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Jin L, Zhao Y, Ye T, He Y, Yao L. Cognitive and emotional impairment in stroke survivors: insights from a multi-center study on inpatient rehabilitation therapy. Brain Inj 2024; 38:630-636. [PMID: 38528739 DOI: 10.1080/02699052.2024.2333398] [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: 04/24/2023] [Accepted: 03/18/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Individuals recovering from stroke often experience cognitive and emotional impairments, but rehab programs tend to focus on motor skills. The aim of this investigation is to systematically assess the change of magnitude of cognitive and emotional function subsequent to a conventional rehabilitative protocol administered to stroke survivors within a defined locale in China. METHODS This is a multicenter study; a total of 1884 stroke survivors who received in-hospital rehabilitation therapy were assessed on admission (T0) and discharge (T1). The tool of InterRAI was used to assess cognitive, emotional, and behavioral abnormality. RESULTS The patients aged >60 years, with a history of hypertension, and long stroke onset duration were more exposed to functional impairment (all p < 0.05). Both cognitive and emotional sections were significantly improved at T1 compared to T0 (p < 0.001). Initially, 64.97% and 46.55% of patients had cognitive or emotional impairment at T0, respectively; this percentage was 58.55% and 37.15% at T1. CONCLUSION Many stroke survivors have ongoing cognitive and emotional problems that require attention. It is essential to focus on rehabilitating these areas during the hospital stay, especially for older patients, those with a longer recovery, and those with hypertension history.
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Affiliation(s)
- Lihua Jin
- Department of Rehabilitation Medicine, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Ying Zhao
- Department of Rehabilitation Medicine, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Ting Ye
- Department of Rehabilitation Medicine, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Ying He
- Department of Rehabilitation Medicine, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Liqing Yao
- Department of Rehabilitation Medicine, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
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2
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Chen CYA, Chiu CC, Huang CY, Cheng YC, Huang MC, Kuo PH, Chen WY. Cluster analysis dissecting cognitive deficits in older adults with major depressive disorder and the association with neurofilament light chain. BMC Geriatr 2024; 24:344. [PMID: 38627748 PMCID: PMC11020442 DOI: 10.1186/s12877-024-04960-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: 08/30/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Cognitive impairment is a growing problem with increasing burden in global aging. Older adults with major depressive disorder (MDD) have higher risk of dementia. Neurofilament light chain (NfL) has been proven as a potential biomarker in neurodegenerative disease, including dementia. We aimed to investigate the association between cognitive deficits and NfL levels in older adults with MDD. METHODS In this cross-sectional study, we enrolled 39 MDD patients and 15 individuals with mild neurocognitive disorder or major neurocognitive disorder, Alzheimer's type, as controls, from a tertiary psychiatric hospital. Both groups were over age 65 and with matched Mini-Mental State Examination (MMSE) score. Demographic data, clinical variables, and plasma NfL levels were obtained. We used cluster analysis according to their cognitive profile and estimated the correlation between plasma NfL levels and each cognitive domain. RESULTS In the MDD group, participants had higher rate of family psychiatry history and current alcohol use habit compared with controls. Control group of neurocognitive disorders showed significantly lower score in total MMSE and higher plasma NfL levels. Part of the MDD patients presented cognitive deficits clustered with that of neurocognitive disorders (cluster A). In cluster A, the total MMSE score (r=-0.58277, p=0.0287) and the comprehension domain (r=-0.71717, p=0.0039) were negatively correlated to NfL levels after adjusting for age, while the associations had not been observed in the other cluster. CONCLUSIONS We noted the negative correlation between NfL levels and cognition in MDD patients clustered with neurodegenerative disorder, Alzheimer's type. NfL could be a promising candidate as a biomarker to predict subtype of patients in MDD to develop cognitive decline. Further longitudinal studies and within MDD cluster analysis are required to validate our findings for clinical implications.
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Affiliation(s)
- Cynthia Yi-An Chen
- Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chih-Chiang Chiu
- Department of Psychiatry, Taipei City Psychiatric Center, Songde branch, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cho-Yin Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Songde branch, Taipei City Hospital, Taipei, Taiwan
| | - Ying-Chih Cheng
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
| | - Ming-Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Songde branch, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wen-Yin Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Songde branch, Taipei City Hospital, Taipei, Taiwan.
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan.
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3
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Park JY, Choi SA, Kim JJ, Park YJ, Kim CK, Cho GJ, Koh SB, Kang SH. Effect of Tablet-based Cognitive Intervention on Cognition in Patients With Mild Cognitive Impairment: A Pilot Study. Dement Neurocogn Disord 2023; 22:130-138. [PMID: 38025410 PMCID: PMC10654482 DOI: 10.12779/dnd.2023.22.4.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/17/2023] [Accepted: 09/05/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Purpose Growing evidence has shown that cognitive interventions can mitigate cognitive decline in patients with mild cognitive impairment (MCI). However, most previous cognitive interventions have been group-based programs. Due to their intrinsic limitations, group-based programs are not widely used in clinical practice. Therefore, we have developed a tablet-based cognitive intervention program. This preliminary study investigated the feasibility and effects of a 12-week structured tablet-based program on cognitive function in patients with MCI. Methods We performed a single-arm study on 24 patients with MCI. The participants underwent a tablet-based cognitive intervention program 5 times a week over a 12-week period. The primary outcome was changes in cognitive function, measured using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). Outcomes were evaluated at baseline, within two weeks of the last program (post-intervention), and at the six-month follow-up session. Results The completion rate of the tablet-based program was 83.3% in patients with MCI. The program improved cognitive function based on the CERAD-K total score (p=0.026), which was maintained for at least three months (p=0.004). There was also an improvement in the depression scale score (p=0.002), which persisted for three months (p=0.027). Conclusions Our 12-week structured tablet-based program is feasible for patients with MCI. Furthermore, although further studies with a double-arm design are required, the program appears to be an effective strategy to prevent cognitive decline in patients with MCI.
