1
|
Gallet Q, Bouteloup V, Locatelli M, Habert MO, Chupin M, Campion JY, Michels PE, Delrieu J, Lebouvier T, Balageas AC, Surget A, Belzung C, Arlicot N, Ribeiro MJS, Gissot V, El-Hage W, Camus V, Gohier B, Desmidt T. Cerebral Metabolic Signature of Chronic Benzodiazepine Use in Nondemented Older Adults: An FDG-PET Study in the MEMENTO Cohort. Am J Geriatr Psychiatry 2024; 32:665-677. [PMID: 37973486 DOI: 10.1016/j.jagp.2023.10.002] [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: 03/22/2023] [Revised: 10/09/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE We sought to examine the association between chronic Benzodiazepine (BZD) use and brain metabolism obtained from 2-deoxy-2-fluoro-D-glucose (FDG) positron emission tomography (PET) in the MEMENTO clinical cohort of nondemented older adults with an isolated memory complaint or mild cognitive impairment at baseline. METHODS Our analysis focused on 3 levels: (1) the global mean brain standardized uptake value (SUVR), (2) the Alzheimer's disease (AD)-specific regions of interest (ROIs), and (3) the ratio of total SUVR on the brain and different anatomical ROIs. Cerebral metabolism was obtained from 2-deoxy-2-fluoro-D-glucose-FDG-PET and compared between chronic BZD users and nonusers using multiple linear regressions adjusted for age, sex, education, APOE ε 4 copy number, cognitive and neuropsychiatric assessments, history of major depressive episodes and antidepressant use. RESULTS We found that the SUVR was significantly higher in chronic BZD users (n = 192) than in nonusers (n = 1,122) in the whole brain (beta = 0.03; p = 0.038) and in the right amygdala (beta = 0.32; p = 0.012). Trends were observed for the half-lives of BZDs (short- and long-acting BZDs) (p = 0.051) and Z-drug hypnotic treatments (p = 0.060) on the SUVR of the right amygdala. We found no significant association in the other ROIs. CONCLUSION Our study is the first to find a greater global metabolism in chronic BZD users and a specific greater metabolism in the right amygdala. Because the acute administration of BZDs tends to reduce brain metabolism, these findings may correspond to a compensatory mechanism while the brain adapts with global metabolism upregulation, with a specific focus on the right amygdala.
Collapse
Affiliation(s)
- Quentin Gallet
- Department of Psychiatry, University Hospital, Angers, France
| | - Vincent Bouteloup
- Centre Inserm U1219 Bordeaux Population Health, CIC1401-EC, Institut de Santé Publique, d'Epidémiologie et de Développement, Université de Bordeaux, CHU de Bordeaux, Pôle Santé Publique, Bordeaux, France
| | - Maxime Locatelli
- CATI, US52-UAR2031, CEA, ICM, Sorbonne Université, CNRS, INSERM, APHP, Ile de France, France; Paris Brain Institute - Institut du Cerveau (ICM), CNRS UMR 7225, INSERM, U 1127, Sorbonne Université F-75013, Paris, France; Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, F-75006, Paris, France
| | - Marie-Odile Habert
- CATI, US52-UAR2031, CEA, ICM, Sorbonne Université, CNRS, INSERM, APHP, Ile de France, France; Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, F-75006, Paris, France; Service de médecine nucléaire, Hôpital Pitié-Salpêtrière, APHP, Paris 75013, France
| | - Marie Chupin
- CATI, US52-UAR2031, CEA, ICM, Sorbonne Université, CNRS, INSERM, APHP, Ile de France, France; Paris Brain Institute - Institut du Cerveau (ICM), CNRS UMR 7225, INSERM, U 1127, Sorbonne Université F-75013, Paris, France
| | | | | | - Julien Delrieu
- Gérontopôle, Department of Geriatrics, CHU Toulouse, Purpan University Hospital, Toulouse, France; UMR1027, Université de Toulouse, UPS, INSERM, Toulouse, France
| | | | | | | | | | - Nicolas Arlicot
- UMR 1253, iBrain, Université de Tours, INSERM, Tours, France; CIC 1415, Université de Tours, INSERM, Tours, France
| | - Maria-Joao Santiago Ribeiro
- CHU de Tours, Tours, France; UMR 1253, iBrain, Université de Tours, INSERM, Tours, France; CIC 1415, Université de Tours, INSERM, Tours, France
| | - Valérie Gissot
- CHU de Tours, Tours, France; UMR 1253, iBrain, Université de Tours, INSERM, Tours, France
| | - Wissam El-Hage
- CHU de Tours, Tours, France; UMR 1253, iBrain, Université de Tours, INSERM, Tours, France; CIC 1415, Université de Tours, INSERM, Tours, France
| | - Vincent Camus
- CHU de Tours, Tours, France; UMR 1253, iBrain, Université de Tours, INSERM, Tours, France
| | - Bénédicte Gohier
- Department of Psychiatry, University Hospital, Angers, France; Université d'Angers, Université de Nantes, LPPL, SFR CONFLUENCES, F-49000 Angers, France
| | - Thomas Desmidt
- CHU de Tours, Tours, France; UMR 1253, iBrain, Université de Tours, INSERM, Tours, France.
| |
Collapse
|
2
|
Corbo I, Troisi G, Marselli G, Casagrande M. The role of cognitive flexibility on higher level executive functions in mild cognitive impairment and healthy older adults. BMC Psychol 2024; 12:317. [PMID: 38816884 PMCID: PMC11140914 DOI: 10.1186/s40359-024-01807-5] [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: 12/16/2023] [Accepted: 05/22/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Mild Cognitive Impairment (MCI) is a preclinical condition between healthy and pathological aging, which is characterized by impairments in executive functions (EFs), including cognitive flexibility. According to Diamond's model, cognitive flexibility is a core executive function, along with working memory and inhibition, but it requires the development of these last EFs to reach its full potential. In this model, planning and fluid intelligence are considered higher-level EFs. Given their central role in enabling individuals to adapt their daily life behavior efficiently, the goal is to gain valuable insight into the functionality of cognitive flexibility in a preclinical form of cognitive decline. This study aims to investigate the role of cognitive flexibility and its components, set-shifting and switching, in MCI. The hypotheses are as follows: (I) healthy participants are expected to perform better than those with MCI on cognitive flexibility and higher-level EFs tasks, taking into account the mediating role of global cognitive functioning; (II) cognitive flexibility can predict performance on higher-level EFs (i.e., planning and fluid intelligence) tasks differently in healthy individuals and those diagnosed with MCI. METHODS Ninety participants were selected and divided into a healthy control group (N = 45; mean age 64.1 ± 6.80; 66.6% female) and an MCI group (N = 45; mean age 65.2 ± 8.14; 40% female). Cognitive flexibility, fluid intelligence, planning, and global cognitive functioning of all participants were assessed using standardized tasks. RESULTS Results indicated that individuals with MCI showed greater impairment in global cognitive functioning and EFs performance. Furthermore, the study confirms the predictive role of cognitive flexibility for higher EFs in individuals with MCI and only partially in healthy older adults.
Collapse
Affiliation(s)
- Ilaria Corbo
- Department of Dynamic and Clinical Psychology, and Health Studies, "Sapienza" University of Rome, Via degli Apuli 1 - 00185, Rome, Italy.
| | - Giovanna Troisi
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Giulia Marselli
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Maria Casagrande
- Department of Dynamic and Clinical Psychology, and Health Studies, "Sapienza" University of Rome, Via degli Apuli 1 - 00185, Rome, Italy
| |
Collapse
|
3
|
Wen X, Song S, Tian H, Cui H, Zhang L, Sun Y, Li M, Wang Y. Intervention of computer-assisted cognitive training combined with occupational therapy in people with mild cognitive impairment: a randomized controlled trial. Front Aging Neurosci 2024; 16:1384318. [PMID: 38832072 PMCID: PMC11146196 DOI: 10.3389/fnagi.2024.1384318] [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: 02/09/2024] [Accepted: 04/22/2024] [Indexed: 06/05/2024] Open
Abstract
Objective Investigate the impact of combined computerized cognitive training and occupational therapy on individuals with mild cognitive impairment (MCI). Methods We randomly assigned 118 MCI patients into two groups: a combined intervention group (n = 37) and a control group (n = 81), the latter receiving standard nursing care. The intervention group additionally underwent 12 weeks of computerized cognitive training and occupational therapy. Blind assessors evaluated cognitive performance, anxiety, depression, and daily living activities before the intervention, post-intervention, and at a 3-month follow-up. Results Repeated-measures analysis of variance showed that the sMoCA scores, HAMA scores, and ADL scores of the experimental group at T2 (post-intervention) and T3 (3-month follow-up) were higher than those of the control group, and the difference was statistically significant (p < 0.001, p < 0.001, p = 0.026). Conclusion Computerized cognitive training combined with occupational therapy can improve patients' cognitive status, enhance their compliance with continuing care, and maintain their anxiety and self-care ability at a stable level. Clinical trial registration https://www.chictr.org.cn/index.html, identifier ChiCTR2200065014.
Collapse
Affiliation(s)
- Xin Wen
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Shangrong Song
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Hui Tian
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Hang Cui
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Lijuan Zhang
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yajie Sun
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Mingyue Li
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yonghong Wang
- The First Hospital of Jilin University, Changchun, Jilin, China
| |
Collapse
|
4
|
Sadek J, Diaz-Piedra B, Saleh L, MacDonald L. A narrative review: suicide and suicidal behaviour in older adults. Front Psychiatry 2024; 15:1395462. [PMID: 38800059 PMCID: PMC11117711 DOI: 10.3389/fpsyt.2024.1395462] [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: 03/04/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Globally, suicide is a public health concern that claims the lives of many each year. The complex etiology and factors contributing to the risk of suicide make it hard to predict the likelihood of death by suicide. Suicide rates have been increasing over the past 25 years in patients aged 65 years and older, and with the expected increases in the size of the older adult population and the under-detection of suicide risk, these rates may continue to increase. To mitigate and attempt to limit this expected increase, it is important to understand the risk and protective factors of suicide in older adults. This narrative review focuses on individuals above the age of 65 and encompasses relevant peer-reviewed publications from the past 25 years to cover fatal and non-fatal suicidal behaviour. It summarizes several important risk factors for suicide and suicidal behaviors while considering how risk can be detected, assessed, prevented, and mitigated. Screening methods to detect suicide and depression in older adults were examined based on their effectiveness and suitability for use in this population. Lastly, the impacts of the COVID-19 pandemic on suicide rates in older adults were described.
Collapse
Affiliation(s)
- Joseph Sadek
- Professor, Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | | | - Leah Saleh
- Faculty of Science, Dalhousie University, Halifax, NS, Canada
| | - Luke MacDonald
- MD Candidate, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
5
|
Au-Yeung WTM, Liu Y, Hanna R, Gothard S, Rodrigues N, Leon Guerrero C, Beattie Z, Kaye J. Feasibility of Deploying Home-Based Digital Technology, Environmental Sensors, and Web-Based Surveys for Assessing Behavioral Symptoms and Identifying Their Precipitants in Older Adults: Longitudinal, Observational Study. JMIR Form Res 2024; 8:e53192. [PMID: 38717798 PMCID: PMC11112478 DOI: 10.2196/53192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Apathy, depression, and anxiety are prevalent neuropsychiatric symptoms experienced by older adults. Early detection, prevention, and intervention may improve outcomes. OBJECTIVE We aim to demonstrate the feasibility of deploying web-based weekly questionnaires inquiring about the behavioral symptoms of older adults with normal cognition, mild cognitive impairment, or early-stage dementia and to demonstrate the feasibility of deploying an in-home technology platform for measuring participant behaviors and their environment. METHODS The target population of this study is older adults with normal cognition, mild cognitive impairment, or early-stage dementia. This is an observational, longitudinal study with a study period of up to 9 months. The severity of participant behavioral symptoms (apathy, depression, and anxiety) was self-reported weekly through web-based surveys. Participants' digital biomarkers were continuously collected at their personal residences and through wearables throughout the duration of the study. The indoor physical environment at each residence, such as light level, noise level, temperature, humidity, or air quality, was also measured using indoor environmental sensors. Feasibility was examined, and preliminary correlation analysis between the level of symptoms and the digital biomarkers and between the level of symptoms and the indoor environment was performed. RESULTS At 13 months after recruitment began, a total of 9 participants had enrolled into this study. The participants showed high adherence rates in completing the weekly questionnaires (response rate: 275/278, 98.9%), and data collection using the digital technology appeared feasible and acceptable to the participants with few exceptions. Participants' severity of behavioral symptoms fluctuated from week to week. Preliminary results show that the duration of sleep onset and noise level are positively correlated with the anxiety level in a subset of our participants. CONCLUSIONS This study is a step toward more frequent assessment of older adults' behavioral symptoms and holistic in situ monitoring of older adults' behaviors and their living environment. The goal of this study is to facilitate the development of objective digital biomarkers of neuropsychiatric symptoms and to identify in-home environmental factors that contribute to these symptoms.
Collapse
Affiliation(s)
| | - Yan Liu
- Oregon Health & Science University, Portland, OR, United States
| | - Remonda Hanna
- Fariborz Maseeh Department of Mathematics + Statistics, Portland State University, Portland, OR, United States
| | - Sarah Gothard
- Oregon Health & Science University, Portland, OR, United States
| | | | | | - Zachary Beattie
- Oregon Health & Science University, Portland, OR, United States
| | - Jeffrey Kaye
- Oregon Health & Science University, Portland, OR, United States
| |
Collapse
|
6
|
Ouyang Q, Xu L, Zhang Y, Huang L, Li L, Yu M. Nonlinear Relationship Between Homocysteine and Mild Cognitive Impairment in Early Parkinson's Disease: A Cross-Sectional Study. Neuropsychiatr Dis Treat 2024; 20:913-921. [PMID: 38707522 PMCID: PMC11069358 DOI: 10.2147/ndt.s460938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024] Open
Abstract
Background Cognitive impairment, a prevalent non-motor symptom in advanced Parkinson's disease (PD), has been associated with hyperhomocysteinemia, an important risk factor for PD progression and cognitive decline in PD. However, evidence regarding the association between homocysteine (Hcy) and cognitive function during early PD remains insufficient. Therefore, this study aims to examine the correlation between Hcy levels and cognitive function in the early stage of PD. Methods The study included 218 individuals in the early stages of PD who were consecutively admitted to the Suining Central Hospital Neurology Department. All the individuals completed the Parkinson's Disease Cognitive Rating Scale (PD-CDR). The Unified Parkinson's Disease Rating Scale part III (UPDRS-III) was employed for measuring the severity of motor symptoms, while the Hoehn-Yahr scale was used to measure the clinical symptom stage. Fasting venous blood samples were also drawn to measure the Hcy concentration, red blood cell folate, and vitamin B12. Results In this cross-sectional study, 47 (21.5%) patients with PD showed cognitive dysfunction. The serum Hcy levels were significantly higher in the cognitive impairment PD (PDCI) group compared with the cognitive normal PD group (P<0.001). The Generalized Additive Model (GAM) analysis revealed a nonlinear relationship between Hcy and the risk of PDCI. Multiple logistic regression analyses demonstrated a positive relationship between elevated Hcy and the risk of PDCI in the fully adjusted model ([OR]:3.1, 95% CI, 1.1-8.5, P=0.028). Segmented linear regression analysis showed that when Hcy levels were above 17.7 umol/l, the risk of PDCI increased by 1.6 times for every 1 unit elevated in Hcy (95% CI:1.1-2.2, P=0.008). Conclusion This study revealed a nonlinear positive correlation between the risk of PDCI and elevated serum Hcy levels in early PD patients, suggesting hyperhomocysteinemia as one of the treatable factors for cognitive impairment in the early stages of PD.
