Effects of Sociodemographic Variables and Depressive Symptoms on MoCA Test Performance in Native Germans and Turkish Migrants in Germany

The validity of the Montreal Cognitive Assessment (MoCA) in migrants is questionable, as sociodemographic factors and the migration process may influence performance. Our aim was to evaluate possible predictors (age, education, sex, depression, and migration) of MoCA results in Turkish migrants and Germans living in Germany. Linear regression models were conducted with a German (n = 419), a Turkish (n = 133), and an overall sample. All predictor analyses reached statistical significance. For the German sample, age, sex, education, and depression were significant predictors, whereas education was the only predictor for Turkish migrants. For the overall sample, having no migration background and higher education were significant predictors. Migration background and education had an impact on MoCA performance in a sample of German and Turkish individuals living in Germany. Thus, culture-specific normative data for the MoCA are needed, and the development of culture-sensitive cognitive screening tools is encouraged.

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Barriers to cognitive screening in acute stroke units

Scientific Reports ◽

10.1038/s41598-021-98853-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tamar Abzhandadze ◽

Dongni Buvarp ◽

Åsa Lundgren-Nilsson ◽

Katharina S. Sunnerhagen

Keyword(s):

Acute Stroke ◽

Care Facility ◽

Sociodemographic Factors ◽

Screening Tools ◽

Outcome Variable ◽

Cognitive Screening ◽

Stroke Units ◽

Explanatory Variables ◽

Tree Methods ◽

Selection Operator

AbstractCognitive impairment is common after stroke. However, not all patients with stroke undergo cognitive screening, despite recommendations. The aim of this retrospective, explorative study was to examine the barriers to cognitive screening in acute stroke units. Data were retrieved from two Swedish Stroke registries. The outcome variable was cognitive screening during the stay at acute stroke units. Forty-three candidate explanatory variables were considered for analysis, encompassing sociodemographic factors and stroke-related outcomes during the stay at acute stroke units. The Least Absolute Shrinkage and Selection Operator and decision-tree methods were used. Of the 1120 patients (56% male, mean age: 72 years, 50% with mild stroke), 44% did not undergo cognitive screening. Walking 10 m post-stroke was the most important attribute for decisions regarding cognitive screening. The classification accuracy, sensitivity, and specificity of the model were 70% (95% CI 63–75%), 71% (63–78%), and 67% (55–77%), respectively. Patient-related parameters that influenced cognitive screening with a valid and reliable screening instrument in acute stroke units included new stroke during the hospitalisation, aphasia at admission, mobility problems, impaired verbal output skills, and planned discharge to another care facility. The barriers to cognitive screening were both patient- and organisation-related, suggesting the need for patient-tailored cognitive screening tools as well as the implementation and systematic adherence to guidelines.

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Rapid review of cognitive screening instruments in MCI: proposal for a process-based approach modification of overlapping tasks in select widely used instruments

International Psychogeriatrics ◽

10.1017/s1041610217002253 ◽

2017 ◽

Vol 30 (5) ◽

pp. 663-672 ◽

Cited By ~ 5

Author(s):

Unai Díaz-Orueta ◽

Alberto Blanco-Campal ◽

Teresa Burke

Keyword(s):

Test Performance ◽

Cognitive Task ◽

Screening Tools ◽

Clinical Population ◽

Screening Tests ◽

Rapid Review ◽

Diagnostic Process ◽

Cognitive Screening ◽

Cognitive Domains ◽

Test Taking

ABSTRACTBackground:A detailed neuropsychological assessment plays an important role in the diagnostic process of Mild Cognitive Impairment (MCI). However, available brief cognitive screening tests for this clinical population are administered and interpreted based mainly, or exclusively, on total achievement scores. This score-based approach can lead to erroneous clinical interpretations unless we also pay attention to the test taking behavior or to the type of errors committed during test performance.Methods:The goal of the current study is to perform a rapid review of the literature regarding cognitive screening tools for dementia in primary and secondary care; this will include revisiting previously published systematic reviews on screening tools for dementia, extensive database search, and analysis of individual references cited in selected studies.Results:A subset of representative screening tools for dementia was identified that covers as many cognitive functions as possible. How these screening tools overlap with each other (in terms of the cognitive domains being measured and the method used to assess them) was examined and a series of process-based approach (PBA) modifications for these overlapping features was proposed, so that the changes recommended in relation to one particular cognitive task could be extrapolated to other screening tools.Conclusion:It is expected that future versions of cognitive screening tests, modified using a PBA, will highlight the benefits of attending to qualitative features of test performance when trying to identify subtle features suggestive of MCI and/or dementia.

