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Hamed SA, Hadad AFE. The effect of anticholinergic drugs on cognition of patients with Parkinson's disease: a cohort study from the Egyptian population. Expert Rev Clin Pharmacol 2024:1-11. [PMID: 38781022 DOI: 10.1080/17512433.2024.2359955] [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: 02/08/2024] [Accepted: 05/22/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Cognitive dysfunction is a non-motor manifestation of Parkinson's disease (PD). We aimed to determine the frequency and patterns of cognitive dysfunction in treated patients with PD and their predictors. RESEARCH DESIGN AND METHODS This study included 80 patients (male = 48; female = 32) and 30 healthy individuals. They underwent neuropsychiatric evaluations. Measurements included Beck's depression inventory - II (BDI-II), mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA). RESULTS Patients had mean age of 55.56 ± 9.06 yrs, duration of PD of 4.86 ± 2.71 yrs and Hoehn and Yahr Scoring of 2.19 ± 0.89. They were on levodopa/carbidopa therapy and adjuvant therapy with benztropine mesylate, an anticholinergic drug, (n = 51) or amantadine sulfate, a dopaminergic drug, (n = 29). Sixteen (20%) had moderate depressive symptoms. Mild and moderate cognitive impairments were reported in 38.8% and 28.8% (by MMSE) and 46.3% and 31.3% (by MoCA). Patients had lower global cognitive scoring (p = 0.0001) and scorings of different cognitive functions (naming, attention, language, abstraction, memory and orientation) than controls. Patients treated with benztropine had lower cognition than with amantadine. Correlation analyses showed that lower cognition was only associated with chronic PD and its treatment (p = 0.0001). CONCLUSIONS Cognitive dysfunction is common with PD (77.5%) particularly with anticholinergic drugs. De-prescription of anticholinergics is recommended for patients with PD.
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Affiliation(s)
- Sherifa Ahmed Hamed
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Ali Farrag El Hadad
- Department of Neurology and Psychiatry, Al Azhar University Hospital, Assiut, Egypt
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2
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Kassir R, Roussel M, Abboud H, Godefroy O. Screening for Cognitive Impairment in Bilinguals: What Is the Influence of the Language of Assessment? Can J Neurol Sci 2024:1-6. [PMID: 38699814 DOI: 10.1017/cjn.2024.264] [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: 05/05/2024]
Abstract
BACKGROUND Bilingualism's impact on cognitive assessment remains underexplored. This study analyzes the efficacy of the Mini-Mental State Examination (MMSE) as a screening tool for bilinguals, specifically examining the influence of language choice on balanced and unbalanced Lebanese bilinguals (Arabic-French) and its implications for diagnosing cognitive impairment. METHODS Ninety-three bilingual healthy controls (mean age = 67.99 ± 9.3) and 29 Alzheimer's disease patients (mean age = 77.2 ± 5.9), including 26 with mild and 3 with moderate dementia, underwent MMSE assessments in both Arabic and French. The study aimed to assess language impact on cognitive screening outcomes in different bilingual subtypes. RESULTS Sensitivity in screening for cognitive impairment using the MMSE varied based on language and bilingualism subtype. For unbalanced bilinguals, using the prominent language increased sensitivity. Conversely, in balanced bilinguals, employing the societal majority language enhanced sensitivity. This suggests that the conventional use of the non-prominent language in cognitive screening for foreigners/immigrants may result in a subtle loss of MMSE sensitivity. CONCLUSION This study emphasizes the critical role of language choice in cognitive assessment for bilinguals. The MMSE's sensitivity is influenced by language selection, with clinical implications for screening procedures. Recommendations include using the prominent language for cognitive screening in dominant bilinguals and the societal majority language for balanced bilinguals. This nuanced approach aims to improve the accuracy and cultural sensitivity of cognitive screening in bilingual populations, addressing the gap in current assessment practices.
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Affiliation(s)
- Rania Kassir
- Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France
- Research Laboratory in Neurosciences (LAREN), Saint-Joseph University, Beirut, Lebanon
| | - Martine Roussel
- Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France
- Department of Neurology, Amiens University Hospital, Amiens, France
| | - Halim Abboud
- Department of Neurology, Saint-Joseph University, Beirut, Lebanon
| | - Olivier Godefroy
- Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France
- Department of Neurology, Amiens University Hospital, Amiens, France
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Truong QC, Cervin M, Choo CC, Numbers K, Bentvelzen AC, Kochan NA, Brodaty H, Sachdev PS, Medvedev ON. Examining the validity of the Mini-Mental State Examination (MMSE) and its domains using network analysis. Psychogeriatrics 2024; 24:259-271. [PMID: 38131467 DOI: 10.1111/psyg.13069] [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: 06/06/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The Mini-Mental State Examination (MMSE) is the most widely used standardised screener for impairments across a range of cognitive domains. However, the degree to which its domains (orientation, registration, attention, recall, language, and visuospatial) capture cognitive functioning measured using standardised neuropsychological tests is unclear. METHOD A longitudinal research design with four biannual assessments over a 6-year period was used with an initial sample of 1037 older adults (aged above 70 years). Participants completed MMSE and neuropsychological tests at each assessment. Network analysis was utilised to investigate unique associations among the MMSE and its domains and neuropsychological test performance at each time point. RESULTS The total MMSE and two of its domains, language and recall, were associated with neuropsychological memory performance. The MMSE orientation, registration and visuospatial domains did not have any unique associations with neuropsychological performance. No stable internal interconnections between MMSE domains were found over time. The association of total MMSE as well as its recall domain with neuropsychological memory performance remained very similar over the 6-year period. CONCLUSIONS The present study adds evidence to the validity of the MMSE and supports the clinical usage of the MMSE, whereby the total score is used for screening patients with or without cognitive impairments, with repeated administration to monitor cognitive changes over time, to inform intervention. However, the tool is not able to diagnose the cases for changes in specific cognitive domains and as such, should not replace a complete neuropsychological assessment.
