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Xu X, Xiao C, Yi M, Yang J, Liao M, Zhou K, Hu L, Ouyang F, Lan L, Fan Y. Cerebral Perfusion Characteristics and Dynamic Brain Structural Changes in Stroke-Prone Renovascular Hypertensive Rats: A Preclinical Model for Cerebral Small Vessel Disease. Transl Stroke Res 2024:10.1007/s12975-024-01239-8. [PMID: 38443727 DOI: 10.1007/s12975-024-01239-8] [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: 12/15/2023] [Revised: 02/08/2024] [Accepted: 02/29/2024] [Indexed: 03/07/2024]
Abstract
Hypertension is a leading cause of cerebral small vessel disease (CSVD) and vascular dementia in elderly individuals. We aimed to assess cerebral perfusion and dynamic changes in brain structure in stroke-prone renovascular hypertensive rats (RHRSPs) with different durations of hypertension and to investigate whether they have pathophysiological features similar to those of humans with CSVD. The RHRSP model was established using the two-kidney, two-clip (2k2c) method, and the Morris water maze (MWM) test, MRI, immunohistochemistry, and biochemical analysis were performed at multiple time points for up to six months following the 2k2c operation. Systolic blood pressure was significantly greater in the RHRSP group than in the sham-operated group at week 4 post-surgery and continued to increase over time, leading to cognitive decline by week 20. Arterial spin labeling revealed cerebral hypoperfusion in the RHRSP group at 8 weeks, accompanied by vascular remodeling and decreased vessel density. Diffusion tensor imaging and Luxol fast blue staining indicated that white matter disintegration and demyelination gradually progressed in the corpus callosum and that myelin basic protein levels decreased. Eight weeks after surgery, blood-brain barrier (BBB) leakage into the corpus callosum was observed. The albumin leakage area was negatively correlated with the myelin sheath area (r=-0.88, p<0.001). RNA-seq analysis revealed downregulation of most angiogenic genes and upregulation of antiangiogenic genes in the corpus callosum of RHRSPs 24 weeks after surgery. RHRSPs developed cerebral hypoperfusion, BBB disruption, spontaneous white matter damage, and cognitive impairment as the duration of hypertension increased. RHRSPs share behavioral and neuropathological characteristics with CSVD patients, making them suitable animal models for preclinical trials related to CSVD.
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Affiliation(s)
- Xiangming Xu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases; National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Chi Xiao
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases; National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Ming Yi
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases; National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Jing Yang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases; National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Mengshi Liao
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases; National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Kun Zhou
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases; National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Liuting Hu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases; National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Fubing Ouyang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases; National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Linfang Lan
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases; National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Yuhua Fan
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases; National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080, China.
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Patrick KS, Chakrabati S, Rhoads T, Busch RM, Floden DP, Galioto R. Utility of the Brief Assessment of Cognitive Health (BACH) computerized screening tool in identifying MS-related cognitive impairment. Mult Scler Relat Disord 2024; 82:105398. [PMID: 38183694 PMCID: PMC10872240 DOI: 10.1016/j.msard.2023.105398] [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: 08/08/2023] [Revised: 12/04/2023] [Accepted: 12/21/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Current guidelines recommend that individuals with MS are screened annually for processing speed deficits, often using the Symbol Digit Modalities Test (SDMT). However, given the heterogeneity of cognitive deficits in individuals with MS, other screening measures that assess a range of cognitive domains are necessary. The current cross-sectional study aimed to examine the ability of the computerized, self-administered Brief Assessment of Cognitive Health (BACH) screening measure to detect the presence of cognitive impairment in adults with MS as determined by performance on a standard neuropsychological test battery. METHODS Seventy-two individuals with MS completed the BACH and a comprehensive neuropsychological test battery. Receiver operating characteristic (ROC) analyses were conducted to investigate the ability of the BACH to identify cognitively impaired and cognitively intact individuals. ROC analyses were also conducted to compare the ability of the SDMT to discriminate between cognitively intact and cognitively impaired groups as a comparison with the BACH. RESULTS Cognitive impairment was observed in 56 % of the sample. The BACH showed acceptable ability to discriminate between cognitively intact and cognitively impaired groups (AUC = 0.78). Additionally, the BACH was able to adequately predict cognitive impairment in domains other than processing speed (AUC = 0.71). The SDMT also demonstrated adequate utility in identifying individuals with cognitive impairment (AUC = 0.73); however, the SDMT was not able to adequately predict cognitive impairment in domains other than processing speed (AUC = 0.56). CONCLUSION The BACH showed adequate ability to detect cognitive impairment in individuals with MS. The BACH was able to identify impairments across various assessed cognitive domains, including individuals with and without processing speed deficits.
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Affiliation(s)
- Karlee S Patrick
- Department of Psychological Sciences, Kent State University, Kent, OH, United States.
| | - Shinjon Chakrabati
- Department of Neurosciences, Case Western Reserve University, Cleveland, OH, United States
| | - Tasha Rhoads
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, OH, United States; Department of Neurology, Neurological Institute, Cleveland Clinic, OH, United States
| | - Robyn M Busch
- Department of Neurology, Neurological Institute, Cleveland Clinic, OH, United States; Epilepsy Center, Neurological Institute, Cleveland Clinic, OH, United States
| | - Darlene P Floden
- Department of Neurology, Neurological Institute, Cleveland Clinic, OH, United States; Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, OH, United States
| | - Rachel Galioto
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, OH, United States; Department of Neurology, Neurological Institute, Cleveland Clinic, OH, United States
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Dyer AH, McNulty H, Caffrey A, Gordon S, Laird E, Hoey L, Hughes CF, Ward M, Strain JJ, O'Kane M, Tracey F, Molloy AM, Cunningham C, McCarroll K. Low-Grade systemic inflammation is associated with domain-specific cognitive performance and cognitive decline in older adults: Data from the TUDA study. Neurobiol Aging 2024; 134:94-105. [PMID: 38043161 DOI: 10.1016/j.neurobiolaging.2023.11.008] [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] [Received: 08/11/2023] [Revised: 11/12/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023]
Abstract
Studies examining the relationships between chronic inflammation, cognitive function and cognitive decline in older adults have yielded conflicting results. In a large cohort of older adults free from established dementia (n = 3270; 73.1 ± 7.9 years; 68.4% female), we evaluated the cross-sectional and longitudinal relationships between serum cytokines (IL-6, IL-10, TNF-α) and both global and domain-specific cognitive performance (Repeatable Battery for Assessment of Neuropsychological Status [RBANS]). Higher IL-6 (OR: 1.33; 1.06, 1.66, p = 0.01), TNF-α (OR: 1.35; 1.09, 1.67, p = 0.01) and IL-6:IL-10 Ratio (OR: 1.43; 1.17, 1.74, p = 0.001) were cross-sectionally associated with impaired global RBANS performance. For specific cognitive domains, greatest effect sizes were observed between higher TNF-α levels and poorer visual-spatial and attention performance. In a subset of participants (n = 725; 69.8 ± 5.5 years; 67.0% female) with repeat assessment performed at a median of 5.4 years, only higher baseline IL-6:IL-10 ratio was associated with impaired incident overall, immediate memory and visual-spatial performance. Associations were stronger in females, but not modified by age or APOE genotype.
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Affiliation(s)
- Adam H Dyer
- Department of Age-Related Healthcare, Tallaght University Hospital, United Kingdom; Department of Medical Gerontology, School of Medicine, Trinity College Dublin, United Kingdom.
| | - Helene McNulty
- The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Aoife Caffrey
- The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Shane Gordon
- The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Eamon Laird
- Department of Physical Education and Sport Science, University of Limerick, United Kingdom
| | - Leane Hoey
- The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Catherine F Hughes
- The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Mary Ward
- The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - J J Strain
- The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Maurice O'Kane
- Clinical Chemistry Laboratory, Altnagelvin Hospital, Western Health and Social Care Trust, Londonderry, Northern Ireland, United Kingdom
| | - Fergal Tracey
- Causeway Hospital, Northern Health and Social Care Trust, Coleraine, Northern Ireland, United Kingdom
| | | | - Conal Cunningham
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, United Kingdom; Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Kevin McCarroll
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, United Kingdom; Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
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Vicario A, López Suárez M, Fernández R, Enders J, Cerezo GH. Arterial Hypertension, Structural Damage of the Brain and Cognitive Test. Vertex 2024; 34:20-29. [PMID: 38197625 DOI: 10.53680/vertex.v34i162.502] [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] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Indexed: 01/11/2024]
Abstract
Introduction The arterial hypertension cause brain vascular damage (white matter lesion) and the burden and progression determine their cognitive consequences. Therefore, arterial hypertension is considered the main modifiable vascular risk factor for cognitive impairment and dementia. Therefore, the aim of the current study was to evaluate the results of cognitive tests in a sample of hypertensive patients and to establish possible associations with structural brain lesions (atrophy, white matter lesions) identified by magnetic resonance imaging Methods Were included 70 hypertensive patients from Heart-Brain study in Argentina with magnetic resonance imaging and cognitive test. Fazekas scale and the Global Cortical Atrophy were used to quantify the white matter lesions and the brain atrophy, respectively. The Mini-Mental Status Examination, Clock Drawing test and Mini-Boston Naming test were used to evaluate the cognitive status. Results average age 69.7 ± 10.6 years, 55.7% female). Based on the linear regression analysis, Fazekas scale and cognitive tests were inversely associated. For each grade of increase in Fazekas scale, the clock drawing test (Coef -0.56, CI 95% -1.01 -0.10, p=0.01) and the Mini-mental Status Examination (Coef -0.7, CI 95% -1.27 -0.13, p=0.01) scores decreased. The subcortical atrophy was significantly associated with the clock drawing test (OR 3.29, CI 95% 1.25-8.63; p=0.016). Conclusion: The cognitive tests, particularly the clock drawing test could be used (in the clinical routine practice) as “subrrogate” of the brain structural hypertension-mediated damage.
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Affiliation(s)
- Augusto Vicario
- Unidad Corazón-Cerebro, Instituto Cardiovascular Buenos Aires (ICBA), Argentina.
| | | | - Ruth Fernández
- Escuela de Salud Pública, Universidad Nacional de Córdoba, Argentina..
| | - Julio Enders
- Sección Prevención Cardiovascular, Instituto Cardiovascular Buenos Aires (ICBA), Argentina..
| | - Gustavo H Cerezo
- Jefe de servicio medicina ambulatoria, Instituto Cardiovascular Buenos Aires (ICBA), Argentina. .
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Zolin A, Zhang C, Ooi H, Sarva H, Kamel H, Parikh NS. Association of liver fibrosis with cognitive decline in Parkinson's disease. J Clin Neurosci 2024; 119:10-16. [PMID: 37976909 DOI: 10.1016/j.jocn.2023.11.019] [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: 08/04/2023] [Revised: 10/23/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Cognitive decline is a common but variable non-motor manifestation of Parkinson's disease. Chronic liver disease contributes to dementia, but its impact on cognitive performance in Parkinson's disease is unknown. We assessed the effect of liver fibrosis on cognition in Parkinson's disease. METHODS We conducted a retrospective cohort study using data from the Parkinson's Progression Markers Initiative. Our exposure was liver fibrosis at baseline, based on the validated Fibrosis-4 score. Our primary outcome was the Montreal Cognitive Assessment, and additional outcome measures were the Symbol Digit Modalities Test, the Benton Judgement of Line Orientation, the Letter-Number Sequencing Test, and the Modified Semantic Fluency Test. We used linear regression models to assess the relationship between liver fibrosis and scores on cognitive assessments at baseline and linear mixed models to evaluate the association between baseline Fibrosis-4 score with changes in each cognitive test over five years. Models were adjusted for demographics, comorbidities, and alcohol use. RESULTS We included 409 participants (mean age 61, 40 % women). There was no significant association between liver fibrosis and baseline performance on any of the cognitive assessments in adjusted models. However, over the subsequent five year period, liver fibrosis was associated with more rapid decline in scores on the Montreal Cognitive Assessment (interaction coefficient, -0.07; 95 % CI, -0.12, -0.02), the Symbol Digit Modalities Test, the Benton Judgement of Line Orientation, and the Modified Semantic Fluency Test. CONCLUSION In people with Parkinson's disease, the presence of comorbid liver fibrosis was associated with more rapid decline across multiple cognitive domains.
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Affiliation(s)
- Aryeh Zolin
- Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - Cenai Zhang
- Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - Hwai Ooi
- Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY, USA; Parkinson's Disease and Movement Disorders Institute, Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - Harini Sarva
- Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY, USA; Parkinson's Disease and Movement Disorders Institute, Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - Hooman Kamel
- Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - Neal S Parikh
- Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY, USA.
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Wang J, Akbari A, Chardahcherik M, Wu J. Ginger (Zingiber Officinale Roscoe) ameliorates ethanol-induced cognitive impairment by modulating NMDA and GABA-A receptors in rat hippocampus. Metab Brain Dis 2024; 39:67-76. [PMID: 37966694 DOI: 10.1007/s11011-023-01301-8] [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: 04/13/2023] [Accepted: 09/24/2023] [Indexed: 11/16/2023]
Abstract
Brain damage caused by ethanol abuse may lead to permanent damage, including severe dementia. The aim of this study was to investigate the effects of ginger powder on ethanol-induced cognitive disorders by examining oxidative damage and inflammation status, and the gene expression of N-methyl-D-aspartate (NMDA) and γ-Aminobutyric acid (GABA)-A receptors in the hippocampus of male rats. 24 adult male Sprague-Dawley rats were allocated randomly to four groups as follows control, ethanol (4g/kg/day, by gavage), ginger (1g/kg/day, by gavage), and ginger-ethanol. At the end of the study, memory and learning were evaluated by the shuttle box test. Moreover, to explore mechanisms involved in ethanol-induced cognitive impairment and the protective effect of ginger, the expression of Nuclear factor kappa B (NF-κB), nuclear factor erythroid 2-related factor 2 (Nrf2), NMDA receptor, and GABA-A receptor was measured along with inflammatory and oxidative biomarkers in the hippocampus tissue. The results showed that ethanol could induce cognitive impairment in the ethanol group, while pretreatment with ginger could reverse it. The gene expression of the NF-κB/ Tumor necrosis factor (TNF)-α/Interleukin (IL)-1β pathway and NMDA and GABA-A receptors significantly increased in the ethanol group compared to the control group. While pretreatment with ginger could significantly improve ethanol-induced cognitive impairment through these pathways in the ginger-ethanol group compared to the ethanol group (P < 0.05). It can be concluded that ginger powder could ameliorate ethanol-induced cognitive impairment by modulating the expression of NMDA and GABA-A receptors and inhibiting oxidative damage and the NF-κB/TNF-α/IL-1β pathway in the rat hippocampus.
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Affiliation(s)
- Jiaojiao Wang
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, 750000, China
| | - Abolfazl Akbari
- Department of Physiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Marjan Chardahcherik
- Department of Biochemistry, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Jun Wu
- Department of Internal Medicine, Xi'an Yanta Qiangsen Meilin Hospital, Xi'an, 710000, China.
