Cognitive status

认知状态
  • 文章类型: Journal Article
    背景:认知障碍预计会影响老龄人口的大部分。假设终身饮食习惯在预防认知能力下降中起作用。在研究最多的饮食成分中,鱼类消费对人类大脑的潜在影响已被广泛研究。
    目的:对观察性研究进行荟萃分析,探讨鱼类摄入与认知障碍/下降和所有类型痴呆之间的关系。
    方法:对电子数据库进行了系统搜索,以确定提供有关鱼类消费和感兴趣结果的定量数据的观察性研究。仅使用极端暴露类别进行荟萃分析的随机效应模型,亚组分析,并进行剂量-反应分析以估计累积风险比(RR)和95%置信区间(CIs).
    结果:荟萃分析包括35项研究。个人报告最高与最低的鱼类消费量与较低的认知障碍/下降的可能性相关(RR=0.82,95%CI:0.75,0.90,I2=61.1%),痴呆(RR=0.82,95%CI:0.73,0.93,I2=38.7%),和阿尔茨海默病(RR=0.80,95%CI:0.67,0.96,I2=20.3%)。剂量-反应关系显示,在150g/d的较高水平的鱼类摄入量高达30%的情况下,认知障碍/下降和所有认知结果的风险显着降低(RR=0.70,95%CI:0.52,0.95)。基于所研究的结果,基于APOEε4等位基因状态的这种关系的结果是混合的。
    结论:目前的研究结果表明,食用鱼类与较低的认知障碍/下降风险呈剂量反应方式相关。而对于痴呆症和阿尔茨海默病,则需要进一步的研究来提高证据的强度。
    BACKGROUND: Cognitive impairment is projected to affect a preponderant proportion of the aging population. Lifelong dietary habits have been hypothesized to play a role in preventing cognitive decline. Among the most studied dietary components, fish consumptionhas been extensively studied for its potential effects on the human brain.
    OBJECTIVE: To perform a meta-analysis of observational studies exploring the association between fish intake and cognitive impairment/decline and all types of dementia.
    METHODS: A systematic search of electronic databases was performed to identify observational studies providing quantitative data on fish consumption and outcomes of interest. Random effects models for meta-analyses using only extreme exposure categories, subgroup analyses, and dose-response analyses were performed to estimate cumulative risk ratios (RRs) and 95% confidence intervals (CIs).
    RESULTS: The meta-analysis comprised 35 studies. Individuals reporting the highest vs. the lowest fish consumption were associated with a lower likelihood of cognitive impairment/decline (RR = 0.82, 95% CI: 0.75, 0.90, I2 = 61.1%), dementia (RR = 0.82, 95% CI: 0.73, 0.93, I2 = 38.7%), and Alzheimer\'s disease (RR = 0.80, 95% CI: 0.67, 0.96, I2 = 20.3%). The dose-response relation revealed a significantly decreased risk of cognitive impairment/decline and all cognitive outcomes across higher levels of fish intake up to 30% for 150 g/d (RR = 0.70, 95% CI: 0.52, 0.95). The results of this relation based on APOE ε4 allele status was mixed based on the outcome investigated.
    CONCLUSIONS: Current findings suggest fish consumption is associated with a lower risk of cognitive impairment/decline in a dose-response manner, while for dementia and Alzheimer\'s disease there is a need for further studies to improve the strength of evidence.
