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Rao S, Cai Y, Zhong Z, Gou T, Wang Y, Liao S, Qiu P, Kuang W. Prevalence, cognitive characteristics, and influencing factors of amnestic mild cognitive impairment among older adults residing in an urban community in Chengdu, China. Front Neurol 2024; 15:1336385. [PMID: 38356893 PMCID: PMC10864602 DOI: 10.3389/fneur.2024.1336385] [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: 11/10/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024] Open
Abstract
Objective Dementia is a significant public health concern, and mild cognitive impairment (MCI) serves as a transitional stage between normal aging and dementia. Among the various types of MCI, amnestic MCI (aMCI) has been identified as having a higher likelihood of progressing to Alzheimer's dimension. However, limited research has been conducted on the prevalence of aMCI in China. Therefore, the objective of this study is to investigate the prevalence of aMCI, examine its cognitive characteristics, and identify associated risk factors. Methods In this cross-sectional study, we investigated a sample of 368 older adults aged 60 years and above in the urban communities of Chengdu, China. The participants underwent a battery of neuropsychological assessments, including the Mini-Mental State Examination (MMSE), the Clinical Dementia Rating (CDR), Auditory Verbal Learning Test (AVLT), Wechsler's Logical Memory Task (LMT), Boston Naming Test (BNT) and Trail Making Test Part A (TMT-A). Social information was collected by standard questionnaire. Multiple logistic regression analysis was utilized to screen for the risk and protective factors of aMCI. Results The data analysis included 309 subjects with normal cognitive function and 59 with aMCI, resulting in a prevalence of 16.0% for aMCI. The average age of participants was 69.06 ± 7.30 years, with 56.0% being females. After controlling for age, gender and education, the Spearman partial correlation coefficient between various cognitive assessments and aMCI ranged from -0.52 for the long-term delayed recall scores in AVLT to 0.19 for the time-usage scores in TMT-A. The results indicated that all cognitive domains, except for naming scores (after semantic cue of BNT) and error quantity (in TMT-A), showed statistically significant associations with aMCI. Furthermore, the multiple logistic regression analysis revealed that older age (OR = 1.044, 95%CI: 1.002~1.087), lower educational level, and diabetes (OR = 2.450, 95%CI: 1.246~4.818) were risk factors of aMCI. Conclusion This study found a high prevalence of aMCI among older adults in Chengdu, China. Individuals with aMCI exhibited lower cognitive function in memory, language, and executive domains, with long-term delayed recall showing the strongest association. Clinicians should prioritize individuals with verbal learning and memory difficulties, especially long-term delayed recall, in clinical practice.
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Affiliation(s)
- Shan Rao
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, Sichuan, China
| | - Yan Cai
- Evidence-Based Nursing Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhujun Zhong
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Tianyuan Gou
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, Sichuan, China
| | - Yangyang Wang
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Shiyi Liao
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Peiyuan Qiu
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Weihong Kuang
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Anlacan VMM, Lanuza PDT, Sanchez AAR, Jamora RDG. Current Status and Challenges in Dementia Care in the Philippines: A Scoping Review. J Alzheimers Dis 2024; 97:1533-1543. [PMID: 38306035 PMCID: PMC10894570 DOI: 10.3233/jad-230845] [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] [Accepted: 12/05/2023] [Indexed: 02/03/2024]
Abstract
Background Dementia prevalence is increasing in low- and middle-income countries such as the Philippines. Objective This study aimed to give an overview of dementia care in the Philippines and to identify gaps in terms of local epidemiology, research, financial coverage, diagnostics, pharmacotherapy, manpower, and caregiver support. Methods This scoping review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines extension for scoping reviews. Six international and two local databases, and government and non-government websites were searched. Data published in the English or Filipino language on dementia epidemiology, research, diagnostics, management, manpower, and training were extracted from the earliest indexed record until June 2022. Results The prevalence of dementia in the Philippines is high and research output on all aspects of dementia is low. Cost is a major barrier as health care coverage is limited, with reliance mainly on out-of-pocket payments, leading to challenges in the proper diagnosis and treatment of dementia. There is a low specialist-to-population ratio, with shortages beyond manpower and training. Conclusions Gaps in dementia care include limited published local data, high healthcare costs, inadequate health financing, and limited manpower.
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Affiliation(s)
- Veeda Michelle M. Anlacan
- Department of Neurosciences, Division of Adult Neurology, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Department of Internal Medicine, Section of Adult Neurology, Cardinal Santos Medical Center, San Juan City, Philippines
- Department of Neurology, Institute of Neurological Sciences, The Medical City, Pasig City, Philippines
| | - Pamela Danielle T. Lanuza
- Department of Neurosciences, Division of Adult Neurology, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Anna Anjelica R. Sanchez
- Department of Internal Medicine, Section of Adult Neurology, Cardinal Santos Medical Center, San Juan City, Philippines
- Department of Clinical Neurosciences, Section of Neurology, University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | - Roland Dominic G. Jamora
- Department of Neurosciences, Division of Adult Neurology, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Department of Internal Medicine, Section of Adult Neurology, Cardinal Santos Medical Center, San Juan City, Philippines
- Institute for Neurosciences, St. Luke’s Medical Center, Quezon City and Global City, Philippines
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Yang L, Tan Q, Wan W, Bu Z, Xuan C, Yu C, Wu J, Yan J. A blood-based, metabolite and demographic characteristic markers panel for the diagnosis of Alzheimer's disease. Bioanalysis 2023; 15:1247-1258. [PMID: 37669269 DOI: 10.4155/bio-2023-0043] [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: 09/07/2023] Open
Abstract
Aims: This work was designed to provide early diagnosis strategies for Alzheimer's disease (AD) based on the identification of blood metabolic biomarkers. Patients & methods: A total of 90 subjects aged 60 years or older were included in this study; 45 patients were assigned to the case group and control group, respectively. A total of 31 target metabolites were quantitatively analyzed by parallel reaction monitoring between the two groups. Results & conclusion: Three metabolites were screened out, including cystine, serine and alanine/sarcosine. Logistic regression and random forest analysis were used to establish AD diagnosis models, and the model combining metabolic biomarkers and demographic variables had higher detection efficiency (area under the curve = 0.869). A combination diagnostic model to provide a scientific reference for early screening and diagnosis of AD was constructed.
