Risk factors of dementia: a comparative study among the geriatric age group in Ernakulam, Southern India

Background: Dementia is the global deterioration of the individual’s intellectual, emotional and cognitive faculties in a state of normal consciousness. Dementia impacts personal, family and societal life. It reduces life span, induces caregiver’s strain at family level and over utilizes health care facility. This study was aimed at describing the risk factors attributing to dementing disorders for developing preventive measures to slow down the incidence of dementia. Methods: The study was conducted in geriatrics OPD of a tertiary hospital in South India. A total of 50 dementia patients and 50 controls aged more than 65 years were selected for the study in a period of 6 months. A semi-structured questionnaire was used to collect data. Results: 40% in the age group of 65-74 years, 61% in the age group of 75-84 years and 63.6% in the age >85 years had dementia. 43.5% of males and 55.5% of females had dementia. Multivariate analysis was done to find out the independent predictors of dementia. Among the morbidities dyslipidemia 3.93 (1.12-13.87) and COPD/bronchial asthma 4.57 (1.02-20.55), less than 5 days of fruit consumption 14.98 (38-59), hearing loss 4.67 (1.15-18.91) were found to be independent risk factors for dementia. Living alone was found to be a protective factor 0.029 (0.003-0.29). Conclusions: Our study reported various risk factors of dementia that were in agreement with findings from other studies conducted in India. Avoidable risk factors such as living alone, fruit intake and control of comorbidities such as hypertension, dyslipidemia and COPD/bronchial asthma needs more attention in old age group.

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Independent Behavior of Commensal Flora for Carriage of Fluoroquinolone-Resistant Bacteria in Patients at Admission

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00823-10 ◽

2010 ◽

Vol 54 (12) ◽

pp. 5193-5200 ◽

Cited By ~ 22

Author(s):

Victoire de Lastours ◽

Françoise Chau ◽

Florence Tubach ◽

Blandine Pasquet ◽

Etienne Ruppé ◽

...

Keyword(s):

Risk Factors ◽

Bacterial Resistance ◽

Care Facility ◽

Health Care Facility ◽

Epidemiological Data ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

E Coli ◽

Commensal Flora ◽

Resistant Strains

ABSTRACT The important role of commensal flora as a natural reservoir of bacterial resistance is now well established. However, whether the behavior of each commensal flora is similar to that of other floras in terms of rates of carriage and risk factors for bacterial resistance is unknown. During a 6-month period, we prospectively investigated colonization with fluoroquinolone-resistant bacteria in the three main commensal floras from hospitalized patients at admission, targeting Escherichia coli in the fecal flora, coagulase-negative Staphylococcus (CNS) in the nasal flora, and α-hemolytic streptococci in the pharyngeal flora. Resistant strains were detected on quinolone-containing selective agar. Clinical and epidemiological data were collected. A total of 555 patients were included. Carriage rates of resistance were 8.0% in E. coli, 30.3% in CNS for ciprofloxacin, and 27.2% in streptococci for levofloxacin; 56% of the patients carried resistance in at least one flora but only 0.9% simultaneously in all floras, which is no more than random. Risk factors associated with the carriage of fluoroquinolone-resistant strains differed between fecal E. coli (i.e., colonization by multidrug-resistant bacteria) and nasal CNS (i.e., age, coming from a health care facility, and previous antibiotic treatment with a fluoroquinolone) while no risk factors were identified for pharyngeal streptococci. Despite high rates of colonization with fluoroquinolone-resistant bacteria, each commensal flora behaved independently since simultaneous carriage of resistance in the three distinct floras was uncommon, and risk factors differed. Consequences of environmental selective pressures vary in each commensal flora according to its local specificities (clinical trial NCT00520715 [http://clinicaltrials.gov/ct2/show/NCT00520715 ]).

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Risk factors for death in patients with severe asthma

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132014000400003 ◽

2014 ◽

Vol 40 (4) ◽

pp. 364-372 ◽

Cited By ~ 19

Author(s):

Andréia Guedes Oliva Fernandes ◽

Carolina Souza-Machado ◽

Renata Conceição Pereira Coelho ◽

Priscila Abreu Franco ◽

Renata Miranda Esquivel ◽

...

