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BACKGROUND: A low education level has been associated with cognitive impairment in older adults. AIM: To determine the association between educational attainment and suspicion of cognitive imparirment in older Chilean population. MATERIAL AND METHODS: Data from 2,005 adults aged ≥ 60 years assessed during 2016-2017 Chilean National Health Survey were included. Education was self-reported and categorized as primary: ≤ 8 years; secondary: 9 to 12 years and beyond secondary: > 12 years. suspicion of cognitive imparirment was assessed with the Mini-Mental questionnaire. RESULTS: Men and women with low education attainment had a higher prevalence of cognitive impairment (33% [95% confidence intervals (CI): 24; 41] and 27% [95% CI: 21; 33], respectively). Men who reported less schooling (≤ 8 years) were more likely to be at risk of suspicion of cognitive imparirment (Odds ratio (OR): 4.53 [95% CI: 1.10, 18.62]) compared to their peers. Women showed a substantially higher magnitude of association than men. The probability of suspicion of cognitive imparirment increased 9-times (OR: 9.96 [95% CI: 1.24; 79.6]) for 9-12 years and 18-times for ≤ 8 years of education (OR: 18.8 [95% CI: 2.42; 146.1]) compared to women with higher education. CONCLUSIONS: Older adults with low education attainment had an increased likelihood of developing suspicion of cognitive imparirment. However, the risk differs by sex, being higher in women than men.
Subject(s)
Humans , Male , Female , Aged , Educational Status , Cognitive Dysfunction/epidemiology , Chile/epidemiology , Risk Factors , Cognition , Life StyleABSTRACT
Background: There is minimal information about the association of head growth at different stages of childhood with cognitive ability. Objective: To determine the relationship of newborn head size and head growth during infancy, childhood and adolescence with attained education, a proxy for cognitive ability. Study design: Prospective birth cohort study. Setting: Married women living in South Delhi between 1969 and 1973. Participants: The New Delhi Birth Cohort study followed up 8030 newborns born in 1969-1973 with head circumference, weight and height measurements at birth and 6-12 monthly until adulthood. Of these, 1526 men and women were followed up at the age of 26-32 years. Outcomes: Association between years of schooling, as an indicator of cognitive ability, and newborn head circumference and conditional measures of head growth during infancy, childhood and adolescence. Results: In unadjusted analyses, newborn head size was positively associated with years of education [(? (95% CI)=0.30 (0.14 to 0.47) years per SD head circumference], as was head growth from birth to 6 months [? (95% CI)=0.44 (0.28 to 0.60) years per SD conditional head growth], 6 months to 2 years [? (95% CI)=0.31 (0.15 to 0.47) years per SD conditional head growth] and 2 to 11 years [? (95% CI)=0.20 (0.03 to 0.36) years per SD conditional head growth]. There were similar findings for height and body mass index (BMI). In the adjusted model containing all growth measures, gestational age, and socioeconomic status (SES) at birth as predictors, only SES was positively associated with educational attainment. Conclusion: Educational attainment in this population is positively associated with socioeconomic status and its influence on inter-related early life (fetal, infant and childhood) factors like nutritional status and brain growth.
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Existen 3 variantes de afasia progresiva primaria (APP), que se distinguen según el dominio lingüístico predominantemente alterado: no fluente, logopénica y semántica. Una herramienta que ayuda a su clasificación es el Sydney Language Battery (Sydbat), el cual no se encuentra validado en Chile. El objetivo del presente trabajo es analizar la posible relación entre edad, años de escolaridad y rendimiento obtenido en las subpruebas del Sydbat en adultos sanos. Participaron 38 adultos sanos a losque se les aplicó el test.El promedio de edad fue 56,8 años (DE = 8,3) y tenían una media de 13,8 años de escolaridad (DE = 3,9). Todos provenían de la Región Metropolitana. Se realizaron correlaciones de Pearson y Spearman, para explorar la correlación entre el rendimiento en las subpruebas, la edad y la escolaridad. Considerando la variabilidad en el rendimiento en las subpruebas, se realizaron modelos uni y multivariados. Se encontraron correlaciones significativas entre edad y la subprueba comprensión (p<0,05) y los años de escolaridad con las subpruebas asociación semántica (p<0,001) y nominación (p<0,01). En personas con más de 12 años de escolaridad, el puntaje en la subprueba asociación semántica varió aproximadamente 2 puntos, con respecto a personas con menos de 12 años de escolaridad (p<0,01). Se concluye que las variaciones en el rendimiento del test, dependen la edad y la escolaridad. A mayor edad, menor es el rendimiento en la subprueba de comprensión. A mayor escolaridad, mayor es el rendimiento en las subpruebas de asociación semántica y nominación. El efecto mencionado debe ser considerado en el proceso de validación de Sydbat.
