Health Variables Research Articles

Predicting cognitive function changes from oral health status: a longitudinal cohort study

Recent studies indicate a potential link between oral health and cognitive function; however, long-term associations remain unclear. This study aimed to identify oral health factors that predict changes in cognitive function among older adults over time. The study included 583 independent older adults (201 male, 382 female) with a mean age of 72.7 years. Cognitive function was assessed using Mini-Mental State Examination (MMSE) at baseline and follow-up over two years, with relative change in MMSE (rMMSE) calculated. Baseline oral health variables included number of remaining teeth, masticatory performance, occlusal force, oral diadochokinesis and tongue pressure. Physical performance and confounding factors were also considered. The relationship between rMMSE and the variables was analyzed using Pearson’s correlation, Mann-Whitney U test, and multiple linear regression analysis. Cognitive function declined in 196 subjects, with rMMSE significantly correlated with oral diadochokinesis. Regression analysis revealed significant associations between cognitive changes and oral diadochokinesis (p = 0.020) and knee extension strength as a physical performance (p = 0.047). Our findings suggest that cognitive decline may be indicated by declines in both physical and oral motor performance. Incorporating oral diadochokinesis testing into health screenings could aid early detection of cognitive decline, improving outcomes and reducing healthcare burdens.

Cross-Country Assessment of Socio-Ecological Drivers of COVID-19 Dynamics in Africa: A Spatial Modelling Approach

Understanding how countries’ socio-economic, environmental, health status, and climate factors have influenced the dynamics of COVID-19 is essential for public health, particularly in Africa. This study explored the relationships between African countries’ COVID-19 cases and deaths and their socio-economic, environmental, health, clinical, and climate variables. It compared the performance of Ordinary Least Square (OLS) regression, the spatial lag model (SLM), the spatial error model (SEM), and the conditional autoregressive model (CAR) using statistics such as the Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), Root Mean Square Error (RMSE), and coefficient of determination (R2). Results showed that the SEM with the 10-nearest neighbours matrix weights performed better for the number of cases, while the SEM with the maximum distance matrix weights performed better for the number of deaths. For the cases, the number of tests followed by the adjusted savings, Gross Domestic Product (GDP) per capita, dependence ratio, and annual temperature were the strongest covariates. For deaths, the number of tests followed by malaria prevalence, prevalence of communicable diseases, adjusted savings, GDP, dependence ratio, Human Immunodeficiency Virus (HIV) prevalence, and moisture index of the moistest quarter play a critical role in explaining disparities across countries. This study illustrates the importance of accounting for spatial autocorrelation in modelling the dynamics of the disease while highlighting the role of countries’ specific factors in driving its dynamics.

Correlates and Brain Substrates of Happiness in Community-Dwelling Older Adults in India.

Happiness has been shown to influence many health-related outcomes in older adults. Identifying correlates and brain substrates of happiness across countries and cultures is an important goal, as the global older adult population continues to increase. We used univariate and multiple regression to examine associations between happiness and several demographic, health, and lifestyle variables in 665 older adults (39% female) from Kerala, India. We also used Bayesian regression to examine associations between cortical thickness and happiness in a sub-sample of 188 participants that completed MRI scanning. Happiness was significantly associated with several variables. In our multiple regression model, which included all significant univariate predictors, self-rated health, depression, anxiety, apathy, social network size, social network diversity, and social support significantly predicted happiness. Demographic indicators (age, sex, education, marital status, residence, and employment status/type), cognitive impairment, comorbidities, and leisure activities were not significantly associated with happiness in the multiple regression model. Cortical thickness in several brain regions was positively associated with happiness scores, including frontal, temporal, parietal, occipital, and cingulate regions. Understanding the key correlates is critical for identifying both modifiable factors that can be targeted in well-being interventions and fixed characteristics that identify those at-risk for reduced happiness. The widespread pattern of brain regions associated with happiness is consistent with the multifactorial nature of happiness and, given that the regions identified do not overlap with those vulnerable to cortical thinning, can help explain why subjective well-being, unlike other cognitive functions, is largely resistant to age-related decline.

