[Incidence of the progression and remission of cognitive decline in older adults].

内容摘要

In communities with higher social inequality, tracking the progression and remission of cognitive dysfunction (PR-CD) and its associated factors provides an epidemiological overview of dementia risk. To investigate the incidence and factors associated with PR-CD in older adults (OAs) at three clinics of the Mexican Social Security Institute in an industrial area of Western Mexico State. A two-year longitudinal study of 231 OAs (&#x2265; 60 years) assessed cognitive function using the Montreal Cognitive Assessment (MoCA). After 2 years, outcomes were categorized into three groups: healthy cognitive function (MoCA scores > 20 on all three measurements), remitting cognitive impairment (one or two measurements with MoCA scores < 20), and progressive cognitive impairment (MoCA scores < 20 on all three measurements). Additionally, sociodemographic, clinical, and functional data were collected. Cumulative incidence and relative risk factors were analyzed using regression. The sample consisted of individuals with six or fewer years of schooling, and 70% identified as female. The incidence of P-CD was 28.1%, while that of R-CD was 32.5%. Factors associated with R-CD included low cognitive reserve and diminished physical performance. In contrast, factors linked to P-CD included age, low educational attainment, low cognitive reserve, age-related sarcopenia, education-related sarcopenia, age-related instrumental Activities of Daily Living (IADLs), and the interaction among age, cognitive reserve, IADLs, and SPBB. In a region of social inequality in Western Mexico State, there is a high incidence of R-CD and P-CD, associated with risk factors that contribute to cognitive dysfunction among OAs. la incidencia de la progresi&#xf3;n y la remisi&#xf3;n del deterioro cognitivo (PR_DC), junto con los factores asociados (FR), ofrece un panorama epidemiol&#xf3;gico del riesgo de demencia en la comunidad, especialmente en zonas con mayor desigualdad social. determinar la incidencia y los factores asociados a la PR_DC en personas adultas mayores (PAM) en tres cl&#xed;nicas del Instituto Mexicano del Seguro Social ubicadas en una zona industrial al poniente del Estado de M&#xe9;xico. estudio longitudinal de dos a&#xf1;os con 231 PAM de &#x2265; 60 a&#xf1;os. Se evalu&#xf3; la funci&#xf3;n cognitiva global mediante la Escala Cognitiva de Montreal (MoCA). Los desenlaces a dos a&#xf1;os fueron: funci&#xf3;n cognitiva saludable (MoCA > 20 en las tres mediciones), remitente (DC-R: una o dos mediciones < 20) y progresivo (DC-P: tres mediciones < 20). Se obtuvieron datos sociodemogr&#xe1;ficos, cl&#xed;nicos y funcionales. Se calcularon las incidencias acumuladas y los FR mediante regresi&#xf3;n. la muestra present&#xf3; una escolaridad de &#x2264; 6 a&#xf1;os y 70% de mujeres. La incidencia de DC-P fue del 28.1% y la de DC-R del 32.5%. Los factores asociados a DC-R fueron la reserva cognitiva y el rendimiento f&#xed;sico. Para DC-P: edad, escolaridad baja, reserva cognitiva baja, edad-sarcopenia, escolaridad-sarcopenia, edad-AVD instrumentales y edad-reserva cognitiva-AVD instrumentales-SPPB. existe una alta incidencia de deterioro cognitivo progresivo y remitente en una muestra de personas que viven en zonas con desigualdad social, vinculada a factores de riesgo que incrementan el deterioro cognitivo.