Evaluation Of Mental Status Research Articles

Psychological resilience of COVID-19 frontline warriors: Need of the hour

Background: Amid the rapid rise of COVID-19 cases, risk of infection from patients, isolation, and other factors are taking its toll on the mental health status of the healthcare professionals. The frontline health workers in the COVID-19 pandemic are undergoing psychological turbulence handling the corona situation. Objectives: The present study assessed the self-reported mental health status of healthcare professionals and studied their perspectives of COVID-19 control. Materials and Methods: A descriptive study was conducted among healthcare professionals in India using a web-based online questionnaire. A total of 152 participants took part in the survey in April 2020. Self-reported mental health status was assessed using the DASS-21 scale. Mann–Whitney and Chi-square tests were applied. Results: The overall prevalence of depression, anxiety, and stress was 13.82%, 8.55%, and 23.68%, respectively. A higher prevalence of depression, anxiety, and stress was found in the frontline workers subgroup. The median (interquartile range) scores of frontline workers for depression, anxiety, and stress were 6 (10.5), 6 (8), and 10 (10), respectively. Fifty percent of the participants responded that quarantine and isolation was the best method for control of COVID-19 in Indian setting. Conclusion: The psychological disturbance was found among frontline health workers involved in the diagnosis and management of COVID-19. Psychological debriefing and regular mental status evaluation in addition to psychological counseling may be indispensable.

Cognitive impairment as a pronostic factor in valvular heart disease among elderly

Mild cognitive impairment causes cognitive changes that are serious enough to be noticed by the individuals. Approximately 15 to 20 percent of people age 65 or older have MCI. This impairment may increase the risk of cardiovascular events. Few studies have shown the impact of altered mental status on mortality and CV events. Even less in elderly with valvular heart disease. We made a monocentric prospective study for 12 months, data collected at the echolab and consultations among patients with valvular disease. To assess mild cognitive impairment (MCI) we have used the Mini Mental Status Evaluation which is a 30-point questionnaire that is used extensively in clinical and research settings. After exclusion for neurological problems, psychiatric disorders, we defined MCI by MMSE < 24. We compared 2 groups of patients G1 < 70 years and G2 > 70 years who were eligible to study. Eighty six patients were included, 48 in G1 and 38 in G2, mean age was G1 58 ± 7 vs. G2 78 ± 5 years. MCI was correlated with female gender (54% vs. 35% P = 0.03), low education state (10% vs. 35% P = 0.001). AF was present in 5% in G1 vs. 12% in G2, and heart failure (HF 22% vs. 37% P = 0.035). Mitral stenosis was identified (20% vs. 17%), MR (10% vs. 12%), LVEF > 50% in (80% vs. 65%), PAH in 38% each group, whereas aortic stenosis was significantly associated with MCI in second group of elderly patients (5% vs. 12% P = 0.04). The medical therapy was similar between 2 groups. Mortality and rehospitalization in 3 months were higher in G2 of (3.6% vs. 12%, P = 0.01 and 20% vs. 36%, P = 0.002). Routine assessment of MCI should be done in elderly with valvular heart disease specially population with AS. A specific management of such high-risk patients should be considered.

Discrepancy between food offered and consumed during hospitalization in older adult patients

