Health Of People Research Articles

The association between green space around schools, screen time for entertainment, and adolescent depressive symptoms: A nationwide study from China

BackgroundNatural green environments are beneficial to people's mental health, while too much screen time may be harmful to adolescents' mental health. However, it is not clear how green spaces and screen time affect mental health together in adolescents. MethodsA total of 22,868 adolescents were recruited from October to December 2021 in eight cities in China, through multistage cluster sampling. The Patient Health Questionnaire (PHQ-9) was used to investigate adolescents' depressive symptoms, and the Normalised Vegetation Index for the 200m, 500m and 1000m buffer zones around the school represents the green cover around the school. We used binary logistic regression to analyse the association between green space, screen time and depressive symptoms. ResultsIn fully adjusted models, the highest quartile of NDVI in the 200m, 500m and 1000m buffer zones around the school was a protective factor for depressive symptoms. For less than 2 h of recreational screen time, the highest quartiles of the NDVI and the association with depressive symptoms were negatively correlated for the 200m, 500m and 1000m buffer zones (NDVI200: 0.904(0.848–0.964)), NDVI500: 0.863(0.808–0.921), NDVI1000: 0.862(0.808–0.920)). The highest quartiles of NDVI in all buffers were not associated with depressive symptoms when the screen time was >2 h. The association between green space and depressive symptoms at lower recreational screen time was observed to be stronger in the group of adolescents with a lower family economic status (NDVI200: 0.780(0.695–0.876), NDVI500: 0.838(0.748–0.938), NDVI1000: 0.783(0.698–0.879)). No potential gender differences were observed. ConclusionsFor adolescents with less than 2 h of recreational screen time per day, the greenery around the school had a protective effect on their mental health, especially for adolescents from economically disadvantaged families. Green spaces around schools are significant in improving health inequities.

Evaluating a volunteer 'Health Champions' intervention supporting people with severe mental illness to manage their physical health: feasibility hybrid randomised controlled trial.

People with severe mental illness (SMI) have worse physical health than the general population. There is evidence that support from volunteers can help the mental health of people with SMI, but little evidence regarding the support they can give for physical health. To evaluate the feasibility of an intervention where volunteer 'Health Champions' support people with SMI in managing their physical health. A feasibility hybrid randomised controlled trial conducted in mental health teams with people with SMI. Volunteers delivered the Health Champions intervention. We collected data on the feasibility of delivering the intervention, and clinical and cost-effectiveness. Participants were randomised by a statistician independent of the research team, to either having a Health Champion or treatment as usual. Blinding was not done. We recruited 48 participants: 27 to the intervention group and 21 to the control group. Data were analysed for 34 participants. No changes were found in clinical effectiveness for either group. Implementation outcomes measures showed high acceptability, feasibility and appropriateness, but with low response rates. No adverse events were identified in either group. Interviews with participants found they identified changes they had made to their physical health. The cost of implementing the intervention was £312 per participant. The Health Champion intervention was feasible to implement, but the implementation of the study measures was problematic. Participants found the intervention acceptable, feasible and appropriate, and it led them to make changes in their physical health. A larger trial is recommended, with tailored implementation outcome measures.

Noise sensitivity model- a qualitative investigation

Noise sensitivity is a concept used to explain the different effects of noise on people's health. Numerous definitions of noise sensitivity have been proposed, though none are universally accepted. Hence, a "system model of noise sensitivity" was developed, suggesting that noise sensitivity may contain a set of factors. Based on this, we conducted semi-structured interviews to investigate noise sensitivity and its factors and used qualitative research methods to analyse the data. More factors of noise sensitivity were discovered, and a revised system model was developed. This expanded model provides a more complete definition of noise sensitivity. We hope the improved understanding could lead to identifying ways of coping with noise issues. In the future, more diverse and individualized approaches could be developed to address the many different aspects of noise sensitivity.

Understanding the medication regimens associated with anticholinergic burden in older people's mental health services in the UK.

Medications with anticholinergic properties are associated with a range of adverse effects that tend to be worse in older people. To investigate medication regimens with high anticholinergic burden, prescribed for older adults under the care of mental health services. Clinical audit of prescribing practice, using a standardised data collection tool. Fifty-seven trusts/healthcare organisations submitted data on medicines prescribed for 7915 patients: two-thirds (66%) were prescribed medication with anticholinergic properties, while just under a quarter (23%) had a medication regimen with high anticholinergic burden (total score ≥3 on the anticholinergic effect on cognition (AEC) scale). Some 16% of patients with a diagnosis of dementia or mild cognitive impairment were prescribed medication regimens with a high anticholinergic burden, compared with 35% of those without such diagnoses. A high anticholinergic burden was mostly because of combinations of commonly prescribed psychotropic medications, principally antidepressant and antipsychotic medications with individual AEC scores of 1 or 2. Adults under the care of older people's mental health services are commonly prescribed multiple medications for psychiatric and physical disorders; these medication regimens can have a high anticholinergic burden, often an inadvertent consequence of the co-prescription of medications with modest anticholinergic activity. Prescribers for older adults should assess the anticholinergic burden of medication regimens, assiduously check for adverse anticholinergic effects and consider alternative medications with less anticholinergic effect where indicated. The use of a scale, such as the AEC, which identifies the level of central anticholinergic activity of relevant medications, can be a helpful clinical guide.

The effectiveness of acceptance and commitment therapy in reducing the symptoms of complicated grief, corona disease anxiety, and improving the quality of life in the survivors of the deceased due to COVID-19

BACKGROUND: COVID-19 is an infectious disease that has threatened the physical and mental health of people and in many cases leads to death. The present study investigated the effectiveness of acceptance and commitment therapy (ACT) in reducing the symptoms of complicated grief, and corona disease anxiety, and improving the quality of life in the survivors of the deceased due to COVID-19. MATERIALS AND METHODS: The research method was an experimental design with pre-test, post-test, and follow-up with a control group and random assignment to the intervention and the control groups. Thirty-eight people who met the study criteria were selected as a sample and assigned to the two intervention and control groups using a simple randomization method (19 people in each group). Measures included the complex grief scale, the coronavirus anxiety scale, and the short form of the World Health Organization quality of life scale. Then, mixed analysis of variance was used to compare the average variables between the two groups. Also, the independent t-test was used to compare the mean quantitative outcomes between the two groups. RESULTS: The results showed that there were significant changes over time between the experimental and control groups (with a small effect coefficient) in complicated grief symptoms (P < 0.05), corona disease anxiety (P = 0.001), and quality of life (P = 0.001). Also, the results of all three variables showed that there were significant differences between pre-test and post-test (P < 0.05) and between pre-test and follow-up (P value < 0.05), but the difference between post-test and follow-up was insignificant. CONCLUSIONS: ACT has significant effects on reducing the symptoms of complicated grief and corona disease anxiety as well as on improving the quality of life in the survivors of the deceased due to COVID-19.

Physical and mental health trajectories: A longitudinal SF-36 analysis in Alpha-1 antitrypsin deficiency-associated COPD

BackgroundThe Short Form 36-Item Health Survey (SF-36) is a health-related quality of life (HRQoL) measure validated in people with chronic obstructive pulmonary disease (COPD). While physical health is often more impaired than mental health in people with COPD, research on alpha-1 antitrypsin deficiency (AATD)-associated COPD is limited. This longitudinal study examines changes in physical and mental health in individuals with AATD and associated factors. MethodsAnalyses included participants of AlphaNet, a disease management program for individuals with AATD-associated lung disease who are prescribed augmentation therapy. Norm-based SF-36 scores for mental and physical component summaries (MCS and PCS) and 8 scales were analyzed. Linear mixed models evaluated mean changes in SF-36 scores over time. ResultsThe study included 2165 participants (mean age 56.9 ± 10.0 years, 47.0 % female). At enrollment, mean PCS score was 37.5 ± 9.6, and mean MCS score was 51.9 ± 10.5. Mean mMRC dyspnea score was 2.3 ± 1.3; 54.6 % had ≥2 exacerbations annually, and 46.5 % used oxygen regularly. Average follow-up was 6.6 ± 3.2 years. The HRQoL remained stable; MCS improved by 0.16 points/year (p < 0.0001), while the PCS score declined by 0.49 points/year (p < 0.0001). Subscales followed similar trends. ConclusionsAt baseline, mental HRQoL scores were higher than physical HRQoL scores, indicating better mental health than physical health in this cohort with AATD-associated lung disease. Stable HRQoL with a slight improvement in mental scores over time and a small decrease in physical scores may be a unique feature of this cohort. Further studies are needed to correlate these findings with disease-specific instruments and patient physiology.

