Screening for mild cognitive impairment among older Albanian patients by clinical pharmacists.

OBJECTIVES: To assess the prevalence of mild cognitive impairment (MCI) and its correlated factors among elderly Albanian patients using different screening tools applied by clinical pharmacists. METHODS: Patients aged 60 years old or more from two primary care centers located in two Albanian cities were included in the study. Two clinical pharmacists applied the MoCA/MoCA B (Montreal Cognitive Assessment/Basic) and the Mini-Cog in Albanian. A predictive multivariate logistic regression analysis and Kappa statistic were conducted. KEY FINDINGS: The prevalence of MCI using MoCA/MoCA B and Mini-Cog scales was 75.73 and 20.39%, respectively. There was a poor degree of agreement between them (Kappa 2.38). Older men had an increased risk of MCI. CONCLUSIONS: The involvement of clinical pharmacists in screening for MCI might help in selecting vulnerable individuals for more specialized examination. The MoCA/MoCA B tool is recommended for higher sensitivity.

Prevalence of potentially inappropriate prescriptions in primary care and correlates with mild cognitive impairment

BACKGROUND: Potentially inappropriate prescribing is clearly associated with adverse health consequences among older people. Nevertheless, scarce evidence exists regarding the prevalence of potentially inappropriate prescriptions (PIP) in Albania, a Western Balkans country. OBJECTIVE: The aim of this study was to assess the prevalence of PIP among older Albanian patients in primary care and to determine the associated sociodemographic and medical factors, including the presence of mild cognitive impairment (MCI). METHODS: Cross-sectional study in two primary healthcare centers located in two different cities of Albania, a middle-income country in the Western Balkans. The Montreal Cognitive Assessment (MoCA) tool was applied to evaluate MCI. PIPs were assessed by two trained pharmacists using the Beers criteria 2019 update. Multivariate logistic regression analysis was conducted for possible risk factors predicting PIP in the study population. RESULTS: At least one PIP was identified among 40.23 % of the participants (174 older patients) and 10.35 % had more than one PIP. MCI was detected among 79.31 % of the patients. The most commonly represented drug groups in PIP were diuretics (24.71 %), benzodiazepines in the presence of MCI and antidepressants (both 8.62 %). The lack of electrolytes monitoring was the most common reason for PIP. According to the multivariate analysis, the only statistically significant association observed was between PIP and number of drugs prescribed [three to four drugs (OR 3.34; 95% CI 1.65:6.76), five or more than five drugs (OR 4.08; 95% CI 1.42:11.69)]. CONCLUSIONS: About four out of 10 older Albanian patients experience PIP in primary care. Further studies are needed for a comprehensive estimation of the prevalence and factors associated with PIP, particularly among elderly with mild cognitive impairment

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Effects of Exercise Training on Weight Loss in Patients Who Have Undergone Bariatric Surgery: a Systematic Review and Meta-Analysis of Controlled Trials.

The combination of bariatric surgery and physical exercise has been suggested as a promising strategy to positively influence obesity, not only body weight but also all associated comorbidities. An electronic search of intervention studies was carried out in which an exercise training program was implemented after bariatric surgery. The quality of each study was assessed and the data were meta-analyzed using a random effect model. Twenty-six articles were included in the systematic review and 16 in the meta-analysis. As the main conclusion, exercise in patients who have undergone bariatric surgery does not seem to be effective in enhancing weight loss (SMD = 0.15; 95% CI = - 0.02, 0.32; p = 0.094). However, the variability in the protocols used makes it too early to reach a definite conclusion.