Cognitive Impairment in Older Adults with Chronic Non-Communicable Diseases: A Narrative Review
DOI:
https://doi.org/10.61182/Keywords:
cognitive dysfunction, noncommunicable diseases, aged, cardiovascular diseases, metabolic syndromeAbstract
Introduction: Cognitive impairment compromises functional independence and worsens health outcomes in older adults. Non-communicable chronic diseases have been previously linked to its onset. Objective: To describe the state of the art on the influence of non-communicable chronic diseases on the development of cognitive impairment in older adults. Methods: Narrative review of freely accessible observational studies, systematic reviews and scoping reviews in Spanish or English, published in the last five years. Findings: Hypertension, myocardial infarction and cerebrovascular disease reduce cognitive reserve; blood-pressure control limits damage and improves recovery. Metabolic syndrome, abdominal obesity, type 2 diabetes and insulin resistance are associated with brain structural and functional changes and poorer cognitive performance. Frailty, sarcopenia, sensory loss, depression, sleep disorders and chronic obstructive pulmonary disease increase the likelihood of cognitive impairment; evidence on chronic kidney disease is heterogeneous. Conclusions: Cognitive impairment is bidirectionally related to chronic diseases in older adults, increasing the risk of dependency, disability and cognitive dysfunction; noncommunicable diseases; aged; cardiovascular diseases; metabolic syndrome death. Strengthening primary health care with a life-course approach is a priority for this population.
References
1. Mehta S, Chawla J. Mild Cognitive Impairment: Background, Etiology, Pathophysiology [Internet]. Medscape; 2025 may [citado el 20 de octubre de 2025]. (Neurology). Disponible en: https://emedicine.medscape.com/article/1136393-overview?st=fpf&scode=msp&socialSite=google&form=fpf&icd=login_success_gg_match_fpf
2. De Jaeger C. Fisiología del envejecimiento. EMC - Kinesiterapia - Medicina Física. abril de 2018;39(2):1–12. https://doi.org/10.1016/S1293-2965(18)89822-X
3. Hall JE, Hall ME, Guyton AC. Guyton and Hall textbook of medical physiology. 14th edition. Philadelphia, PA: Elsevier; 2021. 1132 p.
4. Loscalzo F, Kasper H, Longo J. Harrison’s principles of internal medicine. 21st ed. Vol. 1. New York: McGraw Hill; 2022. 4132 p.
5. Murman D. The Impact of Age on Cognition. Semin Hear. el 9 de julio de 2015;36(03):111–21. https://doi.org/10.1055/s-0035-1555115
6. Kumar V, Abbas AK, Aster JC. Robbins Patología humana. 10 ed. Vol. 1. Barcelona: Elsevier; 2018. 951 p.
7. Jost Z, Kujach S. Understanding Cognitive Decline in Aging: Mechanisms and Mitigation Strategies - A Narrative Review. Clin Interv Aging. 2025; 20:459–69. https://doi.org/10.2147/CIA.S510670
8. University of Washington. Institute for Health Metrics and Evaluation. 2025 [citado el 22 de octubre de 2025]. GBD Compare. Disponible en: http://vizhub.healthdata.org/gbd-compare
9. Martinez R, Morsch P, Soliz P, Hommes C, Ordunez P, Vega E. Life expectancy, healthy life expectancy, and burden of disease in older people in the Americas, 1990–2019: a population-based study. Rev Panam Salud Publica. 2021; 45:1–14. https://doi.org/10.26633/RPSP.2021.114
10. Nichols E, Steinmetz JD, Vollset SE, Fukutaki K, Chalek J, Abd-Allah F, et al. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. The Lancet Public Health. febrero de 2022;7(2): e105–25. https://doi.org/10.1016/S2468-2667(21)00249-8
11. Organización Mundial de la Salud. Demencia. 2025 [citado el 8 de noviembre de 2025]. Demencia. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/dementia
12. Brito ADE. Salud, complejidad y enfermedades no transmisibles Health, Complexity and non-communicable Diseases. Revista finlay. mayo de 2023;13(2):15. https://revfinlay.sld.cu/index.php/finlay/article/view/1250
