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Schroeder MW, Waring ME, Fowler NR, Mace RA, Pagoto SL. Association Between Subjective Cognitive Decline and Twice-Weekly Muscle-Strengthening Activities in Middle-Aged and Older US Adults: An Analysis of the 2019 Behavioral Risk Factor Surveillance System. Am J Health Promot 2024; 38:615-624. [PMID: 38226478 PMCID: PMC11123578 DOI: 10.1177/08901171231224517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
PURPOSE Adults with subjective cognitive decline (SCD), the self-reported concern of reduced cognitive function, are recommended to do physical activity for its brain health benefits. US adults aged ≥45 with SCD are less likely to meet the American College of Sports Medicine (ACSM) aerobic activity recommendations. Their engagement in muscle-strengthening activities is unknown. We aimed to identify if US adults aged ≥45 with SCD are less likely to do twice-weekly muscle-strengthening activities compared to those without SCD. DESIGN Secondary analysis of the 2019 Behavioral Risk Factor Surveillance System (BRFSS) data. SAMPLE 114 164 respondents, representing approximately 59 million US adults aged ≥45. MEASURES SCD was indicated if the respondent reported confusion or memory loss during the past 12 months (yes/no). Respondents reported the frequency of muscle-strengthening activities, which we categorized as meeting the ACSM's recommendations (2+ times per week) or not (<2 times per week). ANALYSIS Crude and adjusted logistic regression models controlling for variables associated with SCD and muscle-strengthening activities. The models used sample weights to represent US adults in the included 31 states and Washington D.C. RESULTS US adults aged ≥45 with SCD were less likely to do twice-weekly muscle-strengthening activities than those without SCD (28.6% [SE: .8%] vs 33.5% [SE: .3%], adjusted OR, .9; 95% CI: .9-1.0). CONCLUSION Primary care providers should encourage middle-aged and older patients to engage in muscle-strengthening and aerobic activities.
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Affiliation(s)
| | - Molly E. Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Nicole R. Fowler
- Indiana University Center for Aging Research, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Center for Health Innovation and Implementation Science, Indiana Clinical and Translational Science Institute, Indianapolis, IN, USA
| | - Ryan A. Mace
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sherry L. Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
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Suchy Y, Simpson A, Mora MG, DesRuisseaux LA, Brothers SL, Mullen CM. Test of Practical Judgment (TOP-J): Construct, Criterion, and Incremental Validity in a Community Sample of Older Adults. Arch Clin Neuropsychol 2024; 39:355-366. [PMID: 38097261 DOI: 10.1093/arclin/acad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE The Test of Practical Judgment (TOP-J) is a stand-alone judgment measure that is considered to tap into aspects of executive functioning (EF) and inform clinical predictions of daily functioning in older adults. Past validation research is variable and has some limitations. The present study sought to examine the reliability and construct, criterion, and incremental validities of scores on TOP-J 9-item version (TOP-J/9). METHOD Participants were 95 community-dwelling older adults aged 60 to 85. Participants completed TOP-J/9, measures of EF and global cognition, and three different modalities of instrumental activities of daily living (IADLs) (self-report, performance-based tasks conducted in the laboratory, and performance-based tasks completed at home over 3 weeks). RESULTS TOP-J/9 scores showed adequate internal consistency (α = 0.73) after correcting for the low number of items. TOP-J/9 was correlated with global cognition and EF, although EF did not survive correction for lower-order processes. Finally, although TOP-J/9 scores were associated with home-based IADL tasks (but not with self-report and laboratory-based IADLs), providing some evidence of criterion validity, they did not incrementally contribute to home-based IADL performance beyond other cognitive measures. However, when two items pertaining to social/ethical judgment were removed, this modified version of TOP-J did relate to EF beyond lower-order processes and contributed uniquely to prediction of home-based IADLs beyond other measures. CONCLUSION Results suggest that TOP-J/9 taps into global cognitive status (but not necessarily EF) and predicts "real-world" functioning (but not above and beyond other cognitive measures). TOP-J psychometrics may be improved by removing two social/ethical items.
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Affiliation(s)
- Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Austin Simpson
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | | | | | | | - Christine M Mullen
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Utah, Salt Lake City, UT, USA
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de Almeida SM, Tresoldi Neto J, Rocha A, Medeiros A, Gonçalves D, Guimarães F. Cerebrospinal Fluid Biomarkers of Symptomatic Neurosyphilis in People With HIV Compared with Uninfected Individuals. J Neurovirol 2024; 30:146-164. [PMID: 38472642 DOI: 10.1007/s13365-024-01199-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024]
Abstract
We evaluated the diagnostic clinical performance characteristics (DCPC) of cerebrospinal fluid (CSF) total protein (TP), white blood cell count (WBC), and lactate (LA) with different cutoff points as adjunct biomarkers of confirmed or presumptive symptomatic neurosyphilis (NS) and the impact of HIV infection. From 5,640 participants who underwent lumbar punctures, 236 participants were included, and classified as either people with HIV (PWH) or people without HIV (PWoH) according to the CDC criteria for confirmed NS (n = 42), presumptive NS (n = 74), systemic syphilis (SS) (n = 38), serological diagnosis of syphilis (n = 18), PWH without SS and NS (n = 10), and negative control (n = 72). In PWoH, for presumptive NS, the combination of CSF TP > 45 mg/dL and/or WBC > 5.0 cells/mm3 is valuable for screening, whereas in PWH, it is not recommended for either screening or case-finding NS, however the DCPC were better in the suppressed group. In PWoH, the value of CSF TP > 45 mg/dL is adequate for both screening and confirmation of presumptive NS, subject to prevalence. For WBC count > 20 cell/mm3, the positive predictive value (PPV) of the test is almost perfect, suggesting a confirmatory test. In PWH, CSF TP is an inadequate marker of NS. The WBC count, with cutoffs of > 10 or > 20 cells/mm3, was moderately applicable for screening.As conclusions: CSF WBC count and TP showed distinct DCPC in confirmed or presumptive NS, better in the former. These biomarkers could be included for presumptive NS diagnosis. DCPC of these biomarkers for the diagnosis of NS is greatly affected by HIV co-infection.
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Affiliation(s)
- Sérgio Monteiro de Almeida
- Virology Section, Hospital de Clínicas, Universidade Federal Do Paraná, Setor Análises Clínicas Rua Padre Camargo, Curitiba, PR, 80060-240, Brazil.
- Neuroinfection Outclinic, Hospital de Clínicas, Universidade Federal Do Paraná, Curitiba, Paraná, Brazil.
| | - José Tresoldi Neto
- Virology Section, Hospital de Clínicas, Universidade Federal Do Paraná, Setor Análises Clínicas Rua Padre Camargo, Curitiba, PR, 80060-240, Brazil
- Neuroinfection Outclinic, Hospital de Clínicas, Universidade Federal Do Paraná, Curitiba, Paraná, Brazil
| | - Amanda Rocha
- Virology Section, Hospital de Clínicas, Universidade Federal Do Paraná, Setor Análises Clínicas Rua Padre Camargo, Curitiba, PR, 80060-240, Brazil
- Neuroinfection Outclinic, Hospital de Clínicas, Universidade Federal Do Paraná, Curitiba, Paraná, Brazil
| | - Ana Medeiros
- Virology Section, Hospital de Clínicas, Universidade Federal Do Paraná, Setor Análises Clínicas Rua Padre Camargo, Curitiba, PR, 80060-240, Brazil
- Neuroinfection Outclinic, Hospital de Clínicas, Universidade Federal Do Paraná, Curitiba, Paraná, Brazil
| | - Debora Gonçalves
- Virology Section, Hospital de Clínicas, Universidade Federal Do Paraná, Setor Análises Clínicas Rua Padre Camargo, Curitiba, PR, 80060-240, Brazil
- Neuroinfection Outclinic, Hospital de Clínicas, Universidade Federal Do Paraná, Curitiba, Paraná, Brazil
| | - Fausto Guimarães
- Virology Section, Hospital de Clínicas, Universidade Federal Do Paraná, Setor Análises Clínicas Rua Padre Camargo, Curitiba, PR, 80060-240, Brazil
- Neuroinfection Outclinic, Hospital de Clínicas, Universidade Federal Do Paraná, Curitiba, Paraná, Brazil
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Miller SE, Mogle JA, Linden-Carmichael AN, Almeida DM. Within-person associations between alcohol use and memory lapses among middle-aged and older adults. Drug Alcohol Rev 2023; 42:1754-1763. [PMID: 37469227 PMCID: PMC10796843 DOI: 10.1111/dar.13721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 06/14/2023] [Accepted: 06/29/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION Alcohol use has been linked to impairment in both short- and long-term measures of objective memory. However, limited research has investigated the association between alcohol use and subjective memory in everyday life. The study purpose was to investigate within- and between-person associations between daily alcohol use and prospective (i.e., forgetting an intended task) and retrospective (i.e., forgetting something learned in the past) memory lapses among middle-aged and older adults. METHODS Participants (n = 925; Mage = 55.2) were non-abstaining adults from the Midlife in the United States (MIDUS) study or the MIDUS Refresher who participated in an 8-day telephone diary asking about their daily experiences. RESULTS Multilevel models revealed that within-individuals, heavier-than-usual alcohol use (i.e., having more drinks than one's daily average number of drinks) was associated with greater odds of reporting any memory lapses (odds ratio [OR] 1.06; 95% confidence interval [CI] 1.01, 1.12), while associations at the between-person level were nonsignificant (OR 1.07; 95% CI 0.99, 1.16). When assessing retrospective and prospective lapses separately, alcohol use was only associated with prospective lapses and only at the between-person level (OR 1.10; 95% CI 1.01, 1.19). Finally, alcohol use was unassociated with reported irritation or interference from memory lapses (p > 0.05). DISCUSSION AND CONCLUSIONS Heavier-than-usual alcohol use may have acute effects on daily memory functioning. Future studies should assess how alcohol use relates to an individual's ability to meet daily cognitive demands, as these findings may have critical implications for harm reduction efforts targeting daily functioning among older adults.
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Affiliation(s)
- Sara E Miller
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Jacqueline A Mogle
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
- Department of Psychology, Clemson University, Clemson, South Carolina, USA
| | - Ashley N Linden-Carmichael
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - David M Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania, USA
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de Almeida SM, Castoldi JR, Riechi SC. Comparison between cerebrospinal fluid biomarkers for differential diagnosis of acute meningitis. Diagnosis (Berl) 2023; 10:298-308. [PMID: 37023413 DOI: 10.1515/dx-2023-0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/23/2023] [Indexed: 04/08/2023]
Abstract
OBJECTIVES Given the difficulty in the differential diagnosis of acute bacterial meningitis (BM) and viral meningitis (VM), we aimed to compare the ability of cerebrospinal fluid (CSF) biomarkers, such as lactate, glucose, lactate dehydrogenase (LDH), C-reactive protein (CRP), total white blood cell count, and predominance of neutrophils, as single tests to differentiate microbiologically defined acute BM and VM. METHODS CSF samples were divided into three groups: BM (n=17), VM (n=14) (both with the etiological agent identified), and normal control groups (n=26). RESULTS All the biomarkers studied were significantly higher in the BM group than in the VM or control groups (p>0.05). CSF lactate showed the best diagnostic clinical performance characteristics: sensitivity (94.12%), specificity (100%), positive and negative predictive value (100 and 97.56%, respectively), positive and negative likelihood ratio (38.59 and 0.06, respectively), accuracy (98.25%), and AUC (0.97). CSF CRP is excellent for screening BM and VM, as its best feature is its specificity (100%). CSF LDH is not recommended for screening or case-finding. LDH levels were higher in Gram-negative diplococcus than in Gram-positive diplococcus. Other biomarkers were not different between Gram-positive and negative bacteria. The highest level of agreement between the CSF biomarkers was between CSF lactate and CRP [kappa coefficient, 0.91 (0.79; 1.00)]. CONCLUSIONS All markers showed significant differences between the studied groups and were increased in acute BM. CSF lactate is better than the other biomarkers studied for screening acute BM due to its high specificity.
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Affiliation(s)
- Sérgio Monteiro de Almeida
- Clinical Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
- Neuroinfection Outclinic, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Juliane Rosa Castoldi
- Clinical Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Salomão Cury Riechi
- Clinical Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
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Chu CS, Wang DY, Liang CK, Chou MY, Hsu YH, Wang YC, Liao MC, Chu WT, Lin YT. Automated Video Analysis of Audio-Visual Approaches to Predict and Detect Mild Cognitive Impairment and Dementia in Older Adults. J Alzheimers Dis 2023; 92:875-886. [PMID: 36847001 DOI: 10.3233/jad-220999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
BACKGROUND Early identification of different stages of cognitive impairment is important to provide available intervention and timely care for the elderly. OBJECTIVE This study aimed to examine the ability of the artificial intelligence (AI) technology to distinguish participants with mild cognitive impairment (MCI) from those with mild to moderate dementia based on automated video analysis. METHODS A total of 95 participants were recruited (MCI, 41; mild to moderate dementia, 54). The videos were captured during the Short Portable Mental Status Questionnaire process; the visual and aural features were extracted using these videos. Deep learning models were subsequently constructed for the binary differentiation of MCI and mild to moderate dementia. Correlation analysis of the predicted Mini-Mental State Examination, Cognitive Abilities Screening Instrument scores, and ground truth was also performed. RESULTS Deep learning models combining both the visual and aural features discriminated MCI from mild to moderate dementia with an area under the curve (AUC) of 77.0% and accuracy of 76.0% . The AUC and accuracy increased to 93.0% and 88.0%, respectively, when depression and anxiety were excluded. Significant moderate correlations were observed between the predicted cognitive function and ground truth, and the correlation was strong excluding depression and anxiety. Interestingly, female, but not male, exhibited a correlation. CONCLUSION The study showed that video-based deep learning models can differentiate participants with MCI from those with mild to moderate dementia and can predict cognitive function. This approach may offer a cost-effective and easily applicable method for early detection of cognitive impairment.
