Emerging risk factors for dementia

Abstract

Analysis of the associations between PTSD and psychotropic PTSD medication use with the risk for dementia showed a significant association between PTSD and the risk for dementia (HR=1.35; 95%CI=1.27-1.43) after adjustment for demographic characteristics, medical and psychiatric comorbidity, and health care utilization. Analysis of the impact of psychotropic PTSD medications including selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI), benzodiazepines (BZA), novel antidepressants (NA) and atypical antipsychotics (AA) on the association between PTSD and the risk for dementia showed significant interactions between PTSD and use of SSRIs (p<.0001), NAs (p=.0016), and AAs (p<.0001). Multivariate analysis showed a significant association between PTSD and an increased risk for dementia among individuals not using any psychotropic PTSD medications at baseline (HR=1.70; 95%CI=1.58-1.82). PTSD patients using SSRIs (HR=2.10; 95%CI=1.82-2.41), NAs (2.19; 95%CI=1.94-2.48) or AAs (4.56; 95%CI=4.04-5.15) were significantly more likely to develop dementia compared to those without PTSD and not using any psychotropic PTSD medications. PTSD patients using SSRIs (HR=1.24; 95%CI=1.08-1.42), NAs (HR=1.29; 95% CI=1.14-1.46) or AAs (HR=2.69; 95%CI=2.38-3.04) were also significantly more likely to develop dementia compared to those with PTSD and not using any psychotropic PTSD medications. SNRI (HR=1.35; 95%CI=1.26-1.46) and BZA drug use (HR=1.40; 95%CI=1.35-1.45) at baseline was associated with an increased risk for dementia regardless of PTSD diagnosis. These findings indicate; 1) evidence for an infectious AD etiology hypothesis in inconclusive, 2) both severe (e.g. sepsis), and less severe (e.g. cellulitis) systemic bacterial infections are collectively and independently associated with an increased risk of dementia among older U.S. veterans hence prevention of systemic bacterial infections could positively influence the risk for dementia among older adults, and 3) PTSD and psychotropic medication use are associated with an increased risk for dementia among U.S. veterans. Further epidemiologic, clinical, and basic science research is required to elucidate the mechanisms and the associations between infections and the risk for vi dementia and to determine if the independent and effect modifying impacts of psychotropic PTSD medication use on the risk for dementia are related to differences in PTSD severity, other psychiatric comorbidity, or whether psychotropic PTSD medication use is an independent risk factor for dementia. vii

Applying Multiple Linear Regression and Neural Network to Predict Business Performance Using the Reliability of Accounting Information System

“…Forexample,AndersonandReeb(2003),Petersen andSchoeman(2008)considerperformanceasacalculationofhowwellacompanycanuseitsassets fromitsprimarymethodofbusinessandproducerevenues.Where,modernliteratureseesperformance asaresultoftheactionsofacompanyorinvestmentoveraspecifictime.Performancehasalsobeen definedastheachievementofparticularbusinessobjectivescalculatedagainstrecognizedstandards, totalityandcost (DavisandCobb,2010;Özer,2012). Mawanda(2008)alsodefinesperformanceasthe abilitytooperateefficiently,profitability,survivegrowandreacttotheenvironmentalopportunities andthreats.Performanceisassessedbyhowefficienttheenterpriseisutilizingresourcesinachieving itsobjectives.Itisthedegreeofachievementbyanindividual,team,organizationorprocess.Other definitionsconsiderperformanceastheoutcomeofapproacheswhichthecompanyusestoaccomplish market-orientedandfinancialaims (Harash,etal.,2014).…”