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Cho SH, Kang HJ, Park YK, Moon SY, Hong CH, Na HR, Song HS, Choi M, Jeong S, Park KW, Kim HS, Chun BO, Jung J, Jeong JH, Choi SH. SoUth Korean study to PrEvent cognitive impaiRment and protect BRAIN health through Multidomain interventions via facE-to-facE and video communication plaTforms in mild cognitive impairment (SUPERBRAIN-MEET): Protocol for a Multicenter Randomized Controlled Trial. Dement Neurocogn Disord 2024; 23:30-43. [PMID: 38362052 PMCID: PMC10864697 DOI: 10.12779/dnd.2024.23.1.30] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 01/18/2024] [Indexed: 02/17/2024] Open
Abstract
Background and Purpose The SoUth Korea study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention (SUPERBRAIN) proved the feasibility of multidomain intervention for elderly people. One-quarter of the Korean population over 65 years of age has mild cognitive impairment (MCI). Digital health interventions may be cost-effective and have fewer spatial constraints. We aim to examine the efficacy of a multidomain intervention through both face-to-face interactions and video communication platforms using a tablet personal computer (PC) application in MCI. Methods Three hundred participants aged 60-85 years, with MCI and at least one modifiable dementia risk factor, will be recruited from 17 centers and randomly assigned in a 1:1 ratio to the multidomain intervention and the waiting-list control groups. Participants will receive the 24-week intervention through the tablet PC SUPERBRAIN application, which encompasses the following five elements: managing metabolic and vascular risk factors, cognitive training, physical exercise, nutritional guidance, and boosting motivation. Participants will attend the interventions at a facility every 1-2 weeks. They will also engage in one or two self-administered cognitive training sessions utilizing the tablet PC application at home each week. They will participate in twice or thrice weekly online exercise sessions at home via the ZOOM platform. The primary outcome will be the change in the total scale index score of the Repeatable Battery for the Assessment of Neuropsychological Status from baseline to study end. Conclusions This study will inform the effectiveness of a comprehensive multidomain intervention utilizing digital technologies in MCI. Trial Registration ClinicalTrials.gov Identifier: NCT05023057.
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Affiliation(s)
- Soo Hyun Cho
- Department of Neurology, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, Korea
| | - Hae Jin Kang
- Department of Medical Nutrition (AgeTech-Service Convergence Major), Graduate School of East-West Medical Science, Kyung Hee University, Suwon, Korea
| | - Yoo Kyoung Park
- Department of Medical Nutrition (AgeTech-Service Convergence Major), Graduate School of East-West Medical Science, Kyung Hee University, Suwon, Korea
| | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, Suwon, Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea
| | - Hae Ri Na
- Department of Neurology, Bobath Memorial Hospital, Seongnam, Korea
| | - Hong-Sun Song
- Department of Sports Sciences, Korea Institute of Sports Science, Seoul, Korea
| | - Muncheong Choi
- Department of Neurology, Ajou University School of Medicine, Suwon, Korea
| | - Sooin Jeong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A University College of Medicine, Busan, Korea
| | - Hyun Sook Kim
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Buong-O Chun
- Graduate School of Physical Education, College of Arts and Physical Education, Myongi University, Yongin, Korea
| | | | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University College of Medicine, Incheon, Korea
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Miller MJ, Cenzer I, Barnes DE, Kelley AS, Covinsky KE. The Prevalence of Cognitive Impairment Among Medicare Beneficiaries Who Use Outpatient Physical Therapy. Phys Ther 2024; 104:pzad115. [PMID: 37615482 PMCID: PMC10822773 DOI: 10.1093/ptj/pzad115] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 05/30/2023] [Accepted: 07/17/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE The objective of this study was to estimate the prevalence of cognitive impairment (including cognitive impairment no dementia [CIND] and dementia) among Medicare fee-for-service beneficiaries who used outpatient physical therapy and to estimate the prevalence of cognitive impairment by measures that are relevant to rehabilitation practice. METHODS This cross-sectional analysis included 730 Medicare fee-for-service beneficiaries in the 2016 wave of the Health and Retirement Study with claims for outpatient physical therapy. Cognitive status, our primary variable of interest, was categorized as normal, CIND, or dementia using a validated approach, and population prevalence of cognitive impairment (CIND and dementia) was estimated by sociodemographic variables and Charlson comorbidity index score. Age-, gender- (man/woman), race-/ethnicity-adjusted population prevalence of CIND and dementia were also calculated for walking difficulty severity, presence of significant pain, self-reported fall history, moderate-vigorous physical activity (MVPA) ≤1×/week, and sleep disturbance frequency using multinomial logistic regression. RESULTS Among Medicare beneficiaries with outpatient physical therapist claims, the prevalence of any cognitive impairment was 20.3% (CIND:15.2%, dementia:5.1%). Cognitive impairment was more prevalent among those who were older, Black, had lower education attainment, or higher Charlson comorbidity index scores. The adjusted population prevalence of cognitive impairment among those who reported difficulty walking across the room was 29.8%, difficulty walking 1 block was 25.9%, difficulty walking several blocks was 20.8%, and no difficulty walking was 16.3%. Additionally, prevalence of cognitive impairment among those with MVPA ≤1×/week was 27.1% and MVPA >1×/week was 14.1%. Cognitive impairment prevalence did not vary by significant pain, self-reported fall history, or sleep disturbance. CONCLUSION One in 5 older adults who use outpatient physical therapist services have cognitive impairment. Furthermore, cognitive impairment is more common in older physical therapist patients who report worse physical function and less physical activity. IMPACT Physical therapists should consider cognitive screening for vulnerable older adults to inform tailoring of clinical practice toward a patient's ability to remember and process rehabilitation recommendations.
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Affiliation(s)
- Matthew J Miller
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, California, USA
| | - Irena Cenzer
- Department of Medicine, Division of Geriatrics, University of California, San Francisco, California, USA
| | - Deborah E Barnes
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA
| | - Amy S Kelley
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Geriatric Research Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - Kenneth E Covinsky
- Department of Medicine, Division of Geriatrics, University of California, San Francisco, California, USA
- San Francisco VA Health Care System, San Francisco, California, USA
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Yang T, Peng P, Jiang S, Yan Y, Hu Y, Wang H, Ye C, Pan R, Sun J, Wu B. Multiple Hypointense Vessels are Associated with Cognitive Impairment in Patients with Single Subcortical Infarction. Transl Stroke Res 2023:10.1007/s12975-023-01206-9. [PMID: 38051469 DOI: 10.1007/s12975-023-01206-9] [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] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 12/07/2023]
Abstract
We aimed to explore the relationship between multiple hypointense vessels and cognitive function in patients with single subcortical infarction (SSI) and the role of SSI with different etiological mechanisms in the above relationship. Multiple hypointense vessels were measured by the number of deep medullary veins (DMVs), DMVs score, and cortical veins (CVs) score. The Montreal Cognitive Assessment (MoCA), the Shape Trail Test (STT), and the Stroop Color and Word Test (SCWT) were assessed to evaluate cognitive function. SSI was dichotomized as branch atheromatous disease (BAD) and cerebral small vessel disease (CSVD)-related SSI by whole-brain vessel-wall magnetic resonance imaging. We included a total of 103 acute SSI patients. After adjustments were made for related risk factors of cognitive function, the SSI patients with higher DMVs score were more likely to have longer STT-B (P = 0.001) and smaller STT-B-1 min (P = 0.014), and the SSI patients with higher CVs score were more likely to have shorter STT-A (P = 0.049). In subgroup analysis, we found that the negative relationship between DMVs scores and cognitive function and the positive relationship between CVs scores and cognitive function were significantly stronger in BAD patients. We provided valuable insights into the associations between DMVs, CVs, and multi-domain cognitive impairment in SSI patients, which underscored the necessity to further study the dynamic alterations of venules and their specific influence on post-stroke cognitive impairment.
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Affiliation(s)
- Tang Yang
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Pengfei Peng
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Shuai Jiang
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Yuying Yan
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Yi Hu
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Hang Wang
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Chen Ye
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Ruosu Pan
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - Jiayu Sun
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China.
| | - Bo Wu
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China.
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Perez-Palomar B, Erdozain AM, Erkizia-Santamaría I, Ortega JE, Meana JJ. Maternal Immune Activation Induces Cortical Catecholaminergic Hypofunction and Cognitive Impairments in Offspring. J Neuroimmune Pharmacol 2023; 18:348-365. [PMID: 37208550 PMCID: PMC10577104 DOI: 10.1007/s11481-023-10070-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 02/07/2023] [Accepted: 05/12/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Impairment of specific cognitive domains in schizophrenia has been associated with prefrontal cortex (PFC) catecholaminergic deficits. Among other factors, prenatal exposure to infections represents an environmental risk factor for schizophrenia development in adulthood. However, it remains largely unknown whether the prenatal infection-induced changes in the brain may be associated with concrete switches in a particular neurochemical circuit, and therefore, if they could alter behavioral functions. METHODS In vitro and in vivo neurochemical evaluation of the PFC catecholaminergic systems was performed in offspring from mice undergoing maternal immune activation (MIA). The cognitive status was also evaluated. Prenatal viral infection was mimicked by polyriboinosinic-polyribocytidylic acid (poly(I:C)) administration to pregnant dams (7.5 mg/kg i.p., gestational day 9.5) and consequences were evaluated in adult offspring. RESULTS MIA-treated offspring showed disrupted recognition memory in the novel object recognition task (t = 2.30, p = 0.031). This poly(I:C)-based group displayed decreased extracellular dopamine (DA) concentrations compared to controls (t = 3.17, p = 0.0068). Potassium-evoked release of DA and noradrenaline (NA) were impaired in the poly(I:C) group (DA: Ft[10,90] = 43.33, p < 0.0001; Ftr[1,90] = 1.224, p = 0.2972; Fi[10,90] = 5.916, p < 0.0001; n = 11); (NA: Ft[10,90] = 36.27, p < 0.0001; Ftr[1,90] = 1.841, p = 0.208; Fi[10,90] = 8.686, p < 0.0001; n = 11). In the same way, amphetamine-evoked release of DA and NA were also impaired in the poly(I:C) group (DA: Ft[8,328] = 22.01, p < 0.0001; Ftr[1,328] = 4.507, p = 0.040; Fi[8,328] = 2.319, p = 0.020; n = 43); (NA: Ft[8,328] = 52.07; p < 0.0001; Ftr[1,328] = 4.322; p = 0.044; Fi[8,398] = 5.727; p < 0.0001; n = 43). This catecholamine imbalance was accompanied by increased dopamine D1 and D2 receptor expression (t = 2.64, p = 0.011 and t = 3.55, p = 0.0009; respectively), whereas tyrosine hydroxylase, DA and NA tissue content, DA and NA transporter (DAT/NET) expression and function were unaltered. CONCLUSIONS MIA induces in offspring a presynaptic catecholaminergic hypofunction in PFC with cognitive impairment. This poly(I:C)-based model reproduces catecholamine phenotypes reported in schizophrenia and represents an opportunity for the study of cognitive impairment associated to this disorder.
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Affiliation(s)
- Blanca Perez-Palomar
- Department of Pharmacology, University of the Basque Country UPV/EHU, Leioa, Bizkaia, E-48940, Spain
- Centro de Investigación Biomédica en Red de Salud Mental CIBERSAM, ISCIII, Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Bizkaia, Spain
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, 63110, USA
- Department of Pharmaceutical and Administrative Sciences, University of Health Sciences and Pharmacy in St. Louis, St. Louis, MO, 63110, USA
| | - Amaia M Erdozain
- Department of Pharmacology, University of the Basque Country UPV/EHU, Leioa, Bizkaia, E-48940, Spain
- Centro de Investigación Biomédica en Red de Salud Mental CIBERSAM, ISCIII, Leioa, Spain
| | - Ines Erkizia-Santamaría
- Department of Pharmacology, University of the Basque Country UPV/EHU, Leioa, Bizkaia, E-48940, Spain
| | - Jorge E Ortega
- Department of Pharmacology, University of the Basque Country UPV/EHU, Leioa, Bizkaia, E-48940, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental CIBERSAM, ISCIII, Leioa, Spain.
- Biocruces Bizkaia Health Research Institute, Bizkaia, Spain.
| | - J Javier Meana
- Department of Pharmacology, University of the Basque Country UPV/EHU, Leioa, Bizkaia, E-48940, Spain
- Centro de Investigación Biomédica en Red de Salud Mental CIBERSAM, ISCIII, Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Bizkaia, Spain
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Johnson DE, McIntyre RS, Mansur RB, Rosenblat JD. An update on potential pharmacotherapies for cognitive impairment in bipolar disorder. Expert Opin Pharmacother 2023; 24:641-654. [PMID: 36946229 DOI: 10.1080/14656566.2023.2194488] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
INTRODUCTION Cognitive impairment is a core feature of bipolar disorder (BD) that impedes recovery by preventing the return to optimal socio-occupational functioning and reducing quality of life. Presently, there are no efficacious treatments for cognitive impairment in BD, but many pharmacological interventions are being considered as they have the potential to target the underlying pathophysiology of the disorder. AREAS COVERED This review summarizes the available evidence for pharmacological interventions for cognitive impairment in bipolar disorder. We searched PubMed, MedLine, and PsycInfo from inception to December 1st, 2022. Traditional treatments, such as lithium, anticonvulsants (lamotrigine), antipsychotics (aripiprazole, asenapine, cariprazine, lurasidone, and olanzapine), antidepressants (vortioxetine, fluoxetine, and tianeptine) and psychostimulants (modafinil), and emerging interventions, such as acetylcholinesterase inhibitors (galantamine and donepezil), dopamine agonists (pramipexole), erythropoietin, glucocorticoid receptor antagonists (mifepristone), immune modulators (infliximab, minocycline and doxycycline), ketamine, metabolic agents (insulin, metformin, and liraglutide), probiotic supplements, and Withania somnifera are discussed. EXPERT OPINION The investigation of interventions for cognitive impairment in BD is a relatively under-researched area. In the past, methodological pitfalls in BD cognition trials have also been a critical limiting factor. Expanding on the existing literature and identifying novel pharmacological and non-pharmacological treatments for cognitive impairment in BD should be a priority.
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Affiliation(s)
- Danica E Johnson
- Mood Disorders Psychopharmacology Unit (MDPU), Toronto Western Hospital, University Health Network, Canada
- Institute of Medical Science, University of Toronto, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), Toronto Western Hospital, University Health Network, Canada
- Department of Psychiatry and Pharmacology, University of Toronto, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit (MDPU), Toronto Western Hospital, University Health Network, Canada
- Department of Psychiatry, University of Toronto, Canada
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit (MDPU), Toronto Western Hospital, University Health Network, Canada
- Department of Psychiatry, University of Toronto, Canada
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Amini R, Counseller Q, Taylor R, Fayyad D, Naimi R. Short Physical Performance Battery and Mediation of the Effect of Mild Cognitive Impairment on Falls by Community-Dwelling Older Adults. J Neuropsychiatry Clin Neurosci 2023; 35:59-68. [PMID: 35686347 DOI: 10.1176/appi.neuropsych.21050145] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The authors examined the association among cognitive function, falling, and physical performance among community-dwelling older adults (ages ≥65 years). METHODS Eight waves of the National Health and Aging Trends Study (NHATS; 2011-2018) were assessed, with 1,225 respondents who participated in all waves. The outcomes were self-reported number of falls and NHATS Short Physical Performance Battery (SPPB) score. The Clock Drawing Test measured participants' executive function, and immediate and delayed word recall tests assessed memory. RESULTS The analyses indicated no direct correlation between executive function and fall risk when controlled for contributing factors. However, executive function and memory significantly predicted the risk for poor physical performance, defined by the NHATS SPPB score. The interaction between pain medication and memory worsened poor physical performance among participants with mild and severe memory impairment, as well as among those with mild to moderate impairment in executive function. CONCLUSIONS Screening older adults living in the community for executive function, memory impairment, and physical performance can predict the risk for falls and the subsequent consequences of falling.
