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Huo K, Shang S, Wang J, Chen C, Dang L, Gao L, Wei S, Zeng L, Qu Q. Trends on Prevalence, All-Cause Mortality, and Survival Status of Dementia Patients in Rural China Based on Pooling Analysis. Int J Public Health 2024; 69:1606786. [PMID: 39238546 PMCID: PMC11374651 DOI: 10.3389/ijph.2024.1606786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 07/31/2024] [Indexed: 09/07/2024] Open
Abstract
Objectives No study has reported secular trends in dementia prevalence, all-cause mortality, and survival status in rural China. Methods We established two cohorts (XRRCC1 and XRRCC2) in the same region of China, 17 years apart, to compare dementia prevalence, all-cause mortality, and survival status, and performed regression analysis to identify associated factors. Results Dementia prevalence was 3.49% in XRRCC1 and 4.25% in XRRCC2, with XRRCC2 showing a significantly higher prevalence (OR = 1.79, 95%CI: 1.2-2.65). All-cause mortality rates for dementia patients were 62.0% in XRRCC1 and 35.7% in XRRCC2. Mortality in the normal population of XRRCC2 decreased by 66% compared to XRRCC1, mainly due to improved survival rates in women with dementia. Dementia prevalence was positively associated with age >65, spouse-absent status, and stroke, and negatively associated with ≥6 years of education. Conclusion Dementia prevalence in rural China increased over 17 years, while mortality decreased. Major risk factors include aging, no spouse, and stroke, with higher education offering some protection.
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Affiliation(s)
- Kang Huo
- Department of Neurology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Suhang Shang
- Department of Neurology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jin Wang
- Department of Neurology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Chen Chen
- Department of Neurology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Liangjun Dang
- Department of Neurology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ling Gao
- Department of Neurology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shan Wei
- Department of Neurology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Qiumin Qu
- Department of Neurology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Center for Brain Science, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Sun H, Liu W, Sun X, Gao Y, Chen Y, Lin Y, Song J, Zhang Z, Wang BH, Li L, Feng H, Tan H, Chen Q, Peng L, Dai W, Wu IXY. Development and Validation of Knowledge Assessment Scales for Dementia and Urinary Incontinence in Community Older People. J Appl Gerontol 2024; 43:1042-1051. [PMID: 38488166 DOI: 10.1177/07334648241236036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2024] Open
Abstract
To develop and validate scales for reliably assessing dementia and urinary incontinence knowledge of older adults in the community. Items were generated through a literature review, refined through a Delphi study (n = 19), and then revised through a pilot study (n = 29). Item analysis and exploratory factor analysis were applied to finalize the scales (n = 244). Construct validity, reliability, and acceptability were evaluated (n = 243). The two knowledge assessment scales for dementia and urinary incontinence, respectively, comprised 12 items and 8 items. Model fit indicators of both met the criteria of confirmatory factor analysis. Cronbach's α were .82 and .70, respectively. Completion ratio and completion time of the two scales was 83.51% and 4.22 ± 1.90 minutes. The knowledge assessment scales for dementia and urinary incontinence with satisfactory validity, reliability, and acceptability, could be served as valid tools for disease prevention and management among older adults in the community.
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Affiliation(s)
- Hui Sun
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Wenqi Liu
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Xuemei Sun
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Yancong Chen
- Changsha Municipal Center for Disease Control and Prevention, Changsha, China
| | - Yali Lin
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Jinlu Song
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Zixuan Zhang
- Changsha Municipal Center for Disease Control and Prevention, Changsha, China
| | - Betty H Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Lingqi Li
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Hui Feng
- Xiangya Nursing School, Central South University, Changsha, China
| | - Hongzhuan Tan
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Qiong Chen
- Xiangya Hospital of Central South University, Changsha, China
| | - Linlin Peng
- Xiangya Hospital of Central South University, Changsha, China
| | - Wenjie Dai
- Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
| | - Irene X Y Wu
- Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
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Chen S, Chen X, Hou X, Fang H, Liu GG, Yan LL. Temporal trends and disparities of population attributable fractions of modifiable risk factors for dementia in China: a time-series study of the China health and retirement longitudinal study (2011-2018). THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 47:101106. [PMID: 38872868 PMCID: PMC11170192 DOI: 10.1016/j.lanwpc.2024.101106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 04/06/2024] [Accepted: 05/16/2024] [Indexed: 06/15/2024]
Abstract
Background In China, dementia poses a significant public health challenge, exacerbated by an ageing population and lifestyle changes. This study assesses the temporal trends and disparities in the population-attributable fractions (PAFs) of modifiable risk factors (MRFs) for new-onset dementia from 2011 to 2018. Methods We used data from the China Health and Retirement Longitudinal Study (CHARLS), covering 75,214 person-waves. We calculated PAFs for 12 MRFs identified by the Lancet Commission (including six early-to mid-life factors and six late-life factors). We also determined the individual weighted PAFs (IW-PAFs) for each risk factor. Subgroup analyses were conducted by sex, socio-economic status (SES), and geographic location. Findings The overall PAF for dementia MRFs had a slight increase from 45.36% in 2011 to 52.46% in 2018, yet this change wasn't statistically significant. During 2011-2018, the most contributing modifiable risk was low education (average IW-PAF 11.3%), followed by depression, hypertension, smoking, and physical inactivity. Over the eight-year period, IW-PAFs for risk factors like low education, hypertension, hearing loss, smoking, and air pollution showed decreasing trends, while others increased, but none of these changes were statistically significant. Sex-specific analysis revealed higher IW-PAFs for traumatic brain injury (TBI), social isolation, and depression in women, and for alcohol and smoking in men. The decline in IW-PAF for men's hearing loss were significant. Lower-income individuals had higher overall MRF PAFs, largely due to later-life factors like depression. Early-life factors, such as TBI and low education, also contributed to SES disparities. Rural areas reported higher overall MRF PAFs, driven by factors like depression, low education, and hearing loss. The study also found that the gap in MRF PAFs across different SES groups or regions either remained constant or increased over the study period. Interpretation The study reveals a slight but non-significant increase in dementia's MRF PAF in China, underscoring the persistent relevance of these risk factors. The findings highlight the need for targeted public health strategies, considering the demographic and regional differences, to effectively tackle and reduce dementia risk in China's diverse population. Funding This work was supported by the PKU Young Scholarship in Global Health and Development.
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Affiliation(s)
- Shanquan Chen
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Xi Chen
- School of Public Health, Yale University, New Haven, CT, United States
| | | | - Hai Fang
- Institute for Global Health and Development, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Gordon G. Liu
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Lijing L. Yan
- Institute for Global Health and Development, Peking University, Beijing, China
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
- School of Public Health, Wuhan University, Wuhan, China
- Duke Global Health Institute, Duke University, Durham, NC, United States
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Liu Y, Gao X, Zhang Y, Zeng M, Liu Y, Wu Y, Hu W, Lai Y, Liao J. Geographical variation in dementia prevalence across China: a geospatial analysis. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 47:101117. [PMID: 38974661 PMCID: PMC11225804 DOI: 10.1016/j.lanwpc.2024.101117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/25/2024] [Accepted: 05/30/2024] [Indexed: 07/09/2024]
Abstract
Background Dementia poses great health and social challenges in China. Dementia prevalence may vary across geographic areas, while comparable estimations on provincial level is lacking. This study aims to estimate dementia prevalence by provinces across China, taking into account risk factors of individual level and potential spatial correlation of provinces. Methods In this study, 17,176 adults aged 50 years or older were included from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS 2018), covering 28 provinces, autonomous regions and municipalities. To improve provincial representativeness, we constructed provincial survey weights based on China 7th census (2020). The prevalence of dementia and 95% Bayesian credible intervals (BCIs) were estimated using a Bayesian conditional autoregressive (CAR) model with spatially varying coefficients of covariates. Findings The weighted prevalence of dementia at provincial level in China in 2018 ranged from 2.62% (95%BCI: 1.70%, 3.91%) to 13.53% (95%BCI: 8.82%, 20.93%). High dementia prevalence was concentrated in North China, with a prominent high-high cluster, while provinces of low prevalence were concentrated on East and South China, characterized by a low-low cluster. Ordered by the median estimation of prevalence, the top 10% of provinces, include Xinjiang, Jilin, and Beijing. Meanwhile, Fujian, Zhejiang, and Guangdong rank among the last. The association between dementia prevalence and drinking, smoking, social isolation, physical inactivity, hearing impairment, hypertension, and diabetes exhibits provincial variation. Interpretation Our study identifies a geospatial disparity in dementia prevalence and risk factor effects across China's provinces, with high-high and low-low clusters in some northern and southern provinces, respectively. The findings emphasize the need for targeted strategies, such as addressing hypertension and hearing impairment, in specific regions for more effective dementia prevention and treatment. Funding National Science Foundation of China/the Economic and Social Research Council, UK Research and Innovation joint call: Understanding and Addressing Health and Social Challenges for Ageing in the UK and China. UK-China Health And Social Challenges Ageing Project (UKCHASCAP): present and future burden of dementia, and policy responses (grant number 72061137003, ES/T014377/1).
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Affiliation(s)
- Yixuan Liu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Xinyuan Gao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Yongjin Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Minrui Zeng
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Yuyang Liu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Shenzhen Health Development Research and Data Management Center, Shenzhen, China
| | - Yanjuan Wu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Weihua Hu
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100871, China
| | - Yingsi Lai
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Jing Liao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
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Jiang B, Liu Q, Li JP, Lin SN, Wan HJ, Yu ZW, Wang J, Zhuang W, Tang JH, Chen CH, Li FY, Bi M, Xiao NA, Zheng KM. Prevalence and risk factors for dementia and mild cognitive impairment among older people in Southeast China: a community-based study. BMC Geriatr 2024; 24:466. [PMID: 38807058 PMCID: PMC11134668 DOI: 10.1186/s12877-024-05054-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/08/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND With the aging population, the number of individuals with dementia in China is increasing rapidly. This community-based study aimed to investigate the prevalence and risk factors for dementia and mild cognitive impairment (MCI) among older adults in China. METHODS In this study, 20,070 individuals aged ≥ 65 were recruited between January 1, 2022, and February 1, 2023, from ten communities in Xiamen City, China. We collected data on age, sex, level of education, and medical history, as well as global cognition and functional status. The prevalence of dementia and MCI was examined, and the risk factors for different groups were assessed. RESULTS The overall prevalence of dementia and MCI was approximately 5.4% (95% confidence interval [CI], 5.1-5.7) and 7.7% (95% CI, 7.4-8.1), respectively. The results also indicated that dementia and MCI share similar risk factors, including older age, female sex, hypertension, and diabetes mellitus. Compared with individuals with no formal education, those with > 6 years of education had an odds ratio for MCI of 1.83 (95% CI, 1.49-2.25). We also found that only 5.5% of the positive participants chose to be referred to the hospital for further diagnosis and treatment during follow-up visits. CONCLUSIONS This study estimated the prevalence and risk factors for dementia and MCI among individuals aged ≥ 65 years in Southeast China. These findings are crucial for preventing and managing dementia and MCI in China.
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Affiliation(s)
- Bin Jiang
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Qi Liu
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Jian-Peng Li
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Si-Ning Lin
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
| | - Hui-Juan Wan
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Zi-Wen Yu
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Jing Wang
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Wei Zhuang
- Department of Neurology, Nanjing County Hospital, Zhangzhou, China
| | - Jia-Hui Tang
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Cai-Hong Chen
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Fa-Yin Li
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Min Bi
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
- Xiamen Key Laboratory of Brain Center, Xiamen, China.
| | - Nai-An Xiao
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
- Department of Neurology, The Third Hospital of Xiamen, Xiamen, China.
| | - Kun-Mu Zheng
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
- Xiamen Key Laboratory of Brain Center, Xiamen, China.
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Li J, Li J, Zhu H, Liu M, Li T, He Y, Xu Y, Huang F, Qin Q. Prediction of Cognitive Impairment Risk among Older Adults: A Machine Learning-Based Comparative Study and Model Development. Dement Geriatr Cogn Disord 2024; 53:169-179. [PMID: 38776891 DOI: 10.1159/000539334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION The prevalence of cognitive impairment and dementia in the older population is increasing, and thereby, early detection of cognitive decline is essential for effective intervention. METHODS This study included 2,288 participants with normal cognitive function from the Ma'anshan Healthy Aging Cohort Study. Forty-two potential predictors, including demographic characteristics, chronic diseases, lifestyle factors, anthropometric indices, physical function, and baseline cognitive function, were selected based on clinical importance and previous research. The dataset was partitioned into training, validation, and test sets in a proportion of 60% for training, 20% for validation, and 20% for testing, respectively. Recursive feature elimination was used for feature selection, followed by six machine learning algorithms that were employed for model development. The performance of the models was evaluated using area under the curve (AUC), specificity, sensitivity, and accuracy. Moreover, SHapley Additive exPlanations (SHAP) was conducted to access the interpretability of the final selected model and to gain insights into the impact of features on the prediction outcomes. SHAP force plots were established to vividly show the application of the prediction model at the individual level. RESULTS The final predictive model based on the Naive Bayes algorithm achieved an AUC of 0.820 (95% CI, 0.773-0.887) on the test set, outperforming other algorithms. The top ten influential features in the model included baseline Mini-Mental State Examination (MMSE), education, self-reported economic status, collective or social activities, Pittsburgh sleep quality index (PSQI), body mass index, systolic blood pressure, diastolic blood pressure, instrumental activities of daily living, and age. The model demonstrated the potential to identify individuals at a higher risk of cognitive impairment within 3 years from older adults. CONCLUSION The predictive model developed in this study contributes to the early detection of cognitive impairment in older adults by primary healthcare staff in community settings.