The Pathways to Community Living Initiative (PCLI) for older adults: implementation and outcomes.

To describe implementation of the Pathways to Community Living Initiative (PCLI) within an Older People's Mental Health (OPMH) service. A retrospective observational study was conducted. Implementation comprised partnership with a specialist Residential Aged Care Facility (RACF). Data were obtained from Clinical Advisory Committee (CAC) discussion and minutes, the PCLI database, and consumer medical records. Eighteen consumers were accepted onto the program between April 2019 and March 2023. Their PCLI and rating scale outcomes alongside interventions facilitating placements are described. Interventions included OPMH case management, wide-reaching liaison, and inservices. Challenges included communication, confusion regarding roles, and differing views on capacity to accommodate complex consumers. Solutions included streamlining communication, including clinical updates in the CAC, facility appointment of a lead PCLI-nurse, and targeted RACF education. Considered interventions strengthened the OPMH and specialist RACF partnership over time. Clarification of professional roles and intersection with other services was crucial. Successful placement for PCLI consumers required consideration of personalised needs and existing resident mix, liaison with stakeholders, and targeted staff training. These strategies may apply to other health services implementing similar initiatives supporting community placements for OPMH consumers with complex needs.

Neurodevelopmental outcomes of school-age children conceived after hysterosalpingography with oil-based or water-based iodinated contrast: long-term follow-up of a nationwide randomized controlled trial.

Does preconceptional exposure to oil-based iodinated contrast media during hysterosalpingography (HSG) impact children's neurodevelopment compared with exposure to water-based alternatives? Our study found no large-sized effects for neurodevelopment in children with preconceptional exposure to oil-based iodinated contrast media during HSG compared with water-based alternatives. HSG is widely used as a diagnostic tool in the female fertility work-up. Tubal flushing with oil-based iodinated contrast has been shown to enhance fertility outcomes in couples with unexplained infertility, increasing the chances of pregnancy and live birth compared with water-based alternatives. However, oil-based contrast contains higher doses of iodine and has a longer half-life, and concerns exist that iodinated contrast media can affect women's iodine status and cause temporary (sub)clinical hypothyroidism in mothers and/or foetuses. Considering that thyroid hormones are vital to embryonal and foetal brain development, oil-based contrast media use could increase the risk of impaired neurodevelopment in children conceived shortly after HSG. Here we examine neurodevelopmental outcomes in school-aged children conceived after HSG. This is a long-term follow-up of the H2Oil trial in which oil-based or water-based contrast was used during HSG (Netherlands; 2012-2014; NTR3270). Of 369 children born <6 months after HSG in the study, we contacted the mothers of 140 children who gave consent to be contacted for follow-up. The follow-up study took place from January to July 2022 (NCT05168228). The study included 69 children aged 6-9 years who were conceived after HSG with oil-based (n = 42) or water-based contrast (n = 27). The assessments targeted intelligence (Wechsler Intelligence Scale for Children), neurocognitive outcomes (computerized neurocognitive tests), behavioural functioning (parent and teacher questionnaires), and academic performance. Linear regression models, adjusted for age, sex, and parental educational attainment were employed to compare groups. School-aged children born to mothers after oil-based contrast HSG did not significantly differ from children born to mothers after water-based contrast HSG, in regards to intelligence, neurocognitive functioning, behavioural functioning, or academic performance, with the exception of better performance for visuomotor integration functions in children exposed to oil-based contrast preconception. After exploratory correction for multiple comparisons, none of the group differences was statistically significant. The small sample size of this follow-up study limited statistical power. This study provides evidence for the absence of large-sized differences between preconceptional exposure to the two contrast media types but does not rule out more subtle effects on neurodevelopment compared to naturally conceived children without preconceptional exposure to HSG. This study contributes to our knowledge about the long-term effects of different types of iodinated contrast media used in fertility work-up, indicating that choosing oil-based over water-based iodinated contrast media is unlikely to have major effect on the long-term neurodevelopmental outcomes of children conceived shortly after HSG. However, further research should focus on the overall safety of iodine exposure during HSG, comparing children conceived after HSG to those conceived naturally as both types of contrast contain high amounts of iodine. The original H2Oil randomized controlled trial was an investigator-initiated study that was funded by the two academic hospitals now merged into the Amsterdam University Medical Centre. The current follow-up study (Neuro-H2Oil) is funded through a research grant awarded to the authors by the Amsterdam Reproduction & Development (AR&D) research institute. S.K. is funded by a AMC MD/PhD Scholarship from the Amsterdam UMC. S.K. reports holding voluntary roles in the civil society organizations Universities Allied for Essential Medicines and People's Health Movement. V.M. reports receiving travel and speaker fees as well as research grants from Guerbet, Merck and Ferring. K.D. reports receiving travel and speaker fees as well as research grants from Guerbet. BWM is supported by a NHMRC Investigator grant (GNT1176437) and reports consultancy, travel support and research funding from Merck, consultancy for Organon and Norgine, and holding stock from ObsEva. The other authors report no conflict of interest. NCT05168228.

