scholarly journals Disfungsi Kognitif Post Operatif pada Geriatri

2021 ◽  
Vol 10 (3) ◽  
pp. 228-239
Author(s):  
Nurmala Dewi Maharani ◽  
◽  
Radian A. Halimi ◽  
Rose Mafiana ◽  
Syafruddin Gaus ◽  
...  
Keyword(s):  
Risk Factors ◽  
Negative Impact ◽  
Memory Performance ◽  
Postoperative Cognitive Dysfunction ◽  
Premature Death ◽  
Emotional Symptoms ◽  
Subjective Memory ◽  
Ability Test ◽  
Tracing Test ◽  
Learning Test

Postoperative Cognitive Dysfunction (POCD) is a neurocognitive disorder characterized by decreased cognitive performance after surgery and anesthesia. POCD is a complication characterized by memory impairment, decreased information processing and reduced attention, accompanied by changes in mood and personality. The incidence of POCD in elderly patients (> 60 years) was approximately 25.8% within seven days after surgery and 10% within three months after surgery. The risk factors and etiology that lead to POCD can be reduced by good patient education, patient care and proper sanitation can prevent the tendency of POCD symptoms in these patients. Examination can be done with the learning test, the word learning test, the tracing test, the manual dexterity test, the ability test to remember a sequence of numbers. Mini Mental Status Examination (MMSE) as a screening test for dementia. MMSE is sometimes used to measure POCD. MMSE can be used in routine clinical practice to identify preoperative subclinical dementia that would put patients at a higher risk of developing POCD. Management in POCD includes two approaches, namely rapid diagnosis and prevention of POCD symptoms. Prevention by knowing the risk factors preoperative, intraoperative and postoperative. In patients with persistent POCD, it has a negative impact on quality of life, subjective memory performance, emotional symptoms, and possible health consequences such as dementia and premature death.

scholarly journals Memory complaints and test performance in healthy elderly persons

2003 ◽  
Vol 61 (4) ◽  
pp. 920-924 ◽  
Author(s):  
Paulo Mattos ◽  
Valéria Lino ◽  
Luciana Rizo ◽  
Ângela Alfano ◽  
Cátia Araújo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Test Performance ◽  
Verbal Learning ◽  
Self Report ◽  
Elderly Persons ◽  
Subjective Memory ◽  
Memory Complaints ◽  
Healthy Elderly ◽  
Clinically Significant ◽  
Learning Test

In order to compare the use of a structured self-report questionnaire with direct questioning about memory problems, 71 healthy and independent aged individuals (63 women) from the community without risk factors for cognitive deficits were objectively asked about subjective memory complaints (SMC), given the Memory Complaint Questionnaire (MAC-Q) and then submitted to the Rey Auditory Verbal Learning Test (RAVLT). SMC positively correlated with higher scores on MAC-Q, although a significant percentage of the sample had SMC and lower scores on MAC-Q and also no SMC and higher scores on MAC-Q. Performance on RAVLT was significantly worse (p<0.05) for the group presenting SMC but not for the group with higher scores on the MAC-Q. We conclude that direct questioning maybe more clinically significant than a self report questionnaire, at least for elderly persons from the community without risk factors for cognitive decline or depression.

Fear of memory decline predicts lower quality of life and increased memory failures in older adults: Preliminary findings from a novel fear-avoidance of memory decline scale.

2020 ◽  
Author(s):  
Francesca Farina ◽  
Marc Patrick Bennett ◽  
James William Griffith ◽  
Bert Lenaert
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Memory Performance ◽  
Fear Avoidance ◽  
Subjective Memory ◽  
Memory Decline ◽  
General Anxiety ◽  
Quality Of Life Scale ◽  
The Impact