AbstractMalnutrition is one of the most frequent geriatric syndromes and a key contributor to frailty. Ageing is commonly associated with modifications in eating habits with changes in appetite and food intake. Malnutrition is not only a sign of illness, but its presence increases morbidity, hospital stay, institutionalization, poor quality of life, in-hospital complications, expenses, and mortality. Hospitalized patients have increased calorie requirements to overcome the increased energy expenditure due to acute disease. We aimed to evaluate the actual consumption of the food offered to a sample of hospitalized older adults. Sixty hospitalized patients (women/men = 23/37) were recruited sequentially. After participants signed an informed consent, we evaluated their mean actual intake of macronutrients (carbohydrates, proteins, and fats) at lunch during three consecutive days, calculated with a nutrition analysis software from the weighted food (first course, second course, side dishes) measured before and after consumption. Other parameters assessed included self-sufficiency by the capacity to perform basic and instrumental activities of daily living (ADL, IADL), cognitive performance with Mini Mental State Evaluation (MMSE), Geriatric Depression Scale (GDS), physical performance with the Short Physical Performance Battery (SPPB) and handgrip dynamometry, EAT-10 test for the assessment of swallowing capacity, and anthropometric parameters. Mean ± SD of the main parameters assessed were as follows: age 77.8 ± 9.3 years, BMI 27.1 ± 8.7 Kg/m2, ADL 3.8 ± 2.0, IADL 4.1 ± 2.8 (indicative of compromise self-efficacy), MMSE 21.8 ± 5.9, SSPB 5.3 ± 3.1, handgrip dynamometry 16.5 ± 7.8 Kg (indicative of mild to moderate cognitive and physical impairment). The mean intake of macronutrients for the 3-day assessment was 65.7 ± 20.6% of carbohydrates, 74.3 ± 30.4% of proteins, and 47.4 ± 38.1% of fats of the total amount offered at lunch. Older patients tended to have lower intakes of carbohydrates, proteins, and fats, while participants with higher SPPB had higher intakes of carbohydrates and proteins. The results of the present study show that hospitalized older adults, with compromised autonomy, physical and cognitive performance, had lower consumption compared to what is offered to them in the hospital despite their elevated nutritional needs due to the acute illness leading to hospitalization. Undernutrition and weight-loss are key factors associated with increased mortality and morbidity. Therefore, it is crucial to set appropriate nutritional interventions in hospitalized patients, particularly those with disability and cognitive decline. Early recognition and treatment of malnutrition are essential preventive measures to improve the quality of care, quality of life, and decrease mortality risk in hospitalized older adults.

Classification of Brain MRI for Alzheimer’s Disease Detection Based on Ensemble Machine Learning

Background: Machine learning is now a powerful tool to help improve medical disorders diagnosis. One of its critical applications is the classification or clustering of neurodegenerative disease by pattern recognition methods based on biomedical signals and medical images. Early detection of these diseases is always useful and vital. In this study, we focused on Alzheimer’s disease (AD) as a type of dementia leading to problems with memory, thinking, and behavior. This disease was named after Dr. Alois Alzheimer in 1906 when he inspected a female patient who died of an unusual mental illness. According to recent studies, four stages are introduced for AD, including pre-dementia, early AD, moderate AD, and advanced AD. There are several methods for AD diagnosis that include mental status evaluation, physical exam, and neurological exam, based on different imaging techniques such as magnetic resonance imaging (MRI). Several methods have been introduced until now for the classification and detection of AD using machine learning algorithms, such as the classification of AD with discrete wavelet transform (DWT) and single linear discriminant analysis (LDA) classifiers and differentiation of AD from normal based on T2-weighted MRI with shearlet transform (ST) and K-nearest neighbors (KNN) classifiers. Objectives: In this work, we proposed a methodology based on DWT with three-level decomposition feature extraction (Figure 1). Methods: Based on statistics (mean, variance, skewness) of features and principal component analysis (PCA) for dimension reduction, we used five classifiers, including multi-layer perceptron neural network (MLPNN) (Figure 2), KNN, support vector machine (SVM) (Figure 3), and naive Bayesian (NB) with the majority vote method to fuse them into one ensemble classifier. Results: The proposed methodology was evaluated using 100 T2-weighted MRI of AD and cognitive normal (CN) subjects, which were chosen from the Harvard Medical School website. The accuracy, specificity, and sensitivity achieved from our methodology were 95%, 90%, and 100%, respectively by using a 10-fold cross-validation strategy. Conclusion: Our study showed that the stacking method for classification of AD and CN was better than using one classifier and comparable with state-of-the-art methods.