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Affiliation(s)
- Jianwei Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Jie Li
- The Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University, Hefei, China
| | - Huafang Zhu
- Ma'anshan Center for Disease Control and Prevention, Ma'anshan, China
| | - Mengyu Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Tengfei Li
- The Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University, Hefei, China
| | - Yeke He
- The Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University, Hefei, China
| | - Yuan Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Fen Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Qirong Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
- Ma'anshan Center for Disease Control and Prevention, Ma'anshan, China
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Wang Y, Dou L, Wang N, Zhao Y, Nie Y. An analysis of factors influencing cognitive dysfunction among older adults in Northwest China based on logistic regression and decision tree modelling. BMC Geriatr 2024; 24:405. [PMID: 38714934 PMCID: PMC11077840 DOI: 10.1186/s12877-024-05024-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Cognitive dysfunction is one of the leading causes of disability and dependence in older adults and is a major economic burden on the public health system. The aim of this study was to investigate the risk factors for cognitive dysfunction and their predictive value in older adults in Northwest China. METHODS A cross-sectional study was conducted using a multistage sampling method. The questionnaires were distributed through the Elderly Disability Monitoring Platform to older adults aged 60 years and above in Northwest China, who were divided into cognitive dysfunction and normal cognitive function groups. In addition to univariate analyses, logistic regression and decision tree modelling were used to construct a model to identify factors that can predict the occurrence of cognitive dysfunction in older adults. RESULTS A total of 12,494 valid questionnaires were collected, including 2617 from participants in the cognitive dysfunction group and 9877 from participants in the normal cognitive function group. Univariate analysis revealed that ethnicity, BMI, age, educational attainment, marital status, type of residence, residency status, current work status, main economic source, type of chronic disease, long-term use of medication, alcohol consumption, participation in social activities, exercise status, social support, total scores on the Balanced Test Assessment, total scores on the Gait Speed Assessment total score, and activities of daily living (ADL) were significantly different between the two groups (all P < 0.05). According to logistic regression analyses, ethnicity, BMI, educational attainment, marital status, residency, main source of income, chronic diseases, annual medical examination, alcohol consumption, exercise status, total scores on the Balanced Test Assessment, and activities of daily living (ADLs) were found to influence cognitive dysfunction in older adults (all P < 0.05). In the decision tree model, the ability to perform activities of daily living was the root node, followed by total scores on the Balanced Test Assessment, marital status, educational attainment, age, annual medical examination, and ethnicity. CONCLUSIONS Traditional risk factors (including BMI, literacy, and alcohol consumption) and potentially modifiable risk factors (including balance function, ability to care for oneself in daily life, and widowhood) have a significant impact on the increased risk of cognitive dysfunction in older adults in Northwest China. The use of decision tree models can help health care workers better assess cognitive function in older adults and develop personalized interventions. Further research could help to gain insight into the mechanisms of cognitive dysfunction and provide new avenues for prevention and intervention.
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Affiliation(s)
- Yu Wang
- Zhejiang Provincial People's Hospital, No.158 Shangtang Road, Hangzhou City, Zhejiang Province, 310014, People's Republic of China
| | - Li Dou
- The Second Affiliated Hospital of Xinjiang Medical University, No. 38, North 2nd Lane, Nanhu East Road, Shuimogou District, Urumqi City, Xinjiang Uygur Autonomous Region, 830063, People's Republic of China
| | - Ni Wang
- School of Nursing, Xinjiang Medical University, No.567 Shangde North Road, Urumqi City, Xinjiang Uygur Autonomous Region, 830000, People's Republic of China
| | - Yanjie Zhao
- School of Nursing, Xinjiang Medical University, No.567 Shangde North Road, Urumqi City, Xinjiang Uygur Autonomous Region, 830000, People's Republic of China
| | - Yuqin Nie
- The Second Affiliated Hospital of Xinjiang Medical University, No. 38, North 2nd Lane, Nanhu East Road, Shuimogou District, Urumqi City, Xinjiang Uygur Autonomous Region, 830063, People's Republic of China.
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Xu T, Bu G, Yuan L, Zhou L, Yang Q, Zhu Y, Zhang S, Liu Q, Ouyang Z, Yang X, Tang B, Jiao B, Bei Y, Shen L. The prevalence and risk factors study of cognitive impairment: Analysis of the elderly population of Han nationality in Hunan province, China. CNS Neurosci Ther 2024; 30:e14478. [PMID: 37736696 PMCID: PMC11017419 DOI: 10.1111/cns.14478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/31/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE A large number of studies have found that the prevalence of cognitive impairment varies in different regions. However, data on cognitive impairment in the Chinese population is still lacking. The goal of this study was to assess the prevalence of cognitive impairment among the elderly in a region of China and explore the associated risk factors. METHODS We performed a population-based cross-sectional survey from April to June 2022. Residents come from three villages and six urban communities in the county-level city of Liuyang in southern China (N = 3233) and the coverage rate of our study population reached 73%. Participants were assessed with a series of clinical examinations and neuropsychological measures. A total of 2598 participants were selected after filtering out those under 60 years old or with incomplete data. Patients with cognitive impairment included those with mild cognitive impairment (MCI) or dementia who met standard diagnostic criteria. RESULTS The prevalence of cognitive impairment, MCI, and dementia among participants aged 60 years and older were 21.48% (95% CI, 19.90-23.10), 15.70% (95% CI, 14.30-17.10), and 5.77 (95% CI, 4.90-6.70), respectively. And residents in villagers were more likely to have cognitive impairment than in urban communities (p < 0.001). Age growth and education level were independent influencing factors for cognitive impairment in all populations (p < 0.001). For lifestyles factors, both smoking and drinking reduced the risk of cognitive impairment (p < 0.05), but when further quantified, the link disappeared. Moreover, having cerebrovascular disease and severe vision impairment were risk factors (p < 0.05). CONCLUSION A representative prevalence of cognitive impairment, MCI, and dementia was found in the elderly Han Chinese population in Southern China. And we further explored the role of known risk factors, particularly in physical activity, smoking, and alcohol consumption.
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Affiliation(s)
- Tianyan Xu
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Guiwen Bu
- Department of NeurologyLiuyang Jili HospitalChangshaChina
| | - Li Yuan
- Department of NeurologyLiuyang Jili HospitalChangshaChina
| | - Lu Zhou
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Qijie Yang
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Yuan Zhu
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Sizhe Zhang
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Qianqian Liu
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Ziyu Ouyang
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Xuan Yang
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Beisha Tang
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
- National Clinical Research Center for Geriatric DisordersCentral South UniversityChangshaChina
- Engineering Research Center of Hunan Province in Cognitive Impairment DisordersCentral South UniversityChangshaChina
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic DiseasesChangshaChina
- Key Laboratory of Hunan Province in Neurodegenerative DisordersCentral South UniversityChangshaChina
| | - Bin Jiao
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
- National Clinical Research Center for Geriatric DisordersCentral South UniversityChangshaChina
- Engineering Research Center of Hunan Province in Cognitive Impairment DisordersCentral South UniversityChangshaChina
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic DiseasesChangshaChina
- Key Laboratory of Hunan Province in Neurodegenerative DisordersCentral South UniversityChangshaChina
| | - Yuzhang Bei
- Department of NeurologyLiuyang Jili HospitalChangshaChina
| | - Lu Shen
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaChina
- National Clinical Research Center for Geriatric DisordersCentral South UniversityChangshaChina
- Engineering Research Center of Hunan Province in Cognitive Impairment DisordersCentral South UniversityChangshaChina
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic DiseasesChangshaChina
- Key Laboratory of Hunan Province in Neurodegenerative DisordersCentral South UniversityChangshaChina
- Key Laboratory of Organ InjuryAging and Regenerative Medicine of Hunan ProvinceChangshaChina
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Zhang Y, Luo H, Lum TY, Knapp M, Vetrano DL, Chui CC, Wang P, Wong GH. Association of Comorbidity With Healthcare Utilization in People Living With Dementia, 2010-2019: A Population-Based Cohort Study. DEMENTIA 2024; 23:422-437. [PMID: 37211819 DOI: 10.1177/14713012231177593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Evidence on the healthcare utilization associated with comorbidity in people with dementia is lacking in Chinese societies. This study aimed to quantify healthcare utilization associated with comorbidity that is common in people living with dementia. We conducted a cohort study using population-based data from Hong Kong public hospitals. Individuals aged 35+ with a dementia diagnosis between 2010 and 2019 were included. Among 88,151 participants, people with at least two comorbidities accounted for 81.2%. Estimates from negative binomial regressions showed that compared to those with one or no comorbid condition other than dementia, adjusted rate ratios of hospitalizations among individuals with six or seven and eight or more conditions were 1.97 [98.75% CI, 1.89-2.05] and 2.74 [2.63-2.86], respectively; adjusted rate ratios of Accident and Emergency department visits among individuals with six or seven and eight or more conditions were 1.53 [1.44-1.63] and 1.92 [1.80-2.05], respectively. Comorbid chronic kidney diseases were associated with the highest adjusted rate ratios of hospitalizations (1.81 [1.74-1.89]), whereas comorbid chronic ulcer of the skin was associated with the highest adjusted rate ratios of Accident and Emergency department visits (1.73 [1.61-1.85]). Healthcare utilization for individuals with dementia differed substantially by both the number of comorbid chronic conditions and the presence of some specific comorbid conditions. These findings further highlight the importance of taking account of multiple long-term conditions in tailoring the care approach and developing healthcare plans for people with dementia.
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Affiliation(s)
- Yingyang Zhang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Hao Luo
- Department of Social Work and Social Administration; Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
| | - Terry Ys Lum
- Department of Social Work and Social Administration; Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
| | - Martin Knapp
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Davide L Vetrano
- Aging Research Center, NVS Department, Karolinska Institutet, Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Celine Cs Chui
- School of Nursing, The University of Hong Kong, Hong Kong, China; School of Public Health, The University of Hong Kong, Hong Kong, China; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong, China
| | - Pengcheng Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Gloria Hy Wong
- Department of Social Work and Social Administration; Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
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Ansari F, Sohel M, Haidary MMH, Mostaq MS, Akter S, Nahar A, Labony FZ, Ahmed A, Hasan MS, Babu MH, Amin MN. Therapeutic potential of clinically proven natural products in the management of dementia. Heliyon 2024; 10:e27233. [PMID: 38533051 PMCID: PMC10963206 DOI: 10.1016/j.heliyon.2024.e27233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/28/2024] Open
Abstract
Dementia is a common neurodegenerative disorder connected to damage to nerve cells in the brain. Although some conventional drugs are available for dementia treatments and are still sanctified for dementia patients, their short- and long-term side effects and other limitations make treating patients more challenging. The authors aimed to explain novel options for treating dementia with natural products and unravel some clinically proven natural products. This article systematically reviewed recent studies that have investigated the role of natural products and their bioactive compounds for dementia. PubMed Central, Scopus, and Google Scholar databases of articles were collected, and abstracts were reviewed for relevance to the subject matter.In this review, we provide mechanistic insights of clinically validated natural products, including like- Yokukansan, Souvenaid, BDW, Hupergene, Bacopa monnier, Omega-3, Tramiprostate and Palmitoylethanolamide with which have therapeutic efficacy against dementia in the management of dementia. As shown by studies, certain natural ingredients could be used to treat and prevent dementia. We strongly believe that the medicinal plants and phytoconstituents alone or in combination with other compounds would be effective treatments against dementia with lesser side effects as compared to currently available treatments. Moreover, these products should be studied further in order to develop novel dementia medications.
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Affiliation(s)
- Farzana Ansari
- Department of Biochemistry and Molecular Biology, Laboratory of Nutrition and Health Research, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Md Sohel
- Department of Biochemistry and Molecular Biology, Mawlana Bhashani Science and Technology University, Santosh, Tangail, 1902, Bangladesh
- Pratyasha Health Biomedical Research Center, Dhaka, 1230, Bangladesh
| | | | - Md Saqline Mostaq
- Department of Pharmacy, University of Asia Pacific, Dhaka, 1205, Bangladesh
| | - Shamima Akter
- Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka, 1230. Bangladesh
| | - Asrafun Nahar
- Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka, 1230. Bangladesh
| | | | - Arman Ahmed
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | - Mohammed Shamim Hasan
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | - Mohammad Hasem Babu
- Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka, 1230. Bangladesh
| | - Mohammad Nurul Amin
- Pratyasha Health Biomedical Research Center, Dhaka, 1230, Bangladesh
- Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka, 1230. Bangladesh
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Liu X, Wang G, Cao Y. The prevalence of mild cognitive impairment and dementia among rural dwellers: A systematic review and meta-analysis. Geriatr Nurs 2024; 56:74-82. [PMID: 38306919 DOI: 10.1016/j.gerinurse.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/04/2024] [Accepted: 01/11/2024] [Indexed: 02/04/2024]
Abstract
The mild cognitive impairment (MCI) and dementia in rural areas are increasingly attracting public attention. However, their prevalence is still unclear. This study aims to reveal the distribution of MCI and dementia in rural areas. We systematically searched PubMed, Web of Science, Embase, and PsycINFO up to June 2023 for cohort and cross-sectional studies. Meta-analysis was conducted using random-effects models to evaluate the prevalence of MCI and dementia. Thirty-five studies with 16,936 participants met the inclusion criteria. The pooled prevalence of MCI and dementia was 27 % (n = 12, 95 %CI = 0.21-0.32, I2 = 99.5 %, P < 0.001) and 7 % (n = 27, 95 %CI = 0.05-0.08, I2 = 99.30 %, P < 0.001), respectively. Subgroup analyses revealed that aged 60 years or older [(MCI: 29 %, 95 %CI = 0.20-0.38, I2 = 99.7 %, P < 0.001), (dementia: 9 % (95 %CI = 0.06-0.12, I2 = 99 %, P < 0.001)], female [(MCI: 29 %, 95 %CI = 0.19-0.40, I2 = 99.3 %, P < 0.001), (dementia: 7 %, 95 % CI = 0.04-0.12, I2 = 98.66 %, P < 0.001)], a-MCI (19 %, 95 %CI = 0.12-0.26, I2 = 97.62 %, P < 0.001) and AD (4 %, 95 %CI = 0.02-0.05, I2 = 98.60 %, P < 0.001) showed higher prevalence. The prevalence of MCI and dementia in rural China was 23 % (95 %CI = 0.18-0.29, I2 = 99.5 %, P < 0.001) and 6 % (95 %CI = 0.04-0.08, I2 = 99.6 %, P < 0.001), respectively. Implementing cognitive impairment screening and intervention measures is necessary to improve the cognitive function of the rural population.
