Ankle–Brachial Index: An Ubiquitous Marker of Cognitive Impairment—The EPIDEMCA Study

Angiology ◽  
2017 ◽  
Vol 69 (6) ◽  
pp. 497-506 ◽  
Author(s):  
Ileana Desormais ◽  
Victor Aboyans ◽  
Maëlenn Guerchet ◽  
Bébène Ndamba-Bandzouzi ◽  
Pascal Mbelesso ◽  
...  

Epidemiological research on the implication of atherosclerosis in the development of cognitive impairment is lacking in low- and middle-income countries, where two-thirds of the individuals affected by dementia live. Individuals aged ≥65 years living in urban and rural areas of 2 countries in Central Africa were invited. Demographic, clinical, and biological data were collected, and the ankle–brachial index (ABI) was measured. Cognitive impairment was defined according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Among 1662 participants (age 72.9 years, 59.3% females), the prevalence of cognitive impairment was 13.6%, which is higher in individuals with ABI ≤ 0.90 and ABI ≥ 1.40 than those with 0.90 < ABI < 1.40 (20.1% and 17% vs 12%, P = .0024). Cognitive impairment was significantly associated with the factors such as age (odds ratio [OR]: 1.09; 95% confidence interval [CI]: 1.07-1.12, P < .0001), female gender (OR: 2.36, 95% CI: 1.59-3.49, P < .0001), smoking (OR: 1.54, 95% CI: 1.06-2.23, P = .0026), and low ABI (≤0.90; OR: 1.52, 95% CI: 1.03-2.25, P = .0359). The ABI, a ubiquitous marker of atherosclerosis, provides independent and incremental information on susceptibility to present with cognitive disorders.

Thorax ◽  
2019 ◽  
Vol 74 (11) ◽  
pp. 1020-1030 ◽  
Author(s):  
Alejandro Rodriguez ◽  
Elizabeth Brickley ◽  
Laura Rodrigues ◽  
Rebecca Alice Normansell ◽  
Mauricio Barreto ◽  
...  

BackgroundUrbanisation has been associated with temporal and geographical differences in asthma prevalence in low-income and middle-income countries (LMICs). However, little is known of the mechanisms by which urbanisation and asthma are associated, perhaps explained by the methodological approaches used to assess the urbanisation-asthma relationship.ObjectiveThis review evaluated how epidemiological studies have assessed the relationship between asthma and urbanisation in LMICs, and explored urban/rural differences in asthma prevalence.MethodsAsthma studies comparing urban/rural areas, comparing cities and examining intraurban variation were assessed for eligibility. Included publications were evaluated for methodological quality and pooled OR were calculated to indicate the risk of asthma in urban over rural areas.ResultsSeventy articles were included in our analysis. Sixty-three compared asthma prevalence between urban and rural areas, five compared asthma prevalence between cities and two examined intraurban variation in asthma prevalence. Urban residence was associated with a higher prevalence of asthma, regardless of asthma definition: current-wheeze OR:1.46 (95% CI:1.22 to 1.74), doctor diagnosis OR:1.89 (95% CI:1.47 to 2.41), wheeze-ever OR:1.44 (95% CI:1.15 to 1.81), self-reported asthma OR:1.77 (95% CI:1.33 to 2.35), asthma questionnaire OR:1.52 (95% CI:1.06 to 2.16) and exercise challenge OR:1.96 (95% CI:1.32 to 2.91).ConclusionsMost evidence for the relationship between urbanisation and asthma in LMICs comes from studies comparing urban and rural areas. These studies tend to show a greater prevalence of asthma in urban compared to rural populations. However, these studies have been unable to identify which specific characteristics of the urbanisation process may be responsible. An approach to understand how different dimensions of urbanisation, using contextual household and individual indicators, is needed for a better understanding of how urbanisation affects asthma.PROSPERO registration numberCRD42017064470.


Author(s):  
Amruth Reddy S. ◽  
Sai Anurag Reddy A. ◽  
Anant A. Takalkar

Background: The 77% of all non-communicable illnesses (NCDs) deaths are in low-and middle-income countries. Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancers (9.3 million), respiratory diseases (4.1 million), and diabetes (1.5 million). These 4 groups of diseases account for over 80% of all premature NCD deaths. Objective was to study prevalence of NCDs and its trends with respect to age and gender.Methods: The present community based descriptive observational study was conducted at Navodaya medical college hospital and research centre, Raichur that caters Urban and rural area of Raichur. The 4063 apparently healthy population from urban and rural part of Raichur were screened during the multi diagnostic mega camp at urban and rural areas around Raichur during the period of January to September 2021. Results: Prevalence of diabetes in our study was 46.3%, hypertension 45.3%, cataract 46.3% and COPD as 20.7%. Prevalence of diabetes was more in 41-60 years i.e., 41.6%.  Prevalence of hypertension was more in 41-50 years i.e., 25.3%. Prevalence of diabetes was more in males i.e., 54.1%. Prevalence of hypertension was more in males i.e., 50.8%.Conclusions: Prevalence of all NCDs was more in above 40 years and more in males except COPD.