Evidence concerning the impact of fear of memory decline on health-related outcomes is limited. To determine the relationship between fear-avoidance of memory decline, quality of life and subjective memory in older adults using a novel scale to measure fear of memory decline. Sixty-seven older adults (59-81 years) completed a 23-item self-report questionnaire designed to capture experiential, cognitive and behavioral components of fear of memory decline, known as the fear and avoidance of memory decline (FAM) scale. Memory performance was assessed using the Wechsler Memory Scale (WMS-IV) and the Memory Failures Scale (MFS). General anxiety was assessed using the Depression, Anxiety and Stress Scales (DASS) and the Geriatric Anxiety Inventory (GAI). Quality of life was assessed using the Older Person’s Quality of Life scale (OPQOL-35). The FAM scale demonstrated good reliability and validity. Three latent factors were observed including: (1) fear-avoidance, (2) problematic beliefs and (3) resilience. After adjusting for age, education, memory performance and general anxiety, higher fear-avoidance predicted lower quality of life (p=.021) and increased memory failures (p=.022). Increased fear of memory decline predicts lower quality of life and subjective memory failures in healthy older adults. Based on these findings, we propose a preliminary fear-avoidance model that explains the development and maintenance of dementia-related functional disability in terms of psychological processes.

Loneliness, social isolation and cardiovascular risk

2019 ◽  
Vol 14 (10) ◽  
pp. 1-8 ◽  
Author(s):  
Jackson Alun ◽  
Barbara Murphy
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Social Isolation ◽  
Mental Health Problems ◽  
Cognitive Disorders ◽  
Premature Death ◽  
Physical And Mental Health ◽  
Cardiac Events ◽  
Patients At Risk ◽  
Traditional Risk Factors

Loneliness and social isolation are increasingly being acknowledged as risk factors for both physical and mental health problems. Recent statistics demonstrate that loneliness and isolation are on the rise internationally, to the point of being classed as an epidemic. In this paper, the authors outline some of the recent research linking loneliness and isolation to significant chronic diseases such as cardiovascular disease and type II diabetes; mental health disorders such as anxiety and depression; cognitive disorders and dementia. Isolation has also been shown to compromise recovery after acute cardiac events, being associated with increased hospital readmission and premature death. Indeed, isolation has now been identified as a risk factor equivalent in effect to traditional risk factors such as smoking, hypertension and obesity. While distinguishing between objective and subjective indicators of isolation, the authors highlight the complexity of this phenomenon, both in terms of definition and measurement, as well as the interplay between subjective and objective indicators. Important clinical implications for health professionals working with cardiac patients are also proposed, in terms of screening for isolation, and possible interventions to support patients at risk of isolation. The aim of the current article is to emphasise the importance of acknowledging loneliness and isolation as key risk factors requiring urgent attention, both in research and in clinical practice.

scholarly journals Cardiovascular diseases burden in Italy, 1990–2017: the Global Burden of Disease Study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Fornari ◽  
P A Cortesi ◽  
F Madotto ◽  
S Conti ◽  
G Crotti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
National Health ◽  
Population Aging ◽  
National Health System ◽  
Total Mortality ◽  
Premature Death ◽  
Global Burden ◽  
High Systolic Blood Pressure ◽  
Life Years

Abstract Background Cardiovascular diseases (CVDs) are still the leading cause of mortality, morbidity and disability in Europe. Consequently, an exhaustive estimation of CVDs burden and cardiovascular risk factors impact is crucial for healthcare planning and resource allocation. In Italy, data on CVDs burden are sparse. This study aims to assess the global Italian CVDs burden and to analyze time changes from 1990 to 2017 within the country and in comparison to other European states. Methods We used data from the 2017 Global Burden of Diseases (GBD) study to estimate CVDs prevalence, mortality and disability-adjusted life-years (DALYs) in Italy from 1990 to 2017. We also analyzed burden attributable to CVDs-related risk factors. Finally, Italian estimations were compared to those of the other 28 European Union countries. Results CVDs were still the first cause of death (34.8% of total mortality) in Italy in 2017. A significant decrease in CVDs burden was observed since 1990: age-standardized prevalence (-12.7%), mortality rate (-53.75%), and DALYs rate (-55.54%) all decreased. Similar patterns were observed also in the majority of European countries. Despite these trends, all-ages CVDs prevalent cases increased from 5.75 million to 7.49 million. More than 80% of CVDs burden could be attributed to known modifiable risk factors such as high systolic blood pressure, dietary risks, high LDL cholesterol, and impaired kidney function. Conclusions Data showed a decline in cardiovascular mortality and DALYs, which reflects the success in terms of reducing disability, premature death and early incidence of CVDs. However, the burden of CVDs is still high, as population aging and the increased prevalent cases require more access to care and generate more years lived with disability, which in turn leads to higher costs for the National Health Service and society. More efficient prevention strategies at community and individual level are needed. Key messages Despite decreasing trends in CVDs mortality and DALYs, the burden of CVDs is still high in Italy. A joined approach of the National Health System stakeholders is needed to keep reducing the CVDs burden.

