Prevalence of Cognitive Impairment Without Dementia and Dementia in Tremembé, Brazil
BACKGROUND:The prevalence of cognitive impairment is insufficiently determined in developing countries. The aim of this study was to ascertain the prevalence of cognitive impairment without dementia and dementia in community-dwelling elderly in Brazil. METHODS:This was a single-phase cross-sectional...
Gespeichert in:
Veröffentlicht in: | Alzheimer disease and associated disorders 2016-07, Vol.30 (3), p.264-271 |
---|---|
Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 271 |
---|---|
container_issue | 3 |
container_start_page | 264 |
container_title | Alzheimer disease and associated disorders |
container_volume | 30 |
creator | César, Karolina G Brucki, Sonia M.D Takada, Leonel T Nascimento, Luiz F.C Gomes, Camila M.S Almeida, Milena C.S Oliveira, Maira O Porto, Fábio H.G Senaha, Mirna L.H Bahia, Valéria S Silva, Thaís B.L Ianof, Jéssica N Spíndola, Lívia Schmidt, Magali T Jorge, Mário S Vale, Patrícia H.F Cecchini, Mário A Cassimiro, Luciana Soares, Roger T Gonçalves, Márcia R Martins, Ana C.S Daré, Patrícia Smid, Jerusa Porto, Claudia S Carthery-Goulart, Maria T Yassuda, Mônica S Mansur, Letícia L Nitrini, Ricardo |
description | BACKGROUND:The prevalence of cognitive impairment is insufficiently determined in developing countries. The aim of this study was to ascertain the prevalence of cognitive impairment without dementia and dementia in community-dwelling elderly in Brazil.
METHODS:This was a single-phase cross-sectional survey of the elderly (aged 60 years and above) living in the municipality of Tremembé, Brazil. Twenty percent of the households with elderly persons were randomly selected from urban and rural areas, to obtain a homogenous representation of all socioeconomic and cultural levels.
RESULTS:We assessed 630 individuals [mean age, 71.3 y (±7.99); mean years of education, 4.9 (±4.54)] and found prevalence rates of 17.5% (95% confidence interval, 14.6-20.6) for dementia and 19.5% (95% confidence interval, 16.6-22.8) for cognitive impairment without dementia. These prevalence rates were influenced by age (P |
doi_str_mv | 10.1097/WAD.0000000000000122 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1814134978</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1814134978</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4222-42d223ac8f828bc66c29c45e45e140006950016cbb0fa065ff87ea17f9de5413</originalsourceid><addsrcrecordid>eNp9kMlOwzAQhi0EomV5A4Ry5ECK7TiOcywtS6VKcCjqMXLcCTU4SbGTVvBGPAcvhquWRRwYjTT6pW-2H6ETgnsEp8nFtD_s4d9BKN1BXRIzHjIS813UxSKNQhwx0kEHzj15JolivI86lHOa8oR30cO9haU0UCkI6iIY1I-VbvQSglG5kNqWUDXBVDfzum2CIaylloGsZj9CV8HEelHmH-_nwaWVb9ocob1CGgfH23qIJtdXk8FtOL67GQ3641AxSmnI6IzSSCpRCCpyxbmiqWIx-CTMX8vT2L_FVZ7jQmIeF4VIQJKkSGcQMxIdorPN2IWtX1pwTVZqp8AYWUHduowI4imWJsKjbIMqWztnocgWVpfSvmYEZ2s_M-9n9tdP33a63dDmJcy-m74M9IDYAKvaNGDds2lXYLM5SNPM_5_9CQDUgRU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1814134978</pqid></control><display><type>article</type><title>Prevalence of Cognitive Impairment Without Dementia and Dementia in Tremembé, Brazil</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>César, Karolina G ; Brucki, Sonia M.D ; Takada, Leonel T ; Nascimento, Luiz F.C ; Gomes, Camila M.S ; Almeida, Milena C.S ; Oliveira, Maira O ; Porto, Fábio H.G ; Senaha, Mirna L.H ; Bahia, Valéria S ; Silva, Thaís B.L ; Ianof, Jéssica N ; Spíndola, Lívia ; Schmidt, Magali T ; Jorge, Mário S ; Vale, Patrícia H.F ; Cecchini, Mário A ; Cassimiro, Luciana ; Soares, Roger T ; Gonçalves, Márcia R ; Martins, Ana C.S ; Daré, Patrícia ; Smid, Jerusa ; Porto, Claudia S ; Carthery-Goulart, Maria T ; Yassuda, Mônica