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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Mild cognitive impairment risk related to multiple functional impairments in older adults in Taiwan
Yi-Chang Chou1,2,3,4, Shih-Han Weng2,3,4, Feng-Shiang Cheng2,3,4
1Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan.
Background:
Mild cognitive impairment (MCI) is a critical transition stage toward dementia, making the identification of modifiable risk factors essential for early intervention. While individual conditions such as sensory loss, tooth loss, and psychological distress are independently linked to cognitive decline, their cumulative and combined longitudinal effects remain under-researched. Therefore, we aimed to evaluate the association between the number and specific combinations of multiple functional impairments, including vision, hearing, tooth loss, and psychological distress, and the risk of incident MCI among community-dwelling older adults in Taiwan.
Methods:
This cohort study analyzed data from 57,494 adults aged ≥65 years who participated in the Taipei City Government's annual physical examination program from 2005 to 2011. The study population comprised community-dwelling older adults with at least two examination records. Functional impairments were categorized as vision impairment, hearing impairment, tooth loss, and psychological distress, assessed via objective measurements and self-administered questionnaires. Impairments ranged from none to multiple. The primary outcome was incident MCI, assessed using the Short Portable Mental Status Questionnaire. Associations between the number and type of impairments and MCI were analyzed using multivariable-adjusted generalized estimating equation models.
Results:
Participants with multiple functional impairments had a significantly higher risk of developing MCI than those without impairments. The adjusted odds ratio (aOR) was 1.57 (95% confidence interval (CI), 1.40-1.76) for a single impairment, 2.41 (95% CI, 2.11-2.76) for dual impairments, and 2.94 (95% CI, 2.38-3.64) for multiple impairments. Combinations involving visual impairment, tooth loss, and psychological distress showed an aOR of 3.40 (95% CI, 2.61-4.44). The highest risk was observed in participants with all four functional impairments (aOR, 5.06; 95% CI, 2.76-9.27).
Conclusion:
These findings suggest that older adults with multiple functional impairments are at a higher risk of developing MCI. Comprehensive assessment and multifaceted intervention strategies targeting multiple impairments may be crucial for reducing the risk of cognitive decline in this population.
Insights
Multiple functional impairments significantly increase the risk of mild cognitive impairment (MCI) in older adults. Addressing vision loss, hearing loss, tooth loss, and psychological distress is key for cognitive health.
Area of Science:
- Gerontology
- Neuroscience
- Public Health
Background:
- Mild cognitive impairment (MCI) is a precursor to dementia, necessitating identification of modifiable risk factors for early intervention.
- While individual impairments like sensory loss, tooth loss, and psychological distress are linked to cognitive decline, their combined longitudinal impact is understudied.
- This research focuses on the cumulative effects of multiple functional impairments on incident MCI in older adults.
Purpose of the Study:
- To evaluate the association between the number and specific combinations of functional impairments (vision, hearing, tooth loss, psychological distress) and the risk of incident MCI.
- To investigate the cumulative impact of multiple impairments on cognitive decline in community-dwelling older adults.
- To identify high-risk profiles for MCI development based on functional impairment combinations.
Main Methods:
- A cohort study involving 57,494 older adults (≥65 years) in Taiwan with at least two examination records between 2005-2011.
- Functional impairments (vision, hearing, tooth loss, psychological distress) were assessed using objective measures and self-administered questionnaires.
- Multivariable-adjusted generalized estimating equation models analyzed associations between impairment counts/types and incident MCI, assessed via the Short Portable Mental Status Questionnaire.
Main Results:
- Participants with multiple functional impairments exhibited a significantly higher risk of developing MCI compared to those without impairments.
- The adjusted odds ratio (aOR) for MCI increased with the number of impairments: 1.57 for single, 2.41 for dual, and 2.94 for multiple impairments.
- The highest risk was observed in individuals with all four impairments (aOR=5.06), with combinations including visual impairment, tooth loss, and psychological distress also showing elevated risk (aOR=3.40).
Conclusions:
- Multiple functional impairments are associated with a substantially increased risk of developing mild cognitive impairment (MCI) in older adults.
- Comprehensive assessments and interventions targeting multiple impairments are crucial for mitigating MCI risk and promoting cognitive health in aging populations.
- The findings underscore the importance of a holistic approach to managing functional deficits to prevent cognitive decline.
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