scholarly journals The Predictive Value of the Mother’s Risk Factors in Formation of Fetal Developmental Delay

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199914
Author(s):  
Maka Chigladze
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Predictive Value ◽  
Negative Impact ◽  
Deficiency Anemia ◽  
Control Group ◽  
Case Group ◽  
Retrospective Case ◽  
Standards Of Living ◽  
Poor Nutrition

The research aimed at studying the mother’s social-hygienic and medical biological risk factors and determining their predictive value. The retrospective case-control study was conducted with 142 pregnant women participating in it. In the case group there were involved 92 mothers whose pregnancy was completed by the birth of a newborn baby suffering from the intrauterine growth restriction. The control group was made of 50 pregnant women, whose pregnancy was completed by the birth of a healthy neonate. The research resulted in specifying the risk factors of high priority: the low standards of living (OR 3.61), chronic stress (OR-3.06), sleeping disorder (OR-3.33) and poor nutrition (OR-3.81). As regards the coexisting pathology the following was revealed: endocrine pathology (OR-3.27), ischemic heart disease (OR-4.35), arterial hypertension (OR-6.47), iron deficiency anemia (OR-4.11), pathology of respiratory system (OR-3.42), chronic genital inflammatory and infectious processes. The preeclampsia (92%) and low amniotic fluid (89%) were detected to have the high predictive value. The awareness of risk factors allows us to employ the timely measures for the reduction of negative impact on the fetus and neonate.

scholarly journals Individual differences in experienced and observational decision-making illuminate interactions between reinforcement learning and declarative memory

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Batel Yifrah ◽  
Ayelet Ramaty ◽  
Genela Morris ◽  
Avi Mendelsohn
Keyword(s):  
Decision Making ◽  
Reinforcement Learning ◽  
Declarative Memory ◽  
Contextual Information ◽  
Memory Performance ◽  
Relevant Information ◽  
Subjective Memory ◽  
Types Of Information ◽  
Reinforcement Learning Models ◽  
Implicit And Explicit

AbstractDecision making can be shaped both by trial-and-error experiences and by memory of unique contextual information. Moreover, these types of information can be acquired either by means of active experience or by observing others behave in similar situations. The interactions between reinforcement learning parameters that inform decision updating and memory formation of declarative information in experienced and observational learning settings are, however, unknown. In the current study, participants took part in a probabilistic decision-making task involving situations that either yielded similar outcomes to those of an observed player or opposed them. By fitting alternative reinforcement learning models to each subject, we discerned participants who learned similarly from experience and observation from those who assigned different weights to learning signals from these two sources. Participants who assigned different weights to their own experience versus those of others displayed enhanced memory performance as well as subjective memory strength for episodes involving significant reward prospects. Conversely, memory performance of participants who did not prioritize their own experience over others did not seem to be influenced by reinforcement learning parameters. These findings demonstrate that interactions between implicit and explicit learning systems depend on the means by which individuals weigh relevant information conveyed via experience and observation.

scholarly journals Addressing Anxiety and Fear during the Female Pelvic Examination

2021 ◽  
Vol 12 ◽  
pp. 215013272199219
Author(s):  
Danielle J. O’Laughlin ◽  
Brittany Strelow ◽  
Nicole Fellows ◽  
Elizabeth Kelsey ◽  
Sonya Peters ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care Providers ◽  
Negative Symptoms ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Pelvic Examination ◽  
Care Providers ◽  
Emotional Symptoms ◽  
Pelvic Examinations ◽  
Anxiety And Fear