State of mental health as a predictor for the outcome in patients with tuberculosis in health centers with high incidence. Lima, Peru. 2015-2017

Mental health problems in people with tuberculosis (TB) have been associated with negative outcomes. Some health care centers in Peru use an evaluation of mental health status proposed by the Dirección de Prevención y Control de Tuberculosis (DPCTB). To evaluate the association between the mental health evaluation indicators at the beginning of treatment and the outcome of people treated with TB. A retrospective cohort study in three health care centers from the district San Juan de Miraflores. The outcome was considered positive (cured) and negative (failure, dropout, death or change of treatment scheme). A significant association was found between the negative outcome and depressive symptoms (RR: 2.39, 95%CI: 1.19-4.78), substance abuse (RR: 2.58; 95%CI: 1.31-5.09) and unprotected sexual intercourse (p = 0.04). The multivariate analysis found association with depressive symptoms (RR: 2.19, 95%CI: 1.10-4.35) and substance abuse (RR: 2.19, 95%CI: 1.14-4.20). Depressive symptoms and drug consumption were associated with negative outcomes. Intervention studies focusing on these factors should be evaluated to improve treatment success.

What Impedes General Practitioners' Identification of Mental Disorders at Outpatient Departments? A Qualitative Study in Shanghai, China.

Background:Mental disorders endanger people’s health and lives. General practitioners (GPs) play a valuable role in identifying and treating mental disorders in outpatient clinical settings. However, there are obstacles for GPs’ identification in developing countries.Objective:This study’s aim was to identify the related obstacles and to propose optimized strategies.Methods:We conducted qualitative interviews with 26 GPs from seven randomly sampled community healthcare centers in Shanghai, China. The interview guide was based primarily on the items from mental status evaluation. After transcribing, coding, condensing, and categorizing talking content, we summarized the theme structure and results.Findings:GPs lacked the confidence and skills to conduct psychiatric evaluation and seldom conducted it. Patients’ behaviors also influenced whether evaluations were conducted. The GPs expressed that they were short of strategies and wished to be well trained and have sufficient practice. We found that two major reasons impeded GPs’ identification. First, the GPs had difficulty making a diagnosis: they lacked diagnostic ability and confidence, they had misunderstandings about diagnoses, and they had unclear qualifications for making psychiatric diagnoses. Second, the GPs lacked skills for evaluation and reevaluation: their evaluation had inadequacies of contents and subjects; they lacked mental state examination evaluation, communication, and severity assessment skills and knowledge.Conclusions:This study found that it is difficult for GPs in developing countries to become competent in the diagnosis and systematic evaluation of mental disorders without external help. Unclear qualification also limited GPs’ diagnoses of mental disorders. We proposed that optimized strategies to overcome these challenges lie in support of changes in policy, programs, and utilizing effective tools, such as the mhGAP, GMHAT/PC, BVC, Grille’s assessment tool, and telemedicine.

Clinical EEG slowing correlates with delirium severity and predicts poor clinical outcomes.

To determine which findings on routine clinical EEGs correlate with delirium severity across various presentations and to determine whether EEG findings independently predict important clinical outcomes. We prospectively studied a cohort of nonintubated inpatients undergoing EEG for evaluation of altered mental status. Patients were assessed for delirium within 1 hour of EEG with the 3-Minute Diagnostic Interview for Confusion Assessment Method (3D-CAM) and 3D-CAM severity score. EEGs were interpreted clinically by neurophysiologists, and reports were reviewed to identify features such as theta or delta slowing and triphasic waves. Generalized linear models were used to quantify associations among EEG findings, delirium, and clinical outcomes, including length of stay, Glasgow Outcome Scale scores, and mortality. We evaluated 200 patients (median age 60 years, IQR 48.5-72 years); 121 (60.5%) met delirium criteria. The EEG finding most strongly associated with delirium presence was a composite of generalized theta or delta slowing (odds ratio 10.3, 95% confidence interval 5.3-20.1). The prevalence of slowing correlated not only with overall delirium severity (R 2 = 0.907) but also with the severity of each feature assessed by CAM-based delirium algorithms. Slowing was common in delirium even with normal arousal. EEG slowing was associated with longer hospitalizations, worse functional outcomes, and increased mortality, even after adjustment for delirium presence or severity. Generalized slowing on routine clinical EEG strongly correlates with delirium and may be a valuable biomarker for delirium severity. In addition, generalized EEG slowing should trigger elevated concern for the prognosis of patients with altered mental status.