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Affiliation(s)
| | - Matti Cervin
- Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden
| | - Carol C Choo
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Adam C Bentvelzen
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Oleg N Medvedev
- University of Waikato, School of Psychology, Hamilton, New Zealand
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Hsiao PJ, Wu CD, Wong PY, Chung MC, Yang YW, Wu LY, Hsiao KY, Chung CJ. APOE-ε4 Alleles Modify the Decline of MMSE Scores Associated With Time-Dependent PM 2.5 Exposure: Findings From a Community-Based Longitudinal Cohort Study. Am J Geriatr Psychiatry 2023:S1064-7481(23)00528-6. [PMID: 38228451 DOI: 10.1016/j.jagp.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE Limited research has explored the long-term effect of reduced PM2.5 exposure on cognitive function. This study aimed to investigate the effects of time-dependent PM2.5 exposure and the interactions of PM2.5 and aging on declines in Mini-Mental State Examination (MMSE) scores, in carriers and non-carriers of the APOE-ε4 allele. METHODS Participants aged over 60 were recruited for this cohort study, undergoing MMSE tests twice from the Taiwan Biobank Program from 2008 to 2020. Participants with dementia or baseline MMSE scores <24 were excluded. Annual PM2.5 levels were estimated using a hybrid kriging/land use regression model with extreme gradient boosting, treated as a time-dependent variable. Generalized estimating equations were used to assess the impacts of repeated PM2.5 on MMSE decline, further stratified by the presence of APOE-ε4 alleles. RESULTS After follow-up, 290 participants out of the overall 7,000 community residents in the Biobank dataset demonstrated incidences of MMSE declines (<24), with an average MMSE score decline of 1.11 per year. Participants with ε4/ε4 alleles in the APOE gene had significantly 3.68-fold risks of MMSE decline. High levels of PM2.5 across all visits were significantly associated with worsening of scores on the overall MMSE. As annual levels of PM2.5 decreased over time, the impact of PM2.5 on MMSE decline also slowly diminished. CONCLUSION Long-term PM2.5 exposure may be associated with increased risk of MMSE decline, despite improvements in ambient PM2.5 levels over time. Validation of these results necessitates a large-scale prospective cohort study with more concise cognitive screening tools.
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Affiliation(s)
- Po-Jen Hsiao
- Department of Urology (P-JH), China Medical University and Hospital, Taichung, Taiwan
| | - Chih-Da Wu
- Department of Geomatics (C-DW), National Cheng Kung University, Tainan, Taiwan; National Institute of Environmental Health Sciences (C-DW), National Health Research Institutes, Miaoli, Taiwan; Innovation and Development Center of Sustainable Agriculture (C-DW), National Chung Hsing University, Taichung, Taiwan
| | - Pei-Yi Wong
- Department of Environmental and Occupational Health (P-YW), National Cheng Kung University, Tainan, Taiwan
| | - Mu-Chi Chung
- Division of Nephrology, Department of Medicine (M-CC), Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Wan Yang
- Department of Neurology (Y-WY), China Medical University and Hospital, Taichung, Taiwan
| | - Laing-You Wu
- Department of Public Health (L-YW, C-JC), College of Public Health, China Medical University, Taichung, Taiwan
| | - Kai-Yu Hsiao
- Division of Thoracic Surgery (K-YH), Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Jung Chung
- Department of Public Health (L-YW, C-JC), College of Public Health, China Medical University, Taichung, Taiwan; Department of Medical Research (C-JC), China Medical University Hospital, Taichung, Taiwan.
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Yaghi N, El Hayeck R, Boulos C, Abifadel M, Yaghi C. Effect of Mediterranean Dietary Pattern on Cognitive Status in Community-Dwelling Older Adults. Nutrients 2023; 15:3911. [PMID: 37764695 PMCID: PMC10537047 DOI: 10.3390/nu15183911] [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: 08/07/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Modifiable factors associated with cognitive decline (CD) require more attention, particularly dietary patterns. This study aimed to investigate the link between cognitive decline and associated factors, particularly dietary patterns (DPs), in community-dwelling older Lebanese of modest economic status. Our cross-sectional national study included 352 participants above 60 years old, from the medico-social centers of the ministry of social affairs all over the country. CD was screened based on literacy. Nutritional and dietary data were collected through a validated food frequency questionnaire. DPs were extracted by the K-mean cluster analysis. CD was found in 32.7% and 61.5% of literate and illiterate groups, respectively. Identified DPs included a Westernized type and Mediterranean type, with high and moderate food intakes. In the context of literacy, independent factors associated with CD were age above 80 years, living in Beirut, frailty, and adopting a Westernized (OR = 3.08, 95% CI: 1.22-7.8) and a high-intake Mediterranean DP (OR = 2.11, 95% CI: 1.05-4.22). In the context of illiteracy, the same factors were associated with CD, but not DP nor frailty, with an age cut-off at 78 years. In a Lebanese sample of older adults, factors associated with CD depend on the level of literacy, with DP only associated with CD in the context of literacy.
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Affiliation(s)
- Nathalie Yaghi
- Department of Nutrition & Dietetics, Faculty of Pharmacy, Saint Joseph University, Beirut 1107 2180, Lebanon;
| | - Rita El Hayeck
- Department of Geriatrics, Working Group on Dementia at Saint Joseph University (GTD-USJ), Faculty of Medicine, Saint Joseph University, Beirut 1107 2180, Lebanon;
| | - Christa Boulos
- Department of Nutrition & Dietetics, Faculty of Pharmacy, Saint Joseph University, Beirut 1107 2180, Lebanon;
| | - Marianne Abifadel
- Laboratory of Biochemistry and Molecular Therapeutics, Faculty of Pharmacy, Pôle Technologie-Santé, Saint Joseph University, Beirut 1004 2020, Lebanon
| | - César Yaghi
- Department of Gastroenterology, Faculty of Medicine, Saint Joseph University, Beirut 1107 2020, Lebanon;
- Hôtel-Dieu de France of Beirut University Hospital, Beirut P.O. Box 166830, Lebanon
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Alb'ool B, Abu Khait A. The presence and severity of neuropsychiatric symptoms and their association with quality of life among patients with dementia. Cogn Neuropsychiatry 2023; 28:307-325. [PMID: 37665567 DOI: 10.1080/13546805.2023.2255342] [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: 11/14/2022] [Accepted: 07/10/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Neuropsychiatric symptoms are common manifestations of dementia. The presence and severity of these symptoms differ depending on different personal and contextual factors. PURPOSE This study aimed to investigate the presence and predictors of neuropsychiatric symptoms and the association between the severity of these symptoms and the quality of life in a sample of patients with dementia in Jordan. METHODS In this cross-sectional study, 112 patients with dementia residing in Jordanian nursing homes were recruited using the consecutive sampling method. RESULTS The mean severity of neuropsychiatric symptoms was 9.58. The most prevalent neuropsychiatric symptoms among patients were depression (61.6%), followed by irritability (55.4%), and a feeling of euphoria (54.5%). The regression analysis results indicated that gender, marital status, and dementia severity significantly predicted the neuropsychiatric symptoms severity score and explained 17.70% of the variance. A significant negative correlation between the severity of neuropsychiatric symptoms and quality of life was found. CONCLUSION The study's results indicate that our sample reported mild neuropsychiatric symptoms. These symptoms' high prevalence and persistence negatively impact patients' quality of life. The study's results can help mental health nurses determine the factors impacting effective treatment strategies to combat these symptoms. Future longitudinal studies are warranted to help explain the importance of early diagnosis and management of these symptoms in preventing dementia progression.
