Seric IgG anti-SARS-CoV-2 pre- and post- Covid-19 pandemic from Mexican asymptomatic subjects.

OBJECTIVE: To detect serum IgG anti-SARS-CoV-2 in pre-and post- Covid-19 pandemic in Mexican asymptomatic subjects in order to know the degree of viral dispersion. MATERIALS AND METHODS: Association of serum IgG antibodies (determined by ELISA) to sociodemographic and clinical data or contact with Covid-19 cases in three groups of subjects: 1) Covid-19 pre-pandemic blood donors (n= 538); 2) Covid-19 post-pandemic blood donors (n= 243); 3) Covid-19 post-pandemic neurological patients (n= 312). None of the subjects studied had been vaccinated. RESULTS: The positive rate of IgG anti-SARS-CoV-2 was notably higher in participants recruited during the pandemic (donors, 29.6%; neurological patients, 15.7%) than in those recruited pre-pan-demic (donors 0.6%) (p <0.001). Other conditions associated to antibody positivity were being a worker in sales or services, or having had previous contact with people with Covid-19, for donnors and neurological patients, and having diabetes mellitus, for neurological patients. Higher positivity levels of anti-SARS-CoV-2 IgG were found in females than in males. The highest proportion of subjects with anti-SARS-CoV-2 antibodies was found in central Mexico. CONCLUSIONS: The dispersion of SARS-CoV-2 in asymptomatic, unvaccinated subjects (donors and neurological patients) recruited in a Mexican health institution, who work in sales or services or had previously had contact with Covid-19 patients is 16 to 30%. The level of positivity for anti-SARS-CoV-2 IgG is higher in females than in males. SARS-CoV-2 antibody seropreva-lence follow-up studies must be favored among the general population, being mandatory for donors.

Seric IgG anti-SARS-CoV-2 pre- and post- Covid-19 pandemic from Mexican asymptomatic subjects / IgG sérica anti-SARS-CoV-2 pre y post pandemia de Covid-19 en mexicanos asintomáticos

Abstract: Objective: To detect serum IgG anti-SARS-CoV-2 in pre- and post- Covid-19 pandemic in Mexican asymptomatic subjects in order to know the degree of viral dispersion. Materials and methods: Association of serum IgG antibodies (determined by ELISA) to sociodemographic and clinical data or contact with Covid-19 cases in three groups of subjects: 1) Covid-19 pre-pandemic blood donors (n= 538); 2) Covid-19 post-pandemic blood donors (n= 243); 3) Covid-19 post-pandemic neurological patients (n= 312). None of the subjects studied had been vaccinated. Results: The positive rate of IgG anti-SARS-CoV-2 was notably higher in participants recruited during the pandemic (donors, 29.6%; neurological patients, 15.7%) than in those recruited pre-pandemic (donors 0.6%) (p <0.001). Other conditions associated to antibody positivity were being a worker in sales or services, or having had previous contact with people with Covid-19, for donnors and neurological patients, and having diabetes mellitus, for neurological patients. Higher positivity levels of anti-SARS-CoV-2 IgG were found in females than in males. The highest proportion of subjects with anti-SARS-CoV-2 antibodies was found in central Mexico. Conclusions: The dispersion of SARS-CoV-2 in asymptomatic, unvaccinated subjects (donors and neurological patients) recruited in a Mexican health institution, who work in sales or services or had previously had contact with Covid-19 patients is 16 to 30%. The level of positivity for anti-SARS-CoV-2 IgG is higher in females than in males. SARS-CoV-2 antibody seroprevalence follow-up studies must be favored among the general population, being mandatory for donors.

Resumen: Objetivo: Detectar IgG sérica anti-SARS-CoV-2 antes y después de la pandemia de Covid-19 en sujetos mexicanos asintomáticos, con la intención de conocer el grado de dispersión viral. Material y métodos: Se analizó la asociación de anticuerpos IgG séricos (determinados por ELISA), datos sociodemográficos y clínicos y contacto con casos de Covid-19 en tres grupos de sujetos: 1) donadores de sangre reclutados antes de la pandemia de Covid-19 (n= 538); 2) donadores (n= 243) y 3) pacientes neurológicos (n= 312) reclutados durante la pandemia de Covid-19. Ninguno de los sujetos estudiados había sido vacunado. Resultados: La tasa de positividad de IgG anti-SARS-CoV-2 fue notablemente mayor en los participantes reclutados durante la pandemia (donadores, 29.6%; pacientes neurológicos, 15.7%) que en los reclutados prepandemia (donadores 0.6%). Otras condiciones asociadas con positividad de anticuerpos fueron trabajar en ventas o servicios, o haber tenido contacto previo con pacientes Covid-19, en donadores y pacientes neurológicos, y haber tenido diabetes mellitus, en pacientes neurológicos. Se encontraron mayores niveles de positividad de IgG anti-SARS-CoV-2 en mujeres que en hombres. La mayor proporción de sujetos con anticuerpos anti-SARS-CoV-2 procedía del centro de México. Conclusiones: La dispersión del SARS-CoV-2 en sujetos asintomáticos, no vacunados (donadores y pacientes neurológicos), reclutados en una institución de salud mexicana, que trabajan en ventas o servicios, o tienen contacto previo con pacientes Covid-19 es de 16 a 30%. El nivel de positividad de IgG anti-SARS-CoV-2 es más alto en mujeres que en hombres. Los estudios de seguimiento de la seroprevalencia del SARS-CoV-2 deben favorecerse en la población general, siendo obligatorios en los donadores.

