scholarly journals Aging with multiple sclerosis: A longitudinal study of physical function, mental health, and memory in two cohorts of US women

2021 ◽  
pp. 135245852110077
Author(s):  
Marianna Cortese ◽  
Kjetil Bjornevik ◽  
Tanuja Chitnis ◽  
Alberto Ascherio ◽  
Kassandra L Munger

Background: It is unknown how individuals with multiple sclerosis (MS) age compared to unaffected peers. Objectives: The objective of the study is to describe the impact of MS on health and functioning in aging women. Methods: We used 10-item Physical Functioning Scale (PF10) scores (from the Short Form-36 (SF-36)) and other indicators of general, physical, mental health, and memory collected repeatedly over 25 years with self-administered questionnaires among participants in the Nurses’ Health Study ( n = 121,700 recruited at ages 30–55) and Nurses’ Health Study II ( n = 116,429 recruited at ages 25–42) to compare women with MS ( n = 733) to unaffected peers in their health and disability, and describe/quantify the burden of aging with MS. Results: Women with MS had a consistently lower PF10 by 0.9–1.7 standard deviations with greater overall variability than unaffected women. PF10-scores gradually decreased with increasing age in both groups, but MS cases declined 3–4 times faster in midlife, while decline was similar in old age. The physical function score of 45-year-old women with MS was comparable to that of 75-year-old unaffected women; 70-year-old women with MS scored similarly to 85-year-old unaffected women. MS cases also reported worse health/more disability throughout adulthood on the other indicators. Conclusion: The age-related decline in physical health is accelerated by 15–30 years in MS patients compared to unaffected peers.

Author(s):  
Panagiotis Zis ◽  
Artemios Artemiadis ◽  
Panagiotis Bargiotas ◽  
Antonios Nteveros ◽  
Georgios M. Hadjigeorgiou

Objectives: The aim of this ecological study was to investigate what the impact of digital learning due to the COVID-19 pandemic was on the burnout and overall mental health (MH) of medical students. Background: During the unprecedented era of the COVID-19 pandemic, the majority of countries worldwide adopted very strong measures. Universities closed their doors, and education continued through digital learning lectures. Methods: An anonymous questionnaire was administered to all 189 eligible candidates before and during the COVID-19 pandemic. Mental health was assessed via the MH domain of the 36-item Short Form Health Survey (SF-36) and burnout with the Maslach Burnout Inventory—Student Survey (MBI-SS). Results: The overall response rate was 81.5%. The overall burnout prevalence did not differ significantly between the two periods (pre-COVID-19 18.1% vs. COVID-19 18.2%). However, the burnout prevalence dropped significantly in year 4 (pre-COVID-19 40.7% vs. COVID-19 16.7%, p = 0.011), whereas it increased significantly in year 6 (pre-COVID-19 27.6% vs. COVID-19 50%, p = 0.01). When looking at each MBI-SS dimension separately, we found that emotional exhaustion decreased significantly in year 4 but increased in year 6, and cynicism increased in all years. The overall MH deteriorated significantly between the two periods (pre-COVID-19 58.8 ± 21.6 vs. COVID-19 48.3 ± 23, p < 0.001). Conclusions: Digital learning in medical studies carries significant risks. Not only does the MH deteriorate, but cynicism levels also increase. Emotional exhaustion was found to increase particularly in final year students, who struggle with the lack of clinical experience just before they start working as qualified junior doctors.


Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 414
Author(s):  
Maria Melania Lica ◽  
Annamaria Papai ◽  
Andreea Salcudean ◽  
Maria Crainic ◽  
Cristina Georgeta Covaciu ◽  
...  

Assessing mental health in children and adolescents with insulin-dependent diabetes (IDD) is an issue that is underperformed in clinical practice and outpatient clinics. The evaluation of their thoughts, emotions and behaviors has an important role in understanding the interaction between the individual and the disease, the factors that can influence this interaction, as well as the effective methods of intervention. The aim of this study is to identify psychopathology in adolescents with diabetes and the impact on treatment management. A total of 54 adolescents with IDD and 52 adolescents without diabetes, aged 12–18 years, completed APS–SF (Adolescent Psychopathology Scale–Short Form) for the evaluation of psychopathology and adjustment problems. There were no significant differences between adolescents with diabetes and control group regarding psychopathology. Between adolescents with good treatment adherence (HbA1c < 7.6) and those with low treatment adherence (HbA1c > 7.6), significant differences were found. In addition, results showed higher scores in girls compared with boys with IDD with regard to anxiety (GAD), Major Depression (DEP), Post-Traumatic Stress Disorder (PTSD), Eating Disturbance (EAT), Suicide (SUI) and Interpersonal Problems (IPP). No significant differences were found regarding the duration of the disease. Strategies such as maladaptive coping, passivity, distorted conception of the self and the surrounding world and using the negative problem-solving strategies of non-involvement and abandonment had positive correlation with poor glycemic control (bad management of the disease). The study highlighted the importance of promoting mental health in insulin-dependent diabetes management.


