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. 2017 Apr;32(4):357-371.
doi: 10.1002/gps.4652. Epub 2017 Feb 1.

Dementia and co-occurring chronic conditions: a systematic literature review to identify what is known and where are the gaps in the evidence?

Mark B Snowden  1 , Lesley E Steinman  2 , Lucinda L Bryant  3 , Monique M Cherrier  1 , Kurt J Greenlund  4 , Katherine H Leith  5 , Cari Levy  6 , Rebecca G Logsdon  7 , Catherine Copeland  2 , Mia Vogel  2 , Lynda A Anderson  8 , David C Atkins  1 , Janice F Bell  9 , Annette L Fitzpatrick  10
Affiliations

Dementia and co-occurring chronic conditions: a systematic literature review to identify what is known and where are the gaps in the evidence?

Mark B Snowden et al. Int J Geriatr Psychiatry. 2017 Apr.

Abstract

Objective: The challenges posed by people living with multiple chronic conditions are unique for people with dementia and other significant cognitive impairment. There have been recent calls to action to review the existing literature on co-occurring chronic conditions and dementia in order to better understand the effect of cognitive impairment on disease management, mobility, and mortality.

Methods: This systematic literature review searched PubMed databases through 2011 (updated in 2016) using key constructs of older adults, moderate-to-severe cognitive impairment (both diagnosed and undiagnosed dementia), and chronic conditions. Reviewers assessed papers for eligibility and extracted key data from each included manuscript. An independent expert panel rated the strength and quality of evidence and prioritized gaps for future study.

Results: Four thousand thirty-three articles were identified, of which 147 met criteria for review. We found that moderate-to-severe cognitive impairment increased risks of mortality, was associated with prolonged institutional stays, and decreased function in persons with multiple chronic conditions. There was no relationship between significant cognitive impairment and use of cardiovascular or hypertensive medications for persons with these comorbidities. Prioritized areas for future research include hospitalizations, disease-specific outcomes, diabetes, chronic pain, cardiovascular disease, depression, falls, stroke, and multiple chronic conditions.

Conclusions: This review summarizes that living with significant cognitive impairment or dementia negatively impacts mortality, institutionalization, and functional outcomes for people living with multiple chronic conditions. Our findings suggest that chronic-disease management interventions will need to address co-occurring cognitive impairment. Copyright © 2017 John Wiley & Sons, Ltd.

Keywords: aging; cognitive impairment; dementia; multiple chronic conditions; public health; systematic literature review.

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Conflict of interest statement

Conflict of Interest

None declared.

Figures

Figure 1
Figure 1
Conceptual Framework. [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 2
Figure 2
Literature search flow chart.
See this image and copyright information in PMC

References

    1. Aarsland D, Andersen K, Larsen JP, et al. Risk of dementia in Parkinson’s disease a community-based, prospective study. Neurology. 2001a;56:730–736. - PubMed
    1. Aarsland D, Ballard C, Larsen JP, McKeith I. A comparative study of psychiatric symptoms in dementia with Lewy bodies and Parkinson’s disease with and without dementia. Int J Geriatr Psychiatry. 2001b;16:528–536. - PubMed
    1. Abbatecola AM, Bo M, Barbagallo M, et al. Severe hypoglycemia is associated with antidiabetic oral treatment compared with insulin analogs in nursing home patients with type 2 diabetes and dementia: results from the DIMORA study. J Am Med Dir Assoc. 2015;16(4):349.e7–349.e12. doi: 10.1016/j.jamda.2014.12.014. - DOI - PubMed
    1. Agüero-Torres H, Fratiglioni L, Guo Z, et al. Dementia is the major cause of functional dependence in the elderly: 3-year follow-up data from a population-based study. Am J Public Health. 1998;88:1452–1456. - PMC - PubMed
    1. Agüero-Torres H, Fratiglioni L, Guo Z, Viitanen M, Winblad B. Mortality from dementia in advanced age: a 5-year follow-up study of incident dementia cases. J Clin Epidemiol. 1999;52:737–743. - PubMed

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