Prevalence and determinants of domain specific cognitive impairment in older adults in North India
Abstract The rapid growth of India's elderly population necessitates understanding the determinants of cognitive health. Objective: This study examined the prevalence of cognitive impairment and its association with socio-demographic, health, and behavioural factors among community-dwelling older adults in urban Delhi. Methods: A community-based cross-sectional study was conducted from January to June 2023 among 290 adults aged ≥60 years in South-West Delhi, selected through multistage sampling. Data on socio-demographics, health status, and lifestyle were collected via structured interviews. Cognitive function was assessed using the Brief Interview for Mental Status (BIMS) and classified as intact, mild to moderate, or severe impairment. Principal Component Analysis (PCA) identified explanatory dimensions; multivariable ordinal logistic regression examined associations; and K-means clustering grouped participants by cognitive profiles. Results: Overall, 52.8% had intact cognition, 37.2% mild to moderate impairment, and 10% severe impairment. Severe impairment was most prevalent among those aged ≥81 years (61.5%) and with no formal education (55.2%), while intact cognition was highest among skilled workers (26.6%) and those with high school or higher education (43.8%). Significant factors included age, education, body mass index (BMI), physical activity, smoking, alcohol use, dietary intake, sleep quality, mental activity, and social engagement (all p<0.001). PCA yielded eight principal components capturing behavioral, health, and socio-demographic domains. K-means clustering identified two distinct cognitive profiles based on performance and associated factors. Conclusion: Cognitive status in older urban adults is shaped by modifiable health and lifestyle factors. Community-based interventions promoting physical activity, social participation, and healthy behaviors may help preserve cognition in aging populations.