Internet of medical things. Measurement of respiratory dynamics using wearable sensors in post-COVID-19 patients.

Nowadays, the measurement of respiratory dynamics is underrated at clinical setting and in the daily life of a subject and it still represents a challenge from a technical and medical point of view. In this article we propose a concept to measure some of its parameters, such as the respiratory rate (RR), using four inertial sensors. Two different experiments were performed to validate the concept. We analyzed the most suitable placement of each sensor to assess those features and we studied the reliability of the system to measure abnormal parameters of respiration (tachypnea, bradypnea and breath holding). Finally, we measured post-COVID-19 patients, some of them with breath alterations after more than a year of the diagnosis. Experimental results showed that the proposed system could be potentially used to measure the respiratory dynamics at clinical setting. Moreover, while RR can be easily calculated by any sensor, other parameters need to be measured with a sensor in a particular position.

Hoy en día, la medición de la dinámica respiratoria está infravalorada en el ámbito clínico y en la vida diaria de un sujeto y sigue representando un reto desde el punto de vista técnico y médico. En este artículo proponemos un concepto para medir algunos de sus parámetros, como la frecuencia respiratoria (FR), utilizando cuatro sensores inerciales. Se realizaron dos experimentos diferentes para validar el concepto. Analizamos la colocación más adecuada de cada sensor para evaluar esas características y estudiamos la fiabilidad del sistema para medir parámetros anormales de la respiración (taquipnea, bradipnea y retención de la respiración). Por último, realizamos mediciones en pacientes post-COVID-19, algunos de ellos con alteraciones respiratorias después de más de un año del diagnóstico. Los resultados experimentales mostraron que el sistema propuesto podría utilizarse potencialmente para medir la dinámica respiratoria en el ámbito clínico. Además, mientras que la FR puede calcularse fácilmente con cualquier sensor, otros parámetros deben medirse con un sensor en una posición determinada.

High education accelerates cognitive decline in dementia: A brief report from the population-based NEDICES cohort.

High education has been associated with faster cognitive decline after diagnosis of Alzheimer's disease (AD), but it is unclear whether these findings extend to other dementia subtypes. OBJECTIVE: We investigated whether educational attainment influences the cognitive trajectories of older adults with different dementia subtypes. METHODS: All participants were selected from NEDICES, a prospective population-based cohort study of Spanish older adults. A total sample of 53 individuals with dementia completed the MMSE-37 at Times 1 and 2 (mean follow-up=2.8±0.5 years) to assess cognitive decline. RESULTS: At follow-up, MMSE-37 scores had decreased by 3.34±4.98 points in low-educated individuals with dementia versus 7.90±4.88 points in high-educated subjects (effect size (r)=0.32, p=0.02). CONCLUSION: Educational level influenced the cognitive trajectories of patients with dementia assessed by the MMSE-37.

A educação mais alta tem sido associada com um declínio cognitive mais rápido após o diagnóstico de doença de Alzheimer (DA), mas não está claro se estes achados podem ser extendidos a outros subtipos de demência. OBJETIVO: Nós investigamos se o nível educacional alcançado influencia as trajetórias cognitivas de adultos idosos com diferentes subtipos de demência. MÉTODOS: Todos os participantes foram selecionados do NEDICES, um estudo de coorte prospectivo de base populacional de idosos adultos espanhóis. Uma amostra total de 53 indivíduos com demência completaram o MEEM-37 nos momentos 1 e 2 (acompanhamento médio de 2.8± 0.5 anos) para avaliação do declínio cognitive. RESULTADOS: No seguimento, o MEEM-37 declinou 3.34±4.98 pontos em indivíduos de baixa escolaridade com demência versus 7.90±4.88 pontos entre os altamente escolarizados (tamanho do efeito (r)=0.32, p=0.02). CONCLUSÃO: O nível educacional influenciou as trajetórias cognitivas de pacientes com demência avaliados pelo MEEM-37.

