Patterns of Cognitive Impairment and Associated Factors Among Elderly Patients Attending a Primary Care Clinic in North-Central Nigeria: A Cross-Sectional Study

Patterns of Cognitive Impairment and Associated Factors Among Elderly Patients Attending a Primary Care Clinic in North-Central Nigeria: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Patterns of Cognitive Impairment and Associated Factors Among Elderly Patients Attending a Primary Care Clinic in North-Central Nigeria: A Cross-Sectional Study NUSIRAT TINUKE ABDULLATEEF, KOLADE MORADEYO ALABI, ISMAIL ABERI OBALOWU, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7132229/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract BACKGROUND Cognitive impairment (CI) is prevalent among older adults, particularly in low- and middle-income countries (LMICs) as the population ages. Some factors, such as age, hypertension, diabetes, and body mass index, contribute to greater cognitive decline. There is a gap in the existing research in the study area; therefore, this study aims to assess patterns of cognitive impairment and associated factors among elderly patients at the General Hospital Ilorin, Kwara State, Nigeria. METHODS This study was a descriptive, hospital-based, cross-sectional analysis involving 228 elderly participants. Data were collected via structured questionnaires, and cognitive impairment was assessed using the Mini-Mental State Examination. Fasting blood glucose, body mass index, and blood pressure were measured using standard procedures. Data analysis was performed with SPSS-24, presenting clinical variables in frequency distribution tables and cognitive impairment prevalence and patterns in bar charts. The Chi-square test assessed significant associations, and multivariate logistic regression identified predictors of cognitive impairment. RESULTS The study found a cognitive impairment prevalence of 36.8%, with mild cognitive impairment at 72.6%, significantly higher than severe cognitive impairment. Significant associations existed between cognitive impairment patterns and risk factors like hypertension and age (p < 0.001 and 0.003). Multiple logistic analyses identified increasing age and systemic hypertension as predictors of cognitive impairment. CONCLUSIONS The study shows that mild cognitive impairment is common in elderly patients, especially those with hypertension and advanced age. Early screening for high-risk groups is encouraged, along with prompt management of modifiable factors to prevent cognitive impairment and delay the progression to dementia. Cognitive Impairment Dementia Elderly Patients Primary Care Clinic Figures Figure 1 INTRODUCTION Cognitive impairment (CI) is a prevalent health condition among the elderly population, significantly impacting public health worldwide, especially in developing countries. 1 It is a condition which manifests when an individual has trouble remembering, learning new things, concentrating, or making decisions that affect their everyday life. 2 CI can be mild or severe, in mild cognitive impairment (MCI), the cognitive deficit is less severe, and the normal daily functions and independence are generally maintained. 2 The severe form of CI is known as dementia, which is a syndrome characterized by a progressive decline in cognitive functions accompanied by deterioration in emotion, social behaviour, and motivation, but consciousness is not affected. 2 The World Health Organization (WHO) and the United Nations define the elderly as a group of persons aged 65 and 60 above, respectively. 3 , 4 The United Nations’ definition is adopted in developing countries. 3 As a result of epidemiological and demographic transition, fertility and mortality rates are declining worldwide with an attendant increase in average life expectancy. 4 The effect of this is an overall increase in the geriatric population, which is projected to increase to around 8.5 billion in 2030 and 9.7 billion in 2050, according to the World Population Prospect Report in the year 2022. 5 This increase in the ageing population will be more in developing countries with the incidental rise in the number of non-communicable diseases (NCDs) and degenerative diseases in the region, including cognitive impairment. A systematic review reported a prevalence of MCI ranging from 0.5–42% in different countries and populations in the Western world. 6 A community-based study by Ogunniyi et al. in South-Western Nigeria reported that approximately 20% of elderly persons had major neuro-cognitive impairment, with MCI six times more common than dementia. 7 Adeloye et al, found the pooled crude prevalence of dementia in Nigeria to be 4.9%, with prevalence slightly higher in women 6 Age is the main risk factor for CI. 8 The prevalence of CI increases more rapidly with age, as a higher prevalence is found among the elderly compared to the younger population. 8 Specific risk factors, such as diabetes, hypertension, and extremes of weight, have been associated with greater cognitive decline and risk of developing CI. 9 Elevated blood pressure in the 4th and 5th decades of life, particularly untreated hypertension, increases the risk of CI 20–30 years later. 10 CI is a chronic complication of diabetes, and it occurs more commonly in older age. 11 , 12 Overweight and obesity may directly or indirectly increase other vascular risk factors linked to the development of CI. 12 In contrast, lower body mass index (BMI) has been reported to be associated with cognitive decline and its progression in the older population. 13 A lower BMI may be associated with a decrease in muscle mass or fat due to inadequate nutrition; lack of vitamins reduces the production of leptin and essential fatty acids, resulting in oxidative damage to neuronal cells and consequential acceleration of neurodegenerative diseases. 13 Early identification, prompt treatment of hypertension and diabetes, and lifestyle modification to manage extremes of weights constitute potential targets for intervention to prevent or delay the progression of MCI among elderly people. Late detection and poor management may worsen the severity of the disease, which would consequently affect their quality of life. To bridge the knowledge gap and add to the existing literature on CI among elderly participants, this study was carried out to determine the pattern of CI and its associated risk factors, such as age, hypertension, diabetes, and body mass index among elderly participants attending a secondary healthcare facility in north-central Nigeria. MATERIALS AND METHODS This hospital-based descriptive cross-sectional study was conducted at the Family Medicine Clinics of the General Hospital, Ilorin (GHI), Kwara State. The study population comprised 228 elderly male and female participants aged 60 years and above attending family medicine clinics at GHI, who gave their consent and satisfied the inclusion criteria. The research was approved by the Ethical Review Committee of GHI, Kwara State. The Lesley Kish statistical formula for determining the minimum sample size for health studies, used by Fisher and his colleagues, was used to calculate the minimum sample size for this study. n = z 2 pq/d 2 . 14 Where n = minimum sample size, z = the standard normal deviation, usually set at 1.96 which corresponds to a 95% confidence level, p = Prevalence (prevalence estimates of neurocognitive disorders in rural communities in south-west Nigeria was found to be 20.9% by Ogunniyi et al. 7 q = 1-p, q = 1- 0.209, therefore q = 0.791, d = Degree of accuracy desired, usually set at 5% (0.05). Therefore, n = (1.96) 2 (0.209) (0.791)/(0.05) 2 = 254.0, approximately. The minimum sample size was 254. However, the study population was less than 10,000; therefore, the sample size was adjusted using the formula: nf = n/1 +(n/N) 15 .nf = the desired sample size when the population is less than 10,000. n = estimated sample size = 254, N = the estimated population size = 1800 (total number of elderly patients seen in 3 months according to the Health Records Department of the hospital). nf = 254/1 +(254/1800) = 222.8 Approximately 223. The participants were recruited during regular clinic hours, and to take care of incomplete or missing data, a 98% response rate was assumed. Hence, the final sample size was adjusted to compensate for the response rate using the formula: ns = n/r, where ns = adjusted sample size of the response rate. n = calculated sample size = 223, r = response ratio = 0.98. ns = 223/0.98 = 227.55 Approximately 228. The final sample size was 228 A systematic random sampling technique was used to select eligible participants for this study. With a sample size of 228, the sampling interval (sampling frame/sample size) was 1800/228 = 7.89, approximately 8. Every 8th elderly participant was recruited, and a total of 4 participants were seen daily. All the selected participants filled out and signed the consent forms. Those with acute medical conditions and with major psychiatric illnesses such as psychosis and bipolar affective disorder were excluded from the study. Structured and Semi-structured questionnaires were used to obtain information from the participants. The Mini-Mental State Examination tool was used to assess levels of cognition. It was invented by Folstein et al in 1975 to assess mental status. 