Nevin Manimala

Eur J Neurol. 2023 Jan 24. doi: 10.1111/ene.15703. Online ahead of print.

ABSTRACT

BACKGROUND: Performance Validity Tests (PVTs) are used in neuropsychological assessments to detect patterns of performance suggesting that the broader evaluation may be an invalid reflection of an individual’s abilities. Data on Functional motor disorder (FMD) are currently poor and conflicting.

OBJECTIVES: We aimed to examine the rate of failure at three different PVTs of non-litigant, non-compensation seeking FMD patients, and we compared their performance to that of healthy controls and controls asked to simulate malingering (healthy simulators).

METHODS: We enrolled 29 non-litigant, non-compensation seeking patients with a clinical diagnosis of FMD, 29 healthy controls and 29 healthy simulators. Three PVTs, the Coin in the Hand Test (CIH), the Rey 15-item Test (REY) and the Finger Tapping Test (FTT), were employed.

RESULTS: FMD Patients showed low rates of failure at the CIH and REY tests (7% and 10%, respectively) and slightly higher at the FTT (15%, n=26) test, which implies a motor task. Their performance was statistically comparable to that of healthy controls but statistically different from that of healthy simulators (p<0.001). 93% of FMD patients, 7% of healthy simulators, and 100% of healthy controls passed at least two of the three tests.

CONCLUSIONS: PVT performance of non-litigant, non-compensation seeking patients with FMD ranged from 7 to 15%. Patient’s performance was comparable to controls and significantly differed from that of simulators. This simple battery of three PVTs could be of practical utility and routinely used in clinical practice.

PMID:36692870 | DOI:10.1111/ene.15703

Eur J Neurol. 2023 Jan 24. doi: 10.1111/ene.15697. Online ahead of print.

ABSTRACT

BACKGROUND: Although cognitive impairment (CI) is frequent in multiple sclerosis (MS) patients, only few studies (and with conflicting results) evaluated early predictors of CI in the long-term. We aimed at determining associations between early clinical/neuroradiological variables with reference to CI after 20 years of MS.

METHODS: We investigated in 170 MS patients the relationship between clinical/MRI data at diagnosis and cognitive status after almost 20 years from MS onset. Among others, number/volume of both white matter lesions (WML) and cortical lesions (CL) were evaluated at diagnosis and after 2 years. All MS patients were followed over time and underwent a comprehensive neuropsychological assessment at the end of study. Advanced statistical methods (unsupervised cluster analysis and random forest model) were conducted.

RESULTS: CI patients showed at diagnosis higher focal cortical pathology compared to cognitively normal (p<0.001). Volumes of both WML and CL emerged as the MRI metrics most associated with long-term CI. Moreover, CL number (especially ≥3) was also strongly associated with long-term CI (≥3 CL: OR=3.7, 95% CI 1.8-7.5; p<0.001), more than WML number: the optimal cut-off of 3 CL (AUC=0.67, specificity=75%, sensitivity=55%) was estimated according to the risk of developing CI.

CONCLUSIONS: These results highlighted the importance of considering both white and grey matter focal damage since early MS stages. Given the low predictive value of WM lesion number and the poor clinical applicability of lesion volume estimation in the daily clinical context, the evaluation of CL number could represent a reliable prognostic marker of CI.

PMID:36692863 | DOI:10.1111/ene.15697

Health Promot J Austr. 2023 Feb;34(1):156-168. doi: 10.1002/hpja.649. Epub 2022 Aug 16.

ABSTRACT

ISSUE ADDRESSED: Men’s sheds (‘Sheds’) have been identified as inherently health promoting and as potential settings to engage ‘hard-to-reach’ men in more structured health promotion initiatives. However, little is known about the socio-demographic or health and wellbeing characteristics of Shed members (‘Shedders’) on which such initiatives might be based. This study captures a baseline cross-sectional analysis of Shedders (n = 384) who participated in ‘Sheds for Life’, a health promotion initiative tailored to Sheds.

METHODS: Objective health measures (body composition, blood pressure, blood lipids) captured via health screening as well as socio-demographic and health and wellbeing measures (physical activity, subjective wellbeing, mental health, social capital, cooking and diet) via questionnaires were assessed. Descriptive statistics were generated and differences between groups were determined via parametric and non-parametric testing. Bivariate analysis was used to determine associations and regression analysis then estimated various predictors on mental wellbeing, life satisfaction and loneliness.

