scholarly journals Changes in Cognition, Depression and Quality of Life after Carotid Stenosis Treatment

2019 ◽  
Vol 16 (1) ◽  
pp. 47-62 ◽  
Author(s):  
Elina Pucite ◽  
Ildze Krievina ◽  
Evija Miglane ◽  
Renars Erts ◽  
Dainis Krievins ◽  
...  

Background:Although several studies have evaluated the change of cognitive performance after severe carotid artery stenosis, the results still remain elusive. The objective of this study was to assess changes in cognitive function, depressive symptoms and Health Related Quality of Life (HRQoL) after carotid stenosis revascularisation and Best Medical Treatment (BMT).Methods:Study involved 213 patients with ≥70% carotid stenosis who underwent assessment of cognitive function using Montreal Cognitive Assessment scale (MoCA), depressive symptoms - using Patient Health Questionnaire-9 (PHQ-9) and HRQoL - using Medical Outcome Survey Short Form version 2 (SF-36v2). The assessment was performed before and at 6 and 12 months followup periods in patients who had Carotid Endarterectomy (CEA), Carotid Artery Stenting (CAS) or received BMT only.Results:Improvement in the total MoCA scores was observed after 6 and 12 months (p<0.001, Kendall's W=0.28) in the CEA group. In the CAS group - after 12 months (p=0.01, Kendall's W=0.261) whereas in the BMT group - no significant changes (p=0.295, Kendall's W=0.081) were observed. Reduction of depressive symptoms was not found in any of the study groups. Comparing mean SF-36v2 scores in the CEA group, there was no significant difference in any of 10 subscales. Likewise in the CAS group - no significant difference in 9 of 10 subscales (p=0.028, η2=0.343) was observed. Three subscales worsened in the BMT group during the 1-year follow-up period.Conclusion:Patients with severe carotid stenosis who underwent revascularisation enhanced their cognitive performance without exerting significant change of depressive symptoms. Preoperative HRQoL may be maintained for at least one year in the CEA group.

2017 ◽  
Vol 13 (1) ◽  
pp. 168-180 ◽  
Author(s):  
Elina Pucite ◽  
Ildze Krievina ◽  
Evija Miglane ◽  
Renars Erts ◽  
Dainis Krievins

Background: Carotid artery disease is not just a causal risk factor of ischemic stroke, but may predispose patients to depressive symptoms and low health related quality of life (HRQoL). Objectives: The objectives of the present study were to assess the association between severe carotid artery stenosis (CAS) and cognitive impairment, frequency of depressive symptoms and status of HRQoL. Methods: Cross - sectional study involved 55 patients with severe CAS and 54 patients with lower extremity peripheral artery disease (PAD). Cognitive impairment was assessed using Montreal Cognitive Assessment Scale (MoCA), depressive symptoms - PHQ-9 scale. HRQoL was measured using Medical Outcome Survey Short Form version 2 (SF-36v2). Results: Median MoCA score 24 [23;26] was significantly lower in patients with severe CAS than in patients with PAD - 26 [25-28],(p=0.005; effect size r=0.3). There was no statistically significant difference of median PHQ-9 scores the in CAS group (median PHQ-9 score 4.0 [5]) and in the PAD group (median PHQ-9 score 5.5 [7]), (p=0.08, effect size r=0.18). Mean SF-36v2 scores were similar in CAS and PAD groups except for bodily pain (p=0.001, Cohen's d value = 0.77) and vitality (p=0.02, Cohen's d value = 0.49). Conclusion: In summary, our findings indicate that severe CAS could play a role in cognitive decline. Further studies should be conducted using larger patient cohorts without ischemic brain lesions and with balanced vascular risk profiles to investigate impact of CAS on cognition. There was no association between severe CAS and depressive symptoms in the present study. As patients with severe CAS did not exhibit physical symptoms, HRQoL was better for those patients than for patients with lower extremity PAD.


2013 ◽  
Vol 25 (7) ◽  
pp. 1097-1105 ◽  
Author(s):  
Maria Fernanda Barroso Sousa ◽  
Raquel Luiza Santos ◽  
Cynthia Arcoverde ◽  
Pedro Simões ◽  
Tatiana Belfort ◽  
...  