Collapse
Affiliation(s)
- Qingrong Ouyang
- Department of Neurology, Suining Central Hospital, Suining, 629000, People’s Republic of China
| | - Lei Xu
- Department of Neurology, Suining Central Hospital, Suining, 629000, People’s Republic of China
| | - Yunwei Zhang
- Department of Neurology, Suining Central Hospital, Suining, 629000, People’s Republic of China
| | - Luwen Huang
- Department of Neurology, Suining Central Hospital, Suining, 629000, People’s Republic of China
| | - Linlin Li
- Department of Neurology, Suining Central Hospital, Suining, 629000, People’s Republic of China
| | - Ming Yu
- Department of Neurology, Suining Central Hospital, Suining, 629000, People’s Republic of China
| |
Collapse
|
7
|
Cai M, Bai D, Hou D, You Q, Wang W, Lu X, Gao J. Effectiveness of nonpharmacological multi-component intervention on depressive symptoms in patients with mild cognitive impairment and dementia: A systematic review and meta-analysis. Int J Ment Health Nurs 2024; 33:297-308. [PMID: 37937694 DOI: 10.1111/inm.13247] [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: 01/05/2023] [Revised: 09/06/2023] [Accepted: 10/13/2023] [Indexed: 11/09/2023]
Abstract
Patients with mild cognitive impairment (MCI) and dementia are more prone to depression than people without MCI or dementia. Some studies have found nonpharmacological multi-component intervention to be more effective than single-component intervention in improving the condition of patients with MCI and dementia; however, their effect on depressive symptoms is still inconsistent. Therefore, it is necessary to explore the effectiveness of nonpharmacological multi-component intervention in improving depressive symptoms in patients with MCI and dementia. This review retrieved papers from PubMed, Embase, Cochrane Library, CINAHL, PsycINFO and CNKI. The retrieval time limit was set from 1 January 1990 to 25 November 2022. The PRISMA 2020 guideline was used to report the included studies. The result showed that nonpharmacological multi-component intervention could improve depressive symptoms in patients with MCI and dementia. Among them, nonpharmacological multi-component intervention with a duration of <6 months, physical and cognitive activities, or other activities had significant effects. However, each study differed in terms of specific measures, duration and frequency of intervention methods. Accordingly, more randomized controlled trials with larger samples are required to discover the best scheme for nonpharmacological multi-component intervention.
Collapse
Affiliation(s)
- Mingjin Cai
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dingxi Bai
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongjiang Hou
- School of Medicine and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qian You
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wei Wang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xianying Lu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Gao
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| |
Collapse
|
8
|
Du Y, Nie J, Zhang J, Fang Y, Wei W, Wang J, Zhang S, Wang J, Li X. Disrupted topological organization of the default mode network in mild cognitive impairment with subsyndromal depression: A graph theoretical analysis. CNS Neurosci Ther 2024; 30:e14547. [PMID: 38105496 PMCID: PMC11017411 DOI: 10.1111/cns.14547] [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: 12/03/2022] [Revised: 10/26/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023] Open
Abstract
AIMS Subsyndromal depression (SSD) is common in mild cognitive impairment (MCI). However, the neural mechanisms underlying MCI with SSD (MCID) are unclear. The default mode network (DMN) is associated with cognitive processes and depressive symptoms. Therefore, we aimed to explore the topological organization of the DMN in patients with MCID. METHODS Forty-two MCID patients, 34 MCI patients without SSD (MCIND), and 36 matched healthy controls (HCs) were enrolled. The resting-state functional connectivity of the DMN of the participants was analyzed using a graph theoretical approach. Correlation analyses of network topological metrics, depressive symptoms, and cognitive function were conducted. Moreover, support vector machine (SVM) models were constructed based on topological metrics to distinguish MCID from MCIND. Finally, we used 10 repeats of 5-fold cross-validation for performance verification. RESULTS We found that the global efficiency and nodal efficiency of the left anterior medial prefrontal cortex (aMPFC) of the MCID group were significantly lower than the MCIND group. Moreover, small-worldness and global efficiency were negatively correlated with depressive symptoms in MCID, and the nodal efficiency of the left lateral temporal cortex and left aMPFC was positively correlated with cognitive function in MCID. In cross-validation, the SVM model had an accuracy of 0.83 [95% CI 0.79-0.87], a sensitivity of 0.88 [95% CI 0.86-0.90], a specificity of 0.75 [95% CI 0.72-0.78] and an area under the curve of 0.88 [95% CI 0.85-0.91]. CONCLUSIONS The coexistence of MCI and SSD was associated with the greatest disrupted topological organization of the DMN. The network topological metrics could identify MCID and serve as biomarkers of different clinical phenotypic presentations of MCI.
Collapse
Affiliation(s)
- Yang Du
- Department of Geriatric Psychiatry, Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghaiChina
- Alzheimer's Disease and Related Disorders CenterShanghai Jiao Tong UniversityShanghaiChina
| | - Jing Nie
- Department of Geriatric Psychiatry, Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghaiChina
- Alzheimer's Disease and Related Disorders CenterShanghai Jiao Tong UniversityShanghaiChina
| | - Jian‐Ye Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yuan Fang
- Department of Geriatric Psychiatry, Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghaiChina
- Alzheimer's Disease and Related Disorders CenterShanghai Jiao Tong UniversityShanghaiChina
| | - Wen‐Jing Wei
- Department of Geriatric Psychiatry, Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghaiChina
- Alzheimer's Disease and Related Disorders CenterShanghai Jiao Tong UniversityShanghaiChina
| | - Jing‐Hua Wang
- Department of Geriatric Psychiatry, Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghaiChina
- Alzheimer's Disease and Related Disorders CenterShanghai Jiao Tong UniversityShanghaiChina
| | - Shao‐Wei Zhang
- Department of Geriatric Psychiatry, Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghaiChina
- Alzheimer's Disease and Related Disorders CenterShanghai Jiao Tong UniversityShanghaiChina
| | - Jin‐Hong Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghaiChina
- Alzheimer's Disease and Related Disorders CenterShanghai Jiao Tong UniversityShanghaiChina
| |
Collapse
|
9
|
Hong S, Cha EJ, Moon Y, Ryu SH, Jeon HJ. Network Analysis Revealed the Role of Helplessness as a Central Feature Among Late-Life Depressive Symptoms in Patients With Mild Cognitive Impairment and Early Stage Dementia. Psychiatry Investig 2024; 21:371-379. [PMID: 38695044 PMCID: PMC11065523 DOI: 10.30773/pi.2023.0259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/07/2023] [Accepted: 01/02/2024] [Indexed: 05/04/2024] Open
Abstract
OBJECTIVE It has been reported that depressive symptoms in older adults are different from those in younger adults, especially when accompanied by cognitive decline. However, few studies have investigated the network structure of depressive symptoms in this population. METHODS The participants consisted of 627 older adults (>60 yr) who were diagnosed with mild cognitive impairment (MCI) or early stage dementia. Among them, 36.7% were male and the mean age was 76.20±7.71 years. The Korean form of Geriatric Depression Scale (KGDS) was used to evaluate their depressive symptoms and network analyses were performed using bootnet R-package to identify the central features among depressive symptoms. RESULTS Of all the KGDS items, we found that KGDS 2 (often feel helpless) had the highest node strength followed by KGDS 21 (in good spirits), KGDS 14 (not confident at all), and KGDS 15 (cheerful and happy). In terms of node betweenness, KGDS 2 also showed the highest value. The edge weights of edges connected to node KGDS 2 were strongest in KGDS 3 (restless and fidgety) and KGDS 28 (easily get tired). CONCLUSION In this study, we presented which symptoms are central among the elderly with MCI and early stage dementia. This result not only increases the understanding of depressive symptoms in this group but would also help determine target symptoms in the treatment program.
Collapse
Affiliation(s)
- Sumin Hong
- Department of Psychiatry, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Eun Jung Cha
- Department of Psychiatry, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Yeonsil Moon
- Department of Neurology, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Hong Jun Jeon
- Department of Psychiatry, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, Republic of Korea
| |
Collapse
|
10
|
Rohn TT, Radin D, Brandmeyer T, Seidler PG, Linder BJ, Lytle T, Mee JL, Macciardi F. Intranasal delivery of shRNA to knockdown the 5HT-2A receptor enhances memory and alleviates anxiety. Transl Psychiatry 2024; 14:154. [PMID: 38509093 PMCID: PMC10954635 DOI: 10.1038/s41398-024-02879-y] [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: 11/28/2023] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 03/22/2024] Open
Abstract
Short-hairpin RNAs (shRNA), targeting knockdown of specific genes, hold enormous promise for precision-based therapeutics to treat numerous neurodegenerative disorders. However, whether shRNA constructed molecules can modify neuronal circuits underlying certain behaviors has not been explored. We designed shRNA to knockdown the human HTR2A gene in vitro using iPSC-differentiated neurons. Multi-electrode array (MEA) results showed that the knockdown of the 5HT-2A mRNA and receptor protein led to a decrease in spontaneous electrical activity. In vivo, intranasal delivery of AAV9 vectors containing shRNA resulted in a decrease in anxiety-like behavior in mice and a significant improvement in memory in both mice (104%) and rats (92%) compared to vehicle-treated animals. Our demonstration of a non-invasive shRNA delivery platform that can bypass the blood-brain barrier has broad implications for treating numerous neurological mental disorders. Specifically, targeting the HTR2A gene presents a novel therapeutic approach for treating chronic anxiety and age-related cognitive decline.
Collapse
Affiliation(s)
- Troy T Rohn
- Department of Biological Sciences, Boise State University, Boise, ID, USA.
- Cognigenics Inc., 1372 S. Eagle Road, Suite 197, Eagle, ID, USA.
| | - Dean Radin
- Cognigenics Inc., 1372 S. Eagle Road, Suite 197, Eagle, ID, USA
| | | | - Peter G Seidler
- Cognigenics Inc., 1372 S. Eagle Road, Suite 197, Eagle, ID, USA
| | - Barry J Linder
- Cognigenics Inc., 1372 S. Eagle Road, Suite 197, Eagle, ID, USA
| | - Tom Lytle
- Cognigenics Inc., 1372 S. Eagle Road, Suite 197, Eagle, ID, USA
| | - John L Mee
- Cognigenics Inc., 1372 S. Eagle Road, Suite 197, Eagle, ID, USA
| | - Fabio Macciardi
- Cognigenics Inc., 1372 S. Eagle Road, Suite 197, Eagle, ID, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| |
Collapse
|
11
|
Conway AE, Verdi M, Shaker MS, Bernstein JA, Beamish CC, Morse R, Madan J, Lee MW, Sussman G, Al-Nimr A, Hand M, Albert DA. Beyond Confirmed Mast Cell Activation Syndrome: Approaching Patients With Dysautonomia and Related Conditions. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00281-2. [PMID: 38499084 DOI: 10.1016/j.jaip.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/23/2024] [Accepted: 03/09/2024] [Indexed: 03/20/2024]
Abstract
Allergist-immunologists face significant challenges as experts in an ever-evolving field of neuroimmunology. Among these challenges is the increasingly frequent need to counsel patients with suspected mast cell activation disorders about perceived comorbidities, which may include hypermobile Ehlers-Danlos syndrome, amplified pain syndrome, fibromyalgia, burning sensation syndromes, migraines, irritable bowel syndrome, and postural orthostatic tachycardia syndrome. Patients may experience comorbid anxiety, panic disorder, and depression associated with disturbed sleep, fatigue, and cognitive impairment that often worsen when their physical symptoms increase in severity. These conditions may mimic mast cell activation disorders and are emotionally taxing for patients and clinicians because they are often accompanied by vague diagnostic courses, perceived unmanageability, social stigma, and significant impairment in quality of life. Combined with relatively poorly researched therapies, it is no surprise that clinicians may feel overwhelmed or find it difficult to provide consistently compassionate care for this population. In this article, we review available therapies for these conditions, which run the gamut from physical therapy to antidepressants to multimodal pain control. We highlight the benefit of multidisciplinary care within the primary care home, which includes an important role by the allergist-immunologist. By outlining simple approaches to initial treatment, we hope to empower clinicians with the tools needed to curb emotional burnout and embrace this patient population with compassion.
Collapse
Affiliation(s)
| | | | - Marcus S Shaker
- Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH; Section of Allergy and Immunology, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
| | - Jonathan A Bernstein
- Department of Internal Medicine, Division of Rheumatology, Allergy, and Immunology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Claire C Beamish
- Department of Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Richard Morse
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH; Section of Pediatric Neurology, Children's Hospital at Dartmouth, Lebanon, NH
| | - Juliette Madan
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Pediatrics, Division of Child Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH; Department of Psychiatry, Division of Child Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Michael W Lee
- Department of Medical Education, Dartmouth Geisel School of Medicine, Hanover, NH
| | - Gordon Sussman
- Division of Immunology, University of Toronto, St Michael's Hospital, Toronto, Ontario, Canada
| | - Amer Al-Nimr
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH; Section of Pediatric Gastroenterology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Matthew Hand
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH; Section of Pediatric Nephrology and Integrative Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Daniel A Albert
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH; Section of Rheumatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| |
Collapse
|
12
|
Yuan H, Wang S, Sun Y, Liu M, Wu F, Sun H, Zhou F. Association between chronic pain classes and cognitive function in older adults: A cross-sectional study based on latent class analysis. Geriatr Nurs 2024; 56:312-320. [PMID: 38422626 DOI: 10.1016/j.gerinurse.2024.02.028] [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: 12/15/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
The purpose of this study was to identify latent classes of chronic pain in older adults based on perceptual, cognitive, behavioral, emotional and social factors, and to explore the associations between each class of chronic pain and different cognitive domains. A total of 629 participants were included. Three classes of chronic pain were identified: "episodic recurrent mild pain with good psychosocial state" (class 1), "episodic recurrent moderate pain with general psychosocial state" (class 2) and "continuous multilocational severe pain with attacks accompanied by poor psychosocial state and avoidance of activity" (class 3). After adjusting for relevant confounders, chronic pain presenting as class 1 was associated with worse memory; class 2 was associated with worse global cognitive function, memory, information processing speed, and executive function; and class 3 was additionally associated with worse attention compared to class 2. The findings contribute to the development of targeted programs for treating pain and improving cognitive functioning.
