Czy istnieje różnica w jakości życia i występowaniu objawów psychiatrycznych u chorych na akromegalię i inne choroby przewlekłe?

Introduction: The study aimed to evaluate the psychological profile of patients with acromegaly in comparison to other chronic diseases such as non-functioning pituitary adenomas, Cushing disease, and plaque psoriasis, and to a healthy control group. Material and methods: A total sample of 153 participants in clinical groups underwent a cross-sectional assessment including the quality of life (AcroQoL, WHOQoL-BREF), psychiatric morbidity (GHQ-28), and the acceptance of illness (AIS), as well as 65 participants in the healthy control group. Results: The whole study sample had a predominance of urban married females (61%) with medium level of education (41%). Patients with acromegaly were diagnosed significantly later than patients from other clinical groups, after the onset of the first symptoms. Acromegaly was related to the presence of more symptoms of anxiety and insomnia, and poorer social relationships compared with the general population but not more than in other chronic diseases. A better quality of life score in all domains of WHOQoL-BREF was associated with a better score on the acceptance of illness scale and lower scores on GHQ-28. Conclusions: Psychiatric morbidity, mainly anxiety and insomnia, occurs in 50% of patients with acromegaly. However, the psychological wellbeing and mood seem to be related to other factors such as the acceptance of the illness. Thus, concerning the diagnosis, treatment, and monitoring of acromegaly an interdisciplinary approach, taking into account psychological and psychiatric consultation, is needed.Wstęp: Celem pracy była ocena profilu psychologicznego pacjentów z akromegalią w porównaniu z pacjentami z innymi chorobami przewlekłymi, takimi jak: nieczynne hormonalnie gruczolaki przysadki, choroba Cushinga, łuszczyca oraz zdrowych z grupy kontrolnej. Materiał i metody: Badaniem objęto 153 chorych w grupach klinicznych, którzy zostali poddani szerokiej ocenie obejmującej: jakość życia (AcroQoL, WHOQoL-BREF), występowanie zaburzeń psychiatrycznych (GHQ-28) i stopień akceptacji choroby (AIS) oraz 65 uczestników z grupy kontrolnej. Wyniki: W całej grupie badanej obserwowano przewagę zamężnych, miejskich kobiet (61%) z wykształceniem średnim (41%). Pacjenci z akromegalią byli diagnozowani znacznie później w stosunku do pozostałych grup chorych, po pojawieniu się pierwszych objawów. Akromegalia charakteryzowała się częstszym występowaniem bezsenności i lęku oraz gorszymi relacjami społecznymi w porównaniu z populacją ogólną, ale nie w stosunku do innych chorób przewlekłych. Lepsza jakość życia we wszystkich domenach formularza WHOQoL-BREF wiązała się z większą akceptacją choroby i niższym wynikiem w skali GHQ-28. Wnioski: Zaburzenia psychiatryczne, głównie lęk i bezsenność, występują u 50% pacjentów z akromegalią. Jednak stan psychiczny i nastrój wydają się związane z innym czynnikiem, jakim jest stopień akceptacji choroby. Podkreśla to potrzebę opieki interdyscyplinarnej, uwzględniającej opiekę psychiatryczną i psychologiczną, w diagnostyce, leczeniu i monitorowaniu pacjentów z akromegalią

The impact of COVID-19 on the lives of community- dwelling people with dementia and informal carers in the context of using the social and medical services – a qualitative study

Background: Older people with dementia are particularly at risk of COVID-19, whilst still little is known about the indirect impact of the Pandemic on the lives of those living with and caring for someone with dementia. The aim of this study was to investigate the impact of the Pandemic on the lives of people with dementia and their informal carers in the context of using social and medical services in Poland. Methods: A qualitative thematic analysis of semi-structured interviews with people with dementia (n = 5) and informal carers (n = 21) was performed. Interviews were collected between June and August 2020 via phone after the first wave of COVID-19 in Poland. Data were analysed using NVivo software by four team members. Results: Three overarching themes emerged: (1) Care re-organization; (2) Psychological responses; (3) Emerging needs. The factor underlying all these elements were a reliance on other people. Regardless of the type of support (informal or formal), a sense of presence of others and maintaining mutual contacts displayed as crucial elements influencing the well-being of people with dementia and informal carers. Conclusions: Social support and engagement are vital to the ongoing health and wellbeing of people living with dementia and their informal carers. Services need sustaining to provide ongoing provision to those living with dementia to reach pre-pandemic levels, if not better. Within the post-pandemic environment people with dementia and their informal carers need reassurance that they can rely on external institutional and social support able to meet their need

