Estimations of the number people with mental diseases associated with toxoplasmosis and identification of risk factors by continent.

Strong evidence exists based on metanalysis of the relationship between toxoplasmosis and many psychiatric diseases: schizophrenia, bipolar disorder, and suicidal behavior. Herein, we estimate the number of cases based on the attributable fraction due to toxoplasmosis on these diseases. The population attributable fraction of mental disease associated with toxoplasmosis was 20,4% for schizophrenia; 27,3% for bipolar disorder; and 0,29% for suicidal behavior (self-harm). The lower and upper estimated number of people with mental disease associated with toxoplasmosis was 4'816.491 and 5'564.407 for schizophrenia; 6'348.946 and 7'510.118,82 for bipolar disorder; and 24.310 and 28.151 for self-harm; for a global total lower estimated number of 11'189.748 and global total upper estimated number of 13'102.678 people with mental disease associated with toxoplasmosis for the year 2019. According to the prediction through the Bayesian model of risk factors for toxoplasmosis associated with mental disease, these varied in importance geographically; thus, in Africa, the most important risk factor was water contamination and in the European region, the cooking conditions of meats. Toxoplasmosis and mental health should be a research priority given the enormous potential impact of reducing this parasite in the general population.

Empirical treatment and mortality in bacteremia due to extended spectrum ß-lactamase producing Enterobacterales (ESßL-E), a retrospective cross-sectional study in a tertiary referral hospital from Colombia.

BACKGROUND: Infections caused by extended spectrum ß-lactamase (ESßL) producing bacteria are common and problematic. When they cause bloodstream infections, they are associated with significant morbidity and mortality. METHODS: A retrospective cross-sectional observational study was conducted in a single center in Pereira, Colombia. It included people hospitalized with bacteremia due to gram-negative bacilli with the extended-spectrum ß-lactamase producing phenotype. A logistic regression analysis was constructed. Clinical characteristics and risk factors for death from sepsis were established. RESULTS: The prevalence of bacteremia due to Enterobacterales with extended-spectrum ß-lactamase producing phenotype was 17%. 110 patients were analyzed. Most patients were men (62%) with a median age of 58 years, hospital mortality was 38%. Admission to intensive care was 45%. The following risk factors for mortality were established: shock requiring vasoactive support, Pitt score > 3 points, and not having an infectious disease consultation (IDC). CONCLUSIONS: bacteremia due to Enterobacterales with extended-spectrum ß-lactamase producing phenotype have a high mortality. Early recognition of sepsis, identification of risk factors for antimicrobial resistance, and prompt initiation of appropriate empiric antibiotic treatment are important. An infectious disease consultation may help improve outcomes.

Relationship between steroid use and superinfections in SARS-CoV-2 patients. A systematic review and meta-analysis.

Introduction: The use of steroids has been proposed as a pharmacological approach to treat the SARS-CoV-2 infection to improve outcomes. However, there are doubts about safety against the development of superinfections and their worse outcomes. Objective: To establish the relative frequency of superinfection associated with using steroids in patients with SARS-CoV-2 infection. Materials and methods: We conducted a systematic literature review and meta-analysis using PRISMA standards in 5 databases (PubMed/Scopus/Cochrane/EMBASE/Google Scholar). The search was carried out between February 2020 and May 2023. The search terms were 'steroids' or 'superinfection' 'and' followed by 'SARS-CoV-2' or 'COVID-19'. Results: We found 77 studies, but only 10 with 3539 patients were included in the systematic review. All patients developed severe disease. The documented OR for superinfection through the meta-analysis was 1.437 (95% IC 0.869-2.378) with a p-value of 0.158 without showing a risk attributed to steroids and the development of superinfections. In the Funnel-plot analysis, no publication biases were found. Conclusion: No relationship was found between using steroids and superinfection in patients with SARS-CoV-2.

