1
|
Mimenza-Alvarado AJ, Bombón-Albán P, Duarte-Flores JO, Gutiérrez-Gutiérrez L, Ávila-Funes JA, Aguilar-Navarro SG. Five-Word Test, Screening of Mixed Dementia in Older Adults. Validation Study. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 52:S0034-7450(21)00085-8. [PMID: 34226035 DOI: 10.1016/j.rcp.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 03/31/2021] [Accepted: 04/21/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION AND OBJECTIVES The prevalence of mixed dementia (MixD), defined as the coexistence of Alzheimer's disease (AD) and vascular dementia (VaD), is likely to increase as the population ages. The five-word test (5WT) is a neuropsychological test that differentiates between major and mild neurocognitive disorder (NCD). The objective of the study is to validate 5WT for the detection of MixD. METHODS 230 participants were evaluated: cognitively healthy (CH) (n=70), mild NCD (n=70), and major NCD (n=90): AD (n=30), VaD (n=30), and MixD (n=30). The Spearman's coefficient, d Sommer and ROC curves were used to determine the construct validity of the 5WT. The linear regression model was performed to determine the association between age and education with 5WT performance. RESULTS The mean age was 79 ±7.7 years (P≤.001), 58% were female (P=.252), and the mean education was 9 ±5.3 years (P≤.001). Construct validity when comparing 5WT and MMSE was: Spearman's correlation ρ=.830 (P<.001) and d Sommer=.41 (P<.001). The area under the curve in the total weighted score (TWS) for MixD was .985, with 98% sensitivity (95%CI, 0.96-1.00) and 99% specificity (95%CI, 0.94-1.00), PPV of 88% (95%CI, 0.82-0.89), NPV of 100% (95%CI, 0.96-1.00), and cut-off point ≤16/20 (P<.001). CONCLUSIONS 5WT is a rapid test with neuropsychological validation for the exploration of cognitive characteristics in major NCD type MixD, regardless of age and education.
Collapse
Affiliation(s)
- Alberto J Mimenza-Alvarado
- Departamento de Geriatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - Paulina Bombón-Albán
- Departamento de Geriatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - J Octavio Duarte-Flores
- Departamento de Geriatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - Lidia Gutiérrez-Gutiérrez
- Departamento de Neurología y Psiquiatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - J Alberto Ávila-Funes
- Departamento de Geriatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México; Bordeaux Population Health Research Center, University of Bordeaux, Inserm, UMR 1219, F-33000 Bordeaux, France
| | - Sara G Aguilar-Navarro
- Departamento de Geriatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
| |
Collapse
|
2
|
Tortajada-Soler M, Sánchez-Valdeón L, Blanco-Nistal M, Benítez-Andrades JA, Liébana-Presa C, Bayón-Darkistade E. Prevalence of Comorbidities in Individuals Diagnosed and Undiagnosed with Alzheimer's Disease in León, Spain and a Proposal for Contingency Procedures to Follow in the Case of Emergencies Involving People with Alzheimer's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3398. [PMID: 32414124 PMCID: PMC7277451 DOI: 10.3390/ijerph17103398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 12/22/2022]
Abstract
Background: Alzheimer's disease (AD) which is the most common type of dementia is characterized by mental or cognitive disorders. People suffering with this condition find it inherently difficult to communicate and describe symptoms. As a consequence, both detection and treatment of comorbidities associated with Alzheimer's disease are substantially impaired. Equally, action protocols in the case of emergencies must be clearly formulated and stated. Methods: We performed a bibliography search followed by an observational and cross-sectional study involving a thorough review of medical records. A group of AD patients was compared with a control group. Each group consisted of 100 people and were all León residents aged ≥65 years. Results: The following comorbidities were found to be associated with AD: cataracts, urinary incontinence, osteoarthritis, hearing loss, osteoporosis, and personality disorders. The most frequent comorbidities in the control group were the following: eye strain, stroke, vertigo, as well as circulatory and respiratory disorders. Comorbidities with a similar incidence in both groups included type 2 diabetes mellitus, glaucoma, depression, obesity, arthritis, and anxiety. We also reviewed emergency procedures employed in the case of an emergency involving an AD patient. Conclusions: Some comorbidities were present in both the AD and control groups, while others were found in the AD group and not in the control group, and vice versa.
