A systematic review of the prevalence of mental and neurocognitive disorders amongst older adults’ populace in Egypt

Dementia health matters: Influence of literacy, fears, and endorsements on dementia risk mitigation and screening among community-dwelling older adults

BACKGROUND

Up to one-third of dementia cases may be preventable, with evidence suggesting that modifying lifestyle and health behaviors can significantly lower the risk of developing dementia. However, motivating older adults to adopt and sustain these changes poses a considerable challenge, particularly when facing the specter of dementia.

AIM

To explore the interaction effect between dementia fear and dementia literacy on the perceived ability of community-dwelling older adults to reduce dementia risk and engage in dementia screening.

METHOD

A cross-sectional study involving 1,067 community-dwelling older adults was conducted from August 2022 to December 2023. Participants completed surveys assessing their dementia literacy, personal dementia fear, motivation to change lifestyle and health behaviors, and willingness to engage in investigational screening for memory in primary care.

FINDINGS

Personal dementia fear exhibited significant positive correlations with motivation to change lifestyle and health behavior (r = 0.621, p < 0.001) and investigational screening for memory in primary care (r = 0.559, p < 0.001), indicating that higher levels of fear are associated with increased motivation. Second, dementia literacy demonstrated positive correlations with motivation to change lifestyle and health behavior (r = 0.349, p < 0.001) and investigational screening (r = 0.269, p < 0.001), suggesting that more excellent knowledge enhances perceived ability. Lastly, both dementia literacy and personal dementia fear were positively correlated with motivation to change health behaviors, with respective effects of β = 0.266 and β = 0.595, highlighting their interactive role in shaping perceptions of risk reduction and screening.

IMPLICATION

The significant contributions of dementia literacy, personal dementia fear, and their interaction highlight the importance of these factors in accepting investigational screening for memory in primary care.

Depression in geriatrics: a systematic review and meta-analysis of prevalence and risk factors in Egypt

BACKGROUND

Depression is the most common psychiatric disorder in older adults, even though it is commonly misdiagnosed and undertreated, leading to exacerbations of preexisting medical conditions and even a higher mortality rate. In the present systematic review with meta-analysis, we quantify the magnitude of depression and its associated risk factors among the older adult population in Egypt.

METHODS

A thorough literature search was performed from 2010 up to October 2023. The results were presented as proportions or risk difference with a 95% confidence interval (CI) calculated using the random effects model. A sensitivity analysis was performed to examine the robustness of the results.

RESULTS

Our study included 14 articles with 5857 older adults published between 2011 and 2023. All the included studies assessed depression in geriatrics using the Geriatric Depression Scale. Of the 14 studies, 5 were for community-dwelling older adults, 3 were for older adults attending primary health care (PHC) centers, 2 were for hospitalized older adults, 3 were for residing in geriatric homes, and one for residing in geriatric homes, hospitalized older adults, and community-dwelling older adults. The overall prevalence of depression among Egyptian geriatrics was 64.6%. The pooled prevalence of depression was 59.6%, 67.0%, 67.0%, and 62.0% for community-dwelling older adults, older adults people attending PHC, hospitalized older adults, and older adults residing in geriatric homes, respectively. Older adults with chronic illness, female sex, and low-income elders and elders who were not employed had a higher risk for depression with pooled risk differences of 34.9%, 17.8%, 23.8%, and 15.1% (P < 0.05), respectively. In contrast, there was no significant difference in risk for depression in the older adults residing in urban areas compared to rural areas, the older adults aged + 70 compared to those less than 70, individuals with low levels of education or who are illiterate compared with those with higher levels of education and the older adults who live alone compared with those living with family.

CONCLUSION

More than half of the older adults in Egypt suffer from depressive symptoms. Chronic diseases, female sex, unemployment, and low-income inequality are the most significant factors contributing to depression among Egypt's older adults.

From insight to action: Exploring knowledge and practices about periodic medical check-up among community dwelling older adults in Egypt

BACKGROUND

Periodic Medical Checkup (PMC) is a preventive practice that is a superior strategy to promote health and reduce community morbidity and mortality.

AIM

Identify the PMC knowledge and practice levels and determine the association between knowledge and practices about the PMC among community-dwelling older adults in Egypt.

METHODS

The study is a cross-sectional survey adopting a descriptive correlation design. It was conducted over three months, from the beginning of December 2023 to the beginning of March 2024. A total of 250 older adults were allocated for this study.

RESULTS

Low rates of knowledge and practice of PMC were found among the study participants, and there was a statistically significant association between the two variables. (r = 0.707, P < 0.001).

CONCLUSION

This study supported our hypotheses by demonstrating a positive association between knowledge and practices about the PMC; the higher knowledge scores were associated with higher practices of PMC.

Golden steps: A nursing approach for vitality, agility, and rumination in geriatric clients with depressive disorders through mindful walking

BACKGROUND

Depression is a prevalent issue among older adults and can significantly impact their overall quality of life. While traditional treatments may not always be sufficient or suitable for all individuals, the potential of alternative interventions, such as mindful walking, offers a ray of hope. This study aimed to evaluate the impact of mindful walking on rumination, agility, vitality, and mindfulness in geriatric patients with depressive disorders.

METHOD

A prospective quasi-experimental design was employed with a purposive sample of 35 clients in the intervention group and 33 in the control group. This study utilized the Ruminative Responses Scale - Short Form (RRS-SF) and Five Facet Mindfulness Questionnaire (FFMQ) to measure the primary outcome. The Timed Up and Go Test (TUG) and State-Level Version of the Subjective Vitality Scale (SVS) were used to measure the secondary outcomes.

RESULTS

Mindful walking significantly affected vitality, mindfulness, and rumination, with effect sizes (ղ2 = 0.168, 0.137, and 0.127), respectively. On the other hand, the intervention had a less significant effect on agility, with an effect size (ղ2 = 0.047).

CONCLUSION

This study revealed that geriatric clients with depressive disorders showed more significant improvements in vitality, followed by improvement in rumination and agility. Integrating mindful walking as a part of care plans for those clients would promote their physical activity and mental well-being.

Comorbidity of depression and type 2 diabetes in Egypt results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD) study

BACKGROUND

Diabetes mellitus and depression are serious common diseases, and the number of people with both conditions is rising steadily. Depression in people with diabetes mellitus results in poorer prognosis through different mechanisms. On the other hand, the presence of diabetes in individuals with depression increases functional impairment that is associated with depression.

AIMS

The study aimed to assess the prevalence and factors associated with depression among adults with type 2 diabetes mellitus attending a diabetes clinic in Cairo, Egypt.

METHODS

A cross-sectional study was conducted among adult patients with diabetes type 2 attending a diabetes clinic in the endocrinology department in Ain Shams University Teaching Hospital, Cairo, Egypt. Data were collected through face-to-face interviews by trained psychiatrists and from patients' records.

RESULTS

The prevalence of depression among diabetic patients was 21.8% (95% CI [15.6%, 29.1%]). Depression was more common among younger age groups and those with a higher level of education. There was no significant difference between those with lifetime depression compared to those without depression regarding physical health complications.

CONCLUSIONS

The prevalence of depression among patients with type 2 diabetes is high. Given the impact of co-morbid diabetes and depression, diabetic patients should be routinely screened for the latter condition.

Cluttered spaces, strained bonds: Examining the correlation between hoarding symptoms and social functioning among long-term care facilities older adult residents

BACKGROUND

Symptoms of hoarding, such as the inability to part with possessions, leading to significant clutter, are commonly observed among residents in long-term care facilities in Egypt. This behavior significantly impacts their social interactions and functioning. Therefore, this study examined the relationship between hoarding symptoms and social functioning among older adult residents in long-term care facilities.

METHODS

The study employed a cross-sectional survey on a purposive sample of 300 older adults.

TOOLS

Saving Inventory-Revised and Functional Idiographic Assessment Template-Questionnaire-Short Form were used.

RESULTS

The findings revealed a significant positive correlation between hoarding symptoms and social functioning (r = 0.682, p < 0.000). A linear regression analysis supported this correlation, establishing hoarding symptoms as a significant predictor of social functioning (adjusted R2 = 0.32).

CONCLUSION

The current study highlighted that a significant proportion of long-term care older adult residents displayed moderate hoarding symptoms and compromised social functioning. A noticeable positive association was observed between hoarding symptoms and social functioning. These results underscore the potential impact of hoarding symptoms on various aspects of social functioning. Given these findings, long-term care nurses should comprehend the various facets of compulsive hoarding behavior and devise effective strategies for assessment and intervention. Establishing support groups within these facilities could provide a platform for these residents to share their experiences and coping strategies. This could reduce interpersonal conflicts and argumentativeness and foster emotional expression and intimacy.