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Affiliation(s)
- Li Yang
- Zhejiang Hospital, lingyin Road, Hangzhou Zhejiang Province, 310013, China
| | - Qilong Tan
- School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, Hangzhou Zhejiang Province, 310012, China
| | - Wenjing Wan
- The Fourth Clinical Medical College, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou Zhejiang Province, 310000, China
| | - Zhibin Bu
- Zhejiang Hospital, lingyin Road, Hangzhou Zhejiang Province, 310013, China
| | - Cheng Xuan
- Zhuji Second People's Hospital, Fengqiao Town, Zhuji Zhejiang Province, 311800, China
| | - Caiyan Yu
- Zhuji Second People's Hospital, Fengqiao Town, Zhuji Zhejiang Province, 311800, China
| | - Jiong Wu
- Zhejiang Hospital, lingyin Road, Hangzhou Zhejiang Province, 310013, China
| | - Jing Yan
- Zhejiang Hospital, lingyin Road, Hangzhou Zhejiang Province, 310013, China
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Oh DJ, Bae JB, Lipnicki DM, Han JW, Sachdev PS, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Skoog I, Najar J, Sterner TR, Guaita A, Vaccaro R, Rolandi E, Scarmeas N, Yannakoulia M, Kosmidis MH, Riedel-Heller SG, Roehr S, Dominguez J, Guzman MFD, Fowler KC, Lobo A, Saz P, Lopez-Anton R, Anstey KJ, Cherbuin N, Mortby ME, Brodaty H, Trollor J, Kochan N, Kim KW. Parental history of dementia and the risk of dementia: A cross-sectional analysis of a global collaborative study. Psychiatry Clin Neurosci 2023; 77:449-456. [PMID: 37165609 PMCID: PMC10524874 DOI: 10.1111/pcn.13561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/06/2023] [Accepted: 05/02/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Parental history of dementia appears to increase the risk of dementia, but there have been inconsistent results. We aimed to investigate whether the association between parental history of dementia and the risk of dementia are different by dementia subtypes and sex of parent and offspring. METHODS For this cross-sectional study, we harmonized and pooled data for 17,194 older adults from nine population-based cohorts of eight countries. These studies conducted face-to-face diagnostic interviews, physical and neurological examinations, and neuropsychological assessments to diagnose dementia. We investigated the associations of maternal and paternal history of dementia with the risk of dementia and its subtypes in offspring. RESULTS The mean age of the participants was 72.8 ± 7.9 years and 59.2% were female. Parental history of dementia was associated with higher risk of dementia (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.15-1.86) and Alzheimer's disease (AD) (OR = 1.72, 95% CI = 1.31-2.26), but not with the risk of non-AD. This was largely driven by maternal history of dementia, which was associated with the risk of dementia (OR = 1.51, 95% CI = 1.15-1.97) and AD (OR = 1.80, 95% CI = 1.33-2.43) whereas paternal history of dementia was not. These results remained significant when males and females were analyzed separately (OR = 2.14, 95% CI = 1.28-3.55 in males; OR = 1.68, 95% CI = 1.16-2.44 for females). CONCLUSIONS Maternal history of dementia was associated with the risk of dementia and AD in both males and females. Maternal history of dementia may be a useful marker for identifying individuals at higher risk of AD and stratifying the risk for AD in clinical trials.
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Affiliation(s)
- Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong Bin Bae
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Ji Won Han
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University, School of Medicine, Jinju, South Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University and Konkuk University Chungju Hospital, Chungju, South Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University and Konkuk University Medical Center, Seoul, South Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, South Korea
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jin Hyeong Jhoo
- Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon, South Korea
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg,Mölndal, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Jenna Najar
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg,Mölndal, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Therese R Sterner
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg,Mölndal, Sweden
| | - Antonio Guaita
- Golgi Cenci Foundation, c. San Martino 10, 20081 Abbiategrasso (MI), Italy
| | - Roberta Vaccaro
- Golgi Cenci Foundation, c. San Martino 10, 20081 Abbiategrasso (MI), Italy
| | - Elena Rolandi
- Golgi Cenci Foundation, c. San Martino 10, 20081 Abbiategrasso (MI), Italy
| | - Nikolaos Scarmeas
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Columbia University, New York, NY
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Roehr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Jacqueline Dominguez
- Institute for Neurosciences, St. Luke’s Medical Center, Quezon City, Philippines
- Institute for Dementia Care Asia, Quezon City, Philippines
| | | | | | - Antonio Lobo
- Department of Medicine and Psychiatry. Zaragoza University. Aragon, Spain
| | - Pedro Saz
- Department of Medicine and Psychiatry. Zaragoza University. Aragon, Spain
| | - Raul Lopez-Anton
- Departamento de Psicología y Sociología. Universidad de Zaragoza, Aragon, Spain
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Sydney, Australia
- Centre for Mental Health Research, Australian National University, Canberra, Australia
- Neuroscience Australia, Sydney, Australia
| | - Nicolas Cherbuin
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Moyra E Mortby
- School of Psychology, University of New South Wales, Sydney, Australia
- Neuroscience Australia, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Julian Trollor
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine & Health, University of New South Wales, Sydney, Australia
| | - Nicole Kochan
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Ki Woong Kim
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
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Hanrahan JG, Burford C, Nagappan P, Adegboyega G, Rajkumar S, Kolias A, Helmy A, Hutchinson PJ. Is dementia more likely following traumatic brain injury? A systematic review. J Neurol 2023; 270:3022-3051. [PMID: 36810827 DOI: 10.1007/s00415-023-11614-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND The association between traumatic brain injury (TBI) and dementia is controversial, and of growing importance considering the ageing demography of TBI. OBJECTIVE To review the scope and quality of the existing literature investigating the relationship between TBI and dementia. METHODS We conducted a systematic review following PRISMA guidelines. Studies that compared TBI exposure and dementia risk were included. Studies were formally assessed for quality with a validated quality-assessment tool. RESULTS 44 studies were included in the final analysis. 75% (n = 33) were cohort studies and data collection was predominantly retrospective (n = 30, 66.7%). 25 studies (56.8%) found a positive relationship between TBI and dementia. Clearly defined and valid measures of assessing TBI history were lacking (case-control studies-88.9%, cohort studies-52.9%). Most studies failed to justify a sample size (case-control studies-77.8%, cohort studies-91.2%), blind assessors to exposure (case-control-66.7%) or blind assessors to exposure status (cohort-3.00%). Studies that identified a relationship between TBI and dementia had a longer median follow-up time (120 months vs 48 months, p = 0.022) and were more likely to use validated TBI definitions (p = 0.01). Studies which clearly defined TBI exposure (p = 0.013) and accounted for TBI severity (p = 0.036) were also more likely to identify an association between TBI and dementia. There was no consensus method by which studies diagnosed dementia and neuropathological confirmation was only available in 15.5% of studies. CONCLUSIONS Our review suggests a relationship between TBI and dementia, but we are unable to predict the risk of dementia for an individual following TBI. Our conclusions are limited by heterogeneity in both exposure and outcome reporting and by poor study quality. Future studies should; (a) use validated methods to define TBI, accounting for TBI severity; (b) follow consensus agreement on criteria for dementia diagnosis; and (c) undertake follow-up that is both longitudinal, to determine if there is a progressive neurodegenerative change or static post-traumatic deficit, and of sufficient duration.