Loneliness Among Older Adults in Latin America, China, and India: Prevalence, Correlates and Association With Mortality.

Objectives: This study was designed to explore prevalence and correlates of self-reported loneliness and to investigate whether loneliness predicts mortality among older adults (aged 65 or above) in Latin America, China and India. Methods: The study investigated population-based cross-sectional (2003-2007) and longitudinal surveys (follow-up 2007-2010) from the 10/66 Dementia Research Group project. Poisson regression and Cox regression analyses were conducted to analyse correlates of loneliness and its association with mortality. Results: The standardised prevalence of loneliness varied between 25.3 and 32.4% in Latin America and was 18.3% in India. China showed a low prevalence of loneliness (3.8%). In pooled meta-analyses, there was robust evidence to support an association between loneliness and mortality across Latin American countries (HR = 1.13, 95% CI 1.01-1.26, I2 = 10.1%) and China (HR = 1.58, 95% CI 1.03-2.41), but there were no associations in India. Conclusion: Our findings suggest potential cultural variances may exist in the concept of loneliness in older age. The effect of loneliness upon mortality is consistent across different cultural settings excluding India. Loneliness should therefore be considered as a potential dimension of public health among older populations.

[Validation of a cutoff for the Depression Scale of the Center for Epidemiologic Studies, Brief Version (CESD-7)]. / Validación de un punto de corte para la Escala de Depresión del Centro de Estudios Epidemiológicos, versión abreviada (CESD-7).

OBJECTIVE: To evaluate the Depression Scale of the Center for Epidemiologic Studies, Brief Version (CESD-7) psychometric properties in Mexican adult population, and validate a cutoff for classifying subjects according to the presence / absence of clinically significant depressive symptoms (CSDS). MATERIALS AND METHODS: Screening cross-sectional study with a subsample of 301 adult residents of the Morelos state in Mexico, originally interviewed for the National Survey of Health and Nutrition 2012. Sensitivity and specificity of the selected cutoff were estimated using as reference the diagnostic criteria of ICD-10 and DSM-IV. RESULTS: The cutoff point estimated was CESD-7=9. Using the ICD-10 the sensitivity and specificity were 90.2 and 86%, and ROC was 88%. Using DSM-IV, the values were 80.4, 89.6, and 85%, respectively. CONCLUSIONS: The short version of the CESD-7 has good psychometric properties and can be used as a screening test to identify probable cases of subjects with clinically significant depressive symptoms.

Validación de un punto de corte para la Escala de Depresión del Centro de Estudios Epidemiológicos, versión abreviada (CESD-7) / Validation of a cutoff for the Depression Scale of the Center for Epidemiologic Studies, Brief Version (CESD-7)

OBJETIVO: Evaluar las propiedades psicométricas de la Escala de Depresión del Centro de Estudios Epidemiológicos, versión abreviada (CESD-7) en población adulta mexicana y validar un punto de corte que permita clasificar a los sujetos según la presencia/ausencia de síntomas depresivos clínicamente significativos (SDCS). MATERIAL Y MÉTODOS: Estudio transversal de tamizaje en una submuestra de 301 adultos residentes del estado de Morelos en México, que fueron entrevistados originalmente para la Encuesta Nacional de Salud y Nutrición 2012. La sensibilidad y especificidad del punto de corte seleccionado se estimaron utilizando como referencia los criterios diagnósticos del ICD-10 y del DSM-IV. RESULTADOS: El punto de corte estimado fue CESD-7=9. Utilizando el ICD-10, los valores obtenidos de sensibilidad y especificidad fueron de 90.2 y 86%, y un valor receptor-operador (ROC) de 88%, y para el DSM-IV los valores encontrados fueron de 80.4, 89.6, y 85%, respectivamente. CONCLUSIONES: La versión abreviada del CESD-7 tiene buenas propiedades psicométricas y puede ser utilizada como una prueba de tamizaje para identificar casos probables de sujetos con síntomas depresivos clínicamente significativos.