Keyword(s):

Risk Factors ◽

Health Care ◽

Asthma Control ◽

Severe Asthma ◽

Airflow Obstruction ◽

Care Facility ◽

Health Care Facility ◽

Control Program ◽

Male Gender ◽

Respiratory Causes

OBJECTIVE: To identify risk factors for death among patients with severe asthma. METHODS: This was a nested case-control study. Among the patients with severe asthma treated between December of 2002 and December of 2010 at the Central Referral Outpatient Clinic of the Bahia State Asthma Control Program, in the city of Salvador, Brazil, we selected all those who died, as well as selecting other patients with severe asthma to be used as controls (at a ratio of 1:4). Data were collected from the medical charts of the patients, home visit reports, and death certificates. RESULTS: We selected 58 cases of deaths and 232 control cases. Most of the deaths were attributed to respiratory causes and occurred within a health care facility. Advanced age, unemployment, rhinitis, symptoms of gastroesophageal reflux disease, long-standing asthma, and persistent airflow obstruction were common features in both groups. Multivariate analysis showed that male gender, FEV1 pre-bronchodilator < 60% of predicted, and the lack of control of asthma symptoms were significantly and independently associated with mortality in this sample of patients with severe asthma. CONCLUSIONS: In this cohort of outpatients with severe asthma, the deaths occurred predominantly due to respiratory causes and within a health care facility. Lack of asthma control and male gender were risk factors for mortality.

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Risk factors for depression during the COVID-19 pandemic: a longitudinal study in middle-aged and older adults

BJPsych Open ◽

10.1192/bjo.2021.997 ◽

2021 ◽

Vol 7 (5) ◽

Author(s):

Jamie Rutland-Lawes ◽

Anna-Stiina Wallinheimo ◽

Simon L. Evans

Keyword(s):

Risk Factors ◽

Older Adults ◽

Longitudinal Study ◽

Regression Models ◽

Protective Factor ◽

Significant Risk ◽

Living Alone ◽

Depression Symptoms ◽

Middle Aged ◽

Increased Risk

Background The COVID-19 pandemic and resultant social restrictions have had widespread psychological ramifications, including a rise in depression prevalence. However, longitudinal studies on sociodemographic risk factors are lacking. Aims To quantify longitudinal changes in depression symptoms during the pandemic compared with a pre-pandemic baseline, in middle-aged and older adults, and identify the risk factors contributing to this. Method A total of 5331 participants aged ≥50 years were drawn from the English Longitudinal Study of Ageing. Self-reported depression symptoms in June/July 2020 were compared with baseline data from 2–3 years prior. Regression models investigated sociodemographic and lifestyle variables that could explain variance in change in depression. Results Within-participant depression scores increased significantly from pre-pandemic levels: 14% met the criteria for clinical depression at baseline, compared with 26% during the pandemic. Younger age, female gender, higher depression scores at baseline, living alone and having a long-standing illness were significant risk factors. Gender-stratified regression models indicated that older age was protective for women only, whereas urban living increased risk among women only. Being an alcohol consumer was a protective factor among men only. Conclusions Depression in UK adults aged ≥50 years increased significantly during the pandemic. Being female, living alone and having a long-standing illness were prominent risk factors. Younger women living in urban areas were at particularly high risk, suggesting such individuals should be prioritised for support. Findings are also informative for future risk stratification and intervention strategies, particularly if social restrictions are reimposed as the COVID-19 crisis continues to unfold.

