51
|
Camacho-Conde JA, Galán-López JM. Depression and Cognitive Impairment in Institutionalized Older Adults. Dement Geriatr Cogn Disord 2021; 49:107-120. [PMID: 32634807 DOI: 10.1159/000508626] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/11/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In the last three decades, the relationship between depression and cognition in geriatric patients has been a popular topic among researchers and clinicians. Clinical and epidemiological research has focused on the identification of risk factors that could be modified in pre-dementia syndromes, at a preclinical and early clinical stage of dementia disorders, with specific attention to the role of depression. The objective of this work was to determine the relationship between depressive disorder and cognitive deterioration in institutionalized older adults. METHODS In this descriptive, correlational study, data were gathered from two nursing homes in the province of Jaen (Spain), from a random sample of 140 older adults (70 nondependent and 70 dependent). The variables were measured using comprehensive geriatric assessment, the Cambridge Cognitive Test (CAMCOG), and the Geriatric Depression Scale (GDS). RESULTS Depression was correlated with cognitive level in the nondependent older adult sample (r = -0.471, p = 0.004). Age was inversely associated with the score obtained in the CAMCOG of the nondependent older adult sample (r = -0.352, p = 0.038). The functional capacity in several activities of daily living was correlated with the score obtained in the CAMCOG in each of the two groups. Depression was more prevalent in the dependent than in the nondependent older adults (82.85 vs. 57.14%). No association was observed between institutionalization time and the score obtained on the cognitive and affective scales (GDS and CAMCOG) in both groups (GDS-nondependent, r = -0.209, p = 0.234; CAMCOG-nondependent, r = 0.007, p = 0.967; GDS-dependent, r = 0.251, p = 0.152; CAMCOG-dependent, r = -0.021, p = 0.907). CONCLUSION Depressive symptomatology is associated with cognitive deterioration. Depression is prevalent in institutions that care for older, more dependent adults.
Collapse
|
52
|
Camacho-Conde JA, Galán-López JM. The Relationship Between Depression and Cognitive Deterioration in Elderly Persons. PSICOLOGIA: TEORIA E PESQUISA 2021. [DOI: 10.1590/0102.3772e37413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract The objective of this research is to describe the relationship between depressive disorder and cognitive deterioration in residentialized elderly people. This is a descriptive and correlational study with 70 elderly. The variables have been assessed with a Psychosocial Variables Questionnaire, CAMCOG and GDS. Depression was significantly correlated with cognitive level in the non-assisted elderly sample (r=0.471, p=0.004). Participants’ age is negatively associated with the score obtained in the CAMCOG of non-assisted sample (r=-0.352, p=0.038). Depression is more frequent in institutions that care for older people when they are more dependent.
Collapse
|
53
|
Wiels WA, Wittens MMJ, Zeeuws D, Baeken C, Engelborghs S. Neuropsychiatric Symptoms in Mild Cognitive Impairment and Dementia Due to AD: Relation With Disease Stage and Cognitive Deficits. Front Psychiatry 2021; 12:707580. [PMID: 34483998 PMCID: PMC8415837 DOI: 10.3389/fpsyt.2021.707580] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The interaction between neuropsychiatric symptoms, mild cognitive impairment (MCI), and dementia is complex and remains to be elucidated. An additive or multiplicative effect of neuropsychiatric symptoms such as apathy or depression on cognitive decline has been suggested. Unraveling these interactions may allow the development of better prevention and treatment strategies. In the absence of available treatments for neurodegeneration, a timely and adequate identification of neuropsychiatric symptom changes in cognitive decline is highly relevant and can help identify treatment targets. Methods: An existing memory clinic-based research database of 476 individuals with MCI and 978 individuals with dementia due to Alzheimer's disease (AD) was reanalyzed. Neuropsychiatric symptoms were assessed in a prospective fashion using a battery of neuropsychiatric assessment scales: Middelheim Frontality Score, Behavioral Pathology in Alzheimer's Disease Rating Scale (Behave-AD), Cohen-Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia (CSDD), and Geriatric Depression Scale (30 items). We subtyped subjects suffering from dementia as mild, moderate, or severe according to their Mini-Mental State Examination (MMSE) score and compared neuropsychiatric scores across these groups. A group of 126 subjects suffering from AD with a significant cerebrovascular component was examined separately as well. We compared the prevalence, nature, and severity of neuropsychiatric symptoms between subgroups of patients with MCI and dementia due to AD in a cross-sectional analysis. Results: Affective and sleep-related symptoms are common in MCI and remain constant in prevalence and severity across dementia groups. Depressive symptoms as assessed by the CSDD further increase in severe dementia. Most other neuropsychiatric symptoms (such as agitation and activity disturbances) progress in parallel with severity of cognitive decline. There are no significant differences in neuropsychiatric symptoms when comparing "pure" AD to AD with a significant vascular component. Conclusion: Neuropsychiatric symptoms such as frontal lobe symptoms, psychosis, agitation, aggression, and activity disturbances increase as dementia progresses. Affective symptoms such as anxiety and depressive symptoms, however, are more frequent in MCI than mild dementia but otherwise remain stable throughout the cognitive spectrum, except for an increase in CSDD score in severe dementia. There is no difference in neuropsychiatric symptoms when comparing mixed dementia (defined here as AD + significant cerebrovascular disease) to pure AD.
