1
|
Kalenzaga S, Clarys D. [Les effets de la méditation de pleine conscience sur les symptômes cognitivo- émotionnels dans le trouble cognitif léger et la maladie d'Alzheimer : une revue de littérature narrative]. Can J Aging 2024; 43:217-229. [PMID: 38130165 DOI: 10.1017/s0714980823000612] [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] [Indexed: 12/23/2023] Open
Abstract
La maladie d'Alzheimer se manifeste par des troubles de la mémoire et un déclin cognitif plus général, le plus souvent associés à des troubles de l'humeur et du comportement. Les traitements médicamenteux ayant une efficacité assez modeste, il apparaît nécessaire de leur associer une prise en charge non pharmacologique. La méditation de pleine conscience, qui a des effets bénéfiques sur le fonctionnement cognitif et sur l'état émotionnel, semble être une piste intéressante. Cette revue de littérature narrative se propose de recenser les études ayant testé l'efficacité d'une intervention basée sur la pleine conscience auprès de personnes souffrant de la maladie d'Alzheimer ou à risque de développer cette maladie. Il apparaît que ces interventions présentent un intérêt pour réduire les symptômes cognitifs (troubles attentionnels et mnésiques notamment) et émotionnels (affects dépressifs et anxiété en particulier). Cependant, elles nécessitent un certain nombre de modifications pour être adaptées à ce public.
Collapse
Affiliation(s)
- Sandrine Kalenzaga
- UMR-CNRS 7295 Centre de Recherches sur la Cognition et l'Apprentissage, Université de Poitiers, 5, rue Théodore Lefebvre, 86000 Poitiers, France
| | - David Clarys
- UMR-CNRS 7295 Centre de Recherches sur la Cognition et l'Apprentissage, Université de Tours, 3 rue des Tanneurs, B.P. 4103, 37041 Tours Cedex 1
| |
Collapse
|
2
|
Sun Y, Zhang H, Liu R, Huang R, Gao Z, Tian L, Zhu Y, Liu Y, Lu C, Wu L. Lancao decoction alleviates cognitive dysfunction: A new therapeutic drug and its therapeutic mechanism. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 128:155531. [PMID: 38492366 DOI: 10.1016/j.phymed.2024.155531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 02/22/2024] [Accepted: 03/10/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Cognitive dysfunction (CD) is a neurodegenerative disease characterized primarily by the decline of learning and memory abilities. The physiological and pathological mechanisms of CD are very complex, which is mainly related to normal function of the hippocampus. Lancao decoction (LC) is a Chinese medicine formula, which has been used to treat neurodegenerative disorders. However, the potential of LC for the treatment of CD, as well as its underlying mechanisms, is unclear. PURPOSE In the study, we aimed to reveal the functional and neuronal mechanisms of LC's treatments for CD in scopolamine-induced mice. METHODS Gas chromatography (GC) was used to determine the stability of LC's extraction. CD model was established by the chronic induction of scopolamine (Scop, 1 mg/kg/day) for 1 week. Behavioral tests including morris water maze (MWM) and y-maze were used to evaluate learning and memory abilities of mice after LC's treatments. Immunofluorescence was used to detected the expressions of cFOS, Brdu and Ki67 after LC's treatments. Pharmacological blockade experiments explored the role of α-Amino-3‑hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) in LC's treatments for CD and its relationships with regeneration, activities and differentiation of neurons. RESULTS The results showed that LC was capable of improving spatial learning and memory and spontaneous alternating abilities in Scop-induced mice, which was similar to donepezil. LC could increase the number of cFOS positive cells, which was used as a marker of neuronal activity to upregulate by neuronal activities in hippocampus, but donepezil did not. Moreover, LC could strengthen neurogenesis and neuro-differentiation by increasing the number of Brdu and Ki67 positive cells in hippocampal dentate gyrus (DG), meanwhile, donepezil could only enhance the number of Ki67 positive cells. Transient inhibition of AMPAR by NBQX blunted the function of LC's treatment for CD and inhibited the enhanced effect of LC on Scop-induced hippocampal neuronal excitability and neurogenesis in mice. CONCLUSION To sum up, our study demonstrated that LC had the function of treating CD by enhancing content of acetylcholine (ACh) to activate AMPAR, which further up-regulated neurogenesis and neuronal differentiation to strengthen neuroactivities in hippocampus.
Collapse
Affiliation(s)
- Yan Sun
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Department of Pharmacy, Nanjing 210029, PR China; College of Chinese Medicine & College of Integrated Chinese and Western Medicine, Key Laboratory of Integrative Biomedicine for Brain Diseases, College of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, PR China
| | - Hailou Zhang
- Interdisciplinary Institute for Personalized Medicine in Brain Disorders and School of Chinese Medicine, Jinan University, Guangzhou 510632, PR China.
| | - Ruiyi Liu
- Interdisciplinary Institute for Personalized Medicine in Brain Disorders and School of Chinese Medicine, Jinan University, Guangzhou 510632, PR China
| | - Rumin Huang
- College of Chinese Medicine & College of Integrated Chinese and Western Medicine, Key Laboratory of Integrative Biomedicine for Brain Diseases, College of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, PR China
| | - Ziwei Gao
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Department of Pharmacy, Nanjing 210029, PR China
| | - Liyuan Tian
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Department of Pharmacy, Nanjing 210029, PR China
| | - Yaping Zhu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Department of Pharmacy, Nanjing 210029, PR China
| | - Yuxin Liu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Department of Pharmacy, Nanjing 210029, PR China
| | - Chao Lu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Department of Pharmacy, Nanjing 210029, PR China
| | - Lei Wu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Department of Pharmacy, Nanjing 210029, PR China.
| |
Collapse
|
3
|
Karim HT, Lee S, Gerlach A, Stinley M, Berta R, Mahbubani R, Tudorascu DL, Butters MA, Gross JJ, Andreescu C. Hippocampal subfield volume in older adults with and without mild cognitive impairment: Effects of worry and cognitive reappraisal. Neurobiol Aging 2024; 141:55-65. [PMID: 38823204 DOI: 10.1016/j.neurobiolaging.2024.02.017] [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: 09/14/2022] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 06/03/2024]
Abstract
Studies have confirmed that anxiety, especially worry and rumination, are associated with increased risk for cognitive decline, including Alzheimer's disease and related dementias (ADRD). Hippocampal atrophy is a hallmark of ADRD. We investigated the association between hippocampus and its subfield volumes and late-life global anxiety, worry, and rumination, and emotion regulation strategies. We recruited 110 participants with varying worry severity who underwent magnetic resonance imaging and clinical interviews. We conducted cross-sectional regression analysis between each subfield and anxiety, worry, rumination, reappraisal, and suppression while adjusting for age, sex, race, education, cumulative illness burden, stress, neuroticism, and intracranial volume. We imputed missing data and corrected for multiple comparisons across regions. Greater worry was associated with smaller subiculum volume, whereas greater use of reappraisal was associated with larger subiculum and CA1 volume. Greater worry may be detrimental to the hippocampus and to subfields involved in early ADRD pathology. Use of reappraisal appears protective of hippocampal structure. Worry and reappraisal may be modifiable targets for ADRD prevention.
Collapse
Affiliation(s)
- Helmet T Karim
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Soyoung Lee
- Department of Psychiatry, University of Maryland, Baltimore, MD, United States
| | - Andrew Gerlach
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Mark Stinley
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Rachel Berta
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Rebecca Mahbubani
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Dana L Tudorascu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States; Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, United States
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - James J Gross
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States.
| |
Collapse
|
4
|
Wang J, Li C, Yu X, Zhao Y, Shan E, Xing Y, Li X. Effect of emotional stimulus on response inhibition in people with mild cognitive impairment: an event-related potential study. Front Neurosci 2024; 18:1357435. [PMID: 38745934 PMCID: PMC11091389 DOI: 10.3389/fnins.2024.1357435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/15/2024] [Indexed: 05/16/2024] Open
Abstract
Background A few studies are emerging to explore the issue of how aging promotes emotional response inhibition. However, there is a lack of empirical study concerning the impact of pathological cognitive impairment on emotional response inhibition. The present study investigated the effect of emotion on response inhibition in people with mild cognitive impairment, the stage of cognitive impairment before dementia. Methods We used two emotional stop-signal tasks to explore whether the dual competition framework considering limited cognitive resources could explain the relationship between emotion and response inhibition in mild cognitive impairment. Results The results showed that negative emotions prolonged N2 latency. The Go trial accuracy was reduced in the high-arousal negative conditions and the stop-signal reaction time was prolonged under high-arousal conditions. This study also verified impaired response inhibition in mild cognitive impairment and found that negative emotions prolonged P3 latency in mild cognitive impairment. Conclusion Emotional information interferes with response inhibition in mild cognitive impairment populations, possibly because emotional information captures more attentional resources, thus interfering with response inhibition that relies on common-pool resources.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Xianwen Li
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| |
Collapse
|
5
|
Zeng Q, Wang Y, Wang S, Luo X, Li K, Xu X, Liu X, Hong L, Li J, Li Z, Zhang X, Zhong S, Liu Z, Huang P, Chen Y, Zhang M. Cerebrospinal fluid amyloid-β and cerebral microbleed are associated with distinct neuropsychiatric sub-syndromes in cognitively impaired patients. Alzheimers Res Ther 2024; 16:69. [PMID: 38570794 PMCID: PMC10988961 DOI: 10.1186/s13195-024-01434-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/23/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) are prevalent in cognitively impaired individuals including Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI). Whereas several studies have reported the associations between NPS with AD pathologic biomarkers and cerebral small vessel disease (SVD), but it remains unknown whether AD pathology and SVD contribute to different sub-syndromes independently or aggravate same symptoms synergistically. METHOD We included 445 cognitively impaired individuals (including 316 MCI and 129 AD) with neuropsychiatric, cerebrospinal fluid (CSF) biomarkers (Aβ42, p-tau, and t-tau) and multi-model MRI data. Psychiatric symptoms were accessed by using the Neuropsychiatric Inventory (NPI). Visual assessment of SVD (white matter hyperintensity, microbleed, perivascular space, lacune) on MRI images was performed by experienced radiologist. Linear regression analyses were conducted to test the association between neuropsychiatric symptoms with AD pathology and CSVD burden after adjustment for age, sex, education, apolipoprotein E (APOE) ε4 carrier status, and clinical diagnosis. RESULTS The NPI total scores were related to microbleed (estimate 2.424; 95% CI [0.749, 4.099]; P =0.005). Considering the sub-syndromes, the hyperactivity was associated with microbleed (estimate 0.925; 95% CI [0.115, 1.735]; P =0.025), whereas the affective symptoms were correlated to CSF level of Aβ42 (estimate -0.006; 95% CI [-0.011, -0.002]; P =0.005). Furthermore, we found the apathy sub-syndrome was associated with CSF t-tau/Aβ42 (estimate 0.636; 95% CI [0.078, 1.194]; P =0.041) and microbleed (estimate 0.693; 95% CI [0.046, 1.340]; P =0.036). In addition, we found a significant interactive effect between CSF t-tau/Aβ42 and microbleed (estimate 0.993; 95% CI [0.360, 1.626]; P =0.019) on severity of apathy sub-syndrome. CONCLUSION Our study showed that CSF Aβ42 was associated with affective symptoms, but microbleed was correlated with hyperactivity and apathy, suggesting the effect of AD pathology and SVD on different neuropsychiatric sub-syndromes.
Collapse
Affiliation(s)
- Qingze Zeng
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Yanbo Wang
- Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
- Department of Neurology, Xinhua Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Shuyue Wang
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Xiao Luo
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Kaicheng Li
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Xiaopei Xu
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Xiaocao Liu
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Luwei Hong
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Jixuan Li
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Zheyu Li
- Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Xinyi Zhang
- Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Siyan Zhong
- Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Zhirong Liu
- Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Peiyu Huang
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Yanxing Chen
- Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China.
| | - Minming Zhang
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China.
| |
Collapse
|
6
|
Pinyopornpanish K, Buawangpong N, Soontornpun A, Thaikla K, Pateekhum C, Nantsupawat N, Wiwatkunupakarn N, Jiraporncharoen W, Angkurawaranon C. A household survey of the prevalence of subjective cognitive decline and mild cognitive impairment among urban community-dwelling adults aged 30 to 65. Sci Rep 2024; 14:7783. [PMID: 38565884 PMCID: PMC10987517 DOI: 10.1038/s41598-024-58150-3] [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: 09/22/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
While it is possible to detect cognitive decline before the age of 60, and there is a report indicating that certain cognitive abilities peak in one's 30s, the evidence regarding cognitive problems in populations younger than 65 years is scarce. This study aims to (1) determine the proportion of community-dwelling adults with different cognitive status, and (2) determine the prevalence of neuropsychiatric behaviors. A population-based survey was conducted in Chiang Mai, Thailand. Individuals aged 30 to 65 were recruited and assessed for demographic data, memory complaints, cognitive performance, and neuropsychiatric symptoms using self-reported questionnaires. In a total of 539 participants, 33.95% had mild cognitive impairment (MCI), 7.05% had subjective cognitive decline (SCD), and 52.50% had neuropsychiatric symptoms. The risk of MCI increased with age, and neuropsychiatric symptoms were significantly higher in those with MCI or SCD than in those without (p < 0.001). The most common complaints were sleep problems, anxiety, and irritability. Screening for MCI in adults aged < 65 years might be useful. However, further investigation on the appropriate age to screen and the program's cost-effectiveness is suggested.
Collapse
Affiliation(s)
- Kanokporn Pinyopornpanish
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nida Buawangpong
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Atiwat Soontornpun
- Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Kanittha Thaikla
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Chanapat Pateekhum
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
| | - Nopakoon Nantsupawat
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nutchar Wiwatkunupakarn
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Wichuda Jiraporncharoen
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand.