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  • 文章类型: Journal Article
    先前的研究强调了一生中不利的社会经济状况对运动技能和认知健康的负面影响。认知活动等因素,身体活动,生活方式,和社会经济地位显著影响一般健康状况和大脑健康。这项试点研究调查了区域剥夺指数(ADI)之间的关系,该指数是邻里级社会经济剥夺的衡量标准,大脑结构(皮质体积和厚度),亚利桑那州成年人的认知状况。确定对ADI敏感的措施可以阐明驱动认知能力下降的机制。
    该研究包括亚利桑那州的22名成年人(平均年龄=56.2±15.2),居住在该地区超过10年(平均=42.7±15.8)。我们使用NeuroTrax™认知筛查测试评估了特定的认知领域,它评估记忆,执行功能,视觉空间处理,注意,信息处理速度,和运动功能。我们还使用FreeSurfer7.2测量了10个皮质区域的皮质厚度和体积。进行了线性回归测试,以检查ADI指标之间的关系,认知状态,和大脑健康措施。
    结果表明,ADI指标与记忆得分之间存在显著的反比关系,解释了25%的差异。国家和州的ADI指标均与运动技能和全球认知呈负相关(r\s<-0.40,p\s<0.05)。相比之下,ADI指标通常与运动相关的体积和皮质厚度测量呈正相关(r\s>0.40,p\s<0.05)。
    研究结果表明,邻里水平的社会剥夺可能会影响记忆和运动状态,主要是通过它对运动大脑健康的影响。
    UNASSIGNED: Previous studies highlight the negative impact of adverse socioeconomic conditions throughout life on motor skills and cognitive health. Factors such as cognitive activity, physical activity, lifestyle, and socioeconomic position significantly affect general health status and brain health. This pilot study investigates the relationships among the Area Deprivation Index (ADI)-a measure of neighborhood-level socioeconomic deprivation, brain structure (cortical volume and thickness), and cognitive status in adults in Arizona. Identifying measures sensitive to ADI could elucidate mechanisms driving cognitive decline.
    UNASSIGNED: The study included 22 adults(mean age = 56.2 ± 15.2) in Arizona, residing in the area for over 10 years(mean = 42.7 ± 15.8). We assessed specific cognitive domains using the NeuroTrax™ cognitive screening test, which evaluates memory, executive function, visual-spatial processing, attention, information processing speed, and motor function. We also measured cortical thickness and volume in 10 cortical regions using FreeSurfer 7.2. Linear regression tests were conducted to examine the relationships between ADI metrics, cognitive status, and brain health measures.
    UNASSIGNED: Results indicated a significant inverse relationship between ADI metrics and memory scores, explaining 25% of the variance. Both national and state ADI metrics negatively correlated with motor skills and global cognition (r\'s < -0.40, p\'s < 0.05). In contrast, ADI metrics generally positively correlated with motor-related volumetric and cortical thickness measures (r\'s > 0.40, p\'s < 0.05).
    UNASSIGNED: The findings suggest that neighborhood-level social deprivation might influence memory and motor status, primarily through its impact on motor brain health.
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  • 文章类型: Journal Article
    使用2012年厄瓜多尔健康调查的数据,确定虐待和其他与老年厄瓜多尔成年人抑郁相关的危险因素,福利,衰老(SABE)。
    这项横断面研究分析了2012年SABE调查的数据,其中包括5235名60岁及以上的成年人。这项研究评估了居住地,教育水平,民族自我认同,自我感知的健康和记忆,孤独,认知状态,和虐待。使用Yesavage抑郁量表评估抑郁症,短版(YDS-SV)。分类变量用卡方检验分析,组间差异用Kruskal-Wallis检验计算,并进行多元线性回归分析。P值≤0.05被认为具有统计学意义。
    平均年龄为71.39±8.59岁,55.10%的样本为女性。72.1%(3.773)的人口中没有滥用。卡方检验表明抑郁症与自我报告的健康状况差(P=0.000)和土著民族(P=0.000)之间存在显着关联。多元线性回归分析显示年龄(P<0.001),滥用(p<0.001),认知状态(P=0.002),根据YDS-SV的评估,独自生活(P=0.034)显着影响了情绪。对于感知的健康状况或居住地(城市或农村),没有发现统计学上的显着关联。
    与厄瓜多尔老年人抑郁症相关的危险因素包括高龄,独自生活,认知能力下降,对健康和认知的自我感知较差,和虐待。
    UNASSIGNED: To identify abuse and other risk factors associated with depression in older Ecuadorian adults using data from the 2012 Ecuador\'s Survey of Health, Welfare, and Aging (SABE).
    UNASSIGNED: This cross-sectional study analyzed data from the 2012 SABE survey, which included 5235 adults aged 60 and above. The study evaluated residence, education level, ethnic self-identification, self-perceived health and memory, loneliness, cognitive status, and abuse. Depression was assessed using the Yesavage Depression Scale, short version (YDS-SV). Categorical variables were analyzed with the Chi-square test, differences between groups were calculated with the Kruskal-Wallis test, and multiple linear regression analysis was performed. A p-value of ≤0.05 was considered statistically significant.
