Cognitive function and associations with demographic, socioeconomic, health and behavioural factors among older adult men and women in rural Bangladesh: a population-based cross-sectional studyResearch in context
Summary: Background: Cognitive impairment has a major impact on health, quality of life and survival and its increasing burden presents a critical global health challenge. Empirical population-based studies of cognitive function and its association with demographic, socioeconomic, health and behavi...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-05-01
|
| Series: | The Lancet Regional Health - Southeast Asia |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772368225000460 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850190186073292800 |
|---|---|
| author | Edward Fottrell Harry Costello Naveed Ahmed Carina King Sanjit Kumer Shaha Tasmin Nahar Malini Pires Andrew Copas Hassan Haghparast-Bidgoli Joanna Morrison Abdul Kuddus Kishwar Azad |
| author_facet | Edward Fottrell Harry Costello Naveed Ahmed Carina King Sanjit Kumer Shaha Tasmin Nahar Malini Pires Andrew Copas Hassan Haghparast-Bidgoli Joanna Morrison Abdul Kuddus Kishwar Azad |
| author_sort | Edward Fottrell |
| collection | DOAJ |
| description | Summary: Background: Cognitive impairment has a major impact on health, quality of life and survival and its increasing burden presents a critical global health challenge. Empirical population-based studies of cognitive function and its association with demographic, socioeconomic, health and behavioural factors among older adults in low-resource setting are rare. This study describes the burden of cognitive impairment and associations with demographic, health and behavioural factors among older adults in rural Bangladesh. Methods: We conducted a population-based cross-sectional study of a random sample of men and women aged 60 years and above in 96 rural villages in Bangladesh. Cognitive function was measured using the Bangla Adaptation of the Mini-mental State Examination (BAMSE), where higher score indicates higher function. Blood pressure, height and weight were measured using standard protocols and fasting glucose and 2-h oral glucose test were used to identify diabetes risk. Interviewer administered survey questionnaires assessed depressive symptoms, anxiety and self-reported health behaviours. Analyses were carried out separately for men and women and examined associations between sociodemographic, health and behaviour factors with BAMSE scores using robust Poisson regression. Findings: Data were gathered from 403 (216 female, 187 male) eligible participants. More than 50% of the population had at least mild cognitive impairment and women had lower cognitive scores than men. Younger age, higher education, wealth, and literacy were significantly associated with higher BAMSE scores among women and men. Associations with marital status varied between men and women, with being married having a positive association with BAMSE among women, i.e. higher cognitive function (relative score ratio (95% CI) 1.08 (1.02, 1.15), p = 0.013), but no association among men (0.94 (0.87, 1.02), p = 0.13). No clear associations were observed with diabetes or hypertension, but overweight and obesity were associated with an increased BAMSE score among women (1.10 (1.02, 1.19), p = 0.011) but not men (1.01 (0.94, 1.10), p = 0.70). Moderate and severe depressive symptoms were associated with lower BAMSE scores among men (0.90 (0.82, 0.99), p = 0.037), but not women (0.94 (0.83, 1.06), p = 0.31). Physical activity was associated with a relative increase in BAMSE score (1.08 (1.01, 1.16), p = 0.020) among women, though no association was seen in men (1.01 (0.95, 1.07), p = 0.76). The consumption of betel was associated with lower BAMSE among women (0.94 (0.89, 1.00), p = 0.056), but there was no evidence of association among men (1.01 (0.96, 1.07), p = 0.61). Interpretation: A large proportion of older adults in rural Bangladesh have impaired cognitive function and there are important gender differences in the distribution of cognitive scores and their association with demographic, socioeconomic, health and behavioural factors in this population. Improvement in health and social care systems, taking into account the specific social, economic and gender dimensions of the context, are needed to prevent and manage the burden of cognitive decline in rural Bangladesh. Funding: This survey and analysis were part of the Bangladesh Diabetes Community-Led Awareness, Response and Evaluation (DClare) study funded by UKRI/MRC (MR/T023562/1) under the Global Alliance for Chronic Diseases Scale-Up Programme. |
| format | Article |
| id | doaj-art-d4546a4f5e2a46fbb3dd6e972b70a8d7 |
| institution | OA Journals |
| issn | 2772-3682 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health - Southeast Asia |
