The Use of an Electronic Painting Platform by Family Caregivers of Persons with Dementia: A Feasibility and Acceptability Study.

Painting is a well-known method for alleviating stress, but it is uncertain whether family caregivers can use an electronic painting platform at home for this purpose. Aim. The aim in this study was to assess the feasibility and acceptability of having family caregivers of persons with dementia (FCPWD) draw electronic paintings using a mobile app, and to assess the preliminary effect of the intervention on their well-being. Methods. This was a two-phase feasibility and acceptability study, with qualitative interviews conducted in Phase 1 and qualitative interviews and a quantitative survey conducted in Phase 2. Caregiving burden, depressive symptoms, self-rated health, and social support were measured before and after the intervention. Participants were asked to draw electronic paintings at any time they liked, and to share the paintings with friends or relatives if they wished. Result. The recruitment rate in Phase 2 was 87.5% (28 out of 32), with 78.6% participants (22 out 28) completing all activities in 8 weeks. The FCPWD regarded the e-painting app as an appropriate channel for expressing their emotions. They found the layout of the app to be easy to use and were satisfied with it. A total of 116 pictures were produced. Log-in frequency was significantly correlated with the sharing of paintings with friends or relatives (r = 0.72, p < 0.001). Conclusion. FCPWD considered the e-painting mobile app to be a feasible and acceptable technology-based psychosocial platform. A further investigation with a larger sample in a full-scale randomized controlled trial is warranted.

Meeting own needs and supporting ability to care: Family caregivers' and health care professionals' perspectives on professional support provided through a potential mobile application.

BACKGROUND: A majority of persons with dementia in Sweden live in their own homes and are often cared for by family members. Caring for a family member may be a positive experience. It may, however, also be a negative experience as symptoms like disturbing behavior and delusions may be difficult to encounter. The burden of being a family caregiver has been shown to affect the caregivers' quality of life. OBJECTIVE: To explore stakeholders' perspectives on a potential mobile application through which family caregivers could be supported by healthcare professionals in caring for a person with dementia living at home. METHOD: Eight individual interviews with family caregivers and a focus group with eight healthcare professionals specialized in dementia care were analyzed using content analysis method. RESULTS: The findings suggest that a mobile application can support family caregivers to meet their own needs in terms of finding structure in everyday life, how to get information and support in their own pace, and how to care for themselves. The findings also suggest the necessity of accessing relevant contact networks to be supported in the ability to care for a family member with dementia. CONCLUSION: Healthcare and social services mediated support provided through user-friendly mobile application has the potential to support family caregivers both in taking care of a person with dementia and caring for themselves. Moreover, it is important that the information provided to family caregivers is personalized according to the needs of the family caregivers as the family member's dementia advances.

Associations Between Functional Biological Age and Cognition Among Older Adults in Rural Bangladesh: Comparisons With Chronological Age.

OBJECTIVES: We constructed a functional biological age (fBioAge) indicator by using four functional variables: grip strength, forced expiratory lung volume, visual acuity, and hearing. Our aim was to compare how chronological age (ChronAge) and fBioAge are related to cognitive abilities in older adults. METHOD: We used data from the Poverty and Health in Aging project, Bangladesh. Participants ( N = 400) were 60+ years of age and diagnosed as nondemented. Examined cognitive abilities were four episodic memory measures (including recall and recognition), two verbal fluency indicators, two semantic knowledge, and two processing speed tasks. RESULTS: fBioAge accounted for cognitive variance beyond that explained by ChronAge also after controlling for medical diagnoses and blood markers. DISCUSSION: Compared with ChronAge, fBioAge was a stronger predictor of cognition during a broad part of the old adult span. fBioAge seems, in that respect, to have the potential to become a useful age indicator in future aging studies.

Different Context but Similar Cognitive Structures: Older Adults in Rural Bangladesh.