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Affiliation(s)
- Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Non-Invasive Neuromodulation Consortium for Mental Disorders, Society of Psychophysiology, Taipei, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Di-Yuan Wang
- Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Kuang Liang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan.,Department of Geriatric Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan.,Department of Internal Medicine, Division of Neurology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Kaohsiung City, Taiwan
| | - Ming-Yueh Chou
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan.,Department of Geriatric Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan
| | - Ying-Hsin Hsu
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Internal Medicine, Division of Neurology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Kaohsiung City, Taiwan.,Chia Nan University, Tainan, Taiwan, Tainan City, Taiwan
| | - Yu-Chun Wang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Mei-Chen Liao
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wei-Ta Chu
- Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Te Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan.,Department of Pharmacy, Tajen University, Pingtung, Taiwan, Yanpu Township, Pingtung County, Taiwan
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Knechtl P, Lehrner J. Visuoconstructional Abilities of Patients With Subjective Cognitive Decline, Mild Cognitive Impairment and Alzheimer's Disease. J Geriatr Psychiatry Neurol 2023:8919887221135549. [PMID: 36630660 DOI: 10.1177/08919887221135549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Via the Vienna Visuoconstructional Test 3.0 (VVT 3.0) delayed recall we combined the assessment of visuoconstructive abilities and memory and investigated the test's potential to support diagnostic processes, including staging and the elaboration of a cognitive profile. METHODS We retrospectively analysed the data of 368 patients of the Department of Neurology, Medical University of Vienna, between 04/2014 and 10/2020 that had performed the VVT 3.0. Our sample involved 70 healthy controls (HC), 29 patients with subjective cognitive decline (SCD), 154 patients with mild cognitive impairment (MCI) and 115 patients with Alzheimer's disease (AD). We investigated the differences in the VVT 3.0 scores, as well as the VVT's ability to differentiate between AD and nonAD by calculating receiver-operating-characteristic (ROC) curves, ideal cut-offs and a logistic regression model. RESULTS Results stated that the VVT 3.0 delayed recall scores were able to differentiate between all diagnostic groups, respectively, except HC-SCD and SCD-MCI. The ROC analyses determined an AUC of 0.890, 95% CI [0.855; 0.925], P < .001, and the ideal cut-off at 29.5 points that maximised sensitivity at 0.896 and specificity at 0.81. The logistic regression model classified 83.4% of AD patients correctly and delivered a significant Cohen's Kappa of 0.619 (P < .001). CONCLUSION As the VVT 3.0 revealed satisfactory values of diagnostic accuracy in our sample, it could enrich clinical diagnosing. However, for more clarity about its informative value in other populations, there remains a need for future studies with other samples.
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Affiliation(s)
- Paula Knechtl
- Department of Neurology, 27271Medical University of Vienna, Wien, Austria
| | - Johann Lehrner
- Department of Neurology, 27271Medical University of Vienna, Wien, Austria
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Costa AN, Nowakowski LM, McCrae CS, Cowan N, Curtis AF. Discrepancies in Objective and Subjective Cognition in Middle-Aged and Older Adults: Does Personality Matter? Gerontol Geriatr Med 2023; 9:23337214221146663. [PMID: 36644685 PMCID: PMC9837265 DOI: 10.1177/23337214221146663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/21/2022] [Accepted: 12/04/2022] [Indexed: 01/13/2023] Open
Abstract
Associations between subjective cognition and current objective functioning are inconclusive. Given known associations between personality and cognition, this study tested whether personality moderates associations between subjective memory and objective cognition in middle-aged and older adults. Participants (N = 62, M age = 63.8, SD = 7.7, 33 men) completed assessments of personality (Big Five Inventory-10), subjective memory (Cognitive Failures Questionnaire [CFQ-memory]), and objective cognition (processing speed, attention, inhibition [Stroop], working memory [Sternberg], set-shifting [Wisconsin Card Sorting Task]). Multiple regressions and simple slopes analyses examined whether personality moderates associations between subjective memory and objective cognition, controlling for age, number of medical conditions, and household income. Extraversion moderated associations between processing speed and CFQ-memory. Agreeableness moderated associations between set-shifting and CFQ-memory. Among individuals with higher extraversion and lower agreeableness, objectively worse cognition was associated with the fewest memory complaints. Findings suggest personality may impact the discrepancies between subjective memory and objective cognition in mid-to-late life.
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Affiliation(s)
| | | | | | | | - Ashley F. Curtis
- University of Missouri, Columbia, USA,University of South Florida, Tampa, USA,Ashley F. Curtis, College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd, MDC Box 22, Tampa, FL, 33612, USA.
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Tanaka S, Saida K, Murayama A, Higuchi D, Shinohara T. Associated factors of new subjective cognitive decline complaints after a 6-month period among community-dwelling older adults during the COVID-19 pandemic in Japan. Psychogeriatrics 2023; 23:136-140. [PMID: 36412008 DOI: 10.1111/psyg.12917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND The aim of this study was to determine the number of new subjective cognitive decline (SCD) complaints and associated factors in community-dwelling older adults during the COVID-19 pandemic in Japan. METHOD A prospective cohort study was conducted in two periods: May to June 2020, and November 2020 to January 2021. We mailed a questionnaire to 1953 older adults in the first survey, and received 700 responses in the second. We analysed 534 participants without SCD in the first survey. We collected data on sociodemographic characteristics and administered the Questionnaire for Medical Checkup of Old-Old (QMCOO) to assess respondents' health condition. SCD was operationally defined using the QMCOO as reports of (1) forgetfulness, and (2) difficulty in naming dates. The subjects were divided into two groups by their condition at the second survey: an SCD (new SCD complaints) and a no-SCD (no new SCD complaints) group. RESULTS A total of 85 (15.9%) participants had new SCD complaints. The Mann-Whitney U-test and chi-squared test showed that the SCD group had significantly more risk factors of SCD: walking speed (P = 0.001), smoking (P = 0.001), and existence of person with whom the patient could consult when disordered (P = 0.002). Multiple logistic regression analysis revealed that walking speed (odds ratio (OR) = 2.115, 95% confidence interval (CI): 1.259-3.553) and the presence of person to consult (OR = 3.619, 95% CI: 1.553-8.433) were significant related factors of new SCD complaints. CONCLUSION Maintenance of physical condition and social support were associated with new SCD complaints during the COVID-19 pandemic.
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Affiliation(s)
- Shigeya Tanaka
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki, Japan
| | - Kosuke Saida
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki, Japan
| | - Akihiko Murayama
- Department of Physical Therapy, Faculty of Rehabilitation, Gunma University of Health and Welfare, Maebashi, Japan
| | - Daisuke Higuchi
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki, Japan
| | - Tomoyuki Shinohara
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki, Japan
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ÖZ D, ÖZBEK İŞBİTİREN Y, KIYI İ, YENER G. Sözel Akıcılık Testleri, Alzheimer Hastalığı klinik ölçütlerine göre evrelenmiş demans ve HKB ayrımında yarar sağlayabilir. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1179620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Demans tarama ve tanısı için klinik pratikte sıklıkla kısa tarama testleri kullanılmaktadır. Mini Mental Durum Testi (MMDT) en sık kullanılan testlerin başında gelmektedir. MMDT’nin demans için duyarlı olduğu bilinmektedir. Ancak, sağlıklı yaşlanma ile demans arasında bir geçiş evresi olarak kabul edilen Hafif Kognitif Bozukluk (HKB)’un ayırt edilmesinde ve Alzheimer Hastalığı tipi demans (AHD) ile HKB’nin ayırıcı tanısında MMDT çoğu zaman yeterli olmamaktadır. Kısa sürede uygulanabilen sözel akıcılık testleri (semantik ve fonemik) MMDT’ye alternatif ya da MMDT ile kullanıldığında HKB ve AH’nin erken evreleri için tanısal doğruluğu daha yüksek bir tarama testi elde edilebilir. Bu çalışmanın amacı MMDT, semantik ve fonemik akıcılık testlerinin ROC eğrisi analizleri ile belirlenen duyarlılık, özgüllük ve kesme puanı değerlerinin sunulmasıdır. Çalışmaya yaş-eğitim-cinsiyet açısından uyumlu 72 sağlıklı birey, 72 HKB ve 72 AHD’li birey dahil edilmiştir. Çalışmanın bulguları MMDT’nin sağlıklı bireyleri ayırt etmede semantik ve fonemik akıcılıktan daha güçlü olduğunu, ancak HKB ve AH ayrımında özgüllüğünün semantik akıcılıktan düşük olduğunu göstermektedir. Tanı doğruluğunun artırılması için kısa zamanda uygulanabilen sözel akıcılık testlerinin, özellikle semantik akıcılık testinin klinik pratiğe eklenmesi yararlı olabilir.
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de Almeida SM, Kussen GB, Cogo LL, Nogueira K. Cerebrospinal fluid lactate as a predictive biomarker for tuberculous meningitis diagnosis. Diagnosis (Berl) 2022; 10:130-139. [PMID: 36476307 DOI: 10.1515/dx-2022-0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022]
Abstract
Abstract
Objectives
The definitive diagnosis of tuberculous meningitis (TBM) is achieved by identifying Mycobacterium tuberculosis (MTb) in cerebrospinal fluid (CSF); however, diagnostic confirmation is difficult due to the inability of current tests for an effective diagnosis. Our objective was to retrospectively assess the characteristics of CSF lactate (CSF-LA) as an adjunct biomarker in the diagnosis of TBM.
Methods
608 CSF laboratory reports were assessed. Of these, 560 had clinically suspected TBM. These were classified as definite (n=36), probable (23), possible (278), or non-TBM (223) according to the international consensus TBM case definitions. An additional 48 CSF samples were negative controls with normal CSF.
Results
Against a reference standard of definite TBM, the cut-off value for CSF-LA was 4.0 mmol/L, the area under the ROC curve was 0.88 (95% CI, 0.82–0.94; p=0.0001), sensitivity was 69%, specificity 90%, negative predictive value 98%. These diagnostic parameters decreased when calculated against those of the other categories of TBM. CSF-LA exhibited high specificity, efficiency, negative predictive value, and clinical utility index in all the groups studied.
Conclusions
CSF-LA is a useful diagnostic marker to rule out TBM when associated with conventional microbiology tests, nucleic acid amplification assays, and clinical algorithms, particularly in endemic areas.
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Affiliation(s)
- Sérgio Monteiro de Almeida
- Virology Section Clinical Pathology Laboratory Hospital De Clínicas , Federal University of Paraná , Curitiba , Brazil
- CSF Section Clinical Pathology Laboratory Hospital De Clínicas , Federal University of Paraná , Curitiba , Brazil
| | - Gislene B. Kussen
- Bacteriology Section, Clinical Pathology Laboratory, Hospital De Clínicas , Federal University of Paraná , Curitiba , Brazil
| | - Laura L. Cogo
- Bacteriology Section, Clinical Pathology Laboratory, Hospital De Clínicas , Federal University of Paraná , Curitiba , Brazil
| | - Keite Nogueira
- Bacteriology Section, Clinical Pathology Laboratory, Hospital De Clínicas , Federal University of Paraná , Curitiba , Brazil
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12
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A Cost-Benefit Analysis of a Group Memory Intervention for Healthy Older Adults with Memory Concerns. Can J Aging 2022; 41:531-539. [PMID: 35726601 DOI: 10.1017/s0714980821000726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This study examines whether memory intervention programs can mitigate health care costs. Research suggests these programs translate to a decreased intention of older adults who are worried about age-normal memory changes to seek traditional outlets for medical/psychiatric help. We employed a cost-benefit analysis approach to analyze the effectiveness of a memory intervention program within Ontario. We leveraged estimates of decreased intentionality to seek physician care following a community-based memory intervention with physician billing profiles to calculate the potential cost savings to the province's health care system. The intervention studied was found to reduce provincial health care spending by $6,094 per program group. This amount exceeds $121.25 in direct costs per attendee associated with administering five program sessions. This analysis justifies further research on how community-based memory and aging programs can offer low-cost solutions to help individuals cope with subjective memory complaints and assist the health care system in prioritizing care for aging patients.
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13
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Smith JR, Betz JF, Garcia EE, Jiang K, Swenor BK, Reed NS, Deal JA. Self-Reported Dual Sensory Impairment and Subjective Cognitive Complaints Among Older Adults in the 2019 National Health Interview Survey. Am J Audiol 2022; 31:1202-1209. [PMID: 36347031 PMCID: PMC9907399 DOI: 10.1044/2022_aja-22-00087] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
PURPOSE Subjective cognitive complaints (SCCs) are associated with poor quality of life, important for clinical care planning and management, and may predict dementia diagnosis. Dual sensory impairment (DSI) is a risk factor for dementia, but whether DSI is associated with SCCs is unknown. We evaluated whether self-reported DSI is associated with SCCs. METHOD We performed a cross-sectional analysis of 9,899 community-dwelling respondents aged 60+ years without dementia or depression in the 2019 National Health Interview Survey. Participants self-reported difficulty remembering or concentrating, seeing even when wearing corrective lenses, and hearing even when using a hearing aid. We defined SCCs and sensory impairment for each mode as reporting at least some difficulty. We categorized sensory impairment into no sensory impairment, vision impairment only, hearing impairment only, and DSI. We then estimated weighted prevalence ratios (PRs) of SCCs by impairment category. RESULTS After weighting (9,899 participants representing a weighted n = 59,261,749), 12% of participants reported vision impairment only, 19% reported hearing impairment only, and 7% reported DSI. Relative to no impairment, after adjustment for potential confounders, vision impairment (PR = 2.07; 95% confidence interval [CI] [1.79, 2.39]), hearing impairment (PR = 2.26; 95% CI [2.00, 2.55]), and DSI (PR = 3.21; 95% CI [2.83, 3.63]) were associated with an increased prevalence of SCCs. CONCLUSIONS In this nationally representative survey of older Americans, DSI was associated with a threefold increased prevalence of SCCs. Although cross-sectional, these data underscore the importance of assessing multiple impairments as exposures when studying subjective cognition in older adults. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21498711.
