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Low S, Moh A, Pandian B, Tan XL, Pek S, Zheng H, Ang K, Tang WE, Lim Z, Subramaniam T, Sum CF, Lim SC. Association Between Plasma LRG1 and Lower Cognitive Function in Asians With Type 2 Diabetes Mellitus. J Clin Endocrinol Metab 2024; 109:e1732-e1740. [PMID: 38170213 DOI: 10.1210/clinem/dgad768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/01/2023] [Accepted: 01/02/2024] [Indexed: 01/05/2024]
Abstract
CONTEXT Leucine-rich α-2-glycoprotein 1 (LRG1) has been implicated in the pathogenesis of diabetic complications, but its association with cognitive function remains unclear. OBJECTIVE Our primary objective is to investigate the longitudinal association between LRG1 and cognitive function in patients with type 2 diabetes mellitus (T2DM). Secondarily, we determine the causal relationship using Mendelian randomization (MR) and the role of arterial stiffness as a potential mediator. METHODS T2DM patients (n = 1039; age = 64.1 ± 6.4 years) were followed-up for 5.3 ± 1.2 years. Plasma LRG1 was measured at baseline using enzyme-linked immunosorbent assay. Baseline and follow-up cognitive function was assessed using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). One-sample MR was performed with rs4806985 as plasma LRG1-associated single-nucleotide polymorphism. Mediation analysis was performed to examine if pulse wave velocity (PWV), an arterial stiffness index, mediated the association between plasma LRG1 and follow-up cognitive function. RESULTS Elevated baseline natural log (Ln)-transformed LRG1 was inversely associated with baseline and follow-up RBANS total score with adjusted coefficients -1.38 (95% CI -2.55 to -.21; P = .021) and -1.38 (95% CI -2.70 to -.07; P = .039), respectively. Genetically predicted higher levels of plasma LRG1 was associated with lower follow-up RBANS total score with coefficient -7.44 (95% CI -14.14 to -.74; P = .030) per unit increase in LnLRG1. Higher PWV accounted for 27.7% of the association between LnLRG1 and follow-up RBANS total score. CONCLUSION Baseline plasma LRG1 was associated with lower cognitive function at follow-up in patients with T2DM, mediated by PWV. MR analysis provided evidence of an association between genetically influenced plasma LRG1 and lower cognitive function at follow-up.
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Affiliation(s)
- Serena Low
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore 768828
- Diabetes Centre, Admiralty Medical Centre, Singapore, 730676
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Singapore 308232
| | - Angela Moh
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore 768828
| | | | - Xin Li Tan
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore 768828
| | - Sharon Pek
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore 768828
| | - Huili Zheng
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore 768828
| | - Keven Ang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore 768828
| | - Wern Ee Tang
- National Healthcare Group Polyclinics, Singapore, 138543
| | - Ziliang Lim
- National Healthcare Group Polyclinics, Singapore, 138543
| | | | - Chee Fang Sum
- Diabetes Centre, Admiralty Medical Centre, Singapore, 730676
| | - Su Chi Lim
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore 768828
- Diabetes Centre, Admiralty Medical Centre, Singapore, 730676
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Singapore 308232
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549
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Nuechterlein KH, Nasrallah H, Velligan D. Measuring Cognitive Impairments Associated With Schizophrenia in Clinical Practice: Overview of Current Challenges and Future Opportunities. Schizophr Bull 2024:sbae051. [PMID: 39088730 DOI: 10.1093/schbul/sbae051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
BACKGROUND Cognitive impairment associated with schizophrenia (CIAS) negatively impacts daily functioning, quality of life, and recovery, yet effective pharmacotherapies and practical assessments for clinical practice are lacking. Despite the pivotal progress made with establishment of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) for clinical research, implementation of the full MCCB is too time-consuming and cost-ineffective for most clinicians in clinical practice. STUDY DESIGN Here we discuss current assessments in relation to delivery format (interview-based and performance-based), validity, ease of use for clinicians and patients, reliability/reproducibility, cost-effectiveness, and suitability for clinical implementation. Key challenges and future opportunities for improving cognitive assessments are also presented. STUDY RESULTS Current assessments that require 30 min to complete would have value in clinical settings, but the associated staff training and time required might preclude their application in most clinical settings. Initial profiling of cognitive deficits may require about 30 min to assist in the selection of evidence-based treatments; follow-up monitoring with brief assessments (10-15 min in duration) to detect treatment-related effects on global cognition may complement this approach. Guidance on validated brief cognitive tests for the strategic monitoring of treatment effects on CIAS is necessary. CONCLUSIONS With increased advancements in technology-based and remote assessments, development of validated formats of remote and in-person assessment, and the necessary training models and infrastructure required for implementation, are likely to be of increasing clinical relevance for future clinical practice.