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Affiliation(s)
| | | | | | - Yu Jeong Park
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chi Kyung Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sung Hoon Kang
- Geumcheon Center for Dementia, Seoul, Korea
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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4
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Liu P, Song S, Yang P, Rao X, Wang Y, Bai X. Aucubin improves chronic unpredictable mild stress-induced depressive behavior in mice via the GR/NF-κB/NLRP3 axis. Int Immunopharmacol 2023; 123:110677. [PMID: 37523973 DOI: 10.1016/j.intimp.2023.110677] [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: 02/27/2023] [Revised: 06/21/2023] [Accepted: 07/18/2023] [Indexed: 08/02/2023]
Abstract
Eucommia ulmoides Oliv (EUO) is a traditional therapeutic drug that tonifies the liver and kidney and may improve depression. However, the mechanism of action of the main component, aucubin (AU), is unknown. To study the therapeutic effect of AU, we constructed a chronic unpredictable mild stress (CUMS) depression model in mice. Depression-like behaviors, pathological damage, hormonal changes, inflammation, intranuclear expression of glucocorticoidreceptor (GR), and hippocampal protein expression were assessed. Immunofluorescence staining of the hippocampus showed that CUMS decreased neuronal regeneration, and axons were observed to be reduced and broken. Intracellular GR expression decreased in the hippocampus and hypothalamus, and serum levels of stress hormones increased. Furthermore, molecular changes indicative of pyroptosis were observed. AU administration reversed these changes and significantly improved the depression-like behavior induced by CUMS. Our results suggested that AU improves depression by promoting the intranuclear expression of GR and inhibiting nuclear factor-kappa B-mediated inflammatory activation-driven cell pyroptosis.
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Affiliation(s)
- Ping Liu
- Department of Clinical Pharmacy, Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi 563000, China; Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563000, China.
| | - Shiyuan Song
- Department of Clinical Pharmacy, Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi 563000, China.
| | - Ping Yang
- Department of Clinical Pharmacy, Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi 563000, China.
| | - Xiuming Rao
- Department of Clinical Pharmacy, Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi 563000, China.
| | - Yuqi Wang
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563000, China.
| | - Xinyu Bai
- Department of Clinical Pharmacy, Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi 563000, China; Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563000, China.
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5
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Munesue Y, Ageyama N, Kimura N, Takahashi I, Nakayama S, Okabayashi S, Katakai Y, Koie H, Yagami KI, Ishii K, Tamaoka A, Yasutomi Y, Shimozawa N. Cynomolgus macaque model of neuronal ceroid lipofuscinosis type 2 disease. Exp Neurol 2023; 363:114381. [PMID: 36918063 DOI: 10.1016/j.expneurol.2023.114381] [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: 07/04/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023]
Abstract
Neuronal ceroid lipofuscinoses (NCLs) are autosomal-recessive fatal neurodegenerative diseases that occur in children and young adults, with symptoms including ataxia, seizures and visual impairment. We report the discovery of cynomolgus macaques carrying the CLN2/TPP1 variant and our analysis of whether the macaques could be a new non-human primate model for NCL type 2 (CLN2) disease. Three cynomolgus macaques presented progressive neuronal clinical symptoms such as limb tremors and gait disturbance after about 2 years of age. Morphological analyses using brain MRI at the endpoint of approximately 3 years of age revealed marked cerebellar and cerebral atrophy of the gray matter, with sulcus dilation, gyrus thinning, and ventricular enlargement. Histopathological analyses of three affected macaques revealed severe neuronal loss and degeneration in the cerebellar and cerebral cortices, accompanied by glial activation and/or changes in axonal morphology. Neurons observed throughout the central nervous system contained autofluorescent cytoplasmic pigments, which were identified as ceroid-lipofuscin based on staining properties, and the cerebral cortex examined by transmission electron microscopy had curvilinear profiles, the typical ultrastructural pattern of CLN2. These findings are commonly observed in all forms of NCL. DNA sequencing analysis identified a homozygous single-base deletion (c.42delC) of the CLN2/TPP1 gene, resulting in a frameshifted premature stop codon. Immunohistochemical analysis showed that tissue from the affected macaques lacked a detectable signal against TPP1, the product of the CLN2/TPP1 gene. Analysis for transmission of the CLN2/TPP1 mutated gene revealed that 47 (49.5%) and 48 (50.5%) of the 95 individuals genotyped in the CLN2-affected macaque family were heterozygous carriers and homozygous wild-type individuals, respectively. Thus, we identified cynomolgus macaques as a non-human primate model of CLN2 disease. The CLN2 macaques reported here could become a useful resource for research and the development of drugs and methods for treating CLN2 disease, which involves severe symptoms in humans.