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Affiliation(s)
- Xueyan Liu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, China
| | - Guangpeng Wang
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Yuelu District, Changsha, Hunan Province, China
| | - Yingjuan Cao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, China; Department of Nursing, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, China; Nursing Theory and Practice Innovation Research Center, Shandong University, Jinan, Shandong, China.
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12
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Lu J, Shan Y, Ji M, Low LF, Kim S, Barcenilla-Wong A, Shen S, Chu W. Development of a method and an assessment construct for person-centered translation of dementia public stigma scales. Front Public Health 2024; 11:1233400. [PMID: 38322363 PMCID: PMC10846308 DOI: 10.3389/fpubh.2023.1233400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 12/11/2023] [Indexed: 02/08/2024] Open
Abstract
Background With the number of people with dementia dramatically increasing over time and dementia becoming a major health concern worldwide, scales have been developed to assess the stigma socially attached to this neurodegenerative disorder. There are, however, almost no available methods and assessment constructs for person-centered translation of dementia public stigma scales. Objective To develop such a method and such an assessment construct by translating the Dementia Public Stigma Scale (DPSS) into standard written Chinese. Methods We translated the DPSS following three major steps: (1) literal translation and mistranslation identification; (2) panel discussions of items with problematic translations; and (3) the final checking of the translated scale. Informed by the translation and adaptation process, we then developed a method for person-centered translation of dementia public stigma scales. Based on this method and our panel discussions, we finally proposed a tripartite assessment construct for quality evaluation of the translation of dementia public stigma scales. Results Forward and backward translation did not work sufficiently in dementia public stigma scale translation. Mistranslations were induced by three major causes, including confusion caused by multiple Chinese meanings of the immediate Chinese direct translation, the lack of immediate Chinese direct translation because of varying positive/negative emotions attached to multiple translations, and the lack of culture-specific idioms in Chinese. Based on these factors, we proposed a tripartite dementia translation assessment construct. Following this assessment tool, we determined the best Chinese version that could further be tested for its psychometric properties among the public. Conclusion A method and an assessment construct for person-centered translation of dementia public stigma scales were developed. Such a method and such an assessment construct could be followed in the translation of dementia public stigma scales and the translation evaluation of such scales.
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Affiliation(s)
- Junfeng Lu
- College of International Studies, Jiaxing University, Jiaxing, China
| | - Yi Shan
- College of International Studies, Jiaxing University, Jiaxing, China
| | - Meng Ji
- School of Languages and Cultures, University of Sydney, Sydney, NSW, Australia
| | - Lee-Fay Low
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Sarang Kim
- Australian Institute of Health and Welfare (AIHW), Canberra, ACT, Australia
| | | | - Sam Shen
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Weiwei Chu
- College of Foreign Languages and Literature, Fudan University, Shanghai, China
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13
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Kong APH, Cheung RTH, Wong GHY, Choy JCP, Dai R, Spector A. Spoken discourse in episodic autobiographical and verbal short-term memory in Chinese people with dementia: the roles of global coherence and informativeness. Front Psychol 2023; 14:1124477. [PMID: 38022958 PMCID: PMC10643863 DOI: 10.3389/fpsyg.2023.1124477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Memory and discourse production are closely related in healthy populations. A few studies in people with amnestic mild cognitive impairment and people with dementia (PWD) suggested similar links, although empirical evidence is insufficient to inform emerging intervention design and natural language processing research. Fine-grained discourse assessment is needed to understand their complex relationship in PWD. Methods Spoken samples from 104 PWD were elicited using personal narrative and sequential picture description and assessed using Main Concept Analysis and other content-based analytic methods. Discourse and memory performance data were analyzed in bivariate correlation and linear multiple regression models to determine the relationship between discourse production and episodic autobiographical memory and verbal short-term memory (vSTM). Results Global coherence was a significant predictor of episodic autobiographical memory, explaining over half of the variance. Both episodic autobiographical memory and vSTM were positively correlated with global coherence and informativeness, and negatively with empty speech indices. Discussion Coherence in personal narrative may be supported by episodic autobiographical memory and vice versa, suggesting potential mechanism of interventions targeting personhood through conversation. Indices of global coherence, informativeness, and empty speech can be used as markers of memory functions in PWD.
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Affiliation(s)
- Anthony Pak-Hin Kong
- Academic Unit of Human Communication, Development, and Information Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Aphasia Research and Therapy (ART) Laboratory, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ryan Tsz Him Cheung
- Academic Unit of Human Communication, Development, and Information Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Gloria H. Y. Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Jacky C. P. Choy
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ruizhi Dai
- Department of Psychology, Guangzhou University, Guangzhou, China
| | - Aimee Spector
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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Yu J, Liu F, Cheng Y, Wang J, Ma W, Chen C, Sun P, Shang S. Burden of ischemic stroke in mainland China and Taiwan province from 1990 to 2019: with forecast for the next 11 years. Int J Qual Health Care 2023; 35:mzad079. [PMID: 37757476 DOI: 10.1093/intqhc/mzad079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/01/2023] [Accepted: 09/25/2023] [Indexed: 09/29/2023] Open
Abstract
Ischemic stroke is featured with high incidence, mortality, and disability. The aim of this study is to use Global Burden of Disease database to describe and compare the burden of ischemic stroke in mainland China and Taiwan province and to further predict the expected changes in the next 11 years using statistical modeling methods. Information on ischemic stroke incidence and mortality in China (mainland and Taiwan province) during 1990-2019 was obtained from the Global Burden of Disease database to analyze the effects of region, gender, and age on the incidence and mortality of ischemic stroke in China. The autoregressive integrated moving average model was used to predict the age-standardized incidence rate and age-standardized mortality rate of ischemic stroke in males and females in mainland China and Taiwan province in the next 11 years. The period from 1990 to 2019 witnessed an overall upward trend in the number of incidence and deaths in mainland China and Taiwan province. In 2019, there were nearly 2.87 million ischemic incidence cases with stroke in mainland China, with more female patients than male in the age group of over 60 years. Among the nearly 1.03 million deaths, the death toll of men under the age of 85 years was higher than that of women, while in Taiwan province, the number of incidence was 28 771, with more female patients of all ages than male. Among the 6788 deaths, the death toll of men under the age of 80 years was higher than that of women. In 2019, the age group with the highest number of patients in the two regions was 65-69 years, while the highest number of deaths was found in people aged 85 years and above. As our autoregressive integrated moving average model predicted, the age-standardized incidence rate value of ischemic stroke is expected to be 163.23/100 000 persons in mainland China by 2030, which would continue to increase, while the age-standardized mortality rate value of ischemic stroke is expected to be 16.41/100 000 persons in Taiwan province by 2030, which showed a decreasing trend. Disease burden of ischemic stroke is still increasing in mainland China and Taiwan province, and health resources should be deployed to implement effective prevention and control strategies, taking into account region, gender, and age.
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Affiliation(s)
| | - Fude Liu
- Department of Neurology, The First Affilated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Yawen Cheng
- Department of Neurology, The First Affilated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Jianyi Wang
- Department of Neurology, The First Affilated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Wenlong Ma
- Department of Neurology, The First Affilated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Chen Chen
- Department of Neurology, The First Affilated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Peng Sun
- Department of Neurology, The First Affilated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Suhang Shang
- Department of Neurology, The First Affilated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
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Huang CY, Wu MY, Huang MC, Yu TS, Yen HR. The association between acupuncture therapy and the risk of reduced pressure ulcers in dementia patients: A retrospective matched cohort study. Integr Med Res 2023; 12:100981. [PMID: 37664454 PMCID: PMC10468362 DOI: 10.1016/j.imr.2023.100981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/26/2023] [Accepted: 08/05/2023] [Indexed: 09/05/2023] Open
Abstract
Background The pressure ulcer is a complication developed from dementia. The aim of this study is to study the association between the development of pressure ulcers and the use of acupuncture therapy in patients with dementia. Methods We performed a retrospective 1:1 propensity score-matched cohort study to investigate the association between acupuncture therapy and the risk of pressure ulcers in patients with dementia. Results A total of 8,994 patients were identified, 237 patients in the acupuncture cohort and 362 patients in the no-acupuncture cohort developed pressure ulcers. A reduced cumulative incidence of pressure ulcers was observed in the acupuncture cohort (P<0.001). The association between acupuncture and reducing the incidence of pressure ulcers was not affected by sex, age, residence, income, or comorbidities. The variables of etiologies to cause dementia did not change the final result. In the subgroups analyses, the patients without medication for dementia control had a significantly lower rate of pressure ulcers development when they had accepted acupuncture therapy (log-rank test, P<0.001). Conclusion Our results revealed the association between acupuncture therapy and a reduced incidence of pressure ulcer development in patients with dementia. This finding offers important ideas for further research.
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Affiliation(s)
- Chia-Yu Huang
- Department of Family Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Mei-Yao Wu
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Ming-Cheng Huang
- Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Teng-Shun Yu
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Hung-Rong Yen
- Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
- Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- International Master Program in Acupuncture, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
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16
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Dukelow T, Vassilev P, Lawrence EG, Jacobson L, Koychev I, Muhammed K, Kennelly SP. Barriers to brain health behaviours: results from the Five Lives Brain Health Ireland Survey. Front Psychol 2023; 14:1101514. [PMID: 37691817 PMCID: PMC10483831 DOI: 10.3389/fpsyg.2023.1101514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/17/2023] [Indexed: 09/12/2023] Open
Abstract
Modifiable risk factors for dementia remain prevalent in Ireland. A detailed examination of barriers to risk reduction behaviours in an Irish context has heretofore been lacking. Many existing studies examining barriers to brain health behaviours fail to examine how they might vary across different modifiable risk factors. This study undertook a detailed assessment of barriers to individual risk reduction behaviours. As existing research suggests that barriers may vary across sociodemographic factors, we sought to investigate the distribution of barriers across age, gender, educational status, and household income. The Five Lives Brain Health Ireland Survey is a cross-sectional survey that was distributed online amongst a non-patient population. The survey captured the following: (1) Sociodemographic factors; (2) Barriers to brain health behaviours; (3) Exposure to, and knowledge of, modifiable risk factors for dementia, namely diet, social interaction, exercise, hypertension, sleep, current low mood/depression, current smoking, alcohol consumption, cognitive stimulation, hearing impairment, diabetes, air pollution, and head injury; (4) Participants' perceptions regarding potential for dementia prevention, and risk reduction. Lack of motivation was the most prevalent barrier to consuming a healthy diet (64%, n = 213), physical activity (77.7%, n = 167), smoking cessation (68%, n = 85), and moderation of alcohol intake (56.3%, n = 67). Practical factors were the most prevalent barriers to addressing low mood (56.5%, n = 87), air pollution (30.1%, n = 58), hearing impairment (63.8%, n = 44), diabetes (11.1%, n = 5), and head injury (80%, n = 8). Emotional factors were the most prevalent barriers to engaging in mentally stimulating activity (56.9%, n = 66), social activity (54.9%, n = 302), and good sleep (70.1%, n = 129). Lack of knowledge was the most prevalent barrier to hypertension control (14.4%, n = 29). Distribution of barriers varied across age, gender, educational status, and household income. This study investigated barriers to lifestyle change to improve brain health in an Irish sample of adults aged 50 and above. Detailed subtyping of barriers, as well as examination of differences according to age, gender, education, and income were undertaken. The heterogeneity of barriers to brain health behaviours revealed in this study highlights the necessity to tailor public health interventions to their target population, taking into account the gender, age, educational status, and income of recipients.
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Affiliation(s)
- Tim Dukelow
- Cork University Hospital (CUH), Cork, Ireland
| | | | - Erin Grace Lawrence
- Five Lives SAS, Tours, France
- Unit of Psychological Medicine, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary, University of London, London, United Kingdom
| | | | - Ivan Koychev
- Five Lives SAS, Tours, France
- Department of Psychiatry, University of Oxford, Oxford, England, United Kingdom
| | - Kinan Muhammed
- Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Oxford, England, United Kingdom
| | - Sean P. Kennelly
- Department of Age Related Health Care, Tallaght University Hospital, Dublin, Ireland
- Trinity College Dublin, Dublin, Ireland
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Casagrande CC, Rempe MP, Springer SD, Wilson TW. Comprehensive review of task-based neuroimaging studies of cognitive deficits in Alzheimer's disease using electrophysiological methods. Ageing Res Rev 2023; 88:101950. [PMID: 37156399 PMCID: PMC10261850 DOI: 10.1016/j.arr.2023.101950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/27/2023] [Accepted: 05/05/2023] [Indexed: 05/10/2023]
Abstract
With an aging population, cognitive decline and neurodegenerative disorders are an emerging public health crises with enormous, yet still under-recognized burdens. Alzheimer's disease (AD) is the most common type of dementia, and the number of cases is expected to dramatically rise in the upcoming decades. Substantial efforts have been placed into understanding the disease. One of the primary avenues of research is neuroimaging, and while positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) are most common, crucial recent advancements in electrophysiological methods such as magnetoencephalography (MEG) and electroencephalography (EEG) have provided novel insight into the aberrant neural dynamics at play in AD pathology. In this review, we outline task-based M/EEG studies published since 2010 using paradigms probing the cognitive domains most affected by AD, including memory, attention, and executive functioning. Furthermore, we provide important recommendations for adapting cognitive tasks for optimal use in this population and adjusting recruitment efforts to improve and expand future neuroimaging work.
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Affiliation(s)
- Chloe C Casagrande
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE 68010, USA
| | - Maggie P Rempe
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE 68010, USA; College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Seth D Springer
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE 68010, USA; College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE 68010, USA; Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE 68178, USA.
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18
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Yiu HC, Zang AY, Chau JPC. Understanding the experience of family caregivers of people with dementia in a culturally tailored support group programme: A qualitative study. Geriatr Nurs 2023; 52:133-141. [PMID: 37301077 DOI: 10.1016/j.gerinurse.2023.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
Studies on support group interventions for family caregivers of people with dementia have not explicitly reported on the incorporation of cultural elements. This study evaluates the impact of a culturally tailored intervention (a six-session programme called 'Cultivate Yourself: Support for Caregivers of Persons with Dementia') that integrates Chinese philosophies for psychosocial well-being among target caregivers in Hong Kong. Thirty-three family caregivers of people with dementia from two older adult centres in Hong Kong participated in the programme from October 2020 to September 2021. Multiple benefits from the programme, namely improvements in family caregivers' psychosocial well-being, caring process and supporting values, were identified during six focus group interviews with 29 participants who attended at least four of the six sessions. Our findings provide insight into strategies for developing a culturally tailored support group programme for Chinese caregivers.