There are 3 variants of primary progressive aphasia (APP), which are distinguished according to the predominantly altered linguistic domain: non-fluent, logopenic, and semantic. A tool that helps in its classification is the Sydney Language Battery (Sydbat), which is not validated in Chile. The objective of this work is to analyze the possible relationship between age, years of schooling and performance obtained in the Sydbat subtests in healthy adults. 38 healthy adults participated in the test. The average age was 56.8 years (SD = 8.3) and they had a mean of 13.8 years of schooling (SD = 3.9). They all came from the Metropolitan Region. Pearson and Spearman correlations were performed to explore the correlation between subtest performance, age, and schooling. Considering the variability in performance in the subtests, univariate and multivariate models were performed. Significant correlations were found between age and the comprehension subtest (p <0.05) and the years of schooling with the semantic association (p <0.001) and nomination (p <0.01) subtests. In participants with more than 12 years of schooling, the score in the semantic association subtest varied approximately 2 points, with respect to people with less than 12 years of schooling (p <0.01). It is concluded that the variations in test performance depend on age andeducation. The older participants are, the lower their performance on the comprehension subtest. The higher the schooling, the higher the performance on the semantic association and nomination subtests. The mentioned effect must be considered in the Sydbat validation process.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aphasia, Primary Progressive/diagnosis , Neuropsychological Tests , Aging , Chile , Cross-Sectional Studies , Analysis of Variance , Age Factors , Educational Status , LanguageABSTRACT
Resumo Este estudo investigou se há contribuição e em que medida os problemas e os indicadores comportamentais emocionais e de conduta explicam o rendimento escolar dos adolescentes. Setenta estudantes participaram, 70 famílias e 21 profes sores. Os adolescentes responderam ao inventário de comportamentos da juventude (YSR), a família do inventário dos professores da criança e o comportamento dos adolescentes (CBCL) e o inventário de conduta do Adolescente (TRF) e crianças. O desempenho escolar foi avaliado a partir da média final nas disciplinas de português e matemática. Na ava liação dos adolescentes, suas famílias e professores, os problemas de atenção explicam o mau desempenho escolar, bem como a terceirização dos problemas identificados pelos adolescentes e os sintomas de isolamento/depressão indicada pelos professores. É realçada a importância de atender tais indicadores, visto sua influência nos adolescentes.
Abstract This study investigates to what extent emotional and behavioral problems impact on and explain the academic per formance of adolescents. 70 students, 70 families and 21 teachers participated in the study, completing the Youth Self-Report (YSR), the Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF). School performance was as sessed using the final grade in Portuguese and mathematics. The evaluation of adolescents, families and teachers shows that attention problems explain low school performance, in addition to the externalization of problems indicated by the adolescents and the isolation or depression indicated by the teachers. The article highlights the importance of attention to these variables, given their influence on adolescents' learning.
Resumen Este estudio investiga en qué medida los indicadores de problemas emocionales y conductuales contribuyen y explican el rendimiento académico de los adolescentes. En la investigación participaron 70 estudiantes, 70 familias y 21 maestros, que respondieron el Autoinforme para jóvenes (YSR, por sus siglas en inglés), el Inventario de conductas de niños y ado lescentes (CBCL, por sus siglas en inglés) y el Informe del educador (TRF, por sus siglas en inglés). El rendimiento escolar se evaluó a partir de la media final en las disciplinas de portugués y matemáticas. En la evaluación de los adolescentes, sus familias y los maestros se destaca que los problemas de atención explican el bajo rendimiento escolar, además de la externalización de los problemas indicados por los adolescentes y los síntomas de aislamiento o depresión señalados por los profesores. Se resalta la importancia de prestar atención a este tipo de indicadores, dada su influencia sobre el aprendizaje de los adolescentes.
