scholarly journals A Public Health Analysis of the Relationship Between Loneliness, Isolation, and Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 240-240
Author(s):  
Christina Victor
Keyword(s):  
Public Health ◽  
Cognitive Function ◽  
Screening Tools ◽  
Community Based ◽  
Public Health Perspective ◽  
Dementia Screening ◽  
The Relationship ◽  
Negative Health Outcomes ◽  
Substantial Heterogeneity

Abstract Loneliness and isolation are now characterised as major public health problems largely because of reported associations with negative health outcomes including dementia. We adopt a public health perspective and review the relationship between loneliness/isolation and dementia focussing on how these concepts are defined, measured, and reported. We identified community based longitudinal studies which measured loneliness/isolation at baseline and dementia at follow up (minimum 12 months) published up to February 2021. We identified 12 papers for loneliness and 15 for isolation which demonstrated substantial heterogeneity in how exposure (loneliness/ isolation) and outcome (dementia) were measured and reported. For example, dementia was measured in 5 different ways: death, hospitalisation, clinical diagnosis, dementia screening tools or cognitive function. Evidence to support a relationship between loneliness/isolation and dementia is inconclusive largely because of this methodological heterogeneity. Using consistent exposure and outcome measures is a prerequisite for determining the health consequences of loneliness and isolation.

Abstract P014: Lower eGFR and Proteinuria Were Independently Associated With Lower Cognitive Abilities in Community-dwelling Men in Japan: SESSA study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Akira Fujiyoshi ◽  
Takayoshi Ohkubo ◽  
Katsuyuki Miura ◽  
Akihiko Shiino ◽  
Naoko Miyagawa ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Abilities ◽  
Estimated Glomerular Filtration Rate ◽  
Subclinical Atherosclerosis ◽  
Community Dwelling ◽  
Community Based ◽  
Lower Egfr ◽  
The Mean ◽  
The Relationship

Introduction: The relationship between chronic kidney disease (CKD) and cognitive function remains to be determined. Existing studies focused primarily on estimated glomerular filtration rate (eGFR) but not proteinuria in relation to cognitive function. Hypothesis: In a community-based sample, lower eGFR and presence of proteinuria are cross-sectionally independently associated with lower cognition. Methods: The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA) randomly recruited and examined participants from Shiga, Japan in 2006-08 at baseline. Among 824 male participants in the follow-up exam (2010-12), we restricted our analyses to those who underwent the Cognitive Abilities Screening Instrument (CASI), age ≥65 years-old, free of stroke, with no missing pertinent covariates. We calculated eGFR (creatinine-based) according to the 2012-guideline by the Japanese Society of Nephrology. We then divided the participants into three groups by eGFR of ≥60, 59-40, and <40 (mL/min/1.73m 2 ), and separately divided into three groups according to proteinuria using urine dipstick: (-), (-/+), and ≥(1+). We defined CKD as either eGFR <60 or proteinuria ≥ (-/+). In linear regression with CASI score being a dependent variable, we computed the score adjusted for age, highest education attained, smoking, drinking, body mass index, hypertension, diabetes, and dyslipidemia. Results: We analyzed 541 men. The mean [standard deviation] of age and unadjusted score were 72.6 [4.3] years and 89.7 [6.0]. Prevalence of CKD was 56%. The score was significantly lower in participants with CKD than those without it (P=0.03). eGFR and proteinuria categories were separately and jointly associated with lower CASI score in a graded fashion (Ps for trend <0.05 in all the models tested. Table 1 ). Conclusions: Lower eGFR and higher degree of proteinuria were independently associated with lower cognitive function in the community-based men. CKD even in its early phase may predispose to lower cognitive function.

scholarly journals Is Loneliness a Cause or Consequence of Dementia? A Public Health Analysis of the Literature

2021 ◽  
Vol 11 ◽  
Author(s):  
Christina R. Victor
Keyword(s):  
Public Health ◽  
Health Outcomes ◽  
Longitudinal Studies ◽  
Rating Scales ◽  
Public Health Problem ◽  
Evidence Base ◽  
Screening Tools ◽  
Major Public Health Problem ◽  
Public Health Perspective ◽  
Negative Health Outcomes

Loneliness has been reframed from a ‘social problem of old age’ into a major public health problem. This transformation has been generated by findings from observational studies of a relationship between loneliness and a range of negative health outcomes including dementia. From a public health perspective, key to evaluating the relationship between loneliness and dementia is examining how studies define and measure loneliness, the exposure variable, and dementia the outcome. If we are not consistently measuring these then building a body of evidence for the negative health outcomes of loneliness is problematic. Three key criteria had to meet for studies to be included in our analysis. To test the proposition that loneliness is a cause of dementia we only included longitudinal studies. For inclusion studies had to measure loneliness at baseline, have samples free of dementia and assess dementia at follow up (specified as a minimum of 12 months). We identified 11 papers published between 2000 and 2018 that meet these criteria. These studies included seven different countries and only one was specifically focused upon dementia: all other studies were cohort studies focused upon ageing and health and wellbeing. There was extensive heterogeneity in how studies measured loneliness and dementia and in the use of co-variates. Loneliness was measured by either self-rating scales (n = 8) or scales (n = 3). Dementia was assessed by clinical tests (n = 5), diagnostic/screening tools (n = 3), cognitive function tests (n = 1), and self-reported doctor diagnosis (n = 2). Substantial variation in loneliness prevalence (range 5–20%) and dementia incidence (5–30 per 1000 person years at risk). Six studies did not report a statistically significant relationship between loneliness and dementia. Significant excess risk of dementia among those who were lonely ranged from 15% to 64%. None of these studies are directly comparable as four different loneliness and dementia measures were used. We suggest that the evidence to support a relationship between loneliness and dementia is inconclusive largely because of methodological limitations of existing studies. If we wish to develop this evidence base, then using a consistent set of loneliness and dementia outcome measures in major longitudinal studies would be of benefit.

Sleep symptomatology is associated with greater subjective cognitive concerns: Findings from the community-based Healthy Brain Project

SLEEP ◽  
2021 ◽  
Author(s):  
Jessica Nicolazzo ◽  
Katharine Xu ◽  
Alexandra Lavale ◽  
Rachel Buckley ◽  
Nawaf Yassi ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Sleep Quality ◽  
Cognitive Performance ◽  
Sex Education ◽  
Severity Index ◽  
Analysis Of Covariance ◽  
Psychomotor Function ◽  
Community Based ◽  
The Relationship ◽  
Insomnia Severity

Abstract Study objectives To examine if sleep symptomatology was associated with subjective cognitive concerns or objective cognitive performance in a dementia-free community-based sample. Methods A total of 1421 middle-aged participants (mean±standard deviation = 57±7; 77% female) from the Healthy Brain Project completed the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS) to measure sleep quality, insomnia symptom severity, and daytime sleepiness, respectively. Participants were classified as having no sleep symptomatology (normal scores on each sleep measure), moderate sleep symptomatology (abnormal scores on one sleep measure), or high sleep symptomatology (abnormal scores on at least two sleep measures), using established cut-off values. Analysis of covariance was used to compare objective cognitive function (Cogstate Brief Battery) and subjective cognitive concerns (Modified Cognitive Function Instrument) across groups. Results Following adjustments for age, sex, education, mood, and vascular risk factors, persons classified as having high sleep symptomatology, versus none, displayed more subjective cognitive concerns (d=0.24) but no differences in objective cognitive performance (d=0.00-0.18). Subjective cognitive concerns modified the association between sleep symptomatology and psychomotor function. The strength of the relationship between high sleep symptomatology (versus none) and psychomotor function was significantly greater in persons with high as compared with low cognitive concerns (β±SE =-0.37±0.16; p=0.02). Conclusions More severe sleep symptomatology was associated with greater subjective cognitive concerns. Persons reporting high levels of sleep symptomatology may be more likely to display poorer objective cognitive function in the presence of subjective cognitive concerns.