Collapse
Affiliation(s)
- Hui Yuan
- School of Nursing, Xuzhou Medical University, Jiangsu, PR China
| | - Shuo Wang
- School of Nursing, Xuzhou Medical University, Jiangsu, PR China
| | - Yumei Sun
- School of Nursing, Peking University, Beijing, PR China
| | - Mengdie Liu
- School of Nursing, Xuzhou Medical University, Jiangsu, PR China
| | - Feng Wu
- School of Nursing, Xuzhou Medical University, Jiangsu, PR China
| | - Hongyu Sun
- School of Nursing, Peking University, Beijing, PR China.
| | - Fang Zhou
- School of Nursing, Xuzhou Medical University, Jiangsu, PR China.
| |
Collapse
|
13
|
Sagar R, Talwar S, Verma R, Tripathi M. Translation and Adaptation of Cognistat in Hindi Language: For Computerized Evaluation of Cognitive Functioning. Arch Clin Neuropsychol 2024:acae008. [PMID: 38402456 DOI: 10.1093/arclin/acae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 11/21/2023] [Accepted: 01/15/2024] [Indexed: 02/26/2024] Open
Abstract
OBJECTIVE Cognitive assessment is a crucial element of the mental health screening process. However, there is a lack of culturally appropriate cognitive screening tools for the Hindi-speaking aging population in India. We aimed to translate and culturally tailor the English version of the computerized Cognistat test for the Hindi-speaking aging population. METHOD The computer-based Cognistat Assessment System was culturally adapted for the North Indian Hindi-speaking population. Participants with mild cognitive impairment (MCI) (n = 30), depression (n = 30), and healthy control (n = 30) groups between the age range of 50 and 83 years were assessed using the translated version of the tool. The group differences were analyzed using analysis of variance, multivariate analysis of variance, Tukey's post hoc analysis for continuous variables, and Fisher's exact test for categorical variables. The correlation between the Cognistat domains was analyzed using Pearson's correlation, and test reliability was assessed using Cronbach's alpha. RESULTS The MCI group had significantly lower scores as compared with the depression and control groups on orientation, language, repetition, and calculation domain tasks. For attention and construction tasks, the MCI group had lower scores than the control group. MCI group scores were significantly lower than the control group on naming domain. The Hindi version of the test was reliable for the Hindi-speaking aging population. CONCLUSIONS Cognistat Hindi can be used by trained healthcare professionals with Hindi-speaking populations for culturally tailored primary evaluation of cognitive difficulties. Future research should focus on further validation and assessment of its properties.
Collapse
Affiliation(s)
- Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India
| | - Shivangi Talwar
- Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India
- Division of Psychiatry, University College London, London, UK
| | - Rohit Verma
- Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India
| | - Manjari Tripathi
- Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India
- Department of Neurology, All India Institute of Medical Sciences, Delhi, India
| |
Collapse
|
14
|
Burling JE, Katz Z, Yuan Z, Munro C, Mimmack K, Ma G, Hanseeuw BJ, Papp KV, Amariglio RE, Vannini P, Rentz DM, Quiroz YT, Johnson KA, Sperling RA, Blacker D, Marshall GA, Yang HS, Gatchel JR. Study Partner Report of Apathy in Older Adults is Associated with AD Biomarkers: Findings from the Harvard Aging Brain Study. Am J Geriatr Psychiatry 2024:S1064-7481(24)00020-4. [PMID: 38443298 DOI: 10.1016/j.jagp.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVES We examined relationships between apathy (self and study-partner-reported) and markers of Alzheimer's disease (AD) in older adults. DESIGN The study utilized a well-characterized sample of participants from the Harvard Aging Brain Study (HABS), a longitudinal cohort study. Participants were cognitively unimpaired without clinically significant neuropsychiatric symptoms at HABS baseline. The dependent variables, apathy evaluation scale-self (AES-S) and informant (AES-I), were administered cross-sectionally between years 6-9 and compared to the independent variables, amyloid and tau PET neuroimaging, from the same year. SETTING Community-dwelling participants assessed at research visits in an academic medical center. PARTICIPANTS Participants (n = 170) completed assessments within 1.5 years of their neuroimaging visit. At the time of apathy assessment, N = 156 were cognitively unimpaired and 14 had progressed to mild cognitive impairment (n = 8) or dementia (n = 6). MEASUREMENTS We utilized linear regression models to assess cross-sectional associations of AES-S and AES-I with AD PET imaging measures (beta-amyloid (Pittsburgh Compound B) and tau (Flortaucipir)), covarying for age, sex, education, and the time between PET scan-apathy assessment. RESULTS AES-I was significantly associated with beta-amyloid and temporal lobe tau, and the associations were retained after further adjusting for depressive symptoms. The associations between AES-S and AD biomarkers were not significant. In an exploratory subgroup analysis of cognitively unimpaired individuals with elevated Aβ, we observed an association between AES-I and inferior temporal tau. CONCLUSIONS Study-partner-reported, but not self-reported, apathy in older adults is associated with AD pathology, and we observed this relationship starting from the preclinical stage. Our findings highlight the importance of collateral information in capturing AD-related apathy.
Collapse
Affiliation(s)
- Jessa E Burling
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA
| | - Zoe Katz
- Washington University School of Medicine in St. Louis (ZK), St. Louis, MO
| | - Ziwen Yuan
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA
| | - Catherine Munro
- Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Department of Psychiatry (CM, YTQ, DB, JRG), Massachusetts General Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Kayden Mimmack
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA
| | - Grace Ma
- Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA; Department of Psychiatry (GM), Brigham and Women's Hospital, Boston, MA
| | - Bernard J Hanseeuw
- Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA; Department of Radiology (BJH), Massachusetts General Research Institute, Boston, MA; Department of Neurology (BJH), Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Kathryn V Papp
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Rebecca E Amariglio
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Patrizia Vannini
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Dorene M Rentz
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Yakeel T Quiroz
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Psychiatry (CM, YTQ, DB, JRG), Massachusetts General Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Keith A Johnson
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA; Department of Radiology (KAJ), Massachusetts General Hospital, Boston, MA
| | - Reisa A Sperling
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Deborah Blacker
- Department of Psychiatry (CM, YTQ, DB, JRG), Massachusetts General Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA; Department of Epidemiology (DB), Harvard T. H. Chan School of Public Health, Boston, MA
| | - Gad A Marshall
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Hyun-Sik Yang
- Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA; Department of Neurology (CM, KVP, REA, PV, DMR, KAJ, RAS, GAM, H-SY), Brigham and Women's Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA
| | - Jennifer R Gatchel
- Department of Psychiatry (CM, YTQ, DB, JRG), Massachusetts General Hospital, Boston, MA; Harvard Medical School (CM, GM, BJH, KVP, REA, PV, DMR, YTQ, KAJ, RAS, DB, GAM, H-SY, JRG), Boston, MA; Department of Psychiatry (JRG), Massachusetts General Hospital, Boston MA; Department of Psychiatry (JRG), McLean Hospital, Belmont, MA; Department of Psychiatry (JRG), Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center (JRG), Houston, TX.
| |
Collapse
|
15
|
Ma C, Yu B, Fan Y, Jia P, Yang S. Exploring Interrelationships between Mental Health Symptoms and Cognitive Impairment in Aging People Living with HIV in China. Dement Geriatr Cogn Disord 2024; 53:19-28. [PMID: 38232713 DOI: 10.1159/000536056] [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: 05/09/2023] [Accepted: 12/29/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION Mental health symptoms and cognitive impairment are highly prevalent and intertwined among aging people living with HIV (PLWH). This study aimed to assess the interrelationships and strength of connections between individual mental health symptoms and cognitive impairment. We sought to identify specific symptoms linking mental health and cognitive impairment in aging PLWH. METHODS Participants in the Sichuan Older People with HIV Infections Cohort Study (SOHICS) were recruited between November 2018 and April 2021 in China. Mental health symptoms, including depression and anxiety, were assessed by the Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder-7 (GAD-7), respectively. Cognitive impairment was assessed by the Montreal Cognitive Assessment-Basic (MoCA-B). Partial correlation networks were used to depict the interrelationships between mental health symptoms and cognitive impairment, and bridge strength was used to identify specific symptoms linking mental health and cognitive impairment. RESULTS Of the 1,587 recruited participants with a mean age of 63.0 years old, 47.0% had mild or severe cognitive impairment. Network analysis revealed that cognitive function, visual perception, and problem-solving task of the MoCA-B were negatively correlated with appetite, energy, and motor of the PHQ-9, respectively. Based on their interrelationships, problem-solving task and motor acted as bridge symptoms. CONCLUSION Problem-solving task and motor may be potential intervention targets to reduce the overall risk of mental health symptoms and cognitive impairment. Future research could assess the feasibility and effectiveness of specific interventions designed for the two symptoms of aging PLWH.
Collapse
Affiliation(s)
- Chunlan Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Bin Yu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China
- Sichuan Research Center of Sexual Sociology and Sex Education, Chengdu, China
| | - Yunzhe Fan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
- Hubei Luojia Laboratory, Wuhan, China
- School of Public Health, Wuhan University, Wuhan, China
- Renmin Hospital, Wuhan University, Wuhan, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
- Department of Clinical Medical College, Affiliated Hospital of Chengdu University, Chengdu, China
| |
Collapse
|
16
|
Li PWC, Yu DSF. Empowerment-based cognitive behavioural therapy for insomnia in persons with mild cognitive impairment: A sequential explanatory mixed-method pilot study. J Sleep Res 2024:e14131. [PMID: 38204434 DOI: 10.1111/jsr.14131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 11/26/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024]
Abstract
Insomnia is an emerging risk factor for the onset of mild cognitive impairment (MCI) and its progression to dementia. Impaired cognition and neuropsychiatric symptoms create challenges for persons with MCI to participate actively in non-pharmacological interventions. This study examined the feasibility and preliminary effects of empowerment-based cognitive-behavioural therapy for insomnia (CBT-I) on sleep, cognitive function, and health-related quality of life (HRQoL) in persons with MCI and sleep problems. Sixty participants were randomly allocated to the intervention or control group to receive empowerment-based CBT-I or usual care, respectively. The 12 week intervention comprised all core CBT-I techniques delivered through a group and individualised face-to-face approach. An empowerment approach with interactive teaching methods, goal setting, and action planning was used to deliver the intervention. Outcome measures included subjective and objective sleep quality and pattern, and a battery of neuropsychological tests and the 12-item Short Form Survey were administered 3 months (T1) and 6 months post-randomisation (T2). This intervention is feasible and highly acceptable for persons with MCI. The intervention group showed significant improvements in subjective and objective sleep-related outcomes compared with the control group. Moreover, the intervention group showed greater improvements in global cognition, processing speed, attention, and mental flexibility than the control group at T1 and/or T2. No significant between-group differences were observed in memory or HRQoL scores. The qualitative data converged with the quantitative data. In conclusion, empowerment-based CBT-I was well received by persons with MCI and had potential positive effects on improving sleep and cognition in this cohort.
Collapse
Affiliation(s)
- Polly W C Li
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Doris S F Yu
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| |
Collapse
|
17
|
Belfiori M, Salis F, Demelas G, Mandas A. Association between Depressive Mood, Antidepressant Therapy and Neuropsychological Performances: Results from a Cross-Sectional Study on Elderly Patients. Brain Sci 2024; 14:54. [PMID: 38248269 PMCID: PMC10813455 DOI: 10.3390/brainsci14010054] [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: 11/28/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Currently, the global demographic landscape is undergoing a transformative shift towards an increasingly aging population. This leads to an increase in chronic pathologies, including depression and cognitive impairment. This study aimed to evaluate the association between depressive mood, whether in treatment or not, and cognitive capacities, assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). METHODS This study included 259 subjects, aged 65 years or older, evaluated at the Geriatric Outpatient Service of the University Hospital of Monserrato, Cagliari, between July 2018 and May 2022, who experienced subjective depressive mood and/or cognitive deficits. RESULTS Only 25.1% of the sample showed no cognitive impairment on the RBANS. Education was a significant regressor of the RBANS Total Scale scores (p < 0.0001) and was negatively associated with mood deflection (r = -0.15, p = 0.0161). Subjects with depressive mood had more impaired attention and visuospatial/constructional abilities compared to untreated euthymic patients. Post-hoc analysis, conducted with the Conover test, showed that untreated euthymic patients (GDS-15 ≤ 5, group 2) had a higher score on the RBANS total scale than patients with mood deflection (GDS-15 > 5, group 1), and treated euthymic patients (GDS-15 ≤ 5, group 3). Finally, different logistic regression analyses revealed a significant negative coefficient for GDS as a regressor of the RBANS total scale (coefficient: -0.04, p = 0.0089), visuospatial/constructional abilities (coefficient: -0.03, p = 0.0009), language (coefficient: -0.05, p = 0.0140), and attention (coefficient: -0.05, p < 0.0001). CONCLUSIONS Our analysis demonstrated that "naturally" euthymic people show better cognitive performances than people with depressive mood and subjects with acceptable mood due to antidepressants. Furthermore, the gender-based difference observed in the language domain suggests the potential utility of incorporating an alternative category for male patients in the Semantic Fluency test.
Collapse
Affiliation(s)
- Maristella Belfiori
- Department of Medical Sciences, and Public Health, University of Cagliari, SS 554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy; (F.S.); (G.D.); (A.M.)
| | - Francesco Salis
- Department of Medical Sciences, and Public Health, University of Cagliari, SS 554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy; (F.S.); (G.D.); (A.M.)
- Department of Biomedical Sciences, University of Cagliari, 09042 Cagliari, Italy
| | - Giorgia Demelas
- Department of Medical Sciences, and Public Health, University of Cagliari, SS 554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy; (F.S.); (G.D.); (A.M.)
| | - Antonella Mandas
- Department of Medical Sciences, and Public Health, University of Cagliari, SS 554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy; (F.S.); (G.D.); (A.M.)
- University Hospital “Azienda Ospedaliero-Universitaria” of Cagliari, 09127 Cagliari, Italy
| |
Collapse
|
18
|
Tran-Chi VL, Maes M, Nantachai G, Hemrungrojn S, Solmi M, Tunvirachaisakul C. Distress Symptoms of Old Age and Mild Cognitive Impairment are Two Distinct Dimensions in Older Adults Without Major Depression. Psychol Res Behav Manag 2024; 17:101-116. [PMID: 38204566 PMCID: PMC10777864 DOI: 10.2147/prbm.s447774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
Background Studies in old adults showed bidirectional interconnections between amnestic mild cognitive impairment (aMCI) and affective symptoms and that adverse childhood experiences (ACE) may affect both factors. Nevertheless, these associations may be confined to older adults with clinical depression. Aim To delineate the relationship between clinical symptoms of aMCI and affective symptoms in older adults without major depression (MDD) or dysfunctions in activities of daily living (ADL). Methods This case-control study recruited 61 participants with aMCI (diagnosed using Petersen's criteria) and 59 older adults without aMCI and excluded subjects with MDD and ADL dysfunctions. Results We uncovered 2 distinct dimensions, namely distress symptoms of old age (DSOA), comprising affective symptoms, perceived stress and neuroticism, and mild cognitive dysfunctions, comprising episodic memory test scores, the total Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. A large part of the variance (37.9%) in DSOA scores was explained by ACE, negative life events (health and financial problems), a subjective feeling of cognitive decline, and education (all positively). ACE and NLE have a highly significant impact on the DSOA score and are not associated with aMCI or its severity. Cluster analysis showed that the diagnosis of aMCI is overinclusive because some subjects with DSOA symptoms may be incorrectly classified as aMCI. Conclusion The clinical impact is that clinicians should carefully screen older adults for DSOA after excluding MDD. DSOA might be misinterpreted as aMCI.
