Frequency and risk factors for HIV-associated neurocognitive disorder and depression in older individuals with HIV in northeastern Brazil

2012 ◽  
Vol 24 (10) ◽  
pp. 1648-1655 ◽  
Author(s):  
Sérgio Murilo Maciel Fernandes Filho ◽  
Heloísa Ramos Lacerda de Melo

ABSTRACTBackground: The study was undertaken to describe the frequency of HIV-associated neurocognitive disorders (HAND) and depressive symptoms in an older population with human immunodeficiency virus (HIV).Methods: A cross-sectional analysis of patients aged 50 years or older infected with HIV was carried out in an outpatient setting in Brazil from March to November 2008. Patients selected were submitted to cognitive evaluation using the Mini-Mental State Examination and International HIV Dementia Scale, and also to functional and depression evaluations.Results: Among the 52 patients evaluated, the frequency of neurocognitive disorder was 36.5%, while for dementia the frequency was 13.5%. No risk factors were identified. Among the patients with cognitive impairment, 73.7% had cortical impairment. The frequency of depressive symptoms was of 34.6%. The female gender was identified as a risk factor (p = 0.018) and patients with depressive symptoms had greater functional impairment (p < 0.001).Conclusion: HAND and depressive symptoms are common in an older population. Patients with cognitive impairment achieved lower scores on the cortical assessment scales. Depressive symptoms are a stronger factor for functional impairment.


2019 ◽  
Vol 29 (2) ◽  
pp. 166-173 ◽  
Author(s):  
Nabil Ahmed Badawy ◽  
Shokria Adely Labeeb ◽  
Mawaheb Falah Alsamdan ◽  
Badria Faleh Alazemi

Objectives: To estimate the prevalence of polypharmacy in community-dwelling, older Kuwaiti patients, describe the number and types of drugs used, and identify risk factors associated with polypharmacy. Subjects and Methods: This was a descriptive cross-sectional questionnaire-based survey in which we interviewed 500 community-dwelling Kuwaiti adults over 65 years of age. The data collection occurred during a 4-month period from March to July 2017. Results: Fifty-two percent (n = 260) of the patients were males, with a mean age of 71.73 ± 5.32 years. The prevalence of polypharmacy (5–8 drugs) and excessive polypharmacy (>8 drugs) was 58.4% (n = 292) and 10.2% (n = 51), respectively. The risk factors associated with an increased number of medicines used were: female gender (p = 0.019), a lower level of education (p = 0.003), a high number of hospital admissions (p = 0.000), clinics visited by the patient (p =0.000), and number of comorbidities (p = 0.000). The most commonly used medications (82.6% of the study population) were blood glucose-lowering agents, excluding insulin. Other commonly used medications were antihypertensive drugs and lipid-modifying agents. Conclusion: A significant sector of the older Kuwaiti patient population has a high prevalence of polypharmacy and is thus exposed to its potential hazards. The current study highlights the need to revise the drug-dispensing policy among community-dwelling, older Kuwaiti people, as well as to initiate educational programs among healthcare practitioners concerning prescribing issues in older individuals.



2017 ◽  
Vol 08 (S 01) ◽  
pp. S020-S022 ◽  
Author(s):  
Xavier Wong-Achi ◽  
Gabriela Egas ◽  
Dayana Cabrera

