Prevalence and risk factors of delirium and subsyndromal delirium in Chinese older adults

2018 ◽  
Vol 18 (12) ◽  
pp. 1625-1628 ◽  
Author(s):  
Ka‐Keung Yam ◽  
Yat‐Fung Shea ◽  
Tuen‐Ching Chan ◽  
Ka‐Chun Chiu ◽  
James Ka‐Hei Luk ◽  
...  
2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Maha Hosam El-Din Ibrahim ◽  
Manal Elmasry ◽  
Fady Nagy ◽  
Ahmed Abdelghani

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.


2021 ◽  
Author(s):  
Jinxia Zhang ◽  
Esmé Eggink ◽  
Xiaoyu Zhang ◽  
Xingming Li ◽  
Bin Jiang ◽  
...  

BACKGROUND China is expected to face among the largest increase of people with dementia worldwide in the coming decades, seriously challenging the Chinese healthcare system. Approximately 40% of all dementia cases might be attributable to potentially modifiable risk factors, suggesting the potential to delay or prevent dementia when targeting these risk factors. Mobile health (mHealth) may improve the accessibility of such dementia prevention strategies in China, given the wide and increasing use of smartphones by the entire Chinese population, including older adults. OBJECTIVE The aim of this qualitative study is to explore the needs and views of Chinese older adults regarding healthy lifestyles to prevent cardiovascular disease (CVD) and dementia through mHealth, facilitating development and cultural adaptation of a coach-supported mHealth platform for the Prevention of Dementia using Mobile Phone Applications (PRODEMOS) study. METHODS We performed semi-structured interviews with older adults, aged 55 and over, from Beijing and Tai’an, China, with an increased dementia risk without a diagnosis of dementia, who possess a smartphone. Participants were recruited through seven hospitals that participate in the PRODEMOS study, and were purposively sampled on age, sex, living situation, and history of CVD and diabetes. Data were analysed using thematic analysis. RESULTS Between February and December 2019 we performed 26 interviews with participants aged 55-86 years. Three main themes were identified: valuing a healthy lifestyle, sociocultural expectations, and need for guidance. First, following a healthy lifestyle was generally deemed important. In addition to generic healthy behaviours, participants regarded certain specific Chinese behaviours as important to prevent disease. Second, the sociocultural context played a crucial role, as an important motive to avoid disease was to limit the burden put on family members. However, time-consuming family and other social obligations could also impede healthy behaviours, such as regular physical activity and a healthy diet. Finally, there seemed to be a need for reliable and personalised lifestyle advice and for guidance from a health professional. CONCLUSIONS In spite of their clear appreciation of healthy lifestyles, Chinese older adults express a need for personalised lifestyle support in order to adopt healthy behaviours. Potentially, the PRODEMOS mHealth intervention can meet these needs through blended lifestyle support to improve risk factors for CVD and dementia.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Zijun Xu ◽  
Dexing Zhang ◽  
Regina W. S. Sit ◽  
Carmen Wong ◽  
Jennifer Y. S. Tiu ◽  
...  

2016 ◽  
Vol 41 (5-6) ◽  
pp. 261-272 ◽  
Author(s):  
Fei Ma ◽  
Tianfeng Wu ◽  
Jiangang Zhao ◽  
Lu Ji ◽  
Aili Song ◽  
...  

