The Interaction of Cognitive and Emotional Status on Subsequent Physical Functioning in Older Mexican Americans: Findings From the Hispanic Established Population for the Epidemiologic Study of the Elderly

Neurocognitive profiles in elderly patients with frontotemporal degeneration or major depressive disorder

Major depressive disorder (MDD) and frontotemporal dementia (FTD) are both disorders in elderly populations that involve the prefrontal cortex and appear to have similar neurocognitive deficits. This review examined whether there are testable deficits in cognition that are consistent across individuals within the same neuropathological condition that could be used to facilitate early diagnoses. Medline and PsychInfo databases were searched for cognitive studies of depressed and FTD patients that used a matched control group and reported findings with means and standard deviations (N = 312). Effect sizes for FTD patients with mild and moderately advanced disease were compared to effect sizes within subgroups of depressed patients, such as inpatients, outpatients and community volunteers. Moderately advanced FTD patients were more impaired than depressed patients over all domains, particularly in language ability, although depressed inpatients appeared similar to FTD patients in some domains. Effect sizes for FTD patients who were in the mild, or early, stage of the disease (MMSE = 28) were similar to those of depressed outpatients but slightly worse than those of community volunteers in all domains except semantic memory and executive ability. In the latter two domains, even mild FTD patients had notably large deficits. All FTD patients showed more severe deficits in some domains relative to other domains. In contrast, depressed patients tended to vary by clinical presentation or disease severity, but the magnitude of impairment for each subgroup remained relatively consistent across domains and they did not have the severe focal deficits in one or two domains demonstrated by FTD patients.

Inconsistent use of diabetes medications, diabetes complications, and mortality in older mexican americans over a 7-year period: data from the Hispanic established population for the epidemiologic study of the elderly

OBJECTIVE

The aim of this study was to examine the relationship between inconsistency in use of diabetes drugs and risk of renal, eye, and circulation problems and death over a 7-year period in community-dwelling older Mexican Americans.

RESEARCH DESIGN AND METHODS

Data are from the four waves of the Hispanic Established Population for the Epidemiologic Study of the Elderly. In-home interviewers assessed consistency in use of diabetes medications among 908 diabetic Mexican Americans, aged >or=65 years. Diabetes and complications were by self-report. Subjects with poor consistency in use of medication were those who, at any time during the 7-year follow-up, discontinued or inconsistently used their diabetes medications and those who had no diabetic medications at home despite self-report of taking medicine for diabetes.

RESULTS

Thirty-six percent of our sample were inconsistent with diabetes medication usage. Older age and lack of supplemental health insurance were significantly associated with inconsistency of use of medication. In a multivariate logistic regression model, subjects with poor consistency in use of medication were more likely to report kidney problems (odds ratio [OR] 1.59; 95% CI 1.13-2.23; P = 0.008) at follow-up compared with those with good consistency, after controlling for age, sex, medication type, duration of diabetes, education, income, marital status, language of interview, insurance status, cognitive function, presence of depressive symptoms, activities of daily living, and instrumental activities of daily living. In Cox regression models, poor consistency with diabetic medication was also associated with increased all-cause mortality (hazard ratio [HR] 1.43; 95% CI 1.13-1.82; P = 0.003) and diabetes-related deaths (1.66; 1.20-2.30; P = 0.002) over a 7-year period after adjusting for relevant confounders.

CONCLUSIONS

Inconsistent use of diabetic medication was associated with an increased risk of kidney problems and deaths over a 7-year period in older Mexican Americans.

Escala de Afrontamiento al Cáncer en pacientes oncológicos en población mexicana

Introducción: Los estilos de afrontamiento son variables psicológicas que pueden predecir la adaptación psicológica y en sentido contrario una mayor disfunción psicosocial en pacientes con cáncer. Se han descrito dos dimensiones: centrados en el problema o activos positivos, caracterizados por la búsqueda de información, planificación y resolución de problemas; y los dirigidos a la emoción o evitativos caracterizados por el escape, distanciamiento o desesperanza. Objetivo: Determinar las propiedades psicométricas de la Escala de Afrontamiento del Cáncer en una muestra de pacientes con cáncer de la población mexicana. Método: Participaron 317 pacientes del Instituto Nacional del Cáncer, de los cuales 148 eran mujeres (46,7%) y 169 hombres (53,4%), con una edad media de 46,2 años. Los participantes completaron al mismo tiempo el Mental Adjustment to Cancer (MAC), el HADS y el Termometro del Distress. Resultados: Mediante el análisis factorial se identificaron cinco factores que explicaron el 53,32% de la varianza, con 22 reactivos. La consistencia interna de la escala global fue satisfactoria (0,81). La validez concurrente mostró asociaciones significativas (Pearson r = - 0,120 – 0,586, p <0,05). Discusión y conclusión: La Escala de Afrontamiento del Cáncer derivada del Mental Adjustment to Cancer tiene propiedades psicométricas adecuadas. Es una herramienta útil para fines de investigación y atención en salud mental durante el tratamiento oncológico.