no correlation with MCI.(6)When grouped by hypertension and cerebrovascular disease,only hypertension comorbid cerebrovascular disease group was associated with higher risk of MCI(OR= 1.60,95% CI: 1.19-2.15).(7)When grouped by diabetes and coronary heart disease,only diabetes group was associated with higher risk of MCI(OR = 1.40,95% CI:1.08-1.81).(8)When grouped by diabetes and cerebrovascular disease,the group of diabetes,cerebrovascular disease and diabetes comorbid cerebrovascular disease was associated with higher risk of MCI(OR = 1.34,1.44,2.18,95% CI: 1.01-1.76,1.10-1.88,1.45-3.29).(9)When grouped by coronary heart disease and cerebrovascular disease,only cerebrovascular disease group was associated with higher risk of MCI(OR = 1.11,95% CI: 1.19-1.99).Conclusion: The prevalence of MCI is higher in patients with chronic diseases,hypertension,diabetes and cerebrovascular diseases,and increase with the number of diseases in community-dwelling older adults in Wuhan city.Some chronic comorbidity has greater damage to the cognitive function of older adult,and the risk of cognitive impairment is higher than that of single disease.It is suggested that according to the condition of chronic diseases in community-dwelling older adults,regular physical examination,standardized treatment,health behavior guidance and screening of cognitive impairment should be strengthened,so as to improve the selfmanagement ability of the older adult on chronic diseases,prevent the occurrence of comorbidity,reduce the incidence of cognitive impairment and improve the quality of life of them.