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Affiliation(s)
- Yoshiko Munesue
- Division of Clinical Medicine, Department of Neurology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Naohide Ageyama
- Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, 1-1 Hachimandai, Tsukuba, Ibaraki 305-0843, Japan
| | - Nobuyuki Kimura
- Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, 1-1 Hachimandai, Tsukuba, Ibaraki 305-0843, Japan; Department of Veterinary Associated Science, Faculty of Veterinary Medicine, Okayama University of Science, 1-3 Ikoinooka, Imabari, Ehime 794-8555, Japan
| | - Ichiro Takahashi
- Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, 1-1 Hachimandai, Tsukuba, Ibaraki 305-0843, Japan
| | - Shunya Nakayama
- Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, 1-1 Hachimandai, Tsukuba, Ibaraki 305-0843, Japan; Laboratory of Veterinary Physiology/Pathophysiology, Nihon University, College of Bioresource Science, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Sachi Okabayashi
- The Corporation for Production and Research of Laboratory Primates, 1-16-2 Sakura, Tsukuba, Ibaraki 305-0843, Japan
| | - Yuko Katakai
- The Corporation for Production and Research of Laboratory Primates, 1-16-2 Sakura, Tsukuba, Ibaraki 305-0843, Japan
| | - Hiroshi Koie
- Laboratory of Veterinary Physiology/Pathophysiology, Nihon University, College of Bioresource Science, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Ken-Ichi Yagami
- Laboratory Animal Resource Center, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Kazuhiro Ishii
- Division of Clinical Medicine, Department of Neurology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Akira Tamaoka
- Division of Clinical Medicine, Department of Neurology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Yasuhiro Yasutomi
- Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, 1-1 Hachimandai, Tsukuba, Ibaraki 305-0843, Japan; Department of Molecular and Experimental Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Nobuhiro Shimozawa
- Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, 1-1 Hachimandai, Tsukuba, Ibaraki 305-0843, Japan.
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Association of Qi-stagnation Constitution and Subjective Sleep Characteristics with Mild Cognitive Impairment among Elderly in Community: A Cross-Sectional Study. Eur J Integr Med 2023. [DOI: 10.1016/j.eujim.2023.102232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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7
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Jin B, Xv Y, Zhang B, Qiao L, Liu H. Comparative efficacy and acceptability of treatments for depressive symptoms in cognitive impairment: A systematic review and Bayesian network meta-analysis. Front Aging Neurosci 2022; 14:1037414. [PMID: 36578447 PMCID: PMC9790988 DOI: 10.3389/fnagi.2022.1037414] [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: 09/05/2022] [Accepted: 11/18/2022] [Indexed: 12/14/2022] Open
Abstract
Background Depressive symptoms play an essential role in cognition decline, while the benefit and acceptability of treatments for depressive symptoms in cognitive impairment are still unknown. Objective To comprehensively evaluate the comparative efficacy and acceptability of treatments for depressive symptoms in cognitive impairment based on the quantitative Bayesian network meta-analysis method (NMA). Method We searched MEDLINE, Embase, the Cochrane Library, CINAHL, and PsycINFO from inception until August 2022 to identify randomized clinical trials (RCTs) evaluating treatments for depressive symptoms in cognitive impairment. Efficacy was evaluated by the Cornell Scale for Depression in Dementia (CSDD), the Hamilton Depression Rating Scale (HDRS), and the Geriatric Depression Scale (GDS) for depression; the Neuropsychiatric Inventory (NPI) and the Cohen-Mansfeld Agitation Inventory (CMAI) for behavior; and the Mini-Mental State Examination (MMSE) for cognition. Safety was evaluated by total adverse events (AEs), serious AEs, diarrhea, headache, and nausea. Results In this study, 13,043 participants from 107 RCTs were included, involving 28 treatments and the discontinuation of antidepressants. On CSDD, aerobic exercise (MD -4.51, 95%CrI -8.60 to -0.37), aripiprazole (MD -1.85, 95%CrI -3.66 to -0.02), behavioral training (MD -1.14, 95%CrI -2.04 to -0.34), electrical current stimulation (MD -3.30, 95%CrI -5.94 to -0.73), massage (MD -12.67, 95%CrI -14.71 to -10.59), music therapy (MD -2.63, 95%CrI -4.72 to -0.58), and reminiscence therapy (MD -2.34, 95%CrI -3.51 to -1.25) significantly outperformed the placebo. On MMSE, cognitive stimulation therapy (MD 1.42, 95%CrI 0.49 to 2.39), electrical current stimulation (MD 4.08, 95%CrI 1.07 to 7.11), and reminiscence therapy (MD 1.31, 95%CrI 0.04 to 2.91) significantly outperformed the placebo. Additionally, no treatments showed a significantly higher risk than the placebo. Conclusion Our NMAs indicated that non-pharmacological interventions were more efficacious and safe than pharmacological treatments for reducing depressive symptoms as well as improving cognitive impairment. Electrical current stimulation, aerobic exercise, and reminiscence therapy could be first recommended considering their beneficial performance on both depression and cognition. Hence, non-pharmacological treatments deserve more attention and extensive application and should at least be considered as an alternative or assistance in clinical settings. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021239621, identifier: CRD42021239621.