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Carpal Tunnel Syndrome in Military Aviators

Military Medicine ◽

10.1093/milmed/usaa077 ◽

2020 ◽

Vol 185 (9-10) ◽

pp. e1506-e1509

Author(s):

J Banks Deal ◽

Anthony J Magee

Keyword(s):

Risk Factors ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Protective Factor ◽

Female Gender ◽

Age Group ◽

White Race ◽

Helicopter Pilots ◽

Tunnel Syndrome ◽

The Military

Abstract Introduction The incidence of carpal tunnel syndrome (CTS) is increased in occupations exposed to repetitive motion, poor wrist posture, and vibration exposure. While all pilots are exposed to these factors, helicopter pilots are especially exposed to vibration. The study is to identify the incidence and risk factors for CTS in military aviators. Materials and Methods Clearance was obtained from Tripler Army Medical Center IRB. The Defense Medical Epidemiological Database was queried for all new cases of CTS from 2006 to 2015. Incidence rates (IRs) were determined for helicopter pilots, fixed-wing pilots, and nonpilot officers. Poisson regression analysis was used to calculate adjusted IR in order to control for demographic factors. Race was also taken into account, where pilots would classify themselves into a white or non-white race, defined by each individual. Race was assessed in the study to see if there were any differences in IR of CTS between white and non-white pilots. Results We identified 7,398 new cases of CTS among 2,319,352 person-years within the study period. Increasing age, female gender, and non-white race were significantly correlated with higher IR. Fixed-wing pilots demonstrated significantly lower adjusted IR than nonpilot officers in each age group. Helicopter pilots demonstrated higher IR than fixed-wing pilots in each age group. Helicopter pilots had lower incidence of CTS early in their career compared to nonpilot officers, but by age 40+, their IR ratio was significantly higher (1.21). Conclusion Analysis of the database indicates that fixed-wing pilot status is a protective factor against development of CTS among U.S. military officers. In contrast, helicopter pilots were found to be at an increased rate of CTS than their fixed-wing counterparts. Their incidence is comparable to their nonpilot officer peers early in their career, but is significantly increased at the senior level. Increasing age and female gender are risk factors in the military officer population as expected. Non-white race was found to increase risk in the military population, in contrast to reports of the civilian population.

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Causes and determinants of neonatal deaths: Evidence from a secondary care hospital in Bangladesh

Bangladesh Journal of Child Health ◽

10.3329/bjch.v43i3.49569 ◽

2020 ◽

Vol 43 (3) ◽

pp. 138-144

Author(s):

Rafiul Alam ◽

Md Shamsur Rahman ◽

Eshrat Jahan ◽

Farhana Afroze ◽

Mohammad Tajul Islam

Keyword(s):

Risk Factors ◽

Perinatal Asphyxia ◽

Child Survival ◽

Significant Risk ◽

Case Fatality ◽

Care Facility ◽

Health Care Facility ◽

Care Hospital ◽

Major Barrier ◽

Neonatal Deaths

Background: Neonatal death is a major barrier to improve child survival in Bangladesh. This study assessed the patterns of neonatal admissions, causes of deaths and associated risk factors to prioritize and design interventions to improve quality of services. Materials & Methods: This study was conducted at the Satkhira District Hospital, a secondary health care facility in Bangladesh. From January to December 2014 hospital records of neonatal admissions and outcomes were reviewed and analyzed. Risk factors were determined by logistic regression analysis. Results: A total of 2,632 neonates were admitted during the period. More than one-third had admission bodyweight below 2500 grams. The leading causes of admissions were perinatal asphyxia (39.6%), prematurity/low-birth weight (LBW) (16.3%), pneumonia (11.9%) and sepsis (10.0%). The overall neonatal case fatality rate (CFR) was 11.7%. The main causes of neonatal deaths were perinatal asphyxia (41.6%) and prematurity/ LBW (35.8%). Most of the deaths (74.3%) occurred on first day of life. Significant risk factors for death were body weight on admission <1500 grams (OR: 17.08; 95% CI: 7.22 - 40.44; p<0.001), first day of life (OR: 7.99; 95% CI: 2.86 -22.27; p<0.001). Conclusions: The main causes of neonatal deaths were perinatal asphyxia and prematurity/LBW and most of the deaths occurred on first day of life. Bangladesh J Child Health 2019; VOL 43 (3) :138-144

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Risk Factors for Atherothrombotic Brain Infarction in Persons Over 62 Years of Age in a Long-Term Health Care Facility

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.1987.tb01311.x ◽

1987 ◽

Vol 35 (1) ◽

pp. 1-3 ◽

Cited By ~ 16

Author(s):

Wilbert S. Aronow ◽

Laurence Starling ◽

Fritzner Etienne ◽

Peter D'Alba ◽

Mildred Edwards ◽

...

