Leszek Bidzan

Bio: Leszek Bidzan is an academic researcher from Gdańsk Medical University. The author has contributed to research in topics: Dementia & Population. The author has an hindex of 13, co-authored 56 publications receiving 491 citations.

A Polish and German Population Study of Quality of Life, Well-Being, and Life Satisfaction in Older Adults During the COVID-19 Pandemic.

Abstract: Introduction Psychological studies undertaken during the COVID-19 pandemic rarely include people in their 60s. In our study, we studied the predictors of the quality of life, wellbeing, sleep and life satisfaction during the pandemic in older people from Germany and Poland, including factors such as risk behaviour, trait anxiety, feeling of threat, sleep quality, optimism, comparing them to three different age groups. Methods 494 adults in four groups: 60+ (N=60), 50-60 (N=139), 36-49 (N=155), <35 (N=140) completed validated self-report questionnaires assessing: socio-demographic data, quality of life, trait anxiety, risk tolerance, coronavirus threat, optimism regarding the pandemic, difficulty relaxing, life satisfaction, wellbeing, sleep quality during the pandemic period. Results Older people rated higher their quality higher of life than younger (mean difference = .74, SE = .19, p < .01) and middle-aged (mean difference = .79, SE = .18, p < .01), life satisfaction than younger (mean difference = 1.23, SE = .31, p < .01) and middle-aged (mean difference = .92, SE = .30, p < .05) as well as wellbeing higher than younger (mean difference = 1.40, SE = .31, p < .01) and middle-aged participants (mean difference = .91, SE = .31, p < .05), but experienced lower levels of trait anxiety and Coronavirus threat (mean difference = -9.19, SE = 1.90, p < .01), compared to younger age groups. They experienced greater risk tolerance (mean difference = 1.38, SE = .33, p < .01), as well as sleep quality (F=1.25; eta2=.01), optimism regarding the pandemic (F=1.96; eta2=.01), and had less difficulty relaxing during the pandemic (F=3.75; eta2=.02) than middle-aged respondents. Conclusions The findings show that the assessed quality of life, life satisfaction and wellbeing during pandemic is affected by the respondent’s age, trait anxiety and the threat of Coronavirus. Older people rated their quality higher of life, life satisfaction and wellbeing during pandemic higher than younger people, but experienced lower levels of trait anxiety and Coronavirus threat compared to younger age groups. They experienced greater risk tolerance, as well as sleep quality, optimism regarding the pandemic, and had less difficulty relaxing during the pandemic than middle-aged respondents.

Aggressive and impulsive behavior in Alzheimer’s disease and progression of dementia

Abstract: Background: The symptoms of Alzheimer's disease (AD) are numerous, including worsening of mood, psychotic symptoms, aggressive and impulsive behaviours, and many others. It is generally assumed that there exists a relationship between the severity of dementia and aggressive symptoms. The aim of this study was to assess the relationship between aggressive and impulsive behaviours and cognitive function disorders in AD patients. Material/Methods: Forty-eight AD patients living in a nursing home were included in the research group on the basis of NINCDS/ADRDA criteria. The subjects underwent two years of naturalistic observation. The intensity of agitation and aggressive behaviours was assessed on the basis of the Cohen-Mansfield Agitation Inventory (CMAI). The Alzheimer's Disease Assessment Scale Cog (ADAS-cog) was used to assess cognitive function. Pharmacotherapy administered during the observation period was also taken into account. Results: Thirty-one patients completed the two year long observation. Individuals with more severe cognitive deficiencies demonstrated a greater intensity of aggressive and impulsive behaviours, as assessed using the CMAI scale. Aggression escalated together with the development of dementia disorders. The intensity of dementia disorders was most significantly connected with physical agitation and verbal aggression. The use of neuroleptics and mood stabilisers decreased the progression of aggressive and impulsive behaviours. Conclusions: There is a relationship between cognitive functioning disorders and the intensification of aggressive and impulsive behaviours. More severe forms of dementia are connected with greater intensification of aggressive and impulsive behaviours as the disease progresses. Periodical administration of pharmacotherapy may reduce the development of aggressive behaviours. Language: en

Efficacy and safety of duloxetine in the treatment of older adult patients with generalized anxiety disorder: a randomized, double-blind, placebo-controlled trial.