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OBJECTIVE: Substance abuse and maltreatment are highly associated with Executive Cognitive Function impairments, but very little is known about how symptoms of a condition known as Dysexecutive Syndrome may impact on real-life activities, especially in adolescents. This study investigated the presence of Executive Cognitive Function deficits in maltreated substance-abusing adolescents relative to healthy control subjects and analyzed the association between executive performance and educational attainment. METHOD: The sample consisted of 15 maltreated adolescent substance abusers and 15 non-maltreated healthy adolescents (controls). They were assessed by the Frontal Assessment Battery, composed of six subtests: Conceptualization, Mental flexibility, Motor programming, Sensitivity to interference, Inhibitory control, and Environmental autonomy. RESULTS: Maltreated adolescents did not differ from controls in sociodemographic variables such as age, ethnicity, and handedness. However, they performed significantly and importantly below controls in almost all domains of Executive Cognitive Function, including abstract abilities, cognitive flexibility, motor planning, and sensitivity to interference. Maltreated adolescents also completed fewer years of formal education vs. controls. The Frontal Assessment Battery total score correlated with educational attainment throughout the sample (r = 0.511; p < 0.01). CONCLUSION: Substance-abusing adolescents with a history of maltreatment performed more poorly vs. controls on a variety of measurements of executive functioning, and the results of the Frontal Assessment Battery were associated with educational attainment. Our results evidence a negative impact of dysexecutive symptoms on educational attainment in adolescents. Strategies focusing on neuropsychological rehabilitation may be relevant to help substance-abusing and maltreated adolescents to perform better at school and perhaps in life.
OBJETIVO: Abuso de substâncias e maus-tratos têm sido altamente associados com déficits nas funções executivas, porém pouco se conhece sobre o impacto da disfunção executiva nas atividades da vida real, especialmente em adolescentes. O objetivo deste estudo foi investigar a presença de déficits nas funções executivas em adolescentes abusadores de substâncias com histórico de maus-tratos, comparando-os com um grupo de jovens controles saudáveis, assim como analisar a associação entre o desempenho executivo e o nível de escolaridade dos participantes. MÉTODO: A amostra foi composta por 15 adolescentes abusadores de substâncias, vítimas de maus tratos e 15 adolescentes saudáveis, sem história de maus-tratos. Todos os participantes foram avaliados pela Bateria de Avaliação Frontal, composto por seis subtestes: Conceituação, Flexibilidade mental, Programação motora, Sensibilidade à interferência, Controle inibitório e Autonomia Ambiental RESULTADOS: Os adolescentes abusadores não diferiram dos controles saudáveis em variáveis sócio-demográficas, tais como idade, etnia e lateralidade. No entanto, apresentaram desempenho significativamente abaixo dos controles em quase todos os domínios das funções executivas, incluindo capacidade de abstração, flexibilidade cognitiva, planejamento motor e sensibilidade à interferência. Os adolescentes vítimas de maus tratos concluíram menos anos de educação formal do que os controles. A pontuação total da Bateria de Avaliação Frontal correlacionou com o nível de escolaridade, na amostra total (r = 0.511; p < 0.01). CONCLUSÃO: Os adolescentes abusadores de substâncias com histórico de maus-tratos apresentam prejuízos em várias medidas de Funções Executivas. Os resultados da Bateria de Avaliação Frontal associam-se com os anos completados de escolaridade. Nossos resultados evidenciam o impacto negativo da disfunção executiva no aproveitamento escolar em adolescentes. Estratégias com foco em reabilitação neuropsicológica podem ser relevantes para ajudar adolescentes abusadores de substâncias e vítimas de maus tratos a atingirem melhor aproveitamento na escola e, talvez, na vida como um todo.
