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.

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 Knowledge about modifiable risk factors for non-communicable diseases adults living with HIV in Rwanda

1970 ◽  
Vol 19 (4) ◽  
pp. 3181-3189
Author(s):  
Juvenal Biraguma ◽  
Eugene Mutimura ◽  
José M Frantz
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Communicable Diseases ◽  
Health Concern ◽  
People Living With Hiv ◽  
Modifiable Risk Factors ◽  
Diabetes Research ◽  
Non Communicable Diseases ◽  
Increased Risk ◽  
Living With Hiv

Background: Non-communicable diseases (NCD) are of international public health concern. Of more concern are people living with HIV (PLHIV), who have the increased risk of developing NCDs, such as hypertension, stroke and diabetes. Research has revealed that there is a relationship between knowledge of NCD risk factors and risk perceptions in the general population. Therefore, an assessment of PLHIV’s NCD risk factors knowledge is quite critical, to design effective NCD prevention programmes.Objective: To assess the level of knowledge of modifiable risk factors for NCDs and its associated factors among adults living with HIV in Rwanda.Methods: A cross-sectional quantitative design was used to collect the data. The study targeted PLHIV who visited the out-patients’ public health centres in three purposively selected provinces of Rwanda. The knowledge assessment questionnaire relating to risk factors for chronic diseases of lifestyle was used to collect the data. Data were analysed using SPSS version 23.Results: Of the 794 respondents, 64.6% were women, and the mean age was 37.9 (±10.8) years. The results revealed that the majority of the respondents (65.0%) had low levels of knowledge about NCD risk factors, while some (35.6%) were of the opinion that they had a low risk of contracting NCDs. Good knowledge was significantly associated with high educational status, a low CD4+ cell count (< 350 cells/mm3) and normotension.Conclusion: The current study findings highlight the need for comprehensive health education, to raise awareness of non-communicable diseases’ risk factors for adults living with HIV in Rwanda.Keywords: Non-communicable diseases, Risk factors, HIV infection, Knowledge, Rwanda.

scholarly journals A Modified CAIDE Risk Score as a Screening Tool for Cognitive Impairment in Older Adults

2021 ◽  
pp. 1-14
Author(s):  
Magdalena I. Tolea ◽  
Jaeyeong Heo ◽  
Stephanie Chrisphonte ◽  
James E. Galvin
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Risk Score ◽  
Clinical Sample ◽  
Community Sample ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Risk Scores ◽  
Predictive Values

Background: Although an efficacious dementia-risk score system, Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) was derived using midlife risk factors in a population with low educational attainment that does not reflect today’s US population, and requires laboratory biomarkers, which are not always available. Objective: Develop and validate a modified CAIDE (mCAIDE) system and test its ability to predict presence, severity, and etiology of cognitive impairment in older adults. Methods: Population consisted of 449 participants in dementia research (N = 230; community sample; 67.9±10.0 years old, 29.6%male, 13.7±4.1 years education) or receiving dementia clinical services (N = 219; clinical sample; 74.3±9.8 years old, 50.2%male, 15.5±2.6 years education). The mCAIDE, which includes self-reported and performance-based rather than blood-derived measures, was developed in the community sample and tested in the independent clinical sample. Validity against Framingham, Hachinski, and CAIDE risk scores was assessed. Results: Higher mCAIDE quartiles were associated with lower performance on global and domain-specific cognitive tests. Each one-point increase in mCAIDE increased the odds of mild cognitive impairment (MCI) by up to 65%, those of AD by 69%, and those for non-AD dementia by >  85%, with highest scores in cases with vascular etiologies. Being in the highest mCAIDE risk group improved ability to discriminate dementia from MCI and controls and MCI from controls, with a cut-off of ≥7 points offering the highest sensitivity, specificity, and positive and negative predictive values. Conclusion: mCAIDE is a robust indicator of cognitive impairment in community-dwelling seniors, which can discriminate well between dementia severity including MCI versus controls. The mCAIDE may be a valuable tool for case ascertainment in research studies, helping flag primary care patients for cognitive testing, and identify those in need of lifestyle interventions for symptomatic control.