16 It is an 11-item questionnaire that tests five domains of cognitive function: orientation, registration, attention, recall, and language. 16 The maximum score is 30. A score of 24–30 is normal, 18–23 indicates mild cognitive impairment, and less than 18 indicates severe cognitive impairment. 17 Blood pressure (BP) was measured by the auscultatory method using a standard mercury sphygmomanometer with an appropriately sized cuff and a Littmann stethoscope, following recommended guidelines. Participants remained at rest while sitting for at least 5 minutes before BP was taken twice, two minutes apart, with readings recorded to the nearest 2 mmHg. The mean BP was categorized using JNC 7. The weight of each participant was measured to the nearest 0.5kg on a standard scale adjusted to zero points before each weighing, with the participant lightly clothed, devoid of any heavy objects and barefoot. Height was measured to the nearest 0.01m using a Stadiometer, with participants standing without headgear. Body mass index (BMI) was calculated as weight (kg) / height² (m²) and classified according to WHO guidelines: Underweight (BMI < 18.5), Normal weight (BMI 18.5–24.9), Overweight (BMI 25-29.9), and Obesity (BMI ≥ 30). Fasting blood samples were taken under aseptic conditions for glucose estimation after an overnight fast of 10–12 hours and then sent for laboratory analysis. The data collected were sorted out and coded before entry into the computer for analysis using the software package of the Statistical Package for Social Sciences (SPSS) Version 24. Frequency distribution tables were generated to present all the socio-demographic data and clinical variables. Bar charts were used to depict the pattern of CI among the respondents. The Chi-square test was used to assess the statistical significance of the association between CI and associated risk factors. A p -value less than or equal to 0.05 was considered statistically significant. A multivariate logistic regression analysis was run further to determine the predictors of CI among the participants. RESULTS Figure 1; below shows the pattern of CI among the respondents. Of all the respondents (228) recruited for this study, only 84 (36.8%) had CI, among which sixty-one respondents (72.6 %) had mild cognitive impairment (MCI) while 23(27.4%) had severe CI. Table 1 shows the proportion of the risk factors associated with CI among the elderly. Slightly more than half, 53.5% of respondents were within the age range of 60 to 69 years. The majority of the respondents, 139 (61.0%) had normal weight. About one-third, 84(36.8%) of the respondents were hypertensive, while respondents that were diabetic constituted only 16.7% of the participants. Table 2 shows the relationship between the pattern of CI and certain risk factors. There was a statistically significant association between the severity of CI and the respondents' ages ( p -value = 0.001). The age group 70-79 years had the highest percentage of respondents with severe CI (42.1%). The highest proportion of respondents with severe CI was found among those who were overweight (38.9%), and the association was not statistically significant. The highest percentage of the respondents with severe CI was found among respondents who were hypertensive (47.1%), and the association was statistically significant ( p -value = 0.003). The respondents who were living with diabetes had a higher percentage of 31.1% of severe CI. Table 2: Association between the pattern of CI and the risk factors N = 84 Variables Patterns of Cognitive Impairment χ² Ρ Severe CI {n (%)} Mild CI {n (%)} Age Groups 15.870 a 0.001 * ≤ 69 0 (0.0) 22 (100.0) 70 – 79 16 (42.1) 22 (57.9) 80 – 89 7 (33.3) 14 (66.7) ≥ 90 0 (0.0) 3 (100.0) Body Mass Index 5.285 0.152 Underweight 0 (0.0) 0 (0.0) Normal 16 (31.4) 35 (68.6) Overweight 7 (38.9) 11 (61.1) Obese 0 (0.0) 15 (100.0) Hypertension status 11.663 0.003 * Normal 4 (11.1) 32 (88.9) Pre hypertension 3 (21.4) 11 (78.6) Hypertensive 16 (47.1) 18 (52.9) Fasting blood Glucose 1.590 0.207 Diabetic 19 (31.1) 42 (68.9) Non-Diabetic 4 (17.4) 19 (82.6) a = Fisher’s Exact value (F) N=total number of respondents, n= number of respondents in various groups, *=p value<0.05 Table 3 shows the results of multiple logistic regression analysis to identify significant risk factors as predictors of CI after taking into consideration the effects of significant confounders. Both age and hypertension, which were already identified as significant predictors of cognitive impairment during bivariate analysis, were also significant after the multivariate analysis. However, being hypertensive was the better predictor of cognitive impairment in this study (r = -1.962, P = 0.002, OR = 2.123). Table 3: Logistic regression of the risk factors of cognitive impairment Variables B p-value Odd ratio 95 % C I Age -0.052 0.050 * 1.949 0.900 – 3.401 Hypertension status Normal RC Prehypertension -0.780 0.353 0.458 0.088 – 2.378 Hypertensive -1.962 0.002 * 2.123 0.041 – 8.150 RC = Reference Category, B = Coefficient of regression (r), OR = Odds ratio, 95% CI = Confidence interval, * = p ≤0.05. DISCUSSION The majority of the participants with cognitive impairment had mild CI, with a prevalence of 72.6%, while 27.4% had severe CI. This pattern is the usual trend seen in most studies. It is comparable to the study by Ramlall et al in South Africa, where the majority of the participants with cognitive impairment had the mild form. 18 It is also comparable with the study by Gela et al in Gondar town, Ethiopia and Tawfik et al in a cross-sectional study among community-dwelling elderly in Egypt, which found that out of 50.2% of cognitively impaired older people studied, 37.7% of them had MCI. 19 , 21 Similarly, Ucheagwu et al in Anambra, South-East Nigeria, where the majority of those with cognitive impairment had mild form. 20 There is a statistically significant relationship (P < 0.001) between the pattern of cognitive impairment and age in this study. This is expected as age has been shown in several studies to be an independent risk factor for cognitive impairment. 8 , 22 , 23 The prevalence of CI increases steeply with age, and this was the pattern in this study. From age group 70 through 90, there is an increase in the prevalence of cognitive impairment, especially the mild form of CI. This finding is comparable to the community-based study by Ogunniyi in Lalupon Southwest Nigeria among the elderly population, where it was found that increased age was associated with lower levels of cognitive performance. 7 Similarly, in a study by Ramlall et al among the heterogeneous elderly population in South Africa, the authors reported an increase in the incidence of CI with the age of the participants. 18 In the same vein, similar findings were reported by Eze et al; and Yusuf et al in Ilorin North Central Nigeria in the study to determine the prevalence of CI among type 2 diabetic participants where the significant association between cognitive impairment and age of the participants 24 , 25 In this study, no respondents were found to have severe CI at the extremes of the age groups. The reasons for these findings might be because of a higher proportion of younger age (young-old) or poor representation of the older adult respondents in the study as only 3 elderly respondents who participated had MCI. The association between the pattern of cognitive impairment and the hypertensive status of the respondents in this study is statistically significant. This depicts that there is a positive linear relationship between CI and hypertension, which implies the likelihood of having cognitive impairment with increasing blood pressure. This is not surprising as studies have shown this relationship. 9 , 10 , 23 This is the trend in this study in which the prevalence of severe CI increased from elderly with normotensive status to those with hypertensive status. This is similar to the study by Ogunniyi et al in Southwest Nigeria, where a significant association was found between neurocognitive impairments and hypertension in the elderly being studied. 7 In his study, it was reported that elderly people with hypertension are at high risk of developing severe CI, most especially vascular dementia. 7 A prospective cohort study by Murray et al to assess the effect of antihypertensive medications and dementia in older African Americans reported a strong association between hypertension and severe CI. 26 In the study, 1236 hypertensive participants who had no dementia at the baseline developed incident severe CI on follow-up, while those prescribed with antihypertensive medication were found to have a significantly reduced risk of developing severe CI. 26 However, the finding in this study was not comparable with that of Chanjoo et al among the Korean elderly population undergoing biannual medical screening. He found a higher risk of developing vascular dementia in elderly participants on antihypertensive drugs with lower blood pressure. 27 This might be as a result of low perfusion to the brain from low BP and also found that certain vascular factors are protective in very old subjects. 