If your spouse had the stroke you will need to demand your doctor give you EXACT PROTOCOLS THAT PREVENT MCI OR DEMENTIA. Non-negotiable.
Cognitive Disorders Double Risk of Cognitive Impairment in Spouses
Cognitive disorders in older adults nearly doubled the risk of dementia or mild cognitive impairment in their spouses, a prospective cohort study showed.
Older people with a cognitive disorder -- defined as dementia or mild cognitive impairment -- were more likely to have a spouse with a cognitive disorder than people who were cognitively normal (OR 1.74, 95% CI 1.12-2.69, P=0.01), reported Ki Woong Kim, MD, PhD, of Seoul National University Bundang Hospital in Korea, and colleagues.
Shared environments may be responsible, in part, for shared cognitive disorders and cognitive performance within couples, they said.
"This study demonstrated that participants' cognitive disorders were associated with spouses' declines in cognitive function and risks of cognitive disorders, and that this association was mediated by factors including physical inactivity and a history of head injury, which were shared within couples," the researchers wrote in JAMA Network Open.
"To our knowledge, this is the first study to reveal how the association among cognitive disorders, cognitive function, and shared risk factors is structured within couples," they added.
The study followed 784 older adults who participated in the Korean Longitudinal Study on Cognitive Aging and Dementia (307 women and 477 men) and their opposite-sex spouses from 2010 to 2020 who were assessed every 2 years. Cognitive assessments included face-to-face diagnostic interviews conducted by geriatric psychiatrists. Participants had a mean age of about 75; spouses had a mean age of about 74.
Among the 784 participants, 121 people had cognitive disorders. Spouses of people with cognitive disorders were older, less educated, less physically active, and more likely to have a history of head injury compared with spouses of people who did not have a cognitive disorder. Cognitive disorders were more prevalent among people whose spouses had cognitive disorders (38.8%) than others (22.6%, P<0.001).
History of head injury (β=0.50 95% CI 0.09-0.90, P=0.02) and age (β=2.57, 95% CI 1.37-3.76, P<0.001) mediated the association between cognitive disorder in participants and their spouses' risk of cognitive disorder.
Physical inactivity mediated the association via major depressive disorder (β=0.33, 95% CI 0.09-0.57, P=0.006 for physical inactivity; β=0.28, 95% CI 0.13-0.44, P<0.001). Major depressive disorder was independently associated with increased risk of cognitive disorder (β=0.35, 95% CI 0.18-0.53, P<0.001).
These factors similarly mediated links between spousal cognitive disorder and memory and executive function.
This analysis shows that "almost 50% of the higher rates of cognitive disorders in spouses of persons with cognitive disorders could be explained by their age, history of major depressive disorder, limited physical activity, and history of head injury," wrote Peter Vitaliano, MS, PhD, of the University of Washington in Seattle, in an invited commentary.
"These findings support previous research and recommend the further study of three areas that are relevant to neurology and psychiatry: assortative mating, dyadic lifestyles, and spouse caregiving," Vitaliano suggested.
Assortative mating -- states and traits that influence a person's choice of a mate and future health -- may be associated with education, diet, or physical activity. Likewise, shared health habits in the dyad may be linked with cognitive outcomes: spouses may have similar chemical or stress exposures, for example.
Caregiving for a cognitively impaired spouse can create chronic stress, which may lead to physiological dysregulation, Vitaliano added. Cross-sectional studies have shown that chronic stress may affect the cognitive performance of spouse caregivers, he noted.
All grades of head injury are associated with increased risk of dementia, Kim and colleagues pointed out.
"In older people, falls are the leading cause of traumatic brain injury, and multiple factors, such as indoor home environment, physical frailty, compromised health status, and depressive symptoms, are associated with the risk of falls," they wrote. "These factors can be shared within couples and may increase the shared risk of head injury within couples."
Because the incidence of head injury was low and injury history was collected retrospectively, the mediating role of head injury needs to be confirmed in larger studies, they added.
Other limitations included the study's cross-sectional design; mediating variables may be symptoms, rather than risk factors, the researchers noted. In addition, dementia and mild cognitive impairment were not analyzed separately due to limited sample size.
Disclosures
The study was supported by the Research of Korea Centers for Disease Control and Prevention (RKCDC).
Kim and co-authors disclosed support from RKCDC.
Vitaliano disclosed no relationships with industry.
Primary Source
JAMA Network Open
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