The association between PM2.5 exposure and neurological disorders: A systematic review and meta-analysis
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Alzheimer's disease is the most common form of dementia, representing 60-80% of cases, and ageing is the primary risk factor for the development of Alzheimer's disease. The objective of this study was to examine the chance of developing dementia (i.e. mild cognitive impairment (MCI), Alzheimer's disease) among geriatric people in Bangladesh.This study included 390 adult citizens of Bangladesh (age range: 60-70 years). The Takeda Three Colors Combination (TTCC) test was used to detect the prevalence of MCI and mild dementia among the subjects, and then the Clinical Dementia Rating was used to determine the level of dementia.The subjects who were aged 60-65 years included 154 with MCI, 76 with mild dementia, 1 with moderate dementia, 4 with severe dementia, and 29 without dementia. The subjects who were aged 66-70 years included 75 with MCI, 36 with mild dementia, 0 with moderate dementia, 2 with severe dementia, and 13 without dementia. The sensitivity of the TTCC was 75% and 58% for the mild dementia and MCI groups, respectively, and the specificity was 52%. The odds ratio of incorrect responses to the TTCC was 3.42 (95% confidence interval: 1.63-7.21) for subjects with mild dementia compared those without dementia. However, the TTCC outcomes revealed no significant differences between the MCI and non-dementia groups. The results showed no significant associations between cognitive decline/developing dementia and social status/occupation.The outcomes of this study indicated that most of the subjects had MCI or mild dementia and were farmers aged 60-65 years.
Clinical Dementia Rating
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Background: The knowledge and awareness of dementia among the public have been poorly estimated by the regional center for dementia.
Methods: To assess the feasibility of dementia care facilities and the attitudes of community members toward dementia care facilities, we conducted semi-structured interviews with patients and caregivers who utilize regional centers for dementia. The questionnaires consisted of an assessment of the understanding of dementia, the items and amount requested for facility use and satisfaction with dementia care facilities.
Results: A total of 151 residents completed this questionnaire form. The rate of interest in
dementia was very high, 48.3% of total responses; however, the knowledge and familiarity
with dementia were very low in comparison to the rate of interest (36.4%, 37.1%, respectively).
Most of the responders suggested that more precise and easily understandable information should be provided by the regional center for dementia.
Conclusion: The public need for dementia care facilities is very high, despite their minimal understanding of dementia. Therefore, it is crucial for the public to receive urgent preventive education. and a conversion of knowledge regarding dementia.
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We performed a retrospective study of 145 consecutive patients referred on suspicion of dementia. We were particularly interested in the occurrence of reversible dementia. Dementia was defined with reference to the ICD-10 criteria.All patients underwent a clinical neurological examination, a battery of blood tests, and a CT scan of the brain.Dementia was found in 63% and in only 4% was it potentially reversible: Three patients had subnormal cobalamin and one patient had normal pressure hydrocephalus. However, treatment did not influence the state of dementia. Hence, patients with reversible dementia were not identified in this study. In the group without dementia one patient had a meningoma. Mental depression was the most common "second" diagnosis in both groups.The number of patients with potential dementia was surprisingly small. We conclude that most patients with reversible dementia are detected by their general practitioner and that the majority of patients suspected of dementia can be diagnosed by the general practitioner, especially if access to CT scans is further liberalised.
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Background: Diabetes mellitus (DM) increases the risk of dementia in the elderly.However, its underlying mechanisms, its connection with Alzheimer disease and vascular cognitive impairment, and effects of therapy remain unclear.Objective: To test the hypothesis that DM promotes specific neuropathologic processes that contribute to dementia and that these processes may be suppressed by antidiabetic therapy.Design: A comprehensive neuropathologic assessment of all cases from a community-based study of incident dementia (Adult Changes in Thought Study) that underwent autopsies (n=259) and had information on DM status (n=196).Biochemical analysis was conducted on a subset of these cases with rapidly frozen brain tissue (n=57).Participants: Autopsy cases were divided into 4 groups: no DM/no dementia (DM-/dementia-), DM/no dementia (DMϩ/dementia-), no DM/dementia (DM-/ dementiaϩ), and DM/dementia (DMϩ/dementiaϩ).Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) diagnosis of dementia was assigned through a consensus of experts following biennial cognitive and physi-cal evaluations.Diabetes was diagnosed based on information obtained from participants' extensive medical records.Results: In cases without dementia (n = 125), neuropathologic and biochemical end points did not differ significantly by DM status.However, we observed 2 patterns of injury in patients with dementia (n=71) by their DM status.Individuals without DM but with dementia (DM-/dementiaϩ) had a greater amyloid- peptide load and increased levels of F 2 -isoprostanes in the cerebral cortex, while DMϩ/dementiaϩ patients had more microvascular infarcts and an increased cortical IL-6 (interleukin 6) concentration.The number of microvascular infarcts was greater in deep cerebral structures in patients with dementia whose diabetes was treated, whereas amyloid plaque load tended to be greater for untreated diabetic patients with dementia.Conclusions: These novel characterizations of 2 different patterns of cerebral injury in patients with dementia depending on DM status may have etiologic and therapeutic implications.