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Affiliation(s)
- Jason R. Smith
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Joshua F. Betz
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Emmanuel E. Garcia
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Kening Jiang
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Bonnielin K. Swenor
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD,Disability Health Research Center, Johns Hopkins University, Baltimore, MD
| | - Nicholas S. Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Disability Health Research Center, Johns Hopkins University, Baltimore, MD
| | - Jennifer A. Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Disability Health Research Center, Johns Hopkins University, Baltimore, MD
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14
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Yu Y, Lv J, Liu J, Chen Y, Chen K, Yang Y. Association between living arrangements and cognitive decline in older adults: A nationally representative longitudinal study in China. BMC Geriatr 2022; 22:843. [PMID: 36348275 PMCID: PMC9644618 DOI: 10.1186/s12877-022-03473-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 09/22/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Living arrangements are critical to the survival and well-being of older people, especially in China where the filial piety culture demands adult children care for and serve their parents. The study aimed to explore the association between living arrangements and cognitive decline among older people in China. METHODS Participants included 6,074 older adults over 60 years old (49.65% male, mean age 67.2 years [range 60-98]) from four waves (2011-2018) of the China Health and Retirement Longitudinal Study. Two to four assessments were conducted over a follow-up of an average of 5.3 years (range, 2-7). Cognitive function was assessed using an adapted Chinese version of Mini-Mental State Examination (MMSE). Living arrangements were classified as follows: living alone, living with spouse, living with adult children, living with spouse and adult children and living with others. Multilevel models were used to investigate the relationship between living arrangements and cognitive decline, as well as the gender difference. RESULTS As the main type of living arrangements of the study participants (44.91%), living with spouse was taken as the reference group. Compared to the reference group, living alone (β=-0.126, P < 0.001), living with adult children (β=-0.136, P < 0.001), living with spouse and adult children (β=-0.040, P < 0.05) and living with others (β=-0.155, P < 0.05) were all related to a faster rate of cognitive decline. Further, the association between living arrangements and cognitive decline varied by gender. Living alone (β=-0.192, P < 0.001) was associated with a faster cognitive decline only in older men. Living with spouse and adult children (β=-0.053, P < 0.05) and living with others (β=-0.179, P < 0.05) were associated with faster cognitive decline only in older women. CONCLUSION This study suggests that living arrangements in older people in China were associated with cognitive decline, and these associations varied by gender. Greater attention to living arrangements might yield practical implications for preserving the cognitive function of the older population.
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Affiliation(s)
- Yifan Yu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17 Section 3, Renmin South Road, 610041 Chengdu, Sichuan China
| | - Junqi Lv
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17 Section 3, Renmin South Road, 610041 Chengdu, Sichuan China
| | - Jing Liu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17 Section 3, Renmin South Road, 610041 Chengdu, Sichuan China
| | - Yueqiao Chen
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17 Section 3, Renmin South Road, 610041 Chengdu, Sichuan China
| | - Kejin Chen
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17 Section 3, Renmin South Road, 610041 Chengdu, Sichuan China
| | - Yanfang Yang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.17 Section 3, Renmin South Road, 610041 Chengdu, Sichuan China
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15
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Cohn‐Schwartz E, Finlay JM, Kobayashi LC. Perceptions of societal ageism and declines in subjective memory during the COVID-19 pandemic: Longitudinal evidence from US adults aged ≥55 years. THE JOURNAL OF SOCIAL ISSUES 2022; 78:JOSI12544. [PMID: 36249550 PMCID: PMC9538955 DOI: 10.1111/josi.12544] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 07/18/2022] [Accepted: 07/18/2022] [Indexed: 05/07/2023]
Abstract
The cognitive health of older adults since the COVID-19 pandemic onset is unclear, as is the potential impact of pandemic-associated societal ageism on perceived cognition. We investigated associations between perceptions of societal ageism and changes in subjective memory over a 10-month period during the COVID-19 pandemic. We collected longitudinal data from monthly online questionnaires in the nationwide COVID-19 Coping Study of US adults aged ≥55 from April 2020 to January 2021 (N = 4444). We analyzed the data using multivariable longitudinal multilevel models. We identified an overall decline in subjective memory, especially in the initial months of the pandemic. Adults who perceived that societal respect for older adults decreased during the pandemic experienced more rapid declines in their subjective memory. These findings suggest that aging adults perceived a decline in their memory, especially during the initial months of the COVID-19 pandemic. Societal interventions to combat ageism may help improve subjective memory and could decrease risk for cognitive decline among middle-aged and older adults.
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Affiliation(s)
- Ella Cohn‐Schwartz
- Epidemiology, Biostatistics, and Community Health SciencesFaculty of Health SciencesBen‐Gurion UniversityBeer‐ShevaIsrael
| | - Jessica M. Finlay
- Center for Social Epidemiology and Population HealthDepartment of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
- Social Environment and Health ProgramSurvey Research CenterUniversity of Michigan Institute for Social ResearchAnn ArborMichiganUSA
| | - Lindsay C. Kobayashi
- Center for Social Epidemiology and Population HealthDepartment of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
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16
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Costa AN, McCrae CS, Cowan N, Curtis AF. Paradoxical relationship between subjective and objective cognition: the role of sleep. J Clin Sleep Med 2022; 18:2009-2022. [PMID: 35638120 PMCID: PMC9340592 DOI: 10.5664/jcsm.10070] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Subjective memory complaints and objective cognitive dysfunction are common in aging populations, however research investigating the associations between them is inconclusive. Given the high prevalence of sleep complaints in middle-aged/older adults, this research tested whether objective cognition interacted with sleep parameters in its associations with subjective cognition. METHODS Cognitively healthy adults aged 50+ completed the Pittsburgh Sleep Quality Index, Cognitive Failures Questionnaire (CFQ) and cognitive tasks: Stroop, Sternberg, and Posner cueing. Multiple regression and simple slope analyses examined whether objective cognition interacted with sleep parameters in its associations with subjective memory. RESULTS Stroop performance and sleep (efficiency and disturbances) had interactive associations with CFQ-memory. Specifically, better Stroop performance (faster reaction time, RT-control trials) was associated with more memory complaints at worst and average, but not best sleep efficiency. Additionally, faster RT was associated with more memory complaints only for worst sleep disturbance. Similarly, Sternberg performance and sleep (efficiency and disturbances) had interactive associations with CFQ-memory. Specifically, higher proportion correct was associated with more memory complaints only at worst sleep efficiency and sleep disturbance. Finally, Posner performance and sleep disturbance had an interactive association with CFQ-memory. Faster exogenous orienting was associated with more memory complaints only for worst sleep disturbance. CONCLUSIONS Objective cognition interacts with sleep efficiency and sleep disturbances in its associations with subjective memory in mid-to-late life. Findings suggest sleep fragmentation plays a role in the discrepant relationship between objective and subjective cognition. Future studies should investigate this relationship in aging populations with sleep disorders and/or cognitive impairments.
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Affiliation(s)
- Amy N Costa
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, MO
| | | | - Nelson Cowan
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, MO
| | - Ashley F Curtis
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, MO.,Department of Psychiatry, University of Missouri-Columbia, Columbia, MO
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17
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Kim S, Lee K. A Network Analysis of Depressive Symptoms in the Elderly with Subjective Memory Complaints. J Pers Med 2022; 12:jpm12050821. [PMID: 35629243 PMCID: PMC9145813 DOI: 10.3390/jpm12050821] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Subjective memory complaints (SMCs) are common among the elderly and are important because they can indicate early cognitive impairment. The factor with the greatest correlation with SMCs is depression. The purpose of this study is to examine depressive symptoms among elderly individuals with SMCs through a network analysis that can analyze disease models between symptoms; (2) Methods: A total of 3489 data collected from elderly individuals in the community were analyzed. The Subjective Memory Complaints Questionnaire and Patient Health Questionnaire-9 were evaluated. For statistical analysis, we investigated the features of the depressive symptoms network, including centrality and clustering; (3) Results: Network analysis of the SMC group showed strong associations in the order of Q1–Q2 (r = 0.499), Q7–Q8 (r = 0.330), and Q1–Q6 (r = 0.239). In terms of centrality index, Q2 was highest in strength and expected influence, followed by Q1 in all of betweenness, strength, and expected influence; (4) Conclusions: The network analysis confirmed that the most important factors in the subjective cognitive decline group were depressed mood and anhedonia, which also had a strong correlation in the network pattern.
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18
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Etholén A, Pietiläinen O, Kouvonen A, Hänninen M, Rahkonen O, Lallukka T. Trajectories of Insomnia Symptoms Among Aging Employees and Their Associations With Memory, Learning Ability, and Concentration After Retirement - A Prospective Cohort Study (2000-2017). J Aging Health 2022; 34:916-928. [PMID: 35482013 PMCID: PMC9483690 DOI: 10.1177/08982643221078740] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objectives We applied a person-oriented approach and used latent class linear mixed
models to identify sleep trajectories that explain memory, concentration,
and learning ability problems after retirement. Methods Data consist of prospective surveys from four phases of the Helsinki Health
Study between 2000–2017 (n = 3748, aged 55–77 years, 80% women). Multinomial
regression was used to examine the associations between sleep trajectories
and cognitive function, adjusting for sociodemographic, health-related
behavior, and health factor covariates. Results Among statutory retirees, three latent group trajectories of insomnia-related
symptoms were identified: stable low, decreasing, and increasing. Among
those who had retired for disability reasons, we identified one additional
latent group trajectory: stable high. Insomnia symptoms were associated with
worse cognitive function. Discussion Early detection of insomnia symptoms would be a potential intervention point
to improve both sleep quality and prevent cognitive decline in later life.
However, intervention studies are needed.
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Affiliation(s)
- Antti Etholén
- Department of Public Health, 176449University of Helsinki, Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, 176449University of Helsinki, Helsinki, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, 176449University of Helsinki, Helsinki, Finland.,Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Mirja Hänninen
- Department of Public Health, 176449University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, 176449University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, 176449University of Helsinki, Helsinki, Finland
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19
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Hallam B, Petersen I, Cooper C, Avgerinou C, Walters K. Time Trends in Incidence of Reported Memory Concerns and Cognitive Decline: A Cohort Study in UK Primary Care. Clin Epidemiol 2022; 14:395-408. [PMID: 35359800 PMCID: PMC8961006 DOI: 10.2147/clep.s350396] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/11/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Brendan Hallam
- UCL Research Department of Primary Care & Population Health, University College London, London, UK
- Correspondence: Brendan Hallam, UCL Research Department of Primary Care & Population Health, University College London, London, UK, Email
| | - Irene Petersen
- UCL Research Department of Primary Care & Population Health, University College London, London, UK
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK
| | - Christina Avgerinou
- UCL Research Department of Primary Care & Population Health, University College London, London, UK
| | - Kate Walters
- UCL Research Department of Primary Care & Population Health, University College London, London, UK
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20
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Lin LH, Wang SB, Xu WQ, Hu Q, Zhang P, Ke YF, Huang JH, Ding KR, Li XL, Hou CL, Jia FJ. Subjective cognitive decline symptoms and its association with socio-demographic characteristics and common chronic diseases in the southern Chinese older adults. BMC Public Health 2022; 22:127. [PMID: 35042501 PMCID: PMC8767737 DOI: 10.1186/s12889-022-12522-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background Subjective cognitive decline (SCD) may be the first symptomatic manifestation of Alzheimer’s disease, but information on its health correlates is still sparse in Chinese older adults. This study aimed to estimate SCD symptoms and its association with socio-demographic characteristics, common chronic diseases among southern Chinese older adults. Methods Participants aged 60 years and older from 7 communities and 2 nursing homes in Guangzhou were recruited and interviewed with standardized assessment tools. Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire–9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure poor sleep quality, depression symptoms and anxiety symptoms. The SCD symptoms were measured by SCD questionnaire 9 (SCD-Q9) which ranged from 0 to 9 points, with a higher score indicating increased severity of the SCD. Participants were divided into low score group (SCD-Q9 score ≤ 3) and higher score group (SCD-Q9 score > 3). Chi-square tests and multivariate logistic regression analysis were used for exploring the influences of different characteristics of socio-demographic and lifestyle factors on SCD symptoms. Univariate and multivariate logistic regression analysis were applied to explore the association between SCD symptoms with common chronic diseases. Results A total of 688 participants were included in our analysis with a mean age of 73.79 (SD = 8.28, range: 60–101), while 62.4% of the participants were females. The mean score of the SCD-Q9 was 3.81 ± 2.42 in the whole sample. A total of 286 participants (41.6%) were defined as the low score group (≤3 points), while 402 participants (58.4%) were the high score group (> 3 points). Multivariate logistic regression analysis revealed that female (OR = 1.99, 95%CI: 1.35–2.93), primary or lower education level (OR = 2.58, 95%CI: 1.38–4.83), nursing home (OR = 1.90, 95%CI: 1.18–3.05), napping habits (OR = 1.59, 95%CI: 1.06–2.40), urolithiasis (OR = 2.72, 95%CI: 1.15–6.40), gout (OR = 2.12, 95%CI: 1.14–3.93), poor sleep quality (OR = 1.93, 95%CI: 1.38–2.71), depression symptoms (OR = 3.01, 95%CI: 1.70–5.34) and anxiety symptoms (OR = 3.11, 95%CI: 1.29–7.46) were independent positive related to high SCD-Q9 score. On the other hand, tea-drinking habits (OR = 0.64, 95%CI: 0.45–0.92), current smoking (OR = 0.46, 95%CI: 0.24–0.90) were independent negative related to high SCD-Q9 score. Conclusions Worse SCD symptoms were closely related to common chronic diseases and socio-demographic characteristics. Disease managers should pay more attention to those factors to early intervention and management for SCD symptoms among southern Chinese older adults.