ABSTRACTBackground: The validity of self-reported quality-of-life (QoL) assessments of people with dementia (PWD) is a critical issue. We designed this study to determine the non-cognitive factors that are associated with self-reported QoL and PWD QoL as rated by family caregivers.Methods: Using a cross-sectional study, we assessed QoL of 41 people with mild Alzheimer's disease (AD). The individuals with AD and their family caregivers completed the Quality of Life in Alzheimer's Disease Scale (QoL-AD), the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia (ASPIDD), the Mini-Mental State Examination (MMSE), the Clinical Dementia Rating (CDR) scale, the Cornell Scale for Depression in Dementia (CSDD), the Pfeffer Functional Activities Questionnaire (FAQ), and the Zarit Burden Interview (ZBI). Univariate and multivariate regression analyses were conducted to examine the contribution of the various cofactors.Results: We observed a significant difference (t = 3.292, p < 0.01, d = 0.727) in the QoL measures of PWD after comparing self-reported assessments with the assessments of family caregivers. Linear regression analysis demonstrated that awareness of disease was related to PWD QoL-AD scores. Both the education levels of family caregivers and the depressive symptoms in PWD were related to the family caregivers’ ratings of PWD QoL.Conclusions: The difference between self-reported QoL and family caregivers’ ratings of QoL in people with mild dementia indicated that cognitive impairment was not the primary factor that accounted for the differences in the QoL assessments. Our findings suggested that non-cognitive factors, such as awareness of disease and depressive symptoms, played an important role in the differences between the self-reported AD QoL ratings and the caregivers’ AD QoL ratings. A major implication is that discrete measures such as cognition or level of function are likely to miss important factors that influence QoL.


2019 ◽  
Vol 32 ◽  
Author(s):  
Jéssica Maria Marcusso Orsini ◽  
Joyce Karla Machado da Silva ◽  
Marcos da Cunha Lopes Virmond ◽  
Camila Costa de Araujo

Abstract Introduction: Patient satisfaction is an important indicator of care quality and can be used to set goals and identify areas for improvement. Objective: To evaluate the satisfaction, quality of life and depressive symptoms of patients at the Uenp (State University of Northern Paraná) Physiotherapy teaching clinic. Method: Cross-sectional, quantitative descriptive study. Sixty-one patients completed a sociodemographic questionnaire, the “Instrument to assess patient satisfaction with physical therapy in the public health system”, the short-form-36 health survey (SF-36) to evaluate quality of life, and the Beck Depression Inventory (BDI) to determine the presence of depression. For statistical analysis, data were described using means and standard deviations, the Shapiro-Wilk test was applied to assess normality, and the variables were analyzed by Pearson’s correlation coefficient, with p ≤ 0.05 considered statistically significant. Results: The patient-therapist relationship was largely classified as “excellent”; the most common response for the item “respect and interest shown to patients” was also “excellent”. Patients scored well on the SF-36, indicating good quality of life; the highest scores were obtained in the “mental health” domain (65.04 ± 23.25). Regarding the depression, most patients (52.44%) displayed depressive symptoms. Correlation between satisfaction and the BDI showed a statistically significant difference in twelve dimensions. Comparison between the SF-36 and BDI indicated a statistically significant difference in eight domains. Conclusion: Patients are satisfied with the treatment received and the competence of the health care team at the clinic.


2020 ◽  
Vol 8 (1) ◽  
pp. 288-302
Author(s):  
Anabela Ribeiro ◽  
Beatriz Rosa ◽  
Jorge Oliveira ◽  
Paulo Lopes

Aim Our aim was to study the executive functioning, functionality, and quality of life of institutionalized old aged persons and to determine the potential roles of self-reported depression and satisfaction with social support on these domains. Method The sample comprised 36 volunteers (13 males and 23 females) aged between 71 and 94 years. The measures used consisted of well-established battery of neuropsychological tests. A comparative study was performed. Results Participants with depressive symptoms shown impaired executive functioning. Cognitive flexibility, functionality in instrumental activities of daily living, and quality of life are more affected in participants with higher levels of depression that also report higher levels of satisfaction with social support. Conclusion This result is intriguing and may highlight the relevance of considering not only depression, but also factors related to social isolation and loneliness in the explanation of cognitive performance, functionality, and quality of life.


2017 ◽  
Vol 34 (2) ◽  
pp. 261-268 ◽  
Author(s):  
Michele Marinho da SILVEIRA ◽  
Mirna Wetters PORTUGUEZ

Abstract The development of anxiety, depressive symptoms, and a decrease in cognitive performance can affect older adults’ quality of life. The objective of this cross-sectional study was to analyze quality of life and determine the prevalence of cognitive impairment, anxiety, and depression symptoms in senior center participants. A total of 120 older adults living in the city of Passo Fundo, RS, Brazil, participated in this study. The convenience sampling technique was used. All participants answered questions relative to socio-demographic variables, quality of life (World Health Organization Quality of Life-Bref), cognitive performance (Addenbrooke’ Cognitive Examination), and emotional state (Geriatric Depression Scale and Beck Anxiety Inventory). The prevalence of anxiety, depressive symptoms, and cognitive impairment were low indicating satisfactory quality of life of the older adults investigated.