S ; Mansur, Letícia L ; Nitrini, Ricardo</creator><creatorcontrib>César, Karolina G ; Brucki, Sonia M.D ; Takada, Leonel T ; Nascimento, Luiz F.C ; Gomes, Camila M.S ; Almeida, Milena C.S ; Oliveira, Maira O ; Porto, Fábio H.G ; Senaha, Mirna L.H ; Bahia, Valéria S ; Silva, Thaís B.L ; Ianof, Jéssica N ; Spíndola, Lívia ; Schmidt, Magali T ; Jorge, Mário S ; Vale, Patrícia H.F ; Cecchini, Mário A ; Cassimiro, Luciana ; Soares, Roger T ; Gonçalves, Márcia R ; Martins, Ana C.S ; Daré, Patrícia ; Smid, Jerusa ; Porto, Claudia S ; Carthery-Goulart, Maria T ; Yassuda, Mônica S ; Mansur, Letícia L ; Nitrini, Ricardo</creatorcontrib><description>BACKGROUND:The prevalence of cognitive impairment is insufficiently determined in developing countries. The aim of this study was to ascertain the prevalence of cognitive impairment without dementia and dementia in community-dwelling elderly in Brazil.
METHODS:This was a single-phase cross-sectional survey of the elderly (aged 60 years and above) living in the municipality of Tremembé, Brazil. Twenty percent of the households with elderly persons were randomly selected from urban and rural areas, to obtain a homogenous representation of all socioeconomic and cultural levels.
RESULTS:We assessed 630 individuals [mean age, 71.3 y (±7.99); mean years of education, 4.9 (±4.54)] and found prevalence rates of 17.5% (95% confidence interval, 14.6-20.6) for dementia and 19.5% (95% confidence interval, 16.6-22.8) for cognitive impairment without dementia. These prevalence rates were influenced by age (P<0.001) and by educational level (P<0.001). There was no significant sex difference among diagnostic groups (P=0.166). The prevalence of dementia was higher in relatively younger individuals (below 70 y) when compared with other studies. Besides, dementia was associated with low socioeconomic status, stroke, previous psychiatric disorder, alcoholism, and epilepsy.
CONCLUSIONS:The prevalence of dementia in this study was higher than in other studies, particularly among younger elderly.</description><identifier>ISSN: 0893-0341</identifier><identifier>EISSN: 1546-4156</identifier><identifier>DOI: 10.1097/WAD.0000000000000122</identifier><identifier>PMID: 26629676</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Aged ; Aged, 80 and over ; Brazil - epidemiology ; Cognitive Dysfunction - diagnosis ; Cognitive Dysfunction - epidemiology ; Cross-Sectional Studies ; Dementia - diagnosis ; Dementia - epidemiology ; Female ; Humans ; Male ; Neuropsychological Tests ; Prevalence</subject><ispartof>Alzheimer disease and associated disorders, 2016-07, Vol.30 (3), p.264-271</ispartof><rights>Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4222-42d223ac8f828bc66c29c45e45e140006950016cbb0fa065ff87ea17f9de5413</citedby><cites>FETCH-LOGICAL-c4222-42d223ac8f828bc66c29c45e45e140006950016cbb0fa065ff87ea17f9de5413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26629676$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>César, Karolina G</creatorcontrib><creatorcontrib>Brucki, Sonia M.D</creatorcontrib><creatorcontrib>Takada, Leonel T</creatorcontrib><creatorcontrib>Nascimento, Luiz F.C</creatorcontrib><creatorcontrib>Gomes, Camila M.S</creatorcontrib><creatorcontrib>Almeida, Milena C.S</creatorcontrib><creatorcontrib>Oliveira, Maira O</creatorcontrib><creatorcontrib>Porto, Fábio H.G</creatorcontrib><creatorcontrib>Senaha, Mirna L.H</creatorcontrib><creatorcontrib>Bahia, Valéria S</creatorcontrib><creatorcontrib>Silva, Thaís B.L</creatorcontrib><creatorcontrib>Ianof, Jéssica N</creatorcontrib><creatorcontrib>Spíndola, Lívia</creatorcontrib><creatorcontrib>Schmidt, Magali