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1.
Alzheimers Dement ; 20(9): 6468-6485, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39115027

RESUMEN

INTRODUCTION: Relationships and interplay of an infection burden (IB) and periodontal pathogens or periodontal disease (Pd) markers with Alzheimer's disease (AD) and all-cause dementia among US adults were examined. METHODS: Less than or equal to 2997 participants from the National Health and Nutrition Survey III were linked to CMS-Medicare [≥45 years (1988-1994); ≤30 years follow-up]. RESULTS: Hepatitis C (hazard ratio = 3.33, p = 0.004) and herpes simplex virus 2 were strongly associated with greater all-cause dementia risk. Porphyromonas gingivalis and Streptococcus oralis were associated with greater AD risk at higher IB. The red-green periodontal pathogen cluster coupled with higher IB count increased the risk of all-cause dementia among minority racial groups. Pocket probing depth associated with dementia risk at lower IB in the overall sample. DISCUSSION: Select viruses and bacteria were associated with all-cause and AD dementia, while the IB interacted with Pd markers in relation to these outcomes. HIGHLIGHTS: Interplay of infection burden (IB) and periodontal disease with dementia was tested. ≤2997 participants from NHANES III were linked to Medicare. Hepatitis C and herpes simplex virus 2 strongly associated with dementia risk. Tetanus sero-positivity increased Alzheimer's disease (AD) risk. Porphyromonas gingivalis and Streptococcus oralis associated with AD at higher IB. Red-green periodontal cluster at high IB, increased dementia in racial minorities. Pocket probing depth associated with dementia risk at lower IB.


Asunto(s)
Enfermedad de Alzheimer , Enfermedades Periodontales , Humanos , Masculino , Femenino , Enfermedad de Alzheimer/epidemiología , Enfermedad de Alzheimer/microbiología , Anciano , Estados Unidos/epidemiología , Enfermedades Periodontales/epidemiología , Encuestas Nutricionales , Persona de Mediana Edad , Factores de Riesgo , Demencia/epidemiología , Medicare/estadística & datos numéricos , Incidencia
2.
Brain Behav Immun ; 113: 91-103, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37393057

RESUMEN

BACKGROUND: Cardiovascular health is associated with brain magnetic resonance imaging (MRI) markers of pathology and infections may modulate this association. METHODS: Using data from 38,803 adults (aged 40-70 years) and followed-up for 5-15 years, we tested associations of prevalent total (47.5%) and hospital-treated infection burden (9.7%) with brain structural and diffusion-weighted MRI (i.e., sMRI and dMRI, respectively) common in dementia phenome. Poor white matter tissue integrity was operationalized with lower global and tract-specific fractional anisotropy (FA) and higher mean diffusivity (MD). Volumetric sMRI outcomes included total, gray matter (GM), white matter (WM), frontal bilateral GM, white matter hyperintensity (WMH), and selected based on previous associations with dementia. Cardiovascular health was measured with Life's Essential 8 score (LE8) converted to tertiles. Multiple linear regression models were used, adjusting for intracranial volumes (ICV) for subcortical structures, and for demographic, socio-economic, and the Alzheimer's Disease polygenic risk score for all outcomes, among potential confounders. RESULTS: In fully adjusted models, hospital-treated infections were inversely related to GM (ß ± SE: -1042 ± 379, p = 0.006) and directly related to WMH as percent of ICV (Loge transformed) (ß ± SE:+0.026 ± 0.007, p < 0.001). Both total and hospital-treated infections were associated with poor WMI, while the latter was inversely related to FA within the lowest LE8 tertile (ß ± SE:-0.0011 ± 0.0003, p < 0.001, PLE8×IB < 0.05), a pattern detected for GM, Right Frontal GM, left accumbens and left hippocampus volumes. Within the uppermost LE8 tertile, total infection burden was linked to smaller right amygdala while being associated with larger left frontal GM and right putamen volumes, in the overall sample. Within that uppermost tertile of LE8, caudate volumes were also positively associated with hospital-treated infections. CONCLUSIONS: Hospital-treated infections had more consistent deleterious effects on volumetric and white matter integrity brain neuroimaging outcomes compared with total infectious burden, particularly in poorer cardiovascular health groups. Further studies are needed in comparable populations, including longitudinal studies with multiple repeats on neuroimaging markers.