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Affiliation(s)
- Banan Alb'ool
- Department of Health Care, Vocational Training Corporation, Irbid, Jordan
| | - Abdallah Abu Khait
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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El-Hayeck R, Wehbé A, Baddoura R, Khoury R, Bassil N, Abou Khaled K, Koussa S, Richa S, Alameddine A, Sellal F. Letter and Category Fluency: Normative Data for Lebanese Older Adults. J Alzheimers Dis 2023; 93:321-332. [PMID: 37005886 DOI: 10.3233/jad-221121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Background: Verbal fluency tasks are frequently used for neuropsychological assessment in clinical practice and research. It consists of two tasks namely category and letter fluency tests. Objective: To determine normative values in category (animals, vegetables, fruits) and letter fluency [Mim () “M”, Alif () “A”, Baa () “B”] tasks in Arabic language in 60 s. Methods: This study was a cross-sectional national survey and included 859 community-dwelling, cognitively intact Lebanese residents aged ≥55 years. Norms were presented according to age (55–64 years, 65–74 years, ≥75 years), sex and level of education (illiterate, no diploma, primary certificate, baccalaureate or higher). Results: Level of education had the most significant positive effect on verbal fluency tasks performance amongst Lebanese older adults. The negative effect of older age was more prominent in the category fluency task compared to the letter fluency task. Women outperformed men in vegetables and fruits categories. Conclusion: This study provides clinicians with normative scores of category and letter fluency tests, which can be used for neuropsychological assessment of older Lebanese patients being evaluated for cognitive disorders.
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Affiliation(s)
- Rita El-Hayeck
- Department of Geriatrics, Saint Joseph University School of Medicine, Beirut, Lebanon
- Working Group on Dementia at Saint Joseph University: Groupe de Travail sur les Démences de l'USJ (GTD-USJ), Saint Joseph University, Beirut, Lebanon
| | - Amine Wehbé
- Department of Geriatrics, Saint Joseph University School of Medicine, Beirut, Lebanon
- Working Group on Dementia at Saint Joseph University: Groupe de Travail sur les Démences de l'USJ (GTD-USJ), Saint Joseph University, Beirut, Lebanon
| | - Rafic Baddoura
- Department of Epidemiology and Public Health, Saint Joseph University School of Medicine, Beirut, Lebanon
- Working Group on Dementia at Saint Joseph University: Groupe de Travail sur les Démences de l'USJ (GTD-USJ), Saint Joseph University, Beirut, Lebanon
| | - Rita Khoury
- Department of Psychiatry, American University of Beirut, Faculty of Medicine & The Medical Center, Beirut, Lebanon
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, MO, USA
| | - Nazem Bassil
- Department of Internal Medicine, Division of Geriatric Medicine, American University of Beirut, Lebanon
| | - Karine Abou Khaled
- Department of Neurology, Saint Joseph University School of Medicine, Beirut, Lebanon
- Working Group on Dementia at Saint Joseph University: Groupe de Travail sur les Démences de l'USJ (GTD-USJ), Saint Joseph University, Beirut, Lebanon
| | - Salam Koussa
- Department of Neurology, Lebanese University, Lebanese Hospital Geitaoui - UMC, Beirut, Lebanon
- Working Group on Dementia at Saint Joseph University: Groupe de Travail sur les Démences de l'USJ (GTD-USJ), Saint Joseph University, Beirut, Lebanon
| | - Sami Richa
- Department of Psychiatry, Saint Joseph University School of Medicine, Beirut, Lebanon
- Working Group on Dementia at Saint Joseph University: Groupe de Travail sur les Démences de l'USJ (GTD-USJ), Saint Joseph University, Beirut, Lebanon
| | - Abbas Alameddine
- Department of Psychiatry, Hôtel-Dieu de France Hospital, Beirut, Lebanon
| | - François Sellal
- Department of Neurology, Hôpitaux Civils de Colmar and INSERM U-1118, School of Medicine, Strasbourg University, Strasbourg, France
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An adapted Arabic version of the Test of Nine Images for the illiterate Lebanese population: Validation and preliminary normative data. J Int Neuropsychol Soc 2023; 29:316-323. [PMID: 35504862 DOI: 10.1017/s1355617722000236] [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] [Indexed: 11/06/2022]
Abstract
OBJECTIVES In the absence of a simple validated instrument to screen for cognitive impairment among illiterate Lebanese older adults, the aims of this study were to validate an Arabic version of the Test of Nine Images (A-TNI93) adapted by the Working Group on Dementia at Saint Joseph University: Groupe de Travail sur les Démences de l'Univesité Saint Joseph (GTD-USJ) for illiterate older Lebanese and to establish normative data. METHOD A national population-based sample of 332 community-dwelling illiterate Lebanese aged 55 years and older was administered the A-TNI93 (GTD-USJ) scoring free and overall recall. The sample is part of a larger national sample (1342 participants) used to validate an Arabic version of the Mini-Mental State Examination already reported. Reproducibility, sensitivity, specificity, and area under the curve of the A-TNI93 (GTD-USJ) scoring to detect cognitive impairment according to Clinical Dementia Rating (CDR) as the gold standard were measured. Normative data were established among 188 cognitively normal participants. RESULTS A threshold score of six on free recall (FR) provided a sensitivity of 66.7% and a specificity of 90.5%. The area under the curve was 0.93. By taking either scores, that is, a FR ≤ 6 or a total recall ≤ 8, the A-TNI93 (GTD-USJ) slightly improved dementia case detection with a sensitivity of 70.8% and a specificity of 88%. Normative data illustrate the distribution of cognitive performance among illiterate older adults. CONCLUSIONS Compared to the CDR requiring physician's competence, the A-TNI93 (GTD-USJ) is a valid Arabic adaptation to screen for cognitive impairment among illiterate Lebanese older adults.
