Multiple chronic conditions: Implications for cognition - Findings from the Wisconsin Registry for Alzheimer's Prevention (WRAP).
Lisa C Bratzke, Beverly A Carlson, Chooza Moon and 3 others
PMID 30029715WHAT IT FOUND
Having multiple chronic conditions was not linked to memory impairment overall.
However, participants with sleep disturbances and apnea had significantly higher rates of memory impairment than those with cardiovascular conditions or those who were healthy.
Key findings
01The presence of multiple chronic conditions (MCC) generally was not associated with either amnestic or non-amnestic mild cognitive impairment.
02Participants in the sleep class (sleep disturbances and apnea) had the highest incidence of new-onset amnestic mild cognitive impairment (19%), significantly higher than the cardiovascular (9%) and healthy (12%) classes.
03Hypercholesterolemia was present in all identified chronic illness classes and was considered a pivotal factor, as removing it caused the class distinctions to disappear.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPsWhat it means for RNs
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What it does not show
The study design is observational and cannot establish a temporal relationship or causation between chronic conditions and cognitive decline; cognitive decline could potentially predict the development of MCC. Chronic illnesses were assessed via self-report, which carries the risk of under- or over-reporting, although participants verified their status at three visits. The cohort was relatively young (mean age 54) and cognitively intact at enrollment, so the findings may not generalize to older adults or those with established dementia. The classification of mild cognitive impairment was based on psychometric norms and required impairment at two visits, which may not capture all subtle or transient cognitive changes.
Declared interests
The authors declared no conflicts of interest. The study was supported by the NIH and non-U.S. government research grants.
The easy way to misread this
Do not conclude that treating sleep apnea will prevent Alzheimer's disease or reverse cognitive decline. This is an observational study showing an association between a specific cluster of chronic conditions (sleep issues) and a higher rate of memory impairment. It does not prove that sleep problems cause the impairment, nor does it test whether treating the sleep problems improves the cognitive outcomes.