Cross-Cultural Comparisons of Subjective Cognitive Complaints in a Diverse Primary Care Population

Background: Very few studies have explored the utility of subjective cognitive complaints (SCCs) in primary care settings. Objective: We aim to investigate associations between SCCs (item-level), objective cognitive function (across domains and global), and mood in a diverse primary care population, including subjects with mild cognitive impairment. Methods: We studied 199 (75.9%females; 57.8%Hispanics; 42.2%African Americans) older adults (mean age 72.5 years) with memory concerns at a primary care clinic. A five-item SCC questionnaire, and objective cognitive assessments, including the Montreal Cognitive Assessment (MoCA) and the Geriatric Depression Scale, were administered. Results: Logistic regression analyses showed associations between SCC score and depressive symptoms. A memory-specific (“memory worsening”) SCC predicted scores on the MoCA (p = 0.005) in Hispanics. Conclusion: SCCs are strongly linked to depressive symptoms in African Americans and Hispanics in a primary care setting; a specific type of SCC is related to global cognitive function in Hispanics.

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5-Cog Study: Cross-Cultural Comparison of Subjective Cognitive Complaints in a Diverse Primary Care Population

Innovation in Aging ◽

10.1093/geroni/igaa057.1162 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 361-361

Author(s):

Emmeline Ayers ◽

Erica F Weiss ◽

Joe Verghese

Keyword(s):

Primary Care ◽

Depressive Symptoms ◽

Cognitive Function ◽

Verbal Learning ◽

Primary Care Clinic ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Cognitive Complaints ◽

Care Clinic ◽

Subjective Cognitive Complaints

Abstract Subjective cognitive complaints (SCC) are risk factors for cognitive decline in older adults. A link between SCC and depressive symptoms has also been reported. These associations have not been much studied in non-White populations. We examined the relationship of SCC with cognitive function and depressive symptoms in adults aged 65 and older attending a primary care clinic in the Bronx. Five common SCC questions (four memory-related and one non-memory-related) were identified by literature review. Linear regressions, adjusted for age, sex and education years, were used to examine associations between individual SCC and cognitive function (Montreal Cognitive Assessment (MoCA) score and Hopkins Verbal Learning Test (HVLT) recall score) and depressive symptoms (Geriatric Depression Scale (GDS) score) for Hispanic (n=53) and non-Hispanic Black (n=47) adults. Mean number of SCC was similar for Blacks and Hispanics (2.3 vs. 2.4, p=0.752). Hispanics performed worse on the MoCA than Blacks (16.4 vs. 18.5, p=0.012), but education explained this difference. GDS and HVLT were similar across groups. For Hispanics only, a response of fair or poor to the question “how is your memory for a person your age?” was associated with worse MoCA scores (β -2.6; p=0.008). SCC were not associated with HVLT scores for either group. Four SCC for Blacks and two for Hispanics were associated with worse GDS scores. In an urban clinic population, SCC for Blacks and Hispanics were associated more with depressive symptoms than cognition. Further research is needed to identify SCC that better correlate with cognitive function in diverse populations.

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The validation of the Malay Yale Food Addiction Scale 2.0: factor structure, item analysis and model fit

Public Health Nutrition ◽

10.1017/s1368980019002684 ◽

2019 ◽

Vol 23 (3) ◽

pp. 402-409

Author(s):

Yogarabindranath Swarna Nantha ◽

Ahalya Kalasivan ◽

Mahalakshmi Ponnusamy Pillai ◽

Poopathy Suppiah ◽

Salmiah Md Sharif ◽

...

Keyword(s):

Primary Care ◽

Psychometric Properties ◽

Factor Structure ◽

Internal Consistency ◽

Food Addiction ◽

Primary Care Clinic ◽

Care Clinic ◽

Primary Care Population ◽

Yale Food Addiction Scale ◽

Yfas 2.0

AbstractObjective:The development of a second version of the Yale Food Addiction Scale (YFAS) coincides with the latest updates in the diagnosis of addiction as documented in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. The objective of the present study was to translate the YFAS 2.0 into the Malay language and test its psychometric properties in a primary-care population.Design:Patients were assessed for food addiction utilizing the Malay YFAS 2.0. The participants were also assessed for eating disorder using the validated Malay Binge Eating Scale. The psychometric properties of the YFAS 2.0 were determined by analysing factor structure, overall item statistics, internal consistency and construct validity.Setting:Between 2017 and 2018, participants were chosen from a regional primary-care clinic in the district of Seremban, Malaysia.Participants:Patients (n 382) from a regional primary-care clinic.Results:The prevalence of food addiction was 5·0%. A two-factor structure of the YFAS was confirmed as the most optimal solution for the scale via confirmatory factor analysis. In both its diagnostic and symptom count version, the YFAS 2.0 had good internal consistency (Kuder–Richardson α > 0·80 and McDonald’s ω > 0·9).Conclusions:We validated a psychometrically sound Malay version of the YFAS 2.0 in a primary-care population. Both diagnostic and symptom count versions of the scale had robust psychometric properties. The questionnaire can be used to develop health promotion strategies to detect food addiction tendencies in a general population.

