Association of disability and cognitive performance in U.S. older adults: the NHANES 2013-2014

Background: Identifying the link between disability and cognitive function is critical to ensuring the health of older adults. The aim of this study was to identify associations between disability and cognitive performance, and to explore the role that comorbidities play in these associations. Methods We conducted a cross-sectional study of 1,516 adults aged 60 years and older who had participated in the National Health and Nutrition Examination Survey (NHANES) 2013–2014 in the United States. Multivariate logistic regression models were used to analyze the association between disability and low cognitive performance. Sample weights were used to ensure the generalizability of the results. Results Among all the participants, 26.1% reported low cognitive performance. Among participants with low cognitive performance, the weighted prevalence of difficulty hearing, difficulty seeing, difficulty walking, difficulty, and difficulty dressing or bathing were 17.7%, 12.2%, 35.9%, and 13.7% respectively. Difficulty hearing, walking, dressing, or bathing were significantly associated with low cognitive performance and varied by the number of comorbidities. There is a positive correlation between the number of disabilities and low cognitive performance. Conclusion In older adults, we observed significant associations between difficulty hearing, difficulty walking, difficulty dressing or bathing and low cognitive performance, and found strong associations in those with high numbers of comorbidities. There is a positive correlation between low cognitive performance and the number of disabilities. This study suggests that attenuating cognitive decline through early intervention for disability and treatment of comorbidities is worth trying.