13. Afshin A, Sur PJ, Fay KA, Cornaby L, Ferrara G, Salama JS, et al. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. mayo de 2019;393(10184):1958–72. https://doi.org/10.1016/S0140-6736(19)30041-8
14. Ritchie H, Roser M. Smoking [Internet]. 2023 ago [citado el 13 de noviembre de 2025]. (Tobacco smoking is one of the world’s largest health problems today.). Disponible en: https://ourworldindata.org/smoking
15. Parry CD, Patra J, Rehm J. Alcohol consumption and non‐communicable diseases: epidemiology and policy implications. Addiction. octubre de 2011;106(10):1718–24. https://doi.org/10.1111/j.1360-0443.2011.03605.x
16. Instituto Nacional de Salud, Observatorio Nacional de Salud. Desigualdades Sociales en Salud en Colombia [Internet]. Bogotá D.C.; 2015 p. 366. Disponible en: https://www.ins.gov.co/direcciones/ons/informes/6.%20desigualdades%20sociales.pdf
17. Departamento Administrativo Nacional de Estadística (DANE). Estadísticas Vitales (EEVV) Defunciones no fetales Año acumulado 2023pr y año corrido 2024pr [Internet]. Bogotá D.C.: DANE; 2024 jun p. 21. Disponible en: https://www.dane.gov.co/files/operaciones/EEVV/bol-EEVV-Defunciones-Itrim2024.pdf
18. Ministerio De Salud Y Protección Social. Análisis de Situación de Salud Colombia [Internet]. Bogotá D.C.; 2024 p. 71. Disponible en: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/PSP/asis-colombia-2024.pdf
19. Baethge C, Goldbeck-Wood S, Mertens S. SANRA—a scale for the quality assessment of narrative review articles. Res Integr Peer Rev. diciembre de 2019;4(1):5. https://doi.org/10.1186/s41073-019-0064-8
20. Zúñiga-Salazar GA, Hincapié-Arias SM, Salazar-Bolaños EE, Lara-Terán JJ, Cáceres-Vinueza SV, Duarte-Vera YC. Efecto de la hipertensión arterial en la función cognitiva de pacientes de 45 a 65 años. Hospital Luis Vernaza, Guayaquil, Ecuador. Arch cardiol Méx. septiembre de 2020;90(3):284–92. https://doi.org/10.24875/acm.20000350
21. Binning L, Basquill C, Tvrda L, Quinn T. Epidemiology and Outcomes Associated with Cognitive Frailty and Reserve in a Stroke Population: Systematic Review and Meta-Analysis. Cerebrovasc Dis. 2025;54(4):536–47. https://doi.org/10.1159/000541670
22. Chin KS. Pathophysiology of dementia. Aust J Gen Pract. el 1 de agosto de 2023;52(8):516–21. https://doi.org/10.31128/AJGP-02-23-6736
23. Fruhwirth V, Enzinger C, Fandler-Höfler S, Kneihsl M, Eppinger S, Ropele S, et al. Baseline white matter hyperintensities affect the course of cognitive function after small vessel disease-related stroke: a prospective observational study. Eur J Neurol. febrero de 2021;28(2):401–10. https://doi.org/10.1111/ene.14593
24. Zeng X, Guan H, Wang Y, Shen S. Declined intrinsic capacity is associated with one-year functional disability in older hypertensive inpatients. BMC Geriatr. 20 de agosto de 2025;25(1):649. https://doi.org/10.1186/s12877-025-06289-7
25. Forte G, Casagrande M. Explaining cognitive decline related to hypertension: The role of heart rate variability in the stairway to cognitive impairment. Physiol Behav. el 1 de abril de 2025;292:114825. https://doi.org/10.1016/j.physbeh.2025.114825
26. Silva LM da, Sampaio CPBM, Guimarães NEDS, Moreno LP, Pontes GS, Ferreira E de JF, et al. Assessment of cognitive function in elderly patients with heart failure. Rev Assoc Med Bras. 2024;70(8):e20240429. https://doi.org/10.1590/1806-9282.20240429
27. Huynh Q, Haji K, DePasquale CG, Hare JL, Leung D, Stanton T, et al. Association of Cognitive Impairment With Evolution of Heart Failure. J Am Heart Assoc. agosto de 2025;14(15):e039697. https://doi.org/10.1161/JAHA.124.039697
28. Sarmiento Buitrago AF, Cerón Perdomo D, Mayorga Bogota MA. Asociación entre el deterioro cognitivo y factores socioeconómicos y sociodemográficos en adultos mayores colombianos. Revista Colombiana de Psiquiatría. abril de 2024;53(2):134–41. https://doi.org/10.1016/j.rcp.2022.02.005.