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand.
| |
Collapse
|
7
|
Burke SL, Grudzien A, Li T, Abril M, Yin W, Tyrell TA, Barnes CP, Hanson K, DeKosky ST. Examining the relationship between anxiety and regional brain volumes in the National Alzheimer's Coordinating Center uniform, imaging, and biomarker datasets. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2024; 6:100201. [PMID: 38312309 PMCID: PMC10837066 DOI: 10.1016/j.cccb.2024.100201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 12/15/2023] [Accepted: 01/10/2024] [Indexed: 02/06/2024]
Abstract
Anxiety has been associated with a greater risk of Alzheimer's disease (AD). Existing research has identified structural differences in regional brain tissue in participants with anxiety, but results have been inconsistent. We sought to determine the association between anxiety and regional brain volumes, and the moderation effect of APOE ε4. Using data from participants in the National Alzheimer's Coordinating Center (NACC) Uniform Data Set, with complete imaging (MRI) and biomarker data (n = 1533), multiple linear regression estimated the adjusted effect of anxiety on 30 structural MRI regions. The moderation effect of APOE ε4 on the relation between structural MRI regions and anxiety was assessed as was the moderation effect of cognitive status. False discovery rate was used to adjust for multiple comparisons. After controlling for intracranial volume, age, sex, years of education, race, Hispanic ethnicity, and cognitive status, seven MRI regions demonstrated lower volumes among participants with anxiety: total cerebrum gray matter volume, right hippocampus volume, hippocampal volume (total), right and left frontal lobe cortical gray matter volume, and right and total temporal lobe cortical gray matter volume. Findings suggest that anxiety is associated with significant atrophy in multiple brain regions, with corresponding ventricular enlargement. Future research should investigate if anxiety-related changes to brain morphology contribute to greater AD risk.
Collapse
Affiliation(s)
- Shanna L. Burke
- School of Social Work, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 SW 8th St. AHC5 585, Miami 33199, FL, USA
- Community-Based Research Institute, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 SW 8th St., Miami 33199, FL, USA
| | - Adrienne Grudzien
- Community-Based Research Institute, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 SW 8th St., Miami 33199, FL, USA
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 S.W. 8th Street, Miami 33199, FL, USA
| | - Marlou Abril
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 S.W. 8th Street, Miami 33199, FL, USA
| | - Wupeng Yin
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 S.W. 8th Street, Miami 33199, FL, USA
| | - Tahirah A. Tyrell
- Charles E. Schmidt College of Medicine, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, USA
| | - Christopher P. Barnes
- Clinical and Translational Science Institute, College of Medicine, University of Florida, PO Box 100212, 2405 SW Archer Road, Gainesville 32608, FL, USA
| | - Kevin Hanson
- Information Services, Division of Research Operations & Services, College of Medicine, University of Florida, PO Box 100212, 2405 SW Archer Road, Gainesville 32608, FL, USA
| | - Steven T. DeKosky
- McKnight Brain Institute, 1Florida Alzheimer's Disease Center, University of Florida, USA
| |
Collapse
|
8
|
Chiang L, Cheong D, Cordato NJ, Smerdely P. Visual art therapy and its effects in older people with mild cognitive impairment: A systematic review. Int J Geriatr Psychiatry 2024; 39:e6053. [PMID: 38185829 DOI: 10.1002/gps.6053] [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: 10/03/2023] [Accepted: 12/30/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION Mild cognitive impairment (MCI) is a known risk factor for the development of dementia. The potential benefits on cognition from non-pharmacological measures such as art-based interventions are of increasing interest. This systematic review examines the evidence for the impact of one form of art-based intervention, visual art therapy (VAT), on the cognition and psychological wellbeing of older people with MCI. METHODS Randomised controlled and quasi-experimental trials evaluating the efficacy of VAT in older persons aged over 60 years with MCI were included. A search was performed on electronic databases: MEDLINE, CINAHL, Embase and PsycINFO. Joanna Briggs Institute critical appraisal and extraction tools were utilised for risk of bias assessment and data extraction, respectively. A narrative descriptive approach was used to outline the findings. RESULTS Seven studies were identified from 4311 articles screened. Improvement in cognition was reported in five studies, with two of these reporting sustained improvement at 6-9 months, while the remaining three studies showed improvement only at the immediate post-intervention period. A positive impact was reported in four of six studies that examined the effect of VAT on participant psychological wellbeing. The overall methodological quality of the studies ranged from moderate in four of five RCTs, to high in the quasi-experimental studies and one RCT. However, the low study power in the context of small sample sizes limits the applicability of these studies to the population of interest. CONCLUSIONS VAT is potentially an effective non-pharmacological intervention that may enhance cognition and provide benefits for psychological wellbeing in older persons with MCI. Given the limited studies available, with the majority emerging over the last 5 years, further research is required to confirm these reported benefits, as well as to determine whether VAT impacts on the progression of cognitive decline in MCI.
Collapse
Affiliation(s)
- Lynn Chiang
- The Department of Aged Care, St George Hospital, Kogarah, New South Wales, Australia
| | - David Cheong
- The Department of Aged Care, St George Hospital, Kogarah, New South Wales, Australia
| | - Nicholas J Cordato
- The Department of Aged Care, St George Hospital, Kogarah, New South Wales, Australia
- Calvary Health Care Sydney, Kogarah, New South Wales, Australia
- University of New South Wales School of Clinical Medicine, St George and Sutherland Clinical Campuses, Sydney, New South Wales, Australia
| | - Peter Smerdely
- The Department of Aged Care, St George Hospital, Kogarah, New South Wales, Australia
- School of Population Health, University of New South Wales, UNSW Medicine and Health, Sydney, New South Wales, Australia
| |
Collapse
|
9
|
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
|
10
|
Tsormpatzoudi SO, Moraitou D, Papaliagkas V, Pezirkianidis C, Tsolaki M. Resilience in Mild Cognitive Impairment (MCI): Examining the Level and the Associations of Resilience with Subjective Wellbeing and Negative Affect in Early and Late-Stage MCI. Behav Sci (Basel) 2023; 13:792. [PMID: 37887442 PMCID: PMC10603887 DOI: 10.3390/bs13100792] [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: 08/25/2023] [Revised: 09/09/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
The current study examines the relationship between the cognitive state of participants [healthy-early mild cognitive impairment (MCI)-late MCI], some subjective wellbeing factors (positive emotions, engagement, positive relationships, meaning in life, accomplishment, and negative emotions), and negative psychological outcomes (depression, anxiety, stress), as well as psychological resilience. We expected that people with advanced MCI would perceive increased negative psychological outcomes, poorer psychological resilience, and lower levels of subjective wellbeing in contrast to early MCI and healthy participants. The study involved 30 healthy, 31 early, and 28 late MCI individuals. A series of questionnaires have been applied to assess the aforementioned constructs. To examine the hypotheses of the study, path analysis (EQS program) was applied. Results showed that early MCI persons maintain the same levels of positive emotions and feelings of accomplishment with healthy peers. Late-stage patients present those feelings in a diminished form, which adversely impacts psychological resilience. Individuals with early and late MCI exhibit negative emotions and stress that impact their resilience; however, those with early MCI experience greater stress, negative emotions, depression, and anxiety. These findings may be utilized to design psychological interventions for resilience enhancement and support brain health in elderly adults who are at risk of neurodegeneration.
Collapse
Affiliation(s)
- Styliani Olympia Tsormpatzoudi
- Neurosciences and Neurodegenerative Diseases, Postgraduate Course, Medical School, Faculty of Health Sciences, Aristotle University, 54124 Thessaloniki, Greece;
| | - Despina Moraitou
- Laboratory of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Faculty of Philosophy, Aristotle University, 54124 Thessaloniki, Greece;
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTH), Balkan Center, Aristotle University, 10th km Thessaloniki-Thermi, 54124 Thessaloniki, Greece
| | - Vasileios Papaliagkas
- Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Christos Pezirkianidis
- Laboratory of Positive Psychology, Panteion University of Social & Political Sciences, Syggrou Ave. 136, 17671 Athens, Greece;
| | - Magda Tsolaki
- Neurosciences and Neurodegenerative Diseases, Postgraduate Course, Medical School, Faculty of Health Sciences, Aristotle University, 54124 Thessaloniki, Greece;
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTH), Balkan Center, Aristotle University, 10th km Thessaloniki-Thermi, 54124 Thessaloniki, Greece
- Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD), 54643 Thessaloniki, Greece
| |
Collapse
|
11
|
Modrego PJ, de Cerio LD, Lobo A. The Interface between Depression and Alzheimer's Disease. A Comprehensive Approach. Ann Indian Acad Neurol 2023; 26:315-325. [PMID: 37970263 PMCID: PMC10645209 DOI: 10.4103/aian.aian_326_23] [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: 04/14/2023] [Revised: 07/04/2023] [Accepted: 07/04/2023] [Indexed: 11/17/2023] Open
Abstract
Depression and Alzheimer's disease (AD) are frequent interacting diseases in the elderly with a negative impact on the quality of life of patients and caregivers. Late-life depression may be regarded either as an early symptom of AD or a risk factor for AD, depending on the context. This review was focused on the latest developments in the fields of the neurobiological basis and treatment of depression in AD. We found that some plausible hypotheses are emerging to correlate with depression in AD, such as neuroinflammation and dysimmune regulation. It seems that depression is not related to amyloid deposition, but this issue is not completely resolved. The response to antidepressants is controversial according to the evidence from 10 small double-blind randomized placebo-controlled clinical trials with antidepressants in AD patients with depression: four with sertraline, one with three arms (sertraline, mirtazapine, placebo), one with fluoxetine, one with imipramine, one with clomipramine, one with escitalopram, and one with vortioxetine. The total number of treated patients completing the trials was 638. The main criterion of a positive response was a reduction in the scores of clinical scales for depression of at least 50%. The weighted OR (odds ratio) was calculated with the method of Mantel-Haenszel: 1.29; 95% CI: 0.77-2.16. No significant differences were found compared with placebo. Antidepressants did not have a meaningful negative influence on cognition, which was measured with the mini-mental state examination (MMSE) in 18 clinical trials. Alternatives other than drugs are also discussed. Although there have been important advances in this field, pathophysiology and treatment deserve further research.
Collapse
Affiliation(s)
- Pedro J. Modrego
- Servicio de Neurologia, Hospital Miguel Servet de Zaragoza, Spain
| | | | - Antonio Lobo
- Department of Psychiatry, University of Zaragoza, Spain
| |
Collapse
|
12
|
Li YD, Luo YJ, Xie L, Tart DS, Sheehy RN, Zhang L, Coleman LG, Chen X, Song J. Activation of hypothalamic-enhanced adult-born neurons restores cognitive and affective function in Alzheimer's disease. Cell Stem Cell 2023; 30:415-432.e6. [PMID: 37028406 PMCID: PMC10150940 DOI: 10.1016/j.stem.2023.02.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/29/2022] [Accepted: 02/14/2023] [Indexed: 04/09/2023]
Abstract
Patients with Alzheimer's disease (AD) exhibit progressive memory loss, depression, and anxiety, accompanied by impaired adult hippocampal neurogenesis (AHN). Whether AHN can be enhanced in impaired AD brain to restore cognitive and affective function remains elusive. Here, we report that patterned optogenetic stimulation of the hypothalamic supramammillary nucleus (SuM) enhances AHN in two distinct AD mouse models, 5×FAD and 3×Tg-AD. Strikingly, the chemogenetic activation of SuM-enhanced adult-born neurons (ABNs) rescues memory and emotion deficits in these AD mice. By contrast, SuM stimulation alone or activation of ABNs without SuM modification fails to restore behavioral deficits. Furthermore, quantitative phosphoproteomics analyses reveal activation of the canonical pathways related to synaptic plasticity and microglia phagocytosis of plaques following acute chemogenetic activation of SuM-enhanced (vs. control) ABNs. Our study establishes the activity-dependent contribution of SuM-enhanced ABNs in modulating AD-related deficits and informs signaling mechanisms mediated by the activation of SuM-enhanced ABNs.
Collapse
Affiliation(s)
- Ya-Dong Li
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Yan-Jia Luo
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Ling Xie
- Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Dalton S Tart
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Ryan N Sheehy
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Pharmacology Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Libo Zhang
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Leon G Coleman
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Xian Chen
- Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Juan Song
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| |
Collapse
|
13
|
Hu S, Patten S, Charlton A, Fischer K, Fick G, Smith EE, Ismail Z. Validating the Mild Behavioral Impairment Checklist in a Cognitive Clinic: Comparisons With the Neuropsychiatric Inventory Questionnaire. J Geriatr Psychiatry Neurol 2023; 36:107-120. [PMID: 35430902 PMCID: PMC9941652 DOI: 10.1177/08919887221093353] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To compare the utility of the Mild Behavioral Impairment-Checklist (MBI-C) and Neuropsychiatric Inventory Questionnaire (NPI-Q) to capture NPS in subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia. METHODS In this cross-sectional memory clinic study, linear regression models compared MBI-C (n = 474) and NPI-Q (n = 1040) scores in relation to Montreal Cognitive Assessment (MoCA) score. RESULTS MBI prevalence was 37% in subjective cognitive decline, 54% in mild cognitive impairment, and 62% in dementia. Worse diagnostic status was associated with higher MBI-C and NPI-Q score (P < .001), lower MoCA (P < .001), and greater age (P < .001). Higher MBI-C (β -.09; 95% CI -.13, -.05) and NPI-Q (β -.17; 95% CI -.23, -.10) scores were associated with lower MoCA scores, with psychosis most strongly associated (β -1.11; 95% CI -1.56, -.65 vs β -1.14; 95% CI -1.55, -.73). CONCLUSIONS The MBI-C captures global and domain-specific NPS across cognitive stages. Both the MBI-C and NPI-Q have utility in characterizing NPS.
