[Usefulness of cognitive plasticity evaluation in the differential diagnosis of cognitive impairment and depression-induced pseudo-dementia]

Relationship between Cognitive Reserve and Cognitive Impairment in Autonomous and Institutionalized Older Adults

It is necessary to determine which variables help prevent the presence of decline or deterioration during the aging process as a function of advancing age. This research analyses the relations between cognitive reserve (CR) and cognitive impairment in 300 individuals. It also aims to confirm the influence of different variables (gender, age, level of studies and institutionalization) in CR and in deterioration in a population of older adults. The results indicate that people with higher CR present less deterioration. Regarding the role of the sociodemographic variables in the level of deterioration and CR, there are no differences between men and women, but there are differences in the variables age, level of studies and institutionalization, in such a way that the older age the greater the cognitive deterioration, the higher the level of studies, the more RC and less deterioration and it was found that the non-institutionalized people present less deterioration and greater CR. It is affirmed that two people with similar clinical characteristics may present different levels of pathology, being the CR the explanation of this fact. The results obtained allow us to affirm that the measurement of CR is considered an essential variable for the diagnosis of neurodegenerative diseases.

Up-regulated miR-192-5p expression rescues cognitive impairment and restores neural function in mice with depression via the Fbln2-mediated TGF-β1 signaling pathway

Depression represents a condition characterized by cognitive deficits and neural dysfunction and has recently been correlated with microRNAs (miRs) and their respective target genes. The present study was conducted with the goal of investigating the expression of miR-192-5p and its target gene fibulin (Fbln)-2 in an attempt to evaluate their roles in the occurrence and progression of cognitive impairment and neural function in mice with chronic unpredictable mild stress (CUMS)-induced depression through regulation of the TGF-β1 signal transduction pathway. Verification of the targeting relationship between miR-192-5p and Fbln2 was provided in the form of initial bioinformatics prediction, followed by a further verification in the form of a dual-luciferase reporter gene assay. Normal mice and models induced by CUMS were assigned into various groups, whereas mimics, inhibitors, and small interfering RNA were introduced to validate the regulatory mechanism by which miR-192-5p regulates Fbln2 depression. Novel object recognition, tail suspension testing, and Morris water maze were all employed 28 d after transfection. Hippocampal electrophysiological recordings, Golgi staining, HPLC mass spectrometry, and fluorescence immunohistochemistry were performed to further evaluate cognitive function and neuron regeneration. CUMS-induced depression was determined to represent a predisposing factor for cognitive impairment and damage to neural function in mice, highlighted by novel object recognition, learning and memory abilities, population spike amplitude, synaptic transmission, cAMP levels, neuronal regeneration, and increased behavioral changes that resemble depression. Furthermore, increased Fbln2 expression, an activated TGF-β1 signaling pathway, and decreased expression of miR-192-5p, synaptophysin, brain-derived neurotrophic factor, N-methyl-d-aspartate receptor subunit 2B, and calmodulin-dependent protein kinase II were noted. Up-regulated miR-192-5p targeting Fbln2 acts to alleviate CUMS-induced depression by inhibiting the TGF-β1 signaling pathway, resulting in the enhanced cognitive function in novel object recognition, learning and memory ability, population spike amplitude, synaptic transmission, neuron regeneration, and alleviation of behavioral symptoms. The central findings of the present study indicate that up-regulated levels of miR-192-5p expression act to suppress activation of the TGF-β1 signaling pathway by means of binding to Fbln2, thereby ameliorating cognitive impairment and strengthening neural function in a mouse model of depression.-Tang, C.-Z., Yang, J.-T., Liu, Q.-H., Wang, Y.-R., Wang, W.-S. Up-regulated miR-192-5p expression rescues cognitive impairment and restores neural function in mice with depression via the Fbln2-mediated TGF-β1 signaling pathway.

[Evaluation of adherence to treatment with calcium and vitamin D in the elderly in a basic health area]

BACKGROUND AND OBJECTIVE

The vitamin D deficiency is high in the elderly population. Calcium and vitamin D supplements is a frequently used measure in individuals at risk for falls and/or fractures. However, this practice has achieved a low level of compliance. The aim is to assess the adherence to treatment with calcium and vitamin D in elders with hypovitaminosis D in an urban area of Madrid.

PATIENTS AND METHODS

Intervention study performed on 438 individuals ≥65years from the 'Peñagrande Cohort' with hypovitaminosis D that were treated with calcium and vitamin D. Adherence at 3 and 12 months was assessed using the Morisky-Green and counting of prescriptions written.

RESULTS

A total of 413 of the 438 individuals with hypovitaminosis D were analysed (18 patients were not treated because of contraindications, and 7 were considered lost). At 3 and 12 months, 63.9% and 47.2%, respectively, were adherents. After a brief educational intervention, 19.3% of individuals without adherence at 3 months became good compliers when measured at one year. Comorbidity was associated with lower rates of adherence to treatment after one year (46.3% versus 35.2%, P=.027). The main cause of non-adherence to calcium was digestive intolerance, and due to oversights for vitamin D. Concordance between adherence assessed by the Morisky test and counting of prescriptions written was high (Kappa index=69.8%).

CONCLUSIONS

Non-adherence to chronic treatment with calcium and vitamin D is a relevant problem in elderly. It is important to assess adherence and implement health education strategies in clinical practice.