What Does the Chinese General Public Understand About Dementia Prevention?

Abstract Background: Although considerable progress has been made on the risk factors of dementia, less is known about the extent of the gaps between the general public’s understanding of dementia prevention and contemporary scientific evidence. This study aimed to determine the beliefs and knowledge of dementia prevention among the Chinese general public and examine the sociodemographic factors of the belief and knowledge of dementia prevention. Methods: The study adopted a cross-sectional design. A total of 358 Chinese adults aged over 40 years were recruited from four healthcare centers. Descriptive statistics and multivariate regression analyses were conducted. We designed questionnaires that include items on the belief of dementia prevention, risk factors for dementia, and health education needs regarding dementia prevention based on previous literature.Results: Only 32.4% of the respondents agreed that dementia is preventable. The correct response rate is low for the items that suggest that cardiovascular risk factors are dementia risk factors. Younger age, higher education, and having contact with patients with dementia are associated with stronger belief that dementia is preventable. Older age, higher income, higher education, having memory complaint, and having contact with patients with dementia are associated with a better understanding of dementia risk factors. A total of 88.9% respondents thought that they are not well informed of dementia from public education, and most respondents (65%) prefer receiving dementia-related health advice from primary care providers.Conclusion: The present study reveals the great gaps between the Chinese general public’s knowledge of dementia prevention and the latest research evidence. Public health educational programs for all age groups are encouraged to close this knowledge gap. More attention and resources should be paid to individuals with low income and low education level as they have limited access to dementia prevention information. Researchers should work in partnership with primary care providers to help translate evidence into community practice with a special focus on the link between cardiovascular risk factors and dementia.

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Underdiagnosis and undertreament of modifiable cardiovascular risk factors: A Childhood Cancer Survivor Study (CCSS) report.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.10515 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 10515-10515

Author(s):

Eric Jessen Chow ◽

Yan Chen ◽

Gregory T. Armstrong ◽

Laura-Mae Baldwin ◽

Todd M. Gibson ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Heart Disease ◽

Cardiovascular Risk ◽

Childhood Cancer ◽

Cardiovascular Risk Factors ◽

Primary Care Providers ◽

Target Range ◽

Care Providers ◽

Increased Risk

10515 Background: Survivors of childhood cancer exposed to cardiotoxic therapies are at increased risk of heart disease. Hypertension, dyslipidemia, and diabetes are modifiable cardiovascular risk factors (CVRFs) that synergistically increase this risk. Therefore, we aimed to determine the prevalence of and predictors associated with CVRF underdiagnosis and undertreatment in this population. Methods: CCSS participants at increased risk of heart disease due to prior cancer therapy were enrolled in an ongoing randomized intervention trial (NCT03104543) to improve CVRF identification and treatment. Participants completed a baseline survey (CVRF status, lifestyle habits, attitudes towards healthcare), anthropometry, and blood draw. Blood pressure, low density lipoprotein, triglyceride, glucose and Hgb A1c were measured and classified as normal/abnormal per standard clinical criteria. Multivariable logistic regression estimated odds ratios (OR [95% confidence intervals]) associated with predictors and risk of CVRF underdiagnosis and undertreatment. Results: As of January 2020, 522 participants (43% male) were available for analysis (47% response), with a median age 38y (range 20-65) and 28y (18-49) from original cancer treatment (75% anthracycline, 47% chest radiation). With mean measured BMI 27.3±6.5 kg/m2, self-reported prevalence rates were hypertension 27%, dyslipidemia 33%, and diabetes 9%. While 90% of participants had a routine check-up ≤2y ago, 58% had a measured CVRF in the abnormal range. Specifically, among previously undiagnosed participants, we observed rates of abnormal blood pressure (26%), lipids (17%), and glucose tolerance (27%). Among those with pre-existing hypertension, dyslipidemia, and diabetes, 11%, 49%, and 54%, respectively, had measurements outside of the usual therapeutic target range. In multivariable analysis, BMI ≥25 kg/m2 (vs < 25) was associated with risk of underdiagnosis (OR 1.8 [1.2-2.8]). For undertreatment, significant adverse factors included older age ( > 35 vs ≤35y: OR 2.5 [1.2-5.1]), BMI ≥30 kg/m2 (vs < 25: OR 3.3 [1.7-6.4]), and greater perceived reliance on others for healthcare decisions (OR 1.7 [1.2-2.4]). Those with greater health-related self-efficacy were less likely to be undertreated (OR 0.5 [0.3-0.96]). Conclusions: CVRF underdiagnosis and undertreatment among childhood cancer survivors at increased risk of heart disease was common. Greater awareness among survivors and primary care providers and more aggressive control of CVRFs may mitigate this risk.

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Time to Act – Guideline-defined Treatment Goals for Cardiovascular Risk Factors Are Not Achieved in Primary Care

European Cardiology Review ◽

10.15420/ecr.2008.4.2.24 ◽

2008 ◽

Vol 4 (2) ◽

pp. 24

Author(s):

J Christoph Geller ◽

Keyword(s):

Risk Factors ◽

Primary Care ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Treatment Goals

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Abstract P720: Primary Stroke Prevention by Primary Care Providers: An Unmet Need

Stroke ◽

10.1161/str.52.suppl_1.p720 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Raymond Reichwein ◽

Alicia Richardson ◽

Cesar Velasco

Keyword(s):