Niveles de actividad física en población adulta del municipio Pereira, Colombia / Levels of physical activity in the adult population of the municipality of Pereira, Colombia

Introducción: En la calidad de vida tiene una fuerte influencia los estilos de vida. A su vez, la inactividad física es uno de los estilos de vida más perjudiciales que genera discapacidad y años de vida perdidos, debido a su papel en la génesis y exacerbación de las enfermedades crónicas no transmisibles. Objetivo: Determinar los niveles de actividad física y factores asociados en la población adulta del municipio Pereira. Métodos: Estudio transversal analítico. Se estimó una muestra de 1000 participantes entre las edades de 18 a 64 años. Los niveles de actividad física se midieron con el cuestionario internacional de actividad física versión larga. Se realizaron análisis bivariados. Resultados: El total de participantes fue de 996. La prevalencia global del cumplimiento de recomendaciones en actividad física del estudio fue de un 52,9 por ciento, en la que prevaleció el dominio de actividad física moderada. Los sujetos de mayor nivel socioeconómico obtuvieron menores prevalencias de actividad física. En cuanto a nivel de escolaridad, las categorías de tecnólogo (58 por ciento) y secundaria (57 por ciento) alcanzaron la más alta prevalencia de cumplimiento de recomendaciones mínimas. Conclusiones: Un poco más de la mitad de la población adulta pereirana cumple las recomendaciones mínimas de actividad física predominando la actividad de intensidad moderada, no obstante, la media presenta problemas de sobrepeso y obesidad. Es importante promover la práctica de actividad física de moderada a alta intensidad e involucrar a todos los estratos socioeconómicos(AU)

Introduction: Lifestyles have a strong influence on quality of life. In turn, physical inactivity is one of the most harmful lifestyles that generates disability and lost years of life, due to its role in the genesis and exacerbation of chronic non-communicable diseases. Objective: To determine the levels of physical activity and associated factors in the adult population of Pereira municipality. Methods: Analytical cross-sectional study. It was estimated a sample of 1000 participants in the ages from 18 to 64. Physical activity levels were measured with the long version of the international questionnaire of physical activity. Bivariate analyses were performed. Results: The total number of participants was 996. The overall prevalence of compliance with recommendations in physical activity of the study was 52.9 percent, in which the domain of moderate physical activity prevailed. Subjects of higher socio-economic status obtained lower prevalences of physical activity. In terms of schooling level, the categories of technologist (58 percent) and secondary school level (57 percent) reached the highest prevalence of compliance with minimum recommendations. Conclusions: A little more than half of the adult population of Pereira meets the minimum recommendations for physical activity, predominating moderate intensity activity; however, the average presents problems of overweight and obesity. It is important to promote the practice of moderate to high intensity physical activity and involve all socio-economic strata(AU)

Closing gaps in histoplasmosis: clinical characteristics and factors associated with probable/histoplasmosis in HIV/AIDS hospitalized patients, a retrospective cross-sectional study in two tertiary centers in Pereira, Colombia.

BACKGROUND: The HIV pandemic continues to cause a high burden of morbidity and mortality due to delayed diagnosis. Histoplasmosis is prevalent in Latin America and Colombia, is difficult to diagnose and has a high mortality. Here we determined the clinical characteristics and risk factors of histoplasmosis in people living with HIV (PLWH) in Pereira, Colombia. MATERIALS AND METHODS: This was a retrospective cross-sectional study (2014-2019) involving two tertiary medical centers in Pereira, Colombia. People hospitalized with HIV were included. Histoplasma antigen detection was performed in urine samples. Probable histoplasmosis was defined according to European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group/National Institute of Allergy and Infectious Diseases Mycoses Study Group criteria. RESULTS: 172 HIV-infected patients were analyzed. Histoplasmosis was confirmed in 29% (n = 50/172) of patients. The logistic regression analysis showed that the risk factors for histoplasmosis were pancytopenia (OR 4.1, 95% CI 1.6-10.3, P = 0.002), < 50 CD4 + cells/µL (OR 3.1, 95% CI 1.3-7.3, P = 0.006) and Aspartate transaminase (AST) levels > 46 IU/L (OR 3.2, 95% CI 1.3-8, P = 0.010). CONCLUSIONS: Histoplasmosis is highly prevalent in hospitalized patients with HIV in Pereira, Colombia. The clinical findings are nonspecific, but there are some clinical abnormalities that can lead to suspicion of the disease, early diagnosis and prompt treatment. Urine antigen detection is useful for diagnosis, but is not widely available. An algorithmic approach is proposed for low-resource clinical settings.