2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Osama Younes ◽  
Reham Amer ◽  
Hosam Fawzy ◽  
Gamal Shama

Abstract Background Emotional and behavioral problems have been noted in a considerable number of patients after open-heart surgery. However, great discrepancy exists in the literature regarding the frequency and the course of psychiatric symptoms, cognitive performance, and quality of life among those patients. This prospective study was designed to assess the pre- and postoperative psychiatric profile, as well as the quality of life of patients undergoing open-heart surgery. Methods One hundred patients who were prepared for cardiac surgery and met our selection criteria were recruited in this study. Each patient was subjected to the Hospital Anxiety and Depression Scale, the Mini-Mental State Examination with selective subtests of Wechsler Adult intelligence scale, and the Short Form 36 questionnaire to assess psychiatric symptoms, cognitive performance, and quality of life respectively. Assessment was done for each of the evaluated items before surgery as well as at 1 week and 6 months postoperatively. Results The anxiety and depressive symptoms were significantly lower at 6 months postoperatively than preoperatively. The cognitive performance declined after 1 week, then improved significantly at the 6-month follow-up. The quality of life scale was significantly lower preoperatively than after surgery. Conclusions Anxiety and depressive symptoms, which occurred in substantial percentage of patients undergoing open-heart surgery, were gradually improved with time. Cognitive functions showed early deterioration with significant improvement at 6 months. Psychiatric problems had an adverse impact on patients’ quality of life which raised the importance of psychiatric consultation before and after cardiac surgeries to shorten recovery time.


Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 79
Author(s):  
Anja Xue ◽  
Vivian Oros ◽  
Pearl La Marca-Ghaemmaghami ◽  
Felix Scholkmann ◽  
Franziska Righini-Grunder ◽  
...  

Background: The COVID-19 pandemic is a global issue which affects the entire population’s mental health. This study evaluates how restrictions to curtail this pandemic change parenting self-efficacy, depressive symptoms, couple satisfaction and health-related quality of life in parents after delivery of a newborn. Methods: In this prospective single center evaluation of parental self-efficacy and quality of life, four validated questionnaires were used to repeatedly assess parenting self-efficacy (Tool to measure Parental Self-Efficacy, TOPSE), depressive symptoms (Edinburgh Postnatal Depression Scale, EPDS), couple satisfaction (Couple Satisfaction Index, CSI) and health-related quality of life (short form 12, SF12). Fifty-three parents of 50 infants answered a total number of 63 questionnaires during the lockdown period to limit the spread of COVID-19. These questionnaires were matched with 63 questionnaires of 58 other parents that had answered them before or after strong pandemic related measures. Results: Parents experienced lower parenting self-efficacy during the strict pandemic measures as compared to before and after (p = 0.04). In terms of age, socioeconomic, marital status and duration of hospitalization we detected no significant difference between both groups. On univariate linear regression, TOPSE scores were associated with gestational age (p = 0.044, parameter estimate: 1.67, 95% CI: 0.048 to 3.301), birth weight (p = 0.035, parameter estimate: 0.008, 95% CI: 0.001 to 0.015), number of newborns’ siblings (p = 0.0554, parameter estimate: 7.49, 95% CI: −0.174 to 15.145) and distance of home from hospital (p = 0.043, parameter estimate: −0.38, 95% CI: −0.745 to −0.011). Interestingly, there was a positive correlation between quality of life and TOPSE scores, suggesting that those who experience a higher self-efficacy also have a higher quality of life. Conclusions: When implementing a lock-down period psychological effects such as lower experience of parental self-efficacy have to be considered.


2020 ◽  
Vol 5 (4) ◽  
pp. 82
Author(s):  
Elren Passos-Monteiro ◽  
Felipe B. Schuch ◽  
Leandro T. Franzoni ◽  
Alberito R. Carvalho ◽  
Natalia A. Gomeñuka ◽  
...  

Nordic walking’s (NW) degree of effectiveness regarding health-related parameters in people with Parkinson’s Disease (PD) is a subject of debate. While NW seems to improve functionality, a clear non-motor benefit has not been demonstrated. The aim of this randomized controlled trial was to compare the effects of 9-week NW and free walking (FW) training programs on quality of life, cognitive function, and depressive symptoms in individuals with PD. Thirty-three people with PD, (Hoehn and Yahr 1–4) were randomized into two groups: NW (n = 16) and FW (n = 17). We analyzed quality of life, cognitive function, depressive symptoms, and motor symptoms. Significant improvements were found in the overall, physical, psychological, social participation, and intimacy domains of quality of life, as well as in cognitive function and depressive symptoms for both groups. Only the NW group showed improvement in the autonomy domain. Individuals with PD had a similar enhancement of non-motor symptoms after walking training, with or without poles. However, the NW group showed a more significant improvement in the autonomy domain, strengthening the applied and clinical potential of NW in people with PD. Future studies are needed to determine the efficacy of walking training without poles in subjects with PD.


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