Stress Assessment for Augmented Reality Applications Based on Head Movement Features.

Augmented reality is one of the enabling technologies of the upcoming future. Its usage in working and learning scenarios may lead to a better quality of work and training by helping the operators during the most crucial stages of processes. Therefore, the automatic detection of stress during augmented reality experiences can be a valuable support to prevent consequences on people's health and foster the spreading of this technology. In this work, we present the design of a non-invasive stress assessment approach. The proposed system is based on the analysis of the head movements of people wearing a Head Mounted Display while performing stress-inducing tasks. First, we designed a subjective experiment consisting of two stress-related tests for data acquisition. Then, a statistical analysis of head movements has been performed to determine which features are representative of the presence of stress. Finally, a stress classifier based on a combination of Support Vector Machines has been designed and trained. The proposed approach achieved promising performances thus paving the way for further studies in this research direction.

The impact of education as a proxy for lifestyle habits on reducing the association with dementia prevalence in the Southern Region of Brazil.

This study aimed to investigate the prevalence of dementia among older adults from Florianópolis, in the Southern Region of Brazil. Data were originally drawn from the Epifloripa Aging Cohort Study, a representative and community-based survey designed to evaluate older people's health. This cross-sectional study was conducted in two phases: the community-screening phase, in which the Mini-Mental State Examination and a multifunctional scale were administered to older subjects and close informants, respectively; and the hospital-diagnosis phase, when the Cambridge Examination and the National Institute on Aging criteria were used. Adjustment for screening accuracy was made in order to estimate dementia prevalence. Of 1184 subjects evaluated in the community, 243 were screened for the diagnosis phase, in which 47 were identified with dementia, resulting in a crude prevalence of 4.5% (95% CI: 3.241-5.758) and an estimated prevalence of 9.2% (95% CI: 7.446-10.954). Dementia was associated with older ages, lower education levels, and the presence of stroke. Mild alcohol use (in comparison with no alcohol use), community-group practice, internet use and a higher level of physical activity, rather than education, decreased the odds ratio for dementia. Education was directly associated with these lifestyle habits. Prevalence was lower than that in previous studies in the country, and multivariate analysis reinforced the importance of lifestyle in preventing cognitive disorders in the older population.

Efficacy and safety of oral versus intravenous cyclophosphamide in treatment of connective tissue disease-related interstitial lung disease.

Interstitial lung disease (ILD) resulting from connective tissue disease (CTD) greatly undermines people's health. Cyclophosphamide (CYC) is a widely used agent in treating CTD-ILD. We compared the efficacy and safety of oral and intravenous CYC in CTD-ILD treatment. The retrospectively enrolled CTD-ILD patients were divided into the oral and intravenous CYC groups. The chest high-resolution computed tomography examination, forced vital capacity (FVC), lung carbon monoxide diffusion capacity (Dlco) determinations, and 6 min walk test (6MWT) were performed pre-treatment and at the 3rd, 6th, and 12th months posttreatment. Radiographic ILD severity was assessed using the Warrick score. Krebs Von den Lungen-6, surfactant protein A (SP-A), SP-D, and erythrocyte sedimentation rate (ESR) before and at the 12th month post-treatment were determined. CYC cumulative dose and occurrence of adverse reactions during treatment were recorded. CYC cumulative dose in the intravenous CYC group was reduced. Compared with oral CYC treatment, intravenous CYC caused decreased Warrick score and increased FVC and 6MWT at the 6th month, and elevated DLco at the 3rd and 6th months posttreatment. SP-A, SP-D and ESR levels in both groups were reduced 12 months posttreatment, with a more evident decrease in the intravenous CYC group. Intravenous CYC had lower total adverse reaction incidence. Compared with oral CYC, intravenous CYC decreases Warrick score and increases FVC and 6MWT at 6 months posttreatment, and reduces SP-A, SP-D, and ESR levels after 12 months of treatment, which shows low CYC cumulative dose and adverse reaction incidence in treating CTD-ILD.

A Framework for Studying EU Health Policy through a Political Determinants of Health Lens: The Case of the European Health Union

Context: The COVID-19 pandemic has highlighted how the European Union (EU) impacts national health systems and people's health. In November 2020, the European Commission launched the European Health Union (EHU) to better coordinate and maximize EU member states’ abilities to deal with cross-border health threats. This article scrutinizes the early institutionalization of the EHU and its implications for EU health policy as a political determinant of health (PDoH). Methods: The article explores how EU health policy may be appreciated from a PDoH perspective. It draws from EU documents and existing research to analyze the early-stage institutionalization of the EHU. The study complements this policy output–focused perspective with an outcome-based exploratory assessment of EU health policy as a PDoH focusing on three examples: joint vaccine procurement, health reforms and investments under the Recovery and Resilience Facility, and the development of a European Health Data Space. Findings: The article shows that the policy change triggered by the EHU and the potential impact on citizens’ health are not necessarily congruent. Modest change can have a potentially strong impact on health outcomes and vice versa. Conclusions: The article argues that the PDoH perspective provides a useful approach that is complementary to policy output–based perspectives, allowing for a more comprehensive assessment of the EU's role in health.

Prevalence and Association of Obesity, Depression, and Psychological Stress Among the Population of Saudi Arabia

Background: Obesity, stress, and depression are widespread global issues that have a significant impact on people's personal and public health. Studies reveal that the incidence of anxiety and sadness is significantly higher in obese people. Purpose: This study aimed to find ‏the prevalence and association of obesity, depression, and psychological stress among the population of Saudi Arabia. Methods: A cross-sectional study involving the society in general Saudi Arabian population that was conducted. A self-administered questionnaire is disseminated to the populace through an online platform. Results: About 72.1 percent of the 1075 respondents were female, while 52.6 percent were between the ages of 21 and 30. The proportion of obese individuals amounted to 20.6%. In contrast to melancholy (39.4%), psychological tension was present at a prevalence of 77.8%. A statistically significant correlation was observed between stress and depression; however, no such correlation was found between depression and overweight or obesity. Conclusion: Our study indicates that, contrary to what the literature suggests, numerous stressors rather than melancholy may be the cause of obesity rather than a risk factor for the condition. Further investigation is required to ascertain the correlation between psychological tension, obesity, and melancholy.