Collapse
Affiliation(s)
- Vinh-Long Tran-Chi
- Ph.D. Program in Clinical Sciences, School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michael Maes
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, People’s Republic of China
- Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
- Kyung Hee University, Dongdaemun-gu, Seoul, South Korea
- Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cognitive Fitness and Biopsychiatry Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Gallayaporn Nantachai
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Somdet Phra Sungharaj Nyanasumvara Geriatric Hospital, Department of Medical Services, Ministry of Public Health, Chon Buri Province, Thailand
| | - Solaphat Hemrungrojn
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cognitive Fitness and Biopsychiatry Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ontario, Canada
- Regional Centre for the Treatment of Eating Disorders and on Track, The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada
- Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, Ontario, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Chavit Tunvirachaisakul
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
19
|
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
|
20
|
Gómez-Soria I, Ferreira C, Oliván-Blazquez B, Aguilar-Latorre A, Calatayud E. Predictive variables of depressive symptoms and anxiety in older adults from primary care: a cross-sectional observational study. Psychogeriatrics 2024; 24:46-57. [PMID: 37885411 DOI: 10.1111/psyg.13039] [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: 04/03/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND By 2050, the number of people aged 60 years and older will have doubled worldwide and the most common mental disorders in this age group are currently depressive symptoms and anxiety. This study aimed to analyze the Basic and Instrumental Activities of Daily Living (BADLs and IADLs, respectively) in older adults; socio-demographic, clinical, lifestyle, and environmental variables; and cognitive impairment related to the appearance of depressive symptoms and anxiety. MATERIAL AND METHODS A cross-sectional observational study was conducted with 327 participants aged ≥65 years in primary care. The variables were Yesavage's Geriatric Depression Scale, the Goldberg Anxiety Subscale, socio-demographic, clinical, lifestyle, environmental variables, BADLs, IADLs, and the Spanish version of the Mini-Mental State Examination. RESULTS An analysis of variance was carried out for the predictive multiple linear regression models. '≥ 1 chronic pathology' and 'low dependency' in BADL are negatively associated with anxiety, while 'physical activity' and 'low dependency' in BADL are associated with positive factors for depressive symptoms. CONCLUSIONS Predictor variables could improve the early detection of anxiety and depressive symptoms by general practitioners and serve as a basis for future studies and personalised-adapted cognitive stimulation programs.
Collapse
Affiliation(s)
- Isabel Gómez-Soria
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Chelo Ferreira
- Department of Applied Mathematics and IUMA, Faculty of Veterinary Sciences, University of Zaragoza, Zaragoza, Spain
| | - Bárbara Oliván-Blazquez
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, Faculty of Social and Labor Sciences, University of Zaragoza, Zaragoza, Spain
| | - Alejandra Aguilar-Latorre
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, Faculty of Human Sciences and Education of Huesca, University of Zaragoza, Huesca, Spain
| | - Estela Calatayud
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| |
Collapse
|
21
|
Baldimtsi E, Mouzakidis C, Karathanasi EM, Verykouki E, Hassandra M, Galanis E, Hatzigeorgiadis A, Goudas M, Zikas P, Evangelou G, Papagiannakis G, Bellis G, Kokkotis C, Tsatalas T, Giakas G, Theodorakis Y, Tsolaki M. Effects of Virtual Reality Physical and Cognitive Training Intervention On Cognitive Abilities of Elders with Mild Cognitive Impairment. J Alzheimers Dis Rep 2023; 7:1475-1490. [PMID: 38225966 PMCID: PMC10789285 DOI: 10.3233/adr-230099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/28/2023] [Indexed: 01/17/2024] Open
Abstract
Background Virtual reality (VR) technology has become increasingly used for assessment and intervention in the neuroscience field. Objective We aimed to investigate the effects of a VR Training System, named VRADA (VR Exercise App for Dementia and Alzheimer's Patients), on the cognitive functioning of older people with mild cognitive impairment (MCI). Methods In this intervention study, 122 older adults with MCI were randomly assigned to five groups (the VRADA group (n = 28), a bike group (n = 11), a physical exercise group (n = 24), a mixed group (physical and cognitive exercise) (n = 31), and a non-contact control group (n = 28). The VRADA group underwent 32 physical and cognitive training sessions, performed 2 or 3 times weekly for 12 weeks in the VR environment. All participants had detailed neuropsychological assessments before and after intervention. Results A series of linear regression models revealed that the VRADA group showed improvement or no deterioration in cognitive decline in global cognitive function (MMSE), verbal memory (Rey Auditory Verbal Learning Test and WAIS forward test), and executive functions, mental flexibility (Trail Making Test B). Conclusions This interventionstudy indicates that the VRADA system improves the cognitive function of elders with MCI.
Collapse
Affiliation(s)
- Eleni Baldimtsi
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Christos Mouzakidis
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
| | - Eleni Maria Karathanasi
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
| | - Eleni Verykouki
- School of Medicine, Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Agriculture, Crop Production and Rural Environment, School of Agricultural Sciences, University of Thessaly, Volos, Greece
| | - Mary Hassandra
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Evangelos Galanis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Antonis Hatzigeorgiadis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Marios Goudas
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Paul Zikas
- ORamaVR S.A., Science and Technology Park of Crete, Heraklion, Crete, Greece
| | - Giannis Evangelou
- ORamaVR S.A., Science and Technology Park of Crete, Heraklion, Crete, Greece
| | - George Papagiannakis
- ORamaVR S.A., Science and Technology Park of Crete, Heraklion, Crete, Greece
- Institute of Computer Science, Foundation for Research and Technology – Hellas (FORTH), University of Crete, Heraklion, Crete, Greece
| | - George Bellis
- Biomechanical Solutions Engineering (BME), Karditsa, Greece
| | - Christos Kokkotis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
- Biomechanical Solutions Engineering (BME), Karditsa, Greece
| | - Themistoklis Tsatalas
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Giannis Giakas
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Yannis Theodorakis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Magda Tsolaki
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh), Balkan Center, Building A, Greece
| |
Collapse
|
22
|
Xue B, Meng X, Liu Q, Luo X. The effect of receptive music therapy on older adults with mild cognitive impairment and depression: a randomized controlled trial. Sci Rep 2023; 13:22159. [PMID: 38092791 PMCID: PMC10719334 DOI: 10.1038/s41598-023-49162-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023] Open
Abstract
This study aims to evaluate the effects of a receptive music therapy intervention on cognitive functions and depressive symptoms in older adults with MCI. A randomized controlled trial was conducted in Wuhan, China. Eighty older adults, over 65, who had MCI and depression symptoms were randomly divided into the intervention and control groups. The intervention group received usual nursing care plus receptive music therapy intervention four times a week, for eight weeks; the control group received usual nursing care during the same period. The linear regression analysis was used to compare the difference between groups. There was a significant difference in the intervention group for the pre-intervention and post-intervention scores of cognitive function and depression. There was no significant difference in the control group before and after the study period and a significant between-group difference in both cognitive function and depression. In conclusion, receptive music therapy intervention significantly improved cognitive function and reduced depressive symptoms in older adults with MCI. It could be widely used in communities and nursing homes to improve the quality of life of older adults.
Collapse
Affiliation(s)
- Bing Xue
- School of Nursing, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei, China
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xianmei Meng
- School of Nursing, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei, China
| | - Qiuxia Liu
- School of Nursing, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei, China
| | - Xianwu Luo
- School of Nursing, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei, China.
| |
Collapse
|
23
|
Trtica LM, Volarić M, Kurevija T, Mihaljević S, Dupan ZK, Wittlinger T. Psycho-social and health predictors of loneliness in older primary care patients and mediating mechanisms linking comorbidities and loneliness. BMC Geriatr 2023; 23:801. [PMID: 38049734 PMCID: PMC10696735 DOI: 10.1186/s12877-023-04436-6] [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: 01/15/2023] [Accepted: 10/28/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Aging is associated with many personal, social, and environmental challenges that increase the risk of loneliness. Loneliness is a painful emotional experience associated with a perceived lack of connection and intimacy. Loneliness accelerates health deterioration, but the presence of chronic health conditions (comorbidities) in older individuals may potentiate the feeling of loneliness. The relationships between health status and loneliness in older individuals have not been assessed in an integrated manner, although it is necessary for planning efficient interventions. The aim of this study was to fill in this knowledge gap, by attempting to create an integrated model of loneliness in older individuals. METHODS The sample consisted of 189 (58% F) older individuals (> 60 years) (mean ± SD, 78.47 ± 6.65), attendees in Primary Health Care. Different factors associated with loneliness in the older population were assessed, and classified as demographic, environmental, physical (health-related), and psychological, in addition to functional abilities. A set of standard questionnaires was used to assess psychological factors and functional abilities. The hierarchical regression model assessed the effect of particular blocks of factors on status loneliness. The second aim was to analyze how psychological factors mediate associations between health status (comorbidity level) and loneliness. RESULTS Indicated that increasing comorbidity, anxiety, lack of positive moods, not having hobbies/activities, low perception of social support, impaired cognitive function, and suppression of emotion expression, are significant predictors of loneliness. Mediation analysis informed us of how to help patients with comorbidities feel less lonely. Interventions that were suggested were those that can reduce anxiety and depression, improve cognitive abilities and emotional regulation control, and enhance social support. CONCLUSIONS Results can help understand the pathophysiology loops linking poor health status (comorbidity level) of older individuals and loneliness, and have significant potentials from the translational perspectives, as a decision-support tool.
Collapse
Affiliation(s)
- Ljiljana Majnarić Trtica
- Department of Family Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Mile Volarić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000, Osijek, Croatia
- School of Medicine, University of Mostar, University Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Tomislav Kurevija
- Department of Family Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Silvio Mihaljević
- Department of Internal Medicine and the History of Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Zdravka Krivdić Dupan
- Department of Radiology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Thomas Wittlinger
- Department of Cardiology, Asklepios Hospital, 38642, Goslar, Germany.
| |
Collapse
|
24
|
Zhang M, Ho E, Nowinski CJ, Fox RS, Ayturk E, Karpouzian-Rogers T, Novack M, Dodge HH, Weintraub S, Gershon R. The Paradox in Positive and Negative Aspects of Emotional Functioning Among Older Adults with Early Stages of Cognitive Impairment. J Aging Health 2023:8982643231199806. [PMID: 37800686 DOI: 10.1177/08982643231199806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Introduction: Emotional functioning in older adults is influenced by normal aging and cognitive impairment, likely heterogeneous across positive versus negative aspects of emotional functioning. Little is known about positive emotional experiences at the early stages of cognitive impairment. Methods: We assessed different aspects of emotional functioning among 448 participants aged 65+ (Normal Control (NC) = 276, Mild Cognitive Impairment (MCI) = 103, and mild dementia of the Alzheimer type (mild DAT) = 69) and tested moderators. Results: Compared to NC, older adults with MCI and mild DAT have maintained many positive aspects of emotional functioning, despite higher levels of negative affect, sadness, and loneliness. Among the oldest-old, the mild DAT group experienced higher fear and lower self-efficacy. Discussion: Older adults at early stages of cognitive impairment can experience positive aspects of emotional functioning, such as positive affect, purpose, and life satisfaction, all of which are important buildable psychological resources for coping.
Collapse
Affiliation(s)
- Manrui Zhang
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Emily Ho
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Cindy J Nowinski
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Department of Neurology, Northwestern University, Chicago, IL, USA
| | - Rina S Fox
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- College of Nursing, University of Arizona, Tuscon, AZ, USA
| | - Ezgi Ayturk
- College of Social Sciences and Humanities, KOC Universitesi, Istanbul, Turkey
| | - Tatiana Karpouzian-Rogers
- Department of Psychiatry and Behavioral Sciences, Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Miriam Novack
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Hiroko H Dodge
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sandra Weintraub
- Department of Psychiatry and Behavioral Sciences, Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Richard Gershon
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| |
Collapse
|
25
|
Zhou Y, Han W, Yao X, Xue J, Li Z, Li Y. Developing a machine learning model for detecting depression, anxiety, and apathy in older adults with mild cognitive impairment using speech and facial expressions: A cross-sectional observational study. Int J Nurs Stud 2023; 146:104562. [PMID: 37531702 DOI: 10.1016/j.ijnurstu.2023.104562] [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: 01/04/2023] [Revised: 06/23/2023] [Accepted: 07/01/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Depression, anxiety, and apathy are highly prevalent in older people with preclinical dementia and mild cognitive impairment. These symptoms have also proven valuable in predicting the progression from mild cognitive impairment to dementia, enabling a timely diagnosis and treatment. However, objective and reliable indicators to detect and distinguish depression, anxiety, and apathy are relatively scarce. OBJECTIVE This study aimed to develop a machine learning model to detect and distinguish depression, anxiety, and apathy based on speech and facial expressions. DESIGN An observational, cross-sectional study design. SETTING(S) The memory outpatient department of a tertiary hospital. PARTICIPANTS 319 older adults diagnosed with mild cognitive impairment. METHODS Depression, anxiety, and apathy were evaluated by the Public Health Questionnaire, General Anxiety Disorder, and Apathy Evaluation Scale, respectively. Speech and facial expressions of older adults with mild cognitive impairment were digitally captured using audio and video recording software. Open-source data analysis toolkits were utilized to extract speech, facial, and text features. The multiclass classification was used to develop classification models, and shapely additive explanations were used to explain the contribution of each feature within the model. RESULTS The random forest method was used to develop a multiclass emotion classification model, which performed well in classifying emotions with a weighted-average F1 score of 96.6 %. The model also demonstrated high accuracy, precision, and recall, with 87.4 %, 86.6 %, and 87.6 %, respectively. CONCLUSIONS The machine learning model developed in this study demonstrated strong classification performance in detecting and differentiating depression, anxiety, and apathy. This innovative approach combines text, audio, and video to provide objective methods for precise classification and remote monitoring of these symptoms in nursing practice. REGISTRATION This study was registered at the Chinese Clinical Trial Registry (registration number: ChiCTR1900023892; registration date: June 19th, 2019).