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Affiliation(s)
- Boru Jin
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China,Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yunting Xv
- Department of Rehabilitation, Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Bixuan Zhang
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Lei Qiao
- Department of General Surgery, Sheng Jing Hospital of China Medical University, Shenyang, Liaoning, China,*Correspondence: Lei Qiao
| | - Huayan Liu
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China,Huayan Liu
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8
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Hu S, He L, Chen B, You Y. Apelin-13 attenuates depressive-like behaviors induced by chronic unpredictable mild stress via activating AMPK/PGC-1α/FNDC5/BDNF pathway. Peptides 2022; 156:170847. [PMID: 35908670 DOI: 10.1016/j.peptides.2022.170847] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 11/30/2022]
Abstract
Chronic stress induces neuronal death and impairs hippocampal neurogenesis, thus leading to cognitive deficits and depressive-like behaviors. Our previous studies found that apelin-13, a novel neuropeptide, and its receptors can improve cognitive impairment and depressive-like behaviors in rats, but its mechanism remains unknown. The study aims to evaluate the underlying mechanism of apelin-13 on cognitive impairment and depressive-like behaviors. A 4-week chronic unpredictable mild stress (CUMS) is used to establish a rat model of depression. Apelin-13(2 ug/day) is administered daily to the rats during the last 1 week. Depressive-like behaviors, including tail suspension test (TST) and sucrose preference test (SPT), are performed. The cognitive functions are established by identify index of novel objects recognition test (NORT) and the number of crossing hidden platform in morris water maze (MWM). The neuronal death is measured by popidium iodide (PI) and flow cytometry. The activity of superoxide dismutase (SOD) and glutathione-peroxidase (GSH-PX) in the hippocampus are determined. The protein expressions of p-AMPK, AMPK, BDNF, FNDC5 and PGC-1α are examined. Golgi staining observed the spine dendritic arborization of the hippocampal cornu ammonis 1 (CA1) subregion. Results showed that apelin-13 improves cognitive impairment and ameliorates depressive-like behaviors. Moreover, apelin-13 significantly inhibits neuronal death via AMPK/PGC-1α/FNDC5/BDNF pathway. Taken together, apelin-13 could exert antidepressant effects via protecting neuron functions, which might be related to the activation of AMPK/PGC-1α/FNDC5/BDNF pathway.
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Affiliation(s)
- Sheng Hu
- The Second Affiliated Hospital of Hainan Medical University, Department of Neurology, Haikou, Hainan 570216, China; Hainan Provincial Key Laboratory of Tropical Brain Research and Transformation, Hainan 571199, China; International Center for Aging and Cancer (ICAC), Hainan Medical University, Hainan 571199, China
| | - Lu He
- The First Affiliated Hospital, Department of Neurosurgery, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
| | - Bin Chen
- The Second Affiliated Hospital of Hainan Medical University, Department of Neurology, Haikou, Hainan 570216, China; Hainan Provincial Key Laboratory of Tropical Brain Research and Transformation, Hainan 571199, China; International Center for Aging and Cancer (ICAC), Hainan Medical University, Hainan 571199, China
| | - Yong You
- The Second Affiliated Hospital of Hainan Medical University, Department of Neurology, Haikou, Hainan 570216, China; First Affiliated Hospital of University of South China, Department of Neurology, Hengyang, Hunan 431001, China; Hainan Provincial Key Laboratory of Tropical Brain Research and Transformation, Hainan 571199, China; International Center for Aging and Cancer (ICAC), Hainan Medical University, Hainan 571199, China.
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9
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Jaatinen R, Luukkaala T, Helminen H, Hongisto MT, Viitanen M, Nuotio MS. Prevalence and prognostic significance of depressive symptoms in a geriatric post-hip fracture assessment. Aging Ment Health 2022; 26:1837-1844. [PMID: 34727812 DOI: 10.1080/13607863.2021.1998357] [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: 10/19/2022]
Abstract
OBJECTIVES To investigate the prevalence and prognostic significance of post-hip fracture depressive symptoms. METHODS A naturalistic clinical cohort study. Data were collected on admission to hospital, geriatric assessment 4-6 months post-fracture and by telephone interview one-year post fracture. Depressive symptoms were assessed at the geriatric assessment using the 15-item Geriatric Depression Scale (GDS-15). Logistic regression analyses with multivariable models were conducted to examine the association of depressive symptoms with changes in mobility and living arrangements and Cox proportional hazards models for mortality between the geriatric assessment and one-year follow-up. RESULTS Of the 1070 patients, 22% (n = 238) had mild and 6% (n = 67) moderate to severe depressive symptoms. Patients with depressive symptoms had poorer nutritional status at baseline, lower scores on the cognitive and physical performance tests and poorer functional abilities in the geriatric assessment than those without. No association was observed between depressive symptoms and any of the outcomes at one-year follow-up. Poor nutritional status and physical functioning remained significant prognostic indicators. CONCLUSION Post-hip fracture depressive symptoms are common and deserve attention during post-hip fracture recovery and rehabilitation. Nonetheless, depressive symptoms have no impact on the change in mobility or living arrangements or mortality. These latter outcomes are mainly explained by poor nutritional status and functioning.
