Mental health in older adults: major neurocognitive, affective, and sleep disorders

Numerous biological, psychological, and social factors influence the mental health of elderly individuals to varying degrees. Apart from components related to the normal aging process and the co-occurrence of various medical conditions, events such as the death of a loved one, retirement, or disability significantly contribute to a variety of mental and emotional problems in this stage of the life cycle. The most frequent problems affect the neurocognitive, emotional, and oneiric spheres. Major neurocognitive disorders reduce one’s overall performance and, thus, increase their need for close care. Affective disorders may be exacerbated by the lack of family support and decreased social interactions, which may lead to significant isolation result in suicidal behavior. The increased frequency of sleep disorders such as insomnia and daytime sleepiness and specific disorders such as obstructive apnea significantly alter the quality of life of this population

Orthostatic hypotension and REM sleep behaviour disorder: Impact on clinical outcomes in α-synucleinopathies

Objective Review the effect of orthostatic hypotension (OH) and rapid-eye-movement sleep behavioural disorder (RBD) on survival, cognitive impairment and postural stability, and discuss pathogenic mechanisms involved in the association of these two common non-motor features with relevant clinical outcomes in α-synucleinopathies. Methods We searched PubMed (January 2007-February 2019) for human studies of OH and RBD evaluating cognitive impairment, postural instability, and survival in Parkinson's disease (PD), dementia with Lewy bodies (DLB), multiple system atrophy (MSA) and pure autonomic failure (PAF). Included studies were analysed for design, key results and limitations as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results OH and RBD showed a positive association with cognitive impairment in PD and DLB, conflicting association in PAF, and no association in MSA. OH was correlated with incident falls and postural instability in PD and DLB but not in MSA. The association between RBD and postural instability was inconclusive; positive in five studies, negative in seven. OH, but not RBD, correlated with reduced survival in PD, DLB and MSA. The combination of OH and RBD was associated with cognitive impairment and more rapid progression of postural instability. Conclusions OH and RBD yielded individual and combined negative effects on disability in α-synucleinopathies, reflecting a malignant' phenotype of PD with early cognitive impairment and postural instability. Underlying mechanisms may include involvement of selected brainstem cholinergic and noradrenergic nuclei

Multiple Sclerosis In South America: Month Of Birth In Different Latitudes Does Not Seem To Interfere With The Prevalence Or Progression Of The Disease [esclerose Múltipla Na América Do Sul: Mês De Nascimento Em Diferentes Latitudes Não Parece Interferir Com A Prevalência Ou Progressão Da Doença]

