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Cui L, Zhang Z, Guo Y, Li Y, Xie F, Guo Q. Category Switching Test: A Brief Amyloid-β-Sensitive Assessment Tool for Mild Cognitive Impairment. Assessment 2024; 31:543-556. [PMID: 37081801 DOI: 10.1177/10731911231167537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
The Category Switching Test (CaST) is a verbal fluency test with active semantic category switching. This study aimed to explore the association between CaST performance and brain amyloid-β (Aβ) burden in patients with mild cognitive impairment (MCI) and the neurofunctional mechanisms. A total of 112 participants with MCI underwent Florbetapir positron emission tomography, resting-state functional magnetic resonance imaging, and a neuropsychological test battery. The high Aβ burden group had worse CaST performance than the low-burden group. CaST score and left middle temporal gyrus fractional amplitude of low-frequency fluctuations (fALFF) related inversely to the global Florbetapir standardized uptake value rate. Functional connectivity between the left middle temporal gyrus and frontal lobe decreased widely and correlated with CaST score in the high Aβ burden group. Thus, CaST score and left middle temporal gyrus fALFF were valuable in discriminating high Aβ burden. CaST might be useful in screening for MCI with high Aβ burden.
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Affiliation(s)
- Liang Cui
- Department of Gerontology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhen Zhang
- Department of Gerontology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yihan Guo
- School of Medicine, The University of Queensland, Brisbane, Australia
| | - Yuehua Li
- Department of Gerontology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fang Xie
- Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Qihao Guo
- Department of Gerontology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Wen C, Gan JH, Huang GW, Wang XD, Lü Y, Niu JP, Meng XL, Cai P, Li Y, Gang BZ, You Y, Lv Y, Ren ZH, Liu S, Zeng Y, Ji Y. Physical exercise frequency and cognition: a multicenter cross-sectional cohort study. Front Aging Neurosci 2024; 16:1381692. [PMID: 38524118 PMCID: PMC10958531 DOI: 10.3389/fnagi.2024.1381692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 02/28/2024] [Indexed: 03/26/2024] Open
Abstract
Background and aims Dementia imposes a heavy burden on society and families, therefore, effective drug treatments, exploring and preventing factors associated with dementia, are paramount. To provide reference points for the best frequency of physical exercise (physical exercise), we investigated the association between frequency of PE and cognition in Chinese old adults. Methods 16,181 Chinese participants aged 65 years or older were included in this study. Associations between PE and cognition were estimated multivariate logistic and linear regression analyses. Associations were further investigated across dementia subtypes (Alzheimer dementia, vascular dementia, and other types of dementia). Subgroup analyses were performed in different age groups, in populations with and without stroke, and those with and without hypertension. Results PE associated with dementia after adjusting for full covariates (OR: 0.5414, 95% CI: 0.4536-0.6491, p < 0.001). Exercise performed at ≥3 times/week associated with lower risk of dementia (OR: 0.4794-0.6619, all p value <0.001). PE was associated with improved cognition (β: 12851, p < 0.001), and any PE frequency contributed to cognitive improvement (p values for exercise performed ≥1 time/week were <0.001). Similar conclusions were identified when we repeated analyses in different dementia subtypes and age groups. Subgroup analyses suggested that the cognition of individuals without hypertension also benefitted from exercising 1-2 times/week (OR: 0.6168, 95% CI: 0.4379-0.8668, p = 0.005). Conclusion The best exercise frequency is exercising ≥3 times/week for individuals from different dementia subtypes and age groups. While for those without hypertension, PE at 1-2 times /week is also beneficial.
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Affiliation(s)
- Chen Wen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jing-Huan Gan
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Guo-Wei Huang
- Department of Nutrition and Food Science, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiao-Dan Wang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin, China
| | - Yang Lü
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jian-Ping Niu
- Department of Neurology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Xin-Ling Meng
- Department of Neurology, Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University, Urumqi, China
| | - Pan Cai
- Dementia Clinic, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yang Li
- Department of Neurology, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Bao-Zhi Gang
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yong You
- Department of Neurology, Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Yan Lv
- Department of Neurology, Hainan General Hospital, Haikou, China
| | - Zhi-Hong Ren
- Department of Neurology, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, Beijing, China
| | - Shuai Liu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin, China
| | - Yan Zeng
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Yong Ji
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing, China
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin, China
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Liu L, Shi Z, Gan J, Liu S, Wen C, Yang Y, Yang F, Ji Y. Characterization of de novo Dementia with Lewy Body with different duration of rapid eye movement sleep behavior disorder. Sleep Med 2024; 114:101-108. [PMID: 38176204 DOI: 10.1016/j.sleep.2023.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/06/2023] [Accepted: 12/25/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Cognitive disorder, parkinsonism, autonomic dysfunction (AuD) and rapid eye movement sleep behavior disorder (RBD) can occur prior to or simultaneously with Dementia with Lewy Body (DLB) onset. RBD is generally linked with progressive neurodegenerative traits. However, associations between RBD with DLB, RBD without DLB, and RBD duration effects on DLB symptoms remain unclear. OBJECTIVES To examine DLB symptom frequency and subtypes in RBD, and explore the effects of different RBD onset times on symptoms in de novo DLB patients. METHODS In this multicenter investigation, we consecutively recruited 271 de novo DLB patients. All had standardized clinical and comprehensive neuropsychological evaluations. Subgroup analyses, performed based on the duration of RBD confirmed by polysomnography before the DLB diagnosis, we compared the proportion of patients with cognitive impairment, parkinsonism, and AuD features between groups. RESULTS Parkinsonism and AuD incidences were significantly elevated in DLB patients with RBD when compared with patients without RBD. Subgroup analyses indicated no significant differences in parkinsonism between DLB patients who developed RBD ≥10 years prior to the DLB diagnosis and DLB patients without RBD. The incidence of non-tremor-predominant parkinsonism and AuD was significantly higher in DLB patients whose RBD duration before the DLB diagnosis was <10 years when compared with DLB patients without RBD. CONCLUSIONS We identified significant symptom and phenotypic variability between DLB patients with and without RBD. Also, different RBD duration effects before the DLB diagnosis had a significant impact on symptomatic phenotypes, suggesting the existence of a slowly progressive DLB neurodegenerative subtype.
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Affiliation(s)
- Lixin Liu
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China; The Psycho Department of Beijing Geriatric Hospital, Beijing, China
| | - Zhihong Shi
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin, China
| | - Jinghuan Gan
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shuai Liu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin, China
| | - Chen Wen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yaqi Yang
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
| | - Fan Yang
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
| | - Yong Ji
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China; Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin, China.
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Huang X, Zhao J, Wang Q, Yan T, Gou S, Zhu X, Yang L, Ye F, Zhang J, Wang Y, Yang S, Le W, Xiang Y. Association between plasma CTRPs with cognitive impairment and neurodegeneration of Alzheimer's disease. CNS Neurosci Ther 2024; 30:e14606. [PMID: 38334009 PMCID: PMC10853890 DOI: 10.1111/cns.14606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/21/2023] [Accepted: 01/06/2024] [Indexed: 02/10/2024] Open
Abstract
AIMS Recent evidence indicated the biological basis of complement 1q (C1q)/tumor necrosis factor (TNF)-related protein (CTRP) 3, 4, and 14 for affecting brain structure and cognitive function. Thus, we aimed to investigate the association between plasma CTRPs with Alzheimer's disease (AD). METHODS A multicenter, cross-sectional study recruited patients with AD (n = 137) and cognitively normal (CN) controls (n = 140). After the data collection of demographic characteristics, lifestyle risk factors, and medical history, plasma levels of tau phosphorylated at threonine 217 (pT217), pT181, neurofilament light (NfL), CTRP3, 4, and 14 were examined and compared. Multivariate logistic regression analysis was applied to determine associations of plasma CTPRs with the presence of AD. The correlation analysis was used to explore correlations between plasma CTPRs with scores of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Activities of Daily Living (ADL) scale, and Clinical Dementia Rating Sum of Boxes (CDR-SB), and levels of plasma pT217, pT181, and NfL. Receiver-operating characteristic (ROC) analysis and Delong's test were used to determine the diagnostic power of plasma CTPRs. RESULTS Plasma levels of CTRP3, 4, and 14 were higher in AD group than those in CN group. After adjusting for conventional risk factors, CTRP3, CTRP4, and CTRP14 were associated with the presence of AD. In AD patients, CTRP3 was negatively correlated with scores of MMSE and MoCA, while positively correlated with ADL score, CDR-SB score, pT217, and pT181; CTRP4 was positively correlated with CDR-SB score, pT181, and NfL; CTRP14 was negatively correlated with MMSE score, while positively correlated with CDR-SB score, pT217, and NfL. An independent addition of CTRP3 and 4 to the basic model combining age, sex, years of education, APOE4 status, BMI, TG, and HDL-C led to a significant improvement in diagnostic power for AD, respectively. CONCLUSIONS All the findings preliminarily uncovered associations between plasma CTRPs and AD and suggested the potential of CTRPs as a blood-derived biomarker for AD.
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Affiliation(s)
- Xiao Huang
- Institute of Neurology, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Jialing Zhao
- Institute of Neurology, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
- Department of Neurology, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
- Department of NeurologyYunyang County People's HospitalChongqingChina
| | - Qinghua Wang
- Department of Neurology and Center for Clinical Neuroscience, Daping HospitalThird Military Medical UniversityChongqingChina
- Chongqing Key Laboratory of Ageing and Brain DiseasesChongqingChina
| | - Tingqi Yan
- Department of Neurology, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Shu Gou
- Department of Neurology, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Xiaofeng Zhu
- Department of NeurologyChengdu Eighth People's HospitalChengduChina
| | - Liu Yang
- Department of Neurology, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Fang Ye
- Department of Neurology, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Jie Zhang
- Institute of Neurology, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
- Department of Neurology, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Yanjiang Wang
- Department of Neurology and Center for Clinical Neuroscience, Daping HospitalThird Military Medical UniversityChongqingChina
- Chongqing Key Laboratory of Ageing and Brain DiseasesChongqingChina
| | - Shaojie Yang
- Department of NeurologyChengdu Eighth People's HospitalChengduChina
| | - Weidong Le
- Institute of Neurology, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Yang Xiang
- Institute of Neurology, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
- Department of Neurology, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
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Pan F, Wang Y, Wang Y, Wang X, Guan Y, Xie F, Guo Q. Sex and APOE genotype differences in amyloid deposition and cognitive performance along the Alzheimer's Continuum. Neurobiol Aging 2023; 130:84-92. [PMID: 37481959 DOI: 10.1016/j.neurobiolaging.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/25/2023]
Abstract
Conflicting findings exist regarding the differences in amyloid burden and cognitive performance based on sex and apolipoprotein E (APOE) genotype. This study aimed to investigate the brain amyloid-β (Aβ) burden and cognitive performances by sex and APOE genotype in a cohort of Aβ-positron emission tomography (PET)-positive participants. Brain Aβ burden was assessed using 18F-florbetapir PET standard uptake value ratios. Cognitive performance was evaluated using standardized neuropsychological tests. In the cognitively normal participants, females had a higher Aβ burden than males in APOE ε4 noncarriers, whereas APOE ε4 carriers had a higher Aβ burden than noncarriers in males. In the cognitively impaired participants, APOE ε4 carriers were more likely to have a higher Aβ burden than noncarriers in the brain regions of the lateral parietal gyrus, frontal gyrus, and precuneus. In addition, females were more likely to have poorer language and visuospatial performance compared to males, while the APOE genotype did not significantly impact cognitive performance. These findings further elucidate the impact of sex and APOE genotype on brain Aβ burden and sex-related cognitive performance should be considered in the Alzheimer's Continuum.
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Affiliation(s)
- Fengfeng Pan
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yifan Wang
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Wang
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoming Wang
- Department of Physiology, Capital Medical University, Key Laboratory for Neurodegenerative Disorders of the Ministry of Education, Beijing, China
| | - Yihui Guan
- Department PET Center, Huashan Hospital, Fudan University, Shaznghai, China
| | - Fang Xie
- Department PET Center, Huashan Hospital, Fudan University, Shaznghai, China.
| | - Qihao Guo
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Cui L, Zhang Z, Huang L, Li Q, Guo YH, Guo QH. Dual-stage cognitive assessment: a two-stage screening for cognitive impairment in primary care. BMC Psychiatry 2023; 23:368. [PMID: 37231438 DOI: 10.1186/s12888-023-04883-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Aging population has led to an increased proportion of older adults and cognitively impaired. We designed a brief and flexible two-stage cognitive screening scale, the Dual-Stage Cognitive Assessment (DuCA), for cognitive screening in primary care settings. METHOD In total, 1,772 community-dwelling participants were recruited, including those with normal cognition (NC, n = 1,008), mild cognitive impairment (MCI, n = 633), and Alzheimer's disease (AD, n = 131), and administered a neuropsychological test battery and the DuCA. To improve performance, the DuCA combines visual and auditory memory tests for an enhanced memory function test. RESULTS The correlation coefficient between DuCA-part 1 and DuCA-total was 0.84 (P < 0.001). The correlation coefficients of DuCA-part 1 with Addenbrooke's Cognitive Examination III (ACE-III) and Montreal Cognitive Assessment Basic (MoCA-B) were 0.66 (P < 0.001) and 0.85 (P < 0.001), respectively. The correlation coefficients of DuCA-total with ACE-III and MoCA-B were 0.78 (P < 0.001) and 0.83 (P < 0.001), respectively. DuCA-Part 1 showed a similar discrimination ability for MCI from NC (area under curve [AUC] = 0.87, 95%CI 0.848-0.883) as ACE III (AUC = 0.86, 95%CI 0.838-0.874) and MoCA-B (AUC = 0.85, 95%CI 0.830-0.868). DuCA-total had a higher AUC (0.93, 95%CI: 0.917-0.942). At different education levels, the AUC was 0.83-0.84 for DuCA-part 1, and 0.89-0.94 for DuCA-total. DuCA-part 1 and DuCA-total's ability to discriminate AD from MCI was 0.84 and 0.93, respectively. CONCLUSION DuCA-Part 1 would aid rapid screening and supplemented with the second part for a complete assessment. DuCA is suited for large-scale cognitive screening in primary care, saving time and eliminating the need for extensively training assessors.