Collapse
Affiliation(s)
- Sophie Hu
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Scott Patten
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Anna Charlton
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Karyn Fischer
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Gordon Fick
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Eric E. Smith
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Zahinoor Ismail
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Zahinoor Ismail, MD, Hotchkiss Brain Institute, University of Calgary, 3280 Hospital Drive NW, TRW Building 1st Floor Calgary, AB T2N 4Z6, Canada.
| |
Collapse
|
14
|
Harper N, Delgadillo M, Erickson A, Boese A, Schulte T, Fairchild JK. Mindfulness attenuates the impact of worry on late-life cognitive function. Aging Ment Health 2023; 27:399-407. [PMID: 35006021 DOI: 10.1080/13607863.2021.2017851] [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: 01/18/2023]
Abstract
Objectives: Worry has been shown to have a negative impact on many aspects of neurocognitive performance. Interestingly, research indicates mindfulness both improves aspects of cognitive ability and reduces worry symptoms. Yet, the impact of mindfulness on the relationship between worry and cognition has yet to be explored. Based on research discussed herein, we hypothesize that those with higher levels of dispositional mindfulness will have better cognitive performance than those with lower levels of dispositional mindfulness, regardless of worry level. The present study investigated the potential moderating influence of mindfulness on the relationship between worry and cognitive performance.Methods: The sample included 113 older veterans who were screened at the VA Palo Alto Health Care System in Palo Alto, CA. Cognitive domains of interest included learning and memory, processing speed, attention, working memory, and executive function. Mindfulness was assessed with the Five Facet Mindfulness Questionnaire (FFMQ), and worry symptoms were assessed using the Penn State Worry Questionnaire (PSWQ). Hypotheses were tested with multiple regression analyses using the Hayes (2003) PROCESS macro.Results: Contrary to what was hypothesized, only mindful awareness significantly moderated the relationship between worry and processing speed.Conclusion: This finding has important implications for introducing mindfulness techniques into older adults' routines to decrease worry and mitigate its negative effects on processing speed.
Collapse
Affiliation(s)
- Nesha Harper
- Psychology Department, Palo Alto University, Palo Alto, CA, USA
| | - Mia Delgadillo
- Psychology Department, Palo Alto University, Palo Alto, CA, USA
| | | | - Aidan Boese
- Psychology Department, Palo Alto University, Palo Alto, CA, USA
| | - Tilman Schulte
- Psychology Department, Palo Alto University, Palo Alto, CA, USA
| | - J Kaci Fairchild
- Department of Veteran Affairs, Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, CA, USA.,Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
15
|
Transcranial Magnetic Stimulation Improves Executive Functioning through Modulation of Social Cognitive Networks in Patients with Mild Cognitive Impairment: Preliminary Results. Diagnostics (Basel) 2023; 13:diagnostics13030415. [PMID: 36766520 PMCID: PMC9914912 DOI: 10.3390/diagnostics13030415] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
(1) Background: Patients with mild cognitive impairment (MCI) often present impairment in executive functions (EFs). This study aimed to investigate the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on EFs in patients with MCI. (2) Methods: A prospective trial was conducted on 11 patients with MCI. Participants underwent 25 min of 20 Hz rTMS for ten days on the right temporo-parietal junction (RTPJ) and medial prefrontal cortex (MPFC). Before (T0) and after rTMS treatment (T1), global cognitive profile and EFs were investigated using the Montreal cognitive assessment (MoCA), trial making test (TMT) A and B, and frontal assessment battery (FAB). Depression symptoms were assessed using the geriatric depression scale (GDS). Statistical analysis included Wilcoxon signed-rank test. (3) Results: After treatment, patients showed a significant improvement in the MoCA EFs subtask (T0 vs. T1, p = 0.015) and TMT-B (T0 vs. T1, p = 0.028). Five MCI patients with EF impairment showed full recovery of these deficits. No significant changes in the GDS were observed. (4) Conclusions: rTMS stimulation over the TPJ and MPFC induced significant short-term improvements in EFs in MCI patients. These findings suggest that the TPJ and MPFC may be involved in the attention-executive skills to redirect attention toward behaviorally relevant stimuli.
Collapse
|
16
|
Russo FA, Mallik A, Thomson Z, de Raadt St. James A, Dupuis K, Cohen D. Developing a music-based digital therapeutic to help manage the neuropsychiatric symptoms of dementia. Front Digit Health 2023; 5:1064115. [PMID: 36744277 PMCID: PMC9895844 DOI: 10.3389/fdgth.2023.1064115] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/02/2023] [Indexed: 01/22/2023] Open
Abstract
The greying of the world is leading to a rapid acceleration in both the healthcare costs and caregiver burden that are associated with dementia. There is an urgent need to develop new, easily scalable modalities of support. This perspective paper presents the theoretical background, rationale, and development plans for a music-based digital therapeutic to manage the neuropsychiatric symptoms of dementia, particularly agitation and anxiety. We begin by presenting the findings of a survey we conducted with key opinion leaders. The findings highlight the value of a music-based digital therapeutic for treating neuropsychiatric symptoms, particularly agitation and anxiety. We then consider the neural substrates of these neuropsychiatric symptoms before going on to evaluate randomized control trials on the efficacy of music-based interventions in their treatment. Finally, we present our development plans for the adaptation of an existing music-based digital therapeutic that was previously shown to be efficacious in the treatment of adult anxiety symptoms.
Collapse
Affiliation(s)
- Frank A. Russo
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada,KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada,LUCID Inc., Toronto, ON, Canada,Correspondence: Frank A. Russo
| | | | | | | | - Kate Dupuis
- Center for Elder Research, Sheridan College, Oakville, ON, Canada
| | - Dan Cohen
- Right to Music, New York, NY, United States
| |
Collapse
|
17
|
The Synergic Effect of AT(N) Profiles and Depression on the Risk of Conversion to Dementia in Patients with Mild Cognitive Impairment. Int J Mol Sci 2023; 24:ijms24021371. [PMID: 36674881 PMCID: PMC9865785 DOI: 10.3390/ijms24021371] [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: 11/22/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
Few studies have addressed the impact of the association between Alzheimer's disease (AD) biomarkers and NPSs in the conversion to dementia in patients with mild cognitive impairment (MCI), and no studies have been conducted on the interaction effect of these two risk factors. AT(N) profiles were created using AD-core biomarkers quantified in cerebrospinal fluid (CSF) (normal, brain amyloidosis, suspected non-Alzheimer pathology (SNAP) and prodromal AD). NPSs were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). A total of 500 individuals with MCI were followed-up yearly in a memory unit. Cox regression analysis was used to determine risk of conversion, considering additive and multiplicative interactions between AT(N) profile and NPSs on the conversion to dementia. A total of 224 participants (44.8%) converted to dementia during the 2-year follow-up study. Pathologic AT(N) groups (brain amyloidosis, prodromal AD and SNAP) and the presence of depression and apathy were associated with a higher risk of conversion to dementia. The additive combination of the AT(N) profile with depression exacerbates the risk of conversion to dementia. A synergic effect of prodromal AD profile with depressive symptoms is evidenced, identifying the most exposed individuals to conversion among MCI patients.
Collapse
|
18
|
Liu Y, Xu Y, Yang X, Miao G, Wu Y, Yang S. Sensory impairment and cognitive function among older adults in China: The mediating roles of anxiety and depressive symptoms. Int J Geriatr Psychiatry 2023; 38:e5866. [PMID: 36639927 DOI: 10.1002/gps.5866] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/06/2023] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Through a cross-sectional study, we explored the association between sensory impairment and cognitive function in Chinese older adults, and tested the mediating roles of anxiety and depressive symptoms between this relationship. METHODS Based on the 2018 Chinese Longitudinal Healthy Longevity Survey, a total of 10,895 older adults aged 65 and above were selected as samples for research. Anxiety, depressive symptoms and cognitive function were evaluated by the Generalized Anxiety Disorder, the Center for Epidemiologic Studies Depression (CES-D10) and the Chinese version of modified Mini-Mental State Examination scales, respectively. Sensory impairment was assessed from self-reported vision and hearing functions. Multiple linear regression and SPSS Macro PROCESS were used for statistical analysis. RESULTS Compared with no sensory impairment, vision impairment (B = -1.012, 95%CI: -1.206, -0.818), hearing impairment (B = -2.683, 95%CI: -2.980, -2.386) and dual sensory impairment (B = -6.302, 95%CI: -6.585, -6.020) have a significant association with cognitive function in older adults, respectively. Anxiety and depressive symptoms not only acted as independent mediators, but also played sequential mediating effects on the relationship between sensory impairment and cognitive function. CONCLUSIONS Greater attention should be paid to anxiety and depressive symptoms of older adults with sensory impairment, which might be beneficial to maintain cognitive function.
Collapse
Affiliation(s)
- Yixuan Liu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yanling Xu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xinyan Yang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Guomei Miao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yinghui Wu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Shujuan Yang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin, China
| |
Collapse
|
19
|
Spampinato MV, Ulber JL, Fayyaz H, Sullivan A, Collins HR. Neuropsychiatric Symptoms and In Vivo Alzheimer's Biomarkers in Mild Cognitive Impairment. J Alzheimers Dis 2023; 96:1827-1836. [PMID: 38007644 DOI: 10.3233/jad-220835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) carry an increased risk of progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD). There is a need to understand how to integrate NPS into the paradigm outlined in the 2018 NIA-AA Research Framework. OBJECTIVE To evaluate a prediction model of MCI-AD progression using a collection of variables, including NPS, cognitive testing, apolipoprotein E4 status (APOE4), imaging and laboratory AD biomarkers. METHODS Of 300 elderly subjects, 219 had stable MCI and 81 MCI-AD progression over a 5-year follow-up. NPS were measured using the Neuropsychiatric Inventory (NPI). A multivariate Cox Proportional Hazards Regression Analysis assessed the effects of APOE4, baseline NPI, baseline CSF amyloid-β, phosphorylated and total tau, baseline AD-signature MRI biomarker, baseline memory and executive function on MCI-AD progression. RESULTS 27% progressed to dementia (median follow-up = 43 months). NPS were found in stable MCI (62.6%) and MCI-AD converters (70.3%). The Cox model exhibited a good fit (p < 0.001), and NPS (HR = 1.033, p = 0.027), phosphorylated tau (HR = 1.011, p = 0.025), total tau (HR = 1.005, p = 0.024), AD-signature MRI biomarker (HR = 0.111, p = 0.002), executive function (HR = 0.727, p = 0.045), and memory performance (HR = 0.387, p < 0.001) were significantly associated with dementia. CONCLUSIONS NPS may inform dementia risk assessment in conjunction with cognitive testing and imaging and laboratory AD biomarkers. NPS is independently associated with the risk of MCI-dementia progression, over and beyond the contributions of CSF biomarkers.
Collapse
Affiliation(s)
- Maria Vittoria Spampinato
- Radiology and Radiological Science Department, Medical University of South Carolina, Charleston, SC, USA
| | - Jenny L Ulber
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Habiba Fayyaz
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Allison Sullivan
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Heather R Collins
- Radiology and Radiological Science Department, Medical University of South Carolina, Charleston, SC, USA
| |
Collapse
|
20
|
Cheng J, Ji X, He L, Zhang Y, Xiao T, Geng Q, Wang Z, Qi S, Zhou F, Zhan J. Epidemiological Characteristics and Factors Associated with Alzheimer's Disease and Mild Cognitive Impairment among the Elderly in Urban and Rural Areas of Hubei Province. J Clin Med 2022; 12:jcm12010028. [PMID: 36614829 PMCID: PMC9820890 DOI: 10.3390/jcm12010028] [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: 10/27/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Utilize the prevalence, associated factors and population distribution of AD and MCI among residents of the Hubei province aged 60 years or over to prove that elderly people who study and communicate with others, take part in regular physical exercise and choose a healthy lifestyle, will prevent or slow the decline in cognitive ability. If elderly people study and communicate with others, take part in regular physical exercise and choose a healthy lifestyle, can prevent or slow the decline in cognitive ability. A cross-sectional study was used for the recruitment of subjects. The screened patients with AD and MCI were then selected as patients in a case−control study. A total of 4314 subjects were recruited into the study. The prevalence of AD and MCI was 1.44% and 10.04%, respectively. The prevalence of AD and MCI differed significantly as a function of age and gender (p < 0.05). The preventative factors for AD and MCI, separately, included a happy marriage (OR = 0.69, 95%CI: 0.36−1.35) and higher education (OR = 0.65, 95%CI: 0.55−0.78). The risk factors for AD and MCI, separately, included infrequent participation in social activities (OR = 1.00, 95%CI: 0.60−1.66) and infrequent communication with children (OR = 1.35, 95%CI: 1.09−1.69). The prevalence of AD for people aged 60 or over in the Hubei province was lower than the national average of 3.06%. The prevalence of MCI was within the national range (5.2−23.4%). The influencing factors of AD and MCI were associated with the participants’ social connections, lifestyle behaviors, somatic diseases and so on. The elderly people who study and communicate with others, take part in regular physical exercise and choose a healthy lifestyle will prevent or slow the decline in cognitive ability. The conclusion section has been replaced.
Collapse
Affiliation(s)
- Jing Cheng
- School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Xiaoqi Ji
- School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Lu He
- School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yutong Zhang
- Department of Epidemiology and Statistics, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Tongtong Xiao
- School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Qiang Geng
- School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Zhihui Wang
- Department of Epidemiology and Statistics, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Shige Qi
- Department of Epidemiology and Statistics, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Fang Zhou
- Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
- Correspondence: (F.Z.); (J.Z.)
| | - Jianbo Zhan
- Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
- Correspondence: (F.Z.); (J.Z.)
| |
Collapse
|
21
|
Wang R, Zhang H, Li H, Ren H, Sun T, Xu L, Liu Y, Hou X. The influence of exercise interventions on cognitive functions in patients with amnestic mild cognitive impairment: A systematic review and meta-analysis. Front Public Health 2022; 10:1046841. [PMID: 36457329 PMCID: PMC9706097 DOI: 10.3389/fpubh.2022.1046841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Patients with amnestic mild cognitive impairment (aMCI) are more likely to develop dementia compared to patients with non-aMCI (naMCI). Among the mixed samples of aMCI and naMCI, exercise interventions are effective for patients with MCI to improve cognitive functions. However, the influence of exercise interventions on patients with aMCI is still unclear. Objective The objective of this systematic review and meta-analysis is to evaluate the influence of exercise interventions on cognitive functions in patients with aMCI. Methods Four literature databases (PubMed, Web of Science, EBSCO, and Cochrane Library) and three Chinese databases (China National Knowledge Infrastructure, Wanfang, and China Science and Technology Journal Database) were searched from their inception to August 31, 2022. Based on the preliminary search of seven databases and their cited references, a total of 2,290 records were identified. Finally, 10 studies with a total of 28 data points involving 575 participants with aMCI were included in this meta-analysis. If the measurements of outcomes were different among studies, the effect size was synthesized using the standardized mean difference (SMD) with a 95% confidence interval (CI). If the measurements were the same, the weight mean difference (WMD) with a 95% CI was used to integrate the effect size. Data synthesis The results showed that exercise interventions had no significant effects on improving several specific domains of cognitive functions including working memory (WMD = -0.05; 95% CI = -0.74 to 0.63; p = 0.88; I 2 = 78%) and attention (SMD = 0.20; 95% CI = -0.31 to 0.72; p = 0.44; I 2 = 60%). Additionally, exercise interventions had a significant effect on global cognitive function (SMD = 0.70; 95% CI = 0.50-0.90; p < 0.00001; I 2 = 29%) and some specific cognitive domains including immediate recall (SMD = 0.55; 95% CI = 0.28-0.81; p < 0.0001; I 2 = 0%), delayed recall (SMD = 0.66; 95% CI = 0.45-0.87; p < 0.00001; I 2 = 37%), and executive function (SMD = 0.38; 95% CI = 0.16-0.60; p= 0.0006; I 2 = 4%). Furthermore, subgroup analysis based on the intervention forms indicated that multi-component interventions (SMD = 0.44; 95% CI = 0.11-0.77; p = 0.009; I 2 = 0%) appeared to be less effective than the single-component intervention (SMD = 0.85; 95% CI = 0.60-1.10; p < 0.00001; I 2 = 10%) in terms of boosting global cognitive function. Conclusion This meta-analysis suggests that the exercise can help patients with aMCI improve global cognitive function. And exercise interventions have positive influence on enhancing several specific cognitive domains such as immediate recall, delayed recall, and executive function.Systematic review registration: http://www.crd.york.ac.uk/PROSPERO, identifier: CRD42022354235.
Collapse
Affiliation(s)
- Rong Wang
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China
| | - Hanyue Zhang
- Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China.,School of Physical Education, Northeast Normal University, Changchun, China
| | - Hongjuan Li
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China
| | - Hong Ren
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China
| | - Tingting Sun
- Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China
| | - Liya Xu
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China
| | - Yang Liu
- Department of Physical Education, Shandong Jianzhu University, Jinan, China
| | - Xiao Hou
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China
| |
Collapse
|
22
|
Hunt NJ, Wahl D, Westwood LJ, Lockwood GP, Le Couteur DG, Cogger VC. Targeting the liver in dementia and cognitive impairment: Dietary macronutrients and diabetic therapeutics. Adv Drug Deliv Rev 2022; 190:114537. [PMID: 36115494 PMCID: PMC10125004 DOI: 10.1016/j.addr.2022.114537] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/04/2022] [Accepted: 09/07/2022] [Indexed: 01/24/2023]
Abstract
Many people living with dementia and cognitive impairment have dysfunctional mitochondrial and insulin-glucose metabolism resembling type 2 diabetes mellitus and old age. Evidence from human trials shows that nutritional interventions and anti-diabetic medicines that target nutrient-sensing pathways overcome these deficits in glucose and energy metabolism and can improve cognition and/or reduce symptoms of dementia. The liver is the main organ that mediates the systemic effects of diets and many diabetic medicines; therefore, it is an intermediate target for such dementia interventions. A challenge is the efficacy of these treatments in older age. Solutions include the targeted hepatic delivery of diabetic medicines using nanotechnologies and titration of macronutrients to optimize hepatic energy metabolism.
Collapse
Affiliation(s)
- Nicholas J Hunt
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2008, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW 2008, Australia; Sydney Nano Institute, The University of Sydney, Sydney, NSW 2008, Australia; ANZAC Research Institute & Centre for Education and Research on Ageing, Concord Repatriation General Hospital, Concord, NSW 2139, Australia
| | - Devin Wahl
- Department of Health and Exercise Science & Centre for Healthy Aging, Colorado State University, CO 80523, United States
| | - Lara J Westwood
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2008, Australia; ANZAC Research Institute & Centre for Education and Research on Ageing, Concord Repatriation General Hospital, Concord, NSW 2139, Australia
| | - Glen P Lockwood
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2008, Australia; ANZAC Research Institute & Centre for Education and Research on Ageing, Concord Repatriation General Hospital, Concord, NSW 2139, Australia
| | - David G Le Couteur
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2008, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW 2008, Australia; ANZAC Research Institute & Centre for Education and Research on Ageing, Concord Repatriation General Hospital, Concord, NSW 2139, Australia
| | - Victoria C Cogger
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2008, Australia; ANZAC Research Institute & Centre for Education and Research on Ageing, Concord Repatriation General Hospital, Concord, NSW 2139, Australia.
| |
Collapse
|
23
|
Kim SJ, Park JK, Yeo MS. Dual-Task-Based Music Therapy to Improve Executive Functioning of Elderly Patients with Early Stage Alzheimer's Disease: A Multiple Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11940. [PMID: 36231236 PMCID: PMC9564779 DOI: 10.3390/ijerph191911940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/17/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
Deficits in executive functioning are a common feature of Alzheimer's disease (AD) and result from impairment in the central executive system. As a result, elderly patients with early stage AD may require interventions that are more cognitively intense than traditional interventions. To address this need, in this multiple case study, we explored a dual-task-based music therapy intervention that involved drum playing and singing designed to induce attentional and motor controls. Three octogenarians diagnosed with early stage AD participated in 12 dual-task-based music therapy sessions over 6 weeks. Measures of executive functioning and the performance of a bimanual drum tapping task were evaluated before and after the intervention. Improvements in executive functioning were observed for participants A and C. After the intervention, reduced mean synchronization errors were found for the simultaneous tapping condition for all three participants. Although there was variability in the functional changes between participants, it is noteworthy that positive improvements in the elderly patients with early stage AD were obtained following dual-task-based music therapy. The results suggest that music therapy integrated into the dual-task paradigm can be an effective way to address degenerative cognitive deficits among elderly patients with early stage AD.
Collapse
Affiliation(s)
- Soo Ji Kim
- Music Therapy Education, Graduate School of Education, Ewha Womans University, Seoul 03760, Korea
- Arts Therapy Education Institute, Ewha Womans University, Seoul 03760, Korea
| | - Jin-Kyoung Park
- Department of Music Therapy, Graduate School, Ewha Womans University, Seoul 03760, Korea
| | - Myung Sun Yeo
- Music Therapy Education, Graduate School of Education, Ewha Womans University, Seoul 03760, Korea
| |
Collapse
|
24
|
Vuic B, Konjevod M, Tudor L, Milos T, Nikolac Perkovic M, Nedic Erjavec G, Pivac N, Uzun S, Mimica N, Svob Strac D. Tailoring the therapeutic interventions for behavioral and psychological symptoms of dementia. Expert Rev Neurother 2022; 22:707-720. [PMID: 35950234 DOI: 10.1080/14737175.2022.2112668] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Behavioral and psychological symptoms of dementia (BPSD) are symptoms of non-cognitive nature, which frequently develop during the course and different stages of dementia. The diagnosis of BPSD is complex due to symptom variety, and relies on detailed clinical evaluation and medical history. Accurate assessment of BPSD is crucial in order to tailor therapeutic intervention (non-pharmacological and pharmacological) for each individual and monitor patient response to therapy. AREAS COVERED This review encompasses the epidemiology, classification, assessment and etiology of BPSD, as well as their impact on caregiver distress, and gives an overview of current and emerging non-pharmacological and pharmacological therapeutic options, as well as potential BPSD biomarkers, in order to provide a framework for improving BPSD diagnosis and developing novel, targeted and specific therapeutic strategies for BPSD. EXPERT OPINION Due to the large heterogeneity of BPSD and of the fact that drugs available only alleviate symptoms, finding an adequate treatment is very challenging and often involves a polytherapeutic approach. Non-pharmacologic interventions have shown promising results in improving BPSD, however further research is needed to confirm their beneficial effects. Thus, the modification of pre-existancing as well as the development of novel pharmacologic and non-pharmacologic solutions should be considered for BPSD therapy.
Collapse
Affiliation(s)
- Barbara Vuic
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Marcela Konjevod
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Lucija Tudor
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Tina Milos
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Matea Nikolac Perkovic
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Gordana Nedic Erjavec
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Nela Pivac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Suzana Uzun
- Department for Biological Psychiatry and Psychogeriatry, University Hospital Vrapce, 10 000 Zagreb, Croatia
| | - Ninoslav Mimica
- Department for Biological Psychiatry and Psychogeriatry, University Hospital Vrapce, 10 000 Zagreb, Croatia
| | - Dubravka Svob Strac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Bijenicka cesta 54, 10000 Zagreb, Croatia
| |
Collapse
|
25
|
Jordan C, Lawlor B, Loughrey D. A systematic review of music interventions for the cognitive and behavioural symptoms of mild cognitive impairment (non-dementia). J Psychiatr Res 2022; 151:382-390. [PMID: 35576664 DOI: 10.1016/j.jpsychires.2022.04.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 04/04/2022] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
Abstract
Music interventions may represent an effective approach to improving symptoms and delaying progression of MCI to dementia. This review identified nine studies (8 RCT's, 1 observational study) that explored the benefits of music interventions to those with MCI. Studies included five music-playing interventions (sample size (n) ranged from 35 to 201, age ranged from 62 to 94), one music listening intervention (n = 100, mean age = 77 (music intervention) mean age = 76 (dance intervention), one music with movement intervention (n = 16, age range 65-84 years) and two music reminiscence interventions (n = 68; 72, age range = 60-85 years). Only individuals with a clinical diagnosis of MCI were included, no individuals with a diagnosis of dementia were included. Studies were limited due to their sample size, failure to consider confounding variables (i.e. socialization), inconsistency with therapist led sessions, failure to match conditions across interventions, limited follow-up period post-intervention and the tendency to focus on depression exclusively as a measure of behavioural symptoms. Different types of music interventions have differential results on cognitive and behavioural symptoms. The different pattern of brain activation and cognitive abilities which support each type of music activity (e.g. listening vs playing music) may offer some explanation towards these differences. A standardised protocol is needed for each type of music intervention to address how music interventions are studied, taking these limitations into consideration.
Collapse
Affiliation(s)
- Catherine Jordan
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
| | - Brian Lawlor
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - David Loughrey
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
26
|
Alhusaini M, Eissa N, Saad AK, Beiram R, Sadek B. Revisiting Preclinical Observations of Several Histamine H3 Receptor Antagonists/Inverse Agonists in Cognitive Impairment, Anxiety, Depression, and Sleep-Wake Cycle Disorder. Front Pharmacol 2022; 13:861094. [PMID: 35721194 PMCID: PMC9198498 DOI: 10.3389/fphar.2022.861094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/22/2022] [Indexed: 12/25/2022] Open
Abstract
A relationship appears to exist between dysfunction of brain histamine (HA) and various neuropsychiatric brain disorders. The possible involvement of brain HA in neuropathology has gained attention recently, and its role in many (patho)physiological brain functions including memory, cognition, and sleep-wake cycle paved the way for further research on the etiology of several brain disorders. Histamine H3 receptor (H3R) evidenced in the brains of rodents and humans remains of special interest, given its unique position as a pre- and postsynaptic receptor, controlling the synthesis and release of HA as well as different other neurotransmitters in different brain regions, respectively. Despite several disappointing outcomes for several H3R antagonists/inverse agonists in clinical studies addressing their effectiveness in Alzheimer's disease (AD), Parkinson's disease (PD), and schizophrenia (SCH), numerous H3R antagonists/inverse agonists showed great potentials in modulating memory and cognition, mood, and sleep-wake cycle, thus suggesting its potential role in neurocognitive and neurodegenerative diseases such as AD, PD, SCH, narcolepsy, and major depression in preclinical rodent models. In this review, we present preclinical applications of selected H3R antagonists/inverse agonists and their pharmacological effects on cognitive impairment, anxiety, depression, and sleep-wake cycle disorders. Collectively, the current review highlights the behavioral impact of developments of H3R antagonists/inverse agonists, aiming to further encourage researchers in the preclinical drug development field to profile the potential therapeutic role of novel antagonists/inverse agonists targeting histamine H3Rs.
Collapse
Affiliation(s)
- Mera Alhusaini
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nermin Eissa
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Department of Biomedical Sciences, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Ali K Saad
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Rami Beiram
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Bassem Sadek
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| |
Collapse
|
27
|
Thaipisuttikul P, Jaikla K, Satthong S, Wisajun P. Rate of conversion from mild cognitive impairment to dementia in a Thai hospital-based population: A retrospective cohort. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12272. [PMID: 35386122 PMCID: PMC8970424 DOI: 10.1002/trc2.12272] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 02/05/2023]
Abstract
Introduction Mild cognitive impairment (MCI) is the state between normal cognition and dementia. This study objective was to estimate an average 1-year rate of conversion from MCI to dementia and explore the associated factors of conversion in a hospital-based cohort. Methods A retrospective cohort study of participants with MCI was conducted in a tertiary care hospital in Thailand. Two hundred fifty participants, 50 years of age or older, were enrolled. Results An average 1-year conversion rate from MCI to dementia was 18.4%. MCI patients who converted to dementia were likely older (P < .001), predominantly female (P = .028), vitamin D deficient (P = .012), and associated with lower Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores during first assessments (P < .001, P < .001 respectively) and follow-up assessments (P < .045, P < .001 respectively). We conducted two models of multivariate analysis, using binary logistic regression. In the first model, adjusted for age, sex, education, vitamin D deficiency, and first assessment MMSE scores, we found that underlying vitamin D deficiency (odds ratio [OR] = 3.13, 95% confidence interval [CI] 1.04 to 9.44) and first assessment MMSE scores (OR = 0.83, 95% CI 0.73 to 0.93) were significantly associated with conversion to dementia. In the second model, adjusted for age, sex, education, vitamin D deficiency and first assessment MoCA scores, only first assessment MoCA scores (OR = 0.58, 95% CI 0.45 to 0.76) were significantly associated with conversion to dementia. Discussion The 1-year conversion rate from MCI to dementia was 18.4%. MMSE and MoCA were useful tools to assess baseline cognitive status in MCI patients and predict dementia progression. The association between vitamin D deficiency and risk of conversion from MCI to dementia requires further investigations.