Understanding of Dementia in the Polish Language: A Frame Semantic Approach

BACKGROUND: With the increasing incidences of dementia in aging societies, attention should be paid to the social context in which people with dementia live. One of its aspects is language transmitting beliefs, perceptions, and behavioral patterns. An analysis of understanding the diagnostic label of dementia may reveal the role of semantics in the process of social cognition of this disease. OBJECTIVE: The overall aim of this study was to investigate the understanding of the word dementia (otępienie) in the Polish language. METHODS: Frame semantics approach was applied. The structure of semantic information was uncovered with the concept of frame utilizing The National Corpus of Polish (the biggest corpus of contemporary Polish language of 1,500 million words). Additional data was collected from Polish speaking adults in Poland. RESULTS: The analyses allowed to identify the otępienie frame for Polish and verify how its elements are filled in by the general population, indicating the selectivity of colloquial knowledge about dementia. Dementia deviates from the prototypical disease. Need to care for the person with dementia outweighs treatment options. The cognitive symptoms and characteristics of the subject are salient. The perceptions of people with dementia embedded in semantics of the diagnostic label might create a basis for prejudicial attitudes among lay part of the society. CONCLUSION: Findings give foundation to further studies on relationship between semantics and social cognition of dementia which has a real impact on the social and clinical situation of people with dementia and may facilitate formulation of tailored messages aimed at building dementia-friendly society

Associations between social connections and cognition: a global collaborative individual participant data meta-analysis

International audienceBackground Poor social connections (eg, small networks, infrequent interactions, and loneliness) are modifiable risk factors for cognitive decline. Existing meta-analyses are limited by reporting aggregate responses, a focus on global cognition, and combining social measures into single constructs. We aimed to investigate the association between social connection markers and the rate of annual change in cognition (ie, global and domain-specific), as well as sex differences, using an individual participant data meta-analysis.Methods We harmonised data from 13 longitudinal cohort studies of ageing in North America, South America, Europe, Africa, Asia, and Australia. Studies were eligible for inclusion if they had baseline data for social connection markers and at least two waves of cognitive scores. Follow-up periods ranged from 0 years to 15 years across cohorts. We included participants with cognitive data for at least two waves and social connection data for at least one wave. We then identified and excluded people with dementia at baseline. Primary outcomes were annual rates of change in global cognition and cognitive domain scores over time until final follow-up within each cohort study analysed by use of an individual participant data meta-analysis. Linear mixed models within cohorts used baseline social connection markers as predictors of the primary outcomes. Effects were pooled in two stages using random-effects meta-analyses. We assessed the primary outcomes in the main (partially adjusted) and fully adjusted models. Partially adjusted models controlled for age, sex, and education; fully adjusted models additionally controlled for diabetes, hypertension, smoking, cardiovascular risk, and depression.Findings Of the 40 006 participants in the 13 cohort studies, we excluded 1392 people with dementia at baseline. 38 614 individual participants were included in our analyses. For the main models, being in a relationship or married predicted slower global cognitive decline (b=0•010, 95% CI 0•000-0•019) than did being single or never married; living with others predicted slower global cognitive (b=0•007, 0•002-0•012), memory (b=0•017, 0•006-0•028), and language (b=0•008, 0•000-0•015) decline than did living alone; and weekly interactions with family and friends (b=0•016, 0•006-0•026) and weekly community group engagement (b=0•030, 0•007-0•052) predicted slower memory decline than did no interactions and no engagement. Never feeling lonely predicted slower global cognitive (b=0•047, 95% CI 0•018-0•075) and executive function (b=0•047, 0•017-0•077) decline than did often feeling lonely. Degree of social support, having a confidante, and relationship satisfaction did not predict cognitive decline across global cognition or cognitive domains. Heterogeneity was low (I²=0•00-15•11%) for all but two of the significant findings (association between slower memory decline and living with others [I²=58•33%] and community group engagement, I²=37•54-72•19%), suggesting robust results across studies.Interpretation Good social connections (ie, living with others, weekly community group engagement, interacting weekly with family and friends, and never feeling lonely) are associated with slower cognitive decline