Background The impact of coronavirus disease (COVID-19) on public mental health in 2019 is verified, but the role of only-child status in the mental health of adolescents confined at home during the COVID-19 epidemic has not been investigated and is not clear. Objective Our study aims to assess the impact of only-child status on the mental health of adolescents confined at home during the COVID-19 outbreak. The exposure risk to COVID-19, adverse experience, parent-child relationship, and resilience have also been measured and considered. Methods From March 20 to 31, 2020, a cross-sectional survey test was conducted on 11,681 adolescents aged from 12 to 18 years in middle schools (Grade 7 to Grade 9) across five provinces in China. The self-reported online questionnarie was used to collected data of demographic information, the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder Scale, the short form of the Childhood Trauma Questionnaire, the Connor-Davidson Resilience Scale and the exposure risk to COVID-19. Results A total of 11,180 valid questionnaires were collected, with an effective rate of 95.7%. 35.2% of only children and 38.8% of non-only children reported depression symptoms, while 20.5% of only children and 24.7% of non-only children reported anxiety symptoms. It was significant that non-only children were more likely to have anxiety and depression symptoms than only children (OR = 1.164, 95%CI: 1.064–1.273, p = 0.001). The risk of exposure to COVID-19 was a risk factor of depression (OR = 2.284, 95%CI: 1.640–3.180, p < 0.001) and anxiety symptoms (OR = 1.959, 95%CI: 1.402–2.737, p < 0.001) in non-only children, but not in only children. For both only children and non-only children, the resilience and parent-child relationship were protective factors of depression and anxiety symptoms, while emotional abuse was a risk factor ( p < 0.001). Conclusion The non-only children are more likely to develop the symptoms of anxiety and depression than only children, during the outbreak of COVID-19 in China. The adolescents with siblings are psychiatrically more vulnerable to exposure risk of COVID-19 and need more attention, especially those with poor parent-child relationship, low resilience and experience of emotional abuse.
Since late stage dementia, including Alzheimer's disease (AD), cannot be reversed by any available drugs, there is increasing research interest in the preclinical stage of AD, i.e., subjective cognitive decline (SCD). SCD is characterized by self-perceptive cognitive decline but is difficult to detect using objective tests. At SCD stage, the cognitive deficits can be more easily reversed compared to that of mild cognitive impairment (MCI) and AD only if accurate diagnosis of SCD and early intervention can be developed. In this paper, we review the recent progress of SCD research including current assessment tools, biomarkers, neuroimaging, intervention and expected prognosis, and the potential relevance to traumatic brain injury (TBI)-induced cognitive deficits.
Background: Stroke is the third leading cause of global year of life lost in all-age and second-ranked cause of disability adjusted life years in middle-aged and elder population. Therefore, it is critical to study the relationship between vascular-related risk factors and cerebrovascular diseases. Several cross-sectional studies have shown that Cystatin C (Cys C) is an independent risk factor for cerebrovascular diseases and levels of Cys C are significantly higher in stroke patients than in healthy individuals. In this meta-analysis, we introduce a Cox proportional hazards model to evaluate the causality between Cys C and the risk of cerebrovascular accident in the elderly. Methods: We searched PubMed, EMBASE, the Web of Science, and the Cochrane Library from 1985 to 2019 for studies on the relationship between serum Cys C and incidence stroke with Cox proportional hazards models. We conducted a subgroup analysis of the selected studies to determine a connection between atherosclerosis and stroke. Finally, 7 research studies, including 26,768 patients without a history of cerebrovascular, were studied. Results: After comparing the maximum and minimum Cys C levels, the hazard ratio for all types of stroke, including ischemic and hemorrhagic stroke, was 1.18 (95% confidence interval 1.04–1.31) with moderate heterogeneity ( I 2 = 43.0%; P = .119) in a fixed-effect model after pooled adjustment for other potential risk factors. In the subgroup analysis, the hazard ratio and 95% confidence interval for Cys C stratified by atherosclerosis was 1.85 (0.97–2.72). As shown in Egger linear regression test, there was no distinct publication bias ( P = .153). Conclusion: Increased serum Cys C is significantly associated with future stroke events in the elderly, especially in patients with carotid atherosclerosis. Thus, serum levels of Cys C could serve as a predicted biomarker for stroke attack.
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