Sociodemographic and academic characteristics of students in the Medical Program at the Universidad Tecnológica de Pereira. Cohorts 1977-2018 / Características sociodemográficas y académicas de los estudiantes del Programa de Medicina de la Universidad Tecnológica de Pereira. Cohortes 1977-2018

Abstract Problem situation: The characterization of students in a Medical Program and its impact on academic performance and successful completion is a relatively unstudied process in medical education. Material and Methods: This observational, descriptive, and cross-sectional study characterized students in the Medical Program at the Universidad Tecnológica de Pereira from 1977-2018. Results: Participants were grouped into applicants (23738), enrolled (3714), graduates (1984), and non-graduates (1730). In the enrolled student subgroup, the male:female ratio varied with a trend favoring females in terms of age when starting the program, age at graduation, graduation percentage, and periods enrolled. Application and enrollment were predominantly composed of students from lower socioeconomic strata, and who had graduated from public schools. There was a progressive participation of women in all groups, completing the program in less time and graduating at a younger age. The applicant/enrollment ratio was 25:1, unmet demand was 96% and the adjusted percentage of non-graduates was 27.4%. Conclusion: This information opens the discussion on the development of educational policies that seek to increase coverage and strengthen student follow-up programs, allowing for a timely and successful graduation.

Resumen Situación Problemática: La caracterización de los estudiantes de un Programa de Medicina y su impacto en el desempeño académico y egreso exitoso, es un proceso relativamente poco estudiado en la educación médica. Materiales y Métodos: El presente estudio observacional, descriptivo, de corte transversal, caracterizó los estudiantes del programa de Medicina de la Universidad Tecnológica de Pereira en el periodo 1977-2018. Resultados: Los participantes fueron clasificados en aspirantes (23738), matriculados (3714), graduados (1984) y no graduados (1730). En el subgrupo de estudiantes matriculados, la relación hombre: mujer fue variable con una tendencia que favoreció a la mujer en términos de edad de ingreso, edad de graduación, porcentaje de graduación y periodos matriculados. Predominó la inscripción y matrícula de estudiantes de estratos socioeconómicos bajos, provenientes del Eje Cafetero y de colegios púbicos. Se apreció una progresiva participación de las mujeres en todos los grupos que presentaron menor tiempo de duración de la carrera y menor edad en el momento de la graduación. La relación inscrita/matriculado fue de 25:1, la demanda insatisfecha fue del 96% y el porcentaje ajustado de estudiantes no graduados fue del 27.4%. Conclusión: Estos datos permiten la discusión sobre el desarrollo de políticas educativas que procuren un aumento en la cobertura y el fortalecimiento de programas de seguimiento del estudiante que le permitan un egreso oportuno y exitoso.

Efectos de la fragilidad en los resultados adversos de la cirugía cardiaca en ancianos / Effects of frailty on the adverse outcomes of cardiac surgery in the elderly

Resumen Introducción: la fragilidad es una condición del paciente anciano, caracterizada por un estado de vulnerabilidad para desenlaces adversos en salud, incluidos los causados por la cirugía cardíaca. Objetivo: establecer la prevalencia de fragilidad en el contexto prequirúrgico del anciano sometido a cirugía cardiaca y establecer el riesgo de desenlaces adversos otorgado por esta condición. Metodología: estudio analítico de cohorte que valoró la fragilidad en 66 pacientes ancianos sometidos a cirugía cardiaca mediante el fenotipo físico de fragilidad de Fried. Se realizó un seguimiento a 30 días, durante el cual se estableció la prevalencia de fragilidad y el riesgo otorgado por esta condición a los desenlaces adversos de la cirugía cardiaca. Resultados: la edad de los pacientes osciló entre los 60 y los 83 años; la mediana fue de 70,5 años. La prevalencia de la fragilidad fue del 31,8%. La fragilidad incrementó los siguientes desenlaces adversos postoperatorios: muerte (p 0,001), ventilación prolongada (p 0,001), uso prolongado de vasoactivos (p 0,001) e infección del sitio operatorio (p 0,004). El riesgo de mortalidad otorgado por la fragilidad fue más alto que el de los puntajes usuales de valoración como el EuroSCORE II (HR 5,49; IC95% 1,0-28,5 vs. HR 1,17 IC95% 1,0-1,29). Conclusión: la fragilidad es una condición frecuente en el paciente anciano sometido a cirugía cardiaca e incrementa el riesgo de eventos adversos, en especial el de mortalidad. Se recomienda incluir la medición de la fragilidad en el protocolo prequirúgico del paciente anciano.