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Affiliation(s)
- Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
| | - Henry Nasrallah
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati School of Medicine, Cincinnati, OH
| | - Dawn Velligan
- Division of Schizophrenia and Related Disorders, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, TX
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Chen S, Sheng J, Yang F, Qiao Y, Wang W, Wen H, Yang Q, Chen X, Tang Y. Magnetic Seizure Therapy vs Modified Electroconvulsive Therapy in Patients With Bipolar Mania: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e247919. [PMID: 38683612 PMCID: PMC11059045 DOI: 10.1001/jamanetworkopen.2024.7919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/22/2024] [Indexed: 05/01/2024] Open
Abstract
Importance Bipolar mania is a common disabling illness. Electroconvulsive therapy (ECT) is an effective treatment for patients with severe mania, though it is limited by the risk of cognitive adverse effects. Magnetic seizure therapy (MST) as an alternative treatment to ECT for bipolar mania has not yet been reported. Objective To compare the effectiveness and cognitive adverse effects of MST and ECT in bipolar mania. Design, Setting, and Participants This randomized clinical trial was conducted at the Shanghai Mental Health Center from July 1, 2017, through April 26, 2021. Forty-eight patients with bipolar mania were recruited and randomly allocated to receive MST or ECT. The data analysis was performed from June 5, 2021, through August 30, 2023. Interventions Patients completed 2 or 3 sessions of MST or ECT per week for a total of 8 to 10 sessions. The MST was delivered at 100% device output with a frequency of 75 Hz over the vertex. Main Outcomes and Measures The primary outcomes were reduction of total Young Manic Rating Scale (YMRS) score and response rate (more than 50% reduction of the total YMRS score compared with baseline). An intention-to-treat (ITT) analysis and repeated-measures analyses of variance were conducted for the primary outcomes. Results Twenty patients in the ECT group (mean [SD] age, 31.6 [8.6] years; 12 male [60.0%]) and 22 patients in the MST group (mean [SD] age, 34.8 [9.8] years; 15 male [68.2%]) were included in the ITT analysis. The response rates were 95.0% (95% CI, 85.4%-100%) in the ECT group and 86.4% (95% CI, 72.1%-100%) in the MST group. The YMRS reduction rate (z = -0.82; 95% CI, -0.05 to 0.10; P = .41) and response rate (χ2 = 0.18; 95% CI, -0.13 to 0.31; P = .67) were not significantly different between the groups. The time-by-group interaction was significant for the language domain (F1,24 = 7.17; P = .01), which was well preserved in patients receiving MST but worsened in patients receiving ECT. No serious adverse effects were reported in either group. Conclusions and Relevance These findings suggest that MST is associated with a high response rate and fewer cognitive impairments in bipolar mania and that it might be an alternative therapy for the treatment of bipolar mania. Trial Registration ClinicalTrials.gov Identifier: NCT03160664.
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Affiliation(s)
- Shan Chen
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Xuhui Mental Health Center, Shanghai, China
| | - Jianhua Sheng
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fuzhong Yang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Qiao
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenzheng Wang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Wen
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiao Yang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaochen Chen
- Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Neuroimaging Core, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Tan J, Loh NHW, Chan HM, Teo K, Lim MJR. Cognition, Emotional States and Health-Related Quality of Life in Awake Craniotomy for Glioma: A Case Series. World Neurosurg 2023; 179:e428-e443. [PMID: 37660841 DOI: 10.1016/j.wneu.2023.08.115] [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: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Awake craniotomy is an effective procedure for optimizing the onco-functional balance of resections in glioma. However, limited data exists on the cognition, emotional states, and health-related quality of life (HRQoL) of patients with glioma who undergo awake craniotomy. This study aims to describe 1) perioperative cognitive function and emotional states in a multilingual Asian population, 2) associations between perioperative cognitive function and follow-up HRQoL, and 3) associations between preoperative emotional states and follow-up HRQoL. METHODS This is a case series of 14 adult glioma patients who underwent awake craniotomy in Singapore. Cognition was assessed with the Montreal Cognitive Assessment and the Repeatable Battery for the Assessment of Neuropsychological Status, emotional states with the Depression, Anxiety and Stress Scale-21 Items, and HRQoL using the EuroQol-5D-5L, the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30, and the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-BN20. RESULTS Patients with better preoperative cognitive scores on all domains reported better HRQoL. Better postoperative immediate memory and language scores were associated with better HRQoL. Moderate preoperative depression scores and mild and moderate preoperative stress scores were associated with poorer HRQoL compared to scores within the normal range. Mild preoperative anxiety scores were associated with better HRQoL compared to scores within the normal range. CONCLUSION This descriptive case series showed that patients with higher preoperative cognitive scores reported better follow-up HRQoL, while patients who reported more preoperative depressive and stress symptomatology reported worse follow-up HRQoL. Future analytical studies may help to draw conclusions about whether perioperative cognition and emotional states predict HRQoL on follow-up.
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Affiliation(s)
- Jaclyn Tan
- Division of Neurosurgery, University Surgical Centre, National University Hospital, Pasir Panjang, Singapore
| | - Ne-Hooi Will Loh
- Department of Anaesthesia, National University Hospital, Pasir Panjang, Singapore
| | - Hui Minn Chan
- Department of Psychological Medicine, National University Health System, Pasir Panjang, Singapore
| | - Kejia Teo
- Division of Neurosurgery, University Surgical Centre, National University Hospital, Pasir Panjang, Singapore
| | - Mervyn Jun Rui Lim
- Division of Neurosurgery, University Surgical Centre, National University Hospital, Pasir Panjang, Singapore.
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Li S, Lu X, Qiu Y, Teng Z, Zhao Z, Xu X, Tang H, Xiang H, Chen J, Wang B, Wu H. Association between uric acid and cognitive dysfunction: A cross-sectional study with newly diagnosed, drug-naïve with bipolar disorder. J Affect Disord 2023; 327:159-166. [PMID: 36739000 DOI: 10.1016/j.jad.2023.01.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 01/14/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cognitive impairment is one of the major symptoms of individuals with bipolar disorder (BD). Purine system disorders may play an important role in cognitive dysfunction. So far, the relationship between cognitive deficits and purinergic metabolism in BD has been seldom discussed in previous studies. This study aims to explore its relevance and potential biological mechanisms. METHODS In this cross-sectional study, 205 first time diagnosed drug-naive individuals with BD and 97 healthy volunteers were recruited. The uric acid(UA) level was measured using automatic biochemical analyzer, and cognitive function was assessed by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Stroop color-word test. In addition, general information and clinical symptoms were collected and evaluated. RESULTS In this study, the UA level of BD group (U = 8475.000, p = 0.038) was found to be significantly higher than that of the healthy controls, but the scores of RBANS (t = -11.302, p < 0.001) and Stroop color-word test (t = -6.962, p < 0.001) were significantly lower than that of the healthy controls. In gender subgroup analysis, females had lower UA level and higher RBANS scores. In correlation analysis, the cognitive function of individuals with BD was found to present a significant negative correlation with UA level in attention (r = -0.23, p = 0.001) and delayed memory(r = -0.16, p = 0.022). LIMITATIONS This is a cross-sectional design. CONCLUSION Elevated UA levels may be a potential mechanism of cognitive impairment in BD. This provides a new possible strategy for the prevention and treatment of cognitive impairment in BD.
