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In. The University of the West Indies, Faculty of Medical Sciences. Faculty of Medical Sciences, Research Day. St. Augustine, Caribbean Medical Journal, March 21, 2019. .
Não convencional em Inglês | MedCarib | ID: biblio-1022636


Objective: To determine social and clinical factors associated with dementia in the oldest old (>85 years). Design and Methodology: A survey in a nationally representative sample of people aged 85 years and older using household enumeration was undertaken. Dementia status was ascertained using standardized interviews and algorithms from the 10/66 schedule. Information was also obtained on age, gender, level of education, ethnicity and previous occupation. Self-report on the presence of angina, heart disease, stroke, diabetes, high cholesterol, and hypertension was elicited and corroborated. Results: Of the participants 61.5% were females. The mean age was 89.0 years and dementia was present in 47.2 % persons. Dementia was significantly associated with age >95 (OR=2.02; 95%CI: 0.86- 4.69), female gender (OR=1.31; 95%CI: 0.85- 2.02), East Indian ethnicity (OR=1.45; 95%CI: 0.81-2.60), being widowed (OR=2.05; 95%CI: 0.59-7), Hindu religion (OR=2.10; 95%CI: 1.23- 3.58), history of working in the agricultural sector (OR=3.20; 95%CI: 1.59-6.48). Level of education (OR=0.14; 95%CI: 0.04-0.45), taking vitamins (OR=0.61; 95% CI: 0.37-0.97) and being of mixed ethnicity (African and East Indian) were protective factors. Of the self-reported disease conditions, those with greater than 3 medical co-morbidities were 2 times (OR=2.21; 95%CI: 0.48-9.94) more likely to have dementia than those with0-2 medical comorbidities. Dementia was not more likely to occur in diabetes (OR= 1.03; 95% CI: 0.65-1.64) and hypertension (OR= 0.67; 95% CI: 0.41-1.08). Conclusion: Our study, the first of its kind in Trinidad, supports more tailored policy and better planning of services for a rapidly expanding older population.

Humanos , Masculino , Feminino , Idoso de 80 Anos ou mais , Demência , Trinidad e Tobago , Determinantes Sociais da Saúde
In. The University of the West Indies, Faculty of Medical Sciences. Faculty of Medical Sciences, Research Day. St. Augustine, Caribbean Medical Journal, March 21, 2019. .
Não convencional em Inglês | MedCarib | ID: biblio-1024064


Objective: To investigate self-reported health status and risk factors for dementia in middle old (75-84 years) individuals. Design and Methodology: This study used the validated 10/66 door- to-door interview protocols. All individuals (836 persons) 75-84 years old were approached. The modified 10/66 dementia algorithm produced output in 811 (97%). Dementia diagnosis was made according to 10/66 criteria from: (1) cognitive tests, the Community Screening Instrument for Dementia (CSI'D), (2) EURO-D depression scale (3) informant interview. Demographic data included information on accommodation, social network, level of impairment and instrumental activities of daily living. Data were analyzed using multilevel logistic regression models. Results: Of the 811 participants, 55% were females. The mean age was 78.9±6.3 years and dementia was present in 198 (24.4%). High level of education, professional employment and having no comorbidities were significant protective factors. In multivariate analyses those with stroke were nearly 5 times more likely (OR=4.81, 95% CI: 2.72, 8.53) to have dementia, and those with diabetes were 2.5 times (OR=2.55; 95% CI: 1.71-3.78) more likely to have dementia than those without these comorbities. Impairment in climbing stairs walking and sight was more common in the dementia group than the non-demented. Individuals with dementia were more likely to be unable to perform all seven instrumental activities of daily living (IADL) and were less active compared with their non-demented counterparts. Conclusion: In the middle old population in Trinidad having diabetes and stroke with varying levels of impairment as well as a sedentary lifestyle puts an individual at increased risk of dementia.

Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Demência , Trinidad e Tobago , Nível de Saúde , Fatores de Risco , Região do Caribe/etnologia
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-18013


OBJECTIVE: To explore approaches use by informal caregivers in Barbados in caring for persons with dementia (PLWD). DESIGN AND METHODS: This study used a qualitative phenomenological approach. Recruitment was carried out via purposive sampling of adult primary informal caregivers of PLWD in Barbados. Data collection was carried out through in-depth, one-on-one, semi-structured interviews. Eight transcripts were analyzed according to Giorgi’s four-step analytic framework within ATLAS.ti data analysis software. RESULTS: The data were analysed and organized according to the following themes: 1. Guiding principles of care, including maintaining patience and optimizing the physical, social, and mental health of the PLWD, with a wide range of sources of personal guidance. 2. Facilitators to care, including intrinsic and extrinsic facilitators such as the assignment of meaning to the caregiving role, resignation from the caregiving role, having ample rest, support from the community, and support from children. 3. Barriers to care, including family issues, lack of time and money, dissatisfaction with formal care services, misunderstanding of the complexities of dementia symptomology, and recommendations for support. CONCLUSIONS: Each caregiver used unique strategies to manage his/her caregiving role by tapping on available resources while also strategically accommodating for difficulties encountered. There needs to be additional research in this extremely vital area. Services should be created/adapted to improve their support for informal caregivers to their unique needs.

Cuidadores , Cuidadores/normas , Demência , Barbados
Clinical laboratory international ; (4): 14-16, Sep. 2009. ilus
Artigo em Inglês | MedCarib | ID: med-17870


The current diagnosis of Alzheimer’s disease is based on clinical and cognition testing. Investigations are attempting to define the usefulness of biomarkers in the management of patients. The criteria for establishing and validating candidate biomarkers are critical. While CSF biomolecules have been proposed, markers in the serum possibly including antibodies to microglial cells may usher in a paradigm shift in the work-up of patients suspected of dementia.

Humanos , Demência , Microglia , Trinidad e Tobago
West Indian Med. J ; 49(4): 347-8, Dec. 2000.
Artigo em Inglês | MedCarib | ID: med-447


A twenty-one-year-old female known to suffer from bipolar type 1 disorder developed features of a pseudodementia. Following prompt initial response to treatment with antidepressants, there was an early recurrence of cognitive impairment. Blood investigations confirmed a macrocytic anaemia and vitamin B12 and folate deficiencies. There was dramatic resolution of cognitive impairment after vitamin replacement. This suggested the occurence of a reversible nutritional dementia and reinforced the need to rule out secondary organic causes of psychiatric symptoms even in patients previously diagnosed with a primary psychiatric disorder.(Au)

Adulto , Relatos de Casos , Feminino , Humanos , Transtorno Bipolar/complicações , Demência/etiologia , Deficiência de Ácido Fólico/complicações , Deficiência de Vitamina B 12/complicações , Demência/diagnóstico , Ácido Fólico/uso terapêutico , Deficiência de Ácido Fólico/complicações , Deficiência de Ácido Fólico/tratamento farmacológico , Vitamina B 12/uso terapêutico , Deficiência de Vitamina B 12/tratamento farmacológico
In. Fraser, Henry S; Hoyos, Michael D. Therapeutics update and other papers: CME in Barbados 1983. Bridgetown, University of the West Indies (Eastern Caribbean Medical Scheme), 1984. p.88-91.
Monografia em Inglês | MedCarib | ID: med-9779