Abstract Introduction: Frailty is a common condition in the elderly patient, and is noted for its vulnerability for adverse outcomes in health, including those caused by cardiac surgery. Objective: To establish the prevalence of frailty in the pre-surgical context of the elderly subjected to cardiac surgery, as well as to establish the risk of adverse outcomes due to this condition. Method: An analytical cohort study was performed in order to evaluate frailty in 66 elderly patients subjected to cardiac surgery, using the physical phenotype of frailty described by Fried. A follow-up was made at 30 days, during which the frailty prevalence was established, as well the risk of adverse outcomes of the cardiac surgery due to this condition. Results: The age of the patients varied between 60 and 83 years, with a median of 70.5 years. The prevalence of frailty was 31.8%. Frailty increased the following post-surgical adverse outcomes: death (P = .001), longer ventilation time (P = .001), prolonged use of vasoactive drugs (P = .001), and infection of the surgical site (P = .004). The mortality risk due to frailty was higher than that of the usual evaluation scores such as Euro SCORE II (HR 5.49; 95% CI; 1.0-28.5 vs. HR 1.17: 95% CI; 1.0-1.29). Conclusion: Frailty is a common condition in the elderly patient subjected to cardiac surgery, and increases the risk of adverse events, particularly, mortality. It is recommended to use measurements of frailty in the pre-surgical protocol of the elderly patient.

Geographic mapping of Enterobacteriaceae with extended-spectrum ß-lactamase (ESBL) phenotype in Pereira, Colombia.

BACKGROUND: Antimicrobial resistance is an ecological and multicausal problem. Infections caused by extended-spectrum ß-lactamase producing Enterobacteriaceae (ESBL-E) can be acquired and transmitted in the community. Data on community-associated ESBL-E infections/colonizations in Colombia are scarce. Georeferencing tools can be used to study the dynamics of antimicrobial resistance at the community level. METHODS: We conducted a study of geographic mapping using modern tools based on geographic information systems (GIS). Two study centers from the city of Pereira, Colombia were involved. The records of patients who had ESBL-producing Enterobacteriaceae were reviewed. Antimicrobial susceptibility testing and phenotypic detection of ESBL was done according to CLSI standards. RESULTS: A population of 415 patients with community-acquired infections/colonizations and 77 hospital discharges were obtained. Geographic distribution was established and heat maps were created. Several hotspots were evidenced in some geographical areas of the south-west and north-east of the city. Many of the affected areas were near tertiary hospitals, rivers, and poultry industry areas. CONCLUSIONS: There are foci of antimicrobial resistance at the community level. This was demonstrated in the case of antimicrobial resistance caused by ESBL in a city in Colombia. Causality with tertiary hospitals in the city, some rivers and the poultry industry is proposed as an explanation of the evidenced phenomenon. Geographic mapping tools are useful for monitoring antimicrobial resistance in the community.

Pobreza multidimensional y determinantes sociales de la salud. Línea de base para dos comunidades vulnerables / Multidimensional poverty index and social determinants of health. Baseline for two vulnerable communities

Resumen Introducción. Las políticas y programas del gobierno, orientados a disminuir las inequidades, tienen efectos sociales, económicos e impacto sobre las condiciones de salud; además, suelen carecer de procesos de evaluación que midan el impacto de sus intervenciones. Por lo tanto, este estudio plantea una línea de base del índice de pobreza multidimensional (IPM) en dos comunidades vulnerables, que permitirá evaluar, con posterioridad, el impacto del desarrollo en una zona franca. Materiales y métodos. El diseño del estudio fue observacional, descriptivo y transversal, a fin de establecer la línea de base de determinantes sociales de la salud, contenidos en el IPM y el efecto potencial de la intervención sobre las variables y dimensiones del IPM en dos corregimientos, antes del desarrollo de una zona franca. Resultados. Los hallazgos muestran las condiciones de vida precarias y de inequidad de las dos poblaciones, sobre todo en la dimensión educativa, los derechos de la población infantil y las condiciones de la vivienda. Las variables que mejor explican la pobreza son el analfabetismo, el rezago escolar y los pisos de tierra sobre los que es inadecuado habitar. La prevalencia de pobreza en Caimalito (80.9%) y Puerto Caldas (66.5%) supera la general de Colombia (24.8%) y de la región central (26.1%). Asimismo, la incidencia ajustada de pobreza en Caimalito (20.1%) y Puerto Caldas (18.5%) son mayores que la de Colombia (13%). Conclusión. Es necesario modificar variables del índice que no discriminen hogares pobres. La simulación de intervenciones aisladas tienen poco o ningún efecto en la reducción de la pobreza.

