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Wang Y, Wang T, Yu Z, Wang J, Liu F, Ye M, Fang X, Liu Y, Liu J. Alterations in structural integrity of superior longitudinal fasciculus III associated with cognitive performance in cerebral small vessel disease. BMC Med Imaging 2024; 24:138. [PMID: 38858645 PMCID: PMC11165890 DOI: 10.1186/s12880-024-01324-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 06/05/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND This study aimed to investigate the alterations in structural integrity of superior longitudinal fasciculus subcomponents with increasing white matter hyperintensity severity as well as the relationship to cognitive performance in cerebral small vessel disease. METHODS 110 cerebral small vessel disease study participants with white matter hyperintensities were recruited. According to Fazekas grade scale, white matter hyperintensities of each subject were graded. All subjects were divided into two groups. The probabilistic fiber tracking method was used for analyzing microstructure characteristics of superior longitudinal fasciculus subcomponents. RESULTS Probabilistic fiber tracking results showed that mean diffusion, radial diffusion, and axial diffusion values of the left arcuate fasciculus as well as the mean diffusion value of the right arcuate fasciculus and left superior longitudinal fasciculus III in high white matter hyperintensities rating group were significantly higher than those in low white matter hyperintensities rating group (p < 0.05). The mean diffusion value of the left superior longitudinal fasciculus III was negatively related to the Montreal Cognitive Assessment score of study participants (p < 0.05). CONCLUSIONS The structural integrity injury of bilateral arcuate fasciculus and left superior longitudinal fasciculus III is more severe with the aggravation of white matter hyperintensities. The structural integrity injury of the left superior longitudinal fasciculus III correlates to cognitive impairment in cerebral small vessel disease.
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Affiliation(s)
- Yifan Wang
- Department of Radiology, Eye& ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, China
| | - Tianyao Wang
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zekuan Yu
- Academy for Engineering and Technology, Fudan University, Shanghai, 200433, China
| | - Junjie Wang
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Fang Liu
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Mengwen Ye
- Academy for Engineering and Technology, Fudan University, Shanghai, 200433, China
| | - Xianjin Fang
- Anhui University of Science and Technology, Anhui, China
| | - Yinhong Liu
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China.
| | - Jun Liu
- Department of Radiology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200050, China.
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Liu C, Li L, Zhu D, Lin S, Ren L, Zhen W, Tan W, Wang L, Tian L, Wang Q, Mao P, Pan W, Li B, Ma X. Individualized prediction of cognitive test scores from functional brain connectome in patients with first-episode late-life depression. J Affect Disord 2024; 352:32-42. [PMID: 38360359 DOI: 10.1016/j.jad.2024.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/17/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND In the realm of cognitive screening, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are widely utilized for detecting cognitive deficits in patients with late-life depression (LLD), However, the interindividual variability in neuroimaging biomarkers contributing to individual-specific symptom severity remains poorly understood. In this study, we used a connectome-based predictive model (CPM) approach on resting-state functional magnetic resonance imaging data from patients with LLD to establish individualized prediction models for the MoCA and the MMSE scores. METHODS We recruited 135 individuals diagnosed with first-episode LLD for this research. Participants underwent the MMSE and MoCA tests, along with resting-state functional magnetic resonance imaging scans. Functional connectivity matrices derived from these scans were utilized in CPM models to predict MMSE or MoCA scores. Predictive precision was assessed by correlating predicted and observed scores, with the significance of prediction performance evaluated through a permutation test. RESULTS The negative model of the CPM procedure demonstrated a significant capacity to predict MoCA scores (r = -0.309, p = 0.002). Similarly, the CPM procedure could predict MMSE scores (r = -0.236, p = 0.016). The predictive models for cognitive test scores in LLD primarily involved the visual network, somatomotor network, dorsal attention network, and ventral attention network. CONCLUSIONS Brain functional connectivity emerges as a promising predictor of personalized cognitive test scores in LLD, suggesting that functional connectomes are potential neurobiological markers for cognitive performance in patients with LLD.
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Affiliation(s)
- Chaomeng Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Li Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Dandi Zhu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Shuo Lin
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Li Ren
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wenfeng Zhen
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Weihao Tan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Lina Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Lu Tian
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Qian Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Peixian Mao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Weigang Pan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Bing Li
- Hebei Provincial Mental Health Center, Baoding, China; Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding, China; The Sixth Clinical Medical College of Hebei University, Baoding, China.
| | - Xin Ma
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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Jang Y, Park J, Chung S, Lewis C, Haley WE, Kim MT. The Role of Sensory Impairment in Cognitive Health Appraisal: A Study of Older Korean Americans Living in Subsidized Senior Housing. J Aging Health 2024:8982643241247249. [PMID: 38621115 DOI: 10.1177/08982643241247249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
OBJECTIVES We examined how the association between cognitive performance and cognitive health appraisal would be moderated by vision and/or hearing impairment. METHODS Data were collected from 315 older Korean-American residents in subsidized senior housing in Los Angeles (M age = 79.4 years). Linear regression models examined the direct and interactive effects of cognitive performance, vision impairment, and hearing impairment on cognitive health appraisal. RESULTS Negative appraisal of cognitive health was associated with lower cognitive performance and poorer ratings for vision and hearing. Moreover, we found a significant interaction between cognitive performance and hearing impairment (β = .13, p < .05), as well as a three-way interaction among cognitive performance, vision impairment, and hearing impairment (β = .12, p < .05). DISCUSSION The association between objective and subjective measures of cognition was weakened when hearing was impaired. Such a pattern was further evident when both vision and hearing were impaired.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
- Department of Social Welfare, Ewha Womans University, Seoul, Korea
| | - Juyoung Park
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University, Seoul, Korea
| | - Charity Lewis
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Miyong T Kim
- School of Nursing, University of Texas at Austin, Austin, TX, USA
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Zhou Y, Yang H, You M, Feng Z, Dong X. Cognition-Enhancement Effect of Median Nerve Electrical Stimulation in Patients with Cognitive Impairment: A Retrospective Cohort Study. World Neurosurg 2024; 184:e537-e545. [PMID: 38320650 DOI: 10.1016/j.wneu.2024.01.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVE People with cognitive impairment often face quality-of-life problems and require ongoing support, which has profound consequences for caregivers and society. Noninvasive brain stimulation techniques, such as median nerve electrical stimulation (MNS), have shown promising potentials in improving cognitive ability in patients with cognitive impairment. Therefore, we aimed to investigate the positive effect and safety of MNS in cognitive impairment. METHODS Patients diagnosed with cognitive impairment from the hospital record management system of the First Affiliated Hospital of Nanchang University from April 1, 2020, to December 31, 2022, were enrolled. Data on patients' basic characteristics, treatment records, and examination results such as the Mini-Mental State Examination (MMSE), activities of daily living (ADL), and P300 event-related potentials before and after treatment were collected. RESULTS Overall, 146 patients with cognitive impairment were enrolled, including 71 patients who underwent conventional therapy (standard treatment group) and 75 patients who underwent conventional therapy and MNS operation (active MNS group). Before treatment, there were no differences between the standard treatment and active MNS groups in terms of age, sex, etiology, duration of symptoms before therapy, hospital stay, whether they had undergone surgery, MMSE score, ADL score, and amplitude and latency of the P300 event-related potentials (P > 0.05). After treatment, we observed significant improvements in the MMSE score, ADL score, amplitude of P300, and decreased latency of P300 event-related potentials in both groups compared with before treatment (P < 0.05). In addition, we observed that the active MNS group showed higher MMSE and ADL scores, higher amplitude of P300 event-related potentials, and lower latency of P300 event-related potentials than the standard treatment group after treatment (P < 0.05). Furthermore, no side effects were associated with MNS operation. CONCLUSIONS These preliminary data provide early evidence that MNS may be a positive effect and safe method for promoting the recovery of cognitive ability in patients with cognitive impairment.
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Affiliation(s)
- Yifan Zhou
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Haihua Yang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Mengyu You
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Zhen Feng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Xiaoyang Dong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
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Dumassais S, Pichora-Fuller MK, Guthrie D, Phillips NA, Savundranayagam M, Wittich W. Strategies used during the cognitive evaluation of older adults with dual sensory impairment: a scoping review. Age Ageing 2024; 53:afae051. [PMID: 38506649 PMCID: PMC10953621 DOI: 10.1093/ageing/afae051] [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: 07/11/2023] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Dual sensory impairment (DSI), the combination of visual and hearing impairments, is associated with increased risk for age-related cognitive decline and dementia. Administering cognitive tests to individuals with sensory impairment is challenging because most cognitive measures require sufficient hearing and vision. Considering sensory limitations during cognitive test administration is necessary so that the effects of sensory and cognitive abilities on test performance can be differentiated and the validity of test results optimized. OBJECTIVE To review empirical strategies that researchers have employed to accommodate DSI during cognitive testing of older adults. METHODS Seven databases (MEDLINE, Embase, Web of Science, CINAHL, PsycINFO, Global Health and the Evidence-Based Medicine Reviews databases) were searched for relevant articles integrating the three concepts of cognitive evaluation, aging, and DSI. Given the inclusion criteria, this scoping review included a total of 67 papers. RESULTS Twenty-eight studies reported five categories of strategies for cognitive testing of older adult participants with DSI: the assistance of experts, the modification of standardized test scoring procedures, the use of communication strategies, environmental modifications, and the use of cognitive tests without visual and/or auditory items. CONCLUSIONS The most used strategy reported in the included studies was drawing on the assistance of team members from related fields during the administration and interpretation of cognitive screening measures. Alternative strategies were rarely employed. Future research is needed to explore the knowledge-to-practice gap between research and current clinical practice, and to develop standardized testing strategies.
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Affiliation(s)
- Shirley Dumassais
- School of Optometry, Université de Montreal, Montreal, Quebec, H3T 1P1, Canada
| | | | - Dawn Guthrie
- Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, Ontario, N2L 3C5, Canada
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, N2L 3C5, Canada
| | - Natalie A Phillips
- Department of Psychology/Centre for Research in Human Development, Concordia University, Montreal, Quebec, H4B 1R6, Canada
| | | | - Walter Wittich
- School of Optometry, Université de Montreal, Montreal, Quebec, H3T 1P1, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, H3S 1M9, Canada
- Centre de réadaptation Lethbridge-Layton-Mackay du Centre intégré universitaire de santé et de services sociaux du Centre-Ouest-de-l’Île-de-Montréal, Montreal, Quebec, H4B 1T3, Canada
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Moradi S, Engdahl B, Johannessen A, Selbæk G, Aarhus L, Haanes GG. Hearing loss, hearing aid use, and performance on the Montreal cognitive assessment (MoCA): findings from the HUNT study in Norway. Front Neurosci 2024; 17:1327759. [PMID: 38260012 PMCID: PMC10800991 DOI: 10.3389/fnins.2023.1327759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Purpose To evaluate the associations between hearing status and hearing aid use and performance on the Montreal Cognitive Assessment (MoCA) in older adults in a cross-sectional study in Norway. Methods This study utilized data from the fourth wave of the Trøndelag Health Study (HUNT4, 2017-2019). Hearing thresholds at frequencies of 0.5, 1, 2, and 4 kHz (or PTA4) in the better hearing ear were used to determine participants' hearing status [normal hearing (PTA4 hearing threshold, ≤ 15 dB), or slight (PTA4, 16-25 dB), mild (PTA4, 26-40 dB), moderate (PTA4, 41-55 dB), or severe (PTA4, ≥ 56 dB) hearing loss]. Both standard scoring and alternate MoCA scoring for people with hearing loss (deleting MoCA items that rely on auditory function) were used in data analysis. The analysis was adjusted for the confounders age, sex, education, and health covariates. Results The pattern of results for the alternate scoring was similar to that for standard scoring. Compared with the normal-hearing group, only individuals with moderate or severe hearing loss performed worse in the MoCA. In addition, people with slight hearing loss performed better in the MoCA than those with moderate or severe hearing loss. Within the hearing loss group, hearing aid use was associated with better performance in the MoCA. No interaction was observed between hearing aid use and participants' hearing status with performance on the MoCA test. Conclusion While hearing loss was associated with poorer performance in the MoCA, hearing aid use was found to be associated with better performance in the MoCA. Future randomized control trials are needed to further examine the efficacy of hearing aid use on the MoCA performance. When compared with standard scoring, the alternate MoCA scoring had no effect on the pattern of results.
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Affiliation(s)
- Shahram Moradi
- Research Group for Disability and Inclusion, Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, University of South-Eastern Norway Campus Porsgrunn, Porsgrunn, Norway
- Research Group for Health Promotion in Settings, Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Tønsberg, Norway
| | - Bo Engdahl
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Aud Johannessen
- Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, University of South-Eastern Norway Campus Vestfold, Horten, Norway
- Norwegian National Centre for Ageing and Health, Tønsberg, Norway
| | - Geir Selbæk
- Norwegian National Centre for Ageing and Health, Tønsberg, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Geriatric Department, Oslo University Hospital, Oslo, Norway
| | - Lisa Aarhus
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
- Medical Department, Diakonhjemmet Hospital, Oslo, Norway
| | - Gro Gade Haanes
- Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, University of South-Eastern Norway Campus Vestfold, Horten, Norway
- USN Research Group of Older Peoples’ Health, University of South-Eastern Norway Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
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Zhang W, Yuan Y, Cui X, Chen S, Zhuang X. The level of serum retinol-binding protein is associated with diabetic mild cognitive impairment. Brain Res 2024; 1822:148670. [PMID: 37944571 DOI: 10.1016/j.brainres.2023.148670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/20/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Several studies have shown that retinol-binding protein (RBP) is linked to diabetes and neurodegenerative diseases. However, no studies have elucidated the relationship between RBP and diabetic cognitive disorders. OBJECTIVE To determine whether the change characteristics of serum RBP are associated with alterations in cognitive functioning in type 2 diabetes mellitus (T2DM). METHODS In this study, 252 patients with T2DM and 34 people as healthy controls were included. According to the Montreal Cognitive Assessment (MoCA), the diabetic subjects were divided into the mild cognitive impairment (MCI) group and the Non-MCI group. Demographic characteristics and clinical indicators as well as serum RBP levels were analyzed. RESULTS The serum RBP levels in the MCI group were lower compared with the Non-MCI group (P = 0.02). The level of RBP was higher in the diabetes without MCI group than in the healthy control (P < 0.001). Serum RBP levels were positively correlated with MoCA scores (r = 0.178, P = 0.003). Binary Logistic regression model analysis showed that low RBP [odds ratio (OR) = 0.936], old age (OR = 1.074), high fasting blood glucose (OR = 1.164), and low fasting C-peptide (OR = 0.722) may be independent risk factors for diabetic MCI. The ROC curve of serum RBP for predicting diabetic MCI showed that the area under the curve was 0.630. CONCLUSIONS Our study revealed an association between serum RBP and diabetic MCI. Serum RBP levels in diabetic MCI are lower and correlated with cognitive function.