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Affiliation(s)
- Reza Amini
- Departments of Public Health and Health Sciences (Amini) and Occupational Therapy (Counseller, Taylor, Naimi), University of Michigan, Flint; Department of Psychology, University of Michigan, Ann Arbor (Fayyad)
| | - Quinn Counseller
- Departments of Public Health and Health Sciences (Amini) and Occupational Therapy (Counseller, Taylor, Naimi), University of Michigan, Flint; Department of Psychology, University of Michigan, Ann Arbor (Fayyad)
| | - Rebekah Taylor
- Departments of Public Health and Health Sciences (Amini) and Occupational Therapy (Counseller, Taylor, Naimi), University of Michigan, Flint; Department of Psychology, University of Michigan, Ann Arbor (Fayyad)
| | - Deena Fayyad
- Departments of Public Health and Health Sciences (Amini) and Occupational Therapy (Counseller, Taylor, Naimi), University of Michigan, Flint; Department of Psychology, University of Michigan, Ann Arbor (Fayyad)
| | - Rachelle Naimi
- Departments of Public Health and Health Sciences (Amini) and Occupational Therapy (Counseller, Taylor, Naimi), University of Michigan, Flint; Department of Psychology, University of Michigan, Ann Arbor (Fayyad)
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13
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Kolli A, Zhou Y, Chung G, Ware EB, Langa KM, Ehrlich JR. Interactions between the apolipoprotein E4 gene and modifiable risk factors for cognitive impairment: a nationally representative panel study. BMC Geriatr 2022; 22:938. [PMID: 36474172 PMCID: PMC9724385 DOI: 10.1186/s12877-022-03652-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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Few studies using rigorous clinical diagnosis have considered whether associations with cognitive decline are potentiated by interactions between genetic and modifiable risk factors. Given the increasing burden of cognitive impairment (CI) and dementia, we assessed whether Apolipoprotein E ε4 (APOE4) genotype status modifies the association between incident CI and key modifiable risk factors . METHODS Older adults (70+) in the US were included. APOE4 status was genotyped. Risk factors for CI were self-reported. Cognitive status (normal, CI, or dementia) was assigned by clinical consensus panel. In eight separate Cox proportional hazard models, we assessed for interactions between APOE4 status and other CI risk factors. RESULT The analytical sample included 181 participants (mean age 77.7 years; 45.9% male). APOE4 was independently associated with a greater hazard of CI in each model (Hazard Ratios [HR] between 1.81-2.66, p < 0.05) except the model evaluating educational attainment (HR 1.65, p = 0.40). The joint effects of APOE4 and high school education or less (HR 2.25, 95% CI: 1.40-3.60, p < 0.001), hypertension (HR 2.46, 95% CI: 1.28-4.73, p = 0.007), elevated depressive symptoms (HR 5.09, 95% CI: 2.59-10.02, p < 0.001), hearing loss (HR 3.44, 95% CI: 1.87-6.33, p < 0.0001), vision impairment (HR 5.14, 95% CI: 2.31-11.43, p < 0.001), smoking (HR 2.35, 95% CI: 1.24-4.47, p = 0.009), or obesity (HR 3.80, 95% CI: 2.11-6.85, p < 0.001) were associated with the hazard of incident CIND (compared to no genetic or modifiable risk factor) in separate models. The joint effect of Apolipoprotein ε4 and type 2 diabetes was not associated with CIND (HR 1.58, 95% CI: 0.67-2.48, p = 0.44). DISCUSSION The combination of APOE4 and selected modifiable risk factors conveys a stronger association with incident CI than either type of risk factor alone.
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Affiliation(s)
- Ajay Kolli
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Kellogg Eye Center, 1000 Wall Street, Ann Arbor, MI, 48105, USA
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Yunshu Zhou
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Kellogg Eye Center, 1000 Wall Street, Ann Arbor, MI, 48105, USA
| | - Grace Chung
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Kellogg Eye Center, 1000 Wall Street, Ann Arbor, MI, 48105, USA
- Department of Health Policy and Management, University of Michigan, Ann Arbor, MI, USA
| | - Erin B Ware
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Kenneth M Langa
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Division of Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
- Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, MI, USA
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Kellogg Eye Center, 1000 Wall Street, Ann Arbor, MI, 48105, USA.
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
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Owrangi M, Gholamzadeh MJ, Vasaghi Gharamaleki M, Mousavi SZ, Kamali AM, Dehghani M, Chakrabarti P, Nami M. Comparative analysis of the chemotherapy-related cognitive impairments in patients with breast cancer: a community-based research. Cancer Invest 2022; 40:811-821. [PMID: 35880822 DOI: 10.1080/07357907.2022.2106489] [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] [Indexed: 11/02/2022]
Abstract
This study aimed to evaluate the effects of two common chemotherapy regimens on breast cancer (BC) survivors' cognition. The participants comprised 35 patients with BC who underwent two chemotherapy regimens, AC-T and TAC, and 24 matched healthy volunteers. The participants were assessed regarding cognitive function through Addenbrooke's Cognitive Examination and Cambridge Brain Science tests. The results represent the AC-T regimen to be more toxic than the TAC in domains of language, concentration, and visuospatial working memory (P-value =0.036, 0.008, and 0.031, respectively) and should be prescribed with caution in patients with BC suffering from baseline cognitive impairments.
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Affiliation(s)
- Maryam Owrangi
- Students' Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Seyedeh Zahra Mousavi
- Students' Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali-Mohammad Kamali
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.,DANA Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran
| | - Mehdi Dehghani
- Hematology research center, Department of Hematology and Medical Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohammad Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.,DANA Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran.,Academy of Health, Senses Cultural Foundation, Sacramento, CA, USA.,Neuroscience Center, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), City of Knowledge, Panama City, Republic of Panama.,Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Pardis, Tehran, Iran.,Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
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15
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Affiliation(s)
- Philip D Harvey
- University of Miami Miller School of Medicine, Miami, and Bruce W. Carter Miami VA Medical Center, Miami
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16
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Keefe RSE, Cañadas E, Farlow D, Etkin A. Digital Intervention for Cognitive Deficits in Major Depression: A Randomized Controlled Trial to Assess Efficacy and Safety in Adults. Am J Psychiatry 2022; 179:482-489. [PMID: 35410496 DOI: 10.1176/appi.ajp.21020125] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors evaluated AKL-T03, an investigational digital intervention delivered through a video game-based interface, designed to target the fronto-parietal network to enhance functional domains for attentional control. AKL-T03 was tested in adult patients with major depressive disorder and a demonstrated cognitive impairment at baseline. METHODS Adults ages 25-55 years on a stable antidepressant medication regimen with residual mild to moderate depression and an objective impairment in cognition (as measured using the symbol coding test) were enrolled in a double-blind randomized controlled study. Participants were randomized either to AKL-T03 or to an expectation-matched digital control intervention. Participants were assessed at baseline and after completion of their 6-week at-home intervention. The primary outcome measure was improvement in sustained attention, as measured by the Test of Variables of Attention (TOVA). RESULTS AKL-T03 (N=37) showed a statistically significant medium-effect-size improvement in sustained attention compared with the control intervention on the TOVA primary outcome (N=37) (partial eta-squared=0.11). Additionally, a composite score derived from all cognitive measures demonstrated significant improvement with AKL-T03 over the control intervention. Individual secondary and exploratory endpoints did not demonstrate statistically significant between-group differences. No serious adverse events were reported, and two patients (5.5%) in the AKL-T03 group reported an intervention-related adverse event (headache). CONCLUSIONS Treatment with AKL-T03 resulted in significant improvement in sustained attention, as well as in cognitive functioning as a whole, compared with a control intervention. AKL-T03 is a safe digital intervention that is effective in the treatment of cognitive impairment associated with major depression. Further research will be needed to understand the clinical consequences of this treatment-induced change.
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Affiliation(s)
- Richard S E Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C. (Keefe); VeraSci, Durham, N.C. (Keefe); Akili Interactive, Boston (Cañadas, Farlow); Department of Psychiatry and Behavioral Sciences and Wu Tsai Neurosciences Institute, Stanford University, Stanford, Calif. (Etkin); Alto Neuroscience, Los Altos, Calif. (Etkin)
| | - Elena Cañadas
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C. (Keefe); VeraSci, Durham, N.C. (Keefe); Akili Interactive, Boston (Cañadas, Farlow); Department of Psychiatry and Behavioral Sciences and Wu Tsai Neurosciences Institute, Stanford University, Stanford, Calif. (Etkin); Alto Neuroscience, Los Altos, Calif. (Etkin)
| | - Deborah Farlow
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C. (Keefe); VeraSci, Durham, N.C. (Keefe); Akili Interactive, Boston (Cañadas, Farlow); Department of Psychiatry and Behavioral Sciences and Wu Tsai Neurosciences Institute, Stanford University, Stanford, Calif. (Etkin); Alto Neuroscience, Los Altos, Calif. (Etkin)
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C. (Keefe); VeraSci, Durham, N.C. (Keefe); Akili Interactive, Boston (Cañadas, Farlow); Department of Psychiatry and Behavioral Sciences and Wu Tsai Neurosciences Institute, Stanford University, Stanford, Calif. (Etkin); Alto Neuroscience, Los Altos, Calif. (Etkin)
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Fernander EM, Adogamhe P, Datta D, Bond C, Zhao Y, Bangirana P, Conroy AL, Opoka RO, John CC. Elevated Plasma Soluble ST2 Levels are Associated With Neuronal Injury and Neuro cognitive Impairment in Children With Cerebral Malaria. Pathog Immun 2022; 7:60-80. [PMID: 35800259 PMCID: PMC9254869 DOI: 10.20411/pai.v7i1.499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background Murine experimental cerebral malaria studies suggest both protective and deleterious central nervous system effects from alterations in the interleukin-33 (IL-33)/ST2 pathway. Methods We assessed whether soluble ST2 (sST2) was associated with neuronal injury or cognitive impairment in a cohort of Ugandan children with cerebral malaria (CM, n=224) or severe malarial anemia (SMA, n=193). Results Plasma concentrations of sST2 were higher in children with CM than in children with SMA or in asymptomatic community children. Cerebrospinal fluid (CSF) sST2 levels were elevated in children with CM compared with North American children. Elevated plasma and CSF ST2 levels in children with CM correlated with increased endothelial activation and increased plasma and CSF levels of tau, a marker of neuronal injury. In children with CM who were ≥5 years of age at the time of their malaria episode, but not in children <5 years of age, elevated risk factor-adjusted plasma levels of sST2 were associated with worse scores for overall cognitive ability and attention over a 2-year follow-up. Conclusions The study findings suggest that sST2 may contribute to neuronal injury and long-term neurocognitive impairment in older children with CM.
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Affiliation(s)
- Elizabeth M. Fernander
- Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Pontian Adogamhe
- Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Dibyadyuti Datta
- Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Caitlin Bond
- Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Yi Zhao
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN
| | - Paul Bangirana
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | - Andrea L. Conroy
- Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robert O. Opoka
- Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda
| | - Chandy C. John
- Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
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Juby AG, Blackburn TE, Mager DR. Use of medium chain triglyceride (MCT) oil in subjects with Alzheimer's disease: A randomized, double-blind, placebo-controlled, crossover study, with an open-label extension. Alzheimers Dement (N Y) 2022; 8:e12259. [PMID: 35310527 PMCID: PMC8919247 DOI: 10.1002/trc2.12259] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/25/2021] [Accepted: 12/21/2021] [Indexed: 12/23/2022]
Abstract
Introduction Cerebral glucose and insulin metabolism is impaired in Alzheimer's disease (AD). Ketones provide alternative energy. Will medium chain triglyceride (MCT) oil, a nutritional source of ketones, impact cognition in AD? Methods This was a 6‐month randomized, double‐blind, placebo‐controlled, crossover study, with 6‐month open‐label extension in probable AD subjects, on stable medications. MCT dose was 42 g/day, or maximum tolerated. Cognition was assessed with Mini‐Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Cognigram®. Results Twenty subjects, average age 72.6 years, 45% women, 70% university educated had baseline MMSE 22.6/30 (10–29); MoCA 15.6/30 (4–27); baseline Cognigram® Part 1: 65–106, Part 2: 48–107. Average MCT oil consumption was 1.8 tablespoons/day (25.2 g, 234 kcal). Eighty percent remained stable or improved. Longer MCT exposure and age > 73, resulted in higher final MMSE (P < .001) and Cognigram® 1 scores. Discussion This is the longest duration MCT AD study to date. Eighty percent had stabilization or improvement in cognition, and better response with 9‐month continual MCT oil.
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Affiliation(s)
- Angela G Juby
- Division of Geriatrics, Department of Medicine, Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada
| | - Toni E Blackburn
- Division of Geriatrics, Department of Medicine, Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada
| | - Diana R Mager
- Department of Agriculture, Food and Nutrition Science University of Alberta Edmonton Alberta Canada
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Pistacchi M, Gioulis M, Marsala SZ. Association between delirium and cognitive impairment: there is a link? Curr Alzheimer Res 2022; 19:47-55. [PMID: 35048808 DOI: 10.2174/1567205019666220120114552] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/15/2021] [Accepted: 12/27/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Delirium and dementia are both disorders involving global cognitive impairment that can occur separately or at the same time in the elderly. OBJECTIVE The aim of this study was to examine the frequency, correlation and relative risk between delirium and cognitive impairment in a prospective population study starting at basal line (onset of delirium) over a period of five years. The secondary aim was to determine any possible correlation between the kind of delirium and a specific type of dementia. MATERIAL AND METHODS We studied 325 patients, diagnosed according to the DSM-IV. The neuropsychological, moods and delirium disorders were evaluated with Hamilton Depression Rating Scale, Delirium Rating Scale-Revised-98, MMSE, Rey auditory-verbal learning test, Digit Span, Symbol Digit Modalities Test, Raven Progressive Matrices, ADL and IADL. RESULTS The prevalence of delirium in our population was 89 cases (27.4%): 78 patients (48 women and 30 men) showed evolution toward dementia (mean age was 67.9 ± 6.1 years for men and 68.4 ± 9.1 for women), and 11 patients (5 men and 6 women) presented only isolated delirium without evolution toward cognitive impairment (mean age of men was 68.1 ± 5.1 years and of women 66.4 ± 7.1). The neuropsychological study of the patients with delirium with dementia evolution revealed statistically significant differences over time with statistically significant intergroup difference and predisposition toward depression. CONCLUSION The association between delirium and cognitive impairment and the possible role of delirium as an early marker of neurodegenerative diseases need to be future investigated.