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Affiliation(s)
- Liang Cui
- Department of Gerontology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Zhen Zhang
- Department of Gerontology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Lin Huang
- Department of Gerontology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Qinjie Li
- Department of Gerontology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Yi-Han Guo
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Qi-Hao Guo
- Department of Gerontology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
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Gan J, Chen Z, Liu S, Shi Z, Liu Y, Wang XD, Liu C, Ji Y. The presence and co-incidence of geriatric syndromes in older patients with mild-moderate Lewy body dementia. BMC Neurol 2022; 22:355. [PMID: 36123648 PMCID: PMC9484208 DOI: 10.1186/s12883-022-02897-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/12/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Geriatric symptoms are common in dementia cases, while few studies have focused on these symptoms in Lewy body dementia (LBD). The purpose of this study is to investigate the distributions of Apolipoprotein E (APOE) ε4 and geriatric symptoms, and explore their associaitons in Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD). METHODS A retrospective study with 185 mild-moderate probable DLB (n = 93) and PDD (n = 92) patients was assigned. Demographic and clinical characteristics, neuropsychological assessments, and APOE genotypes were recorded. Description, correlation and logistic regression models were used to analyze the presence of geriatric symptom complaints and their associations with APOE ε4. RESULTS DLB patients displayed more frequency of fluctuating cognition, visual hallucination, rapid eye movement sleep behavior disorder, delusion, depression, anxiety, apathy, and loss of appetite, whereas the PDD cases had constipation, fear of falling, and insomnia more frequently. The APOE ε4 allele was more common in DLB than PDD (29.9% vs. 7.0%, p < 0.001), and the patients with DLB + APOE ε4 (+) were presented more delusions (p = 0.005) and apathy (p = 0.007) than patients with PDD + APOE ε4 (+). We also found that the APOE ε4 allele was significantly associated with hyperhidrosis (OR = 3.472, 95%CI: 1.082-11.144, p = 0.036) and depression (OR = 3.002, 95%CI: 1.079-8.353, p = 0.035) in DLB patients, while there were no significant associations between APOE ε4 allele and the age at visit, the age at onset, scores of MDS-UPDRS III, H&Y stage, ADL, MMSE, MOCA and NPI, as well as the presences of fluctuating cognition, VH, parkinsonism and RBD in both groups. CONCLUSION The presence and co-incidence of geriatric symptoms are common in patients with mild-moderate LBD. The presence of APOE ε4 allele is associated with hyperhidrosis and depression, but not global cognition, activitives of daily life, motor function and other neuropsychitric symptoms in DLB. These findings improve the awareness of geriatric symptoms, and contribute to the healthcare management of mild-moderate DLB and PDD.
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Affiliation(s)
- Jinghuan Gan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, 119 Nansihuan West Road, Fengtai District, Beijing, 100070, China
| | - Zhichao Chen
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shuai Liu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, 6 Jizhao Road, Jinnan District, Tianjin, 300350, China
| | - Zhihong Shi
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, 6 Jizhao Road, Jinnan District, Tianjin, 300350, China
| | - Yiming Liu
- Department of Neurology, Qilu hospital, Shandong University, Jinan, China
| | - Xiao-Dan Wang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, 6 Jizhao Road, Jinnan District, Tianjin, 300350, China
| | - Chunyan Liu
- Department of Neurology, Aviation General Hospital, Beijing, China
| | - Yong Ji
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, 119 Nansihuan West Road, Fengtai District, Beijing, 100070, China. .,Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, 6 Jizhao Road, Jinnan District, Tianjin, 300350, China.
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Wang Y, Han X, Zhang X, Zhang Z, Cong L, Tang S, Hou T, Liu C, Han X, Zhang Q, Feng J, Yin L, Song L, Dong Y, Liu R, Li Y, Ngandu T, Kivipelto M, Snyder H, Carrillo M, Persson J, Fratiglioni L, Launer LJ, Jia J, Du Y, Qiu C. Health status and risk profiles for brain aging of rural-dwelling older adults: Data from the interdisciplinary baseline assessments in MIND-China. Alzheimers Dement (N Y) 2022; 8:e12254. [PMID: 35441085 PMCID: PMC9009233 DOI: 10.1002/trc2.12254] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/13/2021] [Accepted: 12/15/2021] [Indexed: 02/01/2023]
Abstract
Introduction Multidomain intervention approaches have emerged as a potential strategy to reduce dementia risk. We sought to describe the baseline assessment approaches, health conditions, and risk profiles for brain aging of participants in the randomized controlled Multimodal INterventions to delay Dementia and disability in rural China (MIND‐China). Methods MIND‐China engaged residents who were ≥60 years of age and living in rural communities in the western Shandong province. In March to September 2018, all participants underwent the core module assessments via face‐to‐face interviews, clinical examinations, neuropsychological testings, and laboratory tests. Specific modules of examination were performed for sub‐samples, including brain magnetic resonance imaging scans, genetic and blood biochemical markers, actigraphy testing, cardiopulmonary coupling analysis for sleep quality and disturbances, audiometric testing, and optical coherence tomography examination. We performed descriptive analysis. Results In total, 5765 participants (74.9% of all eligible residents) undertook the baseline assessments. The mean age was 70.9 years (standard deviation, 5.9), 57.2% were women, 40.6% were illiterate, and 88.3% were farmers. The overall prevalence of common chronic diseases was 67.2% for hypertension, 23.4% for dyslipidemia, 23.5% for heart disease, 14.4% for diabetes mellitus, and 5.4% for dementia. The prevalence rates of hypertension, diabetes mellitus, dyslipidemia, obesity, heart disease, depressive symptoms, and dementia were higher in women than in men (P < .05). Overall, 87.1% of the participants had at least two of the 15 chronic diseases (89.3% in women vs 84.2% in men, P < .001). Participants examined for the specific modules were younger, more likely to be women, and more educated than those not examined. Discussion Comprehensive baseline assessments of participants in MIND‐China provide extremely valuable data sources for interdisciplinary research into the complex relationships of aging, health, brain aging, and functional consequences among older adults living in the rural communities. Highlights MIND‐China is a multimodal intervention study among rural residents ≥60 years of age. At baseline, 5765 participants undertook the interdisciplinary assessments. The baseline assessments consisted of core module and specific modules. Specific modules included brain magnetic resonance imaging (MRI), blood biomarkers, ActiGraph, cardiopulmonary coupling (CPC), pure‐tone audiometry (PTA), and optical coherence tomography (OCT).
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Affiliation(s)
- Yongxiang Wang
- Department of Neurology Shandong Provincial Hospital affiliated to Shandong First Medical University Jinan Shandong China.,Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China
| | - Xiaolei Han
- Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China
| | | | | | - Lin Cong
- Department of Neurology Shandong Provincial Hospital affiliated to Shandong First Medical University Jinan Shandong China.,Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China
| | - Shi Tang
- Department of Neurology Shandong Provincial Hospital affiliated to Shandong First Medical University Jinan Shandong China.,Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China
| | - Tingting Hou
- Department of Neurology Shandong Provincial Hospital affiliated to Shandong First Medical University Jinan Shandong China.,Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China
| | - Cuicui Liu
- Department of Neurology Shandong Provincial Hospital affiliated to Shandong First Medical University Jinan Shandong China.,Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China
| | - Xiaojuan Han
- Department of Neurology Shandong Provincial Hospital affiliated to Shandong First Medical University Jinan Shandong China.,Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China
| | - Qinghua Zhang
- Department of Neurology Shandong Provincial Hospital affiliated to Shandong First Medical University Jinan Shandong China.,Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China
| | - Jianli Feng
- Department of Neurology Shandong Second Provincial General Hospital Shandong Provincial ENT Hospital Jinan Shandong China
| | - Ling Yin
- Department of Neurology Shandong Provincial Hospital affiliated to Shandong First Medical University Jinan Shandong China.,Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China
| | - Lin Song
- Department of Neurology Shandong Provincial Hospital affiliated to Shandong First Medical University Jinan Shandong China.,Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China
| | - Yi Dong
- Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China
| | - Rui Liu
- Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China
| | - Yuanjing Li
- Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China
| | - Tiia Ngandu
- Division of Clinical Geriatrics and Center for Alzheimer Research Department of Neurobiology Care Sciences and Society (NVS) Karolinska Institutet Stockholm Sweden.,Department of Public Health and Welfare Finnish Institute for Health and Welfare Finland
| | - Miia Kivipelto
- Division of Clinical Geriatrics and Center for Alzheimer Research Department of Neurobiology Care Sciences and Society (NVS) Karolinska Institutet Stockholm Sweden
| | | | | | - Jonas Persson
- Aging Research Center Department of NVS Karolinska Institutet and Stockholm University Stockholm Sweden
| | - Laura Fratiglioni
- Aging Research Center Department of NVS Karolinska Institutet and Stockholm University Stockholm Sweden
| | - Lenore J Launer
- Intramural Research Program Laboratory of Epidemiology and Population Sciences National Institute on Aging National Institutes of Health Baltimore Maryland USA
| | - Jianping Jia
- Innovation Center for Neurological Disorders Department of Neurology Xuanwu Hospital Capital Medical University Beijing China
| | - Yifeng Du
- Department of Neurology Shandong Provincial Hospital affiliated to Shandong First Medical University Jinan Shandong China.,Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Shandong Provincial Clinical Research Center for Neurological Diseases Jinan Shandong China
| | - Chengxuan Qiu
- Department of Neurology Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.,Aging Research Center Department of NVS Karolinska Institutet and Stockholm University Stockholm Sweden
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9
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Pan FF, Cui L, Li QJ, Guo QH. Validation of a modified Chinese version of Mini-Addenbrooke's Cognitive Examination for detecting mild cognitive impairment. Brain Behav 2022; 12:e2418. [PMID: 34843170 PMCID: PMC8785624 DOI: 10.1002/brb3.2418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/16/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND For detecting mild cognitive impairment (MCI), brief cognitive screening tools are increasingly required for the advantage of time saving and no need for special equipment or trained raters. We aimed to develop a modified Chinese version of Mini-Addenbrooke's Cognitive Examination (C-MACE) and further evaluate its validation in detecting MCI. METHODS A total of 716 individuals aged from 50 to 90 years old were recruited, including 431 cognitively normal controls (NC) and 285 individuals with MCI. The effect size of Cramer's V was used to explore which items in the Chinese version of Addenbrooke's Cognitive Examination-III (ACE-III-CV) best associated with MCI and to form the C-MACE. Receiver operating characteristic (ROC) analyses were carried out to explore the ability of C-MACE, ACE-III-CV, Chinese version of Montreal Cognitive Assessment-Basic (MoCA-BC), and Mini-Mental State Examination (MMSE) in discriminating MCI from NC. RESULTS Five items with greatest effect sizes of Cramer's V were selected from ACE-III-CV to form the C-MACE: Memory Immediate Recall, Memory Delayed Recall, Memory Recognition, Verbal Fluency Animal and Language Naming. With a total score of 38, the C-MACE had a satisfactory classification accuracy in detecting MCI (area under the ROC curve, AUC = 0.892), superior to MMSE (AUC = 0.782) and comparable to ACE-III-CV (AUC = 0.901) and MoCA-BC (AUC = 0.916). In the subgroup of Age > 70 years, Education ≤ 12 years, the C-MACE got a highest classification accuracy (AUC = 0.958) for detecting MCI. CONCLUSION In the Chinese-speaking population, C-MACE derived from ACE-III-CV may identify MCI with a good classification accuracy, especially in aged people with low education.
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Affiliation(s)
- Feng-Feng Pan
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Liang Cui
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Qing-Jie Li
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Qi-Hao Guo
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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10
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Liu L, Zhang T, Li S, Pan G, Yan L, Sun W. Successful Aging Among Community-Dwelling Older Adults in Urban Areas of Liaoning Province: The Crucial Effect of Visual Ability. Risk Manag Healthc Policy 2021; 14:3729-3738. [PMID: 34526829 PMCID: PMC8435618 DOI: 10.2147/rmhp.s324095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/26/2021] [Indexed: 01/29/2023] Open
Abstract
Purpose Successful aging is an effective approach to coping with population aging; however, the definition and associated factors vary due to culture and demographic distribution differences. This study was designed to assess successful aging of the older adults in China and explore the associated factors. Methods A community-based cross-sectional study was performed in Liaoning, China. After double-cognitive function screening, 3558 older adults (1656 males and 1902 females) ≥65 years of age served as our subjects. Successful aging was assessed based on the following: physical disability; cognitive function; activities of daily living; and self-rated psychological/mood status. Results The rate of successful aging was 31.7% in males and 29.4% in females. After adjustment for age, multivariate logistic regression showed that successful aging was significantly associated with, in odds ratio sequence, visual ability, self-rated chronic disease, marital status, and filial piety in males, and with visual ability, self-rated chronic disease, watching television, and ethnicity in females. Conclusion The level of successful aging in China is lower than in other countries. Demographic characteristics, health status, individual behavior, and social-psychological factors are all associated with successful aging. Overall, visual ability had the most crucial role in successful aging for the older adults, whether males or females.
