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Kim JY, Lee JY, Jung JH, Park YC, Jung IC. The effectiveness and safety of Jihwang-eumja (Dihuang Yizi) compared to Western medications in patients with Alzheimer's disease: A systematic review and meta-analysis. Complement Ther Clin Pract 2023; 51:101746. [PMID: 36933451 DOI: 10.1016/j.ctcp.2023.101746] [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: 05/26/2022] [Revised: 02/28/2023] [Accepted: 03/04/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND AND PURPOSE Jihwang-eumja is reported to be effective in decreasing β-amyloid expression and activating monoamine oxidase and acetylcholinesterase in rat models. This systematic review aims to evaluate the effectiveness of Jihwang-eumja in Alzheimer's disease compared to Western medications. METHODS We searched Medline, Embase, CENTRAL, CINAHL, CNKI, ScienceON, KISS, and Kmbase. Randomized controlled trials comparing the effectiveness of Jihwang-eumja and Western medications on the cognition and the activities of daily living in Alzheimer's disease were included. The results were synthesized using meta-analysis. The risk of bias was evaluated using the Cochrane risk-of-bias tool, and the evidence level of each outcome was suggested using the GRADE system. RESULTS A total of 165 studies were screened, and six were included in the systematic review and meta-analysis. A total of 245 and 240 participants were included in the intervention and comparison groups, respectively. The results showed that Mini-Mental State Examination was 3.19 (95%CI: 1.68-4.70) higher, and the standardized mean difference of activities of daily living was 1.13 (95%CI: 0.89-1.37) higher in the Jihwang-eumja group than in Western medications group. The included studies contained some concerns of the risk of bias, and the certainty of the evidence was considered moderate. CONCLUSION Despite the small number of studies and high heterogeneity, we could verify the applicability of Jihwang-eumja for Alzheimer's disease.
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Affiliation(s)
- Ju Yeon Kim
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, Republic of Korea.
| | - Jae Yeong Lee
- College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, Republic of Korea.
| | - Jin-Hyeong Jung
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, Republic of Korea.
| | - Yang-Chun Park
- Division of Respiratory Medicine, Department of Internal Medicine, College of Korean Medicine, Daejeon University, Daejeon, 34520, Republic of Korea.
| | - In Chul Jung
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, Republic of Korea.
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2
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Chen Y, Wang H, Sun Z, Su X, Qin R, Li J, Sun W. Effectiveness of acupuncture for patients with vascular dementia: A systematic review and meta-analysis. Complement Ther Med 2022; 70:102857. [PMID: 35843473 DOI: 10.1016/j.ctim.2022.102857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/23/2022] [Accepted: 07/13/2022] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES This meta-analysis assessed the treatment effectiveness of acupuncture in patients with vascular dementia. METHODS The PubMed, Embase, Cochrane library, and China National Knowledge Infrastructure were searched to identify eligible randomized controlled trials (RCTs). The odds ratios (ORs) and weighted mean differences (WMDs) with 95 % confidence intervals (CIs) were used to assess the pooled effect estimates using a random-effects model for categorical and continuous outcomes, respectively. RESULTS Thirty-four RCTs (2672 patients) were selected for the final meta-analysis. The use of acupuncture showed association with an increased incidence of effective rate (OR: 3.28; 95 % CI: 2.54-4.24; P < 0.001). The pooled WMDs revealed that acupuncture was significantly associated with an improvement in the Hasegawa dementia scale (HDS) (WMD: 4.31; 95 % CI: 3.15-5.47; P < 0.001), and Mini-Mental State Examination scores (MMSE) (WMD: 3.07; 95 % CI: 2.40-3.74; P < 0.001). However, the use of acupuncture showed no association with the level of Activities of daily living (ADL) (WMD: 1.93; 95 % CI: - 2.53 to 6.38; P = 0.397). Finally, acupuncture was associated with lower levels of Scale for the differentiation of syndromes of vascular dementia (SDSVD) (WMD: - 2.15; 95 % CI: - 4.14 to - 0.16; P = 0.034), and National Institutes of Health stroke scale (NIHSS) (WMD: - 3.90; 95 % CI: - 4.87 to - 2.94; P < 0.001). CONCLUSIONS Acupuncture is probably helpful in vascular stroke, but strong supportive data are not yet available. Acupuncture should be used cautiously, owing to the analysis of this study based on low to moderate evidence. Further high-quality, large-scale RCTs should be conducted.
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Affiliation(s)
- Yinghua Chen
- The Fifth Department of Acupuncture, The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China
| | - Haoyu Wang
- The Fifth Department of Acupuncture, The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China
| | - Zhongren Sun
- Heilongjiang University of Chinese Medicine, Harbin 150040, China.
| | - Xiaoqing Su
- The Fifth Department of Acupuncture, The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China
| | - Ruiqi Qin
- The Fifth Department of Acupuncture, The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China
| | - Junfeng Li
- Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Wei Sun
- Heilongjiang University of Chinese Medicine, Harbin 150040, China
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Tran TP, Nguyen DC, Dang TVQ, Tran TK, Vu PT, Vu MH, Le TH, Saw TN, Cho SM, Kariya T, Yamamoto E, Hamajima N, Saw YM. Development of a Vietnamese version of the Revised Hasegawa's Dementia scale. NAGOYA JOURNAL OF MEDICAL SCIENCE 2022; 84:402-417. [PMID: 35967950 PMCID: PMC9350578 DOI: 10.18999/nagjms.84.2.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/06/2021] [Indexed: 12/05/2022]
Abstract
As the aging population grows worldwide, the problem of age-related health is becoming an important public health concern. Dementia is a devastating disease that places a significant physical, emotional, and financial burden on patients, their caregivers, and society. It is predicted to increase in developing countries. The Revised Hasegawa's Dementia Scale (HDS-R) has been used in many Asian countries to measure cognitive function. However, there is still no Vietnamese version of the HDS-R. Therefore, this paper describes the development of the HDS-R scale and manual in Vietnamese language. Two Vietnamese researchers translated the HDS-R from English to Vietnamese. To confirm the accuracy of the translation, two other Vietnamese researchers conducted a back-translation. Another pair of Vietnamese researchers compared the back-translated English version to the original one. All six researchers discussed the inconsistencies between English HDS-R scale and manual and derived the most suitable version for the Vietnamese context. In Questions 4 and Question 7, we changed the words from "cherry blossom" and "train" to "daisy flower" and "bicycle" for the first option, and from "plum blossom" to "rose" for the second option. We also changed the expressions in some places in the manual to fit the Vietnamese language. Future studies are needed to validate this version to be able to access cognitive function in both clinical and public healthcare settings.
