Cognitive Neurology: Integrative Approaches to Prevent and Manage Cognitive Impairment and Dementia

2020 ◽  
pp. 123-140
Author(s):  
Nancy Isenberg
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Cognitive Impairment ◽  
Environmental Risk ◽  
Healthy Aging ◽  
Current Knowledge ◽  
Well Being ◽  
Health Impact ◽  
Brain Health ◽  
The Common

This chapter reviews the increasing prevalence and public health impact of dementia for individuals, families, and societies globally. It discusses the common lifestyle and environmental risk factors of cerebrovascular disease and neurodegeneration and their role in brain health and dementia. It also reviews the spectrum of cognitive impairment and new diagnostic criteria of dementia within the context of a lifespan model of healthy aging. It describes the main findings from observational studies on risk and neuroprotective factors for dementia and Alzheimer’s disease and summarizes the current knowledge of mindset, lifestyle, and mind/body interventions for risk reduction, prevention, and management of dementia, and the promotion of resilience and well-being in aging. This chapter is written for neurologists, psychiatrists, geriatricians, and integrative clinicians.

scholarly journals A comparison of the prevalence of and modifiable risk factors for cognitive impairment among community-dwelling Canadian seniors over two decades, 1991–2009

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242911
Author(s):  
Batholomew Chireh ◽  
Carl D’Arcy
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Cognitive Impairment ◽  
Healthy Aging ◽  
Canadian Community Health Survey ◽  
Community Dwelling ◽  
Health Concern ◽  
Population Census ◽  
Modifiable Risk Factors ◽  
Canadian Population

Background The prevalence of cognitive impairment or dementia is of public health concern globally. Accurate estimates of this debilitating condition are needed for future public health policy planning. In this study, we estimate prevalence and modifiable risk factors for cognitive impairment by sex over approximately 16 years. Methods Canadian Study of Health and Aging (CSHA) baseline data conducted between 1991–1992 were used to measure the prevalence of cognitive impairment and dementia among adults aged 65+ years. The standard Modified Mini-Mental State Examination (3MS) was used for the screening test for cognitive impairment. We compared the CSHA data with Canadian Community Health Survey–Healthy Aging (CCHS-HA) conducted between 2008–2009. The CCHS-HA used a four-dimension cognitive module to screen for cognitive impairment. Only survey community-dwelling respondents were included in the final sample. After applying exclusion criteria, final samples of (N = 8504) respondents in the CSHA sample and (N = 7764) respondents for CCHS–HA sample were analyzed. To account for changes in the age structure of the Canadian population, prevalence estimates were calculated using age-sex standardization to the 2001 population census of Canada. Logistic regression analyses were used to examine predictors of cognitive impairment. A sex stratified analysis was used to examine risk factors for cognitive impairment in the survey samples. Results We found that prevalence of cognitive impairment among respondents in CSHA sample was 15.5% in 1991 while a prevalence of 10.8% was reported in the CCHS–HA sample in 2009, a 4.7% reduction [15.5% (CI = 14.8–16.3), CSHA vs 10.8% (CI = 10.1–11.5), CCHS–HA]. Men reported higher prevalence of cognitive impairment in CSHA study (16.0%) while women reported higher prevalence of cognitive impairment in CCHS–HA (11.6%). In the multivariable analyses, risk factors such as age, poor self-rated health, stroke, Parkinson’s disease, and hearing problems were common to both cohorts. Sex differences in risk factors were also noted. Conclusions This study provides suggestive evidence of a potential reduction in the occurrence of cognitive impairment among community-dwelling Canadian seniors despite the aging of the Canadian population. The moderating roles of improved prevention and treatment of vascular morbidity and improvements in the levels of education of the Canadian population are possible explanations for this decrease in the cognitive impairment.

Prospective Memory Development Across the Lifespan

2020 ◽  
Vol 25 (3) ◽  
pp. 162-173 ◽  
Author(s):  
Sascha Zuber ◽  
Matthias Kliegel
Keyword(s):  
Prospective Memory ◽  
Healthy Aging ◽  
Present Model ◽  
Current Knowledge ◽  
Well Being ◽  
The Elderly ◽  
Cognitive Factors ◽  
Everyday Functioning ◽  
Integrative Framework