29. Roderka MN, Puri S, Batsis JA. Addressing Obesity to Promote Healthy Aging. Clin Geriatr Med. noviembre de 2020;36(4):631–43. https://doi.org/10.1016/j.cger.2020.06.006
30. Rizvi AA, Rizzo M. Age-Related Changes in Insulin Resistance and Muscle Mass: Clinical Implications in Obese Older Adults. Medicina (Kaunas). octubre de 2024;60(10). https://doi.org/10.3390/medicina60101648
31. Abi Saleh R, Lirette ST, Benjamin EJ, Fornage M, Turner ST, Hammond PI, et al. Mediation effects of diabetes and inflammation on the relationship of obesity to cognitive impairment in African Americans. J Am Geriatr Soc. octubre de 2022;70(10):3021–9. https://doi.org/10.1111/jgs.17985
32. Phirom K, Nantakool S, Chuatrakoon B, Rerkasem K. Role of obesity-related anthropometric indicators on cognitive function in obese older adults: A systematic review and meta-analysis. Public Health. abril de 2025;241:60–8. https://doi.org/10.1016/j.puhe.2025.01.040
33. Liu, J., Pan, S., Wang, X. et al. Role of advanced glycation end products in diabetic vascular injury: molecular mechanisms and therapeutic perspectives. Eur J Med Res 28, 553 (2023). https://doi.org/10.1186/s40001-023-01431-w
34. Zhou C, Li J, Dong M, Ping L, Lin H, Wang Y, et al. Altered White Matter Microstructures in Type 2 Diabetes Mellitus: A Coordinate-Based Meta-Analysis of Diffusion Tensor Imaging Studies. Front Endocrinol (Lausanne). 2021;12:658198. https://doi.org/10.3389/fendo.2021.658198
35. Damanik J, Yunir E. Type 2 Diabetes Mellitus and Cognitive Impairment. Acta Med Indones. 2021 Apr;53(2):213-220. PMID: 34251351
36. Gómez-Martínez C, Babio N, Júlvez J, Becerra-Tomás N, Martínez-González MÁ, Corella D, et al. Glycemic Dysregulations Are Associated With Worsening Cognitive Function in Older Participants at High Risk of Cardiovascular Disease: Two-Year Follow-up in the PREDIMED-Plus Study. Front Endocrinol (Lausanne). 2021;12:754347. https://doi.org/10.3389/fendo.2021.754347
37. Vahedi A, Eriksdotter M, Ihle-Hansen H, Wyller TB, Øksengård AR, Fure B. Cognitive impairment in people with physical frailty using the phenotype model: A systematic review and meta analysis. Int J Geriatr Psychiatry. noviembre de 2022;37(11). https://doi.org/10.1002/gps.5822
38. Lee S, Chung JH. Association between frailty and cognitive status among ambulating Korean elderly: An observational study. Medicine (Baltimore). el 9 de agosto de 2024;103(32):e39222. https://doi.org/10.1097/md.0000000000039222
39. Zhang XM, Wu XJ, Cao J, Jiao J, Chen W. Association between Cognitive Frailty and Adverse Outcomes among Older Adults: A Meta-Analysis. J Nutr Health Aging. 2022;26(9):817–25. https://doi.org/10.1007/s12603-022-1833-5
40. Zeng XK, Shen SS, Guan HL, Chen LY, Chen XJ. Coexisting Frailty and Cognitive Impairment as a Predictor of Adverse Outcomes in Older Inpatients After Discharge: Results from a One-Year Follow-Up Study. Clin Interv Aging. 2022;17:1697–706. https://doi.org/10.2147/cia.s376691
41. Zhu Z, Xue H, Huang C, Zhang J, Tu J, Ling K, et al. Association of malnutrition with cognitive frailty in China: a systematic review and meta-analysis. Front Public Health. 2025;13:1567372. https://doi.org/10.3389/fpubh.2025.1567372
42. Huang J, Li M, Luo Q, Li J. The association of sarcopenia, possible sarcopenia and cognitive impairment: A systematic review and meta-analysis. PLoS One. 2025;20(5):e0324258. https://doi.org/10.1371/journal.pone.0324258