2017 ◽  
Vol 19 (5) ◽  
pp. 225-231 ◽  
Author(s):  
Rachel M. Gilbertson ◽  
Maryanna D. Klatt

Background: Mindfulness in Motion is an 8-week mindfulness-based intervention that uses yoga movement, mindfulness meditation, and relaxing music. This study examined the feasibility of using Mindfulness in Motion in people with multiple sclerosis (MS) and the effect of this program on stress, anxiety, depression, fatigue, and quality of life in people with MS. Methods: Twenty-two people with MS completed the 8-week mindfulness program as well as assessments 1 week before and after the intervention. Results: Pre/post comparison of four self-reported questionnaires—the Mental Health Inventory, 36-item Short Form Health Status Survey, Modified Fatigue Impact Scale, and Five Facet Mindfulness Questionnaire—showed significant improvement in physical functioning, vitality, and mental health. Specifically, improvements were seen in anxiety, depression, and positive affect; cognitive, psychosocial, and overall functioning regarding fatigue; and mindfulness in the areas of observing, acting with awareness, nonjudgment, and nonreactivity. Conclusions: Due to the uncertainty in disease progression associated with MS, and the multiplicity of mental and physical symptoms associated with it, programming that addresses anxiety, depression, and fatigue is a key area of future research in MS disease management. Mindfulness in Motion proved to be a feasible program yielding positive results, supporting the need for research to determine the extent to which the program can improve quality-of-life outcomes for people with MS.


2020 ◽  
Vol 35 (6) ◽  
pp. 776-776
Author(s):  
C Roman ◽  
P Arnett

Abstract Objective Advancements in treatments for multiple sclerosis (MS) have led to an increase in the number of older adults living with the disease. Exercise has been shown to be remarkably beneficial for “healthy aging,” while sedentary behavior has proved to have more deleterious effects. Despite evidence for the impact of these factors, their influence on older adults with MS is largely unknown. The current study utilizes volumetric measures and graph theory to investigate the relationship between physical activity/sedentary behavior, structural brain indices, and cognition in older adults with MS. Method Twenty-seven older adults (55+) with MS were scanned during a structural MRI protocol and cognitively evaluated using the Multiple Sclerosis Functional Composite and Symbol Digit Modalities Test. Graph theory metrics were calculated to examine white matter network properties. FreeSurfer was used to calculate volumes for subcortical structures. Exercise was quantified as the ‘days per week engaged in moderate activity,’ while sedentary behavior was measured as ‘hours per day sitting.’ Results Multiple regression interaction analyses were conducted. Results showed an exercise by age interaction, such that exercise protected against the negative effects of age on thalamic volume and assortivity. Hours sitting per day was shown to add to the negative effects of aging on structural networks even after controlling for exercise. Lastly, exercise was observed to be protective against age-related cognitive decline in this sample. Conclusions This is one of the first studies to examine exercise/sedentariness and brain indices in older adults with MS, pointing to possible brain altering and protective interventions for this group.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S192-S192
Author(s):  
Courtney S Thomas Tobin ◽  
Myles D Moody

Abstract To evaluate the impact of early life racial discrimination (ELRD) on mental health among Black adults. Data were from the Nashville Stress and Health Study (n=618). OLS regression models examined the relationship between ELRD and adult psychological distress; logistic regression estimated the probability of past-year major depressive disorder (MDD). We also assessed whether ELRD moderated the relationship between adult discrimination and mental health. Childhood (b=1.07, SE=0.51, p=0.04) and adolescent ELRD (b=1.32, SE=0.42, p=0.002) were associated with adult distress. Individuals who experienced childhood ERLD had 88% lower odds of adult MDD than individuals with no ELRD. Significant interaction analyses showed that ELRD was generally protective against adult discrimination. While ELRD importantly shapes distress and MDD among Black adults, patterns vary by outcome. Results indicate that adult distress and MDD develop through cumulative adversity processes that are further influenced by sensitive periods in the life course.


2003 ◽  
Vol 83 (8) ◽  
pp. 696-706 ◽  
Author(s):  
C Allyson Jones ◽  
Donald C Voaklander ◽  
Maria E Suarez-Almazor

Abstract Background and Purpose. Decreasing hospital stays for patients with total knee arthroplasties (TKAs) have a direct effect on rehabilitation. The identification of modifiable determinants of postsurgical functional status would help physical therapists plan for discharge from hospitals. The purpose of this study was to identify preoperative determinants of functional status after a TKA. Participants. Using a community-based, prospective cohort study, data were collected from 276 patients who received a primary TKA in a Canadian health care region. Data were collected in the month before surgery and 6 months after surgery. Methods. Function was measured using the function subscale of a disease-specific measure—the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index—and a generic health status measure—the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Independent variables examined included demographic variables (eg, age, sex), medical variables (eg, diagnosis, number of comorbid conditions, ambulatory status), surgical variables (eg, type of implant, number of complications), and knee range of motion. Results. At 6 months after surgery, the average WOMAC physical function score was 70.5 (SD=18.2) and the average SF-36 physical function score was 44.8 (SD=25.3). Using multiple regression analyses, baseline function, walking device, walking distance, and comorbid conditions predicted 6-month function (WOMAC: R2=.20; SF-36 physical function: R2=.27). Discussion and Conclusion. Patients who have lower preoperative function may require more intensive physical therapy intervention because they are less likely to achieve functional outcomes similar to those of patients who have less preoperative dysfunction.