27 A descriptive cross-sectional study by Yusuf et al in Ilorin North Central Nigeria among type 2 diabetics found no association between CI and blood pressure. 24 Although some studies have shown a significant association between diabetes and cognitive decline however this index study did not show a significant association between the variables. This is comparable with the study by Eze et al in Abakaliki, Nigeria, which also showed no statistically significant relationship between cognitive impairment and fasting blood glucose. 24 Among the diabetic respondents in the study, there were higher percentages (68.9%) of those with mild cognitive impairment compared to those with severe CI (31.1%). This observation was similar to what was obtained in a hospital-based cross-sectional analytical study by Bashir and his colleague in Kano North-Western Nigeria, where a high percentage of type 2 diabetics had mild CI. 28 The reasons for this finding might be due to the higher prevalence of MCI in the study (more than two-thirds of the respondents had mild forms of cognitive impairment). The presence of certain socio-demographic factors such as low education or other risk factors such as hypertension and obesity could account for the high incidence of mild CI in this study. More than one-third and almost two-thirds of the respondents in the overweight category had mild and severe cognitive impairment, respectively. In addition, all the obese respondents in this study had mild cognitive impairment. Despite all these findings, it is surprising that there was no significant association between the pattern of CI and BMI. Most studies reviewed showed a significant association between BMI and CI. Some suggested that a higher BMI, especially in midlife, was associated with the development of CI in later life, while others found out that a lower BMI at later had a risk of progression from MCI to dementia. 29 , 30 One of those studies was done by Kim et al among the Korean elderly population, where it was found that a higher BMI was associated with a lower risk of severe cognitive impairment. 29 He found out that overweight and obese elderly had lower mean scores of cognitive function compared to normal-weight elderly people. 29 Similarly Ramboud and his colleague in Iran reported a significant association between BMI and cognitive impairment among the elderly respondents. Almost half of this population was either overweight or obese, and one-third of them had cognitive impairment. 30 Ilorin study by Yusuf et al among 2 diabetics also reported a significant association between BMI and cognitive impairment. 31 However, Gao et al in China, in a study to determine the prevalence of MCI among elderly diabetic participants, reported no significant association between CI and BMI, which is in keeping with the findings in the index study. 18 The possible reasons for these differences might be certain biological pathways in the brain responsible for this. First instance, in participants with high BMI, the hormone leptin, secreted mainly from the adipose tissue, might contribute to the regulation of the hippocampal synaptic plasticity and slow down cognitive decline. 30 , 32 Conversely, individuals with low BMI may reflect nutritional deficiencies such as low vitamin B levels, which could aggravate neuro-degeneration and memory loss. 30 , 33 LIMITATIONS The study's cross-sectional design limits its ability to establish causal relationships among variables like CI, blood pressure, fasting plasma glucose, and BMI. A longitudinal approach is necessary for such determinations. Additionally, as the study was conducted in a secondary healthcare setting, its findings may not be generalizable to the wider population. A larger community sample could yield more insights. Also, the potential confounders such as depression and anxiety that might impact CI were not controlled for in this study. CONCLUSION The study found a 36.8% prevalence of CI among elderly respondents, with MCI being the most common at 72.6%. Key predictors of CI were increasing age and hypertension. This highlights the need for early screening for CI in primary care, particularly for elderly individuals with hypertension, to improve their quality of life and overall health outcomes. Abbreviations BMI – Body Mass Index BP – Blood Pressure CI – Cognitive Impairment GHI - General Hospital, Ilorin JNC 7 – Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. MCI – Mild Cognitive Impairment NCD -Non-Communicable Diseases SPSS - 24 - Statistical Package for Social Sciences Version 24 WHO – World Health Organization Declarations Ethical Approval and Consent to Participate: The Ethical Review Committee (ERC) of Kwara State General Hospital, Ilorin, approved the study with approval number GHI/ADM/134/VOL II/377 (approval date: 24 February 2021). The study participants were duly informed, and written consents were obtained and signed. Consent for publication: The consent to use and publish the data obtained from the participants was sought, and the consent forms were signed. Availability of data and material: All the datasets used and analysed during this current study are available from the corresponding author upon reasonable request. Competing interests: All the authors declare that we have no competing interests Funding: The fund for this research was borne by the authors Authors’ Contributions: ANS: Conceptualization, Methodology, Formal Analysis, Resources, Data Curation, Writing – original draft, AKM : Conceptualization, Methodology, Writing – review and editing, Supervision, OIA: Writing – review and editing, Supervision, ACO : Conceptualization, Writing – review and editing, Supervision, YAR: Resources, Data Curation, manuscript writing and review, IAS: Resources, Writing – review and editing. All authors read and approved the final manuscript Acknowledgement: We thank all the consultants and trainers, the resident doctors of the Family Medicine Department at Kwara State General Hospital in Ilorin, and all other staff for their support during this study. We also express our gratitude to Dr. Ibraheem AS for the critical review of the final manuscript. References Bhattacharjee, D., Chaudhary, V., Khate, K., Devi, N. K., Babu, N., Saraswathy, K. N et al (2023). Incidence and risk factors of cognitive impairment: A 6-year follow-up study from North India. Clinical Epidemiology and Global Health. 24:101422. https://doi.org/10.1016/j.cegh.2023.101422 Center for Disease Control and Prevention (CDC) (2022). Cognitive Impairment: A Call for Action Now. Available from: https://www.cdc.gov/aging/healthbrain/index.htm.Accessed on 31 st November, 2022. World Health Organization (WHO) (2022). 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Antihypertensive Medication and Dementia Risk in Older Adult African Americans with Hypertension: A Prospective Cohort Study. J Gen Intern Med. 33(4):455-462. Fekadu SA, Gela YY, Belsti Y, Akalu Y, Dagnew B, Getnet M, et al (2022). Cognitive impairment and associated factors among mature and older adults living in the community of Gondar town, Ethiopia. Sci Rep. 12(1):7545. Bashir J, Yaruba UI (2022). Occurrence of mild cognitive impairment with hyperinsulinaemia in Africans with advanced type 2 diabetes mellitus. IBRO Neuroscience Reports. 12:182-187. Kim S, Kim Y, Park S (2016). Body Mass Index and Decline of Cognitive Function. PLoS One. 11(2). Rambod M, Ghodsin F, Moradi A (2020). The Association Between Body Mass Index and Comorbidity, Quality of Life and Cognitive Function in the Elderly Population. Int J Community Based Nurs Midwifery. 8(1):45-54. Yusuf AR, Odeigha LO, Alabi AN, Abdulkadir M, Obalowu IA, Ademola CO (2022). Body Mass Index, Blood Pressure and Cognitive Impairment among type 2 diabetes in a primary care setting, North Central Nigeria. Annals of African Med Research. 5:158 Estrella-Castillo D, Alvarez-Nemegyei J, Gomez-De-Regil L(2016). Association between body mass index with cognitive or physical functioning, and depression in Mexican elderly: A cross-sectional study. Neuropsychiatry. 6(5):22-23. Liang F, Fu J, Moore JB, Zhang X, Xu Y, Qiu N, et al (2022). Body Mass Index, Waist Circumference, and Cognitive Decline Among Chinese Older Adults: A Nationwide Retrospective Cohort Study. Front Aging Neurosci.14:737532. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7132229","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":485868360,"identity":"cf14f90c-afe2-4b20-9701-69aa81b65c7d","order_by":0,"name":"NUSIRAT TINUKE ABDULLATEEF","email":"","orcid":"","institution":"University of Ilorin Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"NUSIRAT","middleName":"TINUKE","lastName":"ABDULLATEEF","suffix":""},{"id":485868361,"identity":"17fcb437-2656-4acc-b1a8-17535f288ed5","order_by":1,"name":"KOLADE MORADEYO ALABI","email":"","orcid":"","institution":"Tobi Hospital Ilorin","correspondingAuthor":false,"prefix":"","firstName":"KOLADE","middleName":"MORADEYO","lastName":"ALABI","suffix":""},{"id":485868362,"identity":"58f3c222-3abf-4086-9320-68137010dec0","order_by":2,"name":"ISMAIL ABERI OBALOWU","email":"","orcid":"","institution":"Kwara State Teaching Hospital Ilorin","correspondingAuthor":false,"prefix":"","firstName":"ISMAIL","middleName":"ABERI","lastName":"OBALOWU","suffix":""},{"id":485868363,"identity":"dd707ef5-855b-4c5d-a3fe-eaa3526e8e8f","order_by":3,"name":"CHRISTY OLANIKE ADEMOLA","email":"","orcid":"","institution":"South Warwickshire NHS Foundation Trust","correspondingAuthor":false,"prefix":"","firstName":"CHRISTY","middleName":"OLANIKE","lastName":"ADEMOLA","suffix":""},{"id":485868364,"identity":"64808dc8-37db-43d0-97e5-a7ebefbb841d","order_by":4,"name":"ADEBAYO RAMAT YUSUF","email":"","orcid":"","institution":"University of Ilorin Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"ADEBAYO","middleName":"RAMAT","lastName":"YUSUF","suffix":""},{"id":485868365,"identity":"16410ed8-9111-4111-a01b-a63d61a58167","order_by":5,"name":"ABDULRAUF SEGUN IBRAHEEM","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABFklEQVRIiWNgGAWjYBACNgkGBmYwS4LBgOEBkGZvbwCSBhZEakkA0jxnDoC0SOC2BlPLjQSoOA7AJ9378HNBhU00/+zmbRKJe+wSeyTfmG74USDBwN/enYDVYTLHjaVnnEnLnXHnWJlEwrPkxB7pHLObPUCHSZw5uwG7X9IYpHnbDuc23Mgxk0g4wJy4H6jlBg9Qi4FELi4tzL95//3PnQ/RUg902Bmzm3/wa2GT5m04kLsBouVwYo8Ej9ltvLbIHGOz5jmWnLvxzrFii4QDx417eNLKbssYSPDg8ov87Dbm2zw1drnzbjdvvPHhQLVsD/vhbTff/LGR42/vxaoFG+AwAJE8xCoHAfYHpKgeBaNgFIyC4Q8ApO5iUyONFMgAAAAASUVORK5CYII=","orcid":"","institution":"Federal Teaching Hospital Birnin Kebbi","correspondingAuthor":true,"prefix":"","firstName":"ABDULRAUF","middleName":"SEGUN","lastName":"IBRAHEEM","suffix":""}],"badges":[],"createdAt":"2025-07-15 15:38:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7132229/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7132229/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":87050805,"identity":"0bcb55da-7f05-4f08-9826-1f28375cd752","added_by":"auto","created_at":"2025-07-18 14:59:35","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":20668,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePattern of Cognitive Impairment\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7132229/v1/73b45bf48ff13d6f790cd39a.png"},{"id":87836484,"identity":"0b275fd9-a851-48ce-b2e1-190795cc516b","added_by":"auto","created_at":"2025-07-29 13:23:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":765030,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7132229/v1/f62894ae-9f18-403c-ada1-b030661139fe.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003ePatterns of Cognitive Impairment and Associated Factors Among Elderly Patients Attending a Primary Care Clinic in North-Central Nigeria: A Cross-Sectional Study\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eCognitive impairment (CI) is a prevalent health condition among the elderly population, significantly impacting public health worldwide, especially in developing countries.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e It is a condition which manifests when an individual has trouble remembering, learning new things, concentrating, or making decisions that affect their everyday life.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e CI can be mild or severe, in mild cognitive impairment (MCI), the cognitive deficit is less severe, and the normal daily functions and independence are generally maintained.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e The severe form of CI is known as dementia, which is a syndrome characterized by a progressive decline in cognitive functions accompanied by deterioration in emotion, social behaviour, and motivation, but consciousness is not affected.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThe World Health Organization (WHO) and the United Nations define the elderly as a group of persons aged 65 and 60 above, respectively.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e The United Nations\u0026rsquo; definition is adopted in developing countries.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e As a result of epidemiological and demographic transition, fertility and mortality rates are declining worldwide with an attendant increase in average life expectancy.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e The effect of this is an overall increase in the geriatric population, which is projected to increase to around 8.5\u0026nbsp;billion in 2030 and 9.7\u0026nbsp;billion in 2050, according to the World Population Prospect Report in the year 2022.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e This increase in the ageing population will be more in developing countries with the incidental rise in the number of non-communicable diseases (NCDs) and degenerative diseases in the region, including cognitive impairment. A systematic review reported a prevalence of MCI ranging from 0.5\u0026ndash;42% in different countries and populations in the Western world.\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e A community-based study by Ogunniyi et al. in South-Western Nigeria reported that approximately 20% of elderly persons had major neuro-cognitive impairment, with MCI six times more common than dementia.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e Adeloye et al, found the pooled crude prevalence of dementia in Nigeria to be 4.9%, with prevalence slightly higher in women \u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eAge is the main risk factor for CI.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e The prevalence of CI increases more rapidly with age, as a higher prevalence is found among the elderly compared to the younger population.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e Specific risk factors, such as diabetes, hypertension, and extremes of weight, have been associated with greater cognitive decline and risk of developing CI.\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e Elevated blood pressure in the 4th and 5th decades of life, particularly untreated hypertension, increases the risk of CI 20\u0026ndash;30 years later.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e CI is a chronic complication of diabetes, and it occurs more commonly in older age.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e Overweight and obesity may directly or indirectly increase other vascular risk factors linked to the development of CI.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e In contrast, lower body mass index (BMI) has been reported to be associated with cognitive decline and its progression in the older population.\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eA lower BMI may be associated with a decrease in muscle mass or fat due to inadequate nutrition; lack of vitamins reduces the production of leptin and essential fatty acids, resulting in oxidative damage to neuronal cells and consequential acceleration of neurodegenerative diseases.\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e Early identification, prompt treatment of hypertension and diabetes, and lifestyle modification to manage extremes of weights constitute potential targets for intervention to prevent or delay the progression of MCI among elderly people. Late detection and poor management may worsen the severity of the disease, which would consequently affect their quality of life. To bridge the knowledge gap and add to the existing literature on CI among elderly participants, this study was carried out to determine the pattern of CI and its associated risk factors, such as age, hypertension, diabetes, and body mass index among elderly participants attending a secondary healthcare facility in north-central Nigeria.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cp\u003eThis hospital-based descriptive cross-sectional study was conducted at the Family Medicine Clinics of the General Hospital, Ilorin (GHI), Kwara State. The study population comprised 228 elderly male and female participants aged 60 years and above attending family medicine clinics at GHI, who gave their consent and satisfied the inclusion criteria. The research was approved by the Ethical Review Committee of GHI, Kwara State. The Lesley Kish statistical formula for determining the minimum sample size for health studies, used by Fisher and his colleagues, was used to calculate the minimum sample size for this study. n\u0026thinsp;=\u0026thinsp;z\u003csup\u003e2\u003c/sup\u003epq/d\u003csup\u003e2\u003c/sup\u003e.\u003csup\u003e14\u003c/sup\u003e Where n\u0026thinsp;=\u0026thinsp;minimum sample size, z\u0026thinsp;=\u0026thinsp;the standard normal deviation, usually set at 1.96 which corresponds to a 95% confidence level, p\u0026thinsp;=\u0026thinsp;Prevalence (prevalence estimates of neurocognitive disorders in rural communities in south-west Nigeria was found to be 20.9% by Ogunniyi et al.