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A comparative study of chest CT findings regarding the effects of regional dust exposure on patients with COPD living in urban areas and rural areas near cement plants

Respiratory Research ◽

10.1186/s12931-021-01649-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Junghyun Kim ◽

Bom Kim ◽

So Hyeon Bak ◽

Yeon-Mok Oh ◽

Woo Jin Kim

Keyword(s):

Sex Education ◽

Rural Areas ◽

Urban Areas ◽

Smoking Status ◽

Statistical Significance ◽

Dust Exposure ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Wall Area ◽

Copd Patients

Abstract Background The clinical and radiological presentation of chronic obstructive pulmonary disease (COPD) is heterogenous depending on the characterized sources of inflammation. This study aimed to evaluate COPD phenotypes associated with specific dust exposure. Methods This study was designed to compare the characteristics, clinical outcomes and radiological findings between two prospective COPD cohorts representing two distinguishing regions in the Republic of Korea; COPD in Dusty Area (CODA) and the Korean Obstructive Lung Disease (KOLD) cohort. A total of 733 participants (n = 186 for CODA, and n = 547 for KOLD) were included finally. A multivariate analysis to compare lung function and computed tomography (CT) measurements of both cohort studies after adjusting for age, sex, education, body mass index, smoking status, and pack-year, Charlson comorbidity index, and frequency of exacerbation were performed by entering the level of FEV1(%), biomass exposure and COPD medication into the model in stepwise. Results The mean wall area (MWA, %) became significantly lower in COPD patients in KOLD from urban and metropolitan area than those in CODA cohort from cement dust area (mean ± standard deviation [SD]; 70.2 ± 1.21% in CODA vs. 66.8 ± 0.88% in KOLD, p = 0.028) after including FEV1 in the model. COPD subjects in KOLD cohort had higher CT-emphysema index (EI, 6.07 ± 3.06 in CODA vs. 20.0 ± 2.21 in KOLD, p < 0.001, respectively). The difference in the EI (%) was consistently significant even after further adjustment of FEV1 (6.12 ± 2.88% in CODA vs. 17.3 ± 2.10% in KOLD, p = 0.002, respectively). However, there was no difference in the ratio of mean lung density (MLD) between the two cohorts (p = 0.077). Additional adjustment for biomass parameters and medication for COPD did not alter the statistical significance after entering into the analysis with COPD medication. Conclusions Higher MWA and lower EI were observed in COPD patients from the region with dust exposure. These results suggest that the imaging phenotype of COPD is influenced by specific environmental exposure.

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“I am going out!” – lifestyle sports and physical activity in adolescents

BMC Public Health ◽

10.1186/s12889-021-11066-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

K. Janeckova ◽

Z. Hamrik ◽

M. Matusova ◽

P. Badura

Keyword(s):

Physical Activity ◽

Socioeconomic Status ◽

Sedentary Behaviour ◽

Vigorous Physical Activity ◽

Sociodemographic Factors ◽

Linear Regression Models ◽

Great Opportunity ◽

Sport Activities ◽

Lifestyle Activities ◽

Out Of School

Abstract Background Lifestyle sport activities (e.g. parkour or skateboarding) are considered attractive and beneficial for a long-term commitment to physical activity (PA) and might be a great opportunity for adolescents who do not feel comfortable in an organized or competitive atmosphere. The purpose of the study was to assess whether participation in lifestyle activities is associated with moderate-to-vigorous physical activity (MVPA), out-of-school vigorous physical activity (VPA), and sedentary behaviour in adolescents aged 10–15 years, with major demographic variables (sex, age, socioeconomic status) being taken into account. Methods Data from a research project linked to the Health Behaviour in School-aged Children (HBSC) survey collected in 2017 in the Czech Republic was used. The sample consisted of 679 participants (303 of them girls) and was selected by quota sampling. Chi-square tests were used to assess differences in involvement in lifestyle activities according to sex, grade, and socioeconomic status. Ordinal and linear regression models were used to analyse the associations of participation in lifestyle activities and selected energy balance-related behaviours. Results Participation in lifestyle sport activities was significantly associated with a higher level of physical activity (MVPA and out-of-school VPA) after adjustment for sociodemographic factors, as was participation in organized sport. No significant associations were shown for sedentary behaviour. Conclusions Adolescents participating in lifestyle sport activities report being more physically active and, in case of doing multiple such activities concurrently, also spending less time sitting than their peers not involved in lifestyle sport activities. As such, lifestyle sport activities seem to represent a feasible way of increasing overall PA level in adolescent population.