Otitis media in Indigenous Australian children: review of epidemiology and risk factors

2013 ◽  
Vol 128 (S1) ◽  
pp. S16-S27 ◽  
Author(s):  
Jake Jervis-Bardy ◽  
L Sanchez ◽  
A S Carney
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Otitis Media ◽  
Bacterial Load ◽  
Grey Literature ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Health Concern ◽  
Indigenous Australian ◽  
Indigenous Children

AbstractBackground:Otitis media represents a major health concern in Australian Indigenous children (‘Indigenous children’), which has persisted, despite public health measures, for over 30 years.Methods:Global searches were performed to retrieve peer-reviewed and ‘grey’ literature investigating the epidemiology of and risk factors for otitis media in Indigenous children, published between 1985 and 2012.Results:In Indigenous children, the prevalence of otitis media subtypes is 7.1–12.8 per cent for acute otitis media, 10.5–30.3 per cent for active chronic otitis media and 31–50 per cent for tympanic membrane perforation. The initial onset of otitis media in Indigenous children occurs earlier and persists for longer after the first year of life, compared with non-Indigenous children. Indigenous children are colonised by otopathogens more frequently, at younger ages and with a higher bacterial load. Poor community and domestic infrastructure, overcrowding and exposure to tobacco smoke increase the risk of otitis media in Indigenous children; however, the availability of swimming pools plays no role in the prevention or management of otitis media.Conclusion:Despite awareness of the epidemiological burden of otitis media and its risk factors in Indigenous children, studies undertaken since 1985 demonstrate that otitis media remains a significant public health concern in this population.

Abstract 615: Association Between Multiple Modifiable Risk Factors of Cardiovascular Disease and Hypertension in a Rural Population of the United States

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Hadii M Mamudu ◽  
Timir Paul ◽  
Liang Wang ◽  
Sreenivas P Veeranki ◽  
Hemang B Panchal ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Sedentary Lifestyle ◽  
Subclinical Atherosclerosis ◽  
The United States ◽  
Community Dwelling ◽  
Modifiable Risk Factors ◽  
Obesity And Diabetes ◽  
Asymptomatic Individuals ◽  
Study Participants

Background: Hypertension (HTN) is one of the major risk factors for cardiovascular diseases (CVD) that afflicts one-third of the population in United States (US). This study examined the association between multiple modifiable risk factors for HTN in a rural hard-to-reach population. Methods: During January 2011 and December 2012, 1629 community-dwelling asymptomatic individuals from central Appalachia participated in screening for subclinical atherosclerosis, during which the participants were asked to report whether a physician or health worker has informed them that they had HTN (yes/no). Additionally, baseline data consisting of two non-modifiable risk factors (sex, age) and 5 modifiable risk factors (obesity, diabetes, hypercholesterolemia, smoking, and sedentary lifestyle) were collected. Descriptive statistics involving prevalence of risk factors and multivariate logistic regression analyses to determine the strength of association between hypertension and the number of risk factors were conducted. Results: Of the 1629 study participants, about half (49.8%) had hypertension. Among hypertensive patients, 31.4% were obese and 62.3% having hypercholesterolemia. Overall, having 2 risk factors consisted the largest group of participants with HTN. After adjusting for the non-modifiable risk factors (sex, age), obesity and diabetes increased the odds of having HTN by more than two folds ([OR=2.02, CI=1.57-2.60] and [OR=2.30, CI=1.66-3.18], respectively) and hypercholesterolemia and sedentary lifestyle increased the odds for HTN by more than one fold ([OR=1.26, CI=1.02-1.56) and [OR=1.38, CI=1.12-1.70], respectively). Compared to those without HTN, having 2, 3, and 4 or 5 modifiable risk factors were significantly associated with increased odds of having HTN by about two-folds [OR=1.72, CI=1.21-2.44], two and half folds [OR=2.55, 1.74-3.74], and six folds [OR=5.96, 3.42-10.41], respectively. Conclusion: The study suggests that odds of having HTN increases with the number of modifiable risk factors for CVD. Hence, by implementing an integrated CVD program for treating and controlling modifiable risk factors of HTN would decrease the future risk of CVD and help to achieve the 2020 Impact Goal of the American Health Association.

