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Prevalence of cognitive impairment and risk factors among older people of urban India
Abstracts / Journal of the Neurological Sciences 405S (2019) 116543
Russian Foundation For Basic Research (RFBR) project number 1929-01066/2019 doi:10.1016/j.jns.2019.10.1737
WCN19-2156 Journal of the Neurological Sciences 405S (2019) 105399 Poster Session 4 Assessment of motor cortex excitability in a child with hemispheric polymicrogyria and focal epilepsy by navigated transcranial magnetic stimulation: A case report S. Bashira, A. Mirb, R. Al-Bradieb a King Fahad Specialist Hospital, Neurophysiology, Dammam, Saudi Arabia b King Fahad Specialist Hospital, Pediatric Neurology, Dammam, Saudi Arabia To evaluate motor cortex excitability as a function of lateralization relative to the seizure focus in child with intractable epilepsy undergoing navigated transcranial magnetic stimulation (nTMS) for presurgical mapping. nTMS is a method for focal noninvasive cortical stimulation where small intracranial electrical currents are generated by a powerful extracranial fluctuating magnetic field. Resting motor threshold (rMT), motor evoked potentials (MEPs), silent period (SP) serves as a measure of motor cortex excitability was assessed in both hands in 10 year old right-handed girl k/c of epilepsy and left side hemiparesis. There was significant difference in rMT, MEPs and SP between the hemispheres. The response of MEPs was more towards unaffected hemisphere. nTMS is a safe and tolerable procedure in children with intractable epilepsy. These results highlighted the potential for inducing lasting modulation of excitability in M1 by navigated TMS of the healthy M1, possibly reflecting modulation of interactions and demonstrating the potential use of such a paradigm.
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home in Thailand. A mobile application which allows caregivers to evaluate patients’ BPSD at home is needed. Objective To develop an application that caregivers can monitor BPSD in patients with moderate-severe dementia. Method A mobile application was developed to measure 9 common BPSD domains in Thai language. The application was a touchscreenbased questionnaire using Likert scale for frequency of each behavioral domain (frequency score) and visual analogue scale for its impact on caregivers’ emotion (impact score). Concurrent validity was compared to a paper-based version of Neuropsychiatric Inventory (NPI). Results From a total of 50 caregivers’ responses, both total frequency score and total impact score from the application were significantly correlated with NPI total frequency x severity score (ρ = 0.62, p b0.001) and NPI total burden score (ρ = 0.68, p b0.001). Frequency score in each domain from application was significantly correlated with corresponding NPI subscale scores (ρ = 0.31 – 0.73, all p b0.05). Regarding impact scores, every domain was significantly correlated with NPI burden score on corresponding subscales (ρ = 0.38 – 0.66, all p b0.01). Conclusion The mobile application demonstrated strong to very strong correlations with NPI scores in patients with moderate – severe dementia. This application may be useful for caregivers in monitoring BPSD. Further testing for usability in community-dwelling is needed before implication into clinical practice. doi:10.1016/j.jns.2019.10.1739
WCN19-2081 Journal of the Neurological Sciences 405S (2019) 105401 Poster Session 4
doi:10.1016/j.jns.2019.10.1738 Prevalence of cognitive impairment and risk factors among older people of urban India
WCN19-2080 Journal of the Neurological Sciences 405S (2019) 105400 Poster Session 4 Validity of mobile application for monitoring behavioral and psychological symptoms in moderate to severe dementia in Thailand
P.R. Kondaa, P.K. Sharmab, E. Gangulyb, A.R. Gandhic a Mediciti Institute Of Medical Sciences, Intern, Hyderabad, India b Mediciti Institute Of Medical Sciences, Epidemiology-Community Medicine, Hyderabad, India c EdelGiveFoundation-Edelweiss House, Consultant Statistician, Chief Manager- Monitoring and Evaluation, Mumbai, India
P. Rangseekhajee, P. Paholpak, P. Paholpak, S. Aphisitpinyo Faculty of Medicine, Khon Kaen University, Brain and Mind Wellness Research Group, Department of Psychiatry, Khon Kaen, Thailand
Background Cognitive impairment among older people is increasing worldwide because of higher in life expectancy. We hypothesise that multiple factors play role in the development of cognitive impairment and it varies in different populations. Our objective for this research was to study the prevalence and the risk factors of cognitive impairment in older population of urban India.
