1
|
Wood I, Song R, Zhang Y, Jacobsen E, Hughes T, Chang CCH, Ganguli M. Ethnoracial Identity and Cognitive Impairment: A Community Study. Alzheimer Dis Assoc Disord 2024; 38:152-159. [PMID: 38748688 DOI: 10.1097/wad.0000000000000617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/02/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Identifying potentially modifiable risk factors associated with MCI in different ethnoracial groups could reduce MCI burden and health inequity in the population. METHODS Among 2845 adults aged 65+ years, we investigated potential risk exposures including education, physical and mental health, lifestyle, and sensory function, and their cross-sectional associations with MCI. We compared proportions of exposures between Black and White participants and explored relationships among race, MCI, and exposures. Logistic regression modeled MCI as a function of each exposure in the overall sample adjusting for age, sex, educational level, and race, and investigating race*exposure interactions. RESULTS Compared with White participants, Black participants had greater odds of MCI (OR 1.53; 95% CI, 1.13 to 2.06) and were more likely to report depressive symptoms, diabetes, and stroke, to have high blood pressure and BMI, and to be APOE - 4 carriers. Exposures associated with higher odds of MCI were diabetes, stroke, lifetime smoking, sleep disturbances, social isolation, loneliness, depression and anxiety symptoms, and vision and hearing loss. There were no significant interactions between race and any exposure. CONCLUSIONS Black participants had 53% higher odds of MCI adjusting for age, sex, and education. The same exposures were associated with MCI in Black and White participants.
Collapse
Affiliation(s)
- Isabella Wood
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Ruopu Song
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Yingjin Zhang
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Erin Jacobsen
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Tiffany Hughes
- Master of Public Health Program, Midwestern University College of Graduate Studies, Glendale, AZ
| | - Chung-Chou H Chang
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA
- Department of Medicine
| | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh School of Medicine
- Department of Neurology, University of Pittsburgh School of Medicine
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA
| |
Collapse
|
2
|
Zhang F, Yang W. Interaction between activities of daily living and cognitive function on risk of depression. Front Public Health 2024; 12:1309401. [PMID: 38384887 PMCID: PMC10880188 DOI: 10.3389/fpubh.2024.1309401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/04/2024] [Indexed: 02/23/2024] Open
Abstract
Objective There is a lack of literature about the joint effects of activities of daily living (ADL) limitation and cognitive impairment on depression. This study aimed to estimate the association of ADL limitation and cognitive impairment with depression among Chinese older adults aged 65 and above and to test their interaction on both additive and multiplicative scales. Methods Data was drawn from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), including 11,025 eligible participants. Logistic regression models were fitted, and both multiplicative and additive interactions for ADL limitation and cognitive impairment were tested. Results A total of 3,019(27.4%) participants reported depressive symptoms. After controlling for potential confounding factors, ADL limitation and cognitive impairment were both positively associated with depression. The adjusted additive interaction of basic and instrumental activities of daily living limitation were 2.47 (95%CI:1.92-3.19) and 3.67 (95%CI:2.88-4.66), respectively, but the multiplicative interaction items were both insignificant. Conclusion ADL limitation and cognitive impairment were both risk factors for depression among Chinese older adults. Moreover, the significant interaction of ADL limitation and cognitive impairment was found in the additive model, suggesting that improving ADL may be helpful in reducing the risk of depression among older people with cognitive impairment.
Collapse
Affiliation(s)
- Fenghao Zhang
- Department of Neonatology, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Wenyan Yang
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| |
Collapse
|
3
|
Lee TR, Kim GH, Choi MT. Geriatric depression and anxiety screening via deep learning using activity tracking and sleep data. Int J Geriatr Psychiatry 2024; 39:e6071. [PMID: 38372966 DOI: 10.1002/gps.6071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/06/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Geriatric depression and anxiety have been identified as mood disorders commonly associated with the onset of dementia. Currently, the diagnosis of geriatric depression and anxiety relies on self-reported assessments for primary screening purposes, which is uncomfortable for older adults and can be prone to misreporting. When a more precise diagnosis is needed, additional methods such as in-depth interviews or functional magnetic resonance imaging are used. However, these methods can not only be time-consuming and costly but also require systematic and cost-effective approaches. OBJECTIVE The main objective of this study was to investigate the feasibility of training an end-to-end deep learning (DL) model by directly inputting time-series activity tracking and sleep data obtained from consumer-grade wrist-worn activity trackers to identify comorbid depression and anxiety. METHODS To enhance accuracy, the input of the DL model consisted of step counts and sleep stages as time series data, along with minimal depression and anxiety assessment scores as non-time-series data. The basic structure of the DL model was designed to process mixed-input data and perform multi-label-based classification for depression and anxiety. Various DL models, including the convolutional neural network (CNN) and long short-term memory (LSTM), were applied to process the time-series data, and model selection was conducted by comparing the performances of the hyperparameters. RESULTS This study achieved significant results in the multi-label classification of depression and anxiety, with a Hamming loss score of 0.0946 in the Residual Network (ResNet), by applying a mixed-input DL model based on activity tracking data. The comparison of hyper-parameter performance and the development of various DL models, such as CNN, LSTM, and ResNet contributed to the optimization of time series data processing and achievement of meaningful results. CONCLUSIONS This study can be considered as the first to develop a mixed-input DL model based on activity tracking data for the multi-label identification of late-life depression and anxiety. The findings of the study demonstrate the feasibility and potential of using consumer-grade wrist-worn activity trackers in conjunction with DL models to improve the identification of comorbid mental health conditions in older adults. The study also established a multi-label classification framework for identifying the complex symptoms of depression and anxiety.
Collapse
Affiliation(s)
- Tae-Rim Lee
- Department of Artificial Intelligence, Sungkyunkwan University, Suwon, Korea
| | - Geon Ha Kim
- Department of Neurology, EWHA Womans University Mokdong Hospital, EWHA Womans University College of Medicine, Seoul, Korea
| | - Mun-Taek Choi
- Department of Intelligent Robotics, Sungkyunkwan University, Suwon, Korea
| |
Collapse
|
4
|
Xue B, Meng X, Liu Q, Luo X. The effect of receptive music therapy on older adults with mild cognitive impairment and depression: a randomized controlled trial. Sci Rep 2023; 13:22159. [PMID: 38092791 PMCID: PMC10719334 DOI: 10.1038/s41598-023-49162-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023] Open
Abstract
This study aims to evaluate the effects of a receptive music therapy intervention on cognitive functions and depressive symptoms in older adults with MCI. A randomized controlled trial was conducted in Wuhan, China. Eighty older adults, over 65, who had MCI and depression symptoms were randomly divided into the intervention and control groups. The intervention group received usual nursing care plus receptive music therapy intervention four times a week, for eight weeks; the control group received usual nursing care during the same period. The linear regression analysis was used to compare the difference between groups. There was a significant difference in the intervention group for the pre-intervention and post-intervention scores of cognitive function and depression. There was no significant difference in the control group before and after the study period and a significant between-group difference in both cognitive function and depression. In conclusion, receptive music therapy intervention significantly improved cognitive function and reduced depressive symptoms in older adults with MCI. It could be widely used in communities and nursing homes to improve the quality of life of older adults.
Collapse
Affiliation(s)
- Bing Xue
- School of Nursing, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei, China
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xianmei Meng
- School of Nursing, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei, China
| | - Qiuxia Liu
- School of Nursing, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei, China
| | - Xianwu Luo
- School of Nursing, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei, China.
| |
Collapse
|
5
|
Waschkies KF, Soch J, Darna M, Richter A, Altenstein S, Beyle A, Brosseron F, Buchholz F, Butryn M, Dobisch L, Ewers M, Fliessbach K, Gabelin T, Glanz W, Goerss D, Gref D, Janowitz D, Kilimann I, Lohse A, Munk MH, Rauchmann BS, Rostamzadeh A, Roy N, Spruth EJ, Dechent P, Heneka MT, Hetzer S, Ramirez A, Scheffler K, Buerger K, Laske C, Perneczky R, Peters O, Priller J, Schneider A, Spottke A, Teipel S, Düzel E, Jessen F, Wiltfang J, Schott BH, Kizilirmak JM. Machine learning-based classification of Alzheimer's disease and its at-risk states using personality traits, anxiety, and depression. Int J Geriatr Psychiatry 2023; 38:e6007. [PMID: 37800601 DOI: 10.1002/gps.6007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 09/07/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is often preceded by stages of cognitive impairment, namely subjective cognitive decline (SCD) and mild cognitive impairment (MCI). While cerebrospinal fluid (CSF) biomarkers are established predictors of AD, other non-invasive candidate predictors include personality traits, anxiety, and depression, among others. These predictors offer non-invasive assessment and exhibit changes during AD development and preclinical stages. METHODS In a cross-sectional design, we comparatively evaluated the predictive value of personality traits (Big Five), geriatric anxiety and depression scores, resting-state functional magnetic resonance imaging activity of the default mode network, apoliprotein E (ApoE) genotype, and CSF biomarkers (tTau, pTau181, Aβ42/40 ratio) in a multi-class support vector machine classification. Participants included 189 healthy controls (HC), 338 individuals with SCD, 132 with amnestic MCI, and 74 with mild AD from the multicenter DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE). RESULTS Mean predictive accuracy across all participant groups was highest when utilizing a combination of personality, depression, and anxiety scores. HC were best predicted by a feature set comprised of depression and anxiety scores and participants with AD were best predicted by a feature set containing CSF biomarkers. Classification of participants with SCD or aMCI was near chance level for all assessed feature sets. CONCLUSION Our results demonstrate predictive value of personality trait and state scores for AD. Importantly, CSF biomarkers, personality, depression, anxiety, and ApoE genotype show complementary value for classification of AD and its at-risk stages.
Collapse
Affiliation(s)
- Konrad F Waschkies
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Joram Soch
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Margarita Darna
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Anni Richter
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- German Center for Mental Health (DZPG), Munich, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Slawek Altenstein
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Aline Beyle
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurology, University of Bonn, Bonn, Germany
| | | | - Friederike Buchholz
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Michaela Butryn
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Laura Dobisch
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Tatjana Gabelin
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Doreen Goerss
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Daria Gref
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Andrea Lohse
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Matthias H Munk
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
- Department of Neuroradiology, University Hospital LMU, Munich, Germany
| | - Ayda Rostamzadeh
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Nina Roy
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Eike Jakob Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Peter Dechent
- MR-Research in Neurosciences, Department of Cognitive Neurology, Georg-August-University Goettingen, Göttingen, Germany
| | - Michael T Heneka
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Stefan Hetzer
- Berlin Center for Advanced Neuroimaging, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Alfredo Ramirez
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Psychiatry & Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, Texas, USA
| | - Klaus Scheffler
- Department for Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
- Munich Cluster for Systems Neurology (SyNergy) Munich, Munich, Germany
- Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London, UK
| | - Oliver Peters
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
- School of Medicine, Technical University of Munich, Department of Psychiatry and Psychotherapy, Munich, Germany
- University of Edinburgh and UK DRI, Edinburgh, UK
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurology, University of Bonn, Bonn, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Jens Wiltfang
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Björn H Schott
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Jasmin M Kizilirmak
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Neurodidactics and NeuroLab, Institute for Psychology, University of Hildesheim, Hildesheim, Germany
| |
Collapse
|
6
|
Yuan D, Wu J, Li S, Zhang R, Zhou X, Zhang Y. Network analysis of cold cognition and depression in middle-aged and elder population: the moderation of grandparenting. Front Public Health 2023; 11:1204977. [PMID: 37674685 PMCID: PMC10479032 DOI: 10.3389/fpubh.2023.1204977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/27/2023] [Indexed: 09/08/2023] Open
Abstract
Background Cognitive decline and negative emotions are common in aging, especially decline in cold cognition which often co-occurred with depression in middle-aged and older adults. This study analyzed the interactions between cold cognition and depression in the middle-aged and elder populations using network analysis and explored the effects of grandparenting on the cold cognition-depression network. Methods The data of 6,900 individuals (≥ 45 years) from the China Health and Retirement Longitudinal Study (CHARLS) were used. The Minimum Mental State Examination (MMSE) and the Epidemiology Research Center Depression Scale-10 (CESD-10) were used to assess cold cognition and depressive symptoms, respectively. Centrality indices and bridge centrality indices were used to identify central nodes and bridge nodes, respectively. Results Network analysis showed that nodes "language ability" and "depressed mood" were more central nodes in the network of cold cognition and depression in all participants. Meantime, nodes "attention," "language ability" and "hopeless" were three key bridge nodes connecting cold cognition and depressive symptoms. Additionally, the global connectivity of the cold cognition and depression network was stronger in the non-grandparenting than the grandparenting. Conclusion The findings shed a light on the complex interactions between cold cognition and depression in the middle-aged and elder populations. Decline in language ability and depressed mood can serve as predictors for the emergence of cold cognitive dysfunction and depression in individuals during aging. Attention, language ability and hopelessness are potential targets for psychosocial interventions. Furthermore, grandparenting is effective in alleviating cold cognitive dysfunction and depression that occur during individual aging.