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Affiliation(s)
- Li Liu
- Institute of Preventive Medicine, China Medical University, Shenyang, Liaoning, 110122, People's Republic of China.,Institute of Chronic Diseases, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, 111200, People's Republic of China
| | - Tianjiao Zhang
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang, Liaoning, 110122, People's Republic of China
| | - Shuang Li
- Institute of Preventive Medicine, China Medical University, Shenyang, Liaoning, 110122, People's Republic of China.,Institute of Chronic Diseases, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, 111200, People's Republic of China
| | - Guowei Pan
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang, Liaoning, 110122, People's Republic of China
| | - Lingjun Yan
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang, Liaoning, 110122, People's Republic of China
| | - Wei Sun
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang, Liaoning, 110122, People's Republic of China
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11
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Su H, Sun X, Li F, Guo Q. Association between handgrip strength and cognition in a Chinese population with Alzheimer's disease and mild cognitive impairment. BMC Geriatr 2021; 21:459. [PMID: 34380435 PMCID: PMC8356394 DOI: 10.1186/s12877-021-02383-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/14/2021] [Indexed: 11/24/2022] Open
Abstract
Background This study aimed to explore the level and changes in handgrip strength among preclinical Alzheimer’s disease (AD) and AD patients and to evaluate the association between handgrip strength and cognitive function. Methods A total of 1431 participants from the memory clinic of Shanghai JiaoTong University Affiliated Sixth People’s Hospital and community were enrolled in the final analysis, including 596 AD, 288 mild cognitive impairment (MCI), and 547 normal individuals (NC). All participants received a comprehensive neuropsychological assessment. Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment-Basic (MoCA-BC), and the Chinese version of Addenbrooke’s Cognitive Examination III (ACE-III-CV) were used as cognitive tests. The receiver operating characteristic curve (ROC) was plotted to assess the power of handgrip strength as a screening measure to discriminate AD and MCI. Results The results showed that handgrip strength in the MCI group was significantly lower than that of NC group, and the AD group had a further decline (both P < 0.01). Multivariate logistic regression was performed with the handgrip strength quartiles, and the results showed that the ORs of AD for increasing levels of handgrip strength were 1.00, 0.58 (0.46–0.78), 0.51 (0.36–0.73), and 0.50 (0.35–0.68), showing a decreasing trend (Pfor trend < 0.01). The ROC curve demonstrated that the handgrip strength cutoff points for the identification of AD were 16.8 and 20.7 kg among the female participants above and under 70 yrs and 24.4 and 33.3 kg for the male participants above and under 70 yrs, respectively. Similarly, for the identification of MCI, cutoff points were 17.5 and 21.9 kg for females above 70 yrs and under 70 yrs, and 25.8 and 36.2 kg for males above 70 yrs and under 70 yrs, respectively. Conclusions Our study provided the further knowledge on the relationship between noncognitive features and cognition in populations with differing cognitive status, revealed that the stronger handgrip strength was associated with better performances on cognitive function. It can be speculated that handgrip strength can help early recognition of Chinese AD patients.
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Affiliation(s)
- Hang Su
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, 200233, Shanghai, China
| | - Xiaokang Sun
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, 200233, Shanghai, China
| | - Fang Li
- Department of Neurology, Fuxing Hospital, Capital Medical University, Beijing, China.
| | - Qihao Guo
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, 200233, Shanghai, China.
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12
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Zhang L, Li T, Lei Y, Cheng G, Liu B, Yu Y, Yin H, Song L, La Q, Li B, Bao W, Guo Z, Rong S. Association between sleep structure and amnesic mild cognitive impairment in patients with insomnia disorder: a case-control study. J Clin Sleep Med 2021; 17:37-43. [PMID: 32946373 DOI: 10.5664/jcsm.8804] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
STUDY OBJECTIVES To examine the association between sleep structure and amnesic mild cognitive impairment (aMCI) in patients with insomnia disorder. METHODS A total of 256 patients with insomnia disorder were diagnosed by neurologists, 45 of whom were diagnosed with aMCI according to the Petersen criteria, and 45 participants with intact cognition were chosen as controls matched for age and education. A case-control study was conducted to compare sleep structure between aMCI and control patients with insomnia disorder. We evaluated self-reported sleep problems by the Insomnia Severity Index and objective sleep features by polysomnography. Logistic regression models were used to estimate the associations between sleep parameters and aMCI in patients with insomnia disorder. RESULTS There was no significant difference in Insomnia Severity Index scores between the aMCI and control groups. In the logistic regression after adjustment for covariates, people with a longer sleep duration (adjusted odds ratio [aOR] = 0.56, 95% confidence interval [CI]: 0.36-0.89), greater sleep efficiency (aOR = 0.50, 95% CI: 0.32-0.77), and a higher percentage of total sleep time in stage 3 of non-rapid eye movement sleep (N3%) (aOR = 0.02, 95% CI: 0.01-0.15) have a lower relative probability of having aMCI. By contrast, higher N1% (aOR = 2.28, 95% CI: 1.36-3.82) and wake after sleep onset (aOR = 1.31, 95% CI: 1.11-1.55) may be risk factors for aMCI in patients with insomnia. CONCLUSIONS In patients with insomnia disorder, sleep duration, sleep fragmentation, sleep efficiency, N1% and N3% were independently associated with the presence of aMCI. In the clinical setting, if patients with insomnia show much more serious abnormalities in these sleep indices, clinicians should pay attention to their cognitive function. In-depth research would also be worthwhile to elaborate the causality between sleep and cognitive decline.
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Affiliation(s)
- Li Zhang
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, China
| | - Tingting Li
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Yuhua Lei
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Guangwen Cheng
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Buyun Liu
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - YongFei Yu
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, China
| | - HongXiang Yin
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, China
| | - Lin Song
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, China
| | - Qiong La
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, China
| | - Benchao Li
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - ZhenLi Guo
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, China
| | - Shuang Rong
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
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13
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Wang Y, Liu W, Chen K, Shen X. Postoperative Delirium is Not Associated with Long-Term Decline in Activities of Daily Living or Mortality After Laryngectomy. Clin Interv Aging 2021; 16:823-831. [PMID: 34040359 PMCID: PMC8139736 DOI: 10.2147/cia.s303800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/23/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine the relationships between postoperative delirium (POD) and postoperative activities of daily living (ADL) and mortality in patients undergoing laryngectomy. We hypothesized that POD would reduce postoperative ADL and increase postoperative mortality. Patients and Methods The prospective study included older participants (age ≥65 y) undergoing total laryngectomy, partial laryngectomy, total laryngectomy plus neck dissection, or partial laryngectomy plus neck dissection under general anesthesia. The diagnosis of delirium was based on the Confusion Assessment Method algorithm, which was administered on postoperative days 1 through 6. ADL were evaluated using the Chinese version of the Index of ADL scale. Follow-up assessments of ADL and mortality were conducted 24 months after surgery. Results Of 127 participants (aged 70.3 ± 4.1 y), 19 (15.0%) developed POD. POD was not associated with a decrease in ADL after laryngectomy (p=0.599) nor with an increase in postoperative mortality [3/19 (15.8%) vs 12/108 (11.1%), p=0.560, Log rank test]. However, longer surgery duration was significantly associated with worse overall survival (OR, 3.262; 95% CI, 1.261–9.169, p=0.025). Conclusion POD was not associated with long-term ADL or mortality after laryngectomy. Prolonged surgery was the only factor associated with a higher postoperative mortality rate.
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Affiliation(s)
- Yiru Wang
- Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, People's Republic of China
| | - Weiwei Liu
- Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, People's Republic of China
| | - Kaizheng Chen
- Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, People's Republic of China
| | - Xia Shen
- Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, People's Republic of China
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14
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Tang L, Fang P, Fang Y, Lu Y, Xu G, Liu X. Comparison of Effects between Combined Lumbar-Sacral Plexus Block plus General Anesthesia and Unilateral Spinal Anesthesia in Elderly Patients Undergoing Hip Fracture Surgery: A Pilot Randomized Controlled Trial. Evid Based Complement Alternat Med 2021; 2021:6685497. [PMID: 34012474 DOI: 10.1155/2021/6685497] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/11/2021] [Accepted: 04/16/2021] [Indexed: 11/18/2022]
Abstract
Purpose Hip fracture is a common injury in geriatric populations, which is associated with poor quality of life. However, the ideal anesthesia technique for this disease is yet to be identified. This study aimed to compare the combined lumbar-sacral plexus block (CLSB) plus general anesthesia (bispectral index (BIS) 60–80) with the unilateral spinal anesthesia (SA) on activity of daily living in elderly patients undergoing hip fracture surgery. Methods A total of 124 elderly patients undergoing hip fracture surgery were randomly assigned to two groups. Patients in the SA group received light-specific gravity spinal anesthesia, and patients in the CLSB group received lumbar and sacral plexus block with general anesthesia (BIS 60–80). The primary outcomes were 30-day activity of daily living (ADL). The secondary outcomes were postoperative pain scores, postoperative delirium, in-hospital cost, and major complications. Results The ADL scores of postoperative day 30 (POD30) in the CLSB group are higher than those in the SA group (27.34 ± 7.01 versus 24.70 ± 6.40, P=0.045). Compared to preoperative ADL scores, there were higher increased scores in the CLSB group than in POD30 (CLSB group 8.09 ± 3.39 versus SA group 4.87 ± 3.90, P < 0.001). Mild-to-moderate pain did not have differences between the two groups (rest pain: 3 versus 2, P=0.344; motion pain: 5 versus 4, P=0.073). There were no significant differences in incidence of postoperative delirium, PONV, and other complications. Conclusion The unilateral SA can reduce the deterioration of ADL after hip fracture surgery and provide a better postoperative recovery.
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15
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Shao Y, Xu H, Wang J, Dai X, Liang W, Ren L, Wang Y. Agitation and apathy increase risk of dementia in psychiatric inpatients with late-onset psychiatric symptoms. BMC Psychiatry 2021; 21:214. [PMID: 33910556 PMCID: PMC8080316 DOI: 10.1186/s12888-021-03210-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 04/06/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND A diagnosis of dementia in middle-aged and elder people is often complicated by physical frailty and comorbid neuropsychiatric symptoms (NPSs). Previous studies have identified NPSs as a risk factor for dementia. The aim of this study was to figure out to what extent individual NPS and certain demographic factors increased the risk of dementia in middle-aged and senior psychiatric inpatients. METHODS One hundred twenty-seven middle-aged and senior patients admitted to psychiatric wards for late-onset (age ≥ 50 years) psychiatric symptoms were included and categorized into dementia or non-demented psychiatric disorders (NDPD). The patients' demographic information and medical records were collected during the first hospitalization and subjected to statistical analyses. RESULTS 41.73% of the registered psychiatric inpatients were diagnosed as dementia in which Alzheimer's disease (AD) was the dominant subtype. The NDPD group consisted of nine individual diagnoses, except for schizophrenia. The frequencies of dementia inpatients increased with first episode age while that of NDPD inpatients decreased with first episode age. In the enrolled inpatients, most of dementia patients were males while females accounted for a higher proportion of NDPD patients. 58.49% of enrolled dementia inpatients presented cognitive deficit (CD) as the initial symptom while the remaining 41.51% showed NPS as initial symptom. Of the 12 NPSs, agitation and apathy greatly and significantly increased risk of dementia in psychiatric inpatients with late-onset psychiatric symptoms. CONCLUSIONS These results added evidence that the demented patients admitted to psychiatric ward are more likely to be male, older first episode age, and have characteristic NPS including aberrant motor behavior (AMB), hallucinations, agitation, irritability and apathy. Further, this study emphasized the importance of agitation and apathy of NPSs functioning as risk factors of dementia in these inpatients.
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Affiliation(s)
- Yuan Shao
- grid.452897.50000 0004 6091 8446Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Haiyun Xu
- grid.268099.c0000 0001 0348 3990The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Jian Wang
- grid.452897.50000 0004 6091 8446Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Xijian Dai
- grid.452897.50000 0004 6091 8446Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Wei Liang
- grid.452897.50000 0004 6091 8446Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Lina Ren
- grid.452897.50000 0004 6091 8446Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Yongjun Wang
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China.
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16
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Tay MRJ, Ong PL, Puah SH, Tham SL. Acute Functional Outcomes in Critically Ill COVID-19 Patients. Front Med (Lausanne) 2021; 7:615997. [PMID: 33537333 PMCID: PMC7847990 DOI: 10.3389/fmed.2020.615997] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/21/2020] [Indexed: 01/08/2023] Open
Abstract
Background: COVID-19 (Coronavirus Disease 2019) is a global cause of morbidity and mortality currently. We aim to describe the acute functional outcomes of critically ill coronavirus disease 2019 (COVID-19) patients after transferring out of the intensive care unit (ICU). Methods: 51 consecutive critically ill COVID-19 patients at a national designated center for COVID-19 were included in this exploratory, retrospective observational cohort study from January 1 to May 31, 2020. Demographic and clinical data were collected and analyzed. Functional outcomes were measured primarily with the Functional Ambulation Category (FAC), and divided into 2 categories: dependent ambulators (FAC 0–3) and independent ambulators (FAC 4–5). Multivariate analysis was performed to determine associations. Results: Many patients were dependent ambulators (47.1%) upon transferring out of ICU, although 92.2% regained independent ambulation at discharge. On multivariate analysis, we found that a Charlson Comorbidity Index of 1 or more (odds ratio 14.02, 95% CI 1.15–171.28, P = 0.039) and a longer length of ICU stay (odds ratio 1.50, 95% CI 1.04–2.16, P = 0.029) were associated with dependent ambulation upon discharge from ICU. Conclusions: Critically ill COVID-19 survivors have a high level of impairment following discharge from ICU. Such patients should be screened for impairment and managed appropriately by rehabilitation professionals, so as to achieve good functional outcomes on discharge.
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Affiliation(s)
- Matthew Rong Jie Tay
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Poo Lee Ong
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Ser Hon Puah
- Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Shuen Loong Tham
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore, Singapore
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17
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Hao W, Li J, Fu P, Zhao D, Jing Z, Wang Y, Yu C, Yuan Y, Zhou C. Physical frailty and health-related quality of life among Chinese rural older adults: a moderated mediation analysis of physical disability and physical activity. BMJ Open 2021; 11:e042496. [PMID: 33419914 PMCID: PMC7799141 DOI: 10.1136/bmjopen-2020-042496] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The purpose of this study is to explore the mediating effect of physical disability as well as the role of physical activity (PA) as a moderator in the relationship between physical frailty and health-related quality of life (HRQoL) among rural older adults in China. DESIGN Cross-sectional analysis. SETTING Rural households in Shandong of China (Rushan, Qufu, Laolin). PARTICIPANTS AND METHODS A survey was conducted among 3243 rural older adults. The data were collected using questionnaires measuring physical frailty, physical disability, HRQoL and PA. Bootstrap analyses were employed to explore the mediating effect of physical disability and also the moderating role of PA on physical frailty and HRQoL. RESULTS After controlling for age and education, physical disability partially mediated the effect of physical frailty on HRQoL (indirect effect=-0.143, 95% CI -0.175 to -0.113), with the mediating effect accounting for 33.71% of the total effect. PA moderated the relationship between physical frailty and physical disability as well as the relationship between physical disability and HRQoL. Specifically, the interaction term between physical frailty and PA significantly predicted physical disability (β=-0.120, t=-7.058, p<0.001), and the interaction term between physical disability and PA also had a significant predictive effect on HRQoL (β=0.115, t=6.104, p<0.001). CONCLUSIONS PA appears to moderate the indirect effect of physical disability on the association between physical frailty and HRQoL. This study provides support for potential mechanisms in the association between physical frailty and HRQoL. Encouraging rural older adults to increase PA appropriately might improve HRQoL for older adults with physical frailty and physical disability problems.
