1
|
Galkin F, Kochetov K, Keller M, Zhavoronkov A, Etcoff N. Optimizing future well-being with artificial intelligence: self-organizing maps (SOMs) for the identification of islands of emotional stability. Aging (Albany NY) 2022; 14:4935-4958. [PMID: 35723468 PMCID: PMC9271294 DOI: 10.18632/aging.204061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 04/25/2022] [Indexed: 12/18/2022]
Abstract
In this article, we present a deep learning model of human psychology that can predict one’s current age and future well-being. We used the model to demonstrate that one’s baseline well-being is not the determining factor of future well-being, as posited by hedonic treadmill theory. Further, we have created a 2D map of human psychotypes and identified the regions that are most vulnerable to depression. This map may be used to provide personalized recommendations for maximizing one’s future well-being.
Collapse
Affiliation(s)
| | | | | | - Alex Zhavoronkov
- Deep Longevity Limited, Hong Kong.,Insilico Medicine, Hong Kong.,Buck Institute for Research on Aging, Novato, CA 94945, USA
| | - Nancy Etcoff
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
| |
Collapse
|
2
|
Iguacel I, Huybrechts I, Moreno LA, Michels N. Vegetarianism and veganism compared with mental health and cognitive outcomes: a systematic review and meta-analysis. Nutr Rev 2021; 79:361-381. [PMID: 32483598 DOI: 10.1093/nutrit/nuaa030] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
CONTEXT Vegetarian and vegan diets are increasing in popularity. Although they provide beneficial health effects, they may also lead to nutritional deficiencies. Cognitive impairment and mental health disorders have a high economic burden. OBJECTIVE A meta-analysis was conducted to examine the relationship between vegan or vegetarian diets and cognitive and mental health. DATA SOURCES PubMed, Scopus, ScienceDirect, and Proquest databases were examined from inception to July 2018. STUDY SELECTION Original observational or interventional human studies of vegan/vegetarian diets were selected independently by 2 authors. DATA EXTRACTION Raw means and standard deviations were used as continuous outcomes, while numbers of events were used as categorical outcomes. RESULTS Of 1249 publications identified, 13 were included, with 17 809 individuals in total. No significant association was found between diet and the continuous depression score, stress, well-being, or cognitive impairment. Vegans/vegetarians were at increased risk for depression (odds ratio = 2.142; 95%CI, 1.105-4.148) and had lower anxiety scores (mean difference = -0.847; 95%CI, -1.677 to -0.018). Heterogeneity was large, and thus subgroup analyses showed numerous differences. CONCLUSIONS Vegan or vegetarian diets were related to a higher risk of depression and lower anxiety scores, but no differences for other outcomes were found. Subgroup analyses of anxiety showed a higher risk of anxiety, mainly in participants under 26 years of age and in studies with a higher quality. More studies with better overall quality are needed to make clear positive or negative associations. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42018097204.
Collapse
Affiliation(s)
- Isabel Iguacel
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences , University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- CIBERObn (Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición), Zaragoza, Spain
| | - Inge Huybrechts
- Department of Public Health, Ghent University, Ghent, Belgium; and the International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Luis A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón, Zaragoza, Spain; the Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- CIBERObn (Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición) , Zaragoza, Spain
| | | |
Collapse
|
3
|
Khalighi E, Tarjoman A, Abdi A, Borji M. The prevalence of delirium in patients in Iran: a systematic review and meta-analysis. FUTURE NEUROLOGY 2019. [DOI: 10.2217/fnl-2018-0044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: The first systematic review and meta analysis investigating the prevalence of delirium in Iran and the importance of delirium in the health status of patients. Method: This study is a review article to determine the overall prevalence of delirium in patients admitted to the hospitals in Iran, with search time frame to 12 October 2000–12 October 2018. The study examined the prevalence of delirium in general wards and ICUs of Iran according to published article in domestic and foreign journals. The methodological quality of the papers was based on a tool used in previous studies. Data was analyzed using comprehensive meta-analysis (CMA) software. Findings: The findings showed the prevalence of delirium in hospitalized patients in Iran is 21.8% (CI: 17.5–27.5%). The prevalence of delirium in hospitalized patients in Iran based on the hospitalization in ICU is 24.7% (CI: 18.1–32.7%) and in the general ward is 17.5% (CI: 13.6–22.3%). Conclusion: Due to the relatively high prevalence of delirium in patients admitted to hospitals in Iran, prevention is necessary to reduce the incidence of delirium.