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21
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Roth AR, Peng S, Coleman ME, Apostolova LG, Perry BL. Do subjective or objective cognitive measures better predict social network type among older adults? BIODEMOGRAPHY AND SOCIAL BIOLOGY 2022; 67:84-97. [PMID: 35313773 PMCID: PMC9038673 DOI: 10.1080/19485565.2022.2052711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A large literature highlights the link between cognitive function and social networks in later life. Yet there remains uncertainty about the factors driving this relationship. In the present study, we use measures of subjective cognitive decline and clinical cognitive assessments on a sample of older adults to investigate whether the relationship between cognitive function and social networks is driven by psychosocial factors. We found a consistent link between clinical cognitive assessments and social network type, but no association between subjective concerns of cognitive decline and networks. Participants who exhibited signs of clinical cognitive impairment were more likely to have restricted networks (i.e., smaller networks consisting of fewer contacts, more interconnectivity, and less social diversity) compared to their cognitively normal counterparts, regardless of subjective measures of cognitive decline - both from the participant's perspective and study partner's perspective. These findings suggest that neither cognitively impaired older adults nor their network members appear to consciously dissolve social ties on the basis of perceived cognitive decline. However, it remains unclear whether the association between clinical cognitive impairment and social network type indicates the protective nature of social networks against cognitive decline or a subconscious process leading to social contraction.
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Affiliation(s)
- Adam R. Roth
- Department of Sociology, Indiana University, Bloomington, IN, USA
- Indiana University Network Science Institute, Indiana University, Bloomington, IN, USA
| | - Siyun Peng
- Department of Sociology, Indiana University, Bloomington, IN, USA
| | - Max E. Coleman
- Department of Sociology, Indiana University, Bloomington, IN, USA
| | - Liana G. Apostolova
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Brea L. Perry
- Department of Sociology, Indiana University, Bloomington, IN, USA
- Indiana University Network Science Institute, Indiana University, Bloomington, IN, USA
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22
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de Almeida SM, Barros N, Fernandes Dos Santos A, Custodio G, Petterle RR, Nogueira K, Nogueira MB. Clinical performance of amperometry compared with enzymatic ultra violet method for lactate quantification in cerebrospinal fluid. Diagnosis (Berl) 2021; 8:510-514. [PMID: 32857713 DOI: 10.1515/dx-2020-0065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/13/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The differential diagnosis between acute bacterial meningitis (BM) and viral meningitis (VM) is crucial for treatment and prognosis. Cerebrospinal fluid (CSF) lactate (LA) is considered a good biomarker for differentiating BM from VM. The objective of this study was to compare the clinical performance of amperometry, which is not validated for measurement of LA in CSF samples, with a validated method (enzymatic ultra violet), for their ability to discriminate between acute BM and VM. METHODS It was a retrospective, descriptive comparative study, 320 CSF reports were included; LA was quantified in CSF using either Dimension AR machine (Dade Behring) or amperometry (RAPID Point 500, Siemens). All samples with bacteria (n=54) or virus (n=139) identified, compared with a control with normal CSF (n=127). RESULTS CSF LA levels were comparable for amperometry or enzymatic methods on each group studied, in a wide range of LA levels; it was capable to distinguish BM from VM independent of the method used to quantify. CONCLUSIONS The findings support the use of the amperometric method in measuring LA concentrations in CSF in a wide range of values. Amperometry is a less expensive method, validated for blood, easily available in small laboratories including in limited resources countries.
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Affiliation(s)
| | - Nagyla Barros
- Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | | | - Gislaine Custodio
- Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | | | - Keite Nogueira
- Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
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23
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Gutierrez L, Folch A, Rojas M, Cantero JL, Atienza M, Folch J, Camins A, Ruiz A, Papandreou C, Bulló M. Effects of Nutrition on Cognitive Function in Adults with or without Cognitive Impairment: A Systematic Review of Randomized Controlled Clinical Trials. Nutrients 2021; 13:nu13113728. [PMID: 34835984 PMCID: PMC8621754 DOI: 10.3390/nu13113728] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 01/06/2023] Open
Abstract
New dietary approaches for the prevention of cognitive impairment are being investigated. However, evidence from dietary interventions is mainly from food and nutrient supplement interventions, with inconsistent results and high heterogeneity between trials. We conducted a comprehensive systematic search of randomized controlled trials (RCTs) published in MEDLINE-PubMed, from January 2018 to July 2021, investigating the impact of dietary counseling, as well as food-based and dietary supplement interventions on cognitive function in adults with or without cognitive impairment. Based on the search strategy, 197 eligible publications were used for data abstraction. Finally, 61 articles were included in the analysis. There was reasonable evidence that dietary patterns, as well as food and dietary supplements improved cognitive domains or measures of brain integrity. The Mediterranean diet showed promising results, whereas the role of the DASH diet was not clear. Healthy food consumption improved cognitive function, although the quality of these studies was relatively low. The role of dietary supplements was mixed, with strong evidence of the benefits of polyphenols and combinations of nutrients, but with low evidence for PUFAs, vitamin D, specific protein, amino acids, and other types of supplements. Further well-designed RCTs are needed to guide the development of dietary approaches for the prevention of cognitive impairment.
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Affiliation(s)
- Laia Gutierrez
- Nutrition and Metabolic Disorders Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University, 43201 Reus, Spain; (L.G.); (A.F.); (M.R.); (J.F.)
- Nutrition and Metabolic Disorders Research Group, Institute of Health Pere Virgili—IISPV, 43204 Reus, Spain;
| | - Alexandre Folch
- Nutrition and Metabolic Disorders Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University, 43201 Reus, Spain; (L.G.); (A.F.); (M.R.); (J.F.)
- Nutrition and Metabolic Disorders Research Group, Institute of Health Pere Virgili—IISPV, 43204 Reus, Spain;
| | - Melina Rojas
- Nutrition and Metabolic Disorders Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University, 43201 Reus, Spain; (L.G.); (A.F.); (M.R.); (J.F.)
- Nutrition and Metabolic Disorders Research Group, Institute of Health Pere Virgili—IISPV, 43204 Reus, Spain;
| | - José Luis Cantero
- Laboratory of Functional Neuroscience, Pablo de Olavide University, 41013 Seville, Spain; (J.L.C.); (M.A.)
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, 28031 Madrid, Spain; (A.C.); (A.R.)
| | - Mercedes Atienza
- Laboratory of Functional Neuroscience, Pablo de Olavide University, 41013 Seville, Spain; (J.L.C.); (M.A.)
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, 28031 Madrid, Spain; (A.C.); (A.R.)
| | - Jaume Folch
- Nutrition and Metabolic Disorders Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University, 43201 Reus, Spain; (L.G.); (A.F.); (M.R.); (J.F.)
- Nutrition and Metabolic Disorders Research Group, Institute of Health Pere Virgili—IISPV, 43204 Reus, Spain;
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, 28031 Madrid, Spain; (A.C.); (A.R.)
| | - Antoni Camins
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, 28031 Madrid, Spain; (A.C.); (A.R.)
- Department of Pharmacology, Toxicology & Therapeutic Chemistry, Faculty of Pharmacy & Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Institut de Neurociències (UBNeuro), University of Barcelona, 08035 Barcelona, Spain
| | - Agustín Ruiz
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, 28031 Madrid, Spain; (A.C.); (A.R.)
- ACE Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Christopher Papandreou
- Nutrition and Metabolic Disorders Research Group, Institute of Health Pere Virgili—IISPV, 43204 Reus, Spain;
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
| | - Mònica Bulló
- Nutrition and Metabolic Disorders Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University, 43201 Reus, Spain; (L.G.); (A.F.); (M.R.); (J.F.)
- Nutrition and Metabolic Disorders Research Group, Institute of Health Pere Virgili—IISPV, 43204 Reus, Spain;
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-97-775-9388
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Assessing social-emotional development in infants and toddlers using parent-reports: Comparing the ASQ-SE-NL to the Social-Emotional Scale of the Bayley-III-NL. Early Hum Dev 2021; 161:105439. [PMID: 34455202 DOI: 10.1016/j.earlhumdev.2021.105439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/20/2021] [Accepted: 07/30/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The Ages and Stages Questionnaire Social-Emotional (ASQ-SE) is a parent-report screening instrument designed to assess children's social-emotional development and detect those at risk for delay or problems. Psychometric properties of this questionnaire have been studied before, but the ASQ-SE has never been compared to the Social-Emotional Scale of the Bayley-III (Bayley-III-SE). AIM To compare the Dutch ASQ-SE (ASQ-SE-NL) to the Dutch Bayley-III-SE (Bayley-III-NL-SE; criterion measure). METHOD A Dutch community sample of mothers with children aged 3-41 months (n = 1014) filled out both questionnaires. Cut-off scores for the ASQ-SE-NL were determined using: 1) >1 SD above the mean and 2) ROC curves. For the Bayley-III-NL, Dutch norm scores were used. RESULTS Specificity (70.8% and 88.5%) and screen-out accuracy (0.65 and 0.77) of the ASQ-SE-NL were good. Sensitivity was only sufficient (70.6%) when using ROC curves and only for the ASQ-SE-NL ≥18 months age versions. Screen-in accuracy was insufficient (<0.49). Positive predictive value was 34.7% and 32.7%, and negative predictive value was 87.5% and 92.3%. False positive cases on the ASQ-SE-NL scored significantly lower on the Bayley-III-NL-SE than true negative cases. CONCLUSION Using the Bayley-III-NL-SE as the criterion, the ASQ-SE-NL performed well in identifying children not at risk for delay or problems. The ASQ-SE-NL sufficiently detected children at risk for delay or problems in the ≥18 months ASQ-SE-NL age versions when cut-off scores were determined by ROC curves. The ASQ-SE-NL can be used in a monitoring routine, but early rescreening is advised after a positive test result, given the number of false positive results.
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Kim M, Lim KC, Ko H. Factors influencing subjective cognitive function among community-dwelling older adults. Geriatr Nurs 2021; 42:1070-1076. [PMID: 34265487 DOI: 10.1016/j.gerinurse.2021.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Subjective cognitive decline (SCD) is one of the most common complaints in older adults and may increase risk factors for dementia. Therefore, it is important to identify and manage risk factors for subjective cognitive function (SCF). PURPOSE This study aimed to investigate factors influencing SCF in community-dwelling older adults. METHODS With a cross-sectional research design, 164 older adults responded to questionnaires. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé-test, Pearson's correlation coefficient, and multiple regression with SPSS 23.0. RESULTS Participating in religious activities, sleeping well, a lower number of comorbidities, better perceived health status, lower depression, and higher self-esteem were associated with better SCF. Overall, approximately 24.9% of the variability in SCF was explained by perceived health status, religion, and depression. CONCLUSION Multifaceted aspects must be considered when developing interventions to improve SCF in community-dwelling older adults who complain of experiencing SCD.
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Affiliation(s)
- Myoungsuk Kim
- Associate Professor, College of Nursing, Kangwon National University, 1 Gangwondaehakgil, Chuncheon-Si, Gangwon-Do 24341, Korea (ROK)
| | - Kyung-Choon Lim
- Professor, College of Nursing, Sungshin Women's University, Seoul, 01133, Korea (ROK).
| | - Hana Ko
- Assistant Professor, College of Nursing, Gachon University, 191 Hambakmoero, Yeonsu-gu, Incheon, 21936, Korea (ROK)
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Goldberg SM, Lopez OL, Cohen AD, Klunk WE, Aizenstein HA, Mizuno A, Snitz BE. The roles of study setting, response bias, and personality in subjective memory complaints of cognitively normal older adults. Int Psychogeriatr 2021; 33:665-676. [PMID: 32188533 PMCID: PMC7501183 DOI: 10.1017/s1041610220000319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES This study investigated subjective memory complaints in older adults and the roles of setting, response bias, and personality. DESIGN Cognitively normal older adults from two settings completed questionnaires measuring memory complaints, response bias, and personality. SETTINGS (A) Neuroimaging study with community-based recruitment and (B) academic memory clinic. PARTICIPANTS Cognitively normal older adults who (A) volunteer for research (N = 92) or (B) self-referred to a memory clinic (N = 20). MEASUREMENTS Neuropsychological evaluation and adjudication of normal cognitive status were done by the neuroimaging study or memory clinic. This study administered self-reports of subjective memory complaints, response bias, five-factor personality, and depressive symptoms. Primary group differences were examined with secondary sensitivity analyses to control for sex, age, and education differences. RESULTS There was no significant difference in over-reporting response bias between study settings. Under-reporting response bias was higher in volunteers. Cognitive complaints were associated with response bias for two cognitive complaint measures. Neuroticism was positively associated with over-reporting in evaluation-seekers and negatively associated with under-reporting in volunteers. The relationship was reversed for Extraversion. Under-reporting bias was positively correlated with Agreeableness and Conscientiousness in volunteers. CONCLUSION Evaluation-seekers do not show bias toward over-reporting symptoms compared to volunteers. Under-reporting response bias may be important to consider when screening for memory impairment in non-help-seeking settings. The Memory Functioning Questionnaire was less sensitive to reporting biases. Over-reporting may be a facet of higher Neuroticism. Findings help elucidate psychological influences on self-perceived cognitive decline and help seeking in aging and may inform different strategies for assessment by setting.
