ABSTRACTBackground: European health care workers recently experienced serious challenges to their mental health. Following the extremely stressful experience of the COVID-19 pandemic, the war in Ukraine caused a humanitarian influx of refugees in need of social and healthcare. We aimed to explore: (1) how working with refugees has affected the mental well-being of health care workers in the context of the COVID-19 pandemic, and (2) the nature of health care workers' emotional strain related to the refugee situation and the war in Ukraine.Methods: We used a combination of quantitative regression analyses and qualitative content analysis to assess data collected by an online questionnaire in 2022. The study included 1121 health care workers from the Czech arm of the international HEROES Study.Results: Quantitative findings did not indicate that working with Ukrainian refugees was reliably associated with a greater occurrence of symptoms of depression, anxiety, distress, or burnout. Qualitative analysis revealed five categories of emotional strain: impacts on working conditions, emotional reactions to refugees and the war, comparisons with the COVID-19 pandemic, and coping strategies.Conclusions: This study highlights the resilience of health care workers but also points to the need for ongoing support to address the complex emotional challenges they face during health crises.

• MeSH
• adaptace psychologická MeSH
• COVID-19 * psychologie   MeSH
• deprese psychologie   epidemiologie   MeSH
• dospělí MeSH
• duševní zdraví * MeSH
• lidé středního věku MeSH
• lidé MeSH
• pandemie MeSH
• profesionální vyhoření psychologie   MeSH
• průzkumy a dotazníky MeSH
• psychický stres psychologie   MeSH
• SARS-CoV-2 MeSH
• uprchlíci * psychologie   statistika a číselné údaje   MeSH
• úzkost psychologie   MeSH
• zdravotnický personál * psychologie   statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Ukrajina MeSH

BACKGROUND: Long-term deterioration in the mental health of healthcare workers (HCWs) has been reported during and after the COVID-19 pandemic. Determining the impact of COVID-19 incidence and mortality rates on the mental health of HCWs is essential to prepare for potential new pandemics. This study aimed to investigate the association of COVID-19 incidence and mortality rates with depressive symptoms over 2 years among HCWs in 20 countries during and after the COVID-19 pandemic. METHODS: This was a multi-country serial cross-sectional study using data from the first and second survey waves of the COVID-19 HEalth caRe wOrkErS (HEROES) global study. The HEROES study prospectively collected data from HCWs at various health facilities. The target population included HCWs with both clinical and non-clinical roles. In most countries, healthcare centers were recruited based on convenience sampling. As an independent variable, daily COVID-19 incidence and mortality rates were calculated using confirmed cases and deaths reported by Johns Hopkins University. These rates represent the average for the 7 days preceding the participants' response date. The primary outcome was depressive symptoms, assessed by the Patient Health Questionnaire-9. A multilevel linear mixed model (LMM) was conducted to investigate the association of depressive symptoms with the average incidence and mortality rates. RESULTS: A total of 32,223 responses from the participants who responded to all measures used in this study on either the first or second survey, and on both the first and second surveys in 20 countries were included in the analysis. The mean age was 40.1 (SD = 11.1), and 23,619 responses (73.3%) were from females. The 9323 responses (28.9%) were nurses and 9119 (28.3%) were physicians. LMM showed that the incidence rate was significantly and positively associated with depressive symptoms (coefficient = 0.008, standard error 0.003, p = 0.003). The mortality rate was significantly and positively associated with depressive symptoms (coefficient = 0.049, se = 0.020, p = 0.017). CONCLUSIONS: This is the first study to show an association between COVID-19 incidence and mortality rates with depressive symptoms among HCWs during the first 2 years of the outbreak in multiple countries. This study's findings indicate that additional mental health support for HCWs was needed when the COVID-19 incidence and mortality rates increase during and after the early phase of the pandemic, and these findings may apply to future pandemics. TRIAL REGISTRATION: Clinicaltrials.gov, NCT04352634.