T</creatorcontrib><creatorcontrib>Jorge, Mário S</creatorcontrib><creatorcontrib>Vale, Patrícia H.F</creatorcontrib><creatorcontrib>Cecchini, Mário A</creatorcontrib><creatorcontrib>Cassimiro, Luciana</creatorcontrib><creatorcontrib>Soares, Roger T</creatorcontrib><creatorcontrib>Gonçalves, Márcia R</creatorcontrib><creatorcontrib>Martins, Ana C.S</creatorcontrib><creatorcontrib>Daré, Patrícia</creatorcontrib><creatorcontrib>Smid, Jerusa</creatorcontrib><creatorcontrib>Porto, Claudia S</creatorcontrib><creatorcontrib>Carthery-Goulart, Maria T</creatorcontrib><creatorcontrib>Yassuda, Mônica S</creatorcontrib><creatorcontrib>Mansur, Letícia L</creatorcontrib><creatorcontrib>Nitrini, Ricardo</creatorcontrib><title>Prevalence of Cognitive Impairment Without Dementia and Dementia in Tremembé, Brazil</title><title>Alzheimer disease and associated disorders</title><addtitle>Alzheimer Dis Assoc Disord</addtitle><description>BACKGROUND:The prevalence of cognitive impairment is insufficiently determined in developing countries. The aim of this study was to ascertain the prevalence of cognitive impairment without dementia and dementia in community-dwelling elderly in Brazil.
METHODS:This was a single-phase cross-sectional survey of the elderly (aged 60 years and above) living in the municipality of Tremembé, Brazil. Twenty percent of the households with elderly persons were randomly selected from urban and rural areas, to obtain a homogenous representation of all socioeconomic and cultural levels.
RESULTS:We assessed 630 individuals [mean age, 71.3 y (±7.99); mean years of education, 4.9 (±4.54)] and found prevalence rates of 17.5% (95% confidence interval, 14.6-20.6) for dementia and 19.5% (95% confidence interval, 16.6-22.8) for cognitive impairment without dementia. These prevalence rates were influenced by age (P<0.001) and by educational level (P<0.001). There was no significant sex difference among diagnostic groups (P=0.166). The prevalence of dementia was higher in relatively younger individuals (below 70 y) when compared with other studies. Besides, dementia was associated with low socioeconomic status, stroke, previous psychiatric disorder, alcoholism, and epilepsy.
CONCLUSIONS:The prevalence of dementia in this study was higher than in other studies, particularly among younger elderly.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Brazil - epidemiology</subject><subject>Cognitive Dysfunction - diagnosis</subject><subject>Cognitive Dysfunction - epidemiology</subject><subject>Cross-Sectional Studies</subject><subject>Dementia - diagnosis</subject><subject>Dementia - epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Neuropsychological Tests</subject><subject>Prevalence</subject><issn>0893-0341</issn><issn>1546-4156</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMlOwzAQhi0EomV5A4Ry5ECK7TiOcywtS6VKcCjqMXLcCTU4SbGTVvBGPAcvhquWRRwYjTT6pW-2H6ETgnsEp8nFtD_s4d9BKN1BXRIzHjIS813UxSKNQhwx0kEHzj15JolivI86lHOa8oR30cO9haU0UCkI6iIY1I-VbvQSglG5kNqWUDXBVDfzum2CIaylloGsZj9CV8HEelHmH-_nwaWVb9ocob1CGgfH23qIJtdXk8FtOL67GQ3641AxSmnI6IzSSCpRCCpyxbmiqWIx-CTMX8vT2L_FVZ7jQmIeF4VIQJKkSGcQMxIdorPN2IWtX1pwTVZqp8AYWUHduowI4imWJsKjbIMqWztnocgWVpfSvmYEZ2s_M-9n9tdP33a63dDmJcy-m74M9IDYAKvaNGDds2lXYLM5SNPM_5_9CQDUgRU</recordid><startdate>201607</startdate><enddate>201607</enddate><creator>César, Karolina G</creator><creator>Brucki, Sonia M.D</creator><creator>Takada, Leonel T</creator><creator>Nascimento, Luiz F.C</creator><creator>Gomes, Camila M.S</creator><creator>Almeida, Milena C.S</creator><creator>Oliveira, Maira O</creator><creator>Porto, Fábio H.G</creator><creator>Senaha, Mirna L.H</creator><creator>Bahia, Valéria S</creator><creator>Silva, Thaís