Community Study of Dementia in the Older Korean Rural Population

2003 ◽  
Vol 37 (5) ◽  
pp. 606-612 ◽  
Author(s):  
Maeng Je Cho ◽  
Jang Kyu Kim ◽  
Guk-Hee Suh
Keyword(s):  
Risk Factors ◽  
Cerebrovascular Disease ◽  
Vascular Dementia ◽  
Rural Population ◽  
Community Study ◽  
Case Group ◽  
Second Phase ◽  
Two Phase ◽  
Korean Elderly

Objective: This study aims to estimate the prevalence of all dementias, including Alzheimer's disease (AD) and vascular dementia (VaD) in a population of Korean elderly and to identify possible risk factors which correlated with specific types of dementia. Method: A two-phase survey, based on a door-to-door survey, was conducted. Initially, the Korean version of the Psychogeriatric Assessment Scale (PAS-K) was administered to all 1037 participants aged 65 years and older. Three hundred and seventy people sampled from the case groups (n = 320) of PAS-K subscales and the non-case group (n = 50) entered the second phase for clinical evaluation. Dementia was defined using the DSM-III-R, NINCDSADRDA and NINDS-AIREN criteria. Results: Among 1037 elderly people aged 65–94 years who completed the interview, 74 cases of dementia were detected, giving an overall age-standardized prevalence (95% CI) of 6.8% (6.1–7.5) (male 6.3%[5.3–7.4]; female 7.1% [6.1–8.0]). The prevalence (95% CI) of AD was 4.2% (3.6–4.7) (male 2.4% [2.0–2.8]; female 5.3% [4.5–6.1]), and it increased with age. The prevalence (95% CI) of VaD was 2.4% (2.0–2.8) (male 3.5% [2.7–4.3]; female 1.6% [1.2–2.1]). Smoking for longer than 30 pack-years significantly increased the risk of VaD (OR = 11.5 [2.8–44,6]). Conclusion: Long-term smoking, much more prevalent in men, may be closely related to higher risk of cerebrovascular disease that leads to vascular dementia.

The Spectrum of Cerebrovascular Disease and Associated Cognitive Decline

2019 ◽  
pp. 574-599
Author(s):  
Victoria J. Williams ◽  
Steven E. Arnold ◽  
David H. Salat
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Cerebrovascular Disease ◽  
Cognitive Decline ◽  
Vascular Dementia ◽  
Structure And Function ◽  
Vascular Risk Factors ◽  
Vascular Health ◽  
Vascular Risk ◽  
And Function

Throughout the lifespan, common variations in systemic health and illness contribute to alterations in vasculature structure and function throughout the body, significantly increasing risk for cardiovascular and cerebrovascular disease (CVD). CVD is a prevalent cause of mortality in late life; it also promotes brain alterations, contributing to cognitive decline and, when severe, vascular dementia. Even prior to diseased states, individual variation in CVD risk is associated with structural and functional brain alterations. Yet, how cumulative asymptomatic alterations in vessel structure and function contribute to more subtle changes in brain tissue integrity and function that emerge in late life is unclear. Finally, vascular risk factors are associated with the clinical progression of neurodegenerative diseases such as Alzheimer’s disease (AD); however, recent theory posits that vascular degeneration may serve a contributory role in these conditions. This chapter reviews how lifespan changes in vascular health contribute to degenerative changes in neural tissue and the subsequent development of cognitive impairment and/or vascular dementia. It first discusses associations between vascular risk factors and cognition and also how declining vascular health may lead to cognitive impairment and dementia. Next, it identifies basic aspects of cerebrovascular anatomy and physiology sustaining tissue health and discusses how vulnerabilities of this system contribute to neurodegenerative changes. Finally, it reviews evidence of vascular contributions to AD and presents ideas for future research to better understand the full spectrum of cerebrovascular contributions to brain aging, cognitive decline, and dementia.