Asunto(s)
Demencia , Sustancia Blanca , Adulto , Humanos , Sustancia Blanca/diagnóstico por imagen , Sustancia Blanca/patología , Imagen de Difusión Tensora/métodos , Bancos de Muestras Biológicas , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Imagen por Resonancia Magnética/métodos , Sustancia Gris/diagnóstico por imagen , Sustancia Gris/patología , Reino Unido
3.
Alzheimers Dement ; 19(10): 4475-4487, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37547953

RESUMEN

INTRODUCTION: Among older adults, total and hospitalized infection may be associated with incidence of all-cause and Alzheimer's disease (AD) dementias, with variation by cardiovascular health (CVH). METHODS: We used Cox proportional hazards (PH) models to examine the relationships between International Classification of Diseases-10th revision (ICD-10)-specific viral and bacterial infectious agents and incident all-cause and AD dementia among 355,046 UK Biobank participants ≥50 years at baseline. Life's Essential 8 (LE8) index reflected CVH. RESULTS: In both sexes, total infection burden (yes vs. no) was associated with all-cause dementia, with significant interactions by LE8 tertiles, whereby this relationship was significant only in the lowest LE8 tertile. Hospital-treated infection burden (yes vs no) was significantly related to all-cause and AD dementia, with no significant interaction with LE8 tertile. Age group patterns were detected. DISCUSSION: AD and all-cause dementia were related to hospital-treated infections, while CVH modified the relationship of total infection burden with all-cause dementia. Highlights Secondary analysis on >355,000 UK Biobank participants ≥50 years at baseline. Alzheimer's disease and all-cause dementia are both related to hospital-treated infection. Cardiovascular health modifies association of infection burden with all-cause dementia.


Asunto(s)
Enfermedad de Alzheimer , Enfermedades Cardiovasculares , Femenino , Masculino , Humanos , Anciano , Enfermedad de Alzheimer/epidemiología , Bancos de Muestras Biológicas , Reino Unido/epidemiología , Factores de Riesgo , Enfermedades Cardiovasculares/epidemiología
4.
Clin Gerontol ; : 1-15, 2023 Oct 27.
Artículo en Inglés | MEDLINE | ID: mdl-37888842

RESUMEN

OBJECTIVES: We examined links between marital quality and loneliness among aging veterans and explored whether veterans' PTSD symptom severity moderated these associations. METHODS: Data came from 269 Vietnam-Era combat veterans who had a spouse/partner (M age = 60.50). Utilizing two waves of data spanning six years, we estimated multiple regression models that included positive and negative marital quality, PTSD symptom severity, and loneliness in 2010 as predictors of loneliness in 2016. RESULTS: Facets of positive (but not negative) marital quality were associated with veterans' loneliness. Companionship - spousal affection and understanding - was associated with lower subsequent loneliness among veterans with low/moderate - but not high - PTSD symptom severity. Conversely, sociability - the degree to which one's marriage promotes socializing with others - was associated with lower subsequent loneliness regardless of PTSD symptom severity. CONCLUSIONS: Companionship and sociability were each associated with veterans' subsequent loneliness. Whereas benefits of companionship were attenuated at higher levels of PTSD symptom severity, benefits of sociability were not. CLINICAL IMPLICATIONS: For veterans with higher PTSD symptoms, recommending mental health treatment to decrease symptom severity may help them to reap the benefits of close/intimate relationships. However, bolstering veterans' social participation more broadly may provide an additional means of reducing their loneliness.