    UNASSIGNED: The mean age was 71.39 ± 8.59 years and 55.10% of the sample were women. Abuse was absent in 72.1% (3.773) of the population. The Chi-square test indicated significant associations between depression and poor self-reported health (P = 0.000) and indigenous ethnicity (P = 0.000). Multiple linear regression analysis revealed that age (P < 0.001), abuse (p < 0.001), cognitive status (P = 0.002), and living alone (P = 0.034) significantly contributed to mood as assessed by the YDS-SV. No statistically significant association was found for perceived health status or place of residence (urban or rural).
    UNASSIGNED: Risk factors associated with depression in older Ecuadorian adults include advanced age, living alone, cognitive decline, poor self-perception of health and cognition, and abuse.
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  • 文章类型: Journal Article
    背景:鉴于越来越多的人实现了超长的寿命,我们迫切需要更好地了解百岁老人的心理健康。本研究旨在了解精神健康状况的患病率-抑郁症状,焦虑,睡眠障碍,去抑制,以及瑞士百岁老人的异常运动行为。
    方法:通过电话访谈或纸质问卷收集了N=169名参与者的数据,要么直接来自百岁老人,要么通过代理人线人。一半的数据是在由于COVID-19大流行而采取保护措施的时期收集的,一半是在措施解除后收集的。
    结果:我们的样本中普遍存在心理健康状况,特别是抑郁症状(44.51%)和焦虑(42.17%)。在抑郁症状和焦虑之间发现了显着的正相关,在解除抑制和异常运动行为之间。此外,我们确定了心理健康状况发生的统计预测因子.值得注意的是,制度化的生活增加了抑郁症状的几率,而那些受过高等教育或没有认知障碍的人经历了更多的睡眠障碍。最后,认知障碍与抑制抑制和异常运动行为增加有关.
    结论:精神卫生状况的高患病率强调了在高龄患者中需要积极的精神保健策略。此外,至关重要的是要考虑精神健康状况的相互联系的性质,并优先考虑弱势群体,比如机构环境中的百岁老人。
    BACKGROUND: Given the increasing number of people achieving exceptionally long lifespans, there is an urgent need for a better understanding of mental health in centenarians. This study aimed to understand the prevalence of mental health conditions-depressive symptoms, anxiety, sleep disturbances, disinhibition, and aberrant motor behaviour-among centenarians in Switzerland.
    METHODS: Data were collected from N = 169 participants via telephone interviews or paper questionnaires, either directly from centenarians or through proxy informants. Half the data were collected during a period when protective measures were imposed due to the COVID-19 pandemic, and half were collected after the measures were lifted.
    RESULTS: Mental health conditions were prevalent in our sample, particularly depressive symptoms (44.51%) and anxiety (42.17%). Significant positive associations were found between depressive symptoms and anxiety, and between disinhibition and aberrant motor behaviour. Furthermore, we identified statistical predictors for the occurrence of mental health conditions. Notably, institutionalised living increased the odds of depressive symptomatology, while those with higher education levels or an absence of cognitive impairment experienced more sleep disturbances. Finally, cognitive impairment was linked to increased disinhibition and aberrant motor behaviour.
    CONCLUSIONS: The high prevalence of mental health conditions underscores the need for proactive mental health care strategies in advanced old age. Moreover, it is vital to consider the interconnected nature of mental health conditions and to prioritise vulnerable groups, such as centenarians in institutional settings.