OBJECTIVE: To evaluate the Depression Scale of the Center for Epidemiologic Studies, Brief Version (CESD-7) psychometric properties in Mexican adult population, and validate a cutoff for classifying subjects according to the presence / absence of clinically significant depressive symptoms (CSDS). MATERIALS AND METHODS: Screening cross-sectional study with a subsample of 301 adult residents of the Morelos state in Mexico, originally interviewed for the National Survey of Health and Nutrition 2012. Sensitivity and specificity of the selected cutoff were estimated using as reference the diagnostic criteria of ICD-10 and DSM-IV. RESULTS: The cutoff point estimated was CESD-7=9. Using the ICD-10 the sensitivity and specificity were 90.2 and 86%, and ROC was 88%. Using DSM-IV, the values were 80.4, 89.6, and 85%, respectively. CONCLUSIONS: The short version of the CESD-7 has good psychometric properties and can be used as a screening test to identify probable cases of subjects with clinically significant depressive symptoms.

[Health conditions and functional status of older adults in Mexico]. / Condiciones de salud y estado funcional de los adultos mayores en México.

OBJECTIVE: To describe the health conditions and functional status of Mexicans older adults. MATERIALS AND METHODS: Descriptive study with a sample of 8,874 adults aged 60 and over, based on a nationally representative study. We analyzed major indicators associated with health conditions and functional status, obtaining prevalence and statistical tests of differences in proportions. RESULTS: The main conditions of this population are: hypertension (40%), diabetes (24%) and hypercholesterolemia (20%). For mental health indicators, 17.6% had depressive symptoms, 7.3% cognitive decline, and 7.9% dementia. For functional status, 26.9% reported difficulty in daily activities and 24.6% in instrumental activities. CONCLUSIONS: It is required the implementation of a new model of care to address the increasing prevalence of chronic degenerative diseases in old age, as well as the increased disability and consequent dependence resulting from them.

Condiciones de salud y estado funcional de los adultos mayores en México / Health conditions and functional status of older adults in Mexico

Objetivo. Describir las condiciones de salud y el estado funcional de los adultos mayores mexicanos. Material y métodos. Estudio descriptivo con una muestra de 8 874 adultos mayores de 60 años o más con representatividad nacional. Se analizaron indicadores asociados con las principales condiciones de salud y del estado funcional, se reportan las principales prevalencias así como pruebas de diferencias de proporciones. Resultados. Los principales padecimientos en esta población son la hipertensión (40%), diabetes (24%) e hipercolesterolemia (20%). Para los indicadores de salud mental, 17.6% presentó síntomas depresivos; 7.3%, deterioro cognitivo y, 7.9%, demencia. Para el estado funcional, 26.9% reportó dificultad para realizar actividades básicas y, 24.6%, para actividades instrumentales. Conclusiones. Es necesaria la puesta en marcha de un nuevo modelo de atención para hacer frente a la creciente prevalencia de las enfermedades crónicodegenerativas en la vejez, así como al aumento de la discapacidad y consecuente dependencia que resulta de ellas.

Objective. To describe the health conditions and functional status of Mexicans older adults. Materials and methods. Descriptive study with a sample of 8 874 adults aged 60 and over, based on a nationally representative study. We analyzed major indicators associated with health conditions and functional status, obtaining prevalence and statistical tests of differences in proportions. Results. The main conditions of this population are: hypertension (40%), diabetes (24%) and hypercholesterolemia (20%). For mental health indicators, 17.6% had depressive symptoms, 7.3% cognitive decline, and 7.9% dementia. For functional status, 26.9% reported difficulty in daily activities and 24.6% in instrumental activities. Conclusions. It is required the implementation of a new model of care to address the increasing prevalence of chronic degenerative diseases in old age, as well as the increased disability and consequent dependence resulting from them.

Epidemiology of dementias and Alzheimer's disease.

BACKGROUND AND AIMS: Global population aging has been one of the defining processes of the twentieth century, with profound economic, political and social consequences. It is driving the current epidemic of dementia, both in terms of its extent and global distribution. The aim of the study was to summarize recent findings relevant to the epidemiological knowledge of dementia and Alzheimer's disease (AD). METHODS: A narrative mini-review of the literature relevant to the epidemiology of dementia and AD is presented, summarizing important findings and analyzing their implications. RESULTS: It was estimated that in 2010 there were 36.5 million people living with dementia, with 7.7 million new cases yearly and a new case of dementia every 4 sec. The number of persons living with dementia will nearly double every 20 years. Most of these persons will be living in low- and middle-income countries (LMIC). CONCLUSIONS: There are a substantial number of people with dementia worldwide and these numbers will continue to increase mainly in LMIC, producing a wide range of impacts. It is important to make dementia a national public health and social care priority worldwide. Recent reviews and meta-analyses have failed to clearly identify a singular causal or preventive pathway for AD that seems to be a multicausal, heterogeneous and age-related condition.