The Impact of Lawn Bowls Participation on Exercise Immersion and Mental Health of People with Physical Disabilities

The Impact of Lawn Bowls Participation on Exercise Immersion and Mental Health of People with Physical Disabilities

Time Series Forecasting of Air Quality Index in Lahore : A Machine Learning Perspective with Facebook Prophet Model

This research investigates the rising problem of air pollution, which is a serious issue affecting people's health and the environment on a global scale. Focusing on Lahore, Pakistan, a city facing severe pollution, the research examines the Air Quality Index (AQI) from May 2019 to December 2023. Using the Facebook Prophet model for time-series forecasting, the analysis reveals trends at monthly, weekly, and hourly intervals. Peak AQI concentrations are identified in winter months, notably December and January, aligning with hazardous smog levels. Weekly trends show minimum AQI on weekends, particularly Saturday and Sunday. The hourly trend points to peak AQI concentrations between 7:00 and 09:00 AM, correlating with morning traffic and emphasizing the role of vehicular emissions in air quality degradation. These forecasts are crucial for anticipating and mitigating the adverse impact of air pollution on human health. This research underscores the critical need for comprehensive strategies to address air pollution, acknowledging the Lahore High Court and Government's initiatives, such as artificial rain experimentation, closure of commercial markets by 10 PM, ban on cutting trees and smoke-emitting vehicles. In summary, this research significantly contributes to understanding and tackling the increasingly urgent challenges associated with air quality.

Why Are Young People Willing to Pay for Health? Chained Mediation Effect of Negative Emotions and Information Seeking on Health Risk Perception and Health Consumption Behavior.

The perception of health risks can influence people's health behaviors. However, in the context of modern consumer society, few people delve into in-depth discussions on health consumption as a form of health protection behavior. Inspired by the Health Belief Model and Protection Motivation Theory, this study interprets health consumption behavior as a new form of health protection behavior. A survey was conducted on a sample of Chinese youth (N = 885) to explore the mechanisms of action between health risk perception and health consumption behavior using structural equation modeling. The study found that: (1) health risk perception has a significant positive impact on the health consumption behavior of young people; (2) negative emotions and information seeking play mediating roles respectively in the mechanism of the impact of health risk perception on health consumption behavior; and (3) in addition to their individual mediating roles, negative emotions and information seeking behavior collectively play a chained mediation role in this process. Implications of these results, both theoretical and practical, are further discussed.

Lung field-based severity score (LFSS): a feasible tool to identify COVID-19 patients at high risk of progressing to critical disease.

Coronavirus disease 2019 (COVID-19) still poses a threat to people's physical and mental health. We proposed a new semi-quantitative visual classification method for COVID-19, and this study aimed to evaluate the clinical usefulness and feasibility of lung field-based severity score (LFSS). This retrospective study included 794 COVID-19 patients from two hospitals in China between December 2022 and January 2023. Six lung fields on the axial computed tomography (CT) were defined. LFSS and eighteen clinical characteristics were evaluated. LFSS was based on summing up the parenchymal opacification involving each lung field, which was scored as 0 (0%), 1 (1-24%), 2 (25-49%), 3 (50-74%), or 4 (75-100%), respectively (range of LFSS from 0 to 24). Total pneumonia burden (TPB) was calculated using the U-net model. The correlation between LFSS and TPB was analyzed. After performing logistic regression analysis, an LFSS-based model, clinical-based model and combined model were developed. Receiver operating characteristic curves were used to evaluate and compare the performance of three models. LFSS, age, chronic liver disease, chronic kidney disease, white blood cell, neutrophils, lymphocytes and C-reactive protein differed significantly between the non-critical and critical group (all P<0.05). There was a strong positive correlation of LFSS and TPB (Pearson correlation coefficient =0.767, P<0.001). The area under curves of LFSS-based model, clinical-based model and combined model were 0.799 [95% confidence interval (CI): 0.770-0.827], 0.758 (95% CI: 0.727-0.788), and 0.848 (95% CI: 0.821-0.872), respectively. The LFSS derived from chest CT may be a potential new tool to help identify COVID-19 patients at high risk of progressing to critical disease.

