Search

INTRODUCTION: Lifelong bilingualism is associated with a delayed age at onset of dementia, but evidence from community‐based studies is limited. We investigated the relationship between bilingualism and the prevalence of cognitive impairment in a linguistically diverse community. METHODS: A door‐to‐door community study was conducted from January to December 2021 in urban Bengaluru, India. 1234 individuals aged ≥60 years participated in the study. Participants were diagnosed with no cognitive impairment (NCI), mild cognitive impairment (MCI), or dementia using established diagnostic criteria. RESULTS: Dementia prevalence was higher in monolinguals (4.9%) than bilinguals (0.4%) (P =.001). The prevalence of MCI was also higher in monolinguals (8.5%) than bilinguals (5.3%) (P =.001). The study also revealed better cognitive function in bilinguals than monolinguals with NCI, after controlling for confounding variables. DISCUSSION: The current study provides significant support for the protective effect of bilingualism on cognitive impairment in an urban community with extensive bilingual interactional contexts in everyday life. Highlights: Bilingualism has been demonstrated to protect against dementia and mild cognitive impairment in a linguistically diverse community with extensive code‐switching contexts.Bilingual older individuals had superior baseline cognitive performance compared to monolingual older individuals.Bilingualism was found to have an independent effect on general cognition after adjusting for major social determinants of health in the group without cognitive impairment. [ABSTRACT FROM AUTHOR]

Introduction: Prospective, population‐based, aging, and cognition studies are an important approach to understand normal and pathological aging processes. Methods: This is a longitudinal, community‐based cohort study (n = 10,000) in rural India, with long‐term follow‐up for comprehensive evaluation of risk and protective factors associated with cognitive changes during aging. All participants will undergo comprehensive clinical, neurocognitive, and biochemical assessments. Genotyping using genome‐wide association studies will be done for all participants. Whole genome sequencing and brain imaging (magnetic resonance imaging) will be done in a subset. Results: This study will generate a rich database of clinical, neurocognitive, biochemical, neuroimaging, and genetic data that can help identify risk and protective factors for dementia and other related disorders. Discussion: This longitudinal study is first of its kind, involving comprehensive evaluations, spanning phenotype to genotype, in a rural Indian cohort, and has major public health implications. [ABSTRACT FROM AUTHOR]

Background: Active bilingualism provides cognitive reserve/resilience against age‐related neurodegenerative conditions like MCI and dementia. Evidences suggest that bilingualism delay the onset of MCI and dementia by preserving cognitive functioning for a longer period of time. India has a linguistically diverse population where bilingualism is a norm and its effects on cognitive reserve are devoid of immigration, education and socioeconomic status. We conducted a door‐to‐doorcommunity‐based study to investigate the impact of bilingualism on the prevalence of dementia and MCI in healthy older monolingual and bilingual population. The study also examined the effect of bilingualism on cognitive performance. Method: A total of 1145 older adults (366 monolinguals and 779 bilinguals) were recruited. The cognitive functions of elderly persons of ≥ 60 years old residing in urban Bengaluru, India were assessed using Clinical Dementia Rating Scale (CDR), Addenbrooke's Cognitive Examination (ACE‐III), TNI, Verbal Learning Test (VLT), and Instrumental Activities of Daily Living‐Elderly (IADL‐E). The Language Use Questionnaire (LUQ) scores were used to categorize speakers into monolinguals and bilinguals. Based on the neurologic, neuropsychological, and functional data, participants were classified into 3 categories: normal cognitive functioning, MCI (based on Petersen's criteria), and dementia (based on DSM‐IV criteria). Result: There was a significant difference in the proportion of MCI and dementia patients between monolingual (2.10 % dementia and 7.14 % MCI) and bilingual (0.40 % dementia and 4.64 % MCI) elderly (p < 0.001) (Table 1). Healthy elderly bilinguals performed significantly better on global cognition and delayed verbal recall than monolinguals independent of the effects of age, education and gender (Table 2). Conclusion: The findings of this large door‐to‐door community study reveals the protective role of bilingualism in developing cognitive impairment due to MCI and dementia. Furthermore, the study demonstrates the effect of bilingualism as a measure of cognitive reserve/resilience through better cognitive status and episodic memory in older people from a socio‐culturally and linguistically diverse population. [ABSTRACT FROM AUTHOR]