Collapse
Affiliation(s)
- Dongling Yuan
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jialing Wu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shansi Li
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ruoyi Zhang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiao Zhou
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yi Zhang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Medical Psychological Institute of Central South University, Central South University, Changsha, China
- National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| |
Collapse
|
7
|
Völter C, Fricke H, Faour S, Lueg G, Nasreddine ZS, Götze L, Dawes P. Validation of the German Montreal-Cognitive-Assessment-H for hearing-impaired. Front Aging Neurosci 2023; 15:1209385. [PMID: 37539344 PMCID: PMC10394634 DOI: 10.3389/fnagi.2023.1209385] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/26/2023] [Indexed: 08/05/2023] Open
Abstract
Background Hearing loss and dementia are highly prevalent in older age and often co-occur. Most neurocognitive screening tests are auditory-based, and performance can be affected by hearing loss. To address the need for a cognitive screening test suitable for people with hearing loss, a visual version of the Montreal-Cognitive-Assessment was developed and recently validated in English (MoCA-H), with good sensitivity and specificity for identifying cases of dementia. As the MoCA is known to perform differently across languages, revalidation of the German MoCA-H was necessary. The aim of the present study was to assess the diagnostic accuracy of the German MoCA-H among those with normal cognition, mild cognitive impairment (MCI) and dementia and to determine an appropriate performance cut- off. Materials and methods A total of 346 participants aged 60-97 years (M = 77.18, SD = 9.56) were included; 160 were cognitively healthy, 79 with MCI and 107 were living with dementia based on the GPCOG and a detailed medical questionnaire as well as a comprehensive examination by a neurologist in case of cognitive impairment. Performance cut-offs for normal cognition, MCI and dementia were estimated for the MoCA-H score and z-scores using the English MoCA-H cut-off, the balanced cut-off and the Youden's Index. Results A mean score of 25.49 (SD = 3.01) points in the German MoCA-H was achieved in cognitively healthy participants, 20.08 (SD = 2.29) in the MCI and 15.80 (SD = 3.85) in the dementia group. The optimum cut-off for the detection of dementia was ≤21 points with a sensitivity of 96.3% and a specificity of 90%. In the MCI group, a cut-off range between 22 and 24 points is proposed to increase diagnostic accuracy to a sensitivity and specificity of 97.5 and 90%, respectively. Conclusion The German MoCA-H seems to be a sensitive screening test for MCI and dementia and should replace commonly used auditory-based cognitive screening tests in older adults. The choice of a cut-off range might help to better reflect the difficulty in clinical reality in detecting MCI. However, screening test batteries cannot replace a comprehensive cognitive evaluation.
Collapse
Affiliation(s)
- Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Hannah Fricke
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Sarah Faour
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Gero Lueg
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr University Bochum, Herne, Germany
| | | | - Lisa Götze
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Piers Dawes
- Centre for Hearing Research (CHEAR), School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| |
Collapse
|
8
|
Jain N, Wang Y, Zhang Y, Jacobsen E, Andreescu C, Snitz BE, Chang CCH, Ganguli M. It goes both ways: The relationship between anxiety and mild cognitive impairment. Int J Geriatr Psychiatry 2023; 38:e5899. [PMID: 36855309 DOI: 10.1002/gps.5899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/19/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To investigate the relationship between anxiety and mild cognitive impairment (MCI), and whether it is mediated by perceived stress, at the population level. METHOD AND DESIGN In a longitudinal study of 368 adults aged 65+ from a population-based cohort, we annually assessed anxiety symptoms (GAD-7), perceived stress (PSS-4), and ratings on the Clinical Dementia Rating (CDR®), where CDR = 0.5 was operationalized as MCI. Examining data from three consecutive assessment waves, we first determined the associations between anxiety at the first wave with MCI at the third wave, and vice versa. We then used mediation analyses to determine whether the pathways in both directions were mediated by perceived stress at the second wave, adjusting for demographics and other relevant covariates. RESULTS We confirmed significant bidirectional longitudinal associations between anxiety and MCI. Perceived stress was detected as a significant mediator for both pathways between anxiety and MCI, explaining 37.1% of the total effect (TE) of anxiety on incident MCI while conversely explaining 27.1% of the TE of MCI on anxiety. CONCLUSIONS A bidirectional relationship with a 2-year lag between anxiety and MCI was mediated through perceived stress. Clinicians should be sensitive both to potential consequent anxiety when patients present with cognitive impairment, and to potential incipient MCI when the presenting complaint is anxiety. Managing stress may help mitigate adverse outcomes.
Collapse
Affiliation(s)
- Neha Jain
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Yueting Wang
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Yingjin Zhang
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Erin Jacobsen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Chung-Chou H Chang
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.,Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
9
|
Ji Y, Feng Y, Wu S, Wu Y, Wang J, Zhao X, Liu Y. Longitudinal trajectories of depressive symptoms: the role of multimorbidity, mobility and subjective memory. BMC Geriatr 2023; 23:22. [PMID: 36635652 PMCID: PMC9837987 DOI: 10.1186/s12877-023-03733-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 01/06/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The high prevalence of depression among older people in China places a heavy burden on the health system. Multimorbidity, mobility limitation and subjective memory impairment are found to be risk indicators for depression. However, most studies on this topic focused on depression at a single point in time, ignoring the dynamic changes in depressive symptoms and the relationship between the trajectories and these three conditions. Therefore, we aimed to identify distinct trajectories of depressive symptoms in older people and investigate their associations with multimorbidity, mobility limitation and subjective memory impairment. METHODS Data was drawn from China Health and Retirement Longitudinal Study conducted during 2011-2018. A total of 5196 participants who completed 4 visits, conducted every 2-3 years were included in this study. Group-based trajectory modeling was conducted to identify distinct trajectories of depressive symptoms z-scores. Multinomial logistic regression was used to investigate the relationships. RESULTS Four distinct trajectories of depressive symptoms z-scores were identified, labeled as persistently low symptoms (68.69%, n = 3569), increasing symptoms (12.14%, n = 631), decreasing symptoms (14.05%, n = 730) and persistently high symptoms (5.12%, n = 266). Participants with multimorbidity had unfavorable trajectories of depressive symptoms compared with those without multimorbidity, with adjusted odds ratios (95% CIs) of 1.40 (1.15, 1.70), 1.59 (1.33, 1.90) and 2.19 (1.65, 2.90) for the increasing symptoms, decreasing symptoms and persistently high symptoms, respectively. We also observed a similar trend among participants with mobility limitations. Compared with participants who had poor subjective memory, participants with excellent/very good/good subjective memory had a lower risk of developing unfavorable trajectories of depressive symptoms. The adjusted odds ratios (95% CIs) of the increasing symptoms, decreasing symptoms and persistently high symptoms were 0.54 (0.40, 0.72), 0.50 (0.38, 0.65) and 0.48 (0.31, 0.73), respectively. CONCLUSIONS Multimorbidity, mobility limitation and subjective memory impairment were found to be potential risk factors for unfavorable depression trajectories.
Collapse
Affiliation(s)
- Yiman Ji
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Yiping Feng
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Sijia Wu
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Yutong Wu
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Jiongjiong Wang
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Xiangjuan Zhao
- Department of gynecology, Maternal and Child Health Care Hospital of Shandong Province, Jinan, 250014 Shandong China
| | - Yunxia Liu
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| |
Collapse
|
10
|
Divers RM, De Vito AN, Pugh EA, Robinson A, Weitzner DS, Calamia MR. Longitudinal Predictors of Informant-Rated Everyday Function in Mild Cognitive Impairment. J Geriatr Psychiatry Neurol 2023; 36:18-25. [PMID: 35439098 DOI: 10.1177/08919887221093360] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To examine predictors of informant-reported everyday functioning in mild cognitive impairment (MCI) and relations between everyday function and conversion to dementia. METHODS Informants of participants (n = 2614) with mild cognitive impairment (MCI) were administered the Functional Activities Questionnaire (FAQ). Changes in dimensions of functional ability as determined by an exploratory factor analysis (EFA) were examined over 3 years and participant predictors of change were examined using multilevel modeling (MLM). RESULTS The FAQ consisted of 3 factors, multistep, finance, and memory/orientation daily tasks. Impairment in memory/orientation tasks was significantly higher than impairment in multistep tasks. Worse functioning was associated with greater depression, worse memory, worse speed/EF, higher years of education and identifying as White. There was variability in some of these associations with different FAQ factors. Impairments in financial and memory/orientation daily tasks predicted follow-up conversion to dementia. CONCLUSIONS Depression, speed/EF, and memory are consistently associated with domains of everyday functioning. Race, education, and age may be more variability associated with everyday functioning. Specific attention should be paid to subtle declines in the financial and memory/orientation domains as they may uniquely predict future dementia development. Depression may be a modifiable risk factor associated with functional impairment over time.
Collapse
Affiliation(s)
- Ross M Divers
- Department of Psychology, 5779Louisiana State University, Baton Rouge, LA, USA
| | - Alyssa N De Vito
- Department of Psychiatry and Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.,Butler Hospital Memory and Aging Program, Providence, RI, USA
| | - Erika A Pugh
- Department of Psychology, 5779Louisiana State University, Baton Rouge, LA, USA
| | - Anthony Robinson
- Department of Psychology, 5779Louisiana State University, Baton Rouge, LA, USA
| | - Daniel S Weitzner
- Department of Psychology, 5779Louisiana State University, Baton Rouge, LA, USA
| | - Matthew R Calamia
- Department of Psychology, 5779Louisiana State University, Baton Rouge, LA, USA
| |
Collapse
|
11
|
Wang C, Wei C, Hong H, Wei W, Lu G. Latent profile analysis of cognitive function and depressive symptoms in Chinese elderly: results from the China Health and Retirement Longitudinal Study. Psychogeriatrics 2023; 23:108-115. [PMID: 36349873 DOI: 10.1111/psyg.12909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/04/2022] [Accepted: 10/25/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Geriatric cognitive impairment often occurs in conjunction with depressive symptoms. This study focuses on categorising the Chinese elderly with such co-occurring symptoms into homogeneous groups using latent profile analysis (LPA), a person-centred statistical approach. METHODS Information on cognitive function and depressive states of the elderly was extracted from the China Health and Retirement Longitudinal Study. The underlying characteristics were identified by LPA, and based on those findings, differences in demographic characteristics of different subgroups were explored by chi-squared test and analysis of variance. RESULTS A total of 6710 Chinese elderly who met the inclusion criteria were selected from the dataset. Four subgroups were identified among this sample by LPA, based on cognitive function associated with depressive symptoms, and named in this study as follows: mild cognitive impairment (n = 3747, 55.84%), moderate cognitive impairment (n = 1306, 19.46%), mild cognitive impairment combined with depressive symptoms (n = 1114, 16.6%), and moderate cognitive impairment combined with depression (n = 543, 8.09%). Age, gender, marital status, and educational level were all significantly different across subgroups (P < 0.001); religious belief and pension mode, however, were not (P > 0.05). CONCLUSIONS In the present study, four subgroups of cognitive function combined with depressive symptoms were found in Chinese elderly individuals, and differences in demographic factors were noted between the subgroups. In clinical practise, these findings could help clinical workers identify patients accurately and consider the demographic features of each subgroup when designing medical treatment, care, and rehabilitation programmes for those with cognitive impairment and concomitant depressive symptoms.
Collapse
Affiliation(s)
- Chengjue Wang
- Nursing Department, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chengxia Wei
- Nursing Department, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huifang Hong
- Nursing Department, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Wei
- Nursing Department, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Gendi Lu
- Nursing Department, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
12
|
Cui Y, Wang F. The research focus and development trend of art therapy in Chinese education since the 21st century. Front Psychol 2022; 13:1002504. [PMID: 36591086 PMCID: PMC9798422 DOI: 10.3389/fpsyg.2022.1002504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Since the 21st century, art therapy has made great progress and development in China's education. To find out the relationship between art therapy and special children, hundreds of related literatures were analyzed using co-word analysis software, which shows that art therapy is increasingly important in special children and their education. Expressive art therapy has a good development prospect in college students' mental health education and group counseling. The connotation of group painting therapy is constantly enriched. The theme research of mandala painting therapy is closely related, and painting art therapy focuses on the psychological counseling research of different groups, but the two are still in the marginal position in the whole research, and have not been paid attention to. Therefore, in the future research, firstly, we should continue to strengthen the research of art therapy and expressive art therapy in special education and individual mental health education; second, further broaden the depth and breadth of group painting therapy; third, strengthen the study of mandala painting therapy and painting art therapy.
Collapse
Affiliation(s)
- Yingying Cui
- Moscow Art School, Weinan Normal University, Weinan, China,*Correspondence: Yingying Cui,
| | | |
Collapse
|
13
|
Shared brain and genetic architectures between mental health and physical activity. Transl Psychiatry 2022; 12:428. [PMID: 36192376 PMCID: PMC9530213 DOI: 10.1038/s41398-022-02172-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/15/2022] Open
Abstract
Physical activity is correlated with, and effectively treats various forms of psychopathology. However, whether biological correlates of physical activity and psychopathology are shared remains unclear. Here, we examined the extent to which the neural and genetic architecture of physical activity and mental health are shared. Using data from the UK Biobank (N = 6389), we applied canonical correlation analysis to estimate associations between the amplitude and connectivity strength of subnetworks of three major neurocognitive networks (default mode, DMN; salience, SN; central executive networks, CEN) with accelerometer-derived measures of physical activity and self-reported mental health measures (primarily of depression, anxiety disorders, neuroticism, subjective well-being, and risk-taking behaviors). We estimated the genetic correlation between mental health and physical activity measures, as well as putative causal relationships by applying linkage disequilibrium score regression, genomic structural equational modeling, and latent causal variable analysis to genome-wide association summary statistics (GWAS N = 91,105-500,199). Physical activity and mental health were associated with connectivity strength and amplitude of the DMN, SN, and CEN (r's ≥ 0.12, p's < 0.048). These neural correlates exhibited highly similar loading patterns across mental health and physical activity models even when accounting for their shared variance. This suggests a largely shared brain network architecture between mental health and physical activity. Mental health and physical activity (including sleep) were also genetically correlated (|rg| = 0.085-0.121), but we found no evidence for causal relationships between them. Collectively, our findings provide empirical evidence that mental health and physical activity have shared brain and genetic architectures and suggest potential candidate subnetworks for future studies on brain mechanisms underlying beneficial effects of physical activity on mental health.