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Affiliation(s)
- John Gerrard Hanrahan
- Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Charlotte Burford
- Department of General Surgery, East Kent University Hospitals NHS Foundation Trust, Ashford, UK.
| | - Palani Nagappan
- Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Gideon Adegboyega
- Bart's and the London Medical School, Queen Mary University of London, London, UK
| | - Shivani Rajkumar
- Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Angelos Kolias
- Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Adel Helmy
- Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Peter John Hutchinson
- Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
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Bikbov MM, Kazakbaeva GM, Iakupova EM, Panda-Jonas S, Fakhretdinova AA, Tuliakova AM, Rusakova IA, Jonas JB. Cognitive impairment in the population-based ural very old study. Front Aging Neurosci 2022; 14:912755. [PMID: 35928990 PMCID: PMC9344888 DOI: 10.3389/fnagi.2022.912755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
Background Despite its marked importance in public health, the prevalence of cognitive impairment (CI) and its associated factors have only rarely been examined in old populations in general or in Russia at all. Objective To assess CI prevalence and its determinants in a very elderly population in Russia. Materials and methods The population-based Ural Very Old Study, conducted in rural and urban region in Bashkortostan/Russia, included 1,526 (81.1%) out of 1,882 eligible individuals aged 85+ years. A series of medical examinations including the Mini-Mental State Examination (MMSE) for the assessment of CI was performed. Results Mini-Mental State Examination data were available for 1,442 (94.5%) individuals (mean age: 88.3 ± 2.9 years; range: 85–103 years). The median MMSE score was 24 (interquartile range: 19, 27). Prevalence of any CI (MMSE score < 24 points) was 701/1,442 [48.6%; 95% confidence interval (CI): 46.0, 51.2]. Prevalence of mild, moderate and severe CI (MMSE score 19–23 points, 10–18 points, and ≤9 points, respectively) was 357/1,442 (24.8%; 95% CI: 22.5, 27.0), 246/1,442 (17.1%; 95% CI: 15.1, 19.0), and 98/1,442 (6.8%; 95% CI: 5.5, 8.1), resp. A lower MMSE score correlated (regression coefficient r2: 0.31) with older age (beta: −0.13; P < 0.001), rural region of habitation (beta: 0.15; P < 0.001), lower level of education (beta: 0.19; P < 0.001), higher depression score (beta: −0.33; P < 0.001) (or alternatively, higher prevalence of hearing loss (beta: −0.10; P = 0.001), worse visual acuity (beta: −0.10; P = 0.001), and lower physical activity (beta: 0.06; P = 0.04). Conclusion In this elderly study population from rural and urban Russia, prevalence of any, mild, moderate and severe CI was 48.6, 24.8, 17.1, and 6.8%, resp. Besides medical and lifestyle factors, vision and hearing impairment were major factors associated with CI.
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Affiliation(s)
- Mukharram M. Bikbov
- Ufa Eye Research Institute, Ufa, Russia
- *Correspondence: Mukharram M. Bikbov,
| | - Gyulli M. Kazakbaeva
- Ufa Eye Research Institute, Ufa, Russia
- Ural Ophthalmology Institute, Ufa, Russia
| | | | | | | | | | | | - Jost B. Jonas
- Privatpraxis Prof. Jonas und Dr. Panda-Jonas, Heidelberg, Germany
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Jost B. Jonas,
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Zhao L, Wang J, Deng H, Chen J, Ding D. Depressive Symptoms and ADL/IADL Disabilities Among Older Adults from Low-Income Families in Dalian, Liaoning. Clin Interv Aging 2022; 17:733-743. [PMID: 35574289 PMCID: PMC9091470 DOI: 10.2147/cia.s354654] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/20/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to assess the prevalence of depressive symptoms and ADL/IADL disabilities and explore their correlation and associated factors for depressive symptoms among community-dwelling older adults from low-income families in Dalian, Liaoning Province, China. Methods This cross-sectional study included 522 participants aged 60 years and older from low-income families in Dalian. The 30-Item Geriatric Depression Scale was employed to measure depressive symptoms. The Katz ADL Scale and IADL Scale were used to evaluate the performance of activities necessary for independent life. SPSS 22.0 was employed to analyze the data. Logistic regression was used to estimate the relationship between depressive symptoms and ADL/IADL disabilities in five models. Results The prevalence of depressive symptoms among older people from low-income families in Dalian was 57.3%. A total of 19.0% had difficulties performing ADLs, and 40.2% had difficulties performing IADLs. Logistic regression analysis revealed that ADL/IADL disabilities were associated with depressive symptoms even after controlling for people’s sociodemographic characteristics, welfare, health conditions and informal care. The following factors were associated with depressive symptoms: education, self-reported health, number of chronic diseases, and emotional support from families. Conclusion Given that older people from low-income families in Dalian have a notable prevalence rate of depressive symptoms, and ADL/IADL disabilities were independently associated with these symptoms, it is crucial to give priority to this particular group in geriatric health services due to economic and health disparities.
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Affiliation(s)
- Lu Zhao
- Department of Medical Sociology, School of Humanities and Social Sciences, Dalian Medical University, Dalian, 116044, People’s Republic of China
| | - Junting Wang
- Department of Social Medicine, School of Public Health, Dalian Medical University, Dalian, 116044, People’s Republic of China
| | - Haoyuan Deng
- Department of Nutrition and Food Health, School of Public Health, Dalian Medical University, Dalian, 116044, People’s Republic of China
| | - Junfeng Chen
- Department of Social Medicine, School of Public Health, Dalian Medical University, Dalian, 116044, People’s Republic of China
- Correspondence: Junfeng Chen; Ding Ding, Department of Social Medicine, School of Public Health, Dalian Medical University, No. 9 West Section Lvshun South Road, Dalian, 116044, People’s Republic of China, Tel +86 13009493030; +86 18249517190, Email ;
| | - Ding Ding
- Department of Social Medicine, School of Public Health, Dalian Medical University, Dalian, 116044, People’s Republic of China
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Mojica CV, Yu JMF, Ampil ER, Dy JSH, Torio EF, Pilotin RC, Dominguez JC. Demographic and Clinical Profile of Patients with Mild Cognitive Impairment Seen at St. Luke's Medical Center-Global City Memory Service. Dement Geriatr Cogn Disord 2021; 50:387-393. [PMID: 34537768 DOI: 10.1159/000519171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 08/20/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Mild cognitive impairment (MCI) is a dynamic state, which has evolved into a highly defined condition due to its association with dementia syndromes. There are no published data on the demographic and clinical characteristics of MCI in the Philippines. These data will help in defining the population at risk for the condition and in modifying the factors for its prevention. METHODS From 2010 to 2019, 434 subjects were diagnosed with MCI based on the criteria published by the International Working Group on MCI last 2004. The demographic profile, vascular risk factors, and levels of Vitamin B12, Vitamin D, and homocysteine were reviewed. Results of neuropsychological tests, such as Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), Mini-Mental State Exam (MMSE), and Montreal Cognitive Assessment (MoCA), were collected. The Fazekas score of the cranial magnetic resonance imaging of patients was also considered. RESULTS The median age was 72 years [34-97] with 58.3% females. The median years of education were 14 [4-28]. Median ADAS-Cog, MMSE, and MoCA scores were 11.3 [0-27.67], 27 [13-30], and 21 [7-30], respectively. Hypertension and dyslipidemia were present in 66.8% and 64.1%, respectively. Normal homocysteine, Vitamin B12, and Vitamin D levels were found in 64.2%, 59.8%, and 48.8%, respectively. The median Fazekas score was 1 (59.4%). CONCLUSION This is the first study to document the demographic and clinical profile of Filipinos with MCI in a clinical setting. This review serves as a foundation for increased understanding of MCI with the ultimate goal of controlling the factors which may impact its prevention.
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Affiliation(s)
- Christianne V Mojica
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines
| | - Justine Megan F Yu
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines.,Institute for Dementia Care Asia, Quezon City, Philippines
| | - Encarnita R Ampil
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines.,Department of Neuroscience and Behavioral Medicine, Faculty of Medicine and Surgery, University of Sto. Tomas, Manila, Philippines
| | - Jon Stewart H Dy
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines
| | - Erickson F Torio
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines
| | - Ron C Pilotin
- Institute of Radiology, St. Luke's Medical Center, Global City, Philippines
| | - Jacqueline C Dominguez
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines.,Institute for Dementia Care Asia, Quezon City, Philippines
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9
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Dominguez JC, de Guzman MFP, Joson MLC, Fowler K, Natividad BP, Cruz PS, Jiloca JL, Mactal PB, Dominguez JD, Domingo J, Dominguez-Awao JK, Reandelar M, Javier JR, Phung T, Morris JC, Galvin JE. Validation of AD8-Philippines (AD8-P): A Brief Informant-Based Questionnaire for Dementia Screening in the Philippines. Int J Alzheimers Dis 2021; 2021:7750235. [PMID: 34754516 PMCID: PMC8572610 DOI: 10.1155/2021/7750235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 10/06/2021] [Indexed: 11/18/2022] Open
Abstract
AIM This study was aimed at validating the Filipino version of AD8 (AD8-P). METHODS Community-dwelling Filipino older persons aged ≥60 years, together with their informants, participated in this study. Psychologists independently interviewed the informants with AD8-P and administered the Filipino-validated Mini-Mental State Examination (MMSE-P) and Montreal Cognitive Assessment (MoCA-P) to the older persons. Neurologists and geriatrician conducted physical and neurological examination and Clinical Dementia Rating™ (CDR™) to determine cognitive diagnosis and were blinded with the results of AD8-P. Dementia was diagnosed based on DSM-IV-TR criteria. AD8-P discriminatory ability to screen for dementia was evaluated according to DSM-IV-TR diagnostic criteria for dementia. RESULTS A total of 366 community-dwelling Filipino older persons aged ≥60 years, 213 with normal cognition and 153 with dementia, and their informants were included in this study. Majority (90%) were at the mildest stage of dementia. Area under the receiver-operating-characteristic curve (AUROC) for AD8-P was 0.94 (95% CI 0.92 to 0.96), demonstrating excellent overall predictive power to screen for dementia. The optimal AD8-P cut-off score with best balance sensitivity (91.5%) and specificity (77.9%) was ≥3. CONCLUSION AD8-P demonstrated good psychometric properties to screen for dementia, even at the earliest stage of cognitive decline.
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Affiliation(s)
- Jacqueline C. Dominguez
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City 1102, Philippines
- Institute for Dementia Care Asia, Quezon City 1102, Philippines
- Dementia Society of the Philippines, Manila City 1008, Philippines
| | - Ma. Fe P. de Guzman
- Institute for Dementia Care Asia, Quezon City 1102, Philippines
- Dementia Society of the Philippines, Manila City 1008, Philippines
- Research and Biotechnology Division, St. Luke's Medical Center, Quezon City 1102, Philippines
| | - Ma. Lourdes C. Joson
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City 1102, Philippines
- Dementia Society of the Philippines, Manila City 1008, Philippines
- Department of Neuroscience and Behavioral Medicine, Faculty of Medicine and Surgery, University of Santo Tomas, Manila 1008, Philippines
| | - Krizelle Fowler
- Institute for Dementia Care Asia, Quezon City 1102, Philippines
- Dementia Society of the Philippines, Manila City 1008, Philippines
- Research and Biotechnology Division, St. Luke's Medical Center, Quezon City 1102, Philippines
| | - Boots P. Natividad
- Institute for Dementia Care Asia, Quezon City 1102, Philippines
- Research and Biotechnology Division, St. Luke's Medical Center, Quezon City 1102, Philippines
| | - Precy S. Cruz
- Institute for Dementia Care Asia, Quezon City 1102, Philippines
- Dementia Society of the Philippines, Manila City 1008, Philippines
| | - Jose Leo Jiloca
- Institute for Dementia Care Asia, Quezon City 1102, Philippines
- Dementia Society of the Philippines, Manila City 1008, Philippines
- Geriatric Center, St. Luke's Medical Center, Quezon City 1102, Philippines
| | - Primitivo B. Mactal
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City 1102, Philippines
- Dementia Society of the Philippines, Manila City 1008, Philippines
| | - Jayvee Dyne Dominguez
- Institute for Dementia Care Asia, Quezon City 1102, Philippines
- St. Luke's College of Medicine William H. Quasha Memorial, Quezon City 1102, Philippines
| | - Jeffrey Domingo
- Institute for Dementia Care Asia, Quezon City 1102, Philippines
- St. Luke's College of Medicine William H. Quasha Memorial, Quezon City 1102, Philippines
| | - Jhozel Kim Dominguez-Awao
- Institute for Dementia Care Asia, Quezon City 1102, Philippines
- St. Louis University College of Medicine, Baguio City 2600, Philippines
| | - Macario Reandelar
- Research and Biotechnology Division, St. Luke's Medical Center, Quezon City 1102, Philippines
| | - Jem R. Javier
- Department of Linguistics, College of Social Sciences and Philosophy, University of the Philippines, Quezon City 1100, Philippines
| | - ThienKieuThi Phung
- Department of Neurology, Danish Dementia Research Center, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark
| | - John C. Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - James E. Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, USA
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10
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Wang J, Xiao LD, Wang K, Luo Y, Li X. Cognitive Impairment and Associated Factors in Rural Elderly in North China. J Alzheimers Dis 2021; 77:1241-1253. [PMID: 32925043 DOI: 10.3233/jad-200404] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND China has the largest population living with dementia globally and urban-rural differences are significant in prevalence, risk factors, and health resources. Epidemiologic studies on cognitive impairment in rural areas are limited in China and other low- and middle-income countries. OBJECTIVE This study investigated cognitive impairment and associated factors in rural elderly aged 65 years and over in China. METHODS In total, 1,250 participants from ten villages in North China were recruited from June to September, 2017. Face-to-face structured interviews were conducted for data collection. The interviews included socio-demographic information, health status, and psychological assessments. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination. A multivariate logistic regression model with backward method was employed to identify factors associated with cognitive impairment. RESULTS The positive rate of cognitive impairment among rural Chinese elderly aged 65 years and older was 42.9% (95% CI, 40.1-45.6). No significant differences were found in cognitive impairment by age or gender before the age of 75 years. Older age, lack of formal school education, reliance on the basic living allowance as the only income source, poor hearing and vision function, diabetes, and activities of daily living dependence were associated with higher rate of cognitive impairment, while tea consumption and fatty liver disease were associated with lower cognitive impairment rate. CONCLUSION A very high percentage of rural elderly in China had cognitive impairment. Education programs and prevention interventions targeting modifiable risk factors among high-risk populations should be developed through collective efforts involving all stakeholders.