43. Petermann R F, Troncoso-Pantoja C, Martínez S MA, Leiva O AM, Ulloa M N, Celis-Morales C. Los problemas auditivos aumentan el riesgo de deterioro cognitivo en adultos mayores chilenos. Rev otorrinolaringol cir cabeza cuello. marzo de 2019;79(1):9–17. http://dx.doi.org/10.4067/S0718-48162019000100009
44. Conceição Santos de Oliveira D, Gomes-Filho IS, Araújo EM, Xavier Ramos M de S, Freitas Coelho JM, Marques AA, et al. Association between hearing loss and cognitive decline in the elderly: A systematic review with meta-analysis study. PLoS One. 2023;18(11):e0288099. https://doi.org/10.1371/journal.pone.0288099
45. Chen Y. Relationship between self-reported hearing and vision problems, cognitive decline, depressive symptoms, and life satisfaction in older adults: a retrospective observational study. BMC Public Health. el 23 de abril de 2024;24(1):1135. https://doi.org/10.1186/s12889-024-18624-5
46. Cappadona I, Anselmo A, Cardile D, Micali G, Giambò FM, Speciale F, et al. Psychic and Cognitive Impacts of Cardiovascular Disease: Evidence from an Observational Study and Comparison by a Systematic Literature Review. Med Sci (Basel). el 1 de agosto de 2025;13(3). https://doi.org/10.3390/medsci13030105
47. Gong H, Wang Z, Chen Y, Mi T, Wang Y. Depression reduces cognitive function partly through effects on BMI and hypertension: a large observational study and Mendelian randomization analysis. BMC Psychiatry. el 17 de abril de 2025;25(1):393. https://doi.org/10.1186/s12888-025-06846-9
48. Chuang SC, Wu IC, Chang JJ, Tsai YF, Cheng CW, Chiu YF, et al. Sleep habits are associated with cognition decline in physically robust, but not in frail participants: a longitudinal observational study. Sci Rep. el 8 de julio de 2022;12(1):11595. https://doi.org/10.1038/s41598-022-15915-y
49. Tap L, Corsonello A, Formiga F, Moreno-Gonzalez R, Ärnlöv J, Carlsson AC, et al. Is kidney function associated with cognition and mood in late life? : The Screening for CKD among Older People across Europe (SCOPE) study. BMC Geriatr. el 2 de octubre de 2020;20(Suppl 1):297. https://doi.org/10.1186/s12877-020-01707-4
50. Demirhan I, van Oevelen M, Skalli Z, Voorend CGN, Mooijaart SP, Meuleman Y, et al. Association between cognitive functioning and health-related quality of life and its mediation by depressive symptoms in older patients with kidney failure. J Nephrol. septiembre de 2024;37(7):1939–48. https://doi.org/10.1007/s40620-024-02095-3
51. Simargi Y, Mansyur M, Turana Y, Harahap AR, Ramli Y, Siste K, et al. Risk of developing cognitive impairment on patients with chronic obstructive pulmonary disease: A systematic review. Medicine (Baltimore). el 24 de junio de 2022;101(25):e29235. https://doi.org/10.1097/md.0000000000029235
52. Rostamian S, le Cessie S, Marijt KA, Jukema JW, Mooijaart SP, van Buchem MA, et al. Association of cognitive function with increased risk of cancer death and all-cause mortality: Longitudinal analysis, systematic review, and meta-analysis of prospective observational studies. PLoS One. 2022;17(1):e0261826. https://doi.org/10.1371/journal.pone.0261826
Downloads
Published
Data Availability Statement
Este estudio se basó exclusivamente en información publicada previamente. No se generaron ni analizaron datos primarios.
Issue
Section
License
Copyright (c) 2026 H. Mauricio Mendieta L., Liliana R. Lagos V., Ronald F. Cocoma C., Daniela N. Cifuentes G.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