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Yuan XF, Zhang Y, Zhang Y, Wu YH, Shi Y, Cheng Y, Xie F. Reliability and validity of the Brief Assessment of Impaired Cognition (Chinese version) for stroke patients. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:27-33. [PMID: 33879014 DOI: 10.1080/23279095.2021.1908287] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objective and accurate cognitive assessment scales are essential for guiding cognitive rehabilitation following stroke. The aim of this study was to evaluate the validity and reliability of the Mandarin Chinese version of the Brief Assessment of Impaired Cognition (BASIC) in stroke patients. The English version of the BASIC scale was translated into Mandarin Chinese, and 56 stroke patients at a stroke treatment center were enrolled in the study. The Mini-Mental State Examination (MMSE) and BASIC scale were used to evaluate the patients' cognitive function, and content validity, structural validity, concurrent validity, internal consistency, interrater consistency and reliability and test-retest reliability were used to evaluate the test results. The correlation coefficients between each item of the BASIC scale and the total score were between 0.416 and 0.804 (p < 0.05). The total score on the BASIC scale was correlated with the total score on the MMSE (r = 0.479, p < 0.05). Four factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 74.932%. The factor loading of each item on the corresponding factor was > 0.5, indicating that the scale has good structural validity. Internal consistency was good (Cronbach's α = 0.821), as were interrater (ICC > 0.95) and test-retest reliability (ICC = 0.815-0.941). Therefore, the Chinese version of the BASIC scale has good reliability and validity and can assist in screening for cognitive dysfunction or dementia in stroke patients.
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Affiliation(s)
- Xiao-Fang Yuan
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yi Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yu Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Ye-Huan Wu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yue Shi
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yun Cheng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Fan Xie
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Department of Rehabilitation Medicine, School of Clinical Medicine, Soochow University, Soochow, China
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El Osta N, Wehbe A, Sleiman N, Drancourt N, El Osta L, Hennequin M. Dental Criteria Could Alert for Malnutrition Risk and Inappropriate Choice of Food Texture in Older Subjects with Dementia: An Analytical Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15086. [PMID: 36429816 PMCID: PMC9690132 DOI: 10.3390/ijerph192215086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/03/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
Oral health indicators are usually collected to alert for the presence of infectious diseases, but the impact of poor oral health on the nutritional status of older people with dementia is often neglected. This study aims to explore the relationship between the number of posterior dental functional units (PFUs) and the anthropometric measure of malnutrition, the mid-upper arm circumference (MUAC), in older people with dementia while controlling for other variables, and to analyze whether the number of PFUs is considered when adjusting the texture of the food provided at mealtimes. A total of 103 individuals who were 70 years or older with dementia were recruited from seven institutions. Cognitive impairment was assessed using the Mini Mental State Examination. Data were collected from medical records (sociodemographic characteristics, presence of chronic diseases, prescribed medications, results of serum albumin level), as well as questionnaires (type of feeding routes, type of food texture, supplements intake, Activity of Daily Living index), clinical examinations (MUAC), and oral health parameters (PFUs, oral dryness, oral hygiene). MUAC was the dependent outcome variable. MUAC was associated with the number of PFUs (p = 0.032); participants with PFU ≤ 4 were 7.5 times more likely to have MUAC < 21 cm than others. Other associations were found between MUAC and albumin level (OR = 12.5; p = 0.001), modified food texture (OR = 4.2; p = 0.035), and length of institutional stay (OR = 5.2; p = 0.033); however, the type of oral feeding was not significantly related to the number of PFUs (p = 0.487) so there is an inadequate correlation between food texture and oral health status. Similar to MUAC, the number of PFUs could be an oral anthropometric criterion that is recorded during routine hygiene care to alert for the risk of malnutrition and the inappropriate choice of food texture in older individuals with dementia.
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Affiliation(s)
- Nada El Osta
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, 63000 Clermont-Ferrand, France
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut 111, Lebanon
| | - Amine Wehbe
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut 111, Lebanon
| | - Nelly Sleiman
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut 111, Lebanon
| | - Noemie Drancourt
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, 63000 Clermont-Ferrand, France
- CHU of Clermont-Ferrand, Service d’Odontologie, 63003 Clermont-Ferrand, France
| | - Lana El Osta
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut 111, Lebanon
| | - Martine Hennequin
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, 63000 Clermont-Ferrand, France
- CHU of Clermont-Ferrand, Service d’Odontologie, 63003 Clermont-Ferrand, France
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11
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Boutros CF, Khazaal W, Taliani M, Said Sadier N, Salameh P, Hosseini H. One-year recurrence of stroke and death in Lebanese survivors of first-ever stroke: Time-to-Event analysis. Front Neurol 2022; 13:973200. [PMID: 36452174 PMCID: PMC9702576 DOI: 10.3389/fneur.2022.973200] [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] [Received: 06/19/2022] [Accepted: 10/14/2022] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND To date, despite the application of secondary prevention worldwide, first-ever stroke survivors remain at imminent risk of stroke recurrence and death in the short and long term. The present study aimed to assess the cumulative risk rates and identify baseline differences and stroke characteristics of Lebanese survivors. METHODS A prospective longitudinal study was conducted among survivors ≥18 years old who were followed-up for 15 months through a face-to-face interview. Kaplan-Meier method was used to calculate the cumulative rates of stroke mortality and recurrence. Cox-regression univariate and multivariable analyses were performed to identify the predictors of both outcomes. RESULTS Among 150 subjects (mean age 74 ± 12 years; 58.7% men vs. 44.3% women; 95.3% with ischemic stroke vs. 4.3% with intracerebral hemorrhage), high cumulative risk rates of stroke recurrence (25%) and death (21%) were highlighted, especially in the acute phase. Survival rates were lesser in patients with stroke recurrence compared to those without recurrence (Log rank test p < 0.001). Older age was the main predictor for both outcomes (p < 0.02). Large artery atherosclerosis was predominant in patients with stroke recurrence and death compared to small vessel occlusion (p < 0.02). Higher mental component summary scores of quality of life were inversely associated with stroke recurrence (p < 0.01). Lebanese survivors exhibited the highest percentages of depression and anxiety; elevated Hospital Anxiety and Depression Scale (HADS) scores were seen in those with stroke recurrence and those who died (≥80% with mean HADS scores ≥8). Lower Mini-Mental State Examination scores at the acute phase increased the risk of both outcomes by 10% (p < 0.03). Three out of 13 mortalities (23.1%) were presented with early epileptic seizures (p = 0.012). High educational level was the protective factor against stroke recurrence (p = 0.019). Administration of intravenous thrombolysis decreased the risk of both outcomes by 10% (p > 0.05). CONCLUSION Higher rates of stroke recurrence and death were observed in the first year following a stroke in Lebanon. Various factors were identified as significant determinants. Thus, health care providers and officials in Lebanon can use these findings to implement effective preventive strategies to best address the management of these factors to reduce the stroke burden and improve the short and long-term prognosis of stroke survivors.