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Psychooncological distress in low-grade glioma patients—a monocentric study

Acta Neurochirurgica ◽

10.1007/s00701-021-04863-7 ◽

2021 ◽

Author(s):

Alessandra Ley ◽

Marcel Kamp ◽

Christiane von Sass ◽

Daniel Hänggi ◽

Michael Sabel ◽

...

Keyword(s):

Depression Scale ◽

Sociodemographic Factors ◽

Low Grade Glioma ◽

Screening Tools ◽

Histopathological Diagnosis ◽

Low Grade ◽

Distress Screening ◽

Clinical Trial Registration ◽

Eortc Qlq C30 ◽

Eortc Qlq

Summary Background Patients diagnosed with low-grade glioma (LGG) must live with constant knowledge of an upcoming malignant tumor transformation which may lead to increased anxiety and reduced quality of life. Here, we (1) analyzed the prevalence and risk factors for distress in LGG patients using (2) different screening tools to subsequently (3) evaluate their need for psychological support. Method Patients with LGG-suspicious findings in MRI studies as well as patients with histopathological confirmed LGG were screened using three established self-assessment instruments (Hospital Anxiety and Depression Scale, Distress Thermometer, EORTC-QLQ-C30-BN20). Screening results were correlated with sociodemographic factors. Results One hundred forty-nine patients (74 men and 75 women) were prospectively included. Patients were further divided into different subgroups regarding the time of screening and diagnosis. An increased level of distress was observed in 20.8% (mean score 1.21, 95% CI 1.15–1.28) of all patients screened by HADS. Significant associated factors were pre-existing psychiatric disorders (p = 0.003) and psychotropic medication (p = 0.029). HRQoL (p = 0.022) and global health item (p = 0.015), as well as future uncertainty (p = 0.047), assessed by the EORTC-QLQ-C30-BN20 were significantly higher in those patients without histopathological diagnosis. Increased distress was significantly correlated with results in chosen sub-items of the HRQoL questionnaire (p < 0.001). Conclusions Our results demonstrate the need for frequent distress screening. If specific tools are not available, HRQoL questionnaires can also be used. Patients with pre-existing psychological stress should be offered additional psychooncological support, irrespectively of the time of screening or tumor diagnosis. Clinical trial registration number: 4087

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Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio and Their Role as Predictors of Disease Severity of Coronavirus Disease 2019 (COVID-19)

Journal of Laboratory Physicians ◽

10.1055/s-0041-1723057 ◽

2021 ◽

Author(s):

Rohit Jain ◽

Arun Gopal ◽

Basant Kumar Pathak ◽

Sourya Sourabh Mohakuda ◽

TVSVGK Tilak ◽

...

Keyword(s):

Disease Severity ◽

Complete Blood Count ◽

Wide Spectrum ◽

Statistical Significance ◽

Severe Disease ◽

Neutrophil To Lymphocyte Ratio ◽

Screening Tools ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Time Of Admission

Abstract Context Due to the wide spectrum of clinical illness in coronavirus disease 2019 (COVID-19) patients, it is important to stratify patients into severe and nonsevere categories. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been evaluated rapidly by a few studies worldwide for its association with severe disease, but practically none have been conducted in the Indian population. This study was undertaken to examine the role of NLR and PLR in predicting severe disease in Indian patients. Objectives The objective was to study the association of NLR and PLR observed at the time of admission with maximum disease severity during hospitalization and to study their role in predicting disease severity. Material and Methods A total of 229 COVID-19 patients were admitted at the center during the study period. After applying inclusion and exclusion criteria, 191 patients were included in the study. The demographic, clinical, and laboratory (complete blood count, NLR, and PLR) data of all patients were obtained at the time of admission. Maximum disease severity of all patients was assessed during hospitalization. Statistical Analysis Chi-square and Mann–Whitney U tests were used to assess statistical significance. Receiver operating characteristic curve (ROC) was plotted for NLR and PLR to estimate the cutoff values and sensitivity and specificity using Youden’s index for predicting severe disease. Logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals. Results Mean NLR and PLR were significantly higher in severe patients (NLR = 7.41; PLR = 204) compared with nonsevere patients (NLR = 3.30; PLR = 121). ROC analysis showed that NLR, in comparison to PLR, had a higher area under the curve (AUC) of 0.779, with a larger OR of 1.237 and cutoff of 4.1, and showed 69% sensitivity and 78% specificity in predicting severe disease. Cut off for PLR was 115.3, which showed 79% sensitivity and 62% specificity in predicting severe disease. Conclusion NLR and PLR, both showing acceptable AUCs, can be used as screening tools to predict disease severity. However, NLR was a better predictor of disease severity.

