Polypharmacy and Cognition Function Among Rural Adults

2021 ◽  
pp. 1-13
Author(s):  
Rafia S. Rasu ◽  
Nistha Shrestha ◽  
Aliza R. Karpes Matusevich ◽  
Rana Zalmai ◽  
Stephanie Large ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Chronic Disease ◽  
Community Based Participatory Research ◽  
Median Number ◽  
Community Based ◽  
Cross Sectional ◽  
Chronic Medication ◽  
Healthcare Barriers ◽  
The Mean ◽  
Rural Elders

Background: Polypharmacy (using≥5 medications) is associated with poor health outcomes. Mixed results from past studies surrounding chronic medication use, control of chronic conditions, and their effects on cognitive performance warrant further attention. Objective: Investigate a link between polypharmacy and cognition function in rural-dwelling adults in Texas, USA. Methods: Project FRONTIER (Facing Rural Obstacles to Healthcare Now Through Intervention, Education & Research) is a cross-sectional epidemiological study using community-based participatory research in three counties of Texas. Residents age >  40 were eligible for inclusion. The primary outcome is cognitive impairment, and exposures of interest are polypharmacy; comorbidities; and diabetes, hypertension, and depression medication. Logistic regression was used to assess association. Results: Six hundred eighty-nine individuals participated; the mean age was 61, and the majority were female (68.7%).The median number of medications taken by participants was 3.3 (IQR: 0–5); the rate of polypharmacy was 29.6%. Anti-hypertensive agents were the most common medications (15%) used. Polypharmacy users were 2.84 times more likely to have cognitive impairment [OR: 2.84, 95%CI (1.32–6.09)] than those using <  5 medications. Participants on hypertensive medications had 1.85 times higher odds [OR: 1.85, 95%CI (1.14–3.01)] of having cognitive impairment than those who did not have cognitive impairment. Conclusion: Polypharmacy increases the odds of cognitive impairment. The odds of presenting with cognitive impairment increased as the number of medications increased. Additionally, we identified a large, concerning number of participants with pharmacotherapy and poor chronic disease management. A larger study should examine medication adherence among rural elders to manage chronic disease and any healthcare barriers to adherence.

scholarly journals Anxiety and depression symptoms in older adults during coronavirus disease 2019 pandemic: A community-based cross-sectional study

2021 ◽  
Vol 9 ◽  
pp. 205031212110400
Author(s):  
Kemal Jemal ◽  
Tinsae Abeya Geleta ◽  
Berhanu Senbeta Deriba ◽  
Mukemil Awol
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
High Morbidity ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Symptoms Of Depression

Objectives: The coronavirus disease 2019 pandemic has caused high morbidity and mortality in older adults over the world. Because the coronavirus disease 2019 pandemic greatly affects older adults who have a preexisting health condition, they are generally susceptible to a high incidence of severe symptoms of anxiety and depression. Therefore, we aimed to assess the prevalence of anxiety and depression symptoms in older adults during the coronavirus disease 2019 pandemic. Methods: Community-based cross-sectional study was completed in August 2020. Standardized and pretested General Anxiety Disorder–7 and Geriatric Depression Scale were used to screen the symptoms of anxiety and depression, respectively. Data were entered into EpiData (version 4.3.2) and transferred to SPSS (version 24) for further analysis. Bivariate and multivariate logistic regression analyses were carried out to determine the significantly associated variables with a 95% confidence interval at p < 0.05. Results: Of the total older adults interviewed, 68.7% had developed symptoms of anxiety and 59.9% had symptoms of depression during the coronavirus disease 2019 pandemic. Female participants, having a chronic disease and poor knowledge of the coronavirus disease 2019 pandemic, were significantly associated with anxiety symptoms. Age category of 81 to 90 and above 90, lack of social support, and having a chronic disease were significantly associated with symptoms of depression. Conclusion: The symptoms of anxiety and depression among older adults in the North Shoa Zone during coronavirus disease 2019 were higher than before the coronavirus disease 2019 happened. The results were evidence points for developing a psychological intervention to tackle the older adults’ mental health needs in the community during and after the coronavirus disease 2019 pandemic.

scholarly journals Impact of Iron Status on Thyroid Function: A Community Based Cross-Sectional Study in Eastern Nepal

2019 ◽  
Vol 15 (1) ◽  
pp. 18-21 ◽  
Author(s):  
Saroj Thapa ◽  
Madhab Lamsal ◽  
Sanjay Kumar Sah ◽  
Rajendra Kumar Chaudhari ◽  
Basanta Gelal ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Hormone Profile ◽  
Iron Deficient ◽  
The Mean