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Affiliation(s)
- Thi Phuong Tran
- Department of Epidemiology, Faculty of Public Health, Thaibinh University of Medicine and Pharmacy, Thaibinh, Vietnam
| | - Duy Cuong Nguyen
- Department of Emergency Resuscitation, Thaibinh University of Medicine and Pharmacy, Thaibinh, Vietnam
| | - Thi Van Quy Dang
- Department of Environmental Health, Faculty of Public Health, Thaibinh University of Medicine and Pharmacy, Thaibinh, Vietnam
| | - Thi Khuyen Tran
- Department of Epidemiology, Faculty of Public Health, Thaibinh University of Medicine and Pharmacy, Thaibinh, Vietnam
| | - Phong Tuc Vu
- Department of Environmental Health, Faculty of Public Health, Thaibinh University of Medicine and Pharmacy, Thaibinh, Vietnam
| | - Minh Hoang Vu
- Department of Dentomaxillofacial, Thaibinh University of Medicine and Pharmacy, Thaibinh, Vietnam
| | - Thu Hang Le
- Department of Testing and Educational Quality Assurance, Thaibinh University of Medicine and Pharmacy, Thaibinh, Vietnam
| | - Thu Nandar Saw
- Department of Community and Global Health, the University of Tokyo, Tokyo, Japan
| | - Su Myat Cho
- Department of Community and Global Health, the University of Tokyo, Tokyo, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Yu Mon Saw
- Department of Community and Global Health, the University of Tokyo, Tokyo, Japan
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Chen X, Yang J, Zhang H, Huang Y, Cao Y, Yan S, Zong G, Zheng Y, Wang X, Yuan C. Plasma folate levels in relation to cognitive impairment: a community-based cohort of older adults in China. Eur J Nutr 2022; 61:2837-2845. [PMID: 35303753 DOI: 10.1007/s00394-022-02825-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/04/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE Lower plasma level of folate has been associated with an increased risk of age-related cognitive impairment. However, studies that examined this relation have yielded mixed results. We aimed to examine the prospective association of plasma folate level with risk of cognitive impairment in a community-based prospective cohort of older adults in China. METHODS This study included 615 participants (mean age: 76.3 years) without baseline cognitive impairment from the Rugao Longevity and Ageing Study (RuLAS). We used logistic regression to examine the prospective association between baseline plasma folate and risk of cognitive impairment in the next two years. Fasting blood samples were collected and assayed for plasma folate level at baseline. Cognitive impairment was defined as Hasegawa Dementia Scale (HDS) score ≤ 21.5 points. RESULTS During two years' follow-up, 20.7% of the participants developed cognitive impairment. After controlled for age, gender, and plasma homocysteine, a higher level of plasma folate was associated with lower odds of cognitive impairment. The corresponding odds ratio (OR) with 95% confidence interval was 0.41 (0.19-0.89) comparing participants at extreme quintiles of plasma folate (median level 17.2 vs. 6.3 nmol/L). The associations were similar after further adjustment for major demographic and lifestyle factors (OR = 0.42, 0.18-0.98). Moreover, the inverse association was particularly stronger among males (OR = 0.12, 0.03-0.52) but was non-significant among females. CONCLUSION Our findings support a potential beneficial role of higher plasma folate levels in cognitive function in older Chinese adults, particularly among males. Future studies with larger sample size and longer follow-up are warranted to confirm these findings and to identify the optimal plasma folate level for cognitive function.
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Affiliation(s)
- Xiao Chen
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jiaxi Yang
- Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hui Zhang
- Human Phenome Institute, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuhui Huang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yaying Cao
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Shiyu Yan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Geng Zong
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China
| | - Xiaofeng Wang
- Human Phenome Institute, Fudan University, Shanghai, China. .,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
| | - Changzheng Yuan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. .,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Fujii T, Wada M, Hasebe S, Takeuchi K, Yorozuya T, Yakushijin Y. Treatment and prognosis of patients with both cancer and impaired decision-patient with both cancer and dementia making as a symptom of dementia. Geriatr Gerontol Int 2021; 21:1105-1110. [PMID: 34652052 DOI: 10.1111/ggi.14292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 09/02/2021] [Accepted: 09/18/2021] [Indexed: 11/30/2022]
Abstract
AIM In our aging society, the number of patients with both cancer and dementia has recently been increasing. One of the major clinical questions is whether patients with dementia could receive appropriate cancer treatment. The purpose of this study is to know the prognosis of patients with both cancer and impaired decision-making as a symptom of dementia, and to discuss the proper cancer treatment of the patients with dementia. METHODS Patients newly diagnosed with both cancer and impaired decision-making as a symptom of dementia at Ehime University Hospital between January 2010 and December 2016 were reviewed. The data of patients with cancer were retrospectively analyzed using an electronic medical record system. RESULTS In total, 9354 cases were diagnosed with cancer in the Ehime University Hospital over 7 years, and only 105 (1.1%) cases with impaired decision-making as a symptom of dementia were recorded by medical professionals, probably due to poor attention to the cognitive functions of patients with cancer. Analysis of the cancer prognosis of these patients showed that a better prognosis was seen in patients with any therapeutic interventions than in those with no treatment for the cancer itself. However, the prognosis of patients was not significantly different between standard and non-standard treatments. CONCLUSIONS This study suggests that the poor interest of medical professionals in the cognitive function of patients with cancer at the time of diagnosis of cancer and the lack of any guidelines for patients with both cancer and dementia are major problems in our aging society. Geriatr Gerontol Int 2021; 21: 1105-1110.
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Affiliation(s)
- Tomomi Fujii
- Palliative Care Center, Ehime University Hospital, Toon, Japan.,Department of Clinical Oncology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Michiko Wada
- Department of Clinical Oncology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Shinji Hasebe
- Department of Clinical Oncology, Ehime University Graduate School of Medicine, Toon, Japan.,Cancer Center, Ehime University Hospital, Toon, Japan
| | - Kazuto Takeuchi
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Tobe-cho, Japan
| | - Toshihiro Yorozuya
- Departments of Anesthesia and Perioperative Medicine, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yoshihiro Yakushijin
- Department of Clinical Oncology, Ehime University Graduate School of Medicine, Toon, Japan.,Cancer Center, Ehime University Hospital, Toon, Japan
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6
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Wittich W, Pichora-Fuller MK, Johnson A, Joubert S, Kehayia E, Bachir V, Aubin G, Jaiswal A, Phillips N. Effect of Reading Rehabilitation for Age-Related Macular Degeneration on Cognitive Functioning: Protocol for a Nonrandomized Pre-Post Intervention Study. JMIR Res Protoc 2021; 10:e19931. [PMID: 33704074 PMCID: PMC7995070 DOI: 10.2196/19931] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/24/2020] [Accepted: 02/24/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Age-related vision impairments and dementia both become more prevalent with increasing age. Research into the mechanisms of these conditions has proposed that some of their causes (eg, macular degeneration/glaucoma and Alzheimer's disease) could be symptoms of an underlying common cause. Research into sensory-cognitive aging has provided data that sensory decline may be linked to the progression of dementia through reduced sensory stimulation. While hearing loss rehabilitation may have a beneficial effect on cognitive functioning, there are no data available on whether low vision rehabilitation, specifically for reading, could have a beneficial effect on cognitive health. OBJECTIVE The research questions are: (1) Does low vision rehabilitation reduce reading effort? (2) If so, does reduced reading effort increase reading activity, and (3) If so, does increased reading activity improve cognitive functioning? The primary objective is to evaluate cognition before, as well as at 6 months and 12 months after, 3 weeks of low vision reading rehabilitation using magnification in individuals with age-related macular degeneration, with or without coexisting hearing impairments. We hypothesize that improvements postrehab will be observed at 6 months and maintained at 12 months for participants with vision loss and less so for those with dual sensory loss. The secondary objective is to correlate participant characteristics with all cognitive outcomes to identify which may play an important role in reading rehabilitation. METHODS We employ a quasiexperimental approach (nonrandomized, pre-post intervention study). A 3x3 design (3 groups x 3 time points) allows us to examine whether cognitive performance will change before and after 6 months and 12 months of a low vision reading intervention, when comparing 75 low vision and 75 dual sensory impaired (vision & hearing) participants to 75 age-matched healthy controls. The study includes outcome measures of vision (eg, reading acuity and speed), cognition (eg, short-term and long-term memory, processing speed), participant descriptors, demographics, and clinical data (eg, speech perception in noise, mental health). RESULTS The study has received approval, and recruitment began on April 24, 2019. As of March 4, 2021, 38 low vision and 7 control participants have been enrolled. Lockdown forced a pause in recruitment, which will recommence once the COVID-19 crisis has reached a point where face-to-face data collection with older adults becomes feasible again. CONCLUSIONS Evidence of protective effects caused by reading rehabilitation will have a considerable impact on the vision rehabilitation community and their clients as well as all professionals involved in the care of older adults with or without dementia. If we demonstrate that reading rehabilitation has a beneficial effect on cognition, the demand for rehabilitation services will increase, potentially preventing cognitive decline across groups of older adults at risk of developing macular degeneration. TRIAL REGISTRATION ClinicalTrials.gov NCT04276610; Unique Protocol ID: CRIR-1284-1217; https://clinicaltrials.gov/ct2/show/NCT04276610. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19931.
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Affiliation(s)
- Walter Wittich
- School of Optometry, Université de Montréal, Montreal, QC, Canada.,Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada.,Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada.,Department of Psychology, Concordia University, Montreal, QC, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | | | - Aaron Johnson
- Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada.,Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Sven Joubert
- Department of Psychology, Université de Montréal, Montreal, QC, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Eva Kehayia
- Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Vanessa Bachir
- School of Optometry, Université de Montréal, Montreal, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada
| | - Gabrielle Aubin
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada.,Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada.,Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Atul Jaiswal
- School of Optometry, Université de Montréal, Montreal, QC, Canada.,Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada
| | - Natalie Phillips
- Department of Psychology, Concordia University, Montreal, QC, Canada
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Frailty index is associated with increased risk of elevated BNP in an elderly population: the Rugao Longevity and Ageing Study. Aging Clin Exp Res 2020; 32:305-311. [PMID: 31004283 DOI: 10.1007/s40520-019-01189-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 04/01/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS To explore whether frailty, defined by frailty index (FI), is associated with the risk of elevated B-type natriuretic peptide (BNP), a surrogate endpoint of cardiovascular events. METHODS Data of 1382 community-dwelling elders who had no documented cardiovascular diseases aged 70-84 years from the ageing arm of the Rugao Longevity and Ageing Study was used. Traditional risk factor index (TI) was constructed using eight established cardiovascular-related risk factors. FI was constructed using 36 health deficits. Elevated BNP was defined as BNP ≥ 100pg/mL. Cardiovascular events include incident major cardiovascular events and cardiovascular death. RESULTS During a 3-year follow-up period, 97 participants had cardiovascular events. TI was not associated with the risk of elevated BNP, but was associated with cardiovascular events (HR = 1.16, 95% CI 1.01-1.34). Frailty index was not only associated with cardiovascular events (HR = 1.32, 95% CI 1.06-1.64), but also associated with elevated BNP with an OR of 1.22 (95% CI 1.02-1.47) for each 0.1 increment. Further, both frailty (OR = 1.93, 95% CI 1.67-3.17) and pre-frailty (OR = 1.54, 95% CI 1.06-2.25) were associated with increased risk of elevated BNP. CONCLUSION FI is associated with increased risks of both cardiovascular events and surrogated endpoint of cardiovascular disease-elevated BNP. Frailty may be a non-traditional risk factor of cardiovascular diseases and frailty index may be a measurement for early identifying high risk elderly individuals of cardiovascular abnormities.
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Kounnavong S, Ratsavong K, Soundavong K, Xayavong S, Kariya T, Saw YM, Yamamoto E, Horibe K, Toba K, Hamajima N. Cognitive function measured with the Revised Hasegawa's Dementia Scale among elderly individuals in Lao PDR. NAGOYA JOURNAL OF MEDICAL SCIENCE 2019; 81:281-290. [PMID: 31239596 PMCID: PMC6556450 DOI: 10.18999/nagjms.81.2.281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In Lao PDR, measurement of cognitive function has rarely been conducted among elderly individuals. This study aimed to investigate the cognitive function among elderly individuals who lived at their homes with family in Lao PDR. Participants were elderly individuals aged 60 years or over registered with the local government in urban (Vientiane capital; VC) and rural areas (Khammouane province; KP). Those with serious mental/physical diseases, those who could not walk by themselves, or those who could not speak the Lao language were excluded. The information was collected through interviews with the participants and their family members. A newly developed Lao version of the Revised Hasegawa’s Dementia Scale (HDS-R) was applied to measure cognitive function. The participants were 414 elderly individuals (224 males and 190 females) aged 60 to 98 years. The average HDS-R score was 23.0 among 115 men in VC, 22.7 among 92 women in VC, 20.3 among 109 men in KP, and 17.5 among 98 women in KP. The main caregiver was a daughter (40.6%) followed by a spouse (31.4%). Among 414 elderly individuals, 42 (10.0%) stated the necessity of support. Those with HDS-R < 20 accounted for 38.8% in men and 48.9% in women. The adjusted odds ratio of HDS-R < 20 was significant for those in rural areas (3.83) relative to those in urban areas. Among superficially healthy elderly individuals residing with their families, those with reduced cognitive function were more common among women and in rural areas.
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Affiliation(s)
- Sengchanh Kounnavong
- Lao Tropical and Public Health Institute, Ministry of Health, Vientiane, Lao PDR
| | - Kethmany Ratsavong
- Lao Tropical and Public Health Institute, Ministry of Health, Vientiane, Lao PDR
| | | | - Syda Xayavong
- Lao Tropical and Public Health Institute, Ministry of Health, Vientiane, Lao PDR
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kentaro Horibe
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Toba
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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9
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Saw YM, Than TM, Win EM, Cho SM, Khaing M, Latt NN, Aung ZZ, Oo N, Aye HNN, Kariya T, Yamamoto E, Hamajima N. Myanmar language version of the Revised Hasegawa's Dementia Scale. NAGOYA JOURNAL OF MEDICAL SCIENCE 2019; 80:435-450. [PMID: 30587859 PMCID: PMC6295428 DOI: 10.18999/nagjms.80.4.435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Reduced cognitive function among the elderly is an important issue not only in developed countries, but also in developing countries. As a test to measure cognitive function, the Revised Hasegawa’s Dementia Scale (HDS-R) has been used in Asian countries including Japan, Korea, and China. Since there was no HDS-R version in Myanmar language, a questionnaire and manual for the HDS-R were developed. The translation from English to Myanmar language was done by two Myanmar researchers. Back-translation was conducted to confirm the accuracy of the translation by two other Myanmar researchers. Back-translated English was compared to the original by two Japanese researchers, and inconsistencies were discussed by all six researchers to reach consensus. Five Myanmar researchers independently read the questionnaire and manual to verify the expressions are familiar in Myanmar language. The modified points were as follows. 1) The date order in Question 2 is day/month/year. 2) The words to be memorized in Questions 4 and 7 are padauk tree, cat, and bullock cart for the first set, and tamarind tree, dog, and car for the second set. 3) The objects to be memorized in Question 8 are shown with pictures, not actual objects. 4) Like the Lao version, we introduced two new rules; a clear time definition for no reply (10 seconds), and repeating questions twice for those with hearing problems. The revised version of the HDS-R has been prepared to be an applicable standard questionnaire for use on assessment of cognitive function in suspected dementia cases in Myanmar, both in the clinical and public healthcare setting.
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Affiliation(s)
- Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Thet Mon Than
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, The Republic of the Union of Myanmar
| | - Ei Mon Win
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, The Republic of the Union of Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Moe Khaing
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, The Republic of the Union of Myanmar
| | - Nyi Nyi Latt
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Aung Myin Myint Mo Hospital, Gyobingauk, The Republic of the Union of Myanmar
| | - Zaw Zaw Aung
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, The Republic of the Union of Myanmar
| | - Nwe Oo
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, The Republic of the Union of Myanmar
| | - Hnin Nwe Ni Aye
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Mandalay Regional Public Health Department, Ministry of Health and Sports, Nay Pyi Taw, The Republic of the Union of Myanmar
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Kounnavong S, Soundavong K, Xayavong S, Vongpraserth N, Bounsavath P, Houatthongkham S, Phoummalaysith B, Saw YM, Yamamoto E, Toba K, Hamajima N. Lao language version of the Revised Hasegawa's Dementia Scale. NAGOYA JOURNAL OF MEDICAL SCIENCE 2018. [PMID: 28626259 PMCID: PMC5472549 DOI: 10.18999/nagjms.79.2.241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
With the aging of society, the number of elderly with reduced cognitive function has been increasing worldwide. As a test to measure the cognitive function, the Revised Hasegawa’s Dementia Scale (HDS-R) has been used in Japan, Korea, and China. Since there was no HDS-R version for Laotians, the questionnaire and manual were developed through the cooperation of Lao and Japanese researchers. Back-translation was conducted to confirm the accuracy of the translation. The score on the 9-item HDS-R ranges 0 to 30 points, and reduced cognitive function is usually defined as a score of 20 points or lower. After receiving explanation regarding the use of the tool and practicing its implementation, 3 female doctors interviewed 30 superficially healthy volunteers aged 31 to 84 years (12 males and 18 females) who lived with his/her family in Vientiane Capital, Lao PDR. Their score distributed from 4 to 30 points, with an average of 24.7 (standard deviation 5.4) points. Six (20.0%) participants scored 20 points or lower. The discussion before and after the pilot interviews revealed that the following changes needed to be made in accordance to the culture of Lao people; 1) order of date in Question 2, 2) words to be memorized in Questions 4 and 7, 3) objects to be memorized using pictures, not actual objects, in Question 8. Additionally, we introduced new two rules; a clear time definition for no reply (10 seconds), and repetition of questions twice for those with ear problems. The revised version of the HDS-R was thought to be an appropriate standard questionnaire for use in studies on cognitive function among Laotians.
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Affiliation(s)
| | | | - Syda Xayavong
- National Institute of Public Health, Ministry of Health, Vientiane, Lao PDR
| | | | - Phongsavang Bounsavath
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Bounfeng Phoummalaysith
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,National Health Insurance Bureau, Ministry of Health, Vientiane, Lao PDR
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Toba
- National Health Insurance Bureau, Ministry of Health, Vientiane, Lao PDR
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Maeda N, Honda H, Suzuki SO, Fujii N, Kira JI, Iwaki T. Mitochondrial dysfunction and altered ribostasis in hippocampal neurons with cytoplasmic inclusions of multiple system atrophy. Neuropathology 2018; 38:361-371. [PMID: 29961958 DOI: 10.1111/neup.12482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 04/30/2018] [Accepted: 05/01/2018] [Indexed: 11/30/2022]
Abstract
Multiple system atrophy (MSA) is a sporadic adult-onset neurodegenerative disease. It has recently been shown that patients with MSA accompanied by cognitive decline display numerous neuronal cytoplasmic inclusions (NCIs) in the limbic neurons. We examined potential mechanisms underlying the formation of these NCIs by determining of mitochondrial function and statuses of RNA processing by analyzing 12 pathologically confirmed cases of MSA. Among them, four had cognitive impairment Semiquantitative evaluation using immunohistochemistry analyses revealed a significantly greater NCI burden in the hippocampal cornu ammonis 1 (CA1) subfield, subiculum, and amygdala in the cases with cognitive impairments compared with those without cognitive impairment. Immunofluorescent staining revealed that limbic neurons with NCIs often accelerated production of reactive oxygen species (ROS) and degraded mitochondrial quality control. Immunofluorescent staining also revealed that neurons with these NCIs translocated heterogeneous nuclear ribonucleoprotein A1 (HNRNPA1) from the nucleus and aggregated abnormally at the perinuclear rim. Since the NCIs in the hippocampal neurons of MSA with cognitive impairments were more numerous, the neuronal mitochondrial dysfunction and altered ribostasis observed in NCI formation may be involved in the hippocampal degeneration of MSA.
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Affiliation(s)
- Norihisa Maeda
- Department of Neuropathology, Kyushu University, Fukuoka, Japan
- Department of Neurology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Honda
- Department of Neuropathology, Kyushu University, Fukuoka, Japan
| | | | - Naoki Fujii
- Department of Neurology, Neuro-Muscular Center, National Omuta Hospital, Fukuoka, Japan
| | - Jun-Ichi Kira
- Department of Neurology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toru Iwaki
- Department of Neuropathology, Kyushu University, Fukuoka, Japan
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12
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Cognitive screening tools for identification of dementia in illiterate and low-educated older adults, a systematic review and meta-analysis. Int Psychogeriatr 2017; 29:897-929. [PMID: 28274299 DOI: 10.1017/s1041610216001976] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The majority of older adults with dementia live in low- and middle-income countries (LMICs). Illiteracy and low educational background are common in older LMIC populations, particularly in rural areas, and cognitive screening tools developed for this setting must reflect this. This study aimed to review published validation studies of cognitive screening tools for dementia in low-literacy settings in order to determine the most appropriate tools for use. METHOD A systematic search of major databases was conducted according to PRISMA guidelines. Validation studies of brief cognitive screening tests including illiterate participants or those with elementary education were eligible. Studies were quality assessed using the QUADAS-2 tool. Good or fair quality studies were included in a bivariate random-effects meta-analysis and a hierarchical summary receiver operating characteristic (HSROC) curve constructed. RESULTS Forty-five eligible studies were quality assessed. A significant proportion utilized a case-control design, resulting in spectrum bias. The area under the ROC (AUROC) curve was 0.937 for community/low prevalence studies, 0.881 for clinic based/higher prevalence studies, and 0.869 for illiterate populations. For the Mini-Mental State Examination (MMSE) (and adaptations), the AUROC curve was 0.853. CONCLUSION Numerous tools for assessment of cognitive impairment in low-literacy settings have been developed, and tools developed for use in high-income countries have also been validated in low-literacy settings. Most tools have been inadequately validated, with only MMSE, cognitive abilities screening instrument (CASI), Eurotest, and Fototest having more than one published good or fair quality study in an illiterate or low-literate setting. At present no screening test can be recommended.
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13
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Abstract
BACKGROUND The prevalence of dementia is increasing in Asia than in any other continent. However, the applicability of the existing cognitive assessment tools is limited by differences in educational and cultural factors in this setting. We conducted a systematic review of published studies on cognitive assessments tools in Asia. We aimed to rationalize the results of available studies which evaluated the validity of cognitive tools for the detection of cognitive impairment and to identify the issues surrounding the available cognitive impairment screening tools in Asia. METHODS Five electronic databases (CINAHL, MEDLINE, Embase, Cochrane Library, and Science Direct) were searched using the keywords dementia Or Alzheimer Or cognitive impairment And screen Or measure Or test Or tool Or instrument Or assessment, and 2,381 articles were obtained. RESULTS Thirty-eight articles, evaluating 28 tools in seven Asian languages, were included. Twenty-nine (76%) of the studies had been conducted in East Asia with only four studies conducted in South Asia and no study from northern, western, or central Asia or Indochina. Local language translations of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were assessed in 15 and six studies respectively. Only three tools (the Korean Dementia Screening Questionnaire, the Picture-based Memory Intelligence Scale, and the revised Hasegawa Dementia Screen) were derived de novo from Asian populations. These tools were assessed in five studies. Highly variable cut-offs were reported for the MMSE (17-29/30) and MoCA (21-26/30), with 13/19 (68%) of studies reporting educational bias. CONCLUSIONS Few cognitive assessment tools have been validated in Asia, with no published validation studies for many Asian nations and languages. In addition, many available tools display educational bias. Future research should include concerted efforts to develop culturally appropriate tools with minimal educational bias.
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Validation of the General Practitioner Assessment of Cognition - Chinese version (GPCOG-C) in China. Int Psychogeriatr 2013; 25:1649-57. [PMID: 23835084 DOI: 10.1017/s1041610213001117] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND To assess the reliability, validity, and diagnostic utility of the Chinese version of General Practitioner Assessment of Cognition (GPCOG-C). The GPCOG, which is specifically designed for use in primary care to screen for cognitive impairment, consists of a patient section testing cognition, and an informant section asking about decline in cognitive and functional abilities. METHODS The English version of GPCOG was translated, back-translated, and subsequently revised to determine the final GPCOG-C. Our sample comprised 253 community-dwelling volunteers with memory concerns aged 50 years and over and 103 outpatients of a psychogeriatric clinic with memory complaints. Participants were assessed by one of the four general practitioners or six psychogeriatricians. The Mini-Mental State Examination (MMSE), the Hasegawa's Dementia Scale (HDS), and the GPCOG-C were compared against the DSM-IV-defined dementia diagnosis. RESULTS The internal consistency (Cronbach's α) was 0.68 for the GPCOG patient section. The test-retest was 0.98 for the GPCOG-C total. The sequential administration of both components of GPCOG-C had a sensitivity of 97% and a specificity of 89%, with a positive predictive value of 72% and a negative predictive value of 99%. Both the GPCOG-C total and sequential two-stage scoring methods performed at least well as the MMSE and HDS in detecting dementia. The administration time for the two-stage approach was 4.3 ± 2.4 min. CONCLUSIONS The GPCOG-C is a valid, time efficient instrument for dementia screening in China.
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15
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Suzuki Y, Urashima M, Izumi M, Ito Y, Uchida N, Okada S, Ono H, Orimo S, Kohri T, Shigoka H, Shintani S, Tanaka Y, Yoshida A, Ijima M, Ito T, Endo T, Okano H, Maruyama M, Iwase T, Kikuchi T, Kudo M, Takahashi M, Goshi S, Mikami T, Yamashita S, Akiyama K, Ogawa T, Ogawa T, Ono S, Onozawa S, Kobayashi J, Matsumoto M, Matsumoto T, Jomoto K, Mizuhara A, Nishiguchi Y, Nishiwaki S, Aoki M, Ishizuka I, Kura T, Murakami M, Murakami A, Ohta T, Onishi K, Nakahori M, Tsuji T, Tahara K, Tanaka I, Kitagawa K, Shimazaki M, Fujiki T, Kusakabe T, Iiri T, Kitahara S, Horiuchi A, Suenaga H, Washizawa N, Suzuki M. The Effects of Percutaneous Endoscopic Gastrostomy on Quality of Life in Patients With Dementia. Gastroenterology Res 2012; 5:10-20. [PMID: 27785173 PMCID: PMC5051036 DOI: 10.4021/gr392w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2012] [Indexed: 12/11/2022] Open
Abstract
Background To examine the effects of percutaneous endoscopic gastrostomy (PEG) on quality of life (QOL) in patients with dementia. Methods We retrospectively included 53 Japanese community and tertiary hospitals to investigate the relationship between the newly developed PEG and consecutive dementia patients with swallowing difficulty between Jan 1st 2006 and Dec 31st 2008. We set improvements in 1) the level of independent living, 2) pneumonia, 3) peroral intake as outcome measures of QOL and explored the factors associated with these improvements. Results Till October 31st 2010, 1,353 patients with Alzheimer’s dementia (33.1%), vascular dementia (61.7%), dementia with Lewy body disease (2.0%), Pick disease (0.6%) and others were followed-up for a median of 847 days (mean 805 ± 542 days). A total of 509 deaths were observed (mortality 59%) in full-followed patients. After multivariate adjustments, improvement in the level of independent living was observed in milder dementia, or those who can live independently with someone, compared with advanced dementia, characterized by those who need care by someone: Odds Ratio (OR), 3.90, 95% confidence interval (95%CI), 1.59 - 9.39, P = 0.003. Similarly, improvement of peroral intake was noticed in milder dementia: OR, 2.69, 95%CI, 1.17 - 6.17, P = 0.02. Such significant associations were not observed in improvement of pneumonia. Conclusions These results suggest that improvement of QOL after PEG insertion may be expected more in milder dementia than in advanced dementia.
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Affiliation(s)
- Yutaka Suzuki
- Department of Surgery, International University of Health and Welfare Hospital 537-3 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan
| | - Mitsuyoshi Urashima
- Department of Molecular Epidemiology, Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masaki Izumi
- Department of Internal Medicine, Tokyo-Musashino Hospital, 4-11-11 Komone, Itabashi-ku, Tokyo, 173-0037, Japan
| | - Yasuhiko Ito
- Suzuki Internal Medicine Clinic, 4-5-43 Heiwadai, Nagareyama-shi, Chiba, 270-0157, Japan
| | - Nobuyuki Uchida
- Department of Surgery, Haramachi Red-Cross Hospital, 698 Haramachi, Higashi-Agatsuma-machi, Gunma, 377-0882, Japan
| | - Shingo Okada
- Department of Surgery, Kitamihara Clinic, 18-350 Ishikawa-cho, Hakodate-shi, Hokkaido, 041-0802, Japan
| | - Hiromi Ono
- Department of Internal Medicine, Seiwa Memorial Hospital, 5-1-1 Kotoni1,Nishi-ku, Sapporo-shi, Hokkaido, 063-0811, Japan
| | - Satoshi Orimo
- Department of Neurology, Kanto Central Hospital, 6-25-1 Kami-Yoga, Setagaya-ku, Tokyo, 158-8531, Japan
| | - Takayuki Kohri
- Department of Surgery, Tone chuou hospital, 1855-1 Higashiharashinmachi, Numata-shi, Gunma, 378-005, Japan
| | - Hiroaki Shigoka
- Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan
| | - Shuzo Shintani
- Department of Neurology, JA Toride Medical Center, 2-1-1 Hongoh, Toride City, Ibaraki, 302-0022, Japan
| | - Yukiko Tanaka
- The Internal Department, Uchida hospital, 345-1 Kuyahara, Numata-shi, Gunma, 378-0005, Japan
| | - Atsushi Yoshida
- Center for Digestive and Liver Diseases, Ohfuna Chuo Hospital, 6-2-24 Ohfuna, Kamakura, Kanagawa, 247-0056, Japan
| | - Masashi Ijima
- Department of Internal Medicine, Isesaki Municipal Hospital, 12-1 Tsunatorihonmachi, Isesaki-shi, Gunma, 372-0812, Japan
| | - Toru Ito
- Department of Surgery, Nakamura Memorial Hospital, Nishi-14,Minami-1,Chuo-ku, Sapporo-shi, Hokkaido, 060-8570, Japan
| | - Takao Endo
- Department of Gastroenterology, Sapporo Shirakaba-dai hospital, 2-18-7-26 Tukisamu-Higash,Toyohira-ku, Sapporo-shi, Hokkaido, 062-0052, Japan
| | - Hitoshi Okano
- Department of Gastroenterology, Okano clinic, 3 Higashida-cho,Jodoji, Sakyo-ku, Kyoto-shi, Kyoto, 606-8411, Japan
| | - Michio Maruyama
- Deaprtment of Surgery, Tokyo Metropolitan Ohkubo Hospital, 2-44-1 Kabukicho, Sinnjyukuku, Tokyo, 160-8488, Japan
| | - Tsuyoshi Iwase
- Department of Internal medicine, Kyoto kujo hospial, 10 Karahashi Rajomon-cho Minami-ku, Kyoto-shi, Kyoto, 601-8485, Japan
| | - Tsutomu Kikuchi
- Department of Surgery, Kanazawa Nishi Hospital, 6-15-41 Ekinishihonmachi, Kanazawa-shi, Ishikawa, 920-0025, Japan
| | - Michiaki Kudo
- Department of Surgery, Onishi Hospital, 139-1 Onishi, Fujika-shi, Gunma, 370-1401, Japan
| | - Mikako Takahashi
- Department of Internal Medicine, Tsuruika Kyouritsu Hospotal, 9-34 Fumizono-cho, Tsuruoka-shi, Yamagata, 997-0816, Japan
| | - Satoshi Goshi
- Department of Gastroenterology and Hepatology, Japan Agricultural Cooperatives of Niigata Joetsu General Hospital, 148-1 Daidoufukuda, Joetsu-shi, Niigata, 943-8507, Japan
| | - Tatsuya Mikami
- Department of Gastroenterology, Hirosaki Municipal Hospital, 1-8-3 Ohmachi, Hirosaki- shi, Aomori, 036-8004, Japan
| | - Satoyoshi Yamashita
- Department of Gastroenterology, Social Insurance Shimonoseki Welfare Hospital, 3-3-8 Kamishinchi, Shimonoseki-shi, Yamaguchi, 750-0061, Japan
| | - Kazuhiro Akiyama
- Department of Surgery, Tokatsu-clinic Hospital, 865-2 Hinokuchi, Matsudo-shi, Chiba, 271-0067, Japan
| | - Tetsushi Ogawa
- Department of Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-cho, Maebashi-shi, Gunma, 371-0014, Japan
| | - Tomoko Ogawa
- Department of Neurology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara-shi, Tochigi, 329-2763, Japan
| | - Shigeki Ono
- Department of Gastroenterology, Ako City Hospital, 1090 Nakahiro, Ako-shi, Hyogo, 678-0232, Japan
| | - Shigeru Onozawa
- Department of HomeCareMedicine, Kameda Medical Center, 929 Higashicho, Kamogawa-shi, Chiba, 292-8601, Japan
| | - Junya Kobayashi
- Department of Surgery, Fujiyoshida Municipal Hospital, 6530 Kamiyoshida, Fujiyoshida-shi, Yamanashi, 403-0005, Japan
| | - Masami Matsumoto
- Department of Internal Medicine, Nara Prefectural Gojo Hospital, 5-2-59 Noharanishi, Gojo-shi, Nara, 637-8511, Japan
| | - Toshifumi Matsumoto
- Department of Surgery, National Hospital Organization Beppu Medical Center, 1473 Uchikamado, Beppu, Oita, 874-0011, Japan
| | - Kazuaki Jomoto
- Director, Jomoto Gastroenteric & Internal Medical Clinic, 5-8-9 Kuhonnji, Kumamoto-shi, Kumamoto, 862-0976, Japan
| | - Akihiro Mizuhara
- Department of Cardiology and Vascular Surgery, Higashi-Washinomiya Hospital, 3-9-3 Sakurada, Kuki-shi, Saitama, 340-0203, Japan
| | - Yukio Nishiguchi
- Department of Gastro-enterological Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-Hondori Miyakojima-ku, Osaka-shi, Osaka, 534-0021, Japan
| | - Shinji Nishiwaki
- Department of Internal Medicine, Nishimino Kosei Hospital, 986 Oshikoshi, Yoro-gun Yoro-cho, Gifu, 503-1394, Japan
| | - Masahiko Aoki
- Department of Surgery, Ohtawara Red Cross Hospital, 2-7-3 Sumiyoshi-cho, Ohtawara-shi, Tochigi, 324-8686, Japan
| | - Izumi Ishizuka
- Department of Internal medicine, Kohka Public Hospital, 3-39 Rokushin,Minakuchi-cho, Kohka-shi, Shiga, 528-0014, Japan
| | - Toshiroh Kura
- Department of Gastroenterology, Naganuma Municipal Hospital, 2-2-1 Chuo-minami,Naganuma-cho, Yubari-gun, Hokkaido, 069-1332, Japan
| | - Masato Murakami
- Department of Internal Medicine, Murakami Memorial Hospital, 739 Oomachi, Saijo-shi, Ehime, 793-0030, Japan
| | - Akihiko Murakami
- Endoscopy unit, Iwate prefectural central Hospital, 1-4-1 ueda, Morioka-shi, Iwate, 020-0066, Japan
| | - Tomoyuki Ohta
- Center for Gastroenterology, Sapporo Higashi-Tokushukai Hospital, 3-1 North33-East14,Higashi-ku, Sapporo-shi, Hokkaido, 065-0033, Japan
| | - Koji Onishi
- Internal Medicine, Matsue Seikyo General Hospital, 8-8-8 Nishitsuda, Matsue-shi, Shimane, 690-8522, Japan
| | - Masato Nakahori
- Digestive Endoscopy Center, Sendai Kousei Hospital, 4-8 Hirose-machi,Aoba-ku, Sendai-shi, Miyagi, 980-0873, Japan
| | - Tsuyotoshi Tsuji
- Department of Gastroenterology, Akita City Hospital, 4-30 Kawamotomatsuoka-cho, Akita-shi, Akita, 010-0933, Japan
| | - Ko Tahara
- Department of Surgery, Kure Kyosai Hospital, 2-3-28 Nishichuou, Kure-shi, Hiroshima, 737-8505, Japan
| | - Ikuta Tanaka
- Department of Gastroenterology, Japan Red Cross Date General Hospital, 81 Suenaga, Date-shi, Hokkaido, 052-8511, Japan
| | - Kazuhiko Kitagawa
- Department of Surgery, Tsuchida Hospital, 2-11,South-21,West-9,Chuo-ku, Sapporo-shi, Hokkaido, 064-0921, Japan
| | - Makoto Shimazaki
- Department of Gastroenterology, Hirano General Hospital, 176-5 Kurono, Gifu-shi, Gifu, 501-1192, Japan
| | - Takanori Fujiki
- Department of Gastroenterology, Japanese Red Cross Society Shimizu Hospital, 2-2 minami,Shimizu-cho, Kamikawa-gun, Hokkaido, 089-0195, Japan
| | - Toshiro Kusakabe
- Department of Gastroenterology, Higashi Sapporo Hospital, 3-3-7-35 Higashi-Sapporo,Shiroishi-ku, Sapporo-shi, Hokkaido, 003-8585, Japan
| | - Takao Iiri
- Department of Gastroenterology, Tachikawa General Hospital, 3-2-11 Kandamachi, Nagaoka-shi, Niigata, 940-8621, Japan
| | - Shuichirou Kitahara
- Department of Pediatric Surgery, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano-shi, Nagano, 380-8582, Japan
| | - Akira Horiuchi
- Digestive Disease Center, Showa Inan General Hospital, 3230 Akaho, Komagane-shi, Nagano, 399-4117, Japan
| | - Hitoshi Suenaga
- Department of Surgery, Hitachikoh Hospital, 3-4-22 Kujichou, Hitachi-shi, Ibaraki, 319-1222, Japan
| | - Naohiro Washizawa
- Nutritional Therapy Center, Toho University Omori Medical Center, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Masahiko Suzuki
- Department of Neurology, The Jikei University School of Medicine, Aoto Hospital, 6-41-2 Aoto, Katsushika-ku, Tokyo, 125-8506, Japan
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Systematic review on the efficacy and safety of herbal medicines for vascular dementia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2012:426215. [PMID: 22235231 PMCID: PMC3250997 DOI: 10.1155/2012/426215] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2011] [Revised: 04/20/2011] [Accepted: 05/27/2011] [Indexed: 02/07/2023]
Abstract
We present a systematic review of existing research that aims to assess the efficacy and safety of herbal medications (HM), as either monotherapy or adjunct to orthodox medications (OM), mainly comprised of cholinesterase inhibitors, for vascular dementia (VaD). We included 47 studies conducted in mainland China, each testing different HM. Of 43 HM monotherapy studies, 37 reported HM to be significantly better than OM or placebo; six reported similar efficacy between HM and OM. All four HM adjuvant studies reported significant efficacy. No major adverse events for HM were reported. Heterogeneity in diagnostic criteria, interventions and outcome measures hindered comprehensive data analysis. Studies suggested that HM can be a safe and effective treatment for VaD, either alone or in conjunction with OM. However, methodological flaws in the design of the studies limited the extent to which the results could be interpreted. Thirty most commonly used herbal constituents, including Rhizoma Chuanxiong (Chuanxiong in Chinese), Radix Polygoni Multiflori (Heshouwu in Chinese) and Radix Astragali (Huangqi in Chinese). were ranked. Further multi-center trials with large sample sizes, high methodological quality and standardized HM ingredients are necessary for clinical recommendations to be made.
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Li S, Long J, Ma Z, Xu Z, Li J, Zhang Z. Assessment of the therapeutic activity of a combination of almitrine and raubasine on functional rehabilitation following ischaemic stroke. Curr Med Res Opin 2004; 20:409-15. [PMID: 15025850 DOI: 10.1185/030079904125003080] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Stroke is a major cause of disability. Certain experimental studies have suggested that a combination of almitrine + raubasine (Duxil) increases the supply of oxygen to cerebral tissues and may be beneficial in post-stroke rehabilitation. This multicentre clinical study was carried out in order to assess the efficacy of this combination on poststroke rehabilitation. METHODS The trial was a randomised, double-blind, placebo-controlled study. Patients that had experienced an ischaemic cerebrovascular accident (confirmed by CT scan) were included 4-6 weeks after the acute onset and received randomised treatment of either almitrine + raubasine or placebo 2 tablets daily for 3 months. Before treatment, there was a 2-week washout period for stopping all other drugs, except for antihypertensive and antidiabetic drugs. We assessed the patients by Barthel Index (BI), Neurological Functional Deficit Scores (NFDS), and Hasagawa Dementia Scales (HDS) each month after treatment. RESULTS A total of 83 patients were entered into the study and data were available for 74. Of these, 38 patients received almitrine + raubasine and 36 received placebo. The baseline characteristics were comparable between both groups. Almitrine + raubasine was significantly more effective than placebo at increasing BI at 1, 2 or 3 months (14.6 +/- 13.8 versus 3.3 +/- 13.2, p = 0.01; 19.3 +/- 13.6 versus 8.8 +/- 14.0, p = 0.02; 22.6 +/- 14.7 versus 10.7 +/- 17.0, p = 0.02 respectively) and reducing NFDS at 1 month (3.6 +/- 3.2 versus 1.9 +/- 3.5, p = 0.034) after treatment. More almitrine + raubasine-treated patients' NFDS had improved compared with placebo-treated patients at 2 and 3 months (97 versus 78%, p = 0.013; 100 versus 86%, p = 0.023 respectively). Compared with pretreatment, there was a strong tendency towards an improvement of HDS with almitrine + raubasine. The number of adverse events reported was low for the almitrine + raubasine-treated group and the placebo group and all events were mild, of short duration and resolved without treatment. Almitrine + raubasine had no clinically significant effect on blood pressure, heart rate or other laboratory tests. CONCLUSION The results indicate that almitrine + raubasine can accelerate neurological function recovery after stroke to some degree and is well tolerated.
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Tamura H, Tsukamoto H, Mukai S, Kato T, Minamoto A, Ohno Y, Yamashita H, Mishima HK. Improvement in cognitive impairment after cataract surgery in elderly patients. J Cataract Refract Surg 2004; 30:598-602. [PMID: 15050255 DOI: 10.1016/j.jcrs.2003.10.019] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2003] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate whether cognitive impairment improves in elderly patients who have cataract surgery with intraocular lens (IOL) implantation. SETTING Kouki Hospital, Yamaguchi, Japan. METHODS A prospective observational study evaluated patients' scores on the Revised Hasegawa Dementia Scale (HDS-R) and the HDS-R minus 1 item regarding immediate regeneration (ie, function of vision and memory). Twenty patients (6 men, 14 women) with cognitive impairment had cataract surgery in 1 eye between March 1996 and July 2001 at Kouki Hospital, Japan. The mean age of the patients was 81.8 years (range 61 to 90 years). Twenty patients (4 men, 16 women) with cognitive impairment who did not have cataract surgery were selected as a control. The mean age in the control group was 84.3 years (range 70 to 93 years). The HDS-R was administered twice between March 1996 and July 2001. RESULTS The mean HDS-R scores in the cataract surgery group improved from 12.5 points +/- 5.3 (SD) preoperatively to 16.6 +/- 6.2 points postoperatively; the improvement was significant (t = -5.02; P<.0001). After cataract surgery, the grade of cognitive impairment improved in 12 patients (60%), was unchanged in 7 (35%), and was worse in 1 (5%). CONCLUSION Cataract surgery improved cognitive impairment in elderly Japanese patients.
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Affiliation(s)
- Hiroki Tamura
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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