by Doan Thi Hue, Le Thi Thu Ha, Nguyen Van Tuan, Nguyen Van Phi, Le Cong Thien, Nguyen Hoang Yen, Nguyen Thi Hoa, Nguyen Thu Ha, Tran Thi Thu Ha, Tran Thi Thu Huong and Nguyen Hoang Thanh

Objective: Cognitive impairment is a growing public health concern among aging populations, yet evidence from Vietnam remains limited. This study aimed to assess the prevalence of cognitive impairment among older adults in Hanoi and identify demographic, socioeconomic, lifestyle, and health-related determinants.
Method:A cross-sectional study was conducted among 763 adults aged ≥60 years from one urban ward and one rural commune in Hanoi (June–December 2023). Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), with impairment classified into mild, moderate, and severe levels. Mental health, anxiety, and sleep quality were measured using the PHQ-9, GAD-7, and PSQI. Multivariate logistic regression with stepwise forward selection identified independent predictors of cognitive impairment.
Results: Cognitive impairment was highly prevalent, affecting 70.4% of participants (46.1% mild, 19.3% moderate, 5.0% severe). Mean MoCA score was 21.3 (SD=6.3). Age was the strongest predictor (OR=1.11 per year, 95% CI: 1.08–1.15). Female gender (OR=1.63, 95% CI: 1.09–2.44), lower education (OR=0.58 for >high school vs <high school, 95% CI: 0.34–1.00), rural residence (OR=0.58, 95% CI: 0.34–0.99), and lack of pension income (OR=0.54, 95% CI: 0.32–0.93) were significant socioeconomic risk factors. Physical inactivity showed the largest effect size (OR=3.18, 95% CI: 1.34–7.55). Poor sleep quality (OR=1.62, 95% CI: 1.11–2.36) and mental health disorders (OR=1.91, 95% CI: 1.05–3.49) were also independently associated. No significant association was found with COVID-19 status.
Conclusions: Cognitive impairment is widespread among older adults in Hanoi and is shaped by demographic, socioeconomic, and modifiable health factors. Interventions to promote physical activity, mental health, and economic security, alongside improved access to screening and elder care in rural areas, are essential for supporting healthy cognitive aging in Vietnam.

Key words: cognitive impairment, MoCA, older adults, risk factors