Depression in Patients with Schizophrenia in a Psychiatry Hospital in Lagos, Nigeria

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Akinjola O ◽  
◽  
Lawal RA ◽  
Ojo AM ◽  
Adeosun II ◽  
...  
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Second Phase ◽  
Two Phase ◽  
Good Treatment Outcome ◽  
Phase Study ◽  
Poor Social Support ◽  
Schizophrenic Patients

Schizophrenia is a devastating and highly disabling disorder associated with long-term consequences. Treatment is often made difficult by the presence of comorbidities like depression which when considered in management ensures good outcome. This study aimed to determine the prevalence and correlates of depression in schizophrenia. It is a two-phase study involving 320 outpatients recruited by consecutive sampling. The first phase entails confirming diagnosis with Mini International Neuropsychiatric Interview (MINI), psychotic disorder module, assessing socio-demographic characteristic and screening for depressive symptoms with the Beck Depression Inventory (BDI) by a trained assistant. In the second phase, the researcher then assesses for depressive disorder using MINI, depressive disorder module among subjects who screened positive with BDI together with 10% of those who screened negative. Over four-fifth (83.4%) of the participants were less than 50 years, they were mostly females (57.2%), of Yoruba ethnic group (59.7%), Christians (75.6%), and earn below ₦18,000 monthly or nothing (72.2%). Also, a large proportion (86.2%) had good social support. Over a third of the participants were married (38.1%) with about four-fifth of these living with their spouses. The prevalence of depressive symptoms and depressive disorder were 49.7% and 38.4% respectively. Logistic regression revealed that poor social support predicts depressive in Schizophrenia. In conclusion, Depression is common in patients with schizophrenia. Therefore, thorough evaluation of schizophrenic patients is necessary so that, co-morbid depression when present can be detected and considered in management to ensure good treatment outcome.

Impact of Cerebrovascular Disease on the Surgical Treatment of Idiopathic Normal Pressure Hydrocephalus

Neurosurgery ◽  
2006 ◽  
Vol 59 (3) ◽  
pp. 545-552 ◽  
Author(s):  
Diego Spagnoli ◽  
Lucia Innocenti ◽  
Lorenzo Bello ◽  
Mauro Pluderi ◽  
Susanna Bacigaluppi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebrovascular Disease ◽  
Vascular Disease ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Short Term ◽  
Long Term Follow Up ◽  
Short And Long Term

Abstract OBJECTIVE: The influence of cerebrovascular disease (CVD) on the short- and long-term results of surgery was evaluated in a series of consecutive patients with idiopathic normal-pressure hydrocephalus (iNPH). METHODS: Patients with suspected iNPH admitted to our department between June 1996 and June 2003 were evaluated with four clinical and handicap scales. CVD and risk factors for vascular disease were rated. All patients underwent intracranial pressure monitoring via a spinal catheter. Sixty-six patients received a ventriculoperitoneal shunt with a programmable valve. Prospective assessments were programmed at 2 weeks and 3 months after surgery (short-term follow-up). Long-term follow-up evaluations were arranged in June 2004 with patients and/or relatives and health/home care assistants. RESULTS: At the short-term follow-up examination, a significant clinical improvement was globally present in 89% of the patients (P < 0.05). CVD, such as leucoaraiosis or previous strokes, were present in 71% of the patients. Patients both with and without CVD and/or risk factors for vascular disease presented a significant improvement (P < 0.05) after shunting; 85 and 100% of the patients with and without CVD, respectively. At the long-term follow-up examination (mean, 52 ± 24.8 mo), 24% of the patients were dead and 8% had experienced stroke. Globally, 60% of the patients were still improved (P < 0.05); 52 and 79% of the patients with and without CVD, respectively. CONCLUSION: A high success rate in treatment of iNPH is possible in patients with and without CVD. Despite poorer short- and long-term treatment outcome of iNPH patients with CVD, a long-lasting improvement in their quality of life favors surgery.

scholarly journals Risks and Prognoses of Alzheimer's Disease and Vascular Dementia in Patients With Insomnia: A Nationwide Population-Based Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Min Seok Baek ◽  
Kyungdo Han ◽  
Hyuk-Sung Kwon ◽  
Yong-ho Lee ◽  
Hanna Cho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Vascular Dementia ◽  
Cardiovascular Risk Factors ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

