Cognitive function and cardiometabolic disease risk factors in rural South Africa: baseline evidence from the HAALSI study
Year: 2019
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Evidence on cognitive function in older South Africans is limited, with few population-based studies. We aimed to estimate baseline associations between cognitive function and cardiometabolic disease risk factors in rural South Africa. METHODS: We use baseline data from "Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa" (HAALSI), a population-based study of adults aged 40 and above in rural South Africa in 2015. Cognitive function was measured using measures of time orientation, immediate and delayed recall, and numeracy adapted from the Health and Retirement Study cognitive battery (overall total cognitive score range 0-26). We used multiple linear regression to estimate associations between cardiometabolic risk factors (including BMI, hypertension, dyslipidemia, diabetes, history of stroke, alcohol frequency, and smoking status) and the overall cognitive function score, adjusted for potential confounders. RESULTS: In multivariable-adjusted analyses (n = 3018; male = 1520; female = 1498; median age 59 (interquartile range 50-67)), cardiometabolic risk factors associated with lower cognitive function scores included: diabetes (b = - 1.11 [95% confidence interval: - 2.01, - 0.20] for controlled diabetes vs. no diabetes); underweight BMI (b = - 0.87 [CI: - 1.48, - 0.26] vs. normal BMI); and current and past smoking history compared to never smokers. Factors associated with higher cognitive function scores included: obese BMI (b = 0.74 [CI: 0.39, 1.10] vs. normal BMI); and controlled hypertension (b = 0.53 [CI: 0.11, 0.96] vs. normotensive). CONCLUSIONS: We provide an important baseline from rural South Africa on the associations between cardiometabolic disease risk factors and cognitive function in an older, rural South African population using standardized clinical measurements and cut-offs and widely used cognitive assessments. Future studies are needed to clarify temporal associations as well as patterns between the onset and duration of cardiometabolic conditions and cognitive function. As the South African population ages, effective management of cardiometabolic risk factors may be key to lasting cognitive health.
Source: BMC Public Health
Institutions: Australian National University, University of Colorado Boulder, University of the Witwatersrand, Agincourt Health and Socio-Demographic Surveillance System, Brigham and Women's Hospital, Harvard University, Indepth Network, University of Michigan, National Health Laboratory Service, Umeå University
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,390
Awards: Strengthening and stabilising a demographic and health surveillance in Agincourt: foundation for a health and population research programme in South Africa's rural northeast, G1112674395, Preventing cardiometabolic diseases in Africa: life-course and multi-sector approaches., An Innovative Language Controlled Tablet-Based Cognitive Test: Harmonizing Dementia Screening across High and Low Literacy Countries, G4469057728, Investigating and responding to health, population and social transitions in rural Southern Africa., Health, population and social transitions in rural Southern Africa: Elucidating pathways and testing interventions., Endocrine and metabolic diseases in rural South Africa-establishing burden and improving detection, G7923275117, G8186070293, AWI-Gen Phase 2: Genomic and environmental risk factors for cardiometabolic disease in Africans, Health, Aging and Dementia in South Africa: A Longitudinal Study (HAALSI)
OpenAlex ID: W2991457145