Color Choice Preference in Cognitively Impaired Patients: A Look Inside Alzheimer's Disease Through the Use of Lüscher Color Diagnostic.

ObjectiveTo study the emotional state of cognitively impaired patients through the color choice preference in a group of Alzheimer’s disease (AD) patients and compare it with a group of Mild Cognitive Impairment (MCI) patients and a matched control group.MethodsA total of 71 AD, 50 MCI and 68 controls were consecutively evaluated. All patients and controls underwent the Mini Mental State Evaluation (MMSE) and the Lüscher color test.ResultsCognitively impaired patients mainly chose auxiliary colors, in particular violet and brown, and rejected black and gray. AD patients predominantly chose forms corresponding to auxiliary colors. The auxiliary color choice negatively correlated with the MMSE score. MCI patients and controls had a higher presence of anxiety on gray table and controls had higher frustration and ambivalence, i.e., psychic complexity, on basic color tables.Data globally suggest that AD patients live with a feeling of personal change due to instability and emotional insecurity, experiencing physical discomfort and a bodily need of being welcomed in a favorable environment. They aspire to a sensitive understanding by someone with whom they can be identified. Differently, MCI patients have less of these needs; however, they feel more anxious.ConclusionThe comprehension of the inner emotional state of cognitively impaired patients allows us to better communicate with them and effectively approach their behavioral disorders. Like other projective techniques, such as the tree-drawing test and the human figure-drawing test, Lüscher color test is proposed as a simple and unconventional approach to understand the emotional life of AD patients. The awareness of clinicians about the existential fragility and insecurity of such type of patients allows us not only to better manage their behavioral disturbances but also to improve their quality of life and that of their caregivers.

Dementia and associated factors among the elderly in Vietnam: a cross-sectional study

BackgroundDementia poses a serious threat to the wellbeing of the elderly. In the context of the rapidly ageing population of Vietnam however, little is known about the prevalence of symptoms and other related factors. This study aims to detect the prevalence of cognitive symptoms of dementia in the elderly in Vietnam as well as other associated factors.MethodsA cross-sectional study was conducted over a period of six communes at the Northern, Central and Southern region of Vietnam. Prevalence of cognitive symptoms of dementia was the outcome of interest and assessed by Mini Mental State Evaluation (MMSE) questionnaire and was standardized according to the age structure of Vietnam. A total of 3308 adults aged 60 and above were included. Association between having cognitive symptoms of dementia and other factors was assessed with logistic regression.FindingsCognitive symptoms of dementia were perceived in 46.4% of the sample group. The symptoms were more common among participants who were older, female, had a lower educational level, were not physically active or have previously had stroke.ConclusionsPrevalence of cognitive symptoms of dementia in adults aged 60 and above was relatively high in Vietnam. Other modifiable associated factors including physical inactivity and social connectedness should also be considered in designing intervention program to prevent dementia in the future.

A cohort study on the association between dietary patterns which benefit for normal kidney function and the cognitive performance in the Chinese elderly

Objective: To explore the association between dietary pattern which benefit for normal kidney function and the risk of cognitive decline or impairment in the elderly. Methods: In 2015, subjects aged 60 and over from four counties in the Nutrition and Chronic Disease Family Cohort project, were followed up in 2017. Cognitive function was repeatedly assessed, using the Mini Mental State Evaluation (MMSE) scale. Dietary pattern that benefit for normal kidney function was extracted, using the reduced rank regression method and followed by logistic regression models to explore the associations between scores that showing the kidney function on dietary patterns and the risk of cognitive deterioration and impairment in two years among those who were with normal cognition in 2015. Results: Dietary pattern that benefit for normal kidney function, was characterized by high consumption of cereal, vegetables, legume and fruits but with less meat and soy products. Comparing with the group with lowest score quartile on this dietary pattern, the risk of cognitive deterioration in the highest quartile group was significantly low (P<0.01) in two years, with an odds ratio as 0.57 (95%CI: 0.37-0.85). Linear trend was also obviously visible (P=0.007) in this group. The ones at the highest quartile group among the normal cognition ones in 2015, the risk of cognitive impairment also significantly reduced (P<0.05) in two years time, with an odds ratio as 0.52 (95%CI: 0.29-0.93). Also, linear trend could obviously be seen (P=0.01). Conclusion: Dietary pattern that benefit for normal kidney function was both inversely associated with cognitive deterioration and impairment, in two years.