Background: Iron deficiency is the most common nutritional deficiency in the world. The relation between thyroid hormones and iron status is bidirectional. The aim of this study was to assess iron nutrition status and evaluate its relationship with thyroid hormone profile among children of Eastern Nepal. Methods: A  community based cross-sectional study was conducted in eastern Nepal. A total of 200 school children aged 6-12 years were recruited after taking informed consent from their guardians. Blood samples were collected and assayed for free thyroid hormones (fT3 and fT4), thyroid stimulating hormone (TSH), serum iron, total iron binding capacity (TIBC) concentration and percentage transferrin saturation was calculated. Results: The mean serum iron and TIBC was 74.04 µg/dl and 389.38 µg/dl respectively. The median transferring saturation was 19.21%. The overall prevalence of iron deficiency (Transferrin saturation < 16%) was 34% (n=68). The mean concentration of fT3 and fT4 was 2.87 pg/ml and 1.21 ng/dl respectively, while the median TSH concentration was 3.03 mIU/L. Median TSH concentration in iron deficient group (3.11 µg/dl) and iron sufficient group (2.91 µg/dl) was not significantly different. Among iron deficient children 5.9% had   subclinical hypothyroidism (n=4). Iron status indicators were not significantly correlated with thyroid profile parameters in the study population. Conclusions: The prevalence of iron deficiency is high and iron   deficiency does not significantly alter the thyroid hormone profile in the study region.

scholarly journals Polypharmacy Increases Risk of Dyspnea Among Adults With Serious, Life-Limiting Diseases

2019 ◽  
Vol 37 (4) ◽  
pp. 278-285 ◽  
Author(s):  
Kathleen M. Akgün ◽  
Supriya Krishnan ◽  
Shelli L. Feder ◽  
Janet Tate ◽  
Jean S. Kutner ◽  
...  
Keyword(s):  
Symptom Assessment ◽  
Assessment System ◽  
Advanced Illness ◽  
Cross Sectional ◽  
Chronic Medication ◽  
Parallel Group ◽  
Increased Risk ◽  
Dyspnea Score ◽  
The Mean ◽  
Using Data

Background: Polypharmacy is associated with dyspnea in cross-sectional studies, but associations have not been determined in longitudinal analyses. Statins are commonly prescribed but their contribution to dyspnea is unknown. We determined whether polypharmacy was associated with dyspnea trajectory over time in adults with advanced illness enrolled in a statin discontinuation trial, overall, and in models stratified by statin discontinuation. Methods: Using data from a parallel-group unblinded pragmatic clinical trial (patients on statins ≥3 months with life expectancy of 1 month to 1 year, enrolled in the parent study between June 3, 2011, and May 2, 2013, n = 308/381 [81%]), we restricted analyses to patients with available baseline medication count and ≥1 dyspnea score. Polypharmacy was assessed by self-reported chronic medication count. Dyspnea trajectory group, our primary outcome, was determined over 24 weeks using the Edmonton Symptom Assessment System. Results: The mean age of the patients was 73.8 years (standard deviation [SD]: ±11.0) and the mean medication count was 11.6 (SD: ±5.0). We identified 3 dyspnea trajectory groups: none (n = 108), mild (n = 130), and moderate–severe (n = 70). Statins were discontinued in 51.8%, 48.5%, and 42.9% of patients, respectively. In multivariable models adjusting for age, sex, diagnosis, and statin discontinuation, each additional medication was associated with 8% (odds ratio [OR] = 1.08 [1.01-1.14]) and 16% (OR = 1.16 [1.08-1.25]) increased risk for mild and moderate–severe dyspnea, respectively. In stratified models, polypharmacy was associated with dyspnea in the statin continuation group only (mild OR = 1.12 [1.01-1.24], moderate–severe OR = 1.24 [1.11-1.39]) versus statin discontinuation (mild OR = 1.03 [0.95-1.12], and moderate–severe OR = 1.09 [0.98-1.22]). Conclusion: Polypharmacy was strongly associated with dyspnea. Prospective interventions to decrease polypharmacy may impact dyspnea symptoms, especially for statins.

scholarly journals Pattern of blindness in a community based hospital of Nepal

2013 ◽  
Vol 5 (1) ◽  
pp. 50-56
Author(s):  
R Sharma ◽  
S Marasini ◽  
BP Nepal
Keyword(s):  
Age Related Macular Degeneration ◽  
Easy Access ◽  
Retinal Diseases ◽  
Access To Health Services ◽  
Community Based ◽  
Cross Sectional ◽  
Age Related ◽  
Access To Health ◽  
Disease Pattern ◽  
The Mean