Subject(s)
Humans , Adolescent , Domestic Violence , Substance-Related Disorders , Learning Disabilities , Neuropsychological TestsABSTRACT
Aims: The objectives were to determine the impact of health seeking behaviour, educational attainment and financial Strength on home management of malaria in rural communities in Imo State, Nigeria. Study Design: A descriptive survey design was used. Place and Duration of Study: Imo State, Nigeria, between February 2013 and April 2013 Methodology: The sample size was 2674 adults (1650 males, 1024 females, age range 20-70 years). A structured, validated and reliable questionnaire (r=0.81) was used to collect data from 2674 consenting respondents. Results: The result showed that the health seeking behaviours of respondents when they suspect malaria was as follows; 25.7 percent patronized patent medicine stores/chemist, 22.3 percent visited health centers/ hospitals,18.6 percent consulted family members/friends/ neighbor for help. This statistically had a significant influence on the pattern adopted in managing malaria at home (Chi-square = 263.98, P -value < 0.001). Furthermore, 25.4 percent of those who visited the health centers/hospitals used more of Artemisinin-based Combination Therapy in managing malaria. Those who patronized patent medicine/chemist used more of chloroquine/quinine (25.7 percent), only 18.1 percent used a special herb, dogonyaro/Akum shut up leaf (Azadirachta Indica) in managing malaria at home. Those who visited herbalists (20.5%) also used chloroquine/quinine while those that visited prayer houses also used more of chloroquine/quinine (22.3%) and less of ACT (15.5%). The impact of educational attainment on pattern of home management of malaria was statistically significant (Chisquare= 155.47,P-value<0.001). Those who had no formal education used more of Chloroquine/Quinine in managing malaria at home while those who attained secondary and tertiary education adopted more of Artemisinin-based combination Therapy (ACT) in managing malaria. Herbal treatment (Dogonyaro/Akum shut up leaf (Azadirachta Indica), seven leaves and application of local ointment/lotion) were less used by respondents with higher educational attainment. Financial strength was also found to be statistically associated with the pattern of management adopted by the rural dwellers (Chisquare= 118.46, P-value<0.001). Those whose average monthly income was above 30,000 Naira used more of conventional medication and less of herbs. Conclusion: The findings showed that the rural communities need more enlightenment and education on home management of malaria.
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Objetivo: Determinar los Factores de Riesgo Maternos, Obstétricos y Neonatales asociados al parto pretérmino en el Hospital Regional de Ica durante el año 2012. Materiales y métodos: Es un estudio retrospectivo, observacional, analítico, de caso y control. La muestra fue de 107 pacientes, de los cuales31 fueron casos con diagnóstico de parto pretérmino y 76, los controles con diagnóstico de parto a término. Se aplicó la estadística descriptiva para las variables categóricas y de medidas de tendencia central para las variables numéricas. Se empleó la prueba del chi cuadrado con un nivel de significancia estadística de p1 e IC 95%. Resultados: El 23%de los partos pretérminos fueron madres adolescente (OR 2.993 IC [1,123-7,660] X2 0,024 p<0.05). La edad materna extrema en el estudio <19 años fue el 76, 7% (OR 2.292; IC 0,367-14,323; X2 0.368); el estado civil casada tuvo el 20, 5% (OR 1.963; IC 0,517-7, 452; X2 0.316); 84, 1% tuvieron un nivel de instrucción baja:(OR 4,694; IC 1,598-13,855; X2 0.003); infecciones urinarias (OR 1.350; IC 2, 077-13, 116); vaginosis bacteriana(OR 1.224; IC 0,273-5,464); nuliparidad (OR 1.012; IC 0,372-2,751); bajo peso al nacer (OR 66,536; IC18,015-248,746); gemeralidad (OR 14.23; IC 1,610-129,245). Conclusiones: Representaron factores de riesgo maternos: ser madre adolescente, edad extrema materna, procedencia rural, tener grado de instrucción baja, antecedentes patológicos como infección urinaria; factores de riesgo neonatales: bajo peso al nacer y gemelaridad. (AU)