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Affiliation(s)
- Wenjie Zhang
- Department of General Practice, The Second Hospital of Shandong University, Jinan 250000, China
| | - Yuqi Yuan
- Department of Clinical Epidemiology and Evidence-based Medicine, The Second Hospital of Shandong University, Jinan 250000, China
| | - Xiaoxia Cui
- The Second Hospital of Shandong University, Jinan 250000, China
| | - Shihong Chen
- Department of Endocrinology, The Second Hospital of Shandong University, Jinan 250000, China.
| | - Xianghua Zhuang
- Department of Endocrinology, The Second Hospital of Shandong University, Jinan 250000, China.
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Häußler SM, Stankow E, Knopke S, Szczepek AJ, Olze H. Sustained Cognitive Improvement in Patients over 65 Two Years after Cochlear Implantation. Brain Sci 2023; 13:1673. [PMID: 38137121 PMCID: PMC10741742 DOI: 10.3390/brainsci13121673] [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: 10/31/2023] [Revised: 11/21/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
This study aimed to evaluate the long-term benefits of cochlear implantation (CI) on cognitive performance, speech perception, and psychological status in post-lingually deafened patients older than 65 (n = 33). Patients were consecutively enrolled in this prospective study and assessed before, one year after, and two years after CI for speech perception, depressive symptoms, perceived stress, and working memory and processing speed. The Wechsler Adult Intelligence Scale (WAIS) was used for the latter. Thirty-three patients (fourteen men and nineteen women) were included. The scores indicating "hearing in quiet" and "hearing with background noise" improved significantly one year after CI and remained so two years after CI. The sound localization scores improved two years after CI. The depressive symptoms and perceived stress scores were low at the study's onset and remained unchanged. Working memory improved significantly two years after CI, while processing speed improved significantly one year after CI and was maintained after that. The improvement in working memory and processing speed two years after CI suggests there is a sustained positive effect of auditory rehabilitation with CI on cognitive abilities.
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Affiliation(s)
- Sophia Marie Häußler
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität and Berlin Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; (S.M.H.); (E.S.); (S.K.); (A.J.S.)
- Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Elisabeth Stankow
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität and Berlin Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; (S.M.H.); (E.S.); (S.K.); (A.J.S.)
| | - Steffen Knopke
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität and Berlin Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; (S.M.H.); (E.S.); (S.K.); (A.J.S.)
| | - Agnieszka J. Szczepek
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität and Berlin Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; (S.M.H.); (E.S.); (S.K.); (A.J.S.)
| | - Heidi Olze
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität and Berlin Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; (S.M.H.); (E.S.); (S.K.); (A.J.S.)
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Zhai H, Fan W, Xiao Y, Zhu Z, Ding Y, He C, Zhang W, Xu Y, Zhang Y. Voxel-based morphometry of grey matter structures in Parkinson's Disease with wearing-off. Brain Imaging Behav 2023; 17:725-737. [PMID: 37735325 PMCID: PMC10733201 DOI: 10.1007/s11682-023-00793-3] [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] [Accepted: 08/28/2023] [Indexed: 09/23/2023]
Abstract
Our study aimed to investigate the grey matter (GM) changes using voxel-based morphometry (VBM) in Parkinson's disease (PD) patients with wearing-off (WO). 3D-T1-weighted imaging was performed on 48 PD patients without wearing-off (PD-nWO), 39 PD patients with wearing-off (PD-WO) and 47 age and sex-matched healthy controls (HCs). 3D structural images were analyzed by VBM procedure with Statistical Parametric Mapping (SPM12) to detect grey matter volume. Widespread areas of grey matter changes were found in patients among three groups (in bilateral frontal, temporal lobes, lingual gyrus, inferior occipital gyrus, right precuneus, right superior parietal gyrus and right cerebellum). Grey matter reductions were found in frontal lobe (right middle frontal gyrus, superior frontal gyrus and precentral gyrus), right parietal lobe (precuneus, superior parietal gyrus, postcentral gyrus), right temporal lobe (superior temporal gyrus, middle temporal gyrus), bilateral lingual gyrus and inferior occipital gyrus in PD-WO group compared with the PD-nWO group. Our results suggesting that wearing-off may be associated with grey matter atrophy in the cortical areas. These findings may aid in a better understanding of the brain degeneration process in PD with wearing-off.
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Affiliation(s)
- Heng Zhai
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, No. 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong Province, China
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei Province, China
| | - Wenliang Fan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei Province, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, Hubei Province, China
| | - Yan Xiao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei Province, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, Hubei Province, China
| | - Zhipeng Zhu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei Province, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, Hubei Province, China
| | - Ying Ding
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei Province, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, Hubei Province, China
| | - Chentao He
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, No. 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong Province, China
| | - Wei Zhang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei Province, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, Hubei Province, China
| | - Yan Xu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei Province, China
| | - Yuhu Zhang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, No. 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong Province, China.
- Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative Diseases, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
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Conceição Santos de Oliveira D, Gomes-Filho IS, Araújo EM, Xavier Ramos MDS, Freitas Coelho JM, Marques AA, Hintz AM, Firmino Rabelo D, Figueiredo ACMG, da Cruz SS. Association between hearing loss and cognitive decline in the elderly: A systematic review with meta-analysis study. PLoS One 2023; 18:e0288099. [PMID: 37943811 PMCID: PMC10635537 DOI: 10.1371/journal.pone.0288099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/19/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE Hearing loss has been pointed out as a potential predictor for cognitive decline. This study conducted a systematic review to evaluate the scientific evidence on the association between hearing loss in the elderly and cognitive decline, as well as whether race/color influences this relationship. METHOD The search for studies was performed in the following electronic databases: MedLine/PubMed Web of Science, Scopus and Virtual Health Library, and MedRkiv up to August 2022. Studies with epidemiological designs that assess the association between hearing loss and cognitive decline in the elderly were eligible for inclusion. Three independent reviewers performed the selection, data extraction and evaluation of the quality of the studies using the Newcastle-Ottawa Scale. A meta-analysis using a random effects model estimated the global association measurements (Beta coefficient: β) and their 95% confidence intervals (95%CI), and the Higgins and Thompson indicator (I2) was also estimated to assess statistical heterogeneity among the studies. RESULTS 5,207 records were identified in the database surveys, of which only 18 were eligible studies, totaling 19,551 individuals. Hearing loss was associated with cognitive decline in the elderly, with statistical significance: β = -0.13; 95%CI = -0.23 to -0.04; I2 = 98.70%). For black individuals, the magnitude of the association increased: β = -0.64; 95%CI = -3.36 to 2.07; I2 = 95.65%, but it was not statistically significant. CONCLUSION The findings of this systematic review showed the existence of a significant relationship between hearing loss and cognitive decline in the elderly, as well as signaling that among black individuals the magnitude of the association can be increased.
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Affiliation(s)
| | | | - Edna Maria Araújo
- Department of Health, Feira de Santana State University, Bahia, Brazil
| | | | | | - Adan Araújo Marques
- Health Sciences Center, Federal University of Recôncavo of Bahia, Bahia, Brazil
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11
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Zhang P, Abudukelimu N, Sali A, Chen JX, Li M, Mao YY, Zhu Y, Zhu QX. Sociodemographic features associated with the MoCA, SPPB, and GDS scores in a community-dwelling elderly population. BMC Geriatr 2023; 23:557. [PMID: 37704972 PMCID: PMC10500811 DOI: 10.1186/s12877-023-04162-z] [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: 11/08/2022] [Accepted: 07/11/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND An accurate evaluation of cognitive function, physical health, and psychological health is fundamental for assessing health problems in the elderly population, and it is important to identify the necessity of early therapeutic intervention. The objective of this study was to evaluate the states of mental and physical functions and to investigate the relationships between sociodemographic features and these functions in a community-dwelling elderly population. METHODS This community-based cross-sectional study was conducted in a suburban district of Shanghai, China. A total of 1025 participants aged 60-89 years underwent investigations of demographic and lifestyle features and a multidimensional geriatric evaluation comprising the Montreal Cognitive Assessment (MoCA), Short Physical Performance Battery (SPPB), and Geriatric Depression Scale (GDS). RESULTS The results of the multivariate linear regression models demonstrated that the MoCA and SPPB scores decreased with advancing age (all P < 0.01). However, the GDS score did not exhibit an age-related decrease (P = 0.09). Both sex and living alone influenced the MoCA score (P < 0.01 and P = 0.04, respectively), SPPB score (P < 0.01 and P = 0.04, respectively), and GDS score (P < 0.01 and P < 0.01, respectively). A higher education level was related to better MoCA and SPPB scores (all P < 0.01). Furthermore, age and sex had interactive effects on the MoCA score (P = 0.03) and SPPB score (P < 0.01). The kernel-weighted local polynomial smoothing curves exhibited similar trends. CONCLUSIONS It is imperative to develop a more sensitive evaluation of physical function, and to encourage various intellectually and emotionally stimulating social activity strategies to promote healthy aging, especially in elderly women and those living alone who have a low education level.
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Affiliation(s)
- Peng Zhang
- School of Management, Hainan Medical University, Haikou, Hainan, 571199, China
| | - Nazhakaiti Abudukelimu
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China
| | - Ayijiamal Sali
- Department of Medicine, Kashgar Vocational and Technical College, Kashgar, Xinjiang Uygur Autonomous Region, 844099, China
| | - Jin-Xia Chen
- Emergency Department, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, China
| | - Min Li
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China
| | - Yan-Yan Mao
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China
| | - Yi Zhu
- Emergency Department, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, China.
- School of Clinical Medicine, Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China.
| | - Qian-Xi Zhu
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China.
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12
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Herzog JA, Buchman CA, Kallogjeri D, Chen S, Wick C, Durakovic N, Shew MA. Cognitive Assessment in Elderly Cochlear Implant Recipients: Long-Term Analysis. Laryngoscope 2023; 133:2379-2387. [PMID: 36300628 DOI: 10.1002/lary.30466] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/23/2022] [Accepted: 09/20/2022] [Indexed: 08/11/2023]
Abstract
OBJECTIVES To examine long-term speech and cognition outcomes in older adult cochlear implant (CI) recipients. First, by evaluating if CI performance was maintained over an extended follow-up period regardless of preoperative cognitive status. Secondly, by evaluating if there was a difference in the rate of cognitive decline between preoperative mild and normal cognition following CI over an extended period of time. STUDY DESIGN AND SETTING Retrospective cohort study. METHODS CI recipients ≥65 years of age implanted between 2009 and 2014 with 4+ years follow up. Pre- and postoperative audiometric and speech outcome assessments were collected. Cognitive status was measured using the mini mental status examination (MMSE) at numerous time points. RESULTS Fifty-three patients met inclusion. Patients were divided into two groups based on preoperative MMSE with scores considered normal (28-30) and those with mildly impaired cognition (MIC, scores 25-27). Audiometric and speech performance improved significantly at one-year post implantation and this was maintained without significant change at 4+ years, regardless of cognitive status. Mixed modeling analysis controlling for age demonstrated no significant difference in the rate of cognitive decline at 4+ years post implantation between the normal cognition cohort (1.74; 95%CI 0.89-2.6) and MIC (2.9; 95%1.91-3.88). CONCLUSION Speech performance was significantly improved and sustained after CI in both normal cognition and MIC patients. The rate of cognitive decline in older adult CI patients appears to be similar regardless of preoperative cognitive status. Although results demonstrate rates of cognitive decline following CI did not differ between cognition groups over 4+ years, future studies will need to further investigate this over extended time periods with a more comprehensive cognitive testing battery. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2379-2387, 2023.
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Affiliation(s)
- Jacques A Herzog
- Department of Otolaryngology Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Craig A Buchman
- Department of Otolaryngology Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Dorina Kallogjeri
- Department of Otolaryngology Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Stephanie Chen
- Department of Otolaryngology Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Cameron Wick
- Department of Otolaryngology Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Nedim Durakovic
- Department of Otolaryngology Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Matthew A Shew
- Department of Otolaryngology Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
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Huang X, Sun Y, Wu A, Zhang X. Overweight or Obesity among Chinese Han People with Schizophrenia: Demographic, Clinical and Cognitive Correlations. Brain Sci 2023; 13:1245. [PMID: 37759846 PMCID: PMC10527401 DOI: 10.3390/brainsci13091245] [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: 07/27/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
People with schizophrenia are more likely to be afflicted by obesity or overweight compared to the general population. This study aimed to explore the incidence of overweight and obesity, clinical features and cognitive performance of Chinese Han patients with chronic schizophrenia who had overweight or obesity. We obtained data from 985 schizophrenia inpatients about overweight and obesity through body mass index (BMI). All patients were evaluated with the positive and negative syndrome scale, the Mini-mental State Examination (MMSE) and the repeated battery for evaluation of the neuropsychological status (RBANS) scale. We collected demographic and clinical data using self-reported questionnaires. We divided patients into normal weight (BMI < 24 kg/m2), overweight (24 ≤ BMI < 28 kg/m2) and obese (≥28 kg/m2) groups according to the Working Group on Obesity in China (WGOC) criteria. We compared the clinical data between the three groups and then conducted binary logistic regression and linear regression to assess variables that were significantly associated with overweight and obesity and higher BMI. Of the sample, 324 (32.9%) and 191 (19.4%) patients had overweight and obesity, respectively. Patients who had overweight and obesity were younger, had less education, had higher waist and hip circumferences, higher rates of diabetes and a higher sumPANSP score (compared with patients in the normal group, p < 0.05). There were more female patients with obesity (compared with patients in the normal and overweight groups, p < 0.05). Logistic regression analysis indicated that overweight and obesity were associated with sumPANSP (OR = 1.03, 95%CI = 1-1.061, p = 0.049) and diabetes (OR = 1.891, 95%CI = 1.255-2.849, p = 0.002). Further linear regression showed that age (B = -0.004, t = -2.83, p = 0.005), educational level (B = -0.037, t = -2.261, p = 0.024), diabetes (B = 0.133, t = 2.721, p = 0.007) and sumPANSP (B = 0.008, t = 2.552, p = 0.011) were risk factors for higher BMI. We did not find cognitive performance differences between patients with or without overweight and obesity. Overweight and obesity were associated with some demographic and clinical factors in patients with persistent schizophrenia.
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Affiliation(s)
- Xiao Huang
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China; (X.H.)
| | - Yuan Sun
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China;
| | - Anshi Wu
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China; (X.H.)
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 101408, China
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Zhao Q, Du X, Chen W, Zhang T, Xu Z. Advances in diagnosing mild cognitive impairment and Alzheimer's disease using 11C-PIB- PET/CT and common neuropsychological tests. Front Neurosci 2023; 17:1216215. [PMID: 37492405 PMCID: PMC10363609 DOI: 10.3389/fnins.2023.1216215] [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: 05/03/2023] [Accepted: 06/15/2023] [Indexed: 07/27/2023] Open
Abstract
Alzheimer's disease (AD) is a critical health issue worldwide that has a negative impact on patients' quality of life, as well as on caregivers, society, and the environment. Positron emission tomography (PET)/computed tomography (CT) and neuropsychological scales can be used to identify AD and mild cognitive impairment (MCI) early, provide a differential diagnosis, and offer early therapies to impede the course of the illness. However, there are few reports of large-scale 11C-PIB-PET/CT investigations that focus on the pathology of AD and MCI. Therefore, further research is needed to determine how neuropsychological test scales and PET/CT measurements of disease progression interact.
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Affiliation(s)
- Qing Zhao
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Xinxin Du
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Wenhong Chen
- Department of Sleep Medicine, Guangxi Zhuang Autonomous Region People's Hospital, Nanning, Guangxi, China
| | - Ting Zhang
- Department of Rehabilitation, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
- Rehabilitation Therapeutics, School of Nursing of Jilin University, Changchun, Jilin, China
| | - Zhuo Xu
- Department of Rehabilitation, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
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15
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Mailliez A, Ternynck C, Jannin A, Lemaître M, Chevalier B, Le Mapihan K, Defrance F, Mackowiak MA, Rollin A, Mehdi M, Chetboun M, Pattou F, Pasquier F, Vantyghem MC. Cognitive Outcome After Islet Transplantation. Transplant Direct 2023; 9:e1493. [PMID: 37250488 PMCID: PMC10219717 DOI: 10.1097/txd.0000000000001493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 03/21/2023] [Accepted: 04/07/2023] [Indexed: 05/31/2023] Open
Abstract
Severe or repeated hypoglycemia events may favor memory complaints in type 1 diabetes (T1D). Pancreatic islet transplantation (IT) is an alternative option to exogenous insulin therapy in case of labile T1D, implying a maintenance immunosuppression regimen based on sirolimus or mycophenolate, associated with tacrolimus, that may also have neurological toxicity. The objective of this study was to compare a cognitive rating scale Mini-Mental State Examination (MMSE) between T1D patients with or without IT and to identify parameters influencing MMSE. Methods This retrospective cross-sectional study compared MMSE and cognitive function tests between islet-transplanted T1D patients and nontransplanted T1D controls who were transplant candidates. Patients were excluded if they refused. Results Forty-three T1D patients were included: 9 T1D patients before IT and 34 islet-transplanted patients (14 treated with mycophenolate and 20 treated with sirolimus). Neither MMSE score (P = 0.70) nor higher cognitive function differed between islet versus non-islet-transplanted patients, whatever the type of immunosuppression. In the whole population (N = 43), MMSE score was negatively correlated to glycated hemoglobin (r = -0.30; P = 0.048) and the time spent in hypoglycemia on the continuous glucose monitoring (r = -0.32; P = 0.041). MMSE score was not correlated to fasting C-peptide level, time spent in hyperglycemia, average blood glucose, time under immunosuppression, duration of diabetes, or beta-score (success score of IT). Conclusions This first study evaluating cognitive disorders in islet-transplanted T1D patients argues for the importance of glucose balance on cognitive function rather than of immunosuppressive treatment, with a favorable effect of glucose balance improvement on MMSE score after IT.
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Affiliation(s)
- Aurélie Mailliez
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, France
- Univ Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de Risque et Déterminants Moléculaires des Maladies Liées au Vieillissement, Lille, France
| | - Camille Ternynck
- Univ Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France
| | - Arnaud Jannin
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, France
| | - Madleen Lemaître
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, France
| | - Benjamin Chevalier
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, France
| | - Kristell Le Mapihan
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, France
| | - Frédérique Defrance
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, France
| | | | | | | | - Mikael Chetboun
- CHU Lille, Department of Endocrine Surgery, Lille, France
- Inserm U1190, Lille, France
| | - François Pattou
- CHU Lille, Department of Endocrine Surgery, Lille, France
- Inserm U1190, Lille, France
- Univ Lille, European Genomic Institute for Diabetes, Lille, France
| | | | - Marie-Christine Vantyghem
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, France
- Inserm U1190, Lille, France
- Univ Lille, European Genomic Institute for Diabetes, Lille, France
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16
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Eberhard JM, Matthews LJ, Vaden KI, Dubno JR, Eckert MA. Probability Distributions for Associations Between Cognitive Screening and Pure-tone Thresholds in Older Adults. Ear Hear 2023; 44:641-654. [PMID: 36607744 PMCID: PMC10101874 DOI: 10.1097/aud.0000000000001313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Lower general cognitive function is frequently reported in older adults with elevated pure-tone thresholds. Here, we examined reason(s) for this association, including whether this relationship is dependent on the frequency range or extent of hearing loss and cognitive screening performance. DESIGN Linear regression was used to examine associations between better-ear pure-tone thresholds and Mini-Mental Status Exam (MMSE) performance in a cross-sectional sample of relatively healthy older adults (N = 508; 68% women, 60-89+ years; M age = 72). Quantile regression was also used to identify the ranges of 0.5 and 4.0 kHz thresholds and MMSE scores where these variables exhibited significant associations. RESULTS MMSE scores and pure-tone thresholds exhibited small but significant associations, particularly for better-ear 0.5 kHz thresholds. This hearing threshold and cognitive screening association was present among participants with better hearing, including the oldest older adults. There was limited evidence for mediating health condition effects on this association. An item analysis of the MMSE revealed that the MMSE and pure-tone threshold associations were largely due to the delayed recall item of the MMSE. CONCLUSIONS Together, the small effect results are consistent with the extant literature and suggest that there are multiple reasons for modest pure-tone threshold and cognitive screening performance associations.
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Affiliation(s)
- Jacqueline M. Eberhard
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Lois. J. Matthews
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Kenneth I. Vaden
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Judy R. Dubno
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Mark A. Eckert
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
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17
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Tan LF, Li H, Pan A, Teng GG, Koh WP. Association between gout at midlife and cognitive impairment at late life - The Singapore Chinese Health Study. Arch Gerontol Geriatr 2023; 111:104996. [PMID: 36958148 DOI: 10.1016/j.archger.2023.104996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVES The association between gout and risk of cognitive impairment or dementia is not well established. We examined the relationship between having gout at midlife and the risk of developing cognitive impairment later on. METHODS We used data of 16,948 participants from the population-based Singapore Chinese Health Study cohort. Participants were recruited from 1993 to 1998 at mean age of 53 years and re-contacted for three follow-up interviews: 1999 to 2004 for follow-up 1, 2006 to 2010 for follow-up 2, and 2014 to 2016 for follow-up 3. History of physician-diagnosed gout was self-reported at follow-up 1 and follow-up 2, while cognitive function was assessed with the Singapore modified Mini-Mental State Examination during follow-up 3, when participants had a mean age of 73.2 years. RESULTS Gout was reported by 1281 (7.6%) participants at either follow-up 1 or 2, and 2243 (14.4%) had cognitive impairment at follow-up 3. A history of gout was associated with reduced risk of cognitive impairment (OR 0.78, 95% CI 0.65-0.93). This risk was reduced in a stepwise manner with either increased duration of gout or lower age at first diagnosis of gout (Ptrend <0.001). Compared to those without gout, those with gout for ≥20 years (OR 0.56, 95% CI 0.39-0.80) and those with age of onset of gout <50 years old (OR 0.59, 95% CI 0.37-0.94) had a lower risk of developing cognitive impairment. CONCLUSION A young age of onset or a long history of gout was associated with reduced risk of cognitive impairment in late life.
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Affiliation(s)
- Li Feng Tan
- Healthy Ageing Programme, Alexandra Hospital, National University Health System, Singapore
| | - Huiqi Li
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gim Gee Teng
- Chronic Programme, Alexandra Hospital, National University Health System, Singapore; Division of Rheumatology, Department of Medicine, National University Hospital, National University Health System, Singapore.
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore
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Zhou Y, Wei J, Sun Q, Liu H, Liu Y, Luo J, Zhou M. Do Sensory Impairments Portend Cognitive Decline in Older Chinese Adults? Longitudinal Evidence from a Nationally Representative Survey, 2011-2018. J Clin Med 2023; 12:jcm12020430. [PMID: 36675359 PMCID: PMC9866178 DOI: 10.3390/jcm12020430] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/07/2022] [Accepted: 12/28/2022] [Indexed: 01/06/2023] Open
Abstract
Previous studies on longitudinal sensory-cognition association are limited and have yielded inconsistent conclusions in western and developed countries. The present study obtained data from the China Health and Retirement Longitudinal Survey (CHARLS, 2011−2018) and aimed to investigate the longitudinal effects of sensory impairments including single vision impairment (SVI), single hearing impairment (SHI), and dual sensory impairment (DSI) on cognitive decline in middle-aged and older Chinese population. In total, 11,122 participants accomplished all 4 interviews over 8 years and were included. Cognitive performances were assessed using Mini-Mental Status Examination (MMSE) and self-reported sensory status were accepted as well. Confounding variables included age, sex, educational level, marital status, medical, and lifestyle related information. The impact of sensory impairment on cognitive decline over time was assessed using linear mixed-effects models (LMM). After being adjusted for multiple confounders, SVI/SHI/DSI were all shown to be significantly associated with executive functions, episodic memory impairment, and global cognitive decline over 8 years (all p < 0.05). Such associations become less significant among female and relatively younger populations (45−59 years old). Single vision and hearing impairments, along with dual sensory impairment, are all independently associated with subsequent cognitive decline among middle-aged and older Chinese populations over 8 years of longitudinal observation.
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Affiliation(s)
- Yifan Zhou
- Department of Ophthalmology, Putuo People’s Hospital, Tongji University, Shanghai 200060, China
| | - Jin Wei
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People’s Hospital), School of Medicine, Shanghai JiaoTong University, Shanghai 200080, China
- National Clinical Research Center for Eye Diseases, Shanghai 200080, China
| | - Qinglei Sun
- Department of Ophthalmology, Shanghai East Hospital, Shanghai 200120, China
| | - Haiyun Liu
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People’s Hospital), School of Medicine, Shanghai JiaoTong University, Shanghai 200080, China
- National Clinical Research Center for Eye Diseases, Shanghai 200080, China
| | - Ye Liu
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai 200032, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai 200032, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China
- Correspondence: (J.L.); (M.Z.)
| | - Minwen Zhou
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People’s Hospital), School of Medicine, Shanghai JiaoTong University, Shanghai 200080, China
- National Clinical Research Center for Eye Diseases, Shanghai 200080, China
- Correspondence: (J.L.); (M.Z.)
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Ng WQ, Yang H. Investigating the Link Between IADL and Depressive Symptoms in Older Adults: A Cross-Sectional Serial Mediation Model. Clin Gerontol 2023; 46:844-859. [PMID: 36196029 DOI: 10.1080/07317115.2022.2130847] [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: 11/03/2022]
Abstract
OBJECTIVES There is a dearth of research on the psychological processes that underlie the negative relation between impaired instrumental activities of daily living (IADL) and depressive symptoms in older adults. Drawing on the stress process model and the resilience framework, we investigated whether purpose in life and resilience serially mediate the relationship between impaired IADL and depressive symptoms. METHODS We recruited 111 cognitively healthy community-dwelling older adults (ages 54-85; M = 66.5) who scored a minimum of 25 points on the Mini-Mental State Examination. RESULTS We found that purpose in life and resilience serially mediated the relationship between IADL and depressive symptomatology in older adults. This association held true when we controlled for covariates. Additional sensitivity analyses also supported these findings. CONCLUSIONS This study extends our understanding of how IADL limitations contribute to depressive symptoms. Using a community-dwelling, cognitively healthy sample, we demonstrate that functional limitations indirectly influence older adults' depressive symptoms through a decreased sense of purpose in life and decreased resilience. CLINICAL IMPLICATIONS Our findings have implications for intervention programs that aim to alleviate IADL limitations and mental health issues in an aging population and promote healthy aging by improving psychosocial resources (i.e., purpose in life and resilience).
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Affiliation(s)
- Wee Qin Ng
- School of Social Sciences, Singapore Management University, Singapore
| | - Hwajin Yang
- School of Social Sciences, Singapore Management University, Singapore
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20
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Wang C, Wei C, Hong H, Wei W, Lu G. Latent profile analysis of cognitive function and depressive symptoms in Chinese elderly: results from the China Health and Retirement Longitudinal Study. Psychogeriatrics 2023; 23:108-115. [PMID: 36349873 DOI: 10.1111/psyg.12909] [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: 06/17/2022] [Revised: 10/04/2022] [Accepted: 10/25/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Geriatric cognitive impairment often occurs in conjunction with depressive symptoms. This study focuses on categorising the Chinese elderly with such co-occurring symptoms into homogeneous groups using latent profile analysis (LPA), a person-centred statistical approach. METHODS Information on cognitive function and depressive states of the elderly was extracted from the China Health and Retirement Longitudinal Study. The underlying characteristics were identified by LPA, and based on those findings, differences in demographic characteristics of different subgroups were explored by chi-squared test and analysis of variance. RESULTS A total of 6710 Chinese elderly who met the inclusion criteria were selected from the dataset. Four subgroups were identified among this sample by LPA, based on cognitive function associated with depressive symptoms, and named in this study as follows: mild cognitive impairment (n = 3747, 55.84%), moderate cognitive impairment (n = 1306, 19.46%), mild cognitive impairment combined with depressive symptoms (n = 1114, 16.6%), and moderate cognitive impairment combined with depression (n = 543, 8.09%). Age, gender, marital status, and educational level were all significantly different across subgroups (P < 0.001); religious belief and pension mode, however, were not (P > 0.05). CONCLUSIONS In the present study, four subgroups of cognitive function combined with depressive symptoms were found in Chinese elderly individuals, and differences in demographic factors were noted between the subgroups. In clinical practise, these findings could help clinical workers identify patients accurately and consider the demographic features of each subgroup when designing medical treatment, care, and rehabilitation programmes for those with cognitive impairment and concomitant depressive symptoms.
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Affiliation(s)
- Chengjue Wang
- Nursing Department, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chengxia Wei
- Nursing Department, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huifang Hong
- Nursing Department, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Wei
- Nursing Department, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Gendi Lu
- Nursing Department, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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21
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Zeeman M, Figeys M, Brimmo T, Burnstad C, Hao J, Kim ES. Task-Evoked Pupillary Response as a Potential Biomarker of Dementia and Mild Cognitive Impairment: A Scoping Review. Am J Alzheimers Dis Other Demen 2023; 38:15333175231160010. [PMID: 36896819 PMCID: PMC10580717 DOI: 10.1177/15333175231160010] [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] [Indexed: 03/11/2023]
Abstract
Pupil dilation functions as a proxy for cognitive effort and can be measured through automated pupillometry. The aim of this scoping review is to examine how individuals with cognitive impairment differ in task-evoked pupillary responses relative to cognitively healthy individuals. A systematic literature search across six databases was conducted to identify studies examining changes in pupillary responses evoked by cognitive tasks comparing patients with dementia to healthy controls. Eight articles met inclusion criteria and were included for review. Differences in task-evoked pupillary response between cognitively impaired and cognitively healthy participants were observed across studies. Pupil dilation is decreased in patients with Alzheimer's Disease compared to controls, with no difference observed in patients with mild cognitive impairment. A mild, non-significant trend towards reduced pupil dilation in patients with either Parkinson's Disease or Dementia with Lewy Bodies suggests a similar but less pronounced effect than in AD patients. Further research is required to examine the utility of task-evoked pupillary responses as a potential biomarker indexing cognitive decline in individuals transitioning to mild cognitive impairment and/or dementia.
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Affiliation(s)
- Michael Zeeman
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Mathieu Figeys
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Tolani Brimmo
- Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Cleo Burnstad
- Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Jasmine Hao
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Esther S Kim
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Communication Sciences and Disorders, University of Alberta, Edmonton, Canada
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22
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Sex-Specific Interactions Between Hearing and Memory in Older Adults With Mild Cognitive Impairment: Findings From the COMPASS-ND Study. Ear Hear 2022:00003446-990000000-00099. [PMID: 36607746 DOI: 10.1097/aud.0000000000001322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Hearing loss (HL) in older adults is associated with a decline in performance on cognitive tasks and the risk of developing dementia. However, very few studies have investigated sex-related effects on these associations. A previous study of cognitively healthy older adults showed an association between HL and lower cognitive performance in females only. In the present study, we examined the effects of sex and hearing on cognition in individuals with mild cognitive impairment (MCI). We predicted that females with HL would be more likely to show poorer performance on the cognitive measures compared to females with normal hearing (NH), while cognitive performance in males would not depend on hearing. We further predicted that these auditory-cognitive associations would not depend on test modality, and would thus be observed in females for both auditory and visual tests. DESIGN Participants were 101 older adults with amnestic MCI (M = 71 years, 45% females) in the Canadian Consortium on Neurodegeneration in Aging (CCNA) COMPASS-ND study. Performance on the Montreal Cognitive Assessment (MoCA), Rey Auditory Verbal Learning (RAVLT), and Brief Visuospatial Memory Test-Revised (BVMT-R) was analyzed to investigate sex-related differences and/or hearing-related differences. Participants were categorized as having NH or HL using two different measures: pure-tone hearing screening results (normal based on a pure-tone threshold < 25 dB HL at 2000 Hz in the worse ear) and speech-in-noise speech reception thresholds (SRTs; normal < -10 dB SNR on the Canadian Digit Triplet Test [CDTT]). RESULTS Males and female groups did not differ in age, years of education, or other relevant covariates. Yet, females with better hearing on either pure-tone or speech-in-noise measures outperformed their worse hearing counterparts on the MoCA total score. Additionally, females with better hearing were more likely to recall several words on the MoCA delayed recall trial relative to those with worse hearing. Females with NH showed significant correlations between CDTT SRTs and both MoCA and RAVLT scores, while no correlations were observed in males. In contrast, males but not females showed an effect of hearing group on BVMT-R test status. CONCLUSIONS There were sex-specific differences in auditory-cognitive associations in individuals with MCI. These associations were mostly observed in females and on auditory tests. Potential mechanisms and implications are discussed.
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Tong J, Zhang J, Xu L, Liu M, Min J, Yao M, Cheng X, Zhang Q, Sun X, Yuan J. Effect of hearing loss on cognitive function in patients with mild cognitive impairment: A prospective, randomized, and controlled study. Front Aging Neurosci 2022; 14:934921. [PMID: 35978946 PMCID: PMC9376470 DOI: 10.3389/fnagi.2022.934921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background Hearing loss (HL) may increase the risk of cognitive decline in the elderly. However, the randomized controlled study on the effect of HL on cognitive function in mild cognitive impairment (MCI) is very limited. Methods From 1 November 2020 to 30 March 2022, 1,987 individuals aged 55–65 years were randomly divided into the MCI with hearing impairment (MCI-HI), MCI without HI (MCI-nHI), and no MCI (nMCI) groups by stratified sampling, with 30 participants in each group. The Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), the pure tone audiometry (PTA), and the auditory brainstem response (ABR) were measured at baseline and a follow-up 12 months later. The trial protocol was registered with ClinicalTrials.gov with the registration number NCT05336942. Results Among the 90 participants, the average age was 60.41 ± 6.48 years. In the MCI-HI group at baseline, the PTA score of both the ears was negatively correlated with the naming and memory score (p < 0.05), and the PTA score of both the ears was negatively correlated with the MoCA and abstraction score at the 12-month follow-up (p < 0.05). However, there were no significant differences among the PTA, the ABR, the MMSE, and the MoCA scores in the MCI-nHI and nMCI groups (p > 0.05). Regression analysis showed that the PTA score of the right ear at baseline was an important factor associated with the MoCA, visuospatial/executive, naming, and abstraction scores at the 12-month follow-up (β = −0.776 to −0.422, p < 0.05). Conclusion HL was significantly negatively associated with cognitive function only in patients with MCI with hearing impairment (HI), and the PTA of the right ear may be a predictor of cognitive decline after 1 year in patients with MCI with HI. This information may help primary healthcare clinicians to prevent MCI by screening and intervening in care for elderly patients with HL.
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Affiliation(s)
- Jie Tong
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Jie Zhang
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Luli Xu
- Department of Otolaryngology, Shanghai Punan Hospital of Pudong New District, Shanghai, China
| | - Meiling Liu
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Jie Min
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Miaomiao Yao
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Xiaoyan Cheng
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Qi Zhang
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Xirong Sun
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
- Xirong Sun
| | - Jie Yuan
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Jie Yuan
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Li X, Wang F, Li R, Tian H. Quality Care Alleviates Behavioral Cognitive Impairment and Reduces Complications in Elderly Patients with Cardiovascular and Cerebrovascular Diseases. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:8958099. [PMID: 35399839 PMCID: PMC8986416 DOI: 10.1155/2022/8958099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 11/18/2022]
Abstract
Objective Cardiovascular and cerebrovascular disease (CCVD) remains the most common factor of death around the world. Nursing care plays a key role in the recovery of patients with CCVD. This study was to explore the application of quality care in aged patients with CCVD. Methods Totally, 74 aged CCVD patients admitted from June 2018 to June 2019 in Dongying People's Hospital were randomly assigned in 2 groups with the same treatment. The control group was treated with routine care intervention, and the observation group was treated with quality care intervention for 12 weeks. Meanwhile, the frequency of agitation behaviors and cognitive ability were assessed, and complication was counted. Results The observation group showed decreased Cohen-Mansfield Agitation Inventory (CAMI) scores from 47.31 ± 8.27 to 38.73 ± 6.94, raised Mini-Mental State Examination (MMSE) scores from 15.01 ± 3.9 to 19.34 ± 3.15 and Montreal Cognitive Assessment (MoCA) scores from 16.92 ± 5.48 to 20.37 ± 4.16, and reduced complications after quality care intervention. Conclusion Quality care intervention exerted a better application effect on aged CCVD patients, along with reduction of agitation, improvement of mental condition and behavioral cognitive function, and reduced complications.
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Affiliation(s)
- Xiaomei Li
- Record Room, Dongying People's Hospital, Dongying, Shandong, China
| | - Fangning Wang
- Department of Gynecology, Dongying People's Hospital, Dongying, Shandong, China
| | - Rongfen Li
- Department of Urology, Dongying People's Hospital, Dongying, Shandong, China
| | - Hongyan Tian
- Department of Orthopaedics, Dongying People's Hospital, Dongying, Shandong, China
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25
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Utoomprurkporn N, Stott J, Costafreda S, Bamiou DE. The Impact of Hearing Loss and Hearing Aid Usage on the Visuospatial Abilities of Older Adults in a Cohort of Combined Hearing and Cognitive Impairment. Front Aging Neurosci 2022; 14:785406. [PMID: 35283751 PMCID: PMC8914172 DOI: 10.3389/fnagi.2022.785406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/02/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction It has been proposed that hearing loss may result in improved visuospatial abilities. The evidence for this assertion is inconsistent, and limited to studies in congenitally deaf children, despite older adults with age-related hearing loss constituting the vast majority of the hearing impaired population. We assessed visuospatial (visuoconstruction and visuospatial memory) ability in older adult hearing aid users with and without clinically significant cognitive impairment. The primary aim of the study was to determine the effect of hearing loss on visuospatial abilities. Method Seventy-five adult hearing aid users (HA) aged over 65 were recruited, out of whom 30 had normal cognition (NC-HA), 30 had mild cognitive impairment (MCI-HA), and 15 had dementia (D-HA). The Rey Osterrieth Complex figure test (ROCFT) copy, 3 min recall and 30 min recall tests were performed to evaluate the visuoconstructional and visuospatial memory abilities of the participants. Results There were significant differences between the ROCFT copy, 3 min recall, and 30 min recall among the three cohorts (p < 0.005). Compared with previously published normative data, the NC-HA performed significantly better in the ROCFT copy (p < 0.001), immediate recall (p < 0.001), and delay recall (p = 0.001), while the MCI-HA performed similarly to the expected norms derived from population (p = 0.426, p = 0.611, p = 0.697, respectively), and the D-HA performed below this norm. Conclusion Though visuospatial abilities tend to decline when the global cognitive functioning declines, we found suggestive evidence for positive effects of age-related hearing loss on visuospatial cognitive ability. Participants with mild cognitive impairment and hearing loss, who would have been expected to perform worse than normative data, were in fact performing as well as cognitively healthy subjects without hearing loss. Visuospatial ability could be targeted when providing rehabilitation for the older adults with hearing loss.
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Affiliation(s)
- Nattawan Utoomprurkporn
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- UCL Ear Institute, University College London, London, United Kingdom
- Chula Neuroscience Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- *Correspondence: Nattawan Utoomprurkporn,
| | - Joshua Stott
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Sergi Costafreda
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Doris-Eva Bamiou
- UCL Ear Institute, University College London, London, United Kingdom
- NIHR Biomedical Research Centre Hearing and Deafness, London, United Kingdom
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26
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Reed M, Freedman M, Mark Fraser AE, Bromwich M, Santiago AT, Gallucci CE, Frank A. Enhancing Clinical Visibility of Hearing Loss in Cognitive Decline. J Alzheimers Dis 2022; 86:413-424. [DOI: 10.3233/jad-215377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Hearing loss is the largest potentially modifiable risk factor for dementia and is highly prevalent among older adults, yet it goes largely unreported, unidentified, and untreated, at great cost to health and quality of life. Hearing screening is a proven cost-effective solution to overcome delays in its identification and management yet is not typically recommended by physicians for older adults. Objective: To demonstrate the feasibility and value of hearing screening for older adults at risk for dementia in order to enhance physicians’ awareness of hearing loss and improve access to timely hearing care. Methods: Patients referred to two academic medical clinics for memory disorders were offered hearing screening as part of clinic protocol. Patients with hearing loss were recruited to the study if they consented to a post-appointment telephone interview and chart review. Memory Clinic physicians were surveyed about the usefulness of the screening information and referral of patients with hearing loss to audiology. Results: Hearing loss was reliably detected in Memory Clinic patients with both in-office and online screening tools. Physicians reported that screening enhanced their awareness of hearing loss and increased the referral rate to audiology. Conclusion: Hearing screening in Memory Clinic patients is a useful component of clinic protocol that facilitates timely access to management and addresses an important risk factor for dementia.