Investigating Respiratory Disease Transmission Patterns Around the Figuil Cement Works

The objective of this research is to examine the dissemination of respiratory illnesses, exacerbated by the airborne pollutants emitted by the Figuil cement works, among the local population residing in the vicinity. The primary objective is to examine the impact of pollution, particularly the emission of fine particles and noxious gases, on the transmission of respiratory diseases such as asthma, chronic bronchitis and other lung disorders. The modified SEIR (Susceptible-Exposed-Infected-Recovered) epidemiological model is employed for the analysis of transmission dynamics within the community. This model incorporates environmental, health and demographic variables, thereby enabling the simulation of disease transmission as a function of varying pollution levels. Particular emphasis is placed on vulnerable groups, such as children and the elderly, due to immunosenescence, who are more likely to suffer from the adverse effects of pollution. The results will facilitate the formulation of efficacious strategies, including the implementation of awareness-raising campaigns and the introduction of sophisticated systems for the filtration and capture of pollutants at their source, such as fine particle filters or devices for the reduction of nitrogen oxides (NOx), with the objective of limiting the spread of respiratory diseases in at-risk areas and the formulation of suitable control measures.

Cognitive function and electrode mapping’s role in cochlear implant performance

Cognitive function and electrode mapping’s role in cochlear implant performance Amit Walia, Matthew Shew and Craig A. Buchman from Washington University School of Medicine, detail the role of cognitive function and electrode mapping in cochlear implant performance. In a previous article, we explored various factors influencing cochlear implant (CI) performance, including demographic, audiologic, and surgical variables, as well as the importance of cochlear health, as measured by electrocochleography. Beyond cochlear health, cognitive function, device function and surgical variables all play a role in performance. This section highlights the impact of cognitive function and device mapping to further refine and optimize CI outcomes.

Screening of musculoskeletal disorders and levels of depression in transgender people of Multan

Objective: To perceive transgender health issues by evaluating their susceptibility to musculoskeletal problems and depression. Method: The cross-sectional, analytical study was conducted from January to April 2023at the Government Girls Comprehensive Higher Secondary School, Multan, Pakistan, a school for transgenders, and comprised subjects aged 18-40 years. Body mass index was calculated for each subject, and further data was collected using the Standard Nordic Musculoskeletal Questionnaire, Beck Depression Inventory and Numeric Pain Rating Scale. Data was analysed using SPSS 25. Results: Of the 44 subjects, 26(59%) were transgender females and 18(41%) were transgender males. The overall mean age was 25.06±1.53. There were 17(39%) subjects who had received education, and 27(61%) were illiterate. Mean depression score was 24.7±11.5, and mean body mass index was 22.9±3.16. Mean pain intensity was 5.81±2.04. Correlation analysis revealed a complex relationship among age, gender, education, occupation and health variables (p<0.01). Conclusion: Musculoskeletal disorders and the level of depression were high and correlated with the occupation of transgender individuals. Key Words: Transgender persons, Musculoskeletal disorders, Social isolation, Depression.

Brick Kiln Emission Variability and Impact in Environment and Health

Brick Kiln Emission Variability and Impact in Environment and Health

Original Research: Exploring Black Nurses' Perceptions of Workplace Safety and Personal Health.

This study aimed to assess the perceptions of nurses who self-identify as Black or African American regarding their workplace health and safety and to explore how these perceptions are associated with their perceived personal health. Nurses practicing in unhealthy work environments can experience poorer physical and mental health. Recent civil unrest and ongoing dialogue about structural and systemic racism have prompted calls for greater efforts to understand the workplace perceptions and experiences of ethnic minority nurses, and how these influence nurses' personal well-being. But there is a dearth of relevant evidence concerning these nurses, including Black nurses. This cross-sectional, descriptive study involved analysis of secondary data collected from May 1, 2017, through December 31, 2019, by the American Nurses Association's HealthyNurse Survey (N = 19,131). We employed descriptive, bivariate, and multivariate analyses to examine the data for the 1,143 respondents who both self-identified as Black or African American and responded to all items concerning the major variable of personal health. Overall, respondents reported a slight tendency to agree or strongly agree that their practice environments were safe. When looking at various factors explaining personal health, the perception of workplace health and safety was found to be a significant contributing factor. The study findings suggest that, among Black nurses, perceptions about workplace health and safety are associated with perceived personal health. These findings underscore the importance of fostering healthy work environments.