Collapse
Affiliation(s)
- Wietse A Wiels
- Department of Neurology, Universitair Ziekenhuis Brussel, Brussels, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Mandy M J Wittens
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Dieter Zeeuws
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Psychiatry, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Chris Baeken
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Psychiatry, Universitair Ziekenhuis Brussel, Brussels, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Sebastiaan Engelborghs
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
54
|
Kraal AZ, Massimo L, Fletcher E, Carrión CI, Medina LD, Mungas D, Gavett BE, Farias ST. Functional reserve: The residual variance in instrumental activities of daily living not explained by brain structure, cognition, and demographics. Neuropsychology 2021; 35:19-32. [PMID: 33393797 PMCID: PMC8753970 DOI: 10.1037/neu0000705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Cognitive reserve is a concept that explains individual differences in resilience to brain pathology and susceptibility to poor late-life cognitive outcomes. We evaluate the analogous concept of "Functional Reserve," defined as the difference between observed functional abilities and those predicted by brain structure, cognitive performance, and demographics. This study aims to validate the construct of functional reserve by testing its utility in predicting clinical outcomes and exploring its predictors. METHOD Longitudinal data collected annually for up to 7 years from 1,084 older adults (ndementia = 163; nMCI = 333; nCN = 523) were analyzed. Functional reserve was operationalized as the residual variance in the Lawton-Brody Instrumental Activities of Daily Living (IADL) Scale after accounting for demographics (sex/gender, race, ethnicity, education), neuropathology (gray matter, hippocampal, and white matter hyperintensity volumes), and cognition (executive function, verbal episodic memory, semantic memory, and spatial function). Structural equation models estimated (a) functional reserve's associations with 7-year changes in clinical diagnosis and disease severity and (b) predictors of functional reserve. RESULTS Functional reserve was lower in dementia versus cognitively normal individuals. Higher baseline functional reserve was associated with lower concurrent dementia severity and slower clinical progression and attenuated the association of cognition with concurrent dementia severity. Physical function and apathy were the strongest predictors of functional reserve. CONCLUSIONS Results provide preliminary validation of functional reserve for explaining individual differences in susceptibility to IADL dysfunction independent of neuropathology, cognition, and demographics. Physical functioning and apathy are promising modifiable intervention targets to enhance functional reserve in the context of brain atrophy and cognitive decline. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
| | | | - Evan Fletcher
- Department of Neurology, University of California, Davis
| | | | | | - Dan Mungas
- Department of Neurology, University of California, Davis
| | - Brandon E Gavett
- Department of Psychological Science, University of Western Australia
| | | |
Collapse
|
55
|
Xie Z, Wu H, Zhao J. Multifunctional roles of zinc in Alzheimer’s disease. Neurotoxicology 2020; 80:112-123. [DOI: 10.1016/j.neuro.2020.07.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/13/2020] [Accepted: 07/16/2020] [Indexed: 02/06/2023]
|
56
|
Di Nuovo S, De Beni R, Borella E, Marková H, Laczó J, Vyhnálek M. Cognitive Impairment in Old Age. EUROPEAN PSYCHOLOGIST 2020. [DOI: 10.1027/1016-9040/a000391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. A decline in cognitive functioning is part of physiological aging. Accelerated cognitive decline is frequently linked to pathological changes, mostly due to Alzheimer’s Disease (AD), but is present also in Mild Cognitive Impairment (MCI) which is a predictor of transition to dementia. This review aims to summarize possible preventive biological and psychological treatments in different stages of lifespan to avoid more rapid cognitive decline and prevent pathological aging. Psychophysiological approaches aim to prevent brain damage and inflammation, two factors playing probably a major role in middle and old age. Interventions on working memory and imagery, using “cognitive reserve,” are beneficial for tolerating neuropathological age-related changes. Some controversial results are outlined, suggesting explanations for the inconsistency of findings. Although clear evidence from interventional studies is lacking, it seems that multi-domain interventions should be recommended to avoid or delay cognitive decline.