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Affiliation(s)
- Jing Wang
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, P.R. China.,College of Nursing and Health Sciences, Flinders University, Australia
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Australia.,Xiang Ya Nursing School, Central South University, P.R. China
| | - Kai Wang
- Department of Epidemiology & Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China
| | - Yan Luo
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, P.R. China
| | - Xiaomei Li
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, P.R. China
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11
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Dominguez J, de Guzman MF, Chen SHA, Sano M, Waldemar G, Phung TKT. Filipino Multicomponent Intervention to Maintain Cognitive Performance in High-Risk Population (FINOMAIN): Study Protocol for a Cluster Randomized Controlled Trial. Front Neurol 2021; 12:685721. [PMID: 34557142 PMCID: PMC8453078 DOI: 10.3389/fneur.2021.685721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/20/2021] [Indexed: 12/03/2022] Open
Abstract
Background: More than half of the people with dementia live in lower-middle income countries (LMIC), yet we lack research and evidence-based knowledge to guide health promotion and prevention strategies for cognitive decline. In the Philippines, the prevalence of mild cognitive impairment (MCI) and cardiovascular risk factors among older persons are high, making this population at high risk for developing dementia. This protocol describes a cluster randomized controlled trial that aims to investigate the efficacy of a multicomponent intervention to maintain cognitive performance among high-risk population. Methods: This is a cluster-randomized, two-arm, single-blind trial of a multicomponent intervention that combines dance called INDAK (Improving Neurocognition through Dance and Kinesthetics), nutrition counseling, and vascular risk management. The intervention arm will receive 12 months (1-h, twice per week) of INDAK and every 3 months of nutrition counseling and intensive vascular risk management and monitoring. The control group will receive the usual vascular care advice and referral. A total of 605 (20-25 clusters per arm) community-dwelling Filipino older adults aged ≥ 60 years old with MCI will participate in the study and will be assessed at baseline, 6th- and 12th-month follow-up. The primary outcome is cognitive performance assessed by the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog), Mnemonic Similarity Tasks (MST), and executive function composite (EFC). Secondary outcomes are functional connectivity assessed through brain imaging, and measures of behavioral, functional level, and quality of life. Discussion: The study aims to provide scientific evidence on a public health intervention that is contextualized in a community setting to reduce dementia risk among older adults with MCI. This model can be an ecological, low-cost, and effective program, thereby conducive to widespread implementation in the Philippines as well as in other low-resource settings with similar public health challenges. The pilot phase was underway with eight villages (clusters), but temporarily interrupted by the pandemic. The full study is anticipated to start after community restrictions are eased.
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Affiliation(s)
- Jacqueline Dominguez
- St. Luke's Medical Center, Institute for Neurosciences, Quezon City, Philippines
- Institute for Dementia Care Asia, Quezon City, Philippines
| | | | - S. H. Annabel Chen
- Center of Research and Development in Learning, Psychology, School of Social Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Mary Sano
- Department of Psychiatry, Mt. Sinai Alzheimer's Disease Research Center, Icahn School of Medicine, New York, NY, United States
| | - Gunhild Waldemar
- Danish Dementia Research Center, Rigohospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thien Kieu Thi Phung
- Danish Dementia Research Center, Rigohospitalet, University of Copenhagen, Copenhagen, Denmark
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12
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Hendriks S, Peetoom K, Bakker C, van der Flier WM, Papma JM, Koopmans R, Verhey FRJ, de Vugt M, Köhler S. Global Prevalence of Young-Onset Dementia: A Systematic Review and Meta-analysis. JAMA Neurol 2021; 78:1080-1090. [PMID: 34279544 PMCID: PMC8290331 DOI: 10.1001/jamaneurol.2021.2161] [Citation(s) in RCA: 147] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 04/24/2021] [Indexed: 12/22/2022]
Abstract
Importance Reliable prevalence estimates are lacking for young-onset dementia (YOD), in which symptoms of dementia start before the age of 65 years. Such estimates are needed for policy makers to organize appropriate health care. Objective To determine the global prevalence of YOD. Data Sources The PubMed, Embase, CINAHL, and PsycInfo databases were systematically searched for population-based studies on the prevalence of YOD published between January 1, 1990, and March 31, 2020. Study Selection Studies containing data on the prevalence of dementia in individuals younger than 65 years were screened by 2 researchers for inclusion in a systematic review and meta-analysis. Data Extraction and Synthesis Prevalence estimates on 5-year age bands, from 30 to 34 years to 60 to 64 years, were extracted. Random-effects meta-analyses were conducted to pool prevalence estimates. Results were age standardized for the World Standard Population. Heterogeneity was assessed by subgroup analyses for sex, dementia subtype, study design, and economic status based on the World Bank classification and by meta-regression. Main Outcomes and Measures Prevalence estimates of YOD for 5-year age bands. Results A total of 95 unique studies were included in this systematic review, of which 74 with 2 760 379 unique patients were also included in 5-year age band meta-analyses. Studies were mostly conducted in Europe and in older groups in Asia, North America, and Oceania. Age-standardized prevalence estimates increased from 1.1 per 100 000 population in the group aged 30 to 34 years to 77.4 per 100 000 population in the group aged 60 to 64 years. This gives an overall global age-standardized prevalence of 119.0 per 100 000 population in the age range of 30 to 64 years, corresponding to 3.9 million people aged 30 to 64 years living with YOD in the world. Subgroup analyses showed prevalence between men and women to be similar (crude estimates for men, 216.5 per 100 000 population; for women, 293.1 per 100 000 population), whereas prevalence was lower in high-income countries (crude estimate, 663.9 per 100 000 population) compared with upper-middle-income (crude estimate, 1873.6 per 100 000 population) and lower-middle-income (crude estimate, 764.2 per 100 000 population) countries. Meta-regression showed that age range (P < .001), sample size (P < .001), and study methodology (P = .02) significantly influenced heterogeneity between studies. Conclusions and Relevance This systematic review and meta-analysis found an age-standardized prevalence of YOD of 119.0 per 100 000 population, although estimates of the prevalence in low-income countries and younger age ranges remain scarce. These results should help policy makers organize sufficient health care for this subgroup of individuals with dementia. Study Registration PROSPERO CRD42019119288.