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Affiliation(s)
- Michele Pistacchi
- Neurology Service, San Giacomo Hospital, Via dei Carpani 16z, 31033 Castelfranco Veneto (TV), Italy
| | - Manuela Gioulis
- San Martino Hospital, Belluno, Neurology Service, viale europa 22 Belluno, Italy
| | - Sandro Zambito Marsala
- Department od Neurology, Ospedale San Martino, Neurology Service, viale europa 22 Belluno, Italy
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20
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Wu G, Jiang Z, Pu Y, Chen S, Wang T, Wang Y, Xu X, Wang S, Jin M, Yao Y, Liu Y, Ke S, Liu S. Serum short-chain fatty acids and its correlation with motor and non-motor symptoms in Parkinson's disease patients. BMC Neurol 2022; 22:13. [PMID: 34996385 PMCID: PMC8740341 DOI: 10.1186/s12883-021-02544-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/28/2021] [Indexed: 12/13/2022] Open
Abstract
Background Parkinson’s disease (PD) is associated with enteric nervous system dysfunction and gut microbiota dysbiosis. Short-chain fatty acids (SCFAs), derived from gut microbiota, are supposed to anticipate PD pathogenesis via the pathway of spinal cord and vagal nerve or the circulatory system. However, the serum concentration of SCFAs in PD patients is poorly known. This study aims to investigate the exact level of SCFAs in PD patients and its correlation with Parkinson’s symptoms. Methods 50 PD patients and 50 healthy controls were recruited, and their demographic and clinical characteristics were collected. The serum concentration of SCFAs was detected using a gas chromatography-mass spectrometer. SCFAs were compared between PD and control groups. The correlation between serum SCFAs and Parkinson’s symptoms and the potential effects of medications on the serum SCFAs was analyzed. Results Serum propionic acid, butyric acid and caproic acid were lower, while heptanoic acid was higher in PD patients than in control subjects. However, only the serum level of propionic acid was correlated with Unified Parkinson’s Disease Rating Scale (UPDRs) part III score (R = -0.365, P = 0.009), Mini-mental State Examination (MMSE) score (R = -0.416, P = 0.003), and Hamilton Depression Scale (HAMD) score (R = 0.306, P = 0.03). There was no correlation between other serum SCFAs and motor complications. The use of trihexyphenidyl or tizanidine increased the serum concentration of propionic acid. Conclusions Serum SCFAs are altered in PD patients, and the decrease of serum propionic acid level is correlated with motor symptoms, cognitive ability and non-depressed state. Thus, the gut microbial-derived SCFAs potentially affect Parkinson’s symptoms through the blood circulation. Propionic acid supplementation might ameliorate motor and non-motor symptoms of PD patients, although clinical trials are needed to test this hypothesis. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02544-7.
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Affiliation(s)
- Gang Wu
- Department of Pharmacy, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, 317000, Zhejiang, China.,Department of Neurology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, 317000, Zhejiang, China
| | - Zhengli Jiang
- Department of Pharmacy, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, 317000, Zhejiang, China
| | - Yaling Pu
- Clinical Medical College, Shaoxing University of Arts and Sciences, Shaoxing, 312099, Zhejiang, China
| | - Shiyong Chen
- Clinical laboratory Department, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, 317000, Zhejiang, China
| | - Tingling Wang
- Department of Neurology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, 317000, Zhejiang, China
| | - Yajing Wang
- Department of Neurology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, 317000, Zhejiang, China
| | - Xiaoping Xu
- Department of Neurology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, 317000, Zhejiang, China
| | - Shanshan Wang
- Department of Neurology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, 317000, Zhejiang, China
| | - Minya Jin
- Clinical laboratory Department, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, 317000, Zhejiang, China
| | - Yangyang Yao
- Health Management Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, 317000, Zhejiang, China
| | - Yang Liu
- Department of Neurology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, 317000, Zhejiang, China.,Department of Neurology, Saarland University, 66421, Homburg, Germany
| | - Shaofa Ke
- Department of Neurology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, 317000, Zhejiang, China.
| | - Suzhi Liu
- Department of Neurology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, 317000, Zhejiang, China. .,Clinical Medical College, Shaoxing University of Arts and Sciences, Shaoxing, 312099, Zhejiang, China.
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21
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Sridharan ND, Asaadi S, Thirumala PD, Avgerinos ED. A systematic review of cognitive function after carotid endarterectomy in asymptomatic patients. J Vasc Surg 2022:S0741-5214(21)02739-7. [PMID: 34995717 DOI: 10.1016/j.jvs.2021.12.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/04/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Asymptomatic carotid stenosis has been associated with a progressive decline in neurocognitive function. However, the effect of carotid endarterectomy on this process is poorly understood. We aimed to evaluate pre and post-operative cognitive function changes in asymptomatic patients after carotid endarterectomy METHODS: A systematic review of the existing reports in PubMed/MEDLINE, Embase, and Cochran databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement recommendations. All original retrospective or prospective studies (including cohort, cross-sectional, case-control, pilot studies, etc.) and clinical trials that compared pre and post-operative neurocognitive function in asymptomatic patients with carotid stenosis after CEA, which were published from January 2000 to April 2021 were identified and considered eligible for inclusion in the study. RESULTS Thirteen studies (502 CEAs) comparing cognitive function changes before and after CEA were identified. In seven studies with a total number of 272 patients, a mean age range of 67.3 ± 4.8 to 76.35 years old and after follow-up ranging between 1 and 12 months, overall cognitive function improved after CEA. However, in six studies with a total sample of 230, a mean age range of 68.6 ± 6.9 to 74.4±6.1 years, and follow-up ranged from 24 hours to 3 years, showed no change or decline in overall cognitive function after procedures. CONCLUSIONS The lack of standardization of specific cognitive tests and cognitive function assessment timing after CEA does not allow for definite conclusions to be made. However, improving the brain perfusion with combination of CEA and statin therapy may be a protective strategy against cognitive function decline.
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22
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Kowe A, Köhler S, Görß D, Teipel S. The patients' and caregivers' perspective: In-hospital navigation aids for people with dementia- a qualitative study with a value sensitive design approach. Assist Technol 2021:1-10. [PMID: 34919023 DOI: 10.1080/10400435.2021.2020378] [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] [Indexed: 10/19/2022] Open
Abstract
People with dementia (PwD) have serious difficulties orienting themselves in a hospital environment. In this qualitative study, we asked PwD and their informal caregivers about requirements for assistive technology when navigating in inpatient care settings. We aimed to provide user-centred recommendations for the development of an in-hospital navigation aid following a value sensitive design approach. We conducted semi-structured interviews with two stakeholder groups as potential future users of in-hospital navigation aids: PwD (n = 10, agemean = 83.9 years, MMSEmean = 21.2) and informal caregivers (n = 10, agemean = 75.9 years). The interviews were evaluated using qualitative content analysis in a multistage process involving six members of a self-help group for relatives of PwD as co-researchers. Independence and relief/respite were the most important values regarding assistive technology for PwD. Informal caregivers attributed greatest importance to safety and relief/respite. The underlying values of these stakeholder groups contribute to recommendations for designing new assistive technologies for patient-centred in-patient care: Assistive technology needs to overcome age- and disease-related limitations, and the resulting individual risks, while providing subsidiary assistance to maintain the desired independence of PwD for as long as possible.
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Affiliation(s)
- Antonia Kowe
- Department "Ageing of Individuals and Society" (AGIS), Interdisciplinary Faculty, University of Rostock, Rostock, Germany
| | - Stefanie Köhler
- Rostock University Medical Center, Rostock, Germany.,German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Rostock, Germany
| | - Doreen Görß
- Rostock University Medical Center, Rostock, Germany.,German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Rostock, Germany
| | - Stefan Teipel
- Department "Ageing of Individuals and Society" (AGIS), Interdisciplinary Faculty, University of Rostock, Rostock, Germany.,Rostock University Medical Center, Rostock, Germany.,German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Rostock, Germany
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23
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Mone P, Trimarco B, Santulli G. Aspirin, NOACs, warfarin: which is the best choice to tackle cognitive decline in elderly patients? Insights from the GIRAF and ASCEND-Dementia trials presented at the AHA 2021. Eur Heart J Cardiovasc Pharmacother 2021; 8:E7-E8. [PMID: 34849683 PMCID: PMC9890627 DOI: 10.1093/ehjcvp/pvab081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/21/2021] [Indexed: 02/04/2023]
Affiliation(s)
- Pasquale Mone
- Departments of Medicine and Molecular Pharmacology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, New York, NY, USA,ASL (Azienda Sanitaria Locale–Local Health Unit) AV, Avellino, Italy,Department of Preventive Medicine, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Gaetano Santulli
- Corresponding author. Departments of Medicine and Molecular Pharmacology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, New York City, NY, USA. Tel: 00171843033370;
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De Stefano A, Di Giovanni P, Kulamarva G, Di Fonzo F, Massaro T, Contini A, Dispenza F, Cazzato C. Changes in Speech Range Profile Are Associated with Cognitive Impairment. Dement Neurocogn Disord 2021; 20:89-98. [PMID: 34795772 DOI: 10.12779/dnd.2021.20.4.89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/02/2022] Open
Abstract
Background and Purpose The aim of this study was to describe the variations in the speech range profile (SRP) of patients affected by cognitive decline. Methods We collected the data of patients managed for suspected voice and speech disorders, and suspected cognitive impairment. Patients underwent an Ear Nose and Throat evaluation and Mini-Mental State Examination (MMSE). To obtain SRP, we asked the patients to read 18 sentences twice, at their most comfortable pitch and loudness as they would do in daily conversation, and recorded their voice on to computer software. Results The study included 61 patients. The relationship between the MMSE score and SRP parameters was established. Increased severity of the MMSE score resulted in a statistically significant reduction in the average values of the semitones to the phonetogram, and the medium and maximum sound pressure levels (p<0.001). The maximum predictivity of MMSE was based on the highly significant values of semitones (p<0.001) and the maximum sound pressure levels (p=0.010). Conclusions The differences in SRP between the various groups were analyzed. Specifically, the SRP value decreased with increasing severity of cognitive decline. SRP was useful in highlighting the relationship between all cognitive declines tested and speech.
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Karakizlis H, Bohl K, Ziemek J, Dodel R, Hoyer J. Assessment of cognitive impairment and related risk factors in hemodialysis patients. J Nephrol 2021. [PMID: 34655416 DOI: 10.1007/s40620-021-01170-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/17/2021] [Indexed: 11/12/2022]
Abstract
Background Cognitive impairment in hemodialysis patients has been acknowledged over the last years and has been reported in up to 80% of patients. Older age, high prevalence of cardiovascular risk factors, such as stroke and transient ischemic attack, uremia, and multiple metabolic disturbances represent the most common factors for cognitive impairment in hemodialysis patients. Methods We conducted a prospective cohort study on 408 patients from 10 hemodialysis centers in the regional government district of Middle Hesse (Germany). Patients underwent a neuropsychological test battery consisting of five tests, in addition to a phonemic fluency test, to assess cognitive profile. The patients were classified as no cognitive impairment or mildly-, moderately- or severely-impaired cognitive function, depending on the degree of impairment and number of domains where the deficit was determined. We analyzed the cognitive profile and the change in performance over time in hemodialysis patients based on their cognitive status at baseline vs. 1-year follow-up. Results Of 479 eligible patients, 408 completed all tests at baseline. Only 25% (n = 102) of the patients had no cognitive impairment. Fourteen per cent (n = 57), 36.5% (n = 149), and 24.5% (n = 100) of patients showed mild, moderate, and severe impairment, respectively. In patients with cognitive impairment, all cognitive domains were affected, and impairment was significantly associated with depression and education. The most impaired cognitive performance was immediate memory recall, and the best performance was found in naming ability. No significant change was observed after 1-year follow up in any domain. Conclusion Our study shows that the prevalence of cognitive impairment in hemodialysis patients is high and that it is affected by the presence of depression. Furthermore, education has an effect on cognitive test results. As depression has a significant influence on cognitive impairment, its early identification is essential in order to initiate treatment at an early stage, hoping to positively influence cognitive performance. Supplementary Information The online version contains supplementary material available at 10.1007/s40620-021-01170-3.
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Saeedi R, Rezaeimanesh N, Sahraian MA, Moghadasi AN. The Possible Direct Correlation between Cognitive Impairment and Fear of Catching COVID-19 among Patients with Multiple Sclerosis. Iran J Psychiatry 2021; 16:336-342. [PMID: 34616468 PMCID: PMC8452838 DOI: 10.18502/ijps.v16i3.6260] [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] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 02/08/2020] [Accepted: 04/02/2021] [Indexed: 12/15/2022]
Abstract
Objective: The prevalence of cognitive impairment in multiple sclerosis (MS) is significant and it is estimated that 40% to 70% of patients with MS suffer from this impairment. COVID-19 is also a new infectious disease. The symptoms of this disease, which include fever, shortness of breath, and cough, can be mild to severe and can even lead to death. Due to the use of immunosuppressive drugs by Patients with MS, they might be at greater risk of catching COVID-19. Thus, patients with MS may be more afraid of catching the virus. One of the important factors is the relationship between cognitive deficit and the increase in patients' fear of COVID-19. The aim of this study was to assess the relationship between fear of catching COVID-19 and cognitive impairment in patients with MS. Method: This cross-sectional study was conducted at the MS Clinic, Sina hospital, Tehran University of Medical Sciences, Tehran, Iran. Our participants in this project were Patients with MS who were over 18 years old and had no history of other neurological and psychiatric diseases. In addition to obtaining demographic and clinical information, we measured the fear of catching the COVID 2019 via Fear of COVID-19 Scale (FCV-19S), which is 7-item questionnaire. We also used Multiple Sclerosis Neuro Psychological Screening Questionnaire (MSNQ) to assess memory and information processing speed in Patients with MS. Results: After adjustment for age, gender, disease duration, highest level of education, MS type, and EDSS in linear regression model, as well as the MSNQ total score and fear score of catching coronavirus, the results demonstrated a significant positive correlation with P value of 0.00 and β: 0.024. Conclusion: The present study showed a direct relationship between cognitive disorder and level of fear regarding COVID-19. Patients with more cognitive disorders were more afraid of COVID-19.
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Affiliation(s)
- Roghayyeh Saeedi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Rezaeimanesh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Aita SL, Kaewpoowat Q, Yasri S, Rerkasem A, Rerkasem K, Choovuthayakorn J, Ausayakhun S, Robertson K, Roth RM, Robbins NM. Psychometric utility of the international HIV dementia scale and Montreal Cognitive Assessment in HIV-associated asymptomatic neuro cognitive impairment. J Neurovirol 2021; 27:568-578. [PMID: 34185242 DOI: 10.1007/s13365-021-00991-z] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/16/2021] [Accepted: 05/30/2021] [Indexed: 12/14/2022]
Abstract
There is a growing need for brief screening measures for HIV Associated Neurocognitive Disorders (HAND). We compared two commonly used measures (the Montreal Cognitive Assessment [MoCA] and the International HIV Dementia Scale [IHDS]) in their ability to identify asymptomatic HAND (i.e., asymptomatic neurocognitive impairment [ANI]). Participants included 74 Thai PLWH: 38 met Frascati criteria for ANI and 36 were cognitively normal (CN). Participants completed Thai language versions of the MoCA (MoCA-T) and IHDS, and a validated neurocognitive battery. We examined between-group differences for MoCA-T and IHDS total scores, and scale subcomponents. We also conducted receiver operating characteristic (ROC) analyses to determine the ability of the MoCA-T and IHDS to discriminate between CN and ANI groups, and compared their area under the curve (AUC) values. Results revealed lower MoCA-T total score, as well as the Visuospatial/Executive and Delayed Recall subtask scores, in the ANI relative to CN group. Groups did not differ on the IHDS. For ROC analyses, the MoCA-T, but not the IHDS, significantly differentiated the ANI from CN group, and there was a significant difference in AUC values between the MoCA-T (AUC = .71) and IHDS (AUC = .56). Sensitivity and specificity statistics were poor for both screening measures. These data indicate while the MoCA-T functions better than the IHDS in detecting Thai PLWH with ANI, the mildest form of HAND, neither cognitive screener, showed strong utility. Our findings reflect the limited efficacy of common screening measures in detecting subtler cognitive deficits among Thai PLWH, and highlight the need for better screening tools.