Impact of physical activity on life satisfaction among middle-aged and older adults in China: A longitudinal national study.

This study examined the impact of physical activity on life satisfaction in middle-aged and older adults in China. Utilizing longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015 and 2018, a total of 6484 participants aged 45 or older were included in the analysis. Data were collected on sociodemographic, health, and lifestyle variables, physical activity, and life satisfaction. Physical activity was categorized into 3 levels: low (71%), moderate (25%), and high (4%). Ordinal logistic regression and subgroup analysis were used to examine the effect of baseline physical activity on life satisfaction, including the examination of interaction effects. After adjusting for age, gender, education, marriage, residence, smoking, alcohol use, depressive symptoms, and self-rated health at baseline (2015), compared to the moderate-intensity physical exercise group, those in the low-intensity group experienced significantly lower levels of life satisfaction on follow-up (2018). In the subgroup analyses, a significant negative effect of low-intensity physical activity on life satisfaction was found in all groups regardless of age, education, marital status, smoking, alcohol use, sleep duration, weight, presence of chronic diseases, or self-rated health. These results support the promotion of physical exercise to enhance life satisfaction among middle-aged and older adults in China.

Sensitivity analysis of human error in the steel industry: exploring the effects of psychosocial and mental health risk factors and burnout using Bayesian networks.

Human error and the high rates of fatalities and other occupational accidents in the steel industry are of significant global relevance. The aim of this study was to investigate the effect of psychosocial, mental health, and burnout risk factors on human error probabilities in an industrial environment using Bayesian networks. This cross-sectional study was conducted in 2023. The participants were 252 employees of a steel company. Error probabilities related to the tasks of participants were estimated using the Human Error Assessment and Reduction Technique (HEART). Other data was collected using a survey that consisted of demographic information, the Maslach Burnout Inventory, Depression Anxiety Stress Scales, and a short version of the Copenhagen Psychosocial Questionnaire. A theoretical model was drawn in GeNIe academic software (version 2.3). The results showed that all the studied variables were able to significantly affect the distribution of human error probabilities. Considering a distribution of 100% for the high state of these variables, the results showed that the greatest increases in error probability were related to two burnout dimensions: emotional exhaustion (29%) and depersonalization (28%). All the variables, with a probability of 100%, increased the probability of high human error probabilities by 46%. The most important variables in terms of their effect on human error probabilities were burnout dimensions, and these variables also had a mediation effect on the psychosocial and mental health variables. Therefore, preventive measures to control human error should first focus on managing the risks of burnout in workers. This, in turn, can also reduce the effect of psychosocial risk factors and mental health problems on human error in the workplace.

Perceived Cognitive Function in Neurosurgical Patients.

This study explores perceived cognitive function in preoperative cranial neurosurgical patients and its association with neuropsychological testing (NPT). A total of 96 patients were referred for NPT by neurosurgical service. Patients completed the Neuro-QoL Item Bank v2.0-Cognitive Function-Short Form (Neuro-QoL) to measure perceived cognitive function, as well as NPT. Linear regression (LR) models were analyzed for demographic variables (ie, age, sex, handedness, educational attainment, employment/academic status, candidacy vs baseline testing, and history of neurological, mental health, and developmental conditions) and NPT outcomes (ie, intellectual estimation, attention/working memory, processing speed, executive functioning, learning/memory, language, visual-spatial, anxiety symptoms, and depression symptoms). Significant predictors from the LR models were then combined into a single model to identify the most robust predictors of perceived cognitive function. Patients were aged 17 to 79 years (M = 49.64, SD = 18.56) and comprised 45 men and 51 women. The most common referrals for NPT were related to intracranial mass (39%), Chiari malformation type 1 (33%), and deep brain stimulation (20%). Results of the final LR model indicated mental health and developmental history, as well as elevated anxiety symptoms, significantly predicted 50.7% of the variance in perceived cognitive function (F = 30.91, P < .001). Patients referred to determine surgical candidacy reported significantly fewer cognitive complaints (P < .001) vs those referred for baseline testing by approximately 0.5 SDs. Perceived cognitive function in neurosurgical patients appears to be strongly predicted by demographic factors, with mental health variables being robust predictors. Perceived cognition is not a proxy for measured cognitive function.