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e q\u0026thinsp;=\u0026thinsp;1-p, q\u0026thinsp;=\u0026thinsp;1- 0.209, therefore q\u0026thinsp;=\u0026thinsp;0.791, d\u0026thinsp;=\u0026thinsp;Degree of accuracy desired, usually set at 5% (0.05). Therefore, n = (1.96)\u003csup\u003e2\u003c/sup\u003e (0.209) (0.791)/(0.05)\u003csup\u003e2\u003c/sup\u003e = 254.0, approximately. The minimum sample size was 254. However, the study population was less than 10,000; therefore, the sample size was adjusted using the formula: nf\u0026thinsp;=\u0026thinsp;n/1 +(n/N) \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e .nf\u0026thinsp;=\u0026thinsp;the desired sample size when the population is less than 10,000. n\u0026thinsp;=\u0026thinsp;estimated sample size\u0026thinsp;=\u0026thinsp;254, N\u0026thinsp;=\u0026thinsp;the estimated population size\u0026thinsp;=\u0026thinsp;1800 (total number of elderly patients seen in 3 months according to the Health Records Department of the hospital). nf\u0026thinsp;=\u0026thinsp;254/1 +(254/1800)\u0026thinsp;=\u0026thinsp;222.8 Approximately 223. The participants were recruited during regular clinic hours, and to take care of incomplete or missing data, a 98% response rate was assumed. Hence, the final sample size was adjusted to compensate for the response rate using the formula: ns\u0026thinsp;=\u0026thinsp;n/r, where ns\u0026thinsp;=\u0026thinsp;adjusted sample size of the response rate. n\u0026thinsp;=\u0026thinsp;calculated sample size\u0026thinsp;=\u0026thinsp;223, r\u0026thinsp;=\u0026thinsp;response ratio\u0026thinsp;=\u0026thinsp;0.98. ns\u0026thinsp;=\u0026thinsp;223/0.98\u0026thinsp;=\u0026thinsp;227.55 Approximately 228. The final sample size was 228\u003c/p\u003e\u003cp\u003eA systematic random sampling technique was used to select eligible participants for this study. With a sample size of 228, the sampling interval (sampling frame/sample size) was 1800/228\u0026thinsp;=\u0026thinsp;7.89, approximately 8. Every 8th elderly participant was recruited, and a total of 4 participants were seen daily. All the selected participants filled out and signed the consent forms. Those with acute medical conditions and with major psychiatric illnesses such as psychosis and bipolar affective disorder were excluded from the study. Structured and Semi-structured questionnaires were used to obtain information from the participants. The Mini-Mental State Examination tool was used to assess levels of cognition. It was invented by Folstein et al in 1975 to assess mental status.\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e It is an 11-item questionnaire that tests five domains of cognitive function: orientation, registration, attention, recall, and language.\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e The maximum score is 30. A score of 24\u0026ndash;30 is normal, 18\u0026ndash;23 indicates mild cognitive impairment, and less than 18 indicates severe cognitive impairment.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003e Blood pressure (BP) was measured by the auscultatory method using a standard mercury sphygmomanometer with an appropriately sized cuff and a Littmann stethoscope, following recommended guidelines. Participants remained at rest while sitting for at least 5 minutes before BP was taken twice, two minutes apart, with readings recorded to the nearest 2 mmHg. The mean BP was categorized using JNC 7. The weight of each participant was measured to the nearest 0.5kg on a standard scale adjusted to zero points before each weighing, with the participant lightly clothed, devoid of any heavy objects and barefoot. Height was measured to the nearest 0.01m using a Stadiometer, with participants standing without headgear. Body mass index (BMI) was calculated as weight (kg) / height\u0026sup2; (m\u0026sup2;) and classified according to WHO guidelines: Underweight (BMI\u0026thinsp;\u0026lt;\u0026thinsp;18.5), Normal weight (BMI 18.5\u0026ndash;24.9), Overweight (BMI 25-29.9), and Obesity (BMI\u0026thinsp;\u0026ge;\u0026thinsp;30). Fasting blood samples were taken under aseptic conditions for glucose estimation after an overnight fast of 10\u0026ndash;12 hours and then sent for laboratory analysis.\u003c/p\u003e\u003cp\u003eThe data collected were sorted out and coded before entry into the computer for analysis using the software package of the Statistical Package for Social Sciences (SPSS) Version 24. Frequency distribution tables were generated to present all the socio-demographic data and clinical variables. Bar charts were used to depict the pattern of CI among the respondents. The Chi-square test was used to assess the statistical significance of the association between CI and associated risk factors. A \u003cem\u003ep\u003c/em\u003e-value less than or equal to 0.05 was considered statistically significant. A multivariate logistic regression analysis was run further to determine the predictors of CI among the participants.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eFigure 1; below shows the pattern of CI among the respondents. Of all the respondents (228) recruited for this study, only 84 (36.8%) had CI, among which sixty-one respondents (72.6 %) had mild cognitive impairment (MCI) while 23(27.4%) had severe CI.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 1 shows the proportion of the risk factors associated with CI among the elderly. Slightly more than half, 53.5% of respondents were within the age range of 60 to 69 years. The majority of the respondents, 139 (61.0%) had normal weight. About one-third, 84(36.8%) of the respondents were hypertensive, while respondents that were diabetic constituted only 16.7% of the participants.\u003c/p\u003e\n\u003cp\u003e\u003cimg 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\" width=\"565\" height=\"656\"\u003e\u003c/p\u003e\n\u003cp\u003eTable 2 shows the relationship between the pattern of CI and certain risk factors. There was a statistically significant association between the severity of CI and the respondents\u0026apos; ages (\u003cem\u003ep\u003c/em\u003e-value = 0.001). The age group 70-79 years had the highest percentage of respondents with severe CI (42.1%). The highest proportion of respondents with severe CI was found among those who were overweight (38.9%), and the association was not statistically significant. The highest percentage of the respondents with severe CI was found among respondents who were hypertensive (47.1%), and the association was statistically significant (\u003cem\u003ep\u003c/em\u003e-value = 0.003). The respondents who were living with diabetes had a higher percentage of 31.1% of severe CI.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2: Association between the pattern of CI and the risk factors\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eN = 84\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"606\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 34.6535%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatterns of Cognitive Impairment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u0026sup2;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026Rho;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSevere\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eCI {n (%)}\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMild \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eCI {n (%)}\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge Groups\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e15.870\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003e\u0026le; 69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e22 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003e70 \u0026ndash; 79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e16 (42.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e22 (57.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003e80 \u0026ndash; 89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e7 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e14 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003e\u0026ge; 90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e3 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody Mass Index\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e5.285\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e0.152\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003eUnderweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e16 (31.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e35 (68.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003eOverweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e7 (38.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e11 (61.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003eObese\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e15 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHypertension status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e11.663\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e4 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e32 (88.9) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003ePre hypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e3 (21.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e11 (78.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003eHypertensive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e16 (47.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e18 (52.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFasting blood Glucose\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e1.590\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e0.207\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003eDiabetic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e19 (31.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e42 (68.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40.5941%;\"\u003e\n \u003cp\u003eNon-Diabetic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.8218%;\"\u003e\n \u003cp\u003e4 (17.