To review the anxiety and fear risk factors, pathophysiology, symptoms, screening and diagnosis while highlighting treatment considerations for women undergoing a pelvic examination. Methods: We reviewed the literature pertaining to anxiety and fear surrounding the pelvic examination to help guide health care providers’ on available screening options and to review options for individualized patient management. Results: Anxiety and fear are common before and during the pelvic examination. In fact, the pelvic exam is one of the most common anxiety-provoking medical procedures. This exam can provoke negative physical and emotional symptoms such as pain, discomfort, anxiety, fear, embarrassment, and irritability. These negative symptoms can interfere with preventative health screening compliance resulting in delayed or avoided care and significant health consequences. Conclusion: Assessing women for anxiety related to pelvic examinations may help decrease a delay or avoidance of examinations. Risk factor and symptom identification is also a key component in this. General anxiety questionnaires can help identify women with anxiety related to pelvic examinations. Strategies to reduce anxiety, fear and pain during a pelvic examination should routinely be implemented, particularly in women with high-risk factors or those identified with screening techniques as having anxiety, fear or pain with examinations. Treatment options should be targeted at understanding the patient’s concerns, starting conversations about pelvic examinations early, educating patient’s about the examination and offering the presence of a chaperone or support person. During an examination providers should ensure the patient is comfortable, negative phrases are avoided, the correct speculum size is utilized and proper lubrication, draping, dressing and positioning are performed. Treating underlying gynecologic or mental health conditions, consideration of cognitive behavioral therapy and complementary techniques such as lavender aromatherapy and music therapy should also be considered when appropriate.

scholarly journals AB0393 PRE-EXISTING MORBIDITY AS A RISK FACTORS FOR MORTALITY IN IgA VASCULITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1224.3-1225
Author(s):  
J. Nossent ◽  
D. Preen ◽  
W. Raymond ◽  
H. Keen ◽  
C. Inderjeeth
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Mortality Rate ◽  
Data Collection ◽  
Premature Death ◽  
Iga Vasculitis ◽  
Risk Of Death ◽  
Increased Risk ◽  
Serious Infections ◽  
Western Australian

Background:IgA vasculitis is generally considered to be a self-limiting condition, but this is at odds with the increased mortality observed in adult patients with IgA vasculitis (1).Objectives:With sparse data on prognostic factors in IgAV, we investigated whether pre-existing conditions are risk factors for mortality in adult IgAV patients.Methods:Observational population-based cohort study using state-wide linked longitudinal health data for adults with IgAV (n=267) and matched controls (n=1080) between 1980-2015. Charlson comorbidity index (CCI) and serious infections (SI) were recorded over an extensive lookback period prior to diagnosis. Date and causes of death were extracted from the WA Death Registry. Mortality rate (deaths/1000 person-years) ratios (MRR) and time dependent survival analysis assessed the risk of death. Age and gender specific mortality rate data were obtained from the Australian Bureau of Statistics.Results:During 9.9 (±9.8) years lookback IgAV patients accrued higher CCI scores (2.60 vs1.50 p<0.001) and had higher risk of SI (OR 8.4, p<0.001), not fully explained by CCI scores. During 19 years follow-up, the risk of death in IgAV patients (n=137) was higher than in controls (n=397) (MRR 2.06, CI 1.70-2.50, p<0.01) and the general population (SMRR 5.64, CI 4.25, 7.53, p<0.001). Survival in IgAV was reduced at five (72.7 vs. 89.7 %) and twenty years (45.2% vs. 65.6 %) (both p<0.05). CCI (HR1.88, CI:1.25 - 2.73, p=0.001), renal failure (HR 1.48, CI: 1.04 - 2.22, p=0.03) and prior SI (HR 1.48, CI:1.01 – 2.16, p=0.04) were independent risk factors. Death from infections (5.8 vs 1.8%, p=0.02) was significantly more frequent in IgAV patients.Conclusion:Premorbid accrual of comorbidity is increased and predicts premature death in IgAV patients. However, comorbidity does not fully explain the increased risk of serious infections prior to diagnosis or the increased mortality due to infections in IgAV.References:[1]Villatoro-Villar M, Crowson CS, Warrington KJ, Makol A, Ytterberg SR, Koster MJ. Clinical Characteristics of Biopsy-Proven IgA Vasculitis in Children and Adults: A Retrospective Cohort Study. Mayo Clin Proc. 2019;94(9):1769-80.Acknowledgements:The authors would like to acknowledge the support of the Arthritis Foundation of WA and acknowledge the Western Australian Data Linkage Branch, the Western Australian Department of Health, and the data custodians of, the Hospital and Morbidity Data Collection, the Emergency Department Data Collection the WA Cancer Register and the WA Death Register for their assistance with the study.Disclosure of Interests:None declared

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