Collapse
Affiliation(s)
- Ying Zhou
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China.
| | - Wei Han
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Xiuyu Yao
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - JiaJun Xue
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zheng Li
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Yingxin Li
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China.
| |
Collapse
|
26
|
Galarza-Delgado DA, Azpiri-Lopez JR, Colunga-Pedraza IJ, Cardenas-de la Garza JA, Gonzalez-Gonzalez V, Beltran-Aguilar VM, Arias-Peralta AG, De Avila-Gonzalez N, Guajardo-Jauregui N. Cardiovascular health worsening in patients with autoimmune rheumatological diseases during the COVID-19 pandemic. Clin Rheumatol 2023; 42:2677-2690. [PMID: 36627529 PMCID: PMC9838353 DOI: 10.1007/s10067-022-06486-4] [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: 09/17/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 01/12/2023]
Abstract
Rheumatic autoimmune diseases are associated with a myriad of comorbidities. Of particular importance due to their morbimortality are cardiovascular diseases. COVID-19 greatly impacted the world population in many different areas. Patients with rheumatic diseases had to face changes in their healthcare, in addition to unemployment, a decrease in physical activity, social isolation, and lack of access to certain medications. This review summarizes the impact of COVID-19 pandemic on cardiovascular risk factors, comorbidities, and unhealthy behaviors in patients with rheumatic inflammatory autoimmune diseases, particularly focused on rheumatoid arthritis and systemic lupus erythematosus. Searches were carried out in MEDLINE/PubMed and Scopus from August to December 2022. Four reviewers screened the title and abstract of retrieved records. Potentially eligible reports were then reviewed in full text. Differences were reconciled by either consensus or discussion with an external reviewer. During the COVID-19 pandemic, patients with rheumatic diseases showed an increase in the prevalence of mental health disorders (43.2-57.7%), reduced physical activity (56.8%), and a worsening in eating behaviors. Alcohol intake increased (18.2%), especially in early phases of the pandemic. Smoking prevalence decreased (28.2%). Dyslipidemia and hypertension showed no changes. The pandemic and lockdown affected rheumatic patients not only in disease-related characteristics but in the prevalence of their cardiovascular comorbidities and risk factors. Lifestyle changes, such as healthy eating, physical activity, and optimal management of their rheumatic diseases and comorbidities, are essential to manage the long-lasting consequences of the COVID-19 outbreak. Key Points • During the COVID-19 pandemic, anxiety, depression, sedentarism, obesity, and a worsening in eating behaviors increased. •Patients with rheumatic diseases and comorbidities have worse clinical outcomes and a higher cardiovascular disease burden than those without them. •Comparative studies are necessary to precisely elucidate the pandemic's impact on the prevalence of cardiovascular disease, risk factors, and comorbidities in patients with rheumatoid arthritis and systemic lupus erythematosus.
Collapse
Affiliation(s)
- Dionicio A Galarza-Delgado
- Division of Rheumatology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Jose R Azpiri-Lopez
- Division of Cardiology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero y Gonzalitos S/N, 64460, Monterrey, Nuevo León, Mexico.
| | - Iris J Colunga-Pedraza
- Division of Rheumatology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Jesus Alberto Cardenas-de la Garza
- Division of Rheumatology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Valeria Gonzalez-Gonzalez
- Division of Rheumatology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Victor M Beltran-Aguilar
- Division of Rheumatology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Angel G Arias-Peralta
- Division of Cardiology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero y Gonzalitos S/N, 64460, Monterrey, Nuevo León, Mexico
| | - Natalia De Avila-Gonzalez
- Division of Rheumatology, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Natalia Guajardo-Jauregui
- Internal Medicine Department, Hospital Universitario "Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| |
Collapse
|
27
|
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
|
28
|
Manser P, Poikonen H, de Bruin ED. Feasibility, usability, and acceptance of "Brain-IT"-A newly developed exergame-based training concept for the secondary prevention of mild neurocognitive disorder: a pilot randomized controlled trial. Front Aging Neurosci 2023; 15:1163388. [PMID: 37810620 PMCID: PMC10557950 DOI: 10.3389/fnagi.2023.1163388] [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: 02/15/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023] Open
Abstract
Background Exergames provide a promising new approach to implement simultaneous motor-cognitive training, which may support preventing the decline in cognitive functioning in older adults who have a mild neurocognitive disorder (mNCD). Objectives To evaluate feasibility, system usability, and acceptance of "Brain-IT", a newly developed training concept combining exergame-based motor-cognitive training and heart rate variability (HRV) guided resonance breathing for the secondary prevention of mNCD. Methods A pilot randomized controlled trial (RCT) with an allocation ratio of 2:1 (i.e., intervention:control) was conducted. The control group proceeded with usual care. The intervention group performed a 12-week training according to the "Brain-IT" training concept implemented with the "Senso Flex" (Dividat AG) exergaming system in addition to usual care. Feasibility and usability outcomes were analyzed using descriptive statistics. User acceptance was analyzed qualitatively and using Friedman analysis of variance (ANOVA), as well as Wilcoxon signed-rank tests. Results Eighteen participants (77.3 ± 9.8 years; 44.4% females) were included. On average, we recruited 2.2 participants per month, and 35.3% of the individuals contacted were included. The intervention group had an attrition rate of 20% and mean adherence and compliance rates of 85.0 and 84.1%, respectively. The mean system usability score, measured with the system usability scale, was 71.7. High levels of exergame enjoyment, an increase in exergame enjoyment, and internalization of training motivation with large effect sizes (p = 0.03, r = 0.75 and p = 0.03, r = 0.74, respectively), as well as acceptable perceived usefulness, were observed. Preliminary data on the effects of the "Brain-IT" training are promising. Conclusion The feasibility and usability of the "Brain-IT" training are acceptable. However, frequent occurrences of technical problems and difficulties in using the exergame training system were identified as barriers to performing the "Brain-IT" training. To optimize feasibility, either improvements or alternative solutions are required in the hardware and software of the exergame used to implement the "Brain-IT" training. The "Brain-IT" training itself was well-accepted by older adults who have mNCD. Therefore, the effectiveness of the "Brain-IT" training concept should be investigated in future studies. Trial registration clinicaltrials.gov/ct2/show/NCT04996654.
Collapse
Affiliation(s)
- Patrick Manser
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Hanna Poikonen
- Learning Sciences and Higher Education, Department of Humanities, Social and Political Sciences, ETH Zurich, Zurich, Switzerland
| | - Eling D. de Bruin
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
29
|
Seong H, Park J. Symptom profiles and their influencing factors among people with subjective cognitive decline: a secondary analysis of cross-sectional data from the 2019 Korea Community Health Survey using latent class analysis. BMJ Open 2023; 13:e072236. [PMID: 37620262 PMCID: PMC10450090 DOI: 10.1136/bmjopen-2023-072236] [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: 01/27/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVE Subjective cognitive decline, self-perceived cognitive deterioration without objective impairment, is becoming a vital health indicator, especially due to its intermediate stage between normal function and mild cognitive impairment. Cognitive decline often coexists with various symptoms that may interact with each other, serve as prognostic indicators and influence the progression of cognitive decline. This study aims to identify symptom clusters among individuals with subjective cognitive decline, using latent class analysis, and to identify factors affecting these symptom clusters, offering insights into understanding and potentially preventing cognitive decline progression. DESIGN AND SETTING A secondary data analysis of the nationally representative cross-sectional data obtained from the 2019 Korea Community Health Survey. OUTCOMES We performed latent class analysis using six symptoms (pain, sleep deprivation, depression, fatigue, restlessness and apathy) to determine the distinct symptom clusters. After selecting the best latent class model, we identified factors influencing those symptom clusters using multinomial logistic regression analyses. RESULTS We found that a three-latent-class model best fitted the data: a low symptom-burden group (39.9%), a moderate symptom-burden group (44.8%) and a high symptom-burden group (15.3%). Male gender, higher age, higher perceived health status and lower perceived stress status, were strongly associated with lesser odds of being in the moderate (OR: 0.37 (95% CI: 0.33 to 0.41)) to OR: 2.20 (95% CI: 2.03 to 2.39)) and high symptom-burden groups (OR: 0.18 (95% CI: 0.15 to 0.21)) to OR: 8.53 (95% CI: 7.68 to 9.49)) as compared with being in the low symptom-burden group. CONCLUSION Findings may contribute to improving clinical practitioners' understanding of the unique symptom patterns experienced by people with subjective cognitive decline and their influencing factors. Furthermore, we recommend that formal caregivers screen and manage prevalent symptoms considering the factors affecting the symptoms of people with subjective cognitive decline in clinical practice.
Collapse
Affiliation(s)
- Hohyun Seong
- School of Nursing, University of Maryland, Baltimore, Maryland, USA
| | - Jongmin Park
- College of Nursing, Research Institue of Nursing Science, Pusan National University, Yangsan, Korea (the Republic of)
| |
Collapse
|
30
|
Yang EJ, Rahim MA, Griggs E, Iban-Arias R, Pasinetti GM. Transient anxiety-and depression-like behaviors are linked to the depletion of Foxp3-expressing cells via inflammasome in the brain. PNAS NEXUS 2023; 2:pgad251. [PMID: 37614669 PMCID: PMC10443660 DOI: 10.1093/pnasnexus/pgad251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/17/2023] [Accepted: 07/20/2023] [Indexed: 08/25/2023]
Abstract
Forkhead box P3 (Foxp3) is a transcription factor that influences functioning of regulatory T cells (Tregs) that modulate peripheral immune response. Treg-mediated innate immunity and Treg-mediated adaptive immunity are receiving considerable attention for their implication in mechanisms associated with anxiety and depression. Here, we demonstrated that depletion of Foxp3-expressing cells causally promotes transient anxiety- and depression-like behaviors associated with inflammasome activation in "depletion of regulatory T cell" (DEREG) mice. We found that restoration of Foxp3-expressing cells causally reverses neurobehavioral changes through alteration of innate immune responses as assessed by caspase-1 activity and interleukin-1β (IL-1β) release in the hippocampal formation of DEREG mice. Moreover, we found that depletion of Foxp3-expressing cells induces a significant elevation of granulocytes, monocytes, and macrophages in the blood, which are associated with transient expression of the matrix metalloprotease-9. Similarly, we found that depletion of Foxp3-expressing cells in 5xFAD, a mouse model of Alzheimer's disease (AD), exhibits elevated activated caspase-1 and promotion of IL-1β secretion and increased the level of amyloid-beta (Aβ)1-42 and Aβ plaque burden in the hippocampal formation that coincided with an acceleration of cognitive decline at a presymptomatic age in the 5xFAD mice. Thus, our study provides evidence supporting the idea that Foxp3 may have a causal influence on peripheral immune responses. This, in turn, can promote an innate immune response within the brain, potentially leading to anxiety- and depression-like behaviors or cognitive decline.
Collapse
Affiliation(s)
- Eun-Jeong Yang
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Md Al Rahim
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Elizabeth Griggs
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ruth Iban-Arias
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Giulio Maria Pasinetti
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Geriatric Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA
| |
Collapse
|
31
|
Shin YK, Seol GH. Effects of linalyl acetate on oxidative stress, inflammation and endothelial dysfunction: can linalyl acetate prevent mild cognitive impairment? Front Pharmacol 2023; 14:1233977. [PMID: 37576815 PMCID: PMC10416234 DOI: 10.3389/fphar.2023.1233977] [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: 06/03/2023] [Accepted: 07/21/2023] [Indexed: 08/15/2023] Open
Abstract
Mild cognitive impairment (MCI) is a major public health challenge with an increasing prevalence. Although the mechanisms underlying the development of MCI remain unclear, MCI has been reported to be associated with oxidative stress, inflammatory responses, and endothelial dysfunction, suggesting that agents that reduce these factors may be key to preventing MCI. Currently, no agents have been approved for the treatment of MCI, with the efficacy of commonly prescribed cholinesterase inhibitors remaining unclear. Relatively safe natural products that can prevent the development of MCI are of great interest. Linalyl acetate (LA), the major component of clary sage and lavender essential oils, has been shown to have a variety of pharmacological effects, including anti-hypertensive, anti-diabetic, neuroprotective, anti-inflammatory, and antioxidant properties, which may have the potential for the prevention of MCI. The present review briefly summarizes the pathogenesis of MCI related to oxidative stress, inflammatory responses, and endothelial dysfunction as well as the benefits of LA against these MCI-associated factors. The PubMed and Google Scholar databases were used to search the relevant literature. Further clinical research may lead to the development of new strategies for preventing MCI, particularly in high-risk populations with oxidative stress, inflammatory responses, and endothelial dysfunction (e.g., patients with hypertension and/or diabetes mellitus).
Collapse
Affiliation(s)
- You Kyoung Shin
- Department of Basic Nursing Science, College of Nursing, Korea University, Seoul, Republic of Korea
| | - Geun Hee Seol
- Department of Basic Nursing Science, College of Nursing, Korea University, Seoul, Republic of Korea
- BK21 FOUR Program of Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, Republic of Korea
| |
Collapse
|
32
|
Alexopoulos P, Skondra M, Charalampopoulou M, Georgiou EEZ, Demertzis AA, Aligianni SΙ, Gourzis P, Politis A, Εconomou P, Daoussis D. Low cognitive functioning and depressive symptoms in patients with rheumatoid arthritis and systemic sclerosis: a clinical study. BMC Psychiatry 2023; 23:513. [PMID: 37464342 DOI: 10.1186/s12888-023-04995-3] [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: 03/28/2023] [Accepted: 07/02/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Recently, cognitive deficits occurring in rheumatic diseases have attracted scientific attention. Cognitive symptoms in patients with Rheumatoid Arthritis (RA) and Systemic Sclerosis (SSc) have not been thoroughly studied. This study aimed to assess cognitive function and its relationship with depressive symptoms in RA and SSc and compare it to mild neurocognitive disorder due to Alzheimer's disease (MiND) and to individuals without cognitive impairment. METHODS Cognitive function and depressive symptoms were tapped with the Cognitive Telephone Screening Instrument plus (COGTEL+), the Serial Seven Test (SST), the Mini-Mental State Examination (MMSE) and the Geriatric Depression scale-15 (GDS), respectively. Statistical analyses included between groups-, correlation- and regression analyses. Demographic characteristics were considered in the regression models. RESULTS The study included 30 individuals with RA, 24 with SSc, 26 adults without cognitive impairment and 33 individuals with MiND. Lower performance in verbal short-term memory, concentration/attention, verbal fluency and MMSE in patients with RA compared to individuals without cognitive impairment was detected. Of note, performance on verbal fluency, concentration/attention, inductive reasoning and MMSE was lower in RA compared to MiND. Individuals with SSc performed worse in verbal fluency and in MMSE in comparison to adults without cognitive deficits. Verbal fluency deficits in SSc exceeded that in MiND. Performance on MMSE, COGTEL+, prospective memory, working memory, verbal fluency and concentration/attention was related to GDS scores, which did not vary across the groups. CONCLUSIONS Patients with RA and SSc encountered cognitive dysfunction, which partially pertains to depressive symptoms. Of note, the severity of cognitive dysfunction in many cases exceeded that of MiND.
Collapse
Affiliation(s)
- Panagiotis Alexopoulos
- Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece.
- Global Brain Health Institute, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Republic of Ireland.
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Faculty of Medicine, Technical University of Munich, Munich, Germany.
| | - Maria Skondra
- Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece
| | - Marina Charalampopoulou
- Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece
| | - Eliza Eleni-Zacharoula Georgiou
- Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece
| | - Antonios Alexandros Demertzis
- Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece
| | - Suzana Ιoanna Aligianni
- Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece
| | - Philippos Gourzis
- Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece
| | - Antonios Politis
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Psychiatry, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins Medical School, Baltimore, USA
| | - Polychronis Εconomou
- Department of Civil Engineering (Statistics), School of Engineering, University of Patras, Patras, Greece
| | - Dimitrios Daoussis
- Department of Rheumatology, University of Patras Medical School, Patras, Greece
| |
Collapse
|
33
|
Hunsberger HC, Lee S, Jin M, Lanio M, Whye A, Cha J, Scarlata M, Jayaseelan K, Denny CA. Sex-Specific Effects of Anxiety on Cognition and Activity-Dependent Neural Networks: Insights from (Female) Mice and (Wo)Men. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.07.548180. [PMID: 37503264 PMCID: PMC10369916 DOI: 10.1101/2023.07.07.548180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
INTRODUCTION Neuropsychiatric symptoms (NPS), such as depression and anxiety, are observed in 90% of Alzheimer's disease (AD) patients, two-thirds of whom are women. NPS usually manifest long before AD onset creating a therapeutic opportunity. Here, we examined the impact of anxiety on AD progression and the underlying brain-wide neuronal mechanisms. METHODS To gain mechanistic insight into how anxiety impacts AD progression, we performed a cross-sectional analysis on mood, cognition, and neural activity utilizing the ArcCreERT2 x enhanced yellow fluorescent protein (eYFP) x APP/PS1 (AD) mice. The ADNI dataset was used to determine the impact of anxiety on AD progression in human subjects. RESULTS Female AD mice exhibited anxiety-like behavior and cognitive decline at an earlier age than control (Ctrl) mice and male mice. Brain-wide analysis of c-Fos+ revealed changes in regional correlations and overall network connectivity in AD mice. Sex-specific memory trace changes were observed; female AD mice exhibited impaired memory traces in dorsal CA3 (dCA3), while male AD mice exhibited impaired memory traces in the dorsal dentate gyrus (dDG). In the ADNI dataset, anxiety predicted transition to dementia. Female subjects positive for anxiety and amyloid transitioned more quickly to dementia than male subjects. CONCLUSIONS While future studies are needed to understand whether anxiety is a predictor, a neuropsychiatric biomarker, or a comorbid symptom that occurs during disease onset, these results suggest that AD network dysfunction is sexually dimorphic, and that personalized medicine may benefit male and female AD patients rather than a one size fits all approach.
Collapse
Affiliation(s)
- Holly C. Hunsberger
- Division of Systems Neuroscience, Research Foundation for Mental Hygiene, Inc. (RFMH) / New York State Psychiatric Institute (NYSPI), New York, NY, USA
- Center for Neurodegenerative Diseases and Therapeutics, Rosalind Franklin University of Medicine and Science/The Chicago Medical School; North Chicago, IL, USA
| | - Seonjoo Lee
- Department of Psychiatry, Columbia University Irving Medical Center (CUIMC); New York, NY, USA
- Mental Health Data Science, Research Foundation for Mental Hygiene, Inc. (RFMH) / New York State Psychiatric Institute (NYSPI), New York, NY, USA
| | - Michelle Jin
- Neurobiology and Behavior (NB&B) Graduate Program, Columbia University, New York, NY, USA
- Medical Scientist Training Program (MSTP), Columbia University Irving Medical Center (CUIMC), New York, NY, USA
| | - Marcos Lanio
- Neurobiology and Behavior (NB&B) Graduate Program, Columbia University, New York, NY, USA
- Medical Scientist Training Program (MSTP), Columbia University Irving Medical Center (CUIMC), New York, NY, USA
| | - Alicia Whye
- Department of Psychiatry, Columbia University Irving Medical Center (CUIMC); New York, NY, USA
| | - Jiook Cha
- Department of Biostatistics (in Psychiatry), Mailman School of Public Health, Columbia University; New York, NY, USA
- Division of Child and Adolescent Psychiatry, NYSPI/RFMH; New York, NY, USA
- Data Science Institute, Columbia University; New York, NY, USA
- Department of Psychology, Seoul National University; Seoul, South Korea
| | - Miranda Scarlata
- Department of Neuroscience, Vassar College; Poughkeepsie, NY USA
- Department of Social Policy and Intervention, University of Oxford; Oxford, England
| | - Keerthana Jayaseelan
- Barnard College, Columbia University; New York, NY, USA
- Department of Medicine, New York Medical College/Westchester Medical Center; Valhalla, NY, USA
| | - Christine. A. Denny
- Division of Systems Neuroscience, Research Foundation for Mental Hygiene, Inc. (RFMH) / New York State Psychiatric Institute (NYSPI), New York, NY, USA
- Department of Psychiatry, Columbia University Irving Medical Center (CUIMC); New York, NY, USA
| |
Collapse
|
34
|
Ross AB, Shertukde SP, Livingston Staffier K, Chung M, Jacques PF, McKeown NM. The Relationship between Whole-Grain Intake and Measures of Cognitive Decline, Mood, and Anxiety-A Systematic Review. Adv Nutr 2023; 14:652-670. [PMID: 37085091 PMCID: PMC10334137 DOI: 10.1016/j.advnut.2023.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 03/15/2023] [Accepted: 04/07/2023] [Indexed: 04/23/2023] Open
Abstract
Greater intake of whole grains, compared to refined grains, is consistently associated with a reduced risk of cardiovascular disease and type 2 diabetes, both of which are associated with cognitive decline. To better understand the relationship between whole-grain intake, cognition, mood, and anxiety, a systematic review was conducted to synthesize available evidence linking whole grains to these outcomes. Four electronic databases were searched from inception to August 2021 for potentially relevant observational and interventional studies. Risk of bias (RoB) assessments were performed using the newly developed Nutrition Quality Evaluation Strengthening Tools, and the Grades of Recommendation, Assessment, Development, and Evaluation approach was used to determine the strength of evidence for each outcome. In total, 23 studies [4 randomized controlled trials (RCTs) and 19 observational studies] met the predefined eligibility criteria. Of these,12 studies included analysis of whole-grain intake and cognitive decline, 9 included mood outcomes, and 2 included both cognition and mood outcomes. The overall evidence for an association between whole-grain intake and cognition is inconclusive. With respect to mood outcomes, evidence from RCTs prospective cohort and case-control studies suggest that higher intake is linked to improved outcomes for mood and depression although the evidence is mixed for cross-sectional studies. Reporting of whole-grain intake fell short of suggested standards, and the strength of available evidence was low or very low for all outcomes. A high RoB toward studies reporting results was also noted, complicating both the interpretation of some studies and the combined evidence. Of note, few well-designed RCTs assessing the effect of whole-grain intake on measures of cognition, mood, and anxiety were identified, highlighting the need for more studies in this area. The available, although limited, evidence suggests that greater whole-grain intake is associated with better mood and anxiety-related scores and is inconclusive regarding cognitive outcomes. PROSPERO registration: CRD42021266355.
Collapse
Affiliation(s)
| | - Shruti P Shertukde
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Kara Livingston Staffier
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - Mei Chung
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Paul F Jacques
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States; Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - Nicola M McKeown
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States; Programs of Nutrition, Department of Health Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| |
Collapse
|
35
|
Ebrahim IM, Ghahremani M, Camicioli R, Smith EE, Ismail Z. Effects of race, baseline cognition, and APOE on the association of affective dysregulation with incident dementia: A longitudinal study of dementia-free older adults. J Affect Disord 2023; 332:9-18. [PMID: 36997127 DOI: 10.1016/j.jad.2023.03.074] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/10/2023] [Accepted: 03/24/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Affective symptoms are dementia risk factors. Mild behavioral impairment (MBI) is a neurobehavioral syndrome that refines incorporation of psychiatric symptomatology into dementia prognostication by stipulating symptoms must emerge de novo in later life and persist for ≥6 months. Here, we investigated the longitudinal association of MBI-affective dysregulation with incident dementia. METHODS National Alzheimer Coordinating Centre participants with normal cognition (NC) or mild cognitive impairment (MCI) were included. MBI-affective dysregulation was operationalized as Neuropsychiatric Inventory Questionnaire-measured depression, anxiety, and elation at two consecutive visits. Comparators had no neuropsychiatric symptoms (no NPS) in advance of dementia. Cox proportional hazard models were implemented to assess the risk of dementia, adjusted for age, sex, years of education, race, cognitive diagnosis, and APOE-ε4 status, with interaction terms as appropriate. RESULTS The final sample included 3698 no-NPS (age:72.8; 62.7 % female), and 1286 MBI-affective dysregulation participants (age:75; 54.5 % female). MBI-affective dysregulation had lower dementia-free survival (p < 0.0001) and greater incidence of dementia (HR = 1.76, CI:1.48-2.08, p < 0.001) versus no NPS. Interaction analyses revealed that MBI-affective dysregulation was associated with higher dementia incidence in Black participants than White (HR = 1.70, CI:1.00-2.87, p = 0.046), NC than MCI (HR = 1.73, CI:1.21-2.48, p = 0.0028), and APOE-ε4 noncarriers than carriers (HR = 1.47, CI:1.06-2.02, p = 0.0195). Of MBI-affective dysregulation converters to dementia, 85.5 % developed Alzheimer's disease, which increased to 91.4 % in those with amnestic MCI. LIMITATIONS MBI-affective dysregulation was not stratified by symptom to further examine dementia risk. CONCLUSIONS Emergent and persistent affective dysregulation in dementia-free older adults is associated with substantial risk for dementia and should be considered in clinical assessments.
Collapse
Affiliation(s)
- Inaara M Ebrahim
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Maryam Ghahremani
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada; Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada
| | - Richard Camicioli
- Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Canada
| | - Eric E Smith
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Canada; Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Zahinoor Ismail
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada; Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada; Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Canada; Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; School of Medicine and Health, University of Exeter, Exeter, UK.
| |
Collapse
|
36
|
Khurm M, Guo Y, Wu Q, Zhang X, Ghori MU, Rasool MF, Imran I, Saqib F, Wahid M, Guo Z. Conocarpus lancifolius (Combretaceae): Pharmacological Effects, LC-ESI-MS/MS Profiling and In Silico Attributes. Metabolites 2023; 13:794. [PMID: 37512501 PMCID: PMC10385132 DOI: 10.3390/metabo13070794] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 07/30/2023] Open
Abstract
In folklore medicine, Conocarpus lancifolius is used to treat various illnesses. The main objective of this study was a comprehensive investigation of Conocarpus lancifolius leaf aqueous extract (CLAE) for its antioxidant, cardioprotective, anxiolytic, antidepressant and memory-enhancing capabilities by using different in vitro, in vivo and in silico models. The in vitro experimentation revealed that CLAE consumed an ample amount of total phenolics (67.70 ± 0.15 µg GAE/mg) and flavonoids (47.54 ± 0.45 µg QE/mg) with stronger antiradical effects through DPPH (IC50 = 16.66 ± 0.42 µg/mL), TAC (77.33 ± 0.41 µg AAE/mg) and TRP (79.11 ± 0.67 µg GAE/mg) assays. The extract also displayed suitable acetylcholinesterase (AChE) inhibitory (IC50 = 110.13 ± 1.71 µg/mL) activity through a modified Ellman's method. The toxicology examination presented no mortality or any signs of clinical toxicity in both single-dose and repeated-dose tests. In line with the cardioprotective study, the pretreatment of CLAE was found to be effective in relieving the isoproterenol (ISO)-induced myocardial injury in rats by normalizing the heart weight index, serum cardiac biomarkers, lipid profile and various histopathological variations. In the noise-stress-induced model for behavior attributes, the results demonstrated that CLAE has the tendency to increase the time spent in the central zone and elevated open arms in the open field and elevated plus maze tests (examined for anxiety assessment), reduced periods of immobility in the forced swimming test (for depression) and improved recognition and working memory in the novel object recognition and Morris water maze tests, respectively. Moreover, the LC-ESI-MS/MS profiling predicted 53 phytocompounds in CLAE. The drug-likeness and ADMET analysis exhibited that the majority of the identified compounds have reasonable physicochemical and pharmacokinetic profiles. The co-expression of molecular docking and network analysis indicated that top-ranked CLAE phytoconstituents act efficiently against the key proteins and target multiple signaling pathways to exert its cardiovascular-protectant, anxiolytic, antidepressant and memory-enhancing activity. Hence, this artifact illustrates that the observed biological properties of CLAE elucidate its significance as a sustainable source of bioactive phytochemicals, which appears to be advantageous for pursuing further studies for the development of new therapeutic agents of desired interest.
Collapse
Affiliation(s)
- Muhammad Khurm
- School of Pharmacy, Xi'an Jiaotong University, Xi'an 710061, China
| | - Yuting Guo
- School of Pharmacy, Xi'an Jiaotong University, Xi'an 710061, China
| | - Qingqing Wu
- School of Pharmacy, Xi'an Jiaotong University, Xi'an 710061, China
| | - Xinxin Zhang
- School of Pharmacy, Xi'an Jiaotong University, Xi'an 710061, China
| | - Muhammad Umer Ghori
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad 38000, Pakistan
| | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Imran Imran
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Fatima Saqib
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Muqeet Wahid
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Zengjun Guo
- School of Pharmacy, Xi'an Jiaotong University, Xi'an 710061, China
| |
Collapse
|
37
|
Yan H, Wu H, Cai Z, Du S, Li L, Xu B, Chang C, Wang N. The neural correlates of apathy in the context of aging and brain disorders: a meta-analysis of neuroimaging studies. Front Aging Neurosci 2023; 15:1181558. [PMID: 37396666 PMCID: PMC10311641 DOI: 10.3389/fnagi.2023.1181558] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/05/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Apathy is a prevalent mood disturbance that occurs in a wide range of populations, including those with normal cognitive aging, mental disorders, neurodegenerative disorders and traumatic brain injuries. Recently, neuroimaging technologies have been employed to elucidate the neural substrates underlying brain disorders accompanying apathy. However, the consistent neural correlates of apathy across normal aging and brain disorders are still unclear. Methods This paper first provides a brief review of the neural mechanism of apathy in healthy elderly individuals, those with mental disorders, neurodegenerative disorders, and traumatic brain injuries. Further, following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, the structural and functional neuroimaging meta-analysis using activation likelihood estimation method is performed on the apathy group with brain disorders and the healthy elderly, aiming at exploring the neural correlates of apathy. Results The structural neuroimaging meta-analysis showed that gray matter atrophy is associated with apathy in the bilateral precentral gyrus (BA 13/6), bilateral insula (BA 47), bilateral medial frontal gyrus (BA 11), bilateral inferior frontal gyrus, left caudate (putamen) and right anterior cingulate, while the functional neuroimaging meta-analysis suggested that the functional connectivity in putamen and lateral globus pallidus is correlated with apathy. Discussion Through the neuroimaging meta-analysis, this study has identified the potential neural locations of apathy in terms of brain structure and function, which may offer valuable pathophysiological insights for developing more effective therapeutic interventions for affected patients.