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Affiliation(s)
- Stephen L Aita
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, NH, Hanover, USA
| | - Quanhathai Kaewpoowat
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Saowaluck Yasri
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Amaraporn Rerkasem
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kittipan Rerkasem
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Janejit Choovuthayakorn
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Somsanguan Ausayakhun
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kevin Robertson
- Department of Neurology, University of North Carolina at Chapel Hill, NC, Chapel Hill, USA
| | - Robert M Roth
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, NH, Hanover, USA
| | - Nathaniel M Robbins
- Department of Neurology, Geisel School of Medicine at Dartmouth, NH, Hanover, USA.
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Zhang JH, Zhang JF, Song J, Bai Y, Deng L, Feng CP, Xu XY, Guo HX, Wang Y, Gao X, Gu Y, Jin C, Zheng JF, Zhen Z, Su H. Effects of Berberine on Diabetes and Cognitive Impairment in an Animal Model: The Mechanisms of Action. Am J Chin Med 2021; 49:1399-1415. [PMID: 34137676 DOI: 10.1142/s0192415x21500658] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Diabetes is a group of metabolic disorders with an increased risk of developing cognitive impairment and dementia. The hippocampus in the forebrain contains an abundance of insulin receptors related to cognitive function and plays an important role in the pathophysiology of neurodegenerative disorders. Berberine from traditional Chinese medicine has been used to treat diabetes and diabetic cognitive impairment, although its related mechanisms are largely unknown. In this study, a STZ diabetes rat model feeding with a high-fat diet was used to test the effects of berberine compared with metformin. Oral glucose tolerance and hyperinsulinemic-euglycemic clamp were used for glucose metabolism and insulin resistance. The Morris water maze was used to observe the compound effects on cognitive impairment. Serum and hippocampal [Formula: see text]-amyloid peptide (A[Formula: see text], Tau and phosphorylated Tau protein deposition in the hippocampi were measured. The TUNEL assay was used to detect the neuronal apoptosis, supported by histomorphological changes and transmissional electron microscopy (TEM) image. Our data showed that the diabetic rats had a significantly cognitive impairment. In addition to improving glucose metabolism and reducing insulin resistance, berberine significantly improved the cognitive function in the rat. Berberine also effectively decreased the expression of hippocampal tau protein, phosphorylated Tau, and increased insulin receptor antibodies. Moreover, berberine downregulated the abnormal phosphorylation of A[Formula: see text] and Tau protein and improved hippocampal insulin signaling. The TUNEL assay confirmed that berberine reduced hippocampal neuronal apoptosis supported by TEM. Thus, berberine significantly improved the cognitive function in diabetic rats by changing the peripheral and central insulin resistance. The reduction of neuronal injury, A[Formula: see text] deposition, abnormal phosphorylation of Tau protein, and neuronal apoptosis in the hippocampus were observed as the related mechanisms of action.
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Affiliation(s)
| | - Jin-Feng Zhang
- Jingmen Hospital of Traditional Chinese Medicine, Jingmen 448000, P. R. China
| | - Jun Song
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China
| | - Yu Bai
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China
| | - Lan Deng
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China
| | - Chun-Peng Feng
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China
| | - Xin-Yao Xu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China
| | - Hong-Xia Guo
- Langfang Normal University, Langfang 065000, P. R. China
| | - Yi Wang
- Tianjin Anding Hospital, Tianjin 300222, P. R. China
| | - Xin Gao
- Tianjin Anding Hospital, Tianjin 300222, P. R. China
| | - Yan Gu
- Tianjin Third Central Hospital, Tianjin 300170, P. R. China
| | - Chuan Jin
- Tianjin Binhai New Area Dagang Hospital, Tianjin 300270, P. R. China
| | - Jun-Fu Zheng
- Tianjin Binhai New Area TCM Hospital, Tianjin 300451, P. R. China
| | - Zhong Zhen
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China
| | - Hao Su
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China
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Valladão Júnior JBR, Suemoto CK, Goulart AC, Schmidt MI, Passos VMA, Barreto SM, Lotufo PA, Bensenor IM, Santos IS. Anemia and Cognitive Performance in the ELSA-Brasil Cohort Baseline. J Neuropsychiatry Clin Neurosci 2021; 32:227-234. [PMID: 31795805 DOI: 10.1176/appi.neuropsych.19040088] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The association between cognitive performance and hemoglobin concentration has long been a topic of debate, but few data for middle-aged persons have been explored. The authors examined the association between anemia and cognitive performance at baseline assessment in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort study of individuals from six Brazilian cities. METHODS A total of 13,624 participants (mean age=51.6 years [SD=9.0]) were included in this cross-sectional study. Cognitive performance was evaluated by using standardized scores for verbal learning, late recall, word recognition, a semantic verbal fluency test, and the Trail-Making Test, Part B (TMT-B). The association between anemia and cognitive performance was examined by using linear regression models adjusted for sociodemographic characteristics and cardiovascular risk factors. RESULTS Anemia was diagnosed in 713 (5.2%) participants. No association was found between anemia and worse cognitive performance for the main models. Global cognitive scores were similar between participants with and without anemia in adjusted models for the entire sample (β=-0.004; 95% CI=-0.052, 0.044) or for men (β=0.047; 95% CI=-0.053, 0.146) and women (β=-0.015; 95% CI=-0.070, 0.040) separately. In addition, hemoglobin levels (in quintile groups) were not associated with global cognitive scores. Similarly, no significant associations with anemia or hemoglobin levels were observed when each cognitive performance test was evaluated separately. CONCLUSIONS Anemia and hemoglobin levels were not associated with worse cognitive performance in this large cohort.
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Affiliation(s)
- José Benedito R Valladão Júnior
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Claudia K Suemoto
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Alessandra C Goulart
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Maria Ines Schmidt
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Valéria M A Passos
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Sandhi M Barreto
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Paulo A Lotufo
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Isabela M Bensenor
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Itamar S Santos
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
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Chauhan PS, Mishra M, Koul B, Sharma M, Yadav D. Modifiable Risk Factors Associated with Alzheimer's Disease with Special Reference to Sleep Disturbance. CNS Neurol Disord Drug Targets 2021; 20:594-601. [PMID: 33745437 DOI: 10.2174/1871527320666210319111852] [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] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/08/2020] [Accepted: 02/01/2021] [Indexed: 11/22/2022]
Abstract
Sleep disorders has been shown to increase the risk of dementia. This particular aspect may affect the cognition of the patient, leading to behavioral disorders, and depression. In early symptomatic Alzheimer's disease (AD), default mode network (DMN) disruption occurs and progresses along with the course of the disease. This review mainly focuses on the leading causes of AD along with management of conditions like insomnia, obstructive sleep apnea, nighttime sleep duration, circadian rhythm disorder (CRD), neuroendocrine alternation and impaired sleep to prevent the use of drugs that can cause complications, especially falls or additional cognitive deficits. Moreover, this study highlights identification of molecular mechanisms like effect of impaired sleep on amyloid β (Aβ) and Tau dynamics, impaired proteostasis along with appropriate measures to treat few contributing factors lead to insomnia in AD or mild cognitive impairment (MCI).
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Affiliation(s)
| | - Meerambika Mishra
- Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, P.O. Box 110880, Gainesville, FL 32611-0880. United States
| | - Bhupendra Koul
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara-144411, Punjab. India
| | - Mayank Sharma
- Department of Electronics and Communication, ITM University Gwalior, 474001. India
| | - Dhananjay Yadav
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan 38541. South Korea
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Azuar J, Bouaziz-Amar E, Cognat E, Dumurgier J, Clergue-Duval V, Barré T, Amami J, Hispard E, Bellivier F, Paquet C, Vorspan F, Questel F. Cerebrospinal Fluid Biomarkers in Patients With Alcohol Use Disorder and Persistent Cognitive Impairment. Alcohol Clin Exp Res 2021; 45:561-565. [PMID: 33486797 DOI: 10.1111/acer.14554] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The prevalence of cognitive impairment is high among alcohol-dependent patients. Although the clinical presentation of alcohol-related cognitive disorder (ARCD) may resemble that of Alzheimer's disease (AD), the prognosis and treatment of the 2 diseases are different. Cerebrospinal fluid (CSF) biomarkers (tau, phosphorylated tau, and amyloid β) have high diagnostic accuracy in AD and are currently being used to discriminate between psychiatric disorders and AD, but are not used to diagnose ARCD. The aim of this study was to characterize CSF biomarkers in a homogeneous, cognitively impaired alcohol-dependent population. METHODS This single-center study was conducted in an addiction medicine department of a Parisian Hospital. We selected patients with documented persistent cognitive impairment whose MoCA (Montreal Cognitive Assessment) score was below 24/30 after at least 1 month of documented inpatient abstinence from alcohol. We measured the CSF biomarkers (tau, phosphorylated tau, and amyloid β 1-42 and 1-40) in 73 highly impaired alcohol-dependent patients (Alcohol Use Disorders Identification Test score over 11 for women and 12 for men) with. RESULTS Patients' average age was 60 ± 9.1 years and 45 (61.6%) had a normal CSF profile, 8 (11.0%) had a typical CSF AD profile, and 20 (27.4%) had an intermediate CSF profile. CONCLUSIONS This study revealed a high prevalence of AD in alcohol-dependent patients with persistent cognitive deficits and several anomalies in their CSF profiles. Thus, it is important to consider AD in the differential diagnosis of persistent cognitive deficits in patients with alcohol dependence and to use CSF biomarkers in addition to imaging and neuropsychological testing to evaluate alcohol-related cognitive impairment.
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Affiliation(s)
- Julien Azuar
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, APHP, Paris, France.,INSERM U1144, Université de Paris, Paris, France.,FHU NOR-SUD, Network of Research in Substance Use Disorders, APHP, Paris, France
| | - Elodie Bouaziz-Amar
- INSERM U1144, Université de Paris, Paris, France.,Département de Biochimie, Hôpital Lariboisière, APHP, Paris, France
| | - Emmanuel Cognat
- INSERM U1144, Université de Paris, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France.,Centre de Neurologie Cognitive, Groupe Hospitalier Saint Louis Lariboisière Fernand Widal, APHP, Paris, France
| | - Julien Dumurgier
- Faculté de Médecine, Université de Paris, Paris, France.,Centre de Neurologie Cognitive, Groupe Hospitalier Saint Louis Lariboisière Fernand Widal, APHP, Paris, France
| | - Virgile Clergue-Duval
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, APHP, Paris, France.,INSERM U1144, Université de Paris, Paris, France.,FHU NOR-SUD, Network of Research in Substance Use Disorders, APHP, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France
| | - Thomas Barré
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, APHP, Paris, France
| | - Jihed Amami
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, APHP, Paris, France
| | - Eric Hispard
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, APHP, Paris, France
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, APHP, Paris, France.,INSERM U1144, Université de Paris, Paris, France.,FHU NOR-SUD, Network of Research in Substance Use Disorders, APHP, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France
| | - Claire Paquet
- INSERM U1144, Université de Paris, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France.,Centre de Neurologie Cognitive, Groupe Hospitalier Saint Louis Lariboisière Fernand Widal, APHP, Paris, France
| | - Florence Vorspan
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, APHP, Paris, France.,INSERM U1144, Université de Paris, Paris, France.,FHU NOR-SUD, Network of Research in Substance Use Disorders, APHP, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France
| | - Frank Questel
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, APHP, Paris, France.,INSERM U1144, Université de Paris, Paris, France.,FHU NOR-SUD, Network of Research in Substance Use Disorders, APHP, Paris, France
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Moon Y, Lim JS, Lee CN, Choi H. Vulnerable Strata to Non-Adherence and Overuse in Treatment for Patients with Cognitive Impairment. Dement Neurocogn Disord 2020; 19:152-60. [PMID: 33377668 DOI: 10.12779/dnd.2020.19.4.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/24/2020] [Accepted: 11/24/2020] [Indexed: 11/27/2022] Open
Abstract
Background and purpose Appropriate medication treatment could enable both cognitively impaired patients and caregivers to hold on their cognitive functioning and quality of life. Thus, medication management and the factors influencing how management for this condition is carried out must be identified. In this study we aimed to evaluate the frequency of medication nonadherence (MNA) or drug overuse for cognitive impairment (DOC) and to extract significant variables, including the demographic and social characteristics, vascular risk factors, and cognitive status, for the diagnosis of MNA and DOC in Korean patients. Methods We investigated patients aged over 50 years between March 2019 and June 2019 via the cognitive enHancement of patIents with acQuired cognitive impairment (HIQ) campaign. MNA was defined as a participant who was classified as having cognitive impairment but did not take any cognition-related drugs, whereas DOC was defined as a participant who had normal cognition but was taking cognition-related drugs. Results We included 10,767 patients. The MNA group consisted of 337 participants, whereas the DOC group comprised 1,107 participants. The factors that could differentiate the MNA group from the normal-behavior group were age, education, sex, and the total Korean version of Mini-Mental State Examination (K-MMSE) score. The factors that could differentiate the DOC group from the normal medication-behavior group were age, sex, residential distinction, experience of a dementia screening test, and the total K-MMSE score. Conclusions The underlying factors contributing to inadequate dementia-medication management must be understood, and intervention or support is needed to enable safe medication management.
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Lee KS, Park KW. Artificial Intelligence Approaches to Social Determinants of Cognitive Impairment and Its Associated Conditions. Dement Neurocogn Disord 2020; 19:114-23. [PMID: 32985151 DOI: 10.12779/dnd.2020.19.3.114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/25/2020] [Accepted: 09/06/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND PURPOSE This study uses an artificial-intelligence model (recurrent neural network) for evaluating the following hypothesis: social determinants of disease association in a middle-aged or old population are different across gender and age groups. Here, the disease association indicates an association among cerebrovascular disease, hearing loss and cognitive impairment. METHODS Data came from the Korean Longitudinal Study of Ageing (2014-2016), with 6,060 participants aged 53 years or more, that is, 2,556 men, 3,504 women, 3,640 aged 70 years or less (70-), 2,420 aged 71 years or more (71+). The disease association was divided into 8 categories: 1 category for having no disease, 3 categories for having 1, 3 categories for having 2, and 1 category for having 3. Variable importance, the effect of a variable on model performance, was used for finding important social determinants of the disease association in a particular gender/age group, and evaluating the hypothesis above. RESULTS Based on variable importance from the recurrent neural network, important social determinants of the disease association were different across gender and age groups: 1) leisure activity for men; 2) parents alive, income and economic activity for women; 3) children alive, education and family activity for 70-; and 4) brothers/sisters cohabiting, religious activity and leisure activity for 70+. CONCLUSIONS The findings of this study support the hypothesis, suggesting the development of new guidelines reflecting different social determinants of the disease association across gender and age groups.