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Affiliation(s)
- Marilyn Reed
- Baycrest Health Sciences, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Morris Freedman
- Baycrest Health Sciences, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
- Mt. Sinai Hospital, Toronto, ON, Canada
| | | | - Matthew Bromwich
- SHOEBOX Ltd., Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
- University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | | | | | - Andrew Frank
- University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
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27
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Chen J, Dai AX, Tang HL, Lu CH, Liu HX, Hou T, Lu ZJ, Kong N, Peng XY, Lin KX, Zheng ZD, Xu SL, Ying XF, Ji XY, Pan H, Wu J, Zeng X, Wei NL. Increase of ALCAM and VCAM-1 in the plasma predicts the Alzheimer's disease. Front Immunol 2022; 13:1097409. [PMID: 36685605 PMCID: PMC9846483 DOI: 10.3389/fimmu.2022.1097409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 12/14/2022] [Indexed: 01/06/2023] Open
Abstract
Cell adhesion molecules (CAM) are crucial in several pathological inflammation processes in Alzheimer's disease (AD). However, their potential for clinical diagnostics remains unknown. The present investigation evaluated the clinical significance of ALCAM, VCAM-1, NCAM, and ICAM-1 levels in the plasma of participants with cognitive impairment (44 patients with mild cognitive impairment, 71 patients with Alzheimer's dementia, and 18 patients with other dementia) and 28 controls with normal cognitive ability. We also detected plasma levels of multiple inflammatory factors (IFN-gamma, IL-18, IL-1beta, IL-13, IL-8, IL-7, CCL11, MCP-1, TSLP, IL-10, BDNF, IL-17, IL-5, TREM-1) using Multiplex liquid chip and plasma levels of Abeta1-42 and Abeta1-40 using liquid-phase flow cytometry (FCM). Our findings demonstrated a correlation of ALCAM and VCAM-1 with age, the severity of cognitive decline, and MTA, but no significant difference between groups for NCAM and ICAM-1. ALCAM and VCAM-1 both demonstrated a positive correlation with the degree of atrophy in the medial temporal lobe structure. Further analysis revealed no significant correlation in plasma between VCAM-1, ALCAM and Abeta1-40, Abeta1-42. Nevertheless, there was a significant correlation between VCAM-1, ALCAM and many inflammatory factors. Furthermore, the predictive value of ALCAM and VCAM-1 for AD was assessed using a multi-parameter regression model. ALCAM and VCAM-1 in combination with ApoE4, education, age, and MMSE could predict AD with high precision (AUC=0.891; AIC=146.9) without imaging diagnosis. ALCAM and VCAM-1 combination improved the predictive accuracy significantly. In a nutshell, these findings revealed ALCAM and VCAM-1 as reliable indicators of Alzheimer's disease.
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Affiliation(s)
- Jian Chen
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - An-Xiang Dai
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Hai-Liang Tang
- State Key Laboratory for Medical Neurobiology, Department of Neurosurgery, Institutes of Brain Science, Fudan University Huashan Hospital, Shanghai Medical College-Fudan University, Shanghai, China
| | - Chang-Hao Lu
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Hao-Xin Liu
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Ting Hou
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Zhi-Jie Lu
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Nan Kong
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Xin-Yuan Peng
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Kai-Xun Lin
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Zi-Dong Zheng
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Sheng-Liang Xu
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Xiao-Fang Ying
- Department of Geriatrics, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Xiao-Yu Ji
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Brain Function and Disease Laboratory, Shantou University Medical College, Shantou, Guangdong, China
| | - Hui Pan
- The Outpatient Department, Shantou Longhu People's Hospital, Shantou, Guangdong, China
| | - Jie Wu
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Brain Function and Disease Laboratory, Shantou University Medical College, Shantou, Guangdong, China
| | - Xin Zeng
- Department of Geriatrics, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Nai-Li Wei
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
- *Correspondence: Nai-Li Wei,
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Janicki MP, Hendrix JA, McCallion P. Examining older adults with neuroatypical conditions for MCI/dementia: Barriers and recommendations of the Neuroatypical Conditions Expert Consultative Panel. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2022; 14:e12335. [PMID: 35845263 PMCID: PMC9270662 DOI: 10.1002/dad2.12335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/16/2022] [Indexed: 01/04/2023]
Abstract
The Neuroatypical Conditions Expert Consultative Panel composed of numerous clinical and academic experts was convened to examine barriers to the examination of cognitive impairment in adults with a variety of neuroatypical conditions. Neuroatypical conditions affect normative intellectual development and function (such as intellectual disability and intellectual disability with conjoint psychiatric conditions), thought, moods, and cognition (such as severe mental illness), communication functions (such as the autism spectrum and hearing/vision impairments), and brain and motor function (such as cerebral palsy and acquired or traumatic brain injury). The panel concluded that current federal guidance for the assessment of cognitive impairment for mild cognitive impairment (MCI) or dementia does not sufficiently include information as to how to assess such adults. In addition, it concluded that adults with these conditions (1) challenge clinicians when attempting to discern current behavior and function from that which was pre‐existing; (2) often have inherent comprehension and oral communication difficulties, motor task performance impediments, and difficulty with visuals; and (3) pose difficulties when assessed with standardized dementia measures and can benefit from the use of specialized instruments. The panel recommended that federal guidance be broadened to include adaptations of assessment practices to accommodate neuroatypical conditions; that educational packs be developed for clinicians about such conditions and on detecting and diagnosing MCI or dementia; and that research be expanded to produce more evidence‐based information on both assessing adults with neuroatypical conditions for later‐life adult cognitive diseases/disorders and planning post‐diagnostic care.
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Affiliation(s)
- Matthew P. Janicki
- Department of Disability and Human Development University of Illinois Chicago Illinois USA
| | | | - Philip McCallion
- College of Public Health Temple University Philadelphia Pennsylvania USA
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Nicholas SO, Koh EJ, Wee SL, Eikelboom RH, Jayakody DMP, Lin F, Ng TP, Heywood RL. Peripheral Hearing Loss and Its Association with Cognition among Ethnic Chinese Older Adults. Dement Geriatr Cogn Disord 2021; 50:394-400. [PMID: 34592737 DOI: 10.1159/000519291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/05/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Many studies on hearing loss (HL) and cognition are limited by subjective hearing assessments and verbally administered cognition tests, the majority of the document findings in Western populations. This study aimed to assess the association of HL with cognitive impairment among ethnic Chinese Singaporean older adults using visually presented cognitive tests. METHODS The hearing of community-dwelling older adults was assessed using pure tone audiometry. Cognitive function was assessed using the Computerized Cambridge Cognitive Test Battery (CANTAB). Multiple regression analyses examined the association between hearing and cognitive function, adjusted for age, education, and gender. RESULTS HL (pure-tone average [PTA] of thresholds at 0.5, 1, 2, and 4 kHz in the better ear, BE4PTA) was associated with reduced performance in delayed matching and multitasking tasks (β = -0.25, p = 0.019, and β = 0.02, p = 0.023, respectively). Moderate to severe HL was associated with reduced performance in delayed matching and verbal recall memory tasks (β = -10.6, p = 0.019, and β = -0.28, p = 0.042). High-frequency HL was associated with reduced performance in the spatial working memory task (β = 0.004, p = 0.022). All-frequency HL was associated with reduced performance in spatial working memory and multitasking (β = 0.01, p = 0.040, and β = 0.02, p = 0.048). CONCLUSION Similar to Western populations, HL among tonal language-speaking ethnic Chinese was associated with worse performance in tasks requiring working memory and executive function.
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Affiliation(s)
| | - Emily Jiali Koh
- Geriatric Education and Research Institute (GERI), Singapore, Singapore
| | - Shiou Liang Wee
- Geriatric Education and Research Institute (GERI), Singapore, Singapore.,Singapore Institute of Technology, Health and Social Sciences Cluster, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Robert H Eikelboom
- Ear Science Institute Australia, Subiaco, Washington, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Subiaco, Washington, Australia.,Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Dona M P Jayakody
- Ear Science Institute Australia, Subiaco, Washington, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Subiaco, Washington, Australia
| | - Frank Lin
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Departments of Otolaryngology, Medicine, Mental Health, and Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tze Pin Ng
- Geriatric Education and Research Institute (GERI), Singapore, Singapore.,Department of Psychological Medicine, Gerontology Research Program, National University of Singapore (NUS), Singapore, Singapore
| | - Rebecca L Heywood
- Ear Science Institute Australia, Subiaco, Washington, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Subiaco, Washington, Australia.,Department of Otolaryngology, Ng Teng Fong General Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Fröhlich S, Müller K, Voelcker-Rehage C. Normative Data for the CERAD-NP for Healthy High-Agers (80-84 years) and Effects of Age-Typical Visual Impairment and Hearing Loss. J Int Neuropsychol Soc 2021:1-13. [PMID: 34823624 DOI: 10.1017/s1355617721001284] [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] [Indexed: 12/15/2022]
Abstract
OBJECTIVES This study aims to establish reference data for nondemented adults between 80 and 84 years of age based on the German version of the Consortium to Establish a Registry for Alzheimer's disease Neuropsychological (CERAD-NP) test battery and to assess the possible influence of hearing and vision impairments on CERAD-NP performance. METHODS Two hundred one volunteers were examined with the German CERAD-NP test battery, and 18 test scores were calculated from the data. The sample included 99 men (49%), the mean age was 81.8 years (SD = 1.3), and the mean years of education were 13.9 (SD = 3.1). Percentiles for continuous and percentile ranks for discrete test scores were calculated separately for four norm groups. The groups were classified according to gender and education. Multiple regression analysis was used to predict cognitive performance from visual acuity and hearing ability. RESULTS The normative data obtained were consistent with other findings from younger and older age groups. Worse visual acuity predicted slower performance in the Trail Making Test (TMT). None of the other CERAD-NP tests were correlated to sensory functions. CONCLUSIONS Using age-appropriate reference data, such as that established here for the 80-84 year age group can help to improve the detection of cognitive decline and prevent biases that arise when old-old adults are compared to younger old adults. Visual acuity should be considered an influencing factor on TMT performance.
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Affiliation(s)
- Stephanie Fröhlich
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, Faculty of Psychology & Sport Sciences, University of Münster, Münster, Germany
- Department of Sports Psychology (With Focus on Prevention and Rehabilitation), Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany
| | - Katrin Müller
- Department of Sports Psychology (With Focus on Prevention and Rehabilitation), Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany
- Department of Social Science of Physical Activity and Health, Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany
| | - Claudia Voelcker-Rehage
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, Faculty of Psychology & Sport Sciences, University of Münster, Münster, Germany
- Department of Sports Psychology (With Focus on Prevention and Rehabilitation), Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany
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Brumer N, Elkins E, Parada J, Hillyer J, Parbery-Clark A. Examining Delayed Recall in Cochlear Implant Users Using the Montreal Cognitive Assessment, California Verbal Learning Test, Third Edition, and Item Specific Deficit Approach: Preliminary Results. Front Psychol 2021; 12:749045. [PMID: 34803831 PMCID: PMC8599833 DOI: 10.3389/fpsyg.2021.749045] [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: 07/28/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Recent studies using the Montreal Cognitive Assessment (MoCA) suggest delayed recall is challenging for cochlear implant (CI) users. To better understand the underlying processes associated with delayed recall in CI users, we administered the MoCA and the California Verbal Learning Test, Third Edition (CVLT-3), which provides a more comprehensive assessment of delayed recall ability. Methods: The MoCA and CVLT-3 were administered to 18 high-performing CI users. For the CVLT-3, both the traditional scoring and a newer scoring method, the Item-Specific Deficit Approach (ISDA), were employed. Results: The original MoCA score and MoCA delayed recall subtest score did not relate to performance on any CVLT-3 measures regardless of scoring metric applied (i.e., traditional or ISDA). Encoding performance for both the CVLT-3 and ISDA were related. Consolidation, which is only distinctly defined by the ISDA, related to CVLT-3 cued delay recall performance but not free delay recall performance. Lastly, ISDA retrieval only related to CVLT-3 measures when modified. Conclusion: Performance on the MoCA and CVLT-3 in a high performing CI patient population were not related. We demonstrate that the ISDA can be successfully applied to CI users for the quantification and characterization of delayed recall ability; however, future work addressing lower performing CI users, and comparing to normal hearing controls is needed to determine the extent of potential translational applications. Our work also indicates that a modified ISDA retrieval score may be beneficial for evaluating CI users although additional work addressing the clinical relevance of this is still needed.