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  • 文章类型: Journal Article
    阿尔茨海默病(Alzheimerdisease,AD)是一种异质性复杂的疾病,涉及不同的病理生理机制。这种异质性可以反映在不同的萎缩模式或临床表现中。关于早期AD涉及的生化途径,脂质代谢起着重要作用;因此,脂质水平已被评估为潜在的AD诊断生物标志物,其水平可能与不同的AD临床表现有关。因此,这项工作的目的是研究早期AD患者的AD脂质分布并评估其临床意义。为此,在诊断为脑脊液(CSF)生物标志物的早期AD患者(n=31)中进行非靶向血浆脂质组学分析。进行聚类分析以根据脂质水平定义早期AD亚组。然后,研究了每个血脂亚组的临床意义,分析其他变量的差异(认知状态,CSF生物标志物,药物,合并症,年龄,和性别)。聚类分析显示了两组不同的AD患者。与第2组相比,第1组显示出更高的血脂水平和更好的认知状态。然而,其他变量(年龄,性别,药物,合并症,胆固醇,和甘油三酯水平)在两组之间。血脂水平可以区分两个早期AD亚组,表现出不同的认知状态。然而,我们需要进行进一步的研究,通过大型队列和纵向研究来评估这些患者的临床进展.总的来说,这将涉及AD病理机制知识的相关进步,潜在的治疗方法,精准医学。
    Alzheimer disease (AD) is a heterogeneous and complex disease in which different pathophysiological mechanisms are involved. This heterogenicity can be reflected in different atrophy patterns or clinical manifestations. Regarding biochemical pathways involved in early AD, lipid metabolism plays an important role; therefore, lipid levels have been evaluated as potential AD diagnosis biomarkers, and their levels could be related to different AD clinical manifestations. Therefore, the aim of this work is to study AD lipid profiles from early AD patients and evaluate their clinical significance. For this purpose, untargeted plasma lipidomic analysis was carried out in early AD patients (n = 31) diagnosed with cerebrospinal fluid (CSF) biomarkers. Cluster analysis was carried out to define early AD subgroups according to the lipid levels. Then, the clinical significance of each lipid profile subgroup was studied, analyzing differences for other variables (cognitive status, CSF biomarkers, medication, comorbidities, age, and gender). The cluster analysis revealed two different groups of AD patients. Cluster 1 showed higher levels of plasma lipids and better cognitive status than Cluster 2. However, no differences were found for the other variables (age, gender, medication, comorbidities, cholesterol, and triglycerides levels) between both groups. Plasma lipid levels could differentiate two early AD subgroups, which showed different cognitive statuses. However, further research with a large cohort and longitudinal study evaluating the clinical evolution of these patients is required. In general, it would involve a relevant advance in the knowledge of AD pathological mechanisms, potential treatments, and precision medicine.
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  • 文章类型: Journal Article
    本研究旨在开发和验证一系列多重中介模型,以调查老年人日常生活工具活动(IADL)功能与认知状态之间的关联,同时探索其潜在机制。
    这项横断面研究涉及3,665名60岁及以上的个人,他们参加了中国健康与退休纵向调查(CHARLS)。采用串联多重中介模型,探讨IADL功能与认知状态的直接和间接关系,社会参与,抑郁症状介导了这种关系。
    IADL功能下降与认知状态恶化相关[效应=-0.620,95%CI:(-0.692,-0.540)]。睡眠时间,社会参与(SP)和抑郁症状都是IADL功能与认知状态关系的中介。
    这项研究发现了IADL功能和认知状态之间的直接和间接关联,为有效预防和干预老年人认知能力下降提供新的见解。
    UNASSIGNED: This study aimed to develop and validate a serial multiple mediation model to investigate the association between instrumental activities of daily living (IADL) function and cognitive status among older adults while exploring the underlying mechanisms.
    UNASSIGNED: This cross-sectional study involved 3,665 individuals aged 60 years and older who participated in the China Health and Retirement Longitudinal Survey (CHARLS). A serial multiple mediation model was utilized to explore the direct and indirect relationship between IADL function and cognitive status and whether sleep duration, social engagement, and depressive symptoms mediated this relationship.
    UNASSIGNED: Decreased IADL function was associated with worse cognitive status [effect = -0.620, 95% CI: (-0.692, -0.540)]. Sleep duration, social participation (SP), and depressive symptoms all acted as mediators in the relationship between IADL function and cognitive status.
    UNASSIGNED: This study found both direct and indirect associations between IADL function and cognitive status, providing new insights into the effective prevention and intervention of cognitive decline among older adults.