ABSTRACT Introduction: The Mini-Cog is a simple and short test that identifies cognitive impairment. Its detection helps provide an early dementia diagnosis, rapid access to treatments, and even delay or reversion. Materials and Methods: This multicenter, observational, descriptive, and cross-sectional study included 214 patients. Patients enrolled in this study were community dwellers aged ≥55-year-old, without prior diagnosis of cognitive impairment or dementia, with adequate hearing and vision functions. It was conducted in primary care health centers localized in rural communities of Ecuador. Results: Ages ranged from 50 to 98 years and there was predominance of female gender: 66% versus 33%. The percentage of illiteracy was 26.4% (CI: 25.32–27.48), and 63% (CI: 62.1–63.94) of patients had complete primary educational level. The overall prevalence of cognitive impairment was 50.9% (95% CI: 48.5–53.3) and 47.2% (95% CI: 45.2–49.2) in patients with risk factors. We found several established risk factors associated with cognitive impairment onset, including social factors, physiological factors, and comorbidities. Conclusion: This is the first epidemiological research of CI in rural populations in this country using the Mini-Cog as a screening tool. Adopting public health measures for the prevention and control of those modifiable risk factors could reduce the prevalence of cognitive impairment and even its progression to dementia.



2018 ◽  
Vol 12 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Kornanong Yuenyongchaiwat ◽  
Khajonsak Pongpanit ◽  
Somrudee Hanmanop

ABSTRACT Low physical activity and depression may be related to cognitive impairment in the elderly. Objetive: To determine depression and physical activity (PA) among older adults with and without cognitive impairment. Methods: 156 older adults, both males and females, aged ≥60 years, were asked to complete the Thai Mini-Mental State Examination (Thai-MMSE), a global cognitive impairment screening tool. Seventy-eight older adults with cognitive impairment and 78 older adults without cognitive impairment were then separately administered two questionnaires (i.e., the Thai Geriatric Depression Scale; TGDS and Global Physical Activity Questionnaire; GPAQ). Logistic regression analysis was used to determine the risk of developing cognitive impairment in the groups of older individuals with and without cognitive impairment. Results: A cross-sectional study of elderly with a mean age of 74.47 ± 8.14 years was conducted. There were significant differences on the depression scale and in PA between older adults with and without cognitive impairment. Further, participants with low PA and high level of depressive symptoms had an increased risk of cognitive impairment (Odds ratio = 4.808 and 3.298, respectively). Conclusion: Significant differences were noted in PA and on depression scales between older adults with and without cognitive impairment. Therefore, increased PA and decreased depressive symptoms (i.e., having psychological support) are suggested to reduce the risks of cognitive impairment in older adults.



Author(s):  
Karla Liliana Pérez-Sosa ◽  
Edgar Felipe Lares-Bayona

Alcohol is a toxic substance associated with acute and chronic disorders affecting the Central Nervous System and significantly altering brain function. Objective: To determine the relationship between cognitive impairment and alcohol consumption in university students of the Juárez University of the State of Durango. Methodology: It is a cross-sectional, descriptive, comparative, non-probabilistic study, for convenience. A database was designed on the results obtained in a clinical interview on alcohol consumption and the application of the Montreal Cognitive Assessment (MoCA) test. Contribution: The evaluation of cognitive functions show similar results, the male sex presented a better score in Attention and the female one in Orientation. More involvement was identified in the Deferred Memory functions in both groups. In relation to alcohol consumption, the cognitive functions evaluated show lower levels. The female gender was more evident cognitive impairment in relation to alcohol consumption being statistically significant (p <0.025). Alcohol consumption is a risky behavior that deserves to be recognized by the main actors about neurocognitive effects. Alcohol consumption prevention programs and cognitive diagnostic tools are appropriate strategies to reduce risk behaviors in mental health.



2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongyan Wang ◽  
Xiaoling Dai ◽  
Zichuan Yao ◽  
Xianqing Zhu ◽  
Yunzhong Jiang ◽  
...  