This study aimed to investigate the risk and prognosis of Alzheimer's disease (AD) and vascular dementia (VaD) in patients with insomnia using the National Health Insurance Service database covering the entire population of the Republic of Korea from 2007 to 2014. In total, 2,796,871 patients aged 40 years or older with insomnia were enrolled, and 5,593,742 controls were matched using a Greedy digit match algorithm. Mortality and the rate of admission to a long-term care facility were estimated using multivariable Cox analysis. Of all patients with insomnia, 138,270 (4.94%) and 26,706 (0.96%) were newly diagnosed with AD and VaD, respectively. The incidence rate ratios for AD and VaD were 1.73 and 2.10, respectively, in patients with insomnia compared with those without. Higher mortality rates and long-term care facility admission rates were also observed in patients with dementia in the insomnia group. Known cardiovascular risk factors showed interactions with the effects of insomnia on the risk of AD and VaD. However, the effects of insomnia on the incidence of AD and VaD were consistent between the groups with and without cardiovascular risk factors. Insomnia is a medically modifiable and policy-accessible risk factor and prognostic marker of AD and VaD.

scholarly journals Virtual interpolation of discrete multi-objective programming solutions with probabilistic operation

2011 ◽  
Vol 22 (4) ◽  
pp. 379-389
Author(s):  
Ricardo C. Silva ◽  
Edilson F. Arruda ◽  
Fabrício O. Ourique
Keyword(s):  
Probability Distributions ◽  
Phase Method ◽  
Second Phase ◽  
Pareto Optimal ◽  
Two Phase ◽  
Term Operation ◽  
Multi Objective ◽  
Multi Objective Programming ◽  
Objective Programming

This work presents a novel framework to address the long term operation of a class of multi-objective programming problems. The proposed approach considers a stochastic operation and evaluates the long term average operating costs/profits. To illustrate the approach, a two-phase method is proposed which solves a prescribed number of K mono-objective problems to identify a set of K points in the Pareto-optimal region. In the second phase, one searches for a set of non-dominated probability distributions that define the probability that the system operates at each point selected in the first phase, at any given operation period. Each probability distribution generates a vector of average long-term objectives and one solves for the Pareto-optimal set with respect to the average objectives. The proposed approach can generate virtual operating points with average objectives that need not have a feasible solution with an equal vector of objectives. A few numerical examples are presented to illustrate the proposed method.

scholarly journals Skeletal muscle function and need for long-term care of urban elderly people in Japan (the Bunkyo Health Study): a prospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031584 ◽  
Author(s):  
Yuki Someya ◽  
Yoshifumi Tamura ◽  
Hideyoshi Kaga ◽  
Shuko Nojiri ◽  
Kazunori Shimada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Sensitivity ◽  
Muscle Strength ◽  
Cerebrovascular Disease ◽  
Muscle Mass ◽  
Muscle Function ◽  
Long Term Care ◽  
Brain Mri ◽  
Term Care

PurposeThe proportion of elderly individuals (age ≥65 years) in Japan reached 27.7% in 2017, the highest in the world. A serious social problem in a super-aged society is the rise in the number of elderly people who need long-term care (LTC), which is mainly due to cerebrovascular disease, dementia, age-related frailty, falls and fractures, and joint disease. We hypothesised that decreased muscle mass, muscle strength and insulin sensitivity are the common risk factors for these diseases related to needing LTC. We developed a prospective cohort study of elderly subjects in an urban community to test this hypothesis. The primary objective is to prospectively investigate associations between muscle mass, muscle strength, and insulin sensitivity and incidence of main disease and risk factors of needing LTC. The primary outcomes are the incidence of cerebrovascular disease and cognitive decline.ParticipantsParticipants were 1629 people aged 65–84 years living in 13 communities in an urban area (Bunkyo-ku, Tokyo, Japan). Average age was 73.1±5.4 years.Findings to dateWe obtained baseline data on cognitive function, cerebral small vessel disease (SVD) determined by brain MRI, body composition, bone mineral density, arteriosclerosis, physical function, muscle mass, muscle strength and insulin sensitivity. Mild cognitive impairment and dementia were observed in 18.1% and 3.3% of participants, respectively. The prevalence of cerebral SVD was 24.8%. These characteristics are similar to those previously reported in elderly Japanese subjects.Future plansWe will ask participants about their health status, including incidence of cerebrovascular disease, falls, fractures and other diseases every year by mail. We plan to re-evaluate cognitive function, brain MRI parameters and other parameters at 5 and 10 years after the baseline evaluation. We will evaluate whether low muscle function (muscle mass, muscle strength or insulin sensitivity) is a risk factor for cognitive decline or cerebrovascular disease.

