Cognitive impairment among older adults living in the community and in nursing home in Indonesia: a pilot study

Setiyani, Rahmi; Iskandar, Asep

doi:10.1590/1980-5764-DN-2022-0012

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Dementia & Neuropsychologia

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Original Article • Dement. neuropsychol. 16 (3) • jul-sep 2022 • https://doi.org/10.1590/1980-5764-DN-2022-0012 copy

Cognitive impairment among older adults living in the community and in nursing home in Indonesia: a pilot study

COMPROMETIMENTO COGNITIVO ENTRE IDOSOS QUE VIVEM NA COMUNIDADE E EM CASA DE REPOUSO NA INDONÉSIA: UM ESTUDO PILOTO

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The demographic phenomenon of population aging has brought some consequences, including a higher prevalence of cognitive impairment.

Objective:

This study aimed to assess and compare cognitive impairment and its risk factors between older persons living in the community and in nursing home in Indonesia.

Methods:

A cross-sectional study was employed among 99 older adults living in the community and 49 nursing home residents. Cognitive function was assessed using the Mini-Mental State Examination (MMSE).

Results:

Older people living in the community showed a higher score on MMSE than those living in nursing home (p=0.044). Age, marital status, education level, and literacy status were significantly related to the cognitive function of older adults living in the community (p=0.003, p=0.007, p=0.005, p=0.001, respectively), while gender, education level, and literacy status were significantly related to that of nursing home residents (p=0.012, p=0.004, p=0.001, respectively).

Conclusions:

Older adults living in the nursing home were more likely to experience cognitive decline than their counterparts in the community. Factors associated with cognitive decline differ between community-dwelling older adults and nursing home residents.

Keywords:
Cognitive Dysfunction; Frail Elderly; Nursing Homes

Age, mean±SD		Community-dwelling (n=99)	Institutional-dwelling (n=49)	p-value
Age, mean±SD		68.01±6.910	71.71±9.381	0.029^* * Mann-Whitney U test ,⁺ + p≤0.05
Gender, n (%)	Male	26 (26.3)	18 (36.7)	0.190^§ § Chi-square test
Gender, n (%)	Female	73 (73.7)	31 (63.3)	0.190^§ § Chi-square test
Marital status, n (%)	Married	59 (59.6)	3 (6.1)	0.001^§ § Chi-square test ,⁺ + p≤0.05
Marital status, n (%)	Single (unmarried, widowed)	40 (40.4)	46 (93.9)	0.001^§ § Chi-square test ,⁺ + p≤0.05
Years of education, years, n (%)	≥9	13 (13.1)	11 (22.4)	0.148^§ § Chi-square test
Years of education, years, n (%)	<9	86 (86.9)	38 (77.6)	0.148^§ § Chi-square test
Literacy, n (%)	Literate	78 (78.8)	35 (71.4)	0.321^§ § Chi-square test
Literacy, n (%)	Illiterate	21 (21.2)	14 (28.6)	0.321^§ § Chi-square test
Blood pressure, n (%)	Normal	39 (39.4)	19 (38.8)	0.942^§ § Chi-square test
Blood pressure, n (%)	Hypertension	60 (60.6)	30 (61.2)	0.942^§ § Chi-square test
BMI, n (%)	Normal	57 (57.6)	35 (71.4)	0.102^§ § Chi-square test
BMI, n (%)	Abnormal	42 (42.4)	14 (28.6)	0.102^§ § Chi-square test
Smoking status, n (%)	Not smoking	84 (84.8)	41 (83.7)	0.853^§ § Chi-square test
Smoking status, n (%)	Smoking	15 (15.2)	8 (16.3)	0.853^§ § Chi-square test
Cardiovascular/neurological/metabolic disease, n (%)	No	92 (92.9)	46 (93.9)	1.000^\|\| \|\| Fisher’s exact test.
Cardiovascular/neurological/metabolic disease, n (%)	Yes	7 (7.1)	3 (6.1)	1.000^\|\| \|\| Fisher’s exact test.

