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Costa T, Premi E, Borroni B, Manuello J, Cauda F, Duca S, Liloia D. Local functional connectivity abnormalities in mild cognitive impairment and Alzheimer's disease: A meta-analytic investigation using minimum Bayes factor activation likelihood estimation. Neuroimage 2024; 298:120798. [PMID: 39153521 DOI: 10.1016/j.neuroimage.2024.120798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 08/13/2024] [Accepted: 08/15/2024] [Indexed: 08/19/2024] Open
Abstract
Functional magnetic resonance imaging research employing regional homogeneity (ReHo) analysis has uncovered aberrant local brain connectivity in individuals with mild cognitive impairment (MCI) and Alzheimer's disease (AD) in comparison with healthy controls. However, the precise localization, extent, and possible overlap of these aberrations are still not fully understood. To bridge this gap, we applied a novel meta-analytic and Bayesian method (minimum Bayes Factor Activation Likelihood Estimation, mBF-ALE) for a systematic exploration of local functional connectivity alterations in MCI and AD brains. We extracted ReHo data via a standardized MEDLINE database search, which included 35 peer-reviewed experiments, 1,256 individuals with AD or MCI, 1,118 healthy controls, and 205 x-y-z coordinates of ReHo variation. We then separated the data into two distinct datasets: one for MCI and the other for AD. Two mBF-ALE analyses were conducted, thresholded at "very strong evidence" (mBF ≥ 150), with a minimum cluster size of 200 mm³. We also assessed the spatial consistency and sensitivity of our Bayesian results using the canonical version of the ALE algorithm. For MCI, we observed two clusters of ReHo decrease and one of ReHo increase. Decreased local connectivity was notable in the left precuneus (Brodmann area - BA 7) and left inferior temporal gyrus (BA 20), while increased connectivity was evident in the right parahippocampal gyrus (BA 36). The canonical ALE confirmed these locations, except for the inferior temporal gyrus. In AD, one cluster each of ReHo decrease and increase were found, with decreased connectivity in the right posterior cingulate cortex (BA 30 extending to BA 23) and increased connectivity in the left posterior cingulate cortex (BA 31). These locations were confirmed by the canonical ALE. The identification of these distinct functional connectivity patterns sheds new light on the complex pathophysiology of MCI and AD, offering promising directions for future neuroimaging-based interventions. Additionally, the use of a Bayesian framework for statistical thresholding enhances the robustness of neuroimaging meta-analyses, broadening its applicability to small datasets.
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Affiliation(s)
- Tommaso Costa
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy; Neuroscience Institute of Turin (NIT), Turin, Italy.
| | - Enrico Premi
- Stroke Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Barbara Borroni
- Cognitive and Behavioural Neurology, Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Jordi Manuello
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy
| | - Franco Cauda
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy; Neuroscience Institute of Turin (NIT), Turin, Italy
| | - Sergio Duca
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy
| | - Donato Liloia
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy
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Alves S, Duarte N, Gomes B. Forecasted Dementia Prevalence in Portugal (2020-2080). J Geriatr Psychiatry Neurol 2024; 37:403-412. [PMID: 38436576 DOI: 10.1177/08919887241237220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Dementia is a global public health challenge, and its impact on Portugal is yet unclear. This study forecasts dementia prevalence in Portugal until 2080. Using the Gonçalves-Pereira et al (2021) method, we estimated dementia cases among older adults (≥65 years) in the community. Applying age-sex specific prevalence rates of the Gonçalves-Pereira study to population projections for Portugal between 2020-2080, based on the 10/66 Dementia Research Group criteria (10/66 DRG) and the Diagnostic and Statistical Manual of Mental Disorders IV criteria (DSM-IV), to Portugal's population projections (2020-2080) under various growth scenarios (low, medium, and high). We anticipate a more than 2-fold increase in dementia prevalence from 2020 to 2080, both for 10/66 DRG [2.1%-5.0%] and DSM-IV [.8%-2.0%]. By 2080, those aged ≥80 years are projected to constitute 75.0% (vs 59.0% in 2020) of all dementia cases, particularly affecting women. Addressing dementia growth in Portugal calls for a comprehensive global response, while country-level estimates facilitate informed public health planning, policy-making, and resource allocation.
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Affiliation(s)
- Sara Alves
- Santa Casa da Misericórdia de Riba D'Ave/CIDIFAD - Centro de Investigação, Diagnóstico, Formação e Acompanhamento das Demências, Braga, Portugal
- CINTESIS@RISE, ICBAS, Porto, Portugal
| | - Natália Duarte
- Santa Casa da Misericórdia de Riba D'Ave/CIDIFAD - Centro de Investigação, Diagnóstico, Formação e Acompanhamento das Demências, Braga, Portugal
- CINTESIS@RISE, ICBAS, Porto, Portugal
| | - Barbara Gomes
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Alzola P, Buch-Vicente B, Sazatornil J, Puertas-Martín V, Fernández-Calvo B, Sánchez-Benavides G, Rueda-Revé L, Ramos F, Villarejo-Galende A, Contador I. A novel abbreviated version of the Luria neuropsychological diagnosis battery: reliability and convergent validity in Spanish older adults. J Clin Exp Neuropsychol 2024; 46:579-587. [PMID: 38909318 DOI: 10.1080/13803395.2024.2368586] [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: 10/18/2023] [Accepted: 06/08/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVE To estimate the test-retest and inter-rater reliability of the new Spanish abbreviated version of the Luria Neuropsychological Diagnosis (DNA-2) battery for older adults. METHOD A total of thirty cognitively healthy volunteers were examined in this study. The participants completed a comprehensive standardized assessment, encompassing cognitive and functional performance. Intraclass correlation coefficients (ICC) were used to examine test-retest and inter-rater reliability. One month was allowed between administrations. Furthermore, correlations between Luria DNA-2 (total and domain subscores) and other classical cognitive measures were explored. RESULTS The test-retest reliability on the overall Luria DNA-2 score was high (ICC= .834, 95% CI [.680, .917], p < .001). Furthermore, the inter-rater reliability for the total score demonstrated an excellent concordance between administrators (ICC= .990, 95% CI [.979, .995], p < .001). Positive and significant correlations were observed between Luria DNA-2 (both total and domain subscores) and the Addenbrooke's Cognitive Examination (ACE-III; ρ = .857, p < .001). CONCLUSIONS This study supports the adequate reliability of the Luria DNA-2, as an abbreviated neuropsychological battery, for assessing cognitive performance in Spaniards aged 55 years and older. Future studies should continue to explore the psychometric properties of the Luria DNA-2, particularly those related to its diagnostic validity for early detection of cognitive impairment.