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Affiliation(s)
- Wenting Hao
- Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jie Li
- Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Peipei Fu
- Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Dan Zhao
- Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Zhengyue Jing
- Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yi Wang
- Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Caiting Yu
- Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yemin Yuan
- Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
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Lin W, Bao WQ, Ge JJ, Yang LK, Ling ZP, Xu X, Jiang JH, Zuo CT, Wang YH. Forniceal deep brain stimulation in severe Alzheimer’s disease: A case report. World J Clin Cases 2020; 8:4938-4945. [PMID: 33195664 PMCID: PMC7642571 DOI: 10.12998/wjcc.v8.i20.4938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/11/2020] [Accepted: 09/16/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Forniceal deep brain stimulation (DBS) has been proposed as an alternative treatment for Alzheimer’s disease (AD). Previous studies on mild to moderate AD patients demonstrated improvements in cognitive functions brought about by forniceal DBS. Here, we report our longitudinal findings in one severe AD patient for whom the activities of daily living (ADL) rather than cognitive function significantly improved after 3 mo of continuous stimulation.
CASE SUMMARY In 2011, a 62-year-old Chinese male with no previous history of brain injury or other neuropsychological diseases and no family history of dementia developed early symptoms of memory decline and cognitive impairment. Five years later, the symptoms had increased to the extent that they affected his daily living. He lost the ability to work as a businessman and to take care of himself. The patient was given a clinical diagnosis of probable AD and was prescribed donepezil and subsequently memantine, but no improvement in symptoms was observed. The patient then received DBS surgery. After 3 mo of continuous stimulation, the patient’s ADL score decreased from 65 points to 47 points, indicating the quality of the patient’s daily living improved distinctly. Other scores remained unchanged, suggesting no significant improvement in cognitive function. A follow-up positron emission tomography scan demonstrated perceivable increased glucose metabolism in the classical AD-related brain regions.
CONCLUSION Based on this case we hypothesize that forniceal DBS may improve ADL through elevating regional glucose metabolism in the brain.
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Affiliation(s)
- Wei Lin
- Department of Neurosurgery, Joint Logistics Support Unit No. 904 Hospital, Wuxi 214044, Jiangsu Province, China
| | - Wei-Qi Bao
- PET Center, Huashan Hospital, Fudan University, Shanghai 200235, China
| | - Jing-Jie Ge
- PET Center, Huashan Hospital, Fudan University, Shanghai 200235, China
| | - Li-Kun Yang
- Department of Neurosurgery, Joint Logistics Support Unit No. 904 Hospital, Wuxi 214044, Jiangsu Province, China
| | - Zhi-Pei Ling
- Department of Neurosurgery, PLA General Hospital, PLA Postgraduate Medical School, Beijing 100039, China
| | - Xin Xu
- Department of Neurosurgery, PLA General Hospital, PLA Postgraduate Medical School, Beijing 100039, China
| | - Jie-Hui Jiang
- School of Communication and Information Technology, Institute of Biomedical Engineering, Shanghai University, Shanghai 200444, China
| | - Chuan-Tao Zuo
- PET Center, Huashan Hospital, Fudan University, Shanghai 200235, China
| | - Yu-Hai Wang
- Department of Neurosurgery, Joint Logistics Support Unit No. 904 Hospital, Wuxi 214044, Jiangsu Province, China
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Feng X, Jia Y, Cao X, Ji T, Zhao Y, Tian H, Li N, Cheng Z, Chen L. Morita therapy for schizophrenia: An updated meta-analysis. Asian J Psychiatr 2020; 53:102169. [PMID: 32446215 DOI: 10.1016/j.ajp.2020.102169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 01/07/2023]
Abstract
Morita therapy was developed for common mental problems, and our aim was to evaluate the clinical effect of Morita therapy on schizophrenia. The literature was searched in 10 databases, namely, PubMed, Chinese National Knowledge Infrastructure (CNKI), Sinomed, Wanfang, Cochrane Library, UpToDate, Web of Science, Medline, PsycINFO and Embase, from inception to September 4, 2019. Random-effects models were used. For continuous results, the standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated to synthesize the effects. Thirty studies were included, with a total of 2651 patients with schizophrenia. Compared to pharmacotherapy alone and standard care alone, Morita therapy plus pharmacotherapy and Morita therapy plus standard care both had significant effects on mental state (pooled effect size = -1.09, 95% CI: -0.35, -0.83), social functioning (pooled effect size = -0.61, 95% CI: -2.30, -0.92) and behavior (pooled effect size = 1.13, 95% CI: 0.75, 1.51). Significant heterogeneity between studies was found for mental state (I2 = 89%, p < 0.05) and social functioning (I2 = 95%, p < 0.05), but no heterogeneity was found for behavior (I2 = 0%, p = 0.84). Morita therapy has positive effects on mental state and social functioning among patients with schizophrenia, but it leads to some problems with behavior among these patients. Most included studies have unclear bias, and the forest plots show high heterogeneity among the results. Thus, Morita therapy cannot be implemented in clinical practice as a feasible strategy, the conclusion has yet to be confirmed, and new trials and future studies are desired.
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Affiliation(s)
- Xuezhu Feng
- School of Nursing, Jilin University, NO.965 Xinjiang Street, Changchun, 130021, China
| | - Yong Jia
- School of Nursing, Jilin University, NO.965 Xinjiang Street, Changchun, 130021, China
| | - Xuelian Cao
- School of Nursing, Jilin University, NO.965 Xinjiang Street, Changchun, 130021, China
| | - Tianyi Ji
- College of Pharmacy, Jilin University, No. 965 Xinjiang Street Changchun, 130021, China
| | - Yawei Zhao
- Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, 130021, China
| | - Huimin Tian
- School of Nursing, Jilin University, NO.965 Xinjiang Street, Changchun, 130021, China
| | - Na Li
- Laboratory of Molecular Pharmacology, Jilin Provincial Key Laboratory of BioMacromolecules of Chinese Medicine, Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, 130117, Jilin, China
| | - Zhaohua Cheng
- Hepatobiliary and Pancreatic Surgery Department, The Second Hospital Jilin University, Changchun, China.
| | - Li Chen
- School of Nursing, Jilin University, NO.965 Xinjiang Street, Changchun, 130021, China; Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, 130021, China.
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Xing Y, Zhu Z, Du Y, Zhang J, Qu Q, Sun L, Li Y, Guo Y, Peng G, Liu Y, Yu Y, Qiao Y, Xie B, Shi X, Lu J, Jia J, Tang Y. The Efficacy of COGnitive tRaining in patiEnts with Amnestic mild coGnitive impairmENT (COG-REAGENT): Protocol for a Multi-Center Randomized Controlled Trial. J Alzheimers Dis 2020; 75:779-787. [PMID: 32333590 DOI: 10.3233/jad-191314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Yi Xing
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People’s Republic of China, Beijing, China
| | - Zude Zhu
- Collaborative Innovation Center for Language Ability, Jiangsu Normal University, Xuzhou, China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Junjian Zhang
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Qiumin Qu
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Li Sun
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Yang Li
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yanjun Guo
- Department of Neurology, Beijing Friendship Hospital, Beijing, China
| | - Guoping Peng
- Department of Neurology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Yong Liu
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Yueyi Yu
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People’s Republic of China, Beijing, China
| | - Yuchen Qiao
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People’s Republic of China, Beijing, China
| | - Beijia Xie
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People’s Republic of China, Beijing, China
| | - Xinrui Shi
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People’s Republic of China, Beijing, China
| | - Jie Lu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jianping Jia
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People’s Republic of China, Beijing, China
| | - Yi Tang
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People’s Republic of China, Beijing, China
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Shi Z, Cao X, Hu J, Jiang L, Mei X, Zheng H, Chen Y, Wang M, Cao J, Li W, Li T, Li C, Shen Y. Retinal nerve fiber layer thickness is associated with hippocampus and lingual gyrus volumes in nondemented older adults. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109824. [PMID: 31765713 DOI: 10.1016/j.pnpbp.2019.109824] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Abnormal retina structures, such as thinner retinal nerve fiber layer (RNFL), have been frequently reported in patients with Alzheimer's disease (AD). However, the association between RNFL and brain structures in cognitively normal adults remains unknown. We therefore set out to conduct a cross-sectional investigation to determine whether RNFL thickness is associated with brain structure volumes in nondemented older adults. METHODS We measured RNFL thickness by optical coherence tomography and brain structure volumes by 3 T magnetic resonance imaging. Cognitive function was assessed using the Chinese version of Repeatable Battery for the Assessment of Neurological Status. Pearson correlation was initially employed to screen for the potential associations among RNFL thickness, brain structure volumes and cognitive function. And then, multivariable linear regression models were conducted to further examine such associations adjusting for possible confounding factors, including age, sex, years of education and the estimated total intracranial volume (eTIV). RESULTS 113 participants (≥ 65 years old) were screened and 80 of them (mean age: 68 ± 5.3 years; 48% male) were included in the final analysis. RNFL thickness in temporal quadrant was associated with medial temporal lobes volumes [unadjusted: r = 0.155, P = 0.175; adjusted: β = 0.205 (0.014, 0.383), P = 0.035], and especially associated with the hippocampus volume [unadjusted: r = 0.213, P = 0.062; adjusted: β = 0.251 (0.060, 0.435), P = 0.011] after adjusted for age, sex, years of education and eTIV. Moreover, it showed that RNFL thickness in inferior quadrant [unadjusted: r = 0.221, P = 0.052; adjusted: β = 0.226 (0.010. 0.446), P = 0.041] was significantly associated with occipital lobes volumes after the adjustment of age, sex, years of education and eTIV, and selectively associated with the substructure of lingual gyrus volume [unadjusted: r = 0.223, P = 0.050; adjusted: β = 0.278 (0.058, 0.487), P = 0.014]. In addition, average RNFL thickness was associated with the cognitive domain of visuospatial/constructional [unadjusted: r = 0.114, P = 0.322; adjusted: β = 0.216 (0.006, 0.426), P = 0.044] after the adjustment in these nondemented older adults. CONCLUSIONS Quadrant-specific associations exist between RNFL thickness and brain regions vulnerable to aging or neurodegeneration in older adults with normal cognition. These findings would promote further investigations into using RNFL as a noninvasive and less expensive biomarker of neurocognitive aging and AD-related neurodegeneration.
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Affiliation(s)
- Zhongyong Shi
- Department of Psychiatry, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, PR China; Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai 200072, PR China
| | - Xinyi Cao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - Jingxiao Hu
- Soochow University School of Medicine, Suzhou 215006, PR China
| | - Lijuan Jiang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - Xinchun Mei
- Department of Psychiatry, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, PR China; Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai 200072, PR China
| | - Hailin Zheng
- Department of Psychiatry, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, PR China; Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai 200072, PR China
| | - Yupeng Chen
- Department of Psychiatry, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, PR China; Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai 200072, PR China
| | - Meijuan Wang
- Department of Psychiatry, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, PR China
| | - Jing Cao
- Department of Psychiatry, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, PR China
| | - Wei Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China
| | - Ting Li
- Department of Geriatric Psychiatry, Shanghai, Changning Mental Health Center, Shanghai 200335, PR China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai 200030, PR China.
| | - Yuan Shen
- Department of Psychiatry, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, PR China; Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai 200072, PR China.
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Chen YY, Wang CC, Kao TW, Wu CJ, Chen YJ, Lai CH, Zhou YC, Chen WL. The relationship between lead and cadmium levels and functional dependence among elderly participants. Environ Sci Pollut Res Int 2020; 27:5932-5940. [PMID: 31863379 DOI: 10.1007/s11356-019-07381-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023]
Abstract
The adverse impacts of lead and cadmium exposure on health outcomes have been reported in the past. Few studies have been conducted on the relationship between lead and cadmium exposures and disability. We evaluated whether lead and cadmium exposures were associated with functional dependence including the total number of disabilities, activities of daily living (ADL), instrumental activities of daily living (IADL), leisure and social activities (LSA), lower extremity mobility (LEM), and general physical activities (GPA) in an elderly population. A total of 5513 eligible subjects were enrolled in the study from the National Health and Nutrition Examination Survey 2001-2006. Serum lead and cadmium exposure assessments were performed using atomic absorption spectrometry. Functional dependence was assessed by 19 structured questions. The relationships between lead and cadmium exposures and functional dependence were investigated using by multivariable linear regression models. Q2, Q3, and Q4 of lead exposure were significantly associated with the total number of disabilities, with β coefficients of - 0.62 (95% CI - 0.99, - 0.24), - 0.64 (95% CI - 1.02, - 0.26), and - 0.81 (95% CI - 1.19, - 0.42), respectively. This relationship remained significant in males. Furthermore, we analyzed the relationships between lead and cadmium exposure quartiles and various functional dependence metrics, and we determined that lead content was significantly associated with decreased ADL, LEM, and GPA (p < 0.05) and cadmium content was inversely associated with ADL (p < 0.05). Our study demonstrated a strong relationship between exposure to lead and cadmium and functional dependence in an elderly population.