5.
Environ Res ; 204(Pt A): 111976, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34478724

RESUMEN

Growing epidemiological evidence suggests that air pollution may increase the risk of cognitive decline and neurodegenerative disease. A hallmark of neurodegeneration and an important diagnostic biomarker is volume reduction of a key brain structure, the hippocampus. We aimed to investigate the possibility that outdoor air nitrogen dioxide (NO2) and particulate matter with diameter ≤2.5 µm (PM2.5) and ≤10 µm (PM10) adversely affect hippocampal volume, through a meta-analysis. We considered studies that assessed the relation between outdoor air pollution and hippocampal volume by structural magnetic resonance imaging in adults and children, searching in Pubmed and Scopus databases from inception through July 13, 2021. For inclusion, studies had to report the correlation coefficient along with its standard error or 95% confidence interval (CI) between air pollutant exposure and hippocampal volume, to use standard space for neuroimages, and to consider at least age, sex and intracranial volume as covariates or effect modifiers. We meta-analyzed the data with a random-effects model, considering separately adult and child populations. We retrieved four eligible studies in adults and two in children. In adults, the pooled summary ß regression coefficients of the association of PM2.5, PM10 and NO2 with hippocampal volume showed respectively a stronger association (summary ß -7.59, 95% CI -14.08 to -1.11), a weaker association (summary ß -2.02, 95% CI -4.50 to 0.47), and no association (summary ß -0.44, 95% CI -1.27 to 0.40). The two studies available for children, both carried out in preadolescents, did not show an association between PM2.5 and hippocampal volume. The inverse association between PM2.5 and hippocampal volume in adults appeared to be stronger at higher mean PM2.5 levels. Our results suggest that outdoor PM2.5 and less strongly PM10 could adversely affect hippocampal volume in adults, a phenomenon that may explain why air pollution has been related to memory loss, cognitive decline, and dementia.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Enfermedades Neurodegenerativas , Adulto , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Niño , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/análisis , Hipocampo/química , Hipocampo/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Dióxido de Nitrógeno/análisis , Material Particulado/análisis , Material Particulado/toxicidad
6.
Environ Res ; 185: 109365, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32222630

RESUMEN

Associated with numerous cognitive and behavioral functions and with several diseases, the prefrontal cortex is vulnerable to environmental insult. Among other factors, toxins in air pollution have been associated with damage to the prefrontal cortex in children and older adults. We used data from the UK Biobank to assess further associations between an array of toxins in air pollution and gray matter in the prefrontal cortex including the left and right frontal poles, left and right superior frontal gyri, left and right frontal medial cortex, left and right orbitofrontal cortex, and left and right frontal opercula, using multivariate models adjusted for covariates that possibly could confound the association between air pollution and volume of prefrontal gray matter. The results showed inverse associations between PM 2.5, PM 10, and nitrogen oxides and prefrontal volume in models adjusted for age, sex, education, socioeconomic status, race-ethnicity, self-rated overall health, body mass index, total brain volume, smoking status, and alcohol use frequency. Education appeared to moderate the association between air pollution and prefrontal volume. The data in these analyses came from regions whose mean PM 2.5 was near the upper limit and whose mean PM 10 was under those recommended by the World Health Organization. These findings suggest that comparatively low levels of air pollution might be associated with reduced volume of the prefrontal cortex.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Bancos de Muestras Biológicas , Anciano , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Niño , Estudios Transversales , Exposición a Riesgos Ambientales/análisis , Humanos , Material Particulado/análisis , Material Particulado/toxicidad , Corteza Prefrontal , Reino Unido
7.
Folia Parasitol (Praha) ; 652018 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-30213919

RESUMEN

The intracellular parasite Toxoplasma gondii (Nicolle et Manceaux, 1908) infects humans resulting in acute toxoplasmosis, an infection that in immunocompetent people is typically mild but results in persistent latent toxoplasmosis. In that T. gondii appears to affect dopamine synthesis and because addicting drugs affect midbrain dopamine transmission, latent toxoplasmosis could influence substance use. Using both the third and continuous National Health and Nutrition Examination Surveys from the US Centers for Disease Control and Prevention, we used logistic regression to test for associations between T. gondii seropositivity and subject self-report of having ever used tobacco, alcohol, marijuana, cocaine, heroin, or methamphetamine. In the third NHANES dataset, which included data for tobacco, alcohol, marijuana and cocaine, T. gondii seropositivity was associated with a reduced likelihood of self-reported marijuana (OR = 0.71 [95% CI: 0.58; 0.87]; p = 0.001) and cocaine use (OR = 0.72 [95% CI: 0.56; 0.91]; p = 0.006). In the continuous National Health and Nutrition Examination Surveys dataset, which included data for all six substances, T. gondii seropositivity was associated with a reduced likelihood of self-reported tobacco (OR = 0.87 [95% CI: 0.76; 1.00]; p = 0.044), marijuana (OR = 0.60 [95% CI: 0.50; 0.72]; p < 0.001), heroin (OR = 0.60 [95% CI: 0.42; 0.85]; p = 0.005) and methamphetamine use (OR = 0.54 [95% CI: 0.38; 0.77]; p = 0.001). We observed interactions between sex and T. gondii seropositivity in the prediction of self-reported use of tobacco and alcohol. Further, T. gondii seropositivity appeared to remove the protective effect of education and economic status against self-reported cigarette smoking. These findings suggest that T. gondii seropositivity may be inversely associated with some but not all types of substance use in US adults.