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Affiliation(s)
- Nadav Brumer
- Auditory Research Laboratory, Center for Hearing and Skull Base Surgery, Swedish Neuroscience Institute, Seattle, WA, United States
| | - Elizabeth Elkins
- Auditory Research Laboratory, Center for Hearing and Skull Base Surgery, Swedish Neuroscience Institute, Seattle, WA, United States
| | - Jennifer Parada
- Department of Psychology, Bellevue College, Bellevue, WA, United States
| | - Jake Hillyer
- College of Medicine, University of Arizona, Phoenix, AZ, United States
| | - Alexandra Parbery-Clark
- Auditory Research Laboratory, Center for Hearing and Skull Base Surgery, Swedish Neuroscience Institute, Seattle, WA, United States
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Jia X, Wang Z, Huang F, Su C, Du W, Jiang H, Wang H, Wang J, Wang F, Su W, Xiao H, Wang Y, Zhang B. A comparison of the Mini-Mental State Examination (MMSE) with the Montreal Cognitive Assessment (MoCA) for mild cognitive impairment screening in Chinese middle-aged and older population: a cross-sectional study. BMC Psychiatry 2021; 21:485. [PMID: 34607584 PMCID: PMC8489046 DOI: 10.1186/s12888-021-03495-6] [Citation(s) in RCA: 157] [Impact Index Per Article: 52.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 09/15/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are the most commonly used scales to detect mild cognitive impairment (MCI) in population-based epidemiologic studies. However, their comparison on which is best suited to assess cognition is scarce in samples from multiple regions of China. METHODS We conducted a cross-sectional analysis of 4923 adults aged ≥55 years from the Community-based Cohort Study on Nervous System Diseases. Objective cognition was assessed by Chinese versions of MMSE and MoCA, and total score and subscores of cognitive domains were calculated for each. Education-specific cutoffs of total score were used to diagnose MCI. Demographic and health-related characteristics were collected by questionnaires. Correlation and agreement for MCI between MMSE and MoCA were analyzed; group differences in cognition were evaluated; and multiple logistic regression model was used to clarify risk factors for MCI. RESULTS The overall MCI prevalence was 28.6% for MMSE and 36.2% for MoCA. MMSE had good correlation with MoCA (Spearman correlation coefficient = 0.8374, p < 0.0001) and moderate agreement for detecting MCI with Kappa value of 0.5973 (p < 0.0001). Ceiling effect for MCI was less frequent using MoCA versus MMSE according to the distribution of total score. Percentage of relative standard deviation, the measure of inter-individual variance, for MoCA (26.9%) was greater than for MMSE (19.0%) overall (p < 0.0001). Increasing age (MMSE: OR = 2.073 for ≥75 years; MoCA: OR = 1.869 for≥75 years), female (OR = 1.280 for MMSE; OR = 1.163 for MoCA), living in county town (OR = 1.386 and 1.862 for MMSE and MoCA, respectively) or village (OR = 2.579 and 2.721 for MMSE and MoCA, respectively), smoking (OR = 1.373 and 1.288 for MMSE and MoCA, respectively), hypertension (MMSE: OR = 1.278; MoCA: OR = 1.208) and depression (MMSE: OR = 1.465; MoCA: OR = 1.350) were independently associated with greater likelihood of MCI compared to corresponding reference group in both scales (all p < 0.05). CONCLUSIONS MoCA is a better measure of cognitive function due to lack of ceiling effect and with good detection of cognitive heterogeneity. MCI prevalence is higher using MoCA compared to MMSE. Both tools identify concordantly modifiable factors for MCI, which provide important evidence for establishing intervention measures.
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Affiliation(s)
- Xiaofang Jia
- grid.198530.60000 0000 8803 2373National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050 China
| | - Zhihong Wang
- grid.198530.60000 0000 8803 2373National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050 China
| | - Feifei Huang
- grid.198530.60000 0000 8803 2373National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050 China
| | - Chang Su
- grid.198530.60000 0000 8803 2373National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050 China
| | - Wenwen Du
- grid.198530.60000 0000 8803 2373National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050 China
| | - Hongru Jiang
- grid.198530.60000 0000 8803 2373National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050 China
| | - Huijun Wang
- grid.198530.60000 0000 8803 2373National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050 China
| | - Jiaqi Wang
- grid.256883.20000 0004 1760 8442School of Public Health, Hebei Medical University, Shijiazhuang, 050017 China
| | - Fangjun Wang
- Yongkang Center for Disease Control and Prevention, Yongkang, 321300 China
| | - Weiwu Su
- Yuelu District Center for Disease Control and Prevention, Changsha, 410013 China
| | - Huifang Xiao
- Changde Center for Disease Control and Prevention, Changde, 415000 China
| | - Yanxin Wang
- Shaanxi Provincial Center for Disease Control and Prevention, Xian, 710054 China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
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Abstract
Alzheimer disease (AD) is the most common type of dementia characterized by the progressive cognitive and social decline. Clinical drug targets have heavily focused on the amyloid hypothesis, with amyloid beta (Aβ), and tau proteins as key pathophysiologic markers of AD. However, no effective treatment has been developed so far, which prompts researchers to focus on other aspects of AD beyond Aβ, and tau proteins. Additionally, there is a mounting epidemiologic evidence that various environmental factors influence the development of dementia and that dementia etiology is likely heterogenous. In the past decades, new risk factors or potential etiologies have been widely studied. Here, we review several novel epidemiologic and clinical research developments that focus on sleep, hypoxia, diet, gut microbiota, and hearing impairment and their links to AD published in recent years. At the frontiers of AD research, these findings and updates could be worthy of further attention.
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Abstract
Purpose of the Review The goal of this review is to highlight current approaches to diagnosis and treatment for adult-onset hearing loss in patients likely to present to a neurologist's office. The review will discuss primary and secondary causes of acute and chronic hearing loss, and will discuss common situations that can be managed by a neurologist as well as situations that require immediate care and referral for further management by an otolaryngologist-head and neck surgeon. Recent Findings Hearing screening assessments using mobile applications and tablet devices are now available and can be integrated into many clinical practice settings, including in the evaluation of hearing concerns related to various neurological pathologies. For patients presenting with a sudden worsening in hearing, bedside evaluation, including with objective measures of hearing, can inform neurologists about diagnosis and subsequent management. For patients who present with gradual worsening in hearing, particularly those related to neurologic disorders, hearing care can be an important adjunct to ongoing neurologic care. More commonly encountered, age-related hearing loss is highly prevalent among older adults and may affect overall neurological assessment, including neurocognitive testing, as well as patient-provider communication, patient satisfaction, and care outcomes. Hearing loss is increasingly recognized as a potentially modifiable risk factor for dementia. Neurologists can support the hearing health of their patients through the routine use of communication strategies and by integrating simple, low-cost technology with their current clinical practices. Summary Both acute and chronic hearing loss can be a symptom of many conditions managed by neurologists. Few conditions are emergent, requiring immediate referral to and treatment by an otolaryngologist-head and neck surgeon. Despite the range of hearing interventions available, including hearing aids, over-the-counter devices, and aural rehabilitation, hearing loss is a common and under-treated chronic health condition. By promptly addressing a patient's hearing concerns, neurologists can improve patients' awareness of the deficit and support the overall importance of maintaining sensory health across the life course.
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Yue T, Chen Y, Zheng Q, Xu Z, Wang W, Ni G. Screening Tools and Assessment Methods of Cognitive Decline Associated With Age-Related Hearing Loss: A Review. Front Aging Neurosci 2021; 13:677090. [PMID: 34335227 PMCID: PMC8316923 DOI: 10.3389/fnagi.2021.677090] [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: 03/07/2021] [Accepted: 06/24/2021] [Indexed: 12/13/2022] Open
Abstract
Strong links between hearing and cognitive function have been confirmed by a growing number of cross-sectional and longitudinal studies. Seniors with age-related hearing loss (ARHL) have a significantly higher cognitive impairment incidence than those with normal hearing. The correlation mechanism between ARHL and cognitive decline is not fully elucidated to date. However, auditory intervention for patients with ARHL may reduce the risk of cognitive decline, as early cognitive screening may improve related treatment strategies. Currently, clinical audiology examinations rarely include cognitive screening tests, partly due to the lack of objective quantitative indicators with high sensitivity and specificity. Questionnaires are currently widely used as a cognitive screening tool, but the subject's performance may be negatively affected by hearing loss. Numerous electroencephalogram (EEG) and magnetic resonance imaging (MRI) studies analyzed brain structure and function changes in patients with ARHL. These objective electrophysiological tools can be employed to reveal the association mechanism between auditory and cognitive functions, which may also find biological markers to be more extensively applied in assessing the progression towards cognitive decline and observing the effects of rehabilitation training for patients with ARHL. In this study, we reviewed clinical manifestations, pathological changes, and causes of ARHL and discussed their cognitive function effects. Specifically, we focused on current cognitive screening tools and assessment methods and analyzed their limitations and potential integration.
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Affiliation(s)
- Tao Yue
- Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China
- Tianjin International Engineering Institute, Tianjin University, Tianjin, China
| | - Yu Chen
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China
| | - Qi Zheng
- Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China
| | - Zihao Xu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Wei Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China
| | - Guangjian Ni
- Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
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36
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Liu CJ, Chang PS, Griffith CF, Hanley SI, Lu Y. The Nexus of Sensory Loss, Cognitive Impairment, and Functional Decline in Older Adults: A Scoping Review. THE GERONTOLOGIST 2021; 62:e457-e467. [PMID: 34131697 DOI: 10.1093/geront/gnab082] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The prevalence of cognitive impairment and sensory loss in hearing or vision increases with age. Based on the Information Processing Model, cognitive impairment coupled with sensory loss may exacerbate disability in late life. Yet this issue has not been systematically studied. The purpose of this scoping review was to examine the literature that studied the relationship between cognitive impairment, sensory loss, and activities of daily living in older adults. RESEARCH DESIGN AND METHODS Two reviewers independently screened 1,410 studies identified from five electronic databases (Medline, EMBASE, PsycINFO, CINHAL, and the Web of Science). The search was completed in June 2020. A study was eligible if it included measurements of cognitive function, vision or hearing, and activities of daily living. Additionally, the data analyses must address how cognitive impairment and sensory loss are related to the performance of activities of daily living. RESULTS The final review included 15 studies. Findings show an additive effect of cognitive impairment and sensory loss on the activities of daily living. Cognitive impairment or vision loss independently relates to the decline in activities of daily living. Hearing loss relates to the decline only when the loss is severe, or if the daily task is hearing specific. DISCUSSION AND IMPLICATIONS Older adults with coexisting sensory loss and cognitive impairment have the highest risk or prevalence of disability, comparing to cognitive impairment or sensory loss alone. This finding highlights the importance of developing interventions to reduce the risk of disability for older adults experiencing multiple impairments.
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Affiliation(s)
- Chiung-Ju Liu
- Department of Occupational Therapy, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA
| | - Pei-Shiun Chang
- Department of Community and Health Systems, Indiana University School of Nursing, Bloomington, Indiana, USA
| | - Cheryl F Griffith
- Academic Affairs, Office of Clinical Education, Indiana University Health, Indianapolis, Indiana, USA
| | - Stephanie I Hanley
- Department of Occupational Therapy, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA
| | - Yvonne Lu
- Indiana University School of Nursing, Indianapolis, Indiana, USA
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Tadokoro K, Yamashita T, Fukui Y, Nomura E, Ohta Y, Ueno S, Nishina S, Tsunoda K, Wakutani Y, Takao Y, Miyoshi T, Higashi Y, Osakada Y, Sasaki R, Matsumoto N, Kawahara Y, Omote Y, Takemoto M, Hishikawa N, Morihara R, Abe K. Early detection of cognitive decline in mild cognitive impairment and Alzheimer's disease with a novel eye tracking test. J Neurol Sci 2021; 427:117529. [PMID: 34130064 DOI: 10.1016/j.jns.2021.117529] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/24/2021] [Accepted: 06/01/2021] [Indexed: 11/17/2022]
Abstract
Due to an increasing number of dementia patients, the development of a rapid and sensitive method for cognitive assessment is awaited. Here, we examined the usefulness of a novel and short (3 min) eye tracking device to evaluate the cognitive function of normal control (NC, n = 52), mild cognitive impairment (MCI, n = 52), and Alzheimer's disease (AD, n = 70) subjects. Eye tracking total score declined significantly in MCI (**p < 0.01 vs NC) and AD (**p < 0.01 vs NC, ##p < 0.01 vs MCI), and correlated well with the mini-mental state examination (MMSE) score (r = 0.57, *p < 0.05). Furthermore, the eye tracking test, especially memory and deductive reasoning tasks, effectively discriminated NC, MCI and AD. The present novel eye tracking test clearly discriminated cognitive functions among NC, MCI, and AD subjects, thereby providing an advantage for the early detection of MCI and AD in screening.
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Affiliation(s)
- Koh Tadokoro
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Toru Yamashita
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Yusuke Fukui
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan; Department of Clinical Research, National Hospital Organizations Shikoku Medical Center for Children and Adults, Zentsuji, Japan
| | - Emi Nomura
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Yasuyuki Ohta
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Setsuko Ueno
- Department of Neurology, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Saya Nishina
- Department of Neurology, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Keiichiro Tsunoda
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan; Department of Neurology, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Yosuke Wakutani
- Department of Neurology, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Yoshiki Takao
- Department of Neurology, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Takahiro Miyoshi
- Department of Neurology, Himeji Central Hospital, Himeji 672-8501, Japan
| | - Yasuto Higashi
- Department of Neurology, Himeji Central Hospital, Himeji 672-8501, Japan
| | - Yosuke Osakada
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Ryo Sasaki
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Namiko Matsumoto
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Yuko Kawahara
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Yoshio Omote
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Mami Takemoto
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Nozomi Hishikawa
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Ryuta Morihara
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Koji Abe
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
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Chen Y, Li W. Prevalence, Influencing Factors, and Cognitive Characteristics of Depressive Symptoms in Elderly Patients with Schizophrenia. Neuropsychiatr Dis Treat 2021; 17:3645-3654. [PMID: 34934317 PMCID: PMC8684420 DOI: 10.2147/ndt.s341297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 12/02/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate the prevalence, influencing factors, and cognitive characteristics of depressive symptoms in elderly patients with chronic schizophrenia. PATIENTS AND METHODS A total of 241 elderly patients with chronic schizophrenia and 156 healthy controls were enrolled in this study. The Geriatric Depression Scale (GDS) was used to assess depressive symptoms; the Positive and Negative Syndrome Scale was used to assess psychotic symptoms; and both the Mini-Mental State Examination and Montreal Cognitive Assessment were used to assess overall cognitive function, while the Activity of Daily Living Scale was used to assess daily living ability. RESULTS The prevalence of depressive symptoms was 48.5% (117/241) in elderly patients with chronic schizophrenia, which was substantially higher than that of normal controls (17.3%, 27/156). Using a stepwise binary logistic regression analysis, we found that high education (p=0.006, odds ratio [OR]=1.122, 95% confidence interval [CI]:1.034-1.218) and hypertension (p=0.019, OR=0.519, 95% CI: 0.300-0.898) were influencing factors for the comorbidity of depressive symptoms. Compared with individuals without depressive symptoms, individuals with depressive symptoms usually display worse overall cognitive function and more severe impairment of activities of daily living, but fewer psychotic symptoms. Interestingly, the GDS score was negatively correlated with the course of the disease (r=-0.157, p=0.016), suggesting that patients who had recently been admitted to the hospital were more likely to develop depression. CONCLUSION Elderly patients with chronic schizophrenia are often associated with higher levels of depression. Therefore, their overall cognitive function is worse, and their activities of daily living are more seriously impaired. Therefore, these patients should be provided with appropriate psychological comfort, especially those who have recently been admitted to the hospital.