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Prevalence of Depression and Its Associated Factors among Diabetes Mellitus Patients in an Urban Primary Care Clinic

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i1330960 ◽

2021 ◽

pp. 100-106

Author(s):

M. Miskan ◽

K. Ambigga

Keyword(s):

Diabetes Mellitus ◽

Primary Care ◽

Formal Education ◽

Primary Care Clinic ◽

Depression Scale ◽

Diabetic Patients ◽

Cross Sectional ◽

Care Clinic ◽

Prevalence Of Depression ◽

Probable Depression

Aims: To determine the prevalence of depression among patients with Diabetes Mellitus and to identify its associated risk factors. Study design: This is a cross sectional study. Place of study: This study was conducted in an urban primary care clinic in a tertiary hospital in Malaysia. Methodology: This study utilized a self-administered questionnaire, Hospital Anxiety and Depression scale (HADS-D) for the data collection. A total of 358 respondents were eligible to be included in this study. Results: A total of 382 respondents were recruited in this study using universal sampling method. A total number of 358 eligible respondents were included in the final data analysis. The response rate for this study was 94%. Respondents’ mean age was 60.8 years ± 10.3, 56% females, 38% Malays, 76% were married, 37.7% had Diabetes for more than 5 years and 76.3% had completed secondary school education. This study concluded that 63.7% of participants had poor diabetes control and 26% had probable depression. On multiple logistic regression, respondents who earned income less than RM 500 per month were 2.6 times more likely to have probable depression (aOR: 2.64, 95% CI:1.29 -5.43). Patients who received no formal education were 4.5 times more likely to have probable depression (aOR: 4.51 95% CI:1.74-11.63). Respondents with co-morbid illness were almost 3 times more likely to have probable depression (aOR: 2.92, 95% CI: 0.1-0.8). Conclusion: Prevalence of probable depression was high and there was a significant association between depression with income, education level and co-morbid illness. Thus, there is a need to identify and manage depression accordingly among diabetic patients.

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FACT effectiveness in primary care; a single visit RCT for depressive symptoms

The International Journal of Psychiatry in Medicine ◽

10.1177/00912174211010536 ◽

2021 ◽

pp. 009121742110105

Author(s):

B Arroll ◽

H Frischtak ◽

R Roskvist ◽

V Mount ◽

F Sundram ◽

...

Keyword(s):

Primary Care ◽

Depressive Symptoms ◽

Primary Care Clinic ◽

Intervention Group ◽

Psychosocial Assessment ◽

Care Practice ◽

Control Group ◽

Number Needed To Treat ◽

Care Clinic ◽

The Mean

Background Patients with depressive symptoms are common in primary care. Brief, simple therapies are needed. Aim Is a focussed acceptance and commitment therapy (FACT) intervention more effective than the control group for patients with depressive symptoms in primary care at one week follow up? Design and setting: A randomised, blinded controlled trial at a single primary care clinic in Auckland, New Zealand. Methods Patients presenting to their primary care practice for any reason were recruited from the clinic waiting room. Eligible patients who scored ≥2 on the PHQ-2 indicating potential depressive symptoms were randomised using a remote computer to intervention or control groups. Both groups received a psychosocial assessment using the “work-love-play” questionnaire. The intervention group received additional FACT-based behavioural activation activities. The primary outcome was the mean PHQ-8 score at one week. Results 57 participants entered the trial and 52 had complete outcome data after one week. Baseline PHQ-8 scores were similar for intervention (11.0) and control (11.7). After one week, the mean PHQ-8 score was significantly lower in the intervention group (7.4 vs 10.1 for control; p<0.039 one sided and 0.078 two sided). The number needed to treat to achieve a PHQ-8 score ≤6 was 4.0 on intention to treat analysis (p = 0.043 two sided). There were no significant differences observed on the secondary outcomes. Conclusion This is the first effectiveness study to examine FACT in any population. The results suggest that it is effective compared with control, at one week, for patients with depressive symptoms in primary care.

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Feasibility of a Habit Formation Intervention to Delay Frailty Progression Among Older African Americans: A Pilot Study

The Gerontologist ◽

10.1093/geront/gnz143 ◽

2019 ◽

Vol 60 (7) ◽

pp. 1353-1363

Author(s):

Heather Fritz ◽

Yi-Ling Hu ◽

Wassim Tarraf ◽

Pragnesh Patel

Keyword(s):

Primary Care ◽

African Americans ◽

Habit Formation ◽

A Priori ◽

Primary Care Clinic ◽

Later Life ◽

Community Dwelling ◽

Dietary Habit ◽

Care Clinic ◽

Older African Americans

Abstract Background and Objectives Older African Americans are at high risk for becoming frail in later life. Interventions can reverse or delay frailty, yet African Americans have largely been excluded from such research. Many interventions are also time- and resource-intensive, and thus inaccessible to socially disadvantaged older African Americans. We evaluated the feasibility of a low-dose frailty prevention intervention integrated with primary care among 60 community-dwelling, prefrail older African Americans aged 55+ recruited from a primary care clinic. Research Design and Methods We conducted a 2-arm randomized control trial. Participants were assigned to a 4-session intervention (1 session per month), delivered by an occupational therapist, or enhanced usual care. Feasibility criteria were set a priori at 75% for participant retention (including attrition due to death/hospitalization), 80% for session engagement, 2 participants/week for mean participant accrual, and 90% for program satisfaction. Results Participants were 65% female with an average age of 76.6 years, 51.7% lived alone and 39.1% reported <$10,000 in yearly income. Feasibility metrics were met. The study recruited, a mean of, 2.5 participants per week and retained 75% of participants who attended 95% of scheduled sessions. The mean satisfaction score was 29.75 (range = 0–32; SD .25). Changes in physical activity and dietary habit formation as well as changes in secondary outcomes were largely in the expected direction. Discussion and Implications The intervention was feasible to deliver. Qualitative findings from exit interviews suggested changes to the program dose, structure, and content that could improve it for future use.

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