Background: Caregivers of persons living with dementia (CGPwD) tend to have limited access to dementia care‐oriented support group and relevant resources. The disparity in the ratio of mental health professionals available and the number of people with dementia plays a pivotal role in care and services. Support group interventions may not be available or accessible to the vast majority, more so in the Indian context. Hence, the need to test feasibility of providingsupport via using video‐conferencing software were explored. Method: Family caregivers of those persons living with dementia who had accessed an out‐patient facility at a Geriatric Clinic as part of a tertiary care center between January 2020 – January 2023 was screened for recruitment into a single group quasi‐experimental study (n = 341). The responses of the family caregivers were noted down along with the experience of the mental health professionals involved in the process. Content analysis (Krippendorff, 2004, Neuendorf, 2002) was carried out using Atlas.ti.9 web version. Result: The mean age of the CGPwD was 42.5 ± 8.5 years and the mean years spent in care‐giving was 4.02 ± 1.5 years; 42.8% of the persons living with dementia had a definitive diagnosis of Alzheimer's Disease and majority were in the moderate stage of illness. One‐fourth of the caregivers showed interest to sign up for the support group with the first invitation. Of them, Spousal caregivers were noted to show more interest; followed by daughters‐in‐law. Apart from technological challenges, a good number of caregivers measured d that their loved one with dementia has "improved" due to decline in challenging behaviours. Conclusion: Use of technology in psychosocial interventions is a relatively new concept in LAMIC countries such as India. Therefore, familiarization and orientation of such services may pave way to increase in demand for video‐conferencing based support groups at a larger level in the near future. [ABSTRACT FROM AUTHOR]

Highlights • Current and lifetime prevalence of 'any mental morbidity' (excluding tobacco use disorders) among adults was 6.08% and 7.97%, respectively. • The prevalence of tobacco use disorders was found to be 16.06%. • The lifetime prevalence of schizophrenia & other psychotic disorders, mood disorder and neurotic and stress related disorders were 0.39%, 3.53% and 3.42% respectively. • The prevalence of high suicide risk in the state was 0.93%. • Both severe and common mental disorders are having highly prevalent in "Urban metro" in comparison to "Urban non-metro" and "Rural" population. Abstract Aim To estimate the prevalence and distribution of psychiatric morbidity, and study pattern of help-seeking in a community representative sample from the state of Uttar Pradesh in northern India. Method A multi-stage, stratified, random cluster sampling was used. The survey was conducted on 3508 adults during 2015–16 using M.I.N.I 6.0.0, modified Fagerström Nicotine Dependence Scale for all forms of tobacco, questionnaires for epilepsy and intellectual disability. The WHO Pathway Interview Schedule was used to study pattern of help-seeking behaviour. Focused group discussions (FGDs) and key informant interviews (KIIs) were also carried out. Result Current and lifetime prevalence of 'any mental morbidity' (excluding tobacco use disorders) was 6.08% and 7.97%, respectively. The prevalence of substance use disorders, was 16.36%, of which tobacco use disorders alone contributed 16.06%. Neurotic and depressive disorders were the next most common morbidity. Schizophrenia and other psychotic disorders had a current prevalence of 0.09%. High-risk for suicide was reported to be 0.93%. Treatment gap varied between 75 and 100% for different disorders. FGDs and KIIs reflected a higher burden of substance use, including prescription drug abuse, substantial prevalence of cultural mental morbidity , deep rooted stigma, low help-seeking behaviour, and issues surrounding homeless mentally ill persons in the community. Conclusion The survey revealed high mental morbidity and alarming treatment gap. FGDs and KIIs also highlight the burden of morbidity that probably goes un-noticed, due to socio-cultural systems and stigma. Findings from this survey are intended to be the groundwork for the (re)planning of mental healthcare infrastructure in the state. [ABSTRACT FROM AUTHOR]

Highlights • Session on exciting developments in District Mental Health Program of Karnataka state and prospects of moving towards the 'Taluk Mental Health Program'. • Role of technology that facilitated these new developments. • Public health perspectives for special populations including geriatric, children and adolescents and perinatal. • Role of NIMHANS in the redefining Community Psychiatry in India. • Networking between DMHP teams and professionals of Preventive and Social Medicine. Abstract This summary provides details of a one-day symposium, titled ' Community Psychiatry and District Mental Health Program (DMHP)- An update ' that was organized jointly by the Departments of Psychiatry and Epidemiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru in collaboration with the Department of Health and Family Welfare, Government of Karnataka on September 3rd 2018. This symposium was supported by Dr. Ramachandra N Moorthy, foundation for Mental Health and Neurological Sciences, NIMHANS, Bengaluru. [ABSTRACT FROM AUTHOR]

