76 research outputs found

    Benzodiazepines and antidepressants: Effects on cognitive and functional decline in Alzheimer's disease and Lewy body dementia

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    Objectives We aim to study the effects of the prescription of benzodiazepines and antidepressants on cognitive and functional decline in older adults living with Alzheimer's disease (AD) and Lewy body dementia (LBD) over a 5-year follow-up. Methods This is a longitudinal analysis of a Norwegian cohort study entitled “The Dementia Study of Western Norway” (DemVest). We included 196 patients newly diagnosed with AD (n = 111) and LBD (n = 85), followed annually for 5 years. Three prescription groups were defined: only benzodiazepines (BZD), only antidepressants (ADep), and the combination of benzodiazepines and antidepressants (BZD-ADep). Linear mixed-effects models were conducted to analyze the effect of the defined groups on the outcomes. The outcomes were functional decline, measured by the Rapid Disability Rating Scale—2, and cognition measured with the Mini-Mental State Examination. Results Prescription of the combination of benzodiazepines and antidepressants in LBD was associated with faster functional decline. In AD, the prescription of BZD and BZD-ADep was associated with greater functional deterioration. ADep alone did not show positive or negative significant associations with the studied outcomes. Conclusions BZD and especially the combination of BZD and ADep are associated with functional decline in AD and LBD and should be used cautiously.publishedVersio

    Gait speed as a mediator of the effect of sarcopenia on dependency in activities of daily living

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    Background Sarcopenia in older adults is strongly associated with an increase in dependency in activities of daily living (ADL) and with a decline in gait speed. Interestingly, gait speed has been shown to independently predict mortality. In this context, our study aimed to explore the mediator role of gait speed on the relationship between sarcopenia and dependency in ADL. Methods A cross-sectional study was conducted in Colombia, 19 705 older adults with a mean age of 70 years, 55.6% women, 16.1% with sarcopenia, and 14.7% mild, moderate, or severe dependency in ADL, according to ‘SABE Survey 2015’. Sarcopenia was assessed by calf circumference and ADL dependence through the Barthel Index. Gait speed was measured over a distance of 3 m. The association between sarcopenia condition and gait speed and dependency level was analysed by linear regression adjusted by covariates. To examine whether gait speed mediated the association between sarcopenia and dependence components of physical function, simple mediation models were generated using ordinary least squares with the macro PROCESS version 3.2, adjusted for age, sex, and body mass index (BMI). Results Significant differences (P < 0.05) were found in gait speed and dependency in ADL between the sarcopenia and nonsarcopenia groups after adjusting for age, sex, and BMI. BMI was significantly higher in the non-sarcopenia group whereas dependency was significantly higher in the sarcopenia group (19.6% vs. 13.8%). Results from mediation model regression analysis indicated a significant and direct detrimental effect of sarcopenia on dependency in ADL (β = 0.05; P < 0.001), and a significant indirect effect of gait speed on the direct effect ( 0.009 to 0.004). Conclusions The negative effect of sarcopenia on functional dependence was mediated by the gait speed. Therefore, gait speed may positively influence the detrimental effect of sarcopenia for dependency, after adjusting for age, gender, and BMI. Consequently, physical exercise should be promoted and focused to circumvent the gait speed decline associated with age in older people with sarcopenia

    Benzodiazepines and antidepressants: Effects on cognitive and functional decline in Alzheimer's disease and Lewy body dementia

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    Objectives We aim to study the effects of the prescription of benzodiazepines and antidepressants on cognitive and functional decline in older adults living with Alzheimer's disease (AD) and Lewy body dementia (LBD) over a 5-year follow-up. Methods This is a longitudinal analysis of a Norwegian cohort study entitled “The Dementia Study of Western Norway” (DemVest). We included 196 patients newly diagnosed with AD (n = 111) and LBD (n = 85), followed annually for 5 years. Three prescription groups were defined: only benzodiazepines (BZD), only antidepressants (ADep), and the combination of benzodiazepines and antidepressants (BZD-ADep). Linear mixed-effects models were conducted to analyze the effect of the defined groups on the outcomes. The outcomes were functional decline, measured by the Rapid Disability Rating Scale—2, and cognition measured with the Mini-Mental State Examination. Results Prescription of the combination of benzodiazepines and antidepressants in LBD was associated with faster functional decline. In AD, the prescription of BZD and BZD-ADep was associated with greater functional deterioration. ADep alone did not show positive or negative significant associations with the studied outcomes. Conclusions BZD and especially the combination of BZD and ADep are associated with functional decline in AD and LBD and should be used cautiously.publishedVersio

    Body mass index, performance on activities of daily living and cognition: analysis in two different populations

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    Background With this study, we aim to determine the associations of the different categories of the body mass index (BMI) with activities of daily living (ADL) and cognitive performance in two different populations living in the community; Colombian and South Korean older adults. Methods We performed a cross-sectional analysis of two surveys separately; The Survey on Health, Well-Being, and Aging in Colombia (SABE) (n = 23,343) and the Korean Longitudinal Study of aging (KLoSA) (n = 4556). Participants older than 50 years were selected from rural and urban areas achieving a representative sample. Here we investigated the association between BMI categories with function using zero-inflated negative binomial regressions, and with cognition using logistic regression models. Results After adjustment, in Colombia, underweight was associated with an impaired score on the Mini-mental State Examination (MMSE) and worse performance in the instrumental activities of daily living (IADL). Also, being overweight was associated with a better score on the MMSE and the IADL. For both outcomes education level significantly influenced the predictions. In South Korea, there were no significant associations for cognition, IADL, or basic activities of daily living (BADL). Conclusions In the Colombian population, underweight, was associated with reduced cognitive performance and daily functioning. Additionally, being overweight but not obese was associated with better cognition and daily functioning. In South Korea, there were no significant associations between BMI and cognition, IADL, or BADL.publishedVersio

    Motoric Cognitive Risk Syndrome: Prevalence and Cognitive Performance. A cross-sectional study

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    Background Motoric Cognitive Risk Syndrome (MCR) is a predementia stage where slow gait speed and subjective memory complaints are present. The purpose of this study was to estimate the prevalence of MCR and assess its relationship with sociodemographic factors and chronic conditions. Methods This is a secondary analysis of the SABE Colombia study conducted in 2015. The analytic sample consisted of 17·577 participants. After determining MCR prevalence, logistic regression was performed to examine the correlates of MCR. Findings The prevalence of MCR was 10·71 %. The median age was 71 years and women composed 74·63 % of the MCR group. After adjusting for confounding variables MCR was associated with increasing age (OR 1·69, CI 1·43 - 1·92), no or low education (OR 1·99, CI 1·67- 2·37), MMSE (OR 0·93, CI 0·91 - 0·95) and chronic conditions such as mental disorders (OR 1·36, CI 1·11-1·67), history of myocardial infarction (OR 1·24, CI 1·04 - 1·47), hypertension (OR 1·23, CI 1·08 - 1·40) and diabetes (OR 1.18, CI 1.01 – 1.37). Interpretation This study found a prevalence of 10·71 % of MCR in Colombian older adults. Additionally, MCR was associated with chronic conditions and sociodemographic factors identified in prior studies. These results increase the awareness of a novel predementia stage whose identification can be performed by clinicians in the outpatient clinic, minimizing the cost of a full neuropsychologic evaluation performed in a memory clinic.publishedVersio

    Confirmed SARS-CoV-2 infection and mortality : associated factors in hospitalized people 75 and older

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    Introducción: La infección por COVID-19 en adultos mayores plantea desafíos en los sistemas de salud y la atención clínica por parte de la salud personal. Objetivo: Describir los factores asociados a la mortalidad en personas de 75 años y más con COVID-19 en un alto hospital de alta complejidad en Bogotá, Colombia. Métodos: Estudio observacional, analítico y retrospectivo, incluyendo 509 pacientes de 75 años y más hospitalizados con COVID-19. Resultados: el 40,47% fallecieron durante la estancia hospitalaria. Se encontró que a menor tiempo de inicio de los síntomas al ingreso, frecuencia respiratoria superior a 20 respiraciones por minuto, trombocitopenia, lactato deshidrogenasa elevada y el dímero D elevado se asociaron con una mayor mortalidad hospitalaria. Conclusiones: Existe asociación entre la mortalidad y la presencia de disnea, fiebre y delirio. Resultados paraclínicos con lactato deshidrogenasa > 350 (U/L), presencia de dímero D elevado mayor de 1.000 μg/L, así como un cociente PaO2/FiO2 con una mediana menor de 90, se asociaron con mayor mortalidad. Palabras clave: Infecciones por coronavirus, SARS-CoV-2, adulto mayor, mortalidadQ3Q3Introduction: COVID-19 infection in the elderly posed challenges in health systems and clinical care by health personnel. Objective: To describe the factors associated with mortality in persons aged 75 and older with COVID-19 in a high complexity hospital in Bogotá, Colombia. Methods: Observational, analytical and retrospective study, including 509 patients aged 75 and older hospitalized with COVID-19. Results: 40.47% died during hospital stay. It was found that a shorter time of symptom onset at admission, a respiratory rate greater than 20 breaths per minute, having thrombocytopenia, elevated lactate dehydrogenase and elevated D-dimer were associated with higher in-hospital mortality. Conclusions: There is an association between mortality and the presence of dyspnea, fever and delirium. Paraclinical results with lactate dehydrogenase >350 (U/L), the presence of elevated D-dimer greater than 1,000 μg/L, as well as a Pa02/Fi02 ratio with a median of less than 90, were associated with higher mortality. Keywords: Coronavirus infections, SARS-CoV-2, elderly, mortalityhttps://orcid.org/0000-0002-8584-3191https://scholar.google.com/citations?user=ns-9aAgAAAAJ&hl=es&oi=aohttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001337521Revista Internacional - No indexadaS

    Self-reported glaucoma prevalence and related factors, contribution to reported visual impairment, and functional burden in a cross-sectional study in Colombia

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    Objetivo Describir la prevalencia autorreportada de glaucoma en adultos mayores colombianos, enfatizando los factores de riesgo más importantes y las alteraciones funcionales de la vida diaria asociadas. Métodos Este es un análisis secundario de la encuesta de Salud, Bienestar y Envejecimiento realizada en el año 2015. El diagnóstico de glaucoma se obtuvo del autoinforme. Las variables funcionales se evaluaron mediante cuestionarios de actividades de la vida diaria. Se realizó un análisis descriptivo seguido de modelos de regresión bivariados y multivariados ajustando por variables de confusión. Resultados La prevalencia autoinformada de glaucoma fue de 5,67%, con mayor tasa en mujeres, OR 1,22 (1,13–1,40) p = ,003, mayor edad OR 1,02 (1,01–1,02) p < ,001, y con educación superior OR 1,38 (1,28 –1.50) p < .001. El glaucoma se asoció de forma independiente con diabetes OR 1,37 (1,18–1,61) p  < ,001 e hipertensión 1,26 (1,08–1,46) p = ,003. También mostró correlaciones estadísticamente significativas con mala SSR OR 1.15 (1.02–1.32) p < .001, discapacidad visual autoinformada 1.73 (1.50–2.01) p < .001 y deterioro en el manejo del dinero OR 1.59 (1.16–2.08) p = .002, compras de comestibles OR 1.57 (1.26–1.96) p < .001 y preparación de comidas OR 1.31 (1.06–1.63) p  = .013 y haber tenido caídas en el último año OR 1.14 (1.01–1.31) p = 0.041. Conclusión Nuestros hallazgos sugieren que la prevalencia autoinformada de glaucoma en adultos mayores en Colombia es más alta que los datos informados. El glaucoma y la discapacidad visual en adultos mayores representan un problema de salud pública, ya que el glaucoma se asoció con resultados adversos como pérdida funcional y riesgo de caídas, afectando la calidad de vida y su participación en la sociedad.Q2Q2Purpose Describe the self-reported prevalence of glaucoma in Colombian older adults, emphasizing the most important risk factors and associated daily-life functional alterations. Methods This a secondary analysis of the Health, Wellness, and Aging survey conducted in the year 2015. Diagnosis of glaucoma was obtained from self-report. Functional variables were assessed through activities of daily living questionnaires. A descriptive analysis followed by bivariate and multivariate regression models adjusting for confounding variables was conducted. Results Self-reported prevalence of glaucoma was 5.67%, with higher rate in women, OR 1.22 (1.13–1.40) p = .003, older age OR 1.02 (1.01–1.02) p < .001, and with higher education OR 1.38 (1.28–1.50) p < .001. Glaucoma was independently associated with diabetes OR 1.37 (1.18–1.61) p  < .001 and hypertension 1.26 (1.08–1.46) p = .003. It also showed statistically significant correlations with poor SRH OR 1.15 (1.02–1.32) p < .001, self-reported visual impairment 1.73 (1.50–2.01) p < .001, and impairment in money management OR 1.59 (1.16–2.08) p  = .002, grocery shopping OR 1.57 (1.26–1.96) p < .001 and preparing meals OR 1.31 (1.06–1.63) p  = .013 and having had falls during the last year OR 1.14 (1.01–1.31) p = 0.041. Conclusion Our findings suggest the self-reported prevalence of glaucoma in older adults in Colombia to be higher than reported data. Glaucoma and visual impairment in older adults represent a public health concern, since glaucoma was associated with adverse outcomes like functional loss and risk of falling, affecting the quality of life and their participation in society.https://orcid.org/0000-0001-5680-7880https://scholar.google.com/citations?view_op=search_authors&mauthors=carlos+alberto+cano-gutierrez&hl=es&oi=aohttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000054895Revista Internacional - IndexadaS

    The 16th Data Release of the Sloan Digital Sky Surveys : First Release from the APOGEE-2 Southern Survey and Full Release of eBOSS Spectra

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    This paper documents the 16th data release (DR16) from the Sloan Digital Sky Surveys (SDSS), the fourth and penultimate from the fourth phase (SDSS-IV). This is the first release of data from the Southern Hemisphere survey of the Apache Point Observatory Galactic Evolution Experiment 2 (APOGEE-2); new data from APOGEE-2 North are also included. DR16 is also notable as the final data release for the main cosmological program of the Extended Baryon Oscillation Spectroscopic Survey (eBOSS), and all raw and reduced spectra from that project are released here. DR16 also includes all the data from the Time Domain Spectroscopic Survey and new data from the SPectroscopic IDentification of ERosita Survey programs, both of which were co-observed on eBOSS plates. DR16 has no new data from the Mapping Nearby Galaxies at Apache Point Observatory (MaNGA) survey (or the MaNGA Stellar Library "MaStar"). We also preview future SDSS-V operations (due to start in 2020), and summarize plans for the final SDSS-IV data release (DR17).Peer reviewe

    Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

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    A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements
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