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Affiliation(s)
- Sarah M. Goldberg
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Oscar L. Lopez
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Ann D. Cohen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - William E. Klunk
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Howard A. Aizenstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Akiko Mizuno
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Beth E. Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
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de Almeida SM, Santana LB, Jr GG, Kussen GB, Nogueira K. Real-time Polymerase Chain Reaction for Mycobacterium tuberculosis Meningitis is More Sensitive in Patients with HIV Co-Infection. Curr HIV Res 2021; 18:267-276. [PMID: 32368978 DOI: 10.2174/1570162x18666200505083728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Tuberculous meningitis (TbM) is the most severe complication of extra pulmonary tuberculosis (Tb). There is a higher frequency of positive cerebrospinal fluid (CSF) cultures for Mycobacterium tuberculosis (MTb) in samples from human immunodeficiency virus (HIV) co-infected patients than in those from HIV-negative patients. We hypothesized that real time PCR assays for MTb (MTb qPCR) using CSF would be more sensitive in HIV co-infected patients owing to a greater MTb burden. The present study aimed to verify the diagnostic performance of MTb qPCR in CSF of TbM patients who either were co-infected with HIV or were HIVnegative. METHODS A total of 334 consecutive participants with suspected TbM were divided into two groups: HIV co-infected and HIV-negative; each group was categorized into definite TbM, probable TbM, possible TbM, and TbM-negative subgroups based on clinical, laboratory and imaging data. We evaluated the diagnostic characteristics of MTb qPCR analysis to detect TbM in CSF by comparing the results to those obtained for definite TbM (i.e., positive MTb culture) and/or probable TbM in CSF, as gold standard. RESULTS The sensitivity of MTb qPCR in the definite and probable subgroups of the HIV coinfected participants (n = 14) was 35.7%, with a specificity of 93.8%, negative predictive value (NPV) of 94.4%, and negative clinical utility index (CUI-) of 0.89. Results of the HIV-negative group (n = 7) showed lower sensitivity (14.3%) and similar specificity, NPV, and CUI-. CONCLUSION The findings confirmed our hypothesis, despite the low sensitivity. MTb qPCR may significantly contribute to diagnosis when associated with clinical criteria and complementary examinations.
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Affiliation(s)
- Sergio M de Almeida
- Neuroinfection Outclinic, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Lucas B Santana
- Neuroinfection Outclinic, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Gilberto Golin Jr
- Neuroinfection Outclinic, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Gislene B Kussen
- Bacteriology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Keite Nogueira
- Bacteriology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
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Stroehlein JK, Vieluf S, Zimmer P, Schenk A, Oberste M, Goelz C, van den Bongard F, Reinsberger C. Learning to play golf for elderly people with subjective memory complaints: feasibility of a single-blinded randomized pilot trial. BMC Neurol 2021; 21:200. [PMID: 34001020 PMCID: PMC8127313 DOI: 10.1186/s12883-021-02186-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/24/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Subjective Memory Complaints (SMC) in elderly people due to preclinical Alzheimer's Disease may be associated with dysregulation of the Kynurenine Pathway (KP), with an increase in neurotoxic metabolites that affect cognition. Golf is a challenging sport with high demands on motor, sensory, and cognitive abilities, which might bear the potential to attenuate the pathological changes of preclinical AD. This trial investigated the feasibility of learning to play golf for elderly with cognitive problems and its effects on cognitive functions and the KP. METHODS In a 22-week single-blinded randomized controlled trial, elderly people with SMC were allocated to the golf (n = 25, 180 min training/week) or control group (n = 21). Primary outcomes were feasibility (golf exam, adherence, adverse events) and general cognitive function (Alzheimer's Disease Assessment Scale). Secondary outcomes include specific cognitive functions (Response Inhibition, Corsi Block Tapping Test, Trail Making Test), KP metabolites and physical performance (6-Minute-Walk-Test). Baseline-adjusted Analysis-of-Covariance was conducted for each outcome. RESULTS 42 participants were analyzed. All participants that underwent the golf exam after the intervention passed it (20/23). Attendance rate of the golf intervention was 75 %. No adverse events or drop-outs related to the intervention occurred. A significant time*group interaction (p = 0.012, F = 7.050, Cohen's d = 0.89) was found for correct responses on the Response Inhibition task, but not for ADAS-Cog. Moreover, a significant time*group interaction for Quinolinic acid to Tryptophan ratios (p = 0.022, F = 5.769, Cohen's d = 0.84) in favor of the golf group was observed. An uncorrected negative correlation between attendance rate and delta Quinolinic acid to Kynurenic acid ratios in the golf group (p = 0.039, r=-0.443) was found as well. CONCLUSIONS The findings indicate that learning golf is feasible and safe for elderly people with cognitive problems. Preliminary results suggest positive effects on attention and the KP. To explore the whole potential of golfing and its effect on cognitive decline, a larger cohort should be studied over a longer period with higher cardiovascular demands. TRIAL REGISTRATION The trial was retrospectively registered (2nd July 2018) at the German Clinical Trials Register ( DRKS00014921 ).
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Affiliation(s)
- Julia K Stroehlein
- Department of Sports and Health, Institute of Sports Medicine, Paderborn University, Warburger Straße 100, 33098, Paderborn, Germany
| | - Solveig Vieluf
- Department of Sports and Health, Institute of Sports Medicine, Paderborn University, Warburger Straße 100, 33098, Paderborn, Germany
| | - Philipp Zimmer
- Department for Performance and Health, Institute for Sport and Sport Science, Technical University Dortmund, Otto-Hahn-Straße 3, 44227, Dortmund, Germany
| | - Alexander Schenk
- Department for Performance and Health, Institute for Sport and Sport Science, Technical University Dortmund, Otto-Hahn-Straße 3, 44227, Dortmund, Germany
| | - Max Oberste
- Institute of Medical Statistics and Computational Biology, Medical Faculty and University Hospital of Cologne, University of Cologne, Robert-Koch-Straße 10, 50931, Cologne, Germany
| | - Christian Goelz
- Department of Sports and Health, Institute of Sports Medicine, Paderborn University, Warburger Straße 100, 33098, Paderborn, Germany
| | - Franziska van den Bongard
- Department of Sports and Health, Institute of Sports Medicine, Paderborn University, Warburger Straße 100, 33098, Paderborn, Germany
| | - Claus Reinsberger
- Department of Sports and Health, Institute of Sports Medicine, Paderborn University, Warburger Straße 100, 33098, Paderborn, Germany.
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Mendes T, Cardoso S, Guerreiro M, Maroco J, Silva D, Alves L, Schmand B, Simões do Couto F, Figueira ML, de Mendonça A. Memory awareness in patients with Major Depressive Disorder. J Psychiatr Res 2021; 137:411-418. [PMID: 33774535 DOI: 10.1016/j.jpsychires.2021.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/27/2021] [Accepted: 03/05/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Subjective Memory Complaints (SMC) along with cognitive deficits are frequently observed in patients with Major Depressive Disorder (MDD). The relationship between SMC and objective memory performance in patients with MDD was evaluated, in comparison with patients with Mild Cognitive Impairment due to Alzheimer's Disease (MCI-AD) and healthy controls (HC). METHODS Patients with MDD (n = 47), MCI-AD (n = 43) and HC (n = 45) were assessed with a self-report memory complaints scale (SMCS) and underwent a comprehensive clinical and neuropsychological assessment. A discrepancy score between the Logical Memory delayed recall and the SMCS total score was calculated as a measure of memory awareness. RESULTS Patients with MDD (12.5 ± 4.4) and patients with MCI-AD (10.9 ± 4.1) had not significantly different SMCS total scores, whereas HC showed significantly lower scores (4.0 ± 3.0). As much as 74.5% of patients with MDD patients and 65.1% of patients with MCI-AD reported prominent memory complaints, whereas only 4.4% of HC did. Patients with MDD had relatively preserved memory tests, resulting in a higher discrepancy score than both patients with MCI-AD and HC. The SMCS total score correlated positively with depressive symptoms in the 3 groups of participants. CONCLUSIONS Patients with MDD showed inaccurate memory self-awareness as they under-estimated their memory functioning, a pattern distinct from both patients with MCI-AD and HC.
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Affiliation(s)
- Tiago Mendes
- Faculty of Medicine, University of Lisboa, Lisbon, Portugal; Psychiatry and Mental Health Department, Santa Maria Hospital, Lisbon, Portugal.
| | - Sandra Cardoso
- Faculty of Medicine, University of Lisboa, Lisbon, Portugal
| | | | - João Maroco
- Instituto Superior de Psicologia Aplicada, Lisbon, Portugal
| | - Dina Silva
- Faculty of Medicine, University of Lisboa, Lisbon, Portugal; Cognitive Neuroscience Research Group, Department of Psychology and Educational Sciences and Centre for Biomedical Research (CBMR), Universidade do Algarve, Faro, Portugal
| | - Luísa Alves
- Chronic Diseases Research Centre, NOVA Medical School, NOVA University of Lisbon, Portugal
| | - Ben Schmand
- Faculty of Social and Behavioral Sciences, University of Amsterdam, the Netherlands
| | - Frederico Simões do Couto
- Faculty of Medicine, University of Lisboa, Lisbon, Portugal; Psychiatry and Mental Health Department, Santa Maria Hospital, Lisbon, Portugal
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30
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de Almeida SM, Spalanzani RN, Nogueira MB, Sanada B, Cavalli BM, Rotta I, Takahashi GR, Pereira LA, Moreira FB, Dino CL, Graf ME, de Almeida BM, Domino NR, Genelhoud G, Bochnia-Bueno L, Raboni SM. Rapid Serological Tests for SARS-CoV-2: Diagnostic Performance of 4 Commercial Assays. Med Princ Pract 2021; 30:385-394. [PMID: 33887722 PMCID: PMC8339017 DOI: 10.1159/000516776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/15/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To assess the diagnostic performance of lateral flow immunochromatographic assays (LFAs) of 4 different manufacturers to identify SARS-CoV-2 antibodies (IgM, IgG, or total), comparing them with the nucleic acid amplification test (NAAT) or the clinical defined test (definite or probable SARS-CoV-2 infection, respectively). METHODS One hundred nineteen serum samples were randomly selected by convenience and distributed in the following groups: (1) group with SARS-CoV-2 infection (n = 82; RT-qPCR positive [definite, n = 70] and probable [n = 12]); (2) other diseases (n = 27; other viruses identified [n = 8] and SARS of other etiologies [n = 19]); and (3) healthy control group (n = 10). LFAs of 4 manufacturers were compared: MedTest Coronavirus (COVID-19) IgG/IgM (MedLevensohn, Brazil); COVID-19 IgG/IgM ECO Test (Ecodiagnóstica, Brazil); Camtech COVID-19 IgM/IgG Rapid Test Kit (Camtech Diagnostics Pte Ltd, Singapore); and 1-Step COVID-19 Test for total antibodies (Guangzhou Wondfo Biotech Co., China). RESULTS The 4 tests studied showed high diagnostic performance characteristics for the diagnoses of definite or probable SARS-CoV-2 infection. The best measures were for the Wondfo test: sensitivity (86.59%; 95% CI: 77.26-93.11%), specificity (100%; 90.51-100%), DOR (257; 60-1,008), LR+ (33.43; 4.82-231.85), LR- (0.13; 0.08-0.23), accuracy (90.76%; 84.06-95.29%), and Matthews correlation coefficient (MCC) 0.82. Although considering only the probable SARS-CoV-2 infection (PCR-) cases, all the kits studied showed limited values. CONCLUSION Our data demonstrate the excellent performance of LFA for the diagnoses of definite or probable SARS-CoV-2 infection. There was substantial heterogeneity in sensitivities of IgM and IgG antibodies among the different kits. LFA tests cannot replace molecular diagnostics but should be used as an additional screening tool.
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Affiliation(s)
| | | | - Meri B. Nogueira
- Virology Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | - Beatriz Sanada
- Virology Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Indianara Rotta
- Virology Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | | | | | | | | | - Maria E. Graf
- Infectious Diseases Division, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Natalia R. Domino
- Infectious Diseases Division, Universidade Federal do Paraná, Curitiba, Brazil
| | - Gustavo Genelhoud
- Virology Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Sonia M. Raboni
- Infectious Diseases Division, Universidade Federal do Paraná, Curitiba, Brazil
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The Relationship between Physical Activity, Self-Perceived Health, and Cognitive Function in Older Adults. Brain Sci 2021; 11:brainsci11040492. [PMID: 33924507 PMCID: PMC8069357 DOI: 10.3390/brainsci11040492] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022] Open
Abstract
There are consistent associations between physical activity and self-perceived health. However, it is not clear whether associations between self-perceived health and participation in physical activity could be accounted for by associations with cognitive function. In the present study, we examined whether associations between physical activity and cognitive functioning could explain the variability between physical activity and self-perceived health. A sample of 204 older adults performed three cognitive tests selected from the Vienna test system battery: The Determination, Cognitrone, and Visual Memory tests. These tests measure general processing speed, attention, and visual memory, respectively. Participants also completed the 12-item Short Form Health Questionnaire SF-12 to measure perceived health, and the Physical Activity Survey for the Elderly to measure physical activity. Linear regressions and the PROCESS macro for SPSS were used to test our hypotheses. Consistent with our hypotheses, processing speed accounted for significant variance in the relationship between physical activity and self-perceived health. This suggests that cognitive processing speed might be an indirect path by which physical activity relates to enhanced health perceptions. The results demonstrate that associations between physical activity and self-perceptions of health are related to a fundamental cognitive process.