2020 ◽  
Author(s):  
Lamar Gerard Alfons Crombach ◽  
Jeroen Smits

Data for 91 low- and middle- income countries (LMICs) are used to investigate the effect of the demographic transition on economic growth at sub-national level. We introduce a detailed classification of demographic window (DW) phases, determine how these phases are distributed among and within LMICs, and analyze the relationship between the DW and economic growth for 1,921 urban and rural areas of sub-national regions. Many regions in Asia, Latin America and the Middle East have entered the window, but most of sub-Saharan Africa is still in the traditional or pre-window phase. Multilevel analyses reveal higher growth rates in areas with lower and decreasing dependency ratios. Demographic effects are stronger in rural, more developed and more educated regions. Findings indicate that, in the coming years, the DW might strengthen economic growth in rural areas of LMICs, and particularly if accompanied by investments in education and rural development.


VASA ◽  
2020 ◽  
Vol 49 (1) ◽  
pp. 50-56
Author(s):  
Ileana Desormais ◽  
Victor Aboyans ◽  
Maëlenn Guerchet ◽  
Bébène Ndamba-Bandzouzi ◽  
Pascal Mbelesso ◽  
...  

Summary: Background: There is no study available concerning specifically the role of underweight in PAD prevalence. Patients and methods: Individuals ≥ 65 years living in urban and rural areas of two countries in Central Africa (Central African Republic and the Republic of Congo) were invited. Demographic, clinical and biological data were collected, and ankle-brachial index measured. BMI was calculated as weight/height2 and participants were categorized according to the World Health Organization as with underweight (< 18.5 kg/m2), normal weight (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), and obese (≥ 30 kg/m2). Results: Among the 1815 participants (age 73.0 years, 61.8 % females), the prevalence of underweight was 34.1 %, higher in subjects with PAD than in PAD free subjects (37.1 % vs. 33.5 %, p = 0.0333). The overall prevalence of PAD was 14.3 %. Underweight and obesity were still significantly associated with PAD after adjustment to all potential confounding factors (OR: 2.09, p = 0.0009 respectively OR: 1.90, p = 0.0336) while overweight was no more significantly associated with PAD after multivariate analysis. Conclusions: While obesity is a well-known PAD associated marker, low BMI provides novel independent and incremental information on African subject’s susceptibility to present PAD, suggesting a “U-shaped” relationship between BMI and PAD in this population.


2021 ◽  
Vol 301 ◽  
pp. 02004
Author(s):  
Inna Čábelková ◽  
Zhanna Gardanova ◽  
Eduard Neimatov ◽  
Vladimir Esaulov

This research concentrates on the spatial accessibility assessment to healthcare facilities. Specifically, in doing so it compares the situation in urban and rural areas. In many countries, health inequalities continue to be a major public health challenge. Furthermore, there is also urbanization that occurs when people move from rural areas to urban areas. It leads to an increase in urban population and the extent of urban areas. Driven by population growth, many cities in low and middle-income countries are growing at record rates which puts large pressure on the healthcare system and facilities. Our research demonstrates that due to many political, economic, social and cultural factors, the current inequalities in health care between regions, urban and rural areas and different age and income groups are increasing. Thence, there is a pressing need for the improvement of the healthcare in the lagged regions and areas using such means as the advanced technologies, analysis of data, as well as targeted funding and assistance to those who need it the most.


Author(s):  
Lamar Crombach ◽  
Jeroen Smits

AbstractData for low- and middle- income countries (LMICs) are used to investigate the effect of the demographic transition on economic growth at sub-national level. We introduce a detailed classification of demographic window phases, determine how these phases are distributed among and within LMICs, and analyze the relationship between the demographic window of opportunity (DWO) and economic growth for 1921 urban and rural areas of sub-national regions within 91 LMICs. Many areas in Asia, Latin America and the Middle East have entered the window, but most of Sub-Saharan Africa is still in the traditional or pre-window phase. Our analyses reveal higher growth rates in areas passing through the DWO. Positive growth effects are particularly strong in rural and more educated regions and in countries with lower levels of corruption. Policy measures aimed at effectively using the DW for achieving growth should combine investments in education and rural development with better governance.