Most research in cognitive aging is based on literate participants from high-income and Western populations. The extent to which findings generalize to low-income and illiterate populations is unknown. The main aim was to examine the structure of between-person differences in cognitive functions among elderly from rural Bangladesh. We used data from the Poverty and Health in Aging (PHA) project in Bangladesh. The participants (n = 452) were in the age range 60-92 years. Structural equation modeling was used to estimate the fit of a five-factor model (episodic recall, episodic recognition, verbal fluency, semantic knowledge, processing speed) and to examine whether the model generalized across age, sex, and literacy. This study demonstrates that an established model of cognition is valid also among older persons from rural Bangladesh. The model demonstrated strong (or scalar) invariance for age, and partial strong invariance for sex and literacy. Semantic knowledge and processing speed showed weak (or metric) sex invariance, and semantic knowledge demonstrated also sensitivity to illiteracy. In general, women performed poorer on all abilities. The structure of individual cognitive differences established in Western populations also fits a population in rural Bangladesh well. This is an important prerequisite for comparisons of cognitive functioning (e.g., declarative memory) across cultures. It is also worth noting that absolute sex differences in cognitive performance among rural elderly in Bangladesh differ from those usually found in Western samples.

Intimate partner violence and its association with maternal depressive symptoms 6-8 months after childbirth in rural Bangladesh.

BACKGROUND: The prevalence of intimate partner violence (IPV), a gross violation of human rights, ranges widely across the world with higher prevalence reported in low- and middle-income countries. Evidence related mainly to physical health shows that IPV has both direct and indirect impacts on women's health. Little is known about the impact of IPV on the mental health of women, particularly after childbirth. OBJECTIVE: To describe the prevalence of IPV experienced by women 6-8 months after childbirth in rural Bangladesh and the factors associated with physical IPV. The study also aims to investigate the association between IPV and maternal depressive symptoms after childbirth. DESIGN: The study used cross-sectional data at 6-8 months postpartum. The sample included 660 mothers of newborn children. IPV was assessed by physical, emotional, and sexual violence. The Edinburgh Postnatal Depression Scale assessed maternal depressive symptoms. RESULTS: Prevalence of physical IPV was 52%, sexual 65%, and emotional 84%. The husband's education (OR: 0.41, CI: 0.23-0.73), a poor relationship with the husband (OR: 2.64, CI: 1.07-6.54), and emotional violence by spouse (OR: 1.58, CI: 1.35-1.83) were significantly associated with physical IPV experienced by women. The perception of a fussy and difficult child (OR: 1.05, CI: 1.02-1.08), a poor relationship with the husband (OR: 4.95, CI: 2.55-9.62), and the experience of physical IPV (OR: 2.83, CI: 1.72-4.64) were found to be significant predictors of maternal depressive symptoms among women 6-8 months after childbirth. Neither forced sex nor emotional violence by an intimate partner was found to be significantly associated with maternal depressive symptoms 6-8 months postpartum. CONCLUSIONS: It is important to screen for both IPV and depressive symptoms during pregnancy and postpartum. Since IPV and spousal relationships are the most important predictors of maternal depressive symptoms in this study, couple-focused interventions at the community level are suggested.

Prevalence of dementia and factors associated with dementia in rural Bangladesh: data from a cross-sectional, population-based study.

BACKGROUND: There are currently no published reports of dementia prevalence or factors associated with dementia occurrence in Bangladesh. The aims are to report the prevalence of definite and questionable dementia in rural Bangladesh, and examine factors potentially associated with dementia occurrence, including sociodemographic, clinical, social, and nutritional factors. METHODS: We used data from a population-based, cross-sectional study from Matlab, in rural Bangladesh, on 471 persons aged 60+ years. Participants underwent a clinical examination including diagnosis of somatic disorders, and a structured interview including questions about sociodemographic and social factors. Nutritional status was measured with the Mini Nutritional Assessment, and blood tests were conducted to assess a range of nutritional and clinical aspects. Age- and sex-specific dementia prevalence was calculated. Crude and adjusted logistic regression was used to examine associations between dementia and clinical, social, and nutritional factors. Dementia was diagnosed using a two-step procedure by physicians according to DSM-IV criteria. RESULTS: The prevalence of questionable dementia was 11.5% and definite dementia was 3.6%. Dementia prevalence increased with increasing years of age (adjusted OR: 1.04; 95% CI = 1.002-1.1) and decreased with more years of education (adjusted OR: 0.8; 95% CI = 0.6-0.99). Being malnourished increased the odds of dementia almost six-fold (adjusted OR: 5.9; 95% CI = 1.3-26.3), while frequent participation in social activities was associated with a decreased odds (adjusted OR: 0.5; 95% CI = 0.2-0.9). CONCLUSIONS: The prevalence of dementia in rural Bangladesh is similar to other countries in the South Asia region, but lower than reports from other world regions. Malnutrition is strongly associated with dementia occurrence, and is a relevant area for future research within low-income countries.