Asunto(s)
Trastornos Relacionados con Sustancias/epidemiología , Toxoplasmosis/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Centers for Disease Control and Prevention, U.S. , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Prevalencia , Factores de Riesgo , Autoinforme , Estudios Seroepidemiológicos , Trastornos Relacionados con Sustancias/etiología , Toxoplasma/fisiología , Toxoplasmosis/parasitología , Estados Unidos/epidemiología , Adulto Joven
8.
Am J Community Psychol ; 61(1-2): 191-203, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-29400907

RESUMEN

Supportive nonparental adults, particularly nonfamilial adults, provide critical support during the transition to adulthood, opening doors to educational and career paths. This study examined whether economic disadvantage shapes access to these relationships. Results showed that low-income adolescents had reduced access to naturally occurring mentors, and the relationships they did form tended to be close bonds with family and friends, rather than nonfamilial adults. Their mentors were more likely to focus on practical support, and less likely to serve as role models or provide career advice. These effects of socioeconomic status on natural mentoring relationships remained evident, even when accounting for youth race/ethnicity. Findings suggest that networks of support differ depending on a youth's socioeconomic context in ways that could perpetuate social and economic inequalities.


Asunto(s)
Envejecimiento , Tutoría , Pobreza , Adolescente , Adulto , Femenino , Humanos , Relaciones Interpersonales , Entrevistas como Asunto , Estudios Longitudinales , Masculino , Investigación Cualitativa , Adulto Joven
9.
Brain Behav Immun ; 52: 161-168, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26598104

RESUMEN

Prior research has suggested an association between exposure to infectious disease and neurocognitive function in humans. While most of these studies have explored individual viral, bacterial, and even parasitic sources of infection, few have considered the potential neurocognitive burden associated with multiple infections. In this study, we utilized publically available data from a large dataset produced by the Centers for Disease Control and Prevention that included measures of neurocognitive function, sociodemographic variables, and serum antibody data for several infectious diseases. Specifically, immunoglobulin G antibodies for toxocariasis, toxoplasmosis, hepatitis A, hepatitis B, and hepatitis C, cytomegalovirus, and herpes 1 and 2 were available in 5662 subjects. We calculated an overall index of infectious-disease burden to determine if an aggregate measure of exposure to infectious disease would be associated with neurocognitive function in adults aged 20-59 years. The index predicted processing speed and learning and memory but not reaction time after controlling for age, sex, race-ethnicity, immigration status, education, and the poverty-to-income ratio. Interactions between the infectious-disease index and some sociodemographic variables were also associated with neurocognitive function. In summary, an index aggregating exposure to several infectious diseases was associated with neurocognitive function in young- to middle-aged adults.