Collapse
Affiliation(s)
- Macrina Tortajada-Soler
- Facultad de Ciencias de la Salud, Campus de Vegazana, Universidad de León, s/n, C.P. 24071 León, Spain;
| | - Leticia Sánchez-Valdeón
- SALBIS Research Group, Facultad de Ciencias de la Salud, Campus de Ponferrada, Universidad de León, Avda/ Astorga s/n, C.P. 24402 Ponferrada (León), Spain; (C.L.-P.); (E.B.-D.)
| | - Marta Blanco-Nistal
- Complejo Asistencial Universitario de León, C/ Altos de nava s/n, C.P. 24001 León, Spain;
| | - José Alberto Benítez-Andrades
- SALBIS Research Group, Department of Electric, Systems and Automatics Engineering, University of León, s/n, 24071 León, Spain;
| | - Cristina Liébana-Presa
- SALBIS Research Group, Facultad de Ciencias de la Salud, Campus de Ponferrada, Universidad de León, Avda/ Astorga s/n, C.P. 24402 Ponferrada (León), Spain; (C.L.-P.); (E.B.-D.)
| | - Enrique Bayón-Darkistade
- SALBIS Research Group, Facultad de Ciencias de la Salud, Campus de Ponferrada, Universidad de León, Avda/ Astorga s/n, C.P. 24402 Ponferrada (León), Spain; (C.L.-P.); (E.B.-D.)
| |
Collapse
|
3
|
Tzeng NS, Chung CH, Lin FH, Huang CF, Yeh CB, Huang SY, Lu RB, Chang HA, Kao YC, Yeh HW, Chiang WS, Chou YC, Tsao CH, Wu YF, Chien WC. Magnesium oxide use and reduced risk of dementia: a retrospective, nationwide cohort study in Taiwan. Curr Med Res Opin 2018; 34:163-169. [PMID: 28952385 DOI: 10.1080/03007995.2017.1385449] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Dietary magnesium may be associated with a lower risk of dementia; however, the impact of magnesium oxide (MgO), a common laxative, on dementia has yet to be elucidated. This study aimed to investigate the association between the usage of MgO and the risk of developing dementia. METHODS We used a dataset from the National Health Research Institute Database (NHRID) of Taiwan containing one million randomly sampled subjects to identify patients aged ≥50 years with no history of MgO usage. A total of 1547 patients who had used MgO were enrolled, along with 4641 controls who had not used the MgO propensity score matched by age, gender and comorbidity, at a ratio of 1:3. After adjusting for confounding risk factors, a Cox proportional hazards model was used to compare the risk of developing dementia during a 10 year follow-up period. RESULTS Of the enrolled patients, 44 (2.84%) developed dementia, when compared to 199 (4.28%) in the control group. The Cox proportional hazards regression analysis revealed that the patients who had used MgO were less likely to develop dementia with a crude hazard ratio of 0.617 (95% CI, 0.445-0.856, p = .004). After adjusting for age, gender, comorbidity, geographical area and urbanization level of residence, and monthly income, the adjusted hazard ratio was 0.517 (95% CI, 0.412-0.793, p = .001). CONCLUSIONS The patients who used MgO had a decreased risk of developing dementia. Further studies on the effects of MgO in reducing the risk of dementia are therefore warranted.