	Community (n=99)	Nursing home (n=49)	p-value
MMSE score (mean±SD)	24.09±5.043	22.59±5.082	0.044^* * Mann-Whitney U test ,⁺ + p≤0.05.
Orientation	8.20±1.969	8.00±2.363	0.798^* * Mann-Whitney U test
Registration	2.79±0.689	2.86±0.408	0.797^* * Mann-Whitney U test
Attention and calculation	3.23±1.640	2.71±1.696	0.083^* * Mann-Whitney U test
Recalled	2.24±1.001	2.20±0.979	0.727^* * Mann-Whitney U test
Language	7.63±1.549	6.82±1.787	0.004^* * Mann-Whitney U test ,⁺ + p≤0.05.

		Community (n=99)		Nursing home (n=49)
		MMSE score (mean±SD)	p-value	MMSE score (mean±SD)	p-value
Age (correlation coefficient)		r=-0.298	0.003^* * Spearman’s rank test ,⁺ + p≤0.05	r=-0.270	0.061^* * Spearman’s rank test
Gender	Male	24.69±4.038	0.804^§ § Mann-Whitney U test	24.94±4.277	0.012⁺ + p≤0.05 ,^\|\| \|\| Independent t-test.
Gender	Female	23.88±5.364	0.804^§ § Mann-Whitney U test	21.23±5.071	0.012⁺ + p≤0.05 ,^\|\| \|\| Independent t-test.
Marital status	Married	25.27±4.046	0.007⁺ + p≤0.05 ,^§ § Mann-Whitney U test	26.33±2.887	0.185^\|\| \|\| Independent t-test.
Marital status	Single (unmarried, widowed)	22.35±5.860	0.007⁺ + p≤0.05 ,^§ § Mann-Whitney U test	22.35±5.117	0.185^\|\| \|\| Independent t-test.
Years of education (years)	≥9	27.08±2.397	0.005⁺ + p≤0.05 ,^§ § Mann-Whitney U test	26.27±4.474	0.004⁺ + p≤0.05 ,^§ § Mann-Whitney U test
Years of education (years)	<9	23.64±5.190	0.005⁺ + p≤0.05 ,^§ § Mann-Whitney U test	21.53±4.786	0.004⁺ + p≤0.05 ,^§ § Mann-Whitney U test
Literacy	Literate	25.55±3.410	0.001⁺ + p≤0.05 ,^§ § Mann-Whitney U test	23.89±5.184	0.001⁺ + p≤0.05 ,^§ § Mann-Whitney U test
Literacy	Illiterate	18.67±6.374	0.001⁺ + p≤0.05 ,^§ § Mann-Whitney U test	19.36±3.054	0.001⁺ + p≤0.05 ,^§ § Mann-Whitney U test
Blood pressure	Normal	25.15±3.957	0.145^§ § Mann-Whitney U test	21.58±5.480	0.370^§ § Mann-Whitney U test
Blood pressure	Hypertension	23.40±5.561	0.145^§ § Mann-Whitney U test	23.23±4.797	0.370^§ § Mann-Whitney U test
BMI	Normal	24.35±4.658	0.735^§ § Mann-Whitney U test	22.77±5.292	0.700^\|\| \|\| Independent t-test.
BMI	Abnormal	23.74±5.561	0.735^§ § Mann-Whitney U test	22.14±4.672	0.700^\|\| \|\| Independent t-test.
Smoking status	Not smoking	23.99±5.180	0.818^§ § Mann-Whitney U test	22.37±5.333	0.487^\|\| \|\| Independent t-test.
Smoking status	Smoking	24.67±4.304	0.818^§ § Mann-Whitney U test	23.75±3.576	0.487^\|\| \|\| Independent t-test.
Cardiovascular/neurological/metabolic disease	No	23.98±5.146	0.607^§ § Mann-Whitney U test	22.46±5.124	0.471^\|\| \|\| Independent t-test.
Cardiovascular/neurological/metabolic disease	Yes	25.57±3.309	0.607^§ § Mann-Whitney U test	24.67±4.726	0.471^\|\| \|\| Independent t-test.
Living arrangement	Multi-generation	24.32±4.964	0.318^§ § Mann-Whitney U test
Living arrangement	Independent living	23.27±5.347	0.318^§ § Mann-Whitney U test

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Correspondence: Rahmi Setiyani; Email: rahmi.setiyani@unsoed.ac.id.