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Affiliation(s)
- Hing Cheung Yiu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 6/F Esther Lee Building, Shatin, New Territories, Hong Kong.
| | - Amy Yuli Zang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 8/F Esther Lee Building, Shatin, New Territories, Hong Kong
| | - Janita P C Chau
- The Nethersole School of Nursing, Assistant Dean (Alumni Affairs), Faculty of Medicine, The Chinese University of Hong Kong, 8/F Esther Lee Building, Shatin, New Territories, Hong Kong
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19
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Parial LL, Amoah PA, Chan KCH, Lai DWL, Leung AYM. Dementia literacy of racially minoritized people in a Chinese society: a qualitative study among South Asian migrants in Hong Kong. ETHNICITY & HEALTH 2023; 28:757-780. [PMID: 36322705 DOI: 10.1080/13557858.2022.2139818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 10/16/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Research on dementia literacy in Chinese societies is still emerging, and this is especially the case among racially minoritized groups. The present study explored the knowledge, causal beliefs, and help-seeking behaviors of South Asian migrants in Hong Kong about dementia. It also investigated existing community barriers related to dementia knowledge and help-seeking. DESIGN We conducted a qualitative study from a purposive sample of 38 older people and family caregivers from India, Pakistan, and Nepal who lived in Hong Kong. Focus groups and individual in-depth interviews were used to gather information, while thematic analysis was employed to analyze the data. RESULTS Five main themes were identified: normalization with stigmatization of dementia; spiritual and psychosocial attributions of dementia; familial responsibility despite potential caregiving burden; uncertainties versus openness to professional care; and barriers and opportunities in dementia literacy. Ethnic minorities recognized dementia as a disease of normal aging or a mental disorder. They also perceived spiritual and psychosocial factors as their main causes. While participants recognized the potential burden of dementia caregiving, families were their first point of help-seeking, as many of them expressed contrasting feelings of confidence or doubt toward professional services. Utilization of health education strategies, together with collaboration with community leaders, could address the barriers to dementia literacy. CONCLUSIONS This is the first study to explore how ethnic minorities in Asia perceive dementia and its related help-seeking behaviors in their communities. South Asian migrants in Hong Kong have a limited understanding of dementia and may experience delays in obtaining relevant community services. While culture influenced their knowledge, health education may address their misperceptions and help-seeking behaviors toward dementia. Culture- and language-specific programs could also improve dementia knowledge and health service access.
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Affiliation(s)
- Laurence Lloyd Parial
- Centre for Gerontological Nursing, School of Nursing, Hong Kong Polytechnic University, Hong Kong, People's Republic of China
- College of Nursing, University of the Philippines Manila, Manila, Philippines
| | - Padmore Adusei Amoah
- School of Graduate Studies, Lingnan University, Hong Kong, People's Republic of China
| | - Karrie C H Chan
- Hong Kong Christian Service, Hong Kong, People's Republic of China
| | - Daniel W L Lai
- Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, People's Republic of China
| | - Angela Y M Leung
- Centre for Gerontological Nursing, School of Nursing, Hong Kong Polytechnic University, Hong Kong, People's Republic of China
- World Health Organization Collaborating Centre for Community Health Services, School of Nursing, Hong Kong Polytechnic University, Hong Kong, People's Republic of China
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20
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Lobanov-Rostovsky S, He Q, Chen Y, Liu Y, Wu Y, Liu Y, Venkatraman T, French E, Curry N, Hemmings N, Bandosz P, Chan WK, Liao J, Brunner EJ. Growing old in China in socioeconomic and epidemiological context: systematic review of social care policy for older people. BMC Public Health 2023; 23:1272. [PMID: 37391766 PMCID: PMC10311713 DOI: 10.1186/s12889-023-15583-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 04/01/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND From 2020 to 2050, China's population aged ≥65 years old is estimated to more than double from 172 million (12·0%) to 366 million (26·0%). Some 10 million have Alzheimer's disease and related dementias, to approach 40 million by 2050. Critically, the population is ageing fast while China is still a middle-income country. METHODS Using official and population-level statistics, we summarise China's demographic and epidemiological trends relevant to ageing and health from 1970 to present, before examining key determinants of China's improving population health in a socioecological framework. We then explore how China is responding to the care needs of its older population by carrying out a systematic review to answer the question: 'what are the key policy challenges to China achieving an equitable nationwide long-term care system for older people?'. Databases were screened for records published between 1st June 2020 and 1st June 2022 in Mandarin Chinese or English, reflecting our focus on evidence published since introduction of China's second long-term care insurance pilot phase in 2020. RESULTS Rapid economic development and improved access to education has led to widescale internal migration. Changing fertility policies and household structures also pose considerable challenges to the traditional family care model. To deal with increasing need, China has piloted 49 alternative long-term care insurance systems. Our findings from 42 studies (n = 16 in Mandarin) highlight significant challenges in the provision of quality and quantity of care which suits the preference of users, varying eligibility for long-term care insurance and an inequitable distribution of cost burden. Key recommendations include increasing salaries to attract and retain staff, introduction of mandatory financial contributions from employees and a unified standard of disability with regular assessment. Strengthening support for family caregivers and improving smart old age care capacity can also support preferences to age at home. CONCLUSIONS China has yet to establish a sustainable funding mechanism, standardised eligibility criteria and a high-quality service delivery system. Its long-term care insurance pilot studies provide useful lessons for other middle-income countries facing similar challenges in terms of meeting the long-term care needs of their rapidly growing older populations.
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Affiliation(s)
| | - Qianyu He
- Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510275 P.R. China
- Sun Yat-sen Global Health Institute, School of Public Health, Institute of State Governance, Sun Yat-sen University, Guangzhou, 510275 P.R. China
| | - Yuntao Chen
- Department of Epidemiology & Public Health, University College London, London, WC1E 7HB UK
| | - Yuyang Liu
- Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510275 P.R. China
- Sun Yat-sen Global Health Institute, School of Public Health, Institute of State Governance, Sun Yat-sen University, Guangzhou, 510275 P.R. China
- Shenzhen Health Development Research and Data Management Center, Shenzhen, China
| | - Yanjuan Wu
- Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510275 P.R. China
- Sun Yat-sen Global Health Institute, School of Public Health, Institute of State Governance, Sun Yat-sen University, Guangzhou, 510275 P.R. China
| | - Yixuan Liu
- Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510275 P.R. China
- Sun Yat-sen Global Health Institute, School of Public Health, Institute of State Governance, Sun Yat-sen University, Guangzhou, 510275 P.R. China
| | - Tishya Venkatraman
- Department of Epidemiology & Public Health, University College London, London, WC1E 7HB UK
| | - Eric French
- Faculty of Economics, University of Cambridge, CB3 9DD Cambridge, UK
- Institute for Fiscal Studies, University of Cambridge, London, WC1E 7AE UK
| | - Natasha Curry
- Policy Department, Nuffield Trust, W1G 7LP London, UK
| | - Nina Hemmings
- Policy Department, Nuffield Trust, W1G 7LP London, UK
| | - Piotr Bandosz
- Department of Prevention and Medical Education, Medical University of Gdansk, Gdansk, 80-210 Poland
| | - Wing Kit Chan
- School of Government, Sun Yat-sen University, Guangzhou, 510275 P.R. China
| | - Jing Liao
- Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510275 P.R. China
- Sun Yat-sen Global Health Institute, School of Public Health, Institute of State Governance, Sun Yat-sen University, Guangzhou, 510275 P.R. China
| | - Eric John Brunner
- Department of Epidemiology & Public Health, University College London, London, WC1E 7HB UK
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21
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Shen C, Pei M, Wang X, Zhao Y, Wang L, Tan J, Deng K, Li N. Robust estimation of dementia prevalence from two-phase surveys with non-responders via propensity score stratification. BMC Med Res Methodol 2023; 23:130. [PMID: 37237383 DOI: 10.1186/s12874-023-01954-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Missing diagnoses are common in cross-sectional studies of dementia, and this missingness is usually related to whether the respondent has dementia or not. Failure to properly address this issue can lead to underestimation of prevalence. To obtain accurate prevalence estimates, we propose different estimation methods within the framework of propensity score stratification (PSS), which can significantly reduce the negative impact of non-response on prevalence estimates. METHODS To obtain accurate estimates of dementia prevalence, we calculated the propensity score (PS) of each participant to be a non-responder using logistic regression with demographic information, cognitive tests and physical function variables as covariates. We then divided all participants into five equal-sized strata based on their PS. The stratum-specific prevalence of dementia was estimated using simple estimation (SE), regression estimation (RE), and regression estimation with multiple imputation (REMI). These stratum-specific estimates were integrated to obtain an overall estimate of dementia prevalence. RESULTS The estimated prevalence of dementia using SE, RE, and REMI with PSS was 12.24%, 12.28%, and 12.20%, respectively. These estimates showed higher consistency than the estimates obtained without PSS, which were 11.64%, 12.33%, and 11.98%, respectively. Furthermore, considering only the observed diagnoses, the prevalence in the same group was found to be 9.95%, which is significantly lower than the prevalence estimated by our proposed method. This suggested that prevalence estimates obtained without properly accounting for missing data might underestimate the true prevalence. CONCLUSION Estimating the prevalence of dementia using the PSS provides a more robust and less biased estimate.
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Affiliation(s)
- Chong Shen
- Center for Statistical Science, Department of Industrial Engineering, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, 100084, People's Republic of China
| | - Minyue Pei
- Research Center of Clinical Epidemiology, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, People's Republic of China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, People's Republic of China
| | - Xiaoxiao Wang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, People's Republic of China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, People's Republic of China
| | - Yiming Zhao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, People's Republic of China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, People's Republic of China
| | - Luning Wang
- Geriatric Neurology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100039, People's Republic of China
| | - Jiping Tan
- Geriatric Neurology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100039, People's Republic of China.
| | - Ke Deng
- Center for Statistical Science, Department of Industrial Engineering, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, 100084, People's Republic of China.
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, People's Republic of China.
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, People's Republic of China.
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Zhu Z, Zheng Z, Zhou C, Cao L, Zhao G. Trends in Prevalence and Disability-Adjusted Life-Years of Alzheimer's Disease and Other Dementias in China from 1990 to 2019. Neuroepidemiology 2023; 57:206-217. [PMID: 37231950 DOI: 10.1159/000530593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 03/21/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION China has the largest population of people with dementia in the world and is estimated to have approximately a quarter of the entire population with dementia worldwide, bringing a heavy burden on the public and healthcare systems. We aimed to analyze the burden of Alzheimer's disease and other dementias in China over the past three decades. METHODS The data on disease burden owing to Alzheimer's disease and other dementias in China from 1990 to 2019 were extracted from the Global Burden of Disease (GBD) 2019 datasets. The estimated annual percentage changes (EAPCs) were calculated to assess the temporal trends, and the ratio of years lived with disability (YLDs) to disability-adjusted life-years (DALYs) was used as an indicator to evaluate the healthcare system. RESULT In China, the overall age-standardized rates (ASRs) of the prevalence and DALYs of Alzheimer's disease and other dementias increased from 1990 to 2019, and their EAPCs were 0.66 (95% confidence interval [CI], 0.57-0.75) and 0.26 (95% CI, 0.21-0.31), respectively. ASRs and the total number of dementia in females remained higher than in males, but the upward trend in ASRs among men was more pronounced than in women. The female-to-male ratio of the age-standardized DALY rate peaked in the 75-79 year age group in 2019 (female-to-male ratio of 1.32). The YLDs:DALYs ratio in China experienced a gradual increase and finally stayed above the global average since 2011. CONCLUSION China has experienced a remarkably rising burden of dementia over the past three decades. The more significant burden of dementia was in females, but the potentially increasing burden of dementia in males cannot be underestimated.
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Affiliation(s)
- Zeyu Zhu
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Zhilin Zheng
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Chen Zhou
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Lanxiao Cao
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Guohua Zhao
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Shi L, Tao L, Chen N, Liang H. Relationship between socioeconomic status and cognitive ability among Chinese older adults: the moderating role of social support. Int J Equity Health 2023; 22:70. [PMID: 37095501 PMCID: PMC10124054 DOI: 10.1186/s12939-023-01887-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/06/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Understanding the causes and pathways of cognitive decline among older populations is of great importance in China. This study aims to examine whether the discrepancy in socioeconomic status (SES) makes a difference to the cognitive ability among Chinese older adults, and to disentangle the moderating role of different types of social support in the process in which SES influences cognition. METHODS We utilized a nationally representative sample from the 2018 Chinese Longitudinal Healthy Longevity Survey. A cumulative SES score was constructed to measure the combined effect of different socioeconomic statuses on the cognitive ability of the elderly. We further examined the moderating role of two types of social support, including emotional support, and financial support. Hierarchical regression analysis was applied to test the direct effect of SES on cognitive ability, and to investigate the moderating role of social support on the association of the SES with the dependent variables. RESULTS The results showed that the higher SES of older adults was significantly associated with better cognitive ability (β = 0.52, p < 0.001) after controlling for age, sex, marital status, living region, Hukou, health insurance, lifestyle factors, and physical health status. Emotional support and financial support were moderated the relationship between SES score and cognitive ability. CONCLUSION Our results reveal the importance of considering social support in buffering the effects of SES and the associated cognitive ability for aging populations. It highlights the importance of narrowing the socioeconomic gap among the elderly. Policymakers should consider promoting social support to improve the cognitive ability among older adults.
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Affiliation(s)
- Leiyu Shi
- Johns Hopkins Primary Care Policy Center, 624 N Broadway, Baltimore, USA
| | - Lei Tao
- Department of Public and International Affairs, City University of Hong Kong, Hong Kong SAR, China
| | - Nanqian Chen
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hailun Liang
- School of Public Administration and Policy, Renmin University of China, 59 Zhongguancun, Beijing, China.
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24
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Chan OF, Liu Y, Guo Y, Lu S, Chui CHK, Ho HC, Song Y, Cheng W, Chiu RLH, Webster C, Lum TYS. Neighborhood built environments and cognition in later life. Aging Ment Health 2023; 27:466-474. [PMID: 35285762 DOI: 10.1080/13607863.2022.2046697] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objectives: Maintaining good cognition is crucial in later life. However, most existing research has focused on individual factors impacting cognition, and few studies have investigated the association between neighborhood built environment and older adults' cognition. This study examined the association between neighborhood built environment and cognition among community-dwelling older adults and identified variations in this association between different age groups in the older population.Methods: Data were derived from a cross-sectional survey of 1873 people aged 65 years and above in Hong Kong. We merged individual data from the survey with neighborhood built environment data based on community auditing and geographical information system. After controlling for individual covariates, we used multivariable linear regression to examine the association between neighborhood built environment and cognition.Results: Residents aged 80 and younger in neighborhoods with a higher land-use mix and more public transport terminals exhibited better cognition. Only the number of community centers in a neighborhood was positively associated with cognition for people older than 80.Conclusion: The built environment creates diverse impacts on different age groups among older adults. Our findings provide useful information for urban planners and policymakers for planning community facilities and built environments that consider the needs of different age groups within the older population.
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Affiliation(s)
- On Fung Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Yuqi Liu
- Department of Urban Planning, South China University of Technology, Guangzhou, China
| | - Yingqi Guo
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Shiyu Lu
- Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong
| | - Cheryl Hiu Kwan Chui
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong
| | - Yimeng Song
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong
| | - Wei Cheng
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong
| | | | - Chris Webster
- Healthy High Density Cities Lab, The University of Hong Kong, Hong Kong
| | - Terry Yat Sang Lum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
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25
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Wang Y, Liu T, Cai Y, Wu Y, Nie Y, Kuang W, Qiu P, Wan Y. The Chinese version of informant AD8 for mild cognitive impairment and dementia screening in community-dwelling older adults. Public Health Nurs 2023; 40:258-265. [PMID: 36633577 DOI: 10.1111/phn.13166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 11/03/2022] [Accepted: 12/08/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Conducting routine mild cognitive impairment (MCI) and dementia screening for older adults in the community is important, which not only can improve our understanding of these diseases but also can increase early detection and treatment. METHODS To analyze the reliability and validity of the informant AD8 and explore the cut-off values for screening MCI and dementia in the community-dwelling older adults, this study adopted a multi-stage cluster sampling method to recruit 327 participants aged 60 and over in communities. The informant AD8 and Clinical Dementia Rating (CDR) scales were used to evaluate cognitive function of the subjects, and the receiver operating characteristic curves (ROC) was conducted to test the screening efficacy. RESULTS Among the 327 participants, 33.0% of them met the criteria of MCI, and 3.4% of them met the criteria of dementia. The area under the receiver operating characteristic curve (AUC) of the informant AD8 for screening dementia was 0.974, with a screening cut-off of three, sensitivity of 90.9% and specificity of 89.0%. But it has a poor discriminability in MCI screening [AUC = 0.645, 95% confidence interval (CI): 0.578-0.711]. CONCLUSIONS This study suggests that the informant AD8 is an ideal and useful tool for dementia screening in community-dwelling older adults. However, it is less capable to distinguish older adults with MCI from those with normal cognitive function.
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Affiliation(s)
- Yangyang Wang
- Department of Epidemiology and Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Tingting Liu
- Shenzhen Futian District Chronic Disease Prevention and Treatment Hospital, Shenzhen, China
| | - Yan Cai
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yue Wu
- Department of Epidemiology and Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yunbo Nie
- School of Medicine and Dentistry, University of Rochester, New York
| | - Weihong Kuang
- Department of Psychiatry and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Peiyuan Qiu
- Department of Epidemiology and Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yang Wan
- Department of Geriatrics, West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
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26
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Li X, Peng A, Li L, Chen L. Association between walking and square dancing-oriented leisure-time physical activity and cognitive function among middle-aged and elderly people in Southwest China. BMC Geriatr 2023; 23:28. [PMID: 36646990 PMCID: PMC9841134 DOI: 10.1186/s12877-023-03737-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/09/2023] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Southwest China is facing a serious aging problem across the country, but the status of cognitive function in middle-aged and elderly people in this region is superior to the national average. This study intends to reveal the leisure-time physical activity (LTPA) pattern in this region and explore whether this pattern is beneficial for cognitive function. METHODS The data came from the 2019-2021 baseline survey on cognitive function of a natural population cohort conducted by West China Hospital of Sichuan University. A structured questionnaire was used to investigate the LTPA status of the participants, and the Mini-Mental State Examination was used to evaluate their cognitive function. Then, we used multiple linear regression to analyze the association between LTPA and cognitive level, and further subgroup analysis was carried out according to sex, age and waist-to-hip ratio. RESULTS A total of 2697 participants were enrolled, with an average age of 66.19 ± 6.68 years. The average cognitive function score was 27.23 ± 2.72, of which 8.60% indicated mild cognitive impairment. Their median LTPA level was 24.50 MET-hours per week, of which 70.37% reached the activity level recommended by WHO, with the main types being walking (1340 cases, 49.68%), square dancing (270 cases, 10.01%), or walking + square dancing (172 cases, 6.38%). Multiple linear regression showed that cognitive function increased with the amount of LTPA from 11.25 MET-hours/week to 36.40 MET-hours/week (β 0.09 for 11.25 ~ 24.50 MET-hours/week, β 0.38 for 24.50 ~ 36.40 MET-hours/week) but stabilized at more (β 0.39 for ≥36.40 MET-hours/week). The positive association persisted even for those who only walked (β 0.37 for 24.50 ~ 36.40 MET-hours/week, P = 0.008). CONCLUSIONS Middle-aged and elderly people in Southwest China hold a relatively high level of LTPA status, and walking and square dancing-oriented LTPA are positively correlated with cognitive function.
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Affiliation(s)
- Xu Li
- grid.13291.380000 0001 0807 1581Department of Clinical Research and Management, Center of Biostatistics, Design, Measurement and Evaluation (CBDME), West China Hospital, Sichuan University, Chengdu, Sichuan 610041 People’s Republic of China
| | - Anjiao Peng
- grid.13291.380000 0001 0807 1581Department of Neurology, Joint Research Institute of Altitude Health, West China Hospital, Sichuan University, Chengdu, Sichuan 610041 People’s Republic of China
| | - Lin Li
- grid.13291.380000 0001 0807 1581Department of Clinical Research and Management, Center of Biostatistics, Design, Measurement and Evaluation (CBDME), West China Hospital, Sichuan University, Chengdu, Sichuan 610041 People’s Republic of China
| | - Lei Chen
- grid.13291.380000 0001 0807 1581Department of Neurology, Joint Research Institute of Altitude Health, West China Hospital, Sichuan University, Chengdu, Sichuan 610041 People’s Republic of China ,grid.13291.380000 0001 0807 1581Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan 610041 People’s Republic of China
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Song Y, Niu J, Ji Y, Zhang Y, Peng R, Li M, Wang Z, Tang T, Yu Z, Huang Y. Prevalence and risk factors of dementia in elder adults in Xiamen, China: A cross-sectional study. Psychogeriatrics 2023; 23:71-76. [PMID: 36353810 DOI: 10.1111/psyg.12904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 10/20/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND The prevalence of dementia can vary by region and there is a cluster of more than 10 modifiable risk factors for dementia. Therefore, this study aimed to determine the prevalence of dementia in Xiamen, China, and identify independent risk factors associated with dementia. METHODS This cluster sampling-based cross-sectional study enrolled elder adults from Xiamen City and conducted face-to-face interviews between April and August 2019. Data on the demographic characteristics and prevalence of dementia were collected. Multivariable logistic regression was used to analyse the factors associated with dementia. RESULTS A total of 6430 subjects were enrolled. The prevalence of dementia was 7.62% (490/6430). A total of 490 patients were in the dementia group and 196 healthy matched subjects were selected for the control group with similar profiles for age, gender, and occupation as the dementia patients. Dementia patients were at increased risk for cerebrovascular disease, traumatic brain injury, and hypertension (all P < 0.05). Multivariable logistic regression analysis showed hypertension (odds ratio (OR) = 2.4, 95% confidence interval (CI): 1.62-3.63, P < 0.001) and traumatic brain injury (OR = 2.19, 95% CI: 1.16-4.53, P = 0.023) were independent risk factors for dementia. CONCLUSIONS The prevalence of dementia was high among elder adults residing in Xiamen, China. Dementia patients were more likely to have hypertension and traumatic brain injury than the matched control group.
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Affiliation(s)
- Yehua Song
- Department of Neurology, the Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Jianping Niu
- Department of Neurology, the Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Yong Ji
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Yiwen Zhang
- Department of Neurology, the Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Ruiqiang Peng
- Department of Neurology, the Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Miaoduan Li
- Department of Neurology, the Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Zetuo Wang
- Department of Neurology, the Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Ting Tang
- Department of Neurology, the Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Zhenzhen Yu
- Department of Neurology, the Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Yanyan Huang
- Department of Neurology, the Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
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Weekes B, Carthery-Goulart MT. Intervention and Prevention of Dementia in the Greater Bay Area (GBA) of China. Am J Alzheimers Dis Other Demen 2023; 38:15333175231211097. [PMID: 37948093 PMCID: PMC10638877 DOI: 10.1177/15333175231211097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Reserve and resilience are recognized as essential for effective intervention and prevention of dementia. However, it is not known if these factors also protect against risk for dementia in the Greater Bay Area (GBA) of Mainland China. Studies of risk factors across regions of China provide an evidence base for future research in the GBA. However, population-based studies are rare and do not account for the cultural differences in levels of education, income, literacy and modifiable lifestyle factors. Critically, extant studies do not allow for differences in languages spoken across the region, which will bias results and potentially minimize true prevalence. Based on the conclusions reported in this Special Collection, research in the GBA should focus on resilience and reserve using preserved native language communication skills.
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Affiliation(s)
- Brendan Weekes
- School of Psychology, University of Melbourne, Parkville, VIC, Australia
- Faculty of Education, University of Hong Kong, Hong Kong, China
| | - Maria Teresa Carthery-Goulart
- Faculty of Education, University of Hong Kong, Hong Kong, China
- Center of Mathematics, Cognition and Computing, Federal University of ABC, SBC, São Paulo, Brazil
- Cognitive and Behavioral Neurology Group, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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Jhang KM, Wang WF, Hsu KN, Huang SC, Yang SH, Huang LC, Yang YH. A 12-Year Comparison of Alzheimer's Dementia Patients With Their Informants in Taiwan. Am J Alzheimers Dis Other Demen 2023; 38:15333175231218089. [PMID: 38016118 PMCID: PMC10685789 DOI: 10.1177/15333175231218089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
BACKGROUND To update the characteristics of patients with Alzheimer's disease (AD) and their informants in Taiwan and compare them from 12 years ago. METHODS 1218 patients with AD and their informants were recruited from six hospitals in Taiwan. The uniform data set version 3.0 (UDS3, form A1-A3) were administered. RESULTS Compared with the first registration from 2010-2012 (n = 691), the mean clinical dementia rating sum of boxes score was significantly lower, more patients living independently, and more informants not living together with the patients. A total of 11.2%, 4.1%, 12.8%, and 0.5% of the patients had a reported history of cognitive impairment in their mothers, fathers, siblings, and children, respectively. CONCLUSION Compared with the data from 2010, patients have been diagnosed at a milder disease stage, and their informants used telephone contact more frequently instead of living with the patients. Family histories of cognitive impairment in patients with AD remain frequent.
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Affiliation(s)
- Kai-Ming Jhang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Kuang-Nan Hsu
- Department of Neurology, Taitung MacKay Memorial Hospital, Taitung, Taiwan
| | - Shang-Chien Huang
- Department of Psychiatry, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | | | - Ling-Chun Huang
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yuan-Han Yang
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Zhao Y, Ding Y, Liu L, Chan HYL. Feasibility of a Culturally Specific DEmentia Competence Education for Nursing Home Taskforce (DECENT) Programme: A Mixed-Method Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16679. [PMID: 36554559 PMCID: PMC9779405 DOI: 10.3390/ijerph192416679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/04/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
Although educational resources have been developed to build staff's dementia care competence in Western culture, their applicability and cultural relevance to the Chinese population are questionable. To address this gap, the DEmentia Competence Education for Nursing home Taskforce (DECENT) programme was developed and tailored to Chinese staff. This study aimed to evaluate the feasibility and preliminary effects of the DECENT programme. A one-group pretest-posttest study, embedded with a qualitative component, was conducted among 12 healthcare professionals. The DECENT programme comprised eight topics covering essential competencies in dementia care. It was delivered face-to-face by a qualified educator once per week for 60-90 min over 8 weeks. Outcomes were measured at baseline and immediately post-intervention. A satisfaction survey and individual interviews were conducted post-intervention to understand participants' perceptions and experience with the intervention. Nine participants finished the post-intervention assessment. Except for staff's attitudes towards people with dementia, quantitative findings generally demonstrated positive changes following the intervention. Three categories were identified from the qualitative data: well-developed programme, perceived benefits, and barriers. The findings showed that the DECENT programme is feasible and is perceived by nursing home staff as relevant and useful to daily practice. A larger-scale study is needed to evaluate its effectiveness.