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Affiliation(s)
- Sujuan Li
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xiaozi Lu
- Qingdao Memtal Health Center, Qingdao, China
| | - Yan Qiu
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Ziwei Teng
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Ziru Zhao
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xuelei Xu
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Hui Tang
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Hui Xiang
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jindong Chen
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Bolun Wang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China.
| | - Haishan Wu
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Gao Y, Tong X, Hu J, Huang H, Guo T, Wang G, Li Y, Wang G. Decreased resting-state neural signal in the left angular gyrus as a potential neuroimaging biomarker of schizophrenia: An amplitude of low-frequency fluctuation and support vector machine analysis. Front Psychiatry 2022; 13:949512. [PMID: 36090354 PMCID: PMC9452648 DOI: 10.3389/fpsyt.2022.949512] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Schizophrenia (SCH) is primarily diagnosed based on specific clinical symptoms, with the lack of any objective SCH-related biomarkers often resulting in patient misdiagnosis and the underdiagnosis of this condition. This study was developed to assess the utility of amplitude of low-frequency fluctuation (ALFF) values analyzed via support vector machine (SVM) methods as a means of diagnosing SCH. Methods In total, 131 SCH patients and 128 age- and gender-matched healthy control (HC) individuals underwent resting-state functional magnetic resonance imaging (rs-fMRI), with the resultant data then being analyzed using ALFF values and SVM methods. Results Relative to HC individuals, patients with SCH exhibited ALFF reductions in the left angular gyrus (AG), fusiform gyrus, anterior cingulate cortex (ACC), right cerebellum, bilateral middle temporal gyrus (MTG), and precuneus (PCu) regions. No SCH patient brain regions exhibited significant increases in ALFF relative to HC individuals. SVM results indicated that reductions in ALFF values in the bilateral PCu can be used to effectively differentiate between SCH patients and HCs with respective accuracy, sensitivity, and specificity values of 73.36, 91.60, and 54.69%. Conclusion These data indicate that SCH patients may exhibit characteristic reductions in regional brain activity, with decreased ALFF values of the bilateral PCu potentially offering value as a candidate biomarker capable of distinguishing between SCH patients and HCs.
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Affiliation(s)
- Yujun Gao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xin Tong
- School of Mental Health and Psychological Science, Anhui Medical University, Heifei, China
- Wuhan Mental Health Center, Wuhan, China
| | - Jianxiu Hu
- Wuhan Mental Health Center, Wuhan, China
| | | | - Tian Guo
- Wuhan Mental Health Center, Wuhan, China
| | - Gang Wang
- Wuhan Mental Health Center, Wuhan, China
| | - Yi Li
- Wuhan Mental Health Center, Wuhan, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
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Association between abnormal glycolipid level and cognitive dysfunction in drug-naïve patients with bipolar disorder. J Affect Disord 2022; 297:477-485. [PMID: 34715186 DOI: 10.1016/j.jad.2021.10.100] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/13/2021] [Accepted: 10/23/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Cognitive impairment and abnormal glycolipid metabolism are common clinical features of bipolar disorder (BD). The purpose of this study was to investigate the relationship between conventional glycolipid metabolism indicators and cognitive impairment in patients with BD. METHODS A total of 132 drug-naïve patients with BD and 129 healthy controls (HC) were recruited in the study. Five serum glycolipid metabolism indicators were measured and cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Stroop Color-Word Test (Stroop test) for each participant. RESULTS The scores of immediate memory, attention, language and delayed memory in BD group were significantly lower than those in HC group (P < 0.05). The triglyceride (TG) level in BD group was higher than that in HC group (P = 0.011), and the total cholesterol and high-density lipoprotein cholesterol (HDL) levels were lower than those in HC group (P = 0.026; P = 0.001). Regression analysis showed that TG level was significantly correlated with RBANS total score (β = 0.245, P = 0.008), attention (β = 0.289, P = 0.03) and delayed memory (β = 0.221, P = 0.023). Fasting blood glucose (FBG) level was significantly correlated with language subscale score (β = -0.187, P = 0.046) in BD. LIMITATIONS Cross-sectional design and limited control variables. CONCLUSIONS Elevated FBG and TG levels may be associated with cognitive dysfunction in BD patients. Improving glycolipid metabolism in patients with BD may help to improve certain domain-specific cognitive functions.
