Supplementary Material for: Efficiency of Attentional Components in Elderly with Mild Neurocognitive Disorders Shown by the Attention Network Test

<b><i>Aims:</i></b> Complex attention, serving as a main diagnostic item of mild neurocognitive disorders (NCD), has been reported to be susceptible to pathological ageing. This study aimed to evaluate the attention network functions in older adults with subtypes of NCD. <b><i>Methods:</i></b> 36 adults with NCD due to Alzheimer's disease (NCD-AD), 31 adults with NCD due to vascular disease (NCD-vascular) and 137 healthy controls were recruited. Attention Network Test (ANT) was conducted to assess the efficiency of alerting, orienting and executive control. <b><i>Results:</i></b> Significant between-group differences were found in executive control (conventional score: F = 11.472, p < 0.001; ratio score: F = 8.430, p < 0.001) and processing speed (F = 4.958, p = 0.008). NCD subgroups demonstrated poorer performance on the ANT, particularly on executive control (healthy 59.9 ± 45.9, NCD-vascular 88.9 ± 44.8, NCD-AD 97.0 ± 53.9). Moreover, the NCD-AD group showed both less efficient executive control and prominent slowing processing speed (reaction time: healthy 687.5 ± 106.0 ms, NCD-vascular 685.3 ± 97.1 ms, NCD-AD 750.6 ± 132.6 ms). <b><i>Conclusions:</i></b> The NCD-vascular group appeared to be less efficient in executive control, while the NCD-AD group demonstrated less effective executive control and also slower processing speed. These results suggest that the characterized performance of ANT, processing speed and executive control in particular, might help differentiate adults at risk of different forms of cognitive impairment

Prevalence, risk factors, and mortality for ventilator-associated pneumonia in middle-aged, old, and very old critically ill patients

We investigated the epidemiology of ventilator-associated pneumonia in elderly ICU patients. More precisely, we assessed prevalence, risk factors, signs and symptoms, causative bacterial pathogens, and associated outcomes.Secondary analysis of a multicenter prospective cohort (EU-VAP project).Twenty-seven European ICUs.Patients who were mechanically ventilated for greater than or equal to 48 hours. We compared middle-aged (45-64 yr; n = 670), old (65-74 yr; n = 549), and very old patients (≥ 75 yr; n= 516).Ventilator-associated pneumonia occurred in 103 middle-aged (14.6%), 104 old (17.0%), and 73 very old patients (12.8%). The prevalence (n ventilator-associated pneumonia/1,000 ventilation days) was 13.7 in middle-aged patients, 16.6 in old patients, and 13.0 in very old patients. Logistic regression analysis could not demonstrate older age as a risk factor for ventilator-associated pneumonia. Ventilator-associated pneumonia in elderly patients was more frequently caused by Enterobacteriaceae (24% in middle-aged, 32% in old, and 43% in very old patients; p = 0.042). Regarding clinical signs and symptoms at ventilator-associated pneumonia onset, new temperature rise was less frequent among very old patients (59% vs 76% and 74% for middle-aged and old patients, respectively; p = 0.035). Mortality among patients with ventilator-associated pneumonia was higher among elderly patients: 35% in middle-aged patients versus 51% in old and very old patients (p = 0.036). Logistic regression analysis confirmed the importance of older age in the risk of death (adjusted odds ratio for old age, 2.1; 95% CI, 1.2-3.9 and adjusted odds ratio for very old age, 2.3; 95% CI, 1.2-4.4). Other risk factors for mortality in ventilator-associated pneumonia were diabetes mellitus, septic shock, and a high-risk pathogen as causative agent.In this multicenter cohort study, ventilator-associated pneumonia did not occur more frequently among elderly, but the associated mortality in these patients was higher. New temperature rise was less common in elderly patients with ventilator-associated pneumonia, whereas more episodes among elderly patients were caused by Enterobacteriaceae

On the Generic Construction of Identity-Based Signatures with Additional Properties

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