Metabolic syndrome in the setting of obesity: impact on in-hospital complications and outcomes after total knee and hip arthroplasty.

This study aims to evaluate the impact of metabolic syndrome in the setting of obesity on in-hospital outcomes and resource use after total joint replacement (TJR). A retrospective analysis was conducted using the National Inpatient Sample from 2006 to the third quarter of 2015. Discharges representing patients aged 40 years and older with obesity (BMI > 30 kg/m2) who underwent primary TJR were included. Patients were stratified into two groups with and without metabolic syndrome. The inverse probability of treatment weighting (IPTW) method was used to balance covariates. The obese cohort with metabolic syndrome was significantly older, more likely to be female, had higher rates of Medicare insurance, and more likely to be non-Hispanic Black than the obese cohort without metabolic syndrome. In the unweighted analysis, patients with obesity and metabolic syndrome were more likely to experience cardiac, gastrointestinal, genitourinary, and postoperative anemia complications, had a longer length of stay, and were less likely to be discharged home compared to obese patients without metabolic syndrome. After adjusting for covariates using IPTW, patients with obesity and metabolic syndrome were more likely to experience postoperative anemia complications only and had lower rates of home discharge, but there were no significant differences in any other complication variables or length of stay. Given the variability of metabolic health in obesity, the development of tailored perioperative protocols and recommendations acknowledging this variability in metabolic health in obese patients would ultimately potentially benefit patients and improve outcomes of TJR.

12559 Objective Versus Subjective Measures Of Reproductive Development And Psychological Well-Being In Peri-Menarcheal Adolescents: A Pilot Study

Abstract Disclosure: K.C. McCormick: None. M.E. Lujan: None. J. Chang: None. L. Ipp: None. A. Alladeen: None. H. Lamar: None. J. Mendle: None. H. Vanden Brink: None. Introduction: Risk of psychopathology emerges during the pubertal and peri-menarcheal years; however objective physiological measures of maturation often differ from adolescents’ own reports of their development. Understanding how psychological symptoms emerge in relation to both objective and subjective evaluations of reproductive development can provide critical insights into mental health risk and variability in psychological symptom severity during the pre-menarcheal and early post-menarcheal years. Methods: 52 females 9-15 years old (n=16 pre-menarcheal, n=36 &amp;lt;2 years post-menarche) underwent a non-fasting blood draw for reproductive hormones (estradiol, anti-mullerian hormone (AMH), luteinizing hormone (LH), follicle stimulating hormone (FSH)), anthropometry, detailed reproductive and menstrual history, and a series of surveys to evaluate depression (CES-DC), anxiety (MASC), perceptions of pubertal-related change (POPS), and transdiagnostic psychological processes (rumination, emotional clarity) which can contribute to, and are risk factors for, psychopathology. Whether psychological symptoms are associated with objective measures (menarche, gynecological age, reproductive hormone concentrations) versus subjective measures (self-reported tanner stage, severity of dysmenorrhea) were contrasted using t-tests and Pearson Correlation Coefficient analyses (JMP Pro (v17)). Results: The majority of participants (26/36 post-menarcheal and 11/16 pre-menarcheal) exceeded the standard cut-off of 15 for depressive symptoms, consistent with research on mental health symptomatology in this cohort of youth. POPS scores were higher (39±10.9) in post-menarcheal versus pre-menarcheal (31±12.6) adolescents indicating post-menarcheal adolescents reported more puberty-linked change in their lives (Pttest=0.04). Lower emotional clarity was associated with higher AMH concentrations (r= -0.27, p=0.0944). Depressive symptoms tended to be greater (27+14.8) in those with moderate dysmenorrhea versus mild/no dysmenorrhea (19±11.1, Pttest=0.08). Depression (r=0.30, p=0.032) and anxiety symptoms (r=0.32, p=0.027), and rumination (r=0.30, p=0.033) were associated with higher self-reported Tanner scores; POPS was trending (r=0.25, p=0.0776). Neither estradiol nor FSH were associated with any measures of psychological well-being. Conclusion: Both objective measures of reproductive development and adolescent self-reports may help providers assess individual vulnerability to internalizing psychopathology, such as depression and anxiety. Additionally, given population level increases in depressive symptoms in adolescents, researchers should avoid utilizing simple cutoffs for depression and anxiety, which lack specificity and overlook critical variability which can further elucidate mental and physical health dynamics. Presentation: 6/2/2024

