PREVALENCE OF MILD COGNITIVE IMPAIRMENT AMONG OLDER PEOPLE IN KAZAKHSTAN AND POTENTIAL RISK FACTORS

Abstract

Although there is a high prevalence of cognitive impairment among the old population of Kazakhstan, there is a lack of epidemiological research in this area. Assessment of mild cognitive impairment (MCI) as a transitional phase between normal aging and dementia can be proposed as an attainable way of gathering valuable data among the population of Kazakhstan aged 60 and over. This way of screening would help to early diagnose manifestation of cognitive impairment in old people and determine its predisposing risk factors. A commonly used method for MCI is the Montreal Cognitive Assessment (MoCA). A cross-sectional study to provide the first population-based information about cognitive impairment among older people in Kazakhstan can be performed in two stages. The first stage composed of screening for MCI with the MoCA test and assessment of underlying risk factors, and the second stage includes the diagnostic evaluation for MCI of all individuals who were positive on the MoCA test. Through the electronic patient database people aged 60 years and over were selected. Selected individuals confirmed their participation by informed consent form and underwent a psychometric assessment which excluded those with psychotic symptoms or severe clinical conditions. During the first stage, questions on functional status about difficulties in daily life, cognition and social interaction were evaluated. The risk factors gathered from self-report included age, gender, education, alcohol consumption, smoking status, diabetic mellitus, traumatic brain injury, family history of dementia and atherosclerosis. During the second stage, the neuropsychological examination including assessment of memory, attention, speech, executive functions, visuospatial domains was performed. As a result, among 900 people randomly selected, 668 agreed to participate. The mean MoCA score was 21.6 and was similar in men and women. The mean age of study participants in this study is 70 years suggesting that MCI is particularly common in Kazakhstan. In conclusion, the prevalence of MCI among older people in Almaty is high. Among the risk factors, education is the only modifiable risk factor, while high quality management of cardiovascular disease risk factors like hypertension in mid-life will lead to a lower burden of cognitive impairment in the future.