Collapse
Affiliation(s)
- Papan Thaipisuttikul
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital Mahidol University Bangkok Thailand
| | - Kriengsak Jaikla
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital Mahidol University Bangkok Thailand
| | - Sirikorn Satthong
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital Mahidol University Bangkok Thailand
| | - Pattarabhorn Wisajun
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital Mahidol University Bangkok Thailand
| |
Collapse
|
28
|
Depression and bone loss as risk factors for cognitive decline: A systematic review and meta-analysis. Ageing Res Rev 2022; 76:101575. [PMID: 35093615 DOI: 10.1016/j.arr.2022.101575] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 01/24/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Depression is linked to Alzheimer's disease (AD) but it is unclear whether depression is also associated with cognitive decline in the preclinical phase and mild cognitive impairment (MCI). Previous meta-analyses have only investigated AD as an outcome without accounting for individuals showing cognitive decline that does not meet the diagnostic criteria for AD. Other potentially modifiable risk factors such as bone loss have also been less explored and there remains uncertainty around their temporal relationship with cognitive decline. AIMS To conduct a systematic review and meta-analysis investigating depression and bone loss as risk factors for subsequent cognitive decline. METHODS A comprehensive search strategy was developed and applied using four databases; MEDLINE Complete, Embase, PsycINFO and CINAHL Complete. The pooled summary effects were estimated as odds ratios with 95% confidence intervals using a random-effects model. The study protocol was registered with PROSPERO (ID: CRD42020159369). RESULTS A total of 75 longitudinal cohort studies were identified for meta-analysis, of which 70 examined the impact of depression on cognitive decline and five examined the impact of bone loss. Prior exposure to depression was found to be associated with cognitive score reduction (OR 1.33 95% CI 1.17, 1.51), MCI incidence (OR 1.52 95% CI 1.28, 1.79) and AD incidence (OR 1.79 95% CI 1.46, 2.2). Bone loss was also associated with the incidence of AD (OR=1.81 95% CI 1.28, 2.55). CONCLUSIONS Overall, the results support the hypothesis that depression is associated with subsequent cognitive decline. Bone loss was also found to be associated with AD incidence; however, due to the small number of studies, the results should be viewed with caution.
Collapse
|
29
|
Ahmadieh H, Ghassemi F. Assessing the Effects of Alzheimer Disease on EEG Signals Using the Entropy Measure: A Meta-analysis. Basic Clin Neurosci 2022; 13:153-164. [PMID: 36425952 PMCID: PMC9682319 DOI: 10.32598/bcn.2021.1144.3] [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: 07/23/2020] [Revised: 08/14/2020] [Accepted: 10/03/2020] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Alzheimer disease (AD) is the most prevalent neurodegenerative disorder and a type of dementia. About 80% of dementia in older adults is due to AD. According to multiple research articles, AD is associated with several changes in EEG signals, such as slow rhythms, reduction in complexity and functional associations, and disordered functional communication between different brain areas. This research focuses on the entropy parameter. METHODS In this study, the keywords "Entropy," "EEG," and "Alzheimer" were used. In the initial search, 102 articles were found. In the first stage, after investigating the Abstracts of the articles, the number of them was reduced to 62, and upon further review of the remaining articles, the number of articles was reduced to 18. Some papers have used more than one entropy of EEG signals to compare, and some used more than one database. So, 25 entropy measures were considered in this meta-analysis. We used the Standardized Mean Difference (SMD) to find the effect size and compare the effects of AD on the entropy of the EEG signal in healthy people. Funnel plots were used to investigate the bias of meta-analysis. RESULTS According to the articles, entropy seems to be a good benchmark for comparing the EEG signals between healthy people and AD people. CONCLUSION It can be concluded that AD can significantly affect EEG signals and reduce the entropy of EEG signals. HIGHLIGHTS Our primary question addressed in this study is "Can Alzheimer's Disease significantly affect EEG signals or not?" This paper is the first Meta-Analysis study that reveals the effects of Alzheimer's Disease on EEG signals and the caused reduction in the complexity of the EEG signal. According to the articles, results and funnel plots of this Meta-Analysis, entropy seems to be a good benchmark for comparing the EEG signals in healthy people and people who have Alzheimer's Disease. PLAIN LANGUAGE SUMMARY Alzheimer's Disease is one of the most prevalent neurodegenerative disorder which can affect EEG signals. This study is the first Meta-Analysis in this regard and the results confirm that Alzheimer's Disease reduces the complexity of the EEG signals. We used 25 entropy measures applied in 18 articles. The materials in this Meta-Analysis are 1-SMD for finding the effect size and 2- Funnel plot for investigating the bias of Meta-Analysis.
Collapse
Affiliation(s)
- Hajar Ahmadieh
- Department of Biomedical Engineering, Biomedical Engineering Faculty, Amirkabir University of Technology, Tehran, Iran
| | - Farnaz Ghassemi
- Department of Biomedical Engineering, Biomedical Engineering Faculty, Amirkabir University of Technology, Tehran, Iran
| |
Collapse
|
30
|
Roberto N, Portella MJ, Marquié M, Alegret M, Hernández I, Mauleón A, Rosende-Roca M, Abdelnour C, Esteban de Antonio E, Tartari JP, Vargas L, López-Cuevas R, Bojaryn U, Espinosa A, Ortega G, Pérez-Cordón A, Sanabria Á, Orellana A, de Rojas I, Moreno-Grau S, Montrreal L, Alarcón-Martín E, Ruíz A, Tárraga L, Boada M, Valero S. Neuropsychiatric Profile as a Predictor of Cognitive Decline in Mild Cognitive Impairment. Front Aging Neurosci 2021; 13:718949. [PMID: 34955804 PMCID: PMC8693625 DOI: 10.3389/fnagi.2021.718949] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Mild cognitive impairment is often associated with affective and other neuropsychiatric symptoms (NPS). This co-occurrence might have a relevant impact on disease progression, from MCI to dementia. Objective: The aim of this study was to explore the trajectories of cognitive decline in an MCI sample from a memory clinic, taking into consideration a perspective of isolated cognitive functions and based on NPS clusters, accounting for the different comorbid symptoms collected at their baseline visit. Methods: A total of 2,137 MCI patients were monitored over a 2.4-year period. Four clusters of NPS (i.e., Irritability, Apathy, Anxiety/Depression and Asymptomatic) were used to run linear mixed models to explore the interaction of cluster with time on cognitive trajectories using a comprehensive neuropsychological battery (NBACE) administered at baseline and at the three subsequent follow-ups. Results: A significant interaction between cluster and time in cognitive decline was found when verbal learning and cued-recall were explored (p = 0.002 for both memory functions). For verbal learning, the Irritability cluster had the largest effect size (0.69), whereas the Asymptomatic cluster showed the smallest effect size (0.22). For cued-recall, the Irritability cluster had the largest effect size among groups (0.64), and Anxiety/Depression had the smallest effect size (0.21). Conclusions: In MCI patients, the Irritability and Apathy NPS clusters shared similar patterns of worsening in memory functioning, which could point to these NPS as risk factors of a faster cognitive decline, acting as early prognostic markers and helping in the diagnostic process.
Collapse
Affiliation(s)
- Natalia Roberto
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Maria J Portella
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,Department of Psychiatry, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Networking Research Center on Mental Health (CIBERSAM), Madrid, Spain
| | - Marta Marquié
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Montserrat Alegret
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Isabel Hernández
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Ana Mauleón
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Maitee Rosende-Roca
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Carla Abdelnour
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | | | - Juan P Tartari
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Liliana Vargas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Rogelio López-Cuevas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Urszula Bojaryn
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Ana Espinosa
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Gemma Ortega
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Alba Pérez-Cordón
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Ángela Sanabria
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Adelina Orellana
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Itziar de Rojas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Sonia Moreno-Grau
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Laura Montrreal
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Emilio Alarcón-Martín
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Agustín Ruíz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Lluís Tárraga
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Mercè Boada
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Sergi Valero
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| |
Collapse
|
31
|
Xu L, Zhou Y, Hu L, Jiang H, Dong Y, Shen H, Lou Z, Yang S, Ji Y, Ruan L, Zhang X. Deficits in N-Methyl-D-Aspartate Receptor Function and Synaptic Plasticity in Hippocampal CA1 in APP/PS1 Mouse Model of Alzheimer's Disease. Front Aging Neurosci 2021; 13:772980. [PMID: 34916926 PMCID: PMC8669806 DOI: 10.3389/fnagi.2021.772980] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/29/2021] [Indexed: 12/24/2022] Open
Abstract
The N-methyl-D-aspartate receptor is a critical molecule for synaptic plasticity and cognitive function. Impaired synaptic plasticity is thought to contribute to the cognitive impairment associated with Alzheimer’s disease (AD). However, the neuropathophysiological alterations of N-methyl-D-aspartate receptor (NMDAR) function and synaptic plasticity in hippocampal CA1 in transgenic rodent models of AD are still unclear. In the present study, APP/PS1 mice were utilized as a transgenic model of AD, which exhibited progressive cognitive impairment including defective working memory, recognition memory, and spatial memory starting at 6 months of age and more severe by 8 months of age. We found an impaired long-term potentiation (LTP) and reduced NMDAR-mediated spontaneous excitatory postsynaptic currents (sEPSCs) in the hippocampal CA1 of APP/PS1 mice with 8 months of age. Golgi staining revealed that dendrites of pyramidal neurons had shorter length, fewer intersections, and lower spine density in APP/PS1 mice compared to control mice. Further, the reduced expression levels of NMDAR subunits, PSD95 and SNAP25 were observed in the hippocampus of APP/PS1 mice. These results suggest that NMDAR dysfunction, impaired synaptic plasticity, and disrupted neuronal morphology constitute an important part of the neuropathophysiological alterations associated with cognitive impairment in APP/PS1 mice.
Collapse
Affiliation(s)
- Le Xu
- Zhejiang Key Laboratory of Pathophysiology, Department of Pharmacology, School of Medicine, Ningbo University, Ningbo, China.,Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, China
| | - Yiying Zhou
- Zhejiang Key Laboratory of Pathophysiology, Department of Pharmacology, School of Medicine, Ningbo University, Ningbo, China.,Key Laboratory of Addiction Research of Zhejiang Province, Ningbo Kangning Hospital, Ningbo, China
| | - Linbo Hu
- Zhejiang Key Laboratory of Pathophysiology, Department of Pharmacology, School of Medicine, Ningbo University, Ningbo, China
| | - Hongde Jiang
- Zhejiang Key Laboratory of Pathophysiology, Department of Pharmacology, School of Medicine, Ningbo University, Ningbo, China
| | - Yibei Dong
- Zhejiang Key Laboratory of Pathophysiology, Department of Pharmacology, School of Medicine, Ningbo University, Ningbo, China
| | - Haowei Shen
- Zhejiang Key Laboratory of Pathophysiology, Department of Pharmacology, School of Medicine, Ningbo University, Ningbo, China.,Key Laboratory of Addiction Research of Zhejiang Province, Ningbo Kangning Hospital, Ningbo, China
| | - Zhongze Lou
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, China.,Central Laboratory of the Medical Research Center, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, China
| | - Siyu Yang
- Zhejiang Key Laboratory of Pathophysiology, Department of Pharmacology, School of Medicine, Ningbo University, Ningbo, China
| | - Yunxin Ji
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, China
| | - Liemin Ruan
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, China
| | - Xiaoqin Zhang
- Zhejiang Key Laboratory of Pathophysiology, Department of Pharmacology, School of Medicine, Ningbo University, Ningbo, China.,Key Laboratory of Addiction Research of Zhejiang Province, Ningbo Kangning Hospital, Ningbo, China
| |
Collapse
|
32
|
Ahn S, Mathiason MA, Yu F. Longitudinal Cognitive Profiles by Anxiety and Depressive Symptoms in American Older Adults With Subjective Cognitive Decline. J Nurs Scholarsh 2021; 53:698-708. [PMID: 34342395 PMCID: PMC8599627 DOI: 10.1111/jnu.12692] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 05/27/2021] [Accepted: 06/09/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The objective of this study was to determine how anxiety and/or depressive symptoms differentially affect specific cognitive domains over time in persons with subjective cognitive decline (SCD). DESIGN A longitudinal, observational study was conducted using data from the National Alzheimer's Coordinating Center-Uniform Data Set. Mean follow-up was 4.1 ± 2.4 years. METHODS Using information from a total of 1401 participants (age 74.0 ± 8.2 years), linear mixed-effects regression models were used to assess longitudinal changes in global cognition, episodic memory, attention, language, and executive function by baseline psychological (anxiety [A] and/or depressive [D]) symptoms in individuals with SCD. Reference was the group having no symptoms (A-/D-). FINDINGS The A+/D- group was not associated with any cognitive changes. The A-/D+ group was associated with a greater decline in episodic memory and executive function. The A+/D+ group had a greater decline in attention. Changes in global cognition and language were not predicted by any psychological symptoms. CONCLUSIONS Depressive symptoms predicted lower episodic memory and executive function. CLINICAL RELEVANCE Nurses need to pay attention to depressive symptoms in older adults with SCD because managing depressive symptoms may help protect against cognitive decline more typical of early Alzheimer's dementia.