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Affiliation(s)
- Patricia Alzola
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Bárbara Buch-Vicente
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Jaime Sazatornil
- Department of Personality, Psychological Assessment and Treatment, University of Salamanca, Salamanca, Spain
| | - Verónica Puertas-Martín
- Faculty of Health Sciences and Faculty of Education International, International University of La Rioja, La Rioja, Spain
| | - Bernardino Fernández-Calvo
- Department of Psychology, University of Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
| | | | - Laura Rueda-Revé
- General Educational and Psychopedagogical Guidance Teams of Comunidad de Madrid, Madrid, Spain
| | - Francisco Ramos
- Department of Personality, Psychological Assessment and Treatment, University of Salamanca, Salamanca, Spain
| | - Alberto Villarejo-Galende
- Department of Neurology, Hospital 12 de Octubre, Madrid, Spain
- Biomedical Research Networking Center in Neurodegenerative disease (CIBERNED), Madrid, Spain
| | - Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, Salamanca, Spain
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Pearson MJ, Wagstaff R, Williams RJ. Choroid plexus volumes and auditory verbal learning scores are associated with conversion from mild cognitive impairment to Alzheimer's disease. Brain Behav 2024; 14:e3611. [PMID: 38956818 PMCID: PMC11219301 DOI: 10.1002/brb3.3611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/30/2024] [Accepted: 06/01/2024] [Indexed: 07/04/2024] Open
Abstract
PURPOSE Mild cognitive impairment (MCI) can be the prodromal phase of Alzheimer's disease (AD) where appropriate intervention might prevent or delay conversion to AD. Given this, there has been increasing interest in using magnetic resonance imaging (MRI) and neuropsychological testing to predict conversion from MCI to AD. Recent evidence suggests that the choroid plexus (ChP), neural substrates implicated in brain clearance, undergo volumetric changes in MCI and AD. Whether the ChP is involved in memory changes observed in MCI and can be used to predict conversion from MCI to AD has not been explored. METHOD The current study used data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database to investigate whether later progression from MCI to AD (progressive MCI [pMCI], n = 115) or stable MCI (sMCI, n = 338) was associated with memory scores using the Rey Auditory Verbal Learning Test (RAVLT) and ChP volumes as calculated from MRI. Classification analyses identifying pMCI or sMCI group membership were performed to compare the predictive ability of the RAVLT and ChP volumes. FINDING The results indicated a significant difference between pMCI and sMCI groups for right ChP volume, with the pMCI group showing significantly larger right ChP volume (p = .01, 95% confidence interval [-.116, -.015]). A significant linear relationship between the RAVLT scores and right ChP volume was found across all participants, but not for the two groups separately. Classification analyses showed that a combination of left ChP volume and auditory verbal learning scores resulted in the most accurate classification performance, with group membership accurately predicted for 72% of the testing data. CONCLUSION These results suggest that volumetric ChP changes appear to occur before the onset of AD and might provide value in predicting conversion from MCI to AD.
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Affiliation(s)
- Michael J. Pearson
- Faculty of HealthCharles Darwin UniversityDarwinNorthern TerritoryAustralia
| | - Ruth Wagstaff
- Faculty of HealthCharles Darwin UniversityDarwinNorthern TerritoryAustralia
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Alzola P, Carnero C, Bermejo-Pareja F, Sánchez-Benavides G, Peña-Casanova J, Puertas-Martín V, Fernández-Calvo B, Contador I. Neuropsychological Assessment for Early Detection and Diagnosis of Dementia: Current Knowledge and New Insights. J Clin Med 2024; 13:3442. [PMID: 38929971 PMCID: PMC11204334 DOI: 10.3390/jcm13123442] [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: 05/15/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
Dementia remains an underdiagnosed syndrome, and there is a need to improve the early detection of cognitive decline. This narrative review examines the role of neuropsychological assessment in the characterization of cognitive changes associated with dementia syndrome at different states. The first section describes the early indicators of cognitive decline and the major barriers to their identification. Further, the optimal cognitive screening conditions and the most widely accepted tests are described. The second section analyzes the main differences in cognitive performance between Alzheimer's disease and other subtypes of dementia. Finally, the current challenges of neuropsychological assessment in aging/dementia and future approaches are discussed. Essentially, we find that current research is beginning to uncover early cognitive changes that precede dementia, while continuing to improve and refine the differential diagnosis of neurodegenerative disorders that cause dementia. However, neuropsychology faces several barriers, including the cultural diversity of the populations, a limited implementation in public health systems, and the adaptation to technological advances. Nowadays, neuropsychological assessment plays a fundamental role in characterizing cognitive decline in the different stages of dementia, but more efforts are needed to develop harmonized procedures that facilitate its use in different clinical contexts and research protocols.
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Affiliation(s)
- Patricia Alzola
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, 37005 Salamanca, Spain;
| | - Cristóbal Carnero
- Neurology Department, Granada University Hospital Complex, 18014 Granada, Spain
| | - Félix Bermejo-Pareja
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Institute of Health Carlos III, 28029 Madrid, Spain
- Institute of Research i+12, University Hospital “12 de Octubre”, 28041 Madrid, Spain
| | | | | | | | | | - Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, 37005 Salamanca, Spain;
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Pereira ML, Caramelli P, Sá VMD, Rocha PHM, Oliveira JPGD, Amorim RPD, Silva EVD, Delboni VS, Barbosa MT, Miranda LFJRD, de Souza LC. Memory complaint in a middle-income country: a four-year longitudinal study in a cohort with low-education. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1-9. [PMID: 38849124 DOI: 10.1055/s-0044-1787138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
BACKGROUND Memory complaints are frequent in older adults and are associated with higher risk of cognitive decline. OBJECTIVE To investigate the functional outcome of individuals with memory complaints followed up at primary care centers. METHODS Data were collected between 2016 e 2020 in primary health care centers in Brazil. Patients underwent the Brief Cognitive Screening Battery, and the Functional Activities Questionnaire. RESULTS The initial sample (2016) comprised 91 individuals classified into those with subjective cognitive decline (SCD, n = 15), mild cognitive impairment (MCI, n = 45), or dementia (n = 31). During follow-up, 8 individuals (8.8% of the initial sample) died and 26 (28.5% of the initial sample) were not found. Fifty-seven participants underwent clinical reassessment. Of 15 individuals with SCD, 7 were not found (46.7%), 4 (26.7%) progressed to MCI, and 4 (26.7%) remained stable. Of 45 individuals with MCI, 11 were not found (24.4%), 2 (4.4%) died, 6 (13.4%) progressed to dementia, 12 (26.7%) regressed to SCD, and 14 (31.1%) remained stable. Of 31 individuals with dementia, 8 were not found (25.8%), 6 (19.4%) died, 2 (6.5%) regressed to SCD, 7 (22.6%) regressed to MCI, and 8 remained stable (25.8%). Clinical improvement was due to the treatment of reversible causes, such as B12 hypovitaminosis and mood disorders. Older age, lower Mini-Mental State Examination, and higher scores of memory complaint, but not the use of benzodiazepines and of proton pump inhibitors, were predictors of functional status. CONCLUSION Despite their limits (short sample size, missing data), these results support the idea that adequate screening, follow-up, and treatment of reversible causes of dementia in primary care are essential.