Collapse
Affiliation(s)
| | | | - Erika Borella
- Department of Psychology, University of Padua, Italy
| | - Hana Marková
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Czech Republic
| | - Jan Laczó
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Czech Republic
| | - Martin Vyhnálek
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Czech Republic
| |
Collapse
|
57
|
Manera V, Abrahams S, Agüera-Ortiz L, Bremond F, David R, Fairchild K, Gros A, Hanon C, Husain M, König A, Lockwood PL, Pino M, Radakovic R, Robert G, Slachevsky A, Stella F, Tribouillard A, Trimarchi PD, Verhey F, Yesavage J, Zeghari R, Robert P. Recommendations for the Nonpharmacological Treatment of Apathy in Brain Disorders. Am J Geriatr Psychiatry 2020; 28:410-420. [PMID: 31495772 DOI: 10.1016/j.jagp.2019.07.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/26/2019] [Accepted: 07/26/2019] [Indexed: 11/18/2022]
Abstract
Apathy is a common neuropsychiatric syndrome observed across many neurocognitive and psychiatric disorders. Although there are currently no definitive standard therapies for the treatment of apathy, nonpharmacological treatment (NPT) is often considered to be at the forefront of clinical management. However, guidelines on how to select, prescribe, and administer NPT in clinical practice are lacking. Furthermore, although new Information and Communication Technologies (ICT) are beginning to be employed in NPT, their role is still unclear. The objective of the present work is to provide recommendations for the use of NPT for apathy, and to discuss the role of ICT in this domain, based on opinions gathered from experts in the field. The expert panel included 20 researchers and healthcare professionals working on brain disorders and apathy. Following a standard Delphi methodology, experts answered questions via several rounds of web-surveys, and then discussed the results in a plenary meeting. The experts suggested that NPT are useful to consider as therapy for people presenting with different neurocognitive and psychiatric diseases at all stages, with evidence of apathy across domains. The presence of a therapist and/or a caregiver is important in delivering NPT effectively, but parts of the treatment may be performed by the patient alone. NPT can be delivered both in clinical settings and at home. However, while remote treatment delivery may be cost and time-effective, it should be considered with caution, and tailored based on the patient's cognitive and physical profile and living conditions.
Collapse
Affiliation(s)
- Valeria Manera
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France; Association Innovation Alzheimer (VM, PR), Nice, France.