• MeSH
• COVID-19 * mortalita   epidemiologie   psychologie   MeSH
• deprese * epidemiologie   MeSH
• dospělí MeSH
• incidence MeSH
• lidé středního věku MeSH
• lidé MeSH
• průřezové studie MeSH
• SARS-CoV-2 MeSH
• zdravotnický personál * psychologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

INTRODUCTION: Loneliness has a rising public health impact, but research involving neuropathology and representative cohorts has been limited. METHODS: Inverse odds of selection weights were generalized from the autopsy sample of Rush Alzheimer's Disease Center cohorts (N = 680; 89 ± 9 years old; 25% dementia) to the US-representative Health and Retirement Study (N = 8469; 76 ± 7 years old; 5% dementia) to extend external validity. Regressions tested cross-sectional associations between loneliness and (1) Alzheimer's disease (AD) and cerebrovascular pathology; (2) five cognitive domains; and (3) relationships between pathology and cognition, adjusting for depression. RESULTS: In weighted models, greater loneliness was associated with microinfarcts, lower episodic and working memory in the absence of AD pathology, lower working memory in the absence of infarcts, a stronger association of infarcts with lower episodic memory, and a stronger association of microinfarcts with lower working and semantic memory. DISCUSSION: Loneliness may relate to AD through multiple pathways involving cerebrovascular pathology and cognitive reserve. HIGHLIGHTS: Loneliness was associated with worse cognition in five domains. Loneliness was associated with the presence of microinfarcts. Loneliness moderated cognition-neuropathology associations. Transportability methods can provide insight into selection bias.

• MeSH
• Alzheimerova nemoc * psychologie   patologie   MeSH
• cerebrovaskulární poruchy * psychologie   patologie   MeSH
• kognice * fyziologie   MeSH
• lidé MeSH
• neuropsychologické testy statistika a číselné údaje   MeSH
• osamocení * psychologie   MeSH
• průřezové studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND AND OBJECTIVES: The mental health of healthcare workers (HCWs) may have improved after the COVID-19 pandemic. We aimed to model the trajectories of psychological distress, depressive symptoms, and resilience during the COVID-19 pandemic and toward its end in HCWs in Czechia and investigate, which COVID-19 work stressors were associated with these trajectories. METHODS: The study included 322 HCWs from the Czech arm of the international HEROES Study who participated in an online questionnaire in two waves during the pandemic and one wave toward its end. Growth mixture modeling identified trajectory patterns of depressive symptoms (measured with Patient Health Questionnaire), distress (General Health Questionnaire), and resilience (Brief Resilience Scale). Logistic regression was applied to estimate the association of COVID-19 stressors with mental health trajectories, adjusting for baseline characteristics. RESULTS: Trajectory classes revealed both high and low depressive symptoms (high in 61% of participants), distress (high in 82% of participants), and resilience (low in 32% of participants). Depressive symptoms and distress trajectories demonstrated the same shape, first increasing during the pandemic and decreasing toward its end, while resilience remained constant. Exposure to COVID-19 stressors, in particular, the experience of stigmatization, discrimination, and violence, was associated with high depressive symptoms and distress trajectories, but not with resilience. CONCLUSIONS: Interventions provided to HCWs during crises such as pandemic should target distress and depressive symptoms and need to address stigmatization, discrimination, and violence.

• MeSH
• COVID-19 * psychologie   epidemiologie   MeSH
• deprese * psychologie   epidemiologie   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• pracovní stres psychologie   epidemiologie   MeSH
• průzkumy a dotazníky MeSH
• psychická odolnost * MeSH
• psychický distres MeSH
• psychický stres psychologie   epidemiologie   MeSH
• SARS-CoV-2 MeSH
• zdravotnický personál * psychologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Health care workers have been exposed to COVID-19 more than people in other professions, which may have led to stigmatization, discrimination, and violence toward them, possibly impacting their mental health. We investigated (1) factors associated with stigma, discrimination, and violence, (2) the association of stigma, discrimination, and violence with mental health, (3) everyday experiences of stigmatization, discrimination, and violence. We chose a combination of a quantitative approach and qualitative content analysis to analyze data collected at three time points: in 2020, 2021 and 2022. A higher age was associated with lower odds of experiencing stigma, discrimination, and violence, whereas female gender was related to more negative experiences. The intensity of exposure to COVID-19 was associated with greater experience with stigmatization, discrimination, and violence across all three years (for example in 2022: odds ratio, 95% confidence interval: 1.74, 1.18-2.55 for mild exposure; 2.82, 1.95-4.09 for moderate exposure; and 5.74, 3.55-9.26 for severe exposure, when compared to no exposure). Stigma, discrimination, and violence were most strongly associated with psychological distress in 2020 (odds ratio = 2.97, 95% confidence interval 2.27-3.88) and with depressive symptoms in 2021 (odds ratio = 2.78, 95% confidence interval 2.12-3.64). Attention should be given to the destigmatization of contagious diseases and the prevention of discrimination, violence, and mental health problems, both within workplaces and among the public.

• MeSH
• COVID-19 * psychologie   epidemiologie   MeSH
• dospělí MeSH
• duševní zdraví * MeSH
• lidé středního věku MeSH
• lidé MeSH
• násilí psychologie   MeSH
• pandemie * MeSH
• SARS-CoV-2 MeSH
• sociální diskriminace psychologie   MeSH
• společenské stigma * MeSH
• zdravotnický personál * psychologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVES: Previous studies on sex differences in cognitive decline provide inconsistent findings, with many European countries being underrepresented. We determined the association between sex and cognitive decline in a sample of Europeans and explored differences across birth cohorts and regions. METHODS: Participants 50+ years old enrolled in the Survey of Health, Ageing and Retirement in Europe had their cognition measured by tests of immediate recall, delayed recall and verbal fluency biennially up to 17 years of follow-up (median 6, interquartile range 3-9 years). We used linear mixed-effects models to assess the relationship between sex and the rate of cognitive decline, adjusting for sociodemographic and health-related characteristics. RESULTS: Of 66,670 participants (mean baseline age 63.5 ± standard deviation 9.4), 55% were female. Males and females had similar rates of decline in the whole sample in immediate recall (beta for interaction sex × time B = 0.002, 95% CI -0.001 to 0.006), delayed recall (B = 0.000, 95% CI -0.004 to 0.004), and verbal fluency (B = 0.008, 95% CI -0.005 to 0.020). Females born before World War II had a faster rate of decline in immediate recall and delayed recall compared to males, while females born during or after World War II had a slower rate of decline in immediate recall. Females in Central and Eastern Europe had a slower rate of cognitive decline in delayed recall compared to males. DISCUSSION: Our study does not provide strong evidence of sex differences in cognitive decline among older Europeans. However, we identified heterogeneity across birth cohorts and regions.

• MeSH
• kognice MeSH
• kognitivní dysfunkce * diagnóza   epidemiologie   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• longitudinální studie MeSH
• pohlavní dimorfismus * MeSH
• senioři MeSH
• stárnutí psychologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Evropa MeSH

Zdravotničtí pracovníci pečující o pacienty s COVID-19 čelili během pandemie vysokému riziku nákazy, nedostatku personálu, kontaktu se smrtí pacientů a vlastnímu riziku infekce. Tyto faktory výrazně ovlivnily jejich duševní zdraví. Narativní review shrnuje výsledky studií publikovaných v češtině a angličtině mezi lety 2020 a 2024 o dopadu pandemie na duševní zdraví zdravotníků v Česku. Z 20 identifikovaných studií jich splnilo kritéria pro zahrnutí 8. Studie popisují příznaky deprese, stres, syndrom vyhoření, stigmatizaci, diskriminaci a násilí. Výsledky ukazují závažný dopad těchto faktorů na duševní pohodu zdravotníků. Závěrem zdůrazňujeme potřebu preventivních opatření, včetně supervize, psychologické pomoci a podpory ze strany vedení. Důraz na duševní zdraví zdravotníků je klíčový pro jejich ochranu a udržitelnost péče v krizových situacích.

Healthcare workers caring for COVID-19 patients faced a high risk of infection, staff shortages, contact with patient deaths and their own risk of infection during the pandemic. These factors greatly affected their mental health. This narrative review summarizes the results of studies published in Czech and English between 2020 and 2024 on the impact of the pandemic on the mental health of healthcare professionals in the Czechia. Of the 20 studies identified, 8 met the inclusion criteria. Studies describe symptoms of depression, stress, burnout, stigmatization, discrimination, and violence. The results show a severe impact of these factors on the mental well-being of healthcare professionals. Finally, we emphasize the need for preventive measures, including supervision, psychological assistance and support from management. An emphasis on the mental health of healthcare professionals is key to their protection and sustainability of care in crisis situations.

• MeSH
• COVID-19 psychologie   MeSH
• deprese epidemiologie   etiologie   patologie   MeSH
• duševní poruchy epidemiologie   etiologie   patologie   prevence a kontrola   MeSH
• duševní zdraví * MeSH
• průzkumy a dotazníky MeSH
• psychický stres epidemiologie   etiologie   MeSH
• zdravotnický personál * psychologie   MeSH

Healthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021. They completed the General Health Questionnaire-12, the Patient Health Questionnaire-9 and questions about pandemic-relevant exposures. Consistently across countries, women reported elevated mental health problems compared to men. Women also reported increased COVID-19-relevant stressors, including insufficient personal protective equipment and less support from colleagues, while men reported increased contact with COVID-19 patients. At the country level, HCWs in countries with higher gender inequality reported less mental health problems. Higher COVID-19 mortality rates were associated with increased psychological distress merely among women. Our findings suggest that among HCWs, women may have been disproportionately exposed to COVID-19-relevant stressors at the individual and country level. This highlights the importance of considering gender in emergency response efforts to safeguard women's well-being and ensure healthcare system preparedness during future public health crises.

• Publikační typ
• časopisecké články MeSH

INTRODUCTION: We address the extent to which adolescent cognition predicts dementia risk in later life, mediated by educational attainment and occupational complexity. METHODS: Using data from Project Talent Aging Study (PTAS), we fitted two structural equation models to test whether adolescent cognition predicts cognitive impairment (CI) and Ascertain Dementia 8 (AD8) status simultaneously (NCognitive Assessment = 2477) and AD8 alone (NQuestionnaire = 6491) 60 years later, mediated by education and occupational complexity. Co-twin control analysis examined 82 discordant pairs for CI/AD8. RESULTS: Education partially mediated the effect of adolescent cognition on CI in the cognitive assessment aample and AD8 in the questionnaire sample (Ps < 0.001). Within twin pairs, differences in adolescent cognition were small, but intrapair differences in education predicted CI status. DISCUSSION: Adolescent cognition predicted dementia risk 60 years later, partially mediated through education. Educational attainment, but not occupational complexity, contributes to CI risk beyond its role as a mediator of adolescent cognition, further supported by the co-twin analyses. HIGHLIGHTS: Project Talent Aging Study follows enrollees from high school for nearly 60 years. General cognitive ability in high school predicts later-life cognitive impairment. Low education is a risk partially due to its association with cognitive ability.

• MeSH
• demence * epidemiologie   MeSH
• kognice MeSH
• kognitivní dysfunkce * epidemiologie   MeSH
• lidé MeSH
• mladiství MeSH
• školy MeSH
• stupeň vzdělání MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• studie na dvojčatech MeSH

The pandemic due to COVID-19 brought new risks for depression of health care workers, which may have differently influenced men and women. We aimed to investigate (1) whether health care workers in Czechia experienced an increase in depression during the COVID-19 pandemic, (2) which factors contributed the most to this change, and (3) whether the magnitude of the associations differed by gender. We studied 2564 participants of the Czech arm of the international COVID-19 HEalth caRe wOrkErS (HEROES) Study. Online questionnaire was administered to health care workers in summer 2020 (wave 0) and spring 2021 (wave 1). Depression was defined by reaching 10 or more points on the Patient Health Questionnaire. Logistic regression investigated the association of participant ́s characteristics with depression and multivariable decomposition for non-linear models assessed, to what extent the characteristic explained the change in depression occurrence. The prevalence of depression increased twice during the pandemic (11% in wave 0 and 22% in wave 1). Stress accounted for 50% of the difference, experience of death due to COVID-19 for 15% and contact with COVID-19 patients for 14%. Greater resilience and sufficient personal protective equipment were strongly associated with lower occurrence of depression. The protective association of resilience with depression was stronger in men than in women. We conclude that interventions to promote mental health of health care workers in future health crisis should aim at decreasing stress and enhancing resilience. They should be delivered especially to individuals who have contact with the affected patients and may face their death.

• MeSH
• COVID-19 * epidemiologie   MeSH
• lidé MeSH
• pandemie MeSH
• plži * MeSH
• úzkost MeSH
• zdravotnický personál MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH