Anxiety symptoms and mild cognitive impairment among community-dwelling older adults from low- and middle-income countries

Lee Smith; Louis Jacob; Guillermo F. López-Sánchez; Laurie Butler; Yvonne Barnett; Nicola Veronese; Pinar Soysal; Lin Yang; Igor Grabovac; Mark A Tully; Jae Il Shin; Ai Koyanagi

doi:10.1016/j.jad.2021.04.076

Anxiety symptoms and mild cognitive impairment among community-dwelling older adults from low- and middle-income countries

Lee Smith, Louis Jacob, Guillermo F. López-Sánchez, Laurie Butler, Yvonne Barnett, Nicola Veronese, Pinar Soysal, Lin Yang, Igor Grabovac, Mark A Tully, Jae Il Shin, Ai Koyanagi

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Abstract

Anxiety may be a risk factor for mild cognitive impairment (MCI) but there is a scarcity of data on this association especially from low- and middle-income countries (LMICs). Thus, we investigated the association between anxiety and MCI among older adults residing in six LMICs (China, Ghana, India, Mexico, Russia, South Africa), and the mediational effect of sleep problems in this association. Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer's Association criteria. Multivariable logistic regression analysis, meta-analysis, and mediation analysis were conducted to assess associations. The final sample included 32,715 individuals aged ≥50 years with preservation in functional abilities [mean (standard deviation) age 62.1 (15.6) years; 48.3% males]. Country-wise analysis showed a positive association between anxiety and MCI in all countries (OR 1.35-14.33). The pooled estimate based on meta-analysis with random effects was OR=2.27 (95%CI=1.35-3.83). Sleep problems explained 41.1% of this association. Older adults with anxiety had higher odds for MCI in LMICs. Future studies should examine whether preventing anxiety or addressing anxiety among individuals with MCI can lead to lower risk for dementia onset in LMICs, while the role of sleep problems in this association should be investigated in detail. [Abstract copyright: Copyright © 2021. Published by Elsevier B.V.]

Original language	English
Pages (from-to)	57-64
Number of pages	8
Journal	Journal of Affective Disorders
Volume	291
Early online date	2 May 2021
DOIs	https://doi.org/10.1016/j.jad.2021.04.076
Publication status	Published (in print/issue) - 1 Aug 2021

Bibliographical note

Funding Information:
All authors have made a substantial, direct and intellectual contribution to the work. All authors have read and approved the final version of the manuscript, and agree with the order of presentation of the authors. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. This paper uses data from WHO's Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323?08-CN-0020, Y1-AG-1005?01 and through research grants R01-AG034479 and R21-AG034263. Ethical approval was obtained from the WHO Ethical Review Committee and local ethics research review boards. Written informed consent was obtained from all participants.

Funding Information:
This paper uses data from WHO's Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263.

Publisher Copyright:
© 2021

Keywords

Anxiety
mild cognitive impairment
low- and middle-income countries
sleep problems
epidemiology
Low- and middle-income countries
Mild cognitive impairment
Sleep problems
Epidemiology
Prevalence
Humans
Middle Aged
Male
Russia
China
Female
Cognitive Dysfunction/epidemiology
Cross-Sectional Studies
Independent Living
Ghana
Mexico/epidemiology
India
South Africa
Aged
Developing Countries

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Smith, L., Jacob, L., López-Sánchez, G. F., Butler, L., Barnett, Y., Veronese, N., Soysal, P., Yang, L., Grabovac, I., Tully, M. A., Shin, J. I., & Koyanagi, A. (2021). Anxiety symptoms and mild cognitive impairment among community-dwelling older adults from low- and middle-income countries. Journal of Affective Disorders, 291, 57-64. https://doi.org/10.1016/j.jad.2021.04.076