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Affiliation(s)
- Roope Jaatinen
- Department of Geriatric Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland.,Department of Clinical Medicine, Division of Geriatric Medicine, University of Turku, Turku, Finland
| | - Tiina Luukkaala
- Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland.,Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Heli Helminen
- Department of Surgery, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Markus T Hongisto
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Orthopaedics, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Matti Viitanen
- Department of Clinical Geriatrics, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Welfare Division of the City of Turku, Turku, Finland.,Research Services and Department of Clinical Medicine, Turku University Hospital, Turku, Finland
| | - Maria S Nuotio
- Department of Geriatric Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland.,Department of Clinical Medicine, Division of Geriatric Medicine, University of Turku, Turku, Finland.,Welfare Division of the City of Turku, Turku, Finland.,Research Services and Department of Clinical Medicine, Turku University Hospital, Turku, Finland
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10
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Kang B, Pan W, Karel MJ, Corazzini KN, McConnell ES. Care rejection and aggression among veterans with dementia with and without posttraumatic stress disorder: A multi-group analysis. Int J Nurs Stud 2022; 135:104330. [DOI: 10.1016/j.ijnurstu.2022.104330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 06/16/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022]
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11
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Personalized Management and Treatment of Alzheimer's Disease. Life (Basel) 2022; 12:life12030460. [PMID: 35330211 PMCID: PMC8951963 DOI: 10.3390/life12030460] [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: 02/22/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/16/2022] Open
Abstract
Alzheimer’s disease (AD) is a priority health problem with a high cost to society and a large consumption of medical and social resources. The management of AD patients is complex and multidisciplinary. Over 90% of patients suffer from concomitant diseases and require personalized therapeutic regimens to reduce adverse drug reactions (ADRs), drug−drug interactions (DDIs), and unnecessary costs. Men and women show substantial differences in their AD-related phenotypes. Genomic, epigenetic, neuroimaging, and biochemical biomarkers are useful for predictive and differential diagnosis. The most frequent concomitant diseases include hypertension (>25%), obesity (>70%), diabetes mellitus type 2 (>25%), hypercholesterolemia (40%), hypertriglyceridemia (20%), metabolic syndrome (20%), hepatobiliary disorder (15%), endocrine/metabolic disorders (>20%), cardiovascular disorder (40%), cerebrovascular disorder (60−90%), neuropsychiatric disorders (60−90%), and cancer (10%). Over 90% of AD patients require multifactorial treatments with risk of ADRs and DDIs. The implementation of pharmacogenetics in clinical practice can help optimize the limited therapeutic resources available to treat AD and personalize the use of anti-dementia drugs, in combination with other medications, for the treatment of concomitant disorders.
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Tieks A, Oude Voshaar RC, Zuidersma M. Daily associations between affect and cognitive performance in older adults with depression and cognitive impairment: a series of seven single-subject studies in the Netherlands. BMC Geriatr 2022; 22:133. [PMID: 35177005 PMCID: PMC8851709 DOI: 10.1186/s12877-022-02797-y] [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: 11/02/2021] [Accepted: 01/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background Comorbidity between depression and cognitive impairment is common in older adults, increases the disease burden disproportionally, and leads to diagnostic uncertainty. Insight into individual daily associations between affect and cognitive performance may help in personalizing diagnosis and treatment decisions. Our objective was to get insight into the daily associations between affect and cognitive performance within individual older adults. Methods In this single-subject study seven older adults with both depression and cognitive impairment filled in electronic diaries daily for 62-93 consecutive days evaluating positive affect (PA), negative affect (NA), working memory (WM) and visual learning (VL). Time-series analyses using vector autoregressive modelling, Granger causality tests and cumulative orthogonalized impulse response function analyses were performed for each individual separately. Results In one patient higher NA was associated with better WM the next day. For another patient days with higher NA and lower PA were days with worse WM. For a third patient better VL was associated with lower NA and higher PA the next day. No associations were found for four patients. Conclusions These results highlight heterogeneity in the daily associations between affect and cognitive performance and stress the relevance of single-subject studies. These studies may be an important step towards personalized diagnosis and treatment in old age psychiatry. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02797-y.
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Affiliation(s)
- Alieke Tieks
- University of Groningen, University Medical Center Groningen, Interdisciplinary center Psychopathology and Emotion regulation, Groningen, the Netherlands
| | - Richard C Oude Voshaar
- University of Groningen, University Medical Center Groningen, Interdisciplinary center Psychopathology and Emotion regulation, Groningen, the Netherlands
| | - Marij Zuidersma
- University of Groningen, University Medical Center Groningen, Interdisciplinary center Psychopathology and Emotion regulation, Groningen, the Netherlands. .,Department of Psychiatry, HPC CC72, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, Netherlands.
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Liu M, Chen B, Zhong X, Zhang M, Wang Q, Zhou H, Wu Z, Hou L, Peng Q, Zhang S, Yang M, Lin G, Ning Y. Differences in Odor Identification in Early-Onset and Late-Onset Depression. Brain Sci 2022; 12:brainsci12020276. [PMID: 35204039 PMCID: PMC8870099 DOI: 10.3390/brainsci12020276] [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: 01/20/2022] [Revised: 02/04/2022] [Accepted: 02/12/2022] [Indexed: 12/10/2022] Open
Abstract
(1) Background: Odor identification (OI) dysfunction is a potential predictor of developing dementia in late life depression (LLD). However, it is not clear whether patients with early onset depression (EOD) and late onset depression (LOD) may exhibit different OI dysfunctions. The aim of this study was to compare OI between EOD patients and LOD patients and its relationship with cognitive function. (2) Methods: A total of 179 patients with LLD and 189 normal controls were recruited. Participants underwent clinical assessment, olfactory testing, and comprehensive neuropsychological assessment. The OI scores of EOD patients and LOD patients were compared, and correlation analyses and mediation analyses were used to explore the relationship between OI and cognition. (3) Result: LOD patients exhibited lower OI scores than EOD patients and normal controls (NCs). Additionally, the LOD patients exhibited a higher percentage of OI dysfunction than the EOD patients. Moreover, OI scores were associated with global cognition, memory, language, and visuospatial ability in the EOD group (p < 0.05) but were not associated with any cognitive score in the LOD patients (p > 0.05). Finally, the scores of the Auditory Verbal Learning Test Immediate recall and Boston Naming Test exhibited a partially mediating effect on the difference in OI scores between the EOD and LOD patients. (4) Conclusions: LOD patients exhibited worse OI than EOD patients, and their difference in OI was mediated by their memory and language function.