2009 ◽  
Vol 35 (5) ◽  
pp. 436-441 ◽  
Author(s):  
Maria Penha Uchoa Sales ◽  
Maria Irenilza Oliveira ◽  
Isabela Melo Mattos ◽  
Cyntia Maria Sampaio Viana ◽  
Eanes Delgado Barros Pereira

OBJECTIVE: To evaluate changes in health-related quality of life (HRQoL) after twelve months of smoking cessation. METHODS: This was a prospective study to evaluate the effectiveness of a smoking cessation program on the quality of life of 60 self-referred subjects, at a public hospital, during the period of August 2006 to December 2007. The program consisted of 2-h group sessions once a week during the first month and then every 15 days over six months, followed by monthly phone contacts for another six months. The treatment was based on behavior modification and the use of bupropion in combination with nicotinic replacement therapy. Abstinence was verified by exhaled CO measurements. Patient HRQoL was quantified using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) questionnaire. Differences in quality of life scores between quitters and non-quitters at twelve months after the initial intervention were evaluated using analysis of covariance with baseline characteristics as covariates. RESULTS: Self-reported quality of life scores were significantly higher among the 40 quitters than among the 20 non-quitters. The following SF-36 domains were most affected: role-emotional (p = 0.008); general health (p = 0.006); vitality (p < 0.001); and mental health (p = 0.002). At twelve months after the smoking cessation intervention, the SF-36 mental component and physical component summary scores were higher among quitters than among non-quitters (p = 0.004 and p = 0.001, respectively). CONCLUSIONS: Our findings illustrate that smoking abstinence is related to better HRQoL, especially in aspects of mental health.


2004 ◽  
Vol 29 (1) ◽  
pp. 76-89 ◽  
Author(s):  
Jennifer L. Copeland

Aging is associated with a decline in bone mass, muscle mass, strength, and physical function, and women are more likely to suffer from these physical changes than men. The model presented in this paper illustrates the age related changes in anabolic hormones and how this may partly explain the diminished physical function of older women. The model can also be used to identify potential sites of intervention that could delay the atrophy of the musculoskeletal system. Various pharmacological hormone therapies have been shown to be beneficial, but there may be health risks associated with their use. There is evidence that regular physical activity is related to higher levels of anabolic hormones in older persons, therefore exercise could be an alternative to drugs for slowing the age related changes in the endocrine system. However, some research suggests that the hormone response to exercise is blunted in older women. This lower hormonal response may not be a consequence of aging per se but instead may result from secondary characteristics of aging such as a decline in physical fitness and exercise intensity or changes in body composition. Further research is needed to determine whether exercise-induced increases in endogenous hormones have clinical significance in improving muscle or bone mass in aging women. Key words: hormone replacement therapy, exercise, sex steroids, growth hormone, IGF-I


2016 ◽  
Vol 124 (6) ◽  
pp. 1627-1633 ◽  
Author(s):  
Amparo Wolf ◽  
Sandy Goncalves ◽  
Fateme Salehi ◽  
Jeff Bird ◽  
Paul Cooper ◽  
...  

OBJECT The relationship between headaches, pituitary adenomas, and surgical treatment of pituitary adenomas remains unclear. The authors assessed the severity and predictors of self-reported headaches in patients referred for surgery of pituitary adenomas and evaluated the impact of endoscopic transsphenoidal surgery on headache severity and quality of life (QOL). METHODS In this prospective study, 79 patients with pituitary adenomas underwent endoscopic transsphenoidal resection and completed the Headache Impact Test (HIT-6) and the 36-Item Short Form Health Survey (SF-36) QOL questionnaire preoperatively and at 6 weeks and 6 months postoperatively. RESULTS Preoperatively, 49.4% of patients had mild headache severity, 13.9% had moderate severity, 13.9% had substantial severity, and 22.8% had intense severity. Younger age and hormone-producing tumors predisposed greater headache severity, while tumor volume, suprasellar extension, chiasmal compression, and cavernous sinus invasion of the pituitary tumors did not. Preoperative headache severity was found to be significantly associated with reduced scores across all SF-36 QOL dimensions and most significantly associated with mental health. By 6 months postoperatively, headache severity was reduced in a significant proportion of patients. Of the 40 patients with headaches causing an impact on daily living (moderate, substantial, or intense headache), 70% had improvement of at least 1 category on HIT-6 by 6 months postoperatively, while headache worsened in 7.6% of patients. The best predictors of headache response to surgery included younger age, poor preoperative SF-36 mental health score, and hormone-producing microadenoma. CONCLUSIONS The results of this study confirm that surgery can significantly improve headaches in patients with pituitary adenomas by 6 months postoperatively, particularly in younger patients whose preoperative QOL is impacted. A larger multicenter study is underway to evaluate the long-term effect of surgery on headaches in this patient group.


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