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Affiliation(s)
- Yaopian Chen
- Department of Sleep Medicine, Wenzhou Seventh People's Hospital, Wenzhou, People's Republic of China
| | - Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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Fan Z, Guo Y, Hou X, Lv R, Nie S, Xu S, Chen J, Hong Y, Zhao S, Liu X. Selective Impairment of Processing Task-Irrelevant Emotional Faces in Cerebral Small Vessel Disease Patients. Neuropsychiatr Dis Treat 2021; 17:3693-3703. [PMID: 34938077 PMCID: PMC8687691 DOI: 10.2147/ndt.s340680] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/30/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Few reports have implied electrophysiological alterations and neurocognitive abnormalities in patients with cerebral small vessel disease (CSVD), while no investigation is available regarding emotional processing. In the present study, pre-attentive processing of facial expressions was compared between CSVD sufferers and healthy controls using expression-related visual mismatch negativity (EMMN) as the indicator. METHODS A total of 22 CSVD patients (12 males) and 21 age-matched healthy controls (12 males) were recruited for neuropsychological and emotional assessments, as well as electroencephalogram recording and analysis. We employed an expression-related oddball paradigm to investigate automatic emotional processing, and a series of schematic emotional faces (neutral, happy, sad) unrelated to subject's task were present in the test to avoid low-level processing of facial features. RESULTS Although the distinctions of neuropsychological (MoCA and MMSE), emotional (GAD-7 and PHQ-9) and behavioral parameters (reaction time to target stimuli and response accuracy) did not reach significant levels, mean amplitudes of sad EMMN in time intervals of 150-250 ms and 250-350 ms were remarkably reduced in CSVD patients compared with healthy controls, but not for happy EMMN. Furthermore, in the control group, sad EMMN was demonstrated to be larger (more negative) than happy EMMN, while this interesting phenomenon disappeared in the CSVD group. CONCLUSION Our findings confirmed selective impairment of processing expressions which were task-irrelevant in CSVD patients, without the existence of negative bias (sad superiority) effect. The efficacy of EMMN as an electrophysiological evaluation marker of CSVD should be taken into account in future investigations.
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Affiliation(s)
- Zhongyu Fan
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Shandong Provincial Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China
| | - Yunliang Guo
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Xunyao Hou
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Renjun Lv
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu, People's Republic of China
| | - Shanjing Nie
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Song Xu
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Jian Chen
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Yan Hong
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Shuo Zhao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Xueping Liu
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Department of Geriatric Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
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Völter C, Götze L, Dazert S, Wirth R, Thomas JP. Impact of Hearing Loss on Geriatric Assessment. Clin Interv Aging 2020; 15:2453-2467. [PMID: 33408469 PMCID: PMC7779803 DOI: 10.2147/cia.s281627] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/22/2020] [Indexed: 12/11/2022] Open
Abstract
Background Due to the aging society, the incidence of age-related hearing loss (ARHL) is strongly increasing. Hearing loss has a high impact on various aspects of life and may lead to social isolation, depression, loss of gain control, frailty and even mental decline. Comorbidity of cognitive and sensory impairment is not rare. This might have an impact on diagnostics and treatment in the geriatric setting. Objective The aim of the study was to evaluate the impact of hearing impairment on geriatric assessment and cognitive testing routinely done in geriatrics. Material and Methods This review is based on publications retrieved by a selective search in Medline, including individual studies, meta-analyses, guidelines, Cochrane reviews, and other reviews from 1960 until August 2020. Results Awareness of sensory impairment is low among patients and health professionals working with elderly people. The evaluation of the hearing status is not always part of the geriatric assessment and not yet routinely done in psychiatric settings. However, neurocognitive testing as an important part can be strongly influenced by auditory deprivation. Misunderstanding of verbal instructions, cognitive changes, and delayed central processes may lead to a false diagnosis in up to 16% of subjects with hearing loss. To minimize this bias, several neurocognitive assessments were transformed into non-auditory versions recently, eg the most commonly used Hearing-Impaired Montreal Cognitive Assessment (HI-MoCA). However, most of them still lack normative data for elderly people with hearing loss. Conclusion Hearing loss should be taken into consideration when performing geriatric assessment and cognitive testing in elderly subjects. Test batteries suitable for ARLH should be applied.
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Affiliation(s)
- Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr-University Bochum, St. Elisabeth-Hospital, Bochum 44787, Germany
| | - Lisa Götze
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr-University Bochum, St. Elisabeth-Hospital, Bochum 44787, Germany
| | - Stefan Dazert
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr-University Bochum, St. Elisabeth-Hospital, Bochum 44787, Germany
| | - Rainer Wirth
- Department of Geriatric Medicine, Ruhr-University Bochum, Marien Hospital Herne, Herne 44625, Germany
| | - Jan Peter Thomas
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr-University Bochum, St. Elisabeth-Hospital, Bochum 44787, Germany
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Brenowitz WD, Besser LM, Kukull WA, Keene CD, Glymour MM, Yaffe K. Clinician-judged hearing impairment and associations with neuropathologic burden. Neurology 2020; 95:e1640-e1649. [PMID: 32759190 PMCID: PMC7713726 DOI: 10.1212/wnl.0000000000010575] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 03/30/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To examine whether neuropathologic burden is associated with hearing impairment. METHODS We studied 2,755 autopsied participants ≥55 years of age from the National Alzheimer's Coordinating Center database. Participants had at least 1 clinical evaluation at US National Institute on Aging-funded Alzheimer's Disease Center no more than 2 years before death. Patients were classified as hearing impaired by clinician report at baseline. Common dementia neuropathologies included Alzheimer disease pathologic change (Consortium to Establish a Registry for Alzheimer's Disease neuritic plaque density, neurofibrillary degeneration Braak stage), Lewy body disease, gross infarcts, and microinfarcts. Logistic regression models predicted impaired hearing with adjustment for age at death, sex, race, education, center, and follow-up time. Relative risks were calculated with the use of marginal standardization. RESULTS Impaired hearing was common (32%). In participants who were cognitively normal at baseline (n = 580), impaired hearing was associated with higher Braak stage (relative risk [RR] 1.33 per 2-stage increase, 95% confidence interval [CI] 1.06-1.66) but not other pathologies. In participants with dementia (n = 2,175), impaired hearing was positively associated with microinfarcts (RR 1.18, 95% CI 1.00-1.39) and inversely associated with neuritic plaque density (RR 0.91 per score increase, 95% CI 0.85-0.99). Development of impaired hearing in those with cognitive impairment was associated with neocortical Lewy bodies (1.26, 95% CI 1.02-1.55). CONCLUSIONS Impaired hearing, reported before the onset of cognitive impairment, was associated with increased neurofibrillary tangle burden. Impaired hearing in those with cognitive impairment was associated with microinfarcts and neocortical Lewy bodies but not typical Alzheimer disease pathologic change. Functional hearing problems may be a preclinical marker of neurofibrillary neurodegeneration, although replication is needed.
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Affiliation(s)
- Willa D Brenowitz
- From the Departments of Psychiatry and Behavioral Sciences (W.D.B., K.Y.) and Neurology (K.Y.), Weill Institute for Neurosciences, and Department of Epidemiology & Biostatistics (M.M.G., K.Y.), University of California, San Francisco; Florida Atlantic University (L.M.B.), Institute for Human Health and Disease Intervention, School of Urban and Regional Planning, Boca Raton; National Alzheimer's Coordinating Center (W.A.K.), Department of Epidemiology, and Department of Pathology (C.D.K.), University of Washington, Seattle; and San Francisco VA Health Care System (K.Y.), CA.
| | - Lilah M Besser
- From the Departments of Psychiatry and Behavioral Sciences (W.D.B., K.Y.) and Neurology (K.Y.), Weill Institute for Neurosciences, and Department of Epidemiology & Biostatistics (M.M.G., K.Y.), University of California, San Francisco; Florida Atlantic University (L.M.B.), Institute for Human Health and Disease Intervention, School of Urban and Regional Planning, Boca Raton; National Alzheimer's Coordinating Center (W.A.K.), Department of Epidemiology, and Department of Pathology (C.D.K.), University of Washington, Seattle; and San Francisco VA Health Care System (K.Y.), CA
| | - Walter A Kukull
- From the Departments of Psychiatry and Behavioral Sciences (W.D.B., K.Y.) and Neurology (K.Y.), Weill Institute for Neurosciences, and Department of Epidemiology & Biostatistics (M.M.G., K.Y.), University of California, San Francisco; Florida Atlantic University (L.M.B.), Institute for Human Health and Disease Intervention, School of Urban and Regional Planning, Boca Raton; National Alzheimer's Coordinating Center (W.A.K.), Department of Epidemiology, and Department of Pathology (C.D.K.), University of Washington, Seattle; and San Francisco VA Health Care System (K.Y.), CA
| | - C Dirk Keene
- From the Departments of Psychiatry and Behavioral Sciences (W.D.B., K.Y.) and Neurology (K.Y.), Weill Institute for Neurosciences, and Department of Epidemiology & Biostatistics (M.M.G., K.Y.), University of California, San Francisco; Florida Atlantic University (L.M.B.), Institute for Human Health and Disease Intervention, School of Urban and Regional Planning, Boca Raton; National Alzheimer's Coordinating Center (W.A.K.), Department of Epidemiology, and Department of Pathology (C.D.K.), University of Washington, Seattle; and San Francisco VA Health Care System (K.Y.), CA
| | - M Maria Glymour
- From the Departments of Psychiatry and Behavioral Sciences (W.D.B., K.Y.) and Neurology (K.Y.), Weill Institute for Neurosciences, and Department of Epidemiology & Biostatistics (M.M.G., K.Y.), University of California, San Francisco; Florida Atlantic University (L.M.B.), Institute for Human Health and Disease Intervention, School of Urban and Regional Planning, Boca Raton; National Alzheimer's Coordinating Center (W.A.K.), Department of Epidemiology, and Department of Pathology (C.D.K.), University of Washington, Seattle; and San Francisco VA Health Care System (K.Y.), CA
| | - Kristine Yaffe
- From the Departments of Psychiatry and Behavioral Sciences (W.D.B., K.Y.) and Neurology (K.Y.), Weill Institute for Neurosciences, and Department of Epidemiology & Biostatistics (M.M.G., K.Y.), University of California, San Francisco; Florida Atlantic University (L.M.B.), Institute for Human Health and Disease Intervention, School of Urban and Regional Planning, Boca Raton; National Alzheimer's Coordinating Center (W.A.K.), Department of Epidemiology, and Department of Pathology (C.D.K.), University of Washington, Seattle; and San Francisco VA Health Care System (K.Y.), CA
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Utoomprurkporn N, Woodall K, Stott J, Costafreda SG, Bamiou DE. Hearing-impaired population performance and the effect of hearing interventions on Montreal Cognitive Assessment (MoCA): Systematic review and meta-analysis. Int J Geriatr Psychiatry 2020; 35:962-971. [PMID: 32458435 DOI: 10.1002/gps.5354] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/11/2020] [Accepted: 05/17/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Older adults are at high risk of developing age-related hearing loss (HL) and/or cognitive impairment. However, cognitive screening tools rely on oral administration of instructions and stimuli that may be impacted by HL. This systematic review aims to investigate (a) whether people with HL perform worse than those without HL on the Montreal Cognitive Assessment (MoCA), a widely used screening tool for cognitive impairment, and what the effect size of that difference is (b) whether HL treatment mitigates the impact of HL. METHOD We conducted a systematic review and meta-analysis including studies that reported mean MoCA scores and SDs for individuals with HL. RESULTS People with HL performed significantly worse on the MoCA (4 studies, N = 533) with a pooled mean difference of -1.66 points (95% confidence interval CI -2.74 to -0.58). There was no significant difference in MoCA score between the pre- vs post-hearing intervention (3 studies, N = 75). However, sensitivity analysis in the cochlear implant studies (2 studies, N = 33) showed improvement of the MoCA score by 1.73 (95% CI 0.18 to 3.28). CONCLUSION People with HL score significantly lower than individuals with normal hearing on the standard orally administered MoCA. Clinicians should consider listening conditions when administering the MoCA and report the hearing status of the tested individuals, if known, taking this into account in interpretation or make note of any hearing difficulty during consultations which may warrant onward referral. Cochlear implants may improve the MoCA score of individuals with HL, and more evidence is required on other treatments. J Am Geriatr Soc 68:-, 2020.