Vascular dementia
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Objective The aim of this analysis was to perform a meta-analysis evaluating gender difference of delayed healing risk in patients with venous leg ulcers. Methods We searched the PubMed and Web of Knowledge from their inception to 4 July 2015. The meta-analysis of pooled odds ratio and 95% confidence interval for venous leg ulcers healing risk were calculated. Results Twelve studies with 4453 patients were included in the meta-analysis. The pooled odds ratio for healing rate stratified by gender was 1.055 (95% CI 0.955–1.165; Z = 1.05, p = 0.292) by fix-effects model. The Begg's test (z = 2.67, p = 0.007), the Egger's test (t = 4.00, p = 0.003), and asymmetric funnel plot suggested there was significant publication bias. Subgroup analysis showed the pooled odds ratios were 1.048 (95% CI 0.945–1.162; Z = 0.88, p = 0.376) in prospective studies and 1.439 (95% CI 0.757–2.736; Z = 1.11, p = 0.266) in retrospective studies. Sensitivity analyses by only pooled adjusted odds ratios showed the pooled odds ratio was 1.049 (95% CI 0.946–1.163; Z = 0.91, p = 0.365), which indicated the results of meta-analysis were robust. Meta-regression analysis showed the healing rate odds ratio stratified by gender was not related with healing rate (t = 0.73, p = 0.484). Conclusion Our meta-analysis indicates that no gender difference existed for delayed healing in venous leg ulcers. Our results may be also useful in developing a risk score for failure of venous leg ulcers to heal.
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What Is Dementia? What Causes Dementia? Irreversible and Reversible Causes of Dementia Psychological Effects of Dementia Diagnosis of Dementia Dementia and the Patient Dementia and the Caregiver Facing Problem Behaviors Helping the Caregivers Dementia Today and in the Future Bibliography Index
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People aged 90 and older are the fastest growing age group in most parts of the world. Since the prevalence of dementia has been shown to increase exponentially after the age of 65, there is an acceptance that the oldest old population has a high burden of dementia; however, there is a lack of consensus on how best to diagnose dementia in this population. This review summarizes the various approaches to diagnosing dementia and the prevalence and incidence rates of dementia that have been reported. We also summarize the literature on cognitive and functional performance and biomarkers for dementia and discuss the limitations to interpretation of these data. Finally, we make recommendations for both researchers and clinicians who intend to diagnose dementia in the oldest old population.
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Cardiometabolic morbidities and dementia are increasingly common as people age. In this chapter, we summarize the epidemiological literature concerning: (1) mixed dementia due to cerebrovascular and neurodegenerative lesions as the most common form of dementia in older people; (2) the relation of cardiovascular disease with cognitive decline and dementia and the underlying pathophysiological mechanisms; and (3) cardiovascular comorbidities in dementia and impact on dementia care and prognosis. Atherosclerotic and arteriosclerotic disorders resulting from long-term exposures to cardiovascular risk factors, together with neurodegeneration in brain ageing, contribute to accelerated cognitive decline and dementia. The heart-brain connection in ageing has implications for dementia interventions. Furthermore, cardiovascular comorbidities in dementia contribute to poor outcomes, create complex challenges for dementia care, and substantially increase social care costs of dementia. Thus, early recognition and management of cardiovascular comorbidities in dementia may help health and social care providers maximize the well-being of people with dementia.
Cognitive Decline
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