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Affiliation(s)
- Celina F. Boutros
- Institut Mondor de Recherche Biomédicale (IMRB)-INSERM U955, Ecole Doctorale Science de la Vie et de la Santé, Université Paris-Est Créteil, Paris, France
| | - Walaa Khazaal
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
| | - Maram Taliani
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
| | - Najwane Said Sadier
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
- College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Pascale Salameh
- Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie (INSPECT-LB), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
| | - Hassan Hosseini
- Institut Mondor de Recherche Biomédicale (IMRB)-INSERM U955, Ecole Doctorale Science de la Vie et de la Santé, Université Paris-Est Créteil, Paris, France
- Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie (INSPECT-LB), Beirut, Lebanon
- Hôpital Henri Mondor, AP-HP, Créteil, France
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12
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Abanmy N, Alsabhan J, Gard P, Scutt G. Association between the Val66Met polymorphism (rs6265/G196A) of the BDNF gene and cognitive performance with SSRI use in Arab Alzheimer's disease patients. Saudi Pharm J 2022; 29:1392-1398. [PMID: 35002376 PMCID: PMC8720700 DOI: 10.1016/j.jsps.2021.10.007] [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: 09/12/2020] [Accepted: 10/12/2021] [Indexed: 11/16/2022] Open
Abstract
Brain derived neutrophic factor (BDNF) is a protein and a member of the neurotrophin family of growth factors, supports the survival of existing neurons and encourages the growth and differentiation of new neurons and synapses. The BDNF gene Val66Met polymorphism (rs6265/G196A) is responsible for BDNF synthesis that impact BDNF function that includes memory and cognition. This study investigated whether the BDNF gene Val66Met polymorphism (rs6265/G196A) is associated with cognitive function changes in both Alzheimer disease (AD) patients and elderly participants. In addition the impact of SSRI use on cognition improvement will be assessed. Healthy young, middle ages (25–59 years old) and elderly (more than 60 years old) participants (140) as well as 40 AD patients of whom are both of Saudi Arabian origin were recruited. The genotyping for the association study was performed by real-time PCR using Taqman chemistry in the ABI Prism 7900HT Sequence Detection System. Both Mini-Mental Status Examination (MMSE) and Clinical Dementia Rating (CDR) were used to assess cognitive function of healthy and AD participants, respectively. The findings showed that the BDNF Val66Met genotype distributions and allele frequencies have significant association with cognitive performance in both elderly control group and AD patients. The main findings showed that carriers of GG homozygotes (Val/Val) have superior cognitive performance among AD patients and elderly control subjects. In addition the use of SSRIs in 13 AD patients and 17 elderly participants positively improved cognitive function in elderly (p > 0.001) but not in AD patients (p = 0.1).
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Affiliation(s)
- N Abanmy
- College of Pharmacy, King Saud University, Riyadh 14212, Saudi Arabia
| | - J Alsabhan
- College of Pharmacy, King Saud University, Riyadh 14212, Saudi Arabia
| | - P Gard
- School of Pharmacy and biomolecular sciences, University of Brighton, Brighton BN2 4AT, UK
| | - G Scutt
- School of Pharmacy and biomolecular sciences, University of Brighton, Brighton BN2 4AT, UK
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13
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Tuch G, Soo WK, Luo KY, Frearson K, Oh EL, Phillips JL, Agar M, Lane H. Cognitive Assessment Tools Recommended in Geriatric Oncology Guidelines: A Rapid Review. Curr Oncol 2021; 28:3987-4003. [PMID: 34677257 PMCID: PMC8534877 DOI: 10.3390/curroncol28050339] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/24/2021] [Accepted: 10/04/2021] [Indexed: 12/26/2022] Open
Abstract
Cognitive assessment is a cornerstone of geriatric care. Cognitive impairment has the potential to significantly impact multiple phases of a person's cancer care experience. Accurately identifying this vulnerability is a challenge for many cancer care clinicians, thus the use of validated cognitive assessment tools are recommended. As international cancer guidelines for older adults recommend Geriatric Assessment (GA) which includes an evaluation of cognition, clinicians need to be familiar with the overall interpretation of the commonly used cognitive assessment tools. This rapid review investigated the cognitive assessment tools that were most frequently recommended by Geriatric Oncology guidelines: Blessed Orientation-Memory-Concentration test (BOMC), Clock Drawing Test (CDT), Mini-Cog, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Short Portable Mental Status Questionnaire (SPMSQ). A detailed appraisal of the strengths and limitations of each tool was conducted, with a focus on practical aspects of implementing cognitive assessment tools into real-world clinical settings. Finally, recommendations on choosing an assessment tool and the additional considerations beyond screening are discussed.