| spelling | doaj-art-d4546a4f5e2a46fbb3dd6e972b70a8d72025-08-20T02:15:23ZengElsevierThe Lancet Regional Health - Southeast Asia2772-36822025-05-013610057510.1016/j.lansea.2025.100575Cognitive function and associations with demographic, socioeconomic, health and behavioural factors among older adult men and women in rural Bangladesh: a population-based cross-sectional studyResearch in contextEdward Fottrell0Harry Costello1Naveed Ahmed2Carina King3Sanjit Kumer Shaha4Tasmin Nahar5Malini Pires6Andrew Copas7Hassan Haghparast-Bidgoli8Joanna Morrison9Abdul Kuddus10Kishwar Azad11UCL Institute for Global Health, University College London, London, UK; Corresponding author. UCL Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.UCL Institute of Cognitive Neuroscience, University College London, London, UKCentre for Health Research and Implementation, Diabetic Association of Bangladesh, Dhaka, Bangladesh; Department of Internal Medicine, BIRDEM General Hospital, Dhaka, BangladeshDepartment of Global Public Health, Karolinska Institutet, Stockholm, SwedenCentre for Health Research and Implementation, Diabetic Association of Bangladesh, Dhaka, BangladeshCentre for Health Research and Implementation, Diabetic Association of Bangladesh, Dhaka, BangladeshUCL Institute for Global Health, University College London, London, UKUCL Institute for Global Health, University College London, London, UKUCL Institute for Global Health, University College London, London, UKUCL Institute for Global Health, University College London, London, UKCentre for Health Research and Implementation, Diabetic Association of Bangladesh, Dhaka, BangladeshCentre for Health Research and Implementation, Diabetic Association of Bangladesh, Dhaka, BangladeshSummary: Background: Cognitive impairment has a major impact on health, quality of life and survival and its increasing burden presents a critical global health challenge. Empirical population-based studies of cognitive function and its association with demographic, socioeconomic, health and behavioural factors among older adults in low-resource setting are rare. This study describes the burden of cognitive impairment and associations with demographic, health and behavioural factors among older adults in rural Bangladesh. Methods: We conducted a population-based cross-sectional study of a random sample of men and women aged 60 years and above in 96 rural villages in Bangladesh. Cognitive function was measured using the Bangla Adaptation of the Mini-mental State Examination (BAMSE), where higher score indicates higher function. Blood pressure, height and weight were measured using standard protocols and fasting glucose and 2-h oral glucose test were used to identify diabetes risk. Interviewer administered survey questionnaires assessed depressive symptoms, anxiety and self-reported health behaviours. Analyses were carried out separately for men and women and examined associations between sociodemographic, health and behaviour factors with BAMSE scores using robust Poisson regression. Findings: Data were gathered from 403 (216 female, 187 male) eligible participants. More than 50% of the population had at least mild cognitive impairment and women had lower cognitive scores than men. Younger age, higher education, wealth, and literacy were significantly associated with higher BAMSE scores among women and men. Associations with marital status varied between men and women, with being married having a positive association with BAMSE among women, i.e. higher cognitive function (relative score ratio (95% CI) 1.08 (1.02, 1.15), p = 0.013), but no association among men (0.94 (0.87, 1.02), p = 0.13). No clear associations were observed with diabetes or hypertension, but overweight and obesity were associated with an increased BAMSE score among women (1.10 (1.02, 1.19), p = 0.011) but not men (1.01 (0.94, 1.10), p = 0.70). Moderate and severe depressive symptoms were associated with lower BAMSE scores among men (0.90 (0.82, 0.99), p = 0.037), but not women (0.94 (0.83, 1.06), p = 0.31). Physical activity was associated with a relative increase in BAMSE score (1.08 (1.01, 1.16), p = 0.020) among women, though no association was seen in men (1.01 (0.95, 1.07), p = 0.76). The consumption of betel was associated with lower BAMSE among women (0.94 (0.89, 1.00), p = 0.056), but there was no evidence of association among men (1.01 (0.96, 1.07), p = 0.61). Interpretation: A large proportion of older adults in rural Bangladesh have impaired cognitive function and there are important gender differences in the distribution of cognitive scores and their association with demographic, socioeconomic, health and behavioural factors in this population. Improvement in health and social care systems, taking into account the specific social, economic and gender dimensions of the context, are needed to prevent and manage the burden of cognitive decline in rural Bangladesh. Funding: This survey and analysis were part of the Bangladesh Diabetes Community-Led Awareness, Response and Evaluation (DClare) study funded by UKRI/MRC (MR/T023562/1) under the Global Alliance for Chronic Diseases Scale-Up Programme.http://www.sciencedirect.com/science/article/pii/S2772368225000460CognitionAgeingBangladeshHypertensionDiabetesDepression |