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Huo Z, Lin J, Bat BKK, Chan JYC, Tsoi KKF, Yip BHK. Diagnostic accuracy of dementia screening tools in the Chinese population: a systematic review and meta-analysis of 167 diagnostic studies. Age Ageing 2021; 50:1093-1101. [PMID: 33625478 DOI: 10.1093/ageing/afab005] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The rate of undetected dementia is high in China. However, the performance of dementia screening tools may differ in the Chinese population due to the lower education level and cultural diversity. This study aimed to evaluate the diagnostic accuracy of dementia screening tools in the Chinese population. METHODS Eleven electronic databases were searched for studies evaluating the diagnostic accuracy of dementia screening tools in older Chinese adults. The overall diagnostic accuracy was estimated using bivariate random-effects models, and the area under the summary receiver operating characteristic curve was presented. RESULTS One hundred sixty-seven studies including 81 screening tools were identified. Only 134 studies qualified for the meta-analysis. The Mini-Mental State Examination (MMSE) was the most commonly studied tool, with a combined sensitivity (SENS) and specificity (SPEC) of 0.87 (95%CI 0.85-0.90) and 0.89 (95%CI 0.86-0.91), respectively. The Addenbrooke's Cognitive Examination-Revised (ACE-R) (SENS: 0.96, 95%CI 0.89-0.99; SPEC: 0.96, 95%CI 0.89-0.98) and Montreal Cognitive Assessment (MoCA) (SENS: 0.93, 95%CI 0.88-0.96; SPEC: 0.90, 95%CI 0.86-0.93) showed the highest performance. The General Practitioner Assessment of Cognition (GPCOG), Hasegawa's Dementia Scale and Cognitive Abilities Screening Instrument had performances comparable to that of the MMSE. The cut-off scores ranged widely across studies, especially for the MMSE (range: 15-27) and MoCA (range: 14-26). CONCLUSIONS A number of dementia screening tools were validated in the Chinese population after cultural and linguistical adaptations. The ACE-R and MoCA had the best diagnostic accuracy, whereas the GPCOG, with an administration time < 5 minutes, could be considered as a rapid screening tool.
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Affiliation(s)
- Zhaohua Huo
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jiaer Lin
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Baker K K Bat
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Joyce Y C Chan
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kelvin K F Tsoi
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Benjamin H K Yip
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
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Yeo PS, Nguyen TN, Ng MPE, Choo RWM, Yap PLK, Ng TP, Wee SL. Evaluation of the Implementation and Effectiveness of Community-Based Brain-Computer Interface Cognitive Group Training in Healthy Community-Dwelling Older Adults: Randomized Controlled Implementation Trial. JMIR Form Res 2021; 5:e25462. [PMID: 33904819 PMCID: PMC8114157 DOI: 10.2196/25462] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/12/2021] [Accepted: 04/13/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cognitive training can improve cognition in healthy older adults. OBJECTIVE The objectives are to evaluate the implementation of community-based computerized cognitive training (CCT) and its effectiveness on cognition, gait, and balance in healthy older adults. METHODS A single-blind randomized controlled trial with baseline and follow-up assessments was conducted at two community centers in Singapore. Healthy community-dwelling adults aged 55 years and older participated in a 10-week CCT program with 2-hour instructor-led group classes twice a week. Participants used a mobile app to play games targeting attention, memory, decision making, visuospatial abilities, and cognitive flexibility. Implementation was assessed at the participant, provider, and community level (eg, reach, implementation, and facilitators and barriers). Effectiveness measures were the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Color Trails