Association of cognitive function of non-demented elderly primary care attendees with physical, mental, and sociodemographic factors.

Preservation of a population's cognitive functions is a matter of increased concern for all healthcare systems. The detection of factors that are associated with cognitive functions is a matter of increased interest to both the treatment of vulnerable individuals and the implementation of strategies to delay age-related cognitive decline. This study aimed to highlight sociodemographic, physical, and mental health factors associated with the cognitive function in non-demented elderly primary health care attendees. The sample consisted of 362 primary health care attendees aged 60 years or above. A questionnaire regarding sociodemographic and physical health history, along with a battery of psychometric instruments consisting of the Test Your Memory (TYM) test, Geriatric Depression Scale-Short Form (GDS-15), Short Anxiety Screening Test (SAST), and World Health Organization-Five Well-Being Index (WHO-5), were given to all participants.Participants who scored below 39/40 in the TYM, which is the cut-off point for dementia screening in the version of the test we used, were excluded from further assessment. For the rest of the participants, 267 in total, their TYM scores were significantly and negatively correlated with age and SAST scores. Participants with lung and vascular health history problems scored lower in the TYM, as did those with poor education, who lived alone, and who lived in Alexandroupolis. Finally, healthy participants scored higher than individuals with at least one medical condition. Linear multiple regression analysis revealed a model (adjusted R2 = 25.80, F = 10.11, p < 0.001) with three factors (age (beta = -0.32), lung problems (beta = -0.23), and vascular factors (beta = -0.20) that could significantly predict 25.80% of the variance in TYM scores. Preservation of physical health, especially lung and vascular health, along with anxiety alleviation help to counterbalance the negative effect of aging on cognitive function in non-demented elderly primary care attendees.

Procalcitonin and procalcitonin kinetics for diagnosis and prognosis of intravascular catheter-related bloodstream infections in selected critically ill patients: a prospective observational study.

BACKGROUND: Procalcitonin (PCT) has emerged as a valuable marker of sepsis. The potential role of PCT in diagnosis and therapy monitoring of intravascular catheter-related bloodstream infections (CRBSI) in intensive care unit (ICU) is still unclear and was evaluated. METHODS: Forty-six patients were included in the study, provided they were free of infection upon admission and presented the first episode of suspected CRBSI during their ICU stay. Patients who had developed any other infection were excluded. PCT was measured daily during the ICU hospitalization. Primary endpoint was proven CRBSI. Therapy monitoring as according to infection control was also evaluated. RESULTS: Among the 46 patients, 26 were diagnosed with CRBSI. Median PCT on the day of infection suspicion (D0) was 7.70 and 0.10 ng/ml for patients with and without proven CRBSI, respectively (p < 0.001). The area under the curve (AUC) for PCT was 0.990 (95% CI; 0.972 - 1.000), whereas a cut-off value of 0.70 ng/ml provided sensitivity and specificity of 92.3 and 100% respectively. In contrast, the AUC for white blood cells (WBC) was 0.539 (95% CI; 0.369 - 0.709), and for C-reactive protein (CRP), 0.603 (95% CI; 0.438 - 0.768). PCT was the best predictor of proven infection. Moreover, an increase >0.20 ng/ml of PCT between the D0 and any of the 4 preceding days was associated with a positive predictive value exceeding 96%. PCT concentrations from the D2 to D6 after suspected infection tended to decrease in controlled patients, whereas remained stable in non-controlled subjects. A PCT concentration exceeding 1.5 ng/ml during D3 was associated with lack of responsiveness to therapy (p = 0.028). CONCLUSIONS: We suggest that PCT could be a helpful diagnostic and prognostic marker of CRBSI in critically ill patients. Both absolute values and variations should be considered.