scholarly journals Vascular dementia as a frontal subcortical system dysfunction

2000 ◽  
Vol 30 (5) ◽  
pp. 997-1003 ◽  
Author(s):  
JEFFREY C. L. LOOI ◽  
PERMINDER S. SACHDEV
Keyword(s):  
Risk Factors ◽  
Cerebrovascular Disease ◽  
Vascular Dementia ◽  
World Health Organization ◽  
Diagnostic Criteria ◽  
American Psychiatric Association ◽  
World Health ◽  
Distinctive Features ◽  
The World ◽  
Health Organization

Vascular dementia (VaD) is the second most common subtype of dementia in Western countries (Desmond, 1996) and, overall, may be the most common subtype of dementia in the world (Henderson, 1994). Furthermore, the recognition of some major risk factors of cerebrovascular disease makes VaD a form of ‘preventable senility’ (Hachinski, 1992). The last decade has seen a major re-evaluation of the concept of VaD (Erkinjuntti & Hachinski, 1993; Hachinski, 1994), with new diagnostic criteria having been proposed (World Health Organization, 1993; American Psychiatric Association, 1994) but without any consensus (Wetterling et al. 1996). Indeed, some investigators have called for the abandonment of the diagnosis of VaD and the adoption of alternative nosology (Hachinski, 1994). It is therefore time to re-examine the concept of VaD and evaluate its distinctive features.

scholarly journals Neurobiology of Vascular Dementia

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Ana-Maria Enciu ◽  
Stefan N. Constantinescu ◽  
Laurenţiu M. Popescu ◽  
Dafin F. Mureşanu ◽  
Bogdan O. Popescu
Keyword(s):  
Risk Factors ◽  
Neurodegenerative Diseases ◽  
Cerebrovascular Disease ◽  
Vascular Dementia ◽  
Molecular Diagnosis ◽  
Molecular Mechanisms ◽  
Distinct Type ◽  
Genetic Investigation ◽  
New Approach ◽  
Molecular Events

Vascular dementia is, in its current conceptual form, a distinct type of dementia with a spectrum of specific clinical and pathophysiological features. However, in a very large majority of cases, these alterations occur in an already aged brain, characterized by a milieu of cellular and molecular events common for different neurodegenerative diseases. The cell signaling defects and molecular dyshomeostasis might lead to neuronal malfunction prior to the death of neurons and the alteration of neuronal networks. In the present paper, we explore some of the molecular mechanisms underlying brain malfunction triggered by cerebrovascular disease and risk factors. We suggest that, in the age of genetic investigation and molecular diagnosis, the concept of vascular dementia needs a new approach.

scholarly journals Documentation of vascular risk factors in vascular dementia

1998 ◽  
Vol 22 (2) ◽  
pp. 97-99
Author(s):  
Rahul Rao
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Cerebrovascular Disease ◽  
Vascular Dementia ◽  
Case Note ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Noticeable Improvement ◽  
The Impact ◽  
Disease Specific

The diagnosis of vascular dementia may often be made on the basis of structural neuroimaging, this may not always be reliable. In view of this, a retrospective study of 30 case notes with diagnosis of vascular dementia was undertaken to examine the documentation of vascular risk factors and presence of cerebrovascular disease. Specific recommendations were then made for the future case note documentation. Nine months later, 10 case notes were examined to assess the impact of the recommendations. A noticeable improvement in the documentation of most risk factors was observed. The wider implications of these findings are discussed.

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