Collapse
Affiliation(s)
- Sangwoo Ahn
- University of Tennessee College of Nursing, Knoxville, Tennessee, USA
| | | | - Fang Yu
- Edson Chair in Dementia Translational Nursing Science, Arizona State University, Edson College of Nursing and Health Innovation, Phoenix, Arizona, USA
| |
Collapse
|
33
|
Butler LM, Houghton R, Abraham A, Vassilaki M, Durán-Pacheco G. Comorbidity Trajectories Associated With Alzheimer's Disease: A Matched Case-Control Study in a United States Claims Database. Front Neurosci 2021; 15:749305. [PMID: 34690684 PMCID: PMC8531650 DOI: 10.3389/fnins.2021.749305] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/21/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Trajectories of comorbidities among individuals at risk of Alzheimer's disease (AD) may differ from those aging without AD clinical syndrome. Therefore, characterizing the comorbidity burden and pattern associated with AD risk may facilitate earlier detection, enable timely intervention, and help slow the rate of cognitive and functional decline in AD. This case-control study was performed to compare the prevalence of comorbidities between AD cases and controls during the 5 years prior to diagnosis (or index date for controls); and to identify comorbidities with a differential time-dependent prevalence trajectory during the 5 years prior to AD diagnosis. Methods: Incident AD cases and individually matched controls were identified in a United States claims database between January 1, 2000 and December 31, 2016. AD status and comorbidities were defined based on the presence of diagnosis codes in administrative claims records. Generalized estimating equations were used to assess evidence of changes over time and between AD and controls. A principal component analysis and hierarchical clustering was performed to identify groups of AD-related comorbidities with respect to prevalence changes over time (or trajectory), and differences between AD and controls. Results: Data from 186,064 individuals in the IBM MarketScan Commercial Claims and Medicare Supplementary databases were analyzed (93,032 AD cases and 93,032 non-AD controls). In total, there were 177 comorbidities with a ≥ 5% prevalence. Five main clusters of comorbidities were identified. Clusters differed between AD cases and controls in the overall magnitude of association with AD, in their diverging time trajectories, and in comorbidity prevalence. Three clusters contained comorbidities that notably increased in frequency over time in AD cases but not in controls during the 5-year period before AD diagnosis. Comorbidities in these clusters were related to the early signs and/or symptoms of AD, psychiatric and mood disorders, cerebrovascular disease, history of hazard and injuries, and metabolic, cardiovascular, and respiratory complaints. Conclusion: We demonstrated a greater comorbidity burden among those who later developed AD vs. controls, and identified comorbidity clusters that could distinguish these two groups. Further investigation of comorbidity burden is warranted to facilitate early detection of individuals at risk of developing AD.
Collapse
Affiliation(s)
| | | | | | - Maria Vassilaki
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | | |
Collapse
|
34
|
Doborjeh M, Doborjeh Z, Merkin A, Bahrami H, Sumich A, Krishnamurthi R, Medvedev ON, Crook-Rumsey M, Morgan C, Kirk I, Sachdev PS, Brodaty H, Kang K, Wen W, Feigin V, Kasabov N. Personalised predictive modelling with brain-inspired spiking neural networks of longitudinal MRI neuroimaging data and the case study of dementia. Neural Netw 2021; 144:522-539. [PMID: 34619582 DOI: 10.1016/j.neunet.2021.09.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 08/11/2021] [Accepted: 09/12/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Longitudinal neuroimaging provides spatiotemporal brain data (STBD) measurement that can be utilised to understand dynamic changes in brain structure and/or function underpinning cognitive activities. Making sense of such highly interactive information is challenging, given that the features manifest intricate temporal, causal relations between the spatially distributed neural sources in the brain. METHODS The current paper argues for the advancement of deep learning algorithms in brain-inspired spiking neural networks (SNN), capable of modelling structural data across time (longitudinal measurement) and space (anatomical components). The paper proposes a methodology and a computational architecture based on SNN for building personalised predictive models from longitudinal brain data to accurately detect, understand, and predict the dynamics of an individual's functional brain state. The methodology includes finding clusters of similar data to each individual, data interpolation, deep learning in a 3-dimensional brain-template structured SNN model, classification and prediction of individual outcome, visualisation of structural brain changes related to the predicted outcomes, interpretation of results, and individual and group predictive marker discovery. RESULTS To demonstrate the functionality of the proposed methodology, the paper presents experimental results on a longitudinal magnetic resonance imaging (MRI) dataset derived from 175 older adults of the internationally recognised community-based cohort Sydney Memory and Ageing Study (MAS) spanning 6 years of follow-up. SIGNIFICANCE The models were able to accurately classify and predict 2 years ahead of cognitive decline, such as mild cognitive impairment (MCI) and dementia with 95% and 91% accuracy, respectively. The proposed methodology also offers a 3-dimensional visualisation of the MRI models reflecting the dynamic patterns of regional changes in white matter hyperintensity (WMH) and brain volume over 6 years. CONCLUSION The method is efficient for personalised predictive modelling on a wide range of neuroimaging longitudinal data, including also demographic, genetic, and clinical data. As a case study, it resulted in finding predictive markers for MCI and dementia as dynamic brain patterns using MRI data.
Collapse
Affiliation(s)
- Maryam Doborjeh
- Computer Science and Software Engineering Department, School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, New Zealand.
| | - Zohreh Doborjeh
- Department of Audiology, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand
| | - Alexander Merkin
- The National Institute for Stroke and Applied Neurosciences, School of Clinical Sciences, Auckland University of Technology, New Zealand
| | - Helena Bahrami
- School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, New Zealand
| | - Alexander Sumich
- NTU Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Rita Krishnamurthi
- The National Institute for Stroke and Applied Neurosciences, School of Clinical Sciences, Auckland University of Technology, New Zealand
| | - Oleg N Medvedev
- University of Waikato, School of Psychology, Hamilton, New Zealand
| | - Mark Crook-Rumsey
- NTU Psychology, Nottingham Trent University, Nottingham, United Kingdom; School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, New Zealand
| | - Catherine Morgan
- School of Psychology and Centre for Brain Research, University of Auckland, New Zealand; Brain Research New Zealand - Rangahau Roro Aotearoa, Centre of Research Excellence, New Zealand
| | - Ian Kirk
- School of Psychology and Centre for Brain Research, University of Auckland, New Zealand; Brain Research New Zealand - Rangahau Roro Aotearoa, Centre of Research Excellence, New Zealand
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia; Neuropsychiatric Institute, the Prince of Wales Hospital, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Kristan Kang
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia; Neuropsychiatric Institute, the Prince of Wales Hospital, Sydney, Australia
| | - Valery Feigin
- The National Institute for Stroke and Applied Neurosciences, School of Clinical Sciences, Auckland University of Technology, New Zealand; Research Center of Neurology, Moscow, Russia
| | - Nikola Kasabov
- School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, New Zealand; George Moore Chair, Ulster University, Londonderry, United Kingdom
| |
Collapse
|
35
|
Kootar S, Huque MH, Arthur R, Mortby M, Anstey KJ. Association Between Anxiety and Cognitive Decline Over 12 Years in a Population-Based Cohort. J Alzheimers Dis 2021; 84:409-418. [PMID: 34542067 DOI: 10.3233/jad-210282] [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: 11/15/2022]
Abstract
BACKGROUND Findings on the associations between anxiety and cognitive decline are mixed and often confounded. OBJECTIVE We studied whether anxiety symptoms were associated with the risk of cognitive decline after adequate adjustment of confounding factors. METHODS Our study consists of 2,551 community-dwelling older adults recruited between the ages of 60-64 years and followed up for 12 years in the PATH Through Life cohort study. Anxiety symptoms were measured using the Goldberg Anxiety Scale (GAS; range 0-9). General cognitive function, episodic memory, working memory, verbal intelligence, processing speed, and psychomotor speed were measured. Multilevel analyses were carried out to investigate the association between anxiety symptoms and cognitive decline over 12 years, taking into account confounding variables. RESULTS We did not find a significant association between baseline anxiety symptoms and cognitive decline over 12 years. Although some associations between anxiety symptoms with psychomotor speed (β= -0.04, 99% CI: -0.08, 0.00) and processing speed (β= -0.27, 99% CI: -0.48, -0.07) were found, these were attenuated after adjusting for depression. We also did not find an association between cumulative anxiety and decline in cognitive performance. CONCLUSION In this sample of cognitively healthy men and women aged 60 years and above, anxiety symptoms were not associated with the risk of cognitive decline. Long follow-up study time, appropriate selection of confounding factors, and estimating the effect of cumulative anxiety are important to establish the association between anxiety and cognitive symptoms.
Collapse
Affiliation(s)
- Scherazad Kootar
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia
| | - Md Hamidul Huque
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia
| | - Richard Arthur
- Centre for Research on Ageing Health and Wellbeing, School of Population Health, The Australian National University, Acton, ACT, Australia
| | - Moyra Mortby
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia.,Centre for Research on Ageing Health and Wellbeing, School of Population Health, The Australian National University, Acton, ACT, Australia
| |
Collapse
|
36
|
Jang JY, Ho JK, Blanken AE, Dutt S, Nation DA. Affective Neuropsychiatric Symptoms as Early Signs of Dementia Risk in Older Adults. J Alzheimers Dis 2021; 77:1195-1207. [PMID: 32925031 DOI: 10.3233/jad-200190] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Affective neuropsychiatric symptoms (aNPS: depression, anxiety, apathy, irritability) have been linked to increased dementia risk. However, less is known whether this association is independent of Alzheimer's disease (AD) pathophysiology. OBJECTIVE To investigate the contribution of early aNPS to dementia risk in cognitively normal (CN) older adults and mild cognitive impairment (MCI) patients, with and without AD biomarker abnormality. METHODS Participants included 763 community-dwelling, stroke-free older adults identified as CN and 617 with MCI at baseline, drawn from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Baseline assessments included a neuropsychological battery, the Neuropsychiatric Inventory (NPI), and apolipoprotein E ɛ4 (ApoE4) genotyping. A participant subset completed cerebrospinal fluid (CSF) AD biomarker assessment. Time to progression to dementia was measured based on months at follow-up when an individual was diagnosed with dementia, over the follow-up period of 48 months. RESULTS Latent class analysis identified 3 subgroups of older adults in CN and MCI, indicated by the baseline profiles of neuropsychiatric symptoms (NPS). Subgroups with higher aNPS were at increased risk of progression to dementia in both CN (HR = 3.65, 95% CI [1.80, 7.40]) and MCI (HR = 1.52, 95% CI [1.16, 2.00]; HR = 1.86 [1.05, 3.30]) groups, adjusting for age, sex, global cognition, and ApoE4, compared with their counterparts with minimal NPS. There was no difference between higher aNPS and minimal NPS subgroups in their CSF AD biomarker profiles. CONCLUSION Findings suggest that aNPS may represent a neurobiological vulnerability that uniquely contribute to the dementia risk, independent of AD biomarker profiles.
Collapse
Affiliation(s)
- Jung Yun Jang
- Veterans Affairs Boston Healthcare System, Boston, MA, USA
| | - Jean K Ho
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Anna E Blanken
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | | | | |
Collapse
|
37
|
Yang YW, Hsu KC, Wei CY, Tzeng RC, Chiu PY. Operational Determination of Subjective Cognitive Decline, Mild Cognitive Impairment, and Dementia Using Sum of Boxes of the Clinical Dementia Rating Scale. Front Aging Neurosci 2021; 13:705782. [PMID: 34557083 PMCID: PMC8455062 DOI: 10.3389/fnagi.2021.705782] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/10/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: The Clinical Dementia Rating (CDR) Scale is the gold standard for the staging of dementia due to Alzheimer's disease (AD). However, the application of CDR for the staging of subjective cognitive decline (SCD) and mild cognitive impairment (MCI) in AD remains controversial. This study aimed to use the sum of boxes of the CDR (CDR-SB) plus an SCD single questionnaire to operationally determine the different stages of cognitive impairment (CI) due to AD and non-AD. Methods: This was a two-phase study, and we retrospectively analyzed the Show Chwan Dementia registry database using the data selected from 2015 to 2020. Individuals with normal cognition (NC), SCD, MCI, and mild dementia (MD) due to AD or non-AD with a CDR < 2 were included in the analysis. Results: A total of 6,946 individuals were studied, including 875, 1,009, 1,585, and 3,447 with NC, SCD, MCI, and MD, respectively. The cutoff scores of CDR-SB for NC/SCD, SCD/MCI, and MCI/dementia were 0/0.5, 0.5/1.0, and 2.5/3.0, respectively. The receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) values of the test groups were 0.85, 0.90, and 0.92 for discriminating NC from SCD, SCD from MCI, and MCI from dementia, respectively. Compared with the Cognitive Abilities Screening Instrument or the Montreal Cognitive Assessment, the use of CDR-SB is less influenced by age and education. Conclusion: Our study showed that the operational determination of SCD, MCI, and dementia using the CDR-SB is practical and can be applied in clinical settings and research on CI or dementia.