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8317%;\"\u003e\n \u003cp\u003e19 (82.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8713%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8812%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u0026nbsp;\u003c/sup\u003e= Fisher\u0026rsquo;s Exact value (F)\u003c/p\u003e\n\u003cp\u003eN=total number of respondents, n= number of respondents in various groups, *=p value\u0026lt;0.05\u003c/p\u003e\n\u003cp\u003eTable 3 shows the results of multiple logistic regression analysis to identify significant risk factors as predictors of CI after taking into consideration the effects of significant confounders. Both age and hypertension, which were already identified as significant predictors of cognitive impairment during bivariate analysis, were also significant after the multivariate analysis. \u0026nbsp;However, being hypertensive was the better predictor of cognitive impairment in this study (r = -1.962, P = 0.002, OR = 2.123).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Logistic regression of the risk factors of cognitive impairment\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"619\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.3021%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.5396%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3861%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2859%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOdd ratio\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.4863%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95 % C I\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.3021%;\"\u003e\n \u003cp\u003eAge\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.5396%;\"\u003e\n \u003cp\u003e-0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3861%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.050\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2859%;\"\u003e\n \u003cp\u003e1.949\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.4863%;\"\u003e\n \u003cp\u003e0.900 \u0026ndash; 3.401\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.3021%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHypertension status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.5396%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.3861%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17.2859%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.4863%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.3021%;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.5396%;\"\u003e\n \u003cp\u003eRC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.3861%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17.2859%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.4863%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.3021%;\"\u003e\n \u003cp\u003ePrehypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.5396%;\"\u003e\n \u003cp\u003e-0.780\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.3861%;\"\u003e\n \u003cp\u003e0.353\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17.2859%;\"\u003e\n \u003cp\u003e0.458\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.4863%;\"\u003e\n \u003cp\u003e0.088 \u0026ndash; 2.378\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.3021%;\"\u003e\n \u003cp\u003eHypertensive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.5396%;\"\u003e\n \u003cp\u003e-1.962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 19.3861%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17.2859%;\"\u003e\n \u003cp\u003e2.123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.4863%;\"\u003e\n \u003cp\u003e0.041 \u0026ndash; 8.150\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eRC = Reference Category, B = Coefficient of regression (r), OR = Odds ratio, 95% CI = Confidence interval, \u003csup\u003e*\u003c/sup\u003e = p \u0026le;0.05.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe majority of the participants with cognitive impairment had mild CI, with a prevalence of 72.6%, while 27.4% had severe CI. This pattern is the usual trend seen in most studies. It is comparable to the study by Ramlall et al in South Africa, where the majority of the participants with cognitive impairment had the mild form.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e It is also comparable with the study by Gela et al in Gondar town, Ethiopia and Tawfik et al in a cross-sectional study among community-dwelling elderly in Egypt, which found that out of 50.2% of cognitively impaired older people studied, 37.7% of them had MCI.\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e Similarly, Ucheagwu et al in Anambra, South-East Nigeria, where the majority of those with cognitive impairment had mild form.\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThere is a statistically significant relationship (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) between the pattern of cognitive impairment and age in this study. This is expected as age has been shown in several studies to be an independent risk factor for cognitive impairment. \u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e The prevalence of CI increases steeply with age, and this was the pattern in this study. From age group 70 through 90, there is an increase in the prevalence of cognitive impairment, especially the mild form of CI. This finding is comparable to the community-based study by Ogunniyi in Lalupon Southwest Nigeria among the elderly population, where it was found that increased age was associated with lower levels of cognitive performance.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e Similarly, in a study by Ramlall et al among the heterogeneous elderly population in South Africa, the authors reported an increase in the incidence of CI with the age of the participants.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e In the same vein, similar findings were reported by Eze et al; and Yusuf et al in Ilorin North Central Nigeria in the study to determine the prevalence of CI among type 2 diabetic participants where the significant association between cognitive impairment and age of the participants \u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e,\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e In this study, no respondents were found to have severe CI at the extremes of the age groups. The reasons for these findings might be because of a higher proportion of younger age (young-old) or poor representation of the older adult respondents in the study as only 3 elderly respondents who participated had MCI.\u003c/p\u003e\u003cp\u003eThe association between the pattern of cognitive impairment and the hypertensive status of the respondents in this study is statistically significant. This depicts that there is a positive linear relationship between CI and hypertension, which implies the likelihood of having cognitive impairment with increasing blood pressure. This is not surprising as studies have shown this relationship. \u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e This is the trend in this study in which the prevalence of severe CI increased from elderly with normotensive status to those with hypertensive status. This is similar to the study by Ogunniyi et al in Southwest Nigeria, where a significant association was found between neurocognitive impairments and hypertension in the elderly being studied.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e In his study, it was reported that elderly people with hypertension are at high risk of developing severe CI, most especially vascular dementia.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e A prospective cohort study by Murray et al to assess the effect of antihypertensive medications and dementia in older African Americans reported a strong association between hypertension and severe CI.\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e In the study, 1236 hypertensive participants who had no dementia at the baseline developed incident severe CI on follow-up, while those prescribed with antihypertensive medication were found to have a significantly reduced risk of developing severe CI.\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e However, the finding in this study was not comparable with that of Chanjoo et al among the Korean elderly population undergoing biannual medical screening. He found a higher risk of developing vascular dementia in elderly participants on antihypertensive drugs with lower blood pressure.\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e This might be as a result of low perfusion to the brain from low BP and also found that certain vascular factors are protective in very old subjects.\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e A descriptive cross-sectional study by Yusuf et al in Ilorin North Central Nigeria among type 2 diabetics found no association between CI and blood pressure.\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eAlthough some studies have shown a significant association between diabetes and cognitive decline however this index study did not show a significant association between the variables. This is comparable with the study by Eze et al in Abakaliki, Nigeria, which also showed no statistically significant relationship between cognitive impairment and fasting blood glucose.