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Affiliation(s)
- Stevie Hendriks
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, the Netherlands
| | - Kirsten Peetoom
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, the Netherlands
| | - Christian Bakker
- Department of Primary and Community Care, Radboud University Medical Center, Radboud, the Netherlands
- Groenhuysen, Center for Specialized Geriatric Care, Roosendaal, the Netherlands
- Radboudumc Alzheimer Center, Nijmegen, the Netherlands
| | - Wiesje M. van der Flier
- Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC (University Medical Center), Amsterdam, the Netherlands
- Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Janne M. Papma
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Raymond Koopmans
- Department of Primary and Community Care, Radboud University Medical Center, Radboud, the Netherlands
- Radboudumc Alzheimer Center, Nijmegen, the Netherlands
| | - Frans R. J. Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, the Netherlands
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, the Netherlands
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13
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Lopez SMM, Aguilar JS, Fernandez JBB, Lao AGJ, Estrella MRR, Devanadera MKP, Ramones CMV, Villaraza AJL, Guevarra LA, Santiago-Bautista MR, Santiago LA. Neuroactive venom compounds obtained from Phlogiellus bundokalbo as potential leads for neurodegenerative diseases: insights on their acetylcholinesterase and beta-secretase inhibitory activities in vitro. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20210009. [PMID: 34249120 PMCID: PMC8237997 DOI: 10.1590/1678-9199-jvatitd-2021-0009] [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: 01/24/2021] [Accepted: 03/31/2021] [Indexed: 11/22/2022] Open
Abstract
Background Spider venom is a rich cocktail of neuroactive compounds designed to prey capture and defense against predators that act on neuronal membrane proteins, in particular, acetylcholinesterases (AChE) that regulate synaptic transmission through acetylcholine (ACh) hydrolysis - an excitatory neurotransmitter - and beta-secretases (BACE) that primarily cleave amyloid precursor proteins (APP), which are, in turn, relevant in the structural integrity of neurons. The present study provides preliminary evidence on the therapeutic potential of Phlogiellus bundokalbo venom against neurodegenerative diseases. Methods Spider venom was extracted by electrostimulation and fractionated by reverse-phase high-performance liquid chromatography (RP-HPLC) and characterized by matrix-assisted laser desorption ionization-time flight mass spectrometry (MALDI-TOF-MS). Neuroactivity of the whole venom was observed by a neurobehavioral response from Terebrio molitor larvae in vivo and fractions were screened for their inhibitory activities against AChE and BACE in vitro. Results The whole venom from P. bundokalbo demonstrated neuroactivity by inducing excitatory movements from T. molitor for 15 min. Sixteen fractions collected produced diverse mass fragments from MALDI-TOF-MS ranging from 900-4500 Da. Eleven of sixteen fractions demonstrated AChE inhibitory activities with 14.34% (± 2.60e-4) to 62.05% (± 6.40e-5) compared with donepezil which has 86.34% (± 3.90e-5) inhibition (p > 0.05), while none of the fractions were observed to exhibit BACE inhibition. Furthermore, three potent fractions against AChE, F1, F3, and F16 displayed competitive and uncompetitive inhibitions compared to donepezil as the positive control. Conclusion The venom of P. bundokalbo contains compounds that demonstrate neuroactivity and anti-AChE activities in vitro, which could comprise possible therapeutic leads for the development of cholinergic compounds against neurological diseases.
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Affiliation(s)
- Simon Miguel M Lopez
- Department of Biochemistry, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines, 1008.,Institute of Chemistry, College of Science, University of the Philippines Diliman, Quezon City, Philippines, 1101
| | - Jeremey S Aguilar
- Department of Biochemistry, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines, 1008
| | - Jerene Bashia B Fernandez
- Department of Biochemistry, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines, 1008
| | - Angelic Gayle J Lao
- Department of Biochemistry, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines, 1008.,Research Center for Natural and Applied Sciences, University of Santo Tomas, Manila, Philippines, 1015.,The Graduate School, University of Santo Tomas, Manila, Philippines, 1015.,Institute of Chemistry, College of Science, University of the Philippines Diliman, Quezon City, Philippines, 1101
| | - Mitzi Rain R Estrella
- Department of Biochemistry, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines, 1008
| | - Mark Kevin P Devanadera
- Department of Biochemistry, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines, 1008.,Research Center for Natural and Applied Sciences, University of Santo Tomas, Manila, Philippines, 1015.,The Graduate School, University of Santo Tomas, Manila, Philippines, 1015
| | - Cydee Marie V Ramones
- Institute of Chemistry, College of Science, University of the Philippines Diliman, Quezon City, Philippines, 1101
| | - Aaron Joseph L Villaraza
- Institute of Chemistry, College of Science, University of the Philippines Diliman, Quezon City, Philippines, 1101
| | - Leonardo A Guevarra
- Department of Biochemistry, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines, 1008.,Research Center for Natural and Applied Sciences, University of Santo Tomas, Manila, Philippines, 1015
| | - Myla R Santiago-Bautista
- Department of Biochemistry, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines, 1008.,Research Center for Natural and Applied Sciences, University of Santo Tomas, Manila, Philippines, 1015.,The Graduate School, University of Santo Tomas, Manila, Philippines, 1015
| | - Librado A Santiago
- Department of Biochemistry, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines, 1008.,Research Center for Natural and Applied Sciences, University of Santo Tomas, Manila, Philippines, 1015.,The Graduate School, University of Santo Tomas, Manila, Philippines, 1015
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14
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Dominguez J, Jiloca L, Fowler KC, De Guzman MF, Dominguez-Awao JK, Natividad B, Domingo J, Dominguez JD, Reandelar M, Ligsay A, Yu JR, Aichele S, Phung TKT. Dementia Incidence, Burden and Cost of Care: A Filipino Community-Based Study. Front Public Health 2021; 9:628700. [PMID: 34055712 PMCID: PMC8160123 DOI: 10.3389/fpubh.2021.628700] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/12/2021] [Indexed: 11/26/2022] Open
Abstract
Background: In the midst of competing priorities and limited resources in low-middle-income countries (LMIC), convincing epidemiological evidence is critical for urging governments to develop national dementia plans. The majority of primary epidemiological studies on dementia are from high income countries (HIC). Implications for developing countries are typically extrapolated from these outcomes through modeling, meta-analyses, and systematic reviews. In this study, we directly assessed the incidence of dementia, disability adjusted life years (DALYs), and cost of care among community-dwelling Filipino elderly. Methods: This was a follow-up study of the prospective cohort Marikina Memory Ageing Project (MMAP). Baseline assessment was performed in 2011–2012, and follow-up was done in 2015–2016 (N = 748 at follow-up). Incident dementia was determined. Disease burden was computed using the incidence rates and DALYs. Both indirect and direct (medical and non-medical) costs of dementia care were computed. Results: The crude incidence rate was 16 (CI: 13–20) cases per 1,000 person-years (pyr) with 17 (CI: 12–21) per 1,000 pyr for females and 14 (CI: 9–21) per 1,000 pyr for males. Based on this incidence, we project an estimation of 220,632 new cases in 2030, 295,066 in 2040, and 378,461 in 2050. Disease burden was at 2,876 DALYsper 100,000 persons. The economic burden per patient was around Php 196,000 annually (i.e., ~4,070 USD, or 36.7% of average family annual income in the Philippines). The majority (86.29%) of this care expense was indirect cost attributed to estimated lost potential earning of unpaid family caregivers whereas direct medical cost accounted for only 13.48%. Conclusions: We provide the first Filipino community-based data on the incidence of dementia, DALYs, and cost of care to reflect the epidemiologic and economic impact of disease. The findings of this study serve to guide the development of a national dementia plan.