Decreased Function of Delayed Recall in Non-demented Elderly Subjects With Apolipoprotein E ε4 Allele.

Apolipoprotein E (APOE) is the major genetic risk factor for late-onset Alzheimer’s disease (AD). Inconsistent results about the role of APOE ε4 alleles on cognitive decline of community non-dementia elderly have been reported. This study aimed to examine the relationship between APOE ε4 allele and cognitive abilities in the subjects aged 60 years or above from a community in Shanghai, China. A total of 1445 participants voluntarily accepted the analysis of APOE genotype and global cognitive assay using the Mini Mental Status Evaluation (MMSE). There were no significant differences in total MMSE scores between APOE ε4 carriers and non-carriers. In addition, the performances of orientation, registration, attention, calculation, and language had no significant differences between subjects with and without APOE ε4 allele. However, stratified analysis showed that the performance of delayed recall in subjects with APOE ε4 allele was inferior to that in non-ε4 carriers (p = 0.041). Further, the multiple linear regression analysis showed the significant correlations between the presence of APOE ε4 allele and the scores of the delayed memory subdomain if age, gender, and education were adjusted but no significant correlations if the related factors were not adjusted. The results indicate that significant impact of APOE ε4 allele only on the delay memory but not on global or other sub-domains of cognitive abilities.

Effect of Donepezil on Cognitive Deficits Associated With Electroconvulsive Therapy: A Randomized Triple-blind Clinical Trial.

Despite the effectiveness of electroconvulsive therapy (ECT) in a wide range of psychiatric disorders, the role of memory-enhancing agents in post-ECT cognitive disturbances has remained controversial. In this study, we aimed to assess the effect of donepezil on improving the cognitive performance of patients undergoing ECT. In a psychiatry hospital, patients who were admitted for ECT underwent a triple-blind randomized controlled trial. After randomizing the participants into 2 groups, 1 group received ECT with placebo, whereas the other group received ECT plus 5 mg/d donepezil during the ECT period. The patients in both groups were cognitively assessed using the Mini Mental Status Evaluation and Wechsler Memory Scale, 24 hours before ECT and 48 hours after the end of the ECT sessions. The results of Mini Mental Status Evaluation scores did not show any significant difference in memory performance between the 2 groups before and after ECT (F = 0.108, P = 0.743). Moreover, the intervention and placebo groups did not have any significant difference in the scores of the 7 subscales of the Wechsler Memory Scale after ECT (P = 0.07). In addition, the patients on donepezil group tolerated the drug well and did not differ significantly compared with the control group in this regard. Despite a few evidence confirming the effect of acetylcholinesterase inhibitors in improving cognitive defects related to ECT, this study did not find such an effect in patients under ECT. Further studies are required to reach a clear conclusion.

Effect of Mental Health Status on Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation

BackgroundPatients diagnosed with atrial fibrillation suffer more from anxiety and depression than the general population. This study sought to evaluate the association between mental health status and recurrence of atrial tachyarrhythmia (AT) after catheter ablation. MethodsA total of 448 patients who underwent catheter ablation for atrial fibrillation were enrolled in this single-centre prospective cohort study. Mental Health Inventory-5 (MHI-5) was used to assess the mental health status at the end of the blanking period after ablation and lower scores indicated poorer mental health status. Patients with no early recurrence of AT during the blanking period were included for analyses. Multivariate logistic regression was used to examine the association between mental health status and risk of arrhythmia recurrence in the following 3 months. ResultsAmong 335 patients without early recurrence during the blanking period, 36 patients (10.7%) experienced AT recurrence in the 3 months after the mental health status evaluation. Recurrence rates were 35.7%, 13.5%, 10.6%, and 4.6% in patients with an MHI-5 score of 0-52, 53-75, 76-85, and 86-100, respectively (overall P = 0.004). A significant association between low MHI-5 scores and AT recurrence was observed after multivariate adjustment (odds ratio: 8.81 [1.93-40.22], P = 0.005 for the MHI-5 score of 0-52 and 3.61 [1.05-12.35], P = 0.041 for the MHI-5 score of 53-75, compared with an MHI-5 score of 86-100). ConclusionsA poorer mental health status is associated with AT recurrence after catheter ablation. Intervention studies are warranted to evaluate the efficacy of counselling and psychological support after ablation in improving success rates in these patients.