Asunto(s)
Trastornos del Conocimiento/parasitología , Trastornos del Conocimiento/virología , Enfermedades Transmisibles/psicología , Adulto , Trastornos del Conocimiento/epidemiología , Trastornos del Conocimiento/psicología , Enfermedades Transmisibles/epidemiología , Enfermedades Transmisibles/parasitología , Enfermedades Transmisibles/virología , Costo de Enfermedad , Infecciones por Citomegalovirus/psicología , Etnicidad , Femenino , Hepatitis/psicología , Infecciones por Herpesviridae/psicología , Humanos , Aprendizaje , Masculino , Persona de Mediana Edad , Tiempo de Reacción , Factores de Riesgo , Toxoplasmosis/psicología , Estados Unidos/epidemiología , Adulto Joven
10.
Helicobacter ; 21(6): 471-480, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26935014

RESUMEN

BACKGROUND: Helicobacter pylori (H. pylori) infection is associated with cognitive deficits in humans, an association potentially mediated or moderated by folate concentration or inflammation. MATERIALS AND METHODS: We used the National Health and Nutrition Examination Survey (NHANES) datasets to examine whether folate concentration or inflammation mediates or moderates the relationship between H. pylori and cognitive function. Models were performed using linear, Poisson, and zero-inflated Poisson regression, and we performed separate analyses for groups aged 20-59 and 60-90 years with sample sizes ranging from 700 to 1700. RESULTS: We did not find evidence of mediation in either age group. In the 20- to 59-year group, interactions between H. pylori and ferritin (p values ranging from .004 to .039) were associated with worse processing speed, better working memory, and worse reaction time. Interactions between H. pylori and fibrinogen (p values ranging from .023 to .045), C-reactive protein (CRP) (p = .023), and the inflammatory index (p = .045) were associated with worse processing speed. In 60- to 90-year-olds, H. pylori interacted with ferritin and the inflammatory index to predict fewer mathematical errors (p values of .036 and .023). Interactions with folate (p values of .016 and .006) and C-reactive protein (p values ranging from <.001 to .048) were inconsistent in directionality. CONCLUSIONS: In this dataset, representative of the US population, inflammation and folate concentrations moderated but did not mediate the association between H. pylori seropositivity and cognition.


Asunto(s)
Cognición , Ácido Fólico/metabolismo , Infecciones por Helicobacter/patología , Inflamación/patología , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Persona de Mediana Edad , Estados Unidos , Adulto Joven
11.
Folia Parasitol (Praha) ; 632016 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-27827337

RESUMEN

Toxoplasma gondii (Nicolle et Manceaux, 1908) is an intracellular parasite that can cause ongoing latent infection persisting for the duration of a non-definitive host's life. Affecting approximately one-third of the world's population, latent toxoplasmosis has been associated with neuropsychological outcomes and a previous report suggested an association between latent toxoplasmosis and adult height. Given the large number of people with latent toxoplasmosis and its potential associations with human height, we sought to better understand the association between latent toxoplasmosis and human morphology by evaluating seropositivity for T. gondii and multiple body measures reported in the National Health and Nutrition Examination Survey III (NHANES III) and in the more recent continuous NHANES data sets from the United States Centers for Disease Control and Prevention for which data on T. gondii are available. In these analyses, latent toxoplasmosis was not associated with any of the body measures assessed in the NHANES datasets even after taking into account interactions between latent toxoplasmosis and testosterone suggesting that in these samples, latent toxoplasmosis is not associated with adult morphology including height.


Asunto(s)
Tamaño Corporal , Toxoplasmosis/patología , Adulto , Anticuerpos Antiprotozoarios/sangre , Femenino , Humanos , Masculino , Encuestas Nutricionales , Toxoplasma/fisiología , Toxoplasmosis/sangre
12.
Folia Parasitol (Praha) ; 632016 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-27827340

