Factors associated with Severity of Cognitive Impairment among Older Adults attending a Geriatric Centre in Southwest Nigeria

Abstract

Background: Cognitive impairment (CI) is a major public health concern among older adults. Its severity worsens disability and increases dependency. Empirical evidence on factors associated with the severity of CI is scarce among older Nigerians. This study determined the severity, and factors associated with the severity of CI among older adults (≥60 years) at the Geriatric Centre, University College Hospital, Ibadan, Nigeria. 
Methods: A cross-sectional study was conducted among 349 older adults with cognitive impairment. Data were collected with a semi-structured interviewer-administered questionnaire that included the sociodemographic characteristics and clinical parameters. The Mini-Mental State Examination and Katz index were used to assess the severity of CI and activities of daily living respectively. Descriptive and inferential statistics were carried out at α0.05.
Results: Participants' mean age was 75.7±8.3 years and 249 (71.3%) were females. The proportions of mild, moderate, and severe CI were 57.6%, 36.4%, and 6.0% respectively. Increasing age, marital and educational status, living arrangement, income, comorbidity of hypertension, diabetes mellitus and functional disability were significantly associated with CI. Ordinal logistic regression analysis showed that increasing age ≥80 years OR=2.098(1.351-4.754), being currently married OR=1.925(1.058-3.505) and needing assistance in bathing OR=2.706(1.105-6.628) were the most significant factors of increased severity of CI.  
Conclusion: This study showed the severity of CI among older adults in our setting. Advancing age, being currently married, and dependence in bathing were the most significant factors. Routine assessment and taking cognizance of the severity of CI are advocated at first-contact consultation with older adults.