Association between age associated cognitive decline and health related quality of life among Iranian older individuals

Authors

  • Mahshid Foroughan M.D., Iranian Research Center on Aging, Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

Keywords:

Quality of life, Cognitive function, Aging

Abstract

Background: Age associated cognitive decline or normal cognitive aging is related with lower levels of functioning in real life, and may interfere with maintaining independence and health related quality of life (HRQL).  Objective: In this study, health related quality of life and cognitive function in community-dwelling older adults were evaluated with the aim of exploring the association between them by adjusting for potential confounders. Methods: This cross-sectional study, was implemented on 425 community-dwelling older adults aged 60 and over, between August 2016 and October 2016 in health centers of the municipality of Tehran, Iran, using Mini Mental State Examination (MMSE) to assess cognitive function and Short Form-36 scales (SF-36) to assess HRQL. The relation between HRQL and cognitive function was evaluated by Pearson’s correlation coefficient, and the impact of cognitive function on HRQL adjusted for potential confounders was estimated by linear regression model. All analyses were done using SPSS, version 22.0. Results: A positive significant correlation between cognitive function and quality of life (r=0.434; p<0.001) and its dimensions was observed. Two variables of educational level (B=2.704; 95% CI: 2.09 to 3.30; p<0.001) and depression (B=2.554; 95% CI: 2.00 to 3.10; p<0.001) were assumed as potential confounder by changing effect measure after entering the model. After adjusting for potential confounders in regression model, the association between MMSE scores and quality of life persisted (B=2.417; 95% CI: 1.86 to 2.96; p<0.001). Conclusion: The results indicate that cognitive function was associated with HRQL in older adults with age associated cognitive function. Two variables of educational level and depression can affect the relation between cognitive decline and HRQL.

References

Chaves AS, Santos AMd, Alves MTSSd, Filho NS. Association between cognitive decline and the quality

of life of hypertensive elderly individuals. Rev bras geriatr gerontol. 2015; 18(3): 545-56. doi:

1590/1809-9823.2015.14043.

Harada CN, Natelson Love MC, Triebel KL. Normal cognitive aging. Clin Geriatr Med. 2013; 29(4): 737- 52. doi: 10.1016/j.cger.2013.07.002. PMID: 24094294, PMCID: PMC4015335.

Deary IJ, Corley J, Gow AJ, Harris SE, Houlihan LM, Marioni RE, et al. Age-associated cognitive decline.

Br Med Bull. 2009; 92: 135-52. doi: 10.1093/bmb/ldp033. PMID: 19776035.

Pereira RR, Pontes MdLF, Silva AO, Monteiro EA, da Silva CR, Silva LM, et al. Quality of Life and the

Cognitive Condition of Elderly Served in Family Health Unit. Int Arch Med. 2015; 8: 1755-82. doi:

3823/1854.

Williams KN, Kemper S. Exploring interventions to reduce cognitive decline in aging. J Psychosoc Nurs

Ment Health Serv. 2010; 48(5): 42-51. doi: 10.3928/02793695-20100331-03. PMID: 20415290, PMCID:

PMC2923489

Wlodarczyk JH, Brodaty H, Hawthorne G. The relationship between quality of life, Mini-Mental State

Examination, and the Instrumental Activities of Daily Living in patients with Alzheimer's disease. Arch

Gerontol Geriatr. 2004; 39(1): 25-33. doi: 10.1016/j.archger.2003.12.004. PMID: 15158578.

Stephan Y, Caudroit J, Jaconelli A, Terracciano A. Subjective age and cognitive functioning: A 10-year

prospective study. Am J Geriatr Psychiatry. 2014; 22(11): 1180-7. doi: 10.1016/j.jagp.2013.03.007. PMID:

Darvishpoor Kakhki A, Abed Saeedi J, Delavar A, Saeed-O-Zakerin M. Tools for measurement of health

status and quality of life of elderly people. Research in Medicine. 2010; 33(3): 162-73.

Aghamolaei T, Tavafian SS, Zare S. Health related quality of life in elderly people living in Bandar Abbas,

Iran: a population-based study. Acta Med Iran. 2010; 48(3):185-91. PMID: 21137656.

Farajzadeh M, Ghanei Gheshlagh R, Sayehmiri K. Health Related Quality of Life in Iranian Elderly

Citizens: A Systematic Review and Meta-Analysis. Int J Community Based Nurs Midwifery. 2017; 5(2):

-11. PMID: 28409164, PMCID: PMC5385233.