Introduction Many patients with moderate - severe dementia with behavioral and psychological symptoms of dementia (BPSD) were living at
Methods We enrolled 100 randomly selected older men and women aged N60 year, residing in urban India. The study was cross sectional and the
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Abstracts / Journal of the Neurological Sciences 405S (2019) 116543
data collection was done by pretested questionnaire and forms, upon home visits. Measurements included depression, blood pressure, anthropometry, medical history, demographic history and medication. Cognitive impairment was measured using Mini Mental State Examination (MMSE) score b24. Logistic regression analysis was done to identify independently associated factors with cognitive impairment. Results Women had a higher prevalence of cognitive impairment than men. Overall prevalence of cognitive impairment in our study population was 10%. increasing age, living single, no schooling, low weight, low waist and hip ratios, poor activities of daily living (ADL), poor self-rated health, bedridden (past 6 months) and depression were significantly associated with cognitive impairment. Independently associated risk factors on logistic regression were increasing age, no schooling and bedridden status. Conclusion Prevalence of cognitive impairment is low among urban older population of India. Various modifiable factors exist in this population that may increase the burden of cognitive impairment in future. Geriatric health policy could address the modifiable risk factors to manage risk of increasing cognitive impairment and complications.
Results 15.4% men and 31.2% women had depression and over all prevalence of geriatric depression was 23% in our population. Living single (OR:4.26; 95% CI:1.06-17.09), poor self-rated health (OR:12.09; 95% CI:1.41-103.14), bedridden status (OR:5.29; 95% CI:1.21-23.04) and osteoarthritis (OR:4.91; 95% CI:1.39-17.28) were identified as independent correlates on logistic regression. Conclusion The prevalence of geriatric depression in our population was moderate. Various correlates were associated. While addressing geriatric morbidity, screening for elderly depression in routine and management of related factors would be of significance to reduce the risk of chronic comorbidities. doi:10.1016/j.jns.2019.10.1741
WCN19-2085 Journal of the Neurological Sciences 405S (2019) 105403 Poster Session 4
doi:10.1016/j.jns.2019.10.1740
WCN19-2083 Journal of the Neurological Sciences 405S (2019) 105402 Poster Session 4 Correlates of geriatric depression among urban South Indian elders P.R. Kondaa, P.K. Sharmab, E. Gangulyb, A.R. Gandhic a Mediciti Institute Of Medical Sciences, Intern, Hyderabad, India b Mediciti Institute Of Medical Sciences, Epidemiology-Community Medicine, Hyderabad, India c EdelGive Foundation- Edelweiss House, Consultant Statistician-Chief Manager- Monitoring and Evaluation, Mumbai, India Background Depression is expected to be the leading cause of deaths in elderly population globally in next decade. This cross sectional study aimed to explore the previously unidentified correlates and prevalence of depression in urban south Indian elders. Methods One hundred community dwelling urban elders, aged 60 years and older, participated in the study. Pretested questionnaire and forms were administered, by trained investigator, to collect information on chronic health conditions, height, weight, hip and waist circumference, blood pressure, sociodemographic history, changes in vision and cognition, medication and addictions. Presence of depression was defined using Geriatric Depression Scale (GDS) scores N 5, moderate depression as scores 9 – 11 and severe depression as scores between 12 – 15. Independently associated correlates of geriatric depression were identified by using logistic regression analysis.