Cognitive Impairment and Non-Communicable Diseases in Egypt's Aging Population: Insights and Implications from the 2021-2022 Pilot of "A Longitudinal Study of Egyptian Healthy Aging" "AL-SEHA"

As the global population ages, the prevalence of cognitive impairment among older individuals has been steadily rising. Like many countries, Egypt is grappling with the challenges an aging demographic poses. The global network of longitudinal aging studies, modeled after the US Health and Retirement Study (HRS), includes over 40 countries but lacks representation from the Arab/North African region. The proposed 'A Longitudinal Study of Egyptian Healthy Aging' (AL-SEHA) will address this gap by providing data on aging in Egypt, the largest Arab/North African country, shedding light on the intricate relationship between cognitive impairment and non-communicable diseases (NCDs) in Egypt's aging population between 2021 and 2022. This study took place in five governments in Egypt and recruited 299 participants from a population of 50+. The results of the study are from the pilot stage of the original longitudinal study (AL-SEHA).

Emotional eating behaviors in later life: Identifying key factors for healthy aging

BACKGROUND

Pathological, physiological, and psychosocial factors could influence the eating behaviors of older adults in Egypt. Nurses and other healthcare professionals should understand this complex interaction to effectively address their nutritional issues. This study aimed to identify the predictors of emotional eating behaviors among older adults.

METHODS

The study followed a cross-sectional survey. A probability sampling technique was used to select the participants. Data was collected using the Emotional Eating Questionnaire and Perceived Stress Scales.

RESULTS

98 % of the respondents were identified as moderate or severe emotional eaters. The study found a significant positive correlation between perceived stress and emotional eating behaviors (r = .436; p = .000). Multivariate analysis revealed that perceived stress, age, gender, marital status, and body mass index (BMI) have a significant positive relationship with emotional eating behaviors (p < .001), accounting for 39.3 % of the variation.

CONCLUSION

Emotional eating is common among older adults and is influenced by factors such as age, gender, marital status, BMI, and perceived stress. Nurses can use these findings to develop nutritional plans to promote healthy eating habits of this population.

Prevalence of psychiatric disorders in the aging population in the northeastern of Iran

Background

The prevalence of psychiatric disorders by demographic characteristics in elderly people is poorly understood, at least in the northwest of Iran. We aimed to estimate the prevalence of various psychiatric disorders in the elderly population in East Azerbaijan Province, Tabriz. A total of 1000 aging people were randomly selected from the general population. Data were collected using valid structured instruments and face-to-face interviews by trained psychologists. The Structured Clinical Interview for DSM-IV-TR (SCID-IV) and Abbreviated Mental Test Questionnaire were used. Chi-square (χ2) test was used for categorized variables, and an independent T-test was carried out for quantitative variables.

Results

Overall, 38.5% of the elderly had at least one mental disorder (47.2% women, 27.3% men). The prevalence of major depressive disorder (MDD) and any anxiety disorders was 16.6% (22.4% female and 9.3% male) and 16.7% (23.1% female and 8.6% male), respectively. Likewise, the overall prevalence of any depressive symptoms, post-traumatic stress disorder (PTSD), general anxiety disorder (GAD), obsessive-compulsive disorder (OCD), and panic disorders were 21.6%, 7%, 5.3%, and 5.9%, respectively. The prevalence of any mental disorder in the first, second, and third quartiles of the socio-economic level was 54.3%, 37%, and 17.8%, respectively. The prevalence of any mental disorders among the marginalized and the non-marginalized population is 55.3 and 31.5%, respectively.

Conclusions

We found 38.5% (47.2% women, 27.3% men) of the elderly people had any mental disorders, and 21.6% of them had any depressive disorders. The prevalence of mental disorders in elders was almost like adults and middle-aged people in this study. However, the prevalence of mental disorders was higher than in marginalized population and low socio-economic status.