| spellingShingle | Edward Fottrell Harry Costello Naveed Ahmed Carina King Sanjit Kumer Shaha Tasmin Nahar Malini Pires Andrew Copas Hassan Haghparast-Bidgoli Joanna Morrison Abdul Kuddus Kishwar Azad Cognitive function and associations with demographic, socioeconomic, health and behavioural factors among older adult men and women in rural Bangladesh: a population-based cross-sectional studyResearch in context The Lancet Regional Health - Southeast Asia Cognition Ageing Bangladesh Hypertension Diabetes Depression |
| title | Cognitive function and associations with demographic, socioeconomic, health and behavioural factors among older adult men and women in rural Bangladesh: a population-based cross-sectional studyResearch in context |
| title_full | Cognitive function and associations with demographic, socioeconomic, health and behavioural factors among older adult men and women in rural Bangladesh: a population-based cross-sectional studyResearch in context |
| title_fullStr | Cognitive function and associations with demographic, socioeconomic, health and behavioural factors among older adult men and women in rural Bangladesh: a population-based cross-sectional studyResearch in context |
| title_full_unstemmed | Cognitive function and associations with demographic, socioeconomic, health and behavioural factors among older adult men and women in rural Bangladesh: a population-based cross-sectional studyResearch in context |
| title_short | Cognitive function and associations with demographic, socioeconomic, health and behavioural factors among older adult men and women in rural Bangladesh: a population-based cross-sectional studyResearch in context |
| title_sort | cognitive function and associations with demographic socioeconomic health and behavioural factors among older adult men and women in rural bangladesh a population based cross sectional studyresearch in context |
| topic | Cognition Ageing Bangladesh Hypertension Diabetes Depression |
| url | http://www.sciencedirect.com/science/article/pii/S2772368225000460 |
| work_keys_str_mv | AT edwardfottrell cognitivefunctionandassociationswithdemographicsocioeconomichealthandbehaviouralfactorsamongolderadultmenandwomeninruralbangladeshapopulationbasedcrosssectionalstudyresearchincontext AT harrycostello cognitivefunctionandassociationswithdemographicsocioeconomichealthandbehaviouralfactorsamongolderadultmenandwomeninruralbangladeshapopulationbasedcrosssectionalstudyresearchincontext AT naveedahmed cognitivefunctionandassociationswithdemographicsocioeconomichealthandbehaviouralfactorsamongolderadultmenandwomeninruralbangladeshapopulationbasedcrosssectionalstudyresearchincontext AT carinaking cognitivefunctionandassociationswithdemographicsocioeconomichealthandbehaviouralfactorsamongolderadultmenandwomeninruralbangladeshapopulationbasedcrosssectionalstudyresearchincontext AT sanjitkumershaha cognitivefunctionandassociationswithdemographicsocioeconomichealthandbehaviouralfactorsamongolderadultmenandwomeninruralbangladeshapopulationbasedcrosssectionalstudyresearchincontext AT tasminnahar cognitivefunctionandassociationswithdemographicsocioeconomichealthandbehaviouralfactorsamongolderadultmenandwomeninruralbangladeshapopulationbasedcrosssectionalstudyresearchincontext AT malinipires cognitivefunctionandassociationswithdemographicsocioeconomichealthandbehaviouralfactorsamongolderadultmenandwomeninruralbangladeshapopulationbasedcrosssectionalstudyresearchincontext AT andrewcopas cognitivefunctionandassociationswithdemographicsocioeconomichealthandbehaviouralfactorsamongolderadultmenandwomeninruralbangladeshapopulationbasedcrosssectionalstudyresearchincontext AT hassanhaghparastbidgoli cognitivefunctionandassociationswithdemographicsocioeconomichealthandbehaviouralfactorsamongolderadultmenandwomeninruralbangladeshapopulationbasedcrosssectionalstudyresearchincontext AT joannamorrison cognitivefunctionandassociationswithdemographicsocioeconomichealthandbehaviouralfactorsamongolderadultmenandwomeninruralbangladeshapopulationbasedcrosssectionalstudyresearchincontext AT abdulkuddus cognitivefunctionandassociationswithdemographicsocioeconomichealthandbehaviouralfactorsamongolderadultmenandwomeninruralbangladeshapopulationbasedcrosssectionalstudyresearchincontext AT kishwarazad cognitivefunctionandassociationswithdemographicsocioeconomichealthandbehaviouralfactorsamongolderadultmenandwomeninruralbangladeshapopulationbasedcrosssectionalstudyresearchincontext |