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  • 文章类型: Journal Article
    背景:认知和情绪状态影响个人和社会日常活动,对生活质量有很大影响,尤其是老年人。
    目的:这项横断面研究旨在调查克里特岛哈尼亚地区老年人口饮食习惯的心理情感状况,希腊。
    方法:通过简易精神状态检查(MMSE)评估了101名老年受试者的认知状态,使用医院焦虑和抑郁量表(HADS)评估情绪。使用经过验证的食物频率问卷评估营养状况。
    结果:多变量统计分析,调整后的年龄,婚姻状况,教育,和合并症,在男性中,MMSE评分与蔬菜消费量呈正相关(RR1.18;95CI1.03~1.34),与马铃薯消费量呈负相关(RR0.83;95CI0.72~0.95).相反,在女性中,没有观察到任何食物的统计学显著关联.Further,在男性中,鸡肉对情感状态有保护作用(RR0.45;95CI0.27~0.77),鱼(RR0.41;95CI0.21~0.82),水果(RR0.70;95CI0.52-0.94),谷物(RR0.67;95CI0.53-0.87),和奶酪(RR0.78;95CI0.63-0.97)的消费量。在女性中,调整后的模型显示了蔬菜消费的显著有害影响(RR1.33;95CI1.02~1.73)。
    结论:主要以蔬菜为基础的饮食-除了水果和豆类外-与男性更好的认知状态相关,虽然不是女性。水果摄入量较高,和鱼一样,鸡肉,男性的奶酪与更好的情感状态有关,表明充足的蛋白质供应可能在维持情绪平衡方面发挥作用。
    BACKGROUND: Cognitive and mood status influence both personal and social daily activities, with great impact on life quality, particularly among the elderly population.
    OBJECTIVE: This cross-sectional study aimed to investigate the psycho-affective status concerning eating habits within an elderly population of the Chania area in Crete, Greece.
    METHODS: Cognitive status was assessed in 101 elderly subjects through the Mini-Mental State Examination (MMSE), and mood was evaluated using the Hospital Anxiety and Depression Scale (HADS). Nutritional status was assessed using a validated food frequency questionnaire.
    RESULTS: Multivariable statistical analysis, after adjustment for age, marital status, education, and comorbidity, highlighted among males a positive association of the MMSE score with vegetable consumption (RR 1.18; 95%CI 1.03‒1.34) and a negative association with potato consumption (RR 0.83; 95%CI 0.72‒0.95). Conversely, among females, no statistically significant association was observed for any food. Further, among males, a protective effect on affective status was identified for chicken meat (RR 0.45; 95%CI 0.27‒0.77), fish (RR 0.41; 95%CI 0.21‒0.82), fruit (RR 0.70; 95%CI 0.52‒0.94), cereals (RR 0.67; 95%CI 0.53‒0.87), and cheese (RR 0.78; 95%CI 0.63‒0.97) consumption. Among females, the adjusted model showed a significant detrimental effect of vegetable consumption (RR 1.33; 95%CI 1.02‒1.73).
    CONCLUSIONS: A predominantly vegetable-based diet-with the notable exception of fruits and legumes-was associated with better cognitive status in males, albeit not in females. A higher intake of fruit, as well as fish, chicken meat, and cheese among males was associated with a better affective status, indicating that adequate protein supply may play a role in maintaining emotional balance.
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  • 文章类型: Journal Article
    背景:一个持续的全球挑战是管理大脑健康和了解性能在整个生命周期中的变化。
    目标:我们开发并部署了一套可自我管理的,计算机化评估旨在测量视觉和听觉感觉模式中大脑健康的关键指标。在这项试点研究中,我们评估了可用性,可行性,以及以家庭为基础的评估的绩效分布,没有监督的真实世界环境。
    方法:潜在参与者是未经训练的用户,他们在现有的名为BrainHQ的大脑训练应用程序中自我注册。通过招聘电子邮件与参与者联系,并进行远程注册,以完成人口统计问卷和个人设备上的29项独特评估。我们检查了参与者的参与度,评估的描述性和心理测量学特性,绩效和自我报告的人口统计学变量之间的关联,认知概况,和因子载荷。
    结果:在通过招募电子邮件联系的365,782名潜在参与者中,414(0.11%)登记,其中367人(88.6%)完成了至少一项评估,104人(25.1%)完成了所有29项评估。注册参与者是,平均而言,年龄63.6(标准差14.8;范围13-107)岁,主要是女性(265/414,64%),受过教育(329/414,79.5%有学位),和白色(349/414,84.3%的白色和48/414,11.6%的有色人种)。总共72%(21/29)的评估显示没有上限或下限效应,或者具有易于修改的分数界限以消除这些效应。当将表现与自我报告的人口统计学变量相关联时,72%(21/29)的评估对年龄敏感,72%(21/29)的评估对性别不敏感,93%(27/29)的评估对种族和民族不敏感,93%(27/29)的评估对基于教育的差异不敏感。评估很简短,每个任务的平均持续时间为3(SD1.0)分钟。评估中的表现模式揭示了独特的认知特征,并加载到4个独立因素上。
    结论:评估既可用又可行,需要进行全面的规范研究。可扩展和可自我管理的评估的数字工具箱,可以一目了然地(纵向地)评估大脑健康,可能会在临床试验中带来新的未来应用。诊断,和性能优化。
    BACKGROUND: An ongoing global challenge is managing brain health and understanding how performance changes across the lifespan.