Probing the oral-brain connection: oral microbiome patterns in a large community cohort with anxiety, depression, and trauma symptoms, and periodontal outcomes

The role of the oral microbiome in mental health has recently been appreciated within the proposed oral-brain axis. This study examined the structure and composition of the salivary microbiome in a large-scale population-based cohort of individuals reporting mental health symptoms (n = 306) compared to mentally healthy controls (n = 164) using 16S rRNA sequencing. Mental health symptoms were evaluated using validated questionnaires and included depression, anxiety, and posttraumatic stress disorder (PTSD), with accompanying periodontal outcomes. Participants also indicated current or previous diagnoses of anxiety, depression, periodontitis, and gingivitis. Mental and periodontal health variables influenced the overall composition of the oral microbiome. PTSD symptoms correlated with a lower clr-transformed relative abundance of Haemophilus sputorum and a higher clr-transformed relative abundance of Prevotella histicola. The clr-transformed relative abundance of P. histicola was also positively associated with depressive scores and negatively associated with psychological quality of life. Anxiety disorder diagnosis was associated with a lower clr-transformed relative abundance of Neisseria elongate and a higher clr-transformed relative abundance of Oribacterium asaccharolyticum. A higher clr-transformed relative abundance of Shuttleworthia and lower clr-transformed relative abundance of Capnocytophaga were evident in those who reported a clinical periodontitis diagnosis. Higher Eggerthia and lower Haemophilus parainfluenzae clr-transformed relative abundances were associated with reported clinical periodontitis diagnoses and psychotherapeutic efficacy. Functional prediction analysis revealed a potential role for tryptophan metabolism/degradation in the oral-brain axis, which was confirmed by lower plasma serotonin levels across symptomatic groups. This study sheds light on the intricate interplay between oral microbiota, periodontal and mental health outcomes, and a potential role for tryptophan metabolism in the proposed oral-brain axis, emphasizing the need for further exploration to pave the way for novel therapeutic interventions and predicting therapeutic response.

8714 Impact of Adrenalectomy Versus Conservative Therapy On Frailty In Mild Autonomous Cortisol Secretion: A Prospective Multi-Center Cohort Study