Collapse
Affiliation(s)
- Ebrahim Khalighi
- Anesthesiologist, Department of Anesthesiology, Medicine Faculty, Ilam University of Medical Science, Ilam, IR Iran
| | - Asma Tarjoman
- Student Research committee, kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Alireza Abdi
- Department of Nursing, Faculty of Nursing & Midwifery, kermanshah University of Medical Science, Kermanshah, IR Iran
| | - Milad Borji
- Department of Nursing, Faculty of Nursing & Midwifery, kermanshah University of Medical Science, Kermanshah, IR Iran
| |
Collapse
|
4
|
Pérez-Ros P, Martínez-Arnau FM, Baixauli-Alacreu S, Caballero-Pérez M, García-Gollarte JF, Tarazona-Santabalbina F. Delirium Predisposing and Triggering Factors in Nursing Home Residents: A Cohort Trial-Nested Case-Control Study. J Alzheimers Dis 2019; 70:1113-1122. [DOI: 10.3233/jad-190391] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Pilar Pérez-Ros
- Nursing School, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - Francisco Miguel Martínez-Arnau
- Nursing School, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
- Department of Physiotherapy, Universitat de València, Valencia, Spain
| | | | | | | | - Francisco Tarazona-Santabalbina
- Department of Geriatric Medicine, Hospital Universitario de la Ribera, Valencia, Spain
- Faculty of Medicine, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| |
Collapse
|
5
|
Impact of frailty status on the cost of drugs and dietary supplements prescribed to nursing home residents: the SENIOR cohort. Aging Clin Exp Res 2019; 31:875-880. [PMID: 30847844 DOI: 10.1007/s40520-019-01162-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 02/27/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND The financial impact associated with drug consumption has been poorly investigated among frail subjects and, specifically, in nursing home settings. AIMS To determine the association of the average monthly cost of the drugs and dietary supplements consumed by nursing home residents with their frailty status. METHODS This is an analysis of the first follow-up year of the SENIOR cohort. All participants were classified into "frail" or "non-frail" categories according to Fried's criteria at baseline. Monthly bills from the pharmacy were analysed to determine the association between the average monthly cost of the drugs and dietary supplements consumed and frailty status. RESULTS A sample of 87 residents (83.8 ± 9.33 years and 75.9% women) from the SENIOR cohort was included. The prevalence of frailty was 28%. The median number of medications consumed each day was 9 (6-12) (no difference between frail and non-frail subjects; p = 0.15). The overall median monthly cost was € 109.6, of which 49% was covered by Belgian social security and the remaining balance was paid by the patient. When comparing the drug expenses of the frail subjects and the non-frail subjects, the overall average monthly cost did not differ between the 2 groups (p = 0.057). Nevertheless, the expenditure remaining to be paid by the residents, after the Belgian social security intervention, was significantly higher among the frail residents (€ 65.7) than among the non-frail residents (€ 47.6; p = 0.017). CONCLUSIONS Frailty status has an impact on the expenditures related to the consumption of drugs.
Collapse
|
6
|
Abstract
UNLABELLED ABSTRACTBackground:A few studies examine the time evolution of delirium in long-term care (LTC) settings. In this work, we analyze the multivariate Delirium Index (DI) time evolution in LTC settings. METHODS The multivariate DI was measured weekly for six months in seven LTC facilities, located in Montreal and Quebec City. Data were analyzed using a hidden Markov chain/latent class model (HMC/LC). RESULTS The analysis sample included 276 LTC residents. Four ordered latent classes were identified: fairly healthy (low "disorientation" and "memory impairment," negligible other DI symptoms), moderately ill (low "inattention" and "disorientation," medium "memory impairment"), clearly sick (low "disorganized thinking" and "altered level of consciousness," medium "inattention," "disorientation," "memory impairment" and "hypoactivity"), and very sick (low "hypoactivity," medium "altered level of consciousness," high "inattention," "disorganized thinking," "disorientation" and "memory impairment"). Four course types were also identified: stable, improvement, worsening, and non-monotone. Class order was associated with increasing cognitive impairment, frequency of both prevalent/incident delirium and dementia, mortality rate, and decreasing performance in ADL. CONCLUSION Four ordered latent classes and four course types were found in LTC residents. These results are similar to those reported previously in acute care (AC); however, the proportion of very sick residents at enrolment was larger in LTC residents than in AC patients. In clinical settings, these findings could help identify participants with a chronic clinical disorder. Our HMC/LC approach may help understand coexistent disorders, e.g. delirium and dementia.