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Affiliation(s)
- Yuan-Yuei Chen
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Department of General Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Chen-Jung Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, Republic of China
| | - Ying-Jen Chen
- Department of Ophthalmology, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Ching-Huang Lai
- School of Public Health, National Defense Medical Center, Taipei, Republic of China
| | - Yi-Chao Zhou
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
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Shi Z, Mei X, Li C, Chen Y, Zheng H, Wu Y, Zheng H, Liu L, Marcantonio ER, Xie Z, Shen Y. Postoperative Delirium Is Associated with Long-term Decline in Activities of Daily Living. Anesthesiology 2020; 131:492-500. [PMID: 31335550 DOI: 10.1097/aln.0000000000002849] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Postoperative delirium is one of the most common complications in the elderly surgical population. However, its long-term outcomes remain largely to be determined. Therefore a prospective cohort study was conducted to determine the association between postoperative delirium and long-term decline in activities of daily living and postoperative mortality. The hypothesis in the present study was that postoperative delirium was associated with a greater decline in activities of daily living and higher mortality within 24 to 36 months after anesthesia and surgery. METHODS The participants (at least 65 yr old) having the surgeries of (1) proximal femoral nail, (2) hip replacement, or (3) open reduction and internal fixation under general anesthesia were enrolled. The Confusion Assessment Method algorithm was administered to diagnose delirium before and on the first, second, and fourth days after the surgery. Activities of daily living were evaluated by using the Chinese version of the activities of daily living scale (range, 14 to 56 points), and preoperative cognitive function was assessed by using the Chinese Mini-Mental State Examination (range, 0 to 30 points). The follow-up assessments, including activities of daily living and mortality, were conducted between 24 and 36 months after anesthesia and surgery. RESULTS Of 130 participants (80 ± 6 yr, 24% male), 34 (26%) developed postoperative delirium during the hospitalization. There were 32% of the participants who were lost to follow-up, resulting in 88 participants who were finally included in the data analysis. The participants with postoperative delirium had a greater decline in activities of daily living (16 ± 15 vs. 9 ± 15, P = 0.037) and higher 36-month mortality (8 of 28, 29% vs. 7 of 75, 9%; P = 0.009) as compared with the participants without postoperative delirium. CONCLUSIONS Postoperative delirium was associated with long-term detrimental outcomes, including greater decline in activities of daily living and a higher rate of postoperative mortality.
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Affiliation(s)
- Zhongyong Shi
- From the Department of Psychiatry, Shanghai Tenth People's Hospital, Anesthesia and Brain Research Institute (Z.S., X.M., Y.C., Hailin Zheng, Y.W., Y.S.) Department of Anesthesiology (C.L.), Tongji University School of Medicine, Shanghai, China the Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine (Z.S., Z.X.) the Biostatistics Center (Hui Zheng), Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts the Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China (L.L.) the Divisions of General Medicine and Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (E.R.M.)
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Shi Z, Zheng H, Hu J, Jiang L, Cao X, Chen Y, Mei X, Li C, Shen Y. Retinal Nerve Fiber Layer Thinning Is Associated With Brain Atrophy: A Longitudinal Study in Nondemented Older Adults. Front Aging Neurosci 2019; 11:69. [PMID: 31031615 PMCID: PMC6470389 DOI: 10.3389/fnagi.2019.00069] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/12/2019] [Indexed: 12/11/2022] Open
Abstract
Backgrounds: Abnormal retinal nerve fiber layer (RNFL) thickness has been observed in patients with Alzheimer’s disease (AD) and therefore suggested to be a potential biomarker of AD. However, whether the changes in RNFL thickness are associated with the atrophy of brain structure volumes remains unknown. We, therefore, set out a prospective investigation to determine the association between longitudinal changes of RNFL thickness and brain atrophy in nondemented older participants over a period of 12 months. Materials and Methods: We measured the RNFL thickness using optical coherence tomography (OCT) and brain structure volumes by 3T magnetic resonance imaging (MRI) before and after 12 months. Cognitive function was assessed using the Chinese version of Mini-Mental State Examination (CMMSE) and Repeatable Battery for the Assessment of Neurological Status. Associations among the changes of RNFL, brain structures and cognitive function were analyzed with Spearman correlation and multiple linear regression models adjusting for the confounding factors. Results: Fifty old participants were screened and 40 participants (mean age 71.8 ± 3.9 years, 60% were male) were enrolled at baseline. Among them, 28 participants completed the follow-up assessments. The average reduction of RNFL thickness was inversely associated with the decrease of central cingulate cortex volume after the adjustment of age and total intracranial volume (β = −0.41, P = 0.039). Specifically, the reduction of RNFL thickness in the inferior, not other quadrants, was independently associated with the decline of central cingulate cortex volume after the adjustment (β = −0.52, P = 0.006). Moreover, RNFL thinning, central cingulate cortex atrophy and the aggregation of white matter hyperintensities (WMH) were found associated with episodic memory in these older adults with normal cognition. Conclusions: RNFL thinning was associated with cingulate cortex atrophy and episodic memory decline in old participants. The longitudinal changes of RNFL thickness are suggested to be a useful complementary index of neurocognitive aging or neurodegeneration.
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Affiliation(s)
- Zhongyong Shi
- Department of Psychiatry, Shanghai 10th People's Hospital, Tongji University, Shanghai, China.,Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, China
| | - Hailin Zheng
- Department of Psychiatry, Shanghai 10th People's Hospital, Tongji University, Shanghai, China.,Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, China
| | - Jingxiao Hu
- Department of Psychiatry, Shanghai 10th People's Hospital, Tongji University, Shanghai, China.,Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, China
| | - Lijuan Jiang
- Shanghai Key Laboratory of Psychiatric Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyi Cao
- Shanghai Key Laboratory of Psychiatric Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yupeng Chen
- Department of Psychiatry, Shanghai 10th People's Hospital, Tongji University, Shanghai, China.,Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, China
| | - Xinchun Mei
- Department of Psychiatry, Shanghai 10th People's Hospital, Tongji University, Shanghai, China.,Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychiatric Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - Yuan Shen
- Department of Psychiatry, Shanghai 10th People's Hospital, Tongji University, Shanghai, China.,Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, China
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Pang SM, Chan KS, Chung BP, Lau KS, Leung EM, Leung AW, Chan HY, Chan TM. Assessing Quality of Life of Patients with Advanced Chronic Obstructive Pulmonary Disease in the End of Life. J Palliat Care 2019. [DOI: 10.1177/082585970502100311] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Given the limitations of existing health-related quality-of-life (QOL) measures in capturing the end-of-life experience of patients with advanced chronic diseases, an empirically grounded instrument, the quality-of-life concerns in the end of life questionnaire (QOLC-E), was developed. Though it was built on the McGill quality of life questionnaire (MQOL), its sphere is more holistic and culturally specific for the Chinese patients in Hong Kong. One hundred and forty-nine patients with advanced chronic obstructive pulmonary disease (COPD) or metastatic cancer completed the questionnaire. Seven factors (28 items) which emerged from the factor analysis were grouped into four positive (support, value of life, food-related concerns, and healthcare concerns) and four negative (physical discomfort, negative emotions, sense of alienation, and existential distress) subscales. Good internal consistency and concurrent validity were shown. The results also revealed that these two groups of patients had similar QOL concerns. The validity of applying QOLC-E as an outcome measure to evaluate the effectiveness of palliative and psychoexistential interventions has yet to be tested.
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Affiliation(s)
| | - Kin-Sang Chan
- Pulmonary and Palliative Care, Haven of Hope Hospital
| | | | - Kam-Shing Lau
- Department of Respiratory Medicine, Ruttonjee Hospital
| | | | | | | | - Tony M.F. Chan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
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Yang JW, Shi GX, Zhang S, Tu JF, Wang LQ, Yan CQ, Lin LL, Liu BZ, Wang J, Sun SF, Yang BF, Wu LY, Tan C, Chen S, Zhang ZJ, Fisher M, Liu CZ. Effectiveness of acupuncture for vascular cognitive impairment no dementia: a randomized controlled trial. Clin Rehabil 2019; 33:642-652. [PMID: 30672317 DOI: 10.1177/0269215518819050] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE: To evaluate the effectiveness of acupuncture in patients with vascular cognitive impairment no dementia (VCIND) in comparison with citicoline, an agent for cognitive disturbances associated with chronic cerebral disorders. DESIGN: A randomized controlled multicenter trial. SETTING: In three hospitals in Beijing, China. SUBJECTS: A total of 216 patients with VCIND were recruited. INTERVENTIONS: Patients with VCIND (mean age of 65.4 years) were randomized to receive acupuncture (two sessions per week) or oral citicoline (100 mg three times daily) over three months. MAIN MEASURES: The primary outcome was the change from baseline to three months in cognitive symptom, measured by Alzheimer's disease Assessment Scale, cognitive subscale (ADAS-cog). Secondary outcomes included changes from baseline to six months in ADAS-cog, executive function measured by the Clock Drawing Test (CDT), and functional disability measured by the Ability of Daily Living (ADL) scale at three and six months. RESULTS: At three months, the acupuncture group had a greater decrease in mean ADAS-cog score (-2.33 ± 0.31) than the citicoline group (-1.38 ± 0.34) with a mean difference of -0.95 (95% CI, -1.84 to -0.07, P = 0.035). The mean change from baseline to six months in ADAS-cog also significantly favored acupuncture treatments (acupuncture change -2.61 vs citicoline -1.25, difference: -1.36 points; 95% CI, -2.20 to -0.51; P = 0.002). There was no difference between the two groups on CDT and ADL scores at either time point. CONCLUSION: Compared with citicoline, acupuncture has comparable and even superior efficacy with improved cognitive and daily living performance as a complementary and alternative medicine treatment for VCIND.
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Affiliation(s)
- Jing-Wen Yang
- 1 Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Guang-Xia Shi
- 2 Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
| | - Shuai Zhang
- 1 Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jian-Feng Tu
- 2 Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
| | - Li-Qiong Wang
- 1 Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Chao-Qun Yan
- 1 Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Lu-Lu Lin
- 1 Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Bao-Zhen Liu
- 3 Department of Acupuncture and Moxibustion, Beijing Huairou District Hospital of Traditional Chinese Medicine, Beijing, China
| | - Jun Wang
- 4 Department of Acupuncture and Moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - San-Feng Sun
- 3 Department of Acupuncture and Moxibustion, Beijing Huairou District Hospital of Traditional Chinese Medicine, Beijing, China
| | - Bo-Feng Yang
- 1 Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Li-Yu Wu
- 3 Department of Acupuncture and Moxibustion, Beijing Huairou District Hospital of Traditional Chinese Medicine, Beijing, China
| | - Cheng Tan
- 4 Department of Acupuncture and Moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Sheng Chen
- 4 Department of Acupuncture and Moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Zhang-Jin Zhang
- 5 School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Marc Fisher
- 6 Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Cun-Zhi Liu
- 1 Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
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Jing L, Jin Y, Zhang X, Wang F, Song Y, Xing F. The effect of Baduanjin qigong combined with CBT on physical fitness and psychological health of elderly housebound. Medicine (Baltimore) 2018; 97:e13654. [PMID: 30572482 PMCID: PMC6320153 DOI: 10.1097/md.0000000000013654] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 08/24/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND To investigate the effectiveness of Baduanjin qigong combined with cognitive-behavior therapy (CBT) on the physical fitness and psychological health of elderly housebound. MATERIALS AND METHODS The 120 elderly housebound were randomly divided into 3 intervention groups: Baduanjin training, Baduanjin training combined with CBT, and CBT. The interventions were conducted by means of home visits over 6 months. Spirometry, SF-36 health survey of quality of life, and Lawton and Brody Instrumental Activities of Daily Living Scale (IADL) were used to collect physical health data, and self-evaluation of overall health status, self-evaluation of loneliness, and short-form geriatric depression scale (GDS-15) were used to collect mental health data at baseline, 3 months, and 6 months after intervention. Data was analyzed by repeated measures analysis of variance (rANOVA) and chi-squared test (χ test). RESULTS Forced vital capacity (FVC), maximum voluntary ventilation (MVV), quality of life (QOL), and self-reported health status were significantly increased (P < .05) in the group receiving joint Baduanjin and CBT intervention at 3 months and 6 months, as compared to the Baduanjin only group or the CBT only group. Activities of daily living (ADL), self-evaluated loneliness, and level of depression were significantly lowered (P < .05) in the group receiving joint Baduanjin and CBT intervention at 3 months and 6 months, as compared to the Baduanjin only group or the CBT only group. CONCLUSIONS Physical and psychological statuses of elderly housebound were significantly improved by Baduanjin training combined with CBT. The effect of the combined intervention exceeded that of CBT or Baduanjin alone.
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Affiliation(s)
- Liwei Jing
- National Academy of Development and Strategy, Renmin University of China
| | - Yanpeng Jin
- Nursing and Rehabilitation College, North China University of Science and Technology, Tangshan, China
| | - Xiaoli Zhang
- Nursing and Rehabilitation College, North China University of Science and Technology, Tangshan, China
| | - Fenglan Wang
- Nursing and Rehabilitation College, North China University of Science and Technology, Tangshan, China
| | - Yuyu Song
- Nursing and Rehabilitation College, North China University of Science and Technology, Tangshan, China
| | - Fengmei Xing
- Nursing and Rehabilitation College, North China University of Science and Technology, Tangshan, China
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28
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Li D, Hu N, Yu Y, Zhou A, Li F, Jia J. Trajectories of Multidimensional Caregiver Burden in Chinese Informal Caregivers for Dementia: Evidence from Exploratory and Confirmatory Factor Analysis of the Zarit Burden Interview. J Alzheimers Dis 2018; 59:1317-1325. [PMID: 28759966 DOI: 10.3233/jad-170172] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Despite its popularity, the latent structure of 22-item Zarit Burden Interview (ZBI) remains unclear. There has been no study exploring how caregiver multidimensional burden changed. OBJECTIVE The aim of the work was to validate the latent structure of ZBI and to investigate how multidimensional burden evolves with increasing global burden. METHODS We studied 1,132 dyads of dementia patients and their informal caregivers. The caregivers completed the ZBI and a questionnaire regarding caregiving. The total sample was randomly split into two equal subsamples. Exploratory factor analysis (EFA) was performed in the first subsample. In the second subsample, confirmatory factor analysis (CFA) was conducted to validate models generated from EFA. The mean of weighted factor score was calculated to assess the change of dimension burden against the increasing ZBI total score. RESULTS The result of EFA and CFA supported that a five-factor structure, including role strain, personal strain, incompetency, dependency, and guilt, had the best goodness-of-fit. The trajectories of multidimensional burden suggested that three different dimensions (guilt, role strain and personal strain) became the main subtype of burden in sequence as the ZBI total score increased from mild to moderate. Factor dependency contributed prominently to the total burden in severe stage. CONCLUSION The five-factor ZBI is a psychometrically robust measure for assessing multidimensional burden in Chinese caregivers. The changes of multidimensional burden have deepened our understanding of the psychological characteristics of caregiving beyond a single total score and may be useful for developing interventions to reduce caregiver burden.