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Affiliation(s)
- Marcos Leandro Pereira
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Neurociências, Belo Horizonte MG, Brazil
- Khronus Saúde e Educação Ltda, Instituto Khronus de Desenvolvimento Humano, Patos de Minas MG, Brazil
- Centro Universitário de Patos de Minas, Curso de Medicina, Patos de Minas MG, Brazil
| | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Neurociências, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
| | - Vannessa Marinara de Sá
- Khronus Saúde e Educação Ltda, Instituto Khronus de Desenvolvimento Humano, Patos de Minas MG, Brazil
| | | | | | | | - Elvis Vieira da Silva
- Centro Universitário de Patos de Minas, Curso de Medicina, Patos de Minas MG, Brazil
| | | | - Maira Tonidandel Barbosa
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
| | | | - Leonardo Cruz de Souza
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Neurociências, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
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Gutierrez-Tordera L, Papandreou C, Novau-Ferré N, García-González P, Rojas M, Marquié M, Chapado LA, Papagiannopoulos C, Fernàndez-Castillo N, Valero S, Folch J, Ettcheto M, Camins A, Boada M, Ruiz A, Bulló M. Exploring small non-coding RNAs as blood-based biomarkers to predict Alzheimer's disease. Cell Biosci 2024; 14:8. [PMID: 38229129 PMCID: PMC10790437 DOI: 10.1186/s13578-023-01190-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/27/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Alzheimer's disease (AD) diagnosis relies on clinical symptoms complemented with biological biomarkers, the Amyloid Tau Neurodegeneration (ATN) framework. Small non-coding RNA (sncRNA) in the blood have emerged as potential predictors of AD. We identified sncRNA signatures specific to ATN and AD, and evaluated both their contribution to improving AD conversion prediction beyond ATN alone. METHODS This nested case-control study was conducted within the ACE cohort and included MCI patients matched by sex. Patients free of type 2 diabetes underwent cerebrospinal fluid (CSF) and plasma collection and were followed-up for a median of 2.45-years. Plasma sncRNAs were profiled using small RNA-sequencing. Conditional logistic and Cox regression analyses with elastic net penalties were performed to identify sncRNA signatures for A+(T|N)+ and AD. Weighted scores were computed using cross-validation, and the association of these scores with AD risk was assessed using multivariable Cox regression models. Gene ontology (GO) and Kyoto encyclopaedia of genes and genomes (KEGG) enrichment analysis of the identified signatures were performed. RESULTS The study sample consisted of 192 patients, including 96 A+(T|N)+ and 96 A-T-N- patients. We constructed a classification model based on a 6-miRNAs signature for ATN. The model could classify MCI patients into A-T-N- and A+(T|N)+ groups with an area under the curve of 0.7335 (95% CI, 0.7327 to 0.7342). However, the addition of the model to conventional risk factors did not improve the prediction of AD beyond the conventional model plus ATN status (C-statistic: 0.805 [95% CI, 0.758 to 0.852] compared to 0.829 [95% CI, 0.786, 0.872]). The AD-related 15-sncRNAs signature exhibited better predictive performance than the conventional model plus ATN status (C-statistic: 0.849 [95% CI, 0.808 to 0.890]). When ATN was included in this model, the prediction further improved to 0.875 (95% CI, 0.840 to 0.910). The miRNA-target interaction network and functional analysis, including GO and KEGG pathway enrichment analysis, suggested that the miRNAs in both signatures are involved in neuronal pathways associated with AD. CONCLUSIONS The AD-related sncRNA signature holds promise in predicting AD conversion, providing insights into early AD development and potential targets for prevention.
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Affiliation(s)
- Laia Gutierrez-Tordera
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), 43201, Reus, Spain
- Institute of Health Pere Virgili (IISPV), 43204, Reus, Spain
- Center of Environmental, Food and Toxicological Technology-TecnATox, Rovira i Virgili University, 43201, Reus, Spain
| | - Christopher Papandreou
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), 43201, Reus, Spain.
- Institute of Health Pere Virgili (IISPV), 43204, Reus, Spain.
- Center of Environmental, Food and Toxicological Technology-TecnATox, Rovira i Virgili University, 43201, Reus, Spain.
| | - Nil Novau-Ferré
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), 43201, Reus, Spain
- Institute of Health Pere Virgili (IISPV), 43204, Reus, Spain
- Center of Environmental, Food and Toxicological Technology-TecnATox, Rovira i Virgili University, 43201, Reus, Spain
| | - Pablo García-González
- ACE Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
| | - Melina Rojas
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), 43201, Reus, Spain
- Institute of Health Pere Virgili (IISPV), 43204, Reus, Spain
- Center of Environmental, Food and Toxicological Technology-TecnATox, Rovira i Virgili University, 43201, Reus, Spain
| | - Marta Marquié
- ACE Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
| | - Luis A Chapado
- Laboratory of Epigenetics of Lipid Metabolism, Instituto Madrileño de Estudios Avanzados (IMDEA)-Alimentación, CEI UAM+CSIC, 28049, Madrid, Spain
| | - Christos Papagiannopoulos
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45500, Ioannina, Greece
| | - Noèlia Fernàndez-Castillo
- Department de Genetics, Microbiology and Statistics, Faculty of Biology, Universitat de Barcelona, 08007, Barcelona, Spain
| | - Sergi Valero
- ACE Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
| | - Jaume Folch
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), 43201, Reus, Spain
- Institute of Health Pere Virgili (IISPV), 43204, Reus, Spain
- Center of Environmental, Food and Toxicological Technology-TecnATox, Rovira i Virgili University, 43201, Reus, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
| | - Miren Ettcheto
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Science, Universitat de Barcelona, 08028, Barcelona, Spain
- Institute of Neuroscience, Universitat de Barcelona, 08035, Barcelona, Spain
| | - Antoni Camins
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Science, Universitat de Barcelona, 08028, Barcelona, Spain
- Institute of Neuroscience, Universitat de Barcelona, 08035, Barcelona, Spain
| | - Mercè Boada
- ACE Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
| | - Agustín Ruiz
- ACE Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
| | - Mònica Bulló
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), 43201, Reus, Spain.
- Institute of Health Pere Virgili (IISPV), 43204, Reus, Spain.
- Center of Environmental, Food and Toxicological Technology-TecnATox, Rovira i Virgili University, 43201, Reus, Spain.
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029, Madrid, Spain.
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Bonilla-Santos J, González-Hernández A, Cala-Martínez DY, Gómez-Morales DF, Calceto-Garavito LN, Forero-Aldana AE, González-Montealegre RA, Cardona Cumaco YA, Rojas-Bernal LA, Zabaleta-Orozco MA, Parra MA. Prevalence of Mild Cognitive Impairment in Southern Regions of Colombia. J Alzheimers Dis Rep 2023; 7:1455-1464. [PMID: 38225967 PMCID: PMC10789289 DOI: 10.3233/adr-230041] [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: 06/03/2023] [Accepted: 11/26/2023] [Indexed: 01/17/2024] Open
Abstract
Background Recent reports suggest that by 2050 there will be an increase of around 310% of cases affected by dementia in Latin American countries. A previous study in a Southern region reported one of the highest prevalences of dementia in Latin America. Objective To investigate the prevalence of mild cognitive impairment associated with low education, rurality, and demographic characteristics. Methods A cross-sectional study recruited a community-dwelling sample of 823 adults from rural and urban areas of two Southern provinces of Colombia from 2020-2022. Participants were assessed with a neuropsychological protocol validated in Colombia. To obtain general and region-specific prevalence rates, age, sex, schooling, and socioeconomic level were considered and controlled for. Results Most of the participants reported low education and socioeconomic level, the participation of women was higher. It was determined that the prevalence of mild cognitive impairment (MCI) was 53.6%, with 56.6% in the province of Caquetá followed by 51.9% in the province of Huila. The amnestic MCI represented 42.6%, the amnestic multi-domain was 39%, the non-amnestic 16.55%, and the non-amnestic multi-domain 1.81%. Our participants reported comorbidities such as diabetes and hypertension. We also observed a relationship between exposure to pesticides and MCI. Conclusions We observed one of the highest prevalences of MCI in Latin America reported to date. Variables such as age, gender, and education proved risk factors for MCI in the explored regions. Our findings are very much in line with recent studies that highlight the influence of non-canonical risk factors of dementia in underrepresented countries from Latin America.