Abstract Disclosure: M. Bassiony: None. P. Dogra: None. L. Šambula: None. J. Saini: None. U. Ambroziak: None. D. Kastelan: None. I. Bancos: None. Background: Frailty is characterized by a multi-system decline and increased vulnerability to adverse health outcomes. We have recently shown that patients with mild autonomous cortisol secretion (MACS) demonstrate a higher prevalence of frailty compared to patients with nonfunctioning adrenal adenomas (NFA). Objective: To determine the impact of adrenalectomy versus conservative management in patients with MACS, as compared to patients with NFA. Design: Multi-center, prospective cohort study (2019-2023). Methods: Adults with NFA and MACS were assessed for frailty at baseline and 1-year post-adrenalectomy, or conservative follow up. Frailty was assessed by frailty index (FI) that encompasses 47 health variables (comorbidities, symptoms, daily living activities). Patients with FI &amp;gt;0.25 were classified as frail. MACS was defined as post-dexamethasone cortisol&amp;gt;1.8 mcg/dL. Results: Paired frailty assessments were performed in 226 patients (MACS:117 and NFA:109). At baseline, patients’ median age was 63 years (interquartile range, IQR 55-78) and 113 (50%) were women, without differences between patients with MACS vs NFA. In conservatively treated patients with NFA (n=106) and MACS (n=61), baseline FI (median 0.15 vs 0.16, p=0.190) and frailty prevalence (18% vs 20%, p=0.846) were similar between groups. At follow up, patients with MACS demonstrated an increase in FI (mean of 0.013 vs -0.018 in patients with NFA, p=0.009). In conservatively treated patients, and after excluding outliers, post-dexamethasone cortisol positively correlated with a higher delta FI at follow up (estimate 0.015, p=0.01). Compared to conservatively treated, patients with MACS treated with adrenalectomy (n=56) were younger (median age of 58 vs 67 years, p=0.0002), had a similar post-dexamethasone cortisol (median 3.4 vs 2.8 mcg/dL, p=0.853), a higher FI (median 0.26 vs 0.15, p value &amp;lt;0.0001) and frailty prevalence (52% vs 20% P=0.0003) at baseline. At follow up, patients with MACS treated with adrenalectomy showed improved FI when compared to conservatively treated (mean delta FI of -0.025 vs 0.014, p=0.017). Conclusions: Patients with MACS treated conservatively demonstrate an accelerated frailty when compared to patients with NFA. In contrast, frailty improves in patients with MACS treated with adrenalectomy. Presentation: 6/2/2024

Psychological burden and depressive symptoms in caregivers of hemato-oncological patients: the role of medical visits

AbstractInformal caregivers of patients with cancer are known to experience extensive burdens, whereas this issue remains unresolved in the setting of hematological malignancies. Yet, these diseases are characterized by a prolonged course, numerous relapses, and implementation of multiline therapy, administered in outpatient facilities. This study aimed to assess the factors contributing to burden and depressive symptoms in informal caregivers of patients with hematological malignancies, while concentrating on the role of medical visits. The study population comprised patients and their caregivers, recruited at the Rambam Hematology Ambulatory Unit. Participants completed validated questionnaires, including the Center for Epidemiologic Studies Depression Scale and the Zarit Caregiver Burden Interview. The cohort (n = 185) included 115 patients (average age, 62.8 ± 14.5 years; 54 males) and 70 caregivers. Among caregivers, 80% reported high psychological burden, and 50% reported significant depressive symptoms. The burden was higher if caregivers were females and if patients were less educated, less healthy, and more depressed. The caregiver burden and depressive symptoms were significantly linked, and the medical visit frequency predicted the level of both. The caregiver burden fully mediated the link between the independent variables of self-rated health and medical visits and the dependent variable of caregiver depressive symptoms. Informal caregivers of ambulatory patients with hemato-oncological malignancies experience high levels of psychological burden and depressive symptoms. This is partly attributed to the medical visit frequency. Hence, a decrease in the number and length of such visits via the implementation of advanced technology could essentially reduce burden and depressive symptoms of caregivers, without compromising patient outcomes.

The health of cultural values and mahinga kai in the Te Wairoa-Hōpūpū-Hōnengenenge-Mātangirau, Wairoa river catchment and the impacts of sediment

ABSTRACT Te Wairoa Hōpūpū Hōnengenenge Mātangirau (Wairoa River) and its tributaries are significant to the iwi and hapū of Te Rohe o Te Wairoa in Wairoa, an area spanning northern Hawke’s Bay and southern Gisborne located on the Eastern side of Aotearoa-New Zealand’s (A-NZ) North Island. The Wairoa River is valued ecologically and for recreation and mahinga kai (food and resource gathering). The river is also affected by excess sediments. In this paper we present a cultural values framework developed in Wairoa and adapted to focus on the awa (river). Ninety two cultural value assessments were conducted with 55 people along reaches of the Wairoa river and the Waiau, its principal tributary. The data reveal considerable spatial and temporal variability in cultural health and add to knowledge of the direct and indirect impacts of sediment on cultural values. Furthermore, the data highlight the resiliency of cultural values of connectedness despite degradation to the environment, and that a range of methods can be employed to support or enhance the health of cultural values to complement water quality improvements. The use of this framework responds to the increasingly recognised need to include diverse perspectives in monitoring programmes and demonstrates that Māori-led cultural monitoring is a means to produce credible, relevant and legitimate information to support policy and planning.