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Affiliation(s)
- Meiling Liu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, China; (M.L.); (B.C.); (X.Z.); (M.Z.); (Q.W.); (H.Z.); (Z.W.); (L.H.); (Q.P.); (S.Z.); (M.Y.); (G.L.)
| | - Ben Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, China; (M.L.); (B.C.); (X.Z.); (M.Z.); (Q.W.); (H.Z.); (Z.W.); (L.H.); (Q.P.); (S.Z.); (M.Y.); (G.L.)
| | - Xiaomei Zhong
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, China; (M.L.); (B.C.); (X.Z.); (M.Z.); (Q.W.); (H.Z.); (Z.W.); (L.H.); (Q.P.); (S.Z.); (M.Y.); (G.L.)
| | - Min Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, China; (M.L.); (B.C.); (X.Z.); (M.Z.); (Q.W.); (H.Z.); (Z.W.); (L.H.); (Q.P.); (S.Z.); (M.Y.); (G.L.)
| | - Qiang Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, China; (M.L.); (B.C.); (X.Z.); (M.Z.); (Q.W.); (H.Z.); (Z.W.); (L.H.); (Q.P.); (S.Z.); (M.Y.); (G.L.)
| | - Huarong Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, China; (M.L.); (B.C.); (X.Z.); (M.Z.); (Q.W.); (H.Z.); (Z.W.); (L.H.); (Q.P.); (S.Z.); (M.Y.); (G.L.)
| | - Zhangying Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, China; (M.L.); (B.C.); (X.Z.); (M.Z.); (Q.W.); (H.Z.); (Z.W.); (L.H.); (Q.P.); (S.Z.); (M.Y.); (G.L.)
| | - Le Hou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, China; (M.L.); (B.C.); (X.Z.); (M.Z.); (Q.W.); (H.Z.); (Z.W.); (L.H.); (Q.P.); (S.Z.); (M.Y.); (G.L.)
| | - Qi Peng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, China; (M.L.); (B.C.); (X.Z.); (M.Z.); (Q.W.); (H.Z.); (Z.W.); (L.H.); (Q.P.); (S.Z.); (M.Y.); (G.L.)
| | - Si Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, China; (M.L.); (B.C.); (X.Z.); (M.Z.); (Q.W.); (H.Z.); (Z.W.); (L.H.); (Q.P.); (S.Z.); (M.Y.); (G.L.)
| | - Minfeng Yang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, China; (M.L.); (B.C.); (X.Z.); (M.Z.); (Q.W.); (H.Z.); (Z.W.); (L.H.); (Q.P.); (S.Z.); (M.Y.); (G.L.)
| | - Gaohong Lin
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, China; (M.L.); (B.C.); (X.Z.); (M.Z.); (Q.W.); (H.Z.); (Z.W.); (L.H.); (Q.P.); (S.Z.); (M.Y.); (G.L.)
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510000, China; (M.L.); (B.C.); (X.Z.); (M.Z.); (Q.W.); (H.Z.); (Z.W.); (L.H.); (Q.P.); (S.Z.); (M.Y.); (G.L.)
- The First School of Clinical Medicine, Southern Medical University, Guangzhou 510000, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou 510000, China
- Correspondence: ; Tel.: +86-20-81682902
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Xie Z, Deng Y, Xie C, Yao Y. Changes of adrenocorticotropic hormone rhythm and cortisol circadian rhythm in patients with depression complicated with anxiety and their effects on the psychological state of patients. Front Psychiatry 2022; 13:1030811. [PMID: 36741558 PMCID: PMC9889930 DOI: 10.3389/fpsyt.2022.1030811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/05/2022] [Indexed: 01/19/2023] Open
Abstract
Objective: This work was to explore the rhythm of adrenocorticotropic hormone (ACTH) and cortisol in patients with depression and anxiety and their effects on mental state. In this work, with depression complicated with anxiety patients as the A-MDD group (n = 21), and depression without anxiety symptoms as the NA-MDD group (n = 21). Firstly, data features were extracted according to the electroencephalo-graph (EEG) data of different patients, and a DR model was constructed for diagnosis. The Hamilton Depression Scale 24 (HAMD-24) was employed to evaluate the severity, and the ACTH and cortisol levels were detected and compared for patients in the A-MDD group and NA-MDD group. In addition, the psychological status of the patients was assessed using the Toronto Alexithymia Scale (TAS). As a result, the AI-based DR model showed a high recognition accuracy for depression. The HAMD-24 score in the A-MDD group (31.81 ± 5.39 points) was statistically higher than the score in the NA-MDD group (25.25 ± 5.02 points) (P < 0.05). No visible difference was found in ACTH levels of patients in different groups (P > 0.05). The incidence of cortisol rhythm disorder (CRD) in the A-MDD group was much higher (P < 0.05). The differences in TAS scores between the two groups were significantly statistically significant (P < 0.01). In conclusion, the AI-based DR Model achieves a more accurate identification of depression; depression with or without anxiety has different effects on the mental state of patients. CRD may be one of the biological markers of depression combined with anxiety.