Collapse
Affiliation(s)
- Nian-Sheng Tzeng
- a Department of Psychiatry , Tri-Service General Hospital, School of Medicine, National Defense Medical Center , Taipei , Taiwan , ROC
- b Student Counseling Center , National Defense Medical Center , Taipei , Taiwan , ROC
| | - Chi-Hsiang Chung
- c Taiwanese Injury Prevention and Safety Promotion Association , Taipei , Taiwan , ROC
- d School of Public Health , National Defense Medical Center , Taipei , Taiwan , ROC
| | - Fu-Huang Lin
- d School of Public Health , National Defense Medical Center , Taipei , Taiwan , ROC
| | - Ching-Feng Huang
- e Division of Gastroenterology, Children's Medical Center, Taipei Veterans General Hospital
- f School of Medicine, National Yang-Ming University
- g Department of Pediatrics , Tri-Service General Hospital, National Defense Medical Center , Taipei , Taiwan , ROC
| | - Chin-Bin Yeh
- a Department of Psychiatry , Tri-Service General Hospital, School of Medicine, National Defense Medical Center , Taipei , Taiwan , ROC
- h Graduate Institute of Medical Sciences , National Defense Medical Center , Taipei , Taiwan , ROC
| | - San-Yuan Huang
- a Department of Psychiatry , Tri-Service General Hospital, School of Medicine, National Defense Medical Center , Taipei , Taiwan , ROC
- h Graduate Institute of Medical Sciences , National Defense Medical Center , Taipei , Taiwan , ROC
| | - Ru-Band Lu
- a Department of Psychiatry , Tri-Service General Hospital, School of Medicine, National Defense Medical Center , Taipei , Taiwan , ROC
- h Graduate Institute of Medical Sciences , National Defense Medical Center , Taipei , Taiwan , ROC
- i Division of Clinical Psychology , Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University , Tainan , Taiwan , ROC
- j Department of Psychiatry, College of Medicine , National Cheng Kung University , Tainan , Taiwan , ROC
- k Institute of Behavioral Medicine , College of Medicine, National Cheng Kung University , Tainan , Taiwan , ROC
- l Department of Psychiatry , National Cheng Kung University Hospital , Tainan , Taiwan , ROC
- m Center for Neuropsychiatric Research , National Health Research Institute , Zhunan, Miaoli County , Taiwan , ROC
| | - Hsin-An Chang
- a Department of Psychiatry , Tri-Service General Hospital, School of Medicine, National Defense Medical Center , Taipei , Taiwan , ROC
- b Student Counseling Center , National Defense Medical Center , Taipei , Taiwan , ROC
| | - Yu-Chen Kao
- a Department of Psychiatry , Tri-Service General Hospital, School of Medicine, National Defense Medical Center , Taipei , Taiwan , ROC
- n Department of Psychiatry , Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center , Taipei , Taiwan , ROC
| | - Hui-Wen Yeh
- a Department of Psychiatry , Tri-Service General Hospital, School of Medicine, National Defense Medical Center , Taipei , Taiwan , ROC
- o Institute of Bioinformatics and Systems Biology , National Chiao Tung University , Hsin-Chu , Taiwan , ROC
- p Department of Nursing , Tri-Service General Hospital, and School of Nursing, National Defense Medical Center , Taipei , Taiwan , ROC
| | - Wei-Shan Chiang
- a Department of Psychiatry , Tri-Service General Hospital, School of Medicine, National Defense Medical Center , Taipei , Taiwan , ROC
- q Department and Institute of Mathematics , Tamkang University , New Taipei City , Taiwan , ROC
| | - Yu-Ching Chou
- d School of Public Health , National Defense Medical Center , Taipei , Taiwan , ROC
| | - Chang-Huei Tsao
- r Department of Medical Research , Tri-Service General Hospital, National Defense Medical Center , Taipei , Taiwan , ROC
- s Department of Microbiology & Immunology , National Defense Medical Center , Taipei , Taiwan , ROC
| | - Yung-Fu Wu
- r Department of Medical Research , Tri-Service General Hospital, National Defense Medical Center , Taipei , Taiwan , ROC
| | - Wu-Chien Chien
- d School of Public Health , National Defense Medical Center , Taipei , Taiwan , ROC
- r Department of Medical Research , Tri-Service General Hospital, National Defense Medical Center , Taipei , Taiwan , ROC
| |
Collapse
|
4
|
Chen CK, Wu YT, Chang YC. Association between chronic periodontitis and the risk of Alzheimer's disease: a retrospective, population-based, matched-cohort study. ALZHEIMERS RESEARCH & THERAPY 2017; 9:56. [PMID: 28784164 PMCID: PMC5547465 DOI: 10.1186/s13195-017-0282-6] [Citation(s) in RCA: 164] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 06/27/2017] [Indexed: 11/10/2022]
