scholarly journals Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups

Neurology ◽  
2019 ◽  
Vol 93 (24) ◽  
pp. e2257-e2271 ◽  
Author(s):  
Jessica W. Lo ◽  
John D. Crawford ◽  
David W. Desmond ◽  
Olivier Godefroy ◽  
Hanna Jokinen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cognitive Impairment ◽  
Meta Analysis ◽  
Neuropsychological Test ◽  
Cognitive Domain ◽  
Domain Specific ◽  
Individual Participant ◽  
Potential Risk Factors ◽  
Domain Scores

ObjectiveTo address the variability in prevalence estimates and inconsistencies in potential risk factors for poststroke cognitive impairment (PSCI) using a standardized approach and individual participant data (IPD) from international cohorts in the Stroke and Cognition Consortium (STROKOG) consortium.MethodsWe harmonized data from 13 studies based in 8 countries. Neuropsychological test scores 2 to 6 months after stroke or TIA and appropriate normative data were used to calculate standardized cognitive domain scores. Domain-specific impairment was based on percentile cutoffs from normative groups, and associations between domain scores and risk factors were examined with 1-stage IPD meta-analysis.ResultsIn a combined sample of 3,146 participants admitted to hospital for stroke (97%) or TIA (3%), 44% were impaired in global cognition and 30% to 35% were impaired in individual domains 2 to 6 months after the index event. Diabetes mellitus and a history of stroke were strongly associated with poorer cognitive function after covariate adjustments; hypertension, smoking, and atrial fibrillation had weaker domain-specific associations. While there were no significant differences in domain impairment among ethnoracial groups, some interethnic differences were found in the effects of risk factors on cognition.ConclusionsThis study confirms the high prevalence of PSCI in diverse populations, highlights common risk factors, in particular diabetes mellitus, and points to ethnoracial differences that warrant attention in the development of prevention strategies.

scholarly journals Prevalence and risk factors of depression in Chinese patients with type 2 diabetes mellitus: a protocol of systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Xiaobo Liu ◽  
Chao Dong ◽  
Hong Jiang ◽  
Dongling Zhong ◽  
Yuxi Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Systematic Review ◽  
Potential Risk ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Chinese Patients ◽  
Prevalence Of Depression ◽  
Potential Risk Factors

Abstract Background The prevalence of type 2 diabetes mellitus (T2DM) is growing in China. Depression is a significant complication of T2DM, leading to poor management of T2DM. Thus, early detection and treatment of depression in patients with T2DM are essential and effective. Therefore, we plan to conduct a systematic review and meta-analysis to evaluate the prevalence of depression in Chinese patients with T2DM and explore potential risk factors of depression in T2DM. Methods We will search literatures recorded in MEDLINE, EMBASE, the Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), and WanFang Database from their inception onwards. We will manually search gray literatures, reference lists of identified studies, relevant websites, and consult experts in this field. We will include population-based, cross-sectional surveys that investigated the prevalence of depression in Chinese patients with T2DM or/and the possible risk factors of depression in T2DM. Two reviewers will screen studies, extract data, and evaluate risk of bias independently. Agency for Healthcare Research and Quality methodology checklist will be used to assess the risk of bias. If feasible, we will conduct random effects meta-analysis of observational data to summarize the pooled prevalence, and use odds ratio for categorical data to explore potential risk factors. Prevalence estimates will be stratified according to age, gender, and other factors. Statistical heterogeneity will be estimated using Cochran’s Q and I2 index. We will conduct meta-regression to investigate the potential sources of heterogeneity, sensitivity analyses to assess robustness of the synthesized results, and funnel plots and Egger’s test to assess publication bias. Discussion This systematic review and meta-analysis will provide comprehensive evidence of the prevalence and potential risk factors of depression in Chinese patients with T2DM. We expect to provide evidence for healthcare practitioners and policy makers to pay attention to the mental health of patients with T2DM. Our data will highlight the need and importance of early detection and intervention for depression in patients with T2DM. Systematic review registration PROSPERO CRD42020182979.

scholarly journals Risk factors for developing dementia in type 2 diabetes mellitus patients with mild cognitive impairment