| | - Sharon Abrahams
- School of Philosophy, Psychology and Language Sciences (SA), University of Edinburgh, Edinburgh, United Kingdom; Euan MacDonald Centre for Motor Neurone Disease Research (SA, RR), University of Edinburgh, Edinburgh, United Kingdom
| | - Luis Agüera-Ortiz
- Department of Psychiatry (LA-O), Instituto de Investigación Sanitaria (imas12), Hospital Universitario 12 de Octubre & CIBERSAM, Madrid, Spain
| | - François Bremond
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France; INRIA (FB, AK), STARS Team, Sophia Antipolis, France
| | - Renaud David
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France; Centre Hospitalier Universitaire (CHU) de Nice (RD, PR), CMRR, Nice, France
| | - Kaci Fairchild
- Department of Veterans Affairs (KF, JY), VA Palo Alto Health Care System, CA; Department of Psychiatry and Behavioral Sciences (KF, JY), Stanford University School of Medicine, CA
| | - Auriane Gros
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France
| | - Cécile Hanon
- Psychiatric Department, Regional Resource Center of Old Age Psychiatry Corentin-Celton Hospital (CH), Academic Hospital West Paris, AP-HP, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Masud Husain
- Nuffield Department of Clinical Neurosciences (MH, PL), John Radcliffe Hospital Oxford OX3 9DU, United Kingdom; Department of Experimental Psychology (MH, PL), University of Oxford, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging (MH, PL), University of Oxford, Oxford, United Kingdom
| | - Alexandra König
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France; INRIA (FB, AK), STARS Team, Sophia Antipolis, France
| | - Patricia L Lockwood
- Nuffield Department of Clinical Neurosciences (MH, PL), John Radcliffe Hospital Oxford OX3 9DU, United Kingdom; Department of Experimental Psychology (MH, PL), University of Oxford, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging (MH, PL), University of Oxford, Oxford, United Kingdom
| | - Maribel Pino
- Broca Living Lab (MP), AP-HP, Paris Descartes University, Sorbonne Paris Cite, Paris, France
| | - Ratko Radakovic
- Euan MacDonald Centre for Motor Neurone Disease Research (SA, RR), University of Edinburgh, Edinburgh, United Kingdom; Faculty of Medicine and Health Sciences (RR), University of East Anglia, Norwich, United Kingdom; Alzheimer Scotland Dementia Research Centre (RR), University of Edinburgh, Edinburgh, United Kingdom
| | - Gabriel Robert
- EA4712 "Comportement et Noyaux Gris Centraux" (GR), Université de Rennes1, France
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO) (AS), Faculty of Medicine, University of Chile, Santiago, Chile; Neuropsychology and Clinical Neuroscience Laboratory (LANNEC) (AS), Physiopathology Department - ICBM, Chile; Neuroscience and East Neuroscience Departments (AS), Faculty of Medicine, University of Chile, Chile; Memory and Neuropsychiatric Clinic (CMYN) Neurology Department (AS), Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile; Servicio de Neurología (AS), Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Florindo Stella
- Laboratório de Neurociências LIM27 (FS), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brasil; UNESP - Universidade Estadual Paulista (FS), Biosciences Institute, Campus of Rio Claro, Rio Claro, SP, Brazil
| | - Anaïs Tribouillard
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France; ISTR (AT), Institute of Rehabilitation Sciences and Techniques, University of Lyon 1, Lyon, France; Specialised Alzheimer Team (AT), SSIAD Quimper, France
| | | | - Frans Verhey
- Department of Psychiatry and Neuropsychology (FV), Maastricht University, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht, the Netherlands
| | - Jerome Yesavage
- Department of Veterans Affairs (KF, JY), VA Palo Alto Health Care System, CA; Department of Psychiatry and Behavioral Sciences (KF, JY), Stanford University School of Medicine, CA
| | - Radia Zeghari
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France
| | - Philippe Robert
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France; Association Innovation Alzheimer (VM, PR), Nice, France; Centre Hospitalier Universitaire (CHU) de Nice (RD, PR), CMRR, Nice, France
| |
Collapse
|
58
|