Mitchell AJ, Kemp S, Benito‐León J, Reuber M. The influence of cognitive impairment on health‐

related quality of life in neurological disease. Acta Neuropsych. 2010; 22(1): 2-13. doi: 10.1111/j.1601- 5215.2009.00439.x.

Chouiter L, Wodchis WP, Abderhalden C, Von Gunten A. Resident health-related quality of life in Swiss

nursing homes. Eur Psychiatry. 2015; 30(5): 549-54. doi: 10.1016/j.eurpsy.2014.10.001. PMID: 25801468.

Pan CW, Wang X, Ma Q, Sun HP, Xu Y, Wang P. Cognitive dysfunction and health-related quality of life

among older Chinese. Sci Rep. 2015; 5: 17301. doi: 10.1038/srep17301. PMID: 26601612, PMCID:

PMC4658548.

Akdag B, Telci EA, Cavlak U. Factors affecting cognitive function in older adults: a Turkish sample. Int J

Gerontol. 2013; 7(3): 137-41. doi: 10.1016/j.ijge.2013.01.002.

Missotten P, Squelard G, Ylieff M, Di Notte D, Paquay L, De Lepeleire J, et al. Quality of life in older

Belgian people: comparison between people with dementia, mild cognitive impairment, and controls. Int J

Geriatr Psychiatry. 2008; 23(11): 1103-9. doi: 10.1002/gps.1981. PMID: 18213606.

Johansson MM, Marcusson J, Wressle E. Cognition, daily living, and health-related quality of life in 85- year-olds in Sweden. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2012; 19(3): 421-32. doi:

1080/13825585.2011.629290. PMID: 22126333.

Elliott AF, McGwin G Jr, Owsley C. Health-related quality of life and visual and cognitive impairment

among nursing-home residents. Br J Ophthalmol. 2009; 93(2): 240-3. doi: 10.1136/bjo.2008.142356.

PMID: 18971236, PMCID: PMC2745735.

Bischkopf J, Busse A, Angermeyer MC. Mild cognitive impairment–a review of prevalence, incidence and

outcome according to current approaches. Acta Psychiatr Scand. 2002; 106(6): 403-14. PMID: 12392483.

McHorney CA, Ware JE Jr, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36): II.

Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care.

; 31(3): 247-63. doi: 10.1097/00005650-199401000-00004. PMID: 8450681.

Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): translation

and validation study of the Iranian version. Qual Life Res. 2005; 14(3): 875-82. doi: 10.1007/s11136-004- 1014-5. PMID: 16022079.

Eshaghi SR, Ramezani MA, Shahsanaee A, Pooya A. Validity and reliability of the Short Form-36 Items

questionnaire as a measure of quality of life in elderly Iranian population. Am J Appl Sci. 2006; 3(3): 1763- 6. doi: 10.3844/ajassp.2006.1763.1766.

Woodford HJ, George J. Cognitive assessment in the elderly: a review of clinical methods. Qjm. 2007;

(8): 469-84. doi: 10.1093/qjmed/hcm051. PMID: 17566006.

Foroughan M, Jafari Z, Bayan PS, Faraahani Z, Rahgozar M. Validation of mini- mental state examination

(mmse) in the elderly population of tehran. Advances in Cognitive Science. 2008; 10(2): 29-37.

Pinto E, Peters R. Literature review of the Clock Drawing Test as a tool for cognitive screening. Dement

Geriatr Cogn Disord. 2009; 27(3): 201-13. doi: 10.1159/000203344. PMID: 19225234.

Roodsari MS, Kamrani AA, Foroughan M, Mohammadi F, Karimloo M. Validity and Reliability of the

Clock Drawing Test in Older People. IJA. 2013; 8(2): 48-53.

Wolinsky FD, Unverzagt FW, Smith DM, Jones R, Wright E, Tennstedt SL. The effects of the ACTIVE

cognitive training trial on clinically relevant declines in health-related quality of life. J Gerontol B Psychol

Sci Soc Sci. 2006; 61(5): S281-7. doi: 10.1093/geronb/61.5.S281. PMID: 16960242.

Lionakis N, Mendrinos D, Sanidas E, Favatas G, Georgopoulou M. Hypertension in the elderly. World J

Cardiol. 2012; 4(5): 135-47. doi: 10.4330/wjc.v4.i5.135. PMID: 22655162, PMCID: PMC3364500.

Chentli F, Azzoug S, Mahgoun S. Diabetes mellitus in elderly. Indian J Endocrinol Metab. 2015; 19(6):

-52. doi: 10.4103/2230-8210.167553. PMID: 26693423, PMCID: PMC4673801.