Abstract. Prospective Memory (PM; i.e., the ability to remember to perform planned tasks) represents a key proxy of healthy aging, as it relates to older adults’ everyday functioning, autonomy, and personal well-being. The current review illustrates how PM performance develops across the lifespan and how multiple cognitive and non-cognitive factors influence this trajectory. Further, a new, integrative framework is presented, detailing how those processes interplay in retrieving and executing delayed intentions. Specifically, while most previous models have focused on memory processes, the present model focuses on the role of executive functioning in PM and its development across the lifespan. Finally, a practical outlook is presented, suggesting how the current knowledge can be applied in geriatrics and geropsychology to promote healthy aging by maintaining prospective abilities in the elderly.

scholarly journals Association of self-perceived income sufficiency with cognitive impairment among older adults: a population-based study in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
T. Muhammad ◽  
Shobhit Srivastava ◽  
T. V. Sekher
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Psychological Health ◽  
Daily Living ◽  
Basic Needs ◽  
Well Being ◽  
Asset Ownership ◽  
Increased Risk

Abstract Background Greater cognitive performance has been shown to be associated with better mental and physical health and lower mortality. The present study contributes to the existing literature on the linkages of self-perceived income sufficiency and cognitive impairment. Study also provides additional insights on other socioeconomic and health-related variables that are associated with cognitive impairment in older ages. Methods Data for this study is derived from the 'Building Knowledge Base on Population Ageing in India'. The final sample size for the analysis after removing missing cases was 9176 older adults. Descriptive along with bivariate analyses were presented to show the plausible associations of cognitive impairment with potential risk factors using the chi-square test. Also, binary logistic regression analysis was performed to provide the relationship between cognitive impairment and risk factors. The software used was STATA 14. Results About 43% of older adults reported that they had no source of income and 7.2% had income but not sufficient to fulfil their basic needs. Older adults with income but partially sufficient to fulfil their basic needs had 39% significantly higher likelihood to suffer from cognitive impairment than older adults who had sufficient income [OR: 1.39; OR: 1.21–1.59]. Likelihood of cognitive impairment was low among older adults with asset ownership than older adults with no asset ownership [OR: 0.83; CI: 0.72–0.95]. Again, older adults who work by compulsion (73.3%) or felt mental or physical stress due to work (57.6%) had highest percentage of cognitive impairment. Moreover, older adults with poor self-rated health, low instrumental activities of daily living, low activities of daily living, low subjective well-being and low psychological health were at increased risk for cognitive impairment. Conclusion The study highlights the pressing need for care and support and especially financial incentives in the old age to preserve cognitive health. Further, while planning geriatric health care for older adults in India, priority must be given to financially backward, with no asset ownership, with poor health status, older-older, widowed, and illiterate older individuals, as they are more vulnerable to cognitive impairment.

scholarly journals The Social and Health Impact of Accidents at Work: The Analysis of the Italian Case

2021 ◽  
Author(s):  
Di Romano Benini
Keyword(s):  
Risk Factors ◽  
Negative Impact ◽  
Well Being ◽  
Health Impact ◽  
Work Culture ◽  
Organizational Models ◽  
Work Related ◽  
Italian Case ◽  
Increased Risk ◽  
Related Stress

The months of a gradual exit from the pandemic show some significant data and phenomena regarding the phenomenon of accidents at work and occupational diseases. The Italian figure highlights a recovery in injuries and illnesses, but also in the impact of new risk factors deriving from the digitalization of work, which grew with smart working during the pandemic. At the same time, the new organizational models highlight the increased risk of work-related stress diseases. The Italian situation makes clear the need to intervene on the issue of organizational well-being and welfare, to limit the negative impact of risk factors associated with this economic system on society and the health system through a new work culture.

scholarly journals A comprehensive analysis of racial disparities in chemical biomarker concentrations in United States women, 1999-2014

2019 ◽  
Author(s):  
Vy Kim Nguyen ◽  
Adam Kahana ◽  
Julien Heidt ◽  
Katelyn Polemi ◽  
Jacob Kvasnicka ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Risk Factors ◽  
Racial Disparities ◽  
Environmental Risk ◽  
Mexican American ◽  
Age Groups ◽  
Chemical Exposure ◽  
Environmental Risk Factors ◽  
Race Ethnicity

