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Kyaw KT, Levine A. Association of Loneliness with Cognitive Functions. J Prev Alzheimers Dis 2023; 10:903-908. [PMID: 37874113 DOI: 10.14283/jpad.2023.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
INTRODUCTION Observational studies suggest psychosocial factors such as social support and loneliness are associated with vulnerability for cognitive decline in older adults. However, because of racial/ethnic homogeneity in prior studies focused on identifying these associations in predominantly White cohorts, less is known about the generalizability of these putative psychosocial mechanisms in a diverse population. Thus, we evaluated whether lower levels of loneliness were associated with better cognitive performance in our sample. METHODS We conducted a cross-sectional study using 541 participants from (Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa) Dementia Cohort. Participants' self-reported loneliness as exposure. Cognitive performance is measured using a neuropsychological battery as the outcome. Raw scores were converted into Z scores, and global cognitive function was created. Generalized estimated equation and robust regression analysis). RESULTS Better global cognitive function is associated with a lower level of loneliness at (β = -0.0131, 95 % CI -0.1990, -0.0071) after adjustment for age, gender, and education. Lower levels of loneliness were associated with varying cognitive domains after adjustment for age, gender, and education; and persisted after additional adjustments of vascular risk factors. CONCLUSIONS Self-reported lower loneliness was associated with higher levels of cognitive performance in a rural South African cohort of Black older adults. Although these findings and the potential of reverse causality need to be further validated, our results suggest that an intervention study may be merited to assess whether reducing loneliness lessens vulnerability to cognitive decline.
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Affiliation(s)
- K T Kyaw
- Kay Thwe Kyaw, NYU Grossman School of Medicine, NY, USA,
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Nyunt MH, Soe MT, Myint HW, Oo HW, Aye MM, Han SS, Zaw NN, Cho C, Aung PZ, Kyaw KT, Aye TT, San NA, Ortega L, Thimasarn K, Bustos MDG, Galit S, Hoque MR, Ringwald P, Han ET, Kyaw MP. Clinical and molecular surveillance of artemisinin resistant falciparum malaria in Myanmar (2009-2013). Malar J 2017; 16:333. [PMID: 28806957 PMCID: PMC5557565 DOI: 10.1186/s12936-017-1983-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 08/07/2017] [Indexed: 12/18/2022] Open
Abstract
Background Emergence of artemisinin-resistant malaria in Southeast Asian countries threatens the global control of malaria. Although K13 kelch propeller has been assessed for artemisinin resistance molecular marker, most of the mutations need to be validated. In this study, artemisinin resistance was assessed by clinical and molecular analysis, including k13 and recently reported markers, pfarps10, pffd and pfmdr2. Methods A prospective cohort study in 1160 uncomplicated falciparum patients was conducted after treatment with artemisinin-based combination therapy (ACT), in 6 sentinel sites in Myanmar from 2009 to 2013. Therapeutic efficacy of ACT was assessed by longitudinal follow ups. Molecular markers analysis was done on all available day 0 samples. Results True recrudescence treatment failures cases and day 3 parasite positivity were detected at only the southern Myanmar sites. Day 3 positive and k13 mutants with higher prevalence of underlying genetic foci predisposing to become k13 mutant were detected only in southern Myanmar since 2009 and comparatively fewer mutations of pfarps10, pffd, and pfmdr2 were observed in western Myanmar. K13 mutations, V127M of pfarps10, D193Y of pffd, and T448I of pfmdr2 were significantly associated with day 3 positivity (OR: 6.48, 3.88, 2.88, and 2.52, respectively). Conclusions Apart from k13, pfarps10, pffd and pfmdr2 are also useful for molecular surveillance of artemisinin resistance especially where k13 mutation has not been reported. Appropriate action to eliminate the resistant parasites and surveillance on artemisinin resistance should be strengthened in Myanmar. Trial registration This study was registered with ClinicalTrials.gov, identifier NCT02792816.
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Affiliation(s)
- Myat Htut Nyunt
- Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do, Republic of Korea.,Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Myat Thu Soe
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Hla Win Myint
- Magway District Hospital, Ministry of Health and Sports, Magway, Republic of the Union of Myanmar
| | - Htet Wai Oo
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Moe Moe Aye
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Soe Soe Han
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Ni Ni Zaw
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Cho Cho
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Phyo Zaw Aung
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Khin Thiri Kyaw
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Thin Thin Aye
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Naychi Aung San
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | | | - Krongthong Thimasarn
- World Health Organization Country Office for Myanmar, Yangon, Republic of the Union of Myanmar
| | | | - Sherwin Galit
- Research Institute for Tropical Medicine, Alabang, Muntinlupa City, Philippines
| | - Mohammad Rafiul Hoque
- Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do, Republic of Korea
| | | | - Eun-Taek Han
- Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do, Republic of Korea.
| | - Myat Phone Kyaw
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
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Nyunt MH, Aye KM, Kyaw KT, Han SS, Aye TT, Wai KT, Kyaw MP. Challenges encountered by local health volunteers in early diagnosis and prompt treatment of malaria in Myanmar artemisinin resistance containment zones. Malar J 2016; 15:308. [PMID: 27267877 PMCID: PMC4895800 DOI: 10.1186/s12936-016-1368-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 06/02/2016] [Indexed: 11/25/2022] Open
Abstract
Background After artemisinin resistance was reported, the Myanmar artemisinin resistance containment (MARC) project was initiated in 2011. One of the activities of MARC is to train volunteers for early diagnosis and prompt treatment by providing rapid diagnostic tests (RDT) and artemisinin combination therapy. This study aimed to fulfil the gap of information on the challenges faced by malaria volunteers in artemisinin-containment areas. Methods A cross-sectional, descriptive study was conducted in 11 townships in MARC areas to assess the challenges in early diagnosis of malaria and treatment by malaria volunteers using qualitative and quantitative approaches. Results Altogether 405 volunteers participated in the study. Although 97.5 % of volunteers can interpret a positive result for malaria, only 41.2 % correctly stated the persistence of a positive result in recently infected cases. Over 80 % knew the effects of temperature and humidity on performance of the malaria RDT. Unexpectedly, 15.1 % perceived that expired RDTs can still be useful for diagnosis although 98.3 % of respondents cited that the overall results of RDTs were reliable. Although most of them knew the treatment for malaria based on RDT results, some could not give the correct answer, while a few (2 %) mentioned artesunate monotherapy for RDT-negative cases. Training received by volunteers was also varied in study sites and 92.1 % believed that it was not sufficient. A certain portion of them faced the problem of regular supply of RDTs (9.9 %) and drugs (47.5 %), interpretation of result of RDTs (30 %), and performing blood test (20 %). The median RDT tested per month (25th, 75th percentile) was 6.0 (2.0, 15.0) indicating the need for prioritization based on endemicity. Regular reporting, supervision, monitoring system, and proper refresher training using uniform content of guideline to correct misconception of the volunteers, were needed to be strengthened. Moreover, the reliable and regular supply of materials and exchange system for expired RDTs and anti-malarials was important in the effectiveness of volunteers in MARC zones. Conclusions Adequate refresher training, monitoring, supervision, and regular reliable supply of RDTs and anti-malarials were needed for capacity strengthening of volunteers in MARC zones.
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Affiliation(s)
- Myat Htut Nyunt
- Department of Medical Research, Yangon, Republic of the Union of Myanmar.
| | - Khin Myo Aye
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Khin Thiri Kyaw
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Soe Soe Han
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Thin Thin Aye
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Khin Thet Wai
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
| | - Myat Phone Kyaw
- Department of Medical Research, Yangon, Republic of the Union of Myanmar
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