RESUMEN

Changes in behaviour and cognition have been associated with latent infection from the apicomplexan protozoan Toxoplasma gondii (Nicolle et Manceaux, 1908) in both animal and human studies. Further, neuropsychiatric disorders such as schizophrenia have also been associated with latent toxoplasmosis. Previously, we found no association between T. gondii immunoglobulin G antibody (IgG) seropositivity and depression in human adults between the ages of 20 and 39 years (n = 1 846) in a sample representative of the United States collected by the Centers for Disease Control as part of a National Health and Nutrition Examination Survey (NHANES) from three datasets collected between 1999-2004. In the present study, we used NHANES data collected between 2009 and 2012 that included subjects aged 20 to 80 years (n = 5 487) and used the Patient Health Questionnaire 9 (PHQ-9) to assess depression with the overall aim of testing the stability of the results of the prior study. In the current study, the seroprevalence of T. gondii was 13%. The percentage of subjects reporting clinical levels of depression assessed with the PHQ-9 was 8%. As before, we found no association between T. gondii IgG seroprevalence and depression (OR = 1.01, 95% CI = 0.81-1.25; p = 0.944) while controlling for sex, educational attainment, race-ethnicity, age, poverty-to-income ratio and cigarette smoking. We also found no positive associations between anti-T. gondii antibody titre and depression (OR = 1.00, 95% CI = 0.96-1.06; p = 0.868). Moreover, we found no association between T. gondii seroprevalence or antibody titre and suicidal ideation (seroprevalence: OR = 1.22, 95% CI = .85-1.75; p = 0.277, titre: OR = 1.05, 95% CI = 0.98-1.14; p = 0.177). Defining depression to also include subjects currently taking antidepressant medication even with non-elevated questionnaires did not find evidence of a positive association between latent toxoplasmosis and depression. In the present study, neither T. gondii seroprevalence nor anti-T. gondii antibody titre was positively associated with depression or suicidal ideation among subjects aged 20 to 80 years.


Asunto(s)
Depresión/complicaciones , Toxoplasmosis/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Animales , Anticuerpos Antiprotozoarios/sangre , Humanos , Inmunoglobulina G/sangre , Persona de Mediana Edad , Factores de Riesgo , Estudios Seroepidemiológicos , Encuestas y Cuestionarios , Toxoplasma , Toxoplasmosis/sangre , Toxoplasmosis/patología , Adulto Joven
13.
Folia Parasitol (Praha) ; 622015 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-26374832

RESUMEN

The ascarid nematodes Toxocara canis (Werner, 1782) and Toxocara cati (Schrank, 1788) may infect humans resulting in toxocariasis. A prior study associated species of Toxocara Stiles, 1905 with cognitive deficits in children. To determine if a similar association between toxocariasis and cognition exists in adults, we analysed a large dataset from the United States' Center for Disease Control's National Health and Nutrition Examination Survey. We used linear-regression and multivariate models to examine the association between toxocariasis as assessed by the presence of anti-Toxocara IgG antibodies and three measures of cognitive function - simple reaction time (SRT), symbol-digit substitution (SDS) and serial-digit learning (SDL) in 4 279 adults aged 21 to 59 years. Toxocara seroprevalence did not vary with age or blood-lead concentration but did vary with gender, ethnicity, educational attainment and poverty-to-income ratio. Controlling for gender, age, blood-lead concentration, educational attainment, ethnic background and the poverty-to-income ratio, we found that toxocariasis predicted worse performance on the SDS but not on the SRT or the SDL. Moreover, there were significant interactions between toxocariasis and age, gender and educational attainment. In conclusion, toxocariasis appears to be associated with decreased cognitive function. Interactions between toxocariasis and gender, age and educational attainment further suggest that certain groups may be more susceptible than others to the cognitive dysfunction associated with toxocariasis in adults.

14.
Telemed J E Health ; 21(8): 644-51, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25839334

RESUMEN

INTRODUCTION: The rate of telemedicine adoption using interactive video between patient and provider has not met expectations. Technology, regulations, and physician buy-in are cited reasons, but patient acceptance has not received much consideration. We examine attitudes regarding telemedicine to better understand the subjective definitions of its acceptability and utility that shape patients' willingness to use telemedicine. MATERIALS AND METHODS: Using the Montana Health Matters study (a random, statewide survey [n=3,512]), we use latent class analysis to identify groups with similar patterns of attitudes toward telemedicine followed by multinomial logistic regression to estimate predictors of group membership. RESULTS: Although only 5% are amenable to telemedicine regardless of circumstance, 23% would be comfortable if it could be convenient, whereas 29% would be situationally amenable but uncomfortable using telemedicine. Still, a substantial percentage (43%) is unequivocally averse to telemedicine despite the inconvenience of in-person visits. Educational attainment, prior Internet use, and rural residence are main predictors that increase the likelihood of being in an amenable group. CONCLUSIONS: From the patient's perspective, the advantages of reduced travel and convenience are recognized, but questions remain about the equivalence to physician visits. Many people are averse to telemedicine, indicating a perceived incompatibility with patient needs. Only 1.7% of the respondents reported using telemedicine in the previous year; about half were veterans. Hence, few have used telemedicine, and key innovation adoption criteria-trialability and observability-are low. Increased attention to public awareness in the adoption process is needed to increase willingness to embrace telemedicine as a convenient way to obtain quality healthcare services.