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Casale R, Lavrova E, Sanduleanu S, Woodruff HC, Lambin P. Development and external validation of a non-invasive molecular status predictor of chromosome 1p/19q co-deletion based on MRI radiomics analysis of Low Grade Glioma patients. Eur J Radiol 2021; 139:109678. [PMID: 33848780 DOI: 10.1016/j.ejrad.2021.109678] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 03/04/2021] [Accepted: 03/21/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE The 1p/19q co-deletion status has been demonstrated to be a prognostic biomarker in lower grade glioma (LGG). The objective of this study was to build a magnetic resonance (MRI)-derived radiomics model to predict the 1p/19q co-deletion status. METHOD 209 pathology-confirmed LGG patients from 2 different datasets from The Cancer Imaging Archive were retrospectively reviewed; one dataset with 159 patients as the training and discovery dataset and the other one with 50 patients as validation dataset. Radiomics features were extracted from T2- and T1-weighted post-contrast MRI resampled data using linear and cubic interpolation methods. For each of the voxel resampling methods a three-step approach was used for feature selection and a random forest (RF) classifier was trained on the training dataset. Model performance was evaluated on training and validation datasets and clinical utility indexes (CUIs) were computed. The distributions and intercorrelation for selected features were analyzed. RESULTS Seven radiomics features were selected from the cubic interpolated features and five from the linear interpolated features on the training dataset. The RF classifier showed similar performance for cubic and linear interpolation methods in the training dataset with accuracies of 0.81 (0.75-0.86) and 0.76 (0.71-0.82) respectively; in the validation dataset the accuracy dropped to 0.72 (0.6-0.82) using cubic interpolation and 0.72 (0.6-0.84) using linear resampling. CUIs showed the model achieved satisfactory negative values (0.605 using cubic interpolation and 0.569 for linear interpolation). CONCLUSIONS MRI has the potential for predicting the 1p/19q status in LGGs. Both cubic and linear interpolation methods showed similar performance in external validation.
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Affiliation(s)
- Roberto Casale
- The D-Lab, Department of Precision Medicine, GROW- School for Oncology, Maastricht University Maastricht, the Netherlands.
| | - Elizaveta Lavrova
- The D-Lab, Department of Precision Medicine, GROW- School for Oncology, Maastricht University Maastricht, the Netherlands
| | - Sebastian Sanduleanu
- The D-Lab, Department of Precision Medicine, GROW- School for Oncology, Maastricht University Maastricht, the Netherlands
| | - Henry C Woodruff
- The D-Lab, Department of Precision Medicine, GROW- School for Oncology, Maastricht University Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, GROW - School for Oncology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Philippe Lambin
- The D-Lab, Department of Precision Medicine, GROW- School for Oncology, Maastricht University Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, GROW - School for Oncology, Maastricht University Medical Centre+, Maastricht, the Netherlands
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Cheng CH, Chang CC, Chao YP, Lu H, Peng SW, Wang PN. Altered mismatch response precedes gray matter atrophy in subjective cognitive decline. Psychophysiology 2021; 58:e13820. [PMID: 33792049 DOI: 10.1111/psyp.13820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 02/03/2023]
Abstract
The cross-sectional identification of subjective cognitive decline (SCD) in cognitively normal adults is particularly important for the early effective prevention or intervention of the future development of mild cognitive impairments (MCI) or Alzheimer's disease (AD). A pre-attentive neurophysiological signal that reflects the brain's ability to detect the changes of the environment is called mismatch negativity (MMN) or its magnetic counterpart (MMNm). It has been shown that patients with MCI or AD demonstrate reduced MMN/MMNm responses, while the exact profile of MMN/MMNm in SCD is substantially unknown. We applied magnetoencephalographic recordings to interrogate MMNm activities in healthy controls (HC, n = 29) and individuals with SCD (n = 26). Furthermore, we analyzed gray matter (GM) volumes in the MMNm-related regions through voxel-based morphometry and performed apolipoprotein E4 (APOE4) genotyping for all the participants. Our results showed that there were no significant differences in GM volume and proportions of APOE4 carriers between HC and SCD groups. However, individuals with SCD exhibited weakened z-corrected MMNm responses in the left inferior parietal lobule and right inferior frontal gyrus (IFG) as compared to HC. Based on the regions showing significant between-group differences, z-corrected MMNm amplitudes of the right IFG significantly correlated with the memory performance among the SCD participants. Our data suggest that neurophysiological changes of the brain, as indexed by MMNm, precede structural atrophy in the individuals with SCD compared to those without SCD.
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Affiliation(s)
- Chia-Hsiung Cheng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan.,Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chiung-Chih Chang
- Department of Neurology and Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Ping Chao
- Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan.,Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Hsinjie Lu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan.,Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan
| | - Shih-Wei Peng
- Division of General Neurology, Department of Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Neurology, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Pei-Ning Wang
- Division of General Neurology, Department of Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Neurology, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
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Missale F, Taboni S, Carobbio ALC, Mazzola F, Berretti G, Iandelli A, Fragale M, Mora F, Paderno A, Del Bon F, Parrinello G, Deganello A, Piazza C, Peretti G. Validation of the European Laryngological Society classification of glottic vascular changes as seen by narrow band imaging in the optical biopsy setting. Eur Arch Otorhinolaryngol 2021; 278:2397-2409. [PMID: 33710441 PMCID: PMC8165057 DOI: 10.1007/s00405-021-06723-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/23/2021] [Indexed: 12/12/2022]
Abstract
Purpose In 2016, the European Laryngological Society (ELS) proposed a classification for vascular changes occurring in glottic lesions as visible by narrow band imaging (NBI), based on the dichotomic distinction between longitudinal vessels (not suspicious) and perpendicular ones (suspicious). The aim of our study was to validate this classification assessing the interobserver agreement and diagnostic test performance in detecting the final histopathology. Methods A retrospective study was carried out by reviewing clinical charts, preoperative videos, and final pathologic diagnosis of patients submitted to transoral microsurgery for laryngeal lesions in two Italian referral centers. In each institution, two physicians, independently re-assessed each case applying the ELS classification. Results The cohort was composed of 707 patients. The pathologic report showed benign lesions in 208 (29.5%) cases, papillomatosis in 34 (4.8%), squamous intraepithelial neoplasia (SIN) up to carcinoma in situ in 200 (28.2%), and squamous cell carcinoma (SCC) in 265 (37.5%). The interobserver agreement was extremely high in both institutions (k = 0.954, p < 0.001 and k = 0.880, p < 0.001). Considering the diagnostic performance for identification of at least SIN or SCC, the sensitivity was 0.804 and 0.902, the specificity 0.793 and 0.581, the positive predictive value 0.882 and 0.564, and the negative predictive value 0.678 and 0.908, respectively. Conclusion The ELS classification for NBI vascular changes of glottic lesions is a highly reliable tool whose systematic use allows a better diagnostic evaluation of suspicious laryngeal lesions, reliably distinguishing benign ones from those with a diagnosis of papillomatosis, SIN or SCC, thus paving the way towards confirmation of the optical biopsy concept.
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Affiliation(s)
- Francesco Missale
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Stefano Taboni
- Section of Otorhinolaryngology, Head and Neck Surgery, Azienda Ospedaliera di Padova, University of Padua, Padua, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Andrea Luigi Camillo Carobbio
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy. .,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.
| | - Francesco Mazzola
- Department of Otolaryngology, Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giulia Berretti
- Unit of Otorhinolaryngology, Head and Neck Surgery, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Andrea Iandelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Marco Fragale
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Francesco Mora
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Alberto Paderno
- Unit of Otorhinolaryngology, Head and Neck Surgery, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Francesca Del Bon
- Unit of Otorhinolaryngology, Head and Neck Surgery, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | | | - Alberto Deganello
- Unit of Otorhinolaryngology, Head and Neck Surgery, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Cesare Piazza
- Unit of Otorhinolaryngology, Head and Neck Surgery, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Giorgio Peretti
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
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Olivari BS, Baumgart M, Taylor CA, McGuire LC. Population measures of subjective cognitive decline: A means of advancing public health policy to address cognitive health. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12142. [PMID: 33681450 PMCID: PMC7919133 DOI: 10.1002/trc2.12142] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/06/2021] [Indexed: 12/12/2022]
Abstract
Subjective cognitive decline (SCD) is receiving increasing attention as studies have suggested that SCD status is associated with risk of future cognitive decline and dementia. Population-based measures of SCD can be extremely useful to the public health community, health-care providers, researchers, and policymakers. A large population-based SCD measure now exists through the state-based Behavioral Risk Factor Surveillance System (BRFSS). All 50 states have included the cognitive decline module, which asks about SCD, to their BRFSS survey one or more times. Population measures of SCD can aid researchers in designing clinical studies by better estimating the populations that may be at risk for more severe cognitive decline based on their SCD status to ensure that the optimal groups are targeted. Population-level estimates of SCD can also help to inform health-care providers' decisions about initiating cognitive assessments, managing other conditions among those with memory problems, and identifying the needs of caregivers.
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Affiliation(s)
- Benjamin S Olivari
- Division of Population Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention (CDC) Atlanta Georgia USA
| | | | - Christopher A Taylor
- Division of Population Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention (CDC) Atlanta Georgia USA
| | - Lisa C McGuire
- Division of Population Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention (CDC) Atlanta Georgia USA
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Jones JD, Uribe C, Bunch J, Thomas KR. Beyond PD-MCI: objectively defined subtle cognitive decline predicts future cognitive and functional changes. J Neurol 2021; 268:337-345. [PMID: 32804281 PMCID: PMC7855683 DOI: 10.1007/s00415-020-10163-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Cognitive impairment is prevalent among individuals with Parkinson's disease (PD). Effort has been made to identify individuals at risk for cognitive decline and dementia. Objectively-defined subtle cognitive decline (Obj-SCD) is a novel classification that may identify individuals at risk for cognitive decline prior to a diagnosis of mild cognitive impairment (MCI). We examined the utility of Obj-SCD criteria to predict future cognitive decline and difficulties with activities of daily living (ADLs) among individuals with PD. METHOD The sample included 483 individuals newly diagnosed with PD. Participants were followed for a five-year span with yearly visits where they completed neuropsychological tests. Participants were categorized as cognitively normal (CN), the newly proposed Obj-SCD, PD-MCI or Parkinson's disease dementia (PDD). Analyses determined if utilization of Obj-SCD criteria predicted subsequent cognitive impairment and difficulties with ADLs. RESULTS At baseline, 372 (77%) participants were classified as CN, 40 (8.3%) classified as Obj-SCD, and 71 (14.7%) classified as PD-MCI. Analyses revealed that relative to the CN group, participants classified as Obj-SCD at baseline, were more likely to develop PD-MCI or PDD within 5 years (odds ratio 2.413; 95% confidence interval 1.215-4.792). Furthermore, the Obj-SCD represented an intermediate level of impairment, relative to the CN and PD-MCI groups, on an independent measure of cognition (Montreal Cognitive Assessment) and ADL. CONCLUSIONS Findings provide evidence that Obj-SCD criteria can identify individuals at risk for cognitive decline and impairments in ADL. Obj-SCD criteria may identify individuals at risk for cognitive impairment who are not detected by PD-MCI criteria.
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Affiliation(s)
- Jacob D Jones
- Department of Psychology, Center on Aging, California State University San Bernardino, 5500 University Parkway, San Bernardino, CA, 92407-2318, USA.
| | - Carmen Uribe
- Department of Psychology, Center on Aging, California State University San Bernardino, 5500 University Parkway, San Bernardino, CA, 92407-2318, USA
| | - Joseph Bunch
- Department of Psychology, Center on Aging, California State University San Bernardino, 5500 University Parkway, San Bernardino, CA, 92407-2318, USA
| | - Kelsey R Thomas
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
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de Almeida SM, Kussen GMB, Cogo L, Carvalho JH, Nogueira K. Diagnostic characteristics of Xpert MTB/RIF assay for the diagnosis of tuberculous meningitis and rifampicin resistance in Southern Brazil. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:700-707. [PMID: 33331464 DOI: 10.1590/0004-282x20200067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/21/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The timely diagnosis of tuberculous meningitis (TBM) is challenging. Molecular diagnostic tools are necessary for TBM, particularly in low- and middle-income countries. OBJECTIVES We aimed to calculate the diagnostics characteristics of Xpert MTB/RIF for the detection of Mycobacterium tuberculosis in the cerebrospinal fluid (CSF) and the frequency of rifampicin (RIF)-resistance in the CSF samples. METHODS A total of 313 consecutive CSF samples were studied and categorized into TBM definite, probable, possible, or not TBM cases based on the clinical, laboratory, and imaging data. RESULTS For the definite TBM cases (n=7), the sensitivity, specificity, efficiency, and positive likelihood ratio were 100, 97, 97, and 38%, respectively. However, for the TBM definite associated with the probable cases (n=24), the sensitivity decreased to 46%. All CSF samples that were Xpert MTB/RIF-positive were RIF susceptible. CONCLUSION Xpert MTB/RIF showed high discriminating value among the microbiology-proven TBM cases, although the values for the probable and possible TBM cases were reduced. Xpert MTB/RIF contributes significantly to the diagnosis of TBM, mainly when coupled with the conventional microbiological tests and clinical algorithms.