scholarly journals Risk factors for cognitive impairment in older people with diabetes: a community-based study

2019 ◽  
Vol 10 ◽  
pp. 204201881983664 ◽  
Author(s):  
Shuangling Xiu ◽  
Qiuju Liao ◽  
Lina Sun ◽  
Piu Chan
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cognitive Impairment ◽  
Older People ◽  
Multiple Logistic Regression Analysis ◽  
Apoe Genotype ◽  
Community Dwelling ◽  
Urban Living ◽  
Obesity Hypertension

Aim: The aim of this study was to investigate the risk factors for cognitive impairment in older people with diabetes. Methods: This cross-sectional study included 2626 community-dwelling participants with diabetes aged ⩾55 years, living in Beijing, China. The participants were screened for risk factors, including smoking, obesity, hypertension, stroke, coronary heart disease, dyslipidemia, depression, apolipoprotein E (APOE) genotype, and low physical activity. Cognitive function was assessed with the scholarship-adjusted Mini-Mental State Examination (MMSE): MMSE ⩽17 for iliterate participants; MMSE ⩽20 for primary school graduates (⩾6 years of education); and MMSE ⩽24 for junior school graduates or above (⩾9 years of education). Results: The prevalence of cognitive impairment in older people with diabetes was 9.90%. Multiple logistic regression analysis demonstrated that stroke [odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.20–2.43], less than 0.5 h exercise per day (OR = 1.89, 95% CI = 1.37–2.61), and depression (OR = 1.64, 95% CI = 1.06–2.54), but not smoking, obesity, hypertension, dyslipidemia, and coronary heart disease, were independent risks for cognitive impairment in older people with diabetes. In addition, being married (OR = 0.66, 95% CI = 0.47–0.93) and urban living (OR = 0.33, 95% CI = 0.22–0.48) could decrease the risk of cognitive impairment. Conclusions: Stroke, depression, and less than 0.5 h exercise per day were independent risks for cognitive impairment in older people with diabetes, whereas being married and urban living were protective.

Epidemiology and stroke risk factors

2017 ◽  
Author(s):  
Hugh Markus ◽  
Anthony Pereira ◽  
Geoffrey Cloud
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Stroke Risk ◽  
Relative Risk Reduction ◽  
Stroke Care ◽  
Modifiable Risk Factors ◽  
Comprehensive Review ◽  
Stroke Risk Factors ◽  
The United Kingdom ◽  
Numbers Needed To Treat

In this opening chapter on the epidemiology and risk factors for stroke, the ‘size of the problem’ in public health terms both in the United Kingdom and worldwide is set out. Incidence, prevalence, and mortality of stroke are discussed. Epidemiological terms and definitions as applied to stroke care are reviewed and illustrated, including absolute and relative risk reduction and numbers needed to treat. This chapter also discusses aetiological subtyping of stroke which represents a syndrome caused by multiple different underlying pathologies. It ends with a comprehensive review of the major and minor modifiable and non-modifiable risk factors for stroke disease.

Active cancer prevention

2013 ◽  
Author(s):  
Graham Colditz ◽  
Courtney Beers
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
First Century ◽  
Evidence Based ◽  
Modifiable Risk Factors ◽  
Social Commitment ◽  
Incidence And Mortality ◽  
Legislative Support ◽  
Behaviour Changes ◽  
Active Cancer

Chapter 2 describes the key potentially modifiable risk factors that are responsible for more than half of the seven million deaths from cancer worldwide. Using evidence-based strategies to impact individual and population behaviour changes, public health efforts driven by sound knowledge, legislative support/backing, and social commitment have the potential to rapidly reduce the cancer incidence and mortality in the twenty-first century. Our aging population and the burden of cancer that comes due to aging demands we act now to achieve this global benefit.

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