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Affiliation(s)
- Jasmin Bonilla-Santos
- Department of Psychology, Universidad Cooperativa de Colombia, Neiva, Colombia
- Neurocognition and Psychophysiology Laboratory, Universidad Surcolombiana, Neiva, Colombia
| | | | - Dorian Yisela Cala-Martínez
- Department of Psychology, Universidad Cooperativa de Colombia, Neiva, Colombia
- Neurocognition and Psychophysiology Laboratory, Universidad Surcolombiana, Neiva, Colombia
| | | | | | | | | | | | - Luz Angela Rojas-Bernal
- Instituto del cerebro, Hospital Universitario Mayor Méderi, Universidad del Rosario, Bogotá, Colombia
- Clinical Neuropsychology, Universidad Surcolombiana, Neiva, Colombia
| | | | - Mario Alfredo Parra
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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Zegarra-Valdivia JA, Aguzzoli-Peres F, Kornhuber A, Arshad F, Paredes-Manrique CN. One step beyond the lab and clinic: "walking the dementia conversation". Front Public Health 2023; 11:1284692. [PMID: 38145063 PMCID: PMC10748414 DOI: 10.3389/fpubh.2023.1284692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/23/2023] [Indexed: 12/26/2023] Open
Abstract
Millions of dollars have been lost in dementia research over the last 30 years owing to unsuccessful clinical trials aimed at finding an effective treatment for the condition. Although two promising drugs have been identified, the research effort is insufficient. The dehumanization of patients and the pressure to publish have led to a decline in the quality and usefulness of scientific research. One way to tackle these problems is establishing close contact with those who put their faith in researchers. Fine-tuning the participation of patients with dementia and caregivers in research design and improving their connection and communication with researchers could positively contribute to enhancing the perspectives and designing strategies for scientists in order to generate a new and enriching vision. The Walking the Talk for Dementia event showed that people can still live with dementia despite their condition. Approximately 300 people participated in the all-week "Santiago's Camino" symposium. People living with dementia, caregivers, healthcare professionals, activists, clinicians, and researchers participated in this event. The "Walking the Talk for Dementia" (WTD) event vividly demonstrated a strong commitment to upholding Global Brain Health Institute's (GBHI) core values of Authenticity, Fairness, Openness, Respect, Courage, and Empathy (A FORCE) to advance equity in brain health. These values provide clear guidance for their advocacy initiatives aimed at mitigating the global impact of dementia. Research and development are essential across scientific fields, especially in clinical contexts where involving patients and caregivers is critical. The WTD initiative exemplifies this aspect by bringing together researchers, caregivers, and dementia patients on the Camino de Santiago in Spain.
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Affiliation(s)
- Jonathan Adrián Zegarra-Valdivia
- Global Brain Health Institute – University of California, San Francisco, San Francisco, CA, United States
- Trinity College Dublin, Dublin, Ireland
- Faculty of Health Sciences, Universidad Señor de Sipán, Chiclayo, Peru
| | - Fernando Aguzzoli-Peres
- Global Brain Health Institute – University of California, San Francisco, San Francisco, CA, United States
- Trinity College Dublin, Dublin, Ireland
| | - Alex Kornhuber
- Global Brain Health Institute – University of California, San Francisco, San Francisco, CA, United States
- Trinity College Dublin, Dublin, Ireland
| | - Faheem Arshad
- Global Brain Health Institute – University of California, San Francisco, San Francisco, CA, United States
- Trinity College Dublin, Dublin, Ireland
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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10
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Muurling M, Au-Yeung WTM, Beattie Z, Wu CY, Dodge H, Rodrigues NK, Gothard S, Silbert LC, Barnes LL, Steele JS, Kaye J. Differences in Life Space Activity Patterns Between Older Adults With Mild Cognitive Impairment Living Alone or as a Couple: Cohort Study Using Passive Activity Sensing. JMIR Aging 2023; 6:e45876. [PMID: 37819694 PMCID: PMC10600648 DOI: 10.2196/45876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/18/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Measuring function with passive in-home sensors has the advantages of real-world, objective, continuous, and unobtrusive measurement. However, previous studies have focused on 1-person homes only, which limits their generalizability. OBJECTIVE This study aimed to compare the life space activity patterns of participants living alone with those of participants living as a couple and to compare people with mild cognitive impairment (MCI) with cognitively normal participants in both 1- and 2-person homes. METHODS Passive infrared motion sensors and door contact sensors were installed in 1- and 2-person homes with cognitively normal residents or residents with MCI. A home was classified as an MCI home if at least 1 person in the home had MCI. Time out of home (TOOH), independent life space activity (ILSA), and use of the living room, kitchen, bathroom, and bedroom were calculated. Data were analyzed using the following methods: (1) daily averages over 4 weeks, (2) hourly averages (time of day) over 4 weeks, or (3) longitudinal day-to-day changes. RESULTS In total, 129 homes with people living alone (n=27, 20.9%, MCI and n=102, 79.1%, no-MCI homes) and 52 homes with people living as a couple (n=24, 46.2%, MCI and n=28, 53.8%, no-MCI homes) were included with a mean follow-up of 719 (SD 308) days. Using all 3 analysis methods, we found that 2-person homes showed a shorter TOOH, a longer ILSA, and shorter living room and kitchen use. In MCI homes, ILSA was higher in 2-person homes but lower in 1-person homes. The effects of MCI status on other outcomes were only found when using the hourly averages or longitudinal day-to-day changes over time, and they depended on the household type (alone vs residing as a couple). CONCLUSIONS This study shows that in-home behavior is different when a participant is living alone compared to when they are living as a couple, meaning that the household type should be considered when studying in-home behavior. The effects of MCI status can be detected with in-home sensors, even in 2-person homes, but data should be analyzed on an hour-to-hour basis or longitudinally.