Collapse
Affiliation(s)
- Hongjie Yan
- Department of Neurology, Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Huijun Wu
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Zenglin Cai
- Department of Neurology, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
- Department of Neurology, Gusu School, Suzhou Science and Technology Town Hospital, Nanjing Medical University, Suzhou, China
| | - Shouyun Du
- Department of Neurology, Guanyun People’s Hospital, Guanyun, China
| | - Lejun Li
- Department of Neurology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Bingchao Xu
- Department of Neurology, Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Chunqi Chang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
- Pengcheng Laboratory, Shenzhen, China
| | - Nizhuan Wang
- School of Biomedical Engineering, ShanghaiTech University, Shanghai, China
| |
Collapse
|
38
|
Curran E, Palmer VJ, Ellis KA, Chong TWH, Rego T, Cox KL, Anstey KJ, Westphal A, Moorhead R, Southam J, Lai R, You E, Lautenschlager NT. Physical Activity for Cognitive Health: A Model for Intervention Design for People Experiencing Cognitive Concerns and Symptoms of Depression or Anxiety. J Alzheimers Dis 2023:JAD221216. [PMID: 37334591 PMCID: PMC10357152 DOI: 10.3233/jad-221216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND People experiencing cognitive concerns and symptoms of depression or anxiety are at risk for Alzheimer's disease and dementia. We know physical activity can benefit cognition but understanding how to best support engagement is an ongoing challenge. Evidence-based conceptual models of factors underpinning physical activity engagement in target populations can inform intervention tailoring to address this challenge. OBJECTIVE This study (part of a pragmatic physical activity implementation trial) aimed to develop a specified model of physical activity engagement in people experiencing depressive or anxiety symptoms and cognitive concerns, to enable optimized dementia risk reduction intervention tailoring. METHODS We employed a qualitative design, triangulating data from three sources: semi-structured individual interviews with people experiencing cognitive concerns and mild to moderate depressive or anxiety symptoms; review of published evidence; and the Capability, Opportunity and Motivation system of behavior, an existing behavioral science model. Findings were integrated to develop a contextualized model of mechanisms of action for optimizing engagement. RESULTS Twenty-one participants were interviewed, and 24 relevant papers included. Convergent and complementary themes extended understanding of intervention needs. Findings highlighted emotional regulation, capacities to enact intentions despite barriers, and confidence in existing skills as areas of population-specific need that have not previously been emphasized. The final model provides specificity, directionality, and linked approaches for intervention tailoring. CONCLUSION This study demonstrated that people experiencing cognitive concerns and symptoms of depression or anxiety require different interventions to improve physical activity engagement. The novel model can enable more precise intervention tailoring, and, ultimately, benefits for a key at-risk population.
Collapse
Affiliation(s)
- Eleanor Curran
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia
| | - Victoria J Palmer
- ALIVE National Centre for Mental Health Research Translation, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Australia
- Primary Care Mental Health Research Program, Department of General Practice, Melbourne Medical School, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Australia
| | - Kathryn A Ellis
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Terence W H Chong
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia
- St Vincent's Hospital Melbourne, St George's Campus, Melbourne, Australia
| | - Thomas Rego
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia
| | - Kay L Cox
- Medical School, The University of Western Australia, Perth, Australia
| | - Kaarin J Anstey
- University of New South Wales Ageing Futures Institute, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Alissa Westphal
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Rebecca Moorhead
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Jenny Southam
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Rhoda Lai
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Emily You
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Nicola T Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia
- North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia
| |
Collapse
|
39
|
Griffiths J, Seesen M, Sirikul W, Siviroj P. The Relationship between Handgrip Strength, Timed Up-and-Go, and Mild Cognitive Impairment in Older People during COVID-19 Pandemic Restrictions. Behav Sci (Basel) 2023; 13:bs13050410. [PMID: 37232647 DOI: 10.3390/bs13050410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/01/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023] Open
Abstract
The COVID-19 lockdown restrictions affected physical performance and cognitive function in older people as they were confined to their homes. There is an association between physical and cognitive functions. Mild Cognitive Impairment (MCI) is a condition that risks progressing to dementia. This study aimed to identify the relationship between handgrip strength (HGS), Timed Up-and-Go (TUG), and MCI in older people during the COVID-19 pandemic restrictions. The cross-sectional study recruited 464 eligible participants for an interview and anthropometric measurement. The Montreal Cognitive Assessment-Basic (MoCA-B), HGS, and TUG were measured in addition to demographic and health characteristics. A total of 398 participants (85.8%) were found to have MCI when screened with the MoCA-B. Their mean age was 71.09 ± 5.81 years. Forward multiple regression analysis demonstrated that HGS (β = 0.032, p < 0.001), education level (β = 2.801, p < 0.001), TUG (β = -0.022, p = 0.013), Thai Geriatric Depression Score, TGDS (β = -0.248, p = 0.011), and age (β = -1.677, p = 0.019) were associated with MCI. A decrease in HGS and an increased TUG might allow for the early detection of MCI and promote physical training in order to reduce the risk of MCI. Further studies can investigate multidomain indicators for MCI, for example, fine motor skills and pinch strength as components of the motor abilities.
Collapse
Affiliation(s)
- Jiranan Griffiths
- Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Mathuramat Seesen
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Wachiranun Sirikul
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center of Data Analytics and Knowledge Synthesis for Health Care, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Penprapa Siviroj
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| |
Collapse
|
40
|
Liu X, Liu T, Zhou Z, Wan F. The effect of fear of missing out on mental health: differences in different solitude behaviors. BMC Psychol 2023; 11:141. [PMID: 37127680 PMCID: PMC10150542 DOI: 10.1186/s40359-023-01184-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/22/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Depression, anxiety, and stress are the main issues that affect the mental health of individuals. Solitude behavior, fear of missing out, and mental health are all closely related. OBJECTIVE This study was intended to investigate the relationship between solitude behavior, fear of missing out, and mental health. METHODS Short Form of Solitude Behavior Scale, Fear of Missing Out scale, and Depression Anxiety Stress Scale-21 were employed in this study to investigate 616 college students. The collected data were analyzed using SPSS 26.0 for basic data organization, and Mplus 8.3 was used to complete the analysis of the mediation model. RESULTS (1) Positive solitude was positively associated with eccentricity and negatively related to loneliness; social avoidance positively correlated with eccentricity and loneliness. (2) Social avoidance and loneliness affected mental health through the mediating effect of fear of missing out, whereas positive solitude and eccentricity did not affect mental health through fear of missing out. Moreover, the results still held in the model with depression, anxiety, and stress as dependent variables. CONCLUSION The roles of different solitude behavior in the relationship between fear of missing out and mental health differed. Social avoidance and loneliness as not self-determined solitude could activate the fear of missing out, which could affect mental health.
Collapse
Affiliation(s)
- Xinyang Liu
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Tour Liu
- Faculty of Psychology, Tianjin Normal University, Tianjin, China.
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China.
- Tianjin Social Science Laboratory of Students' Mental Development and Learning, Tianjin, China.
| | - Zhao Zhou
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Fuyu Wan
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| |
Collapse
|
41
|
Liu X, Wang G, Cao Y. The effectiveness of exercise on global cognitive function, balance, depression symptoms, and sleep quality in patients with mild cognitive impairment: A systematic review and meta-analysis. Geriatr Nurs 2023; 51:182-193. [PMID: 37011490 DOI: 10.1016/j.gerinurse.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 04/04/2023]
Abstract
This review aimed to examine the effectiveness of exercise on global cognitive function, balance, depression symptoms, and sleep quality in patients with mild cognitive impairment. And systematically retrieved five electronic databases, including the Cochrane library, PubMed, Embase, Web of Science, and PsycINFO, from inception to May 2022. Of 1102 studies, twenty-one studies were included in this meta-analysis. The polled results revealed that exercise could significantly improve global cognitive function (SMD = 0.64, 95%CI: 0.36 to 0.91, Z = 4.56, P < 0.00001), balance (SMD = 0.62, 95%CI: 0.30 to 0.95, Z = 4.56, P = 0.0001) and depression symptoms (SMD = -0.37, 95%CI: -0.64 to -0.10, Z = 2.70, P = 0.007). The exercise was a promising intervention with the potential to be applied in people with mild cognitive impairment.
Collapse
|
42
|
Kim H, Lingler JH, Bender CM, Albert SM, Sereika SM. Do Individuals Aged 50 or Older View Cognitive Conditions Differently Than Physical Conditions? Evidence From a Pooled Analysis of Illness Perceptions in Type 2 Diabetes and Mild Cognitive Impairment. Innov Aging 2023; 7:igad027. [PMID: 37128237 PMCID: PMC10148452 DOI: 10.1093/geroni/igad027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Indexed: 05/03/2023] Open
Abstract
Background and Objectives Type 2 diabetes (T2DM) and mild cognitive impairment (MCI) are common late-life physical and cognitive health conditions. Illness perceptions, an individual's personal beliefs about the conditions, should be explored in the context of disease characteristics (physical or cognitive). This secondary analysis explored illness perceptions with a priori hypotheses about control (perceived controllability) and coherence (perceived understanding) dimensions among persons with T2DM and MCI, treating each as an exemplar of late-life physical and cognitive health conditions. We also explored whether age, education, and comorbid conditions moderate the relationships between T2DM or MCI condition groups and illness perceptions. Research Design and Methods This cross-sectional, descriptive study examined baseline data collected from 146 T2DM to 90 MCI participants in 2 independent studies. The 9-item Brief Illness Perception Questionnaire was used to identify the similarities and differences in illness perceptions among persons with T2DM and MCI. We performed hierarchical linear regression controlling for identified covariates. Results We found that T2DM and MCI participants had significantly different illness perceptions, including perceptions of personal control (b = -0.943, p = .009), treatment control (b = -1.619, p < .001), and coherence (b = -1.265, p = .001), after controlling for covariates. The results suggest that persons with MCI were likely to believe that their condition is less controllable (through their own strategies or medical treatment) and less understandable compared with their T2DM counterparts. Such associations remained statistically significant when the interactions were added to the models. Discussion and Implications As T2DM and MCI are prevalent late-life conditions, health care professionals should consider individuals' subjective perceptions about their conditions in the context of disease characteristics when counseling secondary prevention strategies for disease management. Further research on illness perceptions in other conditions is needed to ensure the replicability of our findings.
Collapse
Affiliation(s)
- Hyejin Kim
- Department of Adult Health and Gerontological Nursing, Rush University College of Nursing, Chicago, Illinois, USA
| | - Jennifer H Lingler
- Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
- Alzheimer’s Disease Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Catherine M Bender
- Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
| | - Steven M Albert
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Susan M Sereika
- Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
43
|
Aguilar Barberà M, Soler Girabau P, Tabuenca Martín AI, Prieto Del Val L. Fortasyn Connect Improves Neuropsychiatric Symptoms in Patients with Mild Cognitive Impairment and Dementia: Results from a Retrospective Real-World Study. J Alzheimers Dis 2023; 93:621-631. [PMID: 37066911 DOI: 10.3233/jad-221122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
BACKGROUND Behavioral and psychological symptoms of dementia (BPSD) manifest in the early stages of the disease and impair patients' and caregivers' quality of life. OBJECTIVE To assess the effectiveness of the nutritional supplement Fortasyn Connect on BPSD for 12 months in people with mild cognitive impairment (MCI) and dementia in clinical practice. METHODS Retrospective, national, single-center study of 236 patients (158 MCI and 78 dementia; 55.1% of AD etiology). BPSD were assessed with the Neuropsychiatric Inventory (NPI) at month 3, 6, and 12. Cognition (Mini-Mental State Examination, MMSE), depression (Geriatric Depression Scale, GDS), and everyday functioning (Blessed Dementia Scale, BLS-D; Rapid Disability Rating Scale 2, RDRS2) were also evaluated. RESULTS Total NPI score, caregiver impact, and symptoms of depression, anxiety, apathy, and irritability improved after 3, 6, and 12 months from Fortasyn Connect initiation (p < 0.001). NPI decreases were more pronounced when baseline NPI score was higher than > 20 points (p < 0.001). The benefit was independent of gender, age, diagnosis, etiology, or concomitant treatment (p < 0.0001), although larger decreases in NPI total score were observed in MCI patients (p < 0.0001). After 12 months, GDS scores decreased (p = 0.042), and MMSE, BLS-D, and RDRS 2 scores remained stable. CONCLUSION Fortasyn Connect improved BPSD over at least a year in patients with MCI and dementia. Depression, anxiety, apathy, and irritability were the symptoms that improved the most. The benefit was independent of patients' characteristics and treatment but was greater if prescribed early and when baseline NPI scores were higher.
Collapse
|
44
|
Hemphill L, Valenzuela Y, Luna K, Szymkowicz SM, Jones JD. Synergistic Associations of Depressive Symptoms and Aging on Cognitive Decline in Early Parkinson’s Disease. Clin Park Relat Disord 2023; 8:100192. [PMID: 36968523 PMCID: PMC10034501 DOI: 10.1016/j.prdoa.2023.100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/20/2023] [Accepted: 03/08/2023] [Indexed: 03/13/2023] Open
Abstract
Objective Parkinson's disease (PD) is the second most common progressive neurodegenerative disorder. About 40%-50% of PD patients experience depression, making it one of the most common neuropsychiatric disturbances in PD. Cognitive deficits (e.g., difficulties with memory, attention) are an additional common complication in PD. Past studies among healthy aging individuals suggest that depression is a risk factor for cognitive decline, and the risk increases with older age. This study aims to examine the association between depressive symptoms on cognitive decline as a function of age among patients with PD. It is hypothesized that older PD patients with more severe depressive symptoms will be at greater risk of cognitive decline than their younger or less depressed counterparts. Methods Four hundred and eighty-seven newly diagnosed patients with PD, were assessed for depression and cognition over a five-year period. Participants completed neuropsychological tests that assessed memory, learning, attention, visuospatial functioning, processing speed, and verbal fluency. Multilevel-modeling was used to examine the longitudinal association between cognition, age, and depressive symptoms. Results Our results indicated a significant three-way interaction (age X occasion X depressive symptoms) predicting language and working memory/attention performance. More specifically, detrimental associations of depressive symptoms on cognitive decline in these domains were more pronounced among older adults. Conclusions Our findings support that older PD patients with comorbid depressive symptoms experience greater cognitive decline compared to their younger counterparts. Findings suggest that older individuals with PD may be more vulnerable to neurotoxic effects of depression (e.g., neuroinflammation, HPA axis disruption), and better management of depression could potentially reduce cognitive decline and dementia risk.
Collapse
Affiliation(s)
- Lea Hemphill
- California State University San Bernardino, San Bernardino, CA, USA
| | - Yenny Valenzuela
- California State University San Bernardino, San Bernardino, CA, USA
| | - Kenya Luna
- California State University San Bernardino, San Bernardino, CA, USA
| | - Sarah M. Szymkowicz
- Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jacob D. Jones
- California State University San Bernardino, San Bernardino, CA, USA
- Corresponding author.
| |
Collapse
|
45
|
Vascular Factors in Patients with Midlife Sensorineural Hearing Loss and the Progression to Mild Cognitive Impairment. Medicina (B Aires) 2023; 59:medicina59030481. [PMID: 36984482 PMCID: PMC10057859 DOI: 10.3390/medicina59030481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 03/05/2023] Open
Abstract
Background and Objectives: Midlife hearing loss (HL) has been considered as a major modifiable risk factor for a later-life progression to dementia. Our aim was to detect a link between precocious sensorineural hearing loss (SNHL) and mild cognitive impairment (MCI) and their association to putative risk factors for a common pathology. Materials and methods: In this study, a retrospective case-control study was carried out. A total of 112 patients were enrolled as following: 81 patients with bilateral SNHL and 31 subjects with normal hearing, whose ages ranged from 50 to 65 years. Both groups performed pure tone audiometry, a tinnitus handicap inventory (THI), Mini-Mental State examination (MMSE), and the Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS-A and HADS-D). Results: The mean age was 58 ± 5.2 in SNHL patients and 53.2 ± 4.8 in the control group. The mean pure tone average in the SNHL group was 40.2 ± 18.7 dB HL on the right side and 41.2 ± 17.2 dB HL on the left side, while in the control group it was 12.5 ± 2.8 dB HL on right side and 12.4 ± 3.1 dB HL on left side. About 64% of patients with SNHL exhibited comorbidities, and the most common condition was hypertension. Altered MoCA test scores were significantly related to the pure tone averages in patients with SNHL compared to the control group (p = 0.0004), while the differences in the HADS-A and HADS-D were not significant. Furthermore, a significant correlation was observed in SNHL patients between an altered MoCA test and hypercholesterolemia (p = 0.043). Conclusions: Hearing impairment and screening tests to detect MCI should be considered in the midlife in order to carry out strategies to prevent the progression to dementia. Hypertension and hypercholesterolemia are two risk factors in the development of endothelial dysfunction, oxidative stress, and vascular inflammation, and may represent the common pathology linking the inner ear and brain damage.