Collapse
|
14
|
Cheng N, Lin A, Bowden S, Gao C, Yung AR, Nelson B, Thompson A, Yuen HP, Brewer WJ, Cagliarini D, Bruxner A, Simmons M, Broussard C, Pantelis C, McGorry PD, Allott K, Wood SJ. Intelligence trajectories in individuals at ultra-high risk for psychosis: An 8-year longitudinal analysis. Schizophr Res 2022; 248:140-148. [PMID: 36055017 DOI: 10.1016/j.schres.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/29/2022] [Accepted: 08/20/2022] [Indexed: 10/14/2022]
Abstract
Cognitive impairment is a well-documented predictor of transition to a full-threshold psychotic disorder amongst individuals at ultra-high risk (UHR) for psychosis. However, less is known about whether change in cognitive functioning differs between those who do and do not transition. Studies to date have not examined trajectories in intelligence constructs (e.g., acquired knowledge and fluid intelligence), which have demonstrated marked impairments in individuals with schizophrenia. This study aimed to examine intelligence trajectories using longitudinal data spanning an average of eight years, where some participants completed assessments over three time-points. Participants (N = 139) at UHR for psychosis completed the Wechsler Abbreviated Scale of Intelligence (WASI) at each follow-up. Linear mixed-effects models mapped changes in WASI Full-Scale IQ (FSIQ) and T-scores on Vocabulary, Similarities, Block Design, and Matrix Reasoning subtests. The sample showed stable and improving trajectories for FSIQ and all subtests. There were no significant differences in trajectories between those who did and did not transition to psychosis and between individuals with good and poor functional outcomes. However, although not significant, the trajectories of the acquired knowledge subtests diverged between transitioned and non-transitioned individuals (β = -0.12, 95 % CI [-0.29, 0.05] for Vocabulary and β = -0.14, 95 % CI [-0.33, 0.05] for Similarities). Overall, there was no evidence for long-term deterioration in intelligence trajectories in this UHR sample. Future studies with a larger sample of transitioned participants may be needed to explore potential differences in intelligence trajectories between UHR transition groups and other non-psychosis outcomes.
Collapse
Affiliation(s)
- Nicholas Cheng
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Stephen Bowden
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Caroline Gao
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Alison R Yung
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia; Division of Psychology and Mental Health, University of Manchester, Manchester, England, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, England, UK; Institute for Mental and Physical Health and Clinical Translation, Deakin University, Australia
| | - Barnaby Nelson
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Andrew Thompson
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Hok Pan Yuen
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Warrick J Brewer
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Daniela Cagliarini
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Annie Bruxner
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Magenta Simmons
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Christina Broussard
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Parkville, Australia
| | - Patrick D McGorry
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Kelly Allott
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Stephen J Wood
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia; School of Psychology, University of Birmingham, Edgbaston, UK.
| |
Collapse
|
15
|
Carcelén-Fraile MDC, Llera-DelaTorre AM, Aibar-Almazán A, Afanador-Restrepo DF, Baena-Marín M, Hita-Contreras F, Brandão-Loureiro V, García-Garro PA, Castellote-Caballero Y. Cognitive Stimulation as Alternative Treatment to Improve Psychological Disorders in Patients with Mild Cognitive Impairment. J Clin Med 2022; 11:jcm11143947. [PMID: 35887711 PMCID: PMC9316027 DOI: 10.3390/jcm11143947] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/20/2022] [Accepted: 07/04/2022] [Indexed: 12/10/2022] Open
Abstract
(1) Background: Mild cognitive impairment is becoming one of the most common clinical manifestations affecting older people. For this reason, developing non-pharmacological strategies to help improve or maintain the physical condition of patients with mild dementia has become a priority. Therefore, the objective of this study is to provide evidence about the effects of a cognitive stimulation program on cognitive performance, anxiety, depression, and quality of life in people with mild cognitive impairment (MCI) and aged > 70. (2) Methods: This study is a randomized clinical trial. A total of 72 elderly people with MCI participated: 35 in the control group who did not receive any intervention and 36 in the experimental group who received a cognitive stimulation program for 12 weeks. Cognitive performance, depression, anxiety and health-related quality of life (HRQoL) were measured using the Mini-Mental State Examination (MMSE), the Yesavage Geriatric Depression Scale, the Hamilton Rating Scale, and the SF-12, respectively. (3) Results: In the experimental group, significant results were obtained on cognitive performance, depression, anxiety and general health, emotional role, social functioning, vitality, mental health and mental component summary domains of the SF-12. (4) Conclusions: a cognitive stimulation program of 12 weeks improves cognitive performance, anxiety, depression, and HRQoL in people with MCI aged > 70.
Collapse
Affiliation(s)
- María del Carmen Carcelén-Fraile
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (M.d.C.C.-F.); (A.M.L.-D.); (F.H.-C.); (Y.C.-C.)
| | - Ana María Llera-DelaTorre
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (M.d.C.C.-F.); (A.M.L.-D.); (F.H.-C.); (Y.C.-C.)
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (M.d.C.C.-F.); (A.M.L.-D.); (F.H.-C.); (Y.C.-C.)
- Correspondence:
| | | | - Mateo Baena-Marín
- Faculty of Health Sciences, University Foundation of the Área Andina, Pereira 660004, Colombia; (D.F.A.-R.); (M.B.-M.)
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (M.d.C.C.-F.); (A.M.L.-D.); (F.H.-C.); (Y.C.-C.)
| | | | - Patricia Alexandra García-Garro
- GIP Pedagogy Research Group, Faculty of Distance and Virtual Education, Antonio José Camacho University Institution, Santiago de Cali 760016, Colombia;
| | - Yolanda Castellote-Caballero
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (M.d.C.C.-F.); (A.M.L.-D.); (F.H.-C.); (Y.C.-C.)
| |
Collapse
|
16
|
Gómez-Soria I, Brandín-de la Cruz N, Cuenca Zaldívar JN, Calvo S, Herrero P, Calatayud E. Effectiveness of Personalized Cognitive Stimulation in Older Adults with Mild Possible Cognitive Impairment: A 12-month Follow-up Cognitive Stimulation in Mild Cognitive Impairment. Clin Gerontol 2022; 45:878-890. [PMID: 34128780 DOI: 10.1080/07317115.2021.1937764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The objective of this study was to analyze the long-term effects of a personalized cognitive stimulation (PCS) program on the global cognition, cognitive aspects, activities of daily living (ADLs), anxiety, and depression in older adults with possible mild cognitive impairment (MCI). METHODS A 12-month follow-up analysis was carried out in a single-blind, randomized clinical trial to research the long-term effects of a 10-week PCS program evaluating the cognitive level, depression, and anxiety of older adults with possible MCI. RESULTS Fifty older adults were assessed 12 months after the CS program, 23 in the intervention group and 27 in the control group. There were significant differences between the groups at 12 months in the global cognition (p = .002), in global orientation (p < .001), and in spatial orientation (p = .004) in favor of the intervention group, measured with the Spanish version of the Mini-Mental Status Examination (MEC-35). CONCLUSIONS A PCS program could be effective in improving global cognition and global and spatial orientation. CLINICAL IMPLICATIONS A PCS program based on cognitive levels in older adults with possible MCI achieves improvements in global cognition and global and spatial orientation. PCS programs can be applied successfully by trained occupational therapists.
Collapse
Affiliation(s)
- Isabel Gómez-Soria
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| | | | | | - Sandra Calvo
- iPhysio Research Group, Universidad San Jorge, Zaragoza, Spain
| | - Pablo Herrero
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| | - Estela Calatayud
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| |
Collapse
|
17
|
Contreras-Somoza LM, Toribio-Guzmán JM, Sánchez-Gómez MC, Irazoki E, Martín-Cilleros MV, Verdugo-Castro S, Parra-Vidales E, Perea-Bartolomé MV, Franco-Martín MÁ. Perceptions of Older People with Cognitive Impairment, Caregivers, and Professionals about ehcoBUTLER (Tablet Health Care Platform): A Qualitative Focus Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116761. [PMID: 35682344 PMCID: PMC9180242 DOI: 10.3390/ijerph19116761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 02/05/2023]
Abstract
EhcoBUTLER is a tablet platform mainly aimed at the elderly with mild cognitive impairment (MCI) to promote their well-being and health. The main objective of this study was to explore the perceptions and feedback level of the ehcoBUTLER potential users and stakeholders to improve its development. Through this exploration, the secondary objective was to contribute to the development of software/apps that promote their integral health. Focus groups were conducted (13 elderly with MCI, 13 with dementia, 12 caregivers, 11 professionals). The content and feedback level were analyzed. Participants liked the appearance of ehcoBUTLER, would like to use it, and were mainly interested in the emotional, healthy lifestyle, cognitive, and ergonomic tools. It is necessary to have prior training, more intuitive/customizable apps, low-price/free, offline/USB content, and add other activities/features. EhcoBUTLER is well-oriented to meet the needs and preferences of potential users. However, improvements in its usability, accessibility, and sustainability are needed. The participants’ perspectives provided a comprehensive view to improve ehcoBUTLER, so that in the future, it can benefit the elderly to be active agents in their health; support caregivers in their role and to have a respite; and professionals to have a multi-intervention platform. The present findings can contribute to the development of tablet software/apps that promote the integral well-being of this population.
Collapse
Affiliation(s)
- Leslie María Contreras-Somoza
- Faculty of Psychology, Campus Ciudad Jardín, University of Salamanca, Avenida de la Merced, 109, 37005 Salamanca, Spain; (E.I.); (M.V.P.-B.); (M.Á.F.-M.)
- Department of Research and Development, Iberian Institute of Research in Psycho-Sciences, INTRAS Foundation, Carretera de la Hiniesta 137, 49024 Zamora, Spain; (J.M.T.-G.); (E.P.-V.)
- Correspondence:
| | - José Miguel Toribio-Guzmán
- Department of Research and Development, Iberian Institute of Research in Psycho-Sciences, INTRAS Foundation, Carretera de la Hiniesta 137, 49024 Zamora, Spain; (J.M.T.-G.); (E.P.-V.)
| | - María Cruz Sánchez-Gómez
- Department of Didactic, Organization and Research Methods, University of Salamanca, Paseo de Canalejas, 169, 37008 Salamanca, Spain; (M.C.S.-G.); (M.V.M.-C.); (S.V.-C.)
| | - Eider Irazoki
- Faculty of Psychology, Campus Ciudad Jardín, University of Salamanca, Avenida de la Merced, 109, 37005 Salamanca, Spain; (E.I.); (M.V.P.-B.); (M.Á.F.-M.)
- Department of Research and Development, Iberian Institute of Research in Psycho-Sciences, INTRAS Foundation, Carretera de la Hiniesta 137, 49024 Zamora, Spain; (J.M.T.-G.); (E.P.-V.)
| | - María Victoria Martín-Cilleros
- Department of Didactic, Organization and Research Methods, University of Salamanca, Paseo de Canalejas, 169, 37008 Salamanca, Spain; (M.C.S.-G.); (M.V.M.-C.); (S.V.-C.)
| | - Sonia Verdugo-Castro
- Department of Didactic, Organization and Research Methods, University of Salamanca, Paseo de Canalejas, 169, 37008 Salamanca, Spain; (M.C.S.-G.); (M.V.M.-C.); (S.V.-C.)
| | - Esther Parra-Vidales
- Department of Research and Development, Iberian Institute of Research in Psycho-Sciences, INTRAS Foundation, Carretera de la Hiniesta 137, 49024 Zamora, Spain; (J.M.T.-G.); (E.P.-V.)
| | - María Victoria Perea-Bartolomé
- Faculty of Psychology, Campus Ciudad Jardín, University of Salamanca, Avenida de la Merced, 109, 37005 Salamanca, Spain; (E.I.); (M.V.P.-B.); (M.Á.F.-M.)
| | - Manuel Ángel Franco-Martín
- Faculty of Psychology, Campus Ciudad Jardín, University of Salamanca, Avenida de la Merced, 109, 37005 Salamanca, Spain; (E.I.); (M.V.P.-B.); (M.Á.F.-M.)
