The effect of an anti-inflammatory diet on chronic pain: a pilot study

Objective

Rheumatic diseases result in chronic pain (CP) and require treatment with drugs whose prolonged administration is associated with side effects. However, publications in the academic literature have suggested that diet modification and food supplementation can play a crucial role in alleviating the symptoms of inflammatory disease. Thus, it is hoped that the use of an anti-inflammatory diet for pain management might result in improved quality of life. Hence, here we aimed to investigate the effect of anti-inflammatory foods in patients with CP caused by rheumatic diseases.

Methods

After an exhaustive bibliography search, we designed a 13-item anti-inflammatory dietary guide based on a Mediterranean diet without red meat, gluten, or cow's milk (the AnMeD-S). We then conducted a pilot study to evaluate the efficacy of this anti-inflammatory diet in patients with CP. A food consumption score (with a maximum of 156 points) was then applied to evaluate patient adhesion to the proposed diet. Forty-five patients with CP were followed-up for 4 months. Variables related with quality of life (including pain perception, depression status, and sleep satisfaction) were measured using 9 validated questionnaires and anthropometric measurements were recorded before and after the participants followed the anti-inflammatory diet.

Results

We found a correlation between increased anti-inflammatory food intake and improved physical characteristics, stress, and pain in the patients we assessed. Moreover, decreased consumption of pro-inflammatory foods was positively correlated with sleep satisfaction. Following the AnMeD-S was associated with improved physical characteristics and quality-of-life in patients with CP.

Conclusion

The AnMeD-S, includes anti-inflammatory foods and restricts the consumption of certain pro-inflammatory foods (such as those containing gluten). This dietary pattern could provide relief from CP and improve the symptoms of stress and depression, as well as reducing sleep disturbances.

The A-to-Z factors associated with cognitive impairment. Results of the DeCo study

Introduction

Cognitive impairment (CI) is known to be mediated by several risk and protective factors, many of which are potentially modifiable. Therefore, it is important to have up-to-date studies that address a standard assessment of psychosocial, clinical and lifestyle variables.

Materials and methods

We conducted a cross-sectional observational study, with a 24-month timeframe, to estimate the relationship between risk and protective factors associated with dementia, according to the A-to-Z Dementia Knowledge. Participants were considered at CI risk if they tested positive for at least one of three validated CI screening tests: The Memory Impairment Screening, Short Portable Mental State Questionnaire, and Semantic Verbal Fluency. The A-to-Z data Collection included Mediterranean Diet Adherence Screener and Geriatric Depression Scale.

Results

The estimated prevalence of CI was 22.6% in a sample of 709 patients with an average of 69.3±10.3 years. The risk factors gradually associated with cognitive decline were hypertension, loneliness, and depression. In contrast, the protective factors gradually associated with less cognitive decline were internet use, reading, and intellectually stimulating jobs. Finally, living alone, having diabetes, taking benzodiazepines, and sleeping more than 9 h were statistically significant associated with CI, whereas to do memory training or a family history of dementia was characteristic of patients without CI.

Conclusion

A joint assessment of the influence of psychosocial, clinical, and lifestyle-related factors is needed to develop dementia prevention strategies.

Addressing Psychosocial Factors in Cognitive Impairment Screening from a Holistic Perspective: The DeCo-Booklet Methodology Design and Pilot Study

Cognitive impairment (CI), an intermediate phase between the decline in physiological cognition and dementia, is known to be mediated by a variety of risk and protective factors, with age being the most influential of these. The multifactorial nature of CI and the worldwide phenomenon of an aging population makes decoupling old age from disease through the concept of healthy aging (HA) a matter of major interest. Focusing on psychosocial variables and psychological constructs, here we designed and piloted a data collection booklet (DeCo-B) to assess CI and HA from a holistic perspective. The DeCo-B comprises six sections: sociodemographic factors, CI, meaning in life, psychosocial factors, health problems, and lifestyle. The estimated prevalence of CI and HA in our cohort were 24.4% and 6.6%, respectively. Spearman correlations mainly identified pairwise associations between the meaning in life domains and psychosocial variables. Moreover, age, marital status, purpose in life, resilience, chronic pain, cognitive reserve, and obstructive sleep apnea were significantly associated with an increased risk of CI. Our results showed that DeCo-B is a suitable tool for researching how modifiable risk and protective factors influence cognitive status. The complex interrelationships between variables should be further investigated and, for practical reasons, the questionnaire should be optimized in future work.

Pharmacists' Knowledge of Factors Associated with Dementia: The A-to-Z Dementia Knowledge List

Dementia is a neurodegenerative disease with no cure that can begin up to 20 years before its diagnosis. A key priority in patients with dementia is the identification of early modifiable factors that can slow the progression of the disease. Community pharmacies are suitable points for cognitive-impairment screening because of their proximity to patients. Therefore, the continuous training of professionals working in pharmacies directly impacts the public health of the population. The main purpose of this study was to assess community pharmacists' knowledge of dementia-related factors. Thus, we conducted a cross-sectional study of 361 pharmacists via an online questionnaire that quizzed their knowledge of a list of dementia-related factors, which we later arranged into the A-to-Z Dementia Knowledge List. We found that younger participants had a better knowledge of risk factors associated with dementia. The risk factors most often identified were a family history of dementia followed by social isolation. More than 40% of the respondents did not identify herpes labialis, sleep more than 9 h per day, and poor hearing as risk factors. A higher percentage of respondents were better able to identify protective factors than risk factors. The least known protective factors were internet use, avoidance of pollution, and the use of anti-inflammatory drugs. Pharmacists' knowledge of dementia-related factors should be renewed with the aim of enhancing their unique placement to easily implement cognitive-impairment screening.

Importance of Increasing Modifiable Risk Factors Knowledge on Alzheimer's Disease Among Community Pharmacists and General Practitioners in Spain

Community pharmacists and general practitioners have daily contact with patients with Alzheimer's disease (AD) but the number of positive cases constantly increases every day. Thus, the aim of this research is to describe the level of AD knowledge among community pharmacists and general practitioners in Spain, in order to see where the biggest gaps in the knowledge are. Therefore, a cross-sectional study has been carried out, using the Alzheimer's disease knowledge survey (ADKS), among members of the Spanish Society of Primary Care Physicians and the Spanish Society of Family and Community Pharmacy to report the differences in AD knowledge in both professional collectives. The ADKS has been responded by 578 community pharmacists and 104 general practitioners and consists of a battery of 30 questions, whose possible answers are true or false. It assesses the AD knowledge in seven areas (impact on the disease, risk factors, course of the disease, diagnosis, care, treatment and symptoms). Results indicate that Spanish pharmacists and general practitioners have a high personal knowledge of AD, nevertheless, it is not associated with greater awareness. Both scored above 80% at the categories: diagnostic, treatment and symptoms. However, lower knowledge level (60% of correct answers) was found in those related to risk factors, such as the ignorance about hypercholesterolemia or hypertension as risk factors for the disease. Community pharmacists are already acting to control cardiovascular risk factors, but a wider knowledge of the relationship of these factors to AD is needed to act against these silent risk factors. Thus, pharmacists may also be involved in the management of AD that includes recognizing early symptoms for early detection of cognitive impairment. Hence, knowledge about risk factors is very important in developing this expanding role.