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Oviedo DC, Tratner AE, Rodríguez-Araña S, Villarreal AE, Rangel G, Carreira MB, Britton GB. Predictors of cognitive change in cognitively healthy older women in Panama: the PARI-HD study. Front Glob Womens Health 2024; 5:1353657. [PMID: 38939750 PMCID: PMC11208464 DOI: 10.3389/fgwh.2024.1353657] [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: 12/11/2023] [Accepted: 05/28/2024] [Indexed: 06/29/2024] Open
Abstract
Background Evidence suggests that a combination of biological and social factors influence risk of dementia differently for women and men. In healthy older women, several factors may contribute to changes in cognition. Objective Describe the characteristics associated with variation in cognition in a sample of cognitively healthy older Panamanian women. Methods The study includes cross-sectional analyses of cognitive domains at baseline (n = 357) and 17-month (SD = 2.0) follow-up (n = 200) for women aged 60 years and older enrolled in the Panama Aging Research Initiative-Health Disparities (PARI-HD) study. Instruments included clinical questionnaires, physiological measures, and a neuropsychological test battery assessing global cognition and seven cognitive domains. Multiple regression analyses examined the associations between demographic and clinical characteristics and cognition at baseline. Repeated measures analyses were used to investigate changes in cognition from baseline to follow-up. Results On average, participants were 68.6 years of age (SD = 5.9) with 16.1 years of education (SD = 4.7). Age, income, and education showed robust associations with baseline cognition. Subjective cognitive impairment was associated with lower performance in global cognition, verbal learning, and memory domains. Only performance in the attention domain decreased at follow-up, and subjective health state and depressive symptoms significantly predicted the change in attention. Discussion Our study findings contribute to the investigation of cognitive health in older Hispanic women and to the understanding of sociodemographic and health-related factors associated with cognitive decline and the progression to cognitive impairment and dementia.
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Affiliation(s)
- Diana C. Oviedo
- Centro de Neurociencias y Unidad de Investigación Clínica, Institiuto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panamá
- Escuela de Psicología, Universidad Santa María la Antigua (USMA), Panama City, Panamá
- Sistema Nacional de Investigación (SNI) SENACYT, Panama City, Panamá
| | - Adam E. Tratner
- Sistema Nacional de Investigación (SNI) SENACYT, Panama City, Panamá
- Florida State University, Panama City, Panamá
| | - Sofía Rodríguez-Araña
- Centro de Neurociencias y Unidad de Investigación Clínica, Institiuto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panamá
| | - Alcibiades E. Villarreal
- Centro de Neurociencias y Unidad de Investigación Clínica, Institiuto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panamá
- Sistema Nacional de Investigación (SNI) SENACYT, Panama City, Panamá
| | - Giselle Rangel
- Centro de Neurociencias y Unidad de Investigación Clínica, Institiuto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panamá
- Sistema Nacional de Investigación (SNI) SENACYT, Panama City, Panamá
| | - María B. Carreira
- Centro de Neurociencias y Unidad de Investigación Clínica, Institiuto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panamá
- Sistema Nacional de Investigación (SNI) SENACYT, Panama City, Panamá
| | - Gabrielle B. Britton
- Centro de Neurociencias y Unidad de Investigación Clínica, Institiuto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Panama City, Panamá
- Sistema Nacional de Investigación (SNI) SENACYT, Panama City, Panamá
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Pereira ML, de Vasconcelos THF, de Oliveira AAR, Campagnolo SB, Figueiredo SDO, Guimarães AFBC, Barbosa MT, de Miranda LFJR, Caramelli P, de Souza LC. Memory complaints at primary care in a middle-income country: clinical and neuropsychological characterization. Dement Neuropsychol 2021; 15:88-97. [PMID: 33907601 PMCID: PMC8049577 DOI: 10.1590/1980-57642021dn15-010009] [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: 06/23/2020] [Accepted: 10/26/2020] [Indexed: 11/22/2022] Open
Abstract
There are different causes of memory complaints in the elderly, such as subjective cognitive decline (SCD), mild cognitive impairment (MCI) or dementia. OBJECTIVE 1) To characterize individuals with memory complaints in a mid-sized city in Brazil, through clinical, cognitive and functional assessment; 2) to compare SCD individuals with MCI and dementia patients in terms of clinical and cognitive variables. METHODS We consecutively included individuals aged ≥50 years, with memory complaints (spontaneous or inquired). Subjects who scored ≥25 on the Memory Complaint Questionnaire or who had spontaneous memory complaints were selected. Participants underwent a semi-structured interview, the Mini-Mental State Examination, Figure Memory Test for visual episodic memory, Clock Drawing Test, Category Fluency (Animals), Neuropsychiatric Inventory, and functional assessment. Individuals were classified as SCD, MCI or dementia. We did not include individuals with previous diagnosis of dementia. RESULTS The final sample consisted of 91 subjects (73.6% women; mean age 67.6±9.8 years): 14.3% had spontaneous complaints and 85.7% had inquired complaints. The most common comorbidities were hypertension (69.2%), diabetes (36.3%), and dyslipidemia (24.2%). Low levels of vitamin B12 and hypothyroidism were found in 26.4 and 16.5%, respectively. Regarding cognitive diagnosis, 16.5% of the sample were classified as SCD, 49.4% as MCI and 34.1% as dementia. MCI and dementia were identified in five (38.5%) and seven (53.4%) patients with spontaneous complaint, respectively. CONCLUSIONS MCI and dementia are frequently underdiagnosed. Potential reversible causes of cognitive decline are common. The diagnosis of dementia is highly frequent among individuals with spontaneous memory complaints.