Test 2 (CTT-2), Berg Balance Scale, and GAITRite walkway measures (single and dual task gait speed, dual task cost, and single and dual task gait variability index [GVI]). RESULTS A total of 94 healthy community-dwelling adults participated in the CCT program (mean age 68.8 [SD 6.3] years). Implementation measures revealed high reach (125/155, 80.6%) and moderate adherence but poor penetration of sedentary older adults (43/125, 34.4%). The effectiveness data were based on intention-to-treat (ITT) and per-protocol (PP) analysis. In the ITT analysis, single task GVI increased (b=2.32, P=.02, 95% CI [0.30 to 4.35]) and RBANS list recognition subtest deteriorated (b=-0.57, P=.01, 95% CI [-1.00 to -0.14]) in both groups. In the PP analysis, time taken to complete CTT-2 (b=-13.5, P=.01, 95% CI [-23.95 to -3.14]; Cohen d effect size = 0.285) was faster in the intervention group. Single task gait speed was not statistically significantly maintained in the intervention group (b=5.38, P=.06, 95% CI [-0.30 to 11.36]) and declined in the control group (Cohen d effect size = 0.414). PP analyses also showed interaction terms for RBANS list recall subtest (b=-0.36, P=.08, 95% CI [-0.75 to 0.04]) and visuospatial domain (b=0.46, P=.08, 95% CI [-0.05 to 0.96]) that were not statistically significant. CONCLUSIONS CCT can be implemented in community settings to improve attention and executive function among healthy older adults. Findings help to identify suitable healthy aging programs that can be implemented on a larger scale within communities. TRIAL REGISTRATION ClinicalTrials.gov NCT04439591; https://clinicaltrials.gov/ct2/show/NCT04439591.
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Affiliation(s)
- Pei Shi Yeo
- Geriatric Education and Research Institute, Singapore, Singapore
| | - Tu Ngoc Nguyen
- Geriatric Education and Research Institute, Singapore, Singapore
| | - Mary Pei Ern Ng
- Geriatric Education and Research Institute, Singapore, Singapore
| | | | | | - Tze Pin Ng
- National University of Singapore, Singapore, Singapore
| | - Shiou Liang Wee
- Geriatric Education and Research Institute, Singapore, Singapore
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The English and Chinese language versions of the Short Form 12-item Health Survey are equivalent. Health Qual Life Outcomes 2021; 19:14. [PMID: 33413452 PMCID: PMC7791772 DOI: 10.1186/s12955-020-01653-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 12/16/2020] [Indexed: 11/17/2022] Open
Abstract
Background The Short Form 12-item Health Survey (SF-12v2) was originally developed in English, but it is also available in Hong Kong (HK) Chinese. While both language versions had their measurement properties well assessed in their respective populations, their measurement invariance in scores has not been examined. Therefore, we aimed to assess their measurement invariance. Methods We conducted a cross-sectional study on individuals aged 18 years or older at a university campus. Those who were bilingual in English and Chinese were randomly assigned to self-complete either the standard English or the HK Chinese SF-12v2. Measurement invariance of the two components and eight scales of the SF-12v2 was concluded if the corresponding 90% confidence interval (CI) for the difference between the two language versions entirely fell within the minimal clinically important difference of ± 3 units. Multiple-group confirmatory factor analysis (CFA) was also performed. Results A total of 1013 participants completed the SF-12v2 (496 in English and 517 in HK Chinese), with a mean age of 22 years (Range 18–58), and 626 participants (62%) were female. There were no significant differences in demographics. Only the physical and mental components and the mental health (MH) scale had their 90% CIs (0.21 to 1.61, − 1.00 to 0.98, and − 0.86 to 2.84, respectively) completely fall within the ± 3 units. The multiple-group CFA showed partial strict invariance. Conclusions The English and HK Chinese versions of the SF-12v2 can be used in studies with their two components and MH scores pooled in the analysis.