\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e Among the diabetic respondents in the study, there were higher percentages (68.9%) of those with mild cognitive impairment compared to those with severe CI (31.1%). This observation was similar to what was obtained in a hospital-based cross-sectional analytical study by Bashir and his colleague in Kano North-Western Nigeria, where a high percentage of type 2 diabetics had mild CI.\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e The reasons for this finding might be due to the higher prevalence of MCI in the study (more than two-thirds of the respondents had mild forms of cognitive impairment). The presence of certain socio-demographic factors such as low education or other risk factors such as hypertension and obesity could account for the high incidence of mild CI in this study.\u003c/p\u003e\u003cp\u003eMore than one-third and almost two-thirds of the respondents in the overweight category had mild and severe cognitive impairment, respectively. In addition, all the obese respondents in this study had mild cognitive impairment. Despite all these findings, it is surprising that there was no significant association between the pattern of CI and BMI. Most studies reviewed showed a significant association between BMI and CI. Some suggested that a higher BMI, especially in midlife, was associated with the development of CI in later life, while others found out that a lower BMI at later had a risk of progression from MCI to dementia.\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e,\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e One of those studies was done by Kim et al among the Korean elderly population, where it was found that a higher BMI was associated with a lower risk of severe cognitive impairment.\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e He found out that overweight and obese elderly had lower mean scores of cognitive function compared to normal-weight elderly people.\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e Similarly Ramboud and his colleague in Iran reported a significant association between BMI and cognitive impairment among the elderly respondents. Almost half of this population was either overweight or obese, and one-third of them had cognitive impairment.\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e Ilorin study by Yusuf et al among 2 diabetics also reported a significant association between BMI and cognitive impairment.\u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eHowever, Gao et al in China, in a study to determine the prevalence of MCI among elderly diabetic participants, reported no significant association between CI and BMI, which is in keeping with the findings in the index study.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e The possible reasons for these differences might be certain biological pathways in the brain responsible for this. First instance, in participants with high BMI, the hormone leptin, secreted mainly from the adipose tissue, might contribute to the regulation of the hippocampal synaptic plasticity and slow down cognitive decline. \u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e,\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e Conversely, individuals with low BMI may reflect nutritional deficiencies such as low vitamin B levels, which could aggravate neuro-degeneration and memory loss. \u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e,\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eLIMITATIONS\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe study's cross-sectional design limits its ability to establish causal relationships among variables like CI, blood pressure, fasting plasma glucose, and BMI. A longitudinal approach is necessary for such determinations. Additionally, as the study was conducted in a secondary healthcare setting, its findings may not be generalizable to the wider population. A larger community sample could yield more insights. Also, the potential confounders such as depression and anxiety that might impact CI were not controlled for in this study.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThe study found a 36.8% prevalence of CI among elderly respondents, with MCI being the most common at 72.6%. Key predictors of CI were increasing age and hypertension. This highlights the need for early screening for CI in primary care, particularly for elderly individuals with hypertension, to improve their quality of life and overall health outcomes.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eBMI \u0026ndash; Body Mass Index\u003c/p\u003e\n\u003cp\u003eBP \u0026ndash; Blood Pressure\u003c/p\u003e\n\u003cp\u003eCI \u0026ndash; Cognitive Impairment\u003c/p\u003e\n\u003cp\u003eGHI - General Hospital, Ilorin\u003c/p\u003e\n\u003cp\u003eJNC 7 \u0026ndash; Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.\u003c/p\u003e\n\u003cp\u003eMCI \u0026ndash; Mild Cognitive Impairment\u003c/p\u003e\n\u003cp\u003eNCD -Non-Communicable Diseases\u003c/p\u003e\n\u003cp\u003eSPSS - 24 -\u0026nbsp;Statistical Package for Social Sciences Version 24\u003c/p\u003e\n\u003cp\u003eWHO \u0026ndash; World Health Organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval and Consent to Participate:\u0026nbsp;\u003c/strong\u003eThe Ethical Review Committee (ERC) of Kwara State General Hospital, Ilorin, approved the study with approval number GHI/ADM/134/VOL II/377 (approval date: 24 February 2021).\u0026nbsp;The study participants were duly informed, and written consents were obtained and signed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e The consent to use and publish the data obtained from the participants was sought, and the consent forms were signed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material:\u003c/strong\u003e All the datasets used and analysed during this current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eAll the authors declare that we have no competing interests \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e The fund for this research was borne by the authors\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions: ANS:\u003c/strong\u003e Conceptualization, Methodology, Formal Analysis, Resources, Data Curation, Writing \u0026ndash; original draft, \u003cstrong\u003eAKM\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eConceptualization, Methodology, Writing \u0026ndash; review and editing, Supervision, \u003cstrong\u003eOIA:\u003c/strong\u003e Writing \u0026ndash; review and editing, Supervision, \u003cstrong\u003eACO\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Conceptualization, Writing \u0026ndash; review and editing, Supervision, \u003cstrong\u003eYAR:\u0026nbsp;\u003c/strong\u003eResources, Data Curation, manuscript writing and review, \u003cstrong\u003eIAS:\u003c/strong\u003e Resources, Writing \u0026ndash; review and editing.\u0026nbsp;All authors read and approved the final manuscript\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement:\u003c/strong\u003e We thank all the consultants and trainers, the resident doctors of the Family Medicine Department at Kwara State General Hospital in Ilorin, and all other staff for their support during this study. We also express our gratitude to Dr. Ibraheem AS for the critical review of the final manuscript. \u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBhattacharjee, D., Chaudhary, V., Khate, K., Devi, N. K., Babu, N., Saraswathy, K. N et al (2023). Incidence and risk factors of cognitive impairment: A 6-year follow-up study from North India. Clinical Epidemiology and Global Health. 24:101422. https://doi.org/10.1016/j.cegh.2023.101422\u003c/li\u003e\n\u003cli\u003eCenter for Disease Control and Prevention (CDC) (2022). Cognitive Impairment: A Call for Action Now. Available from: https://www.cdc.gov/aging/healthbrain/index.htm.Accessed on 31\u003csup\u003est\u003c/sup\u003e November, 2022. \u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO) (2022). Definition of an Older or Elderly Person: A proposed working definition of an older person in Africa for MDS. Available from https://www.who.int/healthfosurvey/ageing/en/index. Accessed on 31\u003csup\u003est\u003c/sup\u003e October, 2022.\u003c/li\u003e\n\u003cli\u003eUnited Nations Department of Economic and Social Affairs (2020). World Population Ageing 2020 Highlights . Available at: https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2020/Sep/un_pop_2020_pf_ageing_10_key_messages.pdf. Accessed on 31\u003csup\u003est\u003c/sup\u003e October, 2022.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO) (2018). Ageing and Health. Available from: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health. Accessed on 31\u003csup\u003est\u003c/sup\u003e November 2022. \u003c/li\u003e\n\u003cli\u003eAdeloye D, Auta A, Ezejimofor M, Oyedokun A, Harhay M, Rudan I et al (2019). Prevalence of dementia in Nigeria: a systematic review of the evidence. J Glob Health Reports. 3:1- 11. \u003c/li\u003e\n\u003cli\u003eOgunniyi A, Adebiyi AO, Adeniran AB,Olakehinde OO, Siwoku AA (2016). Prevalence estimates of major neurocognitive disorders in a rural Nigerian community. Brain Behav. 