Abstract Introduction To explore the prevalence of depressive symptoms and the associated risk factors in frontline nurses under COVID-19 pandemic. Methods This cross-sectional study was conducted from February 20, 2020 to March 20, 2020 and involved 562 frontline nurses. The effective response rate was 87.68%. After propensity score matched, there were 498 participants left. Extensive characteristics, including demographics, dietary habits, life-related factors, work-related factors, and psychological factors were collected based on a self-reported questionnaire. Specific scales measured the levels of sleep quality, physical activity, depressive symptoms, perceived organization support and psychological capital. Adjusted odds ratios and 95% confidence intervals were determined by binary paired logistic regression. Results Of the nurses enrolled in the study, 50.90% had depressive symptoms. Three independent risk factors were identified: poor sleep quality (OR = 1.608, 95% CI: 1.384–1.896), lower optimism of psychological capital (OR = 0.879, 95% CI: 0.805–0.960) and no visiting friend constantly (OR = 0.513, 95% CI: 0.286–0.920). Conclusions This study revealed a considerable high prevalence of depressive symptoms in frontline nurses during the COVID-19 outbreak, and identified three risk factors, which were poor sleep quality, lower optimism of psychological capital, and no visiting friend constantly. Protecting mental health of nurses is important for COVID-19 pandemic control and their wellbeing. These findings enrich the existing theoretical model of depression and demonstrated a critical need for additional strategies that could address the mental health in frontline nurses for policymakers.



2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Dalia Hegazy Ali ◽  
Doha Mostafa Elserafi ◽  
Marwa Abdel Rahman Soltan ◽  
Mohamed Fikry Eissa ◽  
Hanan Ahmed Zein ◽  
...  

Abstract Background Patients with schizophrenia suffer from diffuse cognitive impairment and high prevalence of cardiovascular metabolic risks, associated with poor clinical outcomes. We aimed in this study to test the presence of cognitive impairment in a sample of patients with schizophrenia, and evaluate its possible relations to patients’ metabolic profile. We recruited forty patients diagnosed with schizophrenia and their matched controls from the inpatient departments and outpatient services from January to December 2016. Schizophrenia diagnosis was confirmed by the ICD10 criteria checklist. Symptoms profile and severity were assessed by the Positive and Negative Syndrome Scale. Cognitive profile was assessed through (1) Trail Making Test, Parts A and B and (2) Wechsler Memory Scale-Revised Visual Reproduction Test. Metabolic profile was assessed by measuring the body mass index, fasting blood glucose, and lipid profile. SPSS (V. 22.0, IBM Corp., USA, 2013) was used for data analysis. Results The patients group had a significantly higher means in the speed of processing, executive function, attention, and working memory scores on TMT-A (p = 0.0), TMT-B (p = 0.00), and WMS-R (p = 0.029) and significantly higher FBG levels (p = 0.00). Correlation studies showed that the increase in patients’ age, illness duration, treatments, number of hospitalizations, number of episodes and of ECT sessions received, symptoms severity, and deficits in cognitive function scores was associated with higher BMI and FBG. Conclusions Patients with schizophrenia have a higher prevalence of cognitive impairment and vascular risk factors than the general population. Close monitoring and early management of these risk factors can promote better cognitive abilities and overall functions.



2010 ◽  
Vol 22 (7) ◽  
pp. 1154-1160 ◽  
Author(s):  
Hugo Lövheim ◽  
Ellinor Bergdahl ◽  
Per-Olof Sandman ◽  
Stig Karlsson ◽  
Yngve Gustafson

ABSTRACTBackground: Dementia and depression are common in advanced age, and often co-exist. There are indications of a decreased prevalence of depressive symptoms among old people in recent years, supposedly because of the manifold increase in antidepressant treatment. Whether the prevalence of depressive symptoms has decreased among people in different stages of dementia disorders has not yet been investigated.Methods: A comparison was undertaken of two cross-sectional studies, conducted in 1982 and 2000, comprising 6864 participants living in geriatric care units in the county of Västerbotten, Sweden. Depressive symptoms were measured using the Multi-Dimensional Dementia Assessment Scale (MDDAS), and the cognitive score was measured with Gottfries’ cognitive scale. Drug data were obtained from prescription records.Results: There was a significant decrease in depressive symptom score between 1982 and 2000 in all cognitive function groups except for the group with moderate cognitive impairment. Antidepressant drug use increased in all cognitive function groups.Conclusion: The prevalence of depressive symptoms decreased between 1982 and 2000, in all levels of cognitive impairment except moderate cognitive impairment. This might possibly be explained by the depressive symptoms having different etiologies in different stages of a dementia disorder, which in turn might not be equally susceptible to antidepressant treatment.



Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
Rosa Maria Bruno ◽  
Laura Palagini ◽  
Veronica Mancuso ◽  
Martina Cargiolli ◽  
Angelo Gemignani ◽  
...  

Purpose: Insomnia and short sleep duration have been associated with increased prevalence, incidence and severity of hypertension. However, the relationship between insomnia and use of different antihypertensive drug classes has not been ascertained yet. Methods: 371 hypertensive patients at their first visit in a tertiary Hypertension Outpatient Unit were enrolled. Insomnia Severity Index (ISI), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAY-Y2) were administered. Insomnia was defined as ISI>8, depressive symptoms as BDI>10, trait anxiety as STAI -Y2>40. Patients with self-reported sleep apneas or snoring (n=29) or with incomplete data (n=12) were excluded. Results: Data from 330 patients were analyzed (males 51%, mean age 57±13 years, antihypertensive treatment 84%, previous CV events 9%, diabetes 7%, obesity 24%, smoking 13%, hypercholesterolemia 67%). Insomniacs (n=70, 21%) were older than non-insomniacs (60±11 vs 56±13 years, p=0.02); female gender (62 vs 46%, p=0.01), anxiety (68 vs 34%, p<0.0001) and depressive symptoms (30 vs 6%, p<0.0001) were more prevalent in insomniacs. Insomniacs were treated with higher number of antihypertensive drugs (1.8±1.0 vs 1.5±1.0, p=0.04) and more frequently with angiotensin-receptor-blockers (ARBs, 49 vs 31%, p=0.009) and diuretics (50 vs 28%, p=0.0007), whereas the use of other drug classes was similar. In a multiple logistic regression analysis, adjusted for cardiovascular and psychiatric variables, ARBs use (OR 2.4, CL95% 1.1-5.2), depressive symptoms (OR 3.2, CL95%1.2-8.7) and anxiety (OR 2.9, CL95%1.4-6.1) were associated with a higher probability of insomnia. Conclusions: This cross-sectional analysis suggests that ARBs use may be associated with insomnia in a cohort of hypertensive patients



2018 ◽  
Vol 85 (0) ◽  
Author(s):  
Jael Soares Batista ◽  
Gabriela Hémylin Ferreira Moura ◽  
Francisco Canindé Lopes ◽  
Kaliane Alessandra Rodrigues de Paiva ◽  
Hélio Noberto de Araújo Júnior ◽  
...  

ABSTRACT: The objective of this study was to determine the prevalence of anti Trypanosoma vivax antibodies and the possible risk factors associated with the infection in cattle in Rio Grande do Norte, Northeastern Brazil, through a cross-sectional epidemiological study, with non-probabilistic convenience sampling. A total of 467 cattle’s serum samples were analyzed by indirect immunofluorescence. Forty-two samples tested positive for Trypanosoma vivax IgG antibodies, corresponding to the prevalence of 9%. Risk factors influencing the occurrence of trypanosomiasis were milk exploration, raising of European breeds, productivity category: lactation cow, purchase of new cattle, foraging habits near ponds and rivers, and the presence of mechanical vectors. So, high prevalence in beef animals (59.5%), females (95.2%), European breed (88.1%), lactating cows (85.7%), pasture at banks of dams and rivers (95.2%), in addition to the presence of mechanical vectors (81%) and acquisition of animals (88.1%), indicates the expansion of trypanosomiasis in Northeastern semi-arid region, and the information obtained may explain the epidemiological factors that determine the occurrence of trypanosomiasis by T. vivax in this region.



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