Background/Aims: The prevalence of mild cognitive impairment (MCI) and its subtypes among Chinese older adults, and the contribution of vascular risk factors (VRF) and vascular disorders to MCI remain unclear. This study aims to investigate the prevalence of MCI and its different subtypes, and clarify the role of VRF and vascular diseases in the occurrence of MCI. Methods: A random sample of 5,214 nondementia (DSM-IV) individuals aged ≥65 years underwent neuropsychological assessments and clinical examinations. MCI, including amnestic MCI-single domain (aMCI-SD), amnestic MCI-multiple domains (aMCI-MD), nonamnestic MCI-single domain (naMCI-SD), and nonamnestic MCI-multiple domains (naMCI-MD), was defined according to modifications of the Petersen criteria. VRF (smoking, obesity, and diabetes) and vascular disorders (myocardial infarction, atrial fibrillation, stroke, and hypertension) were assessed based on information through self-report and medical records. Data were analyzed using multivariate logistic regression. Results: The prevalence of MCI was 11.33% (95% CI: 8.21-14.43), and that of aMCI-SD, aMCI-MD, naMCI-SD, and naMCI-MD was 4.48% (95% CI: 2.24-6.74), 2.09% (95% CI: 0.80-3.38), 4.22% (95% CI: 1.38-7.08), and 0.53% (95% CI: 0.32-0.75), respectively. The prevalence of MCI is higher in women than in men. Multivariate logistic regression analysis shows that VRF and vascular diseases were significantly related to increase the odds of MCI and its specific subtype. Conclusions: The prevalence of MCI is almost 11% among Chinese older adults. VRF and vascular disorders are associated with MCI, especially naMCI.


2021 ◽  
Vol 12 ◽  
Author(s):  
Wenjun Gui ◽  
Chengxuan Qiu ◽  
Qi Shao ◽  
Juan Li

Objective: The associations of vascular risk factors (VRFs), apolipoprotein E (APOE), and translocase of outer mitochondrial membrane 40 (TOMM40) with cognitive function have been investigated mostly in western societies. In the present study, we sought to examine the associations of VRFs [i.e., current smoking, current drinking, physical inactivity, obesity, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), diabetes, and hypertension] and variants located in APOE (ε2/3/4) and TOMM40 (rs2075650) with global cognitive function in Chinese older adults, with a focus on their potential interactions.Methods: This is a cross-sectional study that included 422 permanent residents (mean age 69.2 years, 54.3% female) living in Beijing, who were free of dementia. Data were collected through interviews, clinical examinations, and laboratory tests. The two genetic polymorphisms were genotyped, and participants were dichotomized as carriers vs. non-carriers of APOE ε4 or TOMM40 G. Global cognitive function was assessed with the Mini-Mental State Examination (MMSE). Data were analyzed with multivariable linear regression models.Results: Physical inactivity and diabetes were independently associated with a lower MMSE score (all p < 0.05). When four putative VRFs (i.e., current smoking, physical inactivity, high LDL-C, and diabetes) were aggregated, an increasing number of having these factors was associated with a decreasing MMSE score in a dose–response manner (p = 0.001). TOMM40 polymorphisms, independent of the APOE ε4 allele, interacted with aggregated VRFs to influence cognitive performance, such that having one or more of these VRFs was particularly detrimental to the cognition of TOMM40 carriers. Further analyses revealed interactions of the TOMM40 polymorphism with (i) physical inactivity and (ii) diabetes, such that having either physical inactivity or diabetes in combination with carrying a TOMM40 G allele, compared to having neither, was significantly associated with a markedly lower MMSE score (all p < 0.05).Conclusion: This study provides some evidence supporting the association of vascular risk factors with poor cognitive performance among dementia-free Chinese older adults and further revealed their interactions with the TOMM40 polymorphism. The results underscore the vulnerability of global cognitive function to VRFs, which could be reinforced by carrying the TOMM40 rs2075650 G allele. These findings have potential implications for developing tailored intervention programs to maintain cognitive function.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 832-833
Author(s):  
Yaolin Pei ◽  
Bei Wu

Abstract The aims of this study were to examine the prevalence of orofacial pain symptoms in Chinese older adults at the end of life, and to investigate risk factors related to orofacial pain. The sample derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a national respresentative sample of the oldest-old. The results showed that the 6-month prevalence of pain when chewing or biting at the end of life was 11.1%, and the rate was 5% for jaw joint pain/facial pain. Lower SES, smokers, and having chronic diseases were associated with having orofacial symptoms. Unexpectedly, the results revealed that dentate older adults (retain at least one natural tooth) who brushed their teeth more often were more likely to have orofacial symptoms. Older adults have poor oral health, particularly at the end of their life. This study highlights the importance of improving oral health for vulnerable older adults.


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