6(7):1-8. \u003c/li\u003e\n\u003cli\u003eEshkoor SA, Hamid TA, Mun CY, Ng CK (2015). Mild cognitive impairment and its management in older people. Clin Interv Aging. 10:687-93.\u003c/li\u003e\n\u003cli\u003eTakeda JR, Matos TM, Souza-Talarico JN (2017). Cardiovascular risk factors, cognitive and performance in ageing.Dement Neuropsychol. 119(4):442-448. \u003c/li\u003e\n\u003cli\u003eGottes RF, Scheider AL, Albert M, Alonso A, Bardeen R (2014). Mildlife Hypertension and 20 years cognitive changes. J Am Med Assoc Neurol. 71(10):1218-27. \u003c/li\u003e\n\u003cli\u003eSaedi E, Gheini MR, Faiz F, Arami MA (2016). Diabetes mellitus and cognitive impairments.World J Diabetes. 7(17):412-22. \u003c/li\u003e\n\u003cli\u003eXue M, Xu W, Ou Y, Cao XP, Tan MS, Tan L et al (2019). Diabetes mellitus and risks of cognitive impairments and dementia: A systematic review and meta-analysis of 144 prospective studies. Ageing Res Rev. 55.100944.\u003c/li\u003e\n\u003cli\u003eEstrella-Castillo D, Alvarez-Nemegyei J, Gomez-De-Regil L (2016). Association between body mass index with cognitive or physical functioning, and depression in Mexican elderly: A cross-sectional study. Neuropsychiatry. 6(5):22-23.\u003c/li\u003e\n\u003cli\u003eAraoye MO (2004). Sample size determination in Research Methodology with Statistics for Health and Social Sciences.1\u003csup\u003est\u003c/sup\u003e Ed. Ilorin. Nathadex Publi. 115\u0026ndash;121.\u003c/li\u003e\n\u003cli\u003eCharan J, Biswas T (2013). How to calculate sample size for different study designs in medical research? Indian J Psychol. Med. 35(2):121\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eFolstein MF, Folstein SE, McHugh PR (1975). Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. Journnal Psychiatr Res.12(3):189\u0026ndash;98 \u003c/li\u003e\n\u003cli\u003eMitchell AJ (2010). A meta-analysis of mini-mental state: Screening and case-finding tools for the detection of dementia.part I: Evidence-based meta-analysis of multidomain tests. Am J Geriatr psychiatry. 18(9):759\u0026ndash;82.\u003c/li\u003e\n\u003cli\u003eRamlall S, Chipps J, Bhigjee AL, Pillay BJ (2018). Screening a heterogeneous elderly South African population for cognitive impairment: The utility and performance of the Mini-Mental State Examination, Six Item Screener, Arch Gerontol Geriatr. 78:23\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eGela YY, Fekadu SA, Belsti Y, Akalu Y, Dagnew B, Getnet M, et.al (2022). Cognitive impairment and associated factors among mature and older adults living in the community of Gondar town, Ethiopia. Sci Rep. 12(1):7545. \u003c/li\u003e\n\u003cli\u003eUcheagwu V, Giordani B (2023). Prevalence and Patterns of Cognitive Impairment in a Sample of Community-Dwelling Older People in Nigeria. JAR Life. 12:85-92. \u003c/li\u003e\n\u003cli\u003eTawfik AA, Hamza SA, Adly NN, Abdel Kader RM (2024). Pattern of cognitive impairment among community-dwelling elderly in Egypt and its relation to socioeconomic status. J Egypt Public Health Assoc. 99(1):4. \u003c/li\u003e\n\u003cli\u003eKujawski S, Kujawski A, Perkowski R (2021). Cognitive Function Changes in Older People: Result of Second Wave of Cognition of Older People, Educational, Recreational Activities, Nutrition, Comorbidities, Functional Capacity Studies (COPERNICUS). Front Ageing Neurosci. 13:653570. \u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO) (2019). Risk Reduction of Cognitive Decline and Dementia: WHO Guideline. Available from: https://www.who.int/mental_health/neurology/dementia/risk_reduction_gdg_meeting. Accessed on 31\u003csup\u003est\u003c/sup\u003e December, 2022.\u003c/li\u003e\n\u003cli\u003eYusuf AR, Alabi KM, Odeigha LO, Wahab KW, Obalowu IA (2019). Cognitive Impairment among type 2 diabetes patients attending family medicine clinic University of Ilorin Teaching Hospital Ilorin North Central Nigeria. Nigeria J Fam Med. 10(3):1-8. \u003c/li\u003e\n\u003cli\u003eEze CO, Ezeokpo BC, Kalu UA, Onwuekwe IO (2015). The Prevalence of Cognitive Impairment amongst Type 2 Diabetes Mellitus Patients at Abakaliki South-East Nigeria. J Diabetes Metab Syndr Disord. 2:003. \u003c/li\u003e\n\u003cli\u003eMurray MD, Hendrie HC, Lane KA, Zheng M, Ambuehl R, Li S, et al (2018). Antihypertensive Medication and Dementia Risk in Older Adult African Americans with Hypertension: A Prospective Cohort Study. J Gen Intern Med. 33(4):455-462. \u003c/li\u003e\n\u003cli\u003eFekadu SA, Gela YY, Belsti Y, Akalu Y, Dagnew B, Getnet M, et al (2022). Cognitive impairment and associated factors among mature and older adults living in the community of Gondar town, Ethiopia. Sci Rep. 12(1):7545.\u003c/li\u003e\n\u003cli\u003eBashir J, Yaruba UI (2022). Occurrence of mild cognitive impairment with hyperinsulinaemia in Africans with advanced type 2 diabetes mellitus. IBRO Neuroscience Reports. 12:182-187. \u003c/li\u003e\n\u003cli\u003eKim S, Kim Y, Park S (2016). Body Mass Index and Decline of Cognitive Function. PLoS One. 11(2).\u003c/li\u003e\n\u003cli\u003eRambod M, Ghodsin F, Moradi A (2020). The Association Between Body Mass Index and Comorbidity, Quality of Life and Cognitive Function in the Elderly Population. Int J Community Based Nurs Midwifery. 8(1):45-54. \u003c/li\u003e\n\u003cli\u003eYusuf AR, Odeigha LO, Alabi AN, Abdulkadir M, Obalowu IA, Ademola CO (2022). Body Mass Index, Blood Pressure and Cognitive Impairment among type 2 diabetes in a primary care setting, North Central Nigeria. Annals of African Med Research. 5:158 \u003c/li\u003e\n\u003cli\u003eEstrella-Castillo D, Alvarez-Nemegyei J, Gomez-De-Regil L(2016). Association between body mass index with cognitive or physical functioning, and depression in Mexican elderly: A cross-sectional study. Neuropsychiatry. 6(5):22-23. \u003c/li\u003e\n\u003cli\u003eLiang F, Fu J, Moore JB, Zhang X, Xu Y, Qiu N, et al (2022). Body Mass Index, Waist Circumference, and Cognitive Decline Among Chinese Older Adults: A Nationwide Retrospective Cohort Study. Front Aging Neurosci.14:737532.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Cognitive Impairment, Dementia, Elderly Patients, Primary Care Clinic","lastPublishedDoi":"10.21203/rs.3.rs-7132229/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7132229/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBACKGROUND\u003c/b\u003e\u003c/p\u003e\u003cp\u003eCognitive impairment (CI) is prevalent among older adults, particularly in low- and middle-income countries (LMICs) as the population ages. Some factors, such as age, hypertension, diabetes, and body mass index, contribute to greater cognitive decline. There is a gap in the existing research in the study area; therefore, this study aims to assess patterns of cognitive impairment and associated factors among elderly patients at the General Hospital Ilorin, Kwara State, Nigeria.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMETHODS\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study was a descriptive, hospital-based, cross-sectional analysis involving 228 elderly participants. Data were collected via structured questionnaires, and cognitive impairment was assessed using the Mini-Mental State Examination. Fasting blood glucose, body mass index, and blood pressure were measured using standard procedures. Data analysis was performed with SPSS-24, presenting clinical variables in frequency distribution tables and cognitive impairment prevalence and patterns in bar charts. The Chi-square test assessed significant associations, and multivariate logistic regression identified predictors of cognitive impairment.\u003c/p\u003e\u003cp\u003e\u003cb\u003eRESULTS\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe study found a cognitive impairment prevalence of 36.8%, with mild cognitive impairment at 72.6%, significantly higher than severe cognitive impairment. Significant associations existed between cognitive impairment patterns and risk factors like hypertension and age (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001 and 0.003). Multiple logistic analyses identified increasing age and systemic hypertension as predictors of cognitive impairment.\u003c/p\u003e\u003cp\u003e\u003cb\u003eCONCLUSIONS\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe study shows that mild cognitive impairment is common in elderly patients, especially those with hypertension and advanced age. Early screening for high-risk groups is encouraged, along with prompt management of modifiable factors to prevent cognitive impairment and delay the progression to dementia.\u003c/p\u003e","manuscriptTitle":"Patterns of Cognitive Impairment and Associated Factors Among Elderly Patients Attending a Primary Care Clinic in North-Central Nigeria: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-18 14:59:31","doi":"10.21203/rs.3.rs-7132229/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"674e9e55-d7bb-4a54-8e5a-22e48316b369","owner":[],"postedDate":"July 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-29T13:23:22+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-18 14:59:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7132229","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7132229","identity":"rs-7132229","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}