Objective: To assess whether the month of birth in different latitudes of South America might influence the presence or severity of multiple sclerosis (MS) later in life. Methods: Neurologists in four South American countries working at MS units collected data on their patients' month of birth, gender, age, and disease progression. Results: Analysis of data from 1207 MS patients and 1207 control subjects did not show any significant variation in the month of birth regarding the prevalence of MS in four latitude bands (0-10; 11-20; 21-30; and 31-40 degrees). There was no relationship between the month of birth and the severity of disease in each latitude band. Conclusion: The results from this study show that MS patients born to mothers who were pregnant at different Southern latitudes do not follow the seasonal pattern observed at high Northern latitudes.719:00 AM573579Templer, D.I., Trent, N.H., Spencer, D.A., Season of birth in multiple sclerosis (1992) Acta Neurol Scand, 85, pp. 107-109Bharanidharan, P., Monthly distribution of multiple sclerosis patients' births (1997) Int J Biometeorol, 40, pp. 117-118Salemi, G., Ragonese, P., Aridon, P., Is season of birth associated with multiple sclerosis? (2000) Acta Neurol Scand, 101, pp. 381-383Salzer, J., Svenningsson, A., Sundström, P., Season of birth and multiple sclerosis in Sweden (2010) Acta Neurol Scand, 122, pp. 70-73Bayes, H.K., Weir, C.J., O'Leary, C., Timing of birth and risk of multiple sclerosis in the Scottish population (2010) Eur Neur, 63, pp. 36-40Saastamoinen, K.P., Auvinen, M.K., Tienari, P.J., Month of birth is associated with multiple sclerosis but not with HLA-DR15 in Finland (2012) Mult Scler, 18, pp. 563-568Fernandes de Abreu, D.A., Babron, M.C., Rebeix, I., Season of birth and not vitamin D receptor promoter polymorphisms is a risk factor for multiple sclerosis (2009) Mult Scler, 15, pp. 1146-1152Willer, C.J., Dyment, D.A., Sadovnick, A.D., Timing of birth and risk of multiple sclerosis: Population based study (2005) BMJ, 330, p. 120. , Canadian Collaborative Study GroupDeussing, E.C., Jankosky, C.J., Clark, L.L., Estimated incidence of multiple sclerosis among United States Armed Forces personnel using the Defense Medical Surveillance System (2012) Mil Med, 177, pp. 594-600Staples, J., Ponsonby, A.L., Lim, L., Low maternal exposure to ultraviolet radiation in pregnancy, month of birth, and risk of multiple sclerosis in offspring: Longitudinal analysis (2010) BMJ, 340, p. 1640Givon, U., Zeilig, G., Dolev, M., The month of birth and the incidence of multiple sclerosis in the Israeli population (2012) Neuroepidemiology, 38, pp. 64-68Fragoso, Y.D., Shearer, K.D., Adoni, T., Month of birth does not seem to interfere with the development of multiple sclerosis later in life in Brazilian patients (2012) Neuroepidemiology, 39, pp. 70-71Koch, M., de Keyser, J., Tremlett, H., Timing of birth and disease progression in multiple sclerosis (2008) Mult Scler, 14, pp. 793-798Tremlett, H.L., Devonshire, V.A., Does the season or month of birth influence disease progression in multiple sclerosis? (2006) Neuroepidemiology, 26, pp. 195-198Poser, C.M., Paty, D.W., Scheinberg, L., New diagnostic criteria for multiple sclerosis: Guidelines for research protocols (1983) Ann Neurol, 13, pp. 227-231McDonald, W.I., Compston, A., Edan, G., Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the diagnosis of multiple sclerosis (2001) Ann Neurol, 50, pp. 121-127Polman, C.H., Reingold, S.C., Edan, G., Diagnostic criteria for multiple sclerosis: 2005 revisions to the "McDonald Criteria" (2005) Ann Neurol, 58, pp. 840-846Kurtzke, J.F., Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS) (1983) Neurology (Cleveland), 33, pp. 1444-1452Damasceno, A., von Glehn, F., de Deus-Silva, L., Monthly variation of multiple sclerosis activity in the Southern hemisphere: Analysis from 996 relapses in Brazil (2012) Eur J Neurol, 19, pp. 660-662Altmann, D.M., Review series on helminths, immune modulation and the hygiene hypothesis: Nematode coevolution with adaptive immunity, regulatory networks and the growth of inflammatory diseases (2009) Immunology, 126, pp. 1-2Correale, J., Farez, M.F., The impact of environmental infections (parasites) on MS activity (2011) Mult Scler, 17, pp. 1162-1169Watson, P.E., McDonald, B.W., Seasonal variation of nutrient intake in pregnancy: Effects on infant measures and possible influence on diseases related to season of birth (2007) Eur J Clin Nutr, 61, pp. 1271-1280Melcon, M., Melcon, C., Bartoloni, L., Towards establishing MS prevalence in Latin America and the Caribbean (2013) Mult Scler, 19, pp. 145-152. , The "Grupo Colaborativo Multicéntrico para el Estudio de la Esclerosis Multiple en America Latina y el Caribe" (GEEMAL)Taylor, B.V., Pearson, J.F., Clarke, G., MS prevalence in New Zealand, an ethnically and latitudinally diverse country (2010) Mult Scler, 16, pp. 1422-1431Dobson, R., Giovannoni, G., Ramagopalan, S., The month of birth effect in multiple sclerosis: Systematic review, meta-analysis and effect of latitude (2013) J Neurol Neurosurg Psychiatry, 84, pp. 427-43