AbstractBackgroundStark racial disparities in disease incidence among American women remains a persistent public health challenge. These disparities likely result from complex interactions between genetic, social, lifestyle, and environmental risk factors. The influence of environmental risk factors, such as chemical exposure, however, may be substantial and is poorly understood.ObjectivesWe quantitatively evaluated chemical-exposure disparities by race/ethnicity and age in United States (US) women by using biomarker data for 143 chemicals from the National Health and Nutrition Examination Survey (NHANES) 1999-2014.MethodsWe applied a series of survey-weighted, generalized linear models using data from the entire NHANES women population and age-group stratified subpopulations. The outcome was chemical biomarker concentration and the main predictor was race/ethnicity with adjustment for age, socioeconomic status, smoking habits, and NHANES cycle.ResultsThe highest disparities across non-Hispanic Black, Mexican American, Other Hispanic, and other race/multiracial women were observed for pesticides and their metabolites, including 2,5-dichlorophenol, o,p’-DDE, beta-hexachlorocyclohexane, and 2,4-dichlorophenol, along with personal care and consumer product compounds. The latter included parabens, monoethyl phthalate, and several metals, such as mercury and arsenic. Moreover, for Mexican American, Other Hispanic, and non-Hispanic black women, there were several exposure disparities that persisted across age groups, such as higher 2,4- and 2,5-dichlorophenol concentrations. Exposure differences for methyl and propyl parabens, however, were the starkest between non-Hispanic black and non-Hispanic white children with average differences exceeding 4 folds.DiscussionsWe systematically evaluated differences in chemical exposures across women of various race/ethnic groups and across age groups. Our findings could help inform chemical prioritization in designing epidemiological and toxicological studies. In addition, they could help guide public health interventions to reduce environmental and health disparities across populations.

scholarly journals A Novel BrainHealth Index Prototype Improved by Telehealth-Delivered Training During COVID-19

2021 ◽  
Vol 9 ◽  
Author(s):  
Sandra Bond Chapman ◽  
Julie M. Fratantoni ◽  
Ian H. Robertson ◽  
Mark D'Esposito ◽  
Geoffrey S. F. Ling ◽  
...  
Keyword(s):  
Public Health ◽  
Social Engagement ◽  
Scale Up ◽  
Well Being ◽  
Ease Of Use ◽  
Strategy Training ◽  
Analytic Structure ◽  
Brain Health ◽  
Online Platform ◽  
Factor Analytic

Introduction: Brain health is neglected in public health, receiving attention after something goes wrong. Neuroplasticity research illustrates that preventive steps strengthen the brain's component systems; however, this information is not widely known. Actionable steps are needed to scale proven population-level interventions.Objectives: This pilot tested two main objectives: (1) the feasibility/ease of use of an online platform to measure brain health, deliver training, and offer virtual coaching to healthy adults and (2) to develop a data driven index of brain health. Methods: 180 participants, ages 18–87, enrolled in this 12-week pilot. Participants took a BrainHealth Index™ (BHI), a composite of assessments encompassing cognition, well-being, daily-life and social, pre-post training. Participants engaged in online training with three coaching sessions. We assessed changes in BHI, effects of training utilization and demographics, contributions of sub-domain measures to the BHI and development of a factor analytic structure of latent BrainHealth constructs.Results: The results indicated that 75% of participants showed at least a 5-point gain on their BHI which did not depend on age, education, or gender. The contribution to these gains were from all sub-domains, including stress, anxiety and resilience, even though training focused largely on cognition. Some individuals improved due to increased resilience and decreased anxiety, whereas others improved due to increased innovation and social engagement. Larger gains depended on module utilization, especially strategy training. An exploratory factor analytic solution to the correlation matrix of online assessments identified three latent constructs.Discussion/Conclusion: This pilot study demonstrated the efficacy of an online platform to assess changes on a composite BrainHealth Index and efficacy in delivering training modules and coaching. We found that adults, college age to late life, were motivated to learn about their brain and engage in virtual-training with coaching to improve their brain health. This effort intends to scale up to thousands, thus the pilot data, tested by an impending imaging pilot, will be utilized in ongoing machine learning (ML) algorithms to develop a precision brain health model. This pilot is a first step in scaling evidence-based brain health protocols to reach individuals and positively affect public health globally.

scholarly journals The Public Health Implications of Brexit in Wales: A Health Impact Assessment (HIA) approach

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Green
Keyword(s):  
Public Health ◽  
Impact Assessment ◽  
Health Impact Assessment ◽  
Evidence Synthesis ◽  
Well Being ◽  
Health Impact ◽  
Health Impacts ◽  
Advisory Group ◽  
The European Union ◽  
Health And Social Care