Collapse
Affiliation(s)
- Yu-Wan Yang
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Kai-Cheng Hsu
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
- Department of Medicine, China Medical University, Taichung, Taiwan
- Artificial Intelligence Center for Medical Diagnosis, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Yu Wei
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
| | - Ray-Chang Tzeng
- Department of Neurology, Tainan Municipal Hospital, Tainan, Taiwan
| | - Pai-Yi Chiu
- Department of Neurology, Show Chwan Memorial Hospital, Changhua, Taiwan
- Department of Nursing, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| |
Collapse
|
38
|
Smith L, Jacob L, López-Sánchez GF, Butler L, Barnett Y, Veronese N, Soysal P, Yang L, Grabovac I, Tully MA, Shin JI, Koyanagi A. Anxiety symptoms and mild cognitive impairment among community-dwelling older adults from low- and middle-income countries. J Affect Disord 2021; 291:57-64. [PMID: 34023748 DOI: 10.1016/j.jad.2021.04.076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/19/2021] [Accepted: 04/25/2021] [Indexed: 11/25/2022]
Abstract
AIM Anxiety may be a risk factor for mild cognitive impairment (MCI) but there is a scarcity of data on this association especially from low- and middle-income countries (LMICs). Thus, we investigated the association between anxiety and MCI among older adults residing in six LMICs (China, Ghana, India, Mexico, Russia, South Africa), and the mediational effect of sleep problems in this association. METHODS Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer's Association criteria. Multivariable logistic regression analysis, meta-analysis, and mediation analysis were conducted to assess associations. RESULTS The final sample included 32,715 individuals aged ≥50 years with preservation in functional abilities [mean (standard deviation) age 62.1 (15.6) years; 48.3% males]. Country-wise analysis showed a positive association between anxiety and MCI in all countries (OR 1.35-14.33). The pooled estimate based on meta-analysis with random effects was OR=2.27 (95%CI=1.35-3.83). Sleep problems explained 41.1% of this association. CONCLUSIONS Older adults with anxiety had higher odds for MCI in LMICs. Future studies should examine whether preventing anxiety or addressing anxiety among individuals with MCI can lead to lower risk for dementia onset in LMICs, while the role of sleep problems in this association should be investigated in detail.
Collapse
Affiliation(s)
- Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, CB1 1PT, United Kingdom.
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux 78180, France
| | - Guillermo F López-Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, United Kingdom
| | - Laurie Butler
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, CB1 1PT, United Kingdom
| | - Yvonne Barnett
- Anglia Ruskin University, Cambridge, CB1 1PT, United Kingdom
| | - Nicola Veronese
- Department of Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Canada; Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Igor Grabovac
- Department of Social and Behavioural Science, Medical University of Vienna, Kinderspitalgasse 15/1, 1090 Wien, Austria
| | - Mark A Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, United Kingdom
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain
| |
Collapse
|
39
|
Verification of Trail Making Test in Elderly People with Behavioral and Psychological Symptoms of Dementia. AGEING INTERNATIONAL 2021. [DOI: 10.1007/s12126-021-09424-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AbstractIn Alzheimer's disease (AD), attention and executive dysfunction occur early in the disease. However, little is known about the relationship between these disorders and behavioral and psychological symptoms of dementia (BPSD). This study investigated the relationship between BPSD and attention and execution functions. Twenty-five patients with mild cognitive impairment (MCI) and early AD were included. Neuropsychological tests, mini-mental state examination (MMSE), Raven’s colored progressive materials (RCPM), and trail making test (TMT) were conducted for patients with dementia. The dementia behavior disturbance scale (DBD) was used for psychological and behavioral evaluations of patients with dementia. The AD group showed significantly lower MMSE, DBD, and TMT-B scores than the MCI group. Multiple regression analyses revealed a significant correlation between DBD score, MMSE, and TMT-B.Conclusion: BPSD is associated with cognitive function severity in patients with MCI and early AD, suggesting that attentional and executive functions are independent risk factors for these neural substrates.
Collapse
|
40
|
Sergeev K, Runnova A, Zhuravlev M, Kolokolov O, Akimova N, Kiselev A, Titova A, Slepnev A, Semenova N, Penzel T. Wavelet skeletons in sleep EEG-monitoring as biomarkers of early diagnostics of mild cognitive impairment. CHAOS (WOODBURY, N.Y.) 2021; 31:073110. [PMID: 34340349 DOI: 10.1063/5.0055441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
Many neuro-degenerative diseases are difficult to diagnose in their early stages. For example, early diagnosis of Mild Cognitive Impairment (MCI) requires a wide variety of tests to distinguish MCI symptoms and normal consequences of aging. In this article, we use the wavelet-skeleton approach to find some characteristic patterns in the electroencephalograms (EEGs) of healthy adult patients and patients with cognitive dysfunctions. We analyze the EEG activity recorded during natural sleep of 11 elderly patients aged between 60 and 75, six of whom have mild cognitive impairment, and apply a nonlinear analysis method based on continuous wavelet transformskeletons. Our studies show that a comprehensive analysis of EEG signals of the entire sleep state allows us to identify a significant decrease in the average duration of oscillatory patterns in the frequency band [12; 14] Hz in the presence of mild cognitive impairment. Thus, the changes in this frequency range can be interpreted as related to the activity in the motor cortex, as a candidate for developing the criteria for early objective MCI.
Collapse
Affiliation(s)
- Konstantin Sergeev
- Saratov State University, Astrakhanskaya Str., 83, Saratov 410012, Russia
| | - Anastasiya Runnova
- Saratov State University, Astrakhanskaya Str., 83, Saratov 410012, Russia
| | - Maksim Zhuravlev
- Saratov State University, Astrakhanskaya Str., 83, Saratov 410012, Russia
| | - Oleg Kolokolov
- Saratov State Medical University, B. Kazachaya Str., 112, Saratov 410012, Russia
| | - Nataliya Akimova
- Saratov State Medical University, B. Kazachaya Str., 112, Saratov 410012, Russia
| | - Anton Kiselev
- Saratov State Medical University, B. Kazachaya Str., 112, Saratov 410012, Russia
| | - Anastasiya Titova
- Saratov State Medical University, B. Kazachaya Str., 112, Saratov 410012, Russia
| | - Andrei Slepnev
- Saratov State University, Astrakhanskaya Str., 83, Saratov 410012, Russia
| | - Nadezhda Semenova
- Saratov State University, Astrakhanskaya Str., 83, Saratov 410012, Russia
| | - Thomas Penzel
- Saratov State University, Astrakhanskaya Str., 83, Saratov 410012, Russia
| |
Collapse
|
41
|
Xiao S, Li Y, Liu M, Li Y. Electrophysiological Studies of Cognitive Reappraisal Success and Failure in aMCI. Brain Sci 2021; 11:brainsci11070855. [PMID: 34198957 PMCID: PMC8301780 DOI: 10.3390/brainsci11070855] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/08/2021] [Accepted: 06/23/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Although successful reappraisal relies on cognitive resources, how cognitive impairment affects brain processes related to cognitive reappraisal is not yet clear. METHODS Forty-four amnestic mild cognitive impairment (aMCI) subjects and 72 healthy elderly controls (HECs) were divided into the MCI-Failure (n = 23), MCI-Success (n = 21), HEC-Failure (n = 26), and HEC-Success (n = 46) groups according to changes in self-reported affect using reappraisal. All participants viewed 30 negative and 30 neutral images preceded by straightforward descriptions of these images and 30 negative images preceded by more neutral descriptions. RESULTS Reappraisal failure was found to be more common in people with MCI. Reappraisal failure is associated with altered neurophysiological indices of negative-reappraisal stimuli processing that are reflected in smaller theta responsivity to negative-reappraisal stimuli between 350-550 ms. The MCI-Success group showed enhanced LPP for negative-reappraisal stimuli from 1200 to 3500 ms, reflecting compensatory effort to complete the reappraisal task, while subjects in other groups showed reduced LPP for negative-reappraisal stimuli from 550 to 1200 ms. CONCLUSIONS These findings deepen our understanding of how cognitive decline impacts reappraisal and informs early diagnosis and interventions for MCI.
Collapse
Affiliation(s)
- Shasha Xiao
- School of Communication and Information Engineering, Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai 200444, China;
| | - Yingjie Li
- School of Communication and Information Engineering, Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai 200444, China;
- Correspondence: (Y.L.); (Y.L.)
| | - Meng Liu
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200092, China;
| | - Yunxia Li
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200092, China;
- Correspondence: (Y.L.); (Y.L.)
| |
Collapse
|
42
|
Trait anxiety, a personality risk factor associated with Alzheimer's Disease. Prog Neuropsychopharmacol Biol Psychiatry 2021; 105:110124. [PMID: 33035604 DOI: 10.1016/j.pnpbp.2020.110124] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/24/2020] [Accepted: 10/02/2020] [Indexed: 12/25/2022]
Abstract
Alzheimer's disease (AD) is the most common neurodegenerative disease in elderly population and the leading cause of dementia worldwide. While senile plaques and neurofibrillary tangles have been proposed as the principal histopathologic hallmarks of AD, the exact etiology of this disease is still far from being clearly understood. AD has been recognized as pathological consequences of complex interactions among genetic, aging, medical, life style and psychosocial factors. Recently, the roles of neuroticism personality traits in AD incidence and progression have come into focus. More specifically, increasing evidence has further shown that the trait anxiety, one major component of neuroticism predicting the individual vulnerability in response to stress, is a risk factor for AD and may correlated with various AD pathologies. In this review, we summarized recent literature on the association of trait anxiety with AD. We also discussed the possible neuroendocrinological and neurochemical mechanisms of this association, which may provide clinical implications for AD diagnosis and therapy.
Collapse
|
43
|
Garad M, Edelmann E, Leßmann V. Impairment of Spike-Timing-Dependent Plasticity at Schaffer Collateral-CA1 Synapses in Adult APP/PS1 Mice Depends on Proximity of Aβ Plaques. Int J Mol Sci 2021; 22:1378. [PMID: 33573114 PMCID: PMC7866519 DOI: 10.3390/ijms22031378] [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: 12/28/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 12/16/2022] Open
Abstract
Alzheimer's disease (AD) is a multifaceted neurodegenerative disorder characterized by progressive and irreversible cognitive decline, with no disease-modifying therapy until today. Spike timing-dependent plasticity (STDP) is a Hebbian form of synaptic plasticity, and a strong candidate to underlie learning and memory at the single neuron level. Although several studies reported impaired long-term potentiation (LTP) in the hippocampus in AD mouse models, the impact of amyloid-β (Aβ) pathology on STDP in the hippocampus is not known. Using whole cell patch clamp recordings in CA1 pyramidal neurons of acute transversal hippocampal slices, we investigated timing-dependent (t-) LTP induced by STDP paradigms at Schaffer collateral (SC)-CA1 synapses in slices of 6-month-old adult APP/PS1 AD model mice. Our results show that t-LTP can be induced even in fully developed adult mice with different and even low repeat STDP paradigms. Further, adult APP/PS1 mice displayed intact t-LTP induced by 1 presynaptic EPSP paired with 4 postsynaptic APs (6× 1:4) or 1 presynaptic EPSP paired with 1 postsynaptic AP (100× 1:1) STDP paradigms when the position of Aβ plaques relative to recorded CA1 neurons in the slice were not considered. However, when Aβ plaques were live stained with the fluorescent dye methoxy-X04, we observed that in CA1 neurons with their somata <200 µm away from the border of the nearest Aβ plaque, t-LTP induced by 6× 1:4 stimulation was significantly impaired, while t-LTP was unaltered in CA1 neurons >200 µm away from plaques. Treatment of APP/PS1 mice with the anti-inflammatory drug fingolimod that we previously showed to alleviate synaptic deficits in this AD mouse model did not rescue the impaired t-LTP. Our data reveal that overexpression of APP and PS1 mutations in AD model mice disrupts t-LTP in an Aβ plaque distance-dependent manner, but cannot be improved by fingolimod (FTY720) that has been shown to rescue conventional LTP in CA1 of APP/PS1 mice.
Collapse
Affiliation(s)
- Machhindra Garad
- Institute of Physiology, Medical Faculty, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (M.G.); (E.E.)
| | - Elke Edelmann
- Institute of Physiology, Medical Faculty, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (M.G.); (E.E.)
- Center for Behavioral Brain Sciences (CBBS), 39120 Magdeburg, Germany
| | - Volkmar Leßmann
- Institute of Physiology, Medical Faculty, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (M.G.); (E.E.)
- Center for Behavioral Brain Sciences (CBBS), 39120 Magdeburg, Germany
| |
Collapse
|
44
|
Patel P, Masurkar AV. The Relationship of Anxiety with Alzheimer's Disease: A Narrative Review. Curr Alzheimer Res 2021; 18:359-371. [PMID: 34429045 DOI: 10.2174/1567205018666210823095603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/18/2021] [Accepted: 04/05/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND There is an increased effort to better understand neuropsychiatric symptoms of Alzheimer's Disease (AD) as an important feature of symptomatic burden as well as potential modifiable factors of the disease process. Anxiety is one of the most common neuropsychiatric symptoms in Alzheimer's Disease (AD). A growing body of work has emerged that addresses the epidemiology and biological correlations of anxiety in AD. METHODS Here, we review human studies in research and clinical cohorts that examined anxiety in AD. We focused on work related to prevalence across AD stages, correlation with established biomarkers, relationship with AD neuropathology and genetic risk factors, and impact on progression. RESULTS Anxiety is prominent in the early stages and increases across the spectrum of functional stages. Biomarker relationships are strongest at the level of FDG-PET and amyloid measured via PET or cerebrospinal fluid analysis. Neuropathologically, anxiety emerges with early Braak stage tau pathology. The presence of the apolipoprotein E e4 allele is associated with increased anxiety at all stages, most notably at mild cognitive impairment. Anxiety portended a faster progression at all predementia stages. CONCLUSION This body of work suggests a close biological relationship between anxiety and AD that begins in early stages and influences functional decline. As such, we discuss future work that would improve our understanding of this relationship and test the validity of anxiolytic treatment as disease modifying therapy for AD.
