Introduction: Cognitive impairment (CI) is known to be mediated by several risk and protective factors, many of which are potentially modifiable. Therefore, it is important to have up-to-date studies that address a standard assessment of psychosocial, clinical and lifestyle variables.Materials and methods: We conducted a cross-sectional observational study, with a 24-month timeframe, to estimate the relationship between risk and protective factors associated with dementia, according to the A-to-Z Dementia Knowledge. Participants were considered at CI risk if they tested positive for at least one of three validated CI screening tests: The Memory Impairment Screening, Short Portable Mental State Questionnaire, and Semantic Verbal Fluency. The A-to-Z data Collection included Mediterranean Diet Adherence Screener and Geriatric Depression Scale.Results: The estimated prevalence of CI was 22.6% in a sample of 709 patients with an average of 69.3±10.3 years. The risk factors gradually associated with cognitive decline were hypertension, loneliness, and depression. In contrast, the protective factors gradually associated with less cognitive decline were internet use, reading, and intellectually stimulating jobs. Finally, living alone, having diabetes, taking benzodiazepines, and sleeping more than 9 h were statistically significant associated with CI, whereas to do memory training or a family history of dementia was characteristic of patients without CI.Conclusion: A joint assessment of the influence of psychosocial, clinical, and lifestyle-related factors is needed to develop dementia prevention strategies.

Cognitive impairment (CI), an intermediate phase between the decline in physiological cognition and dementia, is known to be mediated by a variety of risk and protective factors, with age being the most influential of these. The multifactorial nature of CI and the worldwide phenomenon of an aging population makes decoupling old age from disease through the concept of healthy aging (HA) a matter of major interest. Focusing on psychosocial variables and psychological constructs, here we designed and piloted a data collection booklet (DeCo-B) to assess CI and HA from a holistic perspective. The DeCo-B comprises six sections: sociodemographic factors, CI, meaning in life, psychosocial factors, health problems, and lifestyle. The estimated prevalence of CI and HA in our cohort were 24.4% and 6.6%, respectively. Spearman correlations mainly identified pairwise associations between the meaning in life domains and psychosocial variables. Moreover, age, marital status, purpose in life, resilience, chronic pain, cognitive reserve, and obstructive sleep apnea were significantly associated with an increased risk of CI. Our results showed that DeCo-B is a suitable tool for researching how modifiable risk and protective factors influence cognitive status. The complex interrelationships between variables should be further investigated and, for practical reasons, the questionnaire should be optimized in future work.

Background: Frailty and polymedication are closely interrelated. Addressing these concurrent conditions in primary care settings relies on the utilization of potentially inappropriate medication (PIM) lists and medication reviews (MRs), particularly in rural areas, where healthcare professionals serve as the sole point of access to the medical system. The aim of this study was to examine the relationship between medication appropriateness and variables related to frailty in a rural municipality in order to propose potential strategies for therapy optimization. Methods: This cross-sectional study included all adult community dwellers aged 50 and above officially registered in the municipality of Tiriez (Albacete, Spain) in 2023 (n = 241). The primary outcome variable was frailty (assessed using the fatigue, resistance, ambulation, illness, and loss of weight (FRAIL) scale). The independent variables were age, gender, medication regimen, history of falls, comorbidities, PIMs (evaluated using the screening tool of older persons’ prescriptions (STOPP) 2023 criteria), fall-risk-increasing drugs (FRID), and anticholinergic burden (ACB). Results: The prevalence of frailty was approximately 20%. FRID and ACB scores were statistically associated (p-value < 0.001) with frailty, 1.1 ± 1.3 vs. 2.5 ± 1.7, and 1.0 ± 1.3 vs. 2.8 ± 2.5, respectively. Regardless of age, frailty was observed to be more prevalent among females (odds ratio (OR) [95% confidence interval (CI)]: 3.5 [1.5, 9.0]). On average, 2.1 ± 1.6 STOPP criteria were fulfilled, with the prolonged use of anxiolytics and anti-peptic-ulcer agents being the most frequent. Priority interventions (PIs) included opioid dose reduction, benzodiazepine withdrawal, and the assessment of antidepressant and antiplatelet treatment plans. Conclusions: The optimization of medication in primary care is of paramount importance for frail patients. Interventional measures should focus on ensuring the correct dosage and combination of drugs for each therapeutic regimen.

Background: Cognitive impairment is a major public health concern due to its impact on functional independence and its risk of progression to dementia. Early detection is critical, but the estimated prevalence varies substantially depending on the screening tool used and the role of modifiable metabolic risk factors, in accelerating cognitive aging. Objective: This study aimed to describe the variability in cognitive performance and the prevalence of low scores across several brief screening tools and cut-offs, and to explore sociodemographic, functional and metabolic factors associated with lower cognitive performance in community-dwelling older adults. Methods: A cross-sectional study was conducted with N = 286 community-dwelling participants aged over 60 years, recruited from community pharmacies in Albacete, Spain. Cognitive status was assessed using the MoCA (cut-offs < 26 and < 21), the Short Portable Mental Status Questionnaire, the Memory Impairment Screen, and the Semantic Verbal Fluency Test (animals). Comorbidities were assessed using active medication prescriptions as proxy variables. Cohen’s Kappa coefficients were computed to assess concordance, and a binary logistic regression was performed to identify potential predictors of cognitive impairment, defined as a MoCA score < 21. Results: The estimated prevalence of suspected cognitive impairment varied from 71.3% using the highest MoCA cut-off (< 26) to 25.2% using the more conservative MoCA < 21 threshold. Concordance analysis revealed low agreement between MoCA < 26 and the other instruments (Kappa < 0.08). However, using the MoCA < 21 cut-off, the observed agreement improved substantially to over 75% (all Kappa values statistically significant at p < 0.001). The adjusted binary logistic regression model demonstrated that older age significantly increased the odds of cognitive impairment (OR = 1.10, p < 0.001), whereas higher cognitive reserve was a protective factor (OR = 0.75, p < 0.001). Conclusions: The estimated prevalence of suspected cognitive impairment is highly dependent on the screening instrument and threshold selected. The findings support the adoption of a more conservative MoCA cut-off < 21 to enhance agreement with other brief instruments and may reduce potential overestimation of impairment. Additionally, the associations observed between metabolic conditions and lower cognitive performance highlight the importance of integrated preventive strategies in primary care, combining sensitive cognitive screening with cardiometabolic risk management.