Sociodemographic and Health-Related Factors Associated with Severity of Cognitive Impairment in Elderly Patients Hospital-ized in a Geriatric Clinic

Accuracy of determining gait independence using adductor pollicis muscle thickness and skeletal muscle mass index in community-dwelling older adults undergoing outpatient rehabilitation

OBJECTIVE

The accuracy of determining gait independence using adductor pollicis muscle thickness (APMT) and skeletal muscle mass index (SMI) in community-dwelling older adults undergoing outpatient rehabilitation remains unclear. The purpose of this study was to compare the accuracy of determining gait independence using APMT and SMI in community-dwelling older adults undergoing outpatient rehabilitation.

METHODS

This study included 98 older adults (mean age: 85.2 years). Participants received outpatient rehabilitation one to three times a week. The main outcomes were gait independence (functional independence measure gait score: 6 or 7), skeletal muscle mass index (SMI), and APMT. Receiver operating characteristic (ROC) curves of APMT and SMI for gait independence were created, and cut-off values were calculated using the Youden index. Additionally, the area under the curve (AUC) s of the APMT model and the SMI model were compared using the Delong test.

RESULTS

Among the 98 participants (male; 19, female; 79), 53 (54.1%) were in the gait independent group. The cut-off value of APMT calculated from the ROC curve was 13 mm; the sensitivity and specificity were 67.9% and 86.7%, respectively; and the AUC was 0.800. The cut-off value of SMI calculated from the ROC curve was 4.6 kg/m2; the sensitivity and specificity were 90.6% and 26.7%, respectively; and the AUC was 0.582. The AUC for the APMT model was significantly higher than the SMI model (P < 0.001).

CONCLUSIONS

The results of this study show that the cut-off value of APMT for determining the gait independence was 13 mm. In addition, APMT had a higher accuracy of determining gait independence than SMI. This indicates that measuring APMT is more useful for predicting gait independence than SMI in community-dwelling older adults undergoing outpatient rehabilitation.

Sociodemographic factors associated with the level of knowledge about management of epileptic patients in Peruvian dental students: a cross-sectional study under a multivariable analysis

BACKGROUND

Epilepsy is a chronic neurological disease that could indirectly affect oral health, and it is necessary for dentists to be familiar with the specific needs of patients with epilepsy. Therefore, aim of the present study was to assess the factors associated with the level of knowledge about management of epileptic patients in Peruvian dental students.

METHODS

This analytical, observational, cross-sectional and prospective study assessed 312 dental students from a Peruvian university during February to April 2022. A validated questionnaire of 20 closed multiple-choice questions was used to measure the level of knowledge about dental management in epileptic patients. A logit model was used to assess the influence of variables: gender, age, year of study, marital status, place of origin and area of residence, with the level of knowledge in dental students considering a significance level of p < 0.05.

RESULTS

Of the total, 28.8%, 36.2% and 34.9% had a poor, fair and good level of knowledge, respectively, about the dental treatment of epileptic patients. On the other hand, it was observed that being a woman (OR = 0.44, CI 0.26-0.75) and being a third year student (OR = 0.39, CI 0.21-0.74) and fourth year student (OR = 0.43, CI 0.23-0.89) constituted a protective factor against poor knowledge about the dental management of epileptic patients, while being from the capital city constituted a risk factor. Finally, age, marital status and the students' area of residence were not considered influential factors (p > 0.05).

CONCLUSION

Most of the students showed a poor and fair level of knowledge about the dental management of epileptic patients, with gender, academic year and place of origin being influential factors. It is advisable that authorities and teachers in the dental profession organize recurrent training programs on the care of patients with chronic diseases requiring special attention, since knowing general concepts, pharmacological management and dental care of epileptic patients will allow future dentists to develop competencies to improve and implement good quality care protocols for this group of patients.

Latent profile analysis of cognitive function and depressive symptoms in Chinese elderly: results from the China Health and Retirement Longitudinal Study

BACKGROUND

Geriatric cognitive impairment often occurs in conjunction with depressive symptoms. This study focuses on categorising the Chinese elderly with such co-occurring symptoms into homogeneous groups using latent profile analysis (LPA), a person-centred statistical approach.

METHODS

Information on cognitive function and depressive states of the elderly was extracted from the China Health and Retirement Longitudinal Study. The underlying characteristics were identified by LPA, and based on those findings, differences in demographic characteristics of different subgroups were explored by chi-squared test and analysis of variance.

RESULTS

A total of 6710 Chinese elderly who met the inclusion criteria were selected from the dataset. Four subgroups were identified among this sample by LPA, based on cognitive function associated with depressive symptoms, and named in this study as follows: mild cognitive impairment (n = 3747, 55.84%), moderate cognitive impairment (n = 1306, 19.46%), mild cognitive impairment combined with depressive symptoms (n = 1114, 16.6%), and moderate cognitive impairment combined with depression (n = 543, 8.09%). Age, gender, marital status, and educational level were all significantly different across subgroups (P < 0.001); religious belief and pension mode, however, were not (P > 0.05).

CONCLUSIONS

In the present study, four subgroups of cognitive function combined with depressive symptoms were found in Chinese elderly individuals, and differences in demographic factors were noted between the subgroups. In clinical practise, these findings could help clinical workers identify patients accurately and consider the demographic features of each subgroup when designing medical treatment, care, and rehabilitation programmes for those with cognitive impairment and concomitant depressive symptoms.

Synthesis, in vitro cholinesterase inhibition, molecular docking, DFT and ADME studies of novel 1,3,4-oxadiazole 2-thiol derivatives

A sequence of 1,3,4-oxadiazole 2-thiol derivatives bearing various alkyl or aryl moieties was designed, synthesized, and characterized by modern spectroscopic methods to yield 17 compounds ( 6a - 6q ) which were screened for acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) enzymes in search of 'lead' compounds for the treatment of Alzheimer disease (AD). The compounds 6q, 6p, 6k, 6o, and 6l showed inhibitory capability against AChE and BChE, with IC 50 values ranging from 11.730.49 to 27.360.29 µM for AChE and 21.830.39 to 39.430.44 µM for BChE, inhibiting both enzymes within a limited range. The SAR ascertained that the substitution of the aromatic moiety had a profound effect on the AChE and BChE inhibitory potential as compared to the aliphatic substitutions which were supported by the molecular docking studies. In silico ADME studies reinforced the drug-likeness of most of the synthesized molecules. These results were additionally supplemented by the molecular orbital analysis (HOMO-LUMO) and electrostatic potential maps got from DFT calculations. ESP maps expose that on all structures, there are two potential binding sites conquered by the most positive and most negative districts.