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Affiliation(s)
- Yayi Zhao
- School of Nursing, Nanjing University of Chinese Medicine, No. 138 Xianlin Avenue, Xianlin District, Nanjing 210038, China
| | - Yaping Ding
- School of Nursing, Nanjing Medical University, No. 101 Longmian Avenue, Jiangning District, Nanjing 211100, China
| | - Li Liu
- Xiangya Nursing School, Central South University, No. 172 Tongzi Slopes Road, Yuelu District, Changsha 410013, China
| | - Helen Y. L. Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin 999077, Hong Kong SAR, China
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31
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Chen H, Wu YY, Zhang W. Age accelerated effect of tooth loss on cognitive function among Chinese older adults. AGING AND HEALTH RESEARCH 2022. [DOI: 10.1016/j.ahr.2022.100099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Qin F, Luo M, Xiong Y, Zhang N, Dai Y, Kuang W, Cen X. Prevalence and associated factors of cognitive impairment among the elderly population: A nationwide cross-sectional study in China. Front Public Health 2022; 10:1032666. [PMID: 36466480 PMCID: PMC9713248 DOI: 10.3389/fpubh.2022.1032666] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background Cognitive impairments are associated with increased risk for progression to dementia. In China, limited surveys have been conducted to estimate the national prevalence and risk factors associated with cognitive impairment in China. This study aims to assess the national prevalence and modifiable risk factors for cognitive impairments in the Chinese elderly population. Methods This cross-sectional study was based on the 2018 China Health and Retirement Longitudinal Study. The Mini Mental State Examination (MMSE) is recommended to test for cognitive impairment. Univariate and multivariate logistic regression models were used in assessing risk factors for cognitive impairments in the Chinese elderly population. Results A total of 3768 participants aged 60 years or older were enrolled in this study. The national prevalence of cognitive impairments was 22.24% in China, and the prevalence of cognitive impairment was higher in the south-west region than in the north region (29.94 vs. 16.53%, p < 0.05). The risk for cognitive impairments was higher in the following participants: not married or not living with spouse relative to married with spouse present (OR = 1.39, 95% CI, 1.15-1.70; p = 0.001), nap duration of ≥ 90 min relative to 30-60 min (OR = 1.54, 95% CI, 1.20-1.98; p = 0.001), sleep duration of ≥ 8 h relative to 6-8 h (OR = 1.73, 95% CI, 1.29-2.31; p < 0.001), and depression relative to no depression (OR = 1.67, 95% CI, 1.41-1.97; p < 0.001). The risk of cognitive impairment was lower in participants living in the urban areas relative to the rural areas (OR = 0.57, 95% CI, 0.47-0.69; p < 0.001) and consuming alcohol once a month relative to never consuming alcohol (OR = 0.69, 95% CI, 0.51-0.94; p = 0.02). Conclusion Cognitive impairment prevalence was high in the Chinese elderly population. The potentially modifiable risk factors for cognitive impairment should be further assessed in the development of interventions for the elderly Chinese population.
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Affiliation(s)
- Feng Qin
- National Chengdu Center for Safety Evaluation of Drugs, State Key Laboratory of Biotherapy/Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, Chengdu, China,Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Min Luo
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yang Xiong
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Ni Zhang
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, China,Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yanping Dai
- National Chengdu Center for Safety Evaluation of Drugs, State Key Laboratory of Biotherapy/Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Weihong Kuang
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, China,Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaobo Cen
- National Chengdu Center for Safety Evaluation of Drugs, State Key Laboratory of Biotherapy/Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Xiaobo Cen
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Utility of Chinese Versions of Addenbrooke’s Cognitive Examination: A Narrative Review. Healthcare (Basel) 2022; 10:healthcare10102052. [DOI: 10.3390/healthcare10102052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/14/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
Addenbrooke’s cognitive examination (ACE) is a cognitive screening tool that has developed through three stages: ACE, ACE-Revised (ACE-R), and ACE-Ⅲ. In addition, mini-Addenbrooke’s Cognitive Examination (M-ACE) and ACE mobile are the additional versions that is derived from ACE-III. ACE and its related versions show better performance than Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in detecting mild cognitive impairment in different neurological disorders. It has been translated into numerous languages, including Chinese. Through reviewing the history, validity, and comparison with other cognitive tests of Chinese versions of ACE, it aims to facilitate the clinical and scientific use, further development, improvement, and validation of Chinese versions of ACE in various neurological disorders and ultimately promote early identification and management of cognitive impairment in China.
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Chambers-Richards T, Chireh B, D’Arcy C. Trends in prevalence of self-reports of Alzheimer’s disease/dementia among non-institutionalized individuals 45+ in Canada, 1994–2014. J Public Health Res 2022; 11:22799036221135221. [PMID: 36386060 PMCID: PMC9647302 DOI: 10.1177/22799036221135221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 10/06/2022] [Indexed: 11/09/2022] Open
Abstract
Background: Alzheimer’s disease/dementia (AD) prevalence is of concern globally and in
Canada owing to the rapidly aging population and increase in life
expectancy. This study explored: (1) trends in the overall prevalence of
self-reported AD/dementia by sex, age groups, educational levels, and
geographic areas in Canada from 1994 to 2014, and (2) assessed what the
observed trends mean in the context of the aging Canadian population and the
health care system. Design and methods: This cross-sectional study used Canadian national survey data. Data for this
study were from two Canadian national health surveys (National Population
Health Survey and the Canadian Community Health Survey), between 1994 and
2014. After age-sex standardization, trends in the prevalence of
self-reported Alzheimer’s disease/dementia were tracked over time. The two
cross-sectional surveys used similar diagnostic criteria over the years. Results: The overall prevalence of Alzheimer’s disease/dementia increased from 0.14 in
1994 to 0.80 in 2014 representing a 0.66-point increase over the 20 years.
Alzheimer’s disease/dementia prevalence increased with age across all years
but was more pronounced after age 80. Men 65+ years, those with lower
education, and Canadians living in Central Canada had an increased
prevalence. Conclusions: The overall prevalence of Alzheimer’s disease/dementia in the community
increased over time. This study highlights the importance of establishing
effective community-based prevention strategies that focus on minimizing
risk and optimizing protection as well as health system capacity
strengthening and preparation for long-term care including increased demand
for neurologists’ services, increased associated disability, psychosocial
difficulties, rising costs, and caregiver burden.
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Affiliation(s)
| | | | - Carl D’Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
- Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada
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Association between egg consumption and cognitive function among Chinese adults: long-term effect and interaction effect of iron intake. Br J Nutr 2022; 128:1180-1189. [PMID: 34736543 DOI: 10.1017/s0007114521004402] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The association between egg consumption and cognitive function is inclusive. We aimed to assess the association between egg consumption and cognitive function in Chinese adults and tested the interaction between egg consumption and Fe intake. The data used were from a nationwide sample (n 4852, age ≥ 55 years) from the China Health and Nutrition Survey between 1991 and 2006. Assessment of cognitive function was conducted in 1997, 2000, 2004 and 2006. Dietary egg intake was obtained by 24-h dietary recalls of 3 consecutive days during home visits between 1991 and 2006. Multivariable mixed linear regression and logistic regression were used. Egg intake was positively associated with global cognitive function. In fully adjusted models, across the quartiles of egg intake the regression coefficients were 0, 0·11 (95 % CI -0·28, 0·51), 0·79 (95 % CI 0·36, 1·22) and 0·92 (95 % CI 0·43, 1·41), respectively. There was a significant interaction between egg intake and Fe intake. The association between high egg intake and cognitive function was stronger among those with low Fe intake than those with high Fe intake. In addition, there was a significant interaction between egg consumption and sex, with the association mainly observed in women but not men. Furthermore, compared with non-consumers, those with higher egg consumption (Q4) had the OR of 0·93 (95 % CI 0·74, 1·19), 0·84 (95 % CI 0·69, 1·02) for self-reported poor memory and self-reported memory decline, respectively. Higher egg intake is associated with better cognition in Chinese adults among those with low Fe intake.
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Liu Y, Wu Y, Cai J, Huang Y, Chen Y, Venkatraman TM, Lobanov‐Rostovsky S, Bandosz P, Yang Y, Wu Y, Liao J, Hao Y, Brunner EJ. Is there a common latent cognitive construct for dementia estimation across two Chinese cohorts? ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12356. [PMID: 36177152 PMCID: PMC9473486 DOI: 10.1002/dad2.12356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/19/2022] [Accepted: 08/09/2022] [Indexed: 11/09/2022]
Abstract
Introduction It is valuable to identify common latent cognitive constructs for dementia prevalence estimation across Chinese aging cohorts. Methods Based on cognitive measures of 12015 Chinese Longitudinal Healthy Longevity Survey (CLHLS; 13 items) and 6623 China Health and Retirement Longitudinal Study (CHARLS; 9 items) participants aged 65 to 99 in 2018, confirmatory factor analysis was applied to identify latent cognitive constructs, and to estimate dementia prevalence compared to Mini-Mental State Examination (MMSE) and nationwide estimates of the literature. Results A common three-factor cognitive construct of orientation, memory, and executive function and language was found for both cohorts with adequate model fits. Crude dementia prevalence estimated by factor scores was similar to MMSE in CLHLS, and was more reliable in CHARLS. Age-standardized dementia estimates of CLHLS were lower than CHARLS among those aged 70+, which were close to the nationwide prevalence reported by the COAST study and Global Burden of Disease. Discussion We verified common three-factor cognitive constructs for both cohorts, providing an approach to estimate dementia prevalence at the national level. Highlights Common three-factor cognitive constructs were identified in Chinese Longitudinal Healthy Longevity Survey (CLHLS) and China Health and Retirement Longitudinal Study (CHARLS).Crude dementia estimates using factor scores were reliable in both cohorts.Estimates of CHARLS were close to current evidence, but higher than that of CLHLS.
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Affiliation(s)
- Yuyang Liu
- Department of Medical StatisticsSchool of Public HealthSun Yat‐sen UniversityGuangzhouPeople's Republic of China
- Sun Yat‐sen Global Health InstituteSchool of Public Health and Institute of State GovernanceSun Yat‐sen UniversityGuangzhouPeople's Republic of China
| | - Yanjuan Wu
- Department of Medical StatisticsSchool of Public HealthSun Yat‐sen UniversityGuangzhouPeople's Republic of China
- Sun Yat‐sen Global Health InstituteSchool of Public Health and Institute of State GovernanceSun Yat‐sen UniversityGuangzhouPeople's Republic of China
| | - Jingheng Cai
- Department of StatisticsSun Yat‐sen UniversityGuangzhouPeople's Republic of China
| | - Yun Huang
- Guangdong Provincial Center for Disease Control and PreventionGuangzhouPeople's Republic of China
| | - Yuntao Chen
- Department of Epidemiology & Public HealthUniversity College LondonLondonUK
| | | | | | - Piotr Bandosz
- Department of Public Health and PolicyUniversity of LiverpoolLiverpoolUK
- Department of Prevention and Medical EducationMedical University of GdanskGdanskPoland
| | - Yung‐Jen Yang
- Social Research InstituteInstitute of EducationUniversity College LondonLondonUK
| | - Yu‐Tzu Wu
- Population Health Sciences InstituteNewcastle UniversityNewcastleUK
| | - Jing Liao
- Department of Medical StatisticsSchool of Public HealthSun Yat‐sen UniversityGuangzhouPeople's Republic of China
- Sun Yat‐sen Global Health InstituteSchool of Public Health and Institute of State GovernanceSun Yat‐sen UniversityGuangzhouPeople's Republic of China
| | - Yuantao Hao
- Department of Medical StatisticsSchool of Public HealthSun Yat‐sen UniversityGuangzhouPeople's Republic of China
- Sun Yat‐sen Global Health InstituteSchool of Public Health and Institute of State GovernanceSun Yat‐sen UniversityGuangzhouPeople's Republic of China
- Peking University Center for Public Health and Epidemic Preparedness & ResponseBeijingPeople's Republic of China
| | - Eric J. Brunner
- Department of Epidemiology & Public HealthUniversity College LondonLondonUK
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Lee S, Zhou J, Liu T, Zhang Q, Tse G. Gender-specific clinical risk scores incorporating blood pressure variability for predicting incident dementia. J Am Med Inform Assoc 2022; 29:1825-1826. [PMID: 35869951 PMCID: PMC9471717 DOI: 10.1093/jamia/ocac117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/21/2022] [Indexed: 07/25/2023] Open
Affiliation(s)
| | | | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Qingpeng Zhang
- School of Data Science, City University of Hong Kong, Hong Kong, Hong Kong, China
| | - Gary Tse
- Corresponding Author: Gary Tse, MD, PhD, FRCP, Family Medicine Research Unit, Cardiovascular Group, Hong Kong, China; Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China; Kent and Medway Medical School, Canterbury, UK;
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Sukik L, Liu J, Shi Z. Tea Consumption Is Associated with Reduced Cognitive Decline and Interacts with Iron Intake: A Population-Based Longitudinal Study on 4,820 Old Adults. J Alzheimers Dis 2022; 90:271-282. [DOI: 10.3233/jad-220344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Background: Previous studies suggest a positive effect of tea intake on cognition. Additional micronutrients that may moderate this association was not previously examined. Objective: To examine the association between tea consumption and cognition and explore the interaction between tea consumption and iron intake. Methods: Data from the China Health and Nutrition Survey between 1997 and 2011 was used. 4,820 individuals (≥55 years) were included in the analyses. Measurement of cognitive function was conducted in 1997, 2000, 2004, and 2006. Tea consumption was self-reported. Food intake was assessed by 24-hour dietary recalls of three consecutive days during home visits between 1997 and 2011. Multivariable mixed linear regression and logistic regression was used to assess the association. Results: Tea consumption was associated with reduced global cognitive function decline. In fully adjusted models, regression coefficients (95% CIs) for those who consumed 0 cups/day,<2 cups/day, 2–3.9 cups/day, and≥4 cups/day of tea were 0, –0.09 (–0.55–0.37), 0.05 (–0.34–0.45), and 0.87 (0.46–1.29), respectively. This effect was stronger in adults > 60 years. Tea consumption of≥4 cups/day was inversely associated with self-reported poor memory (OR 0.70 (95% CI 0.56–0.86)) and memory decline (OR, 0.73 (95% CI 0.62–0.87)). There was a significant interaction between tea consumption and iron intake in relation to cognition. High iron intake was inversely associated with cognition in non-consumers of tea but not in tea consumers. Conclusion: Higher tea intake is associated with reduced cognitive decline in adults and inhibits the adverse effect of high iron intake.