Treatment of Multidrug-Resistant Tuberculosis Infection in Children.

Treatment of Multidrug-Resistant Tuberculosis Infection in Children.

Fine Particulate Matter Air Pollution and Incidence of Cognitive Impairment among the Elderly in China

Background/Aim: Long-term exposure to fine particulate matter (PM2.5) has been shown to increase risk of cognitive impairment. However, research on the relationship between exposure to PM2.5and cognitive function is lacking in developing countries,especially in highly polluted areas.The aim of this study is to determine if exposure to PM2.5 is associated with cognitive function in a diverse, national sample of older adults in china.Methods: This analysis included data on5704older adults aged &amp;#8805;65 years from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2008-2011,which randomly selects half of the counties and cities in 23 of China&amp;#8217;s 31 provinces. We used geographic information system to estimate annual average satellite-derived PM2.5 concentration for the geocoded location of participants&amp;#8217; baseline residences enrolled between 2008 and 2011.The cognitive function was assessed with Mini Mental State Evaluation(MMSE)scale. Association between PM2.5 concentration and cognitive impairment was analyzed by logistic regression model．Results: The average age of participants was 79.6years.Logistic regression analysis resultsshowed that a 10&amp;#956;g/m3 increase in PM2.5 concentration was associated with an increased odds of incident impairment, after adjusting for demographic factors and behavioral factors [RR (95% CI): 1.06 (1.01, 1.11)]. The effect is especially significant in men, current alcohol drinker, current smoker, the elder age group and hypertensive patients.Conclusions: PM2.5 was associated with increased risk of cognitive impairment incidence in the elderly of china. Air pollution reduction is a potential measures for reducing the future population burden of age-related cognitive decline, especially in heavy air polluted area.

Mental status evaluation in older adults with cancer: Development of the Mental Health Index-13.

The Mental Health Index (MHI) is widely used as a measure of mental health status, but has not been evaluated in the geriatric oncology population. This study evaluated the MHI-17 in a geriatric oncology population, to establish validity and scoring rules. The Carolina Senior Registry (NCT01137825) was used to obtain data for 686 patients with cancer 65 and older who completed the MHI-17. The 17-item patient-reported measure produces one total score summing across four domains: anxiety, depression, positive affect, and sense of belonging. Cronbach's alpha (α), confirmatory factor analyses (CFA), item-response theory (IRT) analyses, and differential item functioning (DIF) analyses were used to evaluate internal consistency and validity. The revised MHI retained the 13 best-fitting items from the MHI-17 and resulted in a final model that included two subscales: anxiety (four items, RMSEA 0.11; CFI 0.99; TLI 0.98) and depression (9 items, RMSEA 0.10; CFI 0.96; TL 0.95). IRT analyses of the four anxiety items indicated good fit (RMSEA 0.08) and precise measurement of adults with poor mental health, and the nine depression items also fit well (RMSEA 0.05). No meaningful differences were found by sex, education, or treatment stage. Scores were developed to provide meaningful norms. The new MHI-13 is a shorter, more accurate way to assess mental health in older adults with cancer and most importantly allows clinicians to separately identify anxiety and/or depression - a clinically important distinction as treatment differs among these two types of mental health impairment.

Treatment of Multidrug-resistant Tuberculosis Infection in Children.

Treatment of Multidrug-resistant Tuberculosis Infection in Children.