    OBJECTIVE: We developed and deployed a set of self-administrable, computerized assessments designed to measure key indexes of brain health across the visual and auditory sensory modalities. In this pilot study, we evaluated the usability, feasibility, and performance distributions of the assessments in a home-based, real-world setting without supervision.
    METHODS: Potential participants were untrained users who self-registered on an existing brain training app called BrainHQ. Participants were contacted via a recruitment email and registered remotely to complete a demographics questionnaire and 29 unique assessments on their personal devices. We examined participant engagement, descriptive and psychometric properties of the assessments, associations between performance and self-reported demographic variables, cognitive profiles, and factor loadings.
    RESULTS: Of the 365,782 potential participants contacted via a recruitment email, 414 (0.11%) registered, of whom 367 (88.6%) completed at least one assessment and 104 (25.1%) completed all 29 assessments. Registered participants were, on average, aged 63.6 (SD 14.8; range 13-107) years, mostly female (265/414, 64%), educated (329/414, 79.5% with a degree), and White (349/414, 84.3% White and 48/414, 11.6% people of color). A total of 72% (21/29) of the assessments showed no ceiling or floor effects or had easily modifiable score bounds to eliminate these effects. When correlating performance with self-reported demographic variables, 72% (21/29) of the assessments were sensitive to age, 72% (21/29) of the assessments were insensitive to gender, 93% (27/29) of the assessments were insensitive to race and ethnicity, and 93% (27/29) of the assessments were insensitive to education-based differences. Assessments were brief, with a mean duration of 3 (SD 1.0) minutes per task. The pattern of performance across the assessments revealed distinctive cognitive profiles and loaded onto 4 independent factors.
    CONCLUSIONS: The assessments were both usable and feasible and warrant a full normative study. A digital toolbox of scalable and self-administrable assessments that can evaluate brain health at a glance (and longitudinally) may lead to novel future applications across clinical trials, diagnostics, and performance optimization.
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  • 文章类型: Journal Article
    目的:新冠肺炎大流行对全球心理健康的几个方面产生了有害影响。有害的医疗并发症,Covid-19发病率的上升和在国际上的迅速传播导致了世界各地紧急的公共卫生问题和政治措施。这个比较,横断面研究旨在评估社会人口统计学的变化,通过比较Covid-19大流行前和Covid后时期的人体测量和生活方式参数以及老年人心理健康的几个方面。方法:采用合格的问卷评估抑郁症的患病率,生活质量,认知状态,和地中海饮食(MD)的坚持,以及社会人口统计学,Covid前后3388名老年人的人体测量和生活方式参数。结果:新冠肺炎大流行独立影响居住类型,吸烟习惯,BMI和WHR状态,抑郁症的风险,生活质量,认知状态,身体活动水平,和MD坚持。结论:Covid-19大流行对Covid后时期老年人的日常生活质量和心理健康产生了持续的有害影响。未来的战略和公共政策应制定医疗保健计划,为老年人提供心理和营养咨询和支持,以最大限度地减少Covid大流行的有害影响。
    Ojective: Covid-19 pandemic has exerted deleterious effects on several aspect of mental health worldwide. The detrimental medical complications, the increased prevalence of morbidity and the rapid international spread of Covid-19 have resulted in urgent public health concerns and political measures across the world. This comparative, cross-sectional study aims to assess the changes that were established in sociodemographic, anthropometric and lifestyle parameters and several aspects of mental health of older adults due to Covid-19 pandemic by comparing the pre-Covid period with the post-Covid period. Methods: Qualified questionnaires were applied for assessing the prevalence of depression, quality of life, cognitive status, and Mediterranean Diet (MD) adherence, as well as sociodemographic, anthropometric and lifestyle parameters in 3388 older adults in the pre- and post-Covid period. Results: Covid-19 pandemic independently affected type of residence, smoking habits, BMI and WHR status, risk of depression, quality of life, cognitive status, physical activity levels, and MD adherence. Conclusions: Covid -19 pandemic has exerted persistent detrimental effects on daily quality of life and mental health of older adults in the post-Covid period. Future strategies and public policies should develop healthcare programs to provide psychological and nutritional counseling and support to older adults to minimize the detrimental effects of Covid pandemic.