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Affiliation(s)
- Dan Li
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, P.R. China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, P.R. China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, P.R. China.,Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, P.R. China.,National Clinical Research Center for Geriatric Disorders, Beijing, P.R. China
| | - Nan Hu
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Yueyi Yu
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, P.R. China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, P.R. China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, P.R. China.,Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, P.R. China.,National Clinical Research Center for Geriatric Disorders, Beijing, P.R. China
| | - Aihong Zhou
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, P.R. China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, P.R. China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, P.R. China.,Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, P.R. China.,National Clinical Research Center for Geriatric Disorders, Beijing, P.R. China
| | - Fangyu Li
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, P.R. China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, P.R. China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, P.R. China.,Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, P.R. China.,National Clinical Research Center for Geriatric Disorders, Beijing, P.R. China
| | - Jianping Jia
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, P.R. China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, P.R. China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, P.R. China.,Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, P.R. China.,National Clinical Research Center for Geriatric Disorders, Beijing, P.R. China
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29
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Ross CM. Application and Interpretation of Functional Outcome Measures for Testing Individuals With Cognitive Impairment. Topics in Geriatric Rehabilitation 2018; 34:13-35. [DOI: 10.1097/tgr.0000000000000171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Wu M, Yang Y, Zhang D, Zhao X, Sun Y, Xie H, Jia J, Su Y, Li Y. Association between social support and health-related quality of life among Chinese rural elders in nursing homes: the mediating role of resilience. Qual Life Res 2018; 27:783-92. [PMID: 29124499 DOI: 10.1007/s11136-017-1730-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aims to confirm the relationship between social support and health-related quality of life (HRQOL) among rural Chinese elders in nursing homes, and to examine the mediating role of resilience in the impact of social support on HRQOL. METHODS A cross-sectional survey of 205 elders aged 60 and above was conducted in five rural public nursing homes. Sociodemographic characteristics, the SF-36 questionnaire, and information about social support and resilience were collected. The researchers administered the questionnaires to the participants in a face-to-face setting. Descriptive analysis and a correlation matrix were used to indicate characteristics of the participants and bivariate correlations, respectively. The mediation analyses, composed of regression analysis and PROCESS analysis, were preformed to test both direct and indirect effects of social support on HRQOL, namely the mediating role of resilience. RESULTS Social support was positively related to HRQOL (β = 0.303, p < 0.001) among Chinese rural elders in nursing homes. The mediating role of resilience in the relationship between social support and HRQOL was confirmed (a*b bootstrapped 95% confidence interval = [0.098, 0.257]), which revealed that social support had an indirect effect on HRQOL through resilience. CONCLUSIONS Resilience partially mediates the relationship between social support and HRQOL. The mediation model provides a better understanding of how social support and resilience work together to affect HRQOL, and it could guide the interventions in health care for promoting HRQOL among Chinese rural elders in nursing homes.
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31
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Xiao S, Wang T, Ma X, Qin Y, Li X, Zhao Z, Liu X, Wang X, Xie H, Jiang Q, Sun L, Luo B, Shang L, Chen W, Bai Y, Tang M, He M, Wu L, Ma Q, Hou D, He J. Efficacy and safety of a novel acetylcholinesterase inhibitor octohydroaminoacridine in mild-to-moderate Alzheimer's disease: a Phase II multicenter randomised controlled trial. Age Ageing 2017; 46:767-773. [PMID: 28419192 DOI: 10.1093/ageing/afx045] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Indexed: 11/14/2022] Open
Abstract
Background inhibition of acetylcholinesterase (AChE) has been a effective treatment for Alzheimer's disease (AD). Octohydroaminoacridine, a new AChE inhibitor, is a potential treatment for AD. Method we conducted a multicenter, randomised, double blind, placebo-controlled, parallel-group Phase II clinical trial to investigate the effects of octohydroaminoacridine in patients with mild-to-moderate AD. Patients were randomised to receive placebo thrice daily, octohydroaminoacridine 1 mg/thrice daily (TID) (low-dose group), 2 mg/TID (middle-dose group) or 4 mg/TID (high-dose group). Doses in the middle-dose and high-dose group were titrated over 2-4 weeks. Changes from baseline to Week 16 were assessed with the AD Assessment Scale-Cognitive Subscale (ADAS-cog), Clinician's Interview-Based Impression of Change Plus (CIBIC+), activities of daily living (ADL) and the neuropsychiatric inventory (NPI). ADAS-cog was the primary end point of the study. A two-way analysis of covariance and least squares mean t-test were used. Results at Week 16, the changes from baseline in ADAS-cog were 1.4, -2.1, -2.2 and -4.2 for placebo, low-, middle- and high-dose groups, respectively. Patients in the high-dose group had better performance in CIBIC+ and ADL scores at the end of the study. There was no significant difference in the change in NPI score among the groups. The effects of octohydroaminoacridine were dose dependent, and were effective within 16 weeks of treatment. No evidence was found for more adverse events that occurred in different drug groups than placebo group. Conclusions octohydroaminoacridine significantly improved cognitive function and behaviour in patients with mild-to-moderate AD and this effect was dose dependent.
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Affiliation(s)
- Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiaotong University, Shanghai, China
| | - Tao Wang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiaotong University, Shanghai, China
| | - Xiuqiang Ma
- Department of Health Statistics, The Second Military Medical University, Shanghai, China
| | - Yingyi Qin
- Department of Health Statistics, The Second Military Medical University, Shanghai, China
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhongxin Zhao
- Department of Neurology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Xueyuan Liu
- Department of Neurology, The 10th People's Hospital, Tongji University, Shanghai, China
| | - Xiaoping Wang
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hengge Xie
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, China
| | - Qinpu Jiang
- Mental Health Center of Hebei Province, Baoding, Hebei Province, China
| | - Li Sun
- Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Benyan Luo
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Lan Shang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Weixian Chen
- Department of Geratology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Yan Bai
- Department of psychiatry, First Affiliated Hospital of Kunming Medicine University, Kunming, Yunnan Province, China
| | - Muni Tang
- Guangzhou Psychiatric Hospital, Guangzhou, Guangdong Province, China
| | - Maolin He
- Department of Neurology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Lan Wu
- Department of Neurology, Affiliated Hospital of Guilin Medical School, Guilin, Guangxi Province, China
| | - Qilin Ma
- Department of Neurology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China
| | - Deren Hou
- Neurological Department, The Third Xiangya Hospital of Central South University, Hunan Province, China
| | - Jia He
- Department of Health Statistics, The Second Military Medical University, Shanghai, China
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Cano-Gutiérrez C, Borda MG, Reyes-Ortiz C, Arciniegas AJ, Samper-Ternent R. Assessment of factors associated with functional status in 60 years-old and older adults in Bogotá, Colombia. Biomedica 2017; 37:57-65. [PMID: 28527267 DOI: 10.7705/biomedica.v37i1.3197] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 05/31/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Functional impairment produces a wide range of negative effects such as difficulty in mobility, social isolation, decreased quality of life, disability and institutionalization. Thus, functional status measurement is a marker of social wellbeing. OBJECTIVE To determine and characterize the socio-demographic factors and health conditions related to functional impairment in older adults in Bogotá, Colombia. MATERIALS AND METHODS Data was collected from the SABE Bogotá Study. Functional status was assessed using the Barthel and Lawton scales. Independent variables included socio-demographic factors, comorbidities, anthropometric measurements and physical activity (by tertiles). Bivariate analyzes were performed, and multivariate results were obtained using linear regression models. RESULTS There were 2,000 participants aged 60 years and older, with a mean age of 71.2 ± 8 years. Younger age (standardized beta = -0.15, p<0.01), fewer medications (beta= -0.13, p<0.01), higher MMSE score (beta = 0.3, p< 0.01), higher level of physical activity (middle beta tertile = 0.18, p<0.01, and higher beta tertile= 0.18, p<0.01vs lower tertile) and better performance in the handgrip test (beta= 0.10, p<0.01) were associated with better function in daily life instrumental activities. Similarly, higher MMSE score (beta= 0.3, p<0.01) and better performance in the handgrip test (beta= 0.07, p= 0.02) were associated with better function in daily life basic activities. CONCLUSIONS We found several factors related with functional impairment, which are likely to be modified to reduce dependence in this population.
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Wu M, Yang Y, Zhang D, Sun Y, Xie H, Zhang J, Jia J, Su Y. Prevalence and related factors of successful aging among Chinese rural elders living in nursing homes. Eur J Ageing 2017; 14:419-428. [PMID: 29180947 DOI: 10.1007/s10433-017-0423-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Few studies focus on the prevalence and related factors of successful aging (SA) among Chinese rural elders living in nursing homes. This study aims to make an operational definition of successful aging, estimate the prevalence of SA, and identify factors related to SA among Chinese rural elders living in nursing homes. Data for this cross-sectional study were collected by face-to-face interviews in five rural public nursing homes. A total of 205 elders aged 60 years and above were asked to answer a series of questions. Descriptive analysis, independent sample t tests, χ2 tests, and multivariate logistic regression were used to show the prevalence and related factors of SA. The prevalence of SA in this population is 17.6% based on a multidimensional construct composed of: few chronic diseases, good cognitive and physical functioning, good mental health, and active social engagement. The logistic regression results indicate that successful agers are more likely to be younger, married, resilient, and better off economically, whereas gender, education, and social support are not related to SA independently. This model accounts for 45.8% of the variance in SA. These results suggest some tentative recommendations for elders, relevant decision-makers or employees in nursing homes, and administrative bodies. More rigorous longitudinal design is necessary to investigate the causality of the related factors and SA.
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Affiliation(s)
- Menglian Wu
- School of Nursing, Shandong University, Jinan, 250012 Shandong China
| | - Yang Yang
- School of Nursing, Shandong University, Jinan, 250012 Shandong China
| | - Dan Zhang
- School of Nursing, Shandong University, Jinan, 250012 Shandong China
| | - Yaoyao Sun
- School of Nursing, Shandong University, Jinan, 250012 Shandong China
| | - Hui Xie
- School of Nursing, Shandong University, Jinan, 250012 Shandong China
| | - Jie Zhang
- School of Public Health, Shandong University, Jinan, 250012 Shandong China
- Department of Sociology, State University of New York Buffalo State, Buffalo, NY USA
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan, 250012 Shandong China
| | - Yonggang Su
- School of Nursing, Shandong University, Jinan, 250012 Shandong China
- School of Foreign Languages and Literature, Shandong University, Jinan, 250100 Shandong China
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Shi Z, Zhu Y, Wang M, Wu Y, Cao J, Li C, Xie Z, Shen Y. The Utilization of Retinal Nerve Fiber Layer Thickness to Predict Cognitive Deterioration. J Alzheimers Dis 2016; 49:399-405. [PMID: 26484909 DOI: 10.3233/jad-150438] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Our previous studies have shown that longitudinal reduction in retinal nerve fiber layer (RNFL) thickness is associated with cognitive deterioration. However, whether the combination of longitudinal reduction in RNFL thickness with baseline episodic memory performance can better predict cognitive deterioration remains unknown. Therefore, we set out to re-analyze the data obtained from our previous studies with 78 elderly adults (mean age 74.4 ± 3.83 years, 48.7% male) in the community over a 25-month period. The participants were categorized as either stable participants whose cognitive status did not change (n = 60) or converted participants whose cognitive status deteriorated (n = 18). A logistic regression analysis was applied to determine a conversion score for predicting the cognitive deterioration in the participants. We found that the area under the receiver operating characteristic curve (AUC) for the multivariable model was 0.854 (95% CI 0.762-0.947) using baseline story recall as a predictor, but the AUC increased to 0.915 (95% CI 0.849-0.981) with the addition of the longitudinal reduction of RNFL thickness in the inferior quadrant. The conversion score was significantly higher for the converted participants than the stable participants (0.59 ± 0.30 versus 0.12 ± 0.19, p < 0.001). Finally, the optimal cutoff value of the conversion score (0.134) was determined by the analysis of receiver operating characteristic curve, and this conversion score generated a sensitivity of 0.944 and a specificity of 0.767 in predicting the cognitive deterioration. These findings have established a system to perform a larger scale study to further test whether the longitudinal reduction in RNFL thickness could serve as a biomarker of Alzheimer's disease.
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Affiliation(s)
- Zhongyong Shi
- Department of Psychiatry, Tenth People's Hospital of Tongji University, Shanghai, P.R. China
| | - Yingbo Zhu
- Medical School Tongji University, Shanghai, P.R. China
| | - Meijuan Wang
- Department of Psychiatry, Tenth People's Hospital of Tongji University, Shanghai, P.R. China
| | - Yujie Wu
- Department of Psychiatry, Tenth People's Hospital of Tongji University, Shanghai, P.R. China
| | - Jing Cao
- Department of Psychiatry, Tenth People's Hospital of Tongji University, Shanghai, P.R. China
| | - Chunbo Li
- Department of Biological Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, P.R. China
| | - Zhongcong Xie
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Yuan Shen
- Department of Psychiatry, Tenth People's Hospital of Tongji University, Shanghai, P.R. China
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Khongboon P, Pongpanich S, Chapman RS. Risk Factors for Six Types of Disability among the Older People in Thailand in 2002, 2007, and 2011. J Aging Res 2016; 2016:6475029. [PMID: 27642523 DOI: 10.1155/2016/6475029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/12/2016] [Accepted: 07/26/2016] [Indexed: 11/17/2022] Open
Abstract
Background. There is an important need to characterize risk factors for disability in Thailand, in order to inform effective prevention and control strategies. This study investigated factors associated with risk of 6 types of disability in Thailand's ageing population in 2002, 2007, and 2011. Methods. Data came from the Cross-Sectional National Surveys of Older Persons in Thailand conducted by the National Statistical Office (NSO) in 2002, 2007, and 2011. Stratified two-stage sampling was employed. Interviews of 24,835, 30,427, and 34,173 elderly people aged 60 and above were conducted in the respective study years. Prevalence of disabilities was measured, and factors associated with disability risk were assessed with probability-weighted multiple logistic regression. Results. Disability prevalence decreased slightly over the study period. The characteristics with greatest positive impact on disability prevalence were not working over the past week (average impact: 61.2%), age (53.7% per decade), and suffering from one or more chronic illnesses (46.3%). Conclusions. The strong observed positive impact of not working on disability prevalence suggests that raising the mandatory retirement age might result in some reduction of disability risk. Also, the observed positive impact of living with others (versus alone) on disability risk was somewhat unexpected.
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Gao CY, Lian Y, Zhang M, Zhang LL, Fang CQ, Deng J, Li J, Xu ZQ, Zhou HD, Wang YJ. Association of dementia with death after ischemic stroke: A two-year prospective study. Exp Ther Med 2016; 12:1765-1769. [PMID: 27588095 PMCID: PMC4998104 DOI: 10.3892/etm.2016.3538] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 07/22/2016] [Indexed: 12/27/2022] Open
Abstract
The association between dementia and the risk of death after ischemic stroke was investigated. Neurological, neuropsychological and functional assessments were evaluated in 619 patients with acute ischemic stroke. Dementia was diagnosed at admission and at three months after stroke onset. The patients were scheduled for a two-year follow-up after the index stroke. The Kaplan-Meier survival and Cox proportional hazards regression analyses were used to estimate the cumulative proportion of survival, and the association between dementia and risk of death after stroke. In total, 146 patients (23.6%) were diagnosed with dementia after stroke. The cumulative proportion of surviving cases was 49.3% in patients with dementia after a median follow-up of 21.2±5.6 months, and 92.5% in patients without dementia. Multivariate analysis revealed that dementia (HR, 7.21; 95% CI, 3.85–13.49) was associated with death, independent of age, atrial fibrillation, previous stroke and NIH stroke scale. In conclusion, the mortality rate is increased in stroke patients with dementia. Dementia is an important risk factor for death after stroke, independent of age, atrial fibrillation, previous stroke, and the severity of the stroke.
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Affiliation(s)
- Chang-Yue Gao
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
| | - Yan Lian
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
| | - Meng Zhang
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
| | - Li-Li Zhang
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
| | - Chuan-Qing Fang
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
| | - Juan Deng
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
| | - Jing Li
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
| | - Zhi-Qiang Xu
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
| | - Hua-Dong Zhou
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
| | - Yan-Jiang Wang
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, The Third Military Medical University, Chongqing 400042, P.R. China
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Qiao J, Wang X, Lu W, Cao H, Qin X. Validation of Neuropsychological Tests to Screen for Dementia in Chinese Patients With Parkinson's Disease. Am J Alzheimers Dis Other Demen 2016; 31:368-74. [PMID: 26646116 PMCID: PMC10852760 DOI: 10.1177/1533317515619478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To compare the accuracy of different neuropsychological tests and their combinations for deriving reliable cognitive indices for dementia diagnosis in Parkinson's disease (PD). One hundred forty consecutive patients with PD were recruited and administrated an extensive battery of neuropsychological tests. Discriminant analysis and receiver-operator characteristic curve were used to evaluate their correct classifications and validity. Patients with PD having dementia (PDD; 23.5%) performed significantly worse in all tests than patients without dementia. Age of onset, disease duration, Hoehn-Yahr grade, Unified Parkinson's Disease Rating Scale part III scores, and education were associated with dementia in patients with PD. Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment, and Block Design (BD) showed better specificity and sensitivity when used alone, and combined use of MMSE and BD further increased the validity. Our results indicated that the accuracy of MMSE was better in dementia diagnosis of Chinese patients with PD, and combined use of MMSE and BD could further increase the validity of dementia diagnosis.
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Affiliation(s)
- Jin Qiao
- Department of Neurology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaoyan Wang
- Department of Medical Administration, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wenhui Lu
- Department of Neurology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hongmei Cao
- Department of Neurology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xing Qin
- Department of Neurology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Yuan J, Zhang Z, Wen H, Hong X, Hong Z, Qu Q, Tang M, Wu J, Xu Q, Li H, Cummings JL. Incidence of dementia and subtypes: A cohort study in four regions in China. Alzheimers Dement 2015; 12:262-71. [PMID: 26086181 DOI: 10.1016/j.jalz.2015.02.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 01/09/2015] [Accepted: 02/11/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION There is a dearth of literature on the incidence of dementia in China. METHODS Using a stratified, multistage, cluster-sampling method, 16,921 nondemented participants ≥55 years were recruited from four regional centers in China in 1997 and followed up to 4.5 years. Cases were identified through a three-step protocol, according to standardized criteria for dementia, Alzheimer's dementia (AD), and vascular dementia (VaD). RESULTS The crude incidence in persons ≥65 years was 12.1/1000 person-years for dementia, 8.2/1000 person-years for AD, and 3.1/1000 person-years for VaD. After adjusting for sociodemographic factors, older age and lower education were associated with a higher risk of incident dementia, AD and VaD; regional difference was associated mainly with incidence of VaD (north vs. south: hazard ratio [HR] = 3.59); modestly with AD (east vs. west: HR = 1.55). DISCUSSION The incidence of dementia in Chinese population is comparable with that in Europe and United States.
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Affiliation(s)
- Jing Yuan
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Zhenxin Zhang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China; Department of Clinical Epidemiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
| | - Hongbo Wen
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xia Hong
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Zhen Hong
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Qiumin Qu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Mouni Tang
- Department of Psychiatry, The First Hospital, Huaxi Medical College, Chengdu, People's Republic of China
| | - Jixing Wu
- Department of Neurology, Beijing Sixth Hospital, Beijing, People's Republic of China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, People's Republic of China
| | - Hui Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, People's Republic of China
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Jia J, Wei C, Liang J, Zhou A, Zuo X, Song H, Wu L, Chen X, Chen S, Zhang J, Wu J, Wang K, Chu L, Peng D, Lv P, Guo H, Niu X, Chen Y, Dong W, Han X, Fang B, Peng M, Li D, Jia Q, Huang L. The effects of DL-3-n-butylphthalide in patients with vascular cognitive impairment without dementia caused by subcortical ischemic small vessel disease: A multicentre, randomized, double-blind, placebo-controlled trial. Alzheimers Dement 2015; 12:89-99. [PMID: 26086183 DOI: 10.1016/j.jalz.2015.04.010] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 02/27/2015] [Accepted: 04/06/2015] [Indexed: 11/15/2022]
Affiliation(s)
- Jianping Jia
- Department of Neurology; Xuan Wu Hospital of the Capital Medical University; Beijing China
- Center of Alzheimer's Disease; Beijing Institute for Brain Disorders; Beijing China
| | - Cuibai Wei
- Department of Neurology; Xuan Wu Hospital of the Capital Medical University; Beijing China
| | - Junhua Liang
- Department of Neurology; Xuan Wu Hospital of the Capital Medical University; Beijing China
| | - Aihong Zhou
- Department of Neurology; Xuan Wu Hospital of the Capital Medical University; Beijing China
| | - Xiumei Zuo
- Department of Neurology; Xuan Wu Hospital of the Capital Medical University; Beijing China
| | - Haiqing Song
- Department of Neurology; Xuan Wu Hospital of the Capital Medical University; Beijing China
| | - Liyong Wu
- Department of Neurology; Xuan Wu Hospital of the Capital Medical University; Beijing China
| | - Xiaochun Chen
- Department of Neurology; The Affiliated Union Hospital of Fujian Medical University; Fuzhou Fujian China
| | - Shengdi Chen
- Department of Neurology; Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine; Shanghai China
| | - Junjian Zhang
- Department of Neurology; Zhongnan Hospital of Wuhan University; Wuhan Hubei China
| | - Jiang Wu
- Department of Neurology; The First Teaching Hospital of Jilin University; Changchun Jilin China
| | - Kai Wang
- Department of Neurology; The First Affiliated Hospital of Anhui Medical University; Hefei Anhui China
| | - Lan Chu
- Department of Neurology; The Affiliated Hospital of Guiyang Medical College; Guiyang Guizhou China
| | - Dantao Peng
- Department of Neurology; Beijing Hospital; Beijing China
| | - Peiyuan Lv
- Department of Neurology; Hebei General Hospital; Shijiazhuang Hebei China
| | - Hongzhi Guo
- Department of Neurology; Qilu Hospital of Shandong University; Jinan Shandong China
| | - Xiaoyuan Niu
- Department of Neurology; The First Hospital of Shanxi Medical University; Taiyuan Shanxi China
| | - Yingzhu Chen
- Department of Neurology; Northern Jiangsu People's Hospital of Yangzhou University; Yangzhou Jiangsu China
| | - Wanli Dong
- Department of Neurology; The First Affiliated Hospital of Soochow University; Suzhou Jiangsu China
| | - Xiujie Han
- Department of Neurology; Anshan Changda Hospital; Anshan Liaoning China
| | - Boyan Fang
- Department of Neurology; The First Affiliated Hospital of Liaoning Medical College; Jinzhou Liaoning China
| | - Mao Peng
- Department of Neurology; Xuan Wu Hospital of the Capital Medical University; Beijing China
| | - Dan Li
- Department of Neurology; Xuan Wu Hospital of the Capital Medical University; Beijing China
| | - Qian Jia
- Department of Neurology; Xuan Wu Hospital of the Capital Medical University; Beijing China
| | - Liyuan Huang
- Department of Neurology; Xuan Wu Hospital of the Capital Medical University; Beijing China
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Dong X, Chang ES, Simon MA. Physical function assessment in a community-dwelling population of U.S. Chinese older adults. J Gerontol A Biol Sci Med Sci 2014; 69 Suppl 2:S31-8. [PMID: 25378446 PMCID: PMC4453756 DOI: 10.1093/gerona/glu205] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND This report describes the levels of physical function in U.S. Chinese older adults utilizing self-reported and performance-based measures, and examines the association between sociodemographic characteristics and physical function. METHODS The Population Study of Chinese Elderly in Chicago enrolled an epidemiological cohort of 3,159 community-dwelling Chinese older adults aged 60 and older. We collected self-reported physical function using Katz activities of daily living and Lawton instrumental activities of daily living items, the Index of Mobility scale, and the Index of Basic Physical Activities scale. Participants were also asked to perform tasks in chair stand, tandem stand, and timed walk. We computed Pearson and Spearman correlation coefficients to examine the correlation between sociodemographic and physical function variables. RESULTS A total of 7.8% of study participants experienced activities of daily living impairment, and 50.2% experienced instrumental activities of daily living impairment. With respect to physical performance testing, 11.4% of the participants were not able to complete chair stand for five times, 8.5% of the participants were unable to do chair stands at all. Older age, female gender, lower education level, being unmarried, living with fewer people in the same household, having fewer children, living fewer years in the United States, living fewer years in the community, and worsening health status were significantly correlated with lower levels of physical function. CONCLUSIONS Utilizing self-reported and performance-based measures of physical function in a large population-based study of U.S. Chinese older adults, our findings expand current understanding of minority older adults' functional status.
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Affiliation(s)
- XinQi Dong
- Rush Institute for Healthy Aging, Rush University Medical Center and
| | - E-Shien Chang
- Rush Institute for Healthy Aging, Rush University Medical Center and
| | - Melissa A. Simon
- Department of Obstetrics and Gynecology, Northwestern University Medical Center, Chicago, IL
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Shen Y, Shi Z, Jia R, Zhu Y, Cheng Y, Feng W, Li C. The attenuation of retinal nerve fiber layer thickness and cognitive deterioration. Front Cell Neurosci 2013; 7:142. [PMID: 24065883 PMCID: PMC3777215 DOI: 10.3389/fncel.2013.00142] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 08/15/2013] [Indexed: 11/13/2022] Open
Abstract
Thinner retinal nerve fiber layer (RNFL) has been reported in Alzheimer's disease (AD) patient. However, whether changes in RNFL thickness can predict the cognitive deterioration remains unknown. We therefore set out a prospective clinical investigation to determine the potential association between the attenuation of RNFL thickness and the deterioration of cognitive function over a period of 25 months. We assessed cognitive function using the Repeatable Battery for the Assessment of Neuropsychological Status and measured RNFL thickness employing optical coherence tomography in 78 participants (mean age 72.31 ± 3.98 years, 52% men). The participants were categorized as stable participants whose cognitive status remained no change (N = 60) and converted participants whose cognitive status deteriorated (N = 18). We found that there was an association between the attenuation of superior quadrant RNFL thickness and the deterioration of cognitive function in the stable participants. In the converted participants, however, there was an inverse association between the reduction of inferior quadrant RNFL thickness and decline of cognitive functions [scores of list recall (R = -0.670, P = 0.002), adjusted (R = -0.493, P = 0.031)]. These data showed that less reduction in the inferior quadrant of RNFL thickness might indicate a higher risk for the patients to develop cognitive deterioration. These findings have established a system to embark a larger scale study to further test whether changes in RNFL thickness can serve as a biomarker of AD, and would lead to mechanistic studies to determine the cellular mechanisms of cognitive deterioration.