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Affiliation(s)
- Marijn Muurling
- Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC locatie VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience - Neurodegeneration, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Wan-Tai M Au-Yeung
- Oregon Center for Aging & Technology, Oregon Health & Science University, Portland, OR, United States
- Layton Aging & Alzheimer's Disease Research Center, Oregon Health & Science University, Portland, OR, United States
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
| | - Zachary Beattie
- Oregon Center for Aging & Technology, Oregon Health & Science University, Portland, OR, United States
- Layton Aging & Alzheimer's Disease Research Center, Oregon Health & Science University, Portland, OR, United States
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
| | - Chao-Yi Wu
- Oregon Center for Aging & Technology, Oregon Health & Science University, Portland, OR, United States
- Layton Aging & Alzheimer's Disease Research Center, Oregon Health & Science University, Portland, OR, United States
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Hiroko Dodge
- Oregon Center for Aging & Technology, Oregon Health & Science University, Portland, OR, United States
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Nathaniel K Rodrigues
- Oregon Center for Aging & Technology, Oregon Health & Science University, Portland, OR, United States
- Layton Aging & Alzheimer's Disease Research Center, Oregon Health & Science University, Portland, OR, United States
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
| | - Sarah Gothard
- Oregon Center for Aging & Technology, Oregon Health & Science University, Portland, OR, United States
- Layton Aging & Alzheimer's Disease Research Center, Oregon Health & Science University, Portland, OR, United States
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
| | - Lisa C Silbert
- Oregon Center for Aging & Technology, Oregon Health & Science University, Portland, OR, United States
- Layton Aging & Alzheimer's Disease Research Center, Oregon Health & Science University, Portland, OR, United States
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
- Department of Neurology, Portland Veterans Affairs Medical Center, Portland, OR, United States
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - Joel S Steele
- Oregon Center for Aging & Technology, Oregon Health & Science University, Portland, OR, United States
- Layton Aging & Alzheimer's Disease Research Center, Oregon Health & Science University, Portland, OR, United States
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
- Indigenous Health Department, University of North Dakota, Grand Forks, ND, United States
| | - Jeffrey Kaye
- Oregon Center for Aging & Technology, Oregon Health & Science University, Portland, OR, United States
- Layton Aging & Alzheimer's Disease Research Center, Oregon Health & Science University, Portland, OR, United States
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
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11
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Chakrabarty M, Klooster N, Biswas A, Chatterjee A. The scope of using pragmatic language tests for early detection of dementia: A systematic review of investigations using figurative language. Alzheimers Dement 2023; 19:4705-4728. [PMID: 37534671 DOI: 10.1002/alz.13369] [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: 01/06/2023] [Revised: 06/02/2023] [Accepted: 06/02/2023] [Indexed: 08/04/2023]
Abstract
INTRODUCTION Dementia cases are expected to rise to 81.1 million in 2040. Efforts are underway to develop diagnostic methods to facilitate early detection of the disease. Herein we review research findings focusing on pragmatic dysfunction in patients with dementia and evaluate the usefulness of assessing dementia and its progress with a battery of tests assessing figurative language skills. METHODS A total of 74,778 article titles were identified from EMBASE, PubMed, and Google Scholar databases. After systematic screening, 51 journal articles were selected for the final review. RESULT The review suggests that impaired figurative language might be a marker for early cognitive decline. Different forms of figurative language may be impaired at different stages of the disease and in different types of dementia involving different neuropathologies. CONCLUSION The use of pragmatic tests in combination with the existing diagnostic protocols might increase the probability of early diagnosis. HIGHLIGHTS Pragmatic impairment could be a marker of early cognitive impairment. Figurative language-an important pragmatic aspect-is disrupted in mild cognitive impairment (MCI) and early Alzheimer's disease (AD). Figurative language impairment might precede literal language impairment. Pragmatic tests could be more sensitive than standard neuropsychological tests. Inclusion of pragmatic tests in diagnostic guidelines might bolster early detection.
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Affiliation(s)
- Madhushree Chakrabarty
- Department of Neurology, Institute of Post Graduate Medical Education & Research and Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Nathaniel Klooster
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania, USA
- Hope College, Holland, Michigan, USA
| | - Atanu Biswas
- Department of Neurology, Institute of Post Graduate Medical Education & Research and Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Anjan Chatterjee
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania, USA
- Penn Center for Neuroaesthetics, University of Pennsylvania, Goddard Laboratories, Philadelphia, Pennsylvania, USA
- Penn Memory Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Reeves SM, Williams V, Blacker D, Woods RL. Further evaluation of narrative description as a measure of cognitive function in Alzheimer's disease. Neuropsychology 2023; 37:801-812. [PMID: 36548079 PMCID: PMC10448628 DOI: 10.1037/neu0000884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVE The narrative description (ND) test objectively measures the ability to understand and describe visual scenes. As subtle differences in speech occur early in cognitive decline, we analyzed linguistic features for their utility in detecting cognitive impairment and predicting downstream decline. METHOD Participants (n = 52) with normal cognition to mild dementia performed the ND test (watched twenty 30-s video clips and described the visual content). Cognitive function was followed for up to 5 years. We computed simple linguistic features such as content efficiency, speech rate, and part of speech and unique word counts. We examined (a) relationships between cognitive status and ND score and linguistic features; (b) ability to discriminate early cognitive impairment from normal cognition using ND score and linguistic features; and (c) whether ND score and linguistic features were associated with future cognitive functional decline. RESULTS Many of the linguistic-feature metrics were related to cognitive status. Many of the linguistic features could distinguish between the cognitively normal group and the mild cognitive impairment (MCI) and Dementia groups. The area under the curve (AUC) for ND score alone was 0.74, with a nonsignificant increase to 0.78 when adding mean word length. Among participants with subjective cognitive decline (SCD) at the first visit, a smaller number of words plus more interjections or a lower ND score at baseline were predictive of future cognitive decline. CONCLUSIONS While many linguistic features were associated with cognitive status, and some were able to detect early cognitive impairment or predictive of future cognitive decline, all the features we tested seem to have been captured by the ND score. Thus, adding linguistic measures to the ND test score did not add to its value in assessing current or predicting future cognitive status. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Stephanie M Reeves
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Victoria Williams
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Deborah Blacker
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Russell L Woods
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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13
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Asher S, Suominen AL, Stephen R, Ngandu T, Koskinen S, Solomon A. Association of tooth count with cognitive decline and dementia in the Finnish adult population. J Clin Periodontol 2023; 50:1154-1166. [PMID: 37461219 DOI: 10.1111/jcpe.13851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/16/2023] [Accepted: 06/29/2023] [Indexed: 08/18/2023]
Abstract
AIM To evaluate whether tooth loss is associated with cognitive decline and incident dementia. MATERIALS AND METHODS We analysed data from the Finnish population-based Health 2000 and follow-up Health 2011 surveys (participants aged ≥30 years and without dementia at baseline; N = 5506 at baseline and 3426 at 11-year follow-up). Dementia diagnoses until 2015 were ascertained from national registers (N = 5542). Tooth count was dichotomized as adequate (≥20) versus tooth loss (<20). Tooth loss was further stratified into 10-19 teeth, 1-9 teeth and edentulism. Upper and lower jaws were also considered separately. Baseline cognitive test scores were dichotomized by median as high versus low, and 11-year change as decline versus no decline. RESULTS Tooth loss (<20) was associated with lower baseline overall cognition (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.03-1.43), 11-year cognitive decline (OR = 1.30, 95% CI = 1.05-1.70) and higher 15-year dementia risk (hazard ratio = 1.52, 95% CI = 1.15-2.02) after adjusting for multiple confounders. After adjustment for dentures, associations became non-significant, except for 10-19 teeth remaining and dementia. Results were similar after considering reverse causality bias; however, 10-19 teeth remaining was significantly associated with 11-year cognitive decline even after adjustment for dentures. No jaw-specific differences were observed. CONCLUSIONS Tooth loss adversely impacts the risk of cognitive decline and dementia. The role of dentures should be further explored.