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Affiliation(s)
- Gina Tuch
- Department of Geriatric Medicine, Alfred Health, Melbourne, VIC 3004, Australia
| | - Wee Kheng Soo
- Eastern Health Clinical School, Monash University, Box Hill, VIC 3128, Australia;
- Cancer Services, Eastern Health, Box Hill, VIC 3128, Australia
- Aged Medicine Program, Eastern Health, Box Hill, VIC 3128, Australia
| | - Ki-Yung Luo
- Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia; (K.-Y.L.); (K.F.); (E.L.O.); (H.L.)
| | - Kinglsey Frearson
- Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia; (K.-Y.L.); (K.F.); (E.L.O.); (H.L.)
| | - Ek Leone Oh
- Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia; (K.-Y.L.); (K.F.); (E.L.O.); (H.L.)
| | - Jane L. Phillips
- Queensland University of Technology, Brisbane City, QLD 4000, Australia;
| | - Meera Agar
- University of Technology Sydney, Ultimo, NSW 2007, Australia;
| | - Heather Lane
- Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia; (K.-Y.L.); (K.F.); (E.L.O.); (H.L.)
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14
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Alshaikh AA, Alatawi HS, Alzahrani AM. Neurocognitive dysfunction among type 2 diabetes patients attending primary health care in Jeddah, Saudi Arabia. J Family Med Prim Care 2021; 10:3803-3814. [PMID: 34934684 PMCID: PMC8653469 DOI: 10.4103/jfmpc.jfmpc_423_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/05/2021] [Accepted: 07/19/2021] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Identification of modifiable risk factors of neurocognitive dysfunction (NCDs) that would help in preventing neurocognitive dysfunction by means of appropriate measures. OBJECTIVES The study aims to provide an insight into the extent and cofactors ofNCDs among Saudi type II diabetes (T2DM) patients at the primary care level. SETTINGS AND DESIGN A cross-sectional study was conducted at five randomly selected primary health care centers (PHCCs) of Jeddah, Saudi Arabia. SUBJECT AND METHODS T2DM patients above 40 years, who were followed for T2DM diagnosed ≥ 1 year ago were recruited. The Arabic version of the Mini-Mental State Evaluation (MMSE) was used for screening NCDs, using education-adjusted cut-offs. STATISTICAL ANALYSIS USED Sociodemographic, diabetes-related, and other clinical and lifestyle factors were analyzed as cofactors of NCDs. RESULTS The study included 236 T2DM patients, who had mean ± SD age of 60.29 ± 9.45 years. The majority (61.0%) were female, and mean ± SD duration of T2DM was 14.1 ± 8.4 years (range = 1-45 years). The prevalence of NCDs was 35.2% (95% CI = 29.1%, 41.6%), and 5.1% of the participants had MMSE scores ≤ 10 indicating severe neurocognitive impairment. The congruence of significant sociodemographic factors delineated a high-risk profile, and multivariate regression analysis showed female gender, low educational level, longer duration of diabetes, geriatric age at T2DM diagnosis, inadequate glycemic control, and sedentary lifestyle as the independent risk factors for NCDs. CONCLUSIONS The population of middle-aged and older T2DM patients is highly exposed to NCDs, with the great contribution of other comorbidities and higher risk incurred by older, lowly educated females with long diabetes duration. Further improvements should be achieved to enhance the care offered to diabetic patients by improving glycemic control, screening for comorbidities, and early detection of neurocognitive decline.
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Affiliation(s)
- Alshaymaa A Alshaikh
- Department of Family Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Hind S Alatawi
- Department of Family Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Abdullah M Alzahrani
- Department of Family Medicine, King Saud Bin Abdulaziz University for Health and Sciences, King Abdulaziz Medical City, King Abdullah Inteernational Medical Research Center, Jeddah, Saudi Arabia
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15
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Cheng Y, Wang YZ, Zhang Y, Wang Y, Xie F, Zhang Y, Wu YH, Guo J, Fei X. Comparative analysis of rowland universal dementia assessment scale and mini-mental state examination in cognitive assessment of traumatic brain injury patients. NeuroRehabilitation 2021; 49:39-46. [PMID: 34057101 DOI: 10.3233/nre-210044] [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 Rowland Universal Dementia Assessment Scale (RUDAS) has demonstrated usefulness in cognitive assessment. Studies supporting the use of RUDAS as an evaluation tool in traumatic brain injury (TBI) patients remain limited. This study examined whether the Chinese version of RUDAS can be effectively applied to the cognitive assessment of TBI patients in China. OBJECTIVE To compare the performance of Mini-Mental State Examination (MMSE) and the Chinese version of RUDAS in the cognitive assessment of Chinese patients with TBI so as to provide reference for clinical use. METHODS 86 inpatients with TBI in a hospital were selected from July 2019 to July 2020 and were enrolled as the TBI group, while another 40 healthy individuals matched with age, sex and education level were selected as the control group. All subjects were assessed by trained rehabilitation physicians with MMSE and RUDAS. RESULTS (1) Compared with the control group, the scores of MMSE and RUDAS in the TBI group decreased significantly; (2) The results of MMSE and RUDAS in the TBI group were positively correlated (r = 0.611, P < 0.001); (3) Linear correlation suggested that age was negatively correlated with MMSE (r = -0.344, P = 0.001) and RUDAS (r = -0.407, P < 0.001), while education years were positively correlated with MMSE (r = 0.367, P = 0.001) and RUDAS (r = 0.375, P < 0.001). However, according to the multiple linear regression, the results of RUDAS were not affected by the years of education; (4) Receiver operating curve analysis showed that there was no significant difference in the areas under the curve between MMSE and RUDAS. The best cut-off values of MMSE and RUDAS were 27.5 and 24.5, respectively. CONCLUSIONS MMSE and RUDAS have similar diagnostic efficacy in evaluating cognitive impairment of patients with TBI. Since the Chinese version of RUDAS is not affected by the education level, it is more suitable for TBI patients in China.