Beware of the cortical ribbon : The spectrum – experience from a case series D. Dhara, S.R. Chandraa, K.B. Gangadharb, M.D. Bhatc, A. Gohela a National Institute of Mental Health and Neurosciences- Bengaluru, Neurology, Bengaluru, India b National Institute of Mental Health and Neurosciences- Bengaluru, Psychiatry, Bengaluru, India c National Institute of Mental Health and Neurosciences- Bengaluru, Neuroimaging and Interventional Radiology, Bengaluru, India Introduction Creutzfeldt-Jakob disease (CJD) is a relatively uncommon, fatal, transmissible and rapidly progressive brain disorder with a median survival period of 5 months from diagnosis. Cortical ribboning is considered to be a sensitive marker for CJD. However, definite diagnosis can be made only by histopathological confirmation which is often not possible. Therefore, great caution needs to be exercised before the diagnosis is labelled. Patients and methods Patients referred to the authors with radiological diagnosis of CJD done elsewhere, in the last 2 years were assessed by thorough clinical evaluation, dementia work up, MRI brain, EEG, CSF analysis, autoimmune and paraneoplastic workup. They were followed up over next 1 year both clinically and radiologically. Results Four out of the 12 patients who satisfied WHO criteria for CJD improved considerably during the follow up period of 6 months to 1 year,
Russian Foundation For Basic Research (RFBR) project number 1929-01066/2019 doi:10.1016/j.jns.2019.10.1737
WCN19-2156 Journal of the Neurological Sciences 405S (2019) 105399 Poster Session 4 Assessment of motor cortex excitability in a child with hemispheric polymicrogyria and focal epilepsy by navigated transcranial magnetic stimulation: A case report S. Bashira, A. Mirb, R. Al-Bradieb a King Fahad Specialist Hospital, Neurophysiology, Dammam, Saudi Arabia b King Fahad Specialist Hospital, Pediatric Neurology, Dammam, Saudi Arabia To evaluate motor cortex excitability as a function of lateralization relative to the seizure focus in child with intractable epilepsy undergoing navigated transcranial magnetic stimulation (nTMS) for presurgical mapping. nTMS is a method for focal noninvasive cortical stimulation where small intracranial electrical currents are generated by a powerful extracranial fluctuating magnetic field. Resting motor threshold (rMT), motor evoked potentials (MEPs), silent period (SP) serves as a measure of motor cortex excitability was assessed in both hands in 10 year old right-handed girl k/c of epilepsy and left side hemiparesis. There was significant difference in rMT, MEPs and SP between the hemispheres. The response of MEPs was more towards unaffected hemisphere. nTMS is a safe and tolerable procedure in children with intractable epilepsy. These results highlighted the potential for inducing lasting modulation of excitability in M1 by navigated TMS of the healthy M1, possibly reflecting modulation of interactions and demonstrating the potential use of such a paradigm.
93
home in Thailand. A mobile application which allows caregivers to evaluate patients’ BPSD at home is needed. Objective To develop an application that caregivers can monitor BPSD in patients with moderate-severe dementia. Method A mobile application was developed to measure 9 common BPSD domains in Thai language. The application was a touchscreenbased questionnaire using Likert scale for frequency of each behavioral domain (frequency score) and visual analogue scale for its impact on caregivers’ emotion (impact score). Concurrent validity was compared to a paper-based version of Neuropsychiatric Inventory (NPI). Results From a total of 50 caregivers’ responses, both total frequency score and total impact score from the application were significantly correlated with NPI total frequency x severity score (ρ = 0.62, p b0.001) and NPI total burden score (ρ = 0.68, p b0.001). Frequency score in each domain from application was significantly correlated with corresponding NPI subscale scores (ρ = 0.31 – 0.73, all p b0.05). Regarding impact scores, every domain was significantly correlated with NPI burden score on corresponding subscales (ρ = 0.38 – 0.66, all p b0.01). Conclusion The mobile application demonstrated strong to very strong correlations with NPI scores in patients with moderate – severe dementia. This application may be useful for caregivers in monitoring BPSD. Further testing for usability in community-dwelling is needed before implication into clinical practice. doi:10.1016/j.jns.2019.10.1739
WCN19-2081 Journal of the Neurological Sciences 405S (2019) 105401 Poster Session 4
doi:10.1016/j.jns.2019.10.1738 Prevalence of cognitive impairment and risk factors among older people of urban India
WCN19-2080 Journal of the Neurological Sciences 405S (2019) 105400 Poster Session 4 Validity of mobile application for monitoring behavioral and psychological symptoms in moderate to severe dementia in Thailand
P.R. Kondaa, P.K. Sharmab, E. Gangulyb, A.R. Gandhic a Mediciti Institute Of Medical Sciences, Intern, Hyderabad, India b Mediciti Institute Of Medical Sciences, Epidemiology-Community Medicine, Hyderabad, India c EdelGiveFoundation-Edelweiss House, Consultant Statistician, Chief Manager- Monitoring and Evaluation, Mumbai, India
P. Rangseekhajee, P. Paholpak, P. Paholpak, S. Aphisitpinyo Faculty of Medicine, Khon Kaen University, Brain and Mind Wellness Research Group, Department of Psychiatry, Khon Kaen, Thailand
Background Cognitive impairment among older people is increasing worldwide because of higher in life expectancy. We hypothesise that multiple factors play role in the development of cognitive impairment and it varies in different populations. Our objective for this research was to study the prevalence and the risk factors of cognitive impairment in older population of urban India.