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Affiliation(s)
- Sam Asher
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral Health Teaching Clinic, Kuopio University Hospital, Kuopio, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ruth Stephen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Stockholm, Sweden
| | - Tiia Ngandu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Stockholm, Sweden
| | - Seppo Koskinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Alina Solomon
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Stockholm, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
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14
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Muwanguzi M, Obua C, Maling S, Wong W, Owokuhaisa J, Wakida EK. Barriers and facilitators to cognitive impairment screening among older adults with diabetes mellitus and hypertension by primary healthcare providers in rural Uganda. FRONTIERS IN HEALTH SERVICES 2023; 3:1172943. [PMID: 37323226 PMCID: PMC10266276 DOI: 10.3389/frhs.2023.1172943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/12/2023] [Indexed: 06/17/2023]
Abstract
Background The burden of non-communicable diseases and cognitive impairment exhibit a linear rise in sub-Saharan Africa due to the increase in life expectancy. Non-communicable diseases like diabetes mellitus and hypertension increase the risk for cognitive impairment. To improve our understanding of the underpinnings of the cognitive impairment screening, this study explored the barriers and facilitators of routine cognitive impairment screening in a primary healthcare setting guided by the Capacity, Opportunity, Motivation Behavioral change (COM-B) model. Methods This was a descriptive qualitative study with primary healthcare providers who provide care to older adults with diabetes mellitus and hypertension at three primary healthcare centers in Mbarara district southwestern Uganda. In-depth interviews were conducted using a semi structured interview guide. Interviews were audio-recorded, transcribed verbatim, and analyzed using the framework approach along the COM-B components. Each COM-B component factors were categorized as barriers and facilitators. Results We conducted 20 in-depth interviews with clinical officers, enrolled nurses, and a psychiatric nurse. The questions were guided by the Capacity, Opportunity and Motivation Behavioral change (COM-B) framework to identify barriers and facilitators to cognitive impairment screening. The factors that negatively affected the screening were considered as barriers, while the positive as facilitators. Capacity related barriers to cognitive impairment screening included chronic understaffing, primary healthcare provider non-involvement, lack of training/skills, lack of knowledge and awareness in screening, absence of caretakers, lack of patient awareness of cognitive problems; while facilitators were staff recruitment, primary healthcare provider involvement, and specialized training. Opportunity related barriers to screening included patient overload, infrastructure shortage, and time constraints. Motivation related barriers included lack of screening guidance and policy, while the facilitators were availability of mentorship programs for primary healthcare providers. Conclusions Integrating cognitive impairment screening in primary health care requires engagement of relevant stakeholders with the focus on addressing implementation challenges through capacity development. Timely cognitive impairment screening at the first point of care initiates a cascade of interventions for timely enrollment into care, thus arresting the progress of cognitive impairment that leads to dementia.
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Affiliation(s)
- Moses Muwanguzi
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Celestino Obua
- Department of Pharmacology and Therapeutics, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Samuel Maling
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Wilson Wong
- Department of Medical Education, California University of Science and Medicine, Colton, CA, United States
| | - Judith Owokuhaisa
- Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Edith K. Wakida
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Medical Education, California University of Science and Medicine, Colton, CA, United States
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15
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Abey-Nesbit R, Jamieson HA, Bergler HU, Kerse N, Pickering JW, Teh R. Chronic health conditions and mortality among older adults with complex care needs in Aotearoa New Zealand. BMC Geriatr 2023; 23:318. [PMID: 37217895 DOI: 10.1186/s12877-023-03961-8] [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: 11/16/2022] [Accepted: 04/08/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Older people have more comorbidities than younger groups and multimorbidity will increase. Often chronic conditions affect quality of life, functional ability and social participation. Our study aim was to quantify the prevalence of chronic conditions over a three-year period and their association with mortality after accounting for demographics. METHODS We conducted a retrospective cohort study using routinely collected health data including community-dwelling older adults in New Zealand who had an interRAI Home Care assessment between 1 January 2017 and 31 December 2017. Descriptive statistics and differences between variables of interest among ethnic groups were reported. Cumulative density plots of mortality were developed. Logistic regression models adjusted for age and sex to estimate mortality were created independently for each combination of ethnicity and disease diagnosis. RESULTS The study cohort consisted of 31,704 people with a mean (SD) age of 82.3 years (8.0), and of whom 18,997 (59.9%) were female. Participants were followed for a median 1.1 (range 0 to 3) years. By the end of the follow-up period 15,678 (49.5%) people had died. Nearly 62% of Māori and Pacific older adults and 57% of other ethnicities had cognitive impairment. Diabetes the next most prevalent amongst Māori and Pacific peoples, and coronary heart disease amongst Non-Māori/Non-Pacific individuals. Of the 5,184 (16.3%) who had congestive heart failure (CHF), 3,450 (66.6%) died. This was the highest mortality rate of any of the diseases. There was a decrease in mortality rate with age for both sexes and all ethnicities for those with cancer. CONCLUSIONS Cognitive impairment was the most common condition in community dwelling older adults who had an interRAI assessment. Cardiovascular disease (CVD) has the highest mortality risk for all ethnic groups, and in non-Māori/non-Pacific group of advanced age, risk of mortality with cognitive impairment is as high as CVD risk. We observed an inverse for cancer mortality risk with age. Important differences between ethnic groups are reported.
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Affiliation(s)
| | - Hamish A Jamieson
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | | | - Ngaire Kerse
- Department of General Practice and Primary Health Care, University of Auckland, M&HS Building 507 - Bldg 507, 28 Park Ave, Grafton, 1850, 1023, Auckland, New Zealand
| | - John W Pickering
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Ruth Teh
- Department of General Practice and Primary Health Care, University of Auckland, M&HS Building 507 - Bldg 507, 28 Park Ave, Grafton, 1850, 1023, Auckland, New Zealand.