Abstract T P160: Influence of Polyunsaturated Fatty Acids on Cognition in Elderly Alzheimer's Disease Patients

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Takashi Yamazaki ◽  
Ken Nagata ◽  
Daiki Takano ◽  
Tetsuya Maeda
Keyword(s):  
Alzheimer’S Disease ◽  
Blood Pressure ◽  
Alzheimer's Disease ◽  
Cognitive Function ◽  
Mmse Score ◽  
Characteristic Curve ◽  
Follow Up Study ◽  
Cognitive Stability ◽  
The Relationship

Background: Many genes and environmental factors linked to Alzheimer’s disease (AD) risk affect lipid metabolism or the cardiovascular system, strongly implicating cerebrovascular and metabolic dysfunction in AD pathogenesis. Although some PUFAs may improve cognitive function in aging individuals, it is still unclear how different PUFAs influence AD neuropathology and cognitive function. Objective: To examine the influence of polyunsaturated fatty acid (PUFA) metabolism on AD-associated cognitive decline, we investigated the relationship between serum PUFA profile and neuropsychological test performance. Methods: Cognitive functioning in patients with probable AD (n = 174, mean age 77.6 years) was examined using the Mini-Mental State Exam (MMSE) and clock drawing test (CDT). Serum samples were obtained for PUFA profile, including the eicosapentaenoic acid/arachidonic acid (EPA/AA) ratio, and measurement of brain natriuretic peptide (BNP) concentration. In the follow-up study, 47 subjects repeated MMSE and CDT after 1 year, According to the second MMSE score, the subjects were divided into the following 2 groups: those with unchanged or improved MMSE score and those with lower MMSE score. A receiver operating characteristic curve was used to evaluate the relationship between the EPA/AA ratio and 1-year cognitive stability. Results: In the cross-sectional study, total MMSE score correlated positively with the EPA/AA ratio and systolic blood pressure (SBP), and negatively with age and diastolic blood pressure (DBP) (p < 0.05). In the follow-up study, the MMSE score was lower than baseline in 20 subjects, whereas it was improved or unchanged in 29 patients. The EPA/AA ratio in the stable group was significantly greater than that in the deteriorating group, suggesting an association between higher EPA/AA ratio and cognitive stability over 1 year. The EPA/AA ratio predicted stability of cognitive performance with a sensitivity of 66% and specificity of 70% (odds ratio = 4.43) when the cut-off was 0.67. Conclusion: Our results suggest that serum EPA concentration strongly influences cognitive performances in AD patients. The EPA/AA ratio was a sensitive indicator of cognitive stability in this patient group.

A sustainable community based model of non-communicable disease risk factor surveillance: “SHRADDHA-JAGRITHI project” (Preprint)

2021 ◽  
Author(s):  
Jaideep Menon ◽  
Mathews Numpeli ◽  
Sajeev.P. Kunjan ◽  
Beena.V. Karimbuvayilil ◽  
Aswathy Sreedevi ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Health Workers ◽  
Communicable Disease ◽  
Community Based ◽  
Frontline Health Workers ◽  
The Individual ◽  
Non Communicable Disease

UNSTRUCTURED Abstract: India has a massive non-communicable disease (NCD) burden at an enormous cost to the individual, family, society and health system at large, in spite of which prevention and surveillance is relatively neglected. Risk factors for atherosclerotic cardiovascular disease if diagnosed early and treated adequately would help decrease the mortality and morbidity burden. India is in a stage of rapid epidemiological transition with the state of Kerala being at the forefront, pointing us towards likely disease burden and outcomes for the rest of the country, in the future. A previous study done by the same investigators, in a population of >100,000, revealed poor awareness and treatment of NCDs and also poor adherence to medicines in individuals with CVD. The investigators are looking at a sustainable, community based model of surveillance for NCDs with corporate support wherein frontline health workers check all individuals in the target group ( > age 30 years) with further follow up and treatment planned in a “spoke and hub” model using the public health system of primary health centres (PHCs) as spokes to the hubs of Taluk or District hospitals. All data entry done by frontline health workers would be on a Tab PC ensuring rapid acquisition and transfer of participant health details to PHCs for further follow up and treatment. The model will be evaluated based on the utilisation rate of various services offered at all tier levels. The proportions of the target population screened, eligible individuals who reached the spoke or hub centres for risk stratification and care and community level control for hypertension and diabetes in annual surveys will be used as indicator variables. The model ensures diagnosis and follow up treatment at no cost to the individual entirely through the tiered public health system of the state and country.