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Ersek M, Neradilek MB, Herr K, Hilgeman MM, Nash P, Polissar N, Nelson FX. Psychometric Evaluation of a Pain Intensity Measure for Persons with Dementia. Pain Med 2020; 20:1093-1104. [PMID: 30204895 DOI: 10.1093/pm/pny166] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The goal of this study was to conduct initial psychometric analyses of a seven-item pain intensity measure for persons with dementia (PIMD) that was developed using items from existing pain observational measures. DESIGN AND METHODS We evaluated validity by examining associations with an expert clinician's pain intensity rating (ECPIR) and an established pain observation tool (Mobilization Observation Behaviour Intensity Dementia [MOBID]). We also examined correlations between the PIMD and known correlates of pain: depression, sleep disturbances, agitation, painful diagnoses, and caregiver pain reports. We examined the differences between PIMD scores for "at rest" and "during movement" observations. We assessed reliability by calculating Cronbach's alpha and estimating inter-rater reliability using intraclass correlations (ICCs). Finally, we examined whether six additional "recent changes in behavior" items improved the PIMD's ability to predict expert clinicians' pain ratings. SETTING Sixteen nursing homes located in Alabama, Georgia, Pennsylvania, and New Jersey. PARTICIPANTS One hundred ninety residents with moderate to severe cognitive impairment, mean age of 84 years, 49.5% female, and 70% white. RESULTS PIMD during movement scores were highly correlated with the ECPIR and overall MOBID scores. As expected, there were large differences between at rest and during movement PIMD scores. Associations of PIMD with known correlates of pain were generally low and statistically nonsignificant. Internal consistency was supported with a Cronbach alpha of 0.72 and an inter-rater ICC of 0.82 for during movement PIMD scores. CONCLUSIONS Initial evaluation of the PIMD supports its validity and reliability. Additional testing is needed to evaluate the tool's sensitivity to changes in pain intensity.
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Affiliation(s)
- Mary Ersek
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania.,University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | | | - Keela Herr
- University of Iowa College of Nursing, Iowa City, Iowa
| | - Michelle M Hilgeman
- Tuscaloosa VA Medical Center, Tuscaloosa, Alabama.,Department of Psychology, Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama.,Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Nayak Polissar
- The Mountain-Whisper-Light Statistics, Seattle, Washington
| | - Francis X Nelson
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
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Pei H, Ma L, Cao Y, Wang F, Li Z, Liu N, Liu M, Wei Y, Li H. Traditional Chinese Medicine for Alzheimer's Disease and Other Cognitive Impairment: A Review. Am J Chin Med 2020; 48:487-511. [PMID: 32329645 DOI: 10.1142/s0192415x20500251] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Cognitive impairment (CI) refers to the dysfunction of memory, language, visual space, execution, calculation, understanding, and judgment in one or more aspects. With global aging, CI will become prevalent worldwide. At present, there is no effective cure for CI. However, Nobel laureate Tu Youyou's research on artemisinin has inspired Chinese researchers to focus on traditional Chinese herbs (TCHs) for the treatment of CI. Traditional Chinese Medicine (TCM) has led to a theory for an independent CI system. The pathogenesis of such impairment involves deficiency, phlegm, and stagnation and involves a range of organs, including the brain, kidneys, heart, liver, and spleen. Our current understanding of the etiology and pathogenesis of this condition has led to the realization that TCHs can improve cognitive dysfunction. Clinical research has shown that TCHs can improve the neuropsychological scale score of patients, the TCM symptom score, and the patient's quality of life. Research has also suggested that TCHs can retard Aβ deposits and tauopathy, regulate the metabolism of cholinergic neurotransmitters, and so on. However, due to their complexity, little is known of the safety and efficacy of TCHs in patients with CI. It is likely that we will be able to identify the precise mechanisms associated with the action of TCHs in such patients due to the integration of multiple technologies. This paper summarizes the pharmacokinetics, curative effect, and mechanisms of action of traditional Chinese herbs in order to provide a scientific basis for the improvement of cognitive dysfunction by TCHs.
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Affiliation(s)
- Hui Pei
- Institude of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P. R. China
| | - Lina Ma
- Institude of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P. R. China
| | - Yu Cao
- Institude of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P. R. China
| | - Feixue Wang
- Traditional Chinese Medicine Department, Xuanwu Hospital Capital Medical University, Beijing 100053, P. R. China
| | - Zehui Li
- Institude of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P. R. China
| | - Nanyang Liu
- Institude of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P. R. China
| | - Meixia Liu
- Institude of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P. R. China
| | - Yun Wei
- Institude of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P. R. China
| | - Hao Li
- Institude of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P. R. China
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Parvizi M, Fadai F, Khodaei-Ardakani MR, Amin G, Abdi L, Noroozi M, Ansari I. Effect of Cuscuta epithymum Acquainted with Risperidone on the Improvement of Clinical Symptoms and Cognitive Impairment in Patients with Schizophrenia: A Triple-Blind Randomized Placebo-Controlled Trial. Galen Med J 2019; 8:e1334. [PMID: 34466495 PMCID: PMC8343989 DOI: 10.31661/gmj.v8i0.1334] [Citation(s) in RCA: 4] [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: 08/16/2018] [Revised: 08/29/2019] [Accepted: 09/30/2019] [Indexed: 11/17/2022] Open
Abstract
Background: Cuscuta epithymum (CE) is an established medicinal herb utilized for treating psychosis in Persian medicine. The aim of this study was to investigate the effect of CE combined with risperidone on the clinical symptoms and the cognitive impairment in patients diagnosed with schizophrenia. Materials and Methods: In this triple-blind randomized placebo-controlled trial, the intervention group received a dose of 500 mg of CE in the form of a capsule to be taken twice a day accompanied by an appropriate dose of risperidone. The control group was presented with a placebo identical to that of the CE capsule plus the allocated dose of risperidone. The PANSS and SCoRS questionnaires were used to assess the status of subjects prior to the initiation of the intervention as well as being put to use at the end of the second, fourth, and eighth week post-intervention. Registering and recording intel concerning positive and negative symptoms felt by participants (PANNS), and a test to assess the cognitive impairment of the individuals. Results: After eight weeks of treatment, all negative and positive symptoms besides hostility and somatic concern exhibited a significant improvement in the CE group (P <0.05). In contrast, the CE placebo group displayed no substantial improvement in the cases of the positive, negative and general symptoms (P>0.05) regarding cognitive impairment, after eight weeks of treatment, all symptoms were greatly improved in the CE group (P<0.05), while the effect of the placebo on the patients cognitive impairment remained mostly stationary (P>0.05). Consequently, after eight weeks after the intervention, we can determine that the CE treatment has been noticeably more effective at improving positive, negative and cognitive symptoms of patients with schizophrenia. Conclusion: The results of this study demonstrated that CE, possessing possible antioxidant and neuroprotective properties, safely improved the positive and negative symptoms, and cognitive impairment of patients with schizophrenia.
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Affiliation(s)
- Maedeh Parvizi
- Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farbod Fadai
- Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Gholamreza Amin
- Department of Pharmacognosy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Abdi
- Department of Traditional Medicine, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Noroozi
- Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Iman Ansari
- Medical Students Research Committee, Shahed University, Tehran, Iran
- Correspondence to: Iman Ansari M.D, Medical Students Research Committee, Faculty of Medicine, Shahed University, Italia Street, Felestin Avenue, Tehran, Iran Telephone Number: +989398921692 Email Address:
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Morovic S, Budincevic H, Govori V, Demarin V. Possibilities of Dementia Prevention - It is Never Too Early to Start. J Med Life 2019; 12:332-337. [PMID: 32025250 PMCID: PMC6993301 DOI: 10.25122/jml-2019-0088] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 10/27/2019] [Indexed: 01/21/2023] Open
Abstract
Dementia represents one of the greatest global challenges for health and social care in this century. More than 50 million people worldwide suffer from dementia, and this number is predicted to triple by 2050. Ageing is often associated with cognitive impairment. Therefore, prevention of cognitive impairment is an imperative. Dementia includes a heterogeneous group of disorders, the most common being Alzheimer's disease and vascular dementia. Most cardiovascular risk factors such as hypertension, diabetes mellitus, hypercholesterolemia, atrial fibrillation and smoking are not exclusive risk factors for vascular dementia but also for Alzheimer's disease. The ApoE4 allele is the single non-modifiable risk factor for Alzheimer's disease. Today we know that an important, modifiable risk factor is education. Better education means better protection against dementia. A large number of dementia cases are potentially preventable by early intervention. Early changes in the blood vessel wall can be detected by early ultrasound methods or early biomarkers. These methods allow us to detect changes before the disease becomes clinically evident. Early disease detection enables timely management, and studies have shown that careful control of vascular risk factors can postpone the onset or even reverse disease progression.
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Affiliation(s)
| | | | - Valbona Govori
- Department of Neurology, University Clinical Center, Prishtina, Republic of Kosovo
| | - Vida Demarin
- International Institute for Brain Health, Zagreb, Croatia
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Puy L, Bugnicourt JM, Liabeuf S, Desjardins L, Roussel M, Diouf M, Chillon JM, Choukroun G, Massy ZA, Godefroy O. Cognitive Impairments and Dysexecutive Behavioral Disorders in Chronic Kidney Disease. J Neuropsychiatry Clin Neurosci 2019; 30:310-317. [PMID: 30045680 DOI: 10.1176/appi.neuropsych.18030047] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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] [Indexed: 12/01/2022]
Abstract
The purpose of this study was to characterize cognitive impairments and behavioral disorders in a sample of patients with chronic kidney disease (CKD). A total of 52 patients with CKD were prospectively recruited over a 344-day period. Cognitive functions (memory, action speed, executive function, and language) and behavioral characteristics were assessed with a standardized comprehensive battery. The patients' performances were interpreted with a validated method on the basis of normative data from 1,003 healthy control subjects. Brain MRI and biological data were collected. Multivariable linear regression models and bootstrap analyses were used to identify risk factors for cognitive impairment. Cognitive impairment was observed in 32.5% (95% confidence interval: 17%-48%) of the 40 included patients with full data sets. Action speed and executive functions were the most frequently impaired domains. Dysexecutive behavioral disorders were observed in 27% of patients, and depression was observed in 32.5%. Cognitive impairment was independently associated with stroke volume, high serum parathyroid hormone and uric acid levels, and low serum glucose levels (adjusted R2=0.54, p<0.001 One-third of patients with CKD had cognitive impairments (action speed and executive functions), behavioral dysexecutive disorders (hypoactivity with apathy, irritability, or anosognosia), or depression.