2019 ◽  
Vol Volume 15 ◽  
pp. 167-175 ◽  
Author(s):  
Oana Albai ◽  
Mirela Frandes ◽  
Romulus Timar ◽  
Deiana Roman ◽  
Bogdan Timar
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment

scholarly journals Factors affecting the incidence of postoperative periprosthetic fractures following primary and revision hip arthroplasty: a systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Christos Bissias ◽  
Angelos Kaspiris ◽  
Athanasios Kalogeropoulos ◽  
Konstantinos Papoutsis ◽  
Nikolaos Natsioulas ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Revision Arthroplasty ◽  
Female Gender ◽  
Periprosthetic Fractures ◽  
Factors Affecting ◽  
Potential Risk Factors ◽  
Grade 3

Abstract Objectives The increasing number of hip arthroplasties (HA), due to the growing elderly population, is associated with the risk of femoral periprosthetic fractures (FPFs). The purpose of this study was to identify potential risk factors for the development of FPFs after HA. Methods A systematic review was conducted in five data bases (Medline, Embase, Cochrane, Cinahl, ICTRP) according to the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines up to May 2019, using the key words “risk factor,” “periprosthetic fracture,” and “hip replacement or arthroplasty.” Meta-analysis of the clinical outcomes of HA and subgroup analysis based on the factors that were implicated in FPFs was performed. Results Sixteen studies were included (sample size: 599,551 HA patients, 4253 FPFs, incidence 0.71%). Risk factors statistically associated with increased incidence of FPFs were female gender (+ 40%), previous revision arthroplasty surgery (× 3 times), and the presence of rheumatoid arthritis (× 2.1 times), while osteoarthritis (− 57%), cement application (− 59%), and insertion of Biomet (− 68%) or Thompson’s prosthesis (− 75%) were correlated with low prevalence of FPFs. Obesity, cardiac diseases, advanced age, bad general health (ASA grade ≥ 3), and use of Exeter or Lubinus prosthesis were not linked to the appearance of FPFs. Conclusion This meta-analysis suggested that female gender, rheumatoid arthritis, and revision arthroplasty are major risk factors for the development of FPFs after a HA. In those patients, frequent follow-ups should be planned. Further prospective studies are necessary to clarify all the risk factors contributing to the appearance of FPFs after HA.

Long-Term Cognitive Decline After Stroke: An Individual Participant Data Meta-Analysis

Stroke ◽  
2021 ◽  
Author(s):  
Jessica W. Lo ◽  
John D. Crawford ◽  
David W. Desmond ◽  
Hee-Joon Bae ◽  
Jae-Sung Lim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Recurrent Stroke ◽  
Meta Analysis ◽  
Older Age ◽  
Individual Participant Data ◽  
Individual Participant ◽  
Global Cognition

Background and Purpose: Poststroke cognitive impairment is common, but the trajectory and magnitude of cognitive decline after stroke is unclear. We examined the course and determinants of cognitive change after stroke using individual participant data from the Stroke and Cognition Consortium. Methods: Nine longitudinal hospital-based cohorts from 7 countries were included. Neuropsychological test scores and normative data were used to calculate standardized scores for global cognition and 5 cognitive domains. One-step individual participant data meta-analysis was used to examine the rate of change in cognitive function and risk factors for cognitive decline after stroke. Stroke-free controls were included to examine rate differences. Based on the literature and our own data that showed short-term improvement in cognitive function after stroke, key analyses were restricted to the period beginning 1-year poststroke to focus on its long-term effects. Results: A total of 1488 patients (mean age, 66.3 years; SD, 11.1; 98% ischemic stroke) were followed for a median of 2.68 years (25th–75th percentile: 1.21–4.14 years). After an initial period of improvement through up to 1-year poststroke, decline was seen in global cognition and all domains except executive function after adjusting for age, sex, education, vascular risk factors, and stroke characteristics (−0.053 SD/year [95% CI, −0.073 to −0.033]; P <0.001 for global cognition). Recurrent stroke and older age were associated with faster decline. Decline was significantly faster in patients with stroke compared with controls (difference=−0.078 SD/year [95% CI, −0.11 to −0.045]; P <0.001 for global cognition in a subgroup analysis). Conclusions: Patients with stroke experience cognitive decline that is faster than that of stroke-free controls from 1 to 3 years after onset. An increased rate of decline is associated with older age and recurrent stroke.

scholarly journals Association of Depression and Anxiety With Cognitive Impairment 6 Months After Stroke