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Affiliation(s)
- Sergio Monteiro de Almeida
- Universidade Federal do Paraná, Hospital de Clínicas, Ambulatório de Neuroinfecção Curitiba PR, Brazil.,Universidade Federal do Paraná, Hospital de Clínicas, Laboratório de virologia, Curitiba PR, Brazil
| | | | - Laura Cogo
- Universidade Federal do Paraná, Hospital de Clínicas, Laboratório de Bacteriologia, Curitiba PR, Brazil
| | - José Henrique Carvalho
- Universidade Federal do Paraná, Hospital de Clínicas, Ambulatório de Neuroinfecção Curitiba PR, Brazil
| | - Keite Nogueira
- Universidade Federal do Paraná, Hospital de Clínicas, Laboratório de Bacteriologia, Curitiba PR, Brazil
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Gruters AAA, Ramakers IHGB, Verhey FRJ, Köhler S, Kessels RPC, de Vugt ME. Association Between Proxy- or Self-Reported Cognitive Decline and Cognitive Performance in Memory Clinic Visitors. J Alzheimers Dis 2020; 70:1225-1239. [PMID: 31322557 DOI: 10.3233/jad-180857] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND It is uncertain whether self- and proxy-reported cognitive decline in older adults reflect an actual objective cognitive dysfunction in the clinical sense, and if these are predictive for developing dementia. OBJECTIVE The aim of the present study is to investigate the cross-sectional and longitudinal relation between subjective cognitive decline and objective cognitive performance, depressive symptoms, and to determine the predictive value for development of dementia. METHODS We included 405 patients without dementia at first visit from the Maastricht memory clinic participating in a longitudinal cohort study. Subjective cognitive decline was measured using a self- and proxy-report questionnaire. All patients underwent a standardized neuropsychological assessment. Follow-up assessments were performed yearly for three consecutive years, and once after five years. RESULTS Subjective cognitive decline was associated with lower cognitive performance and more depressive symptoms. When comparing self- (n = 342, 84%) and proxy-reported decline (n = 110, 27%), it was shown that proxy reports were associated with a more widespread pattern of lower cognitive performance. In participants without cognitive impairment proxy-reported decline was not associated with depressive symptoms. In contrast, self-reported decline was associated with a stable course of depressive symptoms at follow-up. Proxy-reported cognitive decline (HR = 1.76, 95% CI = 1.12- 2.78), and mutual complaints (HR = 1.73, CI:1.09- 2.76) predicted incident dementia while self-reported decline did not reach statistical significance (HR = 1.26, 95% CI = 0.65- 2.43). CONCLUSION Proxy-reported cognitive decline was consistently associated with lower cognitive performance and conversion to dementia over 5 years. Self-reported cognitive decline in patients without cognitive impairment might indicate underlying depressive symptoms and thus deserve clinical attention as well.
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Affiliation(s)
- Angélique A A Gruters
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Inez H G B Ramakers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Department of Medical Psychology & Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
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Liu HY, Wang HP, Chen CY, Wu CC, Hua MS, Lin YE, Lin YC, Shyu YIL. Subjective memory complaints predict poorer functional recovery during the first year following hip-fracture surgery among elderly adults. Int J Geriatr Psychiatry 2020; 35:1209-1218. [PMID: 32510713 DOI: 10.1002/gps.5358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 05/27/2020] [Accepted: 06/01/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Subjective memory complaints (SMCs) in the elderly are associated with poor recovery in performing activities of daily living. This study was designed to examine SMCs and their association with recovery and health outcomes of older persons within 1 year following hospital discharge after hip-fracture surgery. METHODS Data were collected between 2012 and 2015 from 194 hip-fractured elders in northern Taiwan. SMCs were assessed by the Prospective and Retrospective Memory Questionnaire. Recovery outcomes included self-care ability (activities of daily living [ADLs] and instrumental activities of daily living [IADLs]), physical function (range of motion and maximal muscle strength), cognitive function, delirium, depressive symptoms, and health-related quality of life (HRQoL). Outcomes were assessed before discharge and 1, 3, 6, and 12 months afterwards. Associations of SMCs with participants' recovery outcomes were examined by the generalized estimating equation approach. RESULTS Participants with SMCs had significantly poorer recovery outcomes than those without SMCs. Additionally, the interaction term for time-by-SMC was significant on ADLs, IADLs, maximal strength of quadriceps muscles, maximal strength of hip abductor muscles, ankle dorsiflexion, and HRQoL, suggesting that negative associations with SMCs increased over time. Participants with SMCs were at significantly higher risk for cognitive impairment and delirium than those without SMCs. CONCLUSIONS Participants with SMCs not only had worse recovery than those without SMCs, but their rate of recovery was also slower during the first year following hip-fracture surgery. Therefore, SMCs need to be assessed to identify patients at high risk for worse recovery outcomes following hip fracture.
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Affiliation(s)
- Hsin-Yun Liu
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Hsiao-Ping Wang
- School of Nursing, Hsin Sheng College of Medical Care and Management, Taoyuan, Taiwan
| | - Ching-Yen Chen
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Chuan Wu
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Mau-Sun Hua
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
| | - Yueh-E Lin
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ya-Chi Lin
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yea-Ing L Shyu
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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Parfenov VA, Zakharov VV, Kabaeva AR, Vakhnina NV. Subjective cognitive decline as a predictor of future cognitive decline: a systematic review. Dement Neuropsychol 2020; 14:248-257. [PMID: 32973979 PMCID: PMC7500809 DOI: 10.1590/1980-57642020dn14-030007] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Over 44 million people suffer from dementia around the world. Researchers
estimated that there will be 48.1 million people with dementia by 2020 and 90.3
million by 2040. In addition to dementia, mild cognitive impairment (MCI) and
subjective cognitive decline (SCD) relate to cognitive impairment. It has been
established that MCI precedes dementia, however the significance of SCD is still
unclear. Recent studies suggest that SCD could be a risk factor for objective
cognitive impairment. SCD is defined as а self-estimated decline in cognitive
capacity in comparison to an individual’s previous level of functioning, which
cannot be determined by neuropsychological tests.
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Spano G, Caffò AO, Lanciano T, Curci A, Bosco A. Visuospatial/executive abilities and mood affect the reliability of a subjective memory complaints measure. Aging Clin Exp Res 2020; 32:1317-1326. [PMID: 31428996 DOI: 10.1007/s40520-019-01307-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/05/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Inconsistent results are reported so far in the literature on the relationship between subjective memory complaints (SMC) and objective memory performance. Mixed findings triggered the need to investigate whether other potential mediating variables, such as mood and non-memory domains, affect the relationship between SMC and memory performance. AIMS The present study aimed to contribute in clarifying the relation between subjective and objective memory considering the potential role of mood and visuospatial/executive functions. METHODS Six hundred and sixty Italian community-dwelling adults (52-91 years old) were enrolled. Italian version of Montreal Cognitive Assessment Test (MoCA), Geriatric Depression Scale and Subjective Memory Complaints Questionnaire (SMCQ) were administered. Four subsamples were composed according to the following criteria: (a) participants with high visuospatial/executive function (VSE) score at MoCA and high mood; (b) participants with high VSE score and low mood; (c) participants with low VSE score and high mood and; (d) participants with low VSE score and low mood. RESULTS Preliminarily, two confirmatory factor analysis have set the one-factor structure of SMCQ as the best fitting model. Diagnostic accuracy of the SMCQ in discriminating high and low memory score was assessed. ROC analyses confirmed that a low score in executive tasks was associated with poor reliability of the SMCQ. On the contrary, well-preserved executive functions and high mood levels ensured a good reliability of SMCQ in detecting memory problems. DISCUSSION AND CONCLUSIONS Although mood is a key mediator in the relationship between subjective and objective memory, preserving executive functions is essential for ensuring the accuracy of memory self-appraisal in adulthood and elderly.
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Affiliation(s)
- Giuseppina Spano
- Department of Agro-Environmental and Territorial Sciences, University of Bari Aldo Moro, Via Amendola 165/A, 70126, Bari, Italy.
- Department of Educational Sciences, Psychology, Communication Sciences, University of Bari Aldo Moro, Via Crisanzio, 42, 70122, Bari, Italy.
| | - Alessandro O Caffò
- Department of Educational Sciences, Psychology, Communication Sciences, University of Bari Aldo Moro, Via Crisanzio, 42, 70122, Bari, Italy
| | - Tiziana Lanciano
- Department of Educational Sciences, Psychology, Communication Sciences, University of Bari Aldo Moro, Via Crisanzio, 42, 70122, Bari, Italy
| | - Antonietta Curci
- Department of Educational Sciences, Psychology, Communication Sciences, University of Bari Aldo Moro, Via Crisanzio, 42, 70122, Bari, Italy
| | - Andrea Bosco
- Department of Educational Sciences, Psychology, Communication Sciences, University of Bari Aldo Moro, Via Crisanzio, 42, 70122, Bari, Italy
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de Almeida SM, Rotta I, de Pereira AP, Tang B, Umlauf A, Ribeiro CEL, Letendre S, Ellis RJ. Cerebrospinal fluid pleocytosis as a predictive factor for CSF and plasma HIV RNA discordance and escape. J Neurovirol 2020; 26:241-251. [PMID: 32002817 PMCID: PMC7261245 DOI: 10.1007/s13365-020-00828-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/10/2020] [Accepted: 01/23/2020] [Indexed: 01/14/2023]
Abstract
The aims of this study were to investigate the frequency of HIV-1 RNA level discordance between the cerebrospinal fluid (CSF) and plasma and of CSF viral escape (CVE) in patients with HIV-1 subtype C on antiretroviral therapy, and evaluate the CSF white blood cell (WBC) performance characteristics in predicting CSF discordance in HIV+ group and the frequency of cognitive impairment in individuals with CSF HIV discordance or escape. HIV-1 RNA levels were assessed in plasma and CSF samples from 68 HIV+ participants without opportunistic infection. CSF discordance was found in 7.4% and CVE in 10%, with comparable frequencies between HIV-1B and C. Twenty samples (29%) showed increased CSF WBC counts. This group had higher CSF and plasma HIV-1 RNA levels than the group with normal WBC counts (p < 0.0001 and 0.006, respectively). The odds of CSF discordance were 18 times higher for a person with CSF WBC count of > 5 cells/mm3 than the group with normal CSF WBC count. CSF WBC counts (cut-off of 15 cells/mm3) showed high-performance characteristics as a predictive biomarker of CSF discordance (AUC the ROC curve 0.98). The frequency of cognitive impairment for CSF escape or discordance was 83% and 80%. The odds of cognitive impairment in these groups were 19 and 15 times higher than those for an HIV(-) person. Viral discordance or escape in the CNS occurs at a comparable frequency for HIV-1C and HIV-1B. The CSF WBC count was effective as a predictive biomarker of CSF and plasma discordance.
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Affiliation(s)
| | - Indianara Rotta
- Virology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | | | - Bin Tang
- Department of Medicine and Psychiatry, University of California, San Diego, CA, USA
| | - Anya Umlauf
- Department of Medicine and Psychiatry, University of California, San Diego, CA, USA
| | - Cléa Elisa Lopes Ribeiro
- Infectious Diseases Unity, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Scott Letendre
- Department of Medicine and Psychiatry, University of California, San Diego, CA, USA
| | - Ronald J Ellis
- Department of Neurosciences and Psychiatry, University of California, San Diego, CA, USA
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Ciocan RA, Cătană CS, Drugan C, Gherman CD, Ciocan A, Drugan TC, Bolboacă SD. Relation between serum cotinine levels and trophic lesions in patients with critical limb ischemia: a pilot study. Acta Clin Belg 2020; 75:149-154. [PMID: 30741123 DOI: 10.1080/17843286.2019.1577530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Aim: To evaluate if smoking, quantified by the serum cotinine levels, is related to the evolution of patients with critical limb ischemia (CLI).Method: A pilot study was conducted on CLI patients who addressed at the Second Surgery Clinic of the Emergency County Hospital, Cluj-Napoca, Romania between November 2015 and December 2016. The sample of patients was split into two groups using the threshold of 15 ng/mL for the serum level of cotinine (low cotinine level - LCL vs. high cotinine level - HCL). Furthermore, the ROC analysis was conducted to identify the threshold of cotinine level able to discriminate between CLI patients with and without trophic lesions.Results: The mean age of patients was 60.7 ± 10.5 years with a significantly higher percentage of male patients (84%). A significant association was identified between urban origin and serum cotinine level, which is related to the increased number of cigarettes smoked per day among urban participants. Excepting necrectomy and toe disarticulation, no differences were found between LCL and HCL group regarding symptoms, signs or comorbidities. In smokers with CLI (38/43), a serum cotinine cut-off of 9.765 ng/mL was observed on eight out of 10 CLI patients with necrectomy and five out of 28 patients without necrectomy.Conclusion: Our study showed higher serum cotinine levels associated with a higher number of smoked cigarettes and necrectomy in patients with CLI. The serum cotinine could be a fair screening test for necrectomy in smokers CLI patients.