Collapse
Affiliation(s)
- Palak Patel
- Department of Neurology, School of Medicine, New York University, New York, NY, United States
| | - Arjun V Masurkar
- Department of Neurology, School of Medicine, New York University, New York, NY, United States
| |
Collapse
|
45
|
Anor CJ, Dadar M, Collins DL, Tartaglia MC. The Longitudinal Assessment of Neuropsychiatric Symptoms in Mild Cognitive Impairment and Alzheimer's Disease and Their Association With White Matter Hyperintensities in the National Alzheimer's Coordinating Center's Uniform Data Set. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:70-78. [PMID: 32389747 PMCID: PMC7529680 DOI: 10.1016/j.bpsc.2020.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPSs) are common in Alzheimer's disease (AD). NPSs contribute to patients' distress, caregiver burden, and institutionalization. White matter hyperintensities (WMHs) appear on magnetic resonance imaging, usually indicative of cerebrovascular disease. WMHs have been associated with certain NPSs. We aimed to assess the relationship between WMH and NPS severity in mild cognitive impairment (MCI) due to AD (MCI-AD) and in AD and to assess the ability of WMHs to predict NPS progression. Data were obtained from the National Alzheimer's Coordinating Center. METHODS A total of 252 participants (114 with MCI-AD and 138 with AD) were used in this study. Baseline WMHs were quantified using an automated segmentation technique. NPSs were measured using the Neuropsychiatric Inventory. Mixed-effect models and correlations were used to determine the relationship between WMHs and NPSs. RESULTS Longitudinal mixed-effect models revealed a significant relationship between increase in Neuropsychiatric Inventory total scores and baseline WMHs (p = .014). There was a significant relationship between baseline WMHs and an increase in delusions (p = .023), hallucinations (p = .040), agitation (p = .093), depression (p = .017), and irritability (p = .002). Correlation plot analysis showed that baseline whole-brain WMHs predicted change in future Neuropsychiatric Inventory total scores (r = .169, p = .008) and predicted change in future agitation severity scores (r = .165, p = .009). WMHs in the temporal lobes (r = .169, p = .008) and frontal lobes (r = .153, p = .016) contributed most to this change. CONCLUSIONS Depression, irritability, and agitation are common NPSs and very distressful to patients and caregivers. Our findings of increased NPS severity over time in MCI-AD and AD with increased WMHs have important implications for treatment, arguing for aggressive treatment of vascular risk factors in patients with MCI-AD or AD.
Collapse
Affiliation(s)
- Cassandra J Anor
- University Health Network Memory Clinic, Department of Neurology, Toronto, Ontario, Canada; Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Mahsa Dadar
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - D Louis Collins
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - M Carmela Tartaglia
- University Health Network Memory Clinic, Department of Neurology, Toronto, Ontario, Canada; Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
46
|
Barak Y, Barson D, Davie G, Glue P, Paleacu D. Internalize at your peril: internalizing disorders as risk factors for dementia-cohort study. GeroScience 2020; 43:253-261. [PMID: 33067707 DOI: 10.1007/s11357-020-00285-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 10/12/2020] [Indexed: 12/21/2022] Open
Abstract
Few studies examined comorbid anxiety and depression's independent association with dementia. We assessed internalizing disorders as risk factors for dementia to avoid pitfalls inherent in separating anxiety and depression. Retrospectively designed prospective comparative cohort study using New Zealand's (NZ) National Minimum Dataset of hospital discharges. Hazards ratios (HRs), estimated from parametric survival models, compared the time to incident dementia after a minimal latency interval of 10 years between those with and without prior diagnosis of an internalizing disorder. A total of 47,932 patients aged 50-54 years were discharged from a publicly funded hospital events in NZ between 1988 and 1992. Of these, 37,631 (79%) met eligibility criteria, and incident dementia was diagnosed in 1594. Rates of incident dementia were higher among patients with an earlier diagnosis of internalizing disorders (572 vs 303 per 100,000 person years at risk (PYAR)). After adjustment for age, sex, ethnicity, and region, those with internalizing disorders were estimated to have a higher risk of developing dementia than those without (adjusted HR = 1.57, 95% CI 1.17-2.10). Females with an earlier diagnosis of internalizing disorders were estimated to have almost twice the risk of developing dementia (adjusted HR 1.80, 95% CI 1.25-2.59). Internalizing disorders affect one in five adults globally. Our findings suggest a significant increase in risk of dementia more than 10 years after the diagnosis of internalizing disorder.
Collapse
Affiliation(s)
- Yoram Barak
- School of Medicine, Dept. of Psychological Medicine, University of Otago, PO Box 56, Dunedin, New Zealand.
| | - David Barson
- School of Medicine, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Gabrielle Davie
- School of Medicine, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Paul Glue
- School of Medicine, Dept. of Psychological Medicine, University of Otago, PO Box 56, Dunedin, New Zealand
| | - Diana Paleacu
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| |
Collapse
|
47
|
Ikeda Y, Han G, Maruta M, Hotta M, Ueno E, Tabira T. Association between Daily Activities and Behavioral and Psychological Symptoms of Dementia in Community-Dwelling Older Adults with Memory Complaints by Their Families. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6831. [PMID: 32962076 PMCID: PMC7558144 DOI: 10.3390/ijerph17186831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/14/2020] [Accepted: 09/17/2020] [Indexed: 11/16/2022]
Abstract
It is important and useful to consider information provided by family members about individuals with memory complaints' instrumental activities of daily living (IADL). The purpose of this study was to clarify the characteristics and relevance of individuals with memory complaints' IADL and behavioral and psychological symptoms of dementia (BPSD) assessed from the perspective of the family members using the Process Analysis of Daily Activity for Dementia and short version Dementia Behavior Disturbance scale. A self-administered questionnaire was sent to 2000 randomly selected members of Consumer's Co-operative Kagoshima, and 621 responded. Of the returned responses, there were 159 participants who answered about individuals with memory complaints. The stepwise multiple regression analysis was used to examine the association between IADL and BPSD. The result showed that many IADL of the individuals with memory complaints were associated with BPSD of apathy, nocturnal wakefulness, and unwarranted accusations, adjusted for age, gender, and the observation list for early signs of dementia. In addition, each IADL was associated with BPSD of apathy, nocturnal wakefulness, and dresses inappropriately. Modifying lifestyle early on when families recognize these changes may help maintain and improve the long-term quality of life of the individuals with memory complaints and their family.
Collapse
Affiliation(s)
- Yuriko Ikeda
- Graduate School of Health Science, Kagoshima University, Kagoshima 890-8544, Japan
| | - Gwanghee Han
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto 860-8556, Japan;
| | - Michio Maruta
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University, Kagoshima 890-8544, Japan;
- Department of Rehabilitation, Medical Corporation, Sanshukai, Okatsu Hospital, Kagoshima 890-0067, Japan
| | - Maki Hotta
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Osaka 565-0871, Japan;
| | - Eri Ueno
- Department of Rehabilitation, Medical Corporation, Nissyoukai, Minamikagoshimasakura Hospital, Kagoshima 890-0069, Japan;
| | - Takayuki Tabira
- Graduate School of Health Science, Kagoshima University, Kagoshima 890-8544, Japan
| |
Collapse
|
48
|
Bateman DR, Gill S, Hu S, Foster ED, Ruthirakuhan MT, Sellek AF, Mortby ME, Matušková V, Ng KP, Tarawneh RM, Freund-Levi Y, Kumar S, Gauthier S, Rosenberg PB, Ferreira de Oliveira F, Devanand DP, Ballard C, Ismail Z. Agitation and impulsivity in mid and late life as possible risk markers for incident dementia. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12016. [PMID: 32995467 PMCID: PMC7507499 DOI: 10.1002/trc2.12016] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 02/17/2020] [Indexed: 12/14/2022]
Abstract
To identify knowledge gaps regarding new-onset agitation and impulsivity prior to onset of cognitive impairment or dementia the International Society to Advance Alzheimer's Research and Treatment Neuropsychiatric Syndromes (NPS) Professional Interest Area conducted a scoping review. Extending a series of reviews exploring the pre-dementia risk syndrome Mild Behavioral Impairment (MBI), we focused on late-onset agitation and impulsivity (the MBI impulse dyscontrol domain) and risk of incident cognitive decline and dementia. This scoping review of agitation and impulsivity pre-dementia syndromes summarizes the current biomedical literature in terms of epidemiology, diagnosis and measurement, neurobiology, neuroimaging, biomarkers, course and prognosis, treatment, and ongoing clinical trials. Validations for pre-dementia scales such as the MBI Checklist, and incorporation into longitudinal and intervention trials, are needed to better understand impulse dyscontrol as a risk factor for mild cognitive impairment and dementia.
Collapse
Affiliation(s)
- Daniel R Bateman
- Department of Psychiatry Indiana University School of Medicine Indianapolis Indiana
- Indiana University Center for Aging Research Regenstrief Institute Indianapolis Indiana
| | - Sascha Gill
- Department of Clinical Neurosciences; and the Ron and Rene Ward Centre for Healthy Brain Aging Research; Hotchkiss Brain Institute University of Calgary Calgary Alberta Canada
| | - Sophie Hu
- Community Health Sciences, and O'Brien Institute for Public Health University of Calgary Calgary Alberta Canada
| | - Erin D Foster
- Ruth Lilly Medical Library Indiana University School of Medicine Indianapolis Indiana
- University of California Berkeley Berkeley CA
| | - Myuri T Ruthirakuhan
- Hurvitz Brain Sciences Research Program Sunnybrook Research Institute Toronto Ontario Canada
- Department of Pharmacology and Toxicology University of Toronto Ontario Canada
| | | | - Moyra E Mortby
- School of Psychology University of New South Wales Sydney New South Wales Australia
- Neuroscience Research Australia University of New South Wales Sydney New South Wales Australia
| | - Veronika Matušková
- International Clinical Research Center St. Anne's University Hospital Brno Brno Czech Republic
- Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine Charles University in Prague and Motol University Hospital Prague Czech Republic
| | - Kok Pin Ng
- Department of Neurology National Neuroscience Institute Singapore Singapore
| | - Rawan M Tarawneh
- Department of Neurology, College of Medicine The Ohio State University Columbus Ohio USA
| | - Yvonne Freund-Levi
- Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society Karolinska Institute Stockholm Sweden
- School of Medical Sciences Örebro University Örebro Sweden
| | - Sanjeev Kumar
- Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Psychiatry University of Toronto Ontario Canada
| | - Serge Gauthier
- McGill Center for Studies in Aging McGill University Montreal Quebec Canada
| | - Paul B Rosenberg
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral, Sciences Johns Hopkins University School of Medicine Baltimore Maryland
| | - Fabricio Ferreira de Oliveira
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina Federal University of São Paulo (UNIFESP), São Paulo São Paulo Brazil
| | - D P Devanand
- New York State Psychiatric Institute and Department of Psychiatry and Department of Psychiatry, College of Physicians and Surgeons Columbia University New York New York
| | - Clive Ballard
- College of Medicine and Health The University of Exeter Exeter UK
| | - Zahinoor Ismail
- Department of Clinical Neurosciences; and the Ron and Rene Ward Centre for Healthy Brain Aging Research; Hotchkiss Brain Institute University of Calgary Calgary Alberta Canada
- Community Health Sciences, and O'Brien Institute for Public Health University of Calgary Calgary Alberta Canada
- Department of Psychiatry, and the Mathison Centre for Mental Health Research & Education Cumming School of Medicine, University of Calgary Calgary Alberta Canada
| |
Collapse
|
49
|
Pifer MA, Segal DL, Jester DJ, Molinari V. Assessment of Anxiety in Long-Term Care Residents: Issues and Strategies. Int J Aging Hum Dev 2020; 93:807-833. [PMID: 32790476 DOI: 10.1177/0091415020943321] [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: 01/17/2023]
Abstract
The experience of clinically significant anxiety and anxiety disorders represent significant and often debilitating problems for many residents in long-term care (LTC) settings. However, anxiety problems often go undetected and untreated in this growing population. The purposes of this paper are to examine the prevalence and impact of anxiety problems among residents in LTC facilities, describe the efficacy of the current instruments that are used to detect anxiety in these settings, and provide clinical guidance for the thorough assessment of anxiety. Regarding measurement tools, the GAI, GAI-SF, GAS-LTC, and the BADS are the only self-report measures designed for older adults that have been successfully validated for use with older adults living in LTC settings. Clinicians should focus on ways to educate LTC directors and staff to emphasize the importance of screening and assessing for anxiety, using validated measures, to improve the assessment and treatment of anxiety in their residents.
Collapse
Affiliation(s)
- Marissa A Pifer
- 14676 Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, CO, USA
| | - Daniel L Segal
- 14676 Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, CO, USA
| | - Dylan J Jester
- 7831 School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Victor Molinari
- 7831 School of Aging Studies, University of South Florida, Tampa, FL, USA
| |
Collapse
|
50
|
Ahn S, Mathiason MA, Salisbury D, Yu F. Factors Predicting the Onset of Amnestic Mild Cognitive Impairment or Alzheimer's Dementia in Persons With Subjective Cognitive Decline. J Gerontol Nurs 2020; 46:28-36. [PMID: 32936925 PMCID: PMC7503215 DOI: 10.3928/00989134-20200619-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 04/01/2020] [Indexed: 11/20/2022]
Abstract
The objective of the current retrospective cohort study was to identify vascular and/or neuropsychiatric risk factors predicting clinical progression in persons with subjective cognitive decline (SCD). Information on 1,525 persons with SCD (mean age = 73.8 [SD = 8.1] years) was obtained from the National Alzheimer's Coordinating Center. Clinical progression occurred from SCD to either amnestic mild cognitive impairment or Alzheimer's dementia over an average of 4.7 (SD = 2.9) years. Stepwise Cox regression was used. Compared to obesity (hazard ratio [HR] = 0.59) in the univariate unadjusted model, obesity (HR = 0.64), current smoking (HR = 2.02), and depressive symptoms (HR = 1.35) were significant after adjusting for covariates in the univariate model. In the multivariate adjusted model, obesity (HR = 0.64), current smoking (HR = 2.04), and depressive symptoms (HR = 1.36) remained significant predictors. Interventions should be designed to minimize transition by managing smoking and depressive symptoms. Further research is required for associations between obesity and clinical progression to test the hypothesis of obesity paradox. [Journal of Gerontological Nursing, 46(8), 28-36.].
Collapse
|