Correlation among decreased regional cerebral oxygen saturation, blood levels of brain injury biomarkers, and cognitive disorder.

ObjectiveThis study was performed to investigate the correlation among decreased regional cerebral oxygen saturation (rSO2), blood levels of brain injury biomarkers, and postoperative cognitive disorder (POCD) after cardiac surgery with cardiopulmonary bypass (CPB).MethodsThis prospective observational study included 59 patients undergoing coronary artery bypass graft surgery with CPB. All patients underwent neuropsychological tests (Mini Mental State Evaluation, Rey Auditory Verbal Learning Test, digit span test, digit symbol substitution test, and Schulte table) the day before and 10 days after the surgery. The blood levels of two brain injury biomarkers, neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP), were measured before and 1 day after the surgery.ResultsThe rSO2 decreased during surgery in 21 (35%) patients. POCD was detected in 22 (37%) patients. After the surgery, no significant changes in the GFAP blood level occurred in any patients. No significant correlations were found among the decreased rSO2, increased NSE blood level, and rate of POCD.ConclusionThese results suggest that a decrease in rSO2 during cardiac surgery is not necessarily related to the development of POCD or an increased blood level of the brain injury biomarker NSE.

Association between blood pressure related dietary patterns and identified cognitive performance in the elderly Chinese-a study by reduced rank regression method

Objective: To study the association between blood pressure related dietary pattern and cognitive impairment in the elderly. Methods: In 2015, all participants who were aged ≥60 and participated in the Nutrition and Chronic disease family cohort were involved in the study. Information on demographic variables, lifestyle and health status was collected. Cognitive performance was assessed by the Mini Mental State Evaluation (MMSE) scale. Blood pressure, height and weight were measured by trained medical personnel and fasting venous blood samples were collected for testing on serum level of triglycerides and total cholesterol. Both SBP and DBP were used as response variables when dietary patterns were identified by reduced rank regression method. Logistic regression models were fit to explore the associations of scores on blood pressure-related dietary pattern and cognitive impairment. Results: Two blood related dietary patterns were identified. The first one was characterized by high consumption of vegetables and less meat, eggs and dessert (Pattern 1), while the second one was with high consumption of meat, soy products, wine and fried foods and less intake of dairy (Pattern 2). Data showed that the Pattern 1 was associated with the risk of cognitive impairment. Comparing with the lowest quartile of score of this dietary pattern, the risk of cognitive impairment in the highest quartile group showed a significant (P<0.01) increase, with OR=1.94 (1.21-3.11) and showing significant (P=0.002) linear trend. However, no significant association was observed (P>0.05) with cognitive impairment in the second dietary pattern. Conclusion: Blood pressure-related dietary pattern was positively associated with cognitive impairment.

Mental State Assessment and Validation Using Personalized Physiological Biometrics.

Mental state monitoring is a critical component of current and future human-machine interfaces, including semi-autonomous driving and flying, air traffic control, decision aids, training systems, and will soon be integrated into ubiquitous products like cell phones and laptops. Current mental state assessment approaches supply quantitative measures, but their only frame of reference is generic population-level ranges. What is needed are physiological biometrics that are validated in the context of task performance of individuals. Using curated intake experiments, we are able to generate personalized models of three key biometrics as useful indicators of mental state; namely, mental fatigue, stress, and attention. We demonstrate improvements to existing approaches through the introduction of new features. Furthermore, addressing the current limitations in assessing the efficacy of biometrics for individual subjects, we propose and employ a multi-level validation scheme for the biometric models by means of k-fold cross-validation for discrete classification and regression testing for continuous prediction. The paper not only provides a unified pipeline for extracting a comprehensive mental state evaluation from a parsimonious set of sensors (only EEG and ECG), but also demonstrates the use of validation techniques in the absence of empirical data. Furthermore, as an example of the application of these models to novel situations, we evaluate the significance of correlations of personalized biometrics to the dynamic fluctuations of accuracy and reaction time on an unrelated threat detection task using a permutation test. Our results provide a path toward integrating biometrics into augmented human-machine interfaces in a judicious way that can help to maximize task performance.