Collapse
|
46
|
Basta M, Skourti E, Alexopoulou C, Zampetakis A, Ganiaris A, Aligizaki M, Simos P, Vgontzas AN. Cretan Aging Cohort-Phase III: Methodology and Descriptive Characteristics of a Long-Term Longitudinal Study on Predictors of Cognitive Decline in Non-Demented Elderly from Crete, Greece. Healthcare (Basel) 2023; 11:healthcare11050703. [PMID: 36900708 PMCID: PMC10000452 DOI: 10.3390/healthcare11050703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/23/2023] [Accepted: 02/25/2023] [Indexed: 03/06/2023] Open
Abstract
Identifying modifiable factors that may predict long-term cognitive decline in the elderly with adequate daily functionality is critical. Such factors may include poor sleep quality and quantity, sleep-related breathing disorders, inflammatory cytokines and stress hormones, as well as mental health problems. This work reports the methodology and descriptive characteristics of a long-term, multidisciplinary study on modifiable risk factors for cognitive status progression, focusing on the 7-year follow-up. Participants were recruited from a large community-dwelling cohort residing in Crete, Greece (CAC; Cretan Aging Cohort). Baseline assessments were conducted in 2013-2014 (Phase I and II, circa 6-month time interval) and follow-up in 2020-2022 (Phase III). In total, 151 individuals completed the Phase III evaluation. Of those, 71 were cognitively non-impaired (CNI group) in Phase II and 80 had been diagnosed with mild cognitive impairment (MCI). In addition to sociodemographic, lifestyle, medical, neuropsychological, and neuropsychiatric data, objective sleep was assessed based on actigraphy (Phase II and III) and home polysomnography (Phase III), while inflammation markers and stress hormones were measured in both phases. Despite the homogeneity of the sample in most sociodemographic indices, MCI persons were significantly older (mean age = 75.03 years, SD = 6.34) and genetically predisposed for cognitive deterioration (APOE ε4 allele carriership). Also, at follow-up, we detected a significant increase in self-reported anxiety symptoms along with a substantial rise in psychotropic medication use and incidence of major medical morbidities. The longitudinal design of the CAC study may provide significant data on possible modifiable factors in the course of cognitive progression in the community-dwelling elderly.
Collapse
Affiliation(s)
- Maria Basta
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, State College, PA 16802, USA
- Correspondence: ; Tel.: +30-2810-392-402; Fax: +30-2810-392-859
| | - Eleni Skourti
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Christina Alexopoulou
- Department of Intensive Care Unit, University Hospital of Heraklion, 71500 Heraklion, Greece
| | - Alexandros Zampetakis
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Andronikos Ganiaris
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Marina Aligizaki
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Panagiotis Simos
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Computational Biomedicine Lab, Institute of Computer Science, Foundation for Research and Technology-Hellas, 70013 Heraklion, Greece
| | - Alexandros N. Vgontzas
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, State College, PA 16802, USA
| |
Collapse
|
47
|
Chu CS, Wang DY, Liang CK, Chou MY, Hsu YH, Wang YC, Liao MC, Chu WT, Lin YT. Automated Video Analysis of Audio-Visual Approaches to Predict and Detect Mild Cognitive Impairment and Dementia in Older Adults. J Alzheimers Dis 2023; 92:875-886. [PMID: 36847001 DOI: 10.3233/jad-220999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
BACKGROUND Early identification of different stages of cognitive impairment is important to provide available intervention and timely care for the elderly. OBJECTIVE This study aimed to examine the ability of the artificial intelligence (AI) technology to distinguish participants with mild cognitive impairment (MCI) from those with mild to moderate dementia based on automated video analysis. METHODS A total of 95 participants were recruited (MCI, 41; mild to moderate dementia, 54). The videos were captured during the Short Portable Mental Status Questionnaire process; the visual and aural features were extracted using these videos. Deep learning models were subsequently constructed for the binary differentiation of MCI and mild to moderate dementia. Correlation analysis of the predicted Mini-Mental State Examination, Cognitive Abilities Screening Instrument scores, and ground truth was also performed. RESULTS Deep learning models combining both the visual and aural features discriminated MCI from mild to moderate dementia with an area under the curve (AUC) of 77.0% and accuracy of 76.0% . The AUC and accuracy increased to 93.0% and 88.0%, respectively, when depression and anxiety were excluded. Significant moderate correlations were observed between the predicted cognitive function and ground truth, and the correlation was strong excluding depression and anxiety. Interestingly, female, but not male, exhibited a correlation. CONCLUSION The study showed that video-based deep learning models can differentiate participants with MCI from those with mild to moderate dementia and can predict cognitive function. This approach may offer a cost-effective and easily applicable method for early detection of cognitive impairment.
Collapse
Affiliation(s)
- Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Non-Invasive Neuromodulation Consortium for Mental Disorders, Society of Psychophysiology, Taipei, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Di-Yuan Wang
- Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Kuang Liang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan.,Department of Geriatric Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan.,Department of Internal Medicine, Division of Neurology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Kaohsiung City, Taiwan
| | - Ming-Yueh Chou
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan.,Department of Geriatric Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan
| | - Ying-Hsin Hsu
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Internal Medicine, Division of Neurology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Kaohsiung City, Taiwan.,Chia Nan University, Tainan, Taiwan, Tainan City, Taiwan
| | - Yu-Chun Wang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Mei-Chen Liao
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wei-Ta Chu
- Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Te Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan.,Department of Pharmacy, Tajen University, Pingtung, Taiwan, Yanpu Township, Pingtung County, Taiwan
| |
Collapse
|
48
|
Matsangidou M, Solomou T, Frangoudes F, Ioannou K, Theofanous P, Papayianni E, Pattichis CS. Affective Out-World Experience via Virtual Reality for Older Adults Living with Mild Cognitive Impairments or Mild Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2919. [PMID: 36833616 PMCID: PMC9957279 DOI: 10.3390/ijerph20042919] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Older adults with cognitive impairments may face barriers to accessing experiences beyond their physical premises. Previous research has suggested that missing out on emotional experiences may affect mental health and impact cognitive abilities. In recent years, there has been growing research interest in designing non-pharmacological interventions to improve the health-related quality of life of older adults. With virtual reality offering endless opportunities for health support, we must consider how virtual reality can be sensitively designed to provide comfortable, enriching out-world experiences to older adults to enhance their emotional regulation. Thirty older adults living with mild cognitive impairment or mild dementia participated in the study. Affect and emotional behavior were measured. The usability and the sense of presence were also assessed. Finally, we assessed the virtual reality experiences based on physiological responses and eye-tracking data. The results indicated that virtual reality can positively enhance the mental health of this population by eliciting a positive affective state and enhancing their emotional regulation. Overall, this paper raises awareness of the role of virtual reality in emotion elicitation, regulation, and expression and enhances our understanding of the use of virtual reality by older adults living with mild cognitive impairments or mild dementia.
Collapse
Affiliation(s)
| | - Theodoros Solomou
- Department of Computer Science, School of Natural & Applied Sciences, University of Cyprus, Nicosia 1678, Cyprus
| | | | - Konstantinos Ioannou
- Department of Computer Science, School of Natural & Applied Sciences, University of Cyprus, Nicosia 1678, Cyprus
| | - Panagiotis Theofanous
- Department of Computer Science, School of Natural & Applied Sciences, University of Cyprus, Nicosia 1678, Cyprus
| | - Ersi Papayianni
- Archangelos Michael Elderly People Nursing Home/Rehabilitation Centre for Patients with Alzheimer (AMEN), Nicosia 1022, Cyprus
| | - Constantinos S. Pattichis
- CYENS Center of Excellence, Nicosia 1016, Cyprus
- Department of Computer Science, School of Natural & Applied Sciences, University of Cyprus, Nicosia 1678, Cyprus
| |
Collapse
|
49
|
Mavragani A, Michels L, Schmidt A, Barinka F, de Bruin ED. Effectiveness of an Individualized Exergame-Based Motor-Cognitive Training Concept Targeted to Improve Cognitive Functioning in Older Adults With Mild Neurocognitive Disorder: Study Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e41173. [PMID: 36745483 PMCID: PMC9941909 DOI: 10.2196/41173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Simultaneous motor-cognitive training is considered promising for preventing the decline in cognitive functioning in older adults with mild neurocognitive disorder (mNCD) and can be highly motivating when applied in the form of exergaming. The literature points to opportunities for improvement in the application of exergames in individuals with mNCD by developing novel exergames and exergame-based training concepts that are specifically tailored to patients with mNCD and ensuring the implementation of effective training components. OBJECTIVE This study systematically explores the effectiveness of a newly developed exergame-based motor-cognitive training concept (called "Brain-IT") targeted to improve cognitive functioning in older adults with mNCD. METHODS A 2-arm, parallel-group, single-blinded randomized controlled trial with a 1:1 allocation ratio (ie, intervention: control), including 34 to 40 older adults with mNCD will be conducted between May 2022 and December 2023. The control group will proceed with the usual care provided by the (memory) clinics where the patients are recruited. The intervention group will perform a 12-week training intervention according to the "Brain-IT" training concept, in addition to usual care. Global cognitive functioning will be assessed as the primary outcome. As secondary outcomes, domain-specific cognitive functioning, brain structure and function, spatiotemporal parameters of gait, instrumental activities of daily living, psychosocial factors, and resting cardiac vagal modulation will be assessed. Pre- and postintervention measurements will take place within 2 weeks before starting and after completing the intervention. A 2-way analysis of covariance or the Quade nonparametric analysis of covariance will be computed for all primary and secondary outcomes, with the premeasurement value as a covariate for the predicting group factor and the postmeasurement value as the outcome variable. To determine whether the effects are substantive, partial eta-squared (η2p) effect sizes will be calculated for all primary and secondary outcomes. RESULTS Upon the initial submission of this study protocol, 13 patients were contacted by the study team. Four patients were included in the study, 2 were excluded because they were not eligible, and 7 were being informed about the study in detail. Of the 4 included patients, 2 already completed all premeasurements and were in week 2 of the intervention period. Data collection is expected to be completed by December 2023. A manuscript of the results will be submitted for publication in a peer-reviewed open-access journal in 2024. CONCLUSIONS This study contributes to the evidence base in the highly relevant area of preventing disability because of cognitive impairment, which has been declared a public health priority by the World Health Organization. TRIAL REGISTRATION ClinicalTrials.gov NCT05387057; https://clinicaltrials.gov/ct2/show/NCT05387057. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41173.
Collapse
Affiliation(s)
| | - Lars Michels
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - André Schmidt
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Filip Barinka
- Clinic for Neurology, Hirslanden Hospital Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Motor Control and Learning Group - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.,Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
| |
Collapse
|
50
|
Lanctôt KL, Ismail Z, Bawa KK, Cummings JL, Husain M, Mortby ME, Robert P. Distinguishing apathy from depression: A review differentiating the behavioral, neuroanatomic, and treatment-related aspects of apathy from depression in neurocognitive disorders. Int J Geriatr Psychiatry 2023; 38:e5882. [PMID: 36739588 PMCID: PMC10107127 DOI: 10.1002/gps.5882] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/17/2023] [Indexed: 01/24/2023]
Abstract
OBJECTIVES This narrative review describes the clinical features of apathy and depression in individuals with neurocognitive disorders (NCDs), with the goal of differentiating the two syndromes on the basis of clinical presentation, diagnostic criteria, neuropathological features, and contrasting responses to treatments. METHODS Literature was identified using PubMed, with search terms to capture medical conditions of interest; additional references were also included based on our collective experience and knowledge of the literature. RESULTS Evidence from current literature supports the distinction between the two disorders; apathy and depression occur with varying prevalence in individuals with NCDs, pose different risks of progression to dementia, and have distinct, if overlapping, neurobiological underpinnings. Although apathy is a distinct neuropsychiatric syndrome, distinguishing apathy from depression can be challenging, as both conditions may occur concurrently and share several overlapping features. Apathy is associated with unfavorable outcomes, especially those with neurodegenerative etiologies (e.g., Alzheimer's disease) and is associated with an increased burden for both patients and caregivers. Diagnosing apathy is important not only to serve as the basis for appropriate treatment, but also for the development of novel targeted interventions for this condition. Although there are currently no approved pharmacologic treatments for apathy, the research described in this review supports apathy as a distinct neuropsychiatric condition that warrants specific treatments aimed at alleviating patient disability. CONCLUSIONS Despite differences between these disorders, both apathy and depression pose significant challenges to patients, their families, and caregivers; better diagnostics are needed to develop more tailored treatment and support.
Collapse
Affiliation(s)
- Krista L. Lanctôt
- Departments of Psychiatry and of Pharmacology and ToxicologyUniversity of TorontoTorontoOntarioCanada
- Neuropsychopharmacology Research GroupHurvitz Brain Sciences ProgramSunnybrook Research InstituteTorontoOntarioCanada
- Bernick Chair in Geriatric PsychopharmacologySunnybrook Health Sciences CentreUniversity of TorontoTorontoOntarioCanada
| | - Zahinoor Ismail
- Departments of Psychiatry, Clinical Neurosciences, and Community Health SciencesHotchkiss Brain InstituteO'Brien Institute of Public HealthUniversity of CalgaryCalgaryAlbertaCanada
| | - Kritleen K. Bawa
- Departments of Psychiatry and of Pharmacology and ToxicologyUniversity of TorontoTorontoOntarioCanada
- Neuropsychopharmacology Research GroupHurvitz Brain Sciences ProgramSunnybrook Research InstituteTorontoOntarioCanada
| | - Jeffrey L. Cummings
- Department of Brain HealthChambers‐Grundy Center for Transformative NeuroscienceSchool of Integrated Health SciencesUniversity of Nevada Las Vegas (UNLV)Las VegasNevadaUSA
| | - Masud Husain
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
| | - Moyra E. Mortby
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
| | - Philippe Robert
- Cognition Behaviour Technology LabUniversity Côte d'Azur (UCA)NiceFrance
- Centre MémoireLe Centre Hospitalier Universitaire de NiceNiceFrance
| |
Collapse
|