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Affiliation(s)
- Jacqueline Dominguez
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines.,Institute for Dementia Care Asia, Quezon City, Philippines
| | - Leo Jiloca
- Geriatric Center, St. Luke's Medical Center, Quezon City, Philippines
| | - Krizelle Cleo Fowler
- Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, Philippines
| | - Ma Fe De Guzman
- Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, Philippines
| | - Jhozel Kim Dominguez-Awao
- Institute for Dementia Care Asia, Quezon City, Philippines.,Department of Internal Medicine, St. Louis University Hospital, Baguio, Philippines
| | - Boots Natividad
- Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, Philippines
| | - Jeffrey Domingo
- Institute for Dementia Care Asia, Quezon City, Philippines.,Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, Philippines
| | - Jayvee Dyne Dominguez
- Institute for Dementia Care Asia, Quezon City, Philippines.,Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, Philippines
| | - Macario Reandelar
- Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, Philippines
| | - Antonio Ligsay
- Section of Clinical Research, St. Luke's Medical Center - College of Medicine, Quezon City, Philippines
| | - Jeryl Ritzi Yu
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines
| | - Stephen Aichele
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Thien Kieu Thi Phung
- Danish Dementia Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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15
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Cao Q, Tan CC, Xu W, Hu H, Cao XP, Dong Q, Tan L, Yu JT. The Prevalence of Dementia: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2021; 73:1157-1166. [PMID: 31884487 DOI: 10.3233/jad-191092] [Citation(s) in RCA: 197] [Impact Index Per Article: 65.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dementia is a severe neurodegenerative disorder and it can be categorized into several subtypes by different pathogenic causes. We sought to comprehensively analyzed the prevalence of dementia from perspectives of geographic region (Asia, Africa, South America, and Europe/North America), age, and gender. We searched PubMed and EMBASE for relevant articles on dementia published from January 1985 to August 2019. In these studies, analyses were stratified by geographic region, age, and gender. Meta-regression was conducted to identify if there were significant differences between groups. We included forty-seven studies. Among the individuals aged 50 and over in the community, the pooled prevalence for all-cause dementia, Alzheimer's disease, and vascular dementia were 697 (CI95%: 546-864) per 10,000 persons, 324 (CI95%: 228-460) per 10,000 persons, and 116 (CI95%: 86-157) per 10,000 persons, respectively. In our study, the prevalence of all-type dementia in individuals aged 100 years and older (6,592 per 10,000 cases) is 244 times higher than in those aged 50-59 (27 per 10,000 cases). The number of people living with dementia approximately doubles every five years. The prevalence was greater in women than in men (788 cases versus 561 cases per 10,000 persons) in overall analysis. In individuals aged 60 to 69 years, AD prevalence in females was 1.9 times greater than that in males (108 cases versus 56 cases per 10,000 persons), while the prevalence of VaD was 1.8 times greater in males than in females (56 cases versus 32 cases per 10,000 persons). Prevalence rate was higher in Europe and North America than in Asia, Africa, and South America.
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Affiliation(s)
- Qing Cao
- Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, Nanjing, China
| | - Chen-Chen Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Wei Xu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Hao Hu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Xi-Peng Cao
- Clinical Research Center, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Qiang Dong
- Department of Neurology & Institute of Neurology, WHO Collaborating Center for Research and Training in Neurosciences, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, Nanjing, China
| | - Jin-Tai Yu
- Department of Neurology & Institute of Neurology, WHO Collaborating Center for Research and Training in Neurosciences, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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16
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McGrattan AM, Zhu Y, Richardson CD, Mohan D, Soh YC, Sajjad A, van Aller C, Chen S, Paddick SM, Prina M, Siervo M, Robinson LA, Stephan BC. Prevalence and Risk of Mild Cognitive Impairment in Low and Middle-Income Countries: A Systematic Review. J Alzheimers Dis 2021; 79:743-762. [DOI: 10.3233/jad-201043] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Mild cognitive impairment (MCI) is a cognitive state associated with increased risk of dementia. Little research on MCI exists from low-and middle-income countries (LMICs), despite high prevalence of dementia in these settings. Objective: This systematic review aimed to review epidemiological reports to determine the prevalence of MCI and its associated risk factors in LMICs. Methods: Medline, Embase, and PsycINFO were searched from inception until November 2019. Eligible articles reported on MCI in population or community-based studies from LMICs and were included as long as MCI was clearly defined. Results: 5,568 articles were screened, and 78 retained. In total, n = 23 different LMICs were represented; mostly from China (n = 55 studies). Few studies were from countries defined as lower-middle income (n = 14), low income (n = 4), or from population representative samples (n = 4). There was large heterogeneity in how MCI was diagnosed; with Petersen criteria the most commonly applied (n = 26). Prevalence of amnesic MCI (aMCI) (Petersen criteria) ranged from 0.6%to 22.3%. Similar variability existed across studies using the International Working Group Criteria for aMCI (range 4.5%to 18.3%) and all-MCI (range 6.1%to 30.4%). Risk of MCI was associated with demographic (e.g., age), health (e.g., cardio-metabolic disease), and lifestyle (e.g., social isolation, smoking, diet and physical activity) factors. Conclusion: Outside of China, few MCI studies have been conducted in LMIC settings. There is an urgent need for population representative epidemiological studies to determine MCI prevalence in LMICs. MCI diagnostic methodology also needs to be standardized. This will allow for cross-study comparison and future resource planning.
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Affiliation(s)
| | - Yueping Zhu
- Department of Psychology and Behavioral Science, Zhejiang University, Hangzhou, China
| | | | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Segamat, Malaysia
| | - Yee Chang Soh
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Segamat, Malaysia
| | - Ayesha Sajjad
- Erasmus School of Health Policy and Management; Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Carla van Aller
- Population Health Sciences Institute, Newcastle University, UK
| | - Shulin Chen
- Department of Psychology and Behavioral Science, Zhejiang University, Hangzhou, China
| | - Stella-Maria Paddick
- Translational and Clinical Research Institute, Newcastle University, UK
- Gateshead NHS Community Health Foundation Trust, Gateshead, UK
| | - Matthew Prina
- Social Epidemiology Research Group, Health Service and Population Research Department, King’s College London, London, UK
| | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Nottingham, UK
| | | | - Blossom C.M. Stephan
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, Nottingham University, UK
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17
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Ganapathy SS, Sooryanarayana R, Ahmad NA, Jamaluddin R, Abd Razak MA, Tan MP, Mohd Sidik S, Mohamad Zahir S, Sandanasamy KS, Ibrahim N. Prevalence of dementia and quality of life of caregivers of people living with dementia in Malaysia. Geriatr Gerontol Int 2020; 20 Suppl 2:16-20. [PMID: 33370858 DOI: 10.1111/ggi.14031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/21/2020] [Accepted: 08/07/2020] [Indexed: 01/20/2023]
Abstract
AIM Dementia is the major cause of disability among older persons and leading physical and psychological sequelae for both the person living with dementia (PLwD) and their caregivers. The aim of this study was to determine the prevalence of dementia in Malaysia and identify the factors influencing quality of life (QoL) of caregivers of PLwD. METHODS A nationwide survey was conducted among individuals aged ≥60 years. Cognition was assessed with the Identification and Intervention for Dementia in Elderly Africans (IDEA) tool. QoL of older caregivers was assessed using the Control, Autonomy, Self-Realization and Pleasure (CASP-19) questionnaire. RESULTS The prevalence of dementia among older adults aged ≥60 years in Malaysia was found to be 8.5%. The prevalence was found to be higher among females, those with no formal education and those in rural areas in Malaysia. The mean QoL of family caregivers of PLwD was significantly lower than the caregivers of older adults without dementia were (P < 0.001). Multivariable linear regression analysis on the subpopulation of PLwD showed that inability to carry out activities of daily living among PLwD (P = 0.014) and low to fair social support for the caregivers (P < 0.001) were negatively associated with QoL of caregivers of PLwD. CONCLUSIONS The high prevalence of dementia among older adults in Malaysia emphasizes the need for affirmative action in Malaysia. The functional capacity of the PLwD and social support determines the QoL of caregivers of PLwD in Malaysia. Thus, the community as a whole needs to provide support to PLwD and their caregivers. Geriatr Gerontol Int 2020; 20: 16-20.