Brain Chip Implant: Public’s knowledge, Attitude, and Determinants. A Multi-Country Study, 2021

Background: In August 2020, a brain chip was announced as implantation in the human brain targeted to boost brain activity without significant side effects. The aim of this work was to examine the level of knowledge, awareness, and public concerns about the use of brain chip implants. Methods: An online cross-sectional survey targeted 326 adults from more than five countries in the Middle East and North Africa during the period from May 2021 to July 2021. The data was collected through a validated self-administrated questionnaire composed of five sections. The collected data were coded and analyzed using suitable tests and methods. Results: According to our results, 54.6% of the study participants mentioned that they had heard about the Brain Chip Implant; while only 6.1% stated that they knew its importance. The most common reported indication for the Brain Chip Implant was improving memory, followed by treatment of epilepsy and improving mental function. Brain Chip Implant safety seemed to be the most common public concern, as most of the participants were hesitant about using it and had concerns regarding its safety.  Conclusion: Medical personnel seems to be the most concerned about the use of the brain chip implant. Safety measures, confidentiality, and security procedures, respectively, are the major issues that might limit the broad use of the brain chip implant.

Depression in Public Servants of Upper Egypt: Gender-specific Prevalence and Determining Factors

Mental health disorders, including depression, cause more than half of worldwide disabilities. We aimed to estimate the prevalence of depression and determine its associated factors among Egyptian public servants. We collected data from 3134 subjects (1619 females and 1515 males) via a self-administered questionnaire, including the Center of Epidemiological Studies-Depression (CES-D) scale, medical history, sociodemographic, familial, occupational, and behavioral characteristics of the recruited Egyptian Public servants. We used logistic and linear regression models to assess the determinants of depression. The prevalence of depression was 43.5% (52.9% in females and 33.4% in males) among public servants. The past history of depression was a significant determining factor of depression; adjusted odds ratio (aOR): 95% confidence interval (CI) was 2.58 (1.87, 3.57) in females and 3.28 (2.20, 4.87) in males. Other determinants were daily working hours: aOR = 1.11 (1.02, 1.19) and high job demands: aOR = 2.19 (1.40–3.41) in males, and the high job control in females: aOR = 0.51 (0.36, 0.73). With the past history of depression, job demands, job control, family structure, education level, and working status of the spouse predicted 41% of the total variance in the CES-D score in females; R² = 0.41; whereas job demands, family structure, job hours per day predicted 40% of in males; R² = 0.40. In conclusion, the determinants of depression varied by gender. Governmental interventions aiming to improve the work environment (job demands, control, and working hours) and individual responsibilities to improve the living arrangement and education level could help to curb the emerging risk of depression.

Depression and associated factors among older adults in Bahir Dar city administration, Northwest Ethiopia, 2020: Cross-sectional study

Background

Depression is the most common psychiatric condition among older adults, and it goes unnoticed by individuals themselves and is under-diagnosed by clinicians due to the misconception that these are normal parts of aging. However, the problem is not properly addressed in Ethiopia. This study aimed to determine the prevalence and associated factors of depression among the older adults in Bahir Dar city.

Methods

A community-based cross-sectional survey was conducted among 423 older adults in Bahir Dar city. A simple random sampling technique was used to select the study participants. Depression was assessed using a 15-item Geriatric Depression Scale (GDS). A multivariable logistic regression analysis was used to explore the potential determinants of depression among the participants.

Results

The prevalence of depression among older adults was found to be 57.9% (95% CI: 53.2–62.6). This study showed that educational status with grades 5-8^th (AOR: 5.72, 95% CI: 2.87–11.34), and 9-12^th grade (AOR: 3.44, 95% CI: 1.59–7.41), income <2004 ETB (AOR = 1.89, 95% CI: 1.16–3.07), cognitive impairments (AOR: 3.54, 95% CI: 2.16–5.81), family history of mental illness (AOR:3.06, 95% CI: 1.03–9.04), and poor quality of life (AOR: 2.78, 95% CI: 1.74–4.46) were significantly associated with depression.

Conclusion

The prevalence of depression among older adults was found to be huge. Having low educational status, low monthly income, cognitive impairments, family history of mental illness, and poor quality of life were associated with depression. Therefore, raising community awareness of mental health, increasing social participation, providing supportive counseling and routine screening of depressive symptoms are essential in combating depression among Bahir-Dar city older adults.

A systematic review of interventions aiming to improve newly-qualified doctors' wellbeing in the United Kingdom

Background

Newly-qualified doctors in the United Kingdom experience a great deal of stress and have poor wellbeing when compared to more senior counterparts. A number of interventions have been put in place to boost healthcare professionals’ wellbeing, but little is known about interventions aimed to improve the wellbeing of newly-qualified doctors in the United Kingdom. This study aims to systematically review current evidence of interventions which improved the wellbeing of newly-qualified junior doctors in the United Kingdom.

