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Biomedical subjects

Conal Cunningham

Publications and source records attributed to Conal Cunningham.

5 recordsLinked to original sources

Co-morbid and socio-demographic factors associated with cognitive performance in an elderly community dwelling Irish population.

BACKGROUND: Epidemiological studies suggest an association between health factors and dementia. The impact of these factors on the cognitive performance of the elderly population is unclear. Possible correlates of poor cognitive performance in a community dwelling elderly Irish population were examined. METHODS: Subjects were from a sample of individuals over 65 years agreeable to interview using the Geriatric Mental State (GMS)-Automated Geriatric Examination for Computed Assisted Taxonomy (AGECAT) package conducted at the subject's home. Associations between patient profiles and Mini Mental State Examination (MMSE) score were investigated in a multivariate model. RESULTS: There were 793 subjects, 528 (66.6%) female with mean (s.d.) age 74.8 (6.7) yrs. Mean MMSE score was 26.5 (3.3). 169 (21.3%) were current smokers, 198 (25%) ex-smokers. Two hundred and twenty-four (28.3%) had a history of hypertension, 85 (10.7%) case level anxiety or depression, 51 (6.4%) stroke, ten0 (1.3%) epilepsy, nine (1.1%) Parkinson's disease and 29 (3.7%) dementia. Two hundred and fifty-five (32.2%) subjects were on psychotropic medications. Factors associated with MMSE score included age (p < or = 0.0001), diagnosis of dementia (p < or = 0.0001), socioeconomic group (p < or = 0.0001), education (p < or = 0.0001), previous stroke (p = 0.0013) and use of psychotropic medication (p = 0.03). Case level anxiety or depression (p = 0.99), Parkinson's disease (p = 0.52), epilepsy (p = 0.26), smoking status (p = 0.99) and hypertension (p = 0.34) were not found to be associated with cognitive performance. CONCLUSION: Factors associated with cognitive performance included age, socioeconomic group, education, previous stroke and use of psychotropic medication. These factors should be adjusted for in studies assessing cognition in this population. Stroke prevention strategies and avoidance of psychotropic medication may benefit cognitive performance.

Age Factors↗

A systematic review of the utility of self-report alcohol screening instruments in the elderly.

BACKGROUND: Effective screening instruments are needed for the detection of alcohol use disorders (AUDs) in the elderly, in view of the significant physical, psychological and social problems associated with this phenomenon. METHODS: This paper provides details on the different self-report alcohol screening instruments that have been studied in the elderly, describing both the instruments themselves and their effectiveness as screening instruments for AUDs in different elderly populations. RESULTS: The vast majority of studies reviewed were carried out in the US, and a high proportion of these were carried out in Veterans Administrations institutions, thus limiting the generalizability of results. The CAGE was the most widely studied screening instrument, followed by the MAST or variations of the MAST, the AUDIT and variations of the AUDIT, and other screening instruments. Sensitivity and specificity of these instruments varied widely, depending on the prevalence of AUDs in the population being studied, the clinical characteristics of the population and the type of AUD being detected. The CAGE performed poorly in psychiatric populations but a newer instrument, the AUDIT-5, has had promising results to date. No studies focussed on elderly people with cognitive impairment, and there is a need for research in this area. CONCLUSIONS: Ease of use, patient acceptability, sensitivity and specificity must all be considered when selecting a self-report alcohol screening instrument for use in the elderly. Furthermore, the prevalence of AUDs in the population and the clinical characteristics of that population must also be taken into account.

Aged↗

Pseudo-hypertension and arterial stiffness: a review.

Hypertension is a condition of persistently elevated blood pressure, associated with increased cardiovascular risk. Non-invasive BP measurement using Korotkoff sounds is the most common method of screening for the condition. The possibility of inaccurate readings leading to a false diagnosis of hypertension (pseudo-hypertension) is of concern. Stiffened arteries in the elderly have been proposed as being the primary cause of pseudo-hypertension. Non-invasive detection of pseudo-hypertension remains problematic. This paper reviews clinical literature on pseudo hypertension and approaches to measuring the compressive stiffness of arteries, as well as biomechanical literature regarding models of arterial stiffness and the origin of Korotkoff sounds. Models of the latter show the importance of the relationship between transmural pressure and cross-sectional area (P1/Csa curve) of the brachial artery as it closes under the influence of the pressure cuff. The review concludes that future research on pseudo-hypertension should include development of new instrumentation to measure the P1/Csa curve of the brachial artery in vivo using non-invasive techniques suitable for application to an elderly population.

Animals↗