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Affiliation(s)
- Zheng Xie
- Department of Psychological Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yajie Deng
- Department of Psychological Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Chunyu Xie
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Yuanlong Yao
- Medical College of Henan University, Kaifeng, Henan, China
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Cacabelos R, Naidoo V, Martínez-Iglesias O, Corzo L, Cacabelos N, Pego R, Carril JC. Pharmacogenomics of Alzheimer's Disease: Novel Strategies for Drug Utilization and Development. Methods Mol Biol 2022; 2547:275-387. [PMID: 36068470 DOI: 10.1007/978-1-0716-2573-6_13] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Alzheimer's disease (AD) is a priority health problem in developed countries with a high cost to society. Approximately 20% of direct costs are associated with pharmacological treatment. Over 90% of patients require multifactorial treatments, with risk of adverse drug reactions (ADRs) and drug-drug interactions (DDIs) for the treatment of concomitant diseases such as hypertension (>25%), obesity (>70%), diabetes mellitus type 2 (>25%), hypercholesterolemia (40%), hypertriglyceridemia (20%), metabolic syndrome (20%), hepatobiliary disorder (15%), endocrine/metabolic disorders (>20%), cardiovascular disorder (40%), cerebrovascular disorder (60-90%), neuropsychiatric disorders (60-90%), and cancer (10%).For the past decades, pharmacological studies in search of potential treatments for AD focused on the following categories: neurotransmitter enhancers (11.38%), multitarget drugs (2.45%), anti-amyloid agents (13.30%), anti-tau agents (2.03%), natural products and derivatives (25.58%), novel synthetic drugs (8.13%), novel targets (5.66%), repository drugs (11.77%), anti-inflammatory drugs (1.20%), neuroprotective peptides (1.25%), stem cell therapy (1.85%), nanocarriers/nanotherapeutics (1.52%), and other compounds (<1%).Pharmacogenetic studies have shown that the therapeutic response to drugs in AD is genotype-specific in close association with the gene clusters that constitute the pharmacogenetic machinery (pathogenic, mechanistic, metabolic, transporter, pleiotropic genes) under the regulatory control of epigenetic mechanisms (DNA methylation, histone/chromatin remodeling, microRNA regulation). Most AD patients (>60%) are carriers of over ten pathogenic genes. The genes that most frequently (>50%) accumulate pathogenic variants in the same AD case are A2M (54.38%), ACE (78.94%), BIN1 (57.89%), CLU (63.15%), CPZ (63.15%), LHFPL6 (52.63%), MS4A4E (50.87%), MS4A6A (63.15%), PICALM (54.38%), PRNP (80.7059), and PSEN1 (77.19%). There is also an accumulation of 15 to 26 defective pharmagenes in approximately 85% of AD patients. About 50% of AD patients are carriers of at least 20 mutant pharmagenes, and over 80% are deficient metabolizers for the most common drugs, which are metabolized via the CYP2D6, CYP2C9, CYP2C19, and CYP3A4/5 enzymes.The implementation of pharmacogenetics can help optimize drug development and the limited therapeutic resources available to treat AD, and personalize the use of anti-dementia drugs in combination with other medications for the treatment of concomitant disorders.
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Affiliation(s)
- Ramón Cacabelos
- Department of Genomic Medicine, International Center of Neuroscience and Genomic Medicine, EuroEspes Biomedical Research Center, Corunna, Spain.
| | - Vinogran Naidoo
- Department of Neuroscience, International Center of Neuroscience and Genomic Medicine, EuroEspes Biomedical Research Center, Corunna, Spain
| | - Olaia Martínez-Iglesias
- Department of Medical Epigenetics, International Center of Neuroscience and Genomic Medicine, EuroEspes Biomedical Research Center, Corunna, Spain
| | - Lola Corzo
- Department of Medical Biochemistry, International Center of Neuroscience and Genomic Medicine, EuroEspes Biomedical Research Center, Corunna, Spain
| | - Natalia Cacabelos
- Department of Medical Documentation, International Center of Neuroscience and Genomic Medicine, EuroEspes Biomedical Research Center, Corunna, Spain
| | - Rocío Pego
- Department of Neuropsychology, International Center of Neuroscience and Genomic Medicine, EuroEspes Biomedical Research Center, Corunna, Spain
| | - Juan C Carril
- Department of Genomics and Pharmacogenomics, International Center of Neuroscience and Genomic Medicine, EuroEspes Biomedical Research Center, Corunna, Spain
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Dobielska M, Bartosik NK, Zyzik KA, Kowalczyk E, Karbownik MS. Mechanisms of Cognitive Impairment in Depression. May Probiotics Help? Front Psychiatry 2022; 13:904426. [PMID: 35757204 PMCID: PMC9218185 DOI: 10.3389/fpsyt.2022.904426] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/16/2022] [Indexed: 12/02/2022] Open
Abstract
Depression is the major cause of disability globally. Apart from lowered mood and accompanying symptoms, it leads to cognitive impairment that altogether predicts disadvantaged social functioning. Reduced cognitive function in depression appears a bit neglected in the field of clinical and molecular psychiatry, while it is estimated to occur in two-thirds of depressed patients and persist in at least one third of remitted patients. This problem, therefore, requires elucidation at the biomolecular and system levels and calls for improvement in therapeutic approach. In this review study, we address the above-mentioned issues by discussing putative mechanisms of cognitive decline in depression: (1) increased oxidative stress and (2) inflammation, (3) disturbed hypothalamus-pituitary-adrenals axis, and (4) reduced monoamines functionality. Moreover, we acknowledge additional underpinnings of cognitive impairment in depressed elderly: (5) vascular-originated brain ischemia and (6) amyloid-beta plaque accumulation. Additionally, by reviewing molecular, pre-clinical and clinical evidence, we propose gut microbiota-targeted strategies as potential adjuvant therapeutics. The study provides a consolidated source of knowledge regarding mechanisms of cognitive impairment in depression and may path the way toward improved treatment options.