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abstract = "Anxiety may be a risk factor for mild cognitive impairment (MCI) but there is a scarcity of data on this association especially from low- and middle-income countries (LMICs). Thus, we investigated the association between anxiety and MCI among older adults residing in six LMICs (China, Ghana, India, Mexico, Russia, South Africa), and the mediational effect of sleep problems in this association. Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer's Association criteria. Multivariable logistic regression analysis, meta-analysis, and mediation analysis were conducted to assess associations. The final sample included 32,715 individuals aged ≥50 years with preservation in functional abilities [mean (standard deviation) age 62.1 (15.6) years; 48.3% males]. Country-wise analysis showed a positive association between anxiety and MCI in all countries (OR 1.35-14.33). The pooled estimate based on meta-analysis with random effects was OR=2.27 (95%CI=1.35-3.83). Sleep problems explained 41.1% of this association. Older adults with anxiety had higher odds for MCI in LMICs. Future studies should examine whether preventing anxiety or addressing anxiety among individuals with MCI can lead to lower risk for dementia onset in LMICs, while the role of sleep problems in this association should be investigated in detail. [Abstract copyright: Copyright {\textcopyright} 2021. Published by Elsevier B.V.]",

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note = "Funding Information: All authors have made a substantial, direct and intellectual contribution to the work. All authors have read and approved the final version of the manuscript, and agree with the order of presentation of the authors. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. This paper uses data from WHO's Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323?08-CN-0020, Y1-AG-1005?01 and through research grants R01-AG034479 and R21-AG034263. Ethical approval was obtained from the WHO Ethical Review Committee and local ethics research review boards. Written informed consent was obtained from all participants. Funding Information: This paper uses data from WHO's Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263. Publisher Copyright: {\textcopyright} 2021",

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Smith, L, Jacob, L, López-Sánchez, GF, Butler, L, Barnett, Y, Veronese, N, Soysal, P, Yang, L, Grabovac, I, Tully, MA, Shin, JI & Koyanagi, A 2021, 'Anxiety symptoms and mild cognitive impairment among community-dwelling older adults from low- and middle-income countries', Journal of Affective Disorders, vol. 291, pp. 57-64. https://doi.org/10.1016/j.jad.2021.04.076

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T1 - Anxiety symptoms and mild cognitive impairment among community-dwelling older adults from low- and middle-income countries

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AU - López-Sánchez, Guillermo F.

AU - Butler, Laurie

AU - Barnett, Yvonne

AU - Veronese, Nicola

AU - Soysal, Pinar

AU - Yang, Lin

AU - Grabovac, Igor

AU - Tully, Mark A

AU - Shin, Jae Il

AU - Koyanagi, Ai

N1 - Funding Information: All authors have made a substantial, direct and intellectual contribution to the work. All authors have read and approved the final version of the manuscript, and agree with the order of presentation of the authors. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. This paper uses data from WHO's Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323?08-CN-0020, Y1-AG-1005?01 and through research grants R01-AG034479 and R21-AG034263. Ethical approval was obtained from the WHO Ethical Review Committee and local ethics research review boards. Written informed consent was obtained from all participants. Funding Information: This paper uses data from WHO's Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263. Publisher Copyright: © 2021

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AB - Anxiety may be a risk factor for mild cognitive impairment (MCI) but there is a scarcity of data on this association especially from low- and middle-income countries (LMICs). Thus, we investigated the association between anxiety and MCI among older adults residing in six LMICs (China, Ghana, India, Mexico, Russia, South Africa), and the mediational effect of sleep problems in this association. Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer's Association criteria. Multivariable logistic regression analysis, meta-analysis, and mediation analysis were conducted to assess associations. The final sample included 32,715 individuals aged ≥50 years with preservation in functional abilities [mean (standard deviation) age 62.1 (15.6) years; 48.3% males]. Country-wise analysis showed a positive association between anxiety and MCI in all countries (OR 1.35-14.33). The pooled estimate based on meta-analysis with random effects was OR=2.27 (95%CI=1.35-3.83). Sleep problems explained 41.1% of this association. Older adults with anxiety had higher odds for MCI in LMICs. Future studies should examine whether preventing anxiety or addressing anxiety among individuals with MCI can lead to lower risk for dementia onset in LMICs, while the role of sleep problems in this association should be investigated in detail. [Abstract copyright: Copyright © 2021. Published by Elsevier B.V.]

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KW - Mexico/epidemiology

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SN - 0165-0327

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SP - 57

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JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -

Anxiety symptoms and mild cognitive impairment among community-dwelling older adults from low- and middle-income countries

Abstract

Bibliographical note

Keywords

UN SDGs

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