Asunto(s)
Actitud hacia los Computadores , Telemedicina/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Montana , Población Rural , Población Urbana
15.
Soc Sci Res ; 50: 367-81, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25592942

RESUMEN

There is consistent evidence that student involvement in extracurricular activities (EAs) is associated with numerous academic benefits, yet understanding how peer associations within EAs might influence this link is not well understood. Using Add Health's comprehensive data on EA participation across 80 schools in the United States, we develop a novel measure of peer associations within EA activities. We find that EA participation with high achieving peers has a nontrivial link to college enrollment, even after considering individual, peer, and school-level factors. This suggests that school policies aimed at encouraging student exposure to high achieving peers in EAs could have an important impact on a student's later educational outcomes.


Asunto(s)
Escolaridad , Actividades Recreativas , Estudiantes/estadística & datos numéricos , Universidades/estadística & datos numéricos , Adolescente , Adulto , Femenino , Humanos , Estudios Longitudinales , Masculino , Estados Unidos , Adulto Joven
16.
Folia Parasitol (Praha) ; 61(4): 285-92, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25185399

RESUMEN

Latent infection with the apicomplexan Toxoplasma gondii (Nicolle et Manceaux, 1908) has been associated with schizophrenia, bipolar disorder and self-harm behaviour. However, the potential relationship between T. gondii immunoglobulin G antibody (IgG) seropositivity and generalised-anxiety disorder (GAD) and panic disorder (PD) has not been investigated. The associations between serum reactivity to T. gondii and major depressive disorder (MDD), GAD and PD were evaluated in a total sample of 1 846 adult participants between the ages of 20 and 39 years from the United States Center for Disease Control's National Health and Nutrition Examination Survey (NHANES). Approximately 16% of the overall sample was seropositive for T. gondii and 7% of the sample met criteria for MDD, 2% for GAD and 2% for PD. There were no significant associations between T. gondii IgG seroprevalence and MDD (OR = 0.484, 95% CI = 0.186-1.258), GAD (OR = 0.737, 95% CI = 0.218-2.490) or PD (OR = 0.683, 95% CI = 0.206-2.270) controlling for sex, ethnicity, poverty-to-income ratio and educational attainment. However, limited evidence suggested a possible association between absolute antibody titres for T. gondii and GAD and PD but not MDD. Toxoplasma gondii seroprevalence was not associated with MDD, GAD or PD within the context of the limitations of this study, although there may be an association of T. gondii serointensity with and GAD and PD, which requires further study.


Asunto(s)
Trastornos de Ansiedad/etiología , Trastorno Depresivo Mayor/etiología , Trastorno de Pánico/etiología , Toxoplasmosis/complicaciones , Adulto , Anticuerpos Antiprotozoarios/sangre , Trastornos de Ansiedad/parasitología , Trastorno Depresivo Mayor/parasitología , Femenino , Humanos , Inmunoglobulina G/sangre , Masculino , Oportunidad Relativa , Trastorno de Pánico/parasitología , Factores de Riesgo , Toxoplasma/inmunología , Toxoplasmosis/inmunología , Toxoplasmosis/patología , Adulto Joven
17.
PLoS One ; 18(6): e0286731, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37285350

RESUMEN

Associated with gastritis, peptic-ulcer disease, and gastric carcinoma, Helicobacter pylori (H. pylori) also has been associated with decreased cognitive function and dementia. In this study, we used data from the UK Biobank to further examine associations between H. pylori seropositivity and serointensity and performance on several cognitive tasks in adults 40 to 70 years of age (M = 55.3, SD = 8.1). In these analyses, H. pylori seropositivity (i.e., either positive or negative for H. pylori) and serointensity (concentration of antibodies against H. pylori antigens) in adjusted models were associated with worse function on tasks of Numeric memory, Reasoning, and errors on the Pairs matching test but better function on the Tower rearrangement task. Together, these findings suggest that H. pylori seropositivity and serointensity might be associated with worse cognitive function in this age group.