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Affiliation(s)
- Nattawan Utoomprurkporn
- UCL Ear Institute, Faculty of Brain Science, University College London, London, UK.,Otoneurology Unit, Otolaryngology Department, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Katherine Woodall
- UCL Ear Institute, Faculty of Brain Science, University College London, London, UK
| | - Joshua Stott
- Division of Psychology and Language Science, Faculty of Brain Sciences, University College London, London, UK
| | - Sergi G Costafreda
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Doris Eva Bamiou
- UCL Ear Institute, Faculty of Brain Science, University College London, London, UK.,Hearing and Deafness, NIHR Biomedical Research Centre, London, UK
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Patel RA, Wharton W, Bay AA, Nid L, Barter JD, Hackney ME. Association between anti-inflammatory interleukin-10 and executive function in African American women at risk for Alzheimer's disease. J Clin Exp Neuropsychol 2020; 42:647-659. [PMID: 32781877 PMCID: PMC9747330 DOI: 10.1080/13803395.2020.1798879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION African-Americans (AAs) are 64% more likely to be diagnosed with AD than non-Hispanic Whites. AAs with elevated AD biomarkers exhibit greater neurodegeneration in AD signature regions compared to non-Hispanic Whites with elevated AD biomarkers. This pilot trial examined whether normal or elevated plasma levels of interleukin (IL)-10 are associated with changes in executive function and short-term memory in AA women at risk for developing AD due to parental history. METHOD Observational study comparing groups with elevated and normal plasma IL-10 levels. Study included 31 AA women (age=58.9±8 years) with parental history of AD. Measures included inflammatory blood biomarkers, executive function and visuospatial short-term memory tests. Multivariate linear regression with adjustment for comorbidities, and Bonferroni corrections for multiple comparisons were used to compare groups. Effect sizes (Cohen's d) were generated. Using endpoints with moderate-large effects between groups, Pearson correlations determined associations between biomarker levels and cognitive performance. RESULTS The elevated IL-10 group performed worse on the Trail-Making Test proportional score ((B-A)/A) (effect size (d =-0.87 (-1.6, -.1)). Moderate effects with large confident intervals were noted in inhibition, set-switching, and body position spatial memory. Significant differences between groups in levels of other inflammatory markers were noted, including IL-7 (p=0.002) and interferon γ (p=0.02). IL-7 remained significant after Bonferroni correction. Correlation matrices revealed moderate-large, significant correlations (yet with wide confidence intervals) between levels of IL-10 and IL-9 with BPST total correct trials, and between interferon γ and delayed recall. CONCLUSIONS Interleukins may incite inflammation, leading to impaired aspects of executive function and short-term memory in this sample of African American women at risk for developing AD. This research provides effect sizes that will be used to power future research that will further investigate the relationship between inflammation, AD biomarkers, and cognitive function in an understudied population.
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Affiliation(s)
- Ruhee A. Patel
- Emory University College of Arts and Sciences, Atlanta, USA
| | - Whitney Wharton
- Emory University School of Nursing, Atlanta, USA,Department of Neurology, Emory University School of Medicine, Atlanta, USA
| | - Allison A. Bay
- Division of General Medicine and Geriatrics, Department of Medicine, Emory University School of Medicine, Atlanta, USA
| | - Liang Nid
- Division of General Medicine and Geriatrics, Department of Medicine, Emory University School of Medicine, Atlanta, USA,Emory University Rollins School of Public Health, Atlanta, USA
| | - Jolie D. Barter
- Division of General Medicine and Geriatrics, Department of Medicine, Emory University School of Medicine, Atlanta, USA
| | - Madeleine E. Hackney
- Emory University School of Nursing, Atlanta, USA,Division of General Medicine and Geriatrics, Department of Medicine, Emory University School of Medicine, Atlanta, USA,Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, USA,Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, GA, USA,Birmingham/Atlanta VA Geriatric Research Clinical and Education Center, Atlanta, USA
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44
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Slade K, Plack CJ, Nuttall HE. The Effects of Age-Related Hearing Loss on the Brain and Cognitive Function. Trends Neurosci 2020; 43:810-821. [PMID: 32826080 DOI: 10.1016/j.tins.2020.07.005] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/22/2020] [Accepted: 07/14/2020] [Indexed: 12/27/2022]
Abstract
Age-related hearing loss (ARHL) is a common problem for older adults, leading to communication difficulties, isolation, and cognitive decline. Recently, hearing loss has been identified as potentially the most modifiable risk factor for dementia. Listening in challenging situations, or when the auditory system is damaged, strains cortical resources, and this may change how the brain responds to cognitively demanding situations more generally. We review the effects of ARHL on brain areas involved in speech perception, from the auditory cortex, through attentional networks, to the motor system. We explore current perspectives on the possible causal relationship between hearing loss, neural reorganisation, and cognitive impairment. Through this synthesis we aim to inspire innovative research and novel interventions for alleviating hearing loss and cognitive decline.
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Affiliation(s)
- Kate Slade
- Department of Psychology, Lancaster University, Lancaster, UK
| | - Christopher J Plack
- Department of Psychology, Lancaster University, Lancaster, UK; Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
| | - Helen E Nuttall
- Department of Psychology, Lancaster University, Lancaster, UK.
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45
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Raymond M, Barrett D, Lee DJ, Peterson S, Raol N, Vivas EX. Cognitive Screening of Adults With Postlingual Hearing Loss: A Systematic Review. Otolaryngol Head Neck Surg 2020; 164:49-56. [DOI: 10.1177/0194599820933255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective To systematically review the evidence for the use of cognitive screening tools for adults with postlingual hearing loss. Data Sources PubMed, Embase, Scopus, PsycINFO (EBSCO), CINAHL (EBSCO), and CENTRAL (Cochrane Library) electronic databases were searched from inception until October 4, 2018. Review Methods Articles were reviewed for inclusion by 2 independent reviewers. The references of included articles were hand-searched for additional relevant articles. Data were extracted by 2 independent extractors. Results Of 2092 articles imported from the search, 81 were included for the review. Nearly a third (31%, n = 25) included patients with profound hearing loss. In total, 23 unique tools were used for 105 unique applications. The Mini Mental Status Exam (MMSE) was the most commonly used (54%, n = 55), followed by the Montreal Cognitive Assessment (MoCA) (19%, n = 10). Nearly half of the tools were used to define patient inclusion or exclusion in a study (48%, n = 50), followed by examination of a change after an intervention (26%, n = 27). Two articles attempted to study the validity of the MMSE and MoCA for screening patients with mild to moderate hearing loss and found mixed effects of the auditory components. There were no validation studies identified from the search. Conclusion Many different cognitive screening tools have been used to study patients with postlingual hearing loss. The effects of the auditory components of these tools may be deleterious but ultimately remain unclear from the available evidence. To date, there has been no validation of any cognitive screening tool to be used for adults with postlingual hearing loss.
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Affiliation(s)
- Mallory Raymond
- Department of Otolaryngology–Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Devon Barrett
- Department of Otolaryngology–Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Daniel Juno Lee
- Department of Otolaryngology–Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Shenita Peterson
- Woodruff Health Sciences Center Library, Emory University, Atlanta, Georgia, USA
| | - Nikhila Raol
- Department of Otolaryngology–Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Esther X. Vivas
- Department of Otolaryngology–Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
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46
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Regal PJ, Lange P. Is hearing impairment by audiometry as much a cognitive score as cognitive domain batteries? Eur Geriatr Med 2020; 11:995-1001. [DOI: 10.1007/s41999-020-00341-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 05/22/2020] [Indexed: 01/24/2023]
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Parada JC, Hillyer J, Parbery-Clark A. Performance on the standard and hearing-impaired Montreal Cognitive Assessment in cochlear implant users. Int J Geriatr Psychiatry 2020; 35:338-347. [PMID: 31989675 DOI: 10.1002/gps.5267] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 01/21/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Commonly used cognitive screening tools were not originally developed for patients with hearing loss (HL) and rely heavily on the ability to hear the instructions and test stimuli. Recently, the Montreal Cognitive Assessment (MoCA) was modified for use with hearing-impaired populations (ie, HI-MoCA). In order to investigate the clinical utility of the HI-MoCA, we assessed performance between the standard MoCA and HI-MoCA among postlingually deafened cochlear implant (CI) users. METHODS We administered the standard MoCA and HI-MoCA to 21 CI users and compared their performance. We assessed differences in pass/fail status when items from the attention and language sections and the delayed recall task were removed. RESULTS There was no significant difference in performance between the standard MoCA and HI-MoCA. Participants scored higher on both test versions when the delayed recall task was removed. Participants also performed better on the delayed recall task on the HI-MoCA than on the standard MoCA. CONCLUSIONS While our findings suggest that the modality of presentation for the MoCA does not influence overall performance for postlingually deafened CI users, visual presentation of stimuli impacted performance on delayed recall. Furthermore, irrespective of presentation modality, our participants scored higher on both MoCA versions when the delayed recall task was removed. Clinically, modifications to the presentation of the MoCA might not be necessary for CI users; however, clinicians should be aware that the delayed recall task is inherently harder for these patients.
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Affiliation(s)
| | - Jake Hillyer
- School of Medicine, Oregon Health & Science University, Portland, OR
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Raymond MJ, Lee AC, Schader LM, Moore RH, Raol NR, Vivas EX. Practices and perceptions of cognitive assessment for adults with age-related hearing loss. Laryngoscope Investig Otolaryngol 2020; 5:137-144. [PMID: 32128440 PMCID: PMC7042642 DOI: 10.1002/lio2.339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/04/2019] [Accepted: 11/20/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To investigate the landscape of cognitive impairment (CI) screening for adults with age-related hearing loss (ARHL) among otolaryngologists and audiologists. To identify provider factors and patient characteristics that impact rates of CI screening and referral. METHODS A 15 question online survey was sent to members of the Georgia Society of Otolaryngology (GSO), Georgia Academy of Audiology (GAA), American Otological Society and American Neurotology Society (AOS/ANS), and posted on the web forum for two hearing disorders special interest groups within the American-Speech-Language-Hearing Association (ASHA). Responses were collected anonymously. Chi-square tests were used to compare responses. RESULTS Of the 66 included respondents, 61% (n = 40) were otolaryngologists and 35% (n = 23) were audiologists. Respondents were significantly more likely to refer patients for CI assessment than to screen (64% vs 21%, respectively, P < .001). The complaint of a neurological symptom, such as memory loss, would prompt screening or referral for only 27.3% (n = 18) and 51.52% (n = 34) of respondents, respectively. Forty-two percent (n = 28) of respondents suggested CI screening with the MMSE vs 20% (n = 13) with the Montreal Cognitive Assessment. CONCLUSIONS Despite recommendations for cognitive assessment in high-risk populations, such as older adults with ARHL, the practice of CI screening and referral is not yet commonplace among otolaryngologists and audiologists. These providers have a unique opportunity to assess adults with ARHL for CI and ensure appropriate referral. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- Mallory J. Raymond
- Department of Otolaryngology – Head and Neck SurgeryEmory University School of MedicineAtlantaGeorgia
| | - Annika C. Lee
- Department of Otolaryngology – Head and Neck SurgeryEmory University School of MedicineAtlantaGeorgia
| | - Lindsey M. Schader
- Department of Biostatistics and Bioinformatics, School of Medicine Biostatistics Collaboration CoreEmory University, Rollins School of Public HealthAtlantaGeorgia
| | - Renee H. Moore
- Department of Biostatistics and Bioinformatics, School of Medicine Biostatistics Collaboration CoreEmory University, Rollins School of Public HealthAtlantaGeorgia
| | - Nikhila R. Raol
- Department of Otolaryngology – Head and Neck SurgeryEmory University School of MedicineAtlantaGeorgia
| | - Esther X. Vivas
- Department of Otolaryngology – Head and Neck SurgeryEmory University School of MedicineAtlantaGeorgia
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Zhang S, Zhao M, Wang F, Liu J, Zheng H, Lei P. Relationship between normal weight obesity and mild cognitive impairment is reflected in cognitive-related genes in human peripheral blood mononuclear cells. Psychogeriatrics 2020; 20:35-43. [PMID: 30950168 DOI: 10.1111/psyg.12452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 01/31/2019] [Accepted: 03/06/2019] [Indexed: 01/12/2023]
Abstract
AIM Obesity contributes to the development of mild cognitive impairment, but the potential role of normal weight obesity in this disease has not been explored in humans. The aim of the study was to reveal the relationship between normal weight obesity and mild cognitive impairment in elderly individuals. METHODS This study consisted of 360 patients with amnestic mild cognitive impairment and 360 cognitively normal controls. Normal weight obesity was defined as having metabolic syndrome but a normal weight. Metabolic health meant having no metabolic syndrome. Reverse transcription quantitative real-time polymerase chain reaction was adopted to measure the messenger RNA expression of four cognitive-related genes (amyloid precursor protein, cyclic adenosine monophosphate-responsive element-binding protein 1, sortilin-related receptor 1, and synapsin I) in peripheral blood mononuclear cells. RESULTS Normal weight obesity was related to a higher risk of amnestic mild cognitive impairment (odds ratio = 3.14, 95% confidence interval: 2.13-4.60). In the patients, the expression of each gene in the peripheral blood mononuclear cells was linearly related to Mini-Mental State Examination and Montreal Cognitive Assessment scores (P < 0.05). The expression of these genes in the patients with metabolic health deviated from the normal levels found in the controls (P < 0.05), and the deviations were more significant in the patients with normal weight obesity (P < 0.05). CONCLUSION Normal weight obesity may be a potential risk factor for amnestic mild cognitive impairment in elderly. This relationship was reflected in the abnormal expression of several cognitive-related genes in peripheral blood mononuclear cells.
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Affiliation(s)
- Shishuang Zhang
- Department of Geriatrics, Tianjin Medical University General Hospital; Tianjin Geriatrics Institute, Tianjin, China
| | - Minghui Zhao
- Department of Geriatrics, Tianjin Medical University General Hospital; Tianjin Geriatrics Institute, Tianjin, China
| | - Feng Wang
- Department of Geriatrics, Tianjin Medical University General Hospital; Tianjin Geriatrics Institute, Tianjin, China
| | - Juan Liu
- Department of Ultrasound, Tianjin People's Hospital, Tianjin, China
| | - Hui Zheng
- Nankai Center for Disease Control and Prevention, Tianjin, China
| | - Ping Lei
- Department of Geriatrics, Tianjin Medical University General Hospital; Tianjin Geriatrics Institute, Tianjin, China
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50
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Garami L, Chow R, Fakuade A, Swaminathan S, Alain C. Orienting Attention to Auditory and Visual Short-term Memory: The Roles of Age, Hearing Loss, and Cognitive Status. Exp Aging Res 2019; 46:22-38. [DOI: 10.1080/0361073x.2019.1693008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Linda Garami
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
| | - Ricky Chow
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
| | - Ayomide Fakuade
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
| | | | - Claude Alain
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
- School of Music, University of Toronto, Toronto, Ontario, Canada
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