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Affiliation(s)
- Laurent Puy
- From the Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Medical Center, Amiens, France (LP, J-MB, MR, OG); INSERM, Clinical Research Centre and Division of Clinical Pharmacology, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (SL, LD); the Nephrology Department, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (GC); INSERM, Jules Verne University of Picardy, Amiens, France (JMC, GC); the Department of Biostatistics, Amiens University Medical Center, Amiens, France (MD); the Division of Nephrology, Ambroise Paré Hospital, APHP, Boulogne-Billancourt/Paris, France (ZAM); INSERM, CESP, University Versailles Saint Quentin, University Paris-Saclay, Villejuif, France (ZAM); and the Clinical Research and Innovation Directorate, Amiens University Medical Center, Amiens, France (LD)
| | - Jean-Marc Bugnicourt
- From the Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Medical Center, Amiens, France (LP, J-MB, MR, OG); INSERM, Clinical Research Centre and Division of Clinical Pharmacology, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (SL, LD); the Nephrology Department, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (GC); INSERM, Jules Verne University of Picardy, Amiens, France (JMC, GC); the Department of Biostatistics, Amiens University Medical Center, Amiens, France (MD); the Division of Nephrology, Ambroise Paré Hospital, APHP, Boulogne-Billancourt/Paris, France (ZAM); INSERM, CESP, University Versailles Saint Quentin, University Paris-Saclay, Villejuif, France (ZAM); and the Clinical Research and Innovation Directorate, Amiens University Medical Center, Amiens, France (LD)
| | - Sophie Liabeuf
- From the Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Medical Center, Amiens, France (LP, J-MB, MR, OG); INSERM, Clinical Research Centre and Division of Clinical Pharmacology, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (SL, LD); the Nephrology Department, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (GC); INSERM, Jules Verne University of Picardy, Amiens, France (JMC, GC); the Department of Biostatistics, Amiens University Medical Center, Amiens, France (MD); the Division of Nephrology, Ambroise Paré Hospital, APHP, Boulogne-Billancourt/Paris, France (ZAM); INSERM, CESP, University Versailles Saint Quentin, University Paris-Saclay, Villejuif, France (ZAM); and the Clinical Research and Innovation Directorate, Amiens University Medical Center, Amiens, France (LD)
| | - Lucie Desjardins
- From the Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Medical Center, Amiens, France (LP, J-MB, MR, OG); INSERM, Clinical Research Centre and Division of Clinical Pharmacology, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (SL, LD); the Nephrology Department, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (GC); INSERM, Jules Verne University of Picardy, Amiens, France (JMC, GC); the Department of Biostatistics, Amiens University Medical Center, Amiens, France (MD); the Division of Nephrology, Ambroise Paré Hospital, APHP, Boulogne-Billancourt/Paris, France (ZAM); INSERM, CESP, University Versailles Saint Quentin, University Paris-Saclay, Villejuif, France (ZAM); and the Clinical Research and Innovation Directorate, Amiens University Medical Center, Amiens, France (LD)
| | - Martine Roussel
- From the Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Medical Center, Amiens, France (LP, J-MB, MR, OG); INSERM, Clinical Research Centre and Division of Clinical Pharmacology, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (SL, LD); the Nephrology Department, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (GC); INSERM, Jules Verne University of Picardy, Amiens, France (JMC, GC); the Department of Biostatistics, Amiens University Medical Center, Amiens, France (MD); the Division of Nephrology, Ambroise Paré Hospital, APHP, Boulogne-Billancourt/Paris, France (ZAM); INSERM, CESP, University Versailles Saint Quentin, University Paris-Saclay, Villejuif, France (ZAM); and the Clinical Research and Innovation Directorate, Amiens University Medical Center, Amiens, France (LD)
| | - Momar Diouf
- From the Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Medical Center, Amiens, France (LP, J-MB, MR, OG); INSERM, Clinical Research Centre and Division of Clinical Pharmacology, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (SL, LD); the Nephrology Department, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (GC); INSERM, Jules Verne University of Picardy, Amiens, France (JMC, GC); the Department of Biostatistics, Amiens University Medical Center, Amiens, France (MD); the Division of Nephrology, Ambroise Paré Hospital, APHP, Boulogne-Billancourt/Paris, France (ZAM); INSERM, CESP, University Versailles Saint Quentin, University Paris-Saclay, Villejuif, France (ZAM); and the Clinical Research and Innovation Directorate, Amiens University Medical Center, Amiens, France (LD)
| | - Jean Marc Chillon
- From the Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Medical Center, Amiens, France (LP, J-MB, MR, OG); INSERM, Clinical Research Centre and Division of Clinical Pharmacology, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (SL, LD); the Nephrology Department, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (GC); INSERM, Jules Verne University of Picardy, Amiens, France (JMC, GC); the Department of Biostatistics, Amiens University Medical Center, Amiens, France (MD); the Division of Nephrology, Ambroise Paré Hospital, APHP, Boulogne-Billancourt/Paris, France (ZAM); INSERM, CESP, University Versailles Saint Quentin, University Paris-Saclay, Villejuif, France (ZAM); and the Clinical Research and Innovation Directorate, Amiens University Medical Center, Amiens, France (LD)
| | - Gabriel Choukroun
- From the Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Medical Center, Amiens, France (LP, J-MB, MR, OG); INSERM, Clinical Research Centre and Division of Clinical Pharmacology, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (SL, LD); the Nephrology Department, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (GC); INSERM, Jules Verne University of Picardy, Amiens, France (JMC, GC); the Department of Biostatistics, Amiens University Medical Center, Amiens, France (MD); the Division of Nephrology, Ambroise Paré Hospital, APHP, Boulogne-Billancourt/Paris, France (ZAM); INSERM, CESP, University Versailles Saint Quentin, University Paris-Saclay, Villejuif, France (ZAM); and the Clinical Research and Innovation Directorate, Amiens University Medical Center, Amiens, France (LD)
| | - Ziad A Massy
- From the Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Medical Center, Amiens, France (LP, J-MB, MR, OG); INSERM, Clinical Research Centre and Division of Clinical Pharmacology, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (SL, LD); the Nephrology Department, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (GC); INSERM, Jules Verne University of Picardy, Amiens, France (JMC, GC); the Department of Biostatistics, Amiens University Medical Center, Amiens, France (MD); the Division of Nephrology, Ambroise Paré Hospital, APHP, Boulogne-Billancourt/Paris, France (ZAM); INSERM, CESP, University Versailles Saint Quentin, University Paris-Saclay, Villejuif, France (ZAM); and the Clinical Research and Innovation Directorate, Amiens University Medical Center, Amiens, France (LD)
| | - Olivier Godefroy
- From the Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Medical Center, Amiens, France (LP, J-MB, MR, OG); INSERM, Clinical Research Centre and Division of Clinical Pharmacology, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (SL, LD); the Nephrology Department, Amiens University Medical Center, and Jules Verne University of Picardy, Amiens, France (GC); INSERM, Jules Verne University of Picardy, Amiens, France (JMC, GC); the Department of Biostatistics, Amiens University Medical Center, Amiens, France (MD); the Division of Nephrology, Ambroise Paré Hospital, APHP, Boulogne-Billancourt/Paris, France (ZAM); INSERM, CESP, University Versailles Saint Quentin, University Paris-Saclay, Villejuif, France (ZAM); and the Clinical Research and Innovation Directorate, Amiens University Medical Center, Amiens, France (LD)
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Ullrich P, Werner C, Bongartz M, Kiss R, Bauer J, Hauer K. Validation of a Modified Life-Space Assessment in Multimorbid Older Persons With Cognitive Impairment. Gerontologist 2019; 59:e66-e75. [PMID: 29394351 DOI: 10.1093/geront/gnx214] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To investigate the validity, reliability, sensitivity to change, and feasibility of a modified University of Alabama at Birmingham Study of Aging Life-Space Assessment (UAB-LSA) in older persons with cognitive impairment (CI). RESEARCH DESIGN AND METHODS The UAB-LSA was modified for use in persons with CI Life-Space Assessment for Persons with Cognitive Impairment (LSA-CI). Measurement properties of the LSA-CI were investigated using data of 118 multimorbid older participants with CI [mean age (SD): 82.3 (6.0) years, mean Mini-Mental State Examination score: 23.3 (2.4) points] from a randomized controlled trial (RCT) to improve motor performance and physical activity. Construct validity was asessed by Spearman's rank (rs) and point-biseral correlations (rpb) with age, gender, motor, and cognitive status, psychosocial factors, and sensor-derived (outdoor) physical activity variables. Test-retest reliability was analyzed using intra-class correlation coefficients (ICCs). Sensitivity to change was determined by standardized response means (SRMs) calculated for the RCT intervention group. RESULTS The LSA-CI demonstrated moderate to high construct validity, with significant correlations of the LSA-CI scores with (outdoor) physical activity (rs = .23-.63), motor status (rs = .27-.56), fear of falling-related psychosocial variables (rs = |.24-.44|), and demographic characteristics (rpb = |.27-.32|). Test-retest reliability was good to excellent (ICC = .65-.91). Sensitivity to change was excellent for the LSA-CI composite score (SRM = .80) and small to moderate for the LSA-CI subscores (SRM = .35-.60). A completion rate of 100% and a mean completion time of 4.1 min) documented good feasibility. DISCUSSION AND IMPLICATIONS The LSA-CI represents a valid, reliable, sensitive, and feasible interview-based life-space assessment tool in multimorbid older persons with CI.
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Affiliation(s)
- Phoebe Ullrich
- AGAPLESION Bethanien Hospital Heidelberg/Geriatric Centre of the University of Heidelberg, Germany
| | - Christian Werner
- AGAPLESION Bethanien Hospital Heidelberg/Geriatric Centre of the University of Heidelberg, Germany
| | - Martin Bongartz
- AGAPLESION Bethanien Hospital Heidelberg/Geriatric Centre of the University of Heidelberg, Germany
| | - Rainer Kiss
- AGAPLESION Bethanien Hospital Heidelberg/Geriatric Centre of the University of Heidelberg, Germany
| | - Jürgen Bauer
- AGAPLESION Bethanien Hospital Heidelberg/Geriatric Centre of the University of Heidelberg, Germany.,Center of Geriatric Medicine, University of Heidelberg, Germany
| | - Klaus Hauer
- AGAPLESION Bethanien Hospital Heidelberg/Geriatric Centre of the University of Heidelberg, Germany.,Center of Geriatric Medicine, University of Heidelberg, Germany
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Casillas A, Liang LJ, Vassar S, Brown A. Trends in Memory Problems and Race/Ethnicity in the National Health and Examination Survey, 1999-2014. Ethn Dis 2019; 29:525-534. [PMID: 31367174 DOI: 10.18865/ed.29.3.525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/18/2022] Open
Abstract
Background Little data exist to describe serial population-level trends in cognitive impairment- especially among minority communities. Because memory problems are among the first warning signs of cognitive impairment, they provide a potential method for monitoring changes in cognitive health at the population level. This exploratory study aimed to: 1) estimate prevalence of memory problems among US residents by race/ethnicity, age category; and 2) examine whether racial/ethnic differences in subjective cognitive concerns (memory problems) varied across recent time periods. Design and Setting Serial cross-sectional analysis of self-reported data from the National Health and Examination Survey (NHANES), 1999-2014. Participants 20,585 participants aged ≥45 years during 1999-2014, who reported race/ethnicity as non-Hispanic White (NHW), non-Hispanic Black (NHB), and Latino/Hispanic. Measurements The outcome of interest was subjective cognitive concerns, identified as self-reported memory problems. The frequencies of memory problems were examined for each 4-year period, across racial/ethnic groups. Results In adjusted analyses, compared with older (aged ≥ 65 years) NHWs, disparities in subjective cognitive concerns were observed for older Latinos for most periods (range of AOR: 1.43 - 2.01, P<.05). Additionally, Latinos without a high school education had significantly higher odds of reporting memory problems than NHW in multiple periods (range of AOR: 1.95 - 2.17, P<.005), while Latino high school graduates did not. There were no significant changes in racial/ethnic differences in subjective cognitive concerns over time. Conclusions The prevalence of subjective cognitive concerns across time periods points to a need to engage patients - particularly older and less-educated Latinos - about warning signs for cognitive impairment. The impact of education on subjective cognitive concerns in older Latinos may be related to acculturation and warrant further investigation.
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Affiliation(s)
- Alejandra Casillas
- General Internal Medicine & Health Services Research, University of California Los Angeles, CA
| | - Li-Jung Liang
- General Internal Medicine & Health Services Research, University of California Los Angeles, CA
| | - Stefanie Vassar
- General Internal Medicine & Health Services Research, University of California Los Angeles, CA
| | - Arleen Brown
- General Internal Medicine & Health Services Research, University of California Los Angeles, CA
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Pengelly J, Pengelly M, Lin KY, Royse C, Karri R, Royse A, Bryant A, Williams G, El-Ansary D. Exercise Parameters and Outcome Measures Used in Cardiac Rehabilitation Programs Following Median Sternotomy in the Elderly: A Systematic Review and Meta-Analysis. Heart Lung Circ 2019; 28:1560-1570. [PMID: 31176628 DOI: 10.1016/j.hlc.2019.05.098] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 01/14/2019] [Revised: 04/04/2019] [Accepted: 05/03/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The aim of this systematic review was to identify exercise parameters and outcome measures used in cardiac rehabilitation programs following median sternotomy, in the elderly cardiac population. DATA SOURCES Five (5) electronic databases were searched for relevant studies published in English after 1997. STUDY SELECTION The screening process was completed by two independent researchers, with a third independent reviewer for overall agreement. Studies were selected if they included only cardiac patients aged ≥65 years who had undergone valve surgery and/or coronary artery bypass grafting via median sternotomy, and who had undertaken a postoperative cardiac rehabilitation exercise intervention assessing physical function and/or cognitive recovery as outcomes. DATA EXTRACTION Two researchers independently completed the data extraction and quality assessment. Quality was assessed using a modified Downs and Black tool. DATA SYNTHESIS In total, 11 articles were included for appraisal with respect to the quality of the study. Only two randomised controlled trials were suitable for meta-analysis. A higher volume of exercise was shown to have a positive effect on functional recovery, assessed using the 6-minute walk test (6MWT) (mean difference=26.97m; 95% confidence interval [CI], 6.96-46.97; p=0.008; I2=0%). No significant improvement was shown between additional exercise compared to standard care in improving VO2peak, maximal power output or quality of life. No studies evaluated the effect of exercise on cognitive recovery. CONCLUSIONS Exercise significantly improves functional recovery in the post-surgical elderly cardiac population, however uncertainty still exists with regard to which modes of exercise and their specific parameters are most effective in improving cognitive recovery.
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Affiliation(s)
- Jacqueline Pengelly
- Department of Health Professions, Swinburne University of Technology, Melbourne, Vic, Australia.
| | | | - Kuan-Yin Lin
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Vic, Australia
| | - Colin Royse
- Department of Health Professions, Swinburne University of Technology, Melbourne, Vic, Australia; Department of Surgery, University of Melbourne, Melbourne, Vic, Australia; Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Vic, Australia
| | - Roshan Karri
- Department of Surgery, University of Melbourne, Melbourne, Vic, Australia
| | - Alistair Royse
- Department of Health Professions, Swinburne University of Technology, Melbourne, Vic, Australia; Department of Surgery, University of Melbourne, Melbourne, Vic, Australia; Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Melbourne, Vic, Australia
| | - Adam Bryant
- Department of Physiotherapy, University of Melbourne, Melbourne, Vic, Australia
| | - Gavin Williams
- Department of Physiotherapy, University of Melbourne, Melbourne, Vic, Australia
| | - Doa El-Ansary
- Department of Health Professions, Swinburne University of Technology, Melbourne, Vic, Australia; Department of Surgery, University of Melbourne, Melbourne, Vic, Australia
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Pearson CF, Quinn CC, Loganathan S, Datta AR, Mace BB, Grabowski DC. The Forgotten Middle: Many Middle-Income Seniors Will Have Insufficient Resources For Housing And Health Care. Health Aff (Millwood) 2019; 38:101377hlthaff201805233. [PMID: 31017490 DOI: 10.1377/hlthaff.2018.05233] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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: 11/05/2022]
Abstract
As people age and require more assistance with daily living and health needs, a range of housing and care options is available. Over the past four decades the market for seniors housing and care-including assisted living and independent living communities-has greatly expanded to accommodate people with more complex needs. These settings provide housing in a community environment that often includes personal care assistance services. Unfortunately, these settings are often out of the financial reach of many of this country's eight million middle-income seniors (those ages seventy-five and older). The private seniors housing industry has generally focused on higher-income people instead. We project that by 2029 there will be 14.4 million middle-income seniors, 60 percent of whom will have mobility limitations and 20 percent of whom will have high health care and functional needs. While many of these seniors will likely need the level of care provided in seniors housing, we project that 54 percent of seniors will not have sufficient financial resources to pay for it. This gap suggests a role for public policy and the private sector in meeting future long-term care and housing needs for middle-income seniors.
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Affiliation(s)
- Caroline F Pearson
- Caroline F. Pearson ( ) is a senior vice president at NORC at the University of Chicago in Illinois
| | - Charlene C Quinn
- Charlene C. Quinn is an associate professor in the Department of Epidemiology and Public Health at the University of Maryland School of Medicine, in Baltimore
| | - Sai Loganathan
- Sai Loganathan is a senior health economist at NORC at the University of Chicago in Bethesda, Maryland
| | - A Rupa Datta
- A. Rupa Datta is a vice president at NORC at the University of Chicago in Illinois
| | - Beth Burnham Mace
- Beth Burnham Mace is chief economist at the National Investment Center for Seniors Housing and Care, in Annapolis, Maryland
| | - David C Grabowski
- David C. Grabowski is a professor in the Department of Health Care Policy, Harvard Medical School, in Boston, Massachusetts
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Zarifkar AH, Zarifkar A, Nami M, Rafati A, Aligholi H, Vafaee F. Ameliorative Effects of Different Transcranial Electrical Stimulation Paradigms on the Novel Object Recognition Task in a Rat Model of Alzheimer Disease. Galen Med J 2019; 8:e1440. [PMID: 34466513 PMCID: PMC8344121 DOI: 10.31661/gmj.v8i0.1440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 12/05/2018] [Revised: 01/08/2019] [Accepted: 01/21/2019] [Indexed: 12/20/2022] Open
Abstract
Background Treatment of Alzheimer as a disease that is associated with cognitive impairment has been associated with some restrictions. Recently, researchers have focused on non-pharmacological treatments, including non-invasive stimulation of the brain by transcranial electrical stimulation (tES). Four main paradigms of transcranial electrical current include transcranial direct current stimulation (tDCS), transcranial alternative current stimulation (tACS), transcranial random noise stimulation (tRNS), transcranial pulse current stimulation (tPCS). The tDCS is a possible new therapeutic option for patients with cognitive impairment, including Alzheimer disease. Materials and Methods The study was done on Sprague-Dawley male rats weighing 250-270 g. to develop Alzheimer's model, the cannula was implanted bilaterally into the hippocampus. Aβ 25-35 (5μg/ 2.5µl/day) was microinjected bilaterally for 4 days. Then, an electrical stimulation paradigm was applied to the animal for 6 days. Animal cognitive capacity was evaluated on day 11 and 12 by novel object recognition (NOR) test. Results Our results showed that application of tDCS; tACS; tRNS and tPCS reversed beta-amyloid-induced impairment (P<0.05). The tRNS Group spent total exploration time around the objects compared to other groups (P<0.05). There was no significant difference between the four different paradigms in discrimination ratio and the percentage of total exploration time. Conclusion The results of this study showed that the use of multiple sessions of different tES paradigms could improve Aβ-induced memory impairment in the NOR test. Therefore, based on evidence, it can be expected that in addition to using tDCS, other stimulatory paradigms may also be considered in the treatment of AD.