Asunto(s)
Infecciones por Helicobacter , Helicobacter pylori , Adulto , Humanos , Infecciones por Helicobacter/patología , Anticuerpos Antibacterianos , Cognición , Reino Unido/epidemiología
18.
Psychiatry Res ; 309: 114410, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-35091160

RESUMEN

Infecting much of the world's population, the herpesviridae virus cytomegalovirus has been associated with lower cognitive function in some but not all studies. In this study, we further investigate associations between cytomegalovirus and cognitive function in a community-based sample of adults aged 40 to 70 years (M = 55.3; SD = 8.1) from the United Kingdom. Adjusted multiple-regression modeling showed no significant associations between cytomegalovirus and performance on nine cognitive tasks. Further, in adjusted interaction models, age, sex, educational attainment, and income did not moderate associations between cytomegalovirus and cognitive function. In this community-based adult sample, cytomegalovirus was not associated with cognitive function.


Asunto(s)
Cognición , Citomegalovirus , Adulto , Escolaridad , Humanos , Reino Unido/epidemiología
19.
Folia Parasitol (Praha) ; 692022 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-35611587

RESUMEN

The nematodes Toxocara canis (Werner, 1782) and Toxocara cati (Schrank, 1788) have been associated with worse human cognitive function in children and middle-aged adults. In this study, we sought to determine the association between Toxocara seropositivity and serointensity determined by detection of IgG antibodies against the Toxocara antigen recombinant Tc-CTL-1 and cognitive function in older adults, including approximately 1,350 observations from the 2013-2014 National Health and Nutrition Examination Survey. Mean fluorescence intensity was used to quantify IgG antibodies against the Toxocara recombinant Tc-CTL-1 antigen, and respondents were considered positive at values greater than 23.1. In adjusted models from sample sizes ranging from 1,274 to 1,288 depending on the individual cognitive task, we found that Toxocara seropositivity was associated with worse performance on the animal-fluency task (b = -1.245, 95% CI: -2.392 to -0.099, P< 0.05) and the digit-symbol coding task (b = -5.159, 95% CI: -8.337 to -1.980, P< 0.001). Toxocara serointensity assessed using log-transformed mean fluorescence intensity as a continuous variable was associated with worse performance on the digit-symbol coding task (b = -1.880, 95% CI: -2.976 to -0.783, P < 0.001). There were no significant associations with tasks assessing memory. Further, age modified the association between Toxocara and cognitive function, although sex, educational attainment, and income did not. These findings suggest that Toxocara might be associated with deficits in executive function and processing speed in older U.S. adults, although additional research is required to better describe cognitive function in older adults who are seropositive for Toxocara spp.


Asunto(s)
Toxocariasis , Animales , Cognición , Inmunoglobulina G , Encuestas Nutricionales , Toxocara , Toxocariasis/complicaciones , Toxocariasis/diagnóstico , Toxocariasis/epidemiología
20.
Pathogens ; 10(11)2021 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-34832565

RESUMEN

Several viral, bacterial, and parasitic diseases have been associated with cognitive function and neuropsychiatric outcomes in humans, including human T-cell lymphotropic virus 1 (HTLV-1). In this study, we sought to further generalize previously reported associations of cognitive function and depression with HTLV-1 seropositivity and serointensity using a community-based sample of adults aged approximately 40 to 70 years (mean = 55.3 years) from the United Kingdom. In this sample, the results of adjusted linear regression models showed no associations of HTLV-1 seropositivity or serointensity with reasoning, pairs-matching, or reaction-time cognitive tasks or with depression. In addition, neither age, sex, educational attainment, nor income moderated associations of HTLV-1 seropositivity or serointensity with cognitive function or depression. In this middle-aged to older middle-aged adult community sample, HTLV-1 seropositivity and serointensity do not appear to be associated with reasoning, pairs-matching, and reaction-time tasks or with depression.

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