Keyword(s):

Risk Factors ◽

Health Care ◽

Brain Infarction ◽

Care Facility ◽

Health Care Facility

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Risk Factors for Development of Carbapenem Resistance Among Gram-Negative Rods

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz027 ◽

2019 ◽

Vol 6 (3) ◽

Cited By ~ 7

Author(s):

Stefan E Richter ◽

Loren Miller ◽

Jack Needleman ◽

Daniel Z Uslan ◽

Douglas Bell ◽

...

Keyword(s):

Risk Factors ◽

Health Care ◽

Care Facility ◽

Health Care Facility ◽

Carbapenem Resistance ◽

High Morbidity ◽

Index Hospitalization ◽

Hospital System ◽

Gram Negative ◽

C Statistic

Abstract Background Infections due to carbapenem-resistant Gram-negative rods (CR-GNR) are increasing in frequency and result in high morbidity and mortality. Appropriate initial antibiotic therapy is necessary to reduce adverse consequences and shorten length of stay. Methods To determine risk factors for recovery on culture of CR-GNR, cases were retrospectively analyzed at a major academic hospital system from 2011 to 2016. Ertapenem resistance (ER-GNR) and antipseudomonal (nonertapenem) carbapenem resistance (ACR-GNR) patterns were analyzed separately. A total of 30951 GNR isolates from 12370 patients were analyzed, 563 of which were ER and 1307 of which were ACR. Results In multivariate analysis, risk factors for ER-GNR were renal disease, admission from another health care facility, ventilation at any point before culture during the index hospitalization, receipt of any carbapenem in the prior 30 days, and receipt of any anti-methicillin-resistant Staphylococcus aureus (anti-MRSA) agent in the prior 30 days (c-statistic, 0.74). Risk factors for ACR-GNR were male sex, admission from another health care facility, ventilation at any point before culture during the index hospitalization, receipt of any carbapenem in the prior 30 days, and receipt of any anti-MRSA agent in the prior 30 days (c-statistic, 0.76). Conclusions A straightforward scoring system derived from these models can be applied by providers to guide empiric antimicrobial therapy; it outperformed use of a standard hospital antibiogram in predicting infections with ER-GNR and ACR-GNR.

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Calcaneal spur: Clinical problem, physical Therapy Analysis

Acta Balneologica ◽

10.36740/abal202001101 ◽

2020 ◽

Vol 62 (1) ◽

pp. 5-11

Author(s):

Włodzisław Kuliński ◽

Katarzyna Sobczyk

Keyword(s):

Risk Factors ◽

Physical Therapy ◽

Care Facility ◽

Health Care Facility ◽

Strong Relationship ◽

Walking Distance ◽

Rehabilitation Centre ◽

Calcaneal Spur ◽

Crucial Part

Introduction: Plantar fasciitis, also called calcaneal spur, is a progressive degenerative condition occurring regardless of age or sex, with heel pain as the first symptom. Calcaneal spur develops over a period of many months or years. Risk factors include overweight or obesity, past injuries, lower limb length discrepancy, foot defects or ill-fitting shoes. Physical therapy is a crucial part of calcaneal spur treatment. Aim: To assess the most common risk factors for calcaneal spur as well as the efficacy of physical therapy and its effects on the quality of life.material and methods: The study group consisted of 40 patients with calcaneal spur treated at the Rehabilitation Centre of the Health Care Facility in Pińczów. Before and after treatment, the patients underwent a physical examination and history-taking, completed a survey and rated their pain on a pain assessment scale, and participated in a painless walking distance test. The data were statistically analysed.Results: The results showed that risk factors significantly contribute to the development of calcaneal spur and that there is a strong relationship between time from diagnosis and period of improvement after treatment. Physical therapy reduced or eliminated pain in the study patients, improved their ability to ambulate, and increased their quality of life. Conclusions: Physical therapy is a crucial part of calcaneal spur treatment.

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