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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Major Neurocognitive Disorders describe the symptoms of a large group of diseases causing a progressive decline in individual's functioning. It is an umbrella term describing a decline in memory, intellectual ability, reasoning, and social skills, as well as changes in normal emotional reactions. The general practitioner is instrumental in the early diagnosis of Major Neurocognitive Disorder. Individual risk factors act as contributing variables affecting the probability of someone developing a Major Neurocognitive Disorder and may be considered predictive factors. This study aimed (i) to show the utility of using the Global Deterioration Scale in primary health care settings as a measure to assess the stage of cognitive function for individuals identified with Major Neurocognitive Disorders and (ii) to identify predictors of severe Major Neurocognitive Disorders. Potential predictors of Major Neurocognitive Disorders considered in this study were: sex, age, years of education, social isolation, hearing impairment, cardiovascular disease, hypertension, diabetes, smoking habits, alcohol consumption, physical activity, hand strength, and nutritional status. The sample comprised 250 adults, 30.4% were classified as having probable Major Neurocognitive Disorder. The variables significantly associated with probable Major Neurocognitive Disorder were age, years of education, hearing impairment, cardiovascular disease, hand strength, nutritional status, and physical activity. In the multivariable model, only age, education, physical activity and hand strength remained significant predictors of probable Major Neurocognitive Disorder. The Global Deterioration Scale seems to be a usefull instrument in primary healthcare settings, as it guides the general practitioner in observing the patients' cognitive functioning. Advanced age, lower education, lower hand strength and absence of physical activities should be taken into account as they increase the chance of severe Major Neurocognitive Disorders. Primary health care providers, including general practitioners are very important in the diagnosis and follow up of Major Neurocognitive Disorder. The general practitioner is in most cases the patients' first and for many patients the only contact, thus having a critical role in evaluating with caution what is part of normal or pathological aging, and the individual factors that can increase the likelihood of developing Major Neurocognitive Disorder to further support patients in the course of the disease.
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PMID:Assessment of Major Neurocognitive Disorders in Primary Health Care: Predictors of Individual Risk Factors. 3262 55

Non-alcoholic fatty liver DISEASE (NAFLD) is the most common chronic liver disease in Western countries and affects approximately 25% of the adult population. Since NAFLD is frequently associated with further metabolic comorbidities such as obesity, type 2 diabetes mellitus, or dyslipidemia, it is generally considered as the hepatic manifestation of the metabolic syndrome. In addition to its potential to cause liver-related morbidity and mortality, NAFLD is also associated with subclinical and clinical cardiovascular disease (CVD). Growing evidence indicates that patients with NAFLD are at substantial risk for the development of hypertension, coronary heart disease, cardiomyopathy, and cardiac arrhythmias, which clinically result in increased cardiovascular morbidity and mortality. The natural history of NAFLD is variable and the vast majority of patients will not progress from simple steatosis to fibrosis and end stage liver disease. However, patients with progressive forms of NAFLD, including non-alcoholic steatohepatitis (NASH) and/or advanced fibrosis, as well as NAFLD patients with concomitant types 2 diabetes are at highest risk for CVD. This review describes the underlying pathophysiological mechanisms linking NAFLD and CVD, discusses the role of NAFLD as a metabolic dysfunction associated cardiovascular risk factor, and focuses on common cardiovascular manifestations in NAFLD patients.
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PMID:NAFLD and cardiovascular diseases: a clinical review. 3269 80


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