Study of correlation of cognitive status and quality of living in elderly residents of old age home

Abstract

Objectives: This study aims to analyze the contributing factors affecting the decline in cognition and the effect of cognitive impairment on quality of life in residents of old age home.

 Methods: This community-based cross-sectional study was carried out among 50 elderly citizens who were 60 and above years of age living in old age homes at Navi Mumbai, Maharashtra. A standardized mini-mental scale examination tool (MMSE) containing a total score of 30 and covers 5 domains was used; based on the score, they were classified into mild, moderate, and severe cognitive impairment. The same study subjects were scored for quality of life (QOL) using Barthel Index of daily living scale, lower score indicating dependency.Data regarding the history of factors including gender, marital status, literacy level, co-morbidities, psychological disease, and reason for stay in Ashram were collected.

 Results: The average age of the 50 participants in the study was 70.66 ± 8.75 years. Of the participants, 23 (or 46%) had finished primary schooling. Co-morbidities were present in 34(68%) participants, and cerebrovascular accident (CVA) in 8 (16%) participants. The most common reason for being in Ashram was 12(24%) participants had no family. The findings showed a moderate, positive, and significant correlation between QOL and MMSE (r=0.569, p=0.001). The mean MMSE scores were higher in participants who had depression in the family and who were divorced and had left the family (29) Progressive age was not correlated with lower MMSE scores but affected quality of life. Residents with higher education status, possibly with better coping up skills had a higher MMSE. Two residents with chronic kidney disease had mild cognitive impairment with profound lower QOL score. Mean MMSE scores were higher in participants who had no CVA - 24.83 ± 3.32 as compared to participants who had CVA- 21.62 ± 2.44. Comorbidities like T2DM, Hypertension, hypothyroidism, peripheral vascular disease, IHD, cancer and COPD did not show direct correlation with MMSE score but physical performance of basic activities were affected.

 Conclusion: Lack of psychosocial support was one of the independent predictors of cognitive decline in residents of old age care centres. It was inferenced that MMSE and QOL had a strong association indicating level of cognition affected their daily basic activities. The results of the current study also showed a significant relationship between cognitive impairment with gender, educational status, co-morbidities and past emotional trauma of inmates. Gradual cognitive deterioration in elderly with multiple risk factors is an imminent process. In order to repress the deterioration, early identification through screening scales and medical management supported with psychological counselling and coping skills should be encouraged.

 Keywords: Cognition, Old age homes, MMSE, QOL, Education