Collapse
|
7
|
Constaín GA, Ocampo Saldarriaga MV, Velásquez Tirado JD, Rodríguez-Gázquez MDLÁ, Betancur Morales LM, Rico Escobar JJ, Castilla Agudelo GA, Maya Osorno AF. Persistent Delirium in Elderly patients Three Months After Hospital Discharge from a University Clinic. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2018; 47:37-45. [PMID: 29428120 DOI: 10.1016/j.rcp.2016.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 09/29/2016] [Accepted: 10/31/2016] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The purpose of the study was to determine the prevalence and characteristics of patients with persistent delirium (PD) at three months after hospital discharge. METHODOLOGY Longitudinal descriptive study to assess the prevalence and characteristics of in-patients aged 65 years and older in the Clinica Universitaria Bolivariana who met DSM-5 criteria for delirium at admission, at discharge, and at a 3-month follow up assessment. Socio-demographic features were determined, and CGI-S and DRS-R98 scales used. RESULTS A total of 30 patients were evaluated between April and October 2013, but 6 did not fulfil the inclusion criteria. The study included 24 patients, with 9 (37.5%) dying during hospitalisation. Of the 15 surviving patients, five (20.8% of the total sample) had their delirium resolved at discharge, and ten (41.6% of the sample) continued with symptoms. These established the PD group, of whom five of them (20.8%) had full PD, and the other five (20.8%) sub-syndromal PD (SSPD). At the final assessment, only two patients (8.3%) continued with full PD, and another two (8.3%) with SSPD. Among the PD group, 30% had a full delirium at admission (prevalence), and 70% developed full delirium during hospitalization (incidence). CONCLUSIONS A significant number of patients did not recover from delirium at leaving hospital, and remained symptomatic three months after discharge. The study findings suggest a course of gradual improvement of delirium, with a persistence of symptoms over time in 40% of the patients, which would have implications for the clinical practice.
Collapse
Affiliation(s)
- Gustavo A Constaín
- Grupo de Investigación de Psiquiatría de Enlace, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia.
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Abstract
BACKGROUND The delirium index (DI) is a valid measure of delirium severity. We proposed to describe longitudinal patterns of severity scores in older long-term care (LTC) residents. METHODS A prospective cohort study of 280 residents in seven LTC facilities in Montreal and Quebec City, Canada, was conducted. DI, Barthel Index, Mini-Mental State Examination, Charlson Comorbidity Index, Cornell Scale for Depression in Dementia, dementia assessment by an MD, and prevalent or incident probable delirium defined according to the Confusion Assessment Method were completed at baseline. The DI was also assessed weekly for 6 months. Demographic characteristics were abstracted from resident charts. Cluster analysis for longitudinal data was used to describe longitudinal patterns of DI scores. RESULTS During the 24 weeks following enrolment, 28 (10.0%) of 280 residents who had prevalent delirium and 76 (27.1%) who had incident delirium were included in our analysis. Average observation period was 18.3 weeks. Four basic types of time evolution patterns were discovered: Improvement, Worsening, Fluctuating, and Steady, including 22%, 18%, 25%, and 35%, of the residents, respectively. With the exception of the Worsening pattern, the average trajectory was stabilized at the 4th week or earlier. Poor baseline cognitive and physical function and greater severity of delirium predicted worse trajectories over 24 weeks. CONCLUSIONS The longitudinal patterns of DI scores found in LTC residents resemble those found in an earlier study of delirium in acute care (AC) settings. However, compared to AC patients, LTC residents have a smaller DI variability over time, a less frequent Improvement pattern, and more frequent Worsening and Fluctuating patterns.
Collapse
|
9
|
Forsberg MM. Delirium Update for Postacute Care and Long-Term Care Settings: A Narrative Review. J Osteopath Med 2017; 117:32-38. [DOI: 10.7556/jaoa.2017.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
Advances have been made in our understanding of the neuropathogenesis, recognition, and strategies for reducing the incidence of delirium in acute-care settings. However, relatively little attention has been given to delirium in elderly patients in the postacute care (PAC) and long-term care (LTC) settings. The present article reviews the most relevant current research pertaining to this population. Hospital patients with delirium are often discharged to PAC settings. Delirium that develops in the LTC setting is often more insidious and subtle in presentation. Despite incorporating systematic screening tools for delirium in PAC and LTC settings, delirium prevention strategies have not yet been shown to be beneficial beyond the acute-care setting. The management of delirium combined with dementia and guidance on when it is appropriate to use antipsychotic medications is also discussed.
Collapse
|
10
|
Abstract
Delirium is defined as a neurocognitive disorder characterized by sudden onset, fluctuating course, and disturbances in level of consciousness, attention, orientation, memory, thought, perception, and behavior (American Psychiatric Association, 2013). It occurs in hyperactive, hypoactive, or mixed forms in up to 50% of older hospital patients (Inouye et al., 2014) and 70% of older long-term care residents (McCusker et al., 2011), many with pre-existing dementia (Fick et al., 2002).
Collapse
|
11
|
Abstract
BACKGROUND Depression is a common problem in long-term care (LTC) settings. We sought to characterize depression symptom trajectories over six months among older residents, and to identify resident characteristics at baseline that predict symptom trajectory. METHODS This study was a secondary analysis of data from a six-month prospective, observational, and multi-site study. Severity of depressive symptoms was assessed with the 15-item Geriatric Depression Scale (GDS) at baseline and with up to six monthly follow-up assessments. Participants were 130 residents with a Mini-Mental State Examination score of 15 or more at baseline and of at least two of the six monthly follow-up assessments. Individual resident GDS trajectories were grouped using hierarchical clustering. The baseline predictors of a more severe trajectory were identified using the Proportional Odds Model. RESULTS Three clusters of depression symptom trajectory were found that described "lower," "intermediate," and "higher" levels of depressive symptoms over time (mean GDS scores for three clusters at baseline were 2.2, 4.9, and 9.0 respectively). The GDS scores in all groups were generally stable over time. Baseline predictors of a more severe trajectory were as follows: Initial GDS score of 7 or more, female sex, LTC residence for less than 12 months, and corrected visual impairment. CONCLUSIONS The six-month course of depressive symptoms in LTC is generally stable. Most residents who experience a more severe symptom trajectory can be identified at baseline.
Collapse
|
12
|
Increased risk of psychosis in patients with hearing impairment: Review and meta-analyses. Neurosci Biobehav Rev 2015; 62:1-20. [PMID: 26743858 DOI: 10.1016/j.neubiorev.2015.12.012] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/24/2015] [Accepted: 12/24/2015] [Indexed: 12/12/2022]
Abstract
Several studies suggest hearing impairment as a risk factor for psychosis. Hearing impairment is highly prevalent and potentially reversible, as it can be easily diagnosed and sometimes improved. Insight in the association between hearing impairment and psychosis can therefore contribute to prevention of psychosis. This paper provides meta-analyses of all epidemiologic evidence on the association between hearing impairment and psychosis and summarizes mechanisms that potentially underlie this relationship. Meta-analyses showed an increased risk of hearing impairment on all psychosis outcomes, such as hallucinations (OR 1.40(95%CI 1.18-1.65; n=227,005)), delusions (OR 1.55(95%CI 1.36-1.78; n=250,470)), psychotic symptoms (OR 2.23(95%CI 1.83-2.72; n=229,647) and delirium (OR 2.67(95%CI 2.05-3.48; n=12,432). Early exposure to hearing impairment elevated the risk of later development of schizophrenia (OR 3.15(95%CI 1.25-7.95; n=50,490)). Potential mechanisms underlying this association include loneliness, diminished theory of mind, disturbances of source monitoring and top-down processing and deafferentiation. Early assessment and treatment of hearing impairment in patients with (high risk of) psychosis may be essential in psychosis treatment and prevention.
Collapse
|
13
|
Regal PJ. Delirium in Swiss nursing home residents. Am J Geriatr Psychiatry 2014; 22:420. [PMID: 24635995 DOI: 10.1016/j.jagp.2013.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 12/05/2013] [Indexed: 10/25/2022]
|
14
|
Making Delirium Prevention Acceptable in Nursing Homes. J Am Med Dir Assoc 2014; 15:6-7. [DOI: 10.1016/j.jamda.2013.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 09/04/2013] [Indexed: 11/23/2022]
|
15
|
Cheong JA. Diagnosis, risk factors, predisposing factors, and predictive models of delirium. Am J Geriatr Psychiatry 2013; 21:931-4. [PMID: 24029013 DOI: 10.1016/j.jagp.2013.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 07/24/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Josepha A Cheong
- Malcom Randall VA Medical Center and University of Florida College of Medicine, Gainesville, FL.
| |
Collapse
|