Abstract: Objective This was a flexible-dosed study to evaluate the efficacy and safety of duloxetine 30–120 mg once daily in the treatment of generalized anxiety disorder (GAD) in older adult patients. Methods Patients with GAD, who were at least 65 years of age, were randomly assigned to double-blind treatment with either duloxetine (N = 151) or placebo (N = 140). The primary efficacy measure was the Hamilton Anxiety Rating Scale (HAM-A) total score, and the primary endpoint was at week 10. Global functioning was assessed by the Sheehan Disability Scale (SDS). Safety and tolerability was assessed by the occurrence of treatment-emergent adverse events, serious adverse events, laboratory analyses, and vital signs. Analyses were conducted on an intent-to-treat basis. Results The overall baseline mean HAM-A total score was 24, and SDS global score was 14. Completion rates were 75% for placebo and 76% for duloxetine. At week 10, duloxetine was superior to placebo on mean changes from baseline in HAM-A total scores (−15.9 vs. −11.7, p < 0.001) and in SDS global scores (−8.6 vs. −5.4, p < 0.001). Treatment-emergent adverse events occurred in ≥5% of duloxetine-treated patients and twice the rate than with placebo including constipation (9% vs. 4%, p = 0.06), dry mouth (7% vs. 1%, p = 0.02), and somnolence (6% vs. 2%, p = 0.14). Conclusion Duloxetine treatment was efficacious in the improvement of anxiety and functioning in older adult patients with GAD, and the safety profile was consistent with previous GAD studies. © 2014 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.

Beta-Amyloid Peptides Enhance the Proliferative Response of Activated CD4+CD28+ Lymphocytes from Alzheimer Disease Patients and from Healthy Elderly

Abstract: Alzheimer's disease (AD) is the most frequent form of dementia among elderly. Despite the vast amount of literature on non-specific immune mechanisms in AD there is still little information about the potential antigen-specific immune response in this pathology. It is known that early stages of AD include β-amyloid (Aβ)- reactive antibodies production and inflammatory response. Despite some evidence gathered proving cellular immune response background in AD pathology, the specific reactions of CD4+ and CD8+ cells remain unknown as the previous investigations yielded conflicting results. Here we investigated the CD4+CD28+ population of human peripheral blood T cells and showed that soluble β-amyloids alone were unable to stimulate these cells to proliferate significantly, resulting only in minor, probably antigen-specific, proliferative response. On the other hand, the exposure of in vitro pre-stimulated lymphocytes to soluble Aβ peptides significantly enhanced the proliferative response of these cells which had also lead to increased levels of TNF, IL-10 and IL-6. We also proved that Aβ peptide-enhanced proliferative response of CD4+CD28+ cells is autonomous and independent from disease status while being associated with the initial, ex vivo activation status of the CD4+ cells. In conclusion, we suggest that the effect of Aβ peptides on the immune system of AD patients does not depend on the specific reactivity to Aβ epitope(s), but is rather a consequence of an unspecific modulation of the cell cycle dynamics and cytokine production by T cells, occurring simultaneously in a huge proportion of Aβ peptide-exposed T lymphocytes and affecting the immune system performance.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Abstract: Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

Abstract: Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated. These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980–2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines. These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions. Anxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments.

Mild Cognitive Impairment as a Clinical Entity and Treatment Target

Abstract: M ILD COGNITIVE i m p a i r m e n t (MCI) has been actively investigated for the past decade. , 2 The term was coined in the late 1980s by the New York University group to identify individuals who were not cognitively normal for age and yet did not have overt dementia, and their outcomes were described in an article examining predictors of dementia by Flicker et al in the early 1990s. Flicker et al characterized MCI as equivalent to a Global Deterioration Scale rating of 3 and found that a diagnostic approach combining a careful, structured interview and the appropriate neuropsychological tests can discriminate those individuals with MCI likely to experience cognitive deterioration from those with a benign prognosis. Recently MCI has been given more specific criteria involving the features outlined in Figure 1 of the comments by Gauthier and Touchon abstracted from Petersen et al. In conjunction with increased attention to the early stages of development of Alzheimer disease (AD), these criteria served to catalyze intense interest in MCI as a possible prodromal stage of AD. Several studies on longitudinal populations were conducted, some retrofitting criteria to longitudinal studies of aging, and several others are either underway or completed and have demonstrated a progression from MCI to AD at an elevated rate over the base rate in the population. Most of these studies examined the amnestic subtype of MCI, in which memory impairment is a key feature. However, other studies, often encompassing a broader definition of MCI, have demonstrated a reversion to normal in some subjects, implying a lack of stability for the construct over time. This has led to a closer inspection of the underlying premises of MCI and a refinement of criteria to recognize that MCI is a heterogeneous condition. Several factors have emerged as contributing to the variability in the outcomes of several of these studies. Among these are the following factors: (1) criteria for MCI, (2) implementation of the criteria, (3) source of subjects, and (4) reference standards for normal performance. Each of these points deserves discussion as it pertains to the comments raised by Gauthier and Touchon.