Zeghari R, Manera V, Fabre R, Guerchouche R, König A, Phan Tran MK, Robert P. The “Interest Game”: A Ludic Application to Improve Apathy Assessment in Patients with Neurocognitive Disorders. J Alzheimers Dis 2020; 74:669-677. [DOI: 10.3233/jad-191282] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Radia Zeghari
- Université Côte d’Azur, CoBTeK Laboratory, Nice, France
- Association IA (Alzheimer-Affect-Autism), Nice, France
| | - Valeria Manera
- Université Côte d’Azur, CoBTeK Laboratory, Nice, France
- Association IA (Alzheimer-Affect-Autism), Nice, France
| | - Roxane Fabre
- Université Côte d’Azur, CoBTeK Laboratory, Nice, France
- Centre Hospitalier Universitaire de Nice, Département de Santé Publique, Nice, France
| | | | - Alexandra König
- Université Côte d’Azur, CoBTeK Laboratory, Nice, France
- Inria Sophia Antipolis, STARS team, Sophia Antipolis, France
| | - Minh Khue Phan Tran
- Université Côte d’Azur, CoBTeK Laboratory, Nice, France
- Inria Sophia Antipolis, STARS team, Sophia Antipolis, France
| | - Philippe Robert
- Université Côte d’Azur, CoBTeK Laboratory, Nice, France
- Association IA (Alzheimer-Affect-Autism), Nice, France
- Centre Hospitalier Universitaire de Nice, Resource & Research Memory Centre, Nice
| |
Collapse
|
59
|
Robert P, Manera V, Derreumaux A, Ferrandez Y Montesino M, Leone E, Fabre R, Bourgeois J. Efficacy of a Web App for Cognitive Training (MeMo) Regarding Cognitive and Behavioral Performance in People With Neurocognitive Disorders: Randomized Controlled Trial. J Med Internet Res 2020; 22:e17167. [PMID: 32159519 PMCID: PMC7097721 DOI: 10.2196/17167] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 01/16/2020] [Accepted: 02/04/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cognitive and behavioral symptoms are the clinical hallmarks of neurocognitive disorders. Cognitive training may be offered to reduce the risks of cognitive decline and dementia and to reduce behavioral symptoms, such as apathy. Information and communication technology approaches, including serious games, can be useful in improving the playful aspect of computerized cognitive training and providing motivating solutions in elderly patients. OBJECTIVE The objective of this study was to assess the effectiveness of employing the MeMo (Memory Motivation) Web app with regard to cognitive and behavioral symptoms in patients with neurocognitive disorders. METHODS MeMo is a Web app that can be used on any Web browser (computer or tablet). The training activities proposed in MeMo are divided into the following two parts: memory and mental flexibility/attention. The study included 46 individuals (mean age 79.4 years) with a diagnosis of neurocognitive disorders at the Institut Claude Pompidou Memory Center in Nice. This randomized controlled study compared the evolution of cognition and behavior between patients not using MeMo (control group) and patients using MeMo (MeMo group) for 12 weeks (four sessions per week). Patients underwent memory and attention tests, as well as an apathy assessment at baseline, week 12 (end of the training period), and week 24 (12 weeks after the end of the training sessions). In addition, to assess the impact of high and low game uses, the MeMo group was divided into patients who used MeMo according to the instructions (about once every 2 days; active MeMo group) and those who used it less (nonactive MeMo group). RESULTS When comparing cognitive and behavioral scores among baseline, week 12, and week 24, mixed model analysis for each cognitive and behavioral score indicated no significant interaction between testing time and group. On comparing the active MeMo group (n=9) and nonactive MeMo group (n=13), there were significant differences in two attention tests (Trial Making Test A [P=.045] and correct Digit Symbol Substitution Test items [P=.045]) and in the Apathy Inventory (AI) (P=.02). Mixed analysis (time: baseline, week 12, and week 24 × number of active days) indicated only one significant interaction for the AI score (P=.01), with a significant increase in apathy in the nonactive MeMo group. CONCLUSIONS This study indicates that the cognitive and behavioral efficacies of MeMo, a Web-based training app, can be observed only with regular use of the app. Improvements were observed in attention and motivation. TRIAL REGISTRATION ClinicalTrials.gov NCT04142801; https://clinicaltrials.gov/ct2/show/NCT04142801.