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Carter C, James T, Higgs P, Cooper C, Rapaport P. Understanding the subjective experiences of memory concern and MCI diagnosis: A scoping review. DEMENTIA 2023; 22:439-474. [PMID: 36574609 PMCID: PMC9841475 DOI: 10.1177/14713012221147710] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Many older people experience memory concerns; a minority receive a diagnosis of Mild Cognitive Impairment (MCI) or Subjective Cognitive decline (SCD). There are concerns that medicalisation of MCI and memory concern may fail to acknowledge subjective experiences. AIM We explore the meaning individuals give to their memory concerns, with or without a diagnosis of MCI and SCD. METHOD We scoped literature exploring subjective experiences of memory concern, with or without a diagnosis of MCI or SCD. We searched CINAHL, PsycINFO and MEDLINE in March 2020, and updated in Sept 2021.We used (Arksey & O'Malley, 2005) framework to guide our scoping review method and thematic analysis to analyse our findings. RESULTS We screened 12,033 search results reviewing the full texts of 92 papers. We included 24 papers, including a total of 453 participants, the majority of whom were female, from White ethnic majority populations (or from studies where ethnicity was not identified) with high levels of education. In 15 out of 24 studies, 272 participants were diagnosed with MCI. We identified two themes; Making a diagnosis personal and Remembering not to forget. We found that subjective experiences include normative comparison with others of the same age and responses including fear, relief, and acceptance, but culminating in uncertainty. CONCLUSION Drawing upon sociology, we highlight the subjective experiences of living with memory concerns, SCD and an MCI diagnosis. We identify a gap between the intended purpose of diagnostic labels to bring understanding and certainty and the lived experiences of those ascribed them.
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Affiliation(s)
- Christine Carter
- Christine Carter, Division of Psychiatry,
University College London, Maple House, 149 Tottenham Court Road, Bloomsbury,
London W1T7NF, UK.
| | - Tiffeny James
- Division of Psychiatry, 4919University College London, London, UK
| | - Paul Higgs
- Division of Psychiatry, 4919University College London, London, UK
| | - Claudia Cooper
- Division of Psychiatry, 4919University College London, London, UK
| | - Penny Rapaport
- Division of Psychiatry, 4919University College London, London, UK
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Yu K, Wild K, Dowling NM, Kaye JA, Silbert LC, Dodge HH. Emotional characteristics of socially isolated older adults with MCI using tablet administered NIH toolbox: I-CONECT study. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12372. [PMID: 36381558 PMCID: PMC9652485 DOI: 10.1002/dad2.12372] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 11/15/2022]
Abstract
Introduction Examining the emotional functioning of individuals with mild cognitive impairment (MCI) could help describe their cognitive status and inform the development of interventions. This study compared the emotional characteristics of socially isolated older adults with and without MCI. Methods We used baseline data from the Internet-based Conversational Engagement Clinical Trial. Emotional characteristics were assessed with the National Institutes of Health Toolbox Emotion Battery (NIHTB-EB). MCI status was determined with a consensus clinical diagnosis. Results This study included 163 participants (mean age = 81.2 years, non-Hispanic Black = 20.7%, MCI = 52.8%). MCI was associated with higher negative affect and lower psychological well-being. Non-Hispanic Black participants scored lower in sadness, higher in positive affect, and higher in meaning and purpose than non-Hispanic White participants. Conclusion Older adults with MCI experience more negative emotions and worse psychological well-being than those with normal cognition. The NIHTB-EB appears to be a sensitive tool to detect emotional characteristics associated with cognitive decline.
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Affiliation(s)
- Kexin Yu
- NIA‐Layton Aging and Alzheimer's Disease CenterOregon Center for Aging & TechnologyDepartment of NeurologyOregon Health & Science UniversityPortlandOregonUSA
| | - Katherine Wild
- NIA‐Layton Aging and Alzheimer's Disease CenterOregon Center for Aging & TechnologyDepartment of NeurologyOregon Health & Science UniversityPortlandOregonUSA
| | - N. Maritza Dowling
- Department of Acute and Chronic CareSchool of Nursingand Department of Epidemiology & BiostatisticsMilken Institute of Public HealthGeorge Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Jeffrey A. Kaye
- NIA‐Layton Aging and Alzheimer's Disease CenterOregon Center for Aging & TechnologyDepartment of NeurologyOregon Health & Science UniversityPortlandOregonUSA
- Portland Veterans Affairs Health Care SystemPortlandOregonUSA
| | - Lisa C. Silbert
- NIA‐Layton Aging and Alzheimer's Disease CenterOregon Center for Aging & TechnologyDepartment of NeurologyOregon Health & Science UniversityPortlandOregonUSA
- Portland Veterans Affairs Health Care SystemPortlandOregonUSA
| | - Hiroko H. Dodge
- NIA‐Layton Aging and Alzheimer's Disease CenterOregon Center for Aging & TechnologyDepartment of NeurologyOregon Health & Science UniversityPortlandOregonUSA
- Department of NeurologyHarvard Medical SchoolMassachusetts General HospitalBostonMassachusettsUSA
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Chernii TV, Cherniy VI, Fokina DО. IMPLEMENTATION OF QUANTITATIVE ELECTROENCEPHALOGRAPHY TO IMPROVE EFFICACY OF DIAGNOSIS AND TREATMENT MANAGEMENT OF CHRONIC CEREBRAL ISCHEMIA. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:2565-2568. [PMID: 36591732 DOI: 10.36740/wlek202211101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The aim: To improve the effectiveness of diagnosis and treatment of chronic cerebral ischemia through the use of quantitative electroencephalography in civil servants on the outpatient and hospital stage. PATIENTS AND METHODS Materials and methods: A total of 150 patients (59 males and 91 females) aged from 40 to 69 years were examined. The patients were divided into three groups statistically correlated with the main disease - chronic cerebral ischemia (CCI), degree of severity - CCI level 2, age and statistical status. Registration of brain biopotentials was performed using a computerized electroencephalograph of «TredexExpert» series. The total spectral power capacity - ASP (μV/√Hz), relative power capacity - RSP (%) were studied in the investigated frequency ranges. RESULTS Results: The study of three groups of patients with CCI of different genesis, an increase in ASP of all studied ranges, but of varying degrees of severity, was found: first, delta and theta ranges, then beta ranges, and finally, to a lesser extent, ASP of the alpha1 range and alphaS range. Therefore, the RSP of alpha1- and alphaS-bands significantly decreased in all studied groups. CONCLUSION Conclusions: 1. In all studied groups, the relative spectral power of the alpha 1 and alphaS bands decreased significantly. An increase in the relative spectral power of the beta-frequency rhythm in all leads was established. 2. The identified neurophysiological differences in the formation and course of dyscirculatory encephalopathy of various genesis are used to monitor the effectiveness of treatment of chronic brain ischemia.