Background: In India, caregivers of persons living with dementia (CGPwD) often have limited access to dementia care resources. The aim of the study is to understand and deliver psychosocial interventions based on the perceived needs of the CGPwD in accordance with their socio‐cultural background and clinical characteristics of the persons with Dementia (PwD). Method: A sample of 32 CGPwDs attending a Dementia clinic at the NIMHANS, India, between July 2021 – October 2021 was chosen purposively. Cross‐sectional in‐depth interviews were carried out along with Zarit Burden Interview, (Zarit et al., 1980) and Hindi Mental Status Examination (Ganguli et al., 1995). Result: The mean age of the CGPwD was 42.5 ± 8.5 years with MMSE score 9±7 indicating moderate to severe dementia. Those caregivers who spent more than 6 hours per day towards day‐to‐day caregiving brought out need for information about the illness seeking clarity about mental health care, support in Activities of daily living (ADLs), managing behavioural and psychological symptoms of Dementia (BPSD) and sharing of caregiver responsibilities, whilst those caregivers who took health related decisions for the PwD where concerned about problems associated with instrumental activities of daily living (iADLs), availability and affordability of caregiving resources such as day care, assisted living options, welfare services. Further results will be presented. Conclusion: : The perceived needs of CGPwD vary based on severity of illness, socio‐economic status of the CGPwD, age of onset of illness, social support network, relationship between the caregiver and person living with Dementia, spiritual values, readiness to participate in support programs, and much more. Though mental health professionals can develop broader themes for intervention, individualised interventions may warrant poor rates of attrition. References Zarit, S. H., Bach‐Peterson, J., & Reever, K. E. (1980). Burden interview. The gerontologist. Ganguli, M., Ratcliff, G., Chandra, V., Sharma, S., Gilby, J., Pandav, R., ... & Dekosky, S. (1995). A Hindi version of the MMSE: the development of a cognitive screening instrument for a largely illiterate rural elderly population in India. International Journal of Geriatric Psychiatry, 10(5), 367‐377. [ABSTRACT FROM AUTHOR]

Purpose To esthetically evaluate the surgical outcome in children with non-syndromic craniosynostosis. Patients and methods Three consecutive patients with non-syndromic trigonocephaly were included in the study. Result A total of three children with isolated non-syndromic metopic craniosynostosis were analyzed. The children were treated with supra-orbital bar advancement and cranial vault remodeling. The mean age at the time of initial operation was 9 months. All children achieved desirable esthetic results and there was no operative mortality. Conclusion The endocranial base in non-syndromic craniosynostosis has a suture-specific dysmorphology that normalizes, to variable degrees, after cranio-orbital surgery in infancy. Hence, timely restorations of facial form by surgery will not only improve morphology but also prevent functional disturbances and will result in less psychological trauma from peers and society in general. [ABSTRACT FROM AUTHOR]

Abstract: Background: Tardive dyskinesia (TD) is one of the most distressing side effects of antipsychotic treatment. As prevalence studies of TD in Asian population are scarce, a cross-sectional study was performed to assess the frequency of TD in Indian patients with schizophrenia and risk factors of TD. Method: Cross-sectional study of 160 Indian patients fulfilling the DSM-IV TR criteria for schizophrenia and who received antipsychotics for at least one year, were examined with two validated scales for TD. Logistic regression analyses were used to examine the relationship between TD and clinical risk factors. Results: The frequency of probable TD in the total sample was 26.4%. The logistic regression yielded significant odds ratios between TD and age, intermittent treatment, and total cumulative antipsychotic dose. The difference of TD between SGA and FGA disappeared after adjusting for important co-variables in regression analysis. Conclusion: Indian patients with schizophrenia and long-term antipsychotic treatment have a high risk of TD, and TD is associated with older age, intermittent antipsychotic treatment, and a high total cumulative antipsychotic dose. Our study findings suggest that there is no significant difference between SGAs with regards to the risk of causing TD as compared to FGAs. [Copyright &y& Elsevier]