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Affiliation(s)
- Amir Hossein Zarifkar
- Department of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Asadollah Zarifkar
- Department of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Correspondence to: Asadollah Zarifkar, Karim Khan Zand Boulevard, Shiraz, Iran Telephone Number: +98713230541-19 Email Address:
| | - Mohammad Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- DANA Brain Health Institute, Iranian Neuroscience Society, Fars Chapter, Shiraz, Iran
| | - Ali Rafati
- Department of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Aligholi
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Vafaee
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
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Moyle W, Jones C, Murfield J, Thalib L, Beattie E, Shum D, Draper B. Using a therapeutic companion robot for dementia symptoms in long-term care: reflections from a cluster-RCT. Aging Ment Health 2019; 23:329-336. [PMID: 29282989 DOI: 10.1080/13607863.2017.1421617] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [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] [Indexed: 01/05/2023]
Abstract
OBJECTIVES We undertook a cluster-randomised controlled trial exploring the effect of a therapeutic companion robot (PARO) compared to a look-alike plush toy and usual care on dementia symptoms of long-term care residents. Complementing the reported quantitative outcomes , this paper provides critical reflection and commentary on individual participant responses to PARO, observed through video recordings , with a view to informing clinical practice and research. METHOD A descriptive, qualitative design with five participants selected from the PARO intervention arm of the trial. The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000508673). RESULTS The five participants and their responses to PARO are presented in terms of three issues: i.) Different pre-intervention clinical presentations and different responses; ii.) Same individual, different response - the need for continual assessment and review; and iii.) The ethics of giving and retrieving PARO. Implications for clinical practice and future research are discussed in relation to each issue. CONCLUSION The findings suggest that one approach does not fit all, and that there is considerable variation in responses to PARO. A number of recommendations are discussed to aid the delivery of psychosocial interventions with PARO in practice, as well as to guide future research.
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Affiliation(s)
- Wendy Moyle
- a Menzies Health Institute Queensland, Griffith University , Nathan, Brisbane , Queensland , Australia.,b School of Nursing and Midwifery, Nathan Campus, Griffith University , Nathan, Brisbane , Queensland , Australia
| | - Cindy Jones
- a Menzies Health Institute Queensland, Griffith University , Nathan, Brisbane , Queensland , Australia.,b School of Nursing and Midwifery, Nathan Campus, Griffith University , Nathan, Brisbane , Queensland , Australia
| | - Jenny Murfield
- a Menzies Health Institute Queensland, Griffith University , Nathan, Brisbane , Queensland , Australia
| | - Lukman Thalib
- c Department of Public Health, College of Health Sciences , Qatar University , Qatar
| | - Elizabeth Beattie
- d School of Nursing , Queensland University of Technology , Kelvin Grove, Brisbane , Queensland , Australia
| | - David Shum
- a Menzies Health Institute Queensland, Griffith University , Nathan, Brisbane , Queensland , Australia.,e School of Applied Psychology, Mt Gravatt Campus, Griffith University , Brisbane , Queensland , Australia.,f Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health , Institute of Psychology, Chinese Academy of Sciences , Beijing , China
| | - Brian Draper
- g School of Psychiatry, University of New South Wales , Sydney , Australia
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Garcia-Agundez A, Folkerts AK, Konrad R, Caserman P, Tregel T, Goosses M, Göbel S, Kalbe E. Recent advances in rehabilitation for Parkinson's Disease with Exergames: A Systematic Review. J Neuroeng Rehabil 2019; 16:17. [PMID: 30696453 PMCID: PMC6352377 DOI: 10.1186/s12984-019-0492-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [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] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 01/23/2019] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE The goal of this contribution is to gather and to critically analyze recent evidence regarding the potential of exergaming for Parkinson's disease (PD) rehabilitation and to provide an up-to-date analysis of the current state of studies on exergame-based therapy in PD patients. METHODS We performed our search based on the conclusions of a previous systematic review published in 2014. Inclusion criteria were articles published in the indexed databases Pubmed, Scopus, Sciencedirect, IEEE and Cochrane published since January 1, 2014. Exclusion criteria were papers with a target group other than PD patients exclusively, or contributions not based on exergames. Sixty-four publications out of 525 matches were selected. RESULTS The analysis of the 64 selected publications confirmed the putative improvement in motor skills suggested by the results of the previous review. The reliability and safety of both Microsoft Kinect and Wii Balance Board in the proposed scenarios was further confirmed by several recent studies. Clinical trials present better (n = 5) or similar (n = 3) results than control groups (traditional rehabilitation or regular exercise) in motor (TUG, BBS) and cognitive (attention, alertness, working memory, executive function), thus emphasizing the potential of exergames in PD. Pilot studies (n = 11) stated the safety and feasibility of both Microsoft Kinect and Wii Balance Board, potentially in home scenarios as well. Technical papers (n = 30) stated the reliability of balance and gait data captured by both devices. Related meta-analyses and systematic reviews (n = 15) further support these statements, generally citing the need for adaptation to patient's skills and new input devices and sensors as identified gaps. CONCLUSION Recent evidence indicates exergame-based therapy has been widely proven to be feasible, safe, and at least as effective as traditional PD rehabilitation. Further insight into new sensors, best practices and different cognitive stadiums of PD (such as PD with Mild Cognitive Impairment), as well as task specificity, are required. Also, studies linking game parameters and results with traditional assessment methods, such as UPDRS scores, are required. Outcomes for randomized controlled trials (RCTs) should be standardized, and follow-up studies are required, particularly for motor outcomes.
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Affiliation(s)
| | - Ann-Kristin Folkerts
- Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Cologne, Germany
| | - Robert Konrad
- Multimedia Communications Lab, Technische Universitaet Darmstadt, Darmstadt, Germany
| | - Polona Caserman
- Multimedia Communications Lab, Technische Universitaet Darmstadt, Darmstadt, Germany
| | - Thomas Tregel
- Multimedia Communications Lab, Technische Universitaet Darmstadt, Darmstadt, Germany
| | - Mareike Goosses
- Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Cologne, Germany
| | - Stefan Göbel
- Multimedia Communications Lab, Technische Universitaet Darmstadt, Darmstadt, Germany
| | - Elke Kalbe
- Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Cologne, Germany
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Abstract
Aims To examine concurrent validity of inertial sensor (APDM ISway) versus force plate center of pressure (COP) measures of postural sway in cognitively impaired older adults. Methods Participants, mean age 85.6 (SD 4.8), were tested in 4 static standing conditions: (1) eyes open/normal base, (2) eyes open/narrow base, (3) eyes closed/normal base, and (4) eyes closed/narrow base. ISway and COP measures were collected. Results Strong correlations between ISway trunk sway smoothness [ISway JERK, (m 2 /s 5 )] and COP path length (r = 0.67-0.85) and COP mean velocity (r = 0.77-0.87); also ISway total sway acceleration path length/trail duration [ISway PATH, (m2/s2)] and COP path length (r = 0.77-0.87) and COP mean velocity (r = 0.77-0.91). Increased sway was detected in narrow versus normal base and eyes closed versus open conditions (P = .001). Conclusions APDM ISway demonstrated concurrent validity to force-plate COP and changes in postural sway were detected between conditions.
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Affiliation(s)
- Ellen L McGough
- Department of Rehabilitation Medicine, University of Washington
| | - Lin-Ya Hsu
- Department of Rehabilitation Medicine, University of Washington
| | | | - Linda Teri
- School of Nursing, University of Washington
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Sheffield JM, Karcher NR, Barch DM. Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective. Neuropsychol Rev 2018; 28:509-533. [PMID: 30343458 DOI: 10.1007/s11065-018-9388-2] [Citation(s) in RCA: 229] [Impact Index Per Article: 38.2] [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: 03/28/2018] [Accepted: 10/15/2018] [Indexed: 12/15/2022]
Abstract
Individuals with disorders that include psychotic symptoms (i.e. psychotic disorders) experience broad cognitive impairments in the chronic state, indicating a dimension of abnormality associated with the experience of psychosis. These impairments negatively impact functional outcome, contributing to the disabling nature of schizophrenia, bipolar disorder, and psychotic depression. The robust and reliable nature of cognitive deficits has led researchers to explore the timing and profile of impairments, as this may elucidate different neurodevelopmental patterns in individuals who experience psychosis. Here, we review the literature on cognitive deficits across the life span of individuals with psychotic disorder and psychotic-like experiences, highlighting the dimensional nature of both psychosis and cognitive ability. We identify premorbid generalized cognitive impairment in schizophrenia that worsens throughout development, and stabilizes by the first-episode of psychosis, suggesting a neurodevelopmental course. Research in affective psychosis is less clear, with mixed evidence regarding premorbid deficits, but a fairly reliable generalized deficit at first-episode, which appears to worsen into the chronic state. In general, cognitive impairments are most severe in schizophrenia, intermediate in bipolar disorder, and the least severe in psychotic depression. In all groups, cognitive deficits are associated with poorer functional outcome. Finally, while the generalized deficit is the clearest and most reliable signal, data suggests specific deficits in verbal memory across all groups, specific processing speed impairments in schizophrenia and executive functioning impairments in bipolar disorder. Cognitive deficits are a core feature of psychotic disorders that provide a window into understanding developmental course and risk for psychosis.
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Affiliation(s)
- Julia M Sheffield
- Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Nashville, TN, 37212, USA.
| | - Nicole R Karcher
- Department of Psychological & Brain Sciences, Washington University St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA.,Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.,Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
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48
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Abstract
Objective: Alzheimer's disease and vascular dementia are responsible for more than 80% of dementia cases. These two conditions share common risk factors including hypertension. Cerebral small vessel disease (CSVD) is strongly associated with both hypertension and cognitive impairment. In this review, we identify the pathophysiological changes in CSVD that are caused by hypertension and further explore the relationship between CSVD and cognitive impairment. Data Sources: We searched and scanned the PubMed database for recently published literatures up to December 2017. We used the keywords of “hypertension”, “cerebral small vessel disease”, “white matter lesions”, “enlarged perivascular spaces”, “lacunar infarcts”, “cerebral microbleeds”, and “cognitive impairment” in the database of PubMed. Study Selection: Articles were obtained and reviewed to analyze the hypertension-induced pathophysiological changes that occur in CSVD and the correlation between CSVD and cognitive impairment. Results: In recent years, studies have demonstrated that hypertension-related changes (e.g., small vascular lesions, inflammatory reactions, hypoperfusion, oxidative stress, damage to autoregulatory processes and the blood-brain barrier, and cerebral amyloid angiopathy) can occur over time in cerebral small vessels, potentially leading to lower cognitive function when blood pressure (BP) control is poor or lacking. Both isolated and co-occurrent CSVD can lead to cognitive deterioration, and this effect may be attributable to a dysfunction in either the cholinergic system or the functionality of cortical and subcortical tracts. Conclusions: We explore the currently available evidence about the hypertensive vasculopathy and inflammatory changes that occur in CSVD. Both are vital prognostic indicators of the development of cognitive impairment. Future studies should be performed to validate the relationship between BP levels and CSVD progression and between the numbers, volumes, and anatomical locations of CSVD and cognitive impairment.
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Affiliation(s)
- Yang Liu
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei 050017; Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China
| | - Yan-Hong Dong
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China
| | - Pei-Yuan Lyu
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei 050017; Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China
| | - Wei-Hong Chen
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei 050017; Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China
| | - Rui Li
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei 050017; Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China
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Kim SM, Kim DH, Yang Y, Ha SW, Han JH. Gait Patterns in Parkinson's Disease with or without Cognitive Impairment. Dement Neurocogn Disord 2018; 17:57-65. [PMID: 30906393 DOI: 10.12779/dnd.2018.17.2.57] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 07/05/2018] [Accepted: 07/05/2018] [Indexed: 11/27/2022] Open
Abstract
Background and Purpose Cognitive and gait disturbance are common symptoms in Parkinson's disease (PD). Although the relationship between cognitive impairment and gait dysfunction in PD has been suggested, specific gait patterns according to cognition are not fully demonstrated yet. Therefore, the aim of this study was to investigate gait patterns in PD patients with or without cognitive impairment. Methods We studied 86 patients at an average of 4.8 years after diagnosis of PD. Cognitive impairment was defined as scoring 1.5 standard deviation below age- and education-specific means on the Korean version of the Mini-Mental State Examination (K-MMSE). Three-dimensional gait analysis was conducted for all patients and quantified gait parameters of temporal-spatial data were used. Relationships among cognition, demographic characteristics, clinical features, and gait pattern were evaluated. Results Cognitive impairment was observed in 41 (47.7%) patients. Compared to patients without cognitive impairment, patients with cognitive impairment displayed reduced gait speed, step length, and stride length. Among K-MMSE subcategories, “registration,” “attention/calculation,” and “visuospatial function” were significantly associated with speed, step length, and stride length. However, age, disease duration, Hoehn-Yahr (HY) stage, or Unified Parkinson's Disease Rating Scale (UPDRS) motor score was not significantly related to any gait analysis parameter. Conclusions Our present study shows that cognitive impairment is associated with slow and short-stepped gait regardless of HY stage or UPDRS motor score, suggesting that cognitive impairment may serve as a surrogate marker of gait disturbance or fall in PD patients.
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Zabyhian S, Mousavi-Bayegi SJ, Baharvahdat H, Faridhosseini F, Sasannejad P, Salehi M, Boroumand M, Hatefipour Z. Cognitive function, depression, and quality of life in patients with ruptured cerebral aneurysms. Iran J Neurol 2018; 17:117-122. [PMID: 30886678 PMCID: PMC6420689] [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] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background: Neuropsychiatric dysfunction is one of the most common complications after aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study was to evaluate cognitive function, depression, and quality of life (QOL) in patients with aSAH. Methods: In this study, we prospectively enrolled patients with SAH due to rupture of anterior circulation aneurysms who referred to Ghaem hospital, Mashhad, Iran, and who had good function outcome [modified Rankin scale (mRS) > 2]. They underwent microsurgery or endovascular treatment. Cognitive function, depression, and QOL were evaluated 6 months after surgery with standard psychiatric examinations, including Mini-Mental State Examination (MMSE) for cognitive function, Hospital Anxiety and Depression Scale (HADS) for depression, and 36-Item Short Form Health Survey (SF-36) for QOL. Risk factors for cognitive dysfunction were assessed. Results: Fifty-three patients were entered the study. The mean of age was 50.9 ± 13.6 years. QOL and its components were affected in most patients. Fifty-five percent of patients suffered from depression. Cognitive impairment was found in 57% of patients. Older patients experienced more cognitive impairment (P < 0.001). Conclusion: Neuropsychological sequels are common in patients with aSAH, even if they classified as good functional outcome (mRS > 2). These complications could be found with appropriate neuropsychological evaluation of these patients to be managed as soon as possible.
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Affiliation(s)
- Samira Zabyhian
- Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Humain Baharvahdat
- Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farhad Faridhosseini
- Department of Psychiatry, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Payam Sasannejad
- Department of Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Salehi
- Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Boroumand
- Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Hatefipour
- Department of Psychiatry, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
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