Abstract
Background Although recent short-term cross-sectional studies have revealed that chronic periodontitis (CP) may be a risk factor for increased cognitive impairment in patients with Alzheimer’s disease (AD), systematic reviews and long-term longitudinal studies have provided less clear evidence regarding the relationship between CP and AD. Therefore, we conducted a retrospective cohort study using the National Health Insurance Research Database (NHIRD) of Taiwan to determine whether patients with CP are at increased risk of developing AD. Methods We conducted a retrospective matched-cohort study using the NHIRD of Taiwan. We identified 9291 patients newly diagnosed with CP between 1997 and 2004. A total of 18,672 patients without CP were matched to the patient cohort according to sex, age, index year, co-morbidity and urbanisation level. Cox proportional hazards regression analyses were performed to evaluate the subsequent risk of AD. Results Patients with CP had a higher prevalence of hyperlipidaemia, depression, traumatic brain injury and co-morbidities, as well as higher urbanisation levels, than those in the unexposed cohort (all p < 0.01). At the final follow-up, totals of 115 (1.24%) and 208 (1.11%) individuals in the CP exposed and unexposed groups, respectively, had developed AD. Patients with 10 years of CP exposure exhibited a higher risk of developing AD than unexposed groups (adjusted HR 1.707, 95% CI 1.152–2.528, p = 0.0077). Conclusions Our findings demonstrate that 10-year CP exposure was associated with a 1.707-fold increase in the risk of developing AD. These findings highlight the need to prevent progression of periodontal disease and promote healthcare service at the national level.
Collapse
Affiliation(s)
- Chang-Kai Chen
- School of Dentistry, Chung Shan Medical University, No. 110, Section 1, Jianguo N. Road, Taichung City, 40201, Taiwan.,Section of Dentistry, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Yung-Tsan Wu
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defence Medical Centre, Taipei, Taiwan
| | - Yu-Chao Chang
- School of Dentistry, Chung Shan Medical University, No. 110, Section 1, Jianguo N. Road, Taichung City, 40201, Taiwan. .,Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan.
| |
Collapse
|
5
|
Tzeng NS, Chung CH, Yeh CB, Huang RY, Yuh DY, Huang SY, Lu RB, Chang HA, Kao YC, Chiang WS, Chou YC, Chien WC. Are Chronic Periodontitis and Gingivitis Associated with Dementia? A Nationwide, Retrospective, Matched-Cohort Study in Taiwan. Neuroepidemiology 2016; 47:82-93. [PMID: 27618156 DOI: 10.1159/000449166] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 08/16/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic periodontitis and gingivitis are associated with various diseases; however, their impact on dementia is yet to be elucidated. This study is aimed at investigating the association between chronic periodontitis and gingivitis, and the risk of developing dementia. METHODS A total of 2,207 patients, with newly diagnosed chronic periodontitis and gingivitis between January 1, 2000 and December 31, 2000, were selected from the National Health Insurance Research Database of Taiwan, along with 6,621 controls matched for sex and age. After adjusting for confounding factors, Cox proportional hazards analysis was used to compare the risk of developing dementia during the 10-year follow-up period. RESULTS Of the study subjects, 25 (1.13%) developed dementia compared to 61 (0.92%) in the control group. Cox proportional hazards regression analysis revealed that the study subjects were more likely to develop dementia (hazard ratio (HR) 2.085, 95% CI 1.552-4.156, p < 0.001). After adjusting for sex, age, monthly income, urbanization level, geographic region, and comorbidities, the HR for dementia was 2.54 (95% CI 1.297-3.352, p = 0.002). CONCLUSIONS Patients with chronic periodontitis and gingivitis have a higher risk of developing dementia. However, further studies on other large or national data sets are required to support the current findings.
Collapse
Affiliation(s)
- Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|