RESULTS: Participants were mostly over 65 years (77.3%), retired (88.6%) with limited educational attainment (77%). The majority were in the ‘at-risk’ categories for objective health measures, with most being referred to their GP following health screening (79.6%). Older Shedders were also more likely to meet physical activity guidelines. Mental wellbeing was positively correlated with life satisfaction and increased social capital and these were also positively correlated with physical activity (P < .05).

CONCLUSIONS: Findings highlight the potential of Sheds in reaching a ‘hard-to-reach’ and ‘at-risk’ cohort of men. Despite a high prevalence of ‘at-risk’ objective health measures, participants report their health in positive terms. Future health promotion initiatives should capitalise on the inherent health-promoting properties of Sheds. SO WHAT?: Findings raise important implications for prioritising and designing health promotion initiatives in Shed settings.

PMID:36692862 | DOI:10.1002/hpja.649

J Nurs Res. 2023 Feb 1;31(1):e252. doi: 10.1097/jnr.0000000000000541.

ABSTRACT

BACKGROUND: Little is known regarding the effects of training programs on family caregivers of older persons with mild cognitive impairment because of the significant differences in outcome variables measured in the various studies in the literature.

PURPOSE: This study was designed to examine the effects of an outpatient-based caregiver training program on the preparedness, health-related quality of life, and depressive symptoms of participants responsible for caring for older persons with mild cognitive impairment.

METHODS: A randomized clinical trial was implemented. Of the 54 family caregiver participants who provided complete and valid data, 28 and 26 were assigned to the experimental and control groups, respectively. The experimental group participated in a researcher-developed training program that provided information on mild cognitive impairment, strategies for maintaining and promoting cognitive function in persons with mild cognitive impairment, managing their own and their care recipients’ healthcare, and managing their own emotional support and stress. Outcomes (caregiver preparedness, health-related quality of life, and depressive symptoms) were assessed before the start of the training program (baseline) and at 1, 3, and 6 months after completion of the program.

RESULTS: After controlling for baseline cognitive function of the care recipients and of caregiver preparedness, the experimental group was shown to be significantly less prepared than the control group at baseline (β = -1.41, p = .031) and better prepared than the control group at all three posttests (group differences: 1.3, 1.53, and 4.24, respectively), with the difference at the third posttest (6 months) reaching statistical significance (p = .008). No impact of the intervention on caregiver depressive symptoms or health-related quality of life was found at posttest.

CONCLUSIONS: The training intervention in this study was found to increase the perceived preparedness of the family caregiver participants to handle various aspects of providing care to persons with mild cognitive impairment. However, no changes were found in depressive symptoms or health-related quality of life.

PMID:36692834 | DOI:10.1097/jnr.0000000000000541

Ophthalmol Ther. 2023 Jan 24. doi: 10.1007/s40123-023-00658-4. Online ahead of print.

ABSTRACT

INTRODUCTION: Male gender is an important risk factor of central serous chorioretinopathy (CSC), and studies have explored the pathophysiological role of androgens in CSC with conflicting results. In this study, we shed light on this hot topic by exploring the risk of CSC in a large cohort of male androgen abusers.

METHODS: This study included male androgen abusers identified through a nationwide anti-doping test program across Danish fitness centers from January 3 2006 to March 1 2018. For each case, we randomly sampled ten male controls using Danish nationwide registries. These controls were matched in age and date. Cases and controls were followed until May 16 2018. Data on diagnoses were extracted using the Danish National Registry of Patients using ICD-10 codes to identify cases with CSC.

RESULTS: We included 1189 cases and 11,890 controls. Mean age at the time of doping sentence was 27.4 ± 6.9 years, and mean length of follow-up was 15.8 ± 3.6 years. We identified no cases of CSC in androgen abusers, and five cases of CSC in the control cohort. The difference between groups was not statistically significant (P = 1.0).

CONCLUSIONS: Male androgen abusers were not at increased risk of CSC. Considering the lack of any signal in this large study, we speculate that if male androgen plays any direct role in the pathophysiology of CSC, its role may be subtle at best.