- Department of Psychiatry and Mental Health, Río Hortega University Hospital, Calle Dulzaina, 2, 47012 Valladolid, Spain
- Department of Psychiatry, Zamora Provincial Hospital, Calle Hernán Cortés, 40, 49071 Zamora, Spain
| |
Collapse
|
18
|
Association Between Mild Neurocognitive Disorder Due to Alzheimer's Disease and Possible Attention-deficit/Hyperactivity Disorder: A Case Report. J Psychiatr Pract 2022; 28:251-258. [PMID: 35511103 DOI: 10.1097/pra.0000000000000627] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Recent literature concerning attention-deficit/hyperactivity disorder (ADHD) underlines the persistence of this neurodevelopmental illness in older patients. Comorbidity with a neurodegenerative disease is thus possible. However, few studies have investigated this topic. To our knowledge, this is the first case report of such a possible association, which raises important questions about clinical presentation, symptoms, diagnosis, and treatment. A 72-year-old man, without any psychiatric history, presented with depression, subjective memory loss, and attention deficit and anxious symptoms, and was diagnosed with mild neurocognitive disorder due to Alzheimer's disease. However, the patient's attentional symptoms appeared to have been present since childhood. A formalized diagnostic interview assessing for ADHD did not allow for a clear diagnosis, possibly due to recall bias. The patient's anxiety symptoms also did not respond well to cognitive behavioral therapy coupled with different antidepressants. We hypothesized the presence of ADHD, with the symptoms balanced until now by the patient's high cognitive capacities, and we postulated that the onset of a neurogenerative process may have disrupted this balance. In this case report, we discuss symptom dimensionality, the interplay between neurodegenerative and neurodevelopmental diseases, and various treatment options. Attentional deficits and anxiety symptoms are frequent in mild neurocognitive disorders due to neurodegenerative illnesses. It is important to explore the time of onset of such symptoms since neurodegenerative processes can worsen neurodevelopmental conditions. Moreover, identification of a pre-existing neurodevelopmental condition can lead to alternative care and treatment options. In addition, the unexplained worsening of ADHD symptoms should prompt clinicians to assess for a neurodegenerative process.
Collapse
|
19
|
Huang W, Zhu W, Chen H, Li F, Huang J, Zhou Y, Sun X, Lan Y. Longitudinal association between depressive symptoms and cognitive decline among middle-aged and elderly population. J Affect Disord 2022; 303:18-23. [PMID: 35108603 DOI: 10.1016/j.jad.2022.01.107] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 12/24/2021] [Accepted: 01/28/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Depression is considered a risk factor for cognitive decline. The long-term impact of depressive symptoms on cognitive performance has not been established thus far. OBJECTIVES This study aimed to determine the longitudinal associations between depressive symptoms and cognitive performance among middle-aged and elderly population. METHODS We included 10,387 adults aged ≥45 years from the Health and Retirement Study (2004 to 2014) in this study. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CESD) scale. Participant's cognitive function was assessed via the telephone interview for cognitive status (TICS); the total cognitive score ranged from 0 to 35. We classified the participants into four clusters according to the quartile of the total cognitive score (TCS). We examined the change of depressive symptoms and cognitive performance by using the unconditional latent growth curve modeling (LGCM) method, and a parallel LGCM method was used to examine the longitudinal associations between depressive symptoms and cognitive performance among middle-aged and elderly adults in each cluster. RESULTS Participants with lower levels of cognitive performance were associated with a greater risk of high depressive symptoms. Results from unconditional LGCM showed a sustained decline in cognitive performance and an increasing trend in depressive symptoms per 2 years for each cluster of participants. The parallel LGCM indicated that baseline levels of depression showed a significant negative correlation with the cognitive performance at baseline (β [95% CI] of intercept(Dep) predicting intercept(TCS) were -0.33 [-0.41, -0.26], -0.03[-0.06, -0.00], -0.05 [-0.07, -0.02] and -0.64 [-0.70,-0.58], for clusters of Q1 to Q3 and the entire population, respectively). Further, a significant positive prospective association was observed between baseline levels of depression and changes in cognitive performance (intercept(Dep) predicting slope(TCS) were -0.05 [-0.08, -0.02], -0.09[-0.13, -0.05], -0.12 [-0.15, -0.08], -0.11 [-0.15, -0.06] and -0.04 [-0.06,-0.02] for clusters of Q1 to Q4 and the entire population, respectively). Moreover, for participants with the highest quartile of TCS, the rising trend of depressive symptoms accelerated the decline of cognitive performance during the follow-up period (Slope(Dep) predicting Slope(TCS): -0.44 [-0.86, -0.01]). CONCLUSION Our results suggest that depressive symptoms were associated with lower cognitive performance and larger subsequent decline during follow-up period. Adults with depression may require more medical attention, and early intervention is required to delay the development of cognitive impairment and dementia.
Collapse
Affiliation(s)
- Wentao Huang
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China.
| | - Wenjing Zhu
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China
| | - Hongyan Chen
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China
| | - Feng Li
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China
| | - Jingxin Huang
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China
| | - Ye Zhou
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China
| | - Xibin Sun
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China
| | - Yutao Lan
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China.
| |
Collapse
|
20
|
Almdahl IS, Agartz I, Hugdahl K, Korsnes MS. Brain pathology and cognitive scores prior to onset of late-life depression. Int J Geriatr Psychiatry 2022; 37. [PMID: 35178780 DOI: 10.1002/gps.5686] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 01/26/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Understanding the biological changes that occur prior to onset of late-life depression (LLD) is key to its prevention. To investigate potential predictors of LLD, we assessed cognitive scores and neurodegenerative and vascular biomarkers in healthy older adults who later developed depression. METHODS Longitudinal data from the Alzheimer's Disease Neuroimaging Initiative of 241 cognitively unimpaired and non-depressed older adults aged 56-90 at baseline with at least 4 years of follow-up were included. Participants were classified based on whether they developed an incident depression (n = 96) or not (n = 145). Cognitive measures of memory, executive functioning, and language, and biomarkers proposed to be related to LLD: hippocampal volume, white matter hyperintensity volume (WMH), and cortical and cerebrospinal fluid (CSF) amyloid beta levels, were compared between the incident depression and the never-depressed groups at four time points: at baseline, the visit prior to onset, at onset, and after the onset of depression. RESULTS In the incident depression group, there was a mild decline in cognitive scores from baseline to the visit before depression onset compared with the never-depressed group. The cognitive differences between the groups became more marked after depression onset. Baseline cortical amyloid burden, CSF amyloid beta levels, and WMH were significant predictors of incident depression. Compared to the non-depressed group, hippocampal volume was not reduced before onset, but was reduced following depression. CONCLUSIONS Amyloid pathology and WMH can predict future development of LLD in cognitively unimpaired individuals and may be involved in precipitating vulnerability for depression in older adults.
Collapse
Affiliation(s)
- Ina S Almdahl
- Department of Old Age Psychiatry, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Maria S Korsnes
- Department of Old Age Psychiatry, Oslo University Hospital, Oslo, Norway.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | | |
Collapse
|
21
|
Xue B, Xiao A, Luo X, Li R. The effect of a game training intervention on cognitive functioning and depression symptoms in the elderly with mild cognitive impairment: A randomized controlled trial. Int J Methods Psychiatr Res 2021; 30:e1887. [PMID: 34291527 PMCID: PMC8633942 DOI: 10.1002/mpr.1887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/10/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This study aimed to explore whether game training could improve cognitive functioning and depression symptoms in the elderly affected by mild cognitive impairment (MCI). METHODS A non-blinded randomized controlled trial was conducted. Participants were 72 patients with MCI and depression from a nursing home in Wuhan. Participants were randomized to either the intervention group or the control group (n = 36 each). The intervention group received regular nursing care plus game training for 50 min, three times per week for 8 weeks, whereas the control group received only regular nursing care during the same research period. Cognitive functioning and depression symptoms were tested in both groups at baseline and at the end of the 8-week intervention. We used the Montreal Cognitive Assessment and the 15-item Geriatric Depression Scale to assess cognitive functioning and depression symptoms, respectively. RESULTS The 8-week game training intervention significantly improved the cognitive and depression scores when compared with the control group and baseline scores (p < 0.05). No significant difference was observed in the control group (p > 0.05). CONCLUSIONS Our results suggest that the implementation of game training can improve the cognitive functioning and depression symptoms of the elderly with MCI, indicated that can be widely used.
Collapse
Affiliation(s)
- Bing Xue
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Ao Xiao
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Xianwu Luo
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China.,Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, China
| | - Rui Li
- Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, China
| |
Collapse
|
22
|
Coulthard E, Blackman J. Sleep and future cognitive decline. Brain 2021; 144:2568-2570. [PMID: 34687209 PMCID: PMC8536927 DOI: 10.1093/brain/awab315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/09/2021] [Indexed: 11/13/2022] Open
Abstract
This scientific commentary refers to ‘Sleep and longitudinal cognitive performance in preclinical and early symptomatic Alzheimer disease’ by Lucey et al. (doi:10.1093/brain/awab272).
Collapse
Affiliation(s)
- Elizabeth Coulthard
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jonathan Blackman
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
23
|
Sowers KL, Gayda-Chelder CA, Galantino ML. Self-reported cognitive impairment in individuals with Primary Immunodeficiency Disease. Brain Behav Immun Health 2021; 9:100170. [PMID: 34589905 PMCID: PMC8474660 DOI: 10.1016/j.bbih.2020.100170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/25/2020] [Accepted: 10/27/2020] [Indexed: 11/18/2022] Open
Abstract
Individuals with Primary Immunodeficiency Disease (PID) have increased risk for infection, autoimmune conditions, and inflammatory disorders. Cognitive impairment, also referred to as brain fog, has been recognized in other medical conditions and as a side-effect of treatments; however, it has not been previously reported in individuals with PID. The phenomenon of brain fog is recognized in other autoimmune or inflammatory conditions, including lupus, multiple sclerosis, chronic fatigue syndrome, and has resulted from chemotherapy treatment for cancer. This research investigates the self-reported memory function of individuals with a diagnosis of PID. Respondents completed a survey which used reliable and valid questionnaires: Memory Functioning Questionnaire, Beck’s Depression Inventory II, and Beck’s Anxiety Inventory. Of the 292 completed surveys, 133 did not report any comorbid neurological diagnosis or incident of concussion (both of which could influence perceived memory function). When compared to normative scores, the respondents in this study were found to have significantly greater perceived memory impairment. The respondents had a significant higher score for anxiety and depression as compared to non-anxious and non-depressed normative values. This study finds that individuals with a diagnosis of PID have a greater degree of perceived memory impairment, or brain fog, in addition to greater levels of anxiety and depression. Individuals with a diagnosis of PID would benefit from prospective surveillance through a comprehensive neuropsychological assessment to track cognitive status and implement corrective measures, should any decline be identified.
Collapse
Affiliation(s)
- Kerri L. Sowers
- Stockton University, 101 Vera King Farris Drive, Galloway, NJ, 08205, USA
- Corresponding author.
| | | | - Mary Lou Galantino
- Stockton University, University of Pennsylvania, University of Witwatersrand, Johannesburg, South Africa
- 101 Vera King Farris Drive, Galloway, NJ, 08205, USA
| |
Collapse
|
24
|
Zacková L, Jáni M, Brázdil M, Nikolova YS, Marečková K. Cognitive impairment and depression: Meta-analysis of structural magnetic resonance imaging studies. Neuroimage Clin 2021; 32:102830. [PMID: 34560530 PMCID: PMC8473769 DOI: 10.1016/j.nicl.2021.102830] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 09/05/2021] [Accepted: 09/12/2021] [Indexed: 12/29/2022]
Abstract
Longitudinal comorbidity of depression and cognitive impairment has been reported by number of epidemiological studies but the underlying mechanisms explaining the link between affective problems and cognitive decline are not very well understood. Imaging studies have typically investigated patients with major depressive disorder (MDD) and mild cognitive impairment (MCI) separately and thus have not identified a structural brain signature common to these conditions that may illuminate potentially targetable shared biological mechanisms. We performed a meta-analysis of. 48 voxel-based morphometry (VBM) studies of individuals with MDD, MCI, and age-matched controls and demonstrated that MDD and MCI patients had shared volumetric reductions in a number of regions including the insula, superior temporal gyrus (STG), inferior frontal gyrus, amygdala, hippocampus, and thalamus. We suggest that the shared volumetric reductions in the insula and STG might reflect communication deficits and infrequent participation in mentally or socially stimulating activities, which have been described as risk factors for both MCI and MDD. We also suggest that the disease-specific structural changes might reflect the disease-specific symptoms such as poor integration of emotional information, feelings of helplessness and worthlessness, and anhedonia in MDD. These findings could contribute to better understanding of the origins of MDD-MCI comorbidity and facilitate development of early interventions.
Collapse
Affiliation(s)
- Lenka Zacková
- Brain and Mind Research Programme, Central European Institute of Technology, Masaryk University (CEITEC MU), 5 Kamenice, Brno 62500, Czech Republic; Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, 664/53 Pekarska, Brno 65691, Czech Republic.
| | - Martin Jáni
- Brain and Mind Research Programme, Central European Institute of Technology, Masaryk University (CEITEC MU), 5 Kamenice, Brno 62500, Czech Republic; Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Jihlavská 20, Brno 62500, Czech Republic
| | - Milan Brázdil
- Brain and Mind Research Programme, Central European Institute of Technology, Masaryk University (CEITEC MU), 5 Kamenice, Brno 62500, Czech Republic; Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, 664/53 Pekarska, Brno 65691, Czech Republic
| | - Yuliya S Nikolova
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1L8, Canada
| | - Klára Marečková
- Brain and Mind Research Programme, Central European Institute of Technology, Masaryk University (CEITEC MU), 5 Kamenice, Brno 62500, Czech Republic; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1L8, Canada
| |
Collapse
|
25
|
Chronic Kidney Disease and Cognitive Impairment. J Stroke Cerebrovasc Dis 2021; 30:105529. [DOI: 10.1016/j.jstrokecerebrovasdis.2020.105529] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/05/2020] [Accepted: 12/01/2020] [Indexed: 12/21/2022] Open
|
26
|
Yu J, Rawtaer I, Feng L, Kua EH, Mahendran R. The functional and structural connectomes associated with geriatric depression and anxiety symptoms in mild cognitive impairment: Cross-syndrome overlap and generalization. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110329. [PMID: 33865926 DOI: 10.1016/j.pnpbp.2021.110329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
Geriatric depression and anxiety disorders often manifest as neuropsychiatric symptoms among those with mild cognitive impairment. Both tend to co-occur, and overlap in symptomology and etiology. Such commonalities are likely to be reflected in the brain as common neural correlates. Using connectome-based predictive modeling (CPM), we examined the functional and structural connectomes predicting depression and anxiety symptoms, and subsequently the overlap and cross-syndrome generalization of the connectomes associated with either disorder. Ninety-one older adults completed self-reported measures of depression and anxiety, and underwent diffusion tensor imaging and resting-state functional magnetic resonance imaging. Functional connectivity (FC) and structural connectivity (SC) matrices were derived from these scans and, in various combinations, entered into CPM models to predict either type of symptoms. Leave-one-out cross-validation was performed. Predictive accuracy was assessed via the correlation between predicted and observed scores (ρpredicted-observed). While FC or SC features alone significantly predicted either type of symptoms, these symptoms were best predicted by models that consisted of both FC and SC features (depression: ρpredicted-observed = 0.497; anxiety: ρpredicted-observed = 0.455). The features common to depression and anxiety were identified and entered into another model which was similarly accurate in predicting either type of symptoms. Moreover, cross-syndrome generalization was observed- the depression-associated features significantly predicted anxiety symptoms (ρpredicted-observed = 0.403) and vice-versa (ρpredicted-observed = 0.378). These FC and SC features are complementary biomarkers of geriatric depression and anxiety symptoms. Both types of symptoms are largely underpinned by common patterns of altered FC and SC, alluding to the transdiagnostic neurobiological susceptibility in both disorders.
Collapse
Affiliation(s)
- Junhong Yu
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore.
| | - Iris Rawtaer
- Department of Psychological Medicine, Sengkang General Hospital, 110 Sengkang E way, 544886, Singapore
| | - Lei Feng
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore
| | - Ee-Heok Kua
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore; Academic Development Department, Duke-NUS Medical School, 8 College Road, 169857, Singapore.
| |
Collapse
|
27
|
Zhao Y, Yin M, Yao X, Li Z. Effects of nurse-led square dancing on older patients with mild cognitive impairment combined with depressive symptoms: A pilot study. Geriatr Nurs 2021; 42:1164-1171. [PMID: 34425421 DOI: 10.1016/j.gerinurse.2021.06.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The present study aimed to verify the feasibility and preliminary effects of nurse-led square dancing designed to improve older adults' cognitive function and depressive symptoms who with MCI. METHODS A quasi-experimental pilot study design was adopted for the present study. Screening for cognitive function was conducted among older adults (≥ 60 years old) living in two communities in Beijing who complained of memory loss. A total of 107 older patients with MCI and depressive symptoms were diagnosed after obtaining informed consent. Thirty-five patients selected from each community were included in the study as control and intervention groups, respectively. The two groups of patients received health education while the intervention group participated in a square dance intervention program led by nurses three times per week for 60 min per session over a period of three months. The Montreal Cognitive Assessment-Peking version (MoCA-P) and Geriatric Depression Scale (GDS-30) were used to assess the cognitive function and depressive symptoms of patients in the two groups at three time intervals; before intervention, at the end of the three-month intervention period, and over a three-month follow-up period after the end of intervention. RESULTS Feasibility of the intervention was established with a high completion rate of 90%. Data collection for 63 out of 70 patients enrolled for the study was completed after six months. MoCA-P and GDS-30 scores of the intervention group were significantly different after the intervention when compared with the control group. A significant improvement in cognition was observed in the intervention group, and depressive symptoms decreased after intervention and follow-up when compared with the control group. During the intervention and follow-up phases, the MoCA-P score of the intervention group increased gradually with time. Furthermore, the MoCA-P and GDS-30 scores of the control group remained unchanged. CONCLUSION This study has revealed that square dance intervention exerts a positive impact on cognitive function and depressive symptoms among older patients suffering from MCI and depressive symptoms. The results of this study support the feasibility and preliminary effects of square dancing on relieving cognitive decline and depressive symptoms. Square dancing is a recommended type of intervention that can be applied to the local Chinese population because of its simplicity, convenience, and suitability for the older adults.
Collapse
Affiliation(s)
- Yu Zhao
- Nursing Department, Peking University First Hospital, Beijing, 100034, PR China.
| | - Min Yin
- School of Nursing, Lanzhou University, 28 Yan Xi Rd, Chengguan District. Lanzhou, Gansu province, 730030, PR China.
| | - Xiuyu Yao
- School of Nursing, Peking Union Medical College, No 0.33, Badachu Road, Shijingshan District, Beijing, 100144, PR China.
| | - Zheng Li
- School of Nursing, Peking Union Medical College, No 0.33, Badachu Road, Shijingshan District, Beijing, 100144, PR China.
| |
Collapse
|
28
|
Moazzami K, Garcia M, Young A, Almuwaqqat Z, Lima BB, Martini A, Alkhalaf M, Shah AJ, Goldstein FC, Hajjar I, Levey AI, Bremner JD, Quyyumi AA, Vaccarino V. Association between symptoms of psychological distress and cognitive functioning among adults with coronary artery disease. Stress Health 2021; 37:538-546. [PMID: 33319483 PMCID: PMC8395370 DOI: 10.1002/smi.3018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 12/14/2022]
Abstract
Greater psychological distress is associated with cognitive impairment in healthy adults. Whether such associations also exist in patients with coronary artery disease (CAD) is uncertain. We assessed cognitive function in 496 individuals with CAD using the verbal and visual memory subtests of the Wechsler Memory Scale and executive functioning measured by the Trail Making Test Parts A and B. We used a composite score of psychological distress derived through summation of Z-transformed psychological distress symptom scales (depression, posttraumatic stress, anxiety, anger, hostility and perceived stress) and scores for each individual psychological scale. Multivariable linear regression models were used to determine the association between memory scores (as outcomes) and the psychological distress scores (both composite score and individual scales). After adjusting for demographic and cardiovascular risk factors, a higher psychological distress score was independently associated with worse memory and executive functioning. Each standard deviation increase in psychological distress score was associated with 3% (95% confidence interval [CI], 1%-5%) to 5% (95% CI, 3-7%) worse cognitive performance (higher Trail A and Trail B, and lower verbal and visual memory scores). Among individuals with CAD, a higher level of psychological distress is independently associated with worse cognitive performance. These findings suggest that psychological risk factors play a role in cognitive trajectories of persons with CAD.
Collapse
Affiliation(s)
- Kasra Moazzami
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Mariana Garcia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - An Young
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Zakaria Almuwaqqat
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Bruno B Lima
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Afif Martini
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Mhmtjamil Alkhalaf
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Amit J Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA.,Atlanta VA Medical Center, Decatur, Georgia, USA
| | - Felicia C Goldstein
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA.,Goizuetta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ihab Hajjar
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA.,Goizuetta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, Georgia, USA.,Division of General Internal Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Allan I Levey
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA.,Goizuetta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - J Douglas Bremner
- Atlanta VA Medical Center, Decatur, Georgia, USA.,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.,Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Arshed A Quyyumi
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| |
Collapse
|
29
|
Martin E, Velayudhan L. Neuropsychiatric Symptoms in Mild Cognitive Impairment: A Literature Review. Dement Geriatr Cogn Disord 2021; 49:146-155. [PMID: 32289790 DOI: 10.1159/000507078] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/07/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) in dementia have received much attention due to their high prevalence and their significant implications. NPS in mild cognitive impairment (MCI), a clinical concept proposed as an intermediate state between normal aging and dementia, is now gradually gaining in interest. We aimed to conduct a selective review to examine the prevalence rate of NPS in MCI and associations of NPS symptoms with disease progression. SUMMARY We searched the PubMed database for articles on NPS in MCI and included articles that fulfilled the inclusion criteria. NPS was present in 35-85% of MCI patients. The most common symptoms were depression, irritability, apathy, anxiety, agitation, and sleep problems. Although the associated risk for disease progression of some symptoms, such as apathy and anxiety, was more consistent across studies, evidence was conflicting for symptoms like depression and sleep problems. NPS tend to co-occur, and certain combinations of NPS had a mutual or cumulative effect on disease progression. Late-onset NPS, even in a mild form (mild behavioural impairment) were found to be associated with an increased risk of dementia, even in the absence of cognitive impairment. Key Messages: NPS are highly prevalent in MCI patients and associated with subsequent cognitive deterioration. Late-onset NPS should raise suspicions of neurodegeneration. Future studies with improvised methodology are required to understand the interrelations of NPS and the role they play in the prognosis for patients with MCI.
Collapse
Affiliation(s)
- Evangelia Martin
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Latha Velayudhan
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom,
| |
Collapse
|
30
|
Kurmyshev MV, Zakharova NV, Bravve LV. [Neuropsychiatric symptoms in patients with mild cognitive impairment]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:68-74. [PMID: 34184481 DOI: 10.17116/jnevro202112105168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To study the prevalence of neuropsychiatric symptoms (NPS) in patients with mild cognitive impairment (MCI) who asked for help in memory clinics. MATERIAL AND METHODS We analysed data on 729 patients with MCI (average age 76.6 years, average MMSE score 25.3), who underwent a course of cognitive neurorehabilitation in a specialized department - a memory clinic. A Russian version of Neuropsychiatric Inventory (NPI) was used. We compared the indicators for the main psychometric scales for the diagnosis of MCI in comparison with the dynamics of NPS. RESULTS The prevalence rates for NPS differed in part from those reported in the literature. The most common symptom was anxiety (54.7%) and irritability (56.5%), while euphoria, as well as delusions and hallucinations were not detected. All disorders significantly reduced at the end of the rehabilitation program. CONCLUSION MCI influences the level of functioning and social interaction in older patients and mediates the quality of life. Thus, given the increase in life expectancy, it is necessary to introduce new methods of examination applicable in the practice of psychiatrists to diagnose and rehabilitate such patients. NPS turned out to be widespread in MCI, but may reduce during the course of complex neurorehabilitation.
Collapse
Affiliation(s)
- M V Kurmyshev
- Alexeev Psychiatric Clinical Hospital No. 1, Moscow, Russia
| | - N V Zakharova
- Alexeev Psychiatric Clinical Hospital No. 1, Moscow, Russia
| | - L V Bravve
- Alexeev Psychiatric Clinical Hospital No. 1, Moscow, Russia
| |
Collapse
|
31
|
Israsena P, Jirayucharoensak S, Hemrungrojn S, Pan-Ngum S. Brain Exercising Games With Consumer-Grade Single-Channel Electroencephalogram Neurofeedback: Pre-Post Intervention Study. JMIR Serious Games 2021; 9:e26872. [PMID: 34128816 PMCID: PMC8277357 DOI: 10.2196/26872] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/27/2021] [Accepted: 04/17/2021] [Indexed: 01/19/2023] Open
Abstract
Background The aging population is one of the major challenges affecting societies worldwide. As the proportion of older people grows dramatically, so does the number of age-related illnesses such as dementia-related illnesses. Preventive care should be emphasized as an effective tool to combat and manage this situation. Objective The aim of this pilot project was to study the benefits of using neurofeedback-based brain training games for enhancing cognitive performance in the elderly population. In particular, aiming for practicality, the training games were designed to operate with a low-cost consumer-grade single-channel electroencephalogram (EEG) headset that should make the service scalable and more accessible for wider adoption such as for home use. Methods Our training system, which consisted of five brain exercise games using neurofeedback, was serviced at 5 hospitals in Thailand. Participants were screened for cognitive levels using the Thai Mental State Examination and Montreal Cognitive Assessment. Those who passed the criteria were further assessed with the Cambridge Neuropsychological Test Automated Battery (CANTAB) computerized cognitive assessment battery. The physiological state of the brain was also assessed using 16-channel EEG. After 20 sessions of training, cognitive performance and EEG were assessed again to compare pretraining and posttraining results. Results Thirty-five participants completed the training. CANTAB results showed positive and significant effects in the visual memory (delayed matching to sample [percent correct] P=.04), attention (median latency P=.009), and visual recognition (spatial working memory [between errors] P=.03) domains. EEG also showed improvement in upper alpha activity in a resting state (open-eyed) measured from the occipital area (P=.04), which similarly indicated improvement in the cognitive domain (attention). Conclusions Outcomes of this study show the potential use of practical neurofeedback-based training games for brain exercise to enhance cognitive performance in the elderly population.
Collapse
Affiliation(s)
- Pasin Israsena
- National Electronics and Computer Technology Center, National Science and Technology Development Agency, Pathumthani, Thailand
| | - Suwicha Jirayucharoensak
- National Electronics and Computer Technology Center, National Science and Technology Development Agency, Pathumthani, Thailand
| | - Solaphat Hemrungrojn
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Cognitive Fitness Research Center, Chulalongkorn University, Bangkok, Thailand
| | - Setha Pan-Ngum
- Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
32
|
Günak MM, Barnes DE, Yaffe K, Li Y, Byers AL. Risk of Suicide Attempt in Patients With Recent Diagnosis of Mild Cognitive Impairment or Dementia. JAMA Psychiatry 2021; 78:659-666. [PMID: 33760039 PMCID: PMC7992018 DOI: 10.1001/jamapsychiatry.2021.0150] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
IMPORTANCE Little is known about the association between mild cognitive impairment (MCI) and suicide. Most studies have focused on dementia and suicidal behavior, with inconsistent results. OBJECTIVES To examine the association between diagnoses of MCI and dementia and suicide attempt and explore potential psychiatric moderators and to assess whether the association differs based on recency of diagnosis. DESIGN, SETTING, AND PARTICIPANTS This nationwide cohort study integrated 5 national databases from the Department of Veterans Affairs (VA) and Centers for Medicare & Medicaid Services and included all VA medical centers in the US. US veterans 50 years or older with MCI diagnoses at baseline (October 1, 2011, to September 30, 2013) or earlier (October 1, 2007, to September 30, 2011) were propensity matched 1:3 with (1) patients with dementia diagnoses and (2) patients without either diagnosis based on demographic characteristics and the Charlson Comorbidity Index. Diagnoses of MCI or dementia were defined as recent if there were no diagnosis codes before baseline. Data were analyzed from March 16, 2020, to January 15, 2021. MAIN OUTCOMES AND MEASURES Information on suicide attempts through December 31, 2016, provided by the National Suicide Prevention Applications Network (nonfatal) and Mortality Data Repository (fatal). RESULTS The study population of 147 595 participants included 21 085 patients with MCI, 63 255 with dementia, and 63 255 in the propensity-matched comparison group. Participants had a mean (SD) age of 74.7 (10.3) years, 143 353 (97.1%) were men, 4242 (2.9%) were women, and 127 065 (86.1%) were non-Hispanic White. A total of 138 patients with MCI (0.7%) and 400 patients with dementia (0.6%) attempted suicide during follow-up, compared with 253 patients without MCI or dementia (0.4%). Exploratory analyses revealed that no psychiatric comorbidity moderated the association between MCI or dementia and suicide attempt. After adjustment for demographic details and medical and psychiatric comorbidities, risk of suicide attempt was consistently highest for patients with a recent MCI or dementia diagnosis, with adjusted hazard ratios (HRs) of 1.73 (95% CI, 1.34-2.22; P < .001) for recent MCI and 1.44 (95% CI, 1.17-1.77; P = .001) for recent dementia. Risk associated with prior diagnosis was not significant (HR for prior MCI, 1.03 [95% CI, 0.78-1.36; P = .84]; HR for prior dementia, 1.14 [95% CI, 0.95-1.36; P = .15]). CONCLUSIONS AND RELEVANCE This study found that older adults with recent MCI or dementia diagnoses were at increased risk of attempting suicide. These findings suggest that involvement of supportive services at the time of or soon after diagnoses of MCI or dementia may help mitigate risk of suicide attempts.
Collapse
Affiliation(s)
- Mia Maria Günak
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands
| | - Deborah E. Barnes
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco,San Francisco Veterans Affairs Health Care System, San Francisco, California,Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Kristine Yaffe
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco,San Francisco Veterans Affairs Health Care System, San Francisco, California,Department of Epidemiology and Biostatistics, University of California, San Francisco,Department of Neurology, University of California, San Francisco
| | - Yixia Li
- Northern California Institute for Research and Education, The Veterans Health Research Institute, San Francisco, California
| | - Amy L. Byers
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco,San Francisco Veterans Affairs Health Care System, San Francisco, California,Department of Medicine, Division of Geriatrics, University of California, San Francisco
| |
Collapse
|
33
|
Zhu W, Huang H, Yang S, Luo X, Zhu W, Xu S, Meng Q, Zuo C, Liu Y, Wang W. Cortical and Subcortical Grey Matter Abnormalities in White Matter Hyperintensities and Subsequent Cognitive Impairment. Neurosci Bull 2021; 37:789-803. [PMID: 33826095 PMCID: PMC8192646 DOI: 10.1007/s12264-021-00657-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/28/2020] [Indexed: 01/18/2023] Open
Abstract
Grey matter (GM) alterations may contribute to cognitive decline in individuals with white matter hyperintensities (WMH) but no consensus has yet emerged. Here, we investigated cortical thickness and grey matter volume in 23 WMH patients with mild cognitive impairment (WMH-MCI), 43 WMH patients without cognitive impairment, and 55 healthy controls. Both WMH groups showed GM atrophy in the bilateral thalamus, fronto-insular cortices, and several parietal-temporal regions, and the WMH-MCI group showed more extensive and severe GM atrophy. The GM atrophy in the thalamus and fronto-insular cortices was associated with cognitive decline in the WMH-MCI patients and may mediate the relationship between WMH and cognition in WMH patients. Furthermore, the main results were well replicated in an independent dataset from the Alzheimer's Disease Neuroimaging Initiative database and in other control analyses. These comprehensive results provide robust evidence of specific GM alterations underlying WMH and subsequent cognitive impairment.
Collapse
Affiliation(s)
- Wenhao Zhu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hao Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shiqi Yang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiang Luo
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shabei Xu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qi Meng
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Chengchao Zuo
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yong Liu
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.
- School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, 100876, China.
- University of the Chinese Academy of Sciences, Beijing, 100049, China.
| | - Wei Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| |
Collapse
|
34
|
The first national action plan on depression in China: Progress and challenges. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 7:100078. [PMID: 34327412 PMCID: PMC8315616 DOI: 10.1016/j.lanwpc.2020.100078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 11/21/2022]
|
35
|
Meeuwsen KD, Groeneveld KM, Walker LA, Mennenga AM, Tittle RK, White EK. Z-score neurofeedback, heart rate variability biofeedback, and brain coaching for older adults with memory concerns. Restor Neurol Neurosci 2021; 39:9-37. [PMID: 33386829 PMCID: PMC7990441 DOI: 10.3233/rnn-201053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND The three-month, multi-domain Memory Boot Camp program incorporates z-score neurofeedback (NFB), heart rate variability (HRV) biofeedback, and one-on-one coaching to teach memory skills and encourage behavior change in diet, sleep, physical fitness, and stress reduction. OBJECTIVE This prospective trial evaluates the Memory Boot Camp program for adults ages 55 to 85 with symptoms of Mild Cognitive Impairment (MCI) and subjective memory complaints. METHODS Participants were evaluated via the Montreal Cognitive Assessment (MoCA), NeuroTrax Global Cognitive Score, measures of anxiety, depression, sleep, quality of life, quantitative electroencephalography (QEEG), and HRV parameters at four timepoints: baseline, pre-program, post-program, and follow-up. The trial included a three-month waiting period between baseline and pre-program, such that each participant acted as their own control, and follow-up took place six months after completion of the program. RESULTS Participants' MoCA scores and self-reported measures of anxiety, depression, sleep quality, and quality of life improved after treatment, and these changes were maintained at follow-up. Physiological changes in HRV parameters after treatment were not significant, however, breathing rate and QEEG parameters were improved at post-program and maintained at follow-up. Finally, participants' improvement in MoCA score over the treatment period was correlated with their improvement in two brain oscillation parameters targeted by the z-score NFB protocol: relative power of delta and relative power of theta. CONCLUSIONS Trial results suggest that the Memory Boot Camp program is a promising treatment strategy for older adults with symptoms of MCI and subjective memory complaints.
Collapse
|
36
|
Zhu W, Huang H, Yang S, Luo X, Zhu W, Xu S, Meng Q, Zuo C, Zhao K, Liu H, Liu Y, Wang W. Dysfunctional Architecture Underlies White Matter Hyperintensities with and without Cognitive Impairment. J Alzheimers Dis 2020; 71:461-476. [PMID: 31403946 DOI: 10.3233/jad-190174] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND White matter hyperintensities (WMH) are common in older adults and are associated with cognitive decline. However, little is known about the functional changes underlying cognitive decline in WMH subjects. OBJECTIVES To investigate whole-brain functional connectivity (FC) underpinnings of cognitive decline in WMH subjects using univariate and multivariate analyses. METHODS Twenty-three WMH subjects with mild cognitive impairment (WMH-MCI), 43 WMH subjects with no cognitive impairment (WMH-nCI), and 55 healthy controls underwent resting-state functional MRI scans. Whole-brain FC was calculated using the fine-grained human Brainnetome Atlas, followed by performance of between-group comparisons and FC-cognition correlation analysis. A multivariate analysis using support vector machine (SVM) was performed to classify WMH-MCI and WMH-nCI subjects based on FC. RESULTS Both the WMH-MCI and WMH-nCI subjects exhibited characteristic impaired FC patterns. Markedly reduced FC involving subcortical nuclei and cortical hub regions of cognitive networks, especially the cingulate cortex, was identified in the WMH-MCI patients. In the WMH-MCI group, several connections involving the cingulate cortex were associated with cognitive decline. The exploratory mediation analyses indicated that FC alterations could partially explain the association between WMH and cognition. Furthermore, an SVM classifier based on FC distinguished WMH-MCI and WMH-nCI subjects with 78.8% accuracy. Connections that contributed most to the classification showed a similar distribution as the connections identified in the univariate analysis. CONCLUSIONS This study provides a new window into the pathophysiology of cognitive impairment in WMH subjects and offer a novel and potential approach for early detection of the cognitive impairment in WMH subjects at the individual level.
Collapse
Affiliation(s)
- Wenhao Zhu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shiqi Yang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiang Luo
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shabei Xu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Meng
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chengchao Zuo
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Zhao
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,School of Information Science and Engineering, Shandong Normal University, Ji'nan, China
| | - Hesheng Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Yong Liu
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Wei Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
37
|
Na S, Im JJ, Jeong H, Lee ES, Lee TK, Chung YA, Song IU. Altered Regional Cerebral Blood Perfusion in Mild Cognitive Impairment Patients with Dizziness. Diagnostics (Basel) 2020; 10:diagnostics10100777. [PMID: 33008120 PMCID: PMC7599883 DOI: 10.3390/diagnostics10100777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/27/2020] [Accepted: 09/29/2020] [Indexed: 11/16/2022] Open
Abstract
Dizziness is a common symptom among the general population, especially in the elderly. Previous studies have reported that dizziness may be associated with various cognitive functions including memory impairment. However, few studies have investigated the neural correlates of dizziness in patients with cognitive impairment. The aim of this study was to examine regional cerebral blood flow (rCBF) in mild cognitive impairment (MCI) patients with or without dizziness using single photon emission computed tomography (SPECT). A total of 50 patients with MCI were recruited. All participants underwent technetium-99m ethyl cysteinate dimer brain SPECT and a neuropsychological battery and completed the Dizziness Handicap Inventory (DHI). Participants were divided into a dizziness group (DHI ≥ 1, n = 18) and a non-dizziness group (DHI = 0, n = 32). Voxel wise differences in rCBF between the groups were estimated. SPECT analysis revealed decreased rCBF in the left superior temporal gyrus, left lateral orbital gyrus, and right middle frontal gyrus in the dizziness group compared with the non-dizziness group (p < 0.005). No significant clusters of increased rCBF were observed in the dizziness group compared with the non-dizziness group. Results of the neuropsychological tests showed a significant difference in Controlled Oral Word Association Test performance between MCI patients with and without dizziness. In conclusion, MCI patients with dizziness showed multifocal frontal and left temporal hypoperfusion compared with patients without dizziness. Our results suggest that hypoperfusion in the frontal and temporal cortices might be reflecting the negative impact of dizziness in MCI patients.
Collapse
Affiliation(s)
- Seunghee Na
- Department of Neurology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea;
| | - Jooyeon Jamie Im
- Department of Nuclear Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea; (J.J.I.); (H.J.)
| | - Hyeonseok Jeong
- Department of Nuclear Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea; (J.J.I.); (H.J.)
- Department of Radiology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea
| | - Eek-Sung Lee
- Department of Neurology, Soonchunhyang University College of Medicine, Bucheon 14584, Korea; (E.-S.L.); (T.-K.L.)
| | - Tae-Kyeong Lee
- Department of Neurology, Soonchunhyang University College of Medicine, Bucheon 14584, Korea; (E.-S.L.); (T.-K.L.)
| | - Yong-An Chung
- Department of Nuclear Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea; (J.J.I.); (H.J.)
- Department of Radiology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea
- Correspondence: (Y.-A.C.); (I.-U.S.); Tel.: +82-32-280-5243 (Y.-A.C.); +82-32-280-5010 (I.-U.S.)
| | - In-Uk Song
- Department of Neurology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea;
- Correspondence: (Y.-A.C.); (I.-U.S.); Tel.: +82-32-280-5243 (Y.-A.C.); +82-32-280-5010 (I.-U.S.)
| |
Collapse
|
38
|
Lovett RM, Curtis LM, Persell SD, Griffith JW, Cobia D, Federman A, Wolf MS. Cognitive impairment no dementia and associations with health literacy, self-management skills, and functional health status. PATIENT EDUCATION AND COUNSELING 2020; 103:1805-1811. [PMID: 32197929 PMCID: PMC7864102 DOI: 10.1016/j.pec.2020.03.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/19/2020] [Accepted: 03/11/2020] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To determine the prevalence of cognitive impairment no dementia (CIND) among a diverse, community-based population, and establish associations between CIND and health literacy, chronic disease self-management and functional health status. METHODS 863 primary care adults without dementia aged 55-74. Adjusted logistic and linear regressions were used to assess associations between CIND (None, Mild, Moderate/Severe) and outcomes. RESULTS 36 % participants exhibited CIND. It was strongly associated with limited health literacy (Newest Vital Signs: Mild [OR 3.25; 95 % CI 1.93, 5.49], Moderate/Severe [OR 6.45; 95 % CI 3.16, 13.2]; Test of Functional Health Literacy in Adults: Mild [OR 3.46; 95 % CI 2.08, 5.75], Moderate/Severe [OR 8.82; 95 % CI 4.87, 16.0]; all p's < 0.001) and poor chronic disease self-management (Mild [B = -11.2; 95 % CI -13.5, -8.90], Moderate/Severe CI [B = -21.0; 95 % CI -23.6, -18.4]; both p's < 0.001). Associations between CIND and functional health status were non-significant. CONCLUSIONS CIND was prevalent in this cohort, and strongly associated with requisite skills for managing everyday health needs. PRACTICE IMPLICATIONS Attention to subtle declines in chronic disease self-care may assist with CIND identification and care management within this population. When CIND is observed, clinicians should also expect and address difficulties with self-management.