Abstract Introduction: Government policies and programs, aimed at reducing inequities, have a social and economic and impact on health conditions. However, they often lack evaluation processes that measure the impact of their interventions. Therefore, this study sets out a baseline of the Multidimensional Poverty Index (MPI) in two vulnerable communities, which will allow to assess the impact of development on a free zone. Materials and methods: Observational, descriptive and transversal study directed to establish the baseline of social determinants of health contained in the MPI, as well as the potential effect of the intervention on the variables and dimensions of the MPI in two precincts, before a free zone is developed. Results: Findings show the precarious living conditions and inequity in both populations, especially in the educational dimension, the rights of children and housing conditions. The variables that best explain poverty are illiteracy, education lag, and gravel floors which make habitability inappropriate. The prevalence of poverty in Caimalito (80.9%) and Puerto Caldas (66.5%) surpasses general poverty indexes in Colombia (24.8%) and in the central region (26.1%). Likewise, the adjusted incidence of poverty in Caimalito (20.1%) and Puerto Caldas (18.5%) is higher than in Colombia (13%). Conclusion: It is necessary to modify index variables that do not discriminate poor households. Simulation of isolated interventions have little or no effect on poverty reduction.

Cumplimiento en la notificación de casos probables de dengue en el Área Metropolitana Centro Occidente de Colombia en el año 2014 / Compliance in reporting probable cases of dengue in the Colombian West Metropolitan Area in 2014

Objetivo: Cuantificar el cumplimiento de notificación de casos probables de dengue en el área Metropolitana Centro Occidente de Colombia, en el año 2014. Métodos: Esta investigación corresponde a un estudio observacional, descriptivo de corte transversal a partir de los registros de diagnósticos de dengue y sus diagnósticos diferenciales identificados en los Registros Individuales de Prestación de Servicios (RIPS) y el Sistema Nacional de Vigilancia en Salud Pública (SIVIGILA) del año 2014, de las Unidades Primarias Generadoras de Datos (UPGD) del Área Metropolitana Centro Occidente del Departamento de Risaralda. Se seleccionaron todos los registros de dengue (Censo) y se obtuvo una muestra de los diagnósticos diferenciales con un nivel de confianza del 95 porciento, una p de 0.5 y una precisión del 5 porciento. Posteriormente se calcularon porcentajes de cumplimiento en la notificación para dengue y para casos probables. Resultados: El 64 porciento de los pacientes con diagnósticos de dengue fueron notificados al SIVIGILA en el año 2014. El 10,7porciento de los diagnósticos diferenciales cumplieron con el criterio de caso probable de dengue y el 12,9 porciento de los casos probables de dengue fueron notificados al SIVIGILA en el año 2014. Discusión: Los resultados de este estudio son importantes porque brindan información sobre el cumplimiento de la notificación obligatoria de los casos de dengue al Sistema de Vigilancia Epidemiológica del dengue de las UPGD públicas del Área Metropolitana Centro Occidente del Departamento de Risaralda, evidenciando un incumplimiento en la notificación. Además, al comparar los resultados con otros estudios realizados tanto a nivelinternacional (Costa Rica, Brasil y Chile) y a nivel nacional (Santander y Valle)se observan problemas similares de notificación en los Sistemas de Vigilancia Epidemiológica respectivos.

El nuevo modelo de Atención Integral en Salud -MIAS- para Colombia. ¿La solución a los problemas del sistema / The new model of Integrated Health Care (IMAS) for Colombia: the solution to the system's problems?