PMID:36692812 | DOI:10.1007/s40123-023-00658-4

Drugs. 2023 Jan 24. doi: 10.1007/s40265-022-01822-z. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to investigate whether ibuprofen use, compared with other non-selective non-steroidal anti-inflammatory drugs (ns-NSAIDs), cyclooxygenase-2 inhibitors (COX-2i) or paracetamol, increases the risk of coronavirus disease 2019 (COVID-19) diagnosis or hospitalisation.

DESIGN: A prevalent user and active comparator cohort study.

SETTING: Two US claims databases (Open Claims and PharMetrics Plus) mapped to the Observational Medical Outcomes Partnership Common Data Model.

PARTICIPANTS: Insured patients with a history of osteoarthritis or back pain and receiving ibuprofen, other ns-NSAIDs, COX-2i or paracetamol between 1 November, 2019 and 31 January, 2020 (study enrolment window 1) or between 1 February, 2020 and 31 October, 2020 (study enrolment window 2).

MAIN OUTCOME MEASURES: Large-scale propensity score matching and empirical calibration were used to minimise confounding. Incidence and hazard ratios of COVID-19 diagnosis and hospitalisation according to drug/s use were estimated and pooled in the same study period across data sources using a fixed-effects meta-analysis. Index treatment episode was the primary risk evaluation window, censored at the time of discontinuation.

RESULTS: A total of 633,562 and 1,063,960 participants were included in periods 1 and 2, respectively, for the ibuprofen versus ns-NSAIDs comparison, 311,669 and 524,470 for ibuprofen versus COX-2i, and 492,002 and 878,598 for ibuprofen versus paracetamol. Meta-analyses of empirically calibrated hazard ratios revealed no significantly differential risk of COVID-19 outcomes in users of ibuprofen versus any of the other studied analgesic classes: hazard ratios were 1.13 (0.96-1.33) for the ibuprofen-ns-NSAIDs comparison, 1.03 (0.83-1.28) for the ibuprofen-COX-2i comparison and 1.13 (0.74-1.73) for ibuprofen-paracetamol comparison on COVID-19 diagnosis in the February 2020-October 2020 window. Similar hazard ratios were found on COVID-19 hospitalisation and across both study periods.

CONCLUSIONS: In patients with osteoarthritis or back pain, we found no differential risks of incident COVID-19 diagnosis or COVID-19 hospitalisation for ibuprofen users compared with other ns-NSAIDs, COX-2i or paracetamol. Our findings support regulatory recommendations that NSAIDs, including ibuprofen, should be prescribed as indicated in the same way as before the COVID-19 pandemic, especially for those who rely on ibuprofen or NSAIDs to manage chronic arthritis or musculoskeletal pain symptoms.

PMID:36692805 | DOI:10.1007/s40265-022-01822-z

Eur J Ageing. 2022 Dec;19(4):1549-1560. doi: 10.1007/s10433-022-00739-6. Epub 2022 Nov 4.

ABSTRACT

With pet ownership on the rise, millions of individuals are exposed to this environmental exposure. Although the subject has been largely studied, more evidence is needed to clarify the potential association of pet ownership with human health. The aim of this research is to study the potential association of pet exposure (any pet, cat, dog, bird, fish) with all-cause, cardiovascular and cancer mortality of older ([Formula: see text] 50 years) European residents. To this end, a total of 23,274 participants from the Survey of Health Ageing and Retirement in Europe (SHARE) were employed (median follow-up 119 months). All-cause mortality (5163 events), as well as cardiovascular (CVD) (1832 events), and cancer mortality (1346 events) were examined using Cox Proportional Hazards models for their relation with pet exposure at baseline. Stratified analyses were also performed by gender and for single or multi-person households. No significant association was observed for any of the pets with all-cause mortality on the whole sample and the fully adjusted models. In stratified analyses, bird exposure significantly increased the risk of all-cause mortality in women [Hazard Ratio [Formula: see text]; 95% CI 1.04-1.44] as well as women living alone [Formula: see text]; 95% CI 1.02-1.85). Cause-specific models revealed an increased risk of death for women bird owners for causes other than cancer and CVD [Formula: see text]; 95% CI 1.05-1.99). In conclusion, bird ownership may be negatively associated with survival of older women in Europe.

PMID:36692784 | DOI:10.1007/s10433-022-00739-6

Eur J Ageing. 2022 Dec;19(4):1479-1491. doi: 10.1007/s10433-022-00731-0. Epub 2022 Sep 30.