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Sun Z, Bo Q, Mao Z, Li F, He F, Pao C, Li W, He Y, Ma X, Wang C. Reduced Plasma Dopamine-β-Hydroxylase Activity Is Associated With the Severity of Bipolar Disorder: A Pilot Study. Front Psychiatry 2021; 12:566091. [PMID: 33995135 PMCID: PMC8115127 DOI: 10.3389/fpsyt.2021.566091] [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: 05/27/2020] [Accepted: 03/29/2021] [Indexed: 12/11/2022] Open
Abstract
Dopamine-β-hydroxylase (DβH) is an enzyme converting dopamine to norepinephrine, a key neurotransmitter in mood disorders, such as major depressive disorder (MDD) and bipolar disorder (BD). Due to overlapping symptomology of unipolar and bipolar depression, the present study attempted to explorer if the plasma DβH activity could discriminate the depressive episodes of BD from MDD. The aim of this study was to compare the plasma DβH activity among MDD patients (n = 104), BD patients (n = 101), and healthy controls (n = 160). Clinical characteristics and cognitive function were assessed using the Young Mania Rating Scale (YMRS), Hamilton Depression Scale (HAM-D), Hamilton Anxiety Scale (HAM-A), Patient Health Questionnaire-9 (PHQ-9), and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Our data showed a lower plasma DβH activity in patients with BD, not MDD, than that in controls. For the BD patients, the plasma DβH activities were negatively correlated with HAM-D scores and HAM-A scores. However, there was no significant correlation between plasma DβH activity and severity of depressive symptoms in MDD patients. No significant correlation between DβH activities and cognitive assessments neither in BD nor in MDD patients. The present study provides evidence that BD is associated with decreased circulating DβH activity.
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Affiliation(s)
- Zuoli Sun
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Qijing Bo
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhen Mao
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Feng Li
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fan He
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Christine Pao
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Wenbiao Li
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yi He
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xin Ma
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Chuanyue Wang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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Association between Lower Extremity Skeletal Muscle Mass and Impaired Cognitive Function in Type 2 Diabetes. Sci Rep 2020; 10:2956. [PMID: 32076075 PMCID: PMC7031513 DOI: 10.1038/s41598-020-59914-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 02/04/2020] [Indexed: 01/28/2023] Open
Abstract
Lower extremity skeletal muscle mass (LESM) in Type 2 Diabetes (T2D) has been linked to adverse clinical events, but it is not known whether it is associated with cognitive difficulties. We conducted a cross-sectional study on 1,235 people (mean age 61.4 ± 8.0 years) with T2D under primary and secondary care in Singapore. Bioelectrical impedance analyses (BIA) measures of upper extremity skeletal muscle mass (UESM), LESM and appendicular skeletal muscle index (SMI) were related to the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) measures of cognition, in multiple linear regression. In multivariable models, tertile 1 LESM (b = −2.62 (−3.92 to −1.32)) and tertile 2 LESM (b = −1.73 (−2.73 to −0.73)), referenced to tertile 3) were significantly associated with decreased RBANS total score. Significant associations of LESM with cognitive domain performances were observed for tertile 1 (b = −3.75 (−5.98 to −1.52)) and tertile 2 (b = −1.98 (−3.69 to −0.27)) with immediate memory, and for tertile 1 (b = −3.05 (−4.86 to −1.24)) and tertile 2 (b = −1.87 (−3.25 to −0.48)) with delayed memory, and for tertile 1 (b = −2.99 (−5.30 to −0.68)) with visuospatial/constructional ability. Tertile 1 SMI (b = −1.94 (−3.79 to −0.08) and tertile 2 SMI (b = −1.75 (−3.14 to −0.37)) were also associated with delayed memory. There were no associations between UESM with cognitive performance. Lower LESM may be a useful marker of possible co-occuring cognitive dysfunction.
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Phillips R, Qi G, Collinson SL, Ling A, Feng L, Cheung YB, Ng TP. The Minimum Clinically Important Difference in the Repeatable Battery for the Assessment of Neuropsychological Status. Clin Neuropsychol 2015; 29:905-23. [DOI: 10.1080/13854046.2015.1107137] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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