A cross-cultural perspective on aging and memory: Comparisons between Bangladesh and Sweden.

Most studies on cognitive aging have been conducted in high-income countries (mainly on Western populations). The main aim of this study was to compare the relative importance of predictors of episodic and semantic memory performance in older people (≥60 years) from Bangladesh (n = 400) and Sweden (n = 1,098). Hierarchical regression models were used in order to study the importance of some commonly used predictors in the two countries. A main finding was that variations in age did not have much impact on episodic and semantic memory performance in Bangladesh. Instead, sex was a strong predictor for semantic memory performance. In Sweden this pattern was reversed. In the Western world, chronological age is believed to be strongly associated with memory performance in cross-sectional studies, particularly in people greater than 60 years of age. This study indicates that the difference between the two countries (in relative importance of the predictors included in this study) is mainly due to the fact that years of education is connected to age in the Western world but to sex in Bangladesh. It remains to be examined whether earlier selective survival is also responsible for the relative absence of cognitive age differences in Bangladesh.

Prevalence and associated factors of depressive and anxiety symptoms during pregnancy: a population based study in rural Bangladesh.

BACKGROUND: Few studies have examined the associated factors of antepartum depressive and anxiety symptoms (ADS and AAS) in low-income countries, yet the World Health Organization identifies depressive disorders as the second leading cause of global disease burden by 2020. There is a paucity of research on mental disorders and their predictors among pregnant women in Bangladesh. This study aims to estimate the prevalence of depressive and anxiety symptoms and explore the associated factors in a cross-section of rural Bangladeshi pregnant women. METHODS: The study used cross-sectional data originating from a rural community-based prospective cohort study of 720 randomly selected women in their third trimester of pregnancy from a district of Bangladesh. The validated Bangla version of the Edinburgh Postnatal Depression Scale was used to measure ADS, and a trait anxiety inventory to assess general anxiety symptoms. Background information was collected using a structured questionnaire at the respondents' homes. RESULTS: Prevalence of ADS was 18% and AAS 29%. Women's literacy (OR 0.59, 95% CI 0.37-0.95), poor partner relationship (OR 2.23, 95% CI 3.37-3.62), forced sex (OR 1.95, 95% CI 1.01-3.75), physical violence by spouse (OR 1.69, 95% CI 1.02-2.80), and previous depression (OR 4.62 95% CI 2.72-7.85) were found to be associated with ADS. The associated factors of AAS were illiteracy, poor household economy, lack of practical support, physical partner violence, violence during pregnancy, and interaction between poor household economy and poor partner relationship. CONCLUSION: Depressive and anxiety symptoms are found to occur commonly during pregnancy in Bangladesh, drawing attention to a need to screen for depression and anxiety during antenatal care. Policies aimed at encouraging practical support during pregnancy, reducing gender-based violence, supporting women with poor partner relationships, and identifying previous depression may ameliorate the potentially harmful consequences of antepartum depression and anxiety for the women and their family, particularly children.

The International Network on Public Health and Aging (INOPA): introducing a life course perspective to the public health agenda.

In this paper, we present an international network of researchers from projects examining the human aging process and its consequences. It is both vital and urgent to include aging and a life course perspective on the public health agenda, particularly in low-income countries. By announcing the network in a publication, we wish not just to position the network but, more importantly, to attract the attention of other potential collaborators either at the project, institutional, decision making, or applied level.

Sex differences in cognition among illiterate Bangladeshis: a comparison with literate Bangladeshis and Swedes.

We investigated the presence and magnitude of sex differences in late adulthood, assessing 426 illiterate Bangladeshis, 239 literate Bangladeshis, and 598 Swedes. The cognitive domains examined included calculation, episodic memory, spatial visualization, and global cognitive ability. In general, men performed at a higher level than women on tasks assessing calculation and spatial visualization, whereas women performed at a higher level than men on the episodic memory task. Notably, the pattern of cognitive sex differences was similar irrespective of nationality and literacy, although the magnitude of the male advantage was inversely related to level of education. Finally, the low performance of the illiterate women demonstrated the penalizing effect restrictions in public exposure might have on cognitive performance.