Introduction Many patients with moderate - severe dementia with behavioral and psychological symptoms of dementia (BPSD) were living at
Methods We enrolled 100 randomly selected older men and women aged N60 year, residing in urban India. The study was cross sectional and the
94
Abstracts / Journal of the Neurological Sciences 405S (2019) 116543
data collection was done by pretested questionnaire and forms, upon home visits. Measurements included depression, blood pressure, anthropometry, medical history, demographic history and medication. Cognitive impairment was measured using Mini Mental State Examination (MMSE) score b24. Logistic regression analysis was done to identify independently associated factors with cognitive impairment. Results Women had a higher prevalence of cognitive impairment than men. Overall prevalence of cognitive impairment in our study population was 10%. increasing age, living single, no schooling, low weight, low waist and hip ratios, poor activities of daily living (ADL), poor self-rated health, bedridden (past 6 months) and depression were significantly associated with cognitive impairment. Independently associated risk factors on logistic regression were increasing age, no schooling and bedridden status. Conclusion Prevalence of cognitive impairment is low among urban older population of India. Various modifiable factors exist in this population that may increase the burden of cognitive impairment in future. Geriatric health policy could address the modifiable risk factors to manage risk of increasing cognitive impairment and complications.
Results 15.4% men and 31.2% women had depression and over all prevalence of geriatric depression was 23% in our population. Living single (OR:4.26; 95% CI:1.06-17.09), poor self-rated health (OR:12.09; 95% CI:1.41-103.14), bedridden status (OR:5.29; 95% CI:1.21-23.04) and osteoarthritis (OR:4.91; 95% CI:1.39-17.28) were identified as independent correlates on logistic regression. Conclusion The prevalence of geriatric depression in our population was moderate. Various correlates were associated. While addressing geriatric morbidity, screening for elderly depression in routine and management of related factors would be of significance to reduce the risk of chronic comorbidities. doi:10.1016/j.jns.2019.10.1741
WCN19-2085 Journal of the Neurological Sciences 405S (2019) 105403 Poster Session 4
doi:10.1016/j.jns.2019.10.1740
WCN19-2083 Journal of the Neurological Sciences 405S (2019) 105402 Poster Session 4 Correlates of geriatric depression among urban South Indian elders P.R. Kondaa, P.K. Sharmab, E. Gangulyb, A.R. Gandhic a Mediciti Institute Of Medical Sciences, Intern, Hyderabad, India b Mediciti Institute Of Medical Sciences, Epidemiology-Community Medicine, Hyderabad, India c EdelGive Foundation- Edelweiss House, Consultant Statistician-Chief Manager- Monitoring and Evaluation, Mumbai, India Background Depression is expected to be the leading cause of deaths in elderly population globally in next decade. This cross sectional study aimed to explore the previously unidentified correlates and prevalence of depression in urban south Indian elders. Methods One hundred community dwelling urban elders, aged 60 years and older, participated in the study. Pretested questionnaire and forms were administered, by trained investigator, to collect information on chronic health conditions, height, weight, hip and waist circumference, blood pressure, sociodemographic history, changes in vision and cognition, medication and addictions. Presence of depression was defined using Geriatric Depression Scale (GDS) scores N 5, moderate depression as scores 9 – 11 and severe depression as scores between 12 – 15. Independently associated correlates of geriatric depression were identified by using logistic regression analysis.
Beware of the cortical ribbon : The spectrum – experience from a case series D. Dhara, S.R. Chandraa, K.B. Gangadharb, M.D. Bhatc, A. Gohela a National Institute of Mental Health and Neurosciences- Bengaluru, Neurology, Bengaluru, India b National Institute of Mental Health and Neurosciences- Bengaluru, Psychiatry, Bengaluru, India c National Institute of Mental Health and Neurosciences- Bengaluru, Neuroimaging and Interventional Radiology, Bengaluru, India Introduction Creutzfeldt-Jakob disease (CJD) is a relatively uncommon, fatal, transmissible and rapidly progressive brain disorder with a median survival period of 5 months from diagnosis. Cortical ribboning is considered to be a sensitive marker for CJD. However, definite diagnosis can be made only by histopathological confirmation which is often not possible. Therefore, great caution needs to be exercised before the diagnosis is labelled. Patients and methods Patients referred to the authors with radiological diagnosis of CJD done elsewhere, in the last 2 years were assessed by thorough clinical evaluation, dementia work up, MRI brain, EEG, CSF analysis, autoimmune and paraneoplastic workup. They were followed up over next 1 year both clinically and radiologically. Results Four out of the 12 patients who satisfied WHO criteria for CJD improved considerably during the follow up period of 6 months to 1 year,