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  • 文章类型: Journal Article
    多药(PP)的使用在老年人中非常普遍,可能导致药物-药物相互作用(DDI)和抗胆碱能负担(ACB),这可能会影响认知功能。我们的目的是确定PP的发生,潜在的DDI和ACB及其在老年人认知结果中的作用。来自636名社区居住成年人的横截面数据(73.2±6.0标准差,58.6%的女性)参与NutBrain研究(2019-2023)进行了分析。参与者被问及他们的药物使用情况,并提取潜在DDI和ACB数据。PP(≥5种药物/天)的关联,潜在的DDI,和ACB伴轻度认知障碍(MCI)和特定认知领域的评估使用逻辑回归校正混杂因素进行评估.进行性别分层分析。总的来说,27.2%的参与者暴露于PP,潜在DDI占42.3%,累积ACB占19%。与男性相比,女性较少接触PP,更多接触ACB。在多变量分析中,重度ACB患者(≥3)患MCI的几率(24%)高出3倍(OR3.34,95CI1.35~8.25).ACB与执行功能不良(OR4.45,95CI1.72-11.49)呈正相关,特别是与正面评估电池和语音和语义流畅性的神经心理学测试呈正相关。在性别分层分析中,ACB与女性的MCI和执行功能以及男性的记忆具有统计学意义。PP,潜在的DDI和抗胆碱能药物的使用在社区居住的老年人中非常普遍。ACB暴露与MCI相关,特别是与执行功能差有关。鼓励临床医生在处方抗胆碱能药时保持警惕。试用注册:试用注册编号NCT04461951,注册日期2020年7月7日(追溯注册,ClinicalTrials.gov)。
    Polypharmacy (PP) use is very common in older people and may lead to drug-drug interactions (DDIs) and anticholinergic burden (ACB) that may affect cognitive function. We aimed to determine the occurrence of PP, potential DDIs and ACB and their role in cognitive outcomes in an older population. Cross-sectional data from 636 community-dwelling adults (73.2 ± 6.0 SD, 58.6% women) participating in the NutBrain study (2019-2023) were analyzed. Participants were asked about their medication use, and data on potential DDIs and ACB were extracted. The associations of PP (≥ 5 drugs/day), potential DDIs, and ACB with mild cognitive impairment (MCI) and specific cognitive domains were assessed using logistic regression adjusted for confounders. Sex-stratified analysis was performed. Overall, 27.2% of the participants were exposed to PP, 42.3% to potential DDIs and 19% to cumulative ACB. Women were less exposed to PP and more exposed to ACB than men. In multivariate analysis, the odds of having MCI (24%) were three times higher in those with severe ACB (≥ 3) (OR 3.34, 95%CI 1.35-8.25). ACB was positively associated with poor executive function (OR 4.45, 95%CI 1.72-11.49) and specifically with the Frontal Assessment Battery and neuropsychological tests of phonological and semantic fluency. In sex-stratified analysis, ACB was statistically significantly associated with MCI and executive function in women and with memory in men. PP, potential DDIs and anticholinergics use are very common in community-dwelling older people. ACB exposure is associated with MCI, particularly with poor executive function. Clinicians are encouraged to be vigilant when prescribing anticholinergics.Trial registration: Trial registration number NCT04461951, date of registration July 7, 2020 (retrospectively registered, ClinicalTrials.gov).
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