ABSTRACT

In recent years, early retirement decisions have become more frequent in the European Union despite political efforts to prevent early retirement. This is a growing problem for the social security system. The study focuses on a life course approach using employment biographies and investigates the influence of work stress and health on early retirement intentions. Data of employees who were born in either 1959 or 1965 of the German cohort study on work, age, health and work participation are analysed (n = 3338). By linking survey and register data from 1993 to 2011, a sequence analysis is conducted to identify employment biographies. To analyse the relationship between the employment biographies and intended early retirement, a longitudinal path analysis is computed and includes work stress, measured through effort-reward imbalance, and self-rated health. The statistical analyses identify three adverse employment biographies, i.e. part-time work, episodes of unemployment or marginal employment. In addition, two favourable employment biographies are determined, characterised by full-time work and few episodes of unemployment. The results of the path analysis show that employment biographies with high work-related stress have early retirement intentions. Among adverse employment biographies, indirect effects of poor health on the association between work stress and early retirement intentions are found. Unexpectedly, among full-time workers, work stress is also associated with early retirement intentions with an additional mediation through health. The findings of this study highlight the importance of the life course perspective when analysing retirement decisions. In addition to health-promoting interventions in the labour market, effects of psychosocial factors should be focussed on in order to reduce early exits from the labour market.

PMID:36692777 | DOI:10.1007/s10433-022-00731-0

Eur J Ageing. 2022 Dec;19(4):977-995. doi: 10.1007/s10433-022-00727-w. Epub 2022 Sep 19.

ABSTRACT

Ongoing demographic changes and global population ageing require organisations to pay special attention to their employment policies. With working life extension and age management increasingly included in discussions about reactive versus proactive personnel policies, the term ‘generativity’ gains special importance as an approach to managing a generationally diverse workforce. Generativity can be understood as an attitude of openness towards the younger generations that focuses on exchanging values, knowledge, and experiences with them. It is a source of positive emotions and better social relationships, personal fulfilment, good energy, and aliveness. In the paper, generativity is discussed in the framework of two theories: the socio-emotional selectivity theory (SST) and successful ageing theory (SOC). The aim of this paper is to assess the relationship between generativity and individual work outcomes. We considered both in-role and extra-role outcomes analysed in the job context. Meta-analysis is conducted of studies that investigate generativity and its relationships with motivational outcomes (job satisfaction, engagement, work motivation, affective commitment, self-efficacy), cognitive outcomes (attitudes toward retirement, career success, self-control), personal outcomes (wellbeing, health, job strain), relational outcomes and extra-role behaviours (organisational citizenship behaviour and sustainable behaviour). The analysis examines 65 independent samples that included 30,540 individuals, and considers the role of three moderators-the cultural context, the measurement method and age. It demonstrates that generativity has significant and positive motivational, cognitive and extra-role behaviour outcomes for workers and that it improves their well-being.

PMID:36692773 | DOI:10.1007/s10433-022-00727-w

Eur J Ageing. 2022 Dec;19(4):1407-1415. doi: 10.1007/s10433-022-00724-z. Epub 2022 Aug 29.

ABSTRACT

This study aimed to explore the effects of age and educational level on recall performance and organisational strategies used during recall as a function of the level of memory task difficulty. Younger (n = 55, age range = 20-39 years) and older (n = 45, age range = 65-75 years) adults learned a word list where the words were either already semantically grouped (easier) or presented in pseudo-random order (harder), and then recalled the words. The number of words recalled was calculated, and an index of clustering was computed to assess organisational strategies. Older adults recalled less words than the younger ones. Older adults with a higher educational level recalled more words than their counterparts with a lower educational level when the memory task was easier, but they all performed similarly on the harder memory task. Moreover, we noted a strong positive association between educational level and semantic organisation in older adults when the memory task was easier. Regardless of educational level, older adults used semantic organisation as much as younger adults when the memory task was easier. However, when the memory task was harder, older adults showed significantly less organisational strategies than younger adults, the latter using semantic organisation to boost their recall performance. In sum, the protective effect of educational level seems to be restricted on recall performance, but not organisational strategies, in easy memory tasks providing sufficient external information about the most efficient mnemonic strategy to use.

PMID:36692769 | DOI:10.1007/s10433-022-00724-z