PREVALENCE OF MILD COGNITIVE IMPAIRMENT AMONG OLDER PEOPLE IN KAZAKHSTAN AND POTENTIAL RISK FACTORS

Although there is a high prevalence of cognitive impairment among the old population of Kazakhstan, there is a lack of epidemiological research in this area. Assessment of mild cognitive impairment (MCI) as a transitional phase between normal aging and dementia can be proposed as an attainable way of gathering valuable data among the population of Kazakhstan aged 60 and over. This way of screening would help to early diagnose manifestation of cognitive impairment in old people and determine its predisposing risk factors. A commonly used method for MCI is the Montreal Cognitive Assessment (MoCA). A cross-sectional study to provide the first population-based information about cognitive impairment among older people in Kazakhstan can be performed in two stages. The first stage composed of screening for MCI with the MoCA test and assessment of underlying risk factors, and the second stage includes the diagnostic evaluation for MCI of all individuals who were positive on the MoCA test. Through the electronic patient database people aged 60 years and over were selected. Selected individuals confirmed their participation by informed consent form and underwent a psychometric assessment which excluded those with psychotic symptoms or severe clinical conditions. During the first stage, questions on functional status about difficulties in daily life, cognition and social interaction were evaluated. The risk factors gathered from self-report included age, gender, education, alcohol consumption, smoking status, diabetic mellitus, traumatic brain injury, family history of dementia and atherosclerosis. During the second stage, the neuropsychological examination including assessment of memory, attention, speech, executive functions, visuospatial domains was performed. As a result, among 900 people randomly selected, 668 agreed to participate. The mean MoCA score was 21.6 and was similar in men and women. The mean age of study participants in this study is 70 years suggesting that MCI is particularly common in Kazakhstan. In conclusion, the prevalence of MCI among older people in Almaty is high. Among the risk factors, education is the only modifiable risk factor, while high quality management of cardiovascular disease risk factors like hypertension in mid-life will lead to a lower burden of cognitive impairment in the future

Physicians' beliefs about brain surgery for drug-resistant epilepsy: A global survey

Purpose: To investigate the opinions of physicians about brain surgery for drug-resistant epilepsy worldwide. Methods: Practicing neurologists, psychiatrists, and neurosurgeons from around the world were invited to participate in an online survey. The survey anonymously collected data about demographics, years in clinical practice, discipline, nation, work setting, and answers to the questions about beliefs and attitudes about brain surgery for drug-resistant epilepsy. Results: In total, 1410 physicians from 20 countries and different world regions participated. The propensity to discuss brain surgery with patients, who have drug-resistant seizures, was higher among men (versus women) [Odds Ratio (OR) 1.67, 95% CI 1.20-2.31; p = 0.002]. In comparison to neurologists, psychiatrists were less likely (OR 0.28, 95% CI 0.17-0.47; p < 0.001) and neurosurgeons were more likely (OR 2.00, 95% CI 1.08-3.72; p = 0.028) to discuss about it. Survey participants working in Africa, Asia, the Middle East, and the Former Union of Soviet Socialist Republics showed a lower propensity to discuss epilepsy surgery with patients. Conclusion: This study showed that on an international level, there is still a knowledge gap concerning epilepsy surgery and much needs to be done to identify and overcome barriers to epilepsy surgery for patients with drug-resistant seizures worldwide

Complementary and alternative medicine in epilepsy: A global survey of physicians’ opinions

Purpose: To investigate the opinions of physicians on the use of complementary and alternative medicine (CAM) in patients with epilepsy (PWE) worldwide. Methods: Online survey addressed to neurologists and psychiatrists from different countries. Results: Totally, 1112 physicians from 25 countries (different world region: Europe, North America, South America, Middle-East, Africa, Former Soviet Union Republics) participated; 804 (72.3%) believed that CAM might be helpful in PWE. The most commonly endorsed CAM included meditation (41%) and yoga (39%). Female sex, psychiatry specialization, and working in North and South America were associated with the belief that CAM is helpful in PWE. Two-hundred and forty five out of 1098 participants (22.3%) used/prescribed CAM to PWE; among them, 174 (71%) people perceived CAM to be less effective and 114 (46.5%) people found CAM to be safer than conventional antiseizure medications (ASMs). The most common reasons to prescribe CAM for PWE were: to satisfy the patient (49.9%), dissatisfaction with the efficacy (35.6%), and dissatisfaction with the adverse effects (31.2%) of conventional therapies. Conclusion: Although the evidence supporting the use of CAM for the treatment of epilepsy is extremely sparse, most physicians worldwide believe that it could be integrated with the use of conventional ASMs, at least in some patients. High-quality controlled trials are warranted to provide robust evidence on the usefulness of CAM options in PWE.Fil: Asadi Pooya, Ali A.. Thomas Jefferson University; Estados UnidosFil: Brigo, Francesco. Hospital of Merano; ItaliaFil: Lattanzi, Simona. Università Politecnica Delle Marche; ItaliaFil: Karakis, Ioannis. University of Emory; Estados UnidosFil: Asadollahi, Marjan. Shahid Beheshti University Of Medical Sciences; IránFil: Trinka, Eugen. Paracelsus Medical University; Austria. Centre for Cognitive Neuroscience; AustriaFil: Talaat El Ghoneimy, Lobna. Cairo University; EgiptoFil: Pretorius, Chrisma. Stellenbosch University; SudáfricaFil: Contreras, Guilca. Hospital Metropolitano; EcuadorFil: Daza Restrepo, Anilu. La Trinidad Medical Center; VenezuelaFil: Valente, Kette. Universidade de Sao Paulo; BrasilFil: D`alessio, Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; Argentina. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic; ArgentinaFil: Turuspekova, Saule T.. Asfendiyarov Kazakh National Medical University; KazajistánFil: Aljandeel, Ghaieb. Medical City; IraqFil: Khachatryan, Samson. National Institute Of Health; ArmeniaFil: Ashkanani, Abdulaziz. Ahmadi Hospital; KuwaitFil: Tomson, Torbjörn. Karolinska Huddinge Hospital. Karolinska Institutet; SueciaFil: Kutlubaev, Mansur. Bashkir State Medical University; RusiaFil: Guekht, Alla. Pirogov Russian National Research Medical University; RusiaFil: Alsaadi, Taoufik. American Center for Psychiatry and Neurology; Emiratos Arabes UnidosFil: Calle Lopez, Yamile. Universidad de Antioquia; ColombiaFil: Mesraoua, Boulenouar. Weill Cornell Medical College; Qatar. Hamad Medical Corporation; QatarFil: Ríos Pohl, Loreto. Clinica Integral de Epilepsia Infanto-Juvenil; ChileFil: Al-Asmi, Abdullah. Sultan Qaboos University; OmánFil: Villanueva, Vicente. Hospital Universitario y Politécnico La Fe; EspañaFil: Igwe, Stanley C.. Alex Ekwueme Federal University Teaching Hospital; NigeriaFil: Kissani, Najib. Cadi Ayyad University; MarruecosFil: Jusupova, Asel. Kyrgyz State Medical Academy; Kirguistá