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Affiliation(s)
- Shubash S Ganapathy
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Rajini Sooryanarayana
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia.,Family Health Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Noor Ani Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Rasidah Jamaluddin
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Mohamad A Abd Razak
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Maw Pin Tan
- Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Suhaila Mohamad Zahir
- Department of Psychiatry and Mental Health, Hospital Tuanku Ja'afar, Ministry of Health Malaysia, Seremban, Malaysia
| | | | - Nurashikin Ibrahim
- Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
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18
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Association between sedentary behavior and the risk of dementia: a systematic review and meta-analysis. Transl Psychiatry 2020; 10:112. [PMID: 32317627 PMCID: PMC7174309 DOI: 10.1038/s41398-020-0799-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 03/12/2020] [Accepted: 03/25/2020] [Indexed: 12/16/2022] Open
Abstract
An increasing number of original studies suggest that sedentary behavior is associated with the risk of dementia, but the results remain inconsistent and inconclusive. In this meta-analysis, we analyzed available observational epidemiological evidence to identify the association between sedentary behavior and the risk of dementia. We searched PubMed and Embase from their inception to March 2019 to identify observational studies examining the association between sedentary behavior and risk of dementia. Two authors independently extracted data and assessed study quality using predefined criteria. The Q statistics and I² methods were used to test for heterogeneity. The publication bias of the included studies was also estimated using Begg's and Egger's tests. We identified 18 relevant cohort studies involving 250,063 participants and 2269 patients with dementia. Pooled result showed that sedentary behavior was significantly associated with increased risk of dementia (RR = 1.30; 95% CI: 1.12-1.51). In addition, subgroup analyses by state, and controlling for the concomitant effects of age, sex, education were conducted for the increase of dementia risk, relating to sedentary, respectively. In general, these subgroup analyses showed no statistically significant differences. The results of our meta-analysis suggested that sedentary behavior was independently associated with a significantly increased risk of dementia, which might have important implications in conducting etiological studies for dementia and developing strategies for dementia prevention.
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19
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Wang F, Zhang C, Hou S, Geng X. Synergistic Effects of Mesenchymal Stem Cell Transplantation and Repetitive Transcranial Magnetic Stimulation on Promoting Autophagy and Synaptic Plasticity in Vascular Dementia. J Gerontol A Biol Sci Med Sci 2020; 74:1341-1350. [PMID: 30256913 DOI: 10.1093/gerona/gly221] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Indexed: 02/07/2023] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) and mesenchymal stem cells (MSCs) transplantation both showed therapeutic effects on cognition impairment in vascular dementia (VD) model rats. However, whether these two therapies have synergistic effects and the molecular mechanisms remain unclear. In our present study, rats were randomly divided into six groups: control group, sham operation group, VD group, MSC group, rTMS group, and MSC+rTMS group. The VD model rats were prepared using a modified 2VO method. rTMS treatment was implemented at a frequency of 5 Hz, the stimulation intensity for 0.5 Tesla, 20 strings every day with 10 pulses per string and six treatment courses. The results of the Morris water maze test showed that the learning and memory abilities of the MSC group, rTMS group, and MSC+rTMS group were better than that of the VD group, and the MSC+rTMS group showed the most significant effect. The protein expression levels of brain-derived neurotrophic factor, NR1, LC3-II, and Beclin-1 were the highest and p62 protein was the lowest in the MSC+rTMS group. Our findings demonstrated that rTMS could further enhance the effect of MSC transplantation on VD rats and provided an important basis for the combined application of MSC transplantation and rTMS to treat VD or other neurological diseases.
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Affiliation(s)
- Fei Wang
- Department of Neurology, General Hospital, Tianjin Medical University, China
| | - Chi Zhang
- Department of Neurology, General Hospital, Tianjin Medical University, China
| | - Siyuan Hou
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Tianjin Medical University, China.,Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), Tianjin Medical University, China
| | - Xin Geng
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Tianjin Medical University, China.,Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), Tianjin Medical University, China
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20
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Gender Differences in Cognitive Impairment among Rural Elderly in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103724. [PMID: 32466167 PMCID: PMC7277614 DOI: 10.3390/ijerph17103724] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 12/12/2022]
Abstract
Elders in rural areas of developing countries are particularly vulnerable to cognitive impairment and gender disparities are notable. Yet, evidence related to gender differences in cognitive impairment in these settings is scarce. This study examined gender differences in cognitive impairment among elderly people aged 65 and above in rural China. A multi-site cross-sectional survey was conducted. In total, 550 males and 700 females were recruited. The Chinese version of the Mini-Mental Status Examination was applied for cognitive impairment screening. Demographic information, lifestyle factors, psychosocial factors, and health-related information were assessed. The prevalence of cognitive impairment was 40.0%in males and 45.1% in females, respectively. Females showed significant higher prevalence after age 75 (62.7% vs. 45.4%, p < 0.005). Older age, hearing impairment, and activities of daily living dependence were common factors associated with cognitive impairment in both females and males. For males, living in a neighborhood with poor social interactions and diabetes were risk factors, while tea consumption was a protective factor. For females, vision impairment and illiteracy were additional risk factors. Individualized interventions and standardized measurements of cognitive function should be developed to suit older populations living in rural and less-developed areas, through collective efforts involving all stakeholders and multidisciplinary teamwork.
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21
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Prediction of Frailty and Dementia Using Oral Health Impact Profile from a Population-Based Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061997. [PMID: 32197375 PMCID: PMC7143751 DOI: 10.3390/ijerph17061997] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/14/2020] [Accepted: 03/16/2020] [Indexed: 12/23/2022]
Abstract
Oral health and dentition have been associated with cognitive ability and frailty, but an applicable screening tool has not yet been developed. This study aimed to establish risk prediction models for dementia and frailty. A sample of 2905 community-dwelling older adults aged ≥58 years using the Taiwan Longitudinal Study on Aging (TLSA) survey was adapted and analyzed for this study. Risk scores were estimated by stepwise logistic regression. In models adjusted for covariates, increased age, female sex, no dental prosthesis (adjusted Odds ratio [adjOR], 1.61; 95% confidence interval [CI], 1.11–2.35), diabetes mellitus, chronic kidney disease, and an increased Oral Health Impact Profile (OHIP)-7T Q3 score (adjOR, 1.33; 95% CI, 1.19–1.49) were all significantly associated with frailty. In addition to these factors, an inability to self-report height or weight (adjOR, 4.52; 95% CI, 3.52–5.81) and an increased OHIP-7T Q7 score (adjOR, 1.21; 95% CI, 1.06–1.37) were significantly associated with dementia. The cut-off points of the risk scores for frailty and dementia were 80 (sensitivity, 80.0%; specificity, 81.2%) and 77 (sensitivity, 83.4%; specificity, 71.5%), respectively. The findings highlighted a number of composite risk factors of frailty and dementia. Importantly, the developed prediction models were easily applicable to screen for frailty and dementia in communities or dental clinics.
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