Introduction: Because of the availability of modern health facilities and moderately easy access to health services in the last 25 years, the blindness due to cataract and trachoma is expected to decline in Nepal. So it is felt that the causes of blindness need to be revised. Objective: To regroup the disease pattern leading to permanent blindness in patients attending a suburban multidisciplinary community-based hospital of Nepal. Materials and methods: A cross-sectional, descriptive study was conducted in patients attending Dhulikhel hospital over a period of 12 months, from March 2010. Only the patients with best corrected visual acuity of < 3/60 were enrolled in the study. A detailed ocular examination was carried out. Results: A total of 76 eyes of 58 patients were analyzed. Of all, 32 were male (55.2 %). The mean age of the patients was 43.03 ± 22.98, with a range of 7 years to 84 years. Retinal diseases had the higher prevalence (23, 39.7 %) followed by amblyopia (10, 17.2 %) and corneal diseases (9, 15.51 %). Anisometropic amblyopia (3.94 %) was the commonest type of amblyopia. Retinitis pigmentosa (9.21 %) and age-related macular degeneration (7.89 %) were common retinal diseases whereas anterior staphyloma (5.26 %) and leucoma (3.94 %) were common corneal diseases. Other important and rare causes of blindness included ethambutol-induced optic neuropathy and vitelliform dystrophy. Conclusion: Periodic collection of statistics on the relative frequency of the causes of blindness is important in socioeconomically developing nations like Nepal. This helps to revise the pattern of blinding diseases so that priorities can be redefined. Nepal J Ophthalmol 2013; 5(9):50-56 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7822

scholarly journals Prevalence of Post-Stroke Cognitive Impairment in China: A Community-Based, Cross-Sectional Study

PLoS ONE ◽  
2015 ◽  
Vol 10 (4) ◽  
pp. e0122864 ◽  
Author(s):  
Yanji Qu ◽  
Lin Zhuo ◽  
Na Li ◽  
Yiqing Hu ◽  
Weihua Chen ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Post Stroke

Prevalence of neurocognitive impairment and its associated factors among patients with HIV in Indonesia

2020 ◽  
Vol 16 (6) ◽  
pp. 258-264
Author(s):  
Linlin Lindayani ◽  
Diwa Agus Sudrajat ◽  
Chanti Melnawati ◽  
Dian Anggarini
Keyword(s):  
Cognitive Impairment ◽  
Associated Factors ◽  
High School Graduates ◽  
Cross Sectional Study ◽  
Neurocognitive Impairment ◽  
Hiv Positive ◽  
Study Participation ◽  
Cross Sectional ◽  
The Mean ◽  
Living With Hiv

Background: Patients with HIV are susceptable to developing HIV-associated neurocognitive disorder (HAND). However, few studies have explored the prevalence of neurocognitive impairment and its associated factors among patients with HIV in Indonesia. Aims: This study aimed to explore the prevalence of neurocognitive impairment in patients with HIV in Indonesia. Methods: A cross-sectional study was conducted among patients with HIV in West Java, Indonesia. Patients were eligible for study participation if they were HIV-positive and were aged over 20 years. The International HIV Dementia Scale (IHDS) was used to measure probable HIV–related dementia. Descriptive categorisations and statistics, using mean scores, standard deviation (SD) calculations or frequency rates, were applied to participant characteristics and major variables. Findings: There were a total 150 participants in this study. The mean age was 38.09 years (SD=3.99); 74% were male; 80.7% were high school graduates. The mean of CD4 counts was 493.3 (SD=139.8), and all participants had been living with HIV for more than 9 years (SD=3.84). The mean of total scores using the IHDS was 10.2 (SD=1.58), and 49.30% of patients with HIV were reported to have cognitive impairment. There was an increased prevalence of cognitive impairment among males with a higher BMI and higher systolic blood pressure Conclusions: Nearly half of patients with HIV in Indonesia are at high risk of cognitive impairment, as measured by IHSD. Health professionals caring for patients with HIV may consider routine neurocognitive impairment screenings during clinical visits to address this risk.

scholarly journals Nithsdale Schizophrenia Surveys 20

2000 ◽  
Vol 177 (4) ◽  
pp. 348-353 ◽  
Author(s):  
C. Kelly ◽  
V. Sharkey ◽  
G. Morrison ◽  
J. Allardyce ◽  
R. G. McCreadie
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Deficits ◽  
Verbal Fluency ◽  
Mini Mental State Examination ◽  
Community Based ◽  
Adult Reading ◽  
The Mean ◽  
National Adult Reading Test ◽  
State Examination