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011748
Author(s):  
Owen A Williams ◽  
Nele Demeyere
Keyword(s):  
Cognitive Impairment ◽  
Acute Stroke ◽  
Spatial Attention ◽  
Anxiety Symptoms ◽  
Cognitive Domain ◽  
Stroke Severity ◽  
Depression And Anxiety ◽  
Post Stroke ◽  
Domain Specific ◽  
Post Stroke Depression

Objective:Investigate the associations between general cognitive impairment and domain specific cognitive impairment with post-stroke depression and anxiety at six-months post-stroke.Methods:Participants were confirmed acute stroke patients from the OCS-CARE study who were recruited on stroke wards in a multi-site study and followed up at a 6 months post-stroke assessment. Depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale sub-scales, with scores greater than seven indicating possible mood disorders. General cognitive impairment at follow-up was assessed using the Montreal Cognitive Assessment, stroke-specific cognitive domain impairments was assessed using the Oxford Cognitive Screen. Linear regression was used to examine the associations between cognition and depression/anxiety symptoms at 6-months, controlling for acute-stroke severity and ADL-impairment, age, sex, education, and co-occurring post-stroke depression/anxiety.Results:437 participants mean age=69.28 years (S.D.=12.17), 226 male (51.72%), were included in analyses. Six-month post-stroke depression (n=115, 26%) was associated with six-month impairment on the MoCA (beta [b] =0.96, standard error [SE] =0.31, p=0.006), and all individual domains assessed by the OCS: spatial attention (b=0.67, SE=0.33, p =0.041), executive function (b=1.37, SE=0.47, p=0.004), language processing (b=0.87, SE=0.38, p=0.028), memory (b=0.76, SE=0.37, p=0.040), number processing (b=1.13, SE=0.40, p=0.005), praxis (b=1.16, SE =0.49, p=0.028). Post-stroke anxiety (n=133, 30%) was associated with impairment on the MoCA (b=1.47, SE=0.42, p=0.001), and spatial attention (b=1.25, SE=0.45, p=0.006), these associations did not remain significant after controlling for co-occurring post-stroke depression.Conclusion:Domain-general and domain-specific post-stroke cognitive impairment was found to be highly related to depressive symptomatology but not anxiety symptomatology.

scholarly journals Prevalence and Risk Factors of Depression in Chinese Patients With Type 2 Diabetes Mellitus: a Protocol of Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Xiaobo LIU ◽  
Chao Dong ◽  
Hong Jiang ◽  
Dongling Zhong ◽  
Yuxi Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Early Detection ◽  
Meta Analysis ◽  
Prevalence Of Depression ◽  
Associated Risk Factors

Abstract Background: The prevalence of type 2 diabetes mellitus (T2DM) is growing in China. Both physical and psychological complications occur along with the development of T2DM. The patients with depression account for a significant proportion of T2DM. Depressive symptoms interfere with blood glucose management, leading to poorer treatment outcome and even relate to the occurrence of other serious complications of T2DM population. Among these T2DM patients with depression, early detection and treatment is essential and effective. Knowledge of the current prevalence of depression in T2DM patients as well as associated risk factors may be meaningful for healthcare planning. Therefore, we plan to conduct a systematic review and meta-analysis to evaluate the Chinese prevalence of depression in T2DM and explore associated risk factors.Methods: We will search literatures recorded in MEDLINE/PubMed, EMBASE, the Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), and Wanfang database (Wanfang Data). The grey literatures and reference list will be manually searched. We will include population-based, cross-sectional surveys that investigated the Chinese prevalence of depression in T2DM or/and researched the possible risk factors. Two reviewers will screen studies, extract data and evaluate quality independently. We will assess inter-rater agreement between reviewers for study inclusion, data extraction, and study quality assessment using Kappa statistics. The primary outcome will be the pooled Chinese prevalence of depression in T2DM patients. The secondary outcome will contain the potential risk factors for depression in patients with T2DM. R software (version 3.6.1) and STATA software (version 12) will be used for data analysis.Discussion: This systematic review will provide comprehensive evidence of the Chinese prevalence and risk factors of depression in patients with T2DM. we expect to provide evidence basis for healthcare practitioners and policy makers to pay attention to the mental health of T2DM. Our data will highlight the need and importance of early detection and intervention for depression in patients with T2DM. Systematic review registration: PROSPERO CRD42020182979.

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