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Affiliation(s)
- Yun Cheng
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, China.,Department of Rehabilitation Medicine, School of Clinical Medicine, Soochow University, Soochow, China
| | - Yong-Zheng Wang
- Department of Rehabilitation Medicine, People's Hospital of Deyang City, Sichuan, China
| | - Yi Zhang
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Ya Wang
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Fan Xie
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yu Zhang
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Ye-Huan Wu
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jing Guo
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xiao Fei
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, China
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16
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Yaghi N, Yaghi C, Abifadel M, Boulos C, Feart C. Dietary Patterns and Risk Factors of Frailty in Lebanese Older Adults. Nutrients 2021; 13:2188. [PMID: 34202045 PMCID: PMC8308408 DOI: 10.3390/nu13072188] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/10/2021] [Accepted: 06/22/2021] [Indexed: 12/13/2022] Open
Abstract
Factors associated with frailty, particularly dietary patterns, are not fully understood in Mediterranean countries. This study aimed to investigate the association of data-driven dietary patterns with frailty prevalence in older Lebanese adults. We conducted a cross-sectional national study that included 352 participants above 60 years of age. Sociodemographic and health-related data were collected. Food frequency questionnaires were used to elaborate dietary patterns via the K-mean cluster analysis method. Frailty that accounted for 15% of the sample was twice as much in women (20%) than men (10%). Identified dietary patterns included a Westernized-type dietary pattern (WDP), a high intake/Mediterranean-type dietary pattern (HI-MEDDP), and a moderate intake/Mediterranean-type dietary pattern (MOD-MEDDP). In the multivariate analysis, age, waist to height ratio, polypharmacy, age-related conditions, and WDP were independently associated with frailty. In comparison to MOD-MEDDP, and after adjusting for covariates, adopting a WDP was strongly associated with a higher frailty prevalence in men (OR = 6.63, 95% (CI) (1.82-24.21) and in women (OR = 11.54, 95% (CI) (2.02-65.85). In conclusion, MOD-MEDDP was associated with the least prevalence of frailty, and WDP had the strongest association with frailty in this sample. In the Mediterranean sample, a diet far from the traditional one appears as the key deleterious determinant of frailty.
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Affiliation(s)
- Nathalie Yaghi
- Department of Nutrition & Dietetics, Faculty of Pharmacy, Saint Joseph University of Beirut, P.O. Box 17-5208 Mar Mikhael, Beirut 1104 2020, Lebanon; (N.Y.); (C.B.)
| | - Cesar Yaghi
- Department of Gastroenterology, Faculty of Medicine, Saint Joseph University of Beirut, P.O. Box 17-5208 Mar Mikhael, Beirut 1104 2020, Lebanon;
- Hotel-Dieu de France of Beirut University Hospital, P.O. Box 166830, Alfred Naccache Blvd, Beirut, Lebanon
| | - Marianne Abifadel
- Laboratory of Biochemistry and Molecular Therapeutics, Faculty of Pharmacy, Pôle Technologie-Santé, Saint Joseph University of Beirut, P.O. Box 17-5208 Mar Mikhael, Beirut 1104 2020, Lebanon;
| | - Christa Boulos
- Department of Nutrition & Dietetics, Faculty of Pharmacy, Saint Joseph University of Beirut, P.O. Box 17-5208 Mar Mikhael, Beirut 1104 2020, Lebanon; (N.Y.); (C.B.)
| | - Catherine Feart
- LEHA team, INSERM U1219, Université de Bordeaux, F-33000 Bordeaux, France
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Khazaal W, Taliani M, Boutros C, Abou-Abbas L, Hosseini H, Salameh P, Sadier NS. Psychological Complications at 3 Months Following Stroke: Prevalence and Correlates Among Stroke Survivors in Lebanon. Front Psychol 2021; 12:663267. [PMID: 34177717 PMCID: PMC8222528 DOI: 10.3389/fpsyg.2021.663267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/13/2021] [Indexed: 02/02/2023] Open
Abstract
Introduction: Stroke continues to be a common and debilitating medical condition which has a significant effect on public health as the second primary source of mortality and the third major root of disability worldwide. A wide range of complications affecting the survivor's life and interfering with the recovery process usually follows stroke; anxiety and depression are considered one of the major complications post-stroke. This study sought to investigate the short-term psychological consequences of stroke among Lebanese survivors and to identify their correlates. Methods: This study is a prospective observational epidemiological study. 143 stroke patients admitted to hospitals in Mount Lebanon and Beirut between February and May 2018.were included in this study. Assessments of complications were carried out at 3 months post-stroke by completing a 30-min face-to-face interview questionnaire. The survey included the socio-demographic -characteristics of the patients, their lifestyle, health indicators, the severity of stroke, and the post-stroke consequences disturbing their quality of life. Results: Complications were recorded for 117 stroke survivors (mean age, 72.46 years; 60.7% male). The analysis of results 3 months post stroke showed that 29 survivors suffered from neuropathic pain (24.8%), 110 (94%) suffered from fatigue, and 81 (69.2%) from cognitive impairment. High rates of anxiety (51.3%), and depression (76.1%) were recorded as well. Multivariate logistic regression confirmed that there is a significant association between depression and the following variables: anxiety (OR = 4.814, p-value = 0.017), pain (OR = 6.868, p-value = 0.002), and physical activity, which acts as a protective factor against depression (OR = 0.261; p-value = 0.029). However, the results of the multivariate logistic regression analysis for anxiety indicated that immobility-related complications increase the risk of anxiety by 8.457 in sedentary duration longer than 12 h (ORa = 8.457, p-value = 0.01). Furthermore, patients with neuropathic pain (24.8%) are 3.858 times more likely to have anxiety compared to patients without neuropathic pain (ORa = 3.858, p-value = 0.019). Conclusion: Using a patient-centered structure more interventions should take place to evaluate stroke survivors' outcomes, and organize rehabilitation services that deal with stroke consequences, particularly high anxiety and depression levels, which are prevalent and persistent among the Lebanese stroke survivors.
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Affiliation(s)
- Walaa Khazaal
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Maram Taliani
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Celina Boutros
- Institut Mondor de Recherche Biomedicale (IMRB)-Inserm U955, Ecole Doctorale Science de la Vie et de la Santé, Université Paris-Est, Creteil, Paris, France
| | - Linda Abou-Abbas
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Hassan Hosseini
- Institut Mondor de Recherche Biomedicale (IMRB)-Inserm U955, Ecole Doctorale Science de la Vie et de la Santé, Université Paris-Est, Creteil, Paris, France
| | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon.,Institut National de Sante Publique, Epidémiologie Clinique et Toxicologie (INSPECT-LB), Beirut, Lebanon.,University of Nicosia Medical school, Nicosia, Cyprus
| | - Najwane Said Sadier
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon.,College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
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Ibrahim MHED, Elmasry M, Nagy F, Abdelghani A. Prevalence and risk factors of delirium and subsyndromal delirium in older adults. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2021. [DOI: 10.1186/s43162-021-00042-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Delirium is a common geriatric problem associated with poor outcomes. Subsyndromal delirium (SSD) is characterized by the presence of certain symptoms of delirium yet, not satisfying the definition of full-blown delirium, defined by categorical elements, and is usually referred to as the presence of one or more symptoms in the confusion assessment method (CAM). This study aimed to investigate the prevalence and risk factors of delirium and SSD in older adults admitted to the hospital. Five hundred eighty-eight elderly (above 65 years) Egyptian patients were recruited from January 2019 to February 2020. After explaining the purpose of the study and assuring the confidentiality of all participants, an informed consent was obtained from the participant or a responsible care giver for those who were not able to give consent. All patients were subjected ‘on admission’ to thorough history taking, clinical examination, and comprehensive geriatric assessment including confusion assessment tools, mini-mental state examination, and functional assessment using Barthel index score.