BackgroundCognitive deficits are a core aspect of schizophrenia but there has been no study of cognitive function in a catchment-area-based population of patients with schizophrenia.AimsTo assess cognitive function in a population of patients with schizophrenia, and relate it to community functioning.MethodAll patients with schizophrenia in Nithsdale, south-west Scotland, were identified (n=182). Measures of assessment were: National Adult Reading Test (NART), Mini-Mental State Examination (MMSE), Rivermead Behavioural Memory Test (RBMT), Executive Interview (EXIT), FAS Verbal Fluency and Health of the Nation Outcome Scales (HoNOS).ResultsWe assessed 138 patients, mean age 48 years (standard deviation (s.d.) 15). Only 14% were in-patients. The mean premorbid IQ as assessed by NART was 98 (s.d. 14); 15% of patients had significant global cognitive impairment (MMSE); 81% had impaired memory (RBMT); 25% had executive dyscontrol (EXIT); and 49% had impaired verbal fluency (FAS). Scores on the functional impairment sub-scale of HoNOS correlated with all measures of cognitive impairment.ConclusionsCognitive dysfunction is pervasive in a community-based population of patients with schizophrenia.

scholarly journals Menstruation: gap in knowledge, belief and practice among adolescent girls in an urban area of Belagavi

2017 ◽  
Vol 4 (10) ◽  
pp. 3640
Author(s):  
Suhasini Kanyadi ◽  
Chandra S. Metgud
Keyword(s):  
Urban Area ◽  
Adolescent Girls ◽  
External Genitalia ◽  
Cross Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Transition Into Adulthood ◽  
The Mean ◽  
Sanitary Pads ◽  
One Year

Background: The period of adolescence, beginning with the onset of puberty, is a crucial transition into adulthood. There is a substantial lacuna in the knowledge, belief and practice about menstruation. This study addresses the gap in knowledge, belief and practice regarding menstruation among adolescent girls. Methods: A community based cross sectional study was conducted over a period of one year, in an urban area of Belagavi among 625 adolescent girls in the age group of 16–19 years. Data was collected by house to house visit using a predesigned, pretested questionnaire. Results: The mean age (±SD) at menarche was found to be 12.8±1.73 years. Our study showed that as the knowledge increased, there was increase in the use of sanitary pad (p<0.001) and increase in the number of girls practicing cleaning of external genitalia during menstruation (p<0.01). However, it was found that 276 (50.5%) and 175 (37.7%) of the girls did not use sanitary pads and practice cleaning of external genitalia during menstruation even after having correct knowledge showing a gap in knowledge and practice. Similarly, among the 494 girls who knew that menstruation is a natural process, 93 (18.8%) girls wrongly believed she shouldn’t sleep in the same place as usual, 124 (25.1%) said she shouldn’t enter the kitchen, 186 (37.7%) believed that certain foods should be avoided and only 37 (7.5%) rightly believed that girls could go to place of worship during menstruation showing a gap in knowledge and belief. Conclusions: The study reported a gap in knowledge, belief and practice among adolescent girls. To bridge this gap causes have to be identified and addressed. 

scholarly journals Association of Habitual Physical Activity With Home Blood Pressure in the Electronic Framingham Heart Study (eFHS): Cross-sectional Study

10.2196/25591 ◽  
2021 ◽  
Vol 23 (6) ◽  
pp. e25591
Author(s):  
Mayank Sardana ◽  
Honghuang Lin ◽  
Yuankai Zhang ◽  
Chunyu Liu ◽  
Ludovic Trinquart ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Habitual Physical Activity ◽  
Step Count ◽  
Daily Step ◽  
Community Based ◽  
Cross Sectional ◽  
Heart Study ◽  
Daily Step Count ◽  
The Mean

Background When studied in community-based samples, the association of physical activity with blood pressure (BP) remains controversial and is perhaps dependent on the intensity of physical activity. Prior studies have not explored the association of smartwatch-measured physical activity with home BP. Objective We aimed to study the association of habitual physical activity with home BP. Methods Consenting electronic Framingham Heart Study (eFHS) participants were provided with a study smartwatch (Apple Watch Series 0) and Bluetooth-enabled home BP cuff. Participants were instructed to wear the watch daily and transmit BP values weekly. We measured habitual physical activity as the average daily step count determined by the smartwatch. We estimated the cross-sectional association between physical activity and average home BP using linear mixed effects models adjusting for age, sex, wear time, antihypertensive drug use, and familial structure. Results We studied 660 eFHS participants (mean age 53 years, SD 9 years; 387 [58.6%] women; 602 [91.2%] White) who wore the smartwatch 5 or more hours per day for 30 or more days and transmitted three or more BP readings. The mean daily step count was 7595 (SD 2718). The mean home systolic and diastolic BP (mmHg) were 122 (SD 12) and 76 (SD 8). Every 1000 increase in the step count was associated with a 0.49 mmHg lower home systolic BP (P=.004) and 0.36 mmHg lower home diastolic BP (P=.003). The association, however, was attenuated and became statistically nonsignificant with further adjustment for BMI. Conclusions In this community-based sample of adults, higher daily habitual physical activity measured by a smartwatch was associated with a moderate, but statistically significant, reduction in home BP. Differences in BMI among study participants accounted for the majority of the observed association.

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