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Affiliation(s)
- Layan Sukik
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Jianghong Liu
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Zumin Shi
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- Biomedical and Pharmaceutical Research Unit, QU Health, Qatar University, Doha, Qatar
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Kong D, Chen A, Zhang J, Xiang X, Lou WQV, Kwok T, Wu B. Public Discourse and Sentiment Toward Dementia on Chinese Social Media: Machine Learning Analysis of Weibo Posts. J Med Internet Res 2022; 24:e39805. [PMID: 36053565 PMCID: PMC9482068 DOI: 10.2196/39805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/15/2022] [Accepted: 07/23/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dementia is a global public health priority due to rapid growth of the aging population. As China has the world's largest population with dementia, this debilitating disease has created tremendous challenges for older adults, family caregivers, and health care systems on the mainland nationwide. However, public awareness and knowledge of the disease remain limited in Chinese society. OBJECTIVE This study examines online public discourse and sentiment toward dementia among the Chinese public on a leading Chinese social media platform Weibo. Specifically, this study aims to (1) assess and examine public discourse and sentiment toward dementia among the Chinese public, (2) determine the extent to which dementia-related discourse and sentiment vary among different user groups (ie, government, journalists/news media, scientists/experts, and the general public), and (3) characterize temporal trends in public discourse and sentiment toward dementia among different user groups in China over the past decade. METHODS In total, 983,039 original dementia-related posts published by 347,599 unique users between 2010 and 2021, together with their user information, were analyzed. Machine learning analytical techniques, including topic modeling, sentiment analysis, and semantic network analyses, were used to identify salient themes/topics and their variations across different user groups (ie, government, journalists/news media, scientists/experts, and the general public). RESULTS Topic modeling results revealed that symptoms, prevention, and social support are the most prevalent dementia-related themes on Weibo. Posts about dementia policy/advocacy have been increasing in volume since 2018. Raising awareness is the least discussed topic over time. Sentiment analysis indicated that Weibo users generally attach negative attitudes/emotions to dementia, with the general public holding a more negative attitude than other user groups. CONCLUSIONS Overall, dementia has received greater public attention on social media since 2018. In particular, discussions related to dementia advocacy and policy are gaining momentum in China. However, disparaging language is still used to describe dementia in China; therefore, a nationwide initiative is needed to alter the public discourse on dementia. The results contribute to previous research by providing a macrolevel understanding of the Chinese public's discourse and attitudes toward dementia, which is essential for building national education and policy initiatives to create a dementia-friendly society. Our findings indicate that dementia is associated with negative sentiments, and symptoms and prevention dominate public discourse. The development of strategies to address unfavorable perceptions of dementia requires policy and public health attention. The results further reveal that an urgent need exists to increase public knowledge about dementia. Social media platforms potentially could be leveraged for future dementia education interventions to increase dementia awareness and promote positive attitudes.
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Affiliation(s)
- Dexia Kong
- Department of Social Work, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Anfan Chen
- School of Journalism and Communication, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Jingwen Zhang
- Department of Communication, University of California, Davis, Davis, CA, United States.,Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
| | - Xiaoling Xiang
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - W Q Vivian Lou
- Department of Social Work & Social Administration, Sau Po Centre on Ageing, University of Hong Kong, Hong Kong, Hong Kong
| | - Timothy Kwok
- Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, United States
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Hou Q, Guan Y, Liu X, Xiao M, Lü Y. Development and validation of a risk model for cognitive impairment in the older Chinese inpatients: An analysis based on a 5-year database. J Clin Neurosci 2022; 104:29-33. [PMID: 35944335 DOI: 10.1016/j.jocn.2022.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/14/2022] [Accepted: 06/24/2022] [Indexed: 11/15/2022]
Abstract
Early diagnosis of cognitive impairment is important but difficult. Prediction models may work as an efficient way to identify high risk individuals for this disease. This study aimed to develop a simple and convenient model to identify high-risk individuals of cognitive impairment in the older Chinese inpatients. We enrolled 1300 inpatients aged 60 years or above from the department of geriatrics of the First Affiliated Hospital of Chongqing Medical University during 2013 to 2017. The model for cognitive impairment was established in the developing cohort of 1100 participants and tested in another validating cohort of 200 participants. Logistic regression analyses were used to identify the candidate variables of cognitive impairment. Receiver operating curve was adopted to validate the model. Logistic regression analyses showed that increasing age, diabetes, depression and low educational level were independently associated with cognitive impairment. The model was generated in the following way: Pmodel = ey/(1 + ey), where y = -6.874 + 0.088 * age + 0.317 * diabetes + 0.647 * depression + 0.345 * education level. The value of Pmodel indicates the probability of cognitive impairment for each patient. The present model proved to be a reliable marker for identifying people at high risk of cognitive impairment (area under curve = 0.790, 95% CI = 0.728-0.852, p < 0.001). It had a high sensitivity (86.2%) but a relatively low specificity (59.4%). It may be helpful to "recognize" those at high risk of cognitive impairment rather than "rule out" those at low risk of this disease.
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Affiliation(s)
- Qingtao Hou
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Guan
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xintong Liu
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Lü
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Sun FC, Lin LC, Chang SC, Li HC, Cheng CH, Huang LY. Reliability and Validity of a Chinese Version of the Cohen–Mansfield Agitation Inventory-Short Form in Assessing Agitated Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159410. [PMID: 35954767 PMCID: PMC9368134 DOI: 10.3390/ijerph19159410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/20/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022]
Abstract
Background: Patients with dementia often present agitated behaviors. The Cohen–Mansfield Agitation Inventory-short form (CMAI-SF) is one of the most widely used instruments to evaluate agitated behaviors that affect patients’ quality of life and impose burden on caregivers. However, there is no simplified Chinese version of the CMAI-SF (C-CMAI-SF) in clinical settings. Purpose: This study aimed to develop a Chinese version of the C-CMAI-SF and examine its validity and reliability. Methods: This cross-sectional study included three phases. In Phase I, the original CMAI-SF was translated to Chinese. In Phase II, experts were invited to examine the content validity index (CVI). Phase III was conducted to test the validity and reliability of the C-CMAI-SF. Results: The scale showed good validity and reliability with a scale-level CVI of 0.89, Cronbach’s alpha (measure of internal consistency) of 0.874, and test–retest correlation coefficient of 0.902 (for 257 individuals). Using factor analysis, three factors were identified. Regarding concurrent validity, the C-CMAI-SF score was correlated with the Neuropsychiatric Inventory (agitation aggression subscale) and the Cornell Scale for Depression in Dementia (agitation subscale). Conclusions: The study demonstrated that the C-CMAI-SF is a valid and reliable instrument for evaluating agitated behaviors in people with dementia. Relevance to clinical practice: The C-CMAI-SF is an easy and quick tool used to identify and evaluate agitated behaviors in busy clinical settings.
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Affiliation(s)
- Feng-Ching Sun
- Department of Nursing, Kaohsiung Municipal United Hospital, Kaohsiung 80457, Taiwan; (F.-C.S.); (L.-Y.H.)
- College of Nursing, Fooyin University, Kaohsiung 83102, Taiwan
| | - Li-Chan Lin
- College of Nursing, Asia University, Taichung 41354, Taiwan;
| | - Shu-Chen Chang
- Department of Nursing, Changhua Christian Hospital, Changhua 50006, Taiwan;
- College of Nursing and Health Sciences, Da-Yeh University, Changhua 515006, Taiwan
| | - Hui-Chi Li
- College of Nursing, Asia University, Taichung 41354, Taiwan;
- Correspondence:
| | - Chia-Hsin Cheng
- Department of Nursing, I-Shou University, Kaohsiung 82445, Taiwan;
| | - Ling-Ya Huang
- Department of Nursing, Kaohsiung Municipal United Hospital, Kaohsiung 80457, Taiwan; (F.-C.S.); (L.-Y.H.)
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Selenium Intake and its Interaction with Iron Intake Are Associated with Cognitive Functions in Chinese Adults: A Longitudinal Study. Nutrients 2022; 14:nu14153005. [PMID: 35893861 PMCID: PMC9332607 DOI: 10.3390/nu14153005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/12/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022] Open
Abstract
Studies on the relation between selenium intake and cognitive function are inconclusive. This study aimed to examine the associations between dietary selenium intake and cognitive function among Chinese adults and tested the interaction effect of selenium intake and iron intake on cognition. Data from 4852 adults aged 55 years and above who attended the 1991–2006 China Health and Nutrition Survey (CHNS) were used. Cognitive function was assessed through face-to-face interviews in 1997, 2000, 2004, and 2006. A 3-day, 24-hour recall was used to collect dietary selenium intake. Multivariable mixed linear regression and logistic regression were used in the analyses. In fully adjusted regression models, the regression coefficients (95% confidence interval) were 0.00, 0.29 (−0.12–0.70), 0.26 (−0.18–0.70), and 0.50 (0.02–0.97) across the quartiles of selenium intake. In the subgroup analysis, the positive association between selenium intake and cognitive function was only observed in the participants who live in the southern region but not those in the northern region. The selenium-intake-to-iron-intake ratio was inversely associated with low global cognition scores. Furthermore, only those with a normal BMI had a positive association between selenium and cognition. In conclusion, high selenium intake was linked to better cognitive function and a lower risk of cognition decline in Chinese adults among those with low iron intake. A substantial interaction was found between selenium intake and BMI or region.
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王 洋, 廖 诗, 蔡 燕, 周 晓, 赵 琴, 邱 培, 万 洋. [5-Year Readmission Status and Risk Factors for Senile Dementia Patients: A Study Based on Chengdu Municipal Medical Insurance Database]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2022; 53:466-473. [PMID: 35642156 PMCID: PMC10409433 DOI: 10.12182/20220560301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
Objective To study the status quo of the readmission of senile dementia patients in Chengdu, and to analyze the primary diagnosis, the economic burden and the influencing factors of readmission. Methods Dementia inpatients aged 60 and above in Chengdu were the subjects of this study. The subjects were diagnosed with dementia between 2013 and 2017. Their heath insurance coverage was either the basic medical insurance for urban employees in Chengdu or the basic medical insurance for urban and rural residents of Chengdu. The rank sum test and the chi-square test were conducted to analyze the differences in readmission rate and the economic burden of hospitalization among subjects with different characteristics. Logistic regression was done to analyze the factors affecting readmission. Results The total number of dementia inpatients over the 5-year period was 27881 patients (78820 admissions). The 30-day readmission rate was 25.14% (7011/27881) and the 5-year readmission rate was 45.79% (12767/27881). The primary diagnoses of 12767 readmitted patients mainly included dementia (28.57%), circulatory system diseases (24.26%), and respiratory system diseases (23.71%). The economic burden of hospitalization was higher for readmitted patients than that of patients who were not readmitted ( Z=33.777, P<0.001). The occurrence of readmission was correlated to the following factors, advanced age (compared to that of the 60-65 yr. group, the 70-75 yr. group: odds ratio [ OR]=1.123, 95% confidence interval [ CI]: 1.019-1.237, and the 75-80 yr. group: OR=1.123, 95% CI: 1.108-1.218), participation in the basic medical insurance for urban employees ( OR=1.674, 95% CI: 1.578-1.775), types of dementia (compared to unspecified dementia, Alzheimer's dementia group: OR=1.256, 95% CI: 1.163-1.357, Parkinson's disease dementia group: OR=1.774, 95% CI: 1.658-1.898, and mixed-type dementia group: OR=1.750, 95% CI: 1.457-2.103), disease condition (compared with patients with only dementia, those who have other diseases: OR=0.536,95% CI :0.493-0.583), length of hospital stay ( OR=1.593, 95% CI: 1.552-1.635), and staying at a lower level hospital (compared to that of tertiary hospitals, secondary hospitals: OR=1.319, 95% CI: 1.248-1.395, primary hospitals: OR=1.744, 95% CI: 1.608-1.891, and other hospitals: OR=1.465, 95% CI: 1.311-1.537). Conclusion Senile dementia patients have a high 30-day readmission rate, and the readmission entails heavy economic burdens on the patients. For the populations covered by medical insurance, the following features are correlated to the occurrence of readmission: advanced age, coverage by the basic medical insurance for urban employees, Alzheimer's dementia, Parkinson's disease dementia, mixed-type dementia, dementia patients without other comorbidities, extended length of stay, and hospitalization at a lower level hospital. However, further research is needed for better understanding of the specific mechanisms so that readmission of senile dementia patients can be reduced and the economic burden of the disease can be minimized.
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Affiliation(s)
- 洋洋 王
- 四川大学华西公共卫生学院(华西第四医院) 流行病与卫生统计学系 (成都 610041)Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 诗艺 廖
- 四川大学华西公共卫生学院(华西第四医院) 流行病与卫生统计学系 (成都 610041)Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 燕 蔡
- 四川大学华西公共卫生学院(华西第四医院) 流行病与卫生统计学系 (成都 610041)Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 晓媛 周
- 四川大学华西公共卫生学院(华西第四医院) 流行病与卫生统计学系 (成都 610041)Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 琴 赵
- 四川大学华西公共卫生学院(华西第四医院) 流行病与卫生统计学系 (成都 610041)Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 培媛 邱
- 四川大学华西公共卫生学院(华西第四医院) 流行病与卫生统计学系 (成都 610041)Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 洋 万
- 四川大学华西公共卫生学院(华西第四医院) 流行病与卫生统计学系 (成都 610041)Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
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Ma X, Wei J, Congdon N, Li Y, Shi L, Zhang D. Longitudinal Association Between Self-Reported Sensory Impairments and Episodic Memory among Older Adults in China: A Prospective Cohort Study. J Geriatr Psychiatry Neurol 2022; 35:382-391. [PMID: 33792435 DOI: 10.1177/08919887211006467] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Sensory impairments, such as visual and hearing impairments, and cognitive decline are prevalent among mid-age and older adults in China. With 4-year longitudinal data from the China Health and Retirement Longitudinal Study, we assessed the association between self-reported sensory impairments and episodic memory. Multivariate linear mixed-effects models were used to estimate the association of baseline sensory impairment in 2011-2012 with cognitive decline at 2- and 4-year follow-up visits. Among the 13,097 participants, longitudinal associations were identified between having hearing loss (β = -0.14, 95% CI: -0.22, -0.05), having both poor hearing and vision (β = -0.14, 95% CI: -0.23, -0.04) and decline in immediate word recall over 4 years, compared to those without self-reported sensory impairment. In addition, these associations were more significant among those aged 60 and older and among women. Further research is needed to investigate these associations in the longer term, providing evidence to support interventions that can prevent or delay sensory impairments and preserve cognitive functions in older adults.