B.L</creator><creator>Ianof, Jéssica N</creator><creator>Spíndola, Lívia</creator><creator>Schmidt, Magali T</creator><creator>Jorge, Mário S</creator><creator>Vale, Patrícia H.F</creator><creator>Cecchini, Mário A</creator><creator>Cassimiro, Luciana</creator><creator>Soares, Roger T</creator><creator>Gonçalves, Márcia R</creator><creator>Martins, Ana C.S</creator><creator>Daré, Patrícia</creator><creator>Smid, Jerusa</creator><creator>Porto, Claudia S</creator><creator>Carthery-Goulart, Maria T</creator><creator>Yassuda, Mônica S</creator><creator>Mansur, Letícia L</creator><creator>Nitrini, Ricardo</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201607</creationdate><title>Prevalence of Cognitive Impairment Without Dementia and Dementia in Tremembé, Brazil</title><author>César, Karolina G ; Brucki, Sonia M.D ; Takada, Leonel T ; Nascimento, Luiz F.C ; Gomes, Camila M.S ; Almeida, Milena C.S ; Oliveira, Maira O ; Porto, Fábio H.G ; Senaha, Mirna L.H ; Bahia, Valéria S ; Silva, Thaís B.L ; Ianof, Jéssica N ; Spíndola, Lívia ; Schmidt, Magali T ; Jorge, Mário S ; Vale, Patrícia H.F ; Cecchini, Mário A ; Cassimiro, Luciana ; Soares, Roger T ; Gonçalves, Márcia R ; Martins, Ana C.S ; Daré, Patrícia ; Smid, Jerusa ; Porto, Claudia S ; Carthery-Goulart, Maria T ; Yassuda, Mônica S ; Mansur, Letícia L ; Nitrini, Ricardo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4222-42d223ac8f828bc66c29c45e45e140006950016cbb0fa065ff87ea17f9de5413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Brazil - epidemiology</topic><topic>Cognitive Dysfunction - diagnosis</topic><topic>Cognitive Dysfunction - epidemiology</topic><topic>Cross-Sectional Studies</topic><topic>Dementia - diagnosis</topic><topic>Dementia - epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Neuropsychological Tests</topic><topic>Prevalence</topic><toplevel>online_resources</toplevel><creatorcontrib>César, Karolina G</creatorcontrib><creatorcontrib>Brucki, Sonia M.D</creatorcontrib><creatorcontrib>Takada, Leonel T</creatorcontrib><creatorcontrib>Nascimento, Luiz F.C</creatorcontrib><creatorcontrib>Gomes, Camila M.S</creatorcontrib><creatorcontrib>Almeida, Milena C.S</creatorcontrib><creatorcontrib>Oliveira, Maira O</creatorcontrib><creatorcontrib>Porto, Fábio H.G</creatorcontrib><creatorcontrib>Senaha, Mirna L.H</creatorcontrib><creatorcontrib>Bahia, Valéria S</creatorcontrib><creatorcontrib>Silva, Thaís B.L</creatorcontrib><creatorcontrib>Ianof, Jéssica N</creatorcontrib><creatorcontrib>Spíndola, Lívia</creatorcontrib><creatorcontrib>Schmidt, Magali T</creatorcontrib><creatorcontrib>Jorge, Mário S</creatorcontrib><creatorcontrib>Vale, Patrícia H.F</creatorcontrib><creatorcontrib>Cecchini, Mário A</creatorcontrib><creatorcontrib>Cassimiro, Luciana</creatorcontrib><creatorcontrib>Soares, Roger T</creatorcontrib><creatorcontrib>Gonçalves, Márcia R</creatorcontrib><creatorcontrib>Martins, Ana C.S</creatorcontrib><creatorcontrib>Daré, Patrícia</creatorcontrib><creatorcontrib>Smid, Jerusa</creatorcontrib><creatorcontrib>Porto, Claudia S</creatorcontrib><creatorcontrib>Carthery-Goulart, Maria T</creatorcontrib><creatorcontrib>Yassuda, Mônica S</creatorcontrib><creatorcontrib>Mansur, Letícia L</creatorcontrib><creatorcontrib>Nitrini, Ricardo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Alzheimer disease and associated disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>César, Karolina G</au><au>Brucki, Sonia M.D</au><au>Takada, Leonel T</au><au>Nascimento, Luiz F.C</au><au>Gomes, Camila M.S</au><au>Almeida, Milena C.S</au><au>Oliveira, Maira O</au><au>Porto, Fábio H.G</au><au>Senaha, Mirna L.H</au><au>Bahia, Valéria S</au><au>Silva, Thaís