Crisis ◽  
2017 ◽  
Vol 38 (5) ◽  
pp. 330-343 ◽  
Author(s):  
Sarantsetseg Davaasambuu ◽  
Suvd Batbaatar ◽  
Susan Witte ◽  
Phillip Hamid ◽  
Maria A. Oquendo ◽  
...  

Abstract. Background: Although 75% of suicides occur in low- and middle-income countries, few studies have examined suicidal behaviors among young people in these countries. Aims: This study aimed to examine what individual characteristics were associated with suicidal plans and attempts among Mongolian youth and whether suicidal risks and behaviors varied by urban and rural locations. Method: Logistic regression analyses were utilized to investigate suicidal plans and attempts among 5,393 adolescents using the Global Student Health Survey – 2013. Results: Adolescents who lived in urban areas were at higher risk for suicidal plans and behaviors than those who lived in rural areas; however, the patterns of suicidal risks were similar. Specifically, individual characteristics, such as being female, feeling lonely and worried, smoking cigarettes, drinking alcohol, and having fights at school, were associated with suicidal plans and behaviors regardless of the residential places. Limitations: A number of important variables have not been included in the questionnaire such as depression, family and parental support, household income, family constructs etc. Conclusion: Given the comparable patterns of risk between urban and rural adolescents and the relatively high rates of suicidal plans and attempts, similar mental health services and interventions are necessitated for both urban and rural areas.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244333
Author(s):  
Sujarwoto Sujarwoto ◽  
Asri Maharani

Background Little attention has been paid to whether CBHIs improve awareness, treatment and control of hypertension in the contexts of low- and middle- income countries (LMICs). This study therefore aims to examine participation in CBHIs for non-communicable diseases (NCDs) and its association with awareness, treatment, and control of hypertension among Indonesians. Methods This study used data from the 2014 Indonesia Family Life Survey (IFLS), drawn from 30,351 respondents aged 18 years and older. Participation in CBHIs was measured by respondents’ participation in CBHIs for NCDs (Posbindu PTM and Posbindu Lansia) during the 12 months prior to the survey. Logistic regressions were used to identify the relationships between participation in CBHIs for NCDs and awareness, treatment, and control of blood pressure among respondents with hypertension. Results The age-adjusted prevalence of hypertension was 31.2% and 29.2% in urban and rural areas, respectively. The overall age-adjusted prevalence was 30.2%. Approximately 41.8% of respondents with hypertension were aware of their condition, and only 6.6% of respondents were receiving treatment. Participation in CBHIs for NCDs was associated with 50% higher odds of being aware and 118% higher odds of receiving treatment among adults with hypertension. There was no significant association between participation in CBHIs for NCDs and controlled hypertension. Conclusion Our data emphasise the importance of CBHIs for NCDs to improve the awareness and treatment of hypertension in the Indonesian population.


2020 ◽  
pp. 1-20
Author(s):  
Andrea M. McGrattan ◽  
Yueping Zhu ◽  
Connor D. Richardson ◽  
Devi Mohan ◽  
Yee Chang Soh ◽  
...  

Background: Mild cognitive impairment (MCI) is a cognitive state associated with increased risk of dementia. Little research on MCI exists from low-and middle-income countries (LMICs), despite high prevalence of dementia in these settings. Objective: This systematic review aimed to review epidemiological reports to determine the prevalence of MCI and its associated risk factors in LMICs. Methods: Medline, Embase, and PsycINFO were searched from inception until November 2019. Eligible articles reported on MCI in population or community-based studies from LMICs. No restrictions on the definition of MCI used as long as it was clearly defined. Results: 4,621 articles were screened, and 78 retained. In total, n = 23 different LMICs were represented; mostly from China (n = 55 studies). Few studies from countries defined as lower-middle income (n = 14), low income (n = 4), or from population representative samples (n = 4). There was large heterogeneity in how MCI was diagnosed; with Petersen criteria the most commonly applied (n = 26). Prevalence of aMCI (Petersen criteria) ranged from 0.6%to 22.3%. Similar variability existed across studies using the International Working Group Criteria for aMCI (range 4.5%to 18.3%) and all-MCI (range 6.1%to 30.4%). Risk of MCI was associated with demographic (e.g., age), health (e.g., cardio-metabolic disease), and lifestyle (e.g., social isolation, smoking, diet and physical activity) factors. Conclusion: Outside of China, few MCI studies have been conducted in LMIC settings. There is an urgent need for population representative epidemiological studies to determine MCI prevalence in LMICs. MCI diagnostic methodology also needs to be standardized. This will allow for cross-study comparison and future resource planning.


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