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Affiliation(s)
- Xiaochen Ma
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Jingkai Wei
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.,Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lu Shi
- Department of Public Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, SC, USA
| | - Donglan Zhang
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, USA
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Xu W, Bai A, Liang Y, Lin Z. Association between depression and motoric cognitive risk syndrome among community-dwelling older adults in China: A 4-year prospective cohort study. Eur J Neurol 2022; 29:1377-1384. [PMID: 35098617 DOI: 10.1111/ene.15262] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Depression can lead to a wide range of adverse health outcomes, including dementia. However, evidence supporting the relationship between depression and motoric cognitive risk syndrome (MCR), a pre-dementia syndrome, remains lacking. This study aimed to examine the association between depression and MCR among community-dwelling Chinese older adults. METHODS Data were taken from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Depression was defined by a Center for Epidemiological Studies Depression Scale (CES-D) score ≥10. MCR was defined as subjective cognitive complaints and objective slow gait speed. Multivariate logistic regression analyses were conducted to examine the cross-sectional and longitudinal associations between depression and MCR at baseline and a 4-year follow-up period for the sample population and gender groups. RESULTS The prevalence of MCR was higher in participants with depression than in those without depression at baseline (12.2% vs. 8.9%; p = 0.001). Participants with depression at baseline had a higher 4-year incidence of MCR than those without depression (14.8% vs. 8.7%; p < 0.001). Both cross-sectional analysis (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.13-1.75) and prospective analysis (OR 1.95, 95% CI 1.56-2.44) demonstrated that depression was significantly associated with MCR. These associations were consistent across different gender groups and stronger among female individuals. CONCLUSIONS Depression is an independent risk factor for MCR among community-dwelling Chinese older adults. Special attention should be paid to the care of older people with depression to reduce the occurrence of MCR and even dementia.
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Affiliation(s)
- Weihao Xu
- Department of Cardiology, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Anying Bai
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuanfeng Liang
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhanyi Lin
- Department of Cardiology, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Jin Q, Huang L. Research progress on multicomponent physical exercise for patients with neurocognitive impairment. Zhejiang Da Xue Xue Bao Yi Xue Ban 2022; 51:38-46. [PMID: 35576108 PMCID: PMC9109772 DOI: 10.3724/zdxbyxb-2021-0312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 01/20/2022] [Indexed: 06/15/2023]
Abstract
Neurocognitive impairment is a group of clinical syndromes characterized by impaired cognitive function and decreased motor ability. Non-pharmacological interventions such as physical exercise have advantages in the treatment of patients with neurocognitive impairment. Multicomponent exercise is a combination of various physical exercises, including strength training, endurance training, balance training and flexibility training, that can improve gait, balance and cardiopulmonary function by increasing muscle mass, strength and endurance in people with neurocognitive impairment, while also reducing the risk of falls in elders. This article reviews the benefits of multicomponent exercise for patients with neurocognitive impairment and its evaluation methods; also describes 4 intervention programs and their clinical application, to provide evidence for clinical practice and promote the application of multicomponent exercise in patients with neurocognitive impairment.
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Affiliation(s)
- Qun Jin
- 1. Nursing Department, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Department, the Third Hospital of Quzhou, Quzhou 324000, Zhejiang Province, China
| | - Lihua Huang
- 1. Nursing Department, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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Wang J, Ding D, Wu B. Enhancement of Aging in Place: An Evolving Understanding of Person-Centered Dementia Care in Home Settings. J Alzheimers Dis 2022; 86:1315-1322. [PMID: 35213380 DOI: 10.3233/jad-215612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There has been a rich body of literature on informal caregivers of persons with dementia (PWD). However, little has been discussed on how to facilitate person-centered dementia care in home settings with spouses as primary caregivers. We tend to take it for granted that spouses provide person-centered care for PWD. However, being spouses of PWD and living with them for several decades does not necessarily mean that it is easier for them to provide person-centered dementia care and maintain valued and healthy relationships. OBJECTIVE The current study aimed to explore dyadic experiences of PWD and their spousal caregivers and develop a culturally and contextually-sensitive understanding of person-centered dementia care in home-based settings. METHODS A total of 20 dyads of PWD and their care partners were selected for this study. A trained qualitative interviewer conducted a one-on-one interview with each participant with dementia and their care partners separately. We adopted both conventional and directed content analyses. RESULTS Our findings provide examples of care partners provide person-centered care, resulting in a profound positive impact on their wellbeing. Adaptive leadership and collaborative work emerged as a key finding in facilitating person-centered dementia care. Cultural relevancy of person-centered dementia care was also interpreted from the data. The study findings provide implications for the evolving of person-centered dementia care model in home-based settings. CONCLUSION Findings from this study highlight the significance of facilitating person-centered dementia care in home-based settings between PWD and their primary family caregivers.
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Affiliation(s)
- Jing Wang
- Fudan University School of Nursing, Shanghai, China
| | - Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, NY, USA.,NYU Aging Incubator, New York, NY, USA
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Hui Z, Yang C, Fan Lee DT. Stressors and coping strategies in Chinese family caregivers of people with dementia in long-term care facilities: A qualitative descriptive study. DEMENTIA 2022; 21:957-971. [PMID: 35130752 DOI: 10.1177/14713012211066661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study aimed to explore the stressors along with coping strategies in Chinese family caregivers whose relative with dementia had been placed into a long-term care facility. METHODS A qualitative descriptive study was conducted with 17 Chinese family caregivers of institutionalised older adults with dementia, recruited via purposeful sampling. Information regarding stressors along with coping strategies was collected through face-to-face semi-structured individual interviews. The interviews were audio-recorded, transcribed, anonymised and imported into MAXQDA 2018.2. Data were analysed with qualitative content analysis. FINDINGS Three categories of stressors emerged: socioeconomic pressure, hassles arising from continuing caregiving and suboptimal care provided by the facility. In particular, the family caregivers' experienced tremendous pressure of negative comments from people around since long-term care placement was traditionally viewed as unfilial in Chinese societies. Various coping strategies were adopted by Chinese family caregivers to deal with the stressors; however, they were not always adaptive. IMPLICATIONS Health care authorities and professionals should recognise family caregivers' stressors after long-term care placement of a relative with dementia with the consideration of the unique socio-cultural needs. Appropriate and effective interventions should be developed and implemented to facilitate family caregivers to cope with stressful situations after long-term care placement and further to safeguard their psychosocial well-being.
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Affiliation(s)
- Zhaozhao Hui
- School of Public Health, Health Science Centre, 26451Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, 26451The Chinese University of Hong Kong, Hong Kong, China
| | - Diana Tze Fan Lee
- The Nethersole School of Nursing, Faculty of Medicine, 26451The Chinese University of Hong Kong, Hong Kong, China
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Nichols E, Steinmetz JD, Vollset SE, Fukutaki K, Chalek J, Abd-Allah F, Abdoli A, Abualhasan A, Abu-Gharbieh E, Akram TT, Al Hamad H, Alahdab F, Alanezi FM, Alipour V, Almustanyir S, Amu H, Ansari I, Arabloo J, Ashraf T, Astell-Burt T, Ayano G, Ayuso-Mateos JL, Baig AA, Barnett A, Barrow A, Baune BT, Béjot Y, Bezabhe WMM, Bezabih YM, Bhagavathula AS, Bhaskar S, Bhattacharyya K, Bijani A, Biswas A, Bolla SR, Boloor A, Brayne C, Brenner H, Burkart K, Burns RA, Cámera LA, Cao C, Carvalho F, Castro-de-Araujo LFS, Catalá-López F, Cerin E, Chavan PP, Cherbuin N, Chu DT, Costa VM, Couto RAS, Dadras O, Dai X, Dandona L, Dandona R, De la Cruz-Góngora V, Dhamnetiya D, Dias da Silva D, Diaz D, Douiri A, Edvardsson D, Ekholuenetale M, El Sayed I, El-Jaafary SI, Eskandari K, Eskandarieh S, Esmaeilnejad S, Fares J, Faro A, Farooque U, Feigin VL, Feng X, Fereshtehnejad SM, Fernandes E, Ferrara P, Filip I, Fillit H, Fischer F, Gaidhane S, Galluzzo L, Ghashghaee A, Ghith N, Gialluisi A, Gilani SA, Glavan IR, Gnedovskaya EV, Golechha M, Gupta R, Gupta VB, Gupta VK, Haider MR, Hall BJ, Hamidi S, Hanif A, Hankey GJ, Haque S, Hartono RK, Hasaballah AI, Hasan MT, Hassan A, Hay SI, Hayat K, Hegazy MI, Heidari G, Heidari-Soureshjani R, Herteliu C, Househ M, Hussain R, Hwang BF, Iacoviello L, Iavicoli I, Ilesanmi OS, Ilic IM, Ilic MD, Irvani SSN, Iso H, Iwagami M, Jabbarinejad R, Jacob L, Jain V, Jayapal SK, Jayawardena R, Jha RP, Jonas JB, Joseph N, Kalani R, Kandel A, Kandel H, Karch A, Kasa AS, Kassie GM, Keshavarz P, Khan MAB, Khatib MN, Khoja TAM, Khubchandani J, Kim MS, Kim YJ, Kisa A, Kisa S, Kivimäki M, Koroshetz WJ, Koyanagi A, Kumar GA, Kumar M, Lak HM, Leonardi M, Li B, Lim SS, Liu X, Liu Y, Logroscino G, Lorkowski S, Lucchetti G, Lutzky Saute R, Magnani FG, Malik AA, Massano J, Mehndiratta MM, Menezes RG, Meretoja A, Mohajer B, Mohamed Ibrahim N, Mohammad Y, Mohammed A, Mokdad AH, Mondello S, Moni MAA, Moniruzzaman M, Mossie TB, Nagel G, Naveed M, Nayak VC, Neupane Kandel S, Nguyen TH, Oancea B, Otstavnov N, Otstavnov SS, Owolabi MO, Panda-Jonas S, Pashazadeh Kan F, Pasovic M, Patel UK, Pathak M, Peres MFP, Perianayagam A, Peterson CB, Phillips MR, Pinheiro M, Piradov MA, Pond CD, Potashman MH, Pottoo FH, Prada SI, Radfar A, Raggi A, Rahim F, Rahman M, Ram P, Ranasinghe P, Rawaf DL, Rawaf S, Rezaei N, Rezapour A, Robinson SR, Romoli M, Roshandel G, Sahathevan R, Sahebkar A, Sahraian MA, Sathian B, Sattin D, Sawhney M, Saylan M, Schiavolin S, Seylani A, Sha F, Shaikh MA, Shaji KS, Shannawaz M, Shetty JK, Shigematsu M, Shin JI, Shiri R, Silva DAS, Silva JP, Silva R, Singh JA, Skryabin VY, Skryabina AA, Smith AE, Soshnikov S, Spurlock EE, Stein DJ, Sun J, Tabarés-Seisdedos R, Thakur B, Timalsina B, Tovani-Palone MR, Tran BX, Tsegaye GW, Valadan Tahbaz S, Valdez PR, Venketasubramanian N, Vlassov V, Vu GT, Vu LG, Wang YP, Wimo A, Winkler AS, Yadav L, Yahyazadeh Jabbari SH, Yamagishi K, Yang L, Yano Y, Yonemoto N, Yu C, Yunusa I, Zadey S, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Murray CJL, Vos T. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health 2022; 7:e105-e125. [PMID: 34998485 PMCID: PMC8810394 DOI: 10.1016/s2468-2667(21)00249-8] [Citation(s) in RCA: 1275] [Impact Index Per Article: 637.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/17/2021] [Accepted: 10/28/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. METHODS We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. FINDINGS We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4-65·1) million cases globally in 2019 to 152·8 (130·8-175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [-7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64-1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52-1·85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41-67]) and western Europe (74% [58-90]), and the largest in north Africa and the Middle East (367% [329-403]) and eastern sub-Saharan Africa (357% [323-395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. INTERPRETATION Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. FUNDING Bill & Melinda Gates Foundation and Gates Ventures.
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Chen NC, Chen CL, Shen FC. The Risk Factors of Severe Hypoglycemia in Older Patients with Dementia and Type 2 Diabetes Mellitus. J Pers Med 2022; 12:67. [PMID: 35055382 PMCID: PMC8779381 DOI: 10.3390/jpm12010067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/29/2021] [Accepted: 01/05/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The adequate glycemic control and risk factors for hypoglycemia in older patients with dementia and type 2 diabetes mellitus (T2DM) remain unclear. This study aimed to analyze the status of glycemic control and determine the risk of hypoglycemia among these groups. METHODS A hospital admission record due to hypoglycemia through an emergency room with glucose supplementation in the Chang Gung Memorial Hospital was identified as a hypoglycemic event. Patients with dementia and T2DM without hypoglycemic events throughout the study period were defined as the control group. We gathered patients aged ≥65 years with a diagnosis of Alzheimer's dementia (AD) and T2DM between 2001 and 2018 in the Chang Gung Research Database (CGRD). We extracted data included medication use, diagnoses, and biochemistry data from hospital records. RESULTS A total of 3877 older patients with dementia and T2DM with regular visits to the outpatient department were enrolled in this study. During the two-year follow-up period, 494 participants (12.7%) experienced hypoglycemia. Multivariable logistic multivariable regression models for hypoglycemic events showed that metformin had a protective effect (odds ratio (OR) = 0.75, p = 0.023), insulin had the highest risk (OR = 4.64, p < 0.001). Hemoglobin A1c (HbA1c) levels were not correlated with hypoglycemic events (OR = 0.95, p = 0.140). Patients with hypoglycemic episodes had a significantly higher proportion of ≥2 Charlson Comorbidity Index scores than those without hypoglycemic episodes (83.2% versus 56.4%, p < 0.001). CONCLUSIONS Drug regimen affects hypoglycemic episodes but not HbA1c in older patients with dementia and T2DM. In addition, patients with more comorbidities experience an increased risk of hypoglycemia.
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Affiliation(s)
- Nai-Ching Chen
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan;
| | - Chien-Liang Chen
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan;
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
| | - Feng-Chih Shen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
- Center for Mitochondrial Research and Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
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