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Affiliation(s)
- Marcos Leandro Pereira
- Programa de Pós-Graduação em Neurociências, Universidade Federal
de Minas Gerais – Patos de Minas, MG, Brazil
- Curso de Medicina, Centro Universitário de Patos de Minas –
Patos de Minas, MG, Brazil
| | | | | | | | | | | | - Maira Tonidandel Barbosa
- Departamento de Clínica Médica, Faculdade de Medicina,
Universidade Federal de Minas Gerais – Belo Horizonte, MG, Brazil
| | | | - Paulo Caramelli
- Programa de Pós-Graduação em Neurociências, Universidade Federal
de Minas Gerais – Patos de Minas, MG, Brazil
- Departamento de Clínica Médica, Faculdade de Medicina,
Universidade Federal de Minas Gerais – Belo Horizonte, MG, Brazil
| | - Leonardo Cruz de Souza
- Programa de Pós-Graduação em Neurociências, Universidade Federal
de Minas Gerais – Patos de Minas, MG, Brazil
- Departamento de Clínica Médica, Faculdade de Medicina,
Universidade Federal de Minas Gerais – Belo Horizonte, MG, Brazil
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Chou CH, Feng IJ, Chen YC, Chen JH, Lin HJ, Wang JJ, Hsu CC, Huang CC. Risk of Dementia in Diabetic Patients with Hyperglycemic Crisis: A Nationwide Taiwanese Population-Based Cohort Study. Neuroepidemiology 2020; 54:419-426. [PMID: 32841952 DOI: 10.1159/000509754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 06/24/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A hyperglycemic crisis episode (HCE) signifies poor control of diabetes and may increase the risk of dementia via microvascular and macrovascular injuries. OBJECTIVES We conducted this study to clarify this issue, which remains unclear. METHODS Using the Taiwan National Health Insurance Database, we identified 9,466 diabetic patients with HCE and the identical number of diabetic patients without HCE who were matched by age and sex for this nationwide population-based cohort study. The risk of dementia was compared between the 2 cohorts by following up until 2014. Investigation of independent predictors of dementia was also done. RESULTS In the overall analysis, the risk of dementia between the 2 cohorts was not different. However, stratified analyses showed that patients with HCE had a higher risk of subsequent dementia in the age subgroup of 45-54 and 55-64 years (adjusted odds ratio [AOR]: 2.4, 95% confidence interval [CI]: 1.6-3.6, and AOR: 1.2, 95% CI: 1.0-1.5, respectively). In the overall analysis, older age, female sex, ≥3 HCEs, hypertension, hyperlipidemia, depression, cerebrovascular disease, Parkinson's disease, and head injury were independent predictors. CONCLUSIONS HCE increased the risk of dementia in diabetic patients aged 45-64 years. Dementia was predicted by ≥3 HCEs. Prevention of recurrent HCE, control of comorbidities, and close follow-up of cognitive decline and dementia are suggested in patients with HCE.
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Affiliation(s)
- Chih-Ho Chou
- Department of Neurology, Chi Mei Medical Center, Tainan, Taiwan.,Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - I-Jung Feng
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Yi-Chen Chen
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Jiann-Hwa Chen
- Department of Emergency Medicine, Cathay General Hospital, Taipei, Taiwan.,Fu Jen Catholic University School of Medicine, Taipei, Taiwan
| | - Hung-Jung Lin
- Department of Emergency Medicine, Chi Mei Medical Center, Tainan, Taiwan.,Department of Emergency Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.,AI Biomed Center, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Chien-Chin Hsu
- Department of Emergency Medicine, Chi Mei Medical Center, Tainan, Taiwan.,Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Chien-Cheng Huang
- Department of Emergency Medicine, Chi Mei Medical Center, Tainan, Taiwan, .,Department of Senior Services, Southern Taiwan University of Science and Technology, Tainan, Taiwan, .,Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan,
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