Abstract On March 29th 2019, the United Kingdom was due to exit the European Union (EU) in a process known informally as ‘Brexit’. The 2 years before this time (and ongoing) experienced a period of unprecedented political and social upheaval with many unknowns and much uncertainty attached to the outcomes and future impact of withdrawal and transitionary period. Public Health Wales commissioned the Wales Health Impact Assessment (HIA) Support Unit to carry out a HIA of Brexit in Wales to assess the potential impact, extent and nature of ‘Brexit’ on health and wellbeing in Wales which would to inform its planning, future work and support other bodies decision-making, planning and policymaking. A comprehensive HIA was conducted over a 6 month period in 2018/19, steered by a Strategic Advisory Group. Methods included; a literature review; stakeholder workshop; interviews with policy leads, a community health profile, and report with evidence synthesis. Trade agreements, economic impacts, changing relationships with EU agencies, uncertainty and loss of regulatory alignment were key pathways for health impacts to occur. Potential impacts included; food standards/safety; environmental regulations; working conditions; and health and social care. Many impacts will affect the whole population. Vulnerable populations included; children/young people; those at risk of unemployment;Welsh areas receiving significant EU funding. Potential indirect impacts were identified on mental well-being. Brexit has the potential to impact significantly on the determinants of health.The HIA has informed and influenced cross-sector planning and policy in response to the short/long-term implications of Brexit to ensure that health and inequalities are considered at every juncture.This unique work demonstrates continued leadership by Wales in the field of impact assessment and ‘health in policies’ and has been positively received. It has transferable learnings for many nation states and health policy leads. Key messages Brexit is a major policy change with major health impacts. HIA is an informative and influencing process to support planning and future policy making.

scholarly journals Conservation of biodiversity as a strategy for improving human health and well-being

2017 ◽  
Vol 372 (1722) ◽  
pp. 20160131 ◽  
Author(s):  
A. Marm Kilpatrick ◽  
Daniel J. Salkeld ◽  
Georgia Titcomb ◽  
Micah B. Hahn
Keyword(s):  
Public Health ◽  
Biodiversity Conservation ◽  
Disease Ecology ◽  
Current Knowledge ◽  
Public Health Intervention ◽  
Well Being ◽  
Pathogen Transmission ◽  
Policy Implications ◽  
Anthropogenic Processes ◽  
Conservation Interventions

The Earth's ecosystems have been altered by anthropogenic processes, including land use, harvesting populations, species introductions and climate change. These anthropogenic processes greatly alter plant and animal communities, thereby changing transmission of the zoonotic pathogens they carry. Biodiversity conservation may be a potential win–win strategy for maintaining ecosystem health and protecting public health, yet the causal evidence to support this strategy is limited. Evaluating conservation as a viable public health intervention requires answering four questions: (i) Is there a general and causal relationship between biodiversity and pathogen transmission, and if so, which direction is it in? (ii) Does increased pathogen diversity with increased host biodiversity result in an increase in total disease burden? (iii) Do the net benefits of biodiversity conservation to human well-being outweigh the benefits that biodiversity-degrading activities, such as agriculture and resource utilization, provide? (iv) Are biodiversity conservation interventions cost-effective when compared to other options employed in standard public health approaches? Here, we summarize current knowledge on biodiversity–zoonotic disease relationships and outline a research plan to address the gaps in our understanding for each of these four questions. Developing practical and self-sustaining biodiversity conservation interventions will require significant investment in disease ecology research to determine when and where they will be effective. This article is part of the themed issue ‘Conservation, biodiversity and infectious disease: scientific evidence and policy implications’.

Common risk factors of breast and ovarian cancer: recent view

2004 ◽  
Vol 14 (5) ◽  
pp. 721-740 ◽  
Author(s):  
G. C. Zografos ◽  
M. Panou ◽  
N. Panou
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Ovarian Cancer ◽  
Gynecological Cancer ◽  
Breast And Ovarian Cancer ◽  
Lifestyle Risk Factors ◽  
Cancer Types ◽  
Common Risk Factors ◽  
The Common ◽  
Lifestyle Risk

Clinicians, epidemiologists, and public health specialists tend to examine breast and ovarian cancer separately. Although this seems fairly rational and expected, both malignancies are estrogen related and thus share many risk factors. In this review, we investigate the common familial, reproductive, anthropometric, nutritional, and lifestyle risk factors of breast and ovarian cancer. We believe that the parallel examination of the two cancer types could significantly contribute to an improved prevention of “gynecological cancer” as a whole.

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