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Cognitive Decline and Dementia in Some Chronic Disorders

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Advanced Age Geriatric Care

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Abstract

The aim of this chapter is to review the association between cognitive impairment and four selected chronic conditions, namely, hearing loss, vitamin B12 and folate deficiencies, thyroid disease and diabetes mellitus. This chapter focuses on the prevalence, pathophysiology and the mechanistic effects of cognitive decline in these disorders. In the first section, hearing loss is discussed. In the second section, a comprehensive review covering the many aspects of vitamin B12 and folate deficiencies is presented. In the third section, thyroid disorders in relation to cognitive decline are discussed. The last section discusses diabetes mellitus and the many mechanisms through which diabetes mellitus increases the risk of cognitive impairment and dementia.

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Author information

Authors and Affiliations

  1. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia

    Nages Nagaratnam

  2. Geriatric Medicine, Rehabilitation and Aged Care Service, Blacktown-Mt Druitt Hospital, Blacktown, NSW, Australia

    Gary Cheuk

Authors
  1. Nages Nagaratnam
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  2. Gary Cheuk
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Corresponding author

Correspondence to Nages Nagaratnam .

Editor information

Editors and Affiliations

  1. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia

    Nages Nagaratnam

  2. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia

    Kujan Nagaratnam

  3. Rehabilitation and Aged Care Service, Blacktown-Mt Druitt Hospital, Blacktown, NSW, Australia

    Gary Cheuk

Multiple Choice Questions

Multiple Choice Questions

  1. 1.

    The following are true of hearing loss in the elderly, EXCEPT:

    1. A.

      Hearing loss in older adults is associated with accelerated cognitive decline and incident dementia.

    2. B.

      Decline in the peripheral auditory system does not have effects on the central auditory system and function.

    3. C.

      Adults with hearing loss who were not wearing hearing aids had higher rates of anxiety, depression and psychosocial disorders.

    4. D.

      In older adults hearing loss may be associated with dementia by decreasing stimulatory input and impeding social interaction.

  1. 2.

    The following are true of B12 and folate deficiencies, EXCEPT:

    1. A.

      In elderly persons B12 and folate deficiencies are common.

    2. B.

      Cognitive decline and some forms of dementia including Alzheimer’s dementia (AD) are associated with low folate levels.

    3. C.

      Decreased concentration of homocysteine has been associated with increased prevalence of poor cognitive function and increased risk of developing dementia and AD.

    4. D.

      The measurement of total vitamin B12 has limitations for it has been shown that the individuals with neurological and vascular abnormalities may present with normal range of B12.

  1. 3.

    The following ate true of thyroid dysfunction, EXCEPT:

    1. A.

      Decreased cognitive functioning such as memory and reaction time has been associated with overt hyperthyroidism.

    2. B.

      Decreased cognitive functioning is associated with both clinical and subclinical hypothyroidism in middle-aged and the elderly.

    3. C.

      In older adults subclinical hyperthyroidism is not associated with coronary heart disease and atrial fibrillation.

    4. D.

      TSH increases with age even with older people without thyroid disease.

  1. 4.

    The following are true with diabetes, EXCEPT:

    1. A.

      Repeated severe hypoglycaemia has been attributed to cause brain damage and cognitive deterioration.

    2. B.

      There is no evidence to support the concept that insulin resistance has an important role in the pathogenesis of cognitive impairment.

    3. C.

      Studies have found a close association between hypertension, cognitive decline and dementia in late life.

    4. D.

      One of the serious complications of diabetes is intensifying ischaemic brain damage.

Answers to MCQs

  1. 1.

    B

  2. 2.

    C

  3. 3.

    C

  4. 4.

    B

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Nagaratnam, N., Cheuk, G. (2019). Cognitive Decline and Dementia in Some Chronic Disorders. In: Nagaratnam, N., Nagaratnam, K., Cheuk, G. (eds) Advanced Age Geriatric Care. Springer, Cham. https://doi.org/10.1007/978-3-319-96998-5_28

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  • DOI: https://doi.org/10.1007/978-3-319-96998-5_28

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