High education accelerates cognitive decline in dementia: A brief report from the population-based NEDICES cohort / Maior educação acelera o declínio cognitive em demência: relato breve da coorte de base populacional NEDICES

ABSTRACT High education has been associated with faster cognitive decline after diagnosis of Alzheimer's disease (AD), but it is unclear whether these findings extend to other dementia subtypes. OBJECTIVE: We investigated whether educational attainment influences the cognitive trajectories of older adults with different dementia subtypes. METHODS: All participants were selected from NEDICES, a prospective population-based cohort study of Spanish older adults. A total sample of 53 individuals with dementia completed the MMSE-37 at Times 1 and 2 (mean follow-up=2.8±0.5 years) to assess cognitive decline. RESULTS: At follow-up, MMSE-37 scores had decreased by 3.34±4.98 points in low-educated individuals with dementia versus 7.90±4.88 points in high-educated subjects (effect size (r)=0.32, p=0.02). CONCLUSION: Educational level influenced the cognitive trajectories of patients with dementia assessed by the MMSE-37.

RESUMO A educação mais alta tem sido associada com um declínio cognitive mais rápido após o diagnóstico de doença de Alzheimer (DA), mas não está claro se estes achados podem ser extendidos a outros subtipos de demência. OBJETIVO: Nós investigamos se o nível educacional alcançado influencia as trajetórias cognitivas de adultos idosos com diferentes subtipos de demência. MÉTODOS: Todos os participantes foram selecionados do NEDICES, um estudo de coorte prospectivo de base populacional de idosos adultos espanhóis. Uma amostra total de 53 indivíduos com demência completaram o MEEM-37 nos momentos 1 e 2 (acompanhamento médio de 2.8± 0.5 anos) para avaliação do declínio cognitive. RESULTADOS: No seguimento, o MEEM-37 declinou 3.34±4.98 pontos em indivíduos de baixa escolaridade com demência versus 7.90±4.88 pontos entre os altamente escolarizados (tamanho do efeito (r)=0.32, p=0.02). CONCLUSÃO: O nível educacional influenciou as trajetórias cognitivas de pacientes com demência avaliados pelo MEEM-37.

Under reporting of dementia deaths on death certificates: a systematic review of population-based cohort studies.

The purpose of this review is to assess the extent to which dementia is omitted as a cause of death from the death certificates of patients with dementia. A systematic literature search was performed to identify population-based cohort studies in which all participants were examined or screened for symptoms of dementia with a validated instrument followed by confirmation of any suspected cases with a clinical examination (two-phase investigation). Data were extracted in a standardized manner and assessed through the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative. Seven studies met the selection criteria. These were from the Americas (5 articles: 2 from Canada, 2 from the US, and 1 from Brazil) and Europe (2 articles: 1 from the UK and 1 from Spain). Each met at least 83% of the STROBE criteria. The reporting of dementia on death certificates was poor in these 7 studies, ranging from 7.2%-41.8%. Respiratory or circulatory-related problems were the most frequently reported causes of death among people who were demented but who were not reported as demented on death certificates. The use of death certificates for studying dementia grossly underestimates the occurrence of dementia in the population. The poor reporting of dementia on these certificates suggests a lack of awareness of the importance of dementia as a cause of death among medical personnel. There is an urgent need to provide better education on the importance of codification of dementia on death certificates in order to minimize errors in epidemiological studies on dementia.

Association of tic disorders with poor academic performance in central Spain: a population-based study.

OBJECTIVE: To analyze the association between tic disorders and poor academic performance in school-aged children. STUDY DESIGN: This was a cross-sectional, observational study conducted in a randomly selected sample of mainstream school-aged children (aged 6-16 years). The sampling frame included different types of schools and educational levels. Children with poor academic performance (eg, repeating a grade, special needs), and tic disorders (defined based on Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criteria) were identified. Children with and without tics and children with and without poor academic performance were compared in terms of clinical features (ie, medical history and neurologic and psychiatric comorbidities), school, and environmental characteristics. Logistic regression analyses were performed using school performance (dependent variable) and tic disorders (independent variable), after adjusting for confounding variables. RESULTS: The study cohort comprised 1867 children (mean age, 10.9 + 2.9 years; 1007 males [53.9%]). Tics were present in 162 children (8.6%), and poor academic performance was noted in 223 (11.9%). Overall poor academic performance was associated with age (OR, 1.71; P < .0001), television viewing (OR, 5.33; P = .04), attention deficit hyperactivity disorder (OR, 1.38; P < .0001), and family history of school dysfunction (OR, 2.43; P = .02) and was negatively associated with higher IQ score (OR, 0.90; P < .0001) and tic disorders (OR, 0.29; P = .01). CONCLUSION: After adjusting for other covariates, the presence of tic disorders was not associated with poor academic performance in our cohort. Early academic support and modification of environmental characteristics are needed for children at higher risk for school dysfunction, to enhance academic performance.