Brain Health Watch

Better Communication Boosts Mental Health for Families of Patients With SABI

Improved communication between physicans and family members of individuals with severe acute brain injury (SABI) about palliative care needs can help address and improve mental health outcomes, according to the results of a study published in JAMA Network Open.

3d illustration of brain anatomy | Image credit: PIC4U - stock.adobe.com

Investigators said that a checklist completed by family members and physicians may help improve communication and targeted, timely treatment needs. A total of 209 family member–patient pairs were included in the study. Individuals had experienced hypoxic ischemic encephalopathy, stroke, and/or traumatic brain injury.

Investigators found that approximately 50% of family members enrolled had at least moderate anxiety or depression, with just 20% at the follow-up. The mean for high levels of depressive symptoms was 50%, and the mean for generalized anxiety disorder (GAD) was 46% with at least moderate anxiety. In the follow-up, 19% had a high level of depressive symptoms and GAD was 22%.

In models adjusted for age, diagnosis, disease severity, and family ethnicity and race, there was no association between the main outcomes of anxiety and depressive symptoms and at least 1 need identified by a physician. Compared with no identification of need, at least 1 need identified by physicians was associated with a 74% higher proportion of perceived goal-discordant care at enrollment and 17 points greater decisional regret at follow-up among families that were comparable by age, diagnosis, ethnicity, race, and severity.

Overall, the investigators found that early communication between family members and physicians and using a palliative care checklist could help improve patients’ treatment and management of their needs.—Ashley Gallagher

Childhood Trauma Associated With Reduced Vascular Function, Worse Sleep Quality

New research results have shown that childhood trauma is associated with reduced vascular function and diminished sleep quality in young adults.

Additionally, the study found that poor sleep efficiency may contribute to vascular dysfunction with increasing exposure to adverse childhood experiences. However, improving sleep quality could offset some of these harmful effects of childhood trauma.

Adverse childhood experiences are highly stressful, as are potentially traumatic events that occur during the first 18 years of life, which is the most critical developmental period. Earlier research has already established that those who experience adverse childhood events have a higher risk for cardiovascular disease later in life, but the biological mechanisms underlying this health disparity are not well understood.

In the new study, investigators aimed to better understand how adverse childhood events increase the risk of cardiovascular disease to aid in developing better preventive measures and treatments.

Among young adults, the investigators found that adverse childhood events had a negative impact on blood vessel function, whereas sleep efficiency had a positive effect regardless of anxiety or depression symptoms. In addition, sleep efficiency appeared to be a mediator of the relationship between adverse childhood events and blood vessel function.—Aislinn Antrim

Obstructive Sleep Apnea May Have Significant Impact on Cognitive Decline in Middle-Aged Individuals

Obstructive Sleep Apnea (OSA) may lead to cognitive changes occurring as early as midlife in otherwise healthy individuals, according to results of a study published in Frontiers in Sleep. The study noted that OSA is a multisystem, debilitating, and chronic breathing disorder that may cause a relatively consistent pattern of cognitive deficits. The investigators noted that recent arguments have surrounded whether cognitive deficits, specifically in middle- aged patients, may be driven by cardiovascular and metabolic comorbidities instead of distinct OSA processes.

In the patient cohort, results showed poorer executive functioning and visuospatial memory, and deficits in vigilance, sustained attention, psychomotor, and impulse control. The investigators also observed, for the first time, effects on social cognition in the study group of male, middle-aged patients with OSA.

The investigators concluded it is likely that sleep fragmentation and associated sleep loss in patients with OSA, and particularly REM-related fragmentation, may impair discrete affective neural systems and disrupt the identification of salient affective social cues.—Davy James

References

Better Communication Boosts Mental Health for Families of Patients With SABI

Plinke WV, Buchbinder SA, Brumback LC, et al. Identification of palliative care needs and mental health outcomes among family members of patients with severe acute brain injury. JAMA Netw Open. 2023;6(4):e239949. doi:10.1001/jamanetworkopen.2023.9949

Childhood Trauma Associated With Reduced Vascular Function, Worse Sleep Quality

Childhood trauma linked to reduced vascular function and diminished sleep quality. News release. American Physiological Society. April 21, 2023. Accessed June 12, 2023. https://www.physiology.org/detail/news/2023/04/21/childhood-trauma-linked-to-reduced-vascular-function-and-diminished-sleep-quality?SSO=Y

Obstructive Sleep Apnea May Have Significant Impact on Cognitive Decline in Middle-Aged Individuals

Gnoni V, Mesquita M, O’Regan D, et al. Distinct cognitive changes in male patients with obstructive sleep apnoea without co-morbidities. Front Sleep. Published online April 6, 2023. Accessed June 6, 2023. https://www.frontiersin.org/articles/10.3389/frsle.2023.1097946