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Affiliation(s)
- Maria Dobielska
- Students' Research Club, Department of Pharmacology and Toxicology, Medical University of Łódź, Łódź, Poland
| | - Natalia Karina Bartosik
- Students' Research Club, Department of Pharmacology and Toxicology, Medical University of Łódź, Łódź, Poland
| | - Kamil A Zyzik
- Institute of Sociology, Jagiellonian University, Kraków, Poland
| | - Edward Kowalczyk
- Department of Pharmacology and Toxicology, Medical University of Łódź, Łódź, Poland
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Xue B, Xiao A, Luo X, Li R. The effect of a game training intervention on cognitive functioning and depression symptoms in the elderly with mild cognitive impairment: A randomized controlled trial. Int J Methods Psychiatr Res 2021; 30:e1887. [PMID: 34291527 PMCID: PMC8633942 DOI: 10.1002/mpr.1887] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/10/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This study aimed to explore whether game training could improve cognitive functioning and depression symptoms in the elderly affected by mild cognitive impairment (MCI). METHODS A non-blinded randomized controlled trial was conducted. Participants were 72 patients with MCI and depression from a nursing home in Wuhan. Participants were randomized to either the intervention group or the control group (n = 36 each). The intervention group received regular nursing care plus game training for 50 min, three times per week for 8 weeks, whereas the control group received only regular nursing care during the same research period. Cognitive functioning and depression symptoms were tested in both groups at baseline and at the end of the 8-week intervention. We used the Montreal Cognitive Assessment and the 15-item Geriatric Depression Scale to assess cognitive functioning and depression symptoms, respectively. RESULTS The 8-week game training intervention significantly improved the cognitive and depression scores when compared with the control group and baseline scores (p < 0.05). No significant difference was observed in the control group (p > 0.05). CONCLUSIONS Our results suggest that the implementation of game training can improve the cognitive functioning and depression symptoms of the elderly with MCI, indicated that can be widely used.
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Affiliation(s)
- Bing Xue
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Ao Xiao
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Xianwu Luo
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China.,Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, China
| | - Rui Li
- Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, China
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Marvanova M, McGrane IR. Treatment Approach and Modalities for Management of Depression in Older People. Sr Care Pharm 2021; 36:11-21. [PMID: 33384030 DOI: 10.4140/tcp.n.2021.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Depression is common in older people, and while the approach to treatment is similar to a younger population, there are several additional treatment considerations to make based on comorbidities and cognitive impairment. Evidence-based psychotherapies such as cognitive behavioral therapy, interpersonal psychotherapy, and problem-solving therapy are recommended for mild-moderate depression in older people; however, the efficacy of these are limited in very old patients (older than 75 years of age) and those with cognitive impairment. Additionally, neuromodulation treatments such as electroconvulsive therapy and transcranial magnetic stimulation could prove beneficial for specific older people with depression. Use of pharmacotherapy that has demonstrated to be safe in older adults, as well as agents with adequate clinical experience in this population, should be considered based on patient-specific characteristics. Because of generally more complex medication regimens, risks of pharmacotherapy should be minimized with careful dosing strategies and special attention to avoid significant drug-drug interactions. While some data are available, antidepressant combination or augmentation strategies are less well studied in older people who fail to achieve remission or those with treatment-resistant depression, compared with younger populations.
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Affiliation(s)
- Marketa Marvanova
- Department of Pharmacy Practice, The University of Montana, Skaggs School of Pharmacy, College of Health Professions, Missoula, Montana
| | - Ian R McGrane
- Department of Pharmacy Practice, The University of Montana, Skaggs School of Pharmacy, College of Health Professions, Missoula, Montana
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Abstract
Purpose of review a)The purpose of this systematic review was to characterize the studies published on grief interventions for bereaved older adults in the last 5 years. Grief intervention studies were included that exclusively focused on older adults as well as those that included older adults in their samples, in order to summarize the most up-to-date treatment options available for bereaved older adults. Recent findings b)Twenty-four articles that investigated grief interventions in older adults were identified. Generally, findings suggest viable treatment approaches for bereaved older adults are those incorporating behavioral activation and guidance on restoration-oriented coping. However, similar to studies of broader adult populations, grief interventions had small effects on grief-related symptoms in older adults. Few studies examined age as a moderator of treatment effects. Studies varied greatly by study design, sample size, and outcomes measured, which all likely impacted the efficacy of results. Summary c)This review suggests that, while there has been a growing focus on older adults, who have unique vulnerabilities in bereavement, the evidence-base of efficacious interventions for this population is limited. Given the need for specialized bereavement support for older adults will increase in the coming years, future research should prioritize rigorous investigations of grief treatment options leveraging technology to increase access and incorporate techniques that enhance engagement in life and connectedness for this vulnerable population.
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