[Incidence of the progression and remission of cognitive decline in older adults].

Background: In communities with higher social inequality, tracking the progression and remission of cognitive dysfunction (PR-CD) and its associated factors provides an epidemiological overview of dementia risk. Objective: To investigate the incidence and factors associated with PR-CD in older adults (OAs) at three clinics of the Mexican Social Security Institute in an industrial area of Western Mexico State. Material and methods: A two-year longitudinal study of 231 OAs (≥ 60 years) assessed cognitive function using the Montreal Cognitive Assessment (MoCA). After 2 years, outcomes were categorized into three groups: healthy cognitive function (MoCA scores > 20 on all three measurements), remitting cognitive impairment (one or two measurements with MoCA scores < 20), and progressive cognitive impairment (MoCA scores < 20 on all three measurements). Additionally, sociodemographic, clinical, and functional data were collected. Cumulative incidence and relative risk factors were analyzed using regression. Results: The sample consisted of individuals with six or fewer years of schooling, and 70% identified as female. The incidence of P-CD was 28.1%, while that of R-CD was 32.5%. Factors associated with R-CD included low cognitive reserve and diminished physical performance. In contrast, factors linked to P-CD included age, low educational attainment, low cognitive reserve, age-related sarcopenia, education-related sarcopenia, age-related instrumental Activities of Daily Living (IADLs), and the interaction among age, cognitive reserve, IADLs, and SPBB. Conclusion: In a region of social inequality in Western Mexico State, there is a high incidence of R-CD and P-CD, associated with risk factors that contribute to cognitive dysfunction among OAs.