[Neuropsychiatric symptoms in older adults with and without dementia in urban and rural regions. Results of the 10/66 Dementia Research Group in Mexico]. / Síntomas neuropsiquiátricos en adultos mayores con y sin demencia de regiones urbana y rural. Resultados del Grupo de Investigación en Demencia 10/66 en México.

OBJECTIVE: To describe, in a Mexican sample of urban and rural residents older than 65 years, with and without dementia, the frequency and severity of neuropsychiatric symptoms. MATERIAL AND METHODS: This work is part of the multi-center, epidemiological study carried out by the 10/66 Dementia Research Group, with 1,003 subjects from an urban region and 1,000 subjects from a rural region. Neuropsychiatric symptoms were assessed with the abbreviated version of the Neuropsychiatric Inventory (NPI-Q). RESULTS: Eighty six and eighty five dementia cases were found in the urban and rural regions, respectively. Subjects with dementia were more frequently widows, older and less educated, and the ones from the rural region had fewer neuropsychiatric symptoms, compared to the urban region. In both regions all symptoms were more severe in subjects with dementia. A high frequency of affective symptoms (depression and apathy specially) was observed, and irritability and anxiety in second term. The caregiver stress levels were associated with the frequency and severity of symptoms. CONCLUSIONS: This is the first study reporting neuropsychiatric symptoms associated with dementia identified by means of culturally validated and population based diagnostic criteria, in Mexican residents of urban and rural settings.

Dependencia y maltrato en el anciano con demencia / Dependência e maltrato em idosos com demência / Dependence and abuse affecting elderly persons with dementia

La relevancia del problema de salud pública que representan en el mundo las demencias, su asociación con la dependencia y el riesgo de maltrato en los ancianos con demencia por parte de sus cuidadores primarios o sus familiares, hacen necesario el análisis y la reflexión “de las implicaciones éticas, económicas, jurídicas, políticas y no sólo las consideraciones médicas”, de este problema, que reviste un interés particular dentro del campo de la Bioética. Se realizó una encuesta con el objetivo de determinar la dependencia física y detectar el maltrato, así como la asociación entre maltrato y respeto de sus preferencias en el anciano con demencia. Se evaluaron 61 ancianos con demencia de leve a moderada, de los cuales 73,8% fueron mujeres y 26,2% hombres. El porcentaje de pacientes que sufren maltrato fue de 29,2% en mujeres y 18,8% en hombres. No se encontró asociación estadísticamente significativa entre maltrato y dependencia física. Sin embargo, se encontró un riesgo de maltrato de 47,30% en ancianos con demencia a quienes no se les respetan sus preferencias con respecto a quienes sí se le respetan, medida con significancia estadística (IC 95%, 6,73-495,18).

The dependence and risk of abuse facing elderly people with dementia at the hand of their caregivers or relatives poses a public health problem the world over. Accordingly, analysis and reflection on the problem in light of “ethical, legal, political implications and not only medical considerations” is essential and of particular interest in the fi eld of the bioethics. The authors conducted a survey to determine the extent of physical dependence and to detect abuse, as well as the association between abuse and respect for the preferences of elderly persons with dementia. Sixty-one elderly persons with mild to moderate dementia were evaluated: 73.8% were women and 26.2%, men. Abuse was reportedamong 29.2% of the women and 18.8% of the men. No statistically significant association was found between abuse and physical dependence. However, risk of abuse was found among 47.30% of the elderly with dementia whose preferences were not being respected,compared to those whose preferences were. This is statistically significant (IC 95%, 6.73-495.18).

A importância mundial do problema da demência na saúde pública, sua associação com a dependência e o risco de abuso de idosos com demência por seus cuidadores e familiares obrigam a analisar e reflexionar “não apenas sobre considerações médicas, mas também sobre as repercussões éticas, econômicas, jurídicas e políticas” desta questão de particular interesse no campo da bioética. Foi realizada uma pesquisa para determinar a dependência física e detectar o abuso, bem como a associação entre abuso e respeito as suas preferências em idosos com demência. Foram avaliados 61 pacientes idosos com demência leve a moderada, dos quais 73,8% eram do sexo feminino e 26,2% de sexo masculino. A porcentagem de pacientes que sofrem abuso foi 29,2% nas mulheres e 18,8% nos homens. Não houve associação estatisticamente significativa entre abuso e dependência física. No entanto, encontrou-se risco de maus tratos de 47,30% em pacientes idosos com demência aos que não se respeitam as suas preferências com relação aos que se lhes respeitam, medido com significância estatística (95% CI, 6,73-495, 18).