B.L</au><au>Ianof, Jéssica N</au><au>Spíndola, Lívia</au><au>Schmidt, Magali T</au><au>Jorge, Mário S</au><au>Vale, Patrícia H.F</au><au>Cecchini, Mário A</au><au>Cassimiro, Luciana</au><au>Soares, Roger T</au><au>Gonçalves, Márcia R</au><au>Martins, Ana C.S</au><au>Daré, Patrícia</au><au>Smid, Jerusa</au><au>Porto, Claudia S</au><au>Carthery-Goulart, Maria T</au><au>Yassuda, Mônica S</au><au>Mansur, Letícia L</au><au>Nitrini, Ricardo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of Cognitive Impairment Without Dementia and Dementia in Tremembé, Brazil</atitle><jtitle>Alzheimer disease and associated disorders</jtitle><addtitle>Alzheimer Dis Assoc Disord</addtitle><date>2016-07</date><risdate>2016</risdate><volume>30</volume><issue>3</issue><spage>264</spage><epage>271</epage><pages>264-271</pages><issn>0893-0341</issn><eissn>1546-4156</eissn><abstract>BACKGROUND:The prevalence of cognitive impairment is insufficiently determined in developing countries. The aim of this study was to ascertain the prevalence of cognitive impairment without dementia and dementia in community-dwelling elderly in Brazil.
METHODS:This was a single-phase cross-sectional survey of the elderly (aged 60 years and above) living in the municipality of Tremembé, Brazil. Twenty percent of the households with elderly persons were randomly selected from urban and rural areas, to obtain a homogenous representation of all socioeconomic and cultural levels.
RESULTS:We assessed 630 individuals [mean age, 71.3 y (±7.99); mean years of education, 4.9 (±4.54)] and found prevalence rates of 17.5% (95% confidence interval, 14.6-20.6) for dementia and 19.5% (95% confidence interval, 16.6-22.8) for cognitive impairment without dementia. These prevalence rates were influenced by age (P<0.001) and by educational level (P<0.001). There was no significant sex difference among diagnostic groups (P=0.166). The prevalence of dementia was higher in relatively younger individuals (below 70 y) when compared with other studies. Besides, dementia was associated with low socioeconomic status, stroke, previous psychiatric disorder, alcoholism, and epilepsy.
CONCLUSIONS:The prevalence of dementia in this study was higher than in other studies, particularly among younger elderly.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>26629676</pmid><doi>10.1097/WAD.0000000000000122</doi><tpages>8</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0893-0341 |
ispartof | Alzheimer disease and associated disorders, 2016-07, Vol.30 (3), p.264-271 |
issn | 0893-0341 1546-4156 |
language | eng |
recordid | cdi_proquest_miscellaneous_1814134978 |
source | MEDLINE; Journals@Ovid Complete |
subjects | Aged Aged, 80 and over Brazil - epidemiology Cognitive Dysfunction - diagnosis Cognitive Dysfunction - epidemiology Cross-Sectional Studies Dementia - diagnosis Dementia - epidemiology Female Humans Male Neuropsychological Tests Prevalence |
title | Prevalence of Cognitive Impairment Without Dementia and Dementia in Tremembé, Brazil |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-21T08%3A40%3A20IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prevalence%20of%20Cognitive%20Impairment%20Without%20Dementia%20and%20Dementia%20in%20Trememb%C3%A9,%20Brazil&rft.jtitle=Alzheimer%20disease%20and%20associated%20disorders&rft.au=C%C3%A9sar,%20Karolina%20G&rft.date=2016-07&rft.volume=30&rft.issue=3&rft.spage=264&rft.epage=271&rft.pages=264-271&rft.issn=0893-0341&rft.eissn=1546-4156&rft_id=info:doi/10.1097/WAD.0000000000000122&rft_dat=%3Cproquest_cross%3E1814134978%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1814134978&rft_id=info:pmid/26629676&rfr_iscdi=true |