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Affiliation(s)
- Răzvan A. Ciocan
- Department of Medical Informatics and Biostatistics, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
- Department of Vascular Surgery, Second Surgical Clinic, Emergency County Hospital Cluj-Napoca, Cluj-Napoca, Romania
| | - Cristina-Sorina Cătană
- Department of Medical Biochemistry, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Cristina Drugan
- Department of Medical Biochemistry, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Claudia D. Gherman
- Department of Vascular Surgery, Second Surgical Clinic, Emergency County Hospital Cluj-Napoca, Cluj-Napoca, Romania
- Department of Practical Skills, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andra Ciocan
- Faculty of Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Tudor C. Drugan
- Department of Medical Informatics and Biostatistics, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Sorana D. Bolboacă
- Department of Medical Informatics and Biostatistics, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
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Hatakenaka Y, Maeda M, Ninomiya H, Hachiya K, Fernell E, Gillberg C. ESSENCE-Q obtained in routine Japanese public child health check-ups may be a valuable tool in neurodevelopmental screening. Acta Paediatr 2020; 109:764-773. [PMID: 31545530 DOI: 10.1111/apa.15029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 09/17/2019] [Accepted: 09/20/2019] [Indexed: 11/29/2022]
Abstract
AIM Our aim was to extend the validity of a questionnaire developed for screening and identifying early symptomatic syndromes eliciting neurodevelopmental clinical examinations-questionnaire (ESSENCE-Q) in young children. METHODS Early symptomatic syndromes eliciting neurodevelopmental clinical examinations-questionnaire data for 207 children, living in Aki City, Japan, in 2014-2015, were obtained from mothers, public health nurses and psychologists at 20- and 40-month routine check-ups at child healthcare centres. These were checked against subsequent ESSENCE diagnoses made by physicians. Receiver operating characteristic curves were constructed, and the area under the curves was compared. Sensitivity, specificity, positive predictive values (PPVs) and negative predictive values were calculated at optimal cut-off values. The clinical utility index was also calculated. RESULTS When the ESSENCE-Q was used by public health nurses, it demonstrated good validity, in terms of high sensitivity and high NPVs, at the 20-month check-up, but not at 40 months. Psychologists demonstrated good validity at both ages, but mothers did not. Good negative utility indexes, indicating screening accuracy, were obtained from the psychologists at both check-ups and from nurses at 20 months. CONCLUSION The ESSENCE-Q results used by nurses and psychologists showed good validity. Future studies should confirm the effectiveness of this tool to identify children in need of clinical detailed neurodevelopmental assessment.
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Affiliation(s)
- Yuhei Hatakenaka
- Faculty of Humanities and Sociologies University of the Ryukyus Nishihara Okinawa Japan
- Kochi Gillberg Neuropsychiatry Centre Kochi Prefectural Medical and Welfare Centre Kochi Japan
- Gillberg Neuropsychiatry Centre Sahlgrenska Academy Gothenburg Sweden
| | - Masato Maeda
- Kochi Gillberg Neuropsychiatry Centre Kochi Prefectural Medical and Welfare Centre Kochi Japan
- Department of Paediatrics Kochi Prefectural Aki General Hospital Aki Kochi Japan
| | - Hitoshi Ninomiya
- Kochi Gillberg Neuropsychiatry Centre Kochi Prefectural Medical and Welfare Centre Kochi Japan
- Faculty of Science and Engineering Department of Civil and Environmental Engineering Toyo University Kawagoe Saitama Japan
| | | | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre Sahlgrenska Academy Gothenburg Sweden
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45
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Dodel R, Deuschl G. [Early diagnosis of dementia]. MMW Fortschr Med 2020; 162:60-68. [PMID: 32248504 DOI: 10.1007/s15006-020-0011-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Richard Dodel
- Universität Duisburg-Essen, Germaniastrasse 1-3, D-45356, Essen, Deutschland.
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46
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Chu H, Liang C, Lee J, Lee M, Sung Y, Tsai C, Tsai C, Lin Y, Ho T, Yang F. Subjective cognitive complaints and migraine characteristics: A cross-sectional study. Acta Neurol Scand 2020; 141:319-327. [PMID: 31856293 DOI: 10.1111/ane.13204] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/27/2019] [Accepted: 12/14/2019] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Subjective cognitive complaints by patients with migraine have been associated with memory impairment. However, whether the severity of memory impairment relates to migraine characteristics, such as attack frequency and aura, remains undetermined. We investigated the relationship between subjective cognitive complaints and migraine characteristics. MATERIALS AND METHODS This cross-sectional study recruited 669 clinic outpatients from Taiwan. We stratified them by migraine frequency and the presence or absence of aura, and we controlled the data for confounding variables. We performed multivariable linear and logistic regressions to investigate whether different migraine frequencies are associated with subjective cognitive complaints, which were evaluated by the subjective memory complaints scale and the Ascertain Dementia 8 (AD8) questionnaire. RESULTS Total subjective memory complaints scores tended to increase with the migraine attack frequency (P = .022) in patients with migraine with aura; similar results were obtained for AD8 scores in women with migraine with aura. Poor sleep quality was associated with a higher total subjective memory complaint (B = 0.08, 95% confidence interval [CI] = 0.03-0.14) and AD8 (B = 0.07, 95% CI = 0.02-0.11) scores. In addition, more severe depression was associated with higher total subjective memory complaints and AD8 scores (B = 0.05, 95% CI = 0.02-0.09; B = 0.08, 95% CI = 0.05-0.11, respectively). CONCLUSIONS Subjective cognitive complaints tend to increase with the frequency of migraines with aura, and this interrelation is substantially influenced by depression severity and sleep disturbances.
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Affiliation(s)
- Hsuan‐Te Chu
- Department of Psychiatry Beitou Branch Tri‐Service General Hospital School of Medicine National Defense Medical Center Taipei Taiwan
| | - Chih‐Sung Liang
- Department of Psychiatry Beitou Branch Tri‐Service General Hospital School of Medicine National Defense Medical Center Taipei Taiwan
| | - Jiunn‐Tay Lee
- Department of Neurology National Defense Medical Center Tri‐Service General Hospital Taipei Taiwan
| | - Meei‐Shyuan Lee
- National Defense Medical CenterSchool of Public Health Taipei Taiwan
| | - Yueh‐Feng Sung
- Department of Neurology National Defense Medical Center Tri‐Service General Hospital Taipei Taiwan
| | - Chia‐Lin Tsai
- Department of Neurology National Defense Medical Center Tri‐Service General Hospital Taipei Taiwan
| | - Chia‐Kuang Tsai
- Department of Neurology National Defense Medical Center Tri‐Service General Hospital Taipei Taiwan
| | - Yu‐Kai Lin
- Department of Neurology National Defense Medical Center Tri‐Service General Hospital Taipei Taiwan
| | - Tsung‐Han Ho
- Department of Neurology National Defense Medical Center Tri‐Service General Hospital Taipei Taiwan
| | - Fu‐Chi Yang
- Department of Neurology National Defense Medical Center Tri‐Service General Hospital Taipei Taiwan
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Huber BN, Jones RG, Capps SC, Buchanan EM. Memory complaints inventory profiles: Differentiating neurocognitive impairment, depression, and non-credible performance. APPLIED NEUROPSYCHOLOGY. ADULT 2020; 29:234-243. [PMID: 32186416 DOI: 10.1080/23279095.2020.1735388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The Memory Complaints Inventory (MCI) is a symptom validity measure designed to assess exaggerated memory complaints. The aim of current study was to develop memory complaint profiles on the MCI to distinguish between various neurocognitive disorders, depression, and non-credible performance. This study utilized MCI scores (N = 244) from a neuropsychology clinic to determine the presence of, and difference between, subjective memory complaints between a depression group, non-credible group, and subgroups of cognitive impairment (Alzheimer's Dementia, Vascular Dementia, and Mild Cognitive Impairment). Significant differences were found on MCI endorsement between cognitive impairment, depression, and non-credible groups. This pattern indicated fewer memory complaints for cognitive impairment groups when compared to depression and non-credible groups; the non-credible group had the highest MCI scores overall. ROC analyses revealed recommended clinical cutoff values with high specificity for distinguishing between the non-credible group and other groups. The findings provided further evidence for the MCI as a symptom validity measure, given its ability to differentiate between a non-credible group and clinical groups. Replication of the study's findings would result in reliable genuine subjective memory complaint profiles to provide additional diagnostic and prognostic specificity in neuropsychological practice.
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Affiliation(s)
- Becca N Huber
- Psychology, Idaho State University, Pocatello, ID, USA.,Psychology, Missouri State University, Springfield, MO, USA
| | - Ryan G Jones
- Neuropsychology, CoxHealth, Springfield, MO, USA
| | - Steven C Capps
- Psychology, Missouri State University, Springfield, MO, USA
| | - Erin M Buchanan
- Psychology, Missouri State University, Springfield, MO, USA.,Cognitive Analytics, Harrisburg University of Science and Technology, Harrisburg, PA, USA
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48
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Semba RD, Tian Q, Carlson MC, Xue QL, Ferrucci L. Motoric cognitive risk syndrome: Integration of two early harbingers of dementia in older adults. Ageing Res Rev 2020; 58:101022. [PMID: 31996326 PMCID: PMC7697173 DOI: 10.1016/j.arr.2020.101022] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/10/2020] [Accepted: 01/21/2020] [Indexed: 12/17/2022]
Abstract
Dementia is characterized by a long preclinical phase that may last years to decades before the onset of mild cognitive impairment. Slow gait speed and subjective memory complaint commonly co-occur during this preclinical phase, and each is a strong independent predictor of cognitive decline and dementia. Motoric cognitive risk (MCR) syndrome is a pre-dementia syndrome that combines these two early harbingers of dementia. The risk of cognitive decline or dementia is stronger for MCR than for either slow gait speed or subjective memory complaint alone. Slow gait speed and subjective memory complaint have several common risk factors: cardiovascular disease, diabetes mellitus, abnormal cortisol profiles, low vitamin D levels, brain atrophy with decreased hippocampal volume, and increased deposition of beta-amyloid in the brain. The underlying pathogenesis of MCR remains poorly understood. Metabolomics and proteomics have great potential to provide new insights into biological pathways involved in MCR during the long preclinical phase preceding dementia.
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Affiliation(s)
- Richard D Semba
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Qu Tian
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Qian-Li Xue
- Departments of Medicine, Biostatistics, and Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
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Cheng CH, Wang PN, Mao HF, Hsiao FJ. Subjective cognitive decline detected by the oscillatory connectivity in the default mode network: a magnetoencephalographic study. Aging (Albany NY) 2020; 12:3911-3925. [PMID: 32100722 PMCID: PMC7066903 DOI: 10.18632/aging.102859] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 02/08/2020] [Indexed: 12/29/2022]
Abstract
Discriminating between those with and without subjective cognitive decline (SCD) in cross-sectional investigations using neuropsychological tests is challenging. The available magnetoencephalographic (MEG) studies have demonstrated altered alpha-band spectral power and functional connectivity in those with SCD. However, whether the functional connectivity in other frequencies and brain networks, particularly the default mode network (DMN), exhibits abnormalities in SCD remains poorly understood. We recruited 26 healthy controls (HC) without SCD and 27 individuals with SCD to perform resting-state MEG recordings. The power of each frequency band and functional connectivity within the DMN were compared between these two groups. Posterior cingulate cortex (PCC)-based connectivity was also used to test its diagnostic accuracy as a predictor of SCD. There were no significant between-group differences of spectral power in the regional nodes. However, compared with HC, those with SCD demonstrated increased delta-band and gamma-band functional connectivity within the DMN. Moreover, node strength in the PCC exhibited a good discrimination ability at both delta and gamma frequencies. Our data suggest that the node strength of delta and gamma frequencies in the PCC may be a good neurophysiological marker in the discrimination of individuals with SCD from those without SCD.
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Affiliation(s)
- Chia-Hsiung Cheng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan.,Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan
| | - Pei-Ning Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Division of General Neurology, Department of Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Neurology, National Yang-Ming University, Taipei, Taiwan
| | - Hui-Fen Mao
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Fu-Jung Hsiao
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
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50
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de Almeida SM, Dalla Costa LM, Siebra C, Arend LNVS, Nogueira KDS. Validation of multiplex PCR for the diagnosis of acute bacterial meningitis in culture negative cerebrospinal fluid. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 77:224-231. [PMID: 31090802 DOI: 10.1590/0004-282x20190028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 12/07/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION This study evaluated the operational characteristics of the multiplex polymerase chain reaction (PCR) for cerebrospinal fluid (CSF) from patients with cellular and biochemical characteristics of acute bacterial meningitis and positive or negative CSF cultures. METHODS Multiplex PCR was performed for 36 CSF samples: culture-proven acute bacterial meningitis (n = 7), culture-negative acute bacterial meningitis (n = 17), lymphocytic meningitis (n = 8), and normal CSF (n = 4). The operational characteristics of multiplex PCR were evaluated with definite and probable bacterial meningitis, using culture positive, cytological and biochemical CSF characteristics as the gold standard. RESULTS Multiplex PCR for CSF was efficient in the group with CSF cellular and biochemical characteristics of acute bacterial meningitis but with a negative CSF culture. This group demonstrated high specificity, positive predictive value, and efficiency. CONCLUSIONS Multiplex PCR for CSF can improve the speed and accuracy of acute bacterial meningitis diagnosis in a clinical setting as a complement to classical immunological and bacteriological assays in CSF. It is also useful for CSF culture-negative acute bacterial meningitis.
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Affiliation(s)
- Sérgio Monteiro de Almeida
- Universidade Federal do Paraná, Complexo Hospital de Clínicas, Ambulatório de Neuroinfecção, Curitiba PR, Brasil.,Universidade Federal do Paraná, Complexo Hospital de Clínicas, Laboratório de Virologia, Curitiba PR, Brasil
| | - Libera Maria Dalla Costa
- Faculdades Pequeno Príncipe, Curitiba PR, Brasil.,Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba PR, Brasil
| | - Christian Siebra
- Laboratório Central do Estado do Paraná, Laboratório de Bacteriologia, Curitiba PR, Brasil
| | | | - Keite da Silva Nogueira
- Universidade Federal do Paraná, Complexo Hospital de Clínicas, Laboratório de Bacteriologia, Curitiba PR, Brasil.,Universidade Federal do Paraná, Departamento de Patologia, Curitiba PR, Brasil
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