Background: Population‐based, prospective, longitudinal, aging and cognition studies are an important approach to understand the pathophysiology of normal and pathological cognitive aging. However, till date there are no comprehensive cohort studies from the Indian population, examining clinical, cognitive phenotypes and associated genetic and neuroimaging correlates. Method: The Srinivaspura Aging, Neuro Senescence and COGnition (SANSCOG) study and the Tata Longitudinal Study on Aging (TLSA) are envisioned as parallel and synchronized, prospective, community‐based cohort studies in India – rural and urban, respectively – with long term follow‐up over many years, for comprehensive evaluation of risk and protective factors associated with cognitive changes due to normal ageing, dementia and other related disorders (n=10,000 for SANSCOG and n=1,000 for TLSA). Both the study cohorts comprise of cognitively healthy individuals aged ≥ 45 years. However, they have distinct population characteristics. Participants in the SANSCOG study are recruited from the villages of Srinivaspur Taluk in Kolar District in southern India, through an area sampling strategy, whereas, those in TLSA are recruited through convenience sampling, from urban Bangalore. Participants are evaluated with detailed clinical, neurocognitive, lifestyle, anthropometric, biochemical and genetic assessments in the baseline visit and during periodic follow‐up visits. End‐to‐end digitization has been done for all the assessments. GWAS, Whole Genome Sequencing & MRI (resting fMRI, structural MRI, DTI & MRS) is being done in a subset of the SANSCOG study cohort (n=1,000) and the entire TLSA cohort (n=1,000). Result: These parallel cohort studies will generate a database comprising of genetic, biochemical, clinical, neuroimaging and neurocognitive data that can help in further exploration of the pathophysiology of normal and pathological cognitive aging using systems biology‐based approaches. Though these two cohorts are contrasting with respect to socio‐economic status, migration, literacy and lifestyle, the harmonization in the assessments across the two studies offers a unique opportunity to compare outcome measures across these two groups. Conclusion: SANSCOG and TLSA studies are landmark cohort studies in India, which employ a combined multi‐level approach, spanning genotype to phenotype and will be able to provide reliable biomarkers to predict the risk factors for development of dementia in the Indian population. [ABSTRACT FROM AUTHOR]

Background: Recruitment and retention of participants is a rate limiting step in any clinical research study, more so in a rural setting. The SANSCOG study is a large‐scale, longitudinal, rural, cohort study, to gather long term data to identify risk and protective factors for normal and pathological aging, dementia and other related disorders. Method: The study will recruit 10,000 participants, out of which 1500 have completed baseline visit. Our recruitment strategy centred around utilising expertise within existing health care set‐up in Srinivaspur, India. We targeted 6 primary health centres and their associated villages. We collaborated with public health officials and gathered census data to identify potential participants (age ≥ 45 years). We formed a field team, conversant with the language and knowledgeable about local culture. By working closely with link workers, who are part of government health system, to promote health and well‐being initiatives in villages (ASHA), we were able to build better connections with the community. In consultation with village leaders, we conducted awareness programs, informing participants about our study. We maintained periodic contact with participants through telephone or in‐person house visits and actively engaged the community through activities like general health awareness camps, street plays and sports events. Though we don't offer any treatment, the clinical team provides brief feedback on participants blood test reports, ECG and MRI and makes appropriate referrals to the primary health system, if necessary. Result: We approached 3891 participants from 19 villages, out of which 48% consented. We observed that despite being marginalized, this community's willingness to contribute to the study, with the notion of potentially helping their future generations, was remarkable. From our experience, the most crucial approach was forming alliance with existing health system to build community connections. We assessed participants interest to continue in the study via telephone calls (n=700) or house visits (n=255); having found the later strategy to be more effective, our approach was modified for subsequent follow‐ups. A pilot follow‐up was completed for 142 participants. Conclusion: The SANSCOG project provides unique insights on recruitment approaches that can be tailored and adopted for increasing study enrolment in rural cohorts in developing countries. [ABSTRACT FROM AUTHOR]

The article focuses on the case-control study regarding the effects of hyperbaric oxygen therapy (HBOT) on bone healing after enucleation mandibular cysts. It states that the rate of filling and changes in the bone density of the lesion were measured. It shows that HBOT merits a place as an effective adjuvant therapy in the surgical management of defects of the mandible and improved bone healing.

• Older adult data analysed for common mental disorders from National mental health survey, India. • Older adults had higher prevalence of depressive disorders and any psychiatric morbidity than young adults. • Female sex, urban living, unemployment and lower income associated with common mental disorders in older adults. • Unlike young adults, marriage was a protective factor against depression for older adults. We estimate the prevalence of common mental disorders (CMD) among older adults and compare them with that of younger adults at the national level. We analysed data on older adults from the National Mental Health Survey of India undertaken across 6 regions and 12 states of India during 2015–16. Multi-stage cluster sampling technique was adopted which permitted state level and subsequently pooled national estimates. Mini International NeuroPsychiatric Interview (MINI) adult version 6.0 was used for measuring psychiatric morbidity. Older adults had a higher lifetime (6.93%) and current (3.53%) prevalence of depressive disorders as compared to the younger adults (4.96% and 2.54%). There was no difference in the prevalence of anxiety disorders in different agegroups. The most prevalent anxiety disorder in older adults was specific phobias (1.72%) followed by agoraphobia (1.6%). All CMD in the older population were more common in females, those living in urban metros, the unemployed, who were not currently married and those with lower household income. These findings support planning better mental health policies and programs for older adults in India. [ABSTRACT FROM AUTHOR]