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Affiliation(s)
- Yuan Shen
- Department of Psychiatry, Tenth People's Hospital, Tongji University Shanghai, People's Republic of China ; Department of Psychiatry, Tongji Hospital, Tongji University Shanghai, People's Republic of China
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Dong X, Simon MA. Urban and rural variations in the characteristics associated with elder mistreatment in a community-dwelling Chinese population. J Elder Abuse Negl 2013; 25:97-125. [PMID: 23473295 DOI: 10.1080/08946566.2013.751811] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study compares the urban and rural differences in characteristics associated with elder mistreatment (EM) in a Chinese population. A cross-sectional study of 269 urban and 135 rural participants aged 60 years or greater was performed. Among those with EM, rural participants were more likely to be women, have lower levels of education and income, have lower levels of health status and quality of life, have worse change in recent health, and have lower levels of psychosocial well-being. Both higher levels of depressive symptoms and lower levels of social support were associated with increased risk of EM.
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Affiliation(s)
- Xinqi Dong
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, USA.
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Li F, Jia XF, Jia J. The Informant Questionnaire on Cognitive Decline in the Elderly individuals in screening mild cognitive impairment with or without functional impairment. J Geriatr Psychiatry Neurol 2012; 25:227-32. [PMID: 23172761 DOI: 10.1177/0891988712464822] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Informant Questionnaire on Cognitive Decline in the Elderly individuals (IQCODE) is a reliable, validated informant-based instrument. Most of the studies well support the validity of the IQCODE in dementia screening, but the sensitivity of the rating scale at the early stage during the course of dementia is limited. In this study, we investigate the utility of the IQCODE for patients with mild cognitive impairment (MCI) and the discriminative power of the IQCODE in patients having MCI with and without functional impairment. The samples included mild Alzheimer disease (AD, N=280), MCI ([N=657], further divided into 2 subgroups: patients with MCI having functional impairment [MCI-fi, N=357] and patients having MCI without functional impairment [MCI-fn, N=300]), and normal cognition (NC, N=274). The IQCODE, Mini-Mental State Examination (MMSE), and other neuropsychological tests were administered to all participants. Logistic regression and receiver-operating characteristic (ROC) curves were used to evaluate the diagnostic ability of the IQCODE, compared to the MMSE. The optimal cutoff scores of the IQCODE were 3.19 for the MCI (sensitivity/specificity: 0.979/0.714) and MCI-fn (0.900/0.817), 3.25 for the MCI-fi (0.978/0.701), and 3.31 for mild AD (0.893/0.779), while the MMSE was identical, that is 26, for both MCI and its functional normal and functional impaired subgroups (0.892/0.755, 0.867/0.745, and 0.913/0.745, respectively) and 24 for mild AD (0.807/0.836). The discriminating accuracy of the IQCODE was slightly superior to that of the MMSE but did not reach statistical significance. Our study suggests that the IQCODE might be useful in screening for MCI, with hierarchical scores indicating functional normal or impaired.
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Affiliation(s)
- Fang Li
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
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Sheng JH, Ng TP, Li CB, Lu GH, He W, Qian YP, Wang JH, Yu SY. The peripheral messenger RNA expression of glycogen synthase kinase-3β genes in Alzheimer's disease patients: a preliminary study. Psychogeriatrics 2012; 12:248-54. [PMID: 23279147 DOI: 10.1111/j.1479-8301.2012.00426.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore the peripheral leucocytic messenger RNA (mRNA) expression of glycogen synthase kinase-3β (GSK-3β) gene in Alzheimer's disease (AD) patients. METHODS Using TaqMan relative quantitative real-time polymerase chain reaction, we analyzed leucocytic gene expression of GSK-3β in 48 AD patients and 49 healthy controls. Clinical data of AD patients were also collected. RESULTS The mRNA expression level of the GSK-3β gene was significantly higher in the AD group (3.13±0.62) than in the normal group (2.77±0.77). Correlational analyses showed that the mRNA expression level of GSK-3β gene in AD patients was associated with the age of onset (P=0.047), age (P=0.055), and Behavioral Pathology in Alzheimer's Disease Rating Scale total score (P=0.062) and subscores: aggressiveness score (P=0.073) and anxieties and phobias score (P=0.067). Through multivariate regression model, older age, higher anxieties and phobias score and aggressiveness score were associated with higher mRNA expression level of GSK-3β gene. CONCLUSION In AD patients, the mRNA expression level of the GSK-3β gene is increased and may be related to age and behavioural pathology in AD.
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Affiliation(s)
- Jian-Hua Sheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Monaci L, Morris RG. Neuropsychological screening performance and the association with activities of daily living and instrumental activities of daily living in dementia: baseline and 18- to 24-month follow-up. Int J Geriatr Psychiatry 2012; 27:197-204. [PMID: 22223145 DOI: 10.1002/gps.2709] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 02/08/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The use of neuropsychological assessment beyond diagnosis is related partly to the extent to which it can indicate everyday function. This study investigates whether the associations between neuropsychological functioning, activities of daily living (ADL) and instrumental activities of daily living (IADL) change over an 18- to 24-month follow-up, exploring whether these change with dementia progression. METHOD Thirty-four patients with probable Alzheimer's disease were assessed at baseline and again after between 18 and 24 months. Neuropsychological function was assessed using the revised Cambridge Cognitive Examination, which includes in it the Mini mental state examination and an executive functions scale. ADL and IADL were also measured, together with background neuropsychiatric features by using the Neuropsychiatric Inventory. RESULTS Pearson correlations between the measures of daily functioning and cognitive abilities and neuropsychiatric symptoms showed that initially neuropsychological test results tended to correlate with IADL rather than ADL measures. Neuropsychiatric symptoms were not correlated whether IADL or ADL. At follow-up, none of the neuropsychological function measures correlated with IADL or ADL, but neuropsychiatric symptoms were correlated with IADL. CONCLUSIONS At baseline, neuropsychological function is associated with IADL but not ADL. At follow-up, the association between neuropsychological function and IADL diminishes, and associations between neuropsychiatric disturbances and IADL emerge.
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Affiliation(s)
- Linda Monaci
- Wolfson Neurorehabilitation Centre, St Georges' Healthcare NHS Trust, London, UK.
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Abstract
OBJECTIVES To assess how cognitive impairment affects rehabilitation outcomes and to determine whether individual benefit regardless of cognition. DESIGN Prospective open observational study. SETTING Two rehabilitation wards admitting older adults after admissions with medical or surgical problems. PARTICIPANTS Two hundred forty-one individuals admitted to two rehabilitation wards, 144 female, mean age 84.4 ± 7.3 (range: 59-103). MEASUREMENTS The Mini-Mental State Examination (MMSE) was administered, and participants were categorized into four groups: cognitively intact (MMSE score: 27-30), mildly impaired (MMSE score: 21-26), moderately impaired (MMSE score: 11-20), and severely impaired (MMSE score: 0-10). Barthel activity of daily living score was calculated on admission, at 2 and 6 weeks (if appropriate), and at discharge to assess level of independence and improvement or deterioration in function. Information relating to mortality, discharge destination, and length of stay was also collected. RESULTS After adjusting for comorbidities and age, all four groups showed improvement in Barthel score from admission to discharge. This improvement was highly significant (P = .005) in participants with normal cognition and mild to moderate impairment. Severely impaired participants also made significant improvement (P = .01). Length of stay was significantly longer for participants with lower cognitive scores. Discharge of 50% of participants occurred by 26, 28, 38, and 47 days for Groups 1 to 4, respectively (P = .001). Higher rates of institutionalization and mortality (P = .02) were associated with lower MMSE score. CONCLUSION All participants improved functionally regardless of cognition. Likelihood of institutionalization, mortality, length of stay, and adverse incidents was higher with lower MMSE scores.
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Feng L, Ng TP, He Y, Li C, Kua EH, Zhang M. Physical Health and Cognitive Function Independently Contributed to Functional Disability among Chinese Older Adults: Data from Two Asian Metropolises. J Aging Res 2011; 2011:960848. [PMID: 21941656 PMCID: PMC3173966 DOI: 10.4061/2011/960848] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Accepted: 07/15/2011] [Indexed: 11/20/2022] Open
Abstract
Objective. We aimed to examine the independent contributions of physical health and cognitive function to disability among Chinese older adults living in two Asian metropolises and explore the potential influences of environment. Design and Participants. Cross-sectional analysis based on data from two population-based studies: the Shanghai Survey of Alzheimer's Disease and Dementia (n = 4639) and the Singapore Longitudinal Ageing Study (n = 2397). Disability was defined as needing help in at least one activity of daily living. Results. The prevalence of functional disability was higher in Shanghai sample (5%) than that in Singapore sample (1.8%). Number of chronic diseases, self-rated health status, cognitive function (measured by the Mini-Mental State Examination), and environment (Singapore versus Shanghai) significantly contributed to functional disability independent of each other. The adjusted Odds Ratio was 1.35 (95%CI 1.22-1.50), 2.85 (95% CI 2.36-3.43), 0.89 (95% CI 0.85-0.94), and 0.68 (95% CI 0.48-0.96), respectively. The strength of associations between health variables and disability appeared to be influenced by environment. Conclusion. Physical health and cognitive function independently contributed to functional disability. The associations are modulated by environmental factors.
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Affiliation(s)
- Lei Feng
- Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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48
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Yin P, Zhang M, Li Y, Jiang Y, Zhao W. Prevalence of COPD and its association with socioeconomic status in China: findings from China Chronic Disease Risk Factor Surveillance 2007. BMC Public Health 2011; 11:586. [PMID: 21781320 PMCID: PMC3152537 DOI: 10.1186/1471-2458-11-586] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 07/22/2011] [Indexed: 11/28/2022] Open
Abstract
Background Socioeconomic status is likely an independent risk factor for Chronic Obstructive Pulmonary Disease (COPD), but little research has been done in China to study this association in a nationwide sample. Methods We used data from the 2007 China Chronic Disease Risk Factor Surveillance of 49,363 Chinese men and women aged 15-69 years to examine the association between the prevalence of self-reported physician diagnosed COPD and socioeconomic status defined by both educational level and annual household income. Multivariable logistic regression modelling was performed with adjustement for potential confounders. Results Both low educational attainment and low household income were independently associated with higher risk of physician-diagnosed COPD. Compared to subjects with high educational level, subjects with low educational level had a significantly increased risk of COPD (OR 1.67, 95%CI 1.32-2.13, p for trend< 0.001 for urban, OR 1.76, 95%CI 1.34-2.30, p for trend < 0.001 for rural) after adjusting for age, sex, smoking status, passive smoking and geographic regions. Similarly increased risk was observed for household income and COPD in urban (OR 1.64, 95%CI 1.28-2.09, P for trend< 0.001) but not rural areas. Among never smokers, low educational level and household income were still associated with a significant higher prevalence of COPD (OR 1.77, 95%CI 1.40-2.25, OR 1.31, 95%CI 1.05-1.62). Removal of those with asthma diagnosis did not alter the observed associations. Conclusions Socioeconomic status is a risk factor for self-reported physician-diagnosed COPD independently of current or passive smoking. Prospective studies are needed in China to better understand the association between socioeconomic status and COPD.
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Affiliation(s)
- Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, Beijing, China.
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49
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Abdulraheem IS, Oladipo AR, Amodu MO. Prevalence and Correlates of Physical Disability and Functional Limitation among Elderly Rural Population in Nigeria. J Aging Res 2011; 2011:369894. [PMID: 21748005 PMCID: PMC3124875 DOI: 10.4061/2011/369894] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Revised: 02/27/2011] [Accepted: 04/12/2011] [Indexed: 12/01/2022] Open
Abstract
Background. The number of people surviving into old age is increasing, and it has now become a global phenomenon. Studies on the prevalence and correlates of physical disability and functional limitation among elderly Nigerians are scanty. Methodology. This is a community-based cross-sectional study conducted in 3 local government areas (LGAs) in Nigeria, using a multistage sampling technique. Functional limitations of 1824 elderly persons were tested using Tinetti performance-oriented mobility assessment tool (TPOMAT) and self-reported activities of daily living (ADL). ADL disability of ten, six, and five basic items were compared. Results. The prevalence ratios (PRs) of physical disability using the ten, six, and five basic ADL items were 28.3 (95% CI 25.2–31. 5), 15.7 (95% CI 13.4–19.8), and 12.1 (95% CI 9.8–15.3), respectively, while functional limitation was 22.5 (95% CI 18.1–24.4). Increased risk of disability was independently associated with female gender PR 3.6 (95% CI 1.5–7.4), advanced age ≥75 years; PR 22.2 (95% CI 14.5, 36.8), arthritis PR 3.7 (95% CI 2.6–4.6), stroke PR 4.8 (95% CI 3.7–7.9) and diabetes PR 6.1 (95% CI 4.3–7.1).
Conclusions. The findings from this study are pointers to unmet needs of the elderly disabled Nigerians.
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Affiliation(s)
- I S Abdulraheem
- Department of Epidemiology and Community Health, College of Medicine, University of Ilorin, 240001 Ilorin, Nigeria
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Chan A, Malhotra C, Østbye T. Correlates of limitations in activities of daily living and mobility among community-dwelling older Singaporeans. Ageing and Society 2011; 31:663-82. [DOI: 10.1017/s0144686x10001200] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
ABSTRACTMost research on activity limitations has focused on the association between chronic health conditions and activity limitations and given little attention to their social and financial implications. In this paper, we study the correlates of limitations in the activities of daily living (ADL) and mobility among older Singaporeans (aged 55 or more years), based on the ‘disability frameworks’ or pathways proposed by Nagi, Verbrugge and the International Classification of Functioning, Disability and Health. Data from the 2005 National Survey of Senior Citizens in Singapore was used. The weighted prevalence of ADL and mobility limitations was calculated, overall and in subgroups. Logistic regression models were used to assess predictors of ADL and mobility limitations and variation in involvement with family, society, work, use of services and perceived financial adequacy, by ADL and mobility status was studied. We found the overall weighted prevalence of ADL and mobility limitation to be 5 and 8 per cent, respectively. Significant risk factors for ADL and mobility limitation were being older (aged 75 or more years), widowed, having diabetes, joint/bone problems, stroke, cancer and low income. Individuals with ADL and mobility limitations had lower involvement with family, society and work, and perceived financial adequacy, while use of services was higher. The findings underline the importance of improving elderly services for sustained integration of disabled elderly within the community.
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