scholarly journals Shiga toxin-producingEscherichia coliin swine: the public health perspective

2014 ◽  
Vol 15 (1) ◽  
pp. 63-75 ◽  
Author(s):  
Marion Tseng ◽  
Pina M. Fratamico ◽  
Shannon D. Manning ◽  
Julie A. Funk
Keyword(s):  
Public Health ◽  
Shiga Toxin ◽  
Animal Studies ◽  
Epidemiologic Studies ◽  
Health Concern ◽  
Human Beings ◽  
Public Health Perspective ◽  
Biological Studies ◽  
Human Illness ◽  
The Relationship

AbstractShiga toxin-producingEscherichia coli(STEC) strains are food-borne pathogens that are an important public health concern. STEC infection is associated with severe clinical diseases in human beings, including hemorrhagic colitis (HC) and hemolytic uremic syndrome (HUS), which can lead to kidney failure and death. Cattle are the most important STEC reservoir. However, a number of STEC outbreaks and HUS cases have been attributed to pork products. In swine, STEC strains are known to be associated with edema disease. Nevertheless, the relationship between STEC of swine origin and human illness has yet to be determined. This review critically summarizes epidemiologic and biological studies of swine STEC. Several epidemiologic studies conducted in multiple regions of the world have demonstrated that domestic swine can carry and shed STEC. Moreover, animal studies have demonstrated that swine are susceptible to STEC O157:H7 infection and can shed the bacterium for 2 months. A limited number of molecular epidemiologic studies, however, have provided conflicting evidence regarding the relationship between swine STEC and human illness. The role that swine play in STEC transmission to people and the contribution to human disease frequency requires further evaluation.

scholarly journals Undergraduate paramedic students’ experience of paramedic tutors teaching public health

2021 ◽  
Vol 18 ◽  
Author(s):  
Marguerite Claire Sendall ◽  
Athena Ng ◽  
Laura McCosker
Keyword(s):  
Public Health ◽  
Public Health System ◽  
Learning Experience ◽  
Teaching Style ◽  
The Public ◽  
The Subject ◽  
Second Year ◽  
The Relationship ◽  
Positive Effect

Introduction Previous studies have shown teaching public health in medical courses improves students’ analytical, problem-solving and communication skills. However, little research to date has shown if public health teaching is helpful to paramedic students. The aim of this study was to examine if having paramedic tutors teach public health had a positive effect on students’ learning and interest in public health. Methods 184 second-year paramedic students at an Australian university completed a printed survey and provided feedback about their learning experience. Students answered multiple choice and open-ended questions about whether their understanding of a public health subject was improved by having a paramedic tutor, and if having different tutors each week affected students’ learning. Results Most students reported their understanding of public health improved when the subject was taught by a paramedic tutor and when paramedic scenario examples were included in teaching. Nearly half felt having different tutors each week made learning difficult. The following themes emerged from student narratives: the relevance of public health to their career; an improved understanding of public health; a realisation about the importance of public health; difficulties presented by an inconsistent teaching style; and poor follow-up and conflicting advice. Conclusion Teaching public health from a paramedic perspective enabled students to understand the relevance of paramedic practice and the role paramedics play in the public health system. Having the same paramedic tutor teaching each week helped students understand the relationship between public health and paramedic practice.

scholarly journals Estimated Glomerular Filtration Rate is a Predictive Factor for High-Sensitivity Cardiac Troponin T in a Community-Based 4.8-year Prospective Study