Results
The current study showed that 19.6% of patients had delirium and 14.1% of patients had SSD with combined prevalence of 33.7%. Most common causes included metabolic, infection, organic brain syndrome, and dehydration. The current study reported significant proportionate relation between cognitive assessment and functional ability, so patients with a score of 23 MMSE had good functional ability, while cognitive assessment using mini-mental score shows inversed relation to delirium and SSD using CAM score.
Conclusion
Delirium is independently associated with adverse short-term and long-term outcomes, including an increase in mortality, length of hospital stay, discharge to an institution, and functional decline on discharge. Subsyndromal delirium (SSD) is characterized by the presence of certain symptoms of delirium, not yet satisfying the definition of full-blown delirium but it can identify patients with early cognitive and functional disabilities, and because of high prevalence of delirium and SSD. Efforts to prevent or early detection may identify patients who warrant clinical attention.
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Ktaiche M, Fares Y, Abou-Abbas L. Stroop color and word test (SCWT): Normative data for the Lebanese adult population. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1578-1586. [PMID: 33780300 DOI: 10.1080/23279095.2021.1901101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The Stroop Color and Word Test (SCWT) is one of the most commonly used measures to assess multiple cognitive functions. Several studies have shown that SCWT performance is influenced by different demographic factors and have recommended the necessity of generating normative data in different cultures. The present study aims to explore the effect of gender, age, and education on SCWT scores and to generate normative data for the Lebanese healthy adults. A sample of 321 healthy participants aged 18 and above was recruited from different Lebanese regions. The SCWT was administered to the participants. A regression-based strategy was applied to generate normative data. The results showed a statistically significant effect of age and education on the SCWT scores whereas no significant effect for gender was found. An interactive calculator was created to calculate estimated Z-scores based on corresponding predictions of the linear regression model. The calculator also provides percentile ranks. The present study is the first to generate normative data for the SCWT test in Lebanon. Neuropsychologists in Lebanon will benefit from this outcome to improve the accurate detection of executive function deficits in clinical settings for the Lebanese adult population.
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Affiliation(s)
- Marwa Ktaiche
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Youssef Fares
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Linda Abou-Abbas
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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Alshammari SA, Alhamdan AA, Bindawas SM, Al-Amoud MM, Al-Orf SM, Al-Muammar MN, Calder PC. Assessing the cognitive status of older adults attending primary healthcare centers in Saudi Arabia using the Mini-Mental State Examination. Saudi Med J 2020; 41:1315-1323. [PMID: 33294888 PMCID: PMC7841595 DOI: 10.15537/smj.2020.12.25576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/18/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To assess the cognitive status of older adults in Saudi Arabia. METHODS This was a cross-sectional, multistage, stratified study of older individuals (≥60 years of age) attending primary healthcare centres in Riyadh, Saudi Arabia between January 2015 and April 2017. We collected data using a structured questionnaire, which incorporated questions regarding demographic and anthropometric variables, the Arabic version of Mini-Mental State Examination, the Mini-Nutritional Assessment tool, and the Modified Katz Index of Independence in activities of daily living. RESULTS Of the 1299 participants, 914 (70.4%) were male, with a mean age of 66.2 ± 5.9 years. Approximately 79.1% of the participants had intact cognitive function, 17.1 had mild cognitive impairment, and 3.8% had severe cognitive impairment. Impaired cognitive function was associated with increased age, female gender, low education, unmarried status, and unemployed (p less than 0.001). Reduced cognitive impairment was significantly associated with functional impairment and malnutrition (p less than 0.001). CONCLUSION Cognitive impairment affected around 21% of the participants. The reduced cognitive function was associated with increased age, female gender, low education level, unmarried, low income, dependency on others, functional impairment, and malnutrition. Such information could motivate health-policy makers to introduce appropriate measures to improve older adults' existing healthcare services in primary care, including cognitive function assessment.
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Affiliation(s)
- Sulaiman A Alshammari
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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21
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Abi Chahine J, Rammal S, Fares Y, Abou Abbas L. Trail Making Test: normative data for the Lebanese adult population. Clin Neuropsychol 2020; 34:29-42. [PMID: 31888415 DOI: 10.1080/13854046.2019.1701710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Trail Making Test (TMT) is a widespread neuropsychological test used to detect cognitive impairment in diverse neuropsychological conditions. Several studies have shown that TMT performance is influenced by different demographic factors. Thus, the present study aims to explore the effect of gender, age, and education on TMT basic and derived scores and to provide normative data for the Lebanese adult population. METHOD A total of 225 healthy Lebanese adults (aged between 18 and 64) were recruited. The two parts of the TMT were administered to the participants. Regression based strategy was applied to generate normative data. RESULTS The results showed statistically significant effect of age and level of education on the TMT-A, TMT-B as well as the difference score TMT B -A. However, the ratio score was affected only by the age. Gender did not have any effect on TMT performance. An interactive calculator was created to calculate estimated Z-scores based on corresponding predictions of linear regression model. The calculator provides also percentile ranks. CONCLUSIONS The present study provides the first normative data for the TMT among the Lebanese population. Neuropsychologists in Lebanon will benefit from this outcome in order to improve the accurate detection of visual scanning/processing speed and executive function deficits in clinical settings for the adult population.
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Affiliation(s)
- Jessica Abi Chahine
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Sahar Rammal
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Youssef Fares
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Linda Abou Abbas
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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