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Affiliation(s)
- Tatiana V Chernii
- STATE INSTITUTION OF SCIENCE «RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE» STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE
| | - Volodymyr I Cherniy
- STATE INSTITUTION OF SCIENCE «RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE» STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE
| | - Daria О Fokina
- STATE INSTITUTION OF SCIENCE «RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE» STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE
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Asher S, Stephen R, Mäntylä P, Suominen AL, Solomon A. Periodontal health, cognitive decline, and dementia: A systematic review and meta-analysis of longitudinal studies. J Am Geriatr Soc 2022; 70:2695-2709. [PMID: 36073186 PMCID: PMC9826143 DOI: 10.1111/jgs.17978] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 06/22/2022] [Accepted: 06/25/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Emerging evidence indicates that poor periodontal health adversely impacts cognition. This review examined the available longitudinal evidence concerning the effect of poor periodontal health on cognitive decline and dementia. METHODS Comprehensive literature search was conducted on five electronic databases for relevant studies published until April 2022. Longitudinal studies having periodontal health as exposure and cognitive decline and/or dementia as outcomes were considered. Random effects pooled estimates and 95% confidence intervals were generated (pooled odds ratio for cognitive decline and hazards ratio for dementia) to assess whether poor periodontal health increases the risk of cognitive decline and dementia. Heterogeneity between studies was estimated by I2 and the quality of available evidence was assessed through quality assessment criteria. RESULTS Adopted search strategy produced 2132 studies for cognitive decline and 2023 for dementia, from which 47 studies (24 for cognitive decline and 23 for dementia) were included in this review. Poor periodontal health (reflected by having periodontitis, tooth loss, deep periodontal pockets, or alveolar bone loss) was associated with both cognitive decline (OR = 1.23; 1.05-1.44) and dementia (HR = 1.21; 1.07-1.38). Further analysis, based on measures of periodontal assessment, found tooth loss to independently increase the risk of both cognitive decline (OR = 1.23; 1.09-1.39) and dementia (HR = 1.13; 1.04-1.23). Stratified analysis based on the extent of tooth loss indicated partial tooth loss to be important for cognitive decline (OR = 1.50; 1.02-2.23) and complete tooth loss for dementia (HR = 1.23; 1.05-1.45). However, the overall quality of evidence was low, and associations were at least partly due to reverse causality. CONCLUSIONS Poor periodontal health and tooth loss appear to increase the risk of both cognitive decline and dementia. However, the available evidence is limited (e.g., highly heterogenous, lacking robust methodology) to draw firm conclusions. Further well-designed studies involving standardized periodontal and cognitive health assessment and addressing reverse causality are highly warranted.
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Affiliation(s)
- Sam Asher
- Institute of DentistryUniversity of Eastern FinlandKuopioFinland
| | - Ruth Stephen
- Neurology, Institute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
| | - Päivi Mäntylä
- Institute of DentistryUniversity of Eastern FinlandKuopioFinland
- Department of Oral and Maxillofacial DiseasesKuopio University HospitalKuopioFinland
| | - Anna Liisa Suominen
- Institute of DentistryUniversity of Eastern FinlandKuopioFinland
- Department of Oral and Maxillofacial DiseasesKuopio University HospitalKuopioFinland
| | - Alina Solomon
- Neurology, Institute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
- Division of Clinical Geriatrics, NVSKarolinska InstituteStockholmSweden
- Aging Epidemiology Research Unit, School of Public HealthImperial College LondonLondonUK
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Williamson J, Yabluchanskiy A, Mukli P, Wu DH, Sonntag W, Ciro C, Yang Y. Sex differences in brain functional connectivity of hippocampus in mild cognitive impairment. Front Aging Neurosci 2022; 14:959394. [PMID: 36034134 PMCID: PMC9399646 DOI: 10.3389/fnagi.2022.959394] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
Mild cognitive impairment (MCI) is the prodromal stage of Alzheimer's Disease (AD). Prior research shows that females are more impacted by MCI than males. On average females have a greater incidence rate of any dementia and current evidence suggests that they suffer greater cognitive deterioration than males in the same disease stage. Recent research has linked these sex differences to neuroimaging markers of brain pathology, such as hippocampal volumes. Specifically, the rate of hippocampal atrophy affects the progression of AD in females more than males. This study was designed to extend our understanding of the sex-related differences in the brain of participants with MCI. Specifically, we investigated the difference in the hippocampal connectivity to different areas of the brain. The Resting State fMRI and T2 MRI of cognitively normal individuals (n = 40, female = 20) and individuals with MCI (n = 40, female = 20) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) were analyzed using the Functional Connectivity Toolbox (CONN). Our results demonstrate that connectivity of hippocampus to the precuneus cortex and brain stem was significantly stronger in males than in females. These results improve our current understanding of the role of hippocampus-precuneus cortex and hippocampus-brainstem connectivity in sex differences in MCI. Understanding the contribution of impaired functional connectivity sex differences may aid in the development of sex specific precision medicine to manipulate hippocampal-precuneus cortex and hippocampal-brainstem connectivity to decrease the progression of MCI to AD.
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Affiliation(s)
- Jordan Williamson
- Neural Control and Rehabilitation Laboratory, Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, United States
| | - Andriy Yabluchanskiy
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Peter Mukli
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Dee H. Wu
- Department of Radiological Science and Medical Physics, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
- Data Institute for Societal Challenges, University of Oklahoma, Norman, OK, United States
- School of Computer Science, Gallogly College of Engineering, University of Oklahoma, Norman, OK, United States
- School of Electrical and Computer Engineering, Gallogly College of Engineering, University of Oklahoma, Norman, OK, United States
| | - William Sonntag
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Carrie Ciro
- Department of Rehabilitation Sciences, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Yuan Yang
- Neural Control and Rehabilitation Laboratory, Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, United States
- Data Institute for Societal Challenges, University of Oklahoma, Norman, OK, United States
- Department of Rehabilitation Sciences, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
- School of Electrical and Computer Engineering, University of Oklahoma, Tulsa, OK, United States
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
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Yamamoto K, Shiota S, Yoshiiwa A, Chishima T, Takigami S, Miyazaki E. Cognitive Function and Olfactory Impairment in Community-Dwelling Older Adults Attending a Salon. J Prim Care Community Health 2022; 13:21501319221117793. [PMID: 35950638 PMCID: PMC9380213 DOI: 10.1177/21501319221117793] [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] [Indexed: 11/16/2022] Open
Abstract
Background: Early detection, treatment, and care are important for the prevention of
dementia. Though olfactory impairment has been reported to be associated
with mild cognitive impairment (MCI), there are few reports involving
community-dwelling older adults with no difficulty in daily life in
Japan. Objective: This study aimed to identify the frequency of MCI in community-dwelling
elderly people attending community salons in a city with a high aging
population, and to determine the usefulness of a pocket olfactory
discrimination test. Methods: We recruited 268 independent older adults attending community salons. The
Japanese version of the MCI Screen was used to evaluate cognitive function,
defining MCI as <49.8 out of 100 scores of the memory performance index
(MPI). The Japanese version of the University of Pennsylvania Smell
Identification Test (UPSIT-J) was used for olfactory discrimination and the
number of correct answers out of 4 questions was noted. Results: Of the salon participants, 138 (51.5%) were classified as having MCI. As the
number of correct answers on the olfactory test decreased, the percentage of
participants with MCI increased. The MPI score of the low UPSIT score group
was significantly lower than that of the high UPSIT score group. Conclusions: This study revealed that approximately half of the elderly local residents
living without daily problems were suspected of having MCI. The UPSIT-J-4 is
a simple olfactory identification test, and can be used at any time and any
place. It is useful for screening cognitive function via olfactory
identification in a salon-like setting.
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Affiliation(s)
- Kyoko Yamamoto
- Oita University Faculty of Medicine, Yufu-shi, Oita, Japan
| | - Seiji Shiota
- Oita University Faculty of Medicine, Yufu-shi, Oita, Japan
| | - Aoi Yoshiiwa
- Oita University Faculty of Medicine, Yufu-shi, Oita, Japan
| | | | | | - Eishi Miyazaki
- Oita University Faculty of Medicine, Yufu-shi, Oita, Japan
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