Can migraine be triggered by unemployment in France? A Bi-Probit/Multinomial probit approach

ABSTRACT Migraine is a major public health issue with massive human, économic and social costs, particularly for women. However, the effects of the labour market on this disease are to date little studied. Because unemployment may trigger migraine due to induced stress, we present in this empirical study estimates of the impact of unemployment on migraine using French household data. The causal impact of unemployment is established using instrumental variable methods. We use a rich database (Health and Professional Itinerary Survey) that allows to measure the presence of migraine, mental health and labour market variables, including working conditions. We show that unemployment increases the probability of migraine among women, with an important marginal effect of 14.4% points. We also show that although the issue is unemployment, inactivity must also be included and instrumented, which leads to estimate a generalization of the bi-probit model in which the first step is a multinomial probit. From a public policy perspective, the results show that prevention and care policies must be put in place and target unemployed women.

The Association Between Social Isolation and Incident Dementia Among Older Adults: Evidence From National Health and Aging Trend Study.

Older adults are vulnerable to social isolation, making it crucial to understand its impact on dementia risk. Yet, existing evidence lacks consistency, with studies using varied measures of social isolation and overlooking potential confounders. We aim to investigate the associations between social isolation and dementia risk among older adults, hypothesizing that this association may diminish after adjusting for confounding factors. We used 2 977 community-dwelling older adults who had no dementia in 2015 from National Health and Aging Trends. Group-based trajectory modeling was used to analyze the trajectories of social isolation, depression, and anxiety from 2011 to 2015. Cox proportional hazards regression models were then employed to estimate the association between social isolation trajectories and incident dementia from 2015 to 2022, adjusting for demographic variables, depression, anxiety, self-rated health, smoking status, and cardiovascular disease-related variables. Three social isolation trajectories were identified: minimal, moderate, and high levels of social isolation. During a mean follow-up of 3.6 years, 19.0% of participants were diagnosed with dementia. When only demographics were adjusted, individuals in the moderate social isolation group were 22% less likely to develop dementia compared to those with high social isolation. This association between social isolation and incident dementia became nonsignificant after further adjustment for depression, anxiety, and health indicators. The association between social isolation and dementia risk may be mediated by factors such as depression and other health indicators.

Traditional Indigenous-Amazonian Therapy Involving Ceremonial Tobacco Drinking as Medicine: A Transdisciplinary Multi-Epistemic Observational Study.

Although the tobacco plant has been employed as a medicinal and sacred herb by Indigenous cultures across the Americas, its usage drastically changed after the 15th-century colonial arrival; its large-scale commodification and global marketing once brought to Europe lead to hedonic and addictive uses harmful to health. As a consequence, tobacco smoking is now one of the largest public health problems worldwide. However, in the Peruvian Amazon, a region of origin of tobacco species, Indigenous healers still know how to use the plant for therapeutic purposes. Due to a general disregard of Indigenous knowledge and stigma, these uses have however not so far been clinically investigated. We hence conducted for the first time a clinical field study assessing a sample of patients treated by a traditional healer specialized in tobacco in the Peruvian Amazon (observational design, pilot study, N = 27). The study was conducted within a transdisciplinary and multi-epistemic medical frame, in close partnership with an Amazonian healer. We used validated self-report scales to quantitatively assess mental health variables before and after the weeklong treatment, and mixed-methods to report experienced effects. Paired-samples t-tests comparing pre- and post-treatment scores revealed significant reductions in anxiety, depression, perceived stress, and general symptom indicators. Experienced effects included initial physical discomfort, followed by psychologically or existentially/spiritually significant insights. Our findings point to a sophisticated therapeutic approach based on Indigenous knowledge of tobacco applications, which should be further investigated. The study also contributes to the burgeoning scientific field on therapeutic uses of contentious psychoactive plants.