Time spent in nature appears to slow Parkinson's, Alzheimer's jamanetworkopen
Data were analyzed between January 2021 and September 2022. To examine associations of each exposure with first ADRD and PD hospitalizations, we used a Cox-equivalent reparameterized Poisson approach . First, we aggregated beneficiaries who lived within the same zip code in each year by the following: sex, 2-year age categories at study entry, race and ethnicity, Medicaid eligibility, and year of follow-up.
We examined associations in the full population and in the subset of urban zip codes . We fitted models with increasing degrees of covariate adjustment to evaluate the impact of potential confounders.
For sensitivity analyses, we ran single-exposure models, modeled the alternative blue space cut point , and additionally adjusted for PM, and meteorological factors. Further, we ran models with adjustment for US Census division instead of region. We excluded individuals who had their first hospital admission within the first year of their follow-up and all records in 2000 to eliminate potential prevalent cases.
Beneficiaries with missing data in any variables included in the main model were removed from the cohort . R software version 3.6.1 was used for analyses, and analyses were conducted on the Harvard Research Computing Environment supported by the Institute for Quantitative Social Science at Harvard University. Two-sidedThe ADRD and PD cohorts included 61 662 472 and 61 673 367 Medicare beneficiaries, respectively. For both cohorts, 55.2% of beneficiaries were women and 44.8% were men; 8.
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Association between cholinesterase activity and critical illness brain dysfunction - Critical CareBackground Delirium is a frequent manifestation of acute brain dysfunction and is associated with cognitive impairment. The hypothesized mechanism of brain dysfunction during critical illness is centered on neuroinflammation, regulated in part by the cholinergic system. Point-of-care serum cholinesterase enzyme activity measurements serve as a real-time index of cholinergic activity. We hypothesized that cholinesterase activity during critical illness would be associated with delirium in the intensive care unit (ICU) and cognitive impairment after discharge. Methods We enrolled adults with respiratory failure and/or shock and measured plasma acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activity on days 1, 3, 5, and 7 after enrollment. AChE values were also normalized per gram of hemoglobin (AChE/Hgb). We assessed for coma and delirium twice daily using the Richmond Agitation Sedation Scale and the Confusion Assessment Method for the ICU to evaluate daily mental status (delirium, coma, normal) and days alive without delirium or coma. Cognitive impairment, disability, and health-related quality of life were assessed at up to 6 months post-discharge. We used multivariable regression to determine whether AChE, AChE/Hgb, and BChE activity were associated with outcomes after adjusting for relevant covariates. Results We included 272 critically ill patients who were a median (IQR) age 56 (39–67) years and had a median Sequential Organ Failure Assessment score at enrollment of 8 (5–11). Higher daily AChE levels were associated with increased odds of being delirious versus normal mental status on the same day (Odds Ratio [95% Confidence Interval] 1.64 [1.11, 2.43]; P = 0.045). AChE/Hgb and BChE activity levels were not associated with delirious mental status. Lower enrollment BChE was associated with fewer days alive without delirium or coma (P = 0.048). AChE, AChE/Hgb, and BChE levels were not significantly associated with cognitive impairment, disability, o
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