Objective: Determine the Risk Factors Maternal, Obstetric and Neonatal associated with preterm birth in the Ica Regional Hospital in 2012. Materials and Methods: A retrospective, observational, analytical, case-control study. The sample included 107 patients, of which 31 cases were diagnosed with preterm labor and 76 controls diagnosed with labor at term. Descriptive statistics for categorical variables and measures of central tendency for numeric variables variables was applied. Chi square test was used with a level of statistical significance of p 1 e 95 % was considered. Results: 23% of teenage mothers were preterm deliveries (OR 2.993 Cl [ 1.123 to 7.660 1 X2 0.024 P < 0.05). Extreme maternal age in the study <19 years was 76,7% (OR 2.292, Cl 0.367 to 14.323,0.368 X2 ), the married civil state had the 20, 5 % (OR 1.963 , Cl 0.517-7,452; X2 0.316 ) 84 1% had a low education level ( OR 4.694, Cl 1.598 to 13.855, X2 0.003 ), urinary tract infection (OR 1.350, Cl 2 077-13,116), bacterial vaginosis (OR 1.224 ; Cl 0.273 to 5-464 ), nulliparity (OR 1.012 , Cl 0.372 to 2.751 ), low birth weight (OR 66.536 , Cl 18.015 to 248.746 ); gemeralidad (OR 14.23 , Cl 1.610 to 129.245 ) . Conclusions: Accounted maternal risk factors: teenage pregnancy, extreme maternal age, rural origin, have low education level, medical history and urinary tract infection, neonatal risk factors: low birth weight and twinning. (AU)
Subject(s)
Humans , Female , Adult , Infant, Low Birth Weight , Risk Factors , Obstetric Labor, Premature , Case-Control Studies , Retrospective Studies , Observational Studies as TopicABSTRACT
The increase in life expectancy can influence the prevalence of dementias in the population. Instruments that evaluate cognitive functions such as the Mini Mental State Examination (MMSE) are necessary for the investigation of dementia. The supposition that patient score on the MMSE can be influenced by academic level points to the need for establishing cut-off values that take into account educational level. The aim of this study was to review MMSE cut-off values adjusted for schooling in a large southern Brazilian sample. Method: Demographic data and MMSE scores of 968 subjects, of which 162 were dementia patients and 806 healthy participants, were analyzed. The sample was grouped according to education. The cut-off values were established by ROC Curve analysis. Results: The total sample mean age was 70.6±7.3 years, and the mean years of education was 7.2±5.3. The cut-off score of 23 points (sensitivity=86%, specificity=83%) was observed as the optimal level to detect dementia on the MMSE instrument for the overall sample. Regarding level of schooling, the cut-off values were: 21 for the illiterate group (sensitivity=93%, specificity=82%), 22 for the low education group (sensitivity=87%, specificity=82%), 23 for the middle education group (sensitivity=86%, specificity=87%) and 24 for the high education group (sensitivity=81%, specificity=87%). Conclusions: The cut-off values revealed by this analysis, and adjusted for level of schooling, can improve the clinical evaluation of cognitive deficits.
A elevação da expectativa de vida pode influenciar na prevalência das demências na população. Instrumentos que avaliem as funções cognitivas, como o Mini Exame do Estado Mental (MEEM), são necessários para a investigação de demência. A suposição de que o resultado do MEEM de um paciente pode ser influenciado pelo nível de escolaridade demonstra a necessidade do estabelecimento de pontos de corte que levem em consideração a escolaridade. O objetivo deste estudo foi revisar os pontos de corte do MEEM ajustados para a escolaridade em uma grande amostra do sul do Brasil. Método: Dados demográficos e escores do MEEM de 968 indivíduos, 162 pacientes com demência e 806 participantes saudáveis foram analisados. A amostra foi agrupada de acordo com a educação. Para estabelecer os pontos de corte foi utilizada a Curva ROC. Resultados: A média de idade da amostra total foi 70,6±7,3 e a média de anos de estudo foi 7,2±5,3. O ponto de corte 23 (sensibilidade=86%), (especificidade=83%) foi o ponto que melhor detectou demência na amostra total. Considerando o nível de escolaridade, os pontos de corte foram: 21 no grupo de analfabetos (sensibilidade=93%, especificidade=82%), 22 no grupo de baixa escolaridade (sensibilidade=87%, especificidade=82%), 23 no grupo de média escolaridade (sensibilidade=86%, especificidade=87%) e 24 no grupo de alta escolaridade (sensibilidade=81%, especificidade=87%). Conclusões: Os pontos de corte, quando se considera a escolaridade, podem aperfeiçoar a avaliação clínica dos déficits cognitivos.