Transcutaneous Electrical Acupoint Stimulation for Elders with Amnestic Mild Cognitive Impairment: A Randomized Controlled Pilot and Feasibility Trial

Background: Amnestic mild cognitive impairment (aMCI) is an important window of opportunity for early intervention and rehabilitation in dementia. The aim of this study was to investigate the feasibility and effect of delivering transcutaneous electrical acupuncture stimulation (TEAS) intervention to elders with aMCI. Methods: A total of 61 aMCI patients were randomly allocated into the intervention group (receiving a 12-week TEAS) and control group (receiving health education). The feasibility outcomes included recruitment rate, retention rate, adherence rate, and an exploration of patients’ views and suggestions on the research. The effective outcomes included cognitive function, sleep quality, and life quality, which were measured by the Montreal cognitive assessment scale (MoCA), auditory verbal learning test—Huashan version (AVLT-H), Pittsburgh sleep quality index (PSQI), and quality of life short-term-12 (QoL SF-12). Results: The recruitment rate, retention rate, and adherence rate were 67.35%, 92.42%, and 85.29%, respectively. Most aspects of the research design and administration of the TEAS intervention were acceptable. The quantitative analysis suggests that compared with the control group, the scores of MoCA, AVLT-H, and SF-12 (mental component summary) were significantly better (p &lt; 0.05); however, the differences were not statistically significant in PSQI and SF-12 (physical component summary) (p &gt; 0.05). Conclusions: The findings demonstrated that the study was feasible. TEAS awas possible for enhancing cognitive function and mental health in people with aMCI.

The societal cost of 'unwanted' loneliness in Spain.

Unwanted loneliness negatively affects people's health and quality of life, increasing morbidity and the risk of premature death; this situation can generate major social costs. The aim of this study is to estimate the social costs of loneliness in Spain for 2021: both tangible costs -monetary value of health costs and production losses- and intangible costs -Quality Adjusted Life Years (QALYs). To estimate costs not derived from mortality, information from a sample of 400 people with unwanted loneliness was compared with that derived from two samples of the general population obtained from the Spanish National Health Surveys. To estimate the costs associated with premature deaths, the population attributable fraction was calculated using the relative risks estimated in previous survival studies. In the baseline scenario, the tangible costs of unwanted loneliness are estimated to be around 14,129million euros in 2021, representing 1.2% of Spain's GDP. Approximately 56.8% of the tangible costs correspond to production losses due to reduced working time, and 43.2% are due to healthcare costs related with increased consultation frequency in healthcare services and higher consumption of medicines related to loneliness. In addition, loneliness generates a reduction in quality of life equivalent to 1.04million QALYs, which corresponds to 2.8% of the total stock of QALYs of the Spanish population over 15 years of age.

Effectiveness of a 14-week protocol for cognitive stimulation therapy for mild dementia: results from a pragmatic study using routinely collected clinical data

Objectives To explore the effectiveness of an adapted 14-week cognitive stimulation therapy (CST) protocol on psychoaffective symptoms and quality of life (QOL) for people living with mild dementia. Method The sample for this pragmatic study were people with dementia who underwent CST between May 2016 and September 2022 during routine healthcare. Measures of participants’ psychoaffective symptoms and QOL were administered before CST (‘baseline’) and following CST (‘post-intervention’). The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety symptoms, depression symptoms, and their sum score (referred to as HADS-total). The Quality of Life-Alzheimer’s Disease (QOL-AD) scale was used to measure participants’ quality of life (both patient and carer ratings were available). Change in these outcomes was assessed using linear mixed models. Results Two hundred and twenty-five participants attended ≥1 session of adapted CST (84% attended at least 9/14 sessions, considered ‘high’ adherence). The mean change [95% confidence interval] in HADS-total scores indicated improvement (−0.9; [−1.9, −0.0]). Mean scores on the other outcomes showed neither improvement nor worsening. Conclusion Overall, this pragmatic study shows that an adapted 14-week face-to-face CST protocol is effective in improving mental health in people with mild dementia and has the potential to be widely implemented within routine healthcare.