Woo J. Nutritional strategies for successful aging. Med Clin North Am. 2011; 95(3): 477-93, ix-x. doi:

1016/j.mcna.2011.02.009. PMID: 21549873.

Johansson Y. self-Perceived Health and Nutritional Status among Home-Living Older People : A

Prospective Study. Linköping University Medical Dissertations. 2009.

Herrera Ponce MS, Barros Lezaeta C, Fernández Lorca MB. Predictors of quality of life in old age: a

multivariate study in Chile. J Popul Ageing. 2011; 4(3): 121-39. doi: 10.1007/s12062-011-9043-7.

Malakouti K, Fathollahi P, Mirabzadeh A, Salavati M, Kahani S. Validation of Geriatric Depression Scale

(GDS-15) in Iran. Pejouhesh dar Pezeshki (Research in Medicine). 2006; 30(4): 361-9. [in Persian].

Rajabi G. Reliability and validity of the general self-efficacy beliefs scale (gse-10) comparing the

psychology students of shahid chamrin university and azad university of marvdasht. New thoughts on

education. 2006; 2(1-2): 111-22.

García Villanueva MZ, Uterga Valiente JM, Rodríguez-Antigüedad Zarranz A. Quality of Life in an Adult

Population of More than 60 Years of Age without Cognitive Impairment. Dement Geriatr Cogn Dis Extra.

; 4(3): 355-63. doi: 10.1159/000365505. PMID: 25337078, PMCID: PMC4202608.

Saccomann IC, Cintra FA, Gallani MC. Health-related quality of life among the elderly with heart failure: a

generic measurement. Sao Paulo Med J. 2010; 128(4): 192-6. doi: 10.1590/S1516-31802010000400003.

PMID: 21120428.

Riazi A, Hobart JC, Lamping DL, Fitzpatrick R, Freeman JA, Jenkinson C, et al. Using the SF-36 measure

to compare the health impact of multiple sclerosis and Parkinson’s disease with normal population health

profiles. J Neurol Neurosurg Psychiatry. 2003; 74(6): 710-4. doi: 10.1136/jnnp.74.6.710. PMID: 12754336,

PMCID: PMC1738466.

Davis JC, Bryan S, Li LC, Best JR, Hsu CL, Gomez C, et al. Mobility and cognition are associated with

wellbeing and health related quality of life among older adults: a cross-sectional analysis of the Vancouver

Falls Prevention Cohort. BMC Geriatr. 2015; 15: 75. doi: 10.1186/s12877-015-0076-2. PMID: 26142897,

PMCID: PMC4491415.

Doorduin J. Cognition: Not a determinant of health related quality of life in middle to old aged men.

Nursing Science University Medical Centre Utrecht; 2011.

Waldorff FB, Rishoj S, Waldemar G. If you don't ask (about memory), they probably won't tell: if elders do

self-report memory problems, their quality of life is probably suffering. J Fam Pract. 2008; 57(1): 41-4.

PMID: 18171569.

Jeong WM, Sohn TY. Analysis of the Factors Affecting the Quality of Life of Elderly in the “Senior

Citizen Academies”. Asian JOT. 2005; 4(1): 13-23. doi: 10.11596/asiajot.4.13.

Ormel J, Rijsdijk FV, Sullivan M, Van Sonderen E, Kempen GI. Temporal and reciprocal relationship

between IADL/ADL disability and depressive symptoms in late life. J Gerontol B Psychol Sci Soc Sci.

; 57(4): 338-47. doi: 10.1093/geronb/57.4.P338. PMID: 12084784.

Saraçlı Ö, Akca AS, Atasoy N, Önder Ö, Şenormancı Ö, Kaygisız İ, et al. The relationship between quality

of life and cognitive functions, anxiety and depression among hospitalized elderly patients. Clin

Psychopharmacol Neurosci. 2015; 13(2): 194-200. doi: 10.9758/cpn.2015.13.2.194. PMID: 26243848,

PMCID: PMC4540029.

Sivertsen H, Bjørkløf GH, Engedal K, Selbæk G, Helvik AS. Depression and quality of life in older

persons: a review. Dement Geriatr Cogn Disord. 2015; 40(5-6): 311-39. doi: 10.1159/000437299. PMID:

Bakar N, Aşılar R. Factors Affecting Depression and Quality of Life in the Elderly. J Gerontol Geriatr Res.

; 4(249): 2. doi: 10.4172/2167-7182.1000249.

Published

2021-12-24

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