Methods

Five key electronic databases were searched. Subsequently, reference scanning and citation search was performed. Studies were included if they were conducted from the commencement of the Foundation Programme in 2004, until 2019. In addition, studies had to be performed on junior doctors: working in the United Kingdom and within their first five years post-qualification and have a quantitative outcome. Studies which did not meet these criteria were excluded. Quality was assessed using the modified Newcastle-Ottawa scale. Bias was not formally assessed using a standardised tool.

Results

Seven papers met the inclusion criteria and identified three main types of interventions: mentorship, mindfulness and clinical preparation interventions. The majority of included studies reported a positive result from the performed intervention, suggesting these to be beneficial in improving junior doctor wellbeing, and thereby reducing anxiety and stress levels. However, most of the studies used small sample sizes.

Conclusions

This review reveals that there is dearth of evidence on the effectiveness of intervention to improve the wellbeing of newly-qualified doctors in the United Kingdom. Most of the identified interventions focused on relieving stress and anxiety inherent within newly-qualified doctors’ training programmes. However, wellbeing interventions need to take into cognisance all the factors which impact on wellbeing, particularly job-related factors. We recommend that future researchers implement large-scale holistic interventions using appropriate research methods.

Systematic review registration: PROSPERO CRD42019127341.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-022-00868-8.

Clinical Guidelines of the Egyptian Psychiatric Association for the Management of Treatment-Resistant Unipolar Depression in Egypt

BACKGROUND

Major depressive disorder (MDD) is a public health burden that creates a strain not only on individuals, but also on the economy. Treatment-resistant depression in the course of major depressive disorder represents a clinically challenging condition that is defined as insufficient response to two or more antidepressant trails with antidepressants of the same or different classes that were administered at adequate daily doses for at least 4 weeks.

OBJECTIVE/HYPOTHESIS

To develop a treatment guideline for Treatment Resistant Depression (TRD).

METHODOLOGY

Experts in the field gathered and reviewed the available evidence about the subject. Then, a series of meetings were held to create recommendations that can be utilized by Egyptian psychiatrists.

RESULTS

The guidelines provide recommendations in various clinical settings. It evaluates different situations, such as patients at risk of resistance, those with resistance and recommends strategies to resolve the clinical case.

CONCLUSION

The consensus guidelines will improve the outcomes of patients, as they provide recommendations across various domains that are of concern for the practicing psychiatrist.

Neuroprotective role of camphor against ciprofloxacin induced depression in rats: modulation of Nrf-2 and TLR4

BACKGROUND

Depression affects people feeling to be anxious, worried, and restless. They also lose interest in activities, concentrating and appetite, they finally may attempt suicide. Depression is the second chronic disease, as a source of the global burden of disease, after heart disease. Its prevalence elevated seven times during the COVID-19.

AIM

The current study was designed to evaluate camphor neuroprotective role against rats' ciprofloxacin-induced depression.

MATERIALS AND METHODS

Depression was induced by administration of ciprofloxacin (50 mg/kg; orally) for 21 days. Wister albino male rats were divided into five groups. Group I (normal control): rats were given normal saline. Group II: rats received camphor (10 mg/kg; i.p.) for 21 days. Group III (depression control): rats received ciprofloxacin only. Groups IV and V: rats received camphor (5 and 10 mg/kg; i.p.) for 21 days concurrent with ciprofloxacin. Behavior tests as forced swimming test, activity cage, and rotarod were estimated. Oxidative stress and antioxidant biomarkers as malondialdehyde (MDA), nitric oxide (NO), catalase, and nuclear factor erythroid 2-related factor 2 (Nrf-2) besides inflammatory biomarkers as Toll-like receptor 4 (TLR4) and tumor necrosis factor alpha (TNF-α) as well as neurotransmitters were determined. Finally, histopathological examination was done.

RESULTS

Camphor increased catalase and Nrf-2 activities, decreased NO, MDA, TNF-α, TLR4 serum levels, and elevating brain contents of serotonin, dopamine, gamma-amino butyric acid (GABA) and P190-RHO GTP protein with normal neuronal cells of the frontal cortex.

CONCLUSION

Camphor has neuroprotective effect via modulation of Nrf-2 and TLR4 against ciprofloxacin-induced depression in rats.