Risk Factors ◽

Primary Care ◽

Primary Prevention ◽

Care Setting ◽

Stroke Risk ◽

Primary Care Setting ◽

Primary Care Providers ◽

Large Vessel ◽

Care Providers ◽

Stroke Risk Factors

Introduction: The majority of patients who present with acute ischemic stroke (AIS) have known stroke risk factors which are not optimally managed. It has been suggested that a CHADS-VASC score can assist with primary prevention by calculating future stroke risk. This however, has not been widely adapted in the primary care setting. Methods: From 2018-2019, 686 AIS patients were included in retrospective analysis. Data elements included: historical stroke risk factors, historical CHADS-VASC score, antiplatelet/anticoagulant use at time of presentation, discharge location, and mRS. Results: Of the 686 AIS patients, 77% were age > 60, and 52% were male. Etiology subtypes were small vessel/lacunar 20%, large vessel 22%, cardioembolic 20%, undetermined 31% (cryptogenic 15%), and other determined 5%. On presentation, the majority of patients had 2 or more stroke risk factors and a calculated historical CHADS-VASC score > 2 (Table 1). Over half of the patients with large vessel or small vessel/lacunar etiology were not on any antiplatelets and 53% of patients with known history of atrial fibrillation weren’t on anticoagulants. Forty-nine percent of patients had a mRS > 3 at discharge. Conclusion: Patients with several stroke risk factors are sub optimally managed by primary care providers. Primary prevention education for PCPs in management of higher stroke risk individuals and additional analysis of the CHADS-VASC tool for this setting is needed. If widely adapted, this tool may prevent strokes by providing adequate risk reduction in the primary care setting.

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Are primary care physicians aware of peripheral artery disease risk reduction and management in the Saudi healthcare transformation era? A health cluster observational study

Vascular ◽

10.1177/17085381211044397 ◽

2021 ◽

pp. 170853812110443

Author(s):

Sultan Alsheikh ◽

Hesham AlGhofili ◽

Omar A Alayed ◽

Abdulkareem Aldrak ◽

Kaisor Iqbal ◽

...

Keyword(s):

Risk Factors ◽

Primary Care ◽

Saudi Arabia ◽

Risk Reduction ◽

Peripheral Artery Disease ◽

Primary Care Physicians ◽

Primary Care Providers ◽

Care Providers ◽

Peripheral Artery ◽

Artery Disease

Introduction Patients with peripheral artery disease (PAD) are often underdiagnosed and undertreated. This study aimed to assess the knowledge of the recommended target levels of blood pressure, low-density lipoprotein cholesterol, glycosylated hemoglobin A1C, and knowledge and attitude about PAD risk reduction therapies among physicians working in primary care settings in Saudi Arabia. Methods This observational cross-sectional study included family medicine consultants, residents, and general practitioners working in a health cluster in the capital city of Saudi Arabia using a self-administered questionnaire. Results Of the 129 physicians who completed the survey, 55% had completed PAD-related continuing medical education hours within the past 2 years. Despite this, the knowledge score of the recommended target levels was high in only 13.2% of the participants. Antiplatelet therapy was prescribed by 68.2% of the participants. Conclusion Here we identified the knowledge and action gaps among primary care providers in Saudi Arabia. Physicians had an excellent attitude about screening for and counseling about risk factors. However, they showed less interference in reducing these risk factors. We recommend addressing these knowledge gaps early in medical school and residency programs.

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Cardiovascular risk stratification in primary care patients with arterial hypertension: Results from the Swiss Hypertension Cohort Study (HccH)

European Journal of Preventive Cardiology ◽

10.1177/2047487319856732 ◽

2019 ◽

Vol 26 (17) ◽

pp. 1843-1851 ◽

Cited By ~ 2

Author(s):

Anja Handschin ◽

Stefanie Brighenti-Zogg ◽

Jonas Mundwiler ◽

Stéphanie Giezendanner ◽

Claudia Gregoriano ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Primary Care ◽

Cohort Study ◽

Cardiovascular Risk ◽

Risk Stratification ◽

Arterial Hypertension ◽

Cardiovascular Risk Factors ◽

Organ Damage ◽

Primary Care Patients

Aims Few data are available on cardiovascular risk stratification in primary care patients treated for arterial hypertension. This study aimed at evaluating the cardiovascular risk profile of hypertensive patients included into the Swiss Hypertension Cohort Study according to the 2013 European Society of Hypertension/European Society of Cardiology Guidelines. Methods The Swiss Hypertension Cohort Study is a prospective, observational study conducted by the Centre for Primary Health Care of the University of Basel from 2006 to 2013. Patients with a diagnosis of arterial hypertension (office blood pressure measurement ≥140/90 mmHg) were enrolled. Office blood pressure measurement, cardiovascular risk factors, subclinical organ damage, diabetes mellitus, and established cardiovascular and renal disease were recorded at baseline and at an annual interval during routine consultations by general practitioners in Switzerland. Results In total, 1003 patients were eligible for analysis (55.6% male, mean age: 64.0 ± 13.2 years). At baseline, 78.5% of patients presented with either more than three additional cardiovascular risk factors, diabetes mellitus or subclinical organ damage, while 44.4% of patients had a high or very high overall cardiovascular risk. Cardiovascular risk factors and information about diabetes mellitus, established cardiovascular disease and renal disease were recorded mostly completely, whereas substantial gaps were revealed regarding the assessment of subclinical organ damage. Conclusion The present findings demonstrate that the majority of primary care patients with arterial hypertension bear a substantial number of additional cardiovascular risk factors, subclinical and/or established organ damage. This emphasizes the need for continuous cardiovascular risk stratification and adequate treatment of arterial hypertension in Switzerland.

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