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Metabolomic Biomarkers for the Detection of Obesity-Driven Endometrial Cancer

Cancers ◽

10.3390/cancers13040718 ◽

2021 ◽

Vol 13 (4) ◽

pp. 718

Author(s):

Kelechi Njoku ◽

Amy E. Campbell ◽

Bethany Geary ◽

Michelle L. MacKintosh ◽

Abigail E. Derbyshire ◽

...

Keyword(s):

Endometrial Cancer ◽

Early Detection ◽

Minimally Invasive ◽

Cancer Detection ◽

Test Performance ◽

Female Genital Tract ◽

Screening Tools ◽

Normal Endometrium ◽

Endometrioid Endometrial Cancer ◽

Post Menopausal

Endometrial cancer is the most common malignancy of the female genital tract and a major cause of morbidity and mortality in women. Early detection is key to ensuring good outcomes but a lack of minimally invasive screening tools is a significant barrier. Most endometrial cancers are obesity-driven and develop in the context of severe metabolomic dysfunction. Blood-derived metabolites may therefore provide clinically relevant biomarkers for endometrial cancer detection. In this study, we analysed plasma samples of women with body mass index (BMI) ≥ 30 kg/m2 and endometrioid endometrial cancer (cases, n = 67) or histologically normal endometrium (controls, n = 69), using a mass spectrometry-based metabolomics approach. Eighty percent of the samples were randomly selected to serve as a training set and the remaining 20% were used to qualify test performance. Robust predictive models (AUC > 0.9) for endometrial cancer detection based on artificial intelligence algorithms were developed and validated. Phospholipids were of significance as biomarkers of endometrial cancer, with sphingolipids (sphingomyelins) discriminatory in post-menopausal women. An algorithm combining the top ten performing metabolites showed 92.6% prediction accuracy (AUC of 0.95) for endometrial cancer detection. These results suggest that a simple blood test could enable the early detection of endometrial cancer and provide the basis for a minimally invasive screening tool for women with a BMI ≥ 30 kg/m2.

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Abstract P146: Sex Differences In The Association Between Systolic Blood Pressure And Carotid Distensibility In Adults

Hypertension ◽

10.1161/hyp.78.suppl_1.p146 ◽

2021 ◽

Vol 78 (Suppl_1) ◽

Author(s):

Mohammad Shah ◽

Jing Tian ◽

Marie-Jeanne BUSCOT ◽

Hoang T Phan ◽

Thomas Marwick ◽

...

Keyword(s):

Blood Pressure ◽

Sex Differences ◽

Early Adulthood ◽

Sociodemographic Factors ◽

Health Study ◽

Adult Health ◽

Linear Regression Models ◽

Carotid Imt ◽

Carotid Plaques ◽

Carotid Distensibility

Background and Aim: We explored sex differences in the association between systolic and diastolic blood pressure (SBP), in early adulthood with carotid plaques, carotid IMT and carotid distensibility (CD) in mid-adulthood. Methods: Participants in the Childhood Determinants of Adult Health study at ages 26-36 years were followed-up at ages 39-49 years. Systolic BP and diastolic BP and carotid ultrasound measures (plaques, IMT and CD) were performed in clinics. We used log binomial and linear regression models with risk factor*gender interactions for predicting these carotid measures. Sex-stratified models adjusted for sociodemographic, health-related behavior and biomedical factors were fitted when likelihood ratio tests suggested the effect of risk factors on outcomes differed by sex. Results: Among 1,286 participants (53% women), men, compared to women, had higher prevalence of carotid plaques (17% vs. 10%), thicker carotid IMT (Mean 0.66 ± 0.09 vs. 0.61 ± 0.07) and lower CD (Mean 1.87 ± 0.60 vs. 2.37 ± 0.77). In women, greater SBP in early adulthood was sharply associated with significantly smaller CD (β -0.016 95%CI -0.023, -0.010 vs. β -0.006 95%CI -0.012, -0.001) than men in mid-adulthood adjusted for sociodemographic factors (Figure 1a). In analyses restricted to women, the effect of SBP on CD has decreased after adjusting for age, education, occupation, DBP and use of contraceptives (β -0.009 95%CI -0.019, 0.000) (Figure 1b). Conclusion: CV health was worse in men than women. However, elevated SBP in women put them at greater risk of poorer CV health compared to men, which was partly explained by sociodemographic, biomedical and female-specific factors.

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