Co-morbid and socio-demographic factors associated with cognitive performance in an elderly community dwelling Irish population

Abstract

Background: Epidemiological studies suggest an association between health factors and dementia. The impact of these factors on the cognitive performance of the elderly population is unclear. Possible correlates of poor cognitive performance in a community dwelling elderly Irish population were examined.

Methods: Subjects were from a sample of individuals over 65 years agreeable to interview using the Geriatric Mental State (GMS)-Automated Geriatric Examination for Computed Assisted Taxonomy (AGECAT) package conducted at the subject's home. Associations between patient profiles and Mini Mental State Examination (MMSE) score were investigated in a multivariate model.

Results: There were 793 subjects, 528 (66.6%) female with mean (s.d.) age 74.8 (6.7) yrs. Mean MMSE score was 26.5 (3.3). 169 (21.3%) were current smokers, 198 (25%) ex-smokers. Two hundred and twenty-four (28.3%) had a history of hypertension, 85 (10.7%) case level anxiety or depression, 51 (6.4%) stroke, ten0 (1.3%) epilepsy, nine (1.1%) Parkinson's disease and 29 (3.7%) dementia. Two hundred and fifty-five (32.2%) subjects were on psychotropic medications. Factors associated with MMSE score included age (p < or = 0.0001), diagnosis of dementia (p < or = 0.0001), socioeconomic group (p < or = 0.0001), education (p < or = 0.0001), previous stroke (p = 0.0013) and use of psychotropic medication (p = 0.03). Case level anxiety or depression (p = 0.99), Parkinson's disease (p = 0.52), epilepsy (p = 0.26), smoking status (p = 0.99) and hypertension (p = 0.34) were not found to be associated with cognitive performance.

Conclusion: Factors associated with cognitive performance included age, socioeconomic group, education, previous stroke and use of psychotropic medication. These factors should be adjusted for in studies assessing cognition in this population. Stroke prevention strategies and avoidance of psychotropic medication may benefit cognitive performance.