2020 ◽  
Author(s):  
Jie Han ◽  
Xiaona Wang ◽  
Ping Ye ◽  
Ruihua Cao ◽  
Wenkai Xiao ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Filtration Rate ◽  
Myocardial Injury ◽  
Estimated Glomerular Filtration Rate ◽  
Troponin T ◽  
Cardiac Troponin T ◽  
Community Based ◽  
Highly Sensitive ◽  
The Relationship

Abstract Objectives: Persistent elevation of cardiac troponin T (cTnT), which is considered as a sensitive and specific biomarker of myocardial injury, is frequently observed in patients with renal insufficiency. Meanwhile, estimated glomerular filtration rate (eGFR) is an independent risk factor of cardiovascular diseases. With a highly sensitive assay, the prevalence of detectable highly sensitive cTnT (hs-cTnT) is greatly improved even in general population. The aim of this study was to better understand the relationship between renal function (eGFR) and myocardial injury (hs-cTnT) in a community-based population.Methods: We analyzed the relationship between baseline eGFR and follow-up hs-cTnT, and the change of hs-cTnT in 1354 participants after 4.8 years follow-up.Results: In Pearson’s correlation analysis, baseline eGFR showed a negative relationship with follow-up hs-cTnT (r=-0.439; P < 0.001). In multiple linear regression analysis, baseline eGFR was independently and negatively associated with follow-up hs-cTnT (β=-0.310, P = 0.005). Stepwise logistic regression models revealed that baseline eGFR was significantly associated with the change in hs-cTnT after 4.8 years follow-up. However, the change in eGFR was not associated with the change in hs-cTnT.Conclusions: Baseline eGFR levels were independently and negatively associated with follow-up hs-cTnT. Furthermore, baseline eGFR levels were an independent predictor of the change in hs-cTnT 4.8 years follow-up, indicating a relationship between renal function and myocardial injury in a community-based population.

scholarly journals Influence of snoring on in incidence of metabolic syndrome: a community-based prospective cohort study in rural Northeast China

2020 ◽  
Author(s):  
Shasha Yu ◽  
Xiaofan Guo ◽  
GuangXiao Li ◽  
Hongmei Yang ◽  
Guozhe Sun ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Rural Areas ◽  
Prospective Cohort ◽  
Fast Blood Glucose ◽  
Fast Blood Glucose Level ◽  
Community Based ◽  
The Relationship

Abstract Background: There is increasing trend of metabolic syndrome (MetS) in rural areas of China in recent years. It is necessary to figure out the possible risk factors of MetS for better intervention. This community-based prospective cohort study was performed to assess the relationship between snoring status and incidence of MetS.Methods: We conducted a cohort study among residents aged ≥ 35 years without MetS in 2012-2013. Among 5,691 residents who met the inclusion criteria, 4,980 residents (2,586 men and 2394 women; follow-up proportion: 87.5%) remained available for follow-up examinations during 2015-2017. The main outcome was the incidence of MetS, defined by the unify criteria in 2009. We divided residents by snoring status and compared outcome between groups. Using a logistic regression model, we estimated the odds ratio (OR) for incidence for MetS, adjusting for confounders, ages, gender, exercise habit, sleep duration, alcohol and smoke consumption. Results: With a median follow up of 4.6 years, incidence of MetS was higher in snorers (men 26.2%, women 33.5%) than in non-snorers (men 19.7%, women 23.2%). Diastolic blood pressure increased in follow-up compared with baseline in male snorers but decreased in male non-snorers. Similarly, fast blood glucose level increased in female snorers at follow-up but decreased in female non-snorers. We found a significant association between snoring and incidence of MetS (adjusted OR=1.51, 95%CI=1.32-1.74). Besides, as the degrees of the snoring increased, the incidence of MetS increased simultaneously. And the OR for the very severe snoring was double compared with non-snorers (adjusted OR=2.10, 95%CI=1.38-3.20). Conclusion: Snoring is associated with higher incidence of MetS in rural Northeast Chinese. More emphasis should be paid to residents with snoring problem.

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