El gobierno colombiano a través de la resolución 429 de 2016 (1), promulgó la política de Atención Integral en Salud, que pretende generar mejores condiciones de salud para la población a través de la regulación de la intervención sectorial e intersectorial, sustentado en lo dispuesto por un gran volumen de normatividad previa que comprende desde la ley 100 de 1993 y sus posteriores modificaciones incluyendo la ley 1438 de 2011 (2) que pretendía fortalecer y la Atención Primaria en Salud, el Plan decenal de Salud Pública, hasta la de más reciente expedición, la Ley estatutaria 1751, que luego de una gran controversia, consagró por fin la salud como un derecho fundamental. No obstante todos estos desarrollos en materia legislativa, no se han podido resolver los graves problemas por los que atraviesa el sector y que han sido reconocidos por el propio gobierno: fragmentación y desintegración de la atención; baja resolutividad; alta carga de enfermedad; fallos del mercado; incentivos negativos entre los agentes y falla regulatoria, lo que ha conllevado a aumentar la inequidad; corrupción; maltrato al usuario; desorden administrativo; modelo de prestación de servicios de salud morbicéntrico y centrado en los actores; deshumanizado; descontextualizado y sin prevalencia de derechos (2-3).

The Colombian government, through Resolution 429 of 2016 (1), enacted the Comprehensive Health Care policy, which aims to generate better health conditions for the population through the regulation of sectoral and intersectoral intervention, This policy is based on the provisions of a large volume of previous legislation ranging from Law 100 of 1993 and its subsequent amendments, including Law 1438 of 2011 (2), which sought to strengthen Primary Health Care and the Ten-Year Public Health Plan, to the more recent Statutory Law 1751, which, after much controversy, finally enshrined health as a fundamental right. Despite all these legislative developments, it has not been possible to resolve the serious problems facing the sector, which have been recognised by the government itself: fragmentation and disintegration of care; low resolvability; high disease burden; market failures; negative incentives among agents and regulatory failure, which has led to increased inequity; corruption; mistreatment of the user; administrative disorder; morbicentric and actor-centred health service delivery model; dehumanised; decontextualised and without prevalence of rights (2-3).

Deterioro cognitivo, nivel educativo y ocupación en una población de una clínica de memoria / Cognitive impairment, education and occupation in a memory clinic population

Introducción: Factores sociodemográficos y genéticos se han relacionado con el desarrollo del deterioro cognitivo y la progresión a demencia. Método: En este estudio se evaluaron características sociodemográficas junto con el genotipo de la apolipoproteína E (ApoE) en individuos mayores de 55 años de edad con deterioro cognitivo leve (DCL) y demencia tipo Alzheimer (DTA) atendidos en una clínica de la memoria. Resultados: De los individuos que consultaron la clínica de la memoria en un período de cuatro años, 155 (36%) cumplieron los criterios de inclusión y se clasificaron en grupos diagnósticos de acuerdo con la cuarta edición revisada del Manual diagnóstico y estadístico de los trastornos mentales (DSM-IV-TR) y los criterios del National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA). Los individuos con DTA y DCL se dedicaron más a ocupaciones predominantemente manuales durante el transcurso de la vida que los individuos cognitivamente sanos (p=0,014). Un porcentaje alto de los individuos con DCL y cognitivamente sanos (43%) dejaron su ocupación principal o cambiaron a una predominantemente manual después del retiro laboral. No se encontraron otros factores asociados con el deterioro cognitivo, entre éstos polimorfismos en ApoE. Conclusión: Estos resultados sustentan una relación entre la ocupación principal durante el transcurso de la vida y el desarrollo de deterioro cognitivo después de los 55 años...

Introduction: Socio-demographic and genetic factors have been involved in the development of cognitive impairment and its progression to dementia. Method: The present study evaluates socio-demographic characteristics and the ApoE genotype in individuals older than 55 years with mild cognitive impairment (MCI) and Alzheimer’s disease (AD), attending a memory clinic. Results: 155 individuals (36%) out of the total population who attended the memory clinic in a four-year period met the inclusion criteria. The study population was classified in diagnostic groups according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and to the National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer’s Disease and Related Disorders Association (NICNCDS-ADRDA) criteria. More AD and MCI individuals worked in mainly manual occupations throughout their lifetime compared to cognitively unimpaired individuals (p=0.014). A high percentage of individuals with MCI and of cognitively unimpaired individuals (43%) left their primary occupation or changed it for a mainly manual occupation after their retirement. No other factors associated to the cognitive impairment, including ApoE genotype, were found. Conclusion: These results support a correlation between the primary occupation during lifetime and the development of cognitive impairment in individuals older than 55 years...