Collapse
Affiliation(s)
- Philippe Robert
- Cognition Behaviour Technology Lab, Université Côte d'Azur, Nice, France.,Association Innovation Alzheimer, Nice, France.,Centre Memoire, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Valeria Manera
- Cognition Behaviour Technology Lab, Université Côte d'Azur, Nice, France.,Association Innovation Alzheimer, Nice, France
| | - Alexandre Derreumaux
- Association Innovation Alzheimer, Nice, France.,Centre Memoire, Centre Hospitalier Universitaire de Nice, Nice, France
| | | | - Elsa Leone
- Centre Memoire, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Roxane Fabre
- Departement de Santé Publique, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Jeremy Bourgeois
- Centre Memoire, Centre Hospitalier Universitaire de Nice, Nice, France
| |
Collapse
|
60
|
Hulme B, Didikoglu A, Bradburn S, Robinson A, Canal M, Payton A, Pendleton N, Murgatroyd C. Epigenetic Regulation of BMAL1 with Sleep Disturbances and Alzheimer's Disease. J Alzheimers Dis 2020; 77:1783-1792. [PMID: 32925059 DOI: 10.3233/jad-200634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND An early symptom of Alzheimer's disease (AD) is a disturbance of the circadian rhythm that is associated with disrupted sleep/wake cycles. OBJECTIVE To investigate if BMAL1, a key gene that drives the circadian cycle, is epigenetically regulated in brains in relation to longitudinal changes in cognition, sleep quality, and AD neuropathology. METHODS Frontal cortex tissues were acquired from the Manchester Brain Bank (N = 96). DNA methylation at six CpG sites at the promoter of BMAL1, determined using bisulfite pyrosequencing, was tested for associations with Braak stage, CERAD score and Thal phase, longitudinal changes in cognition, sleep measurements and cross-section measures of depressive symptoms (BDI score). RESULTS Methylation across all the CpGs strongly correlated with each other. We found increased CpG2 methylation with higher Braak (t(92), p = 0.015) and CERAD (t(94), p = 0.044) stages. No significance was found between longitudinal fluid intelligence, processing speed and memory tests, but methylation at CpG1 (r = 0.20, p = 0.05) and CpG4 (r = 0.20, p = 0.05) positively correlated with vocabulary. CpG2 positively correlated with cross-sectional fluid intelligence (r = 0.20 p = 0.05) and vocabulary (r = 0.22 p = 0.03). Though longitudinal analysis revealed no significance between sleep duration, midsleep and efficiency for any of the CpG sites, CpG3 (B = 0.03, 95% CI, p = 0.03) and CpG5 (B = 0.04, 95% CI, p = 0.01) significantly correlated with night wake. CpG4 correlated with depressive symptoms (B = -0.27, 95% CI, p = 0.02). CONCLUSION Methylation of BMAL1 associated with tau pathology, changes in cognitive measures, a measure of sleep and depressive symptoms, suggesting an involvement of the circadian cycle.
Collapse
Affiliation(s)
- Bethany Hulme
- Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Altug Didikoglu
- Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Steven Bradburn
- Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Andrew Robinson
- Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Maria Canal
- Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Antony Payton
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Neil Pendleton
- Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Chris Murgatroyd
- Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| |
Collapse
|
61
|
Ng KP, Chiew HJ, Rosa-Neto P, Kandiah N, Ismail Z, Gauthier S. Brain Metabolic Dysfunction in Early Neuropsychiatric Symptoms of Dementia. Front Pharmacol 2019; 10:1398. [PMID: 31824321 PMCID: PMC6882863 DOI: 10.3389/fphar.2019.01398] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 11/01/2019] [Indexed: 12/11/2022] Open
Abstract
Neuropsychiatric symptoms (NPS) including behavioral and psychiatric symptoms are common in the dementia stages of Alzheimer's disease (AD) and are associated with poorer outcomes in cognition, functional states, quality of life, and accelerated progression to severe dementia or death. NPS are also increasingly observed in the mild cognitive impairment stage of AD and may predict incipient dementia. As such, there is an emerging conceptual framework, which support NPS as early non-cognitive symptoms of dementia. [18F]fluorodeoxyglucosepositron emission tomography is a technique that is sensitive in detecting resting metabolism associated with NPS in neuropsychiatric conditions, and there is a growing body of literature evaluating the role of NPS as early indicators of brain metabolic dysfunctions in AD. In this mini-review, we examine the frequency and associations of NPS with metabolic dysfunction in the AD continuum, including preclinical, prodromal, and dementia stages of AD. We will also present the validated neurobehavioral syndrome, mild behavioral impairment describes the later life emergence of sustained NPS as an at-risk state for incident cognitive decline and dementia, and an early presentation of neurodegenerative diseases in some. Lastly, we will discuss future directions in the field so as to better understand the neurobiological basis of NPS in the early stages of the AD continuum, and their role in predicting AD pathophysiological progression and incident dementia.
Collapse
Affiliation(s)
- Kok Pin Ng
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Hui Jin Chiew
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Pedro Rosa-Neto
- The McGill University Research Centre for Studies in Aging, Montreal, QC, Canada
| | - Nagaendran Kandiah
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Zahinoor Ismail
- Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Serge Gauthier
- The McGill University Research Centre for Studies in Aging, Montreal, QC, Canada
| |
Collapse
|