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Dementia and co‐occurring chronic conditions: a systematic literature review to identify what is known and where are the gaps in the evidence?

Year: 2017
Type: review
Study design: Systematic Review
Abstract: OBJECTIVE: The challenges posed by people living with multiple chronic conditions are unique for people with dementia and other significant cognitive impairment. There have been recent calls to action to review the existing literature on co-occurring chronic conditions and dementia in order to better understand the effect of cognitive impairment on disease management, mobility, and mortality. METHODS: This systematic literature review searched PubMed databases through 2011 (updated in 2016) using key constructs of older adults, moderate-to-severe cognitive impairment (both diagnosed and undiagnosed dementia), and chronic conditions. Reviewers assessed papers for eligibility and extracted key data from each included manuscript. An independent expert panel rated the strength and quality of evidence and prioritized gaps for future study. RESULTS: Four thousand thirty-three articles were identified, of which 147 met criteria for review. We found that moderate-to-severe cognitive impairment increased risks of mortality, was associated with prolonged institutional stays, and decreased function in persons with multiple chronic conditions. There was no relationship between significant cognitive impairment and use of cardiovascular or hypertensive medications for persons with these comorbidities. Prioritized areas for future research include hospitalizations, disease-specific outcomes, diabetes, chronic pain, cardiovascular disease, depression, falls, stroke, and multiple chronic conditions. CONCLUSIONS: This review summarizes that living with significant cognitive impairment or dementia negatively impacts mortality, institutionalization, and functional outcomes for people living with multiple chronic conditions. Our findings suggest that chronic-disease management interventions will need to address co-occurring cognitive impairment. Copyright © 2017 John Wiley & Sons, Ltd.
DOI: 10.1002/gps.4652
Authors: Mark B. Snowden, Lesley E. Steinman, Lucinda L. Bryant, Monique M. Cherrier, Kurt J. Greenlund, Katherine H. Leith, Cari Levy, Rebecca G. Logsdon, Catherine Copeland, Mia Vogel, Lynda A. Anderson, David C. Atkins, Janice F. Bell, Annette L. Fitzpatrick
Institutions: University of Washington, Colorado School of Public Health, University of Colorado Anschutz, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, University of South Carolina, Denver VA Medical Center, University of Colorado Denver, Emory University, University of California, Davis
Language: English
Subfield: Epidemiology
Field: Medicine
Open Access status: green
OpenAlex ID: W2584951391
FWCI: 0.945
Cites: 168
Cited by: 88
Related to: 10