Collapse
Affiliation(s)
- Rebecca M Lovett
- Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, USA.
| | - Laura M Curtis
- Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, USA.
| | - Stephen D Persell
- Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, USA.
| | - James W Griffith
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 645 N. Michigan Ave. #822, Chicago, IL, USA.
| | - Derin Cobia
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, USA.
| | - Alex Federman
- General Internal Medicine, Icahn School of Medicine, Mount Sinai Hospital, 17 E 102nd St, 7th Floor, New York, NY, USA.
| | - Michael S Wolf
- Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, USA.
| |
Collapse
|
39
|
Derrig H, Lavrencic LM, Broe GA, Draper B, Cumming RG, Garvey G, Hill TY, Daylight G, Chalkley S, Mack H, Lasschuit D, Delbaere K, Radford K. Mild cognitive impairment in Aboriginal Australians. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12054. [PMID: 32864414 PMCID: PMC7443744 DOI: 10.1002/trc2.12054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/01/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Aboriginal Australians have among the highest rates of dementia worldwide, yet no study has investigated the subtypes, risk factors, or longer term outcomes of mild cognitive impairment (MCI) in this population. METHODS A total of 336 community-dwelling Aboriginal Australians aged ≥60 years participated in a longitudinal study, completing a structured interview at baseline. MCI (amnestic subtype, aMCI; non-amnestic subtype, naMCI) and dementia were diagnosed via cognitive screening, medical assessment, and clinical consensus. Associations between life-course factors and baseline MCI subtypes were examined using logistic regression. Conversion to dementia was assessed at 6-year follow-up. RESULTS Prevalent aMCI (n = 24) was associated with older age (odds ratio [OR] = 1.68, 95% confidence interval [CI]: 1.12 to 2.53), head injury (OR = 3.19, 95% CI: 1.35 to 7.56), symptoms of depression (OR = 1.52, 95% CI: 1.04 to 2.24), and lower blood pressure (OR = 0.53, 95% CI: 0.33 to 0.86). Prevalent naMCI (n = 29) was associated with low education (OR = 4.46, 95% CI: 1.53 to 13.05), unskilled work history (OR = 5.62, 95% CI: 2.07 to 13.90), higher body mass index (OR = 1.99, 95% CI: 1.30 to 3.04), and moderate to severe hearing loss (OR = 2.82, 95% CI: 1.06 to 7.55). A small proportion of MCI cases reverted to intact at follow-up (15%), but most remained stable (44%), developed dementia and/or died (41%). DISCUSSION Sociodemographic and clinical factors both contributed to baseline MCI and were distinct for MCI subtypes, with similar patterns of conversion to dementia for amnestic and non-amnestic MCI.
Collapse
Affiliation(s)
- Hannah Derrig
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
| | - Louise M. Lavrencic
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- UNSW Ageing Futures InstituteUniversity of New South WalesSydneyAustralia
- School of Public health and Community MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Gerald A. Broe
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- UNSW Ageing Futures InstituteUniversity of New South WalesSydneyAustralia
- School of Public health and Community MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Brian Draper
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- UNSW Ageing Futures InstituteUniversity of New South WalesSydneyAustralia
- Prince of Wales HospitalRandwickNew South WalesAustralia
| | - Robert G Cumming
- School of Public healthUniversity of SydneySydneyNew South WalesAustralia
| | - Gail Garvey
- Menzies School of Health ResearchBrisbaneQueenslandAustralia
| | - Thi Yen Hill
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- Prince of Wales HospitalRandwickNew South WalesAustralia
| | - Gail Daylight
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
| | - Simon Chalkley
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
| | - Holly Mack
- University of Technology SydneySydneyNew South WalesAustralia
| | - Danielle Lasschuit
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- Prince of Wales HospitalRandwickNew South WalesAustralia
| | - Kim Delbaere
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- UNSW Ageing Futures InstituteUniversity of New South WalesSydneyAustralia
- School of Public health and Community MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Kylie Radford
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- UNSW Ageing Futures InstituteUniversity of New South WalesSydneyAustralia
- School of Medical SciencesUniversity of New South WalesSydneyNew South WalesAustralia
| |
Collapse
|
40
|
Langoni CDS, Resende TDL, Barcellos AB, Cecchele B, Knob MS, Silva TDN, da Rosa JN, Diogo TDS, Filho IGDS, Schwanke CHA. Effect of Exercise on Cognition, Conditioning, Muscle Endurance, and Balance in Older Adults With Mild Cognitive Impairment: A Randomized Controlled Trial. J Geriatr Phys Ther 2020; 42:E15-E22. [PMID: 29738405 DOI: 10.1519/jpt.0000000000000191] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Mild cognitive impairment (MCI) may be a precursor to dementia; however, its progression may be prevented or slowed with exercise. This study aimed at determining the effects of group aerobic and strength training on cognition, conditioning, muscle endurance, and balance in underprivileged community-dwelling older adults with MCI. METHODS This was a single-blind, randomized, and matched-pair controlled (gender, age, body mass index, and Addenbrooke's Cognitive Examination-Revised for MCI diagnosis) clinical trial. It was developed in 4 community centers. Fifty-two sedentary, functionally independent individuals, aged 60 years or more, with MCI were randomized into intervention group (n = 26) and control group (n = 26). Participants were tested before and after a 24-week exercise program. Sociodemographic characteristics, cognition (Mini-Mental State Examination), conditioning (2-minute stationary walk test), lower-limb endurance (30-second sit/stand test), and balance data (Functional Reach test) were collected. The intervention group walked and exercised twice weekly (60 minutes each) using ankle weights, latex resistance bands, and dumbbells. The exercise load and intensity were regularly increased on the basis of a preestablished incremental number of sets and repetitions and on the basis of the participants' correct movement execution with a given load. Data were analyzed with Pearson χ test, Fisher exact test, Student t test, Mann-Whitney U test, 2-way repeated measures analysis of variance, and the Cohen d. RESULTS AND DISCUSSION Before the intervention, no significant differences were found between groups for any of the variables. Postintervention, significant differences were observed in cognition, conditioning, muscle endurance, and balance. Significant time-by-group interactions were detected in all the intergroup analyses. The improvements observed in the intervention group had medium to large effect sizes (0.35-1.15). The control group's decrease in cognition (13.9%) had a large effect size, while its Functional Reach test decrease (11.4%) had a medium effect size, with no significant change in conditioning or muscle endurance. CONCLUSION The training program improved cognitive function, muscle endurance, aerobic conditioning, and balance in older adults with MCI.
Collapse
Affiliation(s)
| | - Thais de Lima Resende
- School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Betina Cecchele
- School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Mateus Soares Knob
- School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Juliana Nunes da Rosa
- School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Tamiris de Souza Diogo
- School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | | |
Collapse
|
41
|
Clement-Carbonell V, Cabañero-Martínez MJ, Fernández-Alcántara M, Ruiz-Robledillo N, Escribano S, Congost-Maestre N, Ferrer-Cascales R. Psychometric properties of the Spanish version of the mild cognitive impairment questionnaire. Res Nurs Health 2020; 43:284-293. [PMID: 32173878 DOI: 10.1002/nur.22017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 02/27/2020] [Indexed: 01/07/2023]
Abstract
The prevalence of mild cognitive impairment (MCI) has significantly increased in recent years. No specific instruments are available in Spanish for assessing health-related quality of life (HRQoL) in people with MCI. The aim of this study was to adapt transculturally and validate the mild cognitive impairment questionnaire (MCQ) in Spanish people with MCI. A standardized transcultural adaptation process was carried out, and the structural equivalence of the Spanish version of the scale was examined. In addition, we studied the reliability and construct validity of the instrument. The sample comprised 100 people with MCI, with a mean age of 79.5 years. In a confirmatory factor analysis, we found the instrument had a one-factor structure and adequate internal consistency. Related to the construct validity, we found meaningful relationships with measures of HRQoL and depression. Our results indicate that the Spanish version of the MCQ is a reliable and valid tool for measuring HRQoL in Spanish patients with MCI. The availability of specific tools, such as the MCQ allows nurses to evaluate new intervention strategies to improve the HRQoL of these patients. Furthermore, this scale can be used by researchers and clinicians to improve the standards of care provided to this population.
Collapse
Affiliation(s)
| | | | | | - Nicolás Ruiz-Robledillo
- Department of Health Psychology, Faculty of Health Science, University of Alicante, Alicante, Spain
| | - Silvia Escribano
- Department of Nursing, Faculty of Health Science, University of Alicante, Alicante, Spain
| | | | - Rosario Ferrer-Cascales
- Department of Health Psychology, Faculty of Health Science, University of Alicante, Alicante, Spain
| |
Collapse
|
42
|
Altuğ H, Fuks KB, Hüls A, Mayer AK, Tham R, Krutmann J, Schikowski T. Air pollution is associated with depressive symptoms in elderly women with cognitive impairment. ENVIRONMENT INTERNATIONAL 2020; 136:105448. [PMID: 31931346 DOI: 10.1016/j.envint.2019.105448] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/17/2019] [Accepted: 12/24/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Studies on air pollution and depression in the elderly are limited and the results are heterogeneous. OBJECTIVES We examined the association of ambient air pollution exposure and diagnosis and symptoms of depression in the elderly; and whether any associations were confounded or modified by cognitive decline. METHODS We enrolled 821 elderly women from the German SALIA cohort (follow-up examination, 2007-2010). Self-reported depressive symptoms and level of cognition were evaluated using the CESD-R Scale and the CERAD-Plus test, respectively. We used two depression endpoints for analyses: self-reported doctor diagnosis of depression and frequency of depressive symptoms (CESD-R score). Long-term concentrations of particulate matter (PM) size fractions and nitrogen oxides (NOx) modeled by land-use regression were assigned to home addresses. Cross-sectional associations were assessed using adjusted logistic and linear regression models. RESULTS Concentrations of coarse particles (PMcoarse), fine particles (PM2.5 and PM2.5 abs) and NO2 were significantly associated with diagnosis of depression (e.g. for PM2.5 OR = 1.62, 95%CI: 1.06, 2.46 and for NO2 OR = 1.54, 95% CI: 1.08, 2.19). Similarly, an increase of one interquartile range in PM10, PM2.5, NO2 and NOx was associated with depressive symptoms assessed with the CESD-R score (e.g. for PM2.5 16.2% difference in the mean; 95% CI: 5.8%, 26.5% and for NO2 14.5%; 95% CI: 4.8%, 24.2%). These associations were stronger in women with cognitive decline (e.g. Pint for PM2.5:0.022 and NO2:0.017) compared to women with normal cognition. In addition, living less than 100 m distance to major roads was significantly associated with diagnosis (OR = 1.99, 95% CI: 1.14, 3.47) and symptoms (19.7%; 95% CI: 4.3%, 35.1%) of depression. We did not observe any interaction effect of cognition on prior diagnosis of depression. CONCLUSIONS Exposure to air pollution was associated with diagnosis of depression and depressive symptoms in elderly women. Women with impaired cognition may be at greater risk of depressive symptoms when exposed to air pollution.
Collapse
Affiliation(s)
- Hicran Altuğ
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Kateryna B Fuks
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Anke Hüls
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany; Department of Human Genetics, Emory University, Atlanta, GA, USA
| | | | - Rachel Tham
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Jean Krutmann
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Tamara Schikowski
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.
| |
Collapse
|
43
|
Psychological stress, cognitive decline and the development of dementia in amnestic mild cognitive impairment. Sci Rep 2020; 10:3618. [PMID: 32108148 PMCID: PMC7046646 DOI: 10.1038/s41598-020-60607-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 02/10/2020] [Indexed: 12/30/2022] Open
Abstract
To determine the relationship between psychological stress with cognitive outcomes in a multi-centre longitudinal study of people with amnestic mild cognitive impairment (aMCI) we assessed three parameters of psychological stress (Recent Life Changes Questionnaire (RLCQ); the Perceived Stress Scale (PSS) and salivary cortisol) and their relationship with rates of cognitive decline over an 18 month follow up period and conversion to dementia over a 5.5 year period. In 133 aMCI and 68 cognitively intact participants the PSS score was higher in the aMCI compared with control group but neither the RLCQ scores nor salivary cortisol measures were different between groups. In the aMCI group the RLCQ and the PSS showed no significant association with cognitive function at baseline, cognitive decline or with conversion rates to dementia but high salivary cortisol levels were associated with RLCQ scores and poorer cognitive function at baseline and lower rates of cognitive decline. No relationship was found between salivary cortisol levels and conversion rate to dementia. We conclude that psychological stress as measured by the RLCQ or PSS was not associated with adverse cognitive outcomes in an aMCI population and hypothesise that this may reflect diminished cortisol production to psychological stress as the disease progresses.
Collapse
|
44
|
Yuan B, Yiengprugsawan V. Associations Between a History of Depression and Cognitive Performance Among Older Adults in Shandong, China. Community Ment Health J 2020; 56:116-125. [PMID: 31535347 DOI: 10.1007/s10597-019-00461-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 09/07/2019] [Indexed: 11/26/2022]
Abstract
This study investigates the relationships between depression and cognitive performance among older adults living in Shandong province. Data were derived from the World Health Organization's Study on global AGEing and adult health (WHO-SAGE) China Wave 1 aged 50 and over residing in Shandong province (n = 1926). Cognitive performance was assessed by overall cognitive score. Data were analysed by multivariate linear regression. In rural Shandong, having a history of depression (- 4.0; p < 0.001), female (- 9.3; p < 0.001), and poor household wealth (- 8.9; p < 0.001) and primary level of education (- 6.4; p < 0.001) were main factors associated with their poor cognitive performance. Notably, in urban Shandong, lowest household wealth (- 12.5; p < 0.001) and not having health insurance (- 9.7; p < 0.001) were significant predictors of adverse cognitive performance. Findings could help inform policy in monitoring depressive symptoms and cognitive performance among older adults in China.
Collapse
Affiliation(s)
- Bo Yuan
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Vasoontara Yiengprugsawan
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, College of Health and Medicine, The Australian National University, 54 Mills Road, Acton, Canberra, 2601, Australia.
- Australian Research Council Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, Sydney, Australia.
| |
Collapse
|
45
|
Arnoriaga-Rodríguez M, Fernández-Real JM. Microbiota impacts on chronic inflammation and metabolic syndrome - related cognitive dysfunction. Rev Endocr Metab Disord 2019; 20:473-480. [PMID: 31884557 DOI: 10.1007/s11154-019-09537-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cognitive dysfunction, one of the major concerns of increased life expectancy, is prevalent in patients with metabolic disorders. Added to the inflammation in the context of aging (inflammaging), low-grade chronic inflammation (metaflammation) accompanies metabolic diseases. Peripheral and central inflammation underlie metabolic syndrome - related cognitive dysfunction. The gut microbiota is increasingly recognized to be linked to both inflammaging and metaflammation in parallel to the pathophysiology of obesity, type 2 diabetes and the metabolic syndrome. Microbiota composition, diversity and diverse metabolites have been related to different metabolic features and cognitive traits. The study of different mouse models has contributed to identify characteristic microbiota profiles and shifts in the microbial gene richness in association with cognitive function. Diet, exercise and prebiotics, probiotics or symbiotics significantly influence cognition and changes in the microbiota. Few studies have analyzed the gut microbiota composition in association with cognitive function in humans. Impaired attention, mental flexibility and executive function have been observed in association with a microbiota ecosystem in cross-sectional and longitudinal studies. Nevertheless, the evidence in humans is still scarce and not causal relationships may be inferred, so larger and long-term studies are required to gain insight into the possible role of microbiota in human cognition.
Collapse
Affiliation(s)
- María Arnoriaga-Rodríguez
- Department of Diabetes, Endocrinology and Nutrition, Dr. Josep Trueta University Hospital, Girona Biomedical Research Institute [IdibGi], Carretera de França s/n, 17007, Girona, Spain
- Nutrition, Eumetabolism and Health Group, Girona Biomedical Research Institute (IdibGi), Girona, Spain
- CIBEROBN Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain
- Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain
| | - José Manuel Fernández-Real
- Department of Diabetes, Endocrinology and Nutrition, Dr. Josep Trueta University Hospital, Girona Biomedical Research Institute [IdibGi], Carretera de França s/n, 17007, Girona, Spain.
- Nutrition, Eumetabolism and Health Group, Girona Biomedical Research Institute (IdibGi), Girona, Spain.
- CIBEROBN Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain.
- Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain.
| |
Collapse
|
46
|
Jang JH, Kim J, Park G, Kim H, Jung ES, Cha JY, Kim CY, Kim S, Lee JH, Yoo H. Beta wave enhancement neurofeedback improves cognitive functions in patients with mild cognitive impairment: A preliminary pilot study. Medicine (Baltimore) 2019; 98:e18357. [PMID: 31852140 PMCID: PMC6922450 DOI: 10.1097/md.0000000000018357] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) is a symptom characterizing cognitive decline and a transitional state between normal aging and dementia; however, there is no definitive diagnosis and treatment for MCI. Neurofeedback (NF), which is a training mechanism that employs operant conditioning to regulate brain activity, has been increasingly investigated concerning its beneficial effects for dementia and MCI. METHODS This study investigated cognitive improvement and hemodynamic changes in the prefrontal cortex (PFC) following NF training in patients with MCI. Five patients with MCI received NF training for enhanced beta band activity in the dorsolateral PFC-16 sessions for 8 weeks-with each session divided into 9 5-minute trials. The primary outcome measure was a cognitive assessment tool: the Korean version of the Montreal Cognitive Assessment. The secondary outcome measures were the Central Nervous System Vital Signs for neurocognitive testing, hemodynamic changes using functional near-infrared spectroscopy in the PFC during a working-memory task, and Beck Depression Inventory scores. RESULTS After completing the training, patients' cognitive function significantly improved in domains such as composite memory, cognitive flexibility, complex attention, reaction time, and executive function. Increased electroencephalogram beta power was observed over NF training sessions (Spearman rank correlation test: r = 0.746, P = .001). The threshold value for gaining positive feedback from pre-NF baseline on beta power significantly increased (Spearman rank correlation test: r = 0.805, P = .001). Hemodynamic response in PFC changed after NF training, and individual differences were identified. Specifically, hypoactivation of the hemodynamic response by emotional distraction recovered following NF training. CONCLUSION We suggest that patients' cognitive processing efficiency was improved by the NF training. These beneficial results suggest that NF training may have potential therapeutic applications to prevent the progression from MCI to dementia. TRIAL REGISTRATION NUMBER Clinical Research Information Service (KCT0003433).
Collapse
Affiliation(s)
- Jung-Hee Jang
- Department of Neurologic Disorders & Aging Brain Constitution, Dunsan Korean Medicine Hospital, Daejeon University
| | - Jieun Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine
| | - Gunhyuk Park
- Herbal Medicine Resources Research Center, Korea Institute of Oriental Medicine, Naju-si, Jeollanam-do, Republic of Korea
| | - Haesook Kim
- Department of Neurologic Disorders & Aging Brain Constitution, Dunsan Korean Medicine Hospital, Daejeon University
| | - Eun-Sun Jung
- Department of Neurologic Disorders & Aging Brain Constitution, Dunsan Korean Medicine Hospital, Daejeon University
| | - Ji-yun Cha
- Department of Neurologic Disorders & Aging Brain Constitution, Dunsan Korean Medicine Hospital, Daejeon University
| | - Chan-young Kim
- Department of Neurologic Disorders & Aging Brain Constitution, Dunsan Korean Medicine Hospital, Daejeon University
| | - Siyeon Kim
- Department of Neurologic Disorders & Aging Brain Constitution, Dunsan Korean Medicine Hospital, Daejeon University
| | - Jun-Hwan Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine
| | - Horyong Yoo
- Department of Neurologic Disorders & Aging Brain Constitution, Dunsan Korean Medicine Hospital, Daejeon University
| |
Collapse
|
47
|
The Efficacy of Cognitive Training for Elderly Chinese Individuals with Mild Cognitive Impairment. BIOMED RESEARCH INTERNATIONAL 2019; 2019:4347281. [PMID: 31886216 PMCID: PMC6907055 DOI: 10.1155/2019/4347281] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 10/11/2019] [Indexed: 01/06/2023]
Abstract
The age of the population is shifting toward the elderly range, which may lead to an increased risk of mild cognitive impairment (MCI). The aims of this study are to evaluate the cognitive function in elderly people using the Montreal Cognitive Assessment (MoCA), to identify the relationship between cognitive function and different characteristics, and to evaluate the efficacy of the intervention after six months of cognitive training. In this study, we included 2886 subjects aged ≧60 years in the baseline survey, and 140 subjects with MCI who participated in the baseline survey were randomly divided into an intervention group (N = 70) and a control group (N = 70). The control group was not provided any intervention measures, and the intervention group was administered cognitive training. The education level, monthly income, sleep time, exercise time, reading times, and time spent engaging in community activities and performing housework were positively correlated with MoCA scores, but age was negatively correlated with MoCA scores. The total MoCA score of the intervention group increased from 19.77 ± 2.24 points to 21.09 ± 2.20 points after six months of cognitive training, but the score of the control group decreased from 20.41 ± 2.10 points to 19.17 ± 2.57 points. The two-way repeated-measures ANOVA revealed a very significant effect of the interaction between time and cognitive training on the total MoCA score. Seventeen participants in the intervention group improved to normal levels, and no participants progressed to dementia after six months of cognitive training. Thus, the efficacy of the intervention was statistically significant. Our study concludes that older age is associated with a cognitive decline. Factors that are more likely to protect against cognitive decline included a higher education level and monthly income, sufficient sleep time, regular physical exercise and reading, frequently engaging in community activities, and continuing to perform housework. Moreover, the cognitive training intervention is effective and may help to decrease the deterioration of cognitive function in patients with MCI, and the interaction between intervention time and cognitive training significantly improves cognitive function.
Collapse
|
48
|
Kume Y, Takahashi T, Itakura Y, Lee S, Makizako H, Ono T, Shimada H, Ota H. Characteristics of Mild Cognitive Impairment in Northern Japanese Community-Dwellers from the ORANGE Registry. J Clin Med 2019; 8:jcm8111937. [PMID: 31717664 PMCID: PMC6912714 DOI: 10.3390/jcm8111937] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/03/2019] [Accepted: 11/08/2019] [Indexed: 11/16/2022] Open
Abstract
A gradually increasing prevalence of mild cognitive impairment (MCI) is recognized in the super-aging society that Japan faces, and early detection and intervention in community-dwellers with MCI are critical issues to prevent dementia. Although many previous studies have revealed MCI/non-MCI differences in older individuals, information on the prevalence and characteristics of MCI in rural older adults is limited. The aim of this study was to investigate differential characteristics between older adults with and without MCI. The investigation was conducted over one year from 2018 to 2019. Participants were recruited from Akita in northern Japan. Neuropsychological assessments were applied to classify MCI, including the National Center for Geriatrics and Gerontology Functional Assessment Tool (NCGG-FAT) and the Touch panel-type Dementia Assessment Scale (TDAS) based on the Alzheimer's disease assessment scale. Our samples consisted of 103 older adults divided into 54 non-MCI and 49 MCI. The MCI group had lower scores of all cognitive items. Our results showed that individuals with MCI had significantly slower walking speed (WS) and worse geriatric depression scale (GDS) compared to non-MCI. In addition, WS was significantly associated with some cognitive items in non-MCI, but not in MCI. Finally, we showed that predictive variables of MCI were WS and GDS. Our study provides important information about MCI in rural community-dwellers. We suggest that older adults living in a super-aging society should receive lower limb training, and avoiding depression in older adults through interaction of community-dwellers may contribute to preventing the onset of MCI.
Collapse
Affiliation(s)
- Yu Kume
- Department of Occupational Therapy, Graduate School of Medicine, Akita University, Akita 010-8543, Japan;
| | - Tomoko Takahashi
- Integrated Community Support Center, Public Health and Welfare Department, City Hall of Yokote, Akita 013-0525, Japan;
| | - Yuki Itakura
- Advanced Research Center for Geriatric and Gerontology, Akita University, Akita 010-8543, Japan;
| | - Sangyoon Lee
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; (S.L.); (H.S.)
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan;
| | - Tsuyosi Ono
- Omori Municipal Hospital, Akita 013-0525, Japan;
| | - Hiroyuki Shimada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; (S.L.); (H.S.)
| | - Hidetaka Ota
- Advanced Research Center for Geriatric and Gerontology, Akita University, Akita 010-8543, Japan;
- Correspondence: ; Tel.: +81-18-801-7061; Fax: +81-18-801-7062
| |
Collapse
|
49
|
The effects of mindfulness and health education programs on the emotional state and cognitive function of elderly individuals with mild cognitive impairment: A randomized controlled trial. J Clin Neurosci 2019; 68:211-217. [DOI: 10.1016/j.jocn.2019.05.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 05/21/2019] [Indexed: 02/08/2023]
|
50
|
Protein misassembly and aggregation as potential convergence points for non-genetic causes of chronic mental illness. Mol Psychiatry 2019; 24:936-951. [PMID: 30089789 DOI: 10.1038/s41380-018-0133-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 06/10/2018] [Accepted: 06/18/2018] [Indexed: 12/13/2022]
Abstract
Chronic mental illnesses (CMI), such as schizophrenia or recurrent affective disorders, are complex conditions with both genetic and non-genetic elements. In many other chronic brain conditions, including Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis and frontotemporal dementia, sporadic instances of the disease are more common than gene-driven familial cases. Yet, the pathology of these conditions can be characterized by the presence of aberrant protein homeostasis, proteostasis, resulting in misfolded or aggregated proteins in the brains of patients that predominantly do not derive from genetic mutations. While visible deposits of aggregated protein have not yet been detected in CMI patients, we propose the existence of more subtle protein misassembly in these conditions, which form a continuum with the psychiatric phenotypes found in the early stages of many neurodegenerative conditions. Such proteinopathies need not rely on genetic variation. In a similar manner to the established aberrant neurotransmitter homeostasis in CMI, aberrant homeostasis of proteins is a functional statement that can only partially be explained by, but is certainly complementary to, genetic approaches. Here, we review evidence for aberrant proteostasis signatures from post mortem human cases, in vivo animal work, and in vitro analysis of candidate proteins misassembled in CMI. The five best-characterized proteins in this respect are currently DISC1, dysbindin-1, CRMP1, TRIOBP-1, and NPAS3. Misassembly of these proteins with inherently unstructured domains is triggered by extracellular stressors and thus provides a converging point for non-genetic causes of CMI.
Collapse
|