Table_1_Physical and mental health conditions account for variability in awareness of age-related changes.docx

BackgroundThe concept of Awareness of Age-Related Changes captures people’s perceptions of the positive (AARC-gains) and negative (AARC-losses) age-related changes they experience in several life domains, including their health. We investigated the cross-sectional associations of number and type of physical and mental health conditions with AARC-gains and AARC-losses.MethodsThe sample comprised 3,786 middle-aged and older adults (mean age = 67.04 years; SD = 6.88) participating to the UK PROTECT study. We used hierarchical regression models to analyze whether after having included sociodemographic variables (model 1), number of physical (model 2) and of mental (model 3) health conditions explained a significant additional amount of variance in AARC-gains and AARC-losses, and whether the association between number of conditions and AARC depended on participants’ age. We used multiple regression models to analyze the associations of types of physical and mental health conditions with AARC-gains and AARC-losses.ResultsA higher number of physical health conditions was associated with higher AARC-gains and higher AARC-losses, but the association did not depend on participant age. After controlling for the number of physical health conditions, a higher number of mental health conditions was associated with higher AARC-losses but not with AARC-gains, and the association was stronger among older participants. Small effects were found between greater AARC-gains and current cancer and between greater AARC-losses and diagnoses of mild cognitive impairment, Parkinson’s disease, arthritic condition, cancer in full remission, osteoporosis, depression, anxiety disorders, and personality disorder. The remaining health conditions were either negligibly or non-statistically related to AARC-losses.ConclusionMiddle-aged and older adults having more physical health conditions and more mental health conditions may be at higher risk of negative views on their own aging. However, specific physical health conditions, such as arthritis, and certain mental health conditions, such as depression, may make adults particularly vulnerable to negative age-related perceptions.</p

Is lifetime traumatic brain injury a risk factor for mild cognitive impairment in veterans compared to non-veterans?

Background: Traumatic brain injury (TBI) is prevalent in veterans and may occur at any stages of their life (before, during, or after military service). This is of particular concern, as previous evidence in the general population has identified TBI as a strong risk factor for mild cognitive impairment (MCI), a known precursor of dementia. Objectives: This study aimed to investigate whether exposure to at least one TBI across the lifetime was a risk factor for MCI in ageing UK veterans compared to non-veterans. Method: This cross-sectional study comprised of data from PROTECT, a cohort study comprising UK veterans and non-veterans aged ≥ 50 years at baseline. Veteran and TBI status were self-reported using the Military Service History Questionnaire (MSHQ) and the Brain Injury Screening Questionnaire (BISQ), respectively. MCI was the outcome of interest, and was defined as subjective cognitive impairment and objective cognitive impairment. Results: The sample population comprised of veterans (n = 701) and non-veterans (n = 12,389). TBI was a significant risk factor for MCI in the overall sample (OR = 1.21, 95% CI 1.11–1.31) compared to individuals without TBI. The prevalence of TBI was significantly higher in veterans compared to non-veterans (69.9% vs 59.5%, p  Conclusion: TBI remains an important risk factor for MCI, irrespective of veteran status. The clinical implications indicate the need for early intervention for MCI prevention after TBI. Data from the PROTECT study, a longitudinal study comprising over 25,000 middle-aged and ageing adults in the UK, were used in this first UK comparative study to explore the association between a lifetime history of traumatic brain injury (TBI) and mild cognitive impairment (MCI) in UK veterans and non-veterans.Lifetime TBI was more prevalent in veterans compared to non-veterans. TBI events in military veterans could be attributed to non-military events.Exposure to a history of TBI irrespective of veteran status increased the risk of MCI by 21% compared to adults with no history of TBI.The risk of MCI did not significantly differ between veterans and non-veterans with TBI. Data from the PROTECT study, a longitudinal study comprising over 25,000 middle-aged and ageing adults in the UK, were used in this first UK comparative study to explore the association between a lifetime history of traumatic brain injury (TBI) and mild cognitive impairment (MCI) in UK veterans and non-veterans. Lifetime TBI was more prevalent in veterans compared to non-veterans. TBI events in military veterans could be attributed to non-military events. Exposure to a history of TBI irrespective of veteran status increased the risk of MCI by 21% compared to adults with no history of TBI. The risk of MCI did not significantly differ between veterans and non-veterans with TBI.</p

Additional file 2: of The assessment and management of pain in patients with dementia in hospital settings: a multi-case exploratory study from a decision making perspective

Interview Schedule for Staff. The interview guide used in interviews with HCPs and HCAs. (PDF 68 kb

WHELDballardetalPLOSMedicine.anonsav

SPSS data file of individual participant dat

Unadjusted mean costs and mean cost differences at baseline and over 9 months (British pounds, 2014–2015).

<p>Unadjusted mean costs and mean cost differences at baseline and over 9 months (British pounds, 2014–2015).</p

Descriptive statistics for baseline cohort and completers.

<p>Descriptive statistics for baseline cohort and completers.</p

Effect estimates of WHELD intervention in comparison to TAU on primary outcome and key secondary outcome measures (multiple imputation analysis).

<p>Effect estimates of WHELD intervention in comparison to TAU on primary outcome and key secondary outcome measures (multiple imputation analysis).</p

CONSORT chart showing flow of participants through the study.

<p>CDR, Clinical Dementia Rating; TAU, treatment as usual.</p

Effect estimates of the WHELD intervention in comparison to treatment as usual for key outcome measures (multiple imputation analysis): Sub-analysis evaluating impact of WHELD in mild to moderate, moderately severe, and severe dementia.

<p>Effect estimates of the WHELD intervention in comparison to treatment as usual for key outcome measures (multiple imputation analysis): Sub-analysis evaluating impact of WHELD in mild to moderate, moderately severe, and severe dementia.</p

Outcome Comparisons: Cognitive Outcomes (Change from Baseline between groups).

<p>Results presented as both median with upper and lower quartiles and mean with